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PubMed1999

Semistarvation-associated eating behaviors among college binge eaters: a preliminary description and assessment scale.

Binge eating is a consequence of semistarvation in victims of war and famine and in volunteers in rare semistarvation experiments. These behaviors include bizarre mixing of ingredients and adulteration of food; eating inappropriate, soiled, or discarded food; secrecy; deception; and defensiveness. Drastic measures to resist overeating persist long after the semistarvation experience, even when food is plentiful. Binge eating, a central feature of bulimia and sometimes of anorexia nervosa, is prevalent in modern society, but the occurrence and frequency of semistarvation-related behaviors have not been well identified or quantified. A Semistarvation-Associated Behaviors Scale was constructed and administered to 40 college students. Among binge eaters, reports of bizarre semistarvation-like behaviors were common and frequent and were associated with dieting.

Adolescent↗
PubMed2006

Prevention of oxidative stress-mediated neuropathology and improved clinical outcome by adjunctive use of a combination of antioxidants and omega-3 fatty acids in schizophrenia.

Schizophrenia is associated with a broad range of neurodevelopmental, structural and behavioral abnormalities that often progress with or without treatment. Evidence indicates that such neurodevelopmental abnormalities may result from defective genes and/or non-genetic factors such as pre-natal and neonatal infections, birth complications, famines, maternal malnutrition, drug and alcohol abuse, season of birth, sex, birth order and life style. Experimentally, these factors have been found to cause the cellular metabolic stress that often results in oxidative stress, such as increased cellular levels of reactive oxygen species (ROS) over the antioxidant capacity. This can trigger the oxidative cell damage (i.e., DNA breaks, protein inactivation, altered gene expression, loss of membrane lipid-bound essential polyunsaturated fatty acids [EPUFAs] and often apoptosis) contributing to abnormal neural growth and differentiation. The brain is preferentially susceptible to oxidative damage since it is under very high oxygen tension and highly enriched in ROS susceptible proteins, lipids and poor DNA repair. Evidence is increasing for increased oxidative stress and cell damage in schizophrenia. Furthermore, treatments with some anti-psychotics together with the lifestyle and dietary patterns, that are pro-oxidant, can exacerbate the oxidative cell damage and trigger progression of neuropathology. Therefore, adjunctive use of dietary antioxidants and EPUFAs, which are known to regulate the growth factors and neuroplasticity, can effectively improve the clinical outcome. The dietary supplementation of either antioxidants or EPUFAs, particularly omega-3 has already been found to improve some psychopathologies. However, a combination of antioxidants and omega-3 EPUFAs, particularly in the early stages of illness, when brain has high degree of neuroplasticity, potentially may be even more effective for long-term improved clinical outcome of schizophrenia.

Antioxidants↗
PubMed2003

Early life predictors of chronic disease.

Many chronic diseases may have their seeds early in life. Observations from the Dutch famine have taught us that the intrauterine environment is an important determinant of adult health. Birth weight has been related to cardiovascular disease (CVD), hypertension, diabetes, and cancer. Critical phases for adult obesity development include time periods between conception and adolescence. A life course approach to chronic disease prevention includes the study of maternal diet during pregnancy, intrauterine exposures, postnatal growth, and the adolescent period.

Adolescent↗
PubMed2006

Genetic predispositions to low-grade inflammation and type 2 diabetes.

Insulin resistance and cardiovascular disease share common pathophysiological mechanisms, as the chronic activation of the innate immune system. This system constitutes the first line of body's defense and is constituted by different barriers (e.g., epithelia, adipose tissue) and different blood and tissue components (e.g., macrophages, neutrophils). This system generates the acute-phase response in which different acute-phase proteins and cytokines are produced in response to different aggressions as infections and traumatisms. The aim of this response is to eradicate these agents, to repair the harmed tissues, and, through increased insulin resistance, to optimize the energetic substrates, which will be drained to vital tissues and organs (i.e., brain and the immune system). Evolutionary pressures have led to survival of the fittest individuals, those with the genetics that allows the best defense against infection and periods of famine. Evidence is reported according to which gene polymorphisms in the molecules regulating the inflammatory cascade are associated with body composition, insulin action, and characteristics of the metabolic syndrome. The evolutive advantages of increased inflammatory responses, hypersecretion of proinflammatory cytokines [tumor necrosis factor-alpha (TNF-alpha), interleukin (IL)-1beta, IL-6, and IL-18], or decreased anti-inflammatory molecules (adiponectin, certain TNF-alpha isoforms, soluble CD14, etc.), would lead in westernized countries to chronic inflammation conditions, such as obesity and type 2 diabetes, resulting in cardiovascular disease.

Diabetes Mellitus, Type 2↗
PubMedDate not supplied

Schistosomiasis: nutritional implications.

Most studies on the interactions of nutrition and schistosomiasis have involved experimental animals. Generally, these studies show that schistosomiasis may be alleviated by severe malnutrition, especially calorie deprivation. However, nutritional modulation of schistosomiasis in experimental animals is observed only when severe deficiencies are induced during the acute disease. Except during overt famine, in humans such severe forms of malnutrition occur mainly in the young, who are not yet exposed to heavy burdens of schistosomal infection. Older individuals, who may be heavily infected, are usually not so severely malnourished. Therefore, the nutritional rehabilitation of severely malnourished children, which should improve immune function, is unlikely to exacerbate the immune-mediated pathogenesis of schistosomal disease. Nutritional interventions can be planned independently of the prevalence or intensity of schistosomiasis in the population. Heavy infection with Schistosoma mansoni can cause both direct nutritional losses and severe disease manifestations. These constitute two important reasons for the administration of mass chemotherapy to the heavily infected segment of a population. Both of these adverse effects can be corrected by a reduction in the intensity of infection; complete cure is not necessary.

Adolescent↗
PubMed1994

Assessing diets to improve world health: nutritional research on disease causation in populations.

Dietary assessment plays a crucial role in our ability to detect relationships between dietary exposure and disease causation. Nutritional problems are at the root of major mass diseases that are impediments to progress toward national and international health goals. This is true for chronic undernutrition and famine as well as many of the chronic diseases afflicting middle-aged and elderly people in industrialized and developing countries. High-quality dietary assessment provides a sound scientific foundation for the primary prevention of mass diseases, whereas inadequate assessment can produce false-negative results and result in apparent inconsistencies between cross-population and within-population findings for a particular disease. The critical role of dietary assessment in the elucidation of disease causation is discussed with regard to high blood pressure, heart disease, breast cancer, and several other major chronic diseases. Improved approaches to dietary assessment need to be made more widely known, not only among research scientists and health practitioners, but also among policymakers who require high-quality dietary data for establishing nutrition goals and making policy decisions.

Adult↗
PubMed1998

Dietary treatment of severe malnutrition in adults.

The aim of this study was to compare the effects of two diets, differing primarily in protein content, on the nutritional rehabilitation of severely malnourished adults. The study took place in the Concern Worldwide Adult Therapeutic Feeding Centre in Baidoa, the town at the epicenter of the 1992 famine in Somalia. The response to treatment in 573 patients admitted to the center between November 1992 and March 1993 was studied. Mortality, appetite, rates of edema loss, and weight gain in 2 groups of patients receiving either a higher-protein (16.4% of energy from protein) or lower-protein (8.5% of energy from protein) diet were compared. Among edematous patients, the use of the lower-protein diet during the initial phase of treatment was associated with a threefold decrease in mortality (P < 0.05) and accelerated resolution of edema (P < 0.05). Among marasmic patients, no differences in mortality or rate of weight gain were observed. The large reduction in mortality associated with the use of the lower-protein diet in edematous patients appeared to be due to the lower amount of dietary protein. However, differences in the 2 diets other than or in addition to the protein content may have contributed. Notwithstanding, the data obtained suggest strongly that severely malnourished adults, particularly those with edema, recover more successfully with a diet of lower protein content than usually recommended. The lower-protein diet used in this study was much cheaper and more easily obtained than the conventional higher-protein diets in Baidoa.

Adult↗
PubMed2006

Global nutrition dynamics: the world is shifting rapidly toward a diet linked with noncommunicable diseases.

Global energy imbalances and related obesity levels are rapidly increasing. The world is rapidly shifting from a dietary period in which the higher-income countries are dominated by patterns of degenerative diseases (whereas the lower- and middle-income countries are dominated by receding famine) to one in which the world is increasingly being dominated by degenerative diseases. This article documents the high levels of overweight and obesity found across higher- and lower-income countries and the global shift of this burden toward the poor and toward urban and rural populations. Dietary changes appear to be shifting universally toward a diet dominated by higher intakes of animal and partially hydrogenated fats and lower intakes of fiber. Activity patterns at work, at leisure, during travel, and in the home are equally shifting rapidly toward reduced energy expenditure. Large-scale decreases in food prices (eg, beef prices) have increased access to supermarkets, and the urbanization of both urban and rural areas is a key underlying factor. Limited documentation of the extent of the increased effects of the fast food and bottled soft drink industries on this nutrition shift is available, but some examples of the heterogeneity of the underlying changes are presented. The challenge to global health is clear.

Chronic Disease↗
PubMed1987

A comparison of five anthropometric indices for identifying factors of malnutrition.

Five anthropometric indices--weight-for-age, height-for-age, weight-for-height, weight velocity, and height velocity--are compared for identifying factors of nutritional status of children. Data come from Matlab, the field station of the International Centre for Diarrhoeal Disease Research, Bangladesh. Weights and heights on approximately 1,400 children aged 12-60 months were taken 11 times at two-month intervals. Dwelling floor space, a proxy for socioeconomic status, is considered a long-term factor; the 1974-1975 Bangladesh famine, a medium-term factor; and season, a short-term factor of nutritional status. The figures of the indices by socioeconomic status at different times show their power to identify the factors visually; the regression analyses test statistical significance of the factors; and the standardized regression coefficients provide relative power of the indices to identify the factors. Weight-for-age and height-for-age appear best for identifying long- and medium-term factors; weight velocity, for identifying short-term factors. Weight-for-height is third in identifying long- and medium-term factors, second for identifying short-term factors. Height velocity identifies short-term factors only. The effect of short-term factors on height velocity appears approximately four months later than it appears on weight velocity. This study clarifies why certain indices do not predict mortality in this study population and others.

Anthropometry↗
PubMed1986

The world economic crisis. Part 1: Repercussions on health.

The widespread economic crisis has resulted in a fall in living standards in the western hemisphere of over 9% (1981-83) and in Sub-Saharan Africa they have fallen to the level of 1970. Food production in the African countries most seriously affected by drought dropped by 15% between 1981 and 1983. Living standards also fell in some countries in Europe and in some of the poorest countries of Asia. The high cost of fuel, the heavy burden of interest payments and unfavourable terms of trade in Africa and Latin America led to serious unemployment, devaluation of national currencies and formidable austerity policies. While some countries have succeeded in protecting their health services from cuts in public expenditure, in many others cuts in health budgets have been substantial. The effects of the crisis in some countries have amounted to the virtual disintegration of rural health services. There are limited data available to show what has been happening to levels of expenditure on health, but those presented here demonstrate that levels of health expenditure per head have fallen in many countries. The cumulative effects on health of increased poverty, unemployment, underemployment and famine, and the reduced capacity of health services to respond to health problems can be documented with facts for a number of countries in Latin America and Africa. Malnutrition has increased and improvements in infant mortality have been checked or reversed. The economic crisis has placed at risk the health of the most vulnerable.

Africa↗
PubMed2003

Social network analysis for health and social interventions among Kenyan scavenging street children.

Street children are a high priority for health policy and service planning in Kenya. Poverty, wars, famine and disease have resulted in street children having a persistent presence in African cities and towns. The Maastricht Social Network Analysis (MSNA) was implemented as the core instrument in a battery to measure the health status of the street children. Owing to the absence of census data of street children in Kenya and the difficulty in tracking this mobile population, we implemented a mixed snowball and convenience sampling design to recruit research subjects. Three hundred street and orphanage children, and 100 primary school children as a control group, were included in the study. The MSNA provided a social diagnosis that complements the clinical diagnosis of the health status of the sample. Only one main methodological question is presented: is the MSNA applicable to describe the personal social networks of (1). children and of (2). people living in a Kenyan culture? Qualitative field observations, key informant interviews and focus groups inform the adaptation of the MSNA instrument, and improve its face validity. A case series analysis is presented. The main result is that the street children population consists of distinct subgroups defined by the UNICEF classification as 'on' and 'of' the street and by gender. Street children networks have some notable deficiencies depending on the subgroup. Constant across the groups is the deficiency of service providers in their networks. The conclusion is that the MSNA is a suitable instrument for obtaining a social diagnosis and gathering other useful information that helps in understanding the social and health backgrounds, status and daily experiences of Kenyan scavenging street children. Applying the MSNA protocol was successful in the diagnosis and interpretation of the findings.

Child↗
PubMed1992

Protein-energy malnutrition and immunological responses.

Historical accounts have suggested a temporal relationship between famines and epidemics. More recently, careful epidemiologic studies have shown a relationship between nutritional deficiencies and heightened risk of morbidity and mortality due to infectious disease. These observations led to studies that examined the effect of protein-energy malnutrition on immunocompetence. The lymphoid tissues, particularly the thymus, were found to be atrophied. There was a reduction in delayed cutaneous hypersensitivity, fewer T cells, especially T helper cells, decreased thymulin activity, impaired secretory immunoglobulin A antibody response, decreased antibody affinity, reduced concentration and activity of complement components and phagocyte dysfunction. These observations were then applied to the study of individual nutrient deficiencies. The interactions of protein-energy malnutrition and the immune system have generated many practical and clinical applications.

History, 20th Century↗
PubMed1997

Increased virulence of coxsackievirus B3 in mice due to vitamin E or selenium deficiency.

Nutrition has long been known to affect the ability of the host to respond to infectious disease. Widespread famines are often accompanied by increased morbidity and mortality due to infectious diseases. The currently accepted view of the relationship between nutrition of the host and its susceptibility to infectious disease is one of a direct relationship with host immune status. That is, if the nutritional status of the host is poor-due to either single or multiple nutrient deficiencies-then the functioning of the host immune system is compromised. This impairment of the immune response will lead to an increased susceptibility to infectious disease. Clearly, the immune response has been shown to be weakened by inadequate nutrition in many model systems and in human studies. However, what about the effect of host nutrition on the pathogen itself? Our laboratory has shown, using a mouse model of coxsackievirus-induced myocarditis, that a host deficiency in either selenium or vitamin E leads to a change in viral phenotype, such that an avirulent strain of the virus becomes virulent and a virulent strain becomes more virulent. The change in phenotype was shown to be due to point mutations in the viral genome. Once the mutations occur, the phenotype change is stable and can now be expressed even in mice of normal nutriture. Our results suggest that nutrition can affect not only the host, but the pathogen as well, and demonstrate a new model of relating host nutritional effects to viral pathogenesis.

Animals↗
PubMed2001

Nutrition among older adults in Africa: the situation at the beginning of the millenium.

Most Africans enter old age after a lifetime of poverty and deprivation, poor access to health care and a diet that is usually inadequate in quantity and quality. However, nutrition interventions in African countries are directed primarily toward infants and young children, as well as pregnant and lactating women. This situational analysis focuses on two key areas to identify priorities for future research and policy development: the nutritional status of older Africans and determinants of undernutrition. Based on the scant evidence available, the prevalence of undernutrition is high in older African men (9.5-36.1%) and women (13.1-27%); however, in some urban areas there is evidence that older adults are experiencing the nutrition transition. Information on micronutrient status is sparse, yet it appears that anemia related to suboptimal folate status is a particular problem. Important determinants of poor nutritional status in the elderly in the African context include inadequate household food security, war and famine, and the indirect impact of HIV infection and AIDS. The rapidly increasing size of the older population, combined with their increased burden of care-giving responsibilities and severe socioeconomic hardship, indicates an urgent need for increased attention to this group, including applied research on nutrition problems and the development and evaluation of nutrition interventions.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Nutrition surveys in Burma and northeast Brazil.

Participation of the author in the Interdepartmental Committee on Nutrition for National Defense sponsored nutrition surveys of Burma and northeast Brazil is described. These surveys not only collected important data on nutritional status but also guided the subsequent research interests of the author. The Brazil survey results contributed to the creation of legislation that mandated the addition of water-dispersible vitamin A to skimmed-milk powder products. This additive has greatly diminished the likelihood of vitamin A deficiency syndrome occurring in children after famine relief efforts.

Brazil↗
PubMed2006

Foraging and feeding ecology of the gray wolf (Canis lupus): lessons from Yellowstone National Park, Wyoming, USA.

The foraging and feeding ecology of gray wolves is an essential component to understanding the role that top carnivores play in shaping the structure and function of terrestrial ecosystems. In Yellowstone National Park (YNP), predation studies on a highly visible, reintroduced population of wolves are increasing our understanding of this aspect of wolf ecology. Wolves in YNP feed primarily on elk, despite the presence of other ungulate species. Patterns of prey selection and kill rates in winter have varied seasonally each year from 1995 to 2004 and changed in recent years as the wolf population has become established. Wolves select elk based on their vulnerability as a result of age, sex, and season and therefore kill primarily calves, old cows, and bulls that have been weakened by winter. Summer scat analysis reveals an increased variety in diet compared with observed winter diets, including other ungulate species, rodents, and vegetation. Wolves in YNP hunt in packs and, upon a successful kill, share in the evisceration and consumption of highly nutritious organs first, followed by major muscle tissue, and eventually bone and hide. Wolves are adapted to a feast-or-famine foraging pattern, and YNP packs typically kill and consume an elk every 2-3 d. However, wolves in YNP have gone without fresh meat for several weeks by scavenging off old carcasses that consist mostly of bone and hide. As patterns of wolf density, prey density, weather, and vulnerability of prey change, in comparison with the conditions of the study period described here, we predict that there will also be significant changes in wolf predation patterns and feeding behavior.

Animals↗
PubMed2004

Patterns of diversifying selection in the phytotoxin-like scr74 gene family of Phytophthora infestans.

Phytophthora infestans, the organism responsible for the Irish famine, causes late blight, a re-emerging disease of potato and tomato. Little is known about the molecular evolution of P. infestans genes. To identify candidate effector genes (virulence or avirulence genes) that may have co-evolved with the host, we mined expressed sequence tag (EST) data from infection stages of P. infestans for secreted and potentially polymorphic genes. This led to the identification of scr74, a gene that encodes a predicted 74-amino acid secreted cysteine-rich protein with similarity to the Phytophthora cactorum phytotoxin PcF. The expression of scr74 was upregulated approximately 60-fold 2 to 4 days after inoculation of tomato and was also significantly induced during early stages of colonization of potato. The scr74 gene was found to belong to a highly polymorphic gene family within P. infestans with 21 different sequences identified. Using the approximate and maximum likelihood (ML) methods, we found that diversifying selection likely caused the extensive polymorphism observed within the scr74 gene family. Pairwise comparisons of 17 scr74 sequences revealed elevated ratios of nonsynonymous to synonymous nucleotide-substitution rates, particularly in the mature region of the proteins. Using ML, all 21 polymorphic amino acid sites were identified to be under diversifying selection. Of these 21 amino acids, 19 are located in the mature protein region, suggesting that selection may have acted on the functional portions of the proteins. Further investigation of gene copy number and organization revealed that the scr74 gene family comprises at least three copies located in a region of no more than 300 kb of the P. infestans genome. We found evidence that recombination contributed to sequence divergence within at least one gene locus. These results led us to propose an evolutionary model that involves gene duplication and recombination, followed by functional divergence of scr74 genes. This study provides support for using diversifying selection as a criterion for identifying candidate effector genes from sequence databases.

Algal Proteins↗
PubMed1994

Nutritional influences on fetal growth.

Fetal growth is a complex, multifactorial phenomena, influenced predominately by the mother and the uterine environment. Although nutrient requirements during the first trimester are quantitatively small, nutritional deprivations during this period can adversely affect placental structure and, indirectly, ultimate birthweight. Maternal pregravid weight and gestational weight gain strongly influence fetal growth, with the effect of weight gain lessening as pregravid weight increases. As shown in the famine studies of World War II, below a threshold lower limit of maternal weight, poor maternal nutrition adversely affects both the placental and fetal weight. Specific nutrients may be associated with growth retardation, such as vitamin A, folate, and iron, whereas supplementation with calcium and magnesium may increase birthweight and length of gestation.

Diet↗