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Biomedical subjects

R A Jacob

Publications and source records attributed to R A Jacob.

At least 55 records · Page 3Linked to original sources

Biochemical markers for assessment of niacin status in young men: urinary and blood levels of niacin metabolites.

Biochemical markers of niacin status were studied in healthy young men fed 6.1 to 32 niacin equivalents (NE) per day over an 11-wk period while residing in a metabolic unit. Methylated metabolites of niacin, N1-methylnicotinamide (NMN) and N1-methyl-2-pyridone-5-carboxamide (2-pyr), in urine and plasma were determined during periods of low (6.1 or 10.1 NE per day), adequate (19 NE per day = 1 RDA) and high (25 or 32 NE per day) niacin intakes and after small test doses of nicotinamide. Urine excretion of less than 1.2 mg/d of either NMN or 2-pyr was a reliable indicator of subjects receiving the lowest intake of 6.1 NE/d, but the NMN metabolite was a better marker of subjects ingesting 10.1 NE/d. The ratio of 2-pyr/NMN in urine was not as good a measure of the 6.1 NE/d intake as the individual metabolite excretions and was not responsive to the 10.1 NE/d intake. Plasma niacin metabolites were generally not as reliable as urinary metabolites for identifying subjects receiving low niacin intakes, however, values for plasma 2-pyr dropped quickly and were eventually nondetectable. After a 1 RDA oral dose of nicotinamide, increases in urine and plasma 2-pyr levels above pre-dose baseline values were significantly decreased in subjects receiving low, as compared to adequate, niacin intake. A leucine supplement had no effect on the rate of repletion of niacin-deficient subjects nor on the level of methylated niacin metabolites in urine or plasma.

Adult↗

Nutrient supplement use by healthy elderly.

As part of a nutritional status survey of 691 non-institutionalized men and women aged 60 years and older, supplement use was reported by 45% of the males and 55% of the females. Supplement use was more prevalent in females than males at each age decade. Vitamins C and E were the most commonly used supplements. Mean dietary nutrient intakes were calculated from a 3-day food diary. The percentage of dietary intakes falling below 2/3 1980 Recommended Dietary Allowance (RDA) was comparable for users and non-users of supplements. Use of supplements markedly decreased the proportion of subjects with inadequate nutrient intake (using a 2/3 RDA criterion), particularly for vitamins B6, B12, and D, folic acid, and calcium. However, for both males and females, potentially excessive intake levels (10 times the RDA) of thiamin, vitamin A, and vitamin E supplementation were observed.

Aged↗

Vitamin A analogs as tests for liver vitamin A status in the rat.

Two chlorinated retinol analogs (Ro 11-0503 and Ro 11-8284) were assayed in rat serum and correlated to retinol in liver. Rats were fed a retinol-free diet to deplete their liver stores, then repleted with 0.5, 1.0, 3.0, and 10.0 mg retinyl palmitate/kg diet. Rats were given intraperitoneal injections of the analog then killed after an additional week on the diets. Analogs were measured by HPLC. The relative abundance of both analogs in serum was inversely correlated with the amount of retinyl palmitate in the liver. Serum analog concentrations may be useful as indications of liver retinol stores.

Animals↗

Dietary intakes and biochemical indicators of nutritional status in an elderly, institutionalized population.

A dietary and biochemical assessment of the nutritional status of 260 elderly men and women, 60-101 y (average 80.5 y), was conducted in 15 long-term-care facilities in the Boston area. Subjects were free of clinically apparent terminal or wasting illness. Nutrient intakes were comparable to those in a simultaneously studied free-living population as were most biochemical markers of nutrient status. Although no specific nutrient deficiencies were identified, blood levels of vitamin A and retinol-binding protein in males and of zinc in both sexes were lower in this institutionalized group than in the free-living subjects. Hematologic indices, albumin, prealbumin, and transferrin levels were also lower than in noninstitutionalized elderly populations. These differences may reflect the greater prevalence of chronic diseases and medication use in a long-term-care population. However, there is no evidence that institutionalization in itself leads to impairment of nutritional status.

Aged↗

Vitamin C status and nutrient interactions in a healthy elderly population.

Vitamin C status and interactions with other nutrients were studied in 677 healthy, noninstitutionalized elderly people aged 60-98 y. Although 6% of the males and 3% of the females showed marginal vitamin C status (plasma ascorbic acid 11 to less than 23 mumol/L), only one person had a plasma ascorbic acid (AA) level less than 11 mumol/L. At all levels of total vitamin C intake, mean plasma AA levels were higher in females than males. Vitamin C supplement use was associated with generally higher blood levels of vitamins B-6, B-12, and E and folate in both sexes and with higher levels of retinol in females. However, after both age and the total dietary intake of the specific nutrient being examined were controlled for, plasma AA levels were significantly correlated only with plasma levels of vitamin E and folate in females.

Aged↗

Ascorbic acid, HDL, and total plasma cholesterol in the elderly.

The relationships between ascorbic acid (plasma and dietary) and plasma HDL cholesterol (HDL-C), total plasma cholesterol (T-C) and T-C:HDL-C ratio were examined in a population of 235 males and 445 females, age 60-98 years. Many known or suspected determinants of HDL-C and T-C, including age, sex, triceps skinfold thickness, fasting blood glucose, alcohol intake, and others, were considered as covariates due to their potential confounding or modifying effects on the relationships under study. The results show that plasma ascorbic acid is significantly (p less than 0.05) correlated with HDL-C (r = 0.09), T-C:HDL-C (r = 0.10), but not with T-C (r = 0.03). There is a strong age interaction with the largest effect of ascorbic acid in the youngest age group studied (60-69 years). The effects of dietary ascorbic acid are similar but slightly reduced in magnitude.

Aged↗

The short and long term effect of gastric partitioning surgery on serum protein levels.

The morbidly obese who undergo elective gastric partitioning surgery serve as models of surgical stress and subsequent severe protein calorie restriction. The short and long term effects of gastric partitioning surgery on circulating proteins and the specific micronutrients carried by the proteins were studied in 22 such patients (ages 23-56 years). Serum micronutrient values paralleled the levels of their carrier proteins. Mean concentrations of both short and long turnover proteins decreased significantly in the early postoperative period, whereas the acute phase reactant ceruloplasmin reached preoperative levels by the seventh postoperative day. Transthyretin and retinol binding protein remained depressed with long term reductions in protein and calorie intake, whereas ceruloplasmin and transferrin were somewhat less sensitive to prolonged protein-calorie restriction. Mean serum albumin, after an initial postoperative fall, rose to the baseline level by 1 month after surgery. Serum albumin levels remained within the normal range despite low protein and calorie intakes.

Adult↗

Protein nutriture of a group of free-living elderly.

The adequacy of the protein intakes of elderly people without overt debilitating diseases was investigated on 691 free-living men and women divided into those aged 60-75 y and those greater than 75 y. In both age groups men and women had average protein intakes of 1.02-1.06 g/kg body weight, values well above the safe level of 0.75 g/kg recommended in a WHO/FAO/UNU report. Although plasma concentrations of albumin, prealbumin, and transferrin declined with age, these were not related to low intakes of protein by individual elderly people. Similarly, upper-arm muscle mass was not less in those elderly people at the lower end of the range of protein intakes. Thus in this population of overtly healthy elderly men and women, there was no evidence of protein deficiency in contrast to other surveys where elderly people with chronic diseases were included.

Age Factors↗

Biochemical indices of human vitamin C status.

Biochemical indicators of ascorbic acid (AA) status were studied in eleven young adult males fed the same AA deficient diet for 14 wk in a live-in metabolic unit. Supplements of AA were added to the diet to give AA-intake periods of 65 mg/d (2 wk), 5 mg/d (4 wk), 605 mg/d (3 wk), 5 mg/d (4 wk), 605 mg/d (4 d), and 65 mg/d (3 d). Blood plasma, erythrocyte, and leukocyte AA levels all reflected AA intake, however, plasma AA showed less variability than red cell AA levels and was considerably easier to determine than leukocyte AA. Plasma AA values less than 0.40 mg/dL (23 mumol/L) reflected marginal AA status. The daily AA intake calculated to maintain plasma AA levels of at least 0.4 mg/dL (23 mumol/L) in healthy young men was 41 mg. The average AA intake estimated to maximize the total body pool was 138 mg/d. Urine and salivary AA levels were not useful indicators of AA status because urinary AA levels did not discriminate well between adequate and deficient AA intakes and salivary AA levels did not consistently reflect AA intake.

Adult↗

Effect of varying ascorbic acid intakes on copper absorption and ceruloplasmin levels of young men.

Intestinal copper absorption and blood measures of copper status were studied in healthy young men receiving varying intakes of ascorbic acid (AA) over 14 wk in a live-in nutrition suite. Copper absorption and retention were assessed by measuring absorption of a stable isotope of copper and total fecal copper during four AA intake periods: 2 wk x 65 mg AA/d, 4 wk x 5 mg/d, 3 wk x 605 mg/d and 4 wk x 5 mg/d. Measures of copper status were serum copper and serum ceruloplasmin determined by both enzymatic and immunochemical methods. Copper absorption, copper retention, total serum copper and the serum level of ceruloplasmin protein were not affected significantly by the changes in AA intake; however, the oxidase activity of serum ceruloplasmin was decreased an average of 21% during the high (605 mg/d) AA intake period. The results suggest that in adult men moderate supplemental intakes of AA reduce ceruloplasmin oxidase activity specifically but do not depress intestinal copper absorption or overall body copper status.

Adult↗

Experimental vitamin C depletion and supplementation in young men. Nutrient interactions and dental health effects.

Biochemical indices of AA clearly showed that the young men in this study were brought into various states of AA depletion and repletion according to their dietary AA intakes. While previous studies have postulated that supplemental intakes of AA may adversely affect body status of vitamins B6 and B12, we found no changes in the B vitamin status of the young men receiving varying AA intakes. Moderate AA supplementation (605 mg/day) showed no antagonistic effect on markers of vitamins B6 and B12. Blood markers of fat-soluble vitamins A and E and iron status were not affected by AA intakes. The propensity of the gingiva to become inflamed or bleed on probing was reduced after normal (65 mg/day) AA intakes as compared to deficient (5 mg/day) intakes and upon supplementary (605 mg/day) AA intakes as compared to normal intakes. The results suggest that AA status may influence early stages of gingival inflammation and crevicular bleeding, and warrant further study of the relationship between AA and periodontal health.

Adult↗

Folic acid malabsorption in atrophic gastritis. Possible compensation by bacterial folate synthesis.

Folic acid absorption was studied in 12 elderly subjects with atrophic gastritis and 10 elderly normal controls using tritium-labeled pteroylmonoglutamic acid. Two folic acid absorption tests were carried out on each subject with 120 ml of either water or 0.1 N HCl. Folic acid absorption was significantly lower in subjects with atrophic gastritis than in normal controls (31% vs. 51%, respectively; p less than 0.01). In subjects with atrophic gastritis, folic acid absorption rose significantly to 54% (p less than 0.001) when administered with acid, but did not change in normal controls (50%). Serum folate levels were normal in all subjects. Proximal small intestinal pH was higher in atrophic gastritis subjects than in normal controls (7.1 vs. 6.7, respectively; p less than 0.05), as were bacterial counts of small intestinal fluid (p less than 0.01). Bacteria cultured from the aspirates of subjects with atrophic gastritis were able to synthesize folate in vitro when incubated in a folate-free medium. Atrophic gastritis results in folic acid malabsorption but not in folate deficiency, possibly due to increased bacterial synthesis of folate in the small intestine.

Aged↗

Plasma ascorbic acid in adult males: effects of depletion and supplementation.

We investigated effects of moderately elevated oral doses of ascorbic acid (AS) on plasma AS turnover in healthy men after abrupt alterations in AS intake. Subjects ate a basal diet of conventional food in which only AS intake was changed. Blood specimens were collected from fasted subjects twice each week during depletion periods. Deproteinized plasma was analyzed after derivatization with 2,4-dinitrophenylhydrazine. Subjects remained healthy and never became frankly scorbutic. The kinetics of log-converted plasma AS values for the depletion periods demonstrated that the slopes calculated by least squares were up to 56% higher for six of nine subjects after 600 mg AS/day. The difference between the mean slopes (M) for loss of plasma AS was significantly different (p less than 0.05, n = 6) after 60 mg AS (M = -0.0222 +/- 0.0145) than after 600 mg AS (M = -0.0246 +/- 0.0003). Leukocyte AS concentration decreased 44.6% in the first depletion period and 77.1% in the second.

Adult↗

Fundic atrophic gastritis in an elderly population. Effect on hemoglobin and several serum nutritional indicators.

The ratio of pepsinogen I to pepsinogen II in the circulation decreases progressively with increasing severity of atrophic gastritis of the fundic gland mucosa. Fasting blood was obtained from 359 free-living and institutionalized elderly people (age range, 60 to 99 years). A pepsinogen I/pepsinogen II ratio less than 2.9, indicating atrophic gastritis, was found in 113 (31.5%) subjects. The prevalence of atrophic gastritis increased significantly with advancing age (P less than .05). Within the atrophic gastritis group, 84 had a pepsinogen I level greater than or equal to 20 micrograms/L, indicating mild to moderate atrophic gastritis, and 29 had a pepsinogen I level less than 20 micrograms/L, indicating severe atrophic gastritis or gastric atrophy. A significant increase in the prevalences of elevated serum gastrin levels (P less than .005), low serum vitamin B12 levels (P less than .005), circulating intrinsic factor antibody (P less than .005), and anemia (P less than .025) was observed with stepwise increases in severity of atrophic gastritis. Subjects with atrophic gastritis exhibited a lower mean serum vitamin B12 level (P less than .05) and a higher mean folate level (P less than .05), but no difference was detected in mean hemoglobin levels or serum levels of iron, ferritin, retinol or alpha-tocopherol. It is concluded that serum pepsinogen I and pepsinogen II levels can be used to determine the prevalence and severity of atrophic gastritis, that atrophic gastritis is common in an elderly population, and that atrophic gastritis is associated with vitamin B12 deficiency and anemia. Further, higher folate levels in atrophic gastritis may be related to an accumulation of 5-methyl tetrahydrofolate in serum due to vitamin B12 deficiency and/or greater folate synthesis by the intestinal flora resulting from bacterial overgrowth secondary to hypo- or achlorhydria.

Aged↗

Response of lingual ascorbic acid test and salivary ascorbate levels to changes in ascorbic acid intake.

This study sought to determine whether the lingual ascorbic acid test (LAAT) and measurement of salivary ascorbate reflect plasma and leukocyte ascorbate levels during controlled periods of ascorbic acid depletion and supplementation. Eleven healthy non-smoking men, aged 19-28 years, ate a diet that was repeated every seven days and was adequate in all nutrients except ascorbic acid (AA). This basal diet, which provided less than 5 mg of AA per day, was supplemented with 60 mg of AA per day for two weeks, 0 mg (placebo) per day for four weeks, 600 mg per day for three weeks, and 0 mg per day for four weeks. Oral examinations, the lingual ascorbic acid test, and measurement of salivary, plasma, and leukocyte ascorbate concentrations were conducted throughout the study. Ascorbic acid concentrations in plasma and leukocytes responded rapidly to changes in vitamin C intake. LAAT-derived ascorbate values were unrelated to ascorbic acid intake and plasma and leukocyte ascorbate concentrations. Salivary ascorbate levels approached the lower limits of detection of the assay and remained constant throughout the investigation. Oral hygiene was consistently excellent, and no severe mucosal or periodontal changes were observed. It was concluded that lingual ascorbic acid test values and salivary ascorbate levels are not related to changes in ascorbic acid intake and are not consistent with plasma or leukocyte ascorbate concentrations.

2,6-Dichloroindophenol↗

The effect of controlled ascorbic acid depletion and supplementation on periodontal health.

To determine if systemic levels of vitamin C influence periodontal health, changes in plaque accumulation, gingival health and periodontal probing depth were measured in healthy subjects housed for 3 months in a nutrition suite that provided controlled periods of ascorbic acid depletion and supplementation. Eleven healthy, nonsmoking men, aged 19 to 28 years, ate a rotating 7-day diet adequate in all nutrients except ascorbic acid. This basal diet, which contained less than 5 mg/day ascorbic acid, was supplemented with 60 mg/day ascorbic acid for 2 weeks, 0 mg/day ascorbic acid for 4 weeks, 600 mg/day ascorbic acid for 3 weeks and 0 mg/day ascorbic acid for 4 weeks. Plasma, urine and leukocyte ascorbate levels, Plaque Index, Gingival Index, Bleeding Index and probing depths were monitored throughout the study. A uniform oral hygiene program was maintained in which oral hygiene instructions were reinforced bi-weekly. Ascorbate concentrations in body fluids and leukocytes responded rapidly to changes in ascorbic acid intake. No mucosal pathoses or changes in plaque accumulation or probing depths were noted during any of the periods of depletion or supplementation. However, measures of gingival inflammation were directly related to the ascorbic acid status. The results suggest that ascorbic acid may influence early stages of gingivitis, particularly crevicular bleeding.

Adult↗