Urinary excretion of 13 dietary flavonoids and phenolic acids in free-living healthy subjects - variability and possible use as biomarkers of polyphenol intake.

OBJECTIVE: Estimation of dietary intake of polyphenols is difficult, due to limited availability of food composition data and bias inherent to dietary assessment methods. The aim of the present study was to evaluate whether we could detect polyphenols and their metabolites in a spot urine sample in a free-living human population and whether it was related to those observed in 24-h urine samples, for potential use as a biomarkers of polyphenol intake. SUBJECTS: Four 24-h urine samples and two spot urine samples were collected from 154 participants of the SU.VI.MAX cohort (a randomized primary-prevention trial evaluating the effect of daily antioxidant supplementation on chronic diseases) in two separate studies over, respectively, a 7- and 2-day periods. Thirteen polyphenols and metabolites (chlorogenic acid (CGA), caffeic acid (CA), m-coumaric acid (mCOU), gallic acid (GA), 4-O-methylgallic acid (MeGA), quercetin (Q), isorhamnetin (MeQ), kaempferol (K), hesperetin (HESP), naringenin (NAR), phloretin (PHLOR), enterolactone (ENL) and enterodiol (END) were measured using HPLC-ESI-MS-MS. RESULTS: Correlations between the urinary excretion levels were observed. The most significant were explained by metabolic filiations (CGA/CA, CA/mCOU, GA/MeGA, Q/MeQ, NAR/PHLOR, ENL/END) or co-occurrence in a same food source (NAR/HESP). Concentrations in spot samples correlated with those in 24-h urine sample (P<0.02, except for CA and for MeQ). Intra-individual variations were smaller than inter-individual variations for all polyphenols (P<0.01) except for MeGA and for PHLOR. CONCLUSION: These results show that these polyphenols and metabolites are useful biomarkers for polyphenol intake.

[Psychotherapeutic practices in France: results of a professional-based health insurance participant survey]. / Usage des psychothérapies en France: résultats d'une enquête auprès des mutualistes de la MGEN.

INTRODUCTION: Today in France, little empirical data on the use of psychotherapy is available. This paper presents an empirical study of psychotherapeutic practices, from the patient's point of view. We will present results regarding frequency of psychotherapies, patients' characteristics, associations between different kinds of therapy, where they take place, and the reasons given for beginning psychotherapy. METHODOLOGY: Data is based on a general and mental health survey conducted by MGEN(1) foundation among 6,500 persons, as well as on general population data collected by the BVA survey institute. RESULTS: Depending on the population studied, between 5 to 11.5% of people have had psychotherapy sessions at least once in their lifetime. Women born at the beginning of the sixties and men born at the beginning of the fifties are those who consulted the most. The vast majority of these psychotherapies are individual, in private practice. They often last more than one year, with a frequency of once per week or more. Thirty percent declare that they have undergone several psychotherapies. The reasons for consultation reported by users are mainly depression or anxiety. There are significant differences between genders for the reasons for consultation, women being concerned by depression, problems with sleep and food, and men being concerned by obsessive thoughts and addiction (alcohol, tobacco). People undergoing psychotherapy give an average of 2.5 reasons for this psychotherapy, and only 28% gave only one reason. A relationship exists between the number of consecutive treatments and the number of reasons given for undergoing psychotherapy. More than 25% of the psychotherapies last less than 6 months. "Intensive psychotherapy" (at least 6 months and a frequency of 2 to 3 times per month) concern 5.9% of the whole population studied, and represent 51.4% of all psychotherapies. People are quite satisfied by their psychotherapy; 90% are satisfied with the results and 60% believe that their condition has been much improved in a durable manner. 16.6% were unsatisfied with the results. There is (in women only) an association between satisfaction and intensity of treatment; satisfaction is lower in those women undergoing intensive psychotherapy; 77. 7% of users have also used some sort of drugs for the problem (80.6% of women and 69.9% of men) with psychotropic drugs most frequently used: 70.8% of the psychotherapy users had taken such drugs for their problem (women 72.9%, men 65.4%). CONCLUSION: In France, psychotherapies are playing an important role and it is necessary to study these techniques better in order to give them the place they deserve in the French mental health policy.

Prescreening tools for diabetes and obesity-associated dyslipidaemia: comparing BMI, waist and waist hip ratio. The D.E.S.I.R. Study.

OBJECTIVE: To compare the sensitivities of BMI, waist circumference and waist hip ratio (WHR) in identifying subjects who should be screened for diabetes and/or for obesity-associated dyslipidaemia. DESIGN: Cross-sectional study. SETTING: Central-western France. PARTICIPANTS: More than 3000 men and women, aged 40-64 years, from the French study: data from an epidemiological study on the insulin resistance syndrome (D.E.S.I.R.). MAIN OUTCOME MEASURES: Sensitivity and specificity for screened diabetes (fasting plasma glucose>or=7.0 mmol/l) and screened dyslipidaemia (triglycerides>or=2.3 mmol/l and/or HDL-cholesterol <0.9/1.1 mmol/l (men/women)) according to BMI, waist circumference and WHR. RESULTS: Sensitivities increased as more corpulent subjects were screened, but they increased slowly after screening the top 30%: body mass index (BMI)>or=27/26 kg/m(2) (men/women) or waist >or=96/83 cm or WHR>or=0.96/0.83. These values were chosen as thresholds. In men, BMI had a nonsignificantly higher sensitivity than waist or WHR for both diabetes and dyslipidaemia (77 vs 74 and 66% P<0.3, 0.09; 56 vs 54 and 49% P<0.5, 0.16). For women, waist had a slightly higher sensitivity than BMI or WHR (82 vs 77 and 77% P<0.8, 0.7) for diabetes; for dyslipidaemia, waist and WHR had similar sensitivities, higher than for BMI (65 and 67 vs 54% P<0.16, 0.13). CONCLUSIONS: We propose that for screening in a French population 40-64 years of age, the more obese 30% of the population, identified either by BMI, waist or WHR be screened for diabetes and obesity-associated dyslipidaemia.

Influence of dietary factors on colorectal cancer survival.

BACKGROUND: Diet has been identified as a major determinant of colorectal cancer (CRC) but little is known of its influence on CRC survival. AIMS: To study the influence of dietary factors on survival in patients who had undergone potentially curative CRC surgery. PATIENTS: Among 171 patients included in a case control study of CRC aetiological factors, 10 year survival data on 148 patients who underwent resection of the tumour for potential cure were obtained from a Registry of Digestive Tumours. METHODS: Tertiles of food and nutrient intakes were entered into Cox proportional hazards survival models, controlling for age, sex, tumour stage, and tumour location. RESULTS: Only five year survival was influenced by the pre-diagnosis diet. High energy intake, as a result of high carbohydrate, protein, and lipid intake, was strongly related to increased survival. Five year relative risk of death for the highest versus the two lowest tertiles of energy intake was 0.18 (95% confidence interval 0.07; 0.44). This effect was similar in both sexes, for the colon and for the rectum. It was stronger in patients with N+/M+ tumours (relative risk 0.06) than in those with less advanced tumours (relative risk 0.37; stage-energy interaction term non-significant). No specific food or nutrient could be identified as having prognostic significance. CONCLUSIONS: Whether high energy intake selects less severe tumoral clones or modifies antitumoral immunity remains unclear. Larger series need to be investigated before conducting intervention studies but our findings should prompt nutritional follow up in CRC patients.