A new systematic review published online today in Public Health Nutrition by Castillo-Lancellotti, Tur and Uauy reviews the effects of folic acid fortification on rates of neural tube defects in 9 countries located in Africa, North America, South America and the Middle East. Folic acid is one of the B-vitamins. It is involved with amino acid metabolism, DNA synthesis and red blood cell production. Developing embryos undergo rapid rates of cell division, and it is thought that folic acid deficiency impairs the closure of the neural tube around week 6 of pregnancy. The abnormal opening in the neural tube is called a neural tube defect (NTD), which occurs in roughly 2 to 10 births per 10,000 births. NTDs are often very serious conditions, resulting in growth retardation, paralysis, increased risk of infection, mental retardation and death in the fetus or infant.
Archive for 'July 2012'
The European Food Safety Authority has released 2 new scientific opinions relating to on Tolerable Upper Intake Levels (UL). Vitamin D: The UL for adults, including pregnant women and lactating women was set at 100 μg (4,000 IU) daily. The same UL was set for children and adolescents but it was reduced to 50 μg (2,000 IU) daily for children 1-10 years because of their smaller body size. In adults, a daily vitamin D dose of 250 μg (10,000 IU) was considered to reflect no observed adverse effect level (NOAEL). Data from European populations indicated that vitamin D intakes from all sources in high consumers are below the UL for all population subgroups. Eicosapentaenoic acid (EPA), Docosahexaenoic acid (DHA), and Docosapentaenoic acid (DPA): The Panel
Most people know that vitamin D is important for bone health and that our bodies can make vitamin D if we spend enough time in the sunshine. Logically, this means that vitamin D status, measured by serum 25(OH)D3, should increase during the summer. Vitamin D levels do increase when people spend more time outside. However, Kluczynksi and colleagues report that baseline vitamin D level accounts for most of the variability in serum 25(OH)D3 levels. Changes in vitamin D supplement intake were the next largest contributor to variations in vitamin D status.
Children from ethnic minority and low-income families have higher rates of poor health and mortality. Diet quality may be one of the contributing factors. Dietary intake data is used to estimate nutrient intakes but reliable nutritional biomarkers would be better to guide policy. Earlier this year Wasantwisut and Neufeld summarized the activities of the Biomarkers of Nutrition for Development (BOND), a working group supported by the NIH Institute of Child Health and Human Development to select nutritional biomarkers. Case examples were given for vitamin A, folate, vitamin B12, iron and zinc. Kant and Graubard report serum nutrient concentrations and vitamin intakes in 2-19 year old children (n = 2,700-7,500 depending upon the nutrient) using NHANES 2003-2006 data.
The accumulation of triglycerides (fat) in the liver is associated with inflammatory signals, obesity and insulin resistance. In many people, nonalcoholic fatty liver disease (NAFLD) and insulin resistance are both present. NAFLD is becoming more prevalent, affecting 1/3 of adults and an increasing number of children but its affect on atherosclerosis is unknown. Sung and colleagues tested whether fatty liver, insulin resistance, and metabolic syndrome were a marker of atherosclerosis, cardiovascular risk factors, and heart disease
Nutrition science examines the role of diet and nutrients affect well-being – physical and psychological. Nutrients are essential for life. Protein, fat, and carbohydrates are used for energy whereas vitamins are essential for cell function. Good nutrition helps prevent disease and promotes health. Just like calorie imbalance can lead to starvation or obesity, inadequate vitamin intakes cause deficiency diseases and excess can be damaging. We are primarily interested in covering new research on the role of vitamins and other key nutrients, eg omega-3 fatty acids, on health. But this week, most of the nutrition studies seem to be focused on disease states. With the caveat that nutrients are not drugs, here are some of the newest findings.
Healthy eating. Easier said than done. At least that is the finding of new studies. Van Lee and colleagues used an index to evaluate diet quality of 749 men and women, 19-30 years, living in the Netherlands. Based on two 24-hour dietary recalls and additional questionnaires, the investigators assigned scores (zero to ten) to 10 components (physical activity, and intakes of vegetable, fruit & fruit juice, fiber, fish, saturated fat, trans fat, acidic drinks and foods, sodium, and alcohol). A perfect diet would have a score of 100. The average score was 59-60. Most of the participants scored high (score measured out of 10) on physical activity (9.4), acidic drinks and foods (9.7), alcohol (8.9) and trans fat (7.0) The lowest scores were fish (1.1) and sodium (2.4)
According to WHO, 346 million people have diabetes. Diabetes is a non-communicable disease caused by a failure of the pancreas to produce insulin or an inability of the body to effectively use insulin to move glucose from the blood into cells. Diabetes increases the risk of stroke and heart disease. It is a chronic disease which requires lifelong medical treatment. Thus, it is expensive to individuals and to society. Bruno and colleagues compare the direct costs of diabetic and non-diabetic people covered by the Italian Health Care System. Diabetes accounted for 11.4% of total health care expenditure. Direct costs were 4-fold higher in individuals with- vs without diabetes.
A new scientific report by Zhang et al emphasizes the need for nutrition guidance to be based on studies measuring biomarkers rather than estimates of dietary intakes. Why? To quote former US Secretary of Defense, Donald Rumsfeld, “there are known unknowns - that is to say things that we now know that we don’t know; But there are also unknown knowns - there are things that we do not know we don’t know”. This is the case with diet records. Did the subjects accurately report everything ingested? Did the days on record reflect their diet over years? Was the nutritional content of everything consumed on the days of record actually measured or was it estimated from tables? What analytical method(s) was used to quantify nutrient content in the foods and dietary supplements? Were food, beverage, and supplement intakes all considered?
The Institute of Medicine released a new report today “How Can Health Care Organizations Become More Health Literate? – Workshop Summary”. Within the United States, approximately 80 million adults have low health literacy. This is 36% of the adult population. The USDA Health Resources and Services Administration says low health literacy is more prevalent among older adults, minority populations, those with low socioeconomic status, and the medically underserved. These are also the populations with poorer nutrition. Yang and colleagues assessed nutritional status in older adults over a 1 year period. Based on Mini-Nutritional Assessment, they found 12% of older adults receiving Medicare home health services were malnourished and 51% were at risk of malnourishment.
Almost 400 years ago, surgeon John Woodall recommended the preventative and curative powers of lemon juice. In 1747, British Royal Navy Surgeon James Lind, conducted a controlled experiment to demonstrate that citrus fruit prevented scurvy which was published in his ‘Treatise on the Scurvy’ in 1753. Based partly on these findings, the vitamin C recommended dietary allowance (RDA) was set to prevent scurvy, the vitamin C deficiency disease. In 2012, Frei and colleagues question whether most people are consuming enough vitamin C? The answer is no.
Vitamin D is an essential nutrient known best for its role in bone health. It is very important for children because they are actively growing. Today researchers in China add new research to further our understanding of the role of vitamin D in infants. The research group, lead by Song, studied 70 pregnant women and their newborn infants in the Beijing urban area. Circulating levels of vitamin D were measured in mothers and their neonates, and anthropometrics were taken. You may be surprised to find out what the levels of deficiency were in this population, and effects of deficiency on newborn size.
Diabetes mellitus is a serious disease in which either pancreatic cells are damaged and cannot produce insulin (type 1 diabetes) or cells in the body no longer react to insulin (type 2 diabetes). People with both types of diabetes, even when treated, have poorer control of blood glucose, and higher levels of markers of oxidative stress found in their blood. A significant cause of diabetic morbidity and mortality is cardiovascular disease. It is thought that oxidative stress initiates and adds to damage to the lining of blood vessels that is the cause of heart and vascular disease. Antioxidants can put a stop to oxidative stress by reducing levels of pro-oxidant species or acting as chain-breaking antioxidants. Some antioxidants are produced naturally by the body, and these include superoxide dismutase and glutathione, and others can be obtained from the diet such as vitamins C and E.
Every July 11, I am reminded that today may be the first day of life for a child. With each birth, parents strive to love and nurture these strangely robust yet precarious persons. The reality is that maternal nutrition during pregnancy already partially set the child’s course. This is why the current discussion in New Zealand is so important. In 2009, New Zealand introduced legislation requiring mandatory fortification of bread with folic acid, similar to existing laws in Canada, Australia, Chile and the US. The law was deferred for 3 years and the public consultation will end on Monday, July 16. Why the controversy? In the Daily Post, a spokesperson for the Coalition of Parents with Children with Spina Bifida is quoted as saying:
Have you ever tried to get a toddler to pretend to be a dinosaur to get them to eat trees, ie broccoli spears? Have you held competitions to see who can eat the vegetables off their plate fastest? Probably. These are old approaches to encourage children to eat a balanced diet. Bailey and colleagues examined the role of dietary supplements in meeting children’s nutrient requirements. First, nutrient intakes from foods did NOT differ between children who were given dietary supplements and those that weren’t (Tables 1 and 2). Second, inadequate vitamin intakes (B6, B12, A, C, D, and E) were more prevalent among non-users than users. Children 2-8y of age had fewer inadequacies than older kids (9-13 and 14-18y) but the majority failed to meet dietary recommendations for calcium and vitamins D and E.
New research finds vitamin D3 supplementation (15,000 IU/d) benefits obese subjects with high blood pressure and low serum 25(OH)D3 concentrations (< 25ng/mL or 62.5 nmol/L). After one month of therapy, Vaidya and colleagues measured improved biomarkers of increased renin-antiotensin activity. It was a small study with only 14 subjects so there is reason to be cautious. However, the subjects were not that unusual. According to the CDC 2nd Nutrition Report (Table 2.13.b),
Getting adequate vitamin D is recommended as part of a comprehensive fracture risk reduction program. Bischoff-Ferrari and co-workers provide new evidence via a pooled analysis of individual elderly patient data using fracture-related end-points, as reported in the New England Journal of Medicine. Data from eleven trials were included, covering 31,022 patients who experience 1,111 hip fractures and 3,770 other fractures. Most patients were post-menopausal women. This is expected because to the higher burden of disease for osteoporosis and related bone fractures in older women has encouraged the search for strategies to improve bone health in this risk group. The pooled analysis included studies that tested vitamin D with or without calcium against a control group, and low-trauma fractures had to be included as an endpoint. The trial found some interesting results.
Oxygen is life, or so the saying going. We need oxygen’s reactive capabilities to fuel our metabolic processes. But it is a bit like storing leaky fuel containers in your car can cause damage to it. The same is true with oxygen, we need it to run but it causes damage in other places. Antioxidants can help but preventing oxidative damage to cells that are particularly affected by oxygen, such as the eyes. Karrpi, Laukkanen and Kuri from the University of Eastern Finland report in the latest issue of the British Journal of Nutrition on whether plasma levels of lutein and zeaxanthin are related to cataract incidence.
Today an article in Scientific American added to the recent debate about the US Preventive Services Task Force’s (USPSTF) recent draft recommendations about vitamin D and calcium intakes. The Institute of Medicine (IOM) provided a report brief when vitamin D and calcium recommendations for the US and Canada were revised. The report brief was cited in the Scientific American article, and leads people to believe that despite intakes lower than recommended, most people achieve blood levels of vitamin D that are adequate for bone health. The IOM states “a majority of the population is meeting its needs for vitamin D,” however there is no discussion of how large the minority not meeting recommendations is.