[Food and nutrition management in the Netherlands: control of the results of prosperity. II].
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Biomedical subjects
Publications and source records attributed to R J Hermus.
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The effects of wheat bran and other sources of dietary fibre on serum total and high density lipoprotein(HDL)-cholesterol were investigated in a group of 62 subjects, with rigid control of dietary intake. It was found that a high-fibre diet with vegetables and fruits as well as a low-fibre diet, to which isolated citrus pectin had been added to the same level as present in the vegetables and fruits diet, caused a small decrease in the concentration of serum cholesterol after 5 weeks. Surprisingly, addition of bran (on average 38 g/day) to a low-fibre diet caused an increase in the level of serum cholesterol by on average 0.34 mmol/l (P less than or equal to 0.005). The amount and type of dietary fibre had no substantial effect on the HDL-cholesterol concentration.
In this experiment the effect of dietary cholesterol in a linoleic acid-rich diet on serum cholesterol was tested. In a cross-over design 41 young healthy students received a linoleic acid-rich diet for 4 weeks at two levels of dietary cholesterol. The diet contained 14 to 15 energy% linoleic acid. The high cholesterol diet was obtained by adding two egg yolks a day to the rations. Supplementation of the linoleic acid-rich diet with the egg yolk cholesterol caused a significant rise of serum cholesterol of about 11 mg/100 ml (0.29 mmole/liter). The dietary cholesterol did not influence serum triglyceride levels. The influence on serum cholesterol was much less than expected, based on several predictive formulas. It is concluded that the presence of a high content of linoleic acid in the diet reduces the effect of dietary cholesterol on serum cholesterol if the cholesterol is provided as egg yolk.
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Forty-four healthy free living volunteers were used to study the effect of the removal of eggs from a habitual egg-rich diet. The subjects, recruited by advertising, normally consumed at least 1 egg per day. During the 3-week experimental period they were not allowed to eat any eggs or products containing large amounts of eggs, except cakes and tarts. Elimination of eggs from a habitual egg-rich diet did result in a small but significant decrease in serum cholesterol levels in all subjects. No correlation could be demonstrated between changes in serum cholesterol levels and the age of the subjects and between changes in serum cholesterol levels and the numbers of eggs eaten per week before the experimental period. A significant negative correlation was found between changes in serum cholesterol levels and the Quételet index for obesity and between changes in serum cholesterol levels and the serum cholesterol levels before the experimental period. The results indicate that a very variable response is present in a human population toward dietary cholesterol. More research seems to be necessary to describe and select the population of hyperresponders, the subjects who are more sensitive to changes in dietary cholesterol, and the hyporesponders. The results moreover indicate that effects of dietary changes in a free-living population are much smaller than can be accomplished in populations under controlled conditions.
In a cross-over experiment, 46 young healthy volunteers consumed in succession a high-fiber and a low-fiber diet for 3 weeks at two levels of dietary cholesterol. Half of the dietary fiber came from fruits and vegetables, and the rest from bread and other cereal products. On the high-fiber diet, concentrations of serum cholesterol decreased on average by 0.44 mmole/liter with high-cholesterol and 0.31 mmole/liter with low-cholesterol regimes; high density lipoprotein-cholesterole decreased by 0.1 mmole/liter; on average fecal weight increased by 115 g/day and mean transit time through the gut was decreased by 18 hr. Only part of the decrease in serum cholesterole may be due directly to the high intake of dietary fiber components. The remainder is due to differences in fat intake: during the high-fiber period subjects consumed less fat and cholesterol than had been planned.
A cross-over study was done with 19 male and 23 female volunteers living in a monastery and a convent, respectively. The effect of a fat gish (mackerel) diet on the blood serum lipid composition was studied. As the normal diet of these volunteers was of the lacto-ovo-vegetarian type, a control diet in which the fish was replaced by full-fat cheese was used. Subjects consuming the fish diet had a daily uptake of polyunsaturated acids of the omega3 family of about 8 g; comparable amounts of linoleic acid were ingested with both diets. Both diets were consumed for a period of 3 weeks. Serum cholesterol was slightly but significantly (7.5%) lower and serum triglycerides considerably lower (35%) on the fish diet, whereas high density lipoprotein cholesterol increased slightly. Lipoprotein analysis showed a strong very low density lipoprotein decrease by the fish diet while, in the men, both low and high density lipoproteins increased. The fatty acid composition of serum lipids showed considerable differences; C20:5omega3 increased in all fractions and C22:6omega3 was found in the triglycerides and the phospholipids, but not in the sterol esters. These increases occurred chiefly at the expense of C18:1omega9 and, in particular, C18:2omega6, which indicates a replacement of omega6 by omega3 acids. Long-chain monoenoic acids which are abundant in the mackerel were not detected in any serum lipid fraction.
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This article is based on discussions of the lung cancer panel at the Hohenheim Consensus Meeting organized by the World Health Organization and the German Ministry of Health in November 1996. Panel members were international experts in the field of diet and cancer who discussed specific questions relating to lung cancer risk factors and prevention.
Potential predictors of toenail selenium levels were studied in 1211 men and 1248 women aged 55-69 years. These subjects were randomly selected cohort members without prevalent cancer (other than skin) participating in a prospective study on diet and cancer in the Netherlands. Information on the considered potential predictors (gender, age, smoking, intake of dietary selenium and alcohol, Quetelet index) was collected together with toenail specimens in 1986. The average toenail selenium concentration was significantly (P < 0.001) lower in men than in women: 0.547 +/- 0.126 microgram/g (mean +/- SD) and 0.575 +/- 0.109 microgram/g, respectively. The gender difference remained significant after adjustment for the other variables in multiple regression analyses. Age was not associated with toenail selenium levels in men or women. An inverse association was observed with current smoking but not with past smoking. The average toenail selenium values for male current smokers were 0.513 +/- 0.106 microgram/g (mean +/- SD) versus 0.571 +/- 0.133 microgram/g for male never- or ex-smokers (P < 0.001). For women these values were 0.548 +/- 0.101 and 0.581 +/- 0.109 microgram/g, respectively (P < 0.001). Dietary selenium intake was positively associated with toenail selenium levels in multivariate analyses (P < 0.001), but the association was weak (partial r = 0.09). Alcohol intake and Quetelet index were not significant independent predictors of toenail selenium. The observed associations had similar directions in men and women but were stronger in men.