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Saberi-Karimian M, Ghazizadeh H, Zanganeh Baygi M, Minaie M, Sadeghi F, Pouraram H, Elmadfa I, Esmaily H, Khadem Rezaian M, Tavallaei S, Mohammadi Bajgiran M, Zare Feyz-Abadi R, Timar A, Sharifan P, Bahrami Taghanaki H, Gholian M, Farahmand SK, Abasalti Z, Farkhani EM, Akhgari A, Smailzadeh A, Izanloo H, Nikpour M, Haghveysi A, Mohammadkarimi A, Yaghoubi A, Rahimi A, Tabatabaei SM, Sheikhzadeh K, Sheikhi M, Shahraki F, Farajian F, Salehizadeh M, Khanavi M, Ghanouni F, Goudarzi S, Ferns GA, Abdollahi Z, Ghayour-Mobarhan M. The national health program for vitamin D supplementation in a developing country. Clin Nutr ESPEN 2023; 54:52-59. [PMID: 36963898 DOI: 10.1016/j.clnesp.2023.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 11/10/2022] [Accepted: 01/12/2023] [Indexed: 01/22/2023]
Abstract
BACKGROUND Previous studies have reported a high frequency of vitamin D deficiency (VDD) among different age groups in Iran. AIMS In this study, the current coverage, status of vitamin D supplement taking, and program efficacy have been evaluated by the Office of Nutrition Department Society in Iran since 2014. METHODS This study was conducted in collaboration with the International UNESCO center for Health-Related Basic Sciences and Human Nutrition and the Office of Nutrition Department Society. Sixty three medical universities were included in the current study to calculate the availability, accessibility and acceptability coverages. Furthermore, 3 medical universities including Mashhad (MUMS), Qom (QUMS) and Zahedan (ZAUMS) University of Medical Sciences were selected based on the results of the National Integrated Micronutrient Survey 2012 (NIMS-II study), in order to assess the status of vitamin D supplement intake in all age ranges. RESULTS Quantitative analysis showed that availability coverage was 74.96% and 77.56% and accessibility was 80.70% and 83.26% in elderly and middle-aged subjects, respectively in 2018. The acceptability was approximately 43.7% and 43.9% among elderly and middle-aged participants, respectively. The availability and acceptability coverage was 80.99% and 85.0% among students in high schools. The mean vitamin D supplement uptake frequency was 27.0% (n = 387); 20.7% and 29.2% in rural and urban area, respectively (P = 0.001). The results showed that there was no significant difference in serum vitamin D levels between urban (20.41 ± 6.43 ng/ml) and rural areas, (P = 0.887). There was no significant difference in the serum vitamin D concentrations between men and women (P = 0.461). CONCLUSIONS The frequency of taking vitamin D supplements was 27.0% in Iran in 2018. The frequency of taking of vitamin D supplements among vitamin D deficient group (serum vitamin D levels <19.99 ng/ml) was 43.6%. Lack of knowledge was the most important reason for not taking vitamin D supplement. Moreover, the serum vitamin D levels have increased in subjects aged 18-30 years old after the implementation of the vitamin D supplementary program.
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Affiliation(s)
- Maryam Saberi-Karimian
- International UNESCO Center for Health Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran; Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamideh Ghazizadeh
- International UNESCO Center for Health Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran; Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehdi Zanganeh Baygi
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mina Minaie
- Office of Nutrition Department Society, Health Ministry, Tehran, Iran
| | - Farzaneh Sadeghi
- Office of Nutrition Department Society, Health Ministry, Tehran, Iran
| | - Hamed Pouraram
- School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Ibrahim Elmadfa
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria
| | - Habibollah Esmaily
- International UNESCO Center for Health Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Khadem Rezaian
- International UNESCO Center for Health Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shima Tavallaei
- International UNESCO Center for Health Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Mohammadi Bajgiran
- International UNESCO Center for Health Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Zare Feyz-Abadi
- International UNESCO Center for Health Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ameneh Timar
- International UNESCO Center for Health Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Payam Sharifan
- International UNESCO Center for Health Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mahdi Gholian
- Deputy of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Zahra Abasalti
- Deputy of Health, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Abbas Akhgari
- Deputy of Food and Drug, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Hassan Izanloo
- Research Center for Environmental Pollutants, Qom University of Medical Sciences, Qom, Iran
| | | | | | | | - Ali Yaghoubi
- Deputy of Health, Qom University of Medical Sciences, Qom, Iran
| | - Alireza Rahimi
- Deputy of Health, Qom University of Medical Sciences, Qom, Iran
| | | | | | - Mahdieh Sheikhi
- Deputy of Health, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Fatemeh Shahraki
- Deputy of Health, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Farzaneh Farajian
- Deputy of Food and Drug, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Mostafa Salehizadeh
- Deputy of Food and Drug, Zahedan University of Medical Sciences, Zahedan, Iran
| | | | | | | | - Gordon A Ferns
- Brighton & Sussex Medical School, Division of Medical Education, Falmer, Brighton, Sussex, BN1 9PH, UK
| | - Zahra Abdollahi
- Office of Nutrition Department Society, Health Ministry, Tehran, Iran.
| | - Majid Ghayour-Mobarhan
- International UNESCO Center for Health Related Basic Sciences and Human Nutrition, Mashhad University of Medical Sciences, Mashhad, Iran.
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El Bilbeisi AH, Al-Jawaldeh A, Albelbeisi A, Abuzerr S, Elmadfa I, Nasreddine L. Association of Household Food Insecurity With Dietary Intakes and Nutrition-Related Knowledge, Attitudes, and Practices Among School-Aged Children in Gaza Strip, Palestine. Front Nutr 2022; 9:890850. [PMID: 35845795 PMCID: PMC9277343 DOI: 10.3389/fnut.2022.890850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 06/08/2022] [Indexed: 11/22/2022] Open
Abstract
Background The present study aimed to determine the association of household food insecurity with dietary intakes and nutrition-related knowledge, attitudes, and practices (KAP) among school-aged children. Methods This cross-sectional study was conducted among a representative sample of school-aged children. A total of 380 children and their parents were selected from all Gaza strip governorates, using a random sampling method. The demographic and socioeconomic characteristics; the Radimer/Cornell food security scale; two non-consecutive days of 24-h dietary recall; anthropometric measurements; and the Food and Agriculture Organization KAP-questionnaire (Module 3) were employed. Statistical analysis was performed using SPSS version 25. Results About 71.6% of school-aged children were household food-insecure, while 28.4% were household food-secure. Significant associations were found between living area, educational level, household monthly income, weight for age and BMI for age z-scores, underweight, malnutrition status, intakes of protein, iron, vitamin D, and zinc among household food-secure, and household food-insecure. After adjustment for confounding variables, having nutrition-related adequate KAP were associated with lower odds of being food-insecure household [OR = 0.519, 95% (CI = 0.320–0.841)], [OR = 0.510, 95% CI = (0.315–0.827)], and [OR = 0.466, 95% CI = (0.285–0.763), P < 0.05 for all], respectively. Conclusions Low socioeconomic status, low anthropometric indices, poor dietary intakes may be associated with a high level of food-insecurity; while having nutrition-related adequate KAP may be protective against food-insecurity among school-aged children.
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Affiliation(s)
- Abdel Hamid El Bilbeisi
- Department of Nutrition, School of Medicine and Health Sciences, University of Palestine, Gaza, Palestine
- *Correspondence: Abdel Hamid El Bilbeisi
| | - Ayoub Al-Jawaldeh
- Regional Office for the Eastern Mediterranean (EMRO), World Health Organization (WHO), Cairo, Egypt
| | - Ali Albelbeisi
- Health Research Unit, Palestinian Ministry of Health, Gaza, Palestine
| | - Samer Abuzerr
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, QC, Canada
| | - Ibrahim Elmadfa
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria
| | - Lara Nasreddine
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
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El Bilbeisi AH, Al-Jawaldeh A, Albelbeisi A, Abuzerr S, Elmadfa I, Nasreddine L. Association of household food insecurity with dietary intakes and nutrition-related knowledge, attitudes, and practices among parents, aged ≥ 18 years in Gaza Strip, Palestine: A descriptive study. Heliyon 2022; 8:e09582. [PMID: 35669548 PMCID: PMC9163506 DOI: 10.1016/j.heliyon.2022.e09582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 01/14/2022] [Accepted: 05/23/2022] [Indexed: 11/04/2022] Open
Abstract
The purpose of this study was to examine the association between household food insecurity and dietary intake and nutrition-related knowledge, attitudes, and practices (KAP) among parents aged ≥18 years in the Gaza Strip, Palestine. The current cross-sectional study was carried out in 2021 among adults (mothers and fathers) aged ≥18 years. A total of 614 participants were selected from all Gaza Strip governorates using a cluster random sampling method. To assess the nutrition-related KAP, we employed the Food and Agriculture Organization (FAO) of the United Nations questionnaire (Modules 5, 6, 7, and 9). Data regarding household food security status, demographic and socioeconomic characteristics of the study participants, anthropometric measurements, and dietary intakes were obtained using standard questionnaires and methods. Statistical analysis was performed using SPSS version 25. About 71.5% and 28.5% of the study participants were household food-insecured and household food-secured, respectively. Significant associations were found between participants from household food-secured and household food-insecured concerning several socio-demographic variables, anthropometric measures, intakes of energy, protein, carbohydrate, and calcium; nutrition-related knowledge and attitudes toward undernutrition and vitamin A deficiency; nutrition-related KAP of iron deficiency anemia; and nutrition-related attitudes and practices of food safety (P-values < 0.05 for all). In conclusion, the demographic and socioeconomic status, anthropometric measurements, and poor dietary intakes may be associated with high levels of household food insecurity, while having nutrition-related adequate KAP may be associated with low levels of household food insecurity among parents aged ≥18 years.
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Affiliation(s)
- Abdel Hamid El Bilbeisi
- Department of Nutrition, School of Medicine and Health Sciences, University of Palestine, Gaza Strip, Palestine
| | - Ayoub Al-Jawaldeh
- Regional Office for the Eastern Mediterranean (EMRO), World Health Organization (WHO), Cairo, Egypt
| | - Ali Albelbeisi
- Health Research Unit, Palestinian Ministry of Health, Palestine
| | - Samer Abuzerr
- Visiting Scholar with the School of Public Health, Department of Social and Preventive Medicine, University of Montreal, Montréal, QC, Canada
| | - Ibrahim Elmadfa
- Department of Nutrition, Faculty of Life Sciences, University of Vienna, Vienna, Austria
| | - Lara Nasreddine
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
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Miller V, Reedy J, Cudhea F, Zhang J, Shi P, Erndt-Marino J, Coates J, Micha R, Webb P, Mozaffarian D, Abbott P, Abdollahi M, Abedi P, Abumweis S, Adair L, Al Nsour M, Al-Daghri N, Al-Hamad N, Al-Hooti S, Al-Zenki S, Alam I, Ali JH, Alissa E, Anderson S, Anzid K, Arambepola C, Arici M, Arsenault J, Asciak R, Barbieri HE, Barengo N, Barquera S, Bas M, Becker W, Beer-Borst S, Bergman P, Biró L, Boindala S, Bovet P, Bradshaw D, Bukhary NBI, Bundhamcharoen K, Caballero M, Calleja N, Cao X, Capanzana M, Carmikle J, Castetbon K, Castro M, Cerdena C, Chang HY, Charlton K, Chen Y, Chen MF, Chiplonkar S, Cho Y, Chuah KA, Costanzo S, Cowan M, Damasceno A, Dastgiri S, De Henauw S, DeRidder K, Ding E, Dommarco R, Don R, Duante C, Duleva V, Duran Aguero S, Ekbote V, El Ati J, El Hamdouchi A, El-kour T, Eldridge A, Elmadfa I, Esteghamati A, Etemad Z, Fadzil F, Farzadfar F, Fernandez A, Fernando D, Fisberg R, Forsyth S, Gamboa-Delgado E, Garriguet D, Gaspoz JM, Gauci D, Geleijnse M, Ginnela B, Grosso G, Guessous I, Gulliford M, Gunnarsdottir I, Hadden W, Hadziomeragic A, Haerpfer C, Hakeem R, Haque A, Hashemian M, Hemalatha R, Henjum S, Hinkov H, Hjdaud Z, Hoffman D, Hopping B, Houshiar-rad A, Hsieh YT, Hung SY, Huybrechts I, Hwalla NC, Ibrahim HM, Ikeda N, Illescas-Zarate D, Inoue M, Janakiram C, Jayawardena R, Jeewon R, Jitnarin N, Johansson L, Jonsdottir O, Jundishapur A, Kally O, Kandiah M, Karupaiah T, Keinan-Boker L, Kelishadi R, Khadilkar A, Kim CI, Koksal E, Konig J, Korkalo L, Koster J, Kovalskys I, Krishnan A, Kruger H, Kuriyan-Raj R, Kweon S, Lachat C, Lai Y, Lanerolle P, Laxmaiah A, Leclercq C, Lee MS, Lee HJ, Lemming EW, Li Y, Lindström J, Ling A, Liputo NIL, Lopez-Jaramillo P, Luke A, Lukito W, Lupotto E, Ma Y, Mahdy ZA, Malekzadeh R, Manan W, Marchioni D, Marques LL, Marques-Vidal P, Martin-Prevel, Y, Mathee A, Matsumura Y, Mazumdar P, Memon A, Mensink G, Meyer A, Mirmiran P, Mirzaei M, Misra P, Misra A, Mitchell C, Mohamed HJBJ, Mohammadi-Nasrabadi F, Mohammadifard N, Moy FM, Musaiger A, Mwaniki E, Myhre J, Nagalla B, Naska A, Ng SA, Ng SW, Ngoan LTN, Noshad S, Ochoa A, Ocke M, Odenkirk J, Oh K, Oleas M, Olivares S, Orfanos P, Ortiz-Ulloa J, Otero J, Ovaskainen ML, Pakseresht M, Palacios C, Palmer P, Pan WH, Panagiotakos D, Parajuli R, Park M, Pekcan G, Petrova S, Piaseu N, Pitsavos C, Polasa K, Posada L, Pourfarzi F, Preston AM, Rached I, Rahbar AR, Rehm C, Richter A, Riley L, Salanave B, Sánchez-Romero LM, Sarrafzadegan N, Sawada N, Sekiyama M, Selamat R, Shamsuddin K, Shariff ZM, Sharma S, Sibai AM, Sinkko H, Sioen I, Sisa I, Skeaff S, Steingrimsdottir L, Strand T, Suarez-Ortegon MF, Swaminathan S, Swan G, Sygnowska E, Szabo M, Szponar L, Tan-Khouw I, Tapanainen H, Tayyem R, Tedla B, Tedstone A, Templeton R, Termote C, Thanopoulou A, Thorgeirsdottir H, Thorsdottir I, Trichopoulos D, Trichopoulou A, Tsugane S, Turrini A, van Oosterhout C, Vartiainen E, Veerman JL, Virtanen S, Vollenweider P, Vossenaar M, Waidyatilaka I, Waskiewicz A, Waterham E, Wieler L, Wondwossen T, Wu S, Yaakub R, Yap M, Yusof S, Zaghloul S, Zajkás G, Zapata M, Zarina K, Zohoori FV. Global, regional, and national consumption of animal-source foods between 1990 and 2018: findings from the Global Dietary Database. The Lancet Planetary Health 2022; 6:e243-e256. [PMID: 35278390 PMCID: PMC8926870 DOI: 10.1016/s2542-5196(21)00352-1] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/25/2021] [Accepted: 12/08/2021] [Indexed: 02/05/2023]
Abstract
Background Methods Findings Interpretation Funding
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El Bilbeisi AH, Al-Jawaldeh A, Albelbeisi A, Abuzerr S, Elmadfa I, Nasreddine L. Households' Food Insecurity and Its Association with Demographic and Socioeconomic Factors in Gaza Strip, Palestine: A Cross-Sectional Study. Ethiop J Health Sci 2022; 32:369-380. [PMID: 35693586 PMCID: PMC9175212 DOI: 10.4314/ejhs.v32i2.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 11/30/2021] [Indexed: 11/30/2022] Open
Abstract
Background This sudy aimed to identify the prevalence of household's food insecurity and its association with demographic and socioeconomic factors. Methods A cross-sectional study was conducted in September 2021 among a representative sample of households in the Gaza strip governorates. A total of 1167 households randomly selected from all five governorates and were included in the study. The Radimer/Cornell food security scale was used to determine the prevalence and levels of household food insecurity. The household's demographic and socioeconomic characteristics were obtained using an interview-based questionnaire. Statistical analysis was performed using SPSS version 25. Results The overall prevalence of household's food insecurity was 71.5%. The prevalence by governorates was highest in Gaza (30.8%), followed by Khanyounis (23.0%), North-Gaza (18.6%), Middle-Area (15.2%) and Rafah (12.4%). Regarding the food insecurity levels, 333 (28.5%) of the households were food secure, 422 (36.2%) had mild food insecurity, 161 (13.8%) had moderate food insecurity, and 251 (21.5%) had severe food insecurity. Significant associations were found between governorates, monthly income, homeownership, work status with the household's food insecurity, (Crude OR [COR] = 2.02, 95% CI = [1.02–3.98], P value < 0.05), (COR = 2.00, 95% CI = [1.04–2.75], P value < 0.05), (COR = 2.36, 95% CI = [1.39–3.99], P value < 0.05), and (COR = 1.14, 95% CI = [0.66–1.97], P value < 0.05), respectively. Conclusions Our study demonstrates that food insecurity is highly prevalent in the Gaza strip and is associated with poor living conditions. Therefore, this high prevalence should be seriously discussed and urgently considered.
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Affiliation(s)
- Abdel Hamid El Bilbeisi
- Department of Nutrition, School of Medicine and Health Sciences, University of Palestine, Gaza Strip, Palestine
| | - Ayoub Al-Jawaldeh
- Regional Office for the Eastern Mediterranean (EMRO), World Health Organization (WHO), Cairo, Egypt
| | | | - Samer Abuzerr
- Visiting Scholar with the School of Public Health, Department of Social and Preventive Medicine, University of Montreal, Montréal, QC, Canada
| | - Ibrahim Elmadfa
- Department of Nutrition, Faculty of Life Sciences, University of Vienna, Vienna, Austria
| | - Lara Nasreddine
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
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El Bilbeisi AH, Al-Jawaldeh A, Albelbeisi A, Abuzerr S, Elmadfa I, Nasreddine L. Households' Food Insecurity and Their Association With Dietary Intakes, Nutrition-Related Knowledge, Attitudes and Practices Among Under-five Children in Gaza Strip, Palestine. Front Public Health 2022; 10:808700. [PMID: 35284364 PMCID: PMC8913882 DOI: 10.3389/fpubh.2022.808700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 01/31/2022] [Indexed: 11/15/2022] Open
Abstract
The present study aimed to determine the households' food insecurity and their association with dietary intakes, nutrition-related knowledge, attitudes and practices (KAP) among under-five children in the Gaza Strip, Palestine. This cross-sectional study was conducted in 2021 among a representative sample of under-five children. A total of 350 children and their proxy were selected from all Gaza strip governorates, using a cluster random sampling method. The Radimer/Cornell food-security scale was used. A 24-h dietary recall was employed for dietary intakes assessment. Nutrition-related KAP for feeding under-five children, anthropometric measurements, and demographic-socioeconomic characteristics were obtained with an interview-based questionnaire. Statistical analysis was performed using SPSS version 25. The children from food-insecure households had a high prevalence of moderate underweight (30.4%), stunting (32.8%), wasting (9.6%), and acute undernutrition (30.4%). Between food-insecure and food-secure groups there were significant differences in weight, height/length, mid-upper arm circumference, weight-for-age and mid-upper arm circumference z-scores, underweight, acute undernutrition, intakes of protein, fat, vitamin D, zinc, continued breastfeeding, having nutrition-related adequate knowledge, having nutrition-related positive attitudes, and achieved minimum dietary diversity score (P < 0.05 for all). Additionally, about (56.0%) food-insecure households have inadequate nutrition-related knowledge, (77.6%) have nutrition-related negative attitudes, and (95.2%) did not achieve a minimum dietary diversity score. In conclusion, the children from food-insecure households had a high prevalence of moderate underweight, stunting, wasting, and acute undernutrition. Moreover, low economic status, poor dietary intakes, low levels of nutrition-related KAP, and lack of dietary diversity could contribute to the high levels of food insecurity among under-five children.
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Affiliation(s)
- Abdel Hamid El Bilbeisi
- Department of Nutrition, School of Medicine and Health Sciences, University of Palestine, Gaza Strip, Palestine
- *Correspondence: Abdel Hamid El Bilbeisi
| | - Ayoub Al-Jawaldeh
- Regional Office for the Eastern Mediterranean (EMRO), World Health Organization (WHO), Cairo, Egypt
| | - Ali Albelbeisi
- Health Research Unit, Palestinian Ministry of Health, Gaza Strip, Palestine
| | - Samer Abuzerr
- Visiting Scholar With the School of Public Health, Department of Social and Preventive Medicine, University of Montreal, Montréal, QC, Canada
| | - Ibrahim Elmadfa
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria
| | - Lara Nasreddine
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut, Lebanon
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Elmadfa I, Meyer AL, Hasenegger V, Moeslinger T, Ekmekcioglu C. The Association of Potassium Status with Parameters of Glucose Metabolism is influenced by Age in Adults. Endocr Metab Immune Disord Drug Targets 2019; 20:788-796. [PMID: 31657684 DOI: 10.2174/1871530319666191028100109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 10/08/2019] [Accepted: 10/08/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Potassium status has been found to affect glucose homeostasis. OBJECTIVE This study therefore aimed at investigating relationships between potassium status or dietary intake and fasting plasma glucose (FPG) or glycated haemoglobin (HbA1c) in a sample of Austrian adults (18-80 years, n = 421, 61% women) from the Austrian Study on Nutritional Status 2012. METHODS Dietary potassium intake was obtained by two 24 h recalls. FPG, plasma K+, and urinary K+ were determined photometrically, HbA1c by HPLC. Associations between the parameters were studied using multiple regression analysis after controlling for confounders and after age stratification of the sample (18-64 y vs. 65-80 y). RESULTS Most of the participants had a potassium intake of less than the estimated adequate daily intake of 4000 mg/d. In the multiple regression analyses in the whole sample plasma K+ had a statistically significant positive effect on FPG only in the crude model (ß = 0.128, p < 0.01) and on HbA1c also in the fully adjusted model (ß = 0.129, p < 0.05). The small effects on HbA1c were also detected in the younger age group but were absent in the older population. However, in this latter, a reverse association of urinary K+ on HbA1c was observed as well as of dietary potassium intake on FPG with no effects in the younger sample. CONCLUSION We suggest that age dependent differences in the association between parameters of potassium status and blood glucose regulation should also be taken into account.
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Affiliation(s)
- Ibrahim Elmadfa
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria
| | - Alexa L Meyer
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria
| | - Verena Hasenegger
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria
| | - Thomas Moeslinger
- Institute of Physiology, Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Cem Ekmekcioglu
- Department of Environmental Health, Center for Public Health, Medical University of Vienna, Vienna, Austria
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Richter M, Baerlocher K, Bauer JM, Elmadfa I, Heseker H, Leschik-Bonnet E, Stangl G, Volkert D, Stehle P. Revised Reference Values for the Intake of Protein. Ann Nutr Metab 2019; 74:242-250. [PMID: 30904906 DOI: 10.1159/000499374] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 03/02/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND Following a timely update process, the nutrition societies of Germany, Austria, and Switzerland (D-A-CH) revised the reference values for the intake of protein in 2017. The Working Group conducted a structured literature search in PubMed considering newly published papers (2000- 2017). SUMMARY For infants < 4 months, the estimated values were set based on the protein intake via breast milk. Reference values for infants > 4 months, children, adolescents, pregnant, and lactating women were calculated using the factorial method considering both requirement for growth and maintenance. For adults, reference values were derived from nitrogen balance studies; for seniors (> 65 years), reports on metabolic and functional parameters under various protein intakes were additionally considered. Reference -values (g protein/kg body weight per day) were set as follows: infants < 4 months: 2.5-1.4, children: 1.3-0.8, adults < 65 years: 0.8, adults > 65 years: 1.0. Key Messages: The reference values for infants, children, adolescents, and adults < 65 years are essentially unchanged compared to recently published values. Scientifically reliable data published between 2000 and 2017 guided the D-A-CH Working Group to set a higher estimated value for adults > 65 years. Since the energy consumption continuously decreases with age, this new estimated protein intake value might be a challenge for the introduction of food-based nutrition concepts for older people.
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Affiliation(s)
| | - Kurt Baerlocher
- Ostschweizer Kinderspital St. Gallen, St. Gallen, Switzerland
| | - Jürgen M Bauer
- Agaples Bethanien Hospital, University of Heidelberg, Heidelberg, Germany
| | - Ibrahim Elmadfa
- Department of Nutrition Sciences, University of Vienna, Vienna, Austria
| | - Helmut Heseker
- German Nutrition Society, Bonn, Germany.,Department of Sports and Health, University of Paderborn, Paderborn, Germany
| | | | - Gabriele Stangl
- Department of Agriculture and Nutritional Sciences, University Halle-Wittenberg, Halle, Germany
| | - Dorothee Volkert
- Department for Biomedicine of Aging, University of Erlangen/Nürnberg, Nürnberg, Germany
| | - Peter Stehle
- Department of Nutrition and Food Sciences, University of Bonn, Bonn, Germany
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9
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Abstract
Zinc has been identified as a critical micronutrient also in high-income countries. There is still some uncertainty about the evaluation of zinc sufficiency due to divergent daily intake reference values. We wanted to exemplify this issue using data from the Austrian Study on Nutritional Status 2012. Plasma zinc concentrations were measured in a nationally representative sample of 872 persons aged 6-80 years (55.5 % female). Dietary zinc intake was estimated from two 24h dietary recalls. Additionally, parameters of the antioxidative status (plasma malondialdehyde (MDA), total antioxidative capacity) and activities of alkaline phosphatase (AP), superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px)) were determined. Zinc status was marginal in schoolchildren (40 % of boys and 22 % of girls) and in elderly (28 % of men and 33 % of women). Dietary zinc intake was also unsatisfactory in these groups with 38 % of boys and 32 % of girls and 64.5 % of older men below the nationally recommended intake levels. However, the adequacy of zinc intake varied with different reference values. Adults were more likely to meet the D-A-CH reference values and those from the European Food Safety Authority than the recommendations of the International Zinc Nutrition Consultative Group (IZiNCG) and the Institute of Medicine, whereas children met the IZiNCG values best. Zinc status correlated weakly with AP activity (r = -0.298, p < 0.001) and some antioxidant status markers (CAT, MDA, GSH-PX, SOD), especially in the elderly (MDA: r = -0.527, p < 0.001, and SOD: r = -0.466, p = 0.002). Our results suggest a suboptimal zinc supply in Austria particularly among schoolchildren and older adults.
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Affiliation(s)
- Ibrahim Elmadfa
- 1 Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria
| | - Alexa L Meyer
- 1 Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria
| | - Timo Kuen
- 1 Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria
| | - Karin Wagner
- 1 Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria
| | - Verena Hasenegger
- 1 Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria
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10
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Elmadfa I, Meyer AL. The Role of the Status of Selected Micronutrients in Shaping the Immune Function. Endocr Metab Immune Disord Drug Targets 2019; 19:1100-1115. [PMID: 31142256 PMCID: PMC7360912 DOI: 10.2174/1871530319666190529101816] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 03/21/2019] [Accepted: 03/21/2019] [Indexed: 02/08/2023]
Abstract
OBJECTIVE This narrative review gives an overview on the essential role of adequate nutrition to an optimally functioning immune defence. Micronutrients act as regulators of the immune response, with the focus of this review on the immunomodulatory effects of the trace elements iron, zinc and selenium, and the vitamins A, D, E, C, B6 and B12 and folic acid. RESULTS Iron deficiency especially impairs the Th1 cell-borne cellular immunity. T lymphocytes are also most affected by a deficiency of zinc, needed for their maturation and the balance between the different T cell subpopulations and acting as a redox signal in the regulation of many enzymes. Selenium is also involved in redox reactions as the glutathione peroxidases and other redox enzymes are selenoproteins. Selenium status has shown special effects on cellular immunity and resistance to viral infections. Vitamin A in the form of retinoic acid induces a humoral Th2 cell response via antigen-presenting cells and is involved in maintaining intestinal immune defence and tolerance through its nuclear receptor RAR and via kinase signalling cascades. Immune tolerance is particularly promoted by vitamin D acting through dendritic cells to stimulate the differentiation of regulatory T cells. Vitamin E has antiinflammatory effects and stimulates naïve T cells especially in the elderly. Besides its antioxidative properties, vitamin C has effects on cell signalling and epigenetic regulation. The B vitamins are required for cytotoxic cellular immunity and modulate T cell responses. CONCLUSION A diverse diet and regular exposure to sunlight are the best sources for a balanced nutrient supply to maintain an optimal immune defence.
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Affiliation(s)
- Ibrahim Elmadfa
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria
| | - Alexa L. Meyer
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria
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11
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Sturtzel B, Elmadfa I, Hermann B, Schippinger W, Ohrenberger G. Effects of an enhanced iron dense foods offering in the daily meals served in geriatric institutions on measures of iron deficiency anemia. BMC Geriatr 2018; 18:123. [PMID: 29801478 PMCID: PMC5970462 DOI: 10.1186/s12877-018-0800-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 04/30/2018] [Indexed: 12/18/2022] Open
Abstract
Background Iron deficiency is one of the most common causes of anemia in geriatric patients. Although the oral iron intake is often inadequate, the potential of iron dense foods in the daily meals of geriatric institutions is rarely considered. To test during a 1- year span whether an improved frequency of iron dense foods in the daily meals has an impact on the oral iron intake, the hemoglobin concentration and anemia prevalence of institutionalized geriatric patients. A parallel, open, pre-and post-oral nutrition intervention study. Two geriatric hospitals participated as intervention centers and one as comparison center. Methods In the two intervention centers, a menu plan adapted with iron dense foods was applied. In the comparison center the regular meals provisions was continued. At months 1, 6 and 12 of the intervention time the routine blood-parameter hemoglobin was taken from the geriatric hospital’s medical report. Component analysis assessed the nutrient density of the offered meals. 2-day-weighing records realized at month 1 and 6 of intervention-time assessed the iron intake. Ninety-nine geriatric patients in the intervention centers and 37 in the comparison center. All of them had multiple chronic diseases and an average age of 84 years. With the non-parametric Friedmann-Test for repeated measurements, we establish differences within the groups. With the Mann-Whitney-U-Test, we establish differences between the groups. For dichotomous variables, the chi-square-test was used. A p-value of< 0.05 was considered statistically significant for all analyses. Results In the intervention centers the iron intake (p < 0.001) and the hemoglobin concentration (p = 0.002) improved significantly (p < 0.001). As in the comparison center the frequency of meat and sausage offerings was twice as much as recommended also the hemoglobin concentration improved (p = 0.001). Conclusion Geriatric patients with anemia or low hemoglobin level benefit optimally from a diet rich in iron dense foods. Enhanced access to such can indeed correct iron deficiency anemia. Trial registration The ethics committee of the Municipality of Vienna (EK-13-043-0513) approved the study.
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Affiliation(s)
- Baerbel Sturtzel
- Department of Nutritional Sciences, University of Vienna, Althanstraße 14, 1090, Vienna, Austria.
| | - Ibrahim Elmadfa
- Department of Nutritional Sciences, University of Vienna, Althanstraße 14, 1090, Vienna, Austria
| | - Brigitte Hermann
- Albert Schweitzer Hospital, Long term care hospital, Albert-Schweitzer-Gasse 36, 8020, Graz, Austria
| | - Walter Schippinger
- Albert Schweitzer Hospital, Long term care hospital, Albert-Schweitzer-Gasse 36, 8020, Graz, Austria
| | - Gerald Ohrenberger
- Haus der Barmherzigkeit, Long term care hospital, Seeböckgasse 30a, 1060, Vienna, Austria
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12
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Pilz S, März W, Cashman KD, Kiely ME, Whiting SJ, Holick MF, Grant WB, Pludowski P, Hiligsmann M, Trummer C, Schwetz V, Lerchbaum E, Pandis M, Tomaschitz A, Grübler MR, Gaksch M, Verheyen N, Hollis BW, Rejnmark L, Karras SN, Hahn A, Bischoff-Ferrari HA, Reichrath J, Jorde R, Elmadfa I, Vieth R, Scragg R, Calvo MS, van Schoor NM, Bouillon R, Lips P, Itkonen ST, Martineau AR, Lamberg-Allardt C, Zittermann A. Rationale and Plan for Vitamin D Food Fortification: A Review and Guidance Paper. Front Endocrinol (Lausanne) 2018; 9:373. [PMID: 30065699 PMCID: PMC6056629 DOI: 10.3389/fendo.2018.00373] [Citation(s) in RCA: 206] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 06/21/2018] [Indexed: 01/14/2023] Open
Abstract
Vitamin D deficiency can lead to musculoskeletal diseases such as rickets and osteomalacia, but vitamin D supplementation may also prevent extraskeletal diseases such as respiratory tract infections, asthma exacerbations, pregnancy complications and premature deaths. Vitamin D has a unique metabolism as it is mainly obtained through synthesis in the skin under the influence of sunlight (i.e., ultraviolet-B radiation) whereas intake by nutrition traditionally plays a relatively minor role. Dietary guidelines for vitamin D are based on a consensus that serum 25-hydroxyvitamin D (25[OH]D) concentrations are used to assess vitamin D status, with the recommended target concentrations ranging from ≥25 to ≥50 nmol/L (≥10-≥20 ng/mL), corresponding to a daily vitamin D intake of 10 to 20 μg (400-800 international units). Most populations fail to meet these recommended dietary vitamin D requirements. In Europe, 25(OH)D concentrations <30 nmol/L (12 ng/mL) and <50 nmol/L (20 ng/mL) are present in 13.0 and 40.4% of the general population, respectively. This substantial gap between officially recommended dietary reference intakes for vitamin D and the high prevalence of vitamin D deficiency in the general population requires action from health authorities. Promotion of a healthier lifestyle with more outdoor activities and optimal nutrition are definitely warranted but will not erase vitamin D deficiency and must, in the case of sunlight exposure, be well balanced with regard to potential adverse effects such as skin cancer. Intake of vitamin D supplements is limited by relatively poor adherence (in particular in individuals with low-socioeconomic status) and potential for overdosing. Systematic vitamin D food fortification is, however, an effective approach to improve vitamin D status in the general population, and this has already been introduced by countries such as the US, Canada, India, and Finland. Recent advances in our knowledge on the safety of vitamin D treatment, the dose-response relationship of vitamin D intake and 25(OH)D levels, as well as data on the effectiveness of vitamin D fortification in countries such as Finland provide a solid basis to introduce and modify vitamin D food fortification in order to improve public health with this likewise cost-effective approach.
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Affiliation(s)
- Stefan Pilz
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- *Correspondence: Stefan Pilz ;
| | - Winfried März
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
- Synlab Academy, Synlab Services GmbH, Mannheim, Germany
| | - Kevin D. Cashman
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Mairead E. Kiely
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Susan J. Whiting
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
| | - Michael F. Holick
- Section of Endocrinology, Nutrition and Diabetes, Department of Medicine, Physiology and Biophysics, Boston University Medical Center, Boston, MA, United States
| | - William B. Grant
- Sunlight, Nutrition and Health Research Center, San Francisco, CA, United States
| | - Pawel Pludowski
- Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children's Memorial Health Institute, Warsaw, Poland
| | - Mickael Hiligsmann
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Christian Trummer
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Verena Schwetz
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Elisabeth Lerchbaum
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Marlene Pandis
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | | | - Martin R. Grübler
- Department of Cardiology, Swiss Cardiovascular Center Bern, Bern University Hospital, Bern, Switzerland
| | - Martin Gaksch
- Department of Laboratory Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Nicolas Verheyen
- Division of Cardiology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Bruce W. Hollis
- Department of Pediatrics, Medical University of South Carolina, Charleston, SC, United States
| | - Lars Rejnmark
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Spyridon N. Karras
- Division of Endocrinology and Metabolism, First Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece
| | - Andreas Hahn
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Hannover, Germany
| | - Heike A. Bischoff-Ferrari
- Department of Geriatrics and Aging Research, University Hospital Zurich and Waid City Hospital, University of Zurich, Zurich, Switzerland
| | - Jörg Reichrath
- Center for Clinical and Experimental Photodermatology, The Saarland University Hospital, Homburg, Germany
| | - Rolf Jorde
- Tromsø Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ibrahim Elmadfa
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna, Austria
| | - Reinhold Vieth
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Robert Scragg
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Mona S. Calvo
- U.S. Food and Drug Administration, Silver Spring, MD, United States
| | - Natasja M. van Schoor
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, Netherlands
| | - Roger Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium
| | - Paul Lips
- Endocrine Section, Department of Internal Medicine, VU University Medical Center, Amsterdam, Netherlands
| | - Suvi T. Itkonen
- Calcium Research Unit, Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Adrian R. Martineau
- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Christel Lamberg-Allardt
- Calcium Research Unit, Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Armin Zittermann
- Clinic for Thoracic and Cardiovascular Surgery, Heart Center North Rhine-Westfalia, Ruhr University Bochum, Bad Oeynhausen, Germany
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13
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Elmadfa I, Meyer AL. The Debate Goes on: New Evidence for the Role of Macronutrient Distribution on Body Weight Development: A Commentary on "Effects of Macronutrient Distribution on Weight and Related Cardiometabolic Profile in Healthy Non-Obese Chinese: A 6-month, Randomized Controlled-Feeding Trial" by Wan et al., EBioMedicine 2017, 22, 200-207. EBioMedicine 2017; 24:32-33. [PMID: 28939486 PMCID: PMC5652134 DOI: 10.1016/j.ebiom.2017.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 09/14/2017] [Indexed: 11/25/2022] Open
Affiliation(s)
- Ibrahim Elmadfa
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Austria, Althanstrasse 14, 1090 Vienna, Austria.
| | - Alexa L Meyer
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Austria, Althanstrasse 14, 1090 Vienna, Austria
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14
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Orfanos P, Naska A, Rodrigues S, Lopes C, Freisling H, Rohrmann S, Sieri S, Elmadfa I, Lachat C, Gedrich K, Boeing H, Katzke V, Turrini A, Tumino R, Ricceri F, Mattiello A, Palli D, Ocké M, Engeset D, Oltarzewski M, Nilsson LM, Key T, Trichopoulou A. Eating at restaurants, at work or at home. Is there a difference? A study among adults of 11 European countries in the context of the HECTOR* project. Eur J Clin Nutr 2017; 71:407-419. [PMID: 27966568 DOI: 10.1038/ejcn.2016.219] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 10/11/2016] [Accepted: 10/12/2016] [Indexed: 01/07/2023]
Abstract
BACKGROUND/OBJECTIVES To compare macronutrient intakes out of home-by location-to those at home and to investigate differences in total daily intakes between individuals consuming more than half of their daily energy out of home and those eating only at home. SUBJECTS/METHODS Data collected through 24-h recalls or diaries among 23 766 European adults. Participants were grouped as 'non-substantial', 'intermediate' and 'very substantial out-of-home' eaters based on energy intake out of home. Mean macronutrient intakes were estimated at home and out of home (overall, at restaurants, at work). Study/cohort-specific mean differences in total intakes between the 'very substantial out-of-home' and the 'at-home' eaters were estimated through linear regression and pooled estimates were derived. RESULTS At restaurants, men consumed 29% of their energy as fat, 15% as protein, 45% as carbohydrates and 11% as alcohol. Among women, fat contributed 33% of energy intake at restaurants, protein 16%, carbohydrates 45% and alcohol 6%. When eating at work, both sexes reported 30% of energy from fat and 55% from carbohydrates. Intakes at home were higher in fat and lower in carbohydrates and alcohol. Total daily intakes of the 'very substantial out-of-home' eaters were generally similar to those of individuals eating only at home, apart from lower carbohydrate and higher alcohol intakes among individuals eating at restaurants. CONCLUSIONS In a large population of adults from 11 European countries, eating at work was generally similar to eating at home. Alcoholic drinks were the primary contributors of higher daily energy intakes among individuals eating substantially at restaurants.
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Affiliation(s)
- P Orfanos
- WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - A Naska
- WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - S Rodrigues
- Faculty of Nutrition and Food Sciences, University of Porto, and Institute of Public Health, Porto, Portugal
| | - C Lopes
- Department of Clinical Epidemiology, Preventive Medicine and Public Health, University of Porto Medical School/Institute of Public Health, Porto, Portugal
| | - H Freisling
- International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - S Rohrmann
- Division of Chronic Disease Epidemiology, Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - S Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - I Elmadfa
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
| | - C Lachat
- Department of Food Safety and Food Quality, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
- Nutrition and Child Health Unit, Institute of Tropical Medicine, Antwerp, Belgium
| | - K Gedrich
- Department of Nutritional Physiology, TUM Technical University of Munich, Freising, Germany
| | - H Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
| | - V Katzke
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - A Turrini
- Council for Agricultural Research and Economics-Research Center for Food and Nutrition (CREA-Alimenti e Nutrizione), Rome, Italy
| | - R Tumino
- Cancer Registry and Histopathology Unit, 'Civic M.P.Arezzo' Hospital, ASP Ragusa, Italy
| | - F Ricceri
- Department of Economics and Statistics, 'Cognetti de Martiis' University of Turin, Turin, Italy
- Unit of Epidemiology, Regional Health Service ASL TO3, Turin, Italy
- Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - A Mattiello
- Dipartimento di Medicina Clinica e Chirurgia Federico II University, Naples, Italy
| | - D Palli
- Cancer Research and Prevention Institute (ISPO), Florence, Italy
| | - M Ocké
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - D Engeset
- Department of Public Health, Sport and Nutrition, University of Agder, Kristiansand, Norway
| | | | - L M Nilsson
- Public Health and Clinical Medicine, Nutritional research, Umeå University, Umeå, Sweden
- Arcum, Arctic Research Centre at Umeå University, Umeå, Sweden
| | - T Key
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
| | - A Trichopoulou
- WHO Collaborating Center for Nutrition and Health, Unit of Nutritional Epidemiology and Nutrition in Public Health, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Hellenic Health Foundation, Athens, Greece
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15
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Abstract
Adequate protein intake is critical for health and development. Generally, protein of animal origin is of higher quality for humans owing to its amino acid pattern and good digestibility. When administered in mixtures it can enhance the quality of plant proteins, but its availability is often low in low-income communities, especially in young children, the elderly, and pregnant and lactating women, who have increased requirements and in whom high-quality protein also stimulates (bone) growth and maintenance. Although high protein intake was associated with increased type 2 diabetes mellitus risk, milk and seafood are good sources of branched chain amino acids and taurine, which act beneficially on glucose metabolism and blood pressure. However, high consumption of protein-rich animal food is also associated with adverse health effects and higher risk for noncommunicable diseases, partly related to other components of these foods, like saturated fatty acids and potential carcinogens in processed meat but also the atherogenic methionine metabolite homocysteine. In moderation, however, animal proteins are especially important for health maintenance in vulnerable persons.
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Affiliation(s)
- Ibrahim Elmadfa
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna 1010, Austria;,
| | - Alexa L. Meyer
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Vienna 1010, Austria;,
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16
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Sturtzel B, Elmadfa I, Ohrenberger G. The energy intake through regular nontherapeutic meals provision in long-term care: impact on nutritional status and related Geriatric Nutritional Risk Index. SpringerPlus 2016; 5:136. [PMID: 26933634 PMCID: PMC4761357 DOI: 10.1186/s40064-016-1763-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 02/12/2016] [Indexed: 11/10/2022]
Abstract
To investigate how the energy intake of institutionalized long-term-care patients through the regular nontherapeutic meals provision is associated with the nutritional status and the Geriatric Nutritional Risk Index (GNRI). A 9 month longitudinal, observational study. Long-term-care Hospital. 66 long-term-care patients with multiple medical conditions and solely oral food-intake. 47 (71 %) patients, predominantly women (n = 39/47), with a mean age of 83.04 (±9.58) years completed study time and 19 (29 %) deceased. At week 1 and week 36 of observation time energy intake was measured by means of three-days-weighing-records. Body composition was assessed with bioelectrical impedance analysis. Serum albumin, body weight and body height were taken from the medical report. Albumin content, body weight and height were used to calculate the Geriatric Nutritional Risk Index: GNRI = [1.489 × albumin (g/L)] + [41.7 × (weight/ideal body weight)]. Energy intake was significantly below 24 kcal/kg body weight per day. The GNRI of the deceased patients was significantly (p = 0.002) lower than the GNRI of the completers. During observation time energy-intake p < 0.001, body fat (p = 0.001) and phase angle (PA) of bio impedance measurement (p = 0.018) and likewise the GNRI (p = 0.021) of the completers decreased significantly. At the beginning and at the end of observation time energy intake correlated significantly with PA (p = 0.028/p < 0.001) and GNRI (p = 0.436/p = 0.004). Also GNRI and PA correlated significantly at the beginning (p = 0.001) and at the end (p < 0.001) of observation time. The energy intake through non therapeutic meals provision was too low for sustaining the nutritional status and likewise the GNRI. The malnourishment and the nutrition related clinical risk of the geriatric patients aggrevated during observation time.
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17
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Khatibzadeh S, Saheb Kashaf M, Micha R, Fahimi S, Shi P, Elmadfa I, Kalantarian S, Wirojratana P, Ezzati M, Powles J, Mozaffarian D. A global database of food and nutrient consumption. Bull World Health Organ 2016; 94:931-934. [PMID: 27994286 PMCID: PMC5153920 DOI: 10.2471/blt.15.156323] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 03/03/2016] [Accepted: 04/07/2016] [Indexed: 11/30/2022] Open
Affiliation(s)
| | - Michael Saheb Kashaf
- Tufts Friedman School of Nutrition Science & Policy, 150 Harrison Avenue, Boston, MA 02111, USA
| | - Renata Micha
- Tufts Friedman School of Nutrition Science & Policy, 150 Harrison Avenue, Boston, MA 02111, USA
| | - Saman Fahimi
- Harvard School of Public Health, Boston, United States of America (USA)
| | - Peilin Shi
- Tufts Friedman School of Nutrition Science & Policy, 150 Harrison Avenue, Boston, MA 02111, USA
| | - Ibrahim Elmadfa
- Institute of Nutritional Sciences, University of Vienna, Vienna, Austria
| | - Shadi Kalantarian
- Harvard School of Public Health, Boston, United States of America (USA)
| | | | - Majid Ezzati
- School of Public Health, Imperial College London, London, England
| | - John Powles
- School of Clinical Medicine, University of Cambridge, Cambridge, England
| | - Dariush Mozaffarian
- Tufts Friedman School of Nutrition Science & Policy, 150 Harrison Avenue, Boston, MA 02111, USA
| | - on behalf of the Global Burden of Diseases Nutrition
- Harvard School of Public Health, Boston, United States of America (USA)
- Tufts Friedman School of Nutrition Science & Policy, 150 Harrison Avenue, Boston, MA 02111, USA
- Institute of Nutritional Sciences, University of Vienna, Vienna, Austria
- School of Public Health, Imperial College London, London, England
- School of Clinical Medicine, University of Cambridge, Cambridge, England
| | - Chronic Diseases Expert Group (NutriCode)
- Harvard School of Public Health, Boston, United States of America (USA)
- Tufts Friedman School of Nutrition Science & Policy, 150 Harrison Avenue, Boston, MA 02111, USA
- Institute of Nutritional Sciences, University of Vienna, Vienna, Austria
- School of Public Health, Imperial College London, London, England
- School of Clinical Medicine, University of Cambridge, Cambridge, England
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18
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Affiliation(s)
| | - Ibrahim Elmadfa
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
| | | | - Peter Raspor
- Department of Food Science and Technology, University of Ljubljana, Ljubljana, Slovenia
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Benton D, Braun H, Cobo J, Edmonds C, Elmadfa I, El-Sharkawy A, Feehally J, Gellert R, Holdsworth J, Kapsokefalou M, Kenney W, Leiper J, Macdonald I, Maffeis C, Maughan R, Shirreffs S, Toth-Heyn P, Watson P. Executive summary and conclusions from the European Hydration Institute expert conference on human hydration, health, and performance. Nutr Rev 2015; 73 Suppl 2:148-50. [DOI: 10.1093/nutrit/nuv056] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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20
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Naska A, Katsoulis M, Orfanos P, Lachat C, Gedrich K, Rodrigues SSP, Freisling H, Kolsteren P, Engeset D, Lopes C, Elmadfa I, Wendt A, Knüppel S, Turrini A, Tumino R, Ocké MC, Sekula W, Nilsson LM, Key T, Trichopoulou A. Eating out is different from eating at home among individuals who occasionally eat out. A cross-sectional study among middle-aged adults from eleven European countries. Br J Nutr 2015; 113:1951-64. [PMID: 25907775 DOI: 10.1017/s0007114515000963] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Eating out has been linked to the current obesity epidemic, but the evaluation of the extent to which out of home (OH) dietary intakes are different from those at home (AH) is limited. Data collected among 8849 men and 14,277 women aged 35-64 years from the general population of eleven European countries through 24-h dietary recalls or food diaries were analysed to: (1) compare food consumption OH to those AH; (2) describe the characteristics of substantial OH eaters, defined as those who consumed 25 % or more of their total daily energy intake at OH locations. Logistic regression models were fit to identify personal characteristics associated with eating out. In both sexes, beverages, sugar, desserts, sweet and savoury bakery products were consumed more OH than AH. In some countries, men reported higher intakes of fish OH than AH. Overall, substantial OH eating was more common among men, the younger and the more educated participants, but was weakly associated with total energy intake. The substantial OH eaters reported similar dietary intakes OH and AH. Individuals who were not identified as substantial OH eaters reported consuming proportionally higher quantities of sweet and savoury bakery products, soft drinks, juices and other non-alcoholic beverages OH than AH. The OH intakes were different from the AH ones, only among individuals who reported a relatively small contribution of OH eating to their daily intakes and this may partly explain the inconsistent findings relating eating out to the current obesity epidemic.
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Affiliation(s)
- Androniki Naska
- WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens,75 Mikras Asias Street,Goudi, Athens11527,Greece
| | - Michail Katsoulis
- Hellenic Health Foundation,Kaisareias 13 and Alexandroupoleos,Athens11527,Greece
| | - Philippos Orfanos
- WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens,75 Mikras Asias Street,Goudi, Athens11527,Greece
| | - Carl Lachat
- Department of Food Safety and Food Quality,Faculty of Bioscience Engineering, Ghent University,Coupure links 653,9000Gent,Belgium
| | - Kurt Gedrich
- Technische Universität München, Center of Life and Food Sciences, Molecular Nutrition Unit,Gregor-Mendel-Strasse 2,85354Freising,Germany
| | - Sara S P Rodrigues
- Faculty of Nutrition and Food Sciences, University of Porto, Rua Dr Roberto Frias,4200-465Porto,Portugal
| | - Heinz Freisling
- International Agency for Research on Cancer (IARC-WHO),150, Cours Albert Thomas,69372Lyon Cedex 08,France
| | - Patrick Kolsteren
- Child Health and Nutrition Unit, Department of Public Health, Institute of Tropical Medicine,Nationalestraat 155,2000Antwerp,Belgium
| | - Dagrun Engeset
- Department of Community Medicine,Faculty of Health Sciences, University of Tromsø,N-9019Tromsø,Norway
| | - Carla Lopes
- Department of Clinical Epidemiology,Predictive Medicine and Public Health, Institute of Public Health, University of Porto, Alameda Professor Hernani Monteiro,4200-319Porto,Portugal
| | - Ibrahim Elmadfa
- Department of Nutritional Sciences,University of Vienna,Althanstrasse 14 (Pharmaziezentrum),A-1090Vienna,Austria
| | - Andrea Wendt
- Division of Cancer Epidemiology, German Cancer Research Centre (Deutsches Krebsforschungszentrum, DKFZ),Im Neuenheimer Feld 280,69120Heidelberg,Germany
| | - Sven Knüppel
- German Institute of Human Nutrition Potsdam-Rehbrücke, Department of Epidemiology,Arthur-Scheunert-Allee 114-116,14558Nuthetal,Germany
| | - Aida Turrini
- National Research Institute on Food and Nutrition (CRA-ex INRAN),Via Ardeatina 546,00178Rome,Italy
| | - Rosario Tumino
- Ragusa Cancer Registry,Azienda Ospedaliera 'Civile M. P. Arezzo' Via Dante N° 109,97100Ragusa,Italy
| | - Marga C Ocké
- National Institute for Public Health and the Environment,PO Box 1,3720BABilthoven,The Netherlands
| | - Wlodzimierz Sekula
- National Food and Nutrition Institute,61/63 Powsinska Street,02-903Warsaw,Poland
| | - Lena Maria Nilsson
- Public Health and Clinical Medicine, Nutritional Research, Umeå University,901 85Umeå,Sweden
| | - Tim Key
- Cancer Epidemiology Unit, University of Oxford, Richard Doll Building, Roosevelt Drive,OxfordOX3 7LF,UK
| | - Antonia Trichopoulou
- WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, University of Athens,75 Mikras Asias Street,Goudi, Athens11527,Greece
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21
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Abstract
Reliable information about the nutritional status is essential to identify potential critical nutrients and the population groups at risk of deficiency, as well as to develop effective public health policies to counteract unfavorable nutrition patterns that contribute to morbidity and mortality. In this review, the important role of biomarkers in the assessment of nutritional status is outlined, major strengths and limitations of established and new biomarkers are described, and important criteria for biomarker selection and development are discussed. Indeed, biomarkers offer a more objective assessment tool than pure dietary approaches that suffer from inadequate data reporting in particular, although biomarkers are often only measured in subsamples because of the higher costs and proband burden they entail. However, biomarkers are subject to individual variability and influences from other factors besides the nutrient of interest. Rapid turnover or tight control of nutrient concentrations in blood (homeostasis) limits their sensitivity as biomarkers, as in the case of many trace elements. The existence of different forms of a micronutrient in the body adds additional complexity. Functional biomarkers, such as enzyme activities, mirror long-term status better but are subject to confounding factors, and some are influenced by several micronutrients, not specific for only 1, so using a combination of biomarkers is advisable. Additionally, the applicability of a biomarker also depends on the existence of adequate reference values and cutoff points for the target population. Therefore, a careful selection is warranted, especially when biomarkers are to be used in larger samples.
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Affiliation(s)
- Ibrahim Elmadfa
- Department of Nutritional Sciences, University of Vienna, Vienna,
Austria
| | - Alexa L. Meyer
- Department of Nutritional Sciences, University of Vienna, Vienna,
Austria
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22
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Krawinkel MB, Strohm D, Weissenborn A, Watzl B, Eichholzer M, Bärlocher K, Elmadfa I, Leschik-Bonnet E, Heseker H. Revised D-A-CH intake recommendations for folate: how much is needed? Eur J Clin Nutr 2014; 68:719-23. [PMID: 24690591 PMCID: PMC4050524 DOI: 10.1038/ejcn.2014.45] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 02/07/2014] [Indexed: 12/31/2022]
Abstract
The D-A-CH reference value (D-A-CH arises from the initial letters of the common country identification for the countries Germany (D), Austria (A) and Switzerland (CH)) for folate equivalents had been set at 400 μg/d for adults in the year 2000. By that time, the prevention of cardiovascular diseases through reduction of homocysteine was considered an important target of the reference value. Since that time a number of research papers revealed that in spite of an inverse association between folate-rich diet and chronic diseases, a preventive effect of folic acid intake on cardiovascular events was not supported by randomized controlled trials, and the reduction of plasma homocysteine levels to around 10-12 μmol/l did not reduce the risk for thromboembolic and cardiovascular diseases in persons already affected by these diseases. These results together with the observation that folate intakes below 400 μg/d result in a sufficient folate status justified a review of the current literature and-consequently-a reduction of the reference value to 300 μg/d for adults. This reference value is expressed as dietary folate equivalents that take into account the difference in bioavailability between folic acid and all types of folates in food. The recommendation to take a daily supplement of 400 μg of synthetic folic acid for women who intend to get pregnant and until the end of the first trimester of pregnancy is maintained.
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Affiliation(s)
- M B Krawinkel
- Institute of Nutritional Sciences, Justus-Liebig-University, Giessen, Germany
| | - D Strohm
- Deutsche Gesellschaft für Ernährung e. V., Bonn, Germany
| | | | - B Watzl
- Max-Rubner-Institut, Karlsruhe, Germany
| | - M Eichholzer
- Institut für Sozial- und Präventivmedizin, Universität Zürich, Zürich, Switzerland
| | - K Bärlocher
- Tanneichenstrasse 10, 9010 St. Gallen, Switzerland
| | - I Elmadfa
- Institute of Nutritional Sciences, University of Vienna, Wien, Austria
| | | | - H Heseker
- Department of Sports and Health, Universität Paderborn, Paderborn, Germany
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Abtahi M, Neyestani TR, Pouraram H, Siassi F, Dorosty AR, Elmadfa I, Doustmohammadian A. Iron-fortified flour: can it induce lipid peroxidation? Int J Food Sci Nutr 2014; 65:649-54. [PMID: 24655144 DOI: 10.3109/09637486.2014.898254] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This community-based study was conducted to evaluate the effects of iron-fortified bread consumption on certain biomarkers of oxidative stress in an apparently healthy population. Evaluation of food intake, anthropometric and laboratory variables was performed in the beginning and after the 8-month intervention for all participants. There was no significant change in oxidative stress biomarkers in women following 8 months intervention. However, in men, final values of total antioxidant capacity, compared to the initial ones, showed a significant decrease in (p = 0.01) which was accompanied by a significant increase in superoxide dismutase (p = 0.002). It could be concluded that although the short-term period (8 months) of extra iron intake did not show severe effects of lipid per oxidation, significant changes of serum iron and some oxidative stress indices suggested that fortification of flour with iron among non-anemic adults in the long term was not without adverse effects.
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Affiliation(s)
- Mitra Abtahi
- Department of Nutrition Research, National Nutrition and Food Technology Research Institute and Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences , Tehran , Islamic Republic of Iran
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24
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Naeini AMA, Elmadfa I, Djazayery A, Barekatain M, Ghazvini MRA, Djalali M, Feizi A. The effect of antioxidant vitamins E and C on cognitive performance of the elderly with mild cognitive impairment in Isfahan, Iran: a double-blind, randomized, placebo-controlled trial. Eur J Nutr 2013; 53:1255-62. [PMID: 24326981 DOI: 10.1007/s00394-013-0628-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2013] [Accepted: 11/18/2013] [Indexed: 11/26/2022]
Abstract
PURPOSE This study was carried out to investigate the effect of vitamins E and C on cognitive performance among the elderly in Iran. METHODS About 256 elderly with mild cognitive impairment, aged 60-75 years, received 300 mg of vitamin E plus 400 mg of vitamin C or placebo daily just for 1 year. BACKGROUND Demographic characteristics, anthropometric variables food consumption, cognitive function by Mini-Mental State Examination (MMSE), and some of the oxidative stress biomarkers were examined. RESULTS Antioxidant supplementation reduced malondialdehyde level (P < 0.001) and raised total antioxidant capacity (P < 0.001) and glutathione (P < 0.01). The serum 8-hydroxydeoxyguanosine remained unchanged (P < 0.4). After adjusting for the covariates effects, MMSE scores following 6- (25.88 ± 0.17) and 12-month antioxidant supplementation (26.8 ± 0.17) did not differ from control group (25.86 ± 0.18 and 26.59 ± 0.18, respectively). CONCLUSION Despite significant improvement in most of the oxidative stress biomarkers, antioxidants' supplementation was not observed to enhance cognitive performance. A large number of kinetic and/or dynamic factors could be suspected.
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Affiliation(s)
- A M Alavi Naeini
- School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
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25
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Abstract
Ten different nut kinds (almonds, Brazil nuts, cashews, hazelnuts, macadamias, peanuts, pecans, pine nuts, pistachios, and walnuts) were evaluated for their total oil and phytosterol content as well as their fatty acid composition. The total oil content was the predominant component; mean values oscillated between 45.2 % (cashews) and 74.7 % (macadamias). Mean total phytosterol content ranged from 71.7 mg (Brazil nuts) to 271.9 mg (pistachios) per 100 g oil. ß-sitosterol was the major sterol (mean >71.7 mg/100 g oil) followed by minor contents of campesterol, ergosterol, and stigmasterol. Almonds, cashews, hazelnuts, macadamias, and pistachios were high in monounsaturated fatty acids (MUFA; > 55 %). MUFA- and polyunsaturated fatty acid (PUFA)-rich nuts were peanuts and pecans, whereas Brazil nuts, pine nuts, and walnuts had the highest PUFA content (> 50 %); the high unsaturated/saturated fatty acid ratio ranged from 4.5 to 11.8. However, the fatty acid pattern of every nut is unique.
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Affiliation(s)
| | | | - Ibrahim Elmadfa
- Institute of Nutritional Sciences, University of Vienna, Austria
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26
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Abstract
Vitamins are essential nutrients for many body functions and particularly important during growth. Adequate supply in pregnancy and in early infancy is therefore crucial, but there is still a lack of knowledge about the needed amounts of vitamins of children older than six months and also during pregnancy. Recommendations for intake levels are generally derived by extrapolation from data for infants based in turn on the contents in breast milk and those for adults. A vitamin of particular importance in pregnancy is folic acid due to its role in the development of the brain and nerve system and the prevention of fetal neural tube defects (NTD). Mandatory fortification of flour and certain other grain products in many countries has been associated with a reduction in NTD incidence. However, other deficiencies or suboptimal status of B vitamins, especially B6 and B12 have been repeatedly reported in pregnant women also in high-income countries. Vitamin A is one of the three most critical micronutrients globally and pregnant women and young children are especially vulnerable to deficiencies. Night blindness, anemia, and immunodeficiency are major consequences of inadequate supply in these populations. Much attention has recently been accorded vitamin D that is also critical in pregnant women and young children for instance because of its involvement in bone mineralization but also its more recently discovered immune-modulating function that is thought to prevent development of autoimmune diseases like diabetes mellitus type I. A healthy balanced diet provides the best basis for optimal pregnancy outcome, lactation performance, and complementary feeding. However, supplements or fortified foods may be needed to cover the high requirements especially of critical vitamins such as vitamin D and folic acid and to correct unfavorable dietary patterns in women or to adapt foods to the needs of young children.
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Affiliation(s)
- Ibrahim Elmadfa
- Department of Nutritional Sciences, University of Vienna, Austria.
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27
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Newson RS, Elmadfa I, Biro G, Cheng Y, Prakash V, Rust P, Barna M, Lion R, Meijer GW, Neufingerl N, Szabolcs I, van Zweden R, Yang Y, Feunekes GIJ. Barriers for progress in salt reduction in the general population. An international study. Appetite 2013; 71:22-31. [PMID: 23891557 DOI: 10.1016/j.appet.2013.07.003] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 07/02/2013] [Accepted: 07/15/2013] [Indexed: 10/26/2022]
Abstract
Salt reduction is important for reducing hypertension and the risk of cardiovascular events, nevertheless worldwide salt intakes are above recommendations. Consequently strategies to reduce intake are required, however these require an understanding of salt intake behaviours to be effective. As limited information is available on this, an international study was conducted to derive knowledge on salt intake and associated behaviours in the general population. An online cohort was recruited consisting of a representative sample from Germany, Austria, United States of America, Hungary, India, China, South Africa, and Brazil (n=6987; aged 18-65 years; age and gender stratified). Participants completed a comprehensive web-based questionnaire on salt intake and associated behaviours. While salt reduction was seen to be healthy and important, over one third of participants were not interested in salt reduction and the majority were unaware of recommendations. Salt intake was largely underestimated and people were unaware of the main dietary sources of salt. Participants saw themselves as mainly responsible for their salt intake, but also acknowledged the roles of others. Additionally, they wanted to learn more about why salt was bad for health and what the main sources in the diet were. As such, strategies to reduce salt intake must raise interest in engaging in salt reduction through improving understanding of intake levels and dietary sources of salt. Moreover, while some aspects of salt reduction can be globally implemented, local tailoring is required to match level of interest in salt reduction. These findings provide unique insights into issues surrounding salt reduction and should be used to develop effective salt reduction strategies and/or policies.
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Affiliation(s)
- R S Newson
- Unilever Research and Development, Vlaardingen, The Netherlands
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28
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Moser U, Elmadfa I. 100 years of vitamins. INT J VITAM NUTR RES 2013; 82:309. [PMID: 23798047 DOI: 10.1024/0300-9831/a000123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Fabian E, Pölöskey P, Kósa L, Elmadfa I, Réthy LA. Nutritional supplements and plasma antioxidants in childhood asthma. Wien Klin Wochenschr 2013; 125:309-15. [PMID: 23636616 DOI: 10.1007/s00508-013-0359-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2012] [Accepted: 03/20/2013] [Indexed: 12/30/2022]
Abstract
OBJECTIVE This study investigated the relationship of plasma antioxidants to airway inflammation and systemic oxidative stress in children suffering from atopic asthma with consideration of the intake of nutritional supplements. SUBJECTS AND RESEARCH METHODS A total of 35 asthmatic children (AG) and 21 healthy controls (CG) participated in this study. Plasma levels of vitamins A and E, β-carotene, coenzyme Q10 and malondialdehyde (MDA) were analyzed with high-performance liquid chromatography (HPLC); the total antioxidant capacity (TAC) was measured photometrically, and selenium was determined by atomic absorption spectroscopy (AAS). The volume of fractionated exhaled nitric oxide (FeNO) was measured with the NIOX nitric oxide monitoring system. RESULTS The plasma antioxidants vitamins A and E, selenium, and coenzyme Q10 but not β-carotene were significantly (p < 0.05) lower in asthmatics than in controls. Further, asthmatic children had significantly reduced plasma concentrations of TAC (p < 0.01), significantly enhanced levels of MDA (p < 0.001), and exhaled a significantly (p < 0.001) higher mean volume of FENO than healthy children. Regular intake of supplements had a significant positive influence on plasma vitamin E (p < 0.01), selenium (p < 0.01), TAC (p < 0.05), MDA (p < 0.01), and FENO (p < 0.01) in asthmatics but not in controls. Additionally, significant negative associations of vitamin E and MDA (AG: p < 0.01; CG: p < 0.05), and vitamin E and FENO (AG: p < 0.05; CG: p > 0.05) were identified. CONCLUSION These results indicate that nutritional supplements beneficially modulate plasma antioxidants and thus might have a positive influence on systemic redox balance and subsequently, pulmonary inflammation in asthmatic children.
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Affiliation(s)
- Elisabeth Fabian
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria.
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Newson RS, Lion R, Crawford RJ, Curtis V, Elmadfa I, Feunekes GIJ, Hicks C, van Liere M, Lowe CF, Meijer GW, Pradeep BV, Reddy KS, Sidibe M, Uauy R. Behaviour change for better health: nutrition, hygiene and sustainability. BMC Public Health 2013; 13 Suppl 1:S1. [PMID: 23530770 PMCID: PMC3605264 DOI: 10.1186/1471-2458-13-s1-s1] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
As the global population grows there is a clear challenge to address the needs of consumers, without depleting natural resources and whilst helping to improve nutrition and hygiene to reduce the growth of noncommunicable diseases. For fast-moving consumer goods companies, like Unilever, this challenge provides a clear opportunity to reshape its business to a model that decouples growth from a negative impact on natural resources and health. However, this change in the business model also requires a change in consumer behaviour. In acknowledgement of this challenge Unilever organised a symposium entitled ‘Behaviour Change for Better Health: Nutrition, Hygiene and Sustainability’. The intention was to discuss how consumers can be motivated to live a more healthy and sustainable lifestlye in today’s environment. This article summarises the main conclusions of the presentations given at the symposium. Three main topics were discussed. In the first session, key experts discussed how demographic changes – particularly in developing and emerging countries – imply the need for consumer behaviour change. The second session focused on the use of behaviour change theory to design, implement and evaluate interventions, and the potential role of (new or reformulated) products as agents of change. In the final session, key issues were discussed regarding the use of collaborations to increase the impact and reach, and to decrease the costs, of interventions. The symposium highlighted a number of key scientific challenges for Unilever and other parties that have set nutrition, hygiene and sustainability as key priorities. The key challenges include: adapting behaviour change approaches to cultures in developing and emerging economies; designing evidence-based behaviour change interventions, in which products can play a key role as agents of change; and scaling up behaviour change activities in cost-effective ways, which requires a new mindset involving public–private partnerships.
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Affiliation(s)
- Rachel S Newson
- Unilever Research and Development, Olivier van Noortlaan 120, 3133 AT Vlaardingen, the Netherlands.
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Giahi L, Elmadfa I, Hoseini M, Klein P. Heat-inactivatedLactobacillus rhamnosusandLactobacillus delbrueckiiinduce efficient maturation and differential cytokine production in human monocyte derived dendritic cells. FOOD AGR IMMUNOL 2013. [DOI: 10.1080/09540105.2011.651445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
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32
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Abstract
The interactions between frying fat and fried foods are of great relevance for the nutritional quality of the final product. In particular, the amount of fat taken up can be positively influenced at the industrial but also at the household level by different pre- and post-frying conditions. The fat uptake during the frying process can also lead to a complete different fatty acid pattern of the product. The change is always towards the predominant fatty acids in the frying fat, which can be beneficial when replacing saturated fatty acids with monounsaturated fatty acids and polyunsaturated fatty acids, but can also be of disadvantage in the case of fish, when the initial content of n-3 fatty acids is significantly reduced. This has also to be considered for nutritional calculation so as not to misrepresent the nutrient composition of the fried product. There have been positive developments in producing frying fats which are low in trans-fatty acids, and fried products low in heat-induced compounds which can address toxicological concerns such as acrylamide formation.
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Affiliation(s)
- Karl-Heinz Wagner
- Department of Nutritional Sciences, University of Vienna, AT-1090 Vienna, Austria.
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33
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Abstract
A high-quality diet is one of the foundations of health and well-being. For a long time in human history, diet was chiefly a source of energy and macronutrients meant to still hunger and give the strength for work and activities that were in general much harder than nowadays. Only few persons could afford to emphasize enjoyment. In the assessment of quality, organoleptic properties were major criteria to detect spoilage and oxidative deterioration of food. Today, food hygiene is a quality aspect that is often taken for granted by consumers, despite its lack being at the origin of most food-borne diseases. The discovery of micronutrients entailed fundamental changes of the concept of diet quality. However, non-essential food components with additional health functions were still barely known or not considered important until recently. With the high burden of obesity and its associated diseases on the rise, affluent, industrialized countries have developed an increased interest in these substances, which has led to the development of functional foods to optimize special body functions, reduce disease risk, or even contribute to therapeutic approaches. Indeed, nowadays, high contents of energy, fat, and sugar are factors associated with a lower quality of food, and products with reduced amounts of these components are valued by many consumers. At the same time, enjoyment and convenience are important quality factors, presenting food manufacturers with the dilemma of reconciling low fat content and applicability with good taste and appealing appearance. Functional foods offer an approach to address this challenge. Deeper insights into nutrient-gene interactions may enable personalized nutrition adapted to the special needs of individuals. However, so far, a varied healthy diet remains the best basis for health and well-being.
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Affiliation(s)
- Ibrahim Elmadfa
- Institute of Nutritional Sciences, University of Vienna, AT-1090 Vienna, Austria.
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Nettleton JA, Villalpando S, Cassani RSL, Elmadfa I. Health Significance of Fat Quality in the Diet. Ann Nutr Metab 2013; 63:96-102. [DOI: 10.1159/000353207] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 05/02/2013] [Indexed: 11/19/2022]
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Vojir F, Schübl E, Elmadfa I. The Origins of a Global Standard for Food Quality and Safety: Codex Alimentarius Austriacus and FAO/WHO Codex Alimentarius. INT J VITAM NUTR RES 2012; 82:223-7. [DOI: 10.1024/0300-9831/a000115] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
In the second half of the 19th century the incidence of food adulterations increased very rapidly, prompting many European countries to put into force food laws to fight these practices. A number of parallel attempts were undertaken to establish a collection of instructions for the assessment of food samples to warrant the comparability of results obtained and interpreted by different experts. The first official steps towards such a standardization was made in 1891 at an international meeting of food chemists and microscopic scientists in Vienna. As a consequence, Austria installed a Scientific Commission in 1891, which drafted chapters for a future Codex Alimentarius Austriacus. In 1907, a Codex Commission was installed by the Ministry of Interior, but it took about four years, from 1907 to 1911, before the first edition of this compendium was published. So far, four editions have followed. The Codex Alimentarius Austriacus is a set of standards and guidelines for stakeholders, authorities, and law courts as a base for their activities. It has evolved over the past 100 years to become a flexible instrument, which has become indispensable for Austria. After 1945, attempts were made in different parts of the world to develop standardized rules for the testing of food samples to prevent trade barriers within the respective region. In Europe for instance, the development of a Codex Alimentarius Europaeus initiated by the Austrian Hans Frenzel, and based upon the model of the Codex Alimentarius Austriacus, made good progress. A number of other European countries were involved in this project. However, the Food and Agriculture Organization (FAO) and the World Health Organization (WHO) of the United Nations were intent on impeding such regional activities to prevent trade barriers at a global level. Between 1960 and 1963, steps were taken to install a FAO/WHO Codex partly in close cooperation with the Codex Alimentarius Europaeus. Since 1963, the FAO/WHO Codex Commission has issued the FAO/WHO Codex Alimentarius, which took its name and some organizational aspects from Codex Alimentarius Europaeus, that was itself modeled after the Codex Alimentarius Austriacus. The Codex Alimentarius Europaeus was incorporated into the Codex Alimentarius Commission as the regional coordinating committee for Europe, thus providing a model for the six regional coordination committees of the Codex Alimentarius Commission existing today.
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Affiliation(s)
- Franz Vojir
- Bureau of the Codex Commission, Ministry of Health, Vienna, Austria
| | - Erwin Schübl
- Bureau of the Codex Commission, Ministry of Health, Vienna, Austria
| | - Ibrahim Elmadfa
- Institute of Nutritional Sciences, University of Vienna, Austria
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Giahi L, Aumueller E, Elmadfa I, Haslberger A. Regulation of TLR4, p38 MAPkinase, IκB and miRNAs by inactivated strains of lactobacilli in human dendritic cells. Benef Microbes 2012; 3:91-8. [DOI: 10.3920/bm2011.0052] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Strain specific properties of probiotics in providing supportive health effects in the immune system and the gastrointestinal tract have been widely investigated in vivo and in vitro. However, the underlying responsible mechanism is poorly described. By unravelling the probiotic-induced responses in a complex network of interacting signalling pathways, we investigated the effect of heat-inactivated Lactobacillus rhamnosus GG (LGG) and Lactobacillus delbrueckii subsp. bulgaricus (L.del) on the expression of TLR4 and signalling factors such as p38 MAPK and I?B at transcription level in human monocyte-derived dendritic cells (DCs). Our findings demonstrated that even inactivated probiotic strains can affect TLR4 expression in a down-regulatory direction as with lipopolysaccharides after 12 hours. LGG significantly down-regulated expression of p38 while I?B expression was significantly reduced in L.del-treated DCs. Moreover, we found these Lactobacillus strains could even modify the immune response at post-transcriptional level by modifying miRNAs expression. Based on our results LGG induced a significant down-regulatory effect on miR-146a expression which is known as a novel fine negative regulator of immune response targeting NFκB. On the other hand, miR-155 was up-regulated by LGG which is consistent with down-regulation of p38 and in LGG-treated DCs. These findings provide genetic and epigenetic explanations for the responsible underlying mechanisms by which probiotics influence immune response by targeting DCs.
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Affiliation(s)
- L. Giahi
- Faculty of Life Sciences, Department of Nutritional Science, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria
- Reproductive Biotechnology Research Center, Avicenna Research Institute (ACECR), P.O. Box 19615, 1177 Tehran, Iran
| | - E. Aumueller
- Faculty of Life Sciences, Department of Nutritional Science, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria
| | - I. Elmadfa
- Faculty of Life Sciences, Department of Nutritional Science, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria
| | - A.G. Haslberger
- Faculty of Life Sciences, Department of Nutritional Science, University of Vienna, Althanstrasse 14, 1090 Vienna, Austria
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Abstract
The food safety security (FSS) concept is perceived as an early warning system for minimizing food safety (FS) breaches, and it functions in conjunction with existing FS measures. Essentially, the function of FS and FSS measures can be visualized in two parts: (i) the FS preventive measures as actions taken at the stem level, and (ii) the FSS interventions as actions taken at the root level, to enhance the impact of the implemented safety steps. In practice, along with FS, FSS also draws its support from (i) legislative directives and regulatory measures for enforcing verifiable, timely, and effective compliance; (ii) measurement systems in place for sustained quality assurance; and (iii) shared responsibility to ensure cohesion among all the stakeholders namely, policy makers, regulators, food producers, processors and distributors, and consumers. However, the functional framework of FSS differs from that of FS by way of: (i) retooling the vulnerable segments of the preventive features of existing FS measures; (ii) fine-tuning response systems to efficiently preempt the FS breaches; (iii) building a long-term nutrient and toxicant surveillance network based on validated measurement systems functioning in real time; (iv) focusing on crisp, clear, and correct communication that resonates among all the stakeholders; and (v) developing inter-disciplinary human resources to meet ever-increasing FS challenges. Important determinants of FSS include: (i) strengthening international dialogue for refining regulatory reforms and addressing emerging risks; (ii) developing innovative and strategic action points for intervention {in addition to Hazard Analysis and Critical Control Points (HACCP) procedures]; and (iii) introducing additional science-based tools such as metrology-based measurement systems.
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Affiliation(s)
- Venkatesh Iyengar
- Biomineral Sciences International, Bethesda MD, USA, and FSNSP, Tufts University, Boston MA, USA
| | - Ibrahim Elmadfa
- Institute of Nutritional Sciences, University of Vienna, Vienna, Austria
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Pouraram H, Elmadfa I, Dorosty AR, Abtahi M, Neyestani TR, Sadeghian S. Long-term consequences of iron-fortified flour consumption in nonanemic men. Ann Nutr Metab 2012; 60:115-21. [PMID: 22433920 DOI: 10.1159/000336184] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Accepted: 01/01/2012] [Indexed: 02/04/2023]
Abstract
BACKGROUND/AIMS Despite the advantages of fortifying flour with iron, there are still special concerns regarding the possible adverse effects of the extra iron consumed by nonanemic individuals. This study aimed to investigate the oxidative stress and iron status following 8 and 16 months of consumption of iron-fortified flour in nonanemic men. METHODS In a before-and-after intervention study, 78 nonanemic apparently healthy 40- to 65-year-old men were randomly selected from Semnan, in the northeast of Iran. Data were collected at three time points. Evaluation of oxidative stress biomarkers as well as the assessment of iron status was performed in all three stages. After baseline data collection, the flour fortification program was started with 30 mg/kg iron as ferrous sulfate. RESULTS After 16 months, serum iron levels had significantly increased from 102.9 ± 31.5 μg/dl (baseline) to 117.2 ± 29.8 μg/dl (p < 0.001). The mean total antioxidant capacity (1.71 ± 0.10 μM) was significantly lower than that at baseline (1.83 ± 0.17 μM; p < 0.01). Among other oxidative stress biomarkers, only superoxide dismutase and glutathione peroxidase activity increased significantly compared to the beginning of the study (p < 0.001 and p < 0.001, respectively). The results of this study did not show any symptoms of iron overload after 8 and 16 months. CONCLUSIONS Our data did not support the safety of flour fortification with 30 mg/kg iron as ferrous sulfate as a community-based approach to control iron deficiency in nonanemic healthy men.
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Affiliation(s)
- Hamed Pouraram
- Institute of Nutritional Sciences, University of Vienna, Vienna, Austria
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Abstract
OBJECTIVE This study aimed to evaluate the status of several vitamins and to investigate the effect of regular individual supplementation on their status in this population. DESIGN An observational study. SETTING State of Burgenland, Austria. PARTICIPANTS A total of 102 non-institutionalized subjects (49% supplementing regularly, 51% without supplementation) aged between 70-90 years were recruited. MEASUREMENTS Plasma levels of vitamins A, D, E, K and C were determined by HPLC. The functional parameters of vitamins B1, B2 and B6, i.e. the activities of the erythrocyte enzymes transketolase, glutathione reductase and glutamic oxaloacetic transaminase, were analyzed photometrically; plasma folate and vitamin B12 were determined by RIA. RESULTS The status of vitamins A, E and C was generally satisfactory. Eighty-eight percent and 42% of participants were deficient in vitamins D and K, respectively, as were 29% for B6; up to 10% of participants were deficient in vitamins B1, B2, B12 and folate. A considerable percentage of participants was, however, at risk for vitamin deficiencies (vitamins B1, B6, B12, folate: 20-30%, vitamin B2: 60%). Except for vitamins A and K, regular intake of supplements had a significant positive influence on vitamin levels. CONCLUSION These results indicate that use of supplements significantly improved the status of several vitamins in elderly people. Due to age-related problems concerning the intake and digestion of nutrients, a moderate, regular supplementation might be a useful option for older people who are otherwise unable to satisfy their micronutrient requirements.
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Affiliation(s)
- E Fabian
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria.
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Abstract
BACKGROUND Since oxidative stress might cause and promote cardiovascular risk factors such as oxidized low-density lipoproteins (oxLDL), apolipoprotein(a) [apo(a)], asymmetric dimethylarginine (ADMA) and fetuin A, we investigated antioxidant enzyme activities in relation to the vascular redox balance and these risk factors in elderly people. MATERIALS AND METHODS For this observational study, a total of 102 subjects were recruited and divided into three groups: A (70-74 years/n = 48), B (75-79 years/n = 35) and C (≥ 80 years/n = 19). Activities of the erythrocyte antioxidant enzymes superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and catalase (CAT) were determined photometrically oxLDL, apo(a), ADMA and fetuin A by ELISA. Plasma concentrations of the lipid peroxidation products malondialdehyde (MDA) and conjugated dienes (CD) were analysed with HPLC. RESULTS There were no significant age-associated alterations in apo(a) levels, but there was a significant age-related decrease in activities of SOD (A>C, B>C: P < 0·01), CAT (A>C: P < 0·05) and GSH-Px (A>C: P < 0·05), accompanied by a significant increase in oxLDL (A<C: P < 0·001; B<C: P < 0·05), ADMA (A<B: P < 0·05; A<C: P < 0·001), MDA (A<C, B<C: P < 0·01) and CD (A<C, B<C: P < 0·01), and a significant decrease in fetuin A (A>C: P < 0·01; B>C: P < 0·05). Consequently, all groups showed significant negative age-associated correlations between CAT and MDA (A, B, C: P < 0·05), GSH-Px and CD (A, C: P < 0·01; B: P < 0·05), SOD and oxLDL (A, B: P < 0·05; C: P < 0·01), and fetuin A and MDA (A: P < 0·01; B, C: P < 0·05), and a significant positive correlation between oxLDL and ADMA (A, B: P < 0·05; C: P < 0·01). CONCLUSIONS This study indicates a significant age-related decrease in antioxidant enzyme activities accompanied by significantly increased systemic oxidative stress, which promotes the cardiovascular risk factors oxLDL, ADMA and fetuin A in elderly people.
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Affiliation(s)
- Elisabeth Fabian
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria.
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Micha R, Kalantarian S, Wirojratana P, Byers T, Danaei G, Elmadfa I, Ding E, Giovannucci E, Powles J, Smith-Warner S, Ezzati M, Mozaffarian D. Estimating the global and regional burden of suboptimal nutrition on chronic disease: methods and inputs to the analysis. Eur J Clin Nutr 2011; 66:119-29. [PMID: 21915137 DOI: 10.1038/ejcn.2011.147] [Citation(s) in RCA: 84] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND/OBJECTIVES Global burdens of cardiovascular disease (CVD), diabetes and cancer are on the rise. Little quantitative data are available on the global impact of diet on these conditions. The objective of this study was to develop systematic and comparable methods to quantitatively assess the impact of suboptimal dietary habits on CVD, diabetes and cancer burdens globally and in 21 world regions. SUBJECTS/METHODS Using a comparative risk assessment framework, we developed methods to establish for selected dietary risk factors the effect sizes of probable or convincing causal diet-disease relationships, the alternative minimum-risk exposure distributions and the exposure distributions. These inputs, together with disease-specific mortality rates, allow computation of the numbers of events attributable to each dietary factor. RESULTS Using World Health Organization and similar evidence criteria for convincing/probable causal effects, we identified 14 potential diet-disease relationships. Effect sizes and ranges of uncertainty will be derived from systematic reviews and meta-analyses of trials or high-quality observational studies. Alternative minimum-risk distributions were identified based on amounts corresponding to the lowest disease rates in populations. Optimal and alternative definitions for each exposure were established based on the data used to quantify harmful or protective effects. We developed methods for identifying and obtaining data from nationally representative surveys. A ranking scale was developed to assess survey quality and validity of dietary assessment methods. Multi-level hierarchical models will be developed to impute missing data. CONCLUSIONS These new methods will allow, for the first time, assessment of the global impact of specific dietary factors on chronic disease mortality. Such global assessment is not only possible but is also imperative for priority setting and policy making.
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Affiliation(s)
- R Micha
- Department of Epidemiology, Harvard School of Public Health, Boston, MA 02115, USA.
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Giahi⁎ L, Elmadfa I. The effect of heat inactivated Lactobacillus rhamnosus and Lactobacillus delbrueckii on human dendritic cell maturation and cytokine profile. Eur J Pharmacol 2011. [DOI: 10.1016/j.ejphar.2011.09.255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Charrondiere UR, Freisling H, Elmadfa I. The distance learning tool ‘Food Composition Study Guide’ contributes to global capacity development in food composition. J Food Compost Anal 2011. [DOI: 10.1016/j.jfca.2010.09.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Fabian E, Töscher S, Elmadfa I, Pieber TR. Use of complementary and alternative medicine supplements in patients with diabetes mellitus. Ann Nutr Metab 2011; 58:101-8. [PMID: 21474927 DOI: 10.1159/000326765] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Accepted: 02/22/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS This study was conducted to evaluate the current use of biologically-based complementary and alternative medicine (CAM) therapies in diabetics, considering health awareness, motivation, and expectations for CAM use. Moreover, patients' attitudes toward cinnamon preparations and the need for appropriate information from health care professionals were determined. METHODS A total of 200 patients (59% men and 41% women) with type 1 (16%) or type 2 diabetes (84%) were interviewed using a standardized, validated questionnaire; the results from 198 respondents were analyzed. RESULTS A third of type 1 and type 2 diabetics (women > men; p < 0.01) reported current use of biologically-based CAM supplements, and intake was significantly (r = 0.203; p < 0.05) correlated to the degree of health awareness/interest in self-care in type 2 diabetics. The use of nutritional supplements (vitamins/multivitamins and minerals), herbal medicine, and cinnamon was reported most frequently. Prevention (36%) and improved well-being/quality of life (13%) but not the positive modulation of diabetes management (4%) were given as main motivations. Eighty-three percent of type 1 diabetics (women > men; p < 0.05) and 70% of type 2 diabetics already knew about the postulated positive effect of cinnamon on blood glucose. Up to 85% reported a willingness or a probable willingness to test the effect of cinnamon on blood glucose. Among patients with type 2 diabetes the subjectively felt disease burden was found to have a significant (r = 0.235; p < 0.01) impact on the willingness to use cinnamon preparations for better diabetes management. CONCLUSION This study indicates a remarkable interest in CAM remedies in the investigated group of diabetics as a strategy for active engagement in health and disease self-management. Healthcare professionals should be aware of the increasing number of patients using CAM supplements and hence incorporate these aspects into patient care in order to ensure patient satisfaction and optimize health care.
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Affiliation(s)
- Elisabeth Fabian
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria.
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Fabian E, Pölöskey P, Kósa L, Elmadfa I, Réthy LA. Activities of antioxidant enzymes in relation to oxidative and nitrosative challenges in childhood asthma. J Asthma 2011; 48:351-7. [PMID: 21401389 DOI: 10.3109/02770903.2011.560319] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND This study aimed to investigate the relationship between antioxidant enzyme activities, extent of airway inflammation, and systemic oxidative stress in children suffering from atopic asthma. METHODS A total of 35 asthmatic (AG) and 21 healthy children (CG) participated in this study. The volume of fractionated exhaled NO (Fe(no)) was measured with the NIOX test system. The activities of the erythrocyte antioxidant enzymes superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px), and the total antioxidant capacity (TAC) were determined photometrically. Plasma interleukin (IL)-6 was measured using ELISA; malondialdehyde (MDA) levels were analyzed using HPLC. RESULTS Compared to healthy controls, asthmatic children exhaled a significantly (p < .001) higher mean volume of Fe(no), had significantly reduced plasma concentrations of TAC (p = .006), and significantly enhanced levels of MDA (p < .001) and IL-6 (p = .012). SOD (p = .027), CAT (p < .001), and GSH-Px (p = .005) were significantly less active in the asthma group and significantly negatively associated with Fe(no) (SOD/Fe(no): p = .017; CAT/Fe(no): p = .008; GSH-Px/Fe(no): p = .001); the oxidative stress marker MDA showed such correlations in both investigated groups (SOD/MDA: AG: p = .001, CG: p = .381; CAT/MDA: AG: p = .003, CG: p = .020; GSH-Px/MDA: AG: p = .006, CG: p = .011). Furthermore, there was a significant (p< .01) positive correlation between MDA/Fe(no) and MDA/IL-6 observed in both groups. CONCLUSIONS These results indicate that inflammation of the bronchial tree, reflected by increased NO formation in the airways and enhanced systemic oxidative stress, is related to an alteration of antioxidant enzyme activities in childhood asthma. Modulating the activity of antioxidant enzymes may therefore have beneficial effects on pulmonary and systemic antioxidant defense mechanisms and could reduce airway inflammation and oxidative stress in asthmatics.
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Affiliation(s)
- Elisabeth Fabian
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria.
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Abstract
INTRODUCTION Adequate nutrition is one of the pillars of public health. Before developing and implementing effective intervention programmes to improve nutrition at the population level, it is important to know the nutritional situation of the target group. ASSESSMENT OF ENERGY AND NUTRIENT INTAKE The estimation of nutrient intake from food consumption requires reliable data on food composition. These data are also the fundamentals of food-based dietary guidelines for healthy nutrition, containing the necessary information on food sources for different nutrients. Furthermore, food composition tables can provide information on chemical forms of nutrients and the presence and amounts of interacting components, and thus provide information on their bioavailability. For some nutrients such as vitamin A, vitamin E and niacin, the concept of equivalence has been introduced to account for differences in the availability and biological activity of different chemical forms. NON-NUTRITIVE FOOD COMPONENTS: Although most food composition tables focus on energy, macro- and micronutrients, interest in non-nutritive components is increasing. Considering the beneficial effects of biologically active secondary plant cell compounds such as polyphenols and carotenoids, more data on these are needed. On the other hand, there are a number of naturally occurring or 'man-made' non-nutritive substances with negative effects, and to control exposure, the main dietary sources must be known. Another aspect is contaminants, which could have detrimental effects on consumers' health. Among these are agrochemicals, industrial pollutants reaching the food chain and substances formed during food preparation. A valid risk assessment requires data on exposure, and thus on the contents of contaminants in foods. However, these data are highly variable and may significantly differ even within narrowly confined regions. CURRENT FOOD COMPOSITION DATABASES ARE FAR FROM COMPLETE: The fact that composition tables generally do not provide information about the origin of substances found in food can also influence their usability. For example, the German Nutrient Data base does not discriminate between naturally occurring and added sucrose impeding the estimation of added sucrose intake that should be limited. Points of focus: Considering the increasing number of persons relying on community nutrition and catering, healthy menu lines can improve the consumers' diets and contribute to nutrient supply. The development and implementation of appropriate guidelines also need food composition databases (FCBs) to compose meals. The ever-increasing number of new food preparations and manufactured products has resulted in a need for procedures for regularly updated data. Moreover, there is a lack of data particularly for essential trace elements such as copper, chromium or molybdenum and also vitamin K, as well as the already mentioned non-nutritive components. Limited comparability between countries is another issue. Regional differences arise especially from the use of local varieties, different soil quality or meteorological aspects. This variability is further increased with composite meals because of variation in recipes. CONCLUSION Information about food composition is necessary for the assessment of diet quality and the development and application of food-based dietary guidelines, providing a useful tool for the field of public health nutrition. In this regard, more attention should be paid to the preparation, extension and maintenance of FCBs.
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Affiliation(s)
- I Elmadfa
- Institute of Nutritional Sciences, University of Vienna, Althanstrasse, Vienna, Austria.
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Fabian E, Gerstorfer I, Thaler HW, Stundner H, Biswas P, Elmadfa I. Nutritional supplementation affects postoperative oxidative stress and duration of hospitalization in patients with hip fracture. Wien Klin Wochenschr 2011; 123:88-93. [DOI: 10.1007/s00508-010-1519-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Accepted: 11/26/2010] [Indexed: 10/18/2022]
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Abdollahi Z, Elmadfa I, Djazayery A, Golalipour M, Sadighi J, Salehi F, Sadeghian Sharif S. Efficacy of Flour Fortification with Folic Acid in Women of Childbearing Age in Iran. Ann Nutr Metab 2011; 58:188-96. [DOI: 10.1159/000329726] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2010] [Accepted: 05/30/2011] [Indexed: 12/12/2022]
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Fabian E, Bogner M, Kickinger A, Wagner KH, Elmadfa I. Intake of Medication and Vitamin Status in the Elderly. Ann Nutr Metab 2011; 58:118-25. [DOI: 10.1159/000327351] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2010] [Accepted: 03/11/2011] [Indexed: 01/02/2023]
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