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Biomedical subjects

K Widhalm

Publications and source records attributed to K Widhalm.

At least 37 records · Page 2Linked to original sources
PubMed1997

Perceived need to alter eating habits among representative samples of adults from all member states of the European Union.

OBJECTIVE: To examine the perceived need to alter eating habits among nationally-representative samples from each member state of the European Union (EU). DESIGN: A cross-sectional study in which quota-controlled, nationally-representative samples of approximately 1000 adults from each country completed a face-to-face interview-assisted questionnaire. SETTING: The survey was conducted between October 1995 and February 1996 in the 15 member states of the European Union. SUBJECTS: 14,331 subjects (aged 15 y upwards) completed the questionnaire. Data were weighted by population size for each country and by sex, age and regional distribution within each member state. RESULTS: 71% of EU subjects agreed with the statement 'I do not need to make changes to the food I eat, as it is already healthy enough'. There was wide variation between the member states ranging from 47% in Finland to 87% in Italy indicating agreement. Overall there was little difference between the sexes except in Austria, Belgium, Germany, Greece and Ireland, but the proportions of subjects agreeing with the statement generally increased with advancing age and decreased with higher levels of education. The effects of demographics were not consistent across member states. A total of 49% of EU subjects agreed with the statement 'I usually do not think of the nutritional aspects of the food I eat'. Significantly more females than males disagreed with the statement in all countries except Portugal. In all member states there were widespread beliefs that people in general should decrease their consumption of savoury snacks and increase their consumption of fruit and vegetables. CONCLUSIONS: The results of this study demonstrate that dietary advice may not be perceived as personally relevant among EU subjects. In addition important target groups for the promotion of healthy eating have been identified for example, males or subjects with low levels of education. Because of the variation in attitudes a single pan-EU healthy eating programme is unlikely to be effective for all countries or for different demographic groups.

Adolescent↗
PubMed1996

The clinical application of two newly developed lipid emulsions (Solipid 20% S&E) in critically ill patients.

OBJECTIVE: The clinical compatibility of two newly developed lipid emulsions based on soy oil (20%) emulsified with egg lecithin (12 g/l) or soy lecithin (15 g/l) (Solipid 20% E&S) has been compared. DESIGN: Double-blind prospective randomized study. SETTING: Intensive care unit of a university hospital. PATIENTS: 20 patients (16 men, 4 women, age 20-59 years) were entered into the study. INTERVENTIONS: One g of lipids/kg body weight per day was administered on day 1 and subsequently 2 g/kg/day on days 2-5. Blood was drawn once a day, lipids, lipoproteins, apoproteins and other routine clinical chemistry parameters were determined. RESULTS: No significant increase of total triglycerides could be observed. Total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, apolipoproteins A I and B usually remained below the reference ranges. Electrolytes, uric acid and glucose, blood cells, parameters of liver and kidney function, coagulation and protein metabolism did not show relevant changes; only the activity of gamma-GT in both groups--independent of the sort of lecithin--increased significantly. CONCLUSION: The results indicate adequate elimination of both tested lipid emulsions from the plasma at usual clinical conditions. Therefore Solipid 20% S&E can be used in critically ill patients.

Adult↗
PubMed1995

Oxyradical damage and mitochondrial enzyme activities in the mdx mouse.

A number of studies have already been undertaken to investigate involvement of oxyradicals in muscle diseases by means of measurements of oxyradical protective enzymes. We investigated o-tyrosine, which is a biomarker for OH radical damage in vivo, in 10 mdx and 10 control mice. We also measured mitochondrial enzymes in muscle homogenates of 10 mdx and 10 control mice. Mdx mice had significantly elevated values for o-tyrosine, succinat-phenacinmetosulfat oxidoreductase. NADH O2 oxidoreductase and cytochrome C oxidoreductase. Our findings confirm the suggestion that elevated oxyradical production occurs in muscular dystrophies with lack of dystrophin. Furthermore, our results demonstrate that OH radical damage does not impair mitochondrial enzyme activities in the mdx mouse.

Animals↗
PubMed1994

Long-term follow-up of children with classical phenylketonuria after diet discontinuation: a review.

The age at which children suffering from classical phenylketonuria can safely discontinue their dietary therapy has been constantly disputed over the past decades. Recently, most phenylketonuria centers have begun to recommend a life-long diet, especially for female patients. Male patients are also advised to continue their diet until at least well into adult age. As a result of this new outlook in therapy management, we reviewed the existing literature and summarized all relevant long-term follow-up data of children who discontinued their debts at an early age, focusing on intellectual and neurological performance. The abilities of these children are compared during dietary treatment and again several years after diet discontinuation. Results show clearly that children maintaining their diets into their teens have fewer deficits than do those terminating their diets before 10 years of age. It seems essential to initiate diet early, and to keep blood phenylalanine levels < 600 mumol/L and well controlled to at least age 10 to ensure satisfactory long-term development of the patient. Furthermore, it seems highly justified to maintain a life-long diet which can be liberalized, but not completely discontinued in adulthood.

Adolescent↗
PubMed1994

Evaluation of clinical and biochemical parameters in children after consumption of microparticulated protein fat substitute (Simplesse).

OBJECTIVE: The objective of this randomized, double-blind, two-way crossover study in healthy children was to evaluate whether microparticulated protein (MPP, Simplesse) fat substitute had any effects on various clinical and biochemical parameters when compared to super premium ice cream (approximately 16% butterfat). METHODS: Twenty-four children (12 males, 12 females), 7-10 years of age, received their normal diet plus two consecutive 7-day treatment regimens consisting of one serving (approximately 196 mL) per day of either ice cream or a frozen dessert made with MPP. Three-day food diaries, routine hematologies, clinical chemistries, urinalyses, fasting plasma lipids and amino acids, vital signs and adverse experiences were compared between treatments. RESULTS: There were no clinically significant effects on any of the parameters following either treatment, although there were statistically significant increases in fasting plasma cholesterol and high-density lipoprotein cholesterol following ice cream when compared to MPP. There were no statistically significant differences between the two treatments in regard to macronutrient consumption. The only adverse experience related to treatment was one episode of vomiting following the ice cream. The children ingested more than five times the amount of MPP than that found in the 90th percentile of frozen dessert consumption by this age group. The protein intake (5.5 g/day) from MPP at this level of consumption would only modestly increase the total daily protein intake. CONCLUSION: Children ingesting approximately 196 mL/day of frozen dessert made with MPP did not show any clinically significant changes in various clinical and biochemical parameters.

Amino Acids↗
PubMed1994

Long-term follow-up of 58 patients with histidinemia treated with a histidine-restricted diet: no effect of therapy.

OBJECTIVE: There is no general agreement as to whether or not patients with histidinemia should be treated with a histidine-restricted diet because the majority of the patients are asymptomatic. Between April 1969 and December 1986 124 children with histidinemia were detected in the Austrian Neonates Screening Program and they received long-term follow-up. DESIGN: Fifty nine patients were treated with a histidine-restricted diet (35 mg/kg). The follow-up included determining biochemical parameters, physical examination and psychological assessment of 58 treated and 43 untreated patients. After termination of the Screening Program information about the patients' development was obtained through questionnaires and follow-up of 20 patients aged 11 to 17 years. RESULTS: Histidine blood levels decreased after institution of the diet, but rose again after termination of the died. In the untreated patients histidine levels were highest at 1 year of age, decreasing with age. When the IQ scores of the treated and the untreated group were compared, significantly higher IQ scores were found in the 4-year-old and 6-year-old untreated patients (P < .05). Clinical symptoms were found in 27 patients; treated and untreated patients were equally affected. The clinical observations included speech defects, psychomotor and general retardation, emotional disturbances, recurrent respiratory infections, and miscellaneous symptoms such as atopic dermatitis. CONCLUSION: We conclude that patients with histidinemia do not benefit from dietary treatment.

Adolescent↗
PubMed1994

Elevated levels of lipoprotein (a) in children with familial hypercholesterolemia.

Lipoprotein(a)[Lp(a)] concentrations and their correlation to total cholesterol (TC), low-density and high-density lipoprotein cholesterol (LDL-C, HDL-C) and triglycerides (TG) were estimated in 20 normal weight children affected with familial hypercholesterolemia (FH) and for comparison in 20 overweight, but otherwise healthy children, matched for sex and age. The mean value of Lp(a) in patients with FH (0.29 g/l, SD = 0.27) was markedly higher than in the control group (0.17g/l, SD = 0.19), but the difference was not statistically significant. However, the frequency distribution of Lp(a) in both groups was different: the proportion of Lp(a) levels above 0.60g/l was significantly greater in patients with FH than in the controls (p < 0.05). These results indicate that even pediatric patients with FH have increased Lp(a) levels. Since Lp(a) elevation above 0.25 to 0.30g/l--in particular in combination with increased LDL concentrations--is is associated with a markedly increased risk of coronary heart disease, cervical atherosclerosis and cerebral infarction, it seems very important to detect these high-risk individuals as early as possible and to treat them appropriately.

Child↗
PubMed1994

[Hyperlipoproteinemias in childhood].

There is general agreement that hyperlipidemic states, in particular hypercholesterolemia, should be diagnosed during childhood, and treatment should start beyond the age of 2 years. The rationale for this procedure is the fact that increased cholesterol levels have been accepted to act as major risk factors for coronary vascular disease in adult populations, and therefore the significance of cholesterol must be inferred from less direct evidence. The diagnosis of hyperlipidemias is based on reference levels for the various age groups which are mainly transferred from studies in the USA. The classification of hyperlipidemias refers to a clinical and genetic concept; thus, familial hypercholesterolemia (incidence 1:500) is the most important disorder for the pediatric age group. Treatment of affected children should include dietary restrictions, in particular for saturated fats, but substitution of animal protein by soy protein has been shown to increase the cholesterol lowering effect. It is concluded that children from families with cardiovascular disease and/or hyperlipidemias should be referred to a special metabolic clinic for appropriate diagnosis and treatment. So far, a general screening for hyperlipidemias is not recommended in the neonatal period or during childhood.

Adolescent↗
PubMed1993

Extracorporeal lipid elimination for treatment of gestational hyperlipidemic pancreatitis.

Gestational hyperlipidemia complicated by pancreatitis during the 24th week of gestation has been successfully managed by long-term extracorporeal elimination of triglyceride-rich lipoproteins. Three modes of treatment (plasma exchange, immunospecific apheresis, and a combination of both treatments) were compared for efficacy as therapy for metabolic derangements, altered blood rheology, and the loss of immunoglobulins. Treatments were performed by means of a peripheral venovenous approach. A combination plasma exchange/apheresis technique was highly effective; the loss of immunoglobulins remained acceptable. Clinical symptoms of pancreatitis subsided within 24 hours of the first treatment. A relapse during the 32nd week of gestation necessitated treatments more frequently than once a week. At the 36th week of gestation, after confirming lung maturity as indicated by a lecithin-sphingomyelin ratio of > 2.0, a cesarean section was performed. A healthy boy was delivered (2470 g; Apgar score, 9/10). This is the first report to show that long-term extracorporeal elimination of lipoproteins is a highly effective treatment of hyperlipidemic gestational pancreatitis.

Adult↗
PubMed1993

Effect of soy protein diet versus standard low fat, low cholesterol diet on lipid and lipoprotein levels in children with familial or polygenic hypercholesterolemia.

The effect on serum lipid and lipoprotein levels of a standard low fat, low cholesterol diet was compared with that of a soy protein-substituted low fat, low cholesterol diet in 23 children with familial or polygenic hypercholesterolemia: 12 boys and 11 girls (mean age, 9.3 +/- 4.5 years) were included in this outpatient program. Group 1 received the soy protein diet for 8 weeks; group 2 received the low fat, low cholesterol diet. After an interruption of 8 weeks, each group was placed on the alternate regimen. Fasting blood samples were collected at the beginning of each dietary period. During the soy protein diet, the levels of total cholesterol decreased by 16% in group 1 and 18% in group 2, and low-density lipoprotein cholesterol (LDL-C) levels decreased about 22% in group 1 and 25% in group 2. During the standard low fat, low cholesterol diet, total cholesterol and LDL-C levels were reduced by 8% and 7% in group 1 and by 12% and 13%, respectively, in group 2. The effect on LDL-C was significantly greater (p < 0.05) in the soy protein group than in the low fat, low cholesterol group. We conclude that a diet substituting soy protein for animal protein has a more beneficial short-term effect on total cholesterol and LDL-C levels in children with hypercholesterolemia than a standard low fat diet.

Adolescent↗
PubMed1993

Histidinemia: a biochemical variant or a disease?

Histidemia, first described by Ghadimi in 1961, is caused by a defect in histidase. The defect results in elevated urinary excretion of histidine and its transamination products, and in high blood histidine. Blood histidine levels in histidinemic patients range from 290 to 1420 microM (normal 70-120 microM). The clinical picture of histidinemia varies from complete normality to severe retardation, with many patients being asymptomatic. No correlation has been found between clinical and biochemical data. Most reported cases have been identified in newborn screening programs. Frequency of histidinemia ranges from 1 in 8000 (Japan) to 1 in 37,000 (Sweden). Histidinemia is inherited as an autosomal recessive trait. Maternal histidinemia is believed to be benign. Studies in animal models have shown similar metabolic changes in animals and humans, but clinical changes differ. Histidinemia may be treated with a low-histidine diet, which reduces elevated histidine levels, although in most cases no improvement of clinical symptoms has been observed.

Amino Acid Metabolism, Inborn Errors↗
PubMed1993

Iron status and iron supplementation in children with classical phenylketonuria.

Iron (Fe) status and Fe supplementation were assessed in 20 children with phenylketonuria (PKU) through dietary intake and through measurements of ferritin, hematocrit, hemoglobin, mean cellular hemoglobin, mean cellular volume, serum Fe, total iron binding capacity, unbounded iron binding capacity, transferrin saturation and transferrin. Findings were compared to reference values and to data from age-matched controls. The prescribed phenylalanine-restricted diet supplied all the recommended nutrients. Dietary Fe was present in the diets, but its bioavailability is questionable as several laboratory results were not within accepted reference values. A ferrous sulphate supplement (5 mg elemental Fe/kg daily) was given for 120 days to a group of PKU children with lower Fe parameters, thus changing some of the parameters studied. Serum ferritin (p < 0.1), transferrin saturation and serum Fe (p < 0.05) increased after the treatment. The need for improved diagnosis of Fe status and determination of whether PKU children can benefit from therapeutic Fe is discussed.

Child↗
PubMed1993

[Gender-specific differences of risk factors of atherosclerosis. A study of 3,850 Vienna employees].

Atherosclerosis is the most frequent cause of death in Austria as well as in the other western industrialized countries. Sex specific differences in the various age groups concerning relative myocardial infarction-mortality stimulated us to investigate the risk factors for atherosclerosis in 3850 employees. An extensive lipid status, liver and kidney function parameters were determined, the blood-pressure was measured, and a cardiovascular centered case history was examined. The mean cholesterol level and the LDL-cholesterol level in males were significantly higher than in females (cholesterol: males 223.8 +/- 56.8 mg/dl, females 208.2 +/- 43.3 mg/dl, LDL-cholesterol: male 151.9 +/- 55.1 mg/dl, female 132.2 +/- 40.1 mg/dl, p < 0.001). The mean HDL-cholesterol level in males were significantly lower than in females (males: 45.0 +/- 11.6 mg/dl, females 56.2 +/- 13.3 mg/dl, p < 0.001). No significant difference concerning smoking-behaviour could be determined between female and male participants in this cohort (33.0% of the males resp. 33.6% of the females stated that they smoked cigarettes). Hypercholesterolaemia and cigarette-smoking are the main risk factors for both sexes, however the situation of women-except for the 6th decade-is much better than that of men. Remarkable is the increasing number of female-smokers, especially at younger age.

Adult↗
PubMed1993

[Screening for risk factors in agricultural schools of 5 Austrian federal counties ].

While screening activities have already been performed in a wide range in adults in Austria, extensive investigations in children and juveniles have so far only been done in a very limited number. In 1094 out of 1732 juveniles attending agricultural schools all lipid parameters were fully documented and thus could be evaluated. On an average, the total cholesterol (169 mg/dl) was too high; the worst findings for lipid parameters cholesterol, HDL-cholesterol, triglycerides, apolipoprotein-A1 were found in pupils of Burgenland. The cholesterol/HDL-cholesterol ratio in Burgenland was significantly (p < 0.01) higher than in Lower Austria. Female participants had a higher total cholesterol, HDL-cholesterol, and apolipoprotein-A1, but lower triglycerides and also lower blood pressure. Juveniles with a positive family history showed lower total cholesterol, but higher triglycerides as well as HDL-cholesterol. In heavy smokers, but also in occasional smokers, a lower total cholesterol, but decreased HDL-cholesterol and apolipoprotein-A1 and increased triglycerides were found. These findings underline the high prevalence of hypercholesterolemia in juveniles justifying screening activities and possibly therapeutic intervention at this young age.

Adolescent↗
PubMed1992

Effect of daytime on resting energy expenditure and thermic effect of food in obese adolescents.

The aim of this study was to investigate the effect of daytime on resting energy expenditure (REE) and thermic effect of food (TEF), REE and TEF were measured in 11 obese boys (mean age +/- SD 11.9 +/- 1.6 years; body mass index 30.1 +/- 4.0 kg/m2) by indirect calorimetry (SensorMedics 2900) on two consecutive days: early in the morning (7:30 a.m.) on one day and at 12 noon on the other day or vice versa. REE was measured for 30 minutes and TEF for 180 minutes after a 600 kcal liquid meal containing 13% protein, 39% fat and 48% carbohydrates. REE measured in the morning was not statistically different from that measured at noon (2191 +/- 358 vs 2223 +/- 319 kcal/24 hours) and morning values were highly correlated with afternoon values (r2 = 0.805). Therefore we conclude that the effect of daytime is negligible for measurements of REE if the patients are in a postabsorptive state and avoid physical activity and stress 10-12 hours prior to measurements. The thermic effect of food calculated in the morning also was not statistically significantly from values found in the afternoon (8.2 +/- 8.8% in the morning and 6.6 +/- 7.5% in the afternoon). However, because of very high within-patient variability the correlation between morning and afternoon values was weaker than for REE (r2 = 0.289).

Adolescent↗
PubMed1992

Serum lipids, lipoproteins and apolipoproteins in children with and without familial history of premature coronary heart disease.

A positive family history of premature cardiovascular disease is recognized as an independent predictor of risk for cardiovascular death in first degree relatives. It is of great interest whether the progeny of families with manifest coronary heart disease can be discriminated from children with a negative family history. Therefore, we examined serum lipids, lipo- and apolipoproteins in 338 offspring whose fathers and/or mothers had been affected with a myocardial infarction before the age of 55, in comparison with 448 age- and sex-matched, healthy controls. Statistical analyses revealed marked differences between the two groups: In both age groups only high-density lipoprotein cholesterol (HDL-C), as a single parameter, and the ratios of total cholesterol (TC)/HDL-C, as well as low-density lipoprotein cholesterol (LDL-C)/HDL-C, showed a significant difference between the risk and nonrisk groups. Whereas the ratio of apolipoprotein A1 (ApoAI) to apolipoprotein B is the strongest discrimination in children less than or equal to 20 years, the ratio of HDL-C/ApoAI takes this position in the older ones. Apolipoproteins seem to be of considerable importance as risk indicators between offspring who might be at higher risk for later cardiovascular diseases, even in childhood and younger adolescence.

Adolescent↗
PubMed1992

Cardiovascular risk factors in obese children in relation to weight and body fat distribution.

To assess the relationship between obesity and body fat distribution with cardiovascular risk factors in children, various measures of obesity and waist-to-hip circumference ratio (WHR) were related to serum lipids, lipoproteins, apolipoproteins, glucose, insulin, uric acid, systolic (SBP) and diastolic blood pressure (DBP). In boys univariate analysis revealed an association of triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (ApoB), the ratio ApoAI/ApoB, cholesterol/HDL-C, glucose and insulin to WHR. SBP and DBP and serum uric acid correlated with all measures of obesity [body mass index (BMI), percent overweight, percent body fat, skinfolds], but not with WHR. In girls lipid parameters (triglycerides, LDL-C, HDL-C, HDL2, ApoAI, ApoB) and atherogenic ratios correlated with measures of obesity and WHR. Glucose, insulin, SBP and DBP showed the highest correlation with WHR (r = 0.598, p less than 0.001 and r = 0.713, p less than 0.001). Multivariate analysis in girls revealed a first step dependency of ApoAI, the ratio cholesterol/ApoAI, insulin, SBP and DBP on WHR, triglycerides, HDL-C, LDL-C and the ratio ApoAI/ApoB, a first step dependency on percent body fat mass. In boys triglycerides, ApoB and the ratio ApoAI/ApoB were related to WHR for insulin, SBP and DBP, but a positive association with the WHR was found, explaining 33, 21.8, and 22.6% of the variance. This study demonstrates that cardiovascular risk factors in obese children are related to obesity and body fat distribution. Obese children with predominantly abdominal fat mass show a risk profile that is less favorable than gluteal-femoral fat distribution. Evaluation of body fat distribution in obese children, therefore, may help to identify persons most susceptible to cardiovascular risk in adulthood.

Adipose Tissue↗