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Noel W Solomons

Publications and source records attributed to Noel W Solomons.

34 records · Page 2Linked to original sources
PubMed2003

Multiple micronutrient deficiencies: future research needs.

There has been a rising current of calls for a moratorium on international nutritional research in favor of an investment in intervention programs, per se. The topic of multiple-micronutrient supplementation reviewed at the International Workshop on Multi-Micronutrient Deficiency Control in the Life Cycle (May 30-June 1, 2001) has confirmed once again, however, the intimate interaction between program development and a supporting agenda of applied research. The areas of research required to produce successful intervention programs include biologic availability, safety and efficacy, communications and behavior, effectiveness, cost-effectiveness (efficiency), and food and pharmaceutical technology. Attention to safety and surveillance for unintended adverse effects has acquired new relevance as we analyze the multi-center International Research on Infant Supplementation (IRIS) I studies. All professionals involved in research projects in this area must assure both the quality and reliability of investigations and adhere to the highest principles of ethical conduct of research in human studies. The fundamental principles of research design and hypothesis development, quality assurance, reliability of measurements, and sound and unbiased interpretation of findings apply to all experimental science, and must be guaranteed for this mission. Agencies, academic institutions, and industry alike must work to create a system in which researchers can uphold these standards, and realize at the same time that the area of multi-micronutrient supplementation in developing countries can be a fertile area for training future researchers.

Cost-Benefit Analysis↗
PubMed2003

Diet and long-term health: an African Diaspora perspective.

The life-stage approach, which views the behaviours and exposures of an individual from the preconceptual situation of the parent through pregnancy, infancy, childhood and adolescence, and into the advancing years through adulthood, is the basis of analysis of strategies to improve long-term health. Among the behaviours of note is the dietary selection pattern, conditioning our exposure to nutrients and dietary constituents that influences growth, nutriture, cognitive and physical performance, and disease resistance and susceptibility. The African Diaspora created a population displaced from Africa to the Western Hemisphere as part of the African slave trade from the 16th to 18th centuries. It continues to manifest distinct dietary and lifestyle practices in the context of a health experience that is different both from the population in their African countries of origin and from the other ethnicities in their countries of displacement and current residence. Afro-Americans are more susceptible to a series of diseases and conditions including low birth weight, violence, and HIV/AIDS, as well as the non-communicable diseases: obesity, diabetes mellitus, cardiovascular disease, hypertension, stroke, renal failure, breast cancer, prostate cancer and lead poisoning. The differential nature of dietary practices are conditioned at times by the poverty and marginalisation of the populace, resulting in either disadvantageous or beneficial outcomes relative to others' eating habits. Serious consideration must be given to the possibility that ethnic difference give rise to different requirements and tolerances for essential nutrients and distinct protective or adverse responses to foods and dietary substances. The major challenges to health improvement for the African Diaspora is coming to grips with the policy and programmatic nuances of differential treatment and the effecting the behavioural changes that would be needed in a population skeptical of the motives of media and of the power elites of their societies.

Black or African American↗
PubMed2003

Alleviation of vitamin A deficiency with palm fruit and its products.

The decreased dietary diversity wrought from the adoption of the settled, agrarian system to replace the hunter-gather and pastoralist lifestyles assured a stable supply of protein and calories from grains and tubers while creating a vulnerability for humans to suffer micronutrient deficiencies. The vitamin A from animal tissue is more bioavailable to humans than the provitamin A in the matrix of green plants. Provitamin A carotenes achieve a dietary vitamin A efficacy nearly equivalent to that of the preformed vitamin only in the context of an oily matrix. The homeostatic regulation of carotene bioconversion by the intestine, moreover, prevents any excess toxic accumulation of vitamin A from provitamin A sources. The efficacy and safety of the palm fruit (genus Elaeis) as a source of vitamin A, in addition to its cultural recognition as a food, are more consistent with the gentler concept of "alleviation" of the public health problem of hypovitaminosis A, then the more aggressive, medical model of "eradication" with its greater potential for risk and collateral damage. The palm fruit and its derivatives achieve new opportunities for creative contribution and sustained use in formats of supplementation (prophylactic in children and women, for lactation), food-to-food fortification (in bakery goods and snacks, as condiments), and even in food diversification strategies. Experience in India, South Africa, and Guatemala begins to define and delineate the opportunities and limitations for the palm fruit to contribute to the alleviation of endemic vitamin A deficiency.

Biological Availability↗
PubMed2003

Public health nutrition in Latin America.

An inquiry into options for Masters-level training and into attitudes and perceptions among a convenience sample of nutrition students and professionals from 11 countries suggests that the term, "Public Health Nutrition", as such, is poorly represented and poorly understood in the Latin American region. At least six countries (Brazil, Chile, Cuba, Mexico, Peru, Puerto Rico) at seven sites have Masters programs to provide training for nutrition in a public health context or public health with an emphasis in nutrition. Exploring alliances from the Americas with the formal PHN discipline emerging in Europe should enrich the mutual perspective on curriculum design. However, the form and context of postgraduate training in Latin America must consider first and foremost its own job-markets, diverse public health needs, and resource allocations in building or transforming training programs.

Dietetics↗
PubMed2002

Ethical consequences for professionals from the globalization of food, nutrition and health.

Globalization is the process of increasing interconnections and linkages, within societies and across geography, due to improved communication and expanded world trade. It limits the differentiation wrought by human cultural evolution, and homogenizes health practices, diet and lifestyle. There are both beneficial and adverse consequences of the globalization process. Globalization also presents a challenge to the development of ethics for practice and advocacy by food and nutrition professionals. Among the related terms, 'morals', 'values' and 'ethics', the latter connotes the basic rules of conduct for interactions within society and with the inanimate environment; rules based on recognized principles (ethical principles). The application of these principles is to resolve ethical dilemmas that arise when more than one interest is at play. Recognized ethical principles include autonomy, beneficence, non-maleficence, justice, utility and stewardship. These can be framed in the context of issues that arise during advocacy for material and behavioural changes to improve the nutritional health of populations. Clearly, at the global level, codes of good conduct and the construction of good food governance can be useful in institutionalizing ethical principles in matters of human diets and eating practices. Ethical dilemmas arise in the context of innate diversity among populations (some individuals benefit, whereas others suffer from the same exposures), and due to the polarity of human physiology and metabolism (practices that prevent some diseases will provoke other maladies). Moreover, the autonomy of one individual to exercise independent will in addressing personal health or treatment of the environment may compromise the health of the individual's neighbours. The challenges for the professional in pursuit of ethical advocacy in a globalized era are to learn the fundamentals of ethical principles; to bear in mind a respect for difference and differentiation that continues to exist, and which should exist, among individuals and societies; and to avoid a total homogenization of agriculture and food supplies.

Dietetics↗
PubMed2002

Nutrition and the extremes of life: dilemmas and enigmas of advanced old age.

Pre-term infants born four months before term have a very low birth weight; in an evolutionary sense, they were never 'meant' to survive through the evolutionary period preceding the technological age. In the same way, evolution failed to contemplate survival to ages 50, 60, 70 and beyond. Because peak reproductive performance comes before the vagaries of a given individual's survival is determined, and the fact of that survival conveys no advantage to disseminating the genetic make-up, natural selection cannot select for advantages related to longevity. Moreover, in the larger context of species survival and biodiversity, the crowding of the human ecosphere with older persons would seem to have had more liabilities than assets over evolution. We cannot learn from nature how to feed and nourish the oldest old. The lessons, if any, would be cruelly averse to our humanitarian values. However, we do have values and they guide us to the goal for quality of life for the assorted conditions of the extremely old. The choices are laissez faire or laissez aller. If we are ignorant about how to achieve the goals, perhaps the 'first do not harm' principle should be operative. Should we decide that prescription of diet and adjustment of nutritional stores are required, hypothesis-based research to provide evidence-based practices is required. We may be facing a true Heisenberg principle. The fact that ageing leads to the greatest heterogeneity among individuals complicates the generation of universal principles for prescriptive actions. Another quandary could be the fact that insufficient individuals within the age groups of interest are available for outcome research in any given area to provide statistically robust findings. Shifting once again to the lowest extreme of human survival, we know that what is good for the full-term infant is not the formula for the 600 g premature neonate. Failing to heed the distinction can be lethal. My suspicion is that what is good dietary practice for the younger adult is also not what is best for octogenarians. I would predict that a new intergenerational confrontation is in the offing as we recognise and raise the issues of alimentation of the extremely old. It is the tyranny of the preventive regimens of assorted guidelines to be imposed across the whole population that may exacerbate the tension between young and old, although the young's consuming a more healthful diet will presumably allow more of them to eventually reach the status of advanced age, and hopefully with greater health, vigour and function.

Aged↗
PubMed2002

Dietary assessment tools for developing countries for use in multi-centric, collaborative protocols.

In recent years, increasing interest in the format of multi-centric studies among different populations in developing nations has evolved in the field of health surveys and epidemiology. Dietary intake data are most often part of these cross-cultural and cross-national collaborative efforts. Various questions have been raised about the appropriate endeavours for dietetics and nutritional sciences in developing societies, the instruments available for application, and the pitfalls and caveats in their use. An important consideration is that studies be hypothesis-driven and not mere 'fishing expeditions' of unfocused data gathering. All known dietary intake measurement tools are within the preview of developing country research, but they often must be adapted individually and differentially to suit a given population. In a multi-centric context, this is complicated. The watchword should be collecting comparable information across sites, not using identical approaches. Choice of dietary intake measurement tools must be honed to the hypotheses and assumptions, on the one hand, and the exigencies and pitfalls of working in the developing country milieu, in which linguistics, seasonality, migration, uncommonness of food systems and ethical considerations present barriers and caveats, on the other. Within the hypotheses, the assumptions regarding the penetration of the measured exposures must be borne in mind. Multi-centre studies in developing countries have relevance and importance in the context of food security, diet and disease, eating behaviour and satiety regulation, and nutritional anthropology.

Adult↗
PubMed2002

Nature's perfect food revisited: recent insights on milk consumption and chronic disease risk.

In Swedish volunteers, consuming spaghetti along with milk raises the insulinemic effect of the meal. In Finnish citizens followed for 19 to 24 years for cancer incidence, different consumption patterns of dairy items had different relationships with colon and rectal carcinogenesis. More definitive and conclusive research into how dairy products might influence chronic disease would seem to be warranted.

Adolescent↗
PubMed2002

All that glitters is not iron (deficiency): revisiting the question of why anemic individuals are anemic.

Three recent surveys from Kenya, the Ivory Coast, and East Java emphasize that anemia is a complex and multifaceted public health problem. A thorough understanding of iron metabolism and its disturbance is central to resolving the problem of anemia but requires intricate analysis. To maximize oxygen-carrying capacity and optimize human function, one must combine issues of sociology, economics, and general health with multiple micronutrient interventions.

Anemia, Iron-Deficiency↗
PubMed2002

Malnutrition and excess mortality in Shangri-La.

Populations living at high altitude in the Tibetan highlands suffer extraordinarily high rates of maternal mortality, infant and juvenile mortality, and infectious morbidity. Poverty and living condition, more than altitude, contribute to the adverse statistics. The traditional nomadic herders are the most affected among the residents. The question remains whether contemporary standards of adequate health and nutrition are compatible with the integral folkways of traditional tribal groups.

Humans↗
PubMed2002

Methods for the measurement of nutrition impact and adaptation of laboratory methods into field settings to enhance and support community-based nutrition research.

International nutrition will become increasingly concerned with evaluation of nutritional status at the community level to diagnose situations of risk for nutrient deficits and excesses, and to monitor the impact of remedial interventions. Advances in biologic concepts and technology (particularly miniaturization of assays) are assisting the creation of noninvasive, robust, and acceptable diagnostic tests of nutritional status for field settings. As with more complex and formal assays, the principles of accuracy, reliability, and construct validity need to be applied.

Biomarkers↗