Fatty acid composition and possible health care effects of coconut constituents

The link between excessive composition of dietary saturated fats and coronary heart disease (CHD) is now well established. Because of its high content of saturated fatty acids, the composition of foods containing coconut oil may therefore be a risk factor for CHD. While the fatty acid composition of coconut oil is well established, relatively little is known about the other constituents of coconut: the milk, water, cream and meat fractions. In this study, we show that while the water fraction is low in lipid content, the milk contains about 24 percent of the fat content of oil and the cream and meat fractions about 34 percent. The other coconut constituents contain significant amounts of medium-chain triglycerides that are formed from fatty acids of chain length 8:0 to 14:0. It is these fatty acids, primarily 14:0, that are thought to be atherogenic. On the other hand, medium-chain triglycerides provide a ready source of energy and may be useful in baby foods or in diet therapy. Nevertheless, the possible negative effects of the saturated acids and the absence of the essential fatty acid linolenic acid from all coconut constituents suggest that the coconut milk, oil and cream should not be used on a regular basis in adults. (AU)

The dietary fatty acids of patients with coronary artery disease and control in Curacao: implications for primary and secondary prevention

Patients with coronary artery diseases are advised to augment their dietary linoleic acid intakes at the expense of saturated fatty acids. We investigated whether the dietary linoleic acid intake of 57 patients with coronary artery disease (47 males, 10 females; ages 61 ñ 10 years) in Curacao is higher as compared with 77 controls (51 males, 26 females; ages 56 ñ 7 years). For this, we measured plasma cholesterol ester fatty acids, which reflect the dietary fatty acid composition of the preceeding weeks. Patients with coronary artery disease and controls had minor differences in cholesterol ester fatty acids. Their cholesterol ester linoleic acid content suggests that the dietary polyunsaturated/saturated fatty acid ratio is far below 1. Comparison with data reported for the the Netherlands, Greenland and Crete showed that the dietary fatty acid composition in Curacao is typically Western with a high intake of saturated fatty acids, a low intake of monounsaturated fatty acids and the consumption of linoleic acid as the predominant polyunsaturated fatty acid. Intake of long chain polyunsaturated fatty acids from fatty fish is low. Reduction of dietary saturated fatty acids, augmentation of fish consumption, and an increase of the O-linolenic/linoleic acid ratio are likely to be of benefit to both primary and secondary prevention from coronary artery disease in Curaco.(AU)

Nutritional influences on the emergence of diabetes mellitus and high blood pressure in Afro-origin populations in Cameroon, Jamaica, and Caribbean migrants to Europe - abstract

Our four nation study is establishing the role of nutrition in evolving diabetes mellitus (DM) and high blood pressure (BP) in these Afro-origin populations. Using highly standardized methods, we are testing whether increasing energy (particularly fat) and Na+ intakes, and decreased K+, Ca+ and antioxidant intakes, are associated with decreasing glucose tolerance (GT) and increasing BP within and between centres. Random community samples, aged 25 - 74 years, are stratified by sex up to 1,500/centre to generate sufficient index cases of impaired (I) GT and `high' BP (> 140 and/or 90 mm Hg but < 160 to 95 mm Hg) for an intervention trial and incident phase. During a 2-hr 759 glucose tolerance test (GTT), a food frequency questionnaire (FQQ), built up from food dairies and 24-hr recalls, and repeat 24-hr urines are supplying mean energy, fat, carbohydrate, fibre, protein and cation intakes. To date, 894 Jamaicans have been seen at the Spanish Town site, some 780 people (360 Afro-Caribbean) in Manchester, with 180 GT tested, 416 Cameroonians (246 urban) and a pilot study completed in Paris. Rates of IGT and DM run at approximately 8 percent and 14 percent in Jamaica, 15 percent of each in Manchester, and 4-8 percent in Cameroon through Jamaica to Manchester. Those at risk of hypertension (> 140 and/or 90 mm Hg) are similarly distributed. As baseline prevalence rates are established, the nutritionally-based intervention programme will be piloted as a randomized trial. Such efforts offer the chance for primary prevention of high BP, diabetes mellitus and their complications in these populations, before or as they face an epidemic from them (AU)

The effect of the level of dietary protein, carbohydrate and fat on urea kinetics in young children during rapid catch-up weight gain

The kinetics of urea metabolism were measured in children recovering from severe malnutrition. For a period of up to 10 d they receive one of four diets which provided 711 kj (170 kcal)/kg per d. Two groups received a diet with a high protein:energy (P:E) ratio of 10.6 percent (HP), enriched with either fat (HP/F) or maize starch and sucrose HP/C). Two groups received a diet with a low P:E ratio of 8.8 percent (LP), enriched with either fat (LP/F) or maize starch and sucrose (LP/C). The rate of weight gain on the HP diets was significsntly greater than on the LP diets. There was no difference in urea production between any of the four diets: HP/F 1.23 (se 0.12), HP/C 1.37 (se 0.14), LP/F 1.64 (se 0.22) LP/C 1.15 (se 0.15) mmol nitrogen/kg per h. On the HP diets urea excretion was 0.77 (se0.07) mmol N/kg per h, 61 percent of production. There was significantly less urea excreted in the urine on diet LP/C than on LP/F (0.36 (se0.05) and 0.64 (se 0.04)mmol N/kg per h respectively). A significantly greater percentage of the urea production was hydrolysed on the LP diets (61 percent) compared with the HP diets (39 percent), with the consequence that 50 percent of urea-N produced was available for synthetic activity on the LP diets compared with 30 percent on the HP diets. The increase in the urea hydrolysed on the LP diets was equivalent in magnitude to the decreased intake of N, so that overall intake plus hydrolysis did not differ between the LP and HP diets. Crude N balance was similiar on diets HP/F, HP/C and LP/C, but was significantly reduced on diet LP/F. These results show that there is an accommodation in urea kinetics during rapid catch-up weight gain, which becomes evident when the P:E ratio of 8.8 percent, protein is limiting for catch-up growth. When the intake has a P:E ratio of 8.8 percent the pattern of urea kinetics can be modified by the relative proportion of fat and carbohydrate in the diet. The measurement of urea kinetics provides a useful approach to the definition of the adequacy of the protein in the diet. (AU)

Cholesterol oxides in Indian ghee: possible cause of unexplained high risk of atherosclerosis in Indian immigrant populations

Two populations of immigrants to London and to the West Indies from the Indian subcontinent have greater than expected morbidity and mortality from atherosclerosis but do not show the commonly accepted major risk factors. This study investigated the hypothesis that ghee, a clarified butter product prized in Indian cooking, contains cholesterol oxides and could therefore be an important source of dietary exposure to cholesterol oxides and an explanation for the high atherosclerosis risk. Substantial amounts of cholesterol oxides were found in ghee (12.3 percent of sterols), but not in fresh butter, by thin-layer and high-performance-liquid chromatography. Dietary exposure to cholesterol oxides from ghee may offer a logical explanation for the high frequency of atherosclerotic complications in these Indian population.(AU)

Fatty acid composition of breast milk fat from women in Curacao - abstract

The new-born infant exclusively breastfed receives approximately 52 percent of his energy from fats, 40 percent from carbohydrates and approximately 8 percent from proteins. Dietary fat in young infants not only serves as the most important source of energy but also contains nutrients essential for normal growth and development of the nervous system. In the very young infant, intestinal absorption of fats is, among other factors, dependent on the fatty acid composition of the fat consumed. The nature of the fat consumed by the mother will have an important influence on the fatty acid composition of human milk fat. Samples were obtained from 47 mothers of low to middle social class, who had lived in Curacao for at least 10 years, and given birth to a normal term infant. Milk was collected at least 14 days after birth by manual expression, and deep frozen until analysed by gas chromatography. The relative concentration of the saturated fatty acids (g/100g total fatty acids) were C6:0, 0.1; C8:0, 0.7; C10.0, 3.2; C12:0, 11.7; C14:0, 9.8; C16:0, 16.8; C18:0, 4.8: and for the unsaturated fatty acids C14:1, 0.2; C16:1, 2.5; C18:1, 26.7; C18:2, 18.3; C18.3, 1.7; C20:2, 0.5; C20:3, 0.6; C20:4, 1.4; C22:5, 0.3 and C22:6, 0.6. This pattern is more similar to that found in Tanzanian women, than to that found in women in Great Britain (AU)

High energy feeding in protein-energy malnutrition

The use of high-fat diet in malnourished children produced accelerated growth of lean tissues as well as adipose tissue, and resulted in rapid nutrition rehabilitation in 25 seriously malnourished babies. Such diets are easy to prepare and relatively cheap, and they offer important advantages over conventional feeding in the hospital treatment of malnourished children.(AU)

A young-child nutrition programme in rural Jamaica

A programme to reduce the morbidity and mortality among young children in rural Jamaica has been developed. Locally recruited and trained health auxiliaries survey all children under five, diagnose malnutrition by application of anthropometric indices, and, according to a rigid protocol, treat the deficient children by education and demonstration at home. This economically feasible approach, relying entirely on local resources, has been followed for two years. The programme did not affect the prevalence of malnutrition, but did reduce young-child mortality by half.(AU)

Glucose tolerance and insulin sensitivity in malnourished children

In malnourished, compared with recovered children, fasting blood glucose concentrations were low and there was impared peripheral glycolysis as shown by a failure of blood lactate to raise after glucose was injected intravenously. Homogenates of muscle biopsies from malnourished and recovered children produced equal amounts of lactate when incubated anaerobically with various substrates, but when compared with homogenates of biopsies from normal children the pattern suggested an impairment of glycolysis. The rate of glucose disappearance after intravenous glucose was slow in the malnourished child and there was possibly diminished sensitivity to exogenous insulin. Isocaloric diets relatively high or low in fat were fed to children who had recovered from malnutrition. Glucose tolerance, insulin sensitivity, fasting plasma insulin and insulin response to intravenous glucose were all the same in children on either diet. (AU)

Preliminary observations on cardiovascular disease in the Bahamas with special reference to the prevalence of hypertension coronary atherosclerosis and composition of depot fat

The aims of the study were to confirm the prevalence of hypertension in Bahamians, to determine at autopsy the degree of coronary atherosclerosis in documented cases of hypertensive disease in Bahamians and to analyse depot fat for fatty acids in Bahamians. Blood pressure was measured by a standard technique in 1488, subjects of ages 10-69 years. The records of 1450 consecutive autopsies were examined and the degree of coronary atherosclerosis graded. There were 130 autopsies of Bahamians with clinical evidence of hypertension. Fatty acids were determined on fat biopsies by gas chromatography. A high mortality rate from and prevalence of hypertensive disease exist in the Bahamas, by contrast to a low mortality rate for myocardial infarction and an apparent low prevalence of coronary heart disease. Depot fat composition of Bahamians shows a high level of linoleic acid (C18:2) (13.3 percent) and a poly-unsaturated/saturated fat ratio of 0.51. The p/s ratio is greater than 0.5 in all countries where the incidence of coronary heart disease is low. It is postulated that the traditional Bahamian diet which is relatively rich in poly-unsaturated fats, modifies the effect of hypertension as a risk factor in the evolution of coronary heart disease in this population (AU)

Dietary fat and serum triglycerides

Fasting serum triglyceride levels from children in our ward who have recovered from malnutrition are about 30 percent of the values reported by others for normal children or similarly recovered patients. Our patients have been treated for malnutrition with a diet containing 60-70 percent of total calories as fat. We have investigated the effects of the dietary fat intake on the fasting level of serum triglycerides by feeding these children a diet containing 30 percent of the calories as fat. Two to 4 days after changing the diet, fasting serum triglycerides rose 200 to 700 percent; thereafter the values stabilized within the normal values usually found in the literature. The rise was accounted for mainly by the d<1.019 lipoprotein triglycerides. Advantage was taken of the wide range of values obtained to study the composition of the d<1.019 lipoprotein. The data obtained support the hypothesis that the components of this lipoprotein fraction are in a constant proportion, thus it would constitute a definite chemical entity. The high sensitivity of infants to changes in the dietary fat intake and the rapidity of this response are being considered in the studies concerning the pathogenic mechanism of the fatty infiltration of the liver produced by protein malnutrition (AU)