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PubMed1983

An approach to urticaria.

As the problem of chronic urticaria is frustrating both to the physician and patient, an attempt to study its aetiology was made. 100 cases of chronic urticaria was studied in 1979. Patients having daily urticaria for more than 6 weeks, were included. There were 52 males and 48 females. A detailed history of the pattern of urticaria, drugs, physical causes, diet and illnesses were asked for, followed by physical examination. Each were then screened through a Diagnostic Tray including basic haematological tests, urinalysis, stools analysis, physical allergy tests, food provocation battery and further special tests. 17 patients had physical urticaria, cold (6), pressure (5), delayed dermographism (1), cholinergic (4), solar (1). 4 patients had severe reactions with aspirin, one with tetracycline; one had undiagnosed thyrotoxicosis. 36 of all the patients had a positive test on provocation with the food battery: aspirin (13), preservatives (3), colour dyes (6), yeast (1) and others (15). It has been suggested that these are not the immediate cause but are aggravating factors. 48% of patients showed dermographism. The number of idiopathic cases about 77% is consistent with the findings of others. We feel that an attempt to exclude treatable causes has brought reassurance to many of the patients. Long term antihistamine therapy was given in these cases.

Adolescent↗
PubMed1981

The major psychoses and neuroses as omega-3 essential fatty acid deficiency syndrome: substrate pellagra.

Pellagra was once a major cause of three behaviorally different mental disorders-schizophreniform, manic-depressive-like, and phobic neurotic - plus drying dermatoses, autonomic neuropathies, tinnitus, and fatigue. In this preliminary study all three of the corresponding present-day mental diseases are found to exhibit, statistically, the same pellagraform physical disorders but to ameliorate not so much with vitamins as with supplements of a newly discovered trace omega-3 essential fatty acid (w3-EFA), which provides the substrate upon which niacin and other B vitamin holoenzymes act uniquely to form the prostaglandin 3 series tissue hormones regulating neurocircuits en block. Since present-day refining and food selection patterns, as well as pure corn diets, deplete both the B vitamins and W3-EFA, the existence of therapeutically cross-reacting homologous catalyst and substrate deficiency forms of pellagra are postulated, the first contributing to the B vitamin deficiency epidemics of 50-100 years ago, the second to the more recent endemic "Diseases of Western Civilization" which express in certain genetic subgroups as the major mental illnesses of today.

Adult↗
PubMedDate not supplied

Immunogenicity of cows' milk in man. (Influence of age and of disease on serum antibodies to five cows' milk proteins).

Passive haemagglutination has been used to measure serum antibodies to the five proteins of cows' milk--bovine serum albumin, bovine gamma-globulin, alpha-lactalbumin, beta-lactoglobulin and casein. Titres of antibodies to these proteins, and a composite cows' milk antibody (CMA) score, have been measured in 1,087 sera from children and adults. Antibodies to all five proteins were detected in many specimens. Age and disease influenced not only the absolute titres of antibody, but also the relative distribution of antibodies to the five antigens. In infants aged 2 months the typical pattern was of antibodies only to casein but in the sera of older children and adults antibodies to casein and to BSA were found in low titres and less frequently than antibodies to the other proteins. Children with coeliac disease had higher titres of antibody to bovine gamma-globulin than to other antigens. Serial studies in a patient with cows' milk intolerance illustrate how the pattern of antibodies varies with age, diet and disease.

Adult↗
PubMed1994

[Determination of bile acids in stools of patients with colonic neoplasms and adenomatous polyps].

Since several years ago, the biliar acids have been incriminated in the etiopathogeny of colon cancer and adenomatous polyps, above all the secondary ones, involved by its aggressive action over the colonic epithelium in these mechanisms. The dietetical habits of developed countries have the high responsibility for this situation, their food pattern being a high animal fat diet, high in refined carbohydrates, animal proteins and low in dietetic fiber (diet type "occidental") unlike to developing countries that have a high natural fiber diet, having a much lower incidence in colon cancer and adenomatous polyps. Dietetic fiber has been studied considering it with a protector effect over the aggressive action of biliar acids on the colon mucous. We have studied 60 patients, 20 of them with colon cancer, 20 with adenomatous and 20 case controls without colonic pathology. All of them had total high biliar acids in stools, a dietetical screening was carried out to determine the intake of animal fat and dietetic fibre during a week. There was a significant correlation in cases of cancer, polyps and biliar acids high in stools. There was also a significant correlation between the undue dietetic habits in colon cancer patients and high bilar acids. In those cases of adenomatous polyps, there was not a significant relation to dietetic habits.

Adenomatous Polyps↗
PubMed1993

Strategies for primary coronary heart disease prevention.

With increasing knowledge of coronary heart disease (CHD) epidemiology, it has become apparent that preventive treatment of high-risk individuals--the high-risk strategy--will reduce individual risk but is insufficient by itself to reduce the burden of CHD in the population as a whole because more than half of the future victims of CHD have risk factor levels below the high range, leaving these persons unprotected. Since the relationship between risk factors and clinical CHD risk is continuous in most instances, without a sharp dividing line between high and low risk, the aim of optimal preventive action must be to shift the entire risk factor distribution curves to the left, in order to reduce the number of persons in the upper end of the distribution on the right. The strategy designed to effect this shift is the community strategy which requires that the whole population adopts preventive measures, i.e. makes changes in lifestyles, especially as regards diet, smoking habits, daily exercise and patterns of stress which favour unhealthy habits or may be harmful in themselves. The two strategies are not alternatives but complementary and, for optimal effectiveness, must be carried out simultaneously in the community. It can be shown that the combined strategy is more effective than either strategy alone. Each of the strategies has on comparison its own particular strengths, adding up to create a community climate favourable for prevention. The practicing physician is primarily concerned with the high-risk strategy but also plays an essential role in providing active support for the community strategy through giving preventive advice on health-promoting living habits to all of his patients and their families.

Coronary Disease↗
PubMed1996

Circadian patterns of total 24-h hydrogen and methane excretion in humans ingesting nonstarch polysaccharide (NSP) diets and the implications for indirect calorimetric and D2 18O methodologies.

OBJECTIVES: To quantify the relationship between substrate fermentation and total 24-h H2 and CH4 excretion on mixed diets and to assess errors incurred in the calculation of energy expenditure and fuel selection by the exclusion of these gases from standard calculations. DESIGN AND SUBJECTS: Twelve healthy, lean men were studied over two consecutive dietary periods of 3 weeks. Measurements of total H2 and CH4 excretion were made during 24h within a whole body calorimeter. Subjects were fed a diet containing 16 g or 38 g of nonstarch polysaccharide (NSP) and 16 g or 19 g resistant starch (RS). Colonic fermentation was measured by balance techniques during the two dietary treatments. RESULTS: There was an inverse non-linear relationship between H2 and CH4 excretion on both diets (r2 = 0.53; P < 0.001), but absolute excretion did not increase significantly as the intake of NSP and RS (from 28 +/- 3 and 48 +/- 4 g/day) increased. No relationship was found between daytime and 24-h measurements of H2 and CH4. H2 and CH4 excretion introduces an error of less than 0.2% and 1% in calculations of energy expenditure and CO2 production from the standard human equations used in indirect calorimetric (IC) and doubly labelled water (DLW) methodologies respectively, and less than 2% in fuel utilisation calculated as % non-protein energy expenditure from IC. CONCLUSIONS: This study provides evidence that neither daytime nor total 24-h rates of H2 or CH4 excretion accurately predict degree of fermentation of NSP+RS in either individual subjects or groups of subjects, probably because of changes in the stochiometry of the fermentation process.

Adult↗
PubMed2000

Prospective study of major dietary patterns and risk of coronary heart disease in men.

BACKGROUND: Previous studies on diet and coronary heart disease (CHD) focused primarily on individual nutrients or foods. OBJECTIVE: We examined whether overall dietary patterns derived from a food-frequency questionnaire (FFQ) predict risk of CHD in men. DESIGN: This was a prospective cohort study of 44875 men aged 40-75 y without diagnosed cardiovascular disease or cancer at baseline in 1986. RESULTS: During 8 y of follow-up, we documented 1089 cases of CHD (nonfatal myocardial infarction and fatal CHD). Using factor analysis, we identified 2 major dietary patterns using dietary data collected through a 131-item FFQ. The first factor, which we labeled the "prudent pattern," was characterized by higher intake of vegetables, fruit, legumes, whole grains, fish, and poultry, whereas the second factor, the "Western pattern," was characterized by higher intake of red meat, processed meat, refined grains, sweets and dessert, French fries, and high-fat dairy products. After adjustment for age and CHD risk factors, the relative risks from the lowest to highest quintiles of the prudent pattern score were 1.0, 0. 87, 0.79, 0.75, and 0.70 (95% CI: 0.56, 0.86; P: for trend = 0.0009). In contrast, the relative risks across increasing quintiles of the Western pattern score were 1.0, 1.21, 1.36, 1.40, and 1.64 (95% CI: 1.24, 2.17; P: for trend < 0.0001). These associations persisted in subgroup analyses according to cigarette smoking, body mass index, and parental history of myocardial infarction. CONCLUSIONS: These data suggest that major dietary patterns derived from the FFQ predict risk of CHD, independent of other lifestyle variables.

Adult↗
PubMedDate not supplied

[The nutrition of liver transplant patients in an intensive medicine service comparing the years 1989 and 1992].

We examined the possible changes undergone in the form of feeding post liver-transplant patients admitted to our Intensive Care Unit (ICU), comparing 1989 and 1992. As biological nutritional parameters, we reviewed blood lymphocyte values and albumin prior to the transplant, immediately after, seven days following and on discharge from the ICU. In the two periods studied, we assessed the features of the nutritional support received by these patients (type and chronology). We found that, in 1992, parenteral nutrition (in significant form, p = 0.04) and oral diet (as trend, p = 0.06) was initiated earlier than in 1989. We noted a tendency to change the overall nutritional pattern, with an increase seen in 1992 in oral diet and a reduction in parenteral nutritional when compared to the 1989 period. In 1992, 24% of patients received oral diet as a first nutrition as against none in 1989. These data must be correlated with the time in the Intensive Medicine Service and the tendency to reduce mortality, even though transplant patients in 1992 were significantly older than in 1989, while their selection and the base pathology altered the pattern of these patients.

Adolescent↗
PubMed1976

Nitrogen metabolism in calves. Effect of giving different amounts of dietary casein with and without formaldehyde treatment.

I. Calves were given a basal diet of straw and flaked maize (12 g nitrogen/kg dry matter (DM)) or diets with some flaked maize replaced by untreated (UT) casein or formaldehyde-treated (FT) casein to give 19, 29 or 34 g N/kg DM. 2. At all intakes rumen ammonia concentrations were lower and amounts of total-N, non-ammonia-N and amino acid-N entering the duodenum were high when FT-rather the UT-casein supplements were given. 3. Direct measurement of casein entering the duodenum indicated that giving FT rather than UT casein led to much greater amounts of dietary casein escaping degradation in the rumen (70--90% compared to 10--20%). Calculated values for fermentable N indicated that with this low degradability diets containing FT-casein would have provided inadequate N for maximum microbial synthesis in the rumen, and this probably accounted for the marked reduction in amounts of non-casein-N entering the duodenum when FT rather than UT casein was given. 4. Amino acid patterns in duodenal digesta samples after giving the basal diet or diets containing UT-casein were similar. Giving diets containing FT-casein led to changes in this pattern which could sometimes, although not always, be accounted for by estimated differences in proportions of dietary and microbial proteins. 5. At the highest level of N intake FT-casein-supplemented diets led to significantly higher concentrations of most essential amino acids and lower concentrations of most non-essential amino acids in plasma than did UT-casein-supplemented diets. Plasma urea concentrations increased with increasing N intake but were not significantly different for UT- and FT-casein-supplemented diets.

Amino Acids↗
PubMed1976

Plasma free amino acids of children consuming a diet with uneven distribution of protein relative to energy.

Adequate N retention and growth have been demonstrated in children consuming diets in which the total daily protein is fed in a single meal, energy intake being spread over a 14 hour period. To elucidate how adequate protein nutriture continues when protein is not consumed in parallel to energy, plasma free amino acids were measured in 11 children fed a casein-modified cow's milk based diet providing all protein (6.4% of calories) in one feeding, while energy was evenly distributed among five feedings. Children were fed at 0800 hours, 1200 hours, 1500 hours (protein-containing meal), 1900 hours, and 2200 hours. Fasting plasma aminograms were determined in all 11 children. During a long-term growth study with the diet, six children had additional determinations 3 and 4 hours after the first feeding on the same day on which the fasting sample was obtained; samples prior to and 3 and 4 hours after the 1500 hour feeding were obtained on a different day. In a seventh child, all six samples were obtained on a single day. Fasting values for total amino acids (TAA), total essential amino acids (TEAA) and TEAA/TAA, Val, Ile and Pro were elevated in most cases, a pattern seen in children fed high protein diets. The 1100 hour and 1200 hour samples showed a marked decrease in TAA, TEAA and TEAA/TAA. A further drop at 1500 hour produced a pattern characteristic of protein deficiency. Following the protein containing meal, TAA increased 50-100%, TEAA 100-200%, with disproportionate increases in Leu, Ile, Val and Pro. The persistence of this pattern in some cases up to 17 hours suggested that EAA were available for protein synthesis when additional energy was subsequently consumed. An aminogram characteristic of protein deficiency was seen only 18-20 hours after the last protein intake.

Amino Acids↗
PubMed1987

Sensitivity of tumour cells to heat and ways of modifying the response.

In our view, the initial effect of hyperthermia on cells is the disorganization of the membrane lipid. Such disorganization alters the membrane's biophysical properties leading to passive changes in transmembrane permeability, shifts in surface charge, and altered stereoorganization of macromolecules associated with the membrane. For example, the passive permeability changes could account for the observed increase in the association of non-histone proteins to chromatin. Surface charge changes resulting from relative changes in the phospholipids could shift the concentration and types of membrane-bound proteins. Such events could initiate hyperthermic cell death. Membranes of tumour cells are characterized by elevated cholesterol. Such differences in cholesterol concentration with their attendant shift of biophysical characteristics could explain the variation in heat sensitivity between cell lines and within the cell cycle. Further support for lipids being the initial target comes from our studies demonstrating enhanced thermosensitivity when anaesthetics are present. Thermosensitivity of solid tumours is not further influenced by lidocaine in host animals fed diets enriched in linoleic acid, a diet which markedly modifies fatty acid, phospholipid patterns and cholesterol concentration of cellular membranes. One should recognize that global measures of change, such as the ratio of unsaturated to saturated fatty acids, in unsaturated fatty acid index, or percentage of unsaturated fatty acids, may not accurately reflect changes in fatty acid patterns which are related to changes in thermosensitivity. For example, we now recognize that double bond location with respect to the headgroup must be considered as well as the relative content of unsaturated fatty acids in the membrane. Further studies bearing on the role of diet and anaesthetics on cell killing and on metastatic spread are needed. An increased understanding of the relationship of membrane biophysics and biochemistry correlated with how cells respond to heat could aid in elucidating the mechanisms of cell death. Such knowledge could provide a more rational basis for cancer therapy. The association between pyrexia and tumour regression was noted as early as 1866 by Busch who observed neoplasm remission in patients afflicted with severe erysipelas (Busch, 1866). Over the past 80 years clinicians have on occasion treated tumours by heat alone or, more recently, in combination with radiotherapy (Dickson, 1979; Jensen, 1903).(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1975

A tool for individualized management of fat-controlled diets.

Presently recommended fat-controlled dietary plans are rigid in pattern and require omission of some foods and substitution of others with little regard for the individual's food preferences. A tool for individualized management of fat-controlled diets has been developed. Commonly eaten foods have been grouped according to their fat content. After the patient's habitual dietary intake is analyzed by computer or food composition table, changes in the diet are recommended, using the food groups, so that the guidelines of a fat-controlled diet may be met with a minimum deviation from individual food preferences.

Adult↗
PubMed2001

The influence of body weight on food and shape attitudes in severely obese patients.

BACKGROUND: Cognitive restraint, binge eating, night eating, body image disparagement and shape overconcern describe the food and weight related attitudes of obese patients. POSTOPERATIVE FINDINGS: At long term follow-up after biliopancreatic diversion, body weight is steadily at normal or nearly normal levels regardless of food intake: any preoccupation for food, weight and diet are thereafter completely abandoned. The normalization of body shape corresponds to a sharp improvement in eating behavior, body image and psychological conditions. CONCLUSION: These results suggest that the dissatisfaction of one's somatic morphology and the consequent dieting account for most of the aberrant eating patterns in obese patients.

Attitude↗
PubMed1982

Mechanism of protection against carbon tetrachloride toxicity. II. Lethality in rats fed a polyunsaturated fatty acid deficient diet.

A PUFA-deficient diet causes deficiency symptoms and alters the fatty acid pattern in liver microsomal lipids. However, CCl4 lethality and sleeping time remain unchanged while the hepatic level of cytochrome P450 is only slightly lowered by the dietary regimen. In accordance, the amplitude of double bond shifting in microsomal lipids is far from being depressed in animals deprived of the peroxidative substrate. In fact, the experimental treatment does not impair intestinal absorption, liver uptake and metabolism of CCl4 given orally. Finally, both in vitro and in vivo peroxidative challenge of arachidonic acid content in hepatic microsomes causes comparable alterations of this parameter, whatever the initial fatty acid pattern following the dietary regimen. These findings provide evidence excluding an influence of the fatty acid composition of the diet on the severity of damages due to halogen-alkane exposure.

Animals↗
PubMed2006

The Mediterranean diet in a world context.

OBJECTIVE: To put the debate on the Mediterranean diet in context by highlighting historical and prospective changes in the level and composition of food consumption in the world and key Mediterranean countries. DESIGN: Data from FAO's food balance sheets are used to illustrate historical evolution. Projections to 2030 are presented from FAO's recent and ongoing work on exploring world food and agriculture futures. SETTING: International. RESULTS AND CONCLUSIONS: Many developing countries are undergoing diet transitions bringing them closer to the diets prevalent in the richer countries, i.e. with more energy-dense foods. There follows an increase in the incidence of diet-related non-communicable diseases, which are superimposed on the health problems related to undernutrition that still afflict them. In parallel, many low-income countries are making little progress towards raising food consumption levels necessary for good nutrition and food security. Wider adoption of food consumption patterns akin to those of the Mediterranean diet hold promise of contributing to mitigate adverse effects of such diet transitions. However, the evolution of food consumption in the Mediterranean countries themselves is not encouraging, as these countries have also followed the trend towards higher shares of energy-dense foods. Possible policy responses to these problems include measures to raise awareness of the benefits of healthier diets and/or to change relative food prices in favour of such diets (by taxing fattening foods) or, at the extreme, making individuals who follow 'bad' diets, and thus are prone to associated diseases, bear a higher part of the consequent costs borne by the public health systems (tax fat people).

Developing Countries↗
PubMed2003

Tracing the Mediterranean diet through principal components and cluster analyses in the Greek population.

OBJECTIVE: To identify dietary patterns, and their socio-demographic and lifestyle correlates in a large sample of Greek adults, and assess their adherence to the traditional Mediterranean diet. DESIGN: Principal component (PC) analysis was used to identify dietary patterns among 28 034 participants of the Greek branch of the European Prospective Investigation into Cancer and Nutrition. Dietary information was collected through a validated, semiquantitative, food-frequency questionnaire. The extracted PCs were subsequently regressed on sociodemographic and lifestyle variables. Analyses were also performed to classify individuals with similar dietary behavior into clusters. RESULTS: Four PCs were identified: PC1 resembled the Mediterranean diet, PC2 approximated a vegetarian diet with emphasis on seed oils, PC3 reflected a preference for sweets, and PC4 reflected a Western diet. PC1 and PC2 were positively associated with age, education, physical activity, and nonsmoking status. Females, in comparison to males, scored higher on PC1 but lower on PC2. Males, younger, more educated individuals, nonsmokers and residents of Greater Athens (Attica) scored higher on PC3. PC4 was associated with younger age, less education, and current smoking. In cluster analyses, cluster A contrasted clusters B and C in having much higher mean PC1- and PC2-scores and substantially lower PC3- and PC4-scores. PC1 and PC4 were, respectively, positively and inversely correlated with an a priori Mediterranean-diet score; PC2 and PC3 were unrelated to it. CONCLUSION: The Mediterranean-like PC1-score as well as the vegetarian-like PC2 were higher among older, more educated people, and were associated with a healthier lifestyle than PC4, which reflected a Western-type diet. PC1 was strongly positively associated with an a priori Mediterranean-diet score.

Adult↗
PubMed1999

Potassium supplementation induces beneficial cardiovascular changes during rest and stress in salt sensitive individuals.

The typical American diet includes high salt and low potassium, a pattern linked to elevated blood pressure (BP) in cross-cultural studies. This study compared resting and stress cardiovascular responses on a high salt, low potassium diet to those observed during 2 interventions: salt restriction and potassium supplementation. Forty-seven percent of the primarily normotensive sample (n = 67 adults) were salt sensitive, showing a decrease in mean arterial pressure > or = 5 mmHg during low salt and equivalent reductions during high potassium. The equivalent benefits of the interventions were maintained, but not enhanced, during exposure to behavioral stress (i.e., no effect on reactivity). Salt resistants (SRs) exhibited no change in resting or stress BP across the diets. High salt increased cardiac index in both groups, whereas vascular tone was decreased only in the SR group. High potassium produced hemodynamic benefits similar to low salt, even with continued high salt intake.

Adult↗