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Biomedical subjects

S Hercberg

Publications and source records attributed to S Hercberg.

At least 37 records · Page 2Linked to original sources

Comparison of the diet of self-declared diabetics with non-diabetic patients in the SU.VI.MAX study: did the diabetics modify their nutritional behavior?

OBJECTIVE: Dietary recommendations, a pillar in the treatment of diabetes, form part of official guidelines. However, it is not known how well these recommendations are followed in the diabetic population in France. The purpose of this study was to compare the habitual diet of self-declared diabetics with non-diabetics and to evaluate whether recommendations are being followed. METHODS: The intakes of several nutrients and foods of 67 self-declared diabetic patients were compared to those of 4658 non-diabetics in the SU.VI.MAX study (a primary prevention trial evaluating the impact of antioxidant supplementation on chronic disease). All patients (aged 45 to 60 years) who had completed at least five 24-hr dietary records over the first 18 months of the SU.VI.MAX study were included. We excluded patients who had not declared a diagnosis of diabetes and those with plasma fasting glucose levels over 7 mmol/l. RESULTS: The diabetic patients who declared being diabetic reported lower carbohydrate intakes (185 +/- 10.4 vs 219 +/- 1.4 g/d for men [p=0.001], 137 +/- 9.6 vs 165 +/- 1.0 g/d for women [0.005]), with a 50% reduction in consumption of oligosaccharides. Lipid intakes were unchanged for men, but reduced for women (61 +/- 4.1 g/d vs 72 +/- 0.4 g/d [p=0.01] with a 20% reduction in saturated fatty acids. Protein consumption was higher in the diabetic than in the non-diabetic men, but comparable for the women. Energy intakes were only lower in the diabetic women (1458 +/- 81 vs 1665 +/- 9 Kcal/d for women [p=0.01]). Micronutrient intakes were similar to those of non-diabetics, but appeared to be inadequate, particularly for anti-oxidants. Diabetic men consumed more margarine and less alcohol than did the non-diabetics. CONCLUSION: Diabetic patients who declared being diabetic did modify their nutritional behaviour, as they reduced their carbohydrate intake (both men and women), increased their protein intake (men only), and decreased their lipid and energy intakes (women only). However, carbohydrate intakes were unbalanced and there was excess protein intake. So patients who declared being diabetic are not as non-compliant in nutrition as commonly thought; they try to modify their diet, but often inappropriately. This may be explained by the fact that dietary advice stems from different sources and may be contradictory. A diabetic education program requires standardised training of health professionals and the provision of unequivocal information to the mass media and the general public.

Antioxidants↗

Evidence for a protective (synergistic?) effect of B-vitamins and omega-3 fatty acids on cardiovascular diseases.

The results of dietary intervention trials favor the hypothesis that higher intakes of B-vitamins (folate, vitamin B(6) and B(12)), and subsequently lower total homocysteine (tHcy) concentrations, are causally associated with a decreased risk of vascular disease in patients with cardiovascular diseases (CVD). The same is true for a higher intake of omega-3 fish fatty acids. Yet, the lack of hard end points and/or appropriate study designs precludes a definitive conclusion about causality. In the future, intervention trials with hard end points and randomized double-blind placebo-controlled designs should be able to elucidate the causality problem. There are several pathways by which B-vitamins and omega-3 fatty acids may exert their protective effect on CVD, a common pathway is a beneficial effect on the endothelial function and hemostasis. With respect to synergy between B-vitamins and omega-3 fatty acids, there is no evidence that fish oils have a tHcy-lowering effect beyond the effect of the B-vitamins. Nevertheless, animal studies clearly illustrate that vitamin B(6)- as well as folate-metabolism are linked with those of long-chain omega-3 fatty acids. Furthermore, a human study indicated synergistic effects of folic acid (synthetic form of folate) and vitamin B(6) together with omega-3 fatty acids on the atherogenic index and the fibrinogen concentration. Although these results are promising, they were produced in very small selective study populations. Thus, confirmation in large well-designed intervention trials is warranted.

Cardiovascular Diseases↗

Contribution of snacks and meals in the diet of French adults: a diet-diary study.

To investigate the relative contributions of meals and snacks in the daily intake of free-living humans, 54 French adults maintained food intake diaries for four 7-day periods. They recorded all food and fluid intakes mentioning whether, in their opinion, each intake event was a snack or a meal. The weekly food diaries also contained information on the circumstances of each event such as time and place, number of persons present, and affective states (hunger, satiety, etc.) before and after intake. On average, 2.7 meals and 1.3 snacks were consumed each day. Very few days included no snacking. Total daily energy and nutrient intake were not different between days with and days without snacks. Snacks differed from meals in several dimensions. Meals were about twice as large as snacks in energy and weight. Nutrient intake, in absolute values, was higher in meals. In proportions, however, snacks contained more CHO and less fat and proteins. Most foods were consumed in larger amounts in the context of meals but a few (sweets, cereal bars, biscuits, and sodas) were mostly consumed as snacks. Hunger was more intense before but less intense after meals than snacks. The satiety ratio was higher for snacks than meals. Time of day affected many intake parameters. For example, afternoon snacks exhibited a high satiety ratio for a modest intake. The present study describes the status of several potential determining factors at the time of snacks in humans, demonstrating a specific role for snacks, as opposed to meals, in the daily eating pattern of healthy adults.

Adult↗

[Hyperhomocysteinemia: an independent risk factor or a simple marker of vascular disease?. 1. Basic data].

Recent epidemiological studies have suggested that hyperhomocysteinemia is associated with increased risk of vascular disease. Homocysteine is a sulphur-containing amino acid whose metabolism stands at the intersection of two pathways: remethylation to methionine, which requires folate and vitamin B12 (or betaine in an alternative reaction); and transsulfuration to cystathionine which requires vitamin B6. The two pathways are coordinated by S-adenosylmethionine which acts as an allosteric inhibitor of the methylenetetrahydrofolate reductase (MTHFR) and as an activator of cystathionine beta-synthase (CBS). Hyperhomocysteinemia arises from disrupted homocysteine metabolism. Severe hyperhomocysteinemia is due to rare genetic defects resulting in deficiencies in CBS, MTHFR, or in enzymes involved in methyl cobalamine synthesis and homocysteine methylation. Mild hyperhomocysteinemia seen in fasting condition is due to mild impairment in the methylation pathway (i.e. folate or B12 deficiencies or MTHFR thermolability). Post-methionine-load hyperhomocysteinaemia may be due to heterozygous cystathionine-beta-synthase defect or B6 deficiency. Patients with homocystinuria and severe hyperhomocysteinemia develop arterial thrombotic events, venous thromboembolism, and more seldom premature arteriosclerosis. Experimental evidence suggests that an increased concentration of homocysteine may result in vascular changes through several mechanisms. High levels of homocysteine induce sustained injury of arterial endothelial cells, proliferation of arterial smooth muscle cells and enhance expression/activity of key participants in vascular inflammation, atherogenesis, and vulnerability of the established atherosclerotic plaque. These effects are supposed to be mediated through its oxidation and the concomitant production of reactive oxygen species. Other effects of homocysteine include: impaired generation and decreased bioavailability of endothelium-derived relaxing factor/nitric oxide; interference with many transcription factors and signal transduction; oxidation of low-density lipoproteins; lowering of endothelium-dependent vasodilatation. In fact, the effect of elevated homocysteine appears multifactorial affecting both the vascular wall structure and the blood coagulation system.

Animals↗

[Hyperhomocysteinemia: an independent risk factor or a simple marker of vascular disease? 2. Epidemiological data].

Elevated plasma total homocysteine (tHcy) is considered as a risk factor for occlusive cardiovascular disease (CVD). This concept is based on the observations of premature vascular disease in patients with homocystinuria and on the association between tHcy and increased risk of CVD in prospective studies. However, some observations have raised questions about tHcy as a risk factor. First, low risk population based prospective studies tend to indicate a weak association or no association between tHcy and CVD. Second, several traditional risk factors for CVD are associated with tHcy and may confound the relation between tHcy and CVD. Third, the C667T transition of the methylenetetrahydrofolate reductase causes a moderate increase in tHcy but no or only minor increased CVD risk. Thus, only placebo-controlled intervention studies with tHcy-lowering B-vitamins and clinical endpoints can provide additional valid arguments for the debate over whether tHcy is a causal CVD risk factor.

Amino Acid Substitution↗

Consequences of iron depletion on health in menstruating women.

OBJECTIVE: To examine the consequences of single iron depletion on health in menstruating women, a common but rarely investigated situation in industrialized countries. DESIGN: We studied data issued from the SU.VI.MAX. cohort via a transversal and a longitudinal (2-y follow-up) approach. SUBJECTS AND METHODS: Iron-depleted menstruating women (ferritin &<15 micro g/l, n=472) were compared with iron-sufficient (ferritin 30-80 micro g/l, n=393) menstruating women (aged 35-51 y) in terms of health variables and quality of life (DUKE score) using logistic regression and analysis of variance. RESULTS: The risk of any infection or of specific types of infections was not increased by iron deficiency. Regarding the DUKE health profile, no specific score was significantly different between the two groups: only the scores reflecting 'physical health' (P=0.09) and 'perceived health' (P=0.12) showed a trend toward a lower level, while the best score for 'mental health' (P=0.11) was found in the group of iron-depleted women. The only significant difference between iron-depleted and iron-sufficient women concerned memory disorders, which were significantly less common in iron-depleted women, Odds ratio=0.7 (0.6-0.9; P=0.03). CONCLUSION: There is no conclusive evidence that an absence of iron stores has negative consequences; however, we must consider that in the case of a worsening of the iron balance, it may lead to a rapid decrease in the level of functional compounds. SPONSORSHIP: The laboratory Robapharm, Pierre Fabre, France.

Adult↗

[The bank of biological material in the SU.VI.MAX study].

The "SUpplémentation en VItamines et Minéraux AntioXydants" (SU.VI.MAX) study is a randomized double-blind, placebo-controlled, primary-prevention trial designed to test the efficacy of a daily supplementation with antioxidant vitamins and minerals at nutritional doses, in reducing several major health problems in industrialized countries, and especially the main causes of premature death (cancers and cardiovascular diseases). This 8-year cohort study started in 1994 in France; 13,535 eligible subjects (women aged 35 to 60, and men aged 45 to 60) were included in 1994 and will be followed up for 8 years. In this paper are described conditions and practical aspects for the realisation of the biological bank developped on the first sample (1994) and completed in 1996 and 1999. Biological material (buffy coat and plasma samples) are saved and stored at -196 degrees C, -80 degrees C and -20 degrees C for any further tests planned at later date (case-control studies and/or validation of new hypothesis).

Adult↗

Background and rationale of the SU.FOL.OM3 study: double-blind randomized placebo-controlled secondary prevention trial to test the impact of supplementation with folate, vitamin B6 and B12 and/or omega-3 fatty acids on the prevention of recurrent ischemic events in subjects with atherosclerosis in the coronary or cerebral arteries.

Cardiovascular diseases are the primary cause of mortality in France. Many epidemiological studies have shown that the total homocysteine concentration is a risk indicator for cardiovascular disease. Furthermore, it has been shown that the homocysteine concentration can be effectively lowered by supplementation with folic acid, vitamin B6 and B12. However, it is not yet known whether a reduction of the homocysteine concentration by such a supplementation indeed leads to a decreased risk of cardiovascular disease. Another possible dietary factor that may lower the risk of cardiovascular disease is fish-oil, which is rich in omega-3 fatty acids. These fatty acids lower platelet aggregation and triglyceride rich lipoproteins and may have antiarrhythmic effects. Some trials have investigated the effect of fish or fish-oil on cardiovascular mortality, and the results, although not conclusive, suggest a protective effect of a higher intake. In the SU.FOL.OM3 study we will evaluate the effect of supplementation at nutritional doses of folate (in the natural 5-methyl-tetrahydrofolate form) in combination with vitamin B6 and B12 and/or omega-3 fatty acids and/or placebo on recurrent ischemic diseases in a factorial design. The supplements will be randomly allocated to the participants in a double-blind fashion. In total 3,000 patients aged between 45 and 80 years who had a past history of myocardial infarction or unstable angina pectoris or an ischemic stroke will be included. The participants will be supplemented and followed up for a period of five years.

Aged↗

Contribution of mineral waters to dietary calcium and magnesium intake in a French adult population.

OBJECTIVE: To assess the contribution of mineral water containing different amounts of calcium and magnesium to the total dietary intakes of these minerals DESIGN: Matched case control study using data issued from the Supplementation en Vitamines et Minéraux Antioxydants (SU.VI.MAX) cohort. SUBJECTS: Subjects were water consumers-240 men and 424 women-divided into the following 4 groups (n=166 per group): regular drinkers of a calcium-rich and magnesium-rich mineral water (calcium, 486 mg/L; magnesium, 84 mg/ L), drinkers of a water classified as a moderately mineralized content (calcium, 202 mg/L; magnesium, 36 mg/L), drinkers of 2 low-mineralized waters (calcium, 9.9 to 67.6 mg/L and magnesium, 1.6 to 2 mg/L, respectively), and drinkers of tap waters. STATISTICAL ANALYSES: Quantitative data were compared using student's t test. Mean comparisons were performed in multivariate analysis by analysis of variance. RESULTS: Dietary calcium intake provided by the various food groups did not differ between the 4 consumer groups, except for calcium provided by mineral water. According to its calcium concentration, mineral water may contribute to one fourth of the total daily calcium intake. Subjects who regularly drink mineral-rich water have a calcium intake that is significantly higher (P< 10(-3)) than those drinking either low-mineral-content water or tap water. Dietary magnesium intake provided by the various food groups did not differ between the 4 consumer groups, except for magnesium provided by mineral water. Depending on the magnesium concentration of the mineral water, it contributed 6% to 17% of total daily magnesium intake. Drinkers of magnesium-rich mineral water and water with a moderate mineral content had magnesium intakes significantly (P< 10(-3)) higher than those of drinkers on low-mineralized or tap water. APPLICATIONS: Mineral-rich water may provide an important supplementary contribution to total calcium and magnesium intake. For dietetics professionals, it may provide-in place of the usual recommendations concerning the consumption of dairy products-a good way to improve calcium and magnesium intakes, particularly in subjects who don't like dairy products.

Adult↗

The use of computerised 24 h dietary recalls in the French SU.VI.MAX Study: number of recalls required.

OBJECTIVE: The 24 h dietary recall is a widely used method to estimate nutritional intakes in epidemiological studies. The objective of the present study was to estimate the number of recalls necessary for an accurate estimation of nutrient intake in French adults followed for 4 y. SUBJECTS AND METHODS: Participants of the SU.VI.MAX study (intervention study on the effects of antioxidant supplementation on chronic diseases) who completed a 24 h dietary recall every 2 months for at least 1 y. Inter- and intra-individual variance ratios (S(w)/S(b)) were calculated by analysis of variance for two time periods: year 1 and 2 (n=4955) and year 3 and 4 (n=1458). The number of recalls necessary was calculated using an accuracy of 0.9. RESULTS: The highest intra-individual/inter-individual variance ratio in the first period was seen for beta-carotene and the lowest for carbohydrate. The number of recalls necessary was five for carbohydrate and calcium intake and 16 for beta-carotene. For proteins, total and saturated fat, fibre, vitamin C and iron eight recalls were required, while nine, 11 and 10 recalls were necessary for mono- and polyunsaturated fat and vitamin E, respectively. The variance ratios in the second period were all lower and fewer recalls were therefore required. The same difference in number of recalls required between the two time periods was observed when only those subjects were included who completed at least 18 recalls (n=727). CONCLUSION: These results indicate that for an accurate estimation of carbohydrate intake only, already five recalls are necessary. Fewer recalls may be needed during long-time follow-up. SPONSORSHIP: The SU.VI.MAX Study has support from public and private sectors: Fruit d'Or Recherche, Candia, Lipton, Kellogg's, Céréal, CERIN, Estée Lauder, L'Oréal, Peugeot, Jet Service, RP Scherer, Sodexho, France Telecom, Santogen, Becton Dickinson, Fould Springer, Boehringer Diagnostic, Seppic Givaudan Lavirotte, Le grand Canal, Danone and Knorr.

Adult↗

Relationships between changes in weight and changes in cardiovascular risk factors in middle-aged French subjects: effect of dieting.

OBJECTIVE: To investigate relationships between changes in weight and changes in cardiovascular risk factors in adults, taking intentionality of weight loss into account. DESIGN: Longitudinal study in middle-aged French subjects from the SU.VI.MAX cohort. SUBJECTS: A total of 1773 men (body mass index (BMI) 25.4+/-3.1 kg/m(2), mean+/-s.d) and 2316 women (BMI 23.3+/-3.8 kg/m(2)) aged 45 y and over at baseline. MEASUREMENTS: Weight, height, blood pressure, serum total cholesterol and fasting blood glucose were measured at baseline and after a 2 y follow-up. Self-reported dieting in order to lose weight, smoking status, leisure-time physical activity, health events and current treatments were assessed through questionnaires. RESULTS: In multivariate analyses, weight change was positively associated with changes in systolic and diastolic blood pressure (P=0.0002 in women, P=0.0001 in men) and with changes in serum total cholesterol (P=0.008 in women, P=0.02 in men), after adjustment for age, baseline level of each cardiovascular risk factor and current treatments. For example, in men, a weight loss of 5 kg was associated with a decrease of 2.5 mmHg in systolic blood pressure and of 1.5 mmHg in diastolic blood pressure. Taking into account self-reported dieting did not modify these associations. CONCLUSIONS: In both genders, systolic and diastolic blood pressure and serum cholesterol increased with weight gain and decreased with weight loss, independently of the intentionality to lose weight. At the population level, modest weight loss may have a substantial impact on cardiovascular risk, and preventing even modest weight gain in adults is an important goal in terms of public health.

Adult↗

Body mass index in 7-9-y-old French children: frequency of obesity, overweight and thinness.

OBJECTIVE: To assess the frequency of different grades of nutritional status (obesity, overweight and thinness) in French children aged 7-9 y using four current definitions based on body mass index (BMI). METHODS: Data were collected in 2000 in a randomly selected sample of French children following the protocol recommended by the European Childhood Obesity Group (ECOG). After computing the BMI (weight/height squared), four references were used to define grades of nutritional status: (1) the French references to define thinness and overweight (3rd and 97th percentiles respectively); (2) the Must et al references to define thinness, overweight and obesity (5th, 85th and 95th percentiles respectively); (3) the International Obesity Task Force cut-offs to define overweight and obesity; and (4) the Center for Disease Control 2000 references to define thinness, overweight and obesity (5th, 85th and 95th percentiles respectively). RESULTS: Age and gender standardized frequencies were estimated in 1582 children. According to the French, Must et al, IOTF and CDC references, overweight (including obesity) affected 16.3, 23.9, 18.1 and 20.6% of children, respectively; obesity affected 9.3, 3.8 and 6.4% of children according to the Must, IOTF and CDC references, respectively. Thinness was present in 3.9, 6.0 and 6.0% of children according to the French, Must and CDC references. Whatever the definition, little difference was observed between sexes. Through age classes, as a rule, overweight and obesity tended to decrease while thinness tended to increase. CONCLUSION: The present study revealed an increasing prevalence of overweight in comparison with previous French data and a trend for increasing prevalence of thinness. The IOTF-based prevalence of overweight (including obesity) in 2000 in France was similar with the prevalence recorded in the late 1980s in the USA and the prevalence of obesity in 2000 in France was similar to the prevalence of obesity in the late 1970s in the USA. Data in France are comparable to those reported in other studies conducted in Western Europe. This study provides baseline information for analysis of time trends and for geographical comparisons.

Body Mass Index↗

Seroprevalence of HSV-1 and HSV-2 infection in the general French population.

BACKGROUND: In spite of the large prevalence and growing incidence of herpes simplex infection (HSV-1 and HSV-2), relatively few large serological surveys are available worldwide and it is still difficult compare frequencies of HSV contaminations in various countries. We present the results of HERPIMAX, the first epidemiological inquiry on HSV prevalence in the general French population. METHODS: Of a cohort of 12,735 presumed healthy adult volunteers included in the prospective study SU.VI.MAX, designed to assess the relation between nutritional supplementations and degenerative diseases, HERPIMAX randomly selected 4412 subjects (females 66.5%, males 33.5%). All serum samples were assessed for HSV-1 and HSV-2 IgG antibodies with a HSV type specific, enzyme immunosorbent assay (EIA). Equivocal result were retested with another HSV type specific immunoblot assay combined with a type common HSV IgG EIA in order to give a definitive interpretation. RESULTS: The mean seroprevalence was 67% for HSV-1 and 17.2% for HSV-2. For HSV-2 the seroprevalence was higher in females (17.9%) compared with males (13.7%) (p<0.001). For both HSV types, there was no significant difference in prevalence as regards age distribution in males and females, whereas prevalence increased significantly with age in females for HSV-1. Univariate analysis showed a significant association between HSV-1 prevalence and education level in males and females (p<0.001) and between HSV-2 prevalence and marital status in both sexes (p<0.001). There were geographical disparities, with a higher HSV-2 prevalence in the south of France as well as in Paris. CONCLUSION: These results confirm a high prevalence of HSV infection in France. They are also in agreement with previous results of other survey carried out in other developed countries as regards higher prevalence of HSV-2 infection in women, the stability of seroprevalence for both HSV types after 35 years of age in females and 45 years of age in males.

Adult↗

Use of multiple correspondence analysis and cluster analysis to study dietary behaviour: food consumption questionnaire in the SU.VI.MAX. cohort.

Although the effects of individual foods or nutrients on the development of diseases and their risk factors have been investigated in many studies, little attention has been given to the effect of overall dietary patterns. The main objectives of this study were to identify dietary patterns and groups of subjects with similar food consumption habits, i.e. 'dietary profiles', using multiple correspondence analysis and cluster analysis. A food frequency questionnaire was sent to a large population-based sample (2923 women and 2,180 men), recruited among the 'SUpplementation en VItamines et Minéraux AntioXydants' (SU.VI.MAX.) cohort participants in France. The food items were dichotomised in order to focus the study on the highest levels of consumption. Multiple correspondence analysis allows the construction of principal components, which optimally summarise the data, and enables the construction of graphical displays. An interesting property of these graphical displays is that associations between food items can be observed on various projection planes, each category of each food item being located at the centre of gravity of the subjects corresponding to this category. An ascending hierarchical classification was unsuccessfully tried in order to determine clusters from these principal components. Therefore, a 'dissection' of the cloud of points was performed according to the orientation of the axes, providing a readily interpretable eight-dietary profiles typology for each sex. This statistical approach allows identification of particular dietary patterns and dietary profiles, which might be more appropriate in studies of diet-disease associations than the single food or nutrient approach that has dominated past epidemiological research.

Adult↗

Consumption of soup and nutritional intake in French adults: consequences for nutritional status.

AIM: The impact of soup consumption on nutrient intake and nutritional indicators was assessed in adults who consumed soup compared to those who did not or who were occasional eaters. METHODS: Data were obtained for 2,188 men and 2,849 women living in France and participating in the SU.VI.MAX cohort, who reported twelve 24-h dietary records during a 2-year follow-up period (60,444 records). Subjects were divided into three groups: (1) those who ate soup 0-2 days or less out of 6 days were classified as occasional or non-consumers; (2) those who consumed soup 3-4 days out of 6 were defined as regular consumers; (3) those who consumed soup 5-6 days out of 6 were defined as heavy consumers. RESULTS: Seven per cent of women and 9% of men were heavy consumers of soup. Respectively, 46 and 42% were regular, and 47 and 49% were occasional or non-consumers. Mean energy intake was lower in heavy consumers than in occasional or non-consumers, but the difference was statistically significant only in women. In men and women, heavy consumers of soup had significantly higher intakes of carbohydrates than occasional and non-consumers (245 g J(-1) vs. 227 g J(-1) in men; 186 g J(-1) vs. 176 g J(-1) in women) and lower lipid intakes (97 g J(-1) vs. 102 g J(-1) in men; 80 g J(-1) vs. 75 g J(-1) in women). Soup consumers presented lower energy intake at dinner than light or non-consumers. In soup consumers, breakfast and lunch contained greater amounts of carbohydrates, lipids and proteins, but dinner contained significantly smaller amounts of lipids and proteins. A higher frequency of BMI > 27 kg m(-2) was found in occasional and non-soup consumers; conversely a higher frequency of BMI between 23 and 27 kg m(-2) was found in regular consumers of soup and a higher frequency of BMI < 23 kg m(-2) in heavy consumers. For women, an association was found between occasional or non- consumers and BMI > 25 kg m(-2) and between heavy consumers and BMI < 22 kg m(-2). Likewise an association was found in men only between heavy consumption of soup and lower value of serum cholesterol. CONCLUSION: The present data suggest that the consumption of soups contributes to a balanced diet. Consumption of soup may be beneficial for a healthy nutritional status in the overall population.

Adult↗