Nutrition - Articles in Press

Low serum retinol and carotenoid levels in children and adolescents with AIDS: Does it really not matter? - Corrected Proof

2010-08-30

To the editor, We appreciate the relevance of your research theme. However, we would like to point out some methodological and practical aspects of the study . First of all, we consider that because the study did not have a calculation of sample size, it does not allow any conclusions to be drawn when there is no difference between groups, and in this case, the Beta error (insufficient power) cannot be avoided. Consequently, the study has no enough statistical power to make support statements of no difference . Second, we consider that in the current literature the methods for classification of lipodystrophy in adults and children are still controversial , and we would like to understand the criteria used in your study, because it mentions it was performed by just two independent physicians. Also, we consider the children’s characteristics presented in Table 2 worrisome. The fact that all the children had been infected via vertical transmission of HIV, with 90% of pregnant women receiving prophylaxis, calls attention to the advanced age at which the children were diagnosed, because protocols allow us to diagnose the infection in the first months of life. The fact that 80% of children had been breastfed is also worrisome. These results are not in accordance with the national AIDS program efforts. Moreover, it seems paradoxical that children of mothers supposedly accompanied in a specialized care center can be diagnosed so late in life and present clinical classifications in categories A and B. A child was categorized as A1 and as a recipient of medical therapy, which is not suitable for this condition . The same table presents the results of a CD4 cell count, but in absolute numbers and not stratified by age, when it is well known that the limits of normality are significantly different in the age group studied. The most worrying, however, is the quantification of viral load, because none of the patients have levels below the limit of detection, considering this as the main goal of the antiviral therapy. Rather, all measurements are in the range above 100,000 copies/mm, which is the main predictor of unfavorable progression of the infectious disease. Finally, we believe that for the classification of nutritional status of children and adolescents the authors could have used the most current references .

Validity and reliability of a nutrition screening tool in hospitalized patients - Corrected Proof

2010-08-30

Abstract: Objective: The British nutrition screening tool is a questionnaire designed to assess the nutrition status of hospitalized patients by nurses. The aim of this study was to evaluate the validity and reliability of this questionnaire in patients on admission to the hospital in Tehran.Methods: For 6 mo, 446 patients aged over 18 y admitted to different wards of a general hospital were studied within the first 24 h of admission. A nutritionist undertook nutritional assessment in all patients to determine their nutritional status as an objective standard. Then a nurse completed the screening tool for patients. Results obtained using the screening tool were compared with those of the nutritional assessment to calculate the sensitivity, specificity, and predictive values. The interrater reliability of the tool was assessed by two nurses who completed the screening tool separately during the first 24 h following admission of each patient. It was also completed by a nurse within 2-d period of admission to test the intrarater reliability.Results: Study participants included 229 women and 217 men with mean age of 49.5 ± 16.0 y. Sensitivity and specificity of the questionnaire were 86.7% (95% CI: 83.9–90.3%) and 61.7% (95% CI: 57.5–66.5%), respectively. Positive and negative predictive values were 79.1% (95% CI: 68.9–77.1%) and 73.1% (95% CI: 75.1–82.9), respectively. The sensitivity of the tool was over 80% for both genders, for all body mass index grades, and for data obtained from gastroenterology, transplant, oncology, and hematology wards. The interrater reliability of screening tool was interpreted as substantial, being k = 0.68 and k = 0.74 on both the first and second days, respectively. The intrarater reliability of the screening tool was also interpreted as substantial, being k = 0.77.Conclusion: The nutrition screening tool is a simple, valid, and reliable tool that can be used by nurses to facilitate identification of patients requiring nutritional interventions.

The Geriatric Nutritional Risk Index predicts increased healthcare costs and hospitalization in a cohort of community-dwelling older adults: Results from the MONICA/KORA Augsburg cohort study, 1994–2005 - Corrected Proof

2010-08-27

Abstract: Objective: To determine if the Geriatric Nutritional Risk Index (GNRI), an index for the risk of nutrition-related complications, is associated with healthcare costs and risk of hospitalization at baseline and after 10 y.Methods: Data from a German population-based cohort of 1999 subjects 55 to 74 y of age at baseline were used. Self-reported physician visits, length of hospital stay, and drug intake were used to estimate costs. The GNRI is based on serum albumin values and the discrepancy between real and ideal body weights. Low GNRI values were defined as mean minus 2 times standard deviation. Mean GNRI values were regarded as normal.Results: Low baseline GNRI was consistently associated with increased total costs, probability of hospitalization, inpatient costs, and pharmaceutical costs at baseline and follow-up, after adjustment for socioeconomic characteristics, lifestyle factors, and coexisting conditions. Subjects with low GNRI at baseline had approximately 47% higher total costs, 50% higher risk of hospitalization, 62% higher inpatient costs and 27% higher pharmaceutical costs at follow-up than subjects with normal GNRI values.Conclusion: The GNRI risk predicted increased future healthcare costs and higher risk of hospitalization in independent-living older adults. The GNRI is a rapid and low-cost tool that might be routinely used in population-based settings.

Is glycyrrhizin sensitivity increased in anorexia nervosa and should licorice be avoided? Case report and review of the literature - Corrected Proof

2010-08-27

Abstract: Objective: Hypokalemia is a potentially life-threatening electrolyte disturbance in anorexia nervosa and is most frequently caused by purging behavior. We report a case of severe hypokalemia in anorexia nervosa induced by daily ingestion of approximately 20 g of licorice.Methods: To confirm the diagnosis of licorice-induced pseudohyperaldosteronism, a re-exposure trial was performed.Results: Cessation of the licorice intake normalized plasma potassium, renin, and aldosterone levels and the urine cortisol/cortisone ratio. Re-exposure confirmed the diagnosis. The pronounced response to a relatively low daily dose of licorice suggests high glycyrrhizin sensitivity.Conclusion: Patients with anorexia nervosa not only have decreased food intake but also selective and sometimes bizarre eating habits that, in association with increased sensitivity to glycyrrhizin, may cause severe hypokalemia.

Treatment with growth hormone, somatostatin, and insulin in combination with hypocaloric parenteral nutrition in gastrointestinal cancer patients after surgery - Corrected Proof

2010-08-27

Abstract: Objective: The metabolic response to gastrointestinal cancer in patients undergoing surgery is associated with hypermetabolism and insulin resistance. The potential use of synergetic anabolic hormones in conjunction with hypocaloric parenteral nutrition (HPN) has become a significant area of investigation. The presented study was performed to determine the clinical efficiency and safety of hormone therapy combined with HPN in patients with gastrointestinal cancer.Methods: One hundred patients with a Nutrition Risk Screening score of 3 or 4 undergoing surgery for gastrointestinal cancer were randomized into two groups. The patients in the control group received standard total parenteral nutrition and systemic insulin. The patients in the study group received HPN and systemic insulin in addition to pretreatment with recombinant human growth hormone and octreotide. Clinical efficiency and safety were evaluated by the measurement of hormones and protein metabolites, immune function, clinical outcome, and adverse events. Follow-ups were performed to determine the influence on prognosis.Results: Treatment with recombinant human growth hormone, octreotide, and insulin in combination with HPN significantly increased protein synthesis, immune function, and metabolic tolerance, decreased infectious complications, and shortened postoperative hospital stays, but did not increase the risk of tumor development and recurrence in the study group compared with the control group.Conclusion: The proper short-term perioperative administration of growth hormone, somatostatin, and insulin in combination with HPN can overcome the postoperative stress response through the increase of protein synthesis to improve immune function in patients with gastrointestinal cancer after surgery.

Intrauterine growth restriction and postnatal high-protein diet affect the kidneys in adult rats - Corrected Proof

Qian Shen, Hong Xu, Li-Ming Wei, Jing Chen, Hai-Mei Liu — 2010-08-23

Abstract: Objective: Intrauterine growth restriction (IUGR) is associated with hypertension and chronic kidney disease in adulthood. Postnatal overnutrition after IUGR may be of pathogenic importance for the development of diabetes and cardiovascular disease. This study was to identify the effects of IUGR and a postnatal high-protein diet on the kidneys in adult rats.Methods: Intrauterine growth restriction was induced in Sprague-Dawley rats by isocaloric protein restriction in pregnant dams. IUGR pups were divided into two groups that were a standard-protein diet (IUGR group) or a high-protein diet (HP group). A comparative proteomic method was used to study the differences of protein expression profiles between normal adult rats and adult rats with IUGR and the effects of a postnatal high-protein diet on the protein expression profiles of the kidneys.Results: The IUGR adults had higher urinary excretion of protein and blood pressure than controls and the HP diet caused more severe hypertension and proteinuria than IUGR itself. The differential proteomic expression analysis found 12 proteins that had significantly differential expression between the IUGR and control groups, which were transcription regulators and structural molecules. The differential proteomic expression analysis between the HP and control groups found 13 proteins that had significantly differential expression and were involved primarily in body metabolism, oxidation reduction, and apoptosis regulation.Conclusion: An HP diet intervention after IUGR worsens the severity of hypertension and proteinuria, and this study may provide valuable experimental evidence of proteins involved in the pathogenesis of kidney disease in IUGR and the effect of postnatal overnutrition.

Antioxidant activity and hepatoprotective effects of whey protein and Spirulina in rats - Corrected Proof

2010-08-16

Abstract: Objectives: The aims of the present study were to evaluate the antioxidant, radical scavenging, and metal-chelating activity of whey protein concentrate (WPC) and Spirulina alone or in combination in vitro and to evaluate their hepatoprotective effects against CCl4 in vivo.Methods: Five concentrations (20, 40, 60, 80, and 100 mg/100 mL) of WPC, Spirulina, and their combination were tested in vitro. In the in vivo study, eight groups of male rats comprised the control group and the groups treated with WPC, Spirulina alone, or in combination with or without CCl4 were used.Results: The in vitro study showed that WPC and Spirulina showed antioxidant, radical scavenging, and metal-chelating activities in dose-dependent manner. The in vivo study showed that both agents succeeded in preventing liver damage induced by CCl4. This prevention was more pronounced in rats receiving the combination of WPC and Spirulina.Conclusion: Whey protein concentrate and Spirulina have free radical scavenging properties and antioxidant activity.

Anti-diabetic effects including diabetic nephropathy of anti-osteoporotic trace minerals on diabetic mice - Corrected Proof

2010-08-16

Abstract: Objective: In our previous study to evaluate the effects of soluble silicon (Si) on bone metabolism, Si and coral sand (CS) as a natural Si-containing material suppressed peroxisome proliferator-activated receptor γ (PPARγ), which regulates both glucose and bone metabolism and increases adipogenesis at the expense of osteogenesis, leading to bone loss. In this study, we investigated the anti-diabetic effects of bone-seeking elements, Si and stable strontium (Sr), and CS as a natural material containing these elements using obese diabetic KKAy mice.Methods: Weanling male mice were fed diets containing 1% Ca supplemented with CaCO3 as the control and CS, and diets supplemented with 50 ppm Si or 750 ppm Sr to control diet for 56 d. The mRNA expressions related to energy expenditure in the pancreas and kidney were quantified by real-time polymerase chain reaction.Results: At the end of feeding, plasma glucose, insulin, leptin, and adiponectin levels decreased significantly in three test groups, while pancreatic PPARγ and adiponectin mRNA expression levels increased significantly toward the normal level, improving the glucose sensitivity of β-cells and inducing a significant decrease in insulin expression. The renal PPARγ, PPARα, and adiponectin expression levels, histologic indices of diabetic glomerulopathy, and plasma indices of renal function were also improved significantly in the test groups.Conclusion: Taken together, anti-osteoporotic trace minerals, Si and Sr, and CS containing them showed novel anti-diabetic effects of lowering blood glucose level, improving the tolerance to insulin, leptin, and adiponectin, and reducing the risk of glomerulopathy through modulation of related gene expression in the pancreas and kidney.

Anti-inflammatory activities of red curry paste extract on lipopolysaccharide-activated murine macrophage cell line - Corrected Proof

2010-08-16

Abstract: Objective: This study investigated anti-inflammatory and antioxidant activities of an ethanol extract from Thai red curry paste.Methods: The RAW264.7 murine macrophage cell line was incubated with the extract (65–260 μg/mL) with or without lipopolysaccharide. The anti-inflammatory activities of the extract were examined by measuring inducible nitric oxide synthase, cyclo-oxygenase-2, tumor necrosis factor-α, and interleukin-6 mRNA and protein level by reverse transcription–polymerase chain reaction, western blotting, and enzyme-linked immunosorbent assay, respectively. Nitric oxide production and intracellular reactive oxygen species generation were determined by the Griess method and fluorescence intensity. The activation of mitogen-activated protein kinases and inhibitor κB were determined by western blot.Results: Exposure of cells with the extract significantly suppressed lipopolysaccharide-induced nitric oxide production and inducible nitric oxide synthase, cyclo-oxygenase-2, tumor necrosis factor-α, and interleukin-6 expressions (P < 0.05) by dose-dependently without cytotoxic effect. Intracellular reactive oxygen species significantly decreased (P < 0.05) in lipopolysaccharide-induced RAW264.7 cells. The inhibitory effect was mediated partly by inhibiting activation of inhibitor κB-α and mitogen-activated protein kinases.Conclusion: These results suggest that the anti-inflammatory and antioxidant properties of Thai red curry paste stem from bioactive compounds present in the spice and herb constituents. The health benefits of Thai red curry paste warrant further investigations in vivo.

Time course of vitamin C distribution and absorption after oral administration in SMP30/GNL knockout mice - Corrected Proof

Mizuki Iwama, Kentaro Shimokado, Naoki Maruyama, Akihito Ishigami — 2010-08-16

Abstract: Objective: Because vitamin C (VC) has multiple metabolic and antioxidant functions, we investigated the movement of VC throughout the tissues of senescence marker protein-30 (SMP30)/gluconolactonase (GNL) knockout (KO) mice.Methods: SMP30/GNL KO mice, which cannot synthesize VC in vivo, were divided into two groups: VC sufficient and VC deficient. Starting at 2 mo of age, both groups had free access to water containing 1.5 and 0.0375 g/L of VC for 1 mo.Results: The average rate of VC retention in 20 tissues of VC-deficient SMP30/GNL KO mice was only 13.7% of that in VC-sufficient mice. Tissues that retained over 20% of VC were the cerebellum, white fat, testes, eyeballs, and pancreas, and those with less than 5% VC were the kidneys and heart. These results clearly indicate the different VC retention capacities among tissues. Next, we examined the time course of VC distribution and absorption in VC-deficient SMP30/GNL KO mice. After oral VC administration, VC content in the liver and kidney peaked at 3 h and then decreased. VC content in the lungs, adrenal glands, skin, white fat, and pancreas peaked at 6 h and in the cerebellum, cerebrum, skeletal muscles, eyeballs, thyroid gland, and testes at 12 h.Conclusion: In this study, we found that exogenous VC administered orally in VC-deficient SMP30/GNL KO mice was distributed at distinctly different rates within individual tissues. The SMP30/GNL KO mice used in this study are a useful animal model that provides unique opportunities for investigating VC movement and metabolism in the entire body.

Malnutrition in pediatric hospital patients: Current issues - Corrected Proof

Koen F.M. Joosten, Jessie M. Hulst — 2010-08-16

Abstract: Malnutrition in hospitalized children is still very prevalent, especially in children with underlying disease and clinical conditions. The purpose of this review is to describe current issues that have to be taken into account when interpreting prevalence data. Weight-for-height and height-for-age standard deviation scores are used for classification for acute and chronic malnutrition, respectively. Body mass index for age can also be used for the definition of acute malnutrition but has a few advantages in the general pediatric population. The new World Health Organization child-growth charts can be used as reference but there is a risk of over- and underestimation of malnutrition rates compared with country-specific growth references. For children with specific medical conditions and syndromes, specific growth references should be used for appropriate interpretation of nutritional status. New screening tools are available to identify children at risk for developing malnutrition during admission. Because of the diversity of medical conditions and syndromes in hospitalized children, assessment of nutritional status and interpretation of anthropometric data need a tailored approach.

A gel-based proteomic analysis of the effects of green tea polyphenols on ovariectomized rats - Corrected Proof

Changxia Shao, Lixia Chen, Chuanwen Lu, Chwan-Li Shen, Weimin Gao — 2010-08-16

Abstract: Objective: Our recent study demonstrated the protective action of green tea polyphenols (GTPs) against bone loss in ovariectomized (OVX) rats through their antioxidant capacities to scavenge reactive oxygen species. The objective of the present study was to evaluate the alterations of liver protein profiles in estrogen-deficient middle-aged rats after GTP treatment by a gel-based proteomic approach. This may lead to understanding the mechanisms of GTPs in promoting bone health.Methods: Liver samples were obtained from 14-mo-old female OVX rats treated with no GTPs (OVX) or 0.5% (w/v) GTPs (OVX + GTP) in drinking water for 16 wk (n = 10/group). Two-dimensional difference gel electrophoresis combined with mass spectrometry was used to compare the liver protein profiles of pooled samples from the OVX and OVX + GTP groups. Liver proteins were labeled in duplicate by reversing the fluorescent dyes.Results: Approximately 800 protein spots were detected. The expression levels of superoxide dismutase-1 and adenosine triphosphate synthase were 2.0-fold and 1.5-fold higher in the OVX + GTP group versus the OVX group, respectively, whereas the expression level of catechol-O-methyltransferase was 1.5-fold lower in the OVX + GTP group versus the OVX group. The changes of superoxide dismutase-1 and catechol-O-methyltransferase in individual liver samples were confirmed by western blots.Conclusion: Our data provide further evidence for the antioxidant role of GTPs by increasing superoxide dismutase-1 and adenosine triphosphate synthase and the estrogen-associated effect of GTPs by decreasing catechol-O-methyltransferase.

Dietary heme adversely affects experimental colitis in rats, despite heat-shock protein induction - Corrected Proof

2010-08-13

Abstract: Objective: Research on dietary modulation of inflammatory bowel disease is in its infancy. Dietary heme, mimicking red meat, is cytotoxic to colonic epithelium and thus may aggravate colitis. Alternatively, heme-induced colonic stress might also result in potential protective heat-shock proteins (HSPs). Therefore, we investigated the effect of dietary heme on trinitrobenzene sulfonic acid (TNBS)–induced colitis in rats.Methods: Rats were fed a high-fat control diet or a similar diet supplemented with heme. After dietary adaptation, rats were rectally infused with TNBS for colitis induction or saline for sham treatment. Colitis severity was evaluated and several markers were quantified in colonic mucosa isolated 1 wk after colitis induction. Furthermore, cytotoxicity of fecal water and serum α-1–acid glycoprotein were measured.Results: Dietary heme increased cytotoxicity of the fecal water. Heme-fed sham-treated rats had higher colonic HSP-25 and heme-oxygenase-1 mRNA levels, which was confirmed by immunohistochemistry. HSP induction by heme was associated with decreased protein levels of myeloperoxidase and interleukin-1β after subsequent TNBS infusion. However, no dietary effects were observed on histologic colitis score. Furthermore, body weight gain, colon length, and food intake were lower and α-1–acid glycoprotein concentrations were higher in heme-fed colitic rats. In addition, somatostatin, involved in mucosal repair, was not changed with TNBS infusion in heme-fed rats.Conclusion: Dietary heme adversely affects colitis, despite HSP induction. We speculate that the irritating influence of dietary heme, being continuously present in the colon, impairs recovery after colitis induction. A diet high in red meat might be a risk factor for inflammatory bowel disease development.

Usefulness of exchanging a tunneled central venous catheter using a subcutaneous fibrous sheath - Corrected Proof

Kouji Masumoto, Genshiro Esumi, Risa Teshiba, Kouji Nagata, Tomoaki Taguchi — 2010-08-13

Abstract: Objectives: The reserve of the venous route to the central veins is important for long-term parenteral nutrition (PN). Frequent catheter-related bloodstream infection (CRBSI) induces occlusion of the venous routes. Therefore, a modified exchange procedure using a tunneled central venous catheter (CVC) with a fibrous sheath was developed to preserve the route to the central veins.Methods: Seven patients who required long-term PN received the modified exchange procedure and the outcome of exchanged CVC was retrospectively reviewed.Results: The procedure was performed 10 times in seven patients. The venous routes were either the subclavicular or the internal jugular vein in all patients. The exchange of the catheter was due to CRBSI or occlusion in almost all patients. The mean duration of new catheter use was 296.2 days following the exchange. Four catheters continued to be used, and the remaining ones were removed. The reasons for removal were severe CRBSI and occlusion, each of which occurred in two catheterized patients, while the reason for removing the remaining catheters was because the patients no longer needed the catheters.Conclusion: The modified catheter exchange using fibrous sheath, even in patients with CRBSI, appears to be an effective procedure for reserving the venous route to the central veins in patients who require either long-term PN or other treatments.

Iron intake, red cell indicators of iron status, and DNA damage in young subjects - Corrected Proof

2010-08-06

Abstract: Objective: This study evaluated the association between primary DNA damage and chromosomal damage with iron intake and red blood cell parameters of iron status in a sample of healthy children and adolescents from a low-socioeconomic community.Methods: The level of primary DNA damage was assessed using an alkaline comet assay and the level of chromosomal damage was assessed using the cytokinesis-block micronucleus assay. A automated complete blood count was used to evaluate red blood cell status. The intake of iron was measured using a food-recall questionnaire.Results: According to hemoglobin levels, only 1 of the 30 subjects evaluated was anemic. Nevertheless, 43% of the sampled subjects showed decreased mean corpuscular volume in addition to an increased amount of primary DNA damage (P < 0.05). Mean corpuscular volume was negatively correlated with primary DNA damage (r = −0.429, P = 0.020) but not with chromosomal damage. The association between iron and primary DNA damage showed a U-shaped curve, indicating that an intake of approximately 15 mg of iron per day (up to two-fold of the dietary recommended intake) could minimize primary DNA damage in this age group. The frequency of micronuclei and nucleoplasmic bridges, indicators of chromosomal breakage/loss and chromosomal end-fusions, respectively, showed a negative correlation with iron intake. These results indicate that an intake of iron >15 mg/d could increase genomic stability in binucleated lymphocytes of the same group.Conclusion: An intake of iron ≥15 mg/d can decrease DNA damage in young subjects.

Dietary diversity and adequacy of women caregivers in a peri-urban informal settlement in South Africa - Corrected Proof

Wilna Oldewage-Theron, Rozanne Kruger — 2010-08-06

Abstract: Objective: Simple measures reflecting dietary quality are preferred for assessment of dietary intakes in low-income communities, e.g. dietary diversity that reflects a healthy, varied, nutritious diet, associated with nutrient adequacy. A strong association between household income and food access suggests dietary diversity assessment as one of the indicators of household food security. The aim of this study was to assess the food security situation of black women in an informal settlement by exploring their food access capabilities through dietary diversity measures and the coping strategies they employ to cope with poverty and hunger.Methods: A randomly selected sample of black women living in an informal settlement completed a pretested socio-demographic questionnaire (socio-economic circumstances) and validated questionnaires (1-wk quantified food frequency questionnaire: diversity measures; 24-h recall: nutrient intake; Cornell Hunger Scale: coping strategies). Food variety scores and food group diversity scores were calculated from frequency analyses for all foods and food groups. Nutrient adequacy ratios for various nutrients and the mean adequacy ratio for their diet were calculated. Relationships between dietary diversity and nutritional adequacy were investigated with Pearson correlations. Food variety score cut points were tested for sensitivity and specificity against nutritional adequacy.Results: Intakes were deficient for all nutrients except carbohydrates. Individual mean ± SD nutrient adequacy ratios ranging between 0.15 ± 0.18 and 0.95 ± 0.19 confirmed the poor dietary quality. Zero to 40 individual foods were consumed, but the mean ± SD food variety score was only 3.17 ± 1.21, indicating low food diversity, as did the low dietary diversity score (2.82 ± 0.99) using 0 to 6 food groups.Conclusions: Limited food access and food variety in poor households resulted in inadequate nutrient intakes (low nutrient adequacy ratios), confirmed by poor dietary diversity (food variety score and food group diversity score). Dietary diversity assessment can successfully replace traditional dietary assessment tools in poverty-stricken or low-income communities where quick assessments are often required to assess the greatest need.

Vitamin C provision improves mood in acutely hospitalized patients - Corrected Proof

Michelle Zhang, Line Robitaille, Shaun Eintracht, L. John Hoffer — 2010-08-06

Abstract: Objective: Hypovitaminosis C and D are highly prevalent in acutely hospitalized patients, but the clinical significance of these biochemical abnormalities is not known. Because deficiencies of vitamin C and D have been linked to psychologic abnormalities, vitamin C or D provision could improve the mood state of acutely hospitalized patients.Methods: Double-blind clinical trial of the effect of vitamin C (500 mg twice daily) or vitamin D (1000 IU twice daily) on mood, as assessed with a validated instrument, the Profile of Mood States.Results: Vitamin C therapy increased plasma (P < 0.0001) and mononuclear leukocyte (P = 0.014) vitamin C concentrations and was associated with a 34% reduction in mood disturbance (P = 0.013). Vitamin D therapy increased plasma 25-hydroxyvitamin D concentrations (P = 0.0004), but had no significant effect on mood.Conclusions: Treatment of hypovitaminosis C improves the mood state of acutely hospitalized patients.

Effects of trans-10,cis-12 CLA on liver size and fatty acid oxidation under energy restriction conditions in hamsters - Corrected Proof

2010-07-12

Abstract: Objective: Little evidence exists concerning the effects of trans-10,cis-12 conjugated linoleic acid (CLA) under energy restriction. Thus, the effects of this CLA isomer on adipose tissue size, liver composition, as well as on expression and activity of carnitine-palmitoyl transferase I (CPT-I) and acyl CoA oxidase (ACO), in hamsters fed an energy-restricted diet were analyzed.Methods: Hamsters were fed a high-fat diet for 7 wk and then subjected to 25% energy-restricted diets supplemented with 0.5% linoleic acid or 0.5% trans-10,cis-12 CLA for 3 wk. Serum insulin, free-triiodothyronine and non-esterified fatty acid levels, liver triacylglycerol, protein and water contents, and CPT-I, ACO, and Peroxisome proliferator-activated receptor alpha (PPARα) expressions and enzyme activities were assessed.Results: Energy restriction reduced liver size, serum levels of insulin, free-triiodothyronine, and non-esterified fatty acid and increased CPT-I activity. Liver composition was not modified. No differences were found between both restricted groups, with the exception of CPT-I and ACO oxidative enzyme activities, which were greater in hamsters fed the CLA diet.Conclusions: Energy restriction does not cause trans-10,cis-12 CLA to induce liver hyperplasia. Although this CLA isomer increases liver CPT-I and ACO activities, this effect does not result in reduced hepatic triacylglyerol content or decreased adipose tissue size. Consequently, this CLA isomer seems not to be a useful tool for inclusion in body weight loss strategies followed during obesity treatment.

Relationship between major dietary patterns and metabolic syndrome among individuals with impaired glucose tolerance - Corrected Proof

2010-07-12

Abstract: Objective: Dietary habits have been associated with the prevalence of the metabolic syndrome and limited data are available in this field for individuals with impaired glucose tolerance. This study focused on the association between major dietary patterns and prevalence of the metabolic syndrome in individuals with impaired glucose tolerance.Methods: This cross-sectional study was done in 425 subjects 35 to 55 y of age. Dietary data were collected using a food-frequency questionnaire. Blood pressure, waist circumference, glucose, triacylglycerols, and high-density lipoprotein cholesterol were measured and metabolic syndrome was defined based on Adult Treatment Panel III guidelines.Results: Five major dietary patterns were found: a western pattern (high in sweets, butter, soda, mayonnaise, sugar, cookies, tail of a lamb, hydrogenated fat, and eggs), a prudent pattern (high in fish, peas, honey, nuts, juice, dry fruits, vegetable oil, liver and organic meat, and coconuts and low in hydrogenated fat and non-leafy vegetables), a vegetarian pattern (high in potatoes, legumes, fruits rich in vitamin C, rice, green leafy vegetables, and fruits rich in vitamin A), a high-fat dairy pattern (high in high-fat yogurt and high-fat milk and low in low-fat yogurt, peas, and bread), and a chicken and plant pattern (high in chicken, fruits rich in vitamin A, green leafy vegetables, and mayonnaise and low in beef, liver, and organic meat). After adjusting for confounding variables, the western pattern was associated with greater odds of having increased triacylglycerol (odds ratio 1.76, 95% confidence interval 1.01–3.07) and blood pressure (odds ratio 2.62, 95% confidence interval 1.32–5.23). The prudent pattern was positively associated with a prevalence of low high-density lipoprotein cholesterol levels (odds ratio 0.55, 95% confidence interval 0.31–0.96). The vegetarian dietary pattern was inversely associated with a risk of an abnormal fasting blood glucose level (odds ratio 2.26, 95% confidence interval 1.25–4.06).Conclusion: Major dietary patterns were significantly associated with the risk of metabolic syndrome.

Magnesium and trace element intake after a lifestyle intervention - Corrected Proof

2010-07-12

Abstract: Objective: Observational studies suggest that some trace elements and magnesium (Mg) improve glucose metabolism, markers of inflammation, and oxidative stress, but supplementation studies have yielded inconsistent results. Our objective was to evaluate whether a lifestyle intervention trial, aimed at reducing total and saturated fat and increasing fiber intake, can affect also the intake of selenium (Se), zinc (Zn), copper (Cu), chromium (Cr), and Mg.Methods: Dietary intake of Se, Cr, Zn, Cu, and Mg was evaluated at baseline and at the end of a lifestyle intervention trial performed in 335 dysmetabolic adults.Results: At baseline, trace element and Mg intake in the intervention (n = 169) and control (n = 166) groups of the trial were not significantly different. The former significantly increased their intake of Se, Mg, and Cr, while the latter reduced the intake of Mg, Zn, and Cr. Between-group differences were significant for Mg, Cr, and Se.Conclusion: Healthier lifestyle recommendations might improve the pattern of micronutrient and Mg intake, which might play an independent role in ameliorating some metabolic, inflammatory, and oxidative markers.

Long-term supplementation of isomalto-oligosaccharides improved colonic microflora profile, bowel function, and blood cholesterol levels in constipated elderly people—A placebo-controlled, diet-controlled trial - Corrected Proof

Chi-Hua Yen, Yun-Hua Tseng, Yi-Wen Kuo, Meng-Chih Lee, Hsiao-Ling Chen — 2010-07-12

Abstract: Objectives: The main purpose of this study was to determine the long-term (8 wk) effects of isomalto-oligosaccharide (IO) supplementation on fecal microflora, bowel function, and biochemical indicators of nutritional status in constipated elderly subjects. We also assessed whether the effect of IO was sustained after its withdrawal.Methods: Thirteen (five male) constipated subjects (age 82.5 ± 1.9 y) participated in this diet-controlled study that consisted of a 4-wk placebo period, two 4-wk IO (10 g/d) -supplementation periods (IO1 and IO2), and a 4-wk post period. Fasting blood was collected on the last day of each period. Stools were collected during the last week of each period. The bowel function was monitored throughout the study.Results: The fecal bifidobacteria, lactobacilli, and bacteroides counts (log counts/g wet feces) significantly increased and clostridia count decreased at the end of the IO1 period. The effects were more pronounced in the IO2 period and then returned to the levels of the IO1 period at the end of the post period. Daily fecal excretion of acetate and propionate increased along with IO supplementation. The frequency of spontaneous defecation increased in the IO2 period, and wet fecal mass increased by 24% in both the IO1 and the IO2 periods. The effects of IO on bowel function diminished in the post period. Plasma total and low-density lipoprotein cholesterol levels were lower with 4- or 8-wk IO supplementation as compared with the placebo and post period, respectively.Conclusions: IO supplementation into a low-fiber diet improved colonic microflora profile and bowel movement in a time-dependent fashion in constipated elderly subjects. These beneficial effects decreased after discontinuation of the supplements.

Long-term intake of fish oil increases oxidative stress and decreases lifespan in senescence-accelerated mice - Corrected Proof

Tsuyoshi Tsuduki, Taro Honma, Kiyotaka Nakagawa, Ikuo Ikeda, Teruo Miyazawa — 2010-07-12

Abstract: Objective: The effects of fish oil including ω-3 polyunsaturated fatty acids on aging and lifespan are not well understood. In this study, the influence of long-term ingestion of fish oil on lifespan was examined in senescence-accelerated (SAMP8) mice.Methods: We investigated the effects of dietary fish oil on lifespan and on lipid composition and oxidative stress in plasma and liver in SAMP8 mice. Male mice were fed a fish oil diet (5% fish oil and 5% safflower oil) or a safflower oil diet (10% safflower oil) from 12 wk of age.Results: The SAMP8 mice fed fish oil did not have a longer maximum lifespan and had a shorter average lifespan than mice fed safflower oil. To examine the mechanism underlying these results, the effects on oxidative stress of long-term ingestion of fish oil were also examined. SAMP8 mice fed fish oil for 28 wk showed strong oxidative stress that caused hyperoxidation of membrane phospholipids and a diminished antioxidant defense system due to a decrease in tocopherol compared with mice fed safflower oil.Conclusion: These findings suggest that intake of fish oil increases oxidative stress, decreases cellular function, and causes organ dysfunction in SAMP8 mice, thereby promoting aging and shortening the lifespan of the mice.

Response to “Sulfur amino acids in methionine-restricted rats: Hyperhomocysteinemia” - Corrected Proof

Amany K. Elshorbagy, Helga Refsum — 2010-07-12

To the Editor: We thank the authors for their interest in the interpretation of our findings. As the authors state, we postulated that S-adenosylmethionine (SAM) is reduced secondary to methionine restriction (MR) and that this hinders allosteric activation of cystathionine beta-synthase (CBS), causing upstream accumulation of homocysteine . However, Tang et al. subsequently showed that shifting mice to a methionine-free diet decreased plasma methionine, transiently elevated plasma total homocysteine (tHcy) (day 7), and decreased CBS activity by an SAM-independent mechanism. Indeed, in their model, despite plasma methionine reduction, hepatic SAM and methionine were not significantly depleted at any of the time points examined (up to day 11). We therefore hypothesize that, on our diet, which provides more methionine (∼20% of the methionine content of control), the 2.5-fold tHcy elevation seen after 3 mo may be driven by hepatic CBS suppression combined with sufficient hepatic availability of the precursors methionine and SAM, which are maintained in the liver despite the marked decrease in serum methionine . In humans, Jacques et al. similarly showed a paradoxical highly significant inverse relation between methionine intake and age- and gender-adjusted plasma tHcy in 1960 subjects from the Framingham Offspring cohort.

Effect of synergic dietary calcium enrichment and induced ferropenic anemia on antioxidant enzymes activity in rats - Corrected Proof

2010-07-01

Abstract: Objective: The aim of this study was to examine the synergism of dietary calcium enrichment (added to goat's or cow's milk) and induced nutritional ferropenic anemia on oxidative status.Methods: Control rats and rats with induced nutritional ferropenic anemia were fed for 14 d with diets containing normal (5000 mg/kg) or double (10 000 mg/kg) the recommended calcium content. Thiobarbituric acid-reactive substances in plasma were measured, as were the activities of the antioxidant enzyme catalase, copper/zinc superoxide dismutase, and glutathione peroxidase in erythrocyte cytosol.Results: Dietary calcium enrichment did not affect oxidative stress as assessed by thiobarbituric acid-reactive substances; however, it significantly upregulated the activities of some antioxidant enzymes examined in the erythrocyte cytosol. In particular, adding calcium to standard or milk-based diets significantly increased glutathione peroxidase activity in control and anemic rats and copper/zinc superoxide dismutase activity in control rats.Conclusion: The increased activities of glutathione peroxidase and copper/zinc superoxide dismutase induced by dietary calcium enrichment suggest that calcium supplementation may protect against oxidative stress even in nutritionally induced ferropenic anemia.

Low-dose creatine supplementation enhances fatigue resistance in the absence of weight gain - Corrected Proof

Eric S. Rawson, Michael J. Stec, Sara J. Frederickson, Mary P. Miles — 2010-07-01

Abstract: Objective: We examined the effects of 6 wk of low-dose creatine supplementation on body composition, muscle function, and body creatine retention.Methods: Twenty healthy men and women (21 ± 2 y old) were randomized to receive creatine (0.03 g · kg−1 · d−1; n = 10, 4 women) or placebo (n = 10, 4 women) for 6 wk in a double-blind placebo-controlled fashion. Participants were tested on two occasions before supplementation to establish a reliable baseline, and then were retested after supplementation. Testing included body composition, maximal strength (three-repetition maximal concentric knee extension at 180 degrees/s), muscle fatigue (five sets of 30 concentric knee extensions at 180 degrees/s), and plasma creatine concentration.Results: There were no significant differences in body mass, fat-free mass, fat mass, body fat percentage, total body water, or maximal strength in either group from before to after supplementation (all P > 0.05). After supplementation, plasma creatine increased significantly in the creatine group (+182%, P = 0.03), with no difference in the placebo group. Compared with baseline values, creatine-supplemented volunteers were more resistant to fatigue during sets 2 (7%), 3 (9%), 4 (9%), and 5 (11%) (all P < 0.05). In placebo-supplemented participants, there was no improvement in fatigue resistance during sets 2 (0%), 3 (1%), 4 (0%), and 5 (−1%) (all P > 0.05).Conclusion: Ingesting a low dose (≈2.3 g/d) of creatine for 6 wk significantly increased plasma creatine concentration and enhanced resistance to fatigue during repeated bouts of high-intensity contractions.

Validation of a food-frequency questionnaire for Flemish and Italian-native subjects in Belgium: The IMMIDIET study - Corrected Proof

2010-06-28

Abstract: Objective: To validate an integrated food-frequency questionnaire (FFQ) developed to assess habitual food intake of Flemish and Italian-native subjects in Belgium as part of the European Collaborative Dietary Habit Profile in European Communities With Different Risk of Myocardial Infarction: the Impact of Migration as a Model of Gene/Environment Interaction (IMMIDIET Project).Methods: The semiquantitative FFQ contained 322 items on food and food preparation. FFQs filled by a sample (n = 70) of the Flemish-Flemish and Flemish-Italian IMMIDIET subpopulations were randomly selected. Five 24-h recalls, administered over a period of 1 y by the same sample, served for validation. Energy and macronutrients were calculated using the Dutch NEVO and the Belgian NUBEL food composition tables. Intakes of energy and macronutrients estimated by the FFQ and repeated 24-h recall, respectively, were compared by means of correlation coefficients, classification into quartiles, and Bland-Altman plotting.Results: The FFQ overestimated intake of energy and most macronutrients by 40–70%. This overestimation largely disappeared when values were expressed as energy percentage. Correlations ranked from 0.40 to 0.60 for energy and most macronutrients (median 0.53); correlations were lower (null to 0.41) for fat and higher (up to 0.90) for alcohol. Classification in quartiles of intake showed good agreement: 83% were classified in the same or adjacent quartile of energy, and 66–90% for macronutrients. Correlations and classification of macronutrient intake into quartiles remained similar when macronutrients were expressed as energy percentage. Stratification according to ethnic subgroup, age, body mass index, or social status showed no differences.Conclusion: The IMMIDIET FFQ is a valuable tool for studies of the role of energy and macronutrients in disease etiology or outcome, but less suitable for estimating absolute intake levels.

Meal-induced thermogenesis and macronutrient oxidation in lean and obese women after consumption of carbohydrate-rich and fat-rich meals - Corrected Proof

2010-06-28

Abstract: Objective: To examine differences in meal-induced thermogenesis and macronutrient oxidation between lean and obese women after consumption of two different isocaloric meals, one rich in carbohydrate (CHO) and one rich in fat.Methods: A total of 19 lean and 22 obese women were studied on two occasions, 1 wk apart. In one visit they consumed a CHO-rich meal and in the other visit a fat-rich meal. The two meals were isocaloric and were given in random order. Resting energy expenditure and macronutrient oxidation rates were measured and calculated in the fasting state and every hour for 3 h after meal consumption.Results: Meal-induced thermogenesis was not different between lean and obese subjects after the CHO-rich (P = 0.89) or fat-rich (P = 0.32) meal, but it was significantly higher after the CHO-rich compared with the fat-rich meal in the lean and the obese individuals (P < 0.05). Protein oxidation rate increased slightly but significantly after the test meals in both groups (P < 0.01). Fat oxidation rate decreased after consumption of the CHO-rich meal (P < 0.001), whereas it increased after consumption of the fat-rich meal in both groups (P < 0.01). CHO oxidation rate increased in both groups after consumption of the CHO-rich meal (P < 0.001). Oxidation rates of protein, fat, and CHO during the experiment were not significantly different between lean and obese participants.Conclusion: Meal-induced thermogenesis and macronutrient oxidation rates were not significantly different between lean and obese women after consumption of a CHO-rich or a fat-rich meal.

Energy-drink consumption in college students and associated factors - Corrected Proof

Sema Attila, Banu Çakir — 2010-06-28

Abstract: Objective: To investigate the frequency of energy-drink consumption and associated factors in a group of college students.Methods: A cross-sectional study was conducted in Hacettepe University (Ankara, Turkey) and included 439 students pursuing a career in medicine, sports, and arts. Only fourth-year students were approached. Data were collected using a self-administered standard questionnaire.Results: In bivariate analyses, frequency of energy-drink consumption was higher in students of arts and sports and in those who did not have breakfast on a regular basis, ever smoked cigarettes, drank alcoholic beverages, and regularly engaged in sports compared with their counterparts. Many students who had “ever” tried an energy drink did so the first time because they wondered about its taste. Of regular users of energy drinks, reasons for using such drinks varied across the three selected groups of students and included obtaining getting energy, staying awake, boosting performance while doing sports, or mixing with alcoholic beverages. About 40% of all current users of energy drinks reported that they mixed those with alcoholic beverages. In multivariate analyses, statistically significant predictors of energy-drink consumption were faculty type, presence of any health insurance, use of alcoholic beverages, and monthly income, controlling for gender. Most students could not correctly define the ingredients of energy drinks or their potential hazardous health effects, and they could not distinguish energy and sports drinks when they were requested to select them from a list of commercial names of various drinks.Conclusion: Consumption of energy drinks, despite the variation in the reason for choosing such drinks, is quite common in college students. Awareness of university students of the ingredients and potential health hazards of energy drinks, in particular in mixing with alcoholic beverages, should be increased.

Beneficial effects of fructo-oligosaccharides supplementation on fecal bifidobacteria and index of peroxidation status in constipated nursing-home residents—A placebo-controlled, diet-controlled trial - Corrected Proof

Chi-Hua Yen, Yi-Wen Kuo, Yun-Hua Tseng, Meng-Chih Lee, Hsiao-Ling Chen — 2010-06-28

Abstract: Objective: This study assessed effects of fructo-oligosaccharides (FOS) supplementation on fecal bifidobacteria, lipid peroxidation index, indices of nutritional status, and whether effects of FOS were sustained after its withdrawal in constipated nursing-home residents. The associations of fecal bifidobacteria and blood measurements were also examined.Methods: Six men and four women participated in a double-blind, diet-controlled study that consisted of a 4-wk placebo (3 mL of fructose syrup) period, a 4-wk FOS (10 g/d) period, and a 4-wk post-FOS period. Stools were collected during the last week of each period to determine the microflora and fecal weight. Fasting blood was collected at the end of each period and analyzed for thiobarbituric acid-reactive substances (TBARS) and biochemical indices.Results: Fecal counts (log counts/gram of dry feces) and daily fecal output of bifidobacteria significantly increased with FOS compared with placebo. The effect on bifidobacteria output was sustained in the post-FOS period. Plasma TBARS concentration was reduced by 16% and 21% in the FOS and post-FOS periods, respectively, compared with that in the placebo period. The plasma cholesterol level was significantly lowered by 7% in the FOS and post-FOS periods compared with that in the placebo period. The increases in fecal bifidobacteria output during the FOS period (log colony-forming units per day) were associated with decreases in plasma TBARS and plasma cholesterol, respectively.Conclusion: Supplementation of FOS increases the daily output of bifidobacteria and decreases plasma TBARS and cholesterol concentrations in constipated nursing-home elderly residents and these effects remained at the end the post-FOS period.

No effects of low and high consumption of dairy products and calcium supplements on body composition and serum lipids in Puerto Rican obese adults - Corrected Proof

Cristina Palacios, José J. Bertrán, Ruth E. Ríos, Sandra Soltero — 2010-06-28

Abstract: Objective: Epidemiologic studies have shown that a high calcium intake is related to lower body weight, fat, and serum lipids in obese individuals. However, clinical studies have shown inconclusive results. The present study was conducted to determine if dairy or calcium supplementation alters body composition or serum lipids in Puerto Rican obese adults without dietary energy restriction or exercise.Methods: A 21-wk randomized clinical trial was conducted in 30 obese adults, aged 21–50 y, with usual calcium intakes <700 mg/d. Subjects were randomly assigned to the following: high dairy (∼1300 mg/d of calcium from dairy products by substituting foods); high calcium (∼1300 mg/d of calcium; ∼700 mg/d from diet and 600 mg/d from a supplement); or placebo. Subjects were asked to continue their established dietary intake (except for the high dairy group) and their physical activity during the study. Body weight was measured monthly; body fat, bone, and serum lipids (total cholesterol, high-density lipoprotein, low-density lipoprotein, and triacylglycerol) were measured at baseline and at 21 wk. Pairwise differences in study endpoints among the groups were assessed using ANOVA and post-hoc analysis.Results: Grand mean calcium intake was 1200 ± 370 (median 1187) mg/d in the high dairy group, 1171 ± 265 (median 1165) mg/d in the high calcium group, and 668 ± 273 (median 691) mg/d in the control group, which was significantly lower compared to the two treatment groups (P < 0.001). There were no significant group effects in any of the outcome variables.Conclusion: A high dairy or calcium diet alone did not alter body composition or serum lipids profile in a sample of Puerto Rican obese adults.

Vitamin C supplementation in patients receiving peripheral parenteral nutrition after gastrointestinal surgery - Corrected Proof

Eriko Yamazaki, Masahiro Horikawa, Ryoji Fukushima — 2010-06-28

Abstract: Objective: We investigated an adequate vitamin C dose during peripheral parenteral nutrition therapy in patients after gastrointestinal surgery by measuring blood concentrations and urine excretions of vitamin C. We also sought to identify the effects of vitamin C on the oxidative status.Methods: In a randomized trial, 2 d after undergoing gastrointestinal surgery, 16 patients started to receive a 5-d continuous intravenous infusion of vitamin C, either 100 or 500 mg/d. Blood concentrations of vitamin C and inflammatory and immunologic parameters were measured preoperatively, the day after surgery, and 3 and 5 d after starting administration of vitamin C (day 3 and day 5). Also, excretions of vitamin C and oxidative stress markers in 24-h, cumulative urine samples, collected and stored under light protection at 0°C, were measured on day 3 and day 5.Results: Mean blood vitamin C concentration decreased markedly after surgery. The concentration returned to normal on day 3 and on day 5 in the 500-mg group and only on day 5 in the 100-mg group. Concentrations differed significantly between the groups on day 3 and on day 5 (P < 0.001 for both days). Urinary vitamin C excretion was above normal on both days in the 500-mg group, but it never reached normal in the 100-mg group (P < 0.001 for both days). Urinary excretion of 8-isoprostane, a marker of oxidative stress, was significantly lower in the 500-mg than in the 100-mg group on day 3 (P = 0.002).Conclusion: Vitamin C dose of 500 mg/d, not 100 mg/d, is adequate for patients undergoing gastrointestinal surgery and receiving peripheral parenteral nutrition therapy. Vitamin C may decrease postsurgical oxidative stress.

Nutritional support in head injury - Corrected Proof

Angela Vizzini, Jaime Aranda-Michel — 2010-06-28

Abstract: Nutritional support is imperative to the recovery of head-injury patients. Hypermetabolism and hypercatabolism place this patient population at increased risk for weight loss, muscle wasting, and malnutrition. Nutrition management may be further complicated by alterations in gastrointestinal motility. Resting energy expenditure should be measured using indirect calorimetry and protein status measured using urine urea nitrogen. Providing early enteral nutrition within 72 hours of injury may decrease infection rates and overall complications. Establishing standards of practice and nutrition protocols will assure patients receive optimal nutrition assessment and intervention in a timely manner.

On heat, respiration, and calorimetry - Corrected Proof

David C. Frankenfield — 2010-06-17

Abstract: The technique of indirect calorimetry developed with the sciences of nutrition and physiology over the course of hundreds of years. It was in fact fundamental to the establishment of these disciplines. This review describes the development of the technology and the principles of body function it has revealed.

A melon pulp concentrate rich in superoxide dismutase reduces stress proteins along the gastrointestinal tract of pigs - Corrected Proof

Jean-Paul Lallès, Dominique Lacan, Jean-Claude David — 2010-06-17

Abstract: Objective: A melon (Cucumis melo LC.) pulp concentrate (MPC) rich in superoxide dismutase (SOD) activity was tested for its ability to decrease stress protein expressions along the gastrointestinal tract in a swine model.Methods: Pig sextuplets weaned at 21 d of age were selected from among six litters (n = 36). After a 2-d fasting period, the pigs were fed at similar levels of intake of the control, MPC1, and MPC2 diets, which provided 0, 12.5, and 50 IU of added SOD per kilogram of food, respectively. One triplet of pigs per litter was slaughtered at 7 d and the second triplet at 14 d after weaning. SOD, catalase, and digestive enzymes were determined enzymatically and stress protein expressions by western blotting.Results: Plasma SOD increased with MPC dose at day 14 (P < 0.05). Mucosal weights in the proximal and mid small intestine were lower at day 14 (P < 0.05), cecum tissue weight was greater (P < 0.05), and sucrase-specific activity in mid and distal small intestine mucosa was lower (P = 0.05) in the MPC2 group than in the control group. MPC supplementation essentially decreased (P < 0.05 to P < 0.001) stress proteins in the stomach (all), the mid small intestine (heat-shock protein-27, neuronal nitric oxide synthase) and the colon (heat-shock protein-70, neuronal nitric oxide synthase).Conclusion: A SOD-rich MPC provided at the dose of 50 IU/kg of food for up to 12 d was effective in lowering the level of stress proteins along the gastrointestinal tract of pigs after weaning.

Concurrent micronutrient deficiencies are prevalent in nonpregnant rural and tribal women from central India - Corrected Proof

2010-06-17

Abstract: Objective: The existence of concurrent micronutrient deficiencies in Indian women of reproductive age has received little attention. This study aimed to comprehensively assess the micronutrient status of nonpregnant rural and tribal women 18–30 y from central India.Methods: Participants (n = 109) were randomly selected using a stratified (rural-tribal) proportionate-to-population size cluster sampling method from 12 subcenters in Ramtek block, Nagpur. Sociodemographic, anthropometric, dietary, and biochemical data, including blood and urine samples, were obtained.Results: Tribal and rural women had similar sociodemographic characteristics and anthropometric status; 63% of women had a body mass index <18.5 kg/m2. The median urinary iodine concentration was 215 μg/L (IQR: 127, 319). The mean (SD) concentration of hemoglobin, serum zinc, retinol, and folate was 112 (13) g/L, 10.8 (1.6) μmol/L, 1.2 (0.3) μmol/L, 18.4 (8.4) nmol/L, respectively, with a geometric mean serum vitamin B12 concentration of 186 pmol/L. The percentage of women with low values for hemoglobin (<120 g/L), serum zinc (<10.7 μmol/L), vitamin B12 (<148 pmol/L), retinol (<0.7 μmol/L), and folate (<6.8 nmol/L) was 66%, 52%, 34%, 4%, and 2%, respectively. Tribal women had a higher prevalence of zinc deficiency (58% versus 39%, P = 0.054) and concurrent deficiency of any two micronutrients (46% versus 26%; P = 0.034), including zinc and anemia (38% versus 21%, P = 0.024).Conclusion: Zinc, vitamin B12, and iron constitute the principal micronutrient deficiencies in these women. Existing supplementation programs should be extended to include 18- to 30-y-old nonpregnant women as the majority of childbearing occurs within this timeframe.

Methodology for adding glycemic index values to 24-hour recalls - Corrected Proof

2010-06-14

Abstract: Objective: To describe a standardized method to assign glycemic index (GI) values to food items, obtained from 3 × 24-h recalls among Aboriginal and Torres Strait Islander and non-Indigenous Australian children, which can be adapted for use with simple food composition databases.Methods: Four published GI databases were used as the source of GI values. Changes were made to a previously published methodology for GI value assignment to accommodate the needs of the Many Rivers Diabetes Prevention Project.Results: There were 1132 food items in the recall database. Two hundred nineteen (19.3%) food items were directly linked to the FoodWorks GI database and 545 (48.1%) items were assigned the GI value of a “closely related” food item in the four GI databases used. Among the top carbohydrate contributors, 113 (35.3%) items have a direct linkage with the FoodWorks GI database. The mean ± SEM dietary GI and glycemic load (GL) of the study population resulting from this methodology are 57.5 ± 0.3 and 143.4 ± 2.6, respectively.Conclusion: This simple method provides opportunities for countries without food composition database that are comprehensive for GI/GL but which contain accurate information on carbohydrates in foods to assign high-quality GI values to food items in epidemiological studies based on 24-h recalls.

β-Hydroxy-β-methylbutyrate modifies human peripheral blood mononuclear cell proliferation and cytokine production in vitro - Corrected Proof

2010-06-14

Abstract: Objective: The main objective was to investigate the potential immunomodulatory effects of β-hydroxy-β-methylbutyrate (HMB) in human cells.Methods: Peripheral blood mononuclear cells were isolated from the blood of eight volunteers and assayed for proliferation, cell cycle progression, surface expression of CD25, intracellular expression of pERK1/2, and cytokine production after in vitro exposure to a range of HMB concentrations (0.1 to 10 mM).Results: Above 1 mM, HMB decreased the extent of proliferation normally observed after stimulation by concanavalin A. The decrease was evident at 10 mM HMB, when the proliferation index was 50% reduced when compared with the absence of HMB. Cell cycle analysis demonstrated an increase in the proportion of cells at the G0-G1 phase at 10 mM HMB. CD25 and pERK1/2 expression were not related to the observed effect on proliferation. HMB affected the concentrations of all five cytokines measured following stimulation. Tumor necrosis factor-α concentration in the culture medium was reduced by ∼35% at all HMB concentrations. Th1/Th2 cytokine production was modified toward a Th2 profile when HMB was at 1 or 10 mM. Thus, HMB at 10 mM impairs lymphocyte proliferation and progression through the cell cycle. The lowest concentration used here (0.1 mM) exerted some actions on cytokine production, including decreasing TNF-α production, but not on proliferation and cell cycle progression.Conclusion: HMB may be a useful agent to consider for modulation of immune function in specific situations.

Relation between degree of obesity and site-specific adipose tissue fatty acid composition in a Mediterranean population - Corrected Proof

2010-06-14

Abstract: Objective: Obesity itself could be a key factor determining fatty acid (FA) composition of adipose tissue (AT). A Mediterranean diet influences this relationship. However, a relation between different overweight and obesity levels (including morbidly obese subjects) and AT FA pattern has not been fully established. The objective of the present study was to analyze potential differences in AT FA composition attending to degree of obesity in patients who follow a Mediterranean dietary pattern.Methods: Our study comprises 60 patients classified as overweight, obese, or morbidly obese (20 subjects in each group). Dietary composition was assessed by a 7-d record, and visceral and subcutaneous AT FAs were analyzed by gas chromatography. Cardiometabolic risk-related parameters were also assessed.Results: Our results showed that dietary habits were similar among groups, although palmitic intake was higher and palmitoleic intake was lower in the morbidly obese group. Concerning AT, we observed significant differences in the visceral depot. Concretely, both total monounsaturated FA (P = 0.039) and palmitoleic acid (P = 0.008) were higher in overweight subjects. Most differences were found in the subcutaneous tissue. Among them, n-9 and total monounsaturated FA (P < 0.001) were significantly higher again in overweight subjects, while 22:6n-3 was higher in morbidly obese subjects. Subcutaneous adipose dihommo-γ-linolenic content and dietary palmitic and palmitoleic acids were independent predictors of body mass index.Conclusions: We confirm the relationship between degree of obesity and dietary and AT FA composition in this Mediterranean population. Despite a similar dietary pattern among groups, overweight and morbidly obese patients have a less detrimental FA profile than obese patients, probably due to differences in adipose tissue metabolism.

Beneficial effects of oligopeptides from marine salmon skin in a rat model of type 2 diabetes - Corrected Proof

Cui-Feng Zhu, Hong-Bing Peng, Gui-Qin Liu, Fan Zhang, Yong Li — 2010-06-14

Abstract: Objective: This study aimed at investigating whether treatment with oligopeptides from marine salmon skin (OMSS) could modulate type 2 diabetes mellitus (T2DM)-related hyperglycemia and β-cell apoptosis in rats induced by high fat diet and low doses of streptozotocin and its therapeutic mechanisms.Methods: Groups of T2DM rats were treated with OMSS or bovine serum albumin (3.0 g/kg/d) for 4 wk and their blood samples, together with those of normal control rats, were collected before and 4 wk after treatment. The levels of fasting blood glucose (FBG) and insulin, serum superoxide dismutase (SOD), malondialdehyde (MDA), and glutathione (GSH), tumor necrosis factor-alpha (TNFα), and interferon-gamma (IFNγ) in rats were determined. The islet cell apoptosis and Fas/FasL expression were detected by TUNEL and immunohistochemistry.Results: In comparison with control rats, higher levels of FBG and frequency of apoptotic islet cells were detected in the bovine serum albumin group of diabetic rats, accompanied by higher levels of Fas expression in the pancreatic islets, serum TNFα, IFNγ, and MDA, but lower levels of SOD and GSH. However, the levels of FBG and frequency of apoptotic islet cells were significantly reduced in OMSS-treated rats. Lower levels of Fas expression were observed in the pancreatic islets of OMSS-treated rats. Significantly reduced levels of serum TNFα, IFNγ, and MDA, but increased levels of SOD and GSH, were detected in OMSS-treated rats.Conclusions: Treatment with OMSS significantly reduced FBG in diabetic rats. This antidiabetic activity may be mediated by down-regulating T2DM-related oxidative stress and inflammation, protecting the pancreatic β-cells from apoptosis.

Consumption of polyphenol concentrate with dietary fructo-oligosaccharides enhances cecal metabolism of quercetin glycosides in rats - Corrected Proof

Jerzy Juśkiewicz, Joanna Milala, Adam Jurgoński, Bogusław Król, Zenon Zduńczyk — 2010-06-14

Abstract: Objective: We verified the hypothesis that the consumption of polyphenol concentrate (PC), rich in quercetin and its glycosides (36 g/100 g), in association with different dietary fiber matrices, that is, an easily fermentable fructo-oligosaccharides (FOS) or non-fermentable cellulose (CEL), causes a disparate adaptive response of the cecal microbial activity in rats. This in turn facilitates further utilization of biologically active polyphenolic compounds, which are not, as usual, digested in the foregut.Methods: Four-week experimental feeding of male Wistar rats consisted of diets containing 5% FOS or CEL, as a source of dietary fiber, with or without 0.3% addition of PC.Results: Positive changes in rat cecum were observed resulting from the ingestion of an FOS-containing diet, such as decreased pH and increased the production of short-chain fatty acids in the digesta, compared with a CEL-containing diet. The addition of PC to the FOS diet did not eliminate the positive effects of the latter, except for a slight increase in cecal pH and a decrease in microbial glycolytic activity. However, a simultaneous increase in the cecal butyrate pool was also observed. An adaptation process of the microflora enzymatic system to dieting with PC and FOS was proven in further enhanced susceptibility of rutin (quercetin 3-O-glucorhamnoside), hyperoside (quercetin 3-O-galactoside), and quercitrin (quercetin 3-O-rhamnoside) to hydrolysis by the cecal digesta solution.Conclusion: Especially when consumed together, PC and FOS are important dietary factors affecting the susceptibility of quercetin glycosides to microbial metabolism in the cecum. The intensification of the hydrolysis of quercetin glycosides by dietary treatments leads also to the increased metabolism of quercetin itself.

Fasting blood glucose levels in patients presenting for elective surgery - Corrected Proof

2010-06-14

Abstract: Objective: The incidence of diabetes mellitus (DM) is increasing worldwide; however, its diagnosis is often delayed. Identifying patients with abnormal fasting blood glucose (FBG) levels preoperatively may have important implications for immediate and long-term outcomes. The aim of the present study was to determine the prevalence of impaired fasting glucose (IFG) and provisional diagnosis of DM (PDD) with potential risk factors in patients presenting for elective surgery.Methods: We measured FBG in consecutive adult patients undergoing elective non-cardiac surgery from September 2006 to August 2007. Patient age, sex, body mass index, and FBG were collected in the morning of their scheduled intervention. FBG was classified according to the World Health Organization categorization. Patients with a history of DM were excluded from the final analysis. The prevalence of IFG and PDD and odds ratio for risk factors were calculated.Results: Four hundred ninety-three patients without a prior diagnosis of DM were sampled; 19.3% (95 of 493) had IFG and 6.5% (32 of 493) had PDD. Male subjects had a greater risk of PDD than female subjects (odds ratio 2.5, 95% confidence interval 1.2–5.5, P = 0.017). Increased body mass index was not a risk factor for IFG or PDD. The prevalence of IFG but not of PDD had a tendency to increase with age after 40 y.Conclusion: More than 25% of patients without a prior diagnosis of DM presenting for elective surgery had increased FBG levels. Obtaining this information may initiate not only an earlier detection of DM in some patients but also affect acute perioperative management and outcomes.

Isoflavonoids and peptides from meju, long-term fermented soybeans, increase insulin sensitivity and exert insulinotropic effects in vitro - Corrected Proof

2010-06-14

Abstract: Objective: Although soybeans have been shown to alleviate metabolic syndromes, fermented soybeans may have even greater effects. We investigated the antidiabetic effects of meju, a soy food that is fermented up to 2 mo, and the mechanism by which it exerts its effects.Methods: Meju was prepared by a traditional fermentation process: soybeans were fermented outdoors for 20 or 60 d. Methanol (M-60) and water (W-60) extracts from meju that had fermented for 60 d contained mostly isoflavonoid aglycones and small peptides, respectively, as opposed to mostly glycosylated isoflavonoids and proteins in the original soybeans.Results: Daidzein, M-60, and W-60 had better insulin-sensitizing actions by activating peroxisome proliferator-activated receptor-γ in 3T3-L1 adipocytes than did unfermented soybeans. In addition, Min6 insulinoma cells treated with genistein, M-60, and W-60 had greater glucose-stimulated insulin secretion capacity and greater β-cell viability than those treated with unfermented soybeans. This improvement was associated with insulin/insulin-like growth factor-1 signaling that was activated by the tyrosine phosphorylation of insulin receptor substrate-2 and serine phosphorylation of Akt, and this in turn increased pancreatic and duodenal homeobox-1 expression. Furthermore, genistein, daidzein, and M-60 stimulated glucagon-like peptide-1 secretion in enteroendocrine NCI-H716 cells, which generated insulinotropic actions.Conclusion: The compositional changes in isoflavonoids and peptides that occurred during a longer fermentation period, without the use of salt, enhanced the antidiabetic effect of soybeans.

The relationship between body composition and selected metabolic syndrome markers in black adolescents in South Africa: The PLAY study - Corrected Proof

Annemarie Zeelie, Sarah J. Moss, Herculina S. Kruger — 2010-06-14

Abstract: Objective: To determine the relationship between body composition and selected markers of the metabolic syndrome in black adolescents.Methods: The group consisted of 232 adolescent boys and girls aged 15–19 y attending two secondary schools in a low socio-economic status area of Potchefstroom, South Africa. Body mass (kg), stature (cm), and waist (WC) and hip circumferences were measured using standard methods. Body mass index and waist:hip ratio were calculated. Percentage body fat and lean body mass were measured by air displacement plethysmography. Fasting plasma insulin, fasting glucose, homeostasis model assessment of insulin resistance (HOMA-IR), systolic blood pressure (SBP), and diastolic blood pressure were measured.Results: Children with a high body fat percentage (boys >20%, girls >25%) had significantly higher serum leptin concentration than children with normal body fat percentage (boys, P = 0.005; girls, P < 0.0001). Girls with a high body fat percentage also reported significantly higher SBP (P = 0.004), diastolic blood pressure (P = 0.03), plasma insulin (P = 0.004), and HOMA-IR (P = 0.004) than girls with normal body fat percentage. Body fat percentage had a significant positive association with HOMA-IR (P = 0.02) and SBP (P = 0.02), respectively. A significant positive correlation was also found between plasma leptin concentration and body mass index (P < 0.0001), WC (P < 0.0001), body fat percentage (P < 0.0001), and fat:height index (P < 0.001).Conclusion: A significant positive association was found between body fat percentage and both SBP and HOMA-IR, respectively. Girls with a high body fat percentage had significantly higher BP, plasma insulin, and HOMA-IR than girls with normal body fat percentage, indicating risk of non-communicable diseases.

Dietary freeze-dried black raspberry's effect on cellular antioxidant status during reflux-induced esophagitis in rats - Corrected Proof

Harini S. Aiyer, Yan Li, Qiao Hong Liu, Nathaniel Reuter, Robert C.G. Martin — 2010-06-11

Abstract: Introduction: Esophageal cancer consists of two distinct types, esophageal adenocarcinoma (EAC) and squamous cell carcinoma, both of which differ significantly in their etiology. Freeze-dried black raspberry (BRB) has been consistent in its ability to modulate the biomarkers and reduce the incidence of carcinogen-induced squamous cell carcinoma in rats. In our previous studies in the esophagoduodenal anastomosis (EDA) model, we have shown that the early modulation of manganese superoxide dismutase (MnSOD) significantly correlates with the development of reflux-induced EAC in rats. In this study we looked at the short-term effects of a BRB-supplemented diet on the modulation of antioxidant enzymes in reflux-induced esophagitis.Methods: Male SD rats (8 wk old; n = 3–5) were randomized into three groups---sham-operated, fed control AIN-93M diet (SH-CD), EDA operated and fed either control diet (EDA-CD) or 2.5% (w/w) BRB diet (EDA-BRB). The effect of both reflux and dietary supplementation was analyzed 2 and 4 wk after EDA surgery.Results: Animals in the EDA groups had significantly lower weight gain and diet intake compared to SH-CD (P < 0.05). The sham-operated animals received an average esophagitis score of 0.1 ± 0.1; this increased significantly in EDA-CD animals to 1.8 ± 0.14 (P < 0.001 versus SH-CD) and in EDA-BRB group to 1.7 ± 0.06 (P < 0.001 versus SH-CD), with BE changes also present. However, dietary supplementation of BRB did not alter or ameliorate the grade of esophagitis or the induction of BE. BRB diet caused a 43% increase in MnSOD levels compared to EDA-CD (0.73 ± 0.16; P = 0.09); however, this effect was not statistically significant and at 4 wk, EDA-CD (0.58 ± 0.12) showed an increase in MnSOD expression compared to SH-CD (0.34 ± 0.01).Conclusions: In conclusion, our data suggest that dietary BRB does not increase the levels of cellular antioxidant enzymes or reduce the levels of lipid peroxidation compared to a control diet, in a short-term study of gastroesophageal reflux induction in the EDA animal model. However, it remains to be tested whether this is indicative of its ineffectiveness to inhibit reflux-induced EAC incidence over the long term.

Influence of polyunsaturated fatty acids and their metabolites on stem cell biology - Corrected Proof

Undurti N. Das — 2010-06-07

Abstract: Proinflammatory cytokines and essential fatty acids (EFAs) and their metabolites are altered in coronary heart disease, stroke, diabetes mellitus, hypertension, cancer, depression, schizophrenia, Alzheimer's disease, and collagen vascular diseases, indicating that these diseases not only are low-grade systemic inflammatory conditions but also have defects in the metabolism of EFAs. EFAs and their metabolites such as eicosanoids, lipoxins, resolvins, protectins, maresins, and nitrolipids are biologically active molecules that regulate gene expression and enzyme activity, modulate inflammation, the immune response, and gluconeogenesis by direct and indirect pathways, function directly as agonists of a number of G-protein–coupled receptors, and thus regulate several cellular processes. EFAs and their metabolites activate phosphatidylinositol 3-kinase/murine thymoma viral oncogene homolog 1 (Akt) and p44/42 mitogen-activated protein kinases and stimulate gluconeogenesis and cell proliferation by Ca2+, phospholipase C/protein kinase, events that are also necessary for stem cell proliferation. Stem cells are pluripotent and expected to be of benefit in the management of many clinical conditions. Therefore, I propose that the beneficial actions of EFAs and their metabolites seen in coronary heart disease, stroke, diabetes mellitus, hypertension, atherosclerosis, cancer, depression, schizophrenia, Alzheimer's disease, and collagen vascular diseases could be ascribed to their ability to enhance the proliferation and differentiation of embryonic stem cells in addition to their capacity to suppress inflammation.

The metabolic syndrome: A syndrome and not a disease - Corrected Proof

Franco Contaldo, Lidia Santarpia, Fabrizio Pasanisi — 2010-06-07

The debate on the most appropriate definition criteria for the metabolic syndrome (MS) still remains open even after Eckel et al.'s recent paper , which summarizes the unified position of the International Diabetes Federation, the American Heart Association/National Heart, Lung, and Blood Institute, the World Heart Federation, International Atherosclerosis Society, and International Association for the Study of Obesity .

Calorimetry and metabolic knowledge - Corrected Proof

Larry H. Bernstein — 2010-06-04

David Frankenfield's review, “On Heat, Respiration, and Calorimetry,” traces the studies on human respiration, heat, and oxygen consumption over a long period. The story offers interlocking benefits. In the first place, one can trace the research on gas exchange and an understanding of the relatedness of oxygen and carbon dioxide. In the second place, one can see the evolution of a clinical measurement tool evolve as each question raised is answered. In the third place, one can trace the changes in hypotheses about metabolism emerging as studies were directed at the questions raised. In the fourth and last place, one can anticipate improvements in calculations of catabolic losses and a future potential to perhaps limit the size of the measurement technology for future use. The biggest challenge, however, is the fact that the science is dependent on the assumption of an equilibrium state that does not apply in acute illness. In addition, variations in body composition and surface area may limit the use of regression equations.

Prevention of diet-induced obesity by dietary black tea polyphenols extract in vitro and in vivo - Corrected Proof

Satoshi Uchiyama, Yoshimasa Taniguchi, Akiko Saka, Aruto Yoshida, Hiroaki Yajima — 2010-06-04

Abstract: Objective: The effects of certain tea components on the prevention of obesity in humans have recently been reported, although it is still unclear whether black tea consumption is beneficial. We obtained black tea extract (BTPE) consisting of polyphenols specific to black tea, and from it, prepared a polymerized polyphenol fraction (BTP). The effectiveness of oral administration of the BTPE was examined in in vitro and in vivo experiments.Methods: Effects of BTPE or BTP on pancreatic lipase activity were investigated in vitro. Male Wistar rats were administered an oral lipid emulsion containing BTPE at a concentration of 500 or 1000 mg/kg body weight and sequential plasma lipid levels were measured. Female C57BL/6N mice were fed a standard or high-fat diet supplemented with 1% or 5% (w/w) BTPE for 8 wk and changes in body weight were examined.Results: BTP and BTPE inhibited pancreatic lipase activity with an IC50 of 15.5 and 36.4 μg/mL in vitro, respectively. BTPE suppressed increases in rat plasma triglyceride levels in a dose-dependent manner after oral administration of a lipid emulsion. Furthermore, administration of the 5% BTPE suppressed increases in body weight (P < 0.05), parametrial adipose tissue mass, and liver lipid content (reduced to 56.9% and 81.7% of control mice, respectively, P < 0.05) in mice fed a high-fat diet.Conclusion: The BTPE may prevent diet-induced obesity by inhibiting intestinal lipid absorption. It was suggested that the major active component in the BTPE was BTP.

Green tea minimally affects biomarkers of inflammation in obese subjects with metabolic syndrome - Corrected Proof

2010-06-03

Abstract: Objective: Green tea (Camellia sinensis) has shown to exert cardioprotective benefits in observational studies. The objective of this clinical trial was to assess the effects of green tea on features of metabolic syndrome and inflammation in obese subjects.Methods: We conducted a randomized controlled trial in obese subjects with metabolic syndrome. Thirty-five subjects [(mean ± SE) age 42.5 ± 1.7 y, body mass index 36.1 ± 1.3 kg/m2] completed the 8-wk study and were randomly assigned to receive green tea (4 cups/d), green tea extract (2 capsules and 4 cups water/d), or no treatment (4 cups water/d). Both the beverage and extract groups had similar dosing of epigallocatechin-3-gallate, the active green tea polyphenol. Fasting blood samples were collected at screening, 4 and 8 wk of the study.Results: Green tea beverage or extract supplementation did not significantly alter features of metabolic syndrome or biomarkers of inflammation including adiponectin, C-reactive protein, interleukin-6, interleukin-1β, soluble vascular cell adhesion molecule-1, soluble intercellular adhesion molecule-1, leptin, or leptin:adiponectin ratio. However, both green tea beverage and extracts significantly reduced plasma serum amyloid alpha versus no treatment (P < 0.005).Conclusion: This study suggests that the daily consumption of green tea beverage or extracts for 8 wk was well tolerated but did not affect the features of metabolic syndrome. However, green tea significantly reduced plasma serum amyloid alpha, an independent cardiovascular disease risk factor, in obese subjects with metabolic syndrome.

Effect of vitamin A, vitamin A plus iron and multiple micronutrient-fortified seasoning powder on infectious morbidity of preschool children - Corrected Proof

Ke Chen, Xuan Zhang, Ting-yu Li, Li Chen, Xiao-ping Wei, Ping Qu, You-xue Liu — 2010-06-02

Abstract: Objective: Improvement of hemoglobin and serum retinol and facilitation of the mobilization of iron storage were achieved with a multiple-micronutrient–fortified diet in preschoolers for 6 mo in a suburb of Chongqing, China. We investigated whether fortification with multiple micronutrients in a diet for preschool children results in changes in children's infectious morbidity compared with diets fortified solely with vitamin A and with vitamin A plus iron.Methods: From December 2005 to June 2006, 226 2- to 6-y-old preschool children were recruited from three nurseries randomly assigned to three different fortified-diet groups for 6 mo. Group I was fortified with vitamin A; groups II and III were fortified with vitamin A plus iron and vitamin A plus iron, thiamine, riboflavin, folic acid, niacinamide, zinc, and calcium, respectively. The secondary functional outcomes, morbidity of diarrhea and respiratory infection, were collected during supplementation.Results: The groups were comparable concerning compliance and loss to follow-up. There was evidence of a lower incidence rate of respiratory-related illnesses, diarrhea-related illness, fewer symptoms of runny nose, cough, and fever, and shorter duration of respiratory-related illnesses and cough for children in group III compared with children in groups I and II. However, there was no significantly or clinically important difference between children in groups I and II.Conclusion: The beneficial effects on infectious morbidity over 6 mo, in addition to some biochemical improvements, highlight the potential of this micronutrient-fortified seasoning powder supplied in a diet for preschool children.