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European food and nutrition policies in action. Finland's food and nutrition policy: progress, problems and recommendations.

Some progress has clearly been made in several aspects of Finland's food and nutrition policy: access to nutrition information and education, improvements in mass catering, increased availability of healthier food products, and pricing and quality requirements favourable to a healthy diet. Finnish eating patterns have improved in relation to some recommended foods and macronutrients. The structural changes in farm and food production are largely the result of new political and economic realities both in Finland and internationally, resulting in the Government focusing on fiscal efficiency, decentralization and a more competitive, consumer-oriented market. This new environment is creating pressures to reduce surplus animal fat production and to expand markets in new foods for Finns and other Europeans who, for reasons of demography, health or working or living arrangements, demand new and sometimes healthier foods. Within this context, some health leaders have been able to make and work for proposals that are consistent both with political and economic imperatives and with health needs. Although the populations health status is improving and in some respects is exemplary, diet-related death and illness rates and risk factors (such as serum cholesterol and obesity) are high and their decline, along with some healthy changes in eating patterns, has slowed since the mid-1980s (ironically, since the adoption of the nutrition policy). The more slowly improvements occur, the higher will be the social and economic costs. Major problems in policy implementation exist. Although much has been done in research and demonstration and in the development of national guidelines (in public catering and labeling, for example) there is an apparent lag in translating such soft technology into action and monitoring its implementation in order to develop corrective measures at the operational level. This problem may increase with decentralized budget control and a less regulated market, where listening to the consumer (whether an individual, retailer or caterer) may not necessarily result in healthier products are more accurate consumer information, especially as foreign products and media continue to attract Finnish young people. The lack of a leading strategic body that can authoritatively assess and anticipate problems in implementation, deal with them and coordinate and monitor the necessary action in fundamental to these issues. Rapid progress in economic and farm policy development and food enterprises can provide conditions supportive of health and nutrition goals if such interests are systematically taken into account and allowed to moderate potential negative changes. If it is to be effective, such accounting will require initiative, clarity of strategic purpose and organization by health and nutrition leaders.

Finland↗

Changes in the composition of digesta during passage through the small intestines of steers.

1. Dry matter (DM), organic matter (OM), nitrogenous constituents, carbohydrate constituents and pH were estimated in digesta taken from eight different sites in the small intestines of slaughtered steers given different diets. Amounts of constituents passing different sites were compared using cellulose as a non-digestible marker. 2. Amounts of the different constituents entering the small intestines varied with the type of diet given but the patterns of removal of each constituent were similar regardless of diet. 3. DM and OM were uniformly down the length of the small intestines. Net digestibilities of 0.62 and 0.63 for DM and OM respectively of the amounts measured in segment 1 digesta (first 3 m post-pylorus) were found at the terminal ileum. DM and OM contents of segment 1 digesta were 5 and 8% higher respectively than in abomasal digesta. Significantly smaller amounts of digesta were found in the proximal quarter of the small intestines than in more distal sections. There was a 10% addition of water to digesta in segment 1 compared with abomasal digesta. Of the water entering the small intestines a net 65% was absorbed therein, most absorption occurring in the first half. 4. Ammonia nitrogen was removed uniformly down the length of the small intestines to a net extent of 75% of that in segment 1 digesta. There was an apparent increase of approximately 18% in the total N (TN) content of segment 1 digesta compared with abomasal digesta. There was an approximate net removal of 80% of the TN measured in segment 1 digesta during passage down the small intestines. Over 95% of the digestible TN was removed in the section of tract between 3 and 15 m from the pylorus. Net removal of nucleic acid N (NA-N) up to the distal ileum was 78% of that in segment 1 digesta, most removal occurred in the proximal quarter of the small intestine. Little or no net loss of diaminopimelic acid-N (DAP-N) occurred in the small intestine. 5. Of the carbohydrates entering the small intestines, there was little or no removal of rhamnose, arabinose or xylose. Net removal of ribose, mannose, galactose and 'starch' glucose up to the distal ileum was 82, 76, 54 and 70% respectively of the amounts found in segment 1 digesta. All disappeared uniformly down the length of the small intestine.

Animal Feed↗

Alteration of the fiber and lipid components of a defined-formula diet: effects on stool characteristics, nutrient digestibility, mineral balance, and energy metabolism in humans.

Eighteen healthy males with a body weight of 70.0 +/- 3.1 kg consumed three defined-formula diets that varied only in their fiber and/or lipid components: 1) 6.4% fiber (100% soy polysaccharides) and 13.1% lipid [50% medium-chain triacylglycerols (MCTs), 40% corn oil, and 10% soy oil]; 2) 3.4% fiber (75% oat fiber, 17.5% gum arabic, and 7.5% carboxymethylcellulose) and 15.6% lipid (20% MCTs, 50% canola oil, and 30% high oleic acid safflower oil); and 3) 4.4% fiber (same as diet 2) and 14.5% lipid (same as diet 1). Consumption of diet 2 resulted in slightly firmer stools and provided the greatest amount of fecal output per unit fiber intake. Total dietary fiber (TDF) digestibility was lowest for men fed diets 2 and 3, but nitrogen and lipid digestibilities and energy metabolism criteria were not different among diets. Although mineral excretion patterns differed among treatments, fiber and lipid components of the diets appeared not to be responsible for these differences. Results indicate that fecal output can be maintained with a lower intake of a blend of oat fiber, gum arabic, and carboxymethylcellulose compared with soy polysaccharides. Except for TDF digestibility, alteration of amounts and/or sources of fiber and lipid components of defined-formula diets used in this experiment did not alter nutrient digestibility, energy metabolism, or mineral retention.

Adult↗

Accumulation, distribution and toxicology of dietary nickel in lake whitefish (Coregonus clupeaformis) and lake trout (Salvelinus namaycush).

An 18-day experiment was conducted to investigate the uptake and sublethal toxicity of dietary Ni in adult lake whitefish (LWF, Coregonus clupeaformis) and lake trout (LT, Salvelinus namaycush) fed diets containing 0, 1000 and 10000 microg Ni/g, prepared with and without brine shrimp. The results of this experiment were used to design an experiment of longer duration in which one of the fish species was selected and exposed to lower dietary Ni doses. In the present study feed refusal was observed in LT and LWF fed 10000 microg Ni/g, after three and 4-5 feedings, respectively. LT fed Ni-contaminated diets exhibited different patterns of Ni accumulation than LWF. Increased Ni concentrations in all LWF tissues, except the intestine, were associated with increased doses of Ni. Copper and Zn concentrations in kidney and liver of LWF were altered. Metallothionein concentrations in kidneys of LT fed 1000 microg Ni/g and 10000 microg Ni/g and LWF fed 10000 microg Ni/g and in livers of LWF fed 10000 microg Ni/g (diet without shrimp only) increased significantly. Increased lipid peroxide production in the plasma of LT fed 10000 microg Ni/g was observed. Blood glucose and electrolytes were affected by Ni exposure. Histopathological alterations were observed in kidneys of LWF fed low and high dose diets, livers of whitefish fed high dose diets, and intestines of LWF fed high dose diets and LT fed low and high dose diets. LT fed high dose diets exhibited significant decreases in weight.

Administration, Oral↗

Profiles of obese children presenting for metabolic evaluation.

BACKGROUND: Obesity, increasingly prevalent among children, causes major morbidities, among which is earlier onset of type 2 diabetes mellitus (DM). METHODS: We reviewed charts of children aged 3 to 18 years (n=106). The population was divided into four age groups. Anthropomorphic measurements, family history, diet and exercise patterns, and selected endocrine/metabolic measurements were recorded, and descriptive statistics were calculated. RESULTS: Obesity in one or both parents correlated with a higher percent of ideal body weight (IBW) (p = 0.01). Fifty-eight percent of the children had first- or second-degree relatives with a history of type 2 DM; 9% had relatives with type 1 DM. Fifty-four percent had dieted and exercised regularly. Mean onset of obesity was at 4.2 +/- 0.9 years. Mean cholesterol was elevated at 176 mg/dl. Average BMI was 26.6 in the youngest children (Group 1; normal mean for this age approximately 15.5), and increased to 37.8 in adolescents (Group 4; normal mean approximately 21). Elevated TSH was present in <1% of the population. The number of patients with an abnormal insulin: glucose ratio (>1:4) increased with age. CONCLUSIONS: Childhood obesity in children is correlated with family histories of obesity and DM. Thyroid dysfunction is seldom found, although mild hypercholesterolemia and insulin insensitivity are prevalent, especially among adolescents.

Adolescent↗

Nutritional assessment and diet quality of visually impaired Spanish children.

BACKGROUND: The visually impaired represents a fairly numerous group in Spain although no data on their nutritional status has previously been published. AIM: This work aims to assess the nutritional state of a sample of visually impaired children and the quality of their diet. SUBJECTS AND METHODS: The sample comprised 229 boys and girls aged between 8 and 18 years (mean = 14, SD = 2.6), all of whom had a visual discapacity and were students of the Centros de Recursos Educativos (CREs; Educational Resources Centres) of the Organización Nacional de Ciegos de España (ONCE; Spanish National Organization for the Blind). RESULTS: This sample featured a high prevalence of overweight (25.8%) and obesity (11.8%) according to the international standard. The mean daily energy consumption and the quantity of carbohydrates, fats, proteins and fibre were greater in boys (2604 kcal day(-1); 290 g of carbohydrates, 126 g of fats and 90 g of proteins) than in girls (2159 kcal day(-1), 232 g of carbohydrates, 107 g of fats and 80 g of proteins). No differences in diet intake according to degree of visual impairment were found. Their diet was unbalanced in comparison with the nutritional objectives for the Spanish population, since consumption of carbohydrates was low and that of fats was very high. The results relating to the quality of the diet reveal quite large deviations from the Mediterranean model. Only 11.9% of the whole sample had a value corresponding to a good quality diet. CONCLUSION: The pattern of dietary consumption was the same as that observed in non visually impaired children in Spain in quantity and quality, nevertheless the prevalence of overweight and obesity is higher than in children without visual handicaps.

Activities of Daily Living↗

Does bracing affect bone density in adolescent scoliosis?

STUDY DESIGN: This is a case-control, cross-sectional analysis of bone density. OBJECTIVES: To determine if bracing during growth affects bone density in adolescent idiopathic scoliosis and whether the effect is local or systemic. SUMMARY OF BACKGROUND DATA: Data concerning the effect of bracing on bone mass in adolescents with idiopathic scoliosis are nonexistent. We were concerned that bone mass loss resulting from long-term brace use may be permanent and may predispose to problems with osteoporosis. METHODS: Healthy adolescent females (n = 85) with scoliosis measuring 20-45 degrees and treated either by brace or observation were studied. Dietary calcium, activity level, body mass index, and pubertal status were evaluated. Scoliosis was measured by Cobb angle. Bone mineral density at the hip and spine were measured by dual energy x-ray absorptiometry to differentiate local versus systemic effects of bracing. Lateral scans of the L3 vertebral body were used to minimize the influence of the pedicles, the effect of the scoliosis, and the interference of the ilium. RESULTS: Mean age, height, and weight were similar between braced and observed groups. After adjusting for curve, Cobb angle, body mass index, activity, and diet, two-way analysis of covariance showed L3 and femoral bone mineral density was the same for braced and observed patients, and pubertal status affected spinal bone mineral density but had no effect on femoral bone mineral density. Pubertal status and body mass index accounted for 53% of the variation in spine bone mineral density and was not affected by brace use. Cobb angle, curve pattern, activity, and diet were not associated with bone mineral density. CONCLUSION: Brace treatment does not adversely affect bone mass at the spine and hip in children with idiopathic scoliosis.

Absorptiometry, Photon↗

Urinary excretion and DNA binding of coal tar components in B6C3F1 mice following ingestion.

Urinary excretion of polycyclic aromatic hydrocarbon (PAH) metabolites and DNA binding of coal tar components in male mice were investigated following the ingestion of a coal tar adulterated diet. Male B6C3F1 mice were able to tolerate an F0927 basal gel diet which contained from 0.1 to 1% coal tar (tar weight/dry food weight) for 15 days. Mice maintained on a 0.1 and 0.2% coal tar diet had body weight gains similar to those of control animals. However, mice maintained on the 0.5 and 1.0% diet had body weight gains considerably lower than control values. Chemical-DNA adduct formation was detected and quantified in lung and forestomach tissue of animals on 0.1, 0.2, 0.5, and 1% coal tar containing diets. A dose-related effect was observed in lung DNA adduct formation while no dose effect was observed in forestomach tissue. In addition, overall adduct levels in lung tissue were considerably higher than forestomach levels for animals on the 0.5 or 1% diet. In contrast, DNA adduct levels were highest in the forestomach of animals on diets lower in coal tar content (0.1 or 0.2%). Chemical-DNA adducts of coal tar components were also evaluated for four other coal tar samples which varied in chemical composition. Mice were maintained on diets containing 0.25% of each coal tar for 15 days. Chemical-DNA adducts were detected in lung, liver, and spleen for all animals receiving these coal tar diets. DNA adduct patterns were similar while quantitative differences were observed between coal tar samples and tissue sites. Highest adduct levels were detected in lung DNA. Benzo[a]pyrene content in coal tar samples could not account for the DNA adduct levels observed with coal tar ingestion. The urinary excretion of select PAH metabolites following coal tar ingestion was evaluated by using urine collected on days 1 and 14 of diet administration. The levels of 1-hydroxypyrene in urine, the major PAH metabolite detected, correlated with the pyrene content of these coal tars. These data demonstrate that coal tar components are readily bioavailable following ingestion.

Animals↗

Simplified subcutaneous fat biopsy for nutritional surveys.

Use of a 3 mm skin-biopsy punch results in skin plus an additional core of subcutaneous fat which is adequate for gas chromatographic analysis of fatty acids. This technique is quicker, cheaper and less traumatic than other methods of fat biopsy and is recommended for population surveys of diet where the pattern of fat intake is being investigated. It has been used in a survey for cardiovascular risk factors on some 3 000 subjects and has proved to be safe and acceptable.

Adipose Tissue↗

Phenylalanine and tyrosine kinetics for different patterns and indispensable amino acid intakes in adult humans.

In a previous paper (Am J Clin Nutr 1993;58:670-83) we described results for plasma amino acid changes, leucine kinetics, and body leucine and nitrogen balance in 20 young men receiving diets for 3 wk. The diets were based on the 1985 FAO/WHO/UNU amino acid requirement pattern (modified FAO diet; n = 7), the Massachusetts Institute of Technology (MIT) requirement pattern (MIT diet; n = 7), or the egg-protein pattern (Egg diet; n = 6). It was concluded, in comparison with the MIT and Egg diets, that the modified FAO diet was not capable of maintaining body amino acid homeostasis or balance. Here we report results from tracer studies with L-[O-2H5]phenylalanine and [2H2]tyrosine that were carried out within the same experiment. The modified FAO diet failed to maintain a mean body phenylalanine balance as determined from rates of phenylalanine hydroxylation (corrected for deuterium-isotopekinetic effects); balance was achieved with the MIT and Egg diets. These results further underscore the inadequacy of the internationally proposed amino acid requirement pattern for healthy adults. We recommend interim use of the MIT, tentative amino acid requirement values in all considerations of adult human amino acid requirements and nutrition.

Adult↗

[Complementary feeding practice in Chinese rural children].

The information of complementary foods consumed by 14649 children aged from 4 to 24 months in poor rural areas was analyzed. On average, it was at 6 months old for children to start complementary feeding. Approximately one third of children started complementary feeding at 4-6 months old and 16.4% children were fed cereal foods before 4 months old. Only 50% of children aged 12 months and above consumed vegetables/fruits daily and 38% of them consumed animal foods. However, 15.8% children never ate animal foods, and 20% children were fed formula milk daily after weaning time. The impact of family dietary pattern on children's diet increased along with the growth of children. It is obvious that the irrational food pattern would undermine growth of children and such diet behavior would eventually result in malnutrition. Poor complementary feeding practice in some selected rural areas in China played a negative role on children's growth. Hence, nutrition education to the mothers and caretaker should be emphasized so that to improve their awareness of the importance of good nutrition practice and guide them to feed weaning children reasonably.

Child, Preschool↗

Nutrition and health promotion in older adults.

During recent decades, the concept of health promotion has become a legitimate part of health care because of the aging of the postwar baby boom generation. As this population ages, the potential strain on health care systems will increase because the greatest use of health care services occurs during the last years of life. In older adults there are many correctable health factors that can be assessed through screening protocols. Hypertension, cholesterol, hearing, vision, diabetes, and cancer screening are well integrated into health promotion programs; nutrition promotion programs are not as well integrated. Reluctance to develop health promotion programs for older adults exists because of a perception that they would not follow such plans or change their lifestyles. However, longitudinal studies have shown that health promotion activities extend the number of years of health in older people although the relationship weakens in older age. Changes in diet and exercise patterns are most effective in the prevention of nutrition-related conditions when they are instituted early in life, but positive effects can occur at any age. If nutritional interventions are instituted early, a substantial reduction in health care expenditures may result from a decrease in the incidence or the delayed onset of these conditions. Changes in behaviors (reducing salt and fat intake) were positively associated with a belief that consuming a healthful diet would contribute to better health. The use of a variety of adult education theories and models will enhance behavior changes that lead to more healthful habits and enable a health educator to be successful in effecting change.

Aged↗

[Studies on caries of Ishibashi rat--III. Experimental caries in Ishibashi rat].

Dental caries was experimentally induced in the Ishibashi rats (ISR) by feeding them with conventional diets or with caries-producing diets, and the pattern and severity of their induced carious lesions were compared with those of the Sprague-Dawley rats (SD). Simultaneously, serum antibody titers against Streptococcus mutans and calcium and phosphorus concentration in the sera and in the femurs were compared between the ISR and SD. The results were as follows: 1. When judged by cavities, ISR showed a higher carious incidence and average number of cavities per one rat than the SD, whichever diet the rats were fed. 2. When judged by fissure caries observed on the thin sections of the teeth, both the carious incidence and average number of fissure lesions in the ISR were not always high compared with those in the SD, and there seemed to be a great variation of caries-susceptibility in the ISR. 3. Caries in the ISR seemed to be more progressive than that in the SD. 4. There were no differences in the serum antibody titers against the S. mutans between the ISR and SD. 5. No differences in the concentration of calcium and phosphorus in the sera and femurs were observed between the ISR and SD, whichever diet they were fed.

Animals↗

Paleomicrobiological study in dental calculus: Streptococcus mutans.

Morphological types of bacterial remains preserved in ancient tartar of teeth from extinct human groups, which included some communities of coastal gatherers, fishermen, hunters, and farmers, and those practicing a mixed economy, were analyzed. Previous studies have shown the presence of bacteria in ancient tartar. The aim of this work was to determine whether Streptococcus mutans was present in ancient populations (500-12,000 years old). Teeth samples were from ancient skulls obtained from different anthropological collections: the north and south of Chile (before the Spanish conquest), Palencia, Spain, and an eastern Mediterranean region (Levant). Optical microscopy showed Gram positive and Gram negative bacteria. Scanning electron microscopy identified morphological types of bacteria. Transmission electron microscopy enabled categorization of bacterial structures. Fluorescence microscopy helped label and identify S. mutans, using polyclonal antibodies. Bacterial morphotypes were related to different subsistence patterns. Hunters, fishermen, and gatherers had a less diverse flora with bacillary and coccal morphotypes. Agricultural groups showed greater diversity with additional filamentous and spiral morphotypes. The best preserved ultrastructural feature was the cell wall. The existence and colonization capacity of the mutans-like streptococci preserved in tartar was established for the ancient populations studied, with the exception of Cerro Sotta (south of Chile). Hence, their occurrence could not be related to diet or subsistence pattern.

Antibodies, Bacterial↗

Effects of dietary sewage solids on feedlot performance, carcass characteristics, serum constituents and tissue elements of growing lambs.

Twenty fine-wool wether lambs were allotted randomly at weaning to be fed a conventional diet (CD) formulated for growing lambs, or the same basal mixture plus dried gamma-irradiated solids from primary sewage sludge (SS) incorporated as 7% of the dry matter. Feedlot performance and chemical elements in whole blood were monitored during 90 d, after which lambs were slaughtered and carcass data were collected. Concentrations of Ag, Ca, Cd, Co, Cr, Cu, Fe, K, Mg, Mn, Na, Ni, P, Pb and Zn were measured in livers, kidneys, bones, spleens and muscles. Sewage solids in the diet did not affect performance appreciably, although dressing percentages from lambs fed SS were 4% lower than CD-fed animals (P less than .05). Rib eye areas, fat thicknesses, quality and yield grades were similar (P greater than .05). Element concentrations in whole blood at weaning, after 56 d of the feeding trial and at slaughter did not differ (P greater than .05) between dietary groups. Serum chemistry determinations showed no biologically meaningful patterns related to diets. Lambs fed SS had higher (P less than .05) concentrations of Cu in livers (51.1 vs 34.3 +/- 3.8 micrograms/g, mean +/- SE) and Pb in kidneys (4.0 vs 2.2 +/- .3 micrograms/g) and lower (P less than .05) Mg in kidneys (.69 vs .72 +/- .01 mg/g). None of the elements in spleen and muscle tissue differed (P greater than .05) between diet groups. Lambs fed SS had elevated (P less than .05) bone Co, Cu, Fe, K and Na compared with those of CD.(ABSTRACT TRUNCATED AT 250 WORDS)

Animal Feed↗

MyPyramid food intake pattern modeling for the Dietary Guidelines Advisory Committee.

Modeling analyses using the MyPyramid intake patterns were conducted in collaboration with the 2005 Dietary Guidelines Advisory Committee in response to their research questions and to determine likely effects of possible recommendations on overall dietary adequacy. Scenarios modeled included the feasibility of using the food patterns for lacto-ovo-vegetarian diets, of varying fat levels within the patterns, and of increasing dietary flexibility through food group substitutions. Food pattern modeling was a useful tool to identify possible impacts on diet quality of potential Dietary Guidelines recommendations. Modeling analyses can help researchers explore the overall effect of specific dietary recommendations on intake patterns.

Databases, Factual↗

Residence of college students affects dietary intake, physical activity, and serum lipid levels.

OBJECTIVE: Dietary intake, physical activity, and serum lipid levels of college students living on and off campus were compared. DESIGN: Subjects completed a questionnaire regarding lifestyle factors and a 3-day food record. Lipid levels were determined. SUBJECTS: College students enrolled in an introductory nutrition class. MAIN OUTCOME MEASURES: Energy and nutrient intakes and serum lipid levels. STATISTICAL ANALYSES PERFORMED: Analysis of variance and Student's t tests were used to determine differences in energy and nutrient intakes and serum lipid levels between men and women living on and off campus; chi 2 analysis was used to determine whether there were associations between residence and lifestyle factors; stepwise multiple regression analysis was used to investigate relationships among serum lipid levels, nutrient intakes, and exercise levels. RESULTS: Of the 104 participants, 81% were women and 19% were men; 51% lived on campus. In women, there was a statistically significant difference in age based on residence. Reported percentage of energy from protein was significantly higher in subjects living off campus. Serum triglyceride level and the ratio of total cholesterol to high-density lipoprotein were also significantly higher in students living off campus. APPLICATIONS/CONCLUSIONS: Residence may affect serum lipid levels; living arrangements influence lifestyle factors such as food choices, nutrient content of the diet, and activity patterns. University foodservice directors are challenged to offer low-fat foods that students will choose to eat. Nutrition education is important for all students because their lifestyle may predispose them to development of chronic disease.

Adolescent↗

Impact of energy intake and exercise on resting metabolic rate.

Resting metabolic rate is modulated by the amount of calories consumed in the diet relative to energy expenditure. Excessive consumption of energy appears to increase resting metabolic rate while fasting and very low calorie dieting causes resting metabolic rate to decrease. Since the metabolic rate at rest is the primary component of daily energy expenditure, its reduction with caloric restriction makes it difficult for obese individuals to lose weight and to maintain weight that is lost. Whether exercise has a carry-over effect on resting metabolic rate remains controversial, even though this question has been studied extensively during the last 90 years. Reasons for contradictory results include variations in control of prior diet and exercise patterns, inadequate exercise frequency, intensity and duration, and the possibility of response to exercise varying between individuals. Several lines of evidence suggest exercise may modulate resting metabolic rate. Bed rest in sedentary individuals leads to a reduction in resting metabolic rate. Similarly, in highly trained runners, cessation of daily exercise training lowers resting metabolic rate by about 7 to 10%. Resting metabolic rate is depressed in previously sedentary obese individuals on a very low calorie diet, but it quickly returns to the predieting level when exercise of sufficient frequency, intensity and duration is undertaken while dieting. These findings suggest caloric intake and daily exercise can modulate resting metabolic rate. Exercise of adequate intensity and duration may also enhance resting metabolic rate.

Basal Metabolism↗