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Biomedical subjects

F J Kok

Publications and source records attributed to F J Kok.

At least 55 records · Page 3Linked to original sources
PubMed2000

Arginine intake and risk of coronary heart disease mortality in elderly men.

From experimental studies, the hypothesis is derived that the amino acid arginine, the precursor of NO, could restore the impaired endothelial function and increased platelet activation observed in atherosclerosis. We investigated whether dietary intake of arginine is associated with reduced coronary heart disease risk in elderly persons. The study population consisted of 806 men aged 64 to 84 years at baseline who participated in the Zutphen Elderly Study, a population-based cohort followed up for 10 years. Information about habitual food consumption was collected by use of the cross-check dietary history method. Ninety (11.2%) of the 806 men died from coronary heart disease. Mean+/-SD baseline arginine intake was 4. 35+/-1.07 g/d. Meat was the main source of arginine intake (37.1%), followed by bread (13.1%) and milk and milk products (12.1%). Arginine intake was not associated with coronary heart disease mortality. After adjustment for age, the relative risk (RR) for the medium tertile of arginine intake was 0.72 (95% CI 0.44 to 1.18), and the RR for the highest tertile was 0.71 (95% CI 0.43 to 1.19, P: for trend=0.19) compared with the lowest tertile of arginine intake. After additional adjustment for history of coronary heart disease and diabetes mellitus, energy intake, body mass index, smoking habit, physical activity, and other relevant dietary and biological risk factors, the RR was 1.86 (95% CI 1.06 to 3.27) for the medium intake and 1.56 (95% CI 0.83 to 2.93) for the highest intake (P: for trend=0.17). These results do not support the hypothesis that dietary arginine intake lowers the risk of coronary heart disease mortality.

Aged↗
PubMed2000

Serum carotenoids, alpha-tocopherol, and lung function among Dutch elderly.

Antioxidant vitamins (provitamins) may protect against loss of lung function over time. We studied the association between serum carotenoids (alpha-carotene, beta-carotene, lycopene, beta-cryptoxanthin, zeaxanthin, and lutein), alpha-tocopherol, and lung function among noninstitutionalized Dutch elderly age 65 to 85 yr (n = 528). Multiple linear regression analysis was performed with FEV(1) or FVC as dependent variables and serum levels of antioxidants in quintiles as independent variables. We adjusted for age, gender, height, and pack-years of smoking. Subjects in the fifth quintile of serum beta-carotene had a 195 ml (95% confidence interval [95% CI]: 40 to 351 ml) higher and those in the fifth quintile of alpha-carotene had a 257 ml (95% CI: 99 to 414 ml) higher FEV(1) compared with subjects in the first quintile of these carotenoids. Significant (p < 0.05) positive trends were observed between alpha-carotene, beta-carotene, lycopene, and FEV(1) and between alpha-carotene, beta-carotene, and FVC. Subjects in the highest quintile of the other carotenoids or alpha-tocopherol did not have significantly higher FEV(1) or FVC compared with subjects in the first quintile of these antioxidants. In conclusion, this study shows that from the six major serum carotenoids and alpha-tocopherol studied, particularly alpha-carotene, beta-carotene, and lycopene were positively associated with lung function in the elderly and may be considered as candidates for further investigations.

Aged↗
PubMed2000

Human studies to substantiate health effects of antioxidants. What is needed?

Biomarkers fulfil a crucial role in studying disease etiology, both with respect to biological plausibility, laboratory methodology, and in human studies. Markers should preferably reflect the mainstream causal process relevant to a major proportion of disease. Such markers may provide the evidence required to justify health claims regarding the role of antioxidants in the etiology of chronic diseases, e.g., cancer, cardiovascular disease and cataract. Regarding study design, type A claims, addressing enhanced biological function, would at least require human intervention studies. Type B claims, addressing reduced disease risk, would require prospective data, if possible experimental. (Nested) case control studies may be used to establish the predictive validity of precursor lesions of disease that can serve to substitute studies assessing disease occurrence as endpoints. Scientifically sound and practically feasible requirements for justification of health claims need be developed further.

Antioxidants↗
PubMed1999

Alcohol intake assessment: the sober facts.

Recent recommendations in regard to the level of alcohol intake have mainly been based on epidemiologic studies which relied on self-reported amounts of alcohol consumed. Therefore, it is important to be aware of the quality of self-reported measures of alcohol intake. Alcohol intake assessment methods were reviewed with respect to their capacity to rank individuals according to alcohol intake and their ability to explain the variation in the level of intake in population samples. In 33 methodological papers published after 1984, alcohol intake was assessed by five main methods: quantity frequency, extended quantity frequency, retrospective diary, prospective diary, and 24-hour recalls. The mean level of alcohol intake differed by 20% between these methods. It was also found that when researchers asked specifically about intake of beer, wine, and liquor, this resulted in 20% higher estimates of intake. These percentages were similar among populations with low and high mean alcohol consumption (4 vs. 10 drinks per week). It was found that ranking of individuals according to intake was satisfactory, with weighted correlation coefficients between methods ranging from 0.63 to 0.73. The authors conclude that, when there is sufficient evidence that alcohol intake is underestimated in a population, methods that enquire about both the frequency and amount consumed, for beer, wine, and liquor, separately, will yield the most realistic levels of intake.

Alcohol Drinking↗
PubMed1999

Dietary fiber and plant foods in relation to colorectal cancer mortality: the Seven Countries Study.

Many observational studies have found that higher consumption of vegetables, and to a lesser extent of fruits, was associated with lower risk of colorectal cancer. In particular, fiber or foods high in fiber have received attention in the potential prevention of colorectal cancer. We performed an ecological analysis with data of the Seven Countries Study, to investigate whether intake of fiber and plant foods contributes to cross-cultural differences in 25-year colorectal-cancer mortality in men. In the Seven Countries Study, around 1960 12,763 men aged 40 to 59 were enrolled in 16 cohorts in 7 countries. Baseline dietary information was gathered in small random samples per cohort, and nutrient intakes were based on chemical analyses of the average diets per cohort. Crude and energy-adjusted mortality-rate ratios were calculated for a change of 10% of the mean intake of fiber and plant foods, i.e., total plant foods, fruits, vegetables, potatoes, grains, and related sub-groups. Fiber intake was inversely associated with colorectal-cancer mortality with an energy-adjusted rate ratio of 0.89 (95% confidence interval 0.80-0.97). An increase of 10 gram of daily intake of fiber was associated with a 33% lower 25-year colorectal-cancer mortality risk. Intakes of vitamin B6 [0.84 (0.71-0.99)] and alpha-tocopherol [0.94 (0.89-0.99)] were also inversely associated with risk. Consumption of plant foods and related sub-groups was not related to colorectal cancer. It appears that fiber intake best indicates the part of plant food consumption, including whole grains, that is relevant for lowering colorectal cancer risk.

Adult↗
PubMed1999

Duration of shiftwork related to body mass index and waist to hip ratio.

OBJECTIVE: An elevated cardiovascular disease risk for shiftworkers has frequently been reported, however, the mechanism is still unknown. Changes in eating habits, in physical activity or metabolic factors could be involved. In this study we assessed the relationship between body mass index (BMI) as a possible indicator of changed eating habits or metabolic involvement and duration of shiftwork. DESIGN: Data from an ongoing cohort study among 377 shiftworkers and non-shiftworking controls, all starting in a new job were used. Anthropometric measurements were carried out at the start of the assignment. Job history was obtained by a questionnaire. RESULTS: A positive relationship was observed between BMI and waist to hip ratio (WHR) and duration of shiftwork experience, with an adjustment for age. The linear regression coefficients, with additional adjustments for sex, smoking status, physical activity and educational level were 0.12 kg/m2 per y in shiftwork for BMI (P<0.05) and 0.0016 per y in shiftwork for WHR (P<0.05). CONCLUSIONS: These results suggest a relationship between years worked in shifts with BMI and WHR for both males and females. Whether this might reflect an effect of changed dietary habits or a metabolic effect is not yet clear.

Adolescent↗
PubMed1999

Effect of 50- and 100-mg vitamin E supplements on cellular immune function in noninstitutionalized elderly persons.

BACKGROUND: It has been suggested that vitamin E can counteract the age-associated decline in cellular immune responsiveness (CIR). Particularly, T helper cell type 1 (Th1) activity, ie, interferon (IFN) gamma-producing Th1 activity and, hence, delayed-type hypersensitivity (DTH) would be enhanced by vitamin E supplementation. OBJECTIVE: Our aim was to study the effects of 6 mo supplementation with 50 and 100 mg vitamin E on CIR in the elderly. DESIGN: A double-blind, placebo-controlled trial was conducted in 161 healthy elderly subjects aged 65-80 y. CIR was measured in vivo by means of DTH skin tests and in vitro by assessing the production of interleukin (IL) 2, IFN-gamma (a typical Th1 cytokine), and IL-4 (a typical Th2 cytokine) by peripheral blood mononuclear cells after stimulation with phytohemagglutinin. RESULTS: Both DTH and IL-2 production showed a trend toward increased responsiveness with increasing dose of vitamin E. However, IFN-gamma production decreased whereas IL-4 production increased in the groups receiving vitamin E. Only the change in the number of positive DTH reactions was borderline significantly larger in the 100-mg vitamin E group than in the placebo group (P = 0.06, Bonferroni adjusted). Subjects receiving 100 mg vitamin E with low baseline DTH reactivity or who were physically less active had a significantly larger increase in the cumulative diameter of the skin induration resulting from the DTH test than did the placebo group (P = 0.03), although this difference was not significant after Bonferroni correction (P = 0.07). CONCLUSION: Possible beneficial effects of 100-mg vitamin E supplementation may be more pronounced in particular subgroups of elderly subjects.

Aged↗
PubMed1999

Postprandial response of activated factor VII in elderly women depends on the R353Q polymorphism.

BACKGROUND: Activated factor VII (FVIIa) is a very potent coagulant and may be a key determinant of the outcome of a cardiovascular event. The main determinants of FVIIa are the R353Q polymorphism and dietary fat intake, which may have an interactive effect. OBJECTIVE: The objective was to investigate whether the response of FVIIa to a fat-rich breakfast varies across genotypes of the R353Q polymorphism. DESIGN: Ninety-one apparently healthy elderly women (>60 y of age), 56 with the RR genotype and 35 with the RQ or QQ genotype, participated in a randomized, controlled crossover study. Subjects received 5 breakfasts, each on a separate day: 1 low-fat control breakfast and 4 high-fat test breakfasts. Blood samples were taken for measurement of FVIIa at 0800 before each breakfast (fasting) and at 1300 and 1500. RESULTS: The mean (+/-SD) fasting FVIIa concentration was 93.3 +/- 26.7 U/L in women with the RR genotype, 49.3 +/- 19.1 U/L in those with the RQ genotype and 39.5 +/- 17.2 U/L in those with the QQ genotype. The mean absolute response to all 4 test breakfasts was 37.0 U/L in those with the RR genotype and 16. 1 U/L in those carrying the Q allele (P < 0.001 for difference). Likewise, the FVIIa response relative to fasting FVIIa was significantly higher in women homozygous for the R allele. CONCLUSION: This observation may indicate a considerable difference in cardiovascular risk between genotype groups as a result of an increase in FVIIa after a fat-rich diet.

Aged↗
PubMed1999

Benefits of leisure-time physical activity on the cardiovascular risk profile at older age.

BACKGROUND: Intensity, frequency and duration of physical activity may contribute in different ways to the maintenance of cardiovascular health. Their relative importance may also change at different stages in life and this should be taken into account for activity recommendations. METHODS: The relationship of frequency and duration of leisure-time physical activities with cardiovascular risk factors was studied in 4942 male and 5885 female participants aged 50-69, of the German Cardiovascular Prevention Study (1984-1991). RESULTS: After adjustment for several possible confounders, women with modest levels (2-12 times per month, 0.5-2 h per week) of moderate-to-vigorous activity (> or =5 kcal/kg/h) had significantly lower systolic blood pressure (-1.8%), resting heart rate (-3.1%) and body mass index (-3.2%) values than sedentary women. Beneficial differences increased with frequency and duration of activity. Light activities (3-4.5 kcal/kg/h), conducted > or =5 times a week, were significantly associated with favourable lower diastolic blood pressure (-1.4%), resting heart rate (-2.3%) among women, and body mass index (women -2.9%, men -2.2%) among both genders. Recommended activity levels (> or =5 times, > or =3.5 h weekly) were associated with a lower prevalence of multiple risk factors (odds ratio [OR] = 0.55, 95% CI: 0.41-0.75 for men and OR = 0.44 95% CI: 0.31-0.63 for women). CONCLUSIONS: For sedentary elderly, even less physical activity than currently recommended, is likely to improve the cardiovascular risk profile.

Adult↗
PubMed1999

Functional biochemical and nutrient indices in frail elderly people are partly affected by dietary supplements but not by exercise.

A decline in dietary intake due to inactivity and, consequently, development of a suboptimal nutritional status is a major problem in frail elderly people. However, benefits of micronutrient supplementation, all-round physical exercise or a combination of both on functional biochemical and hematologic indicators of nutritional and health status in frail elderly subjects have not been tested thoroughly. A 17-wk randomized controlled trial was performed in 145 free-living frail elderly people (43 men, 102 women, mean age, 78 +/- 5.7 y). Based on a 2 x 2 factorial design, subjects were assigned to one of the following: 1) nutrient-dense foods, 2) exercise, 3) both (1) and (2) or 4) a control group. Foods were enriched with micronutrients, frequently characterized as deficient [25-100% of the recommended daily allowance (RDA)] in elderly people. Exercises focused on skill training, including strength, endurance, coordination and flexibility. Dietary intake, blood vitamin levels and nutritional and health indicators, including (pre)albumin, ferritin, transferrin, C-reactive protein, hemoglobin and lymphocytes were measured. At baseline, 28% of the total population had an energy intake below 6.3 MJ, up to a maximum of 93% having vitamin intakes below two thirds of the Dutch RDA. Individual deficiencies in blood at baseline ranged from 3% for erythrocyte glutathione reductase-alpha to 39% for 25-hydroxy vitamin D and 42% for vitamin B-12. These were corrected after 17 wk in the two groups receiving the nutrient-dense foods, whereas no significant changes were observed in the control or exercise group. Biochemical and hematologic indicators at baseline were within the reference ranges (mean albumin, 46 g/L; prealbumin, 0.25 g/L; hemoglobin, 8.6 mmol/L) and were not affected by any of the interventions. The long-term protective effects of nutrient supplementation and exercise, by maintaining optimal nutrient levels and thereby reducing the initial chance of developing critical biochemical values, require further investigation. Other indicative functional variables for suboptimal nutritional status, in addition to those currently selected, should also be explored.

Aged↗
PubMed1999

Omega-3 fatty acids in adipose tissue and risk of myocardial infarction: the EURAMIC study.

Omega-3 fatty acids have potential antiatherogenic, antithrombotic, and antiarrhythmic properties, but their role in coronary heart disease remains controversial. To evaluate the association of omega-3 fatty acids in adipose tissue with the risk of myocardial infarction in men, a case-control study was conducted in eight European countries and Israel. Cases (n=639) included patients with a first myocardial infarction admitted to coronary care units within 24 hours from the onset of symptoms. Controls (n=700) were selected to represent the populations originating the cases. Adipose tissue levels of fatty acids were determined by capillary gas chromatography. The mean (+/-SD) proportion of alpha-linolenic acid was 0.77% (+/-0.19) of fatty acids in cases and 0.80% (+/-0.19) of fatty acids in controls (P=0.01). The relative risk for the highest quintile of alpha-linolenic acid compared with the lowest was 0.42 (95% confidence interval [CI] 0.22 to 0.81, P-trend=0.02). After adjusting for classical risk factors, the relative risk for the highest quintile was 0.68 (95% CI 0.31 to 1.49, P-trend=0.38). The mean proportion of docosahexaenoic acid was 0.24% (+/-0.13) of fatty acids in cases and 0.25% (+/-0.13) of fatty acids in controls (P=0. 14), with no evidence of association with risk of myocardial infarction. In this large case-control study we could not detect a protective effect of docosahexaenoic acid on the risk of myocardial infarction. The protective effect of alpha-linolenic acid was attenuated after adjusting for classical risk factors (mainly smoking), but it deserves further research.

Adipose Tissue↗
PubMed1999

Consumption of plant foods and stomach cancer mortality in the seven countries study. Is grain consumption a risk factor? Seven Countries Study Research Group.

Plant foods are generally considered to be beneficial for health. A higher consumption of fruits, and to a lesser extent vegetables, is consistently associated with a lower risk of stomach cancer. Results on the association between stomach cancer and grain consumption are less clear. We associated plant food consumption with 25-year stomach cancer mortality at population level in the Seven Countries Study. Around 1960, > 12,000 men aged 40-59 years from 7 countries and 16 cohorts were enrolled. In each cohort, dietary information was collected in small random samples. Crude and adjusted associations were calculated for a change of 10% of mean intake. Results differed for the plant foods studied: an inverse association was observed for fruits (adjusted rate ratio = 0.96, 95% confidence interval = 0.91-0.99), a positive relation for refined grains (adjusted rate ratio = 1.07, 95% confidence interval = 1.03-1.12), and no association for total plant foods, vegetables, whole grains, and potatoes. A high intake of refined grains was correlated with a low consumption of fruits. In conclusion, high intake of refined grains may increase stomach cancer risk. However, because adjustment could only be limited in this study, high intake of refined grains may just reflect the deleterious effect of a diet low in fruits or other characteristics associated with low fruit consumption.

Adult↗
PubMed1999

Anti-malarial drug use among preschool children in an area of seasonal malaria transmission in Kenya.

The aims of this study were to estimate the proportion of asymptomatic Kenyan preschool children using anti-malarial drugs, to identify factors associated with chloroquine use, and to assess the validity of frequency of febrile episodes and drug use reported by mothers or carers. Of 318 children studied, 38% (95% confidence interval [CI] = 30-47%]) tested positive for chloroquine or sulfadoxine. Of chloroquine-positive children, 15% had concentrations exceeding the estimated minimum therapeutically effective values. Among those testing negative for sulfadoxine, chloroquine-positive children were more frequently parasitemic (odds ratio = 2.6, 95% CI = 1.3-5.2), and had lower mean hemoglobin concentrations (6.1 g/L, 95% CI = 2.1-10.1) than chloroquine-negative children. Mothers over-reported the frequency of malaria or fever episodes as usually defined in medical studies, and underreported anti-malarial drug use. We conclude that anti-malarials are frequently given for treatment of malaria or malaria-associated illness, rather than prophylactically or for symptoms unrelated to malaria. Questionnaire surveys cannot replace biochemical markers to obtain information on anti-malarial drug use.

Adult↗
PubMed1998

Adipose tissue omega-3 and omega-6 fatty acid content and breast cancer in the EURAMIC study. European Community Multicenter Study on Antioxidants, Myocardial Infarction, and Breast Cancer.

The fatty acid content of adipose tissue in postmenopausal breast cancer cases and controls from five European countries in the European Community Multicenter Study on Antioxidants, Myocardial Infarction, and Cancer (EURAMIC) breast cancer study (1991-1992) was used to explore the hypothesis that fatty acids of the omega-3 family inhibit breast cancer and that the degree of inhibition depends on background levels of omega-6 polyunsaturates. Considered in isolation, the level of omega-3 or omega-6 fat in adipose tissue displayed little consistent association with breast cancer across study centers. The ratio of long-chain omega-3 fatty acids to total omega-6 fat showed an inverse association with breast cancer in four of five centers. In Malaga, Spain, the odds ratio for the highest tertile relative to the lowest reached 0.32 (95% confidence interval 0.13-0.82). In this center, total omega-6 fatty acid was strongly associated with breast cancer. With all centers pooled, the odds ratio for long-chain omega-3 to total omega-6 reached 0.80 for the second tertile and 0.65 for the third tertile, a downward trend bordering on statistical significance (p for trend = 0.055). While not definitive, these results provide evidence for the hypothesis that the balance between omega-3 and omega-6 fat may play a role in breast cancer.

Adipose Tissue↗
PubMed1998

The effect of six months training on weight, body fatness and serum lipids in apparently healthy elderly Dutch men and women.

OBJECTIVE: To investigate the effect of a six-months training program on changes in body weight and lipid concentrations, and their interrelationship in elderly people. DESIGN: Intervention study. The elderly subjects were randomly assigned to a control group or one of two supervised aerobic training groups, either all round activities or ergometer cycling, both exercising 3-4 times a week for six months. SUBJECTS: 229 elderly men and women, aged 60-80 y. MEASUREMENTS: Various fatness parameters by anthropometry, serum lipids and peak power output. RESULTS: During the intervention, no significant changes were observed in weight or body fatness in subjects of the training groups. Serum high density lipoprotein (HDL), low density lipoprotein (LDL) and total cholesterol and triglycerides tended to change in a favourable direction in the elderly of the intervention groups, but only triglyceride concentration in women of the cycle ergometer group (mean difference with controls: -0.24 mmol/L, 95% confidence interval (CI): -0.45, -0.03) and total serum cholesterol and HDL-cholesterol concentrations in subjects of the all-round activity group, (-0.32mmol/L, 95% CI: -0.63, -0.01 and -0.15mmol/L, 95% CI -0.25, -0.05, respectively) were significantly reduced as compared to controls. Regression analysis showed that the intervention-control difference in change of all lipids was independent of changes in weight, body fat and previous engagement in sport activity. CONCLUSION: Regular physical exercise in an elderly population resulted in favourable changes in serum lipid concentrations that were not significant, but no change in body weight or fatness. Change in lipid concentration could not be attributed to change in weight or body fat.

Aged↗
PubMed1998

Functional food science and defence against reactive oxidative species.

This paper assesses critically the science base that underpins the argument that oxidative damage is a significant causative factor in the development of human diseases and that antioxidants are capable of preventing or ameliorating these disease processes. The assessment has been carried out under a number of headings, and some recommendations for future research are made based on the present day knowledge base. The knowledge database (1) Consideration of the basic science that underlies understanding of the role of free radicals in causing cellular pathologies, and the role of antioxidants in preventing this, shows that an imbalance of reactive oxygen species and antioxidant defence systems may lead to chemical modifications of biologically relevant macromolecules. This imbalance provides a logical pathobiochemical mechanism for the initiation and development of several disease states. Experimental data obtained in vivo provide evidence that antioxidants function in systems that scavenge reactive oxygen species and that these are relevant to what occurs in vivo. The relevance in vivo of these observations depends inter alia on knowledge of the uptake and distribution of the antioxidant within the human body, and on what tissue levels of the antioxidant may be expected in relation to dietary levels. (2) There is some way to go until validated precise methods are available for measuring biomarkers of oxidative damage in human subjects in vivo under minimally invasive conditions. With respect to oxidative damage in DNa, HPLC and GC-mass spectrophotometry methods have both merits and limitations. Lipid oxidation products in plasma are best measured as isoprostanes or as lipid hydroperoxides using specific HPLC techniques. Development of isoprostane measurement will advance specificity and precision. The measurement of oxidative damage to proteins has some potential but such methods have not been effectively exploited. (3) Epidemiological studies support the hypothesis that the major antioxidant nutrients vitamin E and vitamin C, and beta-carotene (which may or may not be acting as an antioxidant in vivo), may play a beneficial role in prevention of several chronic disorders. More research is needed on the impact of other non-nutrient compounds, such as other carotenoids and flavonoids, on human health. In general, human intervention studies using hard end-points are the gold standard. Trials are restricted mainly to the major antioxidants and do not allow firm conclusions because of inconsistent findings, an insufficient number of studies and the use of varying doses. There is evidence that large doses of beta-carotene may be deleterious to the health of certain subgroups of the population such as heavy habitual smokers. (4) With respect to the safety of administration of supplementary vitamins, vitamin C is safe at levels of supplementation up to 600 mg/d, and higher levels, up to 2000 mg/d, are without risk. Vitamin E has a very low human toxicity and an intake of 1000 mg/d is without risk; 3200 mg/d has been shown to be without any consistent risk. Large intakes of beta-carotene must be viewed with caution because they have been shown to confer detriment to a population at high risk of lung cancer when administered after many years of high risk (smoking) behaviour. Until further work clarifies the situation in heavy smokers with respect to taking supplements, larger doses should be avoided by such individuals. There is little reliable information about the human toxicology of flavonoids and related non-nutrient antioxidant constituents of the diet. (5) The food industry has long experience in the control of oxidative damage in foods and this experience can be used to advantage for the protection of food antioxidants which are beneficial. Some of these, such as vitamins C and E and beta-carotene, are well known, and strategies for their protection in foods are already exploited by food technologies. (ABSTRACT TRUNCATED)

Antioxidants↗
PubMed1998

Aflatoxin and liver cancer in Sudan.

This study investigated whether aflatoxin contamination of peanut products may contribute to the incidence of hepatocellular carcinoma (HCC) in Sudan. Thirty-seven peanut butter and peanut samples were collected from local markets. Aflatoxin concentrations were significantly higher in West Sudan [87.4 +/- 197.3 (SD) micrograms/kg], a high-risk area, than in Central Sudan (8.5 +/- 6.8 micrograms/kg), a low-risk area. In West Sudan, humid local storage conditions of peanut products were related to high aflatoxin concentrations. In a small case-control study of HCC patients (n = 24) and controls (n = 34), an odds ratio of 7.5 (95% confidence interval = 1.4-40.2) was observed for humid vs. dry local storage conditions. Development of an index of individual HCC exposure was less successful, probably because of year-to-year variability in aflatoxins in food. These preliminary findings justify further research into the role of aflatoxins and hepatitis in HCC incidence in Sudan.

Adult↗