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PubMed1992

[Prevalence of bone decalcification in the treatment of Crohn's disease].

In clinically active Crohn's disease the bone mineralization is impaired due to calcium malabsorption by the inflamed intestinal wall which is potentiated by diarrhoea and the thus accelerated transit time. To this we must add the shortening of the gut after operations, the inadequate dietary calcium supply or possibly calcium elimination in case of concurrent lactose intolerance. Corticoid treatment leads also to deterioration of bone mineralization. This is the reason why the authors assessed in 98 patients with Crohn's disease the bone mineralization, using the method of clavicular bone index (NIBA). Then treatment was started: a high protein diet, calcium forte, Ossin (sodium fluoride), vitamin D forte, anabolics and regular physical exercise. Check-up examinations after one year revealed that the index was restored in the majority of patients (60.84%) to normal. The above treatment is thus effective. It must be, however, regular and of a long-term character, in some patients it must extend over many years. We had, however, also patients who although subjected to an extensive resection of the gut and treated for prolonged periods with corticoids, had permanently an index between 100 and 120% without treatment.

Adult↗
PubMedDate not supplied

[Diet, nutrition and bone health].

Nutrition is an important "modifiable" factor in the development and maintenance of bone mass and in the prevention of osteoporosis. The improvement of calcium intake in prepuberal age translates to gain in bone mass and, with genetic factor, to achievement of Peak Bone Mass (PBM), the higher level of bone mass reached at the completion of physiological growth. Individuals with higher PBM achieved in early adulthood will be at lower risk for developing osteoporosis later in life. Achieved the PBM, it is important maintain the bone mass gained and reduce the loss. This is possible adopting a correct behaviour eating associated to regular physical activity and correct life style. The diet is nutritionally balanced with caloric intake adequate to requirement of individual. This is moderate in protein (1 g/kg/die), normal in fat and the carbohydrates provide 55-60% of the caloric intake. A moderate intake of proteins is associated with normal calcium metabolism and presumably does'nt alter bone turnover. An adequate intake of alkali-rich foods may help promote a favorable effect of dietary protein on the skeleton. Lactose intolerance may determinate calcium malabsorption or may decrease calcium intake by elimination of milk and dairy products. Omega3 fatty acids may "down-regulate" pro-inflammatory cytokines and protect against bone loss by decreasing osteoclast activation and bone reabsorption. The diet is characterized by food containing high amount of calcium, potassium, magnesium and low amount of sodium. If it is impossible to reach the requirement with only diet, it is need the supplement of calcium and vitamin D. Other vitamins (Vit. A, C, E, K) and mineral (phosphorus, fluoride, iron, zinc, copper and boron) are required for normal bone metabolism, thus it is need adequate intake of these dietary components. It is advisable reduce ethanol, caffeine, fibers, phytic and ossalic acid intake. The efficacy of phytoestrogens is actually under investigation. Some drugs may interfere with calcium and other nutrients and produce an unfavourable effect on bone health.

Bone Development↗
PubMed1992

[Probiotics].

Probiotics, living cultures of micro-organisms, are currently of great interest as counterparts to antibiotics. The idea behind the use of probiotics is that the development and stability of intestinal microflora can be enhanced. The protection against infections is increased, resulting in fewer health problems and increased productivity. The mechanism of action of probiotics is not yet known, although there are several hypotheses. There is increasing evidence to suggest that probiotics act by stimulating the host's immune systems. The only accepted example of effective protection against infections provided by living micro-organism is the 'Nurmi concept', whereby one-day-old chicks acquire an enhanced protection against Salmonella infections when they are administered the complex intestinal flora of older chicks. The effects of probiotics on the growth, feed conversion or production of farm animals are, even in specific situations, not consistent enough to consider their use out of economic considerations. Probiotics are used to (re)establish the intestinal flora of patients or persons with lactose intolerance. The claims that probiotics have cholesterol-lowering and anti-tumour actions are based on animal experiments and require further investigations.

Animal Nutritional Physiological Phenomena↗
PubMed2005

Intake levels and major food sources of energy and nutrients in the Taiwanese elderly.

The purpose of this article is to examine dietary intake levels and major food sources of energy and nutrients for the Taiwanese elderly in order to relate nutrient intakes to food choices and to provide suggestions for dietary improvement. The data were derived from the 24-hour recalls from 1,911 subjects (955 males and 956 females) aged 65 and above, who participated in the Elderly NAHSIT carried out from 1999 to 2000. The differences in food consumption patterns between the elderly and younger adults (aged 19 to 64) were also evaluated by comparison with data obtained from NAHSIT 1993-1996. The results revealed that cereals/roots, meat, other protein-rich foods and fats/oils contributed most to daily energy intake. The energy contributions from fats/oils, poultry, meat, other protein-rich foods, refreshments/snacks, alcoholic beverages, and miscellaneous food groups were lower in elderly diets compared with those of younger adults. Meat and cereals/roots were the major food sources of protein. The main carbohydrate-contributing food group was cereals/roots, while primary lipid sources were meat and fats/oils for the elderly. The food groups with a high contribution to vitamin intake were the following: vegetables for vitamin A; meat and cereals/roots for vitamin B1; dairy products, vegetables, cereals/roots and meat for vitamin B2; cereals/roots, seafood and meat for niacin; meat, vegetables and cereals/roots for vitamin B6; plant oils for vitamin E; and vegetables and fruit for vitamin C. The highest ranked food sources for minerals are listed as follows: dairy products, vegetables and seafood for calcium; dairy products and cereals/roots for phosphorous; vegetables and meat for iron; and vegetables, cereals/ roots, other protein-rich foods and seafood for magnesium. The elderly were found to consume more salt, dairy products and vegetables, but less poultry and meat than their younger counterparts. In summary, differences in consumption patterns between the elderly and younger adults was reflected in differences in common food sources of energy and specific nutrients. The dietary patterns of the elderly are in general "healthier" than that of younger adults except for higher salt intake among the elderly. Nonetheless, our elderly population needs to increase their intake of calcium, magnesium, vitamins E and B6, and dietary fiber, and decrease their consumption of salt. Promoting the ingestion of whole-grain and nut products may be a useful strategy to improve the nutritional status of the Taiwanese elderly, aiming at increasing the percentage of energy obtained from carbohydrates and the daily intake of vitamins E and B6, magnesium, and dietary fiber. Suitable strategies are also needed to improve the calcium status of Taiwanese elderly, particularly as a high proportion of them are either lactose intolerant or dislike dairy products.

Aged↗
PubMed2005

Common variable immunodeficiency (CVID) presenting with malabsorption due to giardiasis.

Common variable immunodeficiency is characterized with B-cell and T-cell dysfunction and hypogammaglobulinemia. Recurrent bacterial infections, such as otitis media, chronic sinusitis and recurrent pneumonia due to diminished immunoglobulin (Ig) levels and impaired antibody production are frequently observed in common variable immunodeficiency. Almost half of the patients with common variable immunodeficiency have problems related to the gastrointestinal system. A 39-year-old woman was referred to our department with the complaint of chronic diarrhea. She had experienced diarrhea without mucus or blood in the last year and had lost 30 kg. In her medical history, she had suffered from recurrent upper and lower respiratory infections like sinusitis, otitis media and pneumonia since childhood. Serum immunoglobulin levels were low. There were no parasites or ova in her stool examinations. Esophagogastroduodenoscopy detected widespread macroscopic nodular appearance on duodenum, and biopsies from the duodenum revealed giardiasis invading the tissue. She was diagnosed as common variable immunodeficiency. After metronidazole therapy and intravenous immunoglobulin infusion was started, her diarrhea attacks ceased and she regained her normal weight. Common gastrointestinal system problems in patients with common variable immunodeficiency are lactose intolerance, lymphoid hyperplasia/diffuse lymphoid infiltration, loss of villi and infection, especially with Giardia lamblia. Giardiasis may lead to severe mucosal flattening and sometimes to lymphoid hyperplasia at the lamina propria of the duodenum. Medical history should be evaluated carefully regarding recurrent respiratory infections. In such cases with chronic diarrhea, common variable immunodeficiency should be kept in mind as a possible cause.

Adult↗
PubMedDate not supplied

Celiac disease symptoms in a female collegiate tennis player: a case report.

OBJECTIVE: To present the case of a collegiate tennis player with celiac disease symptoms. BACKGROUND: Celiac disease is a common intestinal disorder that is often confused with other conditions. It causes severe intestinal damage manifested by several uncomfortable signs and symptoms. Failure by the sports medicine staff to recognize symptoms consistent with celiac disease and treat them appropriately can have deleterious consequences for the athlete. DIFFERENTIAL DIAGNOSIS: Irritable bowel syndrome, Crohn disease, Addison disease, lupus erythematosus, juvenile rheumatoid arthritis, lactose intolerance, herpes zoster, psychogenic disorder (depression), fibromyalgia, complex regional pain syndrome, hyperthyroidism, anemia, type I diabetes. TREATMENT: The athlete underwent a series of blood and allergen tests to confirm or refute a diagnosis of celiac disease. When celiac disease was suspected, dietary modifications were made to eliminate all wheat-based and gluten-based products from the athlete's diet. UNIQUENESS: The athlete was able to fully compete in a competitive National Collegiate Athletic Association Division I tennis program while experiencing the debilitating effects associated with celiac disease. The immediacy of symptom onset was notable because the athlete had no history of similar complaints. CONCLUSIONS: Celiac disease is a potentially life-threatening condition that affects more people than reported. A properly educated sports medicine staff can help to identify symptoms consistent with celiac disease early, so damage to the intestine is minimized. Prompt recognition and appropriate management allow the athlete to adjust the diet accordingly, compete at a high-caliber level, and enjoy a healthier quality of life.

Journal Article↗
PubMed2006

[Functional and inflammatory bowel disorders].

BACKGROUND: Current investigations suggest that postinflammatory mechanisms might induce subtle changes in the mucosa and enteric nervous system which cannot be readily detected by routine diagnostic measures in subgroups of functional bowel disorders, especially in postinfectious irritable bowel syndrome (PI-IBS). DEFINITION OF PI-IBS: Characteristic of IBS is a symptom cluster with abdominal pain/discomfort and altered bowel movement without pathologic findings during routine work-up. PI-IBS is characterized by acute onset of symptoms, fever, vomiting, diarrhea and/or positive stool culture. EPIDEMIOLOGY: The incidence of PI-IBS is 10-17% in unselected IBS patients of whom 70% develop diarrhea, 26% alternating bowel movement and 8% constipation. PATHOPHYSIOLOGY: Initial gastrointestinal infections might induce subtle ongoing inflammation with consecutive altered mucosal function. Pathomechanisms include mutations within the interleukin-(IL-) 10 promoter polymorphism, hyperplasia of specialized cells including Paneth and enteroendocrine cells (EC) through cytokines as well as inflammatory-mediated modulation of neurones and neurotransmitters within the enteric nervous system. DIAGNOSIS, DIFFERENTIAL DIAGNOSIS, AND THERAPY: It is essential to exclude alarm symptoms. IBS can be positively diagnosed with a sensitivity and specificity of > 90% by standardized questionnaires. Indications of PI-IBS are the acute onset of symptoms, fever, vomiting, diarrhea and/or positive stool culture. Differential diagnoses include lactose intolerance, small bowel bacterial overgrowth, bile acid malabsorption, celiac disease, giardiasis, chronic inflammatory bowel disease, collagenous colitis, and diverticulitis. Therapeutic options in PI-IBS remain symptomatic. So far, no specific anti-inflammatory treatment modalities are available.

Biopsy↗
PubMed1991

[Evaluation of a new Israel infant soy formula].

A new infant soy formula has recently been developed in Israel and is being produced (Materna Tsimchit, Trima Industries, Kibbutz Ma'aborot). We compared its efficacy with that of a well-known imported soy formula (Isomil, Ross Laboratories, USA) in a prospective, randomized, double-blind study. 45 normal infants, aged 1-6 months, were monitored for over 2 months after the soy formula was started either because of cow-milk allergy or lactose intolerance. 22 received Materna Tsimchit and 23 Isomil. The study revealed no significant differences between the products with regard to compliance, behavior, symptoms, physical examination (including growth parameters and nutritional assessment), stool characteristics and complete blood counts. We conclude, given the limitations of the present study, that the new Israeli product is as effective as the foreign product.

Growth↗
PubMed1990

Aetiology of bacterial diarrhoea in north Indian children with special reference to Campylobacter jejuni.

A total of 184 cases of acute diarrhoea, in patients aged 1-36 months, were studied clinicobacteriologically. Enteropathogens were isolated in 22.28% cases. Campylobacter jejuni was isolated from 2.17% cases only. Salmonellae were isolated from 7.6% cases and 64.28% of them were S typhimurium. More than 75% of all isolates of salmonellae, shigellae, Esch coli and Campylobacter jejuni were sensitive to gentamicin and cephaloridine. Secondary lactose intolerance was noted in 6.52% cases only.

Campylobacter↗
PubMed1979

[Acute infectious gastroenteritis. Etiology and its correlation with clinical manifestations and fecal mucus].

343 children with acute diarrhea were studied from january 1976 to september 1977. Rotavirus was the agent most frequently isolated (18 per cent) followed by Shigella (12 per cent) and Salmonella (10 per cent). Enterotoxigenic E. coli was identified in 8 per cent and invasive E. coli only in two cases. 80 per cent of isolated rotavirus fell in the neonate group and 25 per cent in the infant group. Diarrhea caused by rotavirus had a short duration, fever was negligible and abundant liquid stools were present without leukocytes in the fecal mucus and with a high percentage (48 per cent) of transient lactose intolerance. Polymorphonuclear leukocytes were found in fecal mucus in 75 per cent of cases caused by Shigella and only in 40 per cent of cases where the causal agent was Salmonella.

Adenoviridae↗
PubMed1990

[Secondary osteopenia].

A total of 2484 newly detected metabolic bone diseases during the past 17 years comprised 79.67% cases of osteoporoses and 20.33% of osteomalacia. The group of osteoporoses included 325 patients (16.43%) with the primary form of the disease, in 1654 patients (83.57%) a cause of decalcification of bones (secondary form) was found. With advancing time the number of secondary osteoporoses rises steadily, while the number of primary cases remains at the same level. In the aetiology of demineralization a major part was played by lactose intolerance, maldigestion and malabsorption, idiopathic, hypercalciuria, diabetes and steroids. The female: male ratio in primary osteoporoses was 4.71:1 and in secondary osteoporoses 2.35:1. Primary osteomalacia was recorded in 113 patients (22.38%) and secondary in 392 (77.62%). Here too with advancing time the number of secondary forms is increasing. The largest groups are hepatic and renal affections, smaller ones malabsorption and antiepileptic drugs. The female: male ratio in primary osteomalacia is 2.13:1 and in secondary osteomalacia 2.26:1. With the development of knowledge on the aetiopathogenesis of bone demineralizations we expect in future a further increase of secondary forms of the disease at the expanse of primary ones.

Female↗
PubMed1990

Nutrition and health in China, 1949 to 1989.

Since the establishment of a new social order in 1949, China's attempts to feed and nurture its large population has been a topic of serious study in many disciplines. This review focuses on dietary sources of Chinese population and incidence, increase and decline of important diet related health disorders in China during the last four decades. Literature published since 1949 on goiter, rickets, riboflavin deficiency, beri beri, vision impairment, favism, cancer, atherosclerosis and coronary heart disease, hypertension, dental and smoking related diseases, diabetes mellitus, pancreatitis, lactose intolerance, mineral deficiency, Kashin-Beck disease, parasitic diseases and genetic disorders are reviewed. Also presented selectively are reports related to ethnodietetics, health care, maternal health and pediatric care as well as longevity. In the 1980s, total caloric intake of Chinese population showed a 19% increase on a daily basis from that of late 1940s. In overall terms, plant derived foods supplied 93% of energy, 87% of protein and 55% of fat to the Chinese. Among the animal foods, pork remains the most common and least expensive form of meat, contributing more than 90% of China's total meat production excluding poultry and fish. In 1949, the life expectancy in China was only 36 years. In early 1980s, it has increased to 68 years. This increase in life expectancy is attributed mostly to improved nutrition and lowering of mortality due to decrease in infectious diseases. Though population, disease and mortality statistics of modern China are spotty and sometimes questionable, common consensus among the researchers is that since 1949 the public health situation in China has improved tremendously.

China↗
PubMed1989

Effect of phototherapy on nutrients utilization in newborn infants with jaundice.

The effect of phototherapy on digestion and absorption of nutrients was performed in 25 male, newborn infants with hyperbilirubinemia. The infants were divided into 2 groups; one group was fed with lactose formula whereas the other group received the non-lactose formula. The quantities of daily volume, fat and energy intakes of both groups were similar. Protein intake was significantly higher in the latter group. During 72-hours of phototherapy, there were decreases in serum bilirubin in all infants and mean weight change was decreased in infants fed with non-lactose formula. Treatment by phototherapy in jaundiced infants did not affect protein, fat and energy absorption. The presence of loose stool, lower stool pH and trace in reducing substances in some subjects fed with lactose formula suggests mild lactose intolerance. Prospective study in clinical trial needs to be further assessed and clarified on other nutrients such as amino acids and riboflavin status in these infants during phototherapy.

Absorption↗
PubMed1989

Oral rehydration therapy in a rehydration centre at a teaching hospital in southern Africa.

A study was carried out to delineate the use of oral rehydration therapy (ORT) for gastro-enteritis in a unit that had previously used intravenous therapy (IVT) almost exclusively. Most children with dehydrating gastro-enteritis who were 5% or less dehydrated received ORT initially, while those who were more severely affected were given IVT. The success rate using ORT alone was 73%, which was much lower than that achieved in other studies. Possible factors associated with this poor outcome are discussed. It was concluded that with the exceptions of lactose intolerance and coexisting infection, lack of commitment to ORT and the easy access to IVT must have contributed significantly to the suboptimal outcome.

Attitude of Health Personnel↗
PubMed1989

[Diabetic osteopathies. 3. The effect of diabetic complications on bone mineralization].

Using the method of assessment of clavicular corticodiaphyseal indices, the authors investigated the mineralization of bones in a group of 215 type II diabetics and in 40 type I diabetics. From both groups patients were selected without detectable complications and these were compared with a sub-group of patients who had some complications. Furthermore the authors investigated the number of fractures of vertebral bodies and other bones. The poorest results as regards mineralization were found in complications which interfere with calcium absorption: enteropathies, chronic pancreatitis, gastrectomies, renal disease and in women also liver disease, in both with impaired vitamin D conversion. An adverse effect was exerted also by a reduced dietary calcium intake in subjects with lactose intolerance or increased urinary calcium excretion in idiopathic hypercalciuria. Low values were recorded in all patients with motor disorders in angiopathies, otherwise this complication alone did not cause major decalcification. Hysterectomy with ovariectomy were manifested by decalcification only in women where the operation was performed during a certain period before the menopause. Neuropathy and retinopathy alone without impaired locomotor activity do not cause deterioration of the bone mineralization in diabetics. Surprisingly good results were achieved also in a group of diabetics with steatosis of the liver but without severe damage of liver function. With a exceptions the number of fractures of vertebral bodies and other bones correlated with the level of their mineralization.

Bone Density↗
PubMedDate not supplied

[Current problems of lactase deficiency].

The tests with lactose loading followed by the assay of blood sugar were conducted in 500 normal subjects, aged from 18 to 89 years, and 262 patients with gastro-intestinal diseases, aged from 25 to 55 years. When lactose malabsorption was detected, aspiration biopsy of the small intestine mucosa was performed followed by the study of the structure and the level of a number of disaccharidases (lactase, maltase, saccharase). Lactose malabsorption was detected in 72 (14.4%) out of 500 normal subjects (10.6%--aged 18-59, and 20%--aged 60-89 years), among them there were 12.5% of Russians, 13% of Byelorussians and 5.8% of Ukrainians (aged 25-55 years). The secondary lactose malabsorption was recorded in 44% of patients with ulcerative colitis, in 33% of patients with chronic enterocolitis, in 11.5% of patients with gastric ulcer, in 8% of those with duodenal ulcer, in 23.5% of patients with chronic gastritis attended by lowered secretory function, and in 8% of those with enhanced secretory function.

Adolescent↗
PubMed1986

Distribution of adult lactase phenotypes in the Tuareg of Niger.

The adult lactase phenotype, lactose absorber or malabsorber, was determined using the lactose tolerance test with breath hydrogen assay in a group of Tuareg, a traditionally nomadic pastoralist population in the central Sahara. Out of a total of 118 subjects, 103 (87.3%) were lactose absorbers and 15 (12.7%) lactose malabsorbers. The frequency of the "lactase suppression gene" in this population sample was .357 (SD .043). The low frequency of lactase suppression in the Tuareg supports the hypothesis of natural selection in favor of the "lactase persistence gene" in milk-dependent nomadic pastoralist.

Adolescent↗