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J J Cerda

Publications and source records attributed to J J Cerda.

At least 19 recordsLinked to original sources
PubMed1995

Controlled dietary folate affects folate status in nonpregnant women.

In a study designed to estimate the requirement for dietary folate in nonpregnant women, 17 women (21-27 y) consumed 200, 300, or 400 micrograms/d of total folate for 70 d which was provided by low folate conventional foods (30 micrograms) plus supplemental folic acid. Group means for initial serum and erythrocyte folate and plasma homocysteine concentrations were not significantly different. Serum and erythrocyte folate decreased relative to the initial value in the 200 micrograms/d group (43.4 +/- 12.1%, 13.6 +/- 16.6%, respectively; mean +/- SD), in contrast to an increase in the 400 micrograms/d group (16.8 +/- 52.0%, 10.2 +/- 18.5%, respectively). The final serum folate in the 200 and 300 micrograms/d groups (6.4 +/- 0.8 nmol/L, 7.3 +/- 1.1 nmol/L, respectively) was significantly lower than that of the 400 micrograms/d group (14.3 +/- 2.0 nmol/L), with evidence in the 200 micrograms/d and 300 micrograms/d groups of low ( < 6.8 nmol/L) serum folate concentrations. Differences in final erythrocyte folate did not reach statistical significance, although low values ( < 362 nmol/L) were frequent in subjects with 200 micrograms/d intake. In the 200 micrograms/d group, plasma homocysteine was negatively correlated with serum and erythrocyte folate, and final mean plasma homocysteine (12.6 +/- 1.7 mumol/L) was significantly higher than that of the 300 or 400 micrograms/d groups. Elevated plasma homocysteine levels ( > 16 mumol/L) were observed in the 200 micrograms/d group only.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Relative bioavailability of deuterium-labeled monoglutamyl tetrahydrofolates and folic acid in human subjects.

The bioavailability of orally administered monoglutamyl folic acid and various (6S)-tetrahydrofolates was examined in humans with stable-isotope methods. Folic acid (PteGlu), tetrahydrofolate (H4folate), 5-formyl-H4folate, 10-formyl-H4folate, and 5-methyl-H4folate were prepared for oral administration in 3',5'-2H2 labeled (d2) form, and [glu-2H4]folic acid (d4-PteGlu) was prepared for intravenous injection. In each of five trials, fasting adult males (n = 7) on a folate saturation regimen (2 mg/d) were given a single oral dose of one of the d2-folates in apple juice, as well as an intravenous injection of d4-PteGlu as a control. Urine was collected for 48 h and the isotope labeling of urinary folates determined by mass spectrometry. Isotope excretion ratios of urinary folates were used as criteria of bioavailability (pooled SE = 0.10): PteGlu (1.53, least squares mean), 10-formyl-H4folate (1.02), 5-methyl-H4folate (0.99), 5-formyl-H4folate (0.1.13), and H4folate (0.71). These results indicate that differences exist in the bioavailability of monoglutamyl folates under these experimental conditions. This variation, whether due to differences in absorption or postabsorptive events, must be considered in quantitative studies of folate utilization with this type of protocol.

Administration, Oral↗
PubMed1992

In vivo folate kinetics during chronic supplementation of human subjects with deuterium-labeled folic acid.

Six healthy men (22-31 y) were supplemented for 4 wk with folic acid labeled with deuterium [3',5'-2H2; 3.6 mumol/d (1.6 mg/d)] to permit evaluation of in vivo kinetics of this vitamin. Total folate in urine, serum and erythrocytes was determined by microbiological assay, and isotopic labeling of urinary and erythrocyte folate was determined by gas chromatography-mass spectrometry. During supplementation, serum folate reached maximal concentration in approximately 18 d, whereas excretion of total and deuterium-labeled folates increased rapidly and reached isotopic steady state in 1-2 wk. Isotopic labeling of erythrocyte folate increased continually over the entire supplementation period. Upon cessation of supplementation, red blood cell folate and urinary folate excretion (total and labeled) decreased linearly. The decline in total serum folate could be described with a biexponential model that yielded a slow-phase half-life of 18.7 +/- 2.3 d. This model also indicated a turnover of 4.5% of the total body folate pool per day. Pool sizes of total body folate before and after supplementation (at steady state) were calculated to be 10 mumol (4.4 mg) and 98.9 mumol (43.7 mg), respectively. These kinetic data and stable isotope methodology may be used to address a wide range of experimental questions related to folate metabolism.

Adult↗
PubMed1991

Oral mesalamine (Asacol) for mildly to moderately active ulcerative colitis. A multicenter study.

OBJECTIVE: To evaluate the efficacy and safety of a pH-sensitive, polymer-coated oral preparation of mesalamine in patients with mildly to moderately active ulcerative colitis. DESIGN: A multicenter, double-blind, placebo-controlled randomized trial. SETTING: Five university-based medical centers, one inflammatory bowel disease center, and three private practice sites. PATIENTS: A total of 158 patients with newly or previously diagnosed active ulcerative colitis. INTERVENTION: A pH-sensitive, polymer-coated oral preparation of mesalamine (5-aminosalicylic acid) was used at 1.6 and 2.4 g/d for 6 weeks. MEASUREMENTS: Efficacy was measured by scores for stool frequency, rectal bleeding, patient's functional assessment, sigmoidoscopic findings, and physician's global assessment. Stringent criteria for disease activity were established prospectively. RESULTS: The analysis of protocol-compliant patients showed a significant improvement at 3 weeks in patients taking 2.4 g/d of mesalamine compared with patients taking placebo (32% versus 9%; P = 0.003). At 6 weeks, both the 1.6 g/d (43%) and 2.4 g/d (49%) doses were significantly superior to placebo (23%) (P = 0.03 and P = 0.003, respectively). In addition, more patients worsened in the placebo group compared with the 2.4 g/d group (50% versus 19%; P = 0.003); however, there was no statistically significant difference in worsening between the 1.6 g/d mesalamine group and the placebo group. The oral mesalamine tablet was well tolerated, and no clinically significant changes were observed in hematologic, hepatic, or renal laboratory profiles. CONCLUSION: Colon-targeted oral mesalamine at 2.4 g/d is effective therapy for mildly to moderately active ulcerative colitis. It is well tolerated and should provide a viable therapeutic alternative to sulfasalazine.

Administration, Oral↗
PubMed1991

Relative bioavailability of deuterium-labeled monoglutamyl and hexaglutamyl folates in human subjects.

The bioavailability of orally administered mono- and polyglutamyl folates was examined in humans by using stable-isotope methods. [3',5'-2H2]Folic acid (d2-FA) and [3',5'-2H2]pteroylhexaglutamate (d2-PteGlu6) were prepared for oral administration and (glu-2H4)folic acid (d4-FA) was prepared for intravenous (iv) injection. In two trials, adult males (n = 7) on a folate saturation regimen (2 mg/d) were given a single 677-nmol oral dose of either d2-FA or d2-PteGlu6 in apple juice along with an iv injection of 502 nmol d4-FA as a control. Urine was collected for 48 h and the isotope labeling of urinary folates determined by mass spectrometry. The excretion ratio of urinary folates (% of d2-folate dose/% of d4-folate dose) resulting from oral d2-FA and iv d4-FA was 1.45 +/- 0.10 (mean +/- SEM) whereas the ratio for oral d2-PteGlu6 and iv d4-FA was 0.67 +/- 0.04. These results indicate that the d2-PteGlu6 is available to humans as a source of folate although its bioavailability is substantially less than that of d2-FA under these conditions.

Administration, Oral↗
PubMed1991

Bioavailability of pyridoxine-5'-beta-D-glucoside determined in humans by stable-isotopic methods.

Stable-isotopic methods were employed to evaluate the utilization of dietary pyridoxine-5'-beta-D-glucoside (PN-glucoside), a major form of vitamin B-6 in plant-derived foods, as a source of available vitamin B-6 for adult men (20-35 y old, n = 5). Deuterium-labeled forms of free pyridoxine (PN) and PN-glucoside were compared using the urinary excretion of labeled forms of the vitamin B-6 metabolite 4-pyridoxic acid as the main index of absorption and metabolism. When comparing orally administered, isotopically labeled PN and PN-glucoside in separate groups of subjects, similar bioavailability was observed although within-group variability was high. A dual-label study designed to examine the bioavailability of these compounds when administered simultaneously indicated that the utilization of deuterated PN-glucoside was 58 +/- 13% (mean +/- SEM) relative to that of deuterated PN. PN-glucoside was detected in all urine samples, which provided additional evidence of incomplete metabolic utilization. In contrast, intravenously administered PN-glucoside underwent approximately half the metabolic utilization of oral PN-glucoside. These studies indicate that the bioavailability of dietary PN-glucoside, although incomplete, is substantially greater in humans than previously found in rats. In addition, the difference between oral and intravenous routes suggests a role of beta-glucosidase(s) of the intestinal mucosa, microflora, or both in the release of free PN from dietary PN-glucoside.

Administration, Oral↗
PubMed1990

Stable-isotope methods for assessment of folate bioavailability.

Research was conducted to determine whether stable-isotope-labeled folates could be employed for studies of folate absorption and metabolism in human subjects. Two deuterium-labeled forms of folic acid were evaluated for simultaneous in vivo use, with quantification of relative bioavailability by measurement of urinary excretion of labeled folates. Adult male subjects (n = 11) were given saturation doses of 2 mg unlabeled folic acid/d for 7 d before the study. After an overnight fast each subject consumed 677 nmol each of 3',5'-labeled bideuterofolic acid and glutamate-labeled tetradeuterofolic acid. The 48-h urinary excretion of deuterated folates represented 5-6% of the ingested dose. The molar ratio of labeled folates in urine was not significantly different from the molar ratio in the ingested dose, which indicated equivalent absorption and metabolism of these labeled forms of the vitamin. These results support the validity of this protocol for in vivo studies of folate bioavailability.

Adult↗
PubMed1989

The usefulness of branched chain amino acids in patients with acute or chronic hepatic encephalopathy.

Hepatic encephalopathy (HE) is a neuropsychiatric syndrome associated with acute liver failure or chronic parenchymal liver disease. It has been hypothesized that changes in protein and amino acid metabolism and catabolism contribute to the pathogenesis of HE. Clinical investigations into the use of branched chain amino acids (BCAA) in the therapy of nutritional support for patients with HE have markedly increased. We have reviewed the rational basis for, and the controversies related to, the use of BCAA in the treatment of HE. We conclude that data on the use of BCAA in HE are controversial. There is marked variation in study design, and often, a lack of appropriate controls in patient numbers, as well as in consistent use of comparable measures of response. The ultimate role for BCAA in the treatment of HE is uncertain and will require additional objective information from well-designed and controlled clinical studies.

Amino Acids, Branched-Chain↗
PubMed1989

Dietary therapy in gastrointestinal disease.

Diet therapy is an important factor in overall care of most GI patients. Historically, diets have been used unscientifically in many of these patients without positive results. Nutritional care and diet therapy are critical for two reasons. First, malnutrition is an expected sequelae to most, if not all, GI diseases or disorders. Failure to eat, digest, or assimilate nutrients can provoke malnutrition in just a few weeks, although careful assessment of anthropometric, clinical, biochemical, and nutritional history by a trained professional can protect against this. Diet therapy through the elimination of offending foods such as wheat gluten or lactose, or inclusion of specialized products such as medium chain triglycerides or elemental formulas, can sustain nutritional status. Dietary components such as insoluble fiber appear to have physiologic effects, while soluble fibers may have metabolic effects important to diabetes and cardiovascular disease. There is a high potential for malnutrition in Crohn's disease during active and remittent phases. Elemental enteral formulas or TPN are used during the active phase to ensure optimal nutritional status and bowel rest. Hyperalimentation using the GI tract during remittent stage maintains this. Avoiding offending foods by Crohn's patients is an acceptable practice as long as entire categories of foods are not deleted. Avoiding all foods containing gluten from wheat, rye, barley, and oats, however, is a crucial prerequisite to recovery from celiac disease. Gluten is commonly used as a stabilizer, emulsifier, and extender in the food industry and is not always shown on food labels. Careful consultation with a registered dietitian can identify hidden sources of gluten in the diet.(ABSTRACT TRUNCATED AT 250 WORDS)

Gastrointestinal Diseases↗
PubMed1989

The narcotic bowel syndrome.

In this editorial, we review the narcotic bowel syndrome, its etiology, presentation, and treatment. We suggest this is an often overlooked diagnosis in many clinical settings.

Abdomen↗
PubMed1988

The effects of grapefruit pectin on patients at risk for coronary heart disease without altering diet or lifestyle.

Dietary intake of cholesterol has been linked to coronary heart disease. The effect of grapefruit pectin (Citrus paradisi) on plasma cholesterol, triglycerides, very low-density lipoprotein cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and the low-density lipoprotein:high-density lipoprotein cholesterol ratio was studied. The study design was a 16-week double-blind, crossover (placebo or pectin) using 27 human volunteers screened to be at medium to high risk for coronary heart disease due to hypercholesterolemia. The study did not interfere with the subjects' current diet or lifestyle. Grapefruit pectin supplementation decreased plasma cholesterol 7.6%, low-density lipoprotein cholesterol 10.8%, and the low-density lipoprotein:high-density lipoprotein cholesterol ratio 9.8%. The other plasma lipid fractions studied showed no significant differences. We conclude that a grapefruit pectin-supplemented diet, without change in lifestyle, can significantly reduce plasma cholesterol.

Adult↗
PubMed1988

Grapefruit pectin inhibits hypercholesterolemia and atherosclerosis in miniature swine.

We studied the effect of dietary grapefruit pectin on plasma cholesterol and the development of atherosclerosis in 18 miniature swine. Pigs were randomized to one of three diets: no added fat (I), added fat/cellulose (II), and added fat/pectin (III). Plasma cholesterol was measured monthly. Arteries were examined for atherosclerosis at the termination of the experiment. Pectin supplementation of an added fat diet resulted in a significantly lower average plasma cholesterol than did cellulose supplementation (168 mg/dl vs. 249 mg/dl, p less than 0.05). The pectin-fed pigs also developed less atherosclerosis of their aortas (1.1% vs. 7.0%, p less than 0.05) and coronary arteries (2.9% vs. 26.2% cross-sectional narrowing, p less than 0.05). Plasma cholesterol levels correlated with the severity of aortic (r = 0.836) and coronary artery (r = 0.735) atherosclerosis. We conclude that dietary grapefruit pectin supplementation inhibits hypercholesterolemia and appears to be proportionately protective against atherosclerosis.

Animals↗
PubMed1988

Human intestinal brush border angiotensin-converting enzyme activity and its inhibition by antihypertensive Ramipril.

Angiotensin-converting enzyme (ACE) has been identified as a prominent brush border membrane-bound enzyme of human jejunum. In this study, we purified brush border membrane vesicles enriched in ACE, and characterized the ACE with regard to (a) its stability in the membrane, (b) substrate hydrolysis kinetics compared with pulmonary endothelial ACE, and (c) pharmacologic interaction with Ramipril. These investigations resulted in the following findings. The uninhibited enzyme is stable in native membranes in vitro, with a half-life of 195 +/- 7 h. Kinetic analysis of ACE hydrolysis activity revealed the presence of a single enzyme species, which yielded a high Vmax and displayed a Km similar to purified ACE from lung endothelium. Brush border ACE was inhibited by Ramipril, one of the most specific and potent orally administered ACE inhibitors indicated for hypertension. We determined the brush border ACE value of IC50 = 3 X 10(-9) M Ramipril-diacid, which is the same value for serum and lung ACE. Brush border ACE remains 100% inhibited by 10 microM Ramipril during at least 8 days in vitro. The data indicate that ACE is a prominent jejunal brush border enzyme that behaves pharmacologically and kinetically like its peripheral circulation counterpart. This study suggests that high doses of orally administered ACE inhibitors may affect intestinal epithelial function.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1988

Methanol production from the degradation of pectin by human colonic bacteria.

When ingested, pectin can lower serum cholesterol levels in humans. Pectin is degraded by fecal bacteria in the colon. We examined the release of methanol (MeOH) by this degradation. A 0.2% glucose (2 g/L) mixture was used as the control medium. A pure culture of pectinolytic Erwinia carotovora was the control bacterium. The chief substrates were, in set 1, 0.2% pectin (2 g/L) and, in set 2, 0.1% glucose (1 g/L) and 0.1% pectin (1 g/L). Cultures of fecal bacteria and E carotovora grew for 72 h in each of the solutions. By 72 h the fecal flora culture in set 1 cleaved 30% of the possible methoxyl groups on pectin. The fecal flora in set 2 cleaved 90.7% of all possible methoxyl groups. Balance studies suggest that all of the free MeOH comes from methoxyl groups on pectin. This study demonstrates that fecal bacteria are capable of degrading pectin to release MeOH.

Bacteria↗
PubMed1988

Red blood cell uptake of supplemental folate in patients on anticonvulsant drug therapy.

A group of epileptics (n = 18) and a control group (n = 10) of subjects aged 21-42 y were given 1-mg supplements of folate daily for 1 mo. Anticonvulsant therapy involved phenytoin alone or in combination with phenobarbital. Serum and red blood cell (RBC) folate levels were determined on days 1, 14, and 28. Mean serum and RBC folate levels were greater (p less than 0.05) for the control subjects compared with the epileptic subjects throughout the study. The percent increase in either serum or RBC folate was not different (p greater than 0.05) between the groups. The percent increase in serum folate when expressed as a percent of RBC folate was greater (p less than 0.05) for those epileptics who initially had deficient blood folate levels (serum folate less than 7 nmol/L; RBC folate less than 317 nmol/L) than those who did not. Deficient epileptics may have had an impaired RBC incorporation of circulating (serum) folate compared with nondeficient epileptics.

Adult↗