Effect of Season on 25-OH Vitamin D in Serum of Rhesus Monkeys Housed in Puerto Rico.

OBJECTIVE: Vitamin D blood levels have been shown to be partially dependent upon season in temperate climates, however, this same evaluation has not yet been reported in fully tropical climates. Herein, we assessed the vitamin D levels in the blood of Rhesus monkeys housed at the Puerto Rico Caribbean Primate Research Center collected in the island's "summer"(May-October) and "winter" (November-April) months. MATERIALS AND METHODS: In 2006 through 2014, repeated measurements of blood samples were collected from 5 Rhesus monkeys (IACUC-approved) during "summer" and "winter" months to assess 25-OH vitamin D, determined via HPLC. UV-B and UV-A (KJ/m2/day) were measured using a ground based radiometer for these time periods. A paired t-test and a multilevel mixed- effect model approach was performed for data analysis. RESULTS: The difference of the mean serum values of 25-OH vitamin D between seasons showed lower levels during "winter" than "summer" months. About 23% of the variance in levels can be attributed to difference between the monkeys. The means of UV-B and UV-A, as a proxy for sunlight intensity, were greater (over the entire study interval) during the "summer" as opposed to "winter" months (p < 0.001). CONCLUSION: Vitamin D levels were substantially higher in the "summer" rather than the "winter" months. This observation implies that even in fully tropical regions, such as Puerto Rico, time of year can have an influence on vitamin D status. While comparable studies have not been undertaken in humans, it would not be unreasonable to suggest that similar results would be obtained should such a study be done.

Effect of Housing Type on 25 OH Vitamin D in Serum of Rhesus Monkeys.

OBJECTIVE: Vitamin D status is primarily dependent upon sun exposure and dietary sources, however genetic, cultural, and environmental factors can have a modulating role in the measured amount. One under-reported factor is the effect of regular living quarters on the degree of sun exposure. Herein, we assess vitamin D status in the blood of Rhesus monkeys (Macaca mulatta) housed in high amounts of sunlight (corn-cribs), medium sunlight (corrals with shaded areas), and minimal sunlight (quarantine cages). METHODS: Fifty-five male Rhesus monkeys, aged 1 to 31 years were housed in varying amounts of sun exposure at the Caribbean Primate Research Center. Serum was collected and analyzed for 25 OH Vitamin D which is the preferred metabolite for determination of Vitamin D using High Performance Liquid Chromatography (HPLC). RESULTS: 25 OH Vitamin D levels in blood were significantly greater in corn-cribhoused monkeys than in corral or quarantine-housed animals (p > 0.01 and p > 0.001 respectively). Significant differences of serum levels were not found when ages of animals housed in the same environment were compared. CONCLUSION: Monkeys housed in a tropical environment with the greatest amount of exposure to sunlight maintain the highest serum levels of 25 OH vitamin D independent of age. These findings emphasize the importance of documenting the environment in which subjects typically spend their time when Vitamin D results are interpreted.

Number and Type of Meals consumed by Children in a Subset of Schools in San Juan, Puerto Rico.

OBJECTIVE: Eating patterns of children have been investigated in the U.S. and have been found to be changeable over extended time periods. Trends can be correlated to changes in the same periods for determinants of overall health such as body mass index (BMI). In Puerto Rico, there have been no such studies so similar correlations cannot be done. Herein, we present baseline information on the number and types of eating occasions in a convenience sample of children from the area of San Juan so that future changes in patterns can be monitored over time. METHODS: Multiple 24 hour recall questionnaires were administered to school children at 3 different grade levels. Number of eating occasions and type of meal (breakfast, lunch, dinner and snacks) were quantified. Factors considered for analysis were age, gender and BMI of the children, participation in the School Lunch Program (SLP) and if meals were eaten on a weekday or weekend day. RESULTS: Approximately 40% of children were categorized as overweight. There was a trend toward fewer eating occasions in older vs. younger children and fewer eating occasions on weekend days vs. weekdays. Lunch and dinner were consumed more frequently than breakfast and participants in the SLP had more eating occasions than non-participants. CONCLUSION: The number of eating occasions in Puerto Rican youth is maintained at about 5 for weekdays and about 4.5 per day for weekend days with a trend toward fewer meals as a function of increasing age. This data can be used as baseline information in future studies that wish to correlate changes in dietary patterns with health.

Assessment of the national school lunch program in a subset of schools in San Juan, Puerto Rico: participants vs. non-participants.

OBJECTIVE: Extensive evaluations of the national school lunch program (NSLP) have been carried out on the U.S. mainland. Puerto Rico, a commonwealth of the U.S. is a participant in this program, but has never been included in assessment studies. Herein, we present assessment information and compare results with comparable mainland studies. METHODS: Multiple 24-hr recall questionnaires were administered to groups of participating (P) and non-participating (NP) children in the lunch program at 3 educational levels. Comparisons were made for children within the study as well as between comparable children in mainland studies for total intake of several macro- and micro-nutrients, contribution of the lunch to the total daily intake and adherence to U.S. Recommended Dietary Allowances (RDA's) or to Dietary Reference Intakes (DRI's) including acceptable macronutrient distribution ranges (AMDR's). RESULTS: Target intakes were met by P for % of the RDA of energy from protein, for all water soluble vitamins, iron, zinc and cholesterol. P did not achieve target intakes for total energy, energy from carbohydrates and fat nor for fat soluble vitamins, calcium, magnesium, phosphorus, potassium and fiber. Recommended levels were exceeded for sodium, total fat and saturated fat. Comparing P vs NP, the vast majority of both groups fell within AMDR recommendations for macronutrients but not all micronutrients. CONCLUSION: For the most part, our results parallel those obtained in the National sample however, results suggest that P in the lunch program in Puerto Rico have a healthier intake of several nutrients than NP students. The unique feature of this study is that it is the first assessment of the NSLP in a completely Hispanic population.

Macronutrient Adequacy of a Mediterranean-type Meal Examined at Recommended and Below Recommended Energy Values.

Background: Mediterranean style eating pattern is regarded as among the worlds' healthiest. Numerous studies have shown that the Mediterranean eating pattern can promote weight loss, however, if combined with caloric restriction as promoted via internet sites, are inherent advantages retained or do macronutrients fall below recommended levels and if so, at which energy values does this occur? Objective: To address this question. Methods: We have formulated a meal which was developed from items on menus in Barcelona, Spain. Macronutrients were determined using NDSR software and the meal was assessed for carbohydrate, fat and protein content at recommended levels of 2500 and 2000 kcal/day as well as at 1600, 1200 and 800 kcal/day through control of portion sizes. Authenticity of the meal as being Mediterranean- type was verified by comparison to established standards contained in dietary guidelines for Americans as well as similarity to percent of macronutrients published in the literature. Results: Comparison of our results to guidelines for a Mediterranean style eating pattern showed fruit, protein and oil intake to be sufficient but not so for the vegetables, grains and dairy food groups. All macronutrients reached dietary recommended amounts when analyzed at energy values of 2500 and 2000 kcal/day. Fat and carbohydrate content satisfied recommended amounts at intakes of 1600 and 1200 kcal/day but the amount of protein was insufficient at all values below 2000 kcal/day. Conclusion: Although a Mediterranean-style eating pattern is among the healthiest, in order to maintain macronutrient adequacy, it should not be energy compromised.

High Carbohydrate vs High Fat Diets: Which is Preferable for Long-term Use?

Background: Commercial manufacturers have formulated diets to promote not only weight reduction but also to reduce risks of chronic diseases. Objective: To determine if these formulations satisfy requirements for essential nutrients and their suitability for long term use. Methods: We have selected two established commercial diets, one high carbohydrate, low fat (diet 1) and the other, low carbohydrate, high fat (diet 2) and determined "representative meals" through use of recipes suggested in the manufacturer's manuals. Nutrition Data System for Research (NDSR) software has been used to perform the most extensive nutrient analysis to date of these diets. Results: Tables report macronutrients (energy), vitamins, minerals, essential amino acids, essential fatty acids and nutrient-related components for a total of 62 entries. Diet 1 satisfied requirements for 50 of these (81%) with only vitamin B12, vitamin D, and essential fatty acids not reaching recommended levels, while fiber and glycemic load exceeded suggested values. Diet 2 satisfied requirements for forty- six of the components (71%) but had excess percentage of fat, especially saturated fat, sodium and cholesterol as well as decreased percentage of carbohydrate resulting in suboptimal intake of B-complex vitamins (B1, niacin and total folate) as well as fiber. Conclusions: Neither diet satisfied adequacies for all reported nutrients. However, based on nutrient content alone diet 1, if supplemented, could be sustained over the long term whereas diet 2, even if supplemented, should not be encouraged for long term adaptation.

Validation and reproducibility of a semi-quantitative food frequency questionnaire for use in Puerto Rican children.

OBJECTIVE: Knowledge of the diet of specific populations is of importance in the assessment of nutrient intake. Herein, we assess the reproducibility and validity of an interviewer-administered food frequency questionnaire (FFQ) in Puerto Rican children at two educational levels--elementary (ES) and high school (HS). METHODS: The FFQ contained 97 items including supplements. It was administered twice (FFQ1 and FFQ2) within a 2 week interval between which three dietary food records (DFR's) were collected. In all, 94 ES children (40 boys and 54 girls) and 89 HS children (42 boys and 47 girls) participated in this IRB-approved study. RESULTS: Results showed correlations between FFQ1 and FFQ2 for representative macro- and micronutrients lower than reported in the literature. Correlation coefficients were higher for HS (mean R = 0.43) compared to ES (mean R = 0.21) and higher for girls than for boys at both school levels. Results for validation also showed lower correlations between the FFQ2 and DFR's compared to other studies, which was higher in HS students (mean R = 0.34) compared to ES students (mean R = 0.10). However, these same nutrients were cross-classified into equivalent quartiles for both the FFQ and DFR with an accuracy of about 66%. CONCLUSION: We have designed and validated a FFQ, appropriate for use in Puerto Rican schoolchildren to estimate energy intake in younger students and energy and micronutrients in older students. The significance of this research is that there is now an updated instrument for use in dietary studies in Puerto Rican youth.

Vitamin D Content in Milk of the Rhesus Monkey.

OBJECTIVE: Milk is the first and continued source of ingested Vitamin D. Extensive studies have been carried out in humans measuring Vitamin D in lactating mothers but to date few values have been obtained for milk of non-human primates and none for rhesus monkeys. Consequently. we have determined Vitamin D and antirachitic activity (ARA) in milk samples obtained from 21 rhesus monkeys. METHODS: Lactating dams were sampled by hand-stripping. 25(OH)D2, Vitamin D2, 25(OH)D3, Vitamin D3 and ARA were assessed in foremilk using LC-MS/MS techniques. RESULTS: 25(OH)D2 and Vitamin D2 were below detectible limits (<0.5 ng/g), 25(OH) D3 =4.2 ± 1.8 ng/ml, Vitamin D3 = 6.1 ± 3.1 ng/ml and ARA = 1080 ± 480 IU/L. CONCLUSION: This is the first report of content of Vitamin D and ARA activity in foremilk of the rhesus monkey and can serve as a reference for future studies.

Plasma ascorbate in a population of children: influence of age, gender, vitamin C intake, BMI and smoke exposure.

The objective of this study is to determine the influence of several personal and lifestyle factors on the levels of circulating vitamin C in a population of children. To accomplish this objective, blood samples were collected from 511 healthy children residing in the Greater San Juan area. The population was stratified into 4 percentile groups (approaching quartiles) according to plasma ascorbate levels from lowest to highest concentrations. Comparisons were made between percentile groups on the basis of age, gender, body mass index (BMI), dietary intake of vitamin C (corrected and uncorrected for energy intake) and exposure to environmental tobacco smoke (ETS). Smoke exposure was determined using urinary cotinine, which is a highly sensitive bioindicator for ETS. Dietary vitamin C was determined via one 24hr recall questionnaire. When all 4 percentile groups were used as a basis of comparison, no differences were noted for any of the factors between groups, however when comparing percentile group 1 (lowest blood ascorbate) to an aggregate value of percentile, groups 2-4, it was found that vitamin C intake (corrected for energy intake) paralleled blood values with a statistically significant association. Among personal and environmental factors only exposure to ETS showed a significant difference in blood levels between groups 2-4 and group 1. No differences between percentile groups were noted for age gender or BMI. These results emphasize that ETS is strongly associated with lowered blood ascorbate levels with the obvious implication of reduced antioxidant protection and increased risk of adverse health consequences.

Influence of environmental tobacco smoke on vitamin C status in children.

BACKGROUND: It is known that vitamin C status is compromised in smokers. The vitamin C status of nonsmokers who are exposed to environmental tobacco smoke (ETS) is now being elucidated. OBJECTIVE: We assessed vitamin C status in children who were either exposed or not exposed to ETS, and we sought to associate changes in vitamin C status with the amount of ETS exposure. DESIGN: The study group included 512 children aged 2-12 y; 50% of them were exposed to ETS in the home because their parents smoked. Dietary intake of vitamin C, obtained with a 24-h recall questionnaire, and blood ascorbate concentrations were compared in the exposed and unexposed groups. Smoke exposure was assessed by measuring a biomarker, urinary cotinine. Age, sex, and body mass index were examined as potential correlates of vitamin C status in each exposure category. RESULTS: Plasma ascorbate concentrations were lower, by 3.2 micro mol/L on average, in ETS-exposed children than in unexposed children who consumed equivalent amounts of vitamin C; this was a highly significant difference (P = 0.002). This reduction in plasma ascorbate occurred even with very low exposure to ETS. CONCLUSIONS: ETS can reduce concentrations of ascorbate, an important blood antioxidant, even when the amount of smoke exposure is minimal. Children exposed to ETS should be encouraged to consume increased amounts of foods rich in vitamin C or should be given the equivalent amount of this vitamin as a supplement.

Blood and nutritional profiles of an individual consuming a high protein-low fat diet.

This is the case of a normal weight, physically active 24-year old Puerto Rican woman consuming a highly unusual diet. Through careful selection of foods, the diet contains a high percent protein, a low percent fat, adequate fiber and zero cholesterol. Popular commercial diets high in protein all contain high fat, high cholesterol and low fiber. Blood samples were taken and dietary recalls were collected for 6 consecutive days to evaluate hematological and nutritional parameters. A blood lipid profile showed low circulating levels of cholesterol and triglycerides and a beneficial HDL/LDL ratio. However, nutritional analysis revealed insufficient ingestion of vitamin D and an unhealthy balance of servings from the food pyramid. Long-term consequences of this diet could put the subject at risk for kidney and bone diseases. Immediate discontinuation of the diet is the preferred recommendation to the subject. This case report illustrates the danger of adapting a self-prescribed eating plan without the consultation of a dietitian or other qualified health professional.

Plasma homocysteine concentrations in a population of rhesus monkeys (Macaca mulatta): reference ranges and accompanying plasma concentrations of folate and vitamin B12.

The circulating level of homocysteine (Hcy) is recognized as a major independent risk factor for cardiovascular disease in humans. Nonhuman primates are being investigated to see whether they will be accurate models for Hcy indicators of cardiovascular dysfunction. Normal reference values are available in humans for Hcy as classified by age, gender, ethnic origin, and biological factors, however similar information in nonhuman primates had not been published previously. The purpose of this report is to provide normal Hcy values in a large group of nonhuman primates in light of age, gender, and physiologic state (pregnancy and lactation) and to compare these values to the same parameters in humans to highlight similar and dissimilar trends. In addition, plasma levels of folic acid and vitamin B(12), which are determinants of Hcy status in humans, are presented. Samples obtained from a troop of 149 rhesus monkeys (Macaca mulatta) fed a high protein commercial diet were analyzed for Hcy by using high-performance liquid chromatography. Folate and vitamin B(12) levels were determined by using an autoanalyzer. Results (mean [95% confidence interval]) for the entire troop were: Hcy, 4.5 (4.2-4.9) micromol/L; folic acid, 8.6 (8.0-9.1) micromol/L; and vitamin B(12), 673 (611-741) pmol/L. Quantitative values are similar to published values for another species of wild-caught macaques. Similar to trends noted for humans, male monkeys had higher Hcy values than did female animals, pregnant animals had lower values than did nonpregnant ones, and Hcy levels were inversely proportional to plasma folate and vitamin B(12) concentrations. However, homocysteine levels in rhesus monkeys did not vary consistently with age, whereas they increase with age in humans.

Use of games to improve scores on memory-type examinatios

Las técnicas que facilitan la memoria, tales como juegos de palabras, son las técnicas de enseñanza comunmente usadas, pero son ellas transmisores de información efectivas? Para contestar ésta pregunta, se hizo una lista de científicos y se examinaron con pruebas de tipo pareo usando tres métodos diferentes al preparar los examenes. Estos incluyeron dos métodos tradicionales: 1) Identidad de los científicos que se les dieron (DEFINE). 2) Identidad de los científicos buscados en una referencia de biblioteca (BUSCAR) y el método no tradicional consistió de deducir la identidad de los científicos resolviendo un rompe cabeza de palabras (ROMPE CABEZA). Los resutlados entre la pre- y pos-prueba demostraron un aumento significativo usando todos los métodos, sin embargo, el ROMPE CABEZA tenía mayor aumento, luego el DEFINE o el BUSCAR. Un cuestionario indicó que el ROMPE CABEZA fue el método proferido de estudios, y los estudiantes se sintieron igual de confiados usando el ROMPE CABEZA como método de preparación que con los otros dos métodos tradicionales. Se concluye que los juegos de palabras deben de promoverse como método para mejorar la memoria

Treatment of tropical sprue: the work of Dr. Bailey K. Ashford examined in retrospect

Tropical sprue is a malabsorption syndrome that responds to treatment with folic acid and a broad-spectrum antibiotic. Eighty years ago, prior to the identification of the vitamins and the discovery of penicillin, clinical trials often consisted of best guess treatments based upon current knowledge and available technology. Dietary interventions were emerging as effective treatments for alleviation of diseases such as pellagra and beri beri. Representative of his generation of clinicians, Bailey K. Ashford, MD, one of the pivotal figures in academic medicine in Puerto Rico, carried out dietary studies in his patients with tropical sprue. This historical retrospective presents an examination of the diets used by Ashford in terms of nutrient content and comparison to current recommended dietary allowances. Results show the diets to be inadequate for sustained nutrient value and especially low in folic acid. In summary, Ashford recognized the basic causes of tropical sprue but was unable to effectively treat the syndrome due to lack of adequate resources.

A profile of knowledge and attitudes toward tobacco usage of first and fourth year medical students at the University of Puerto Rico

Estudiantes de medicina del Recinto de Ciencias Médicas de la Universidad de Puerto Rico que terminaban su primero y cuarto año de estudios fueron sometidos a un cuestionario titulado "Actitud sobre el uso del tabaco de los profesionales de la salud en Puerto Rico". El porciento de cada grupo que fuma actualmente resultó ser 18.5%. Entre los estudiantes varones 24.2% de ler año y 13.5% de 4to año fuman, mientras que entre los estudiantes mujeres los porcientos obtenidos son de 9.1% para ler año y 3.2% para 4to año. Se pudo observar en este estudio que hay tendencia a empezar a fumar a una edad más temprana que en años anteriores, al comparar los resultados obtenidos con los de una encuesta realizada hace 20 años. Ambos grupos demostraron que sabían sobre los riesgos y consecuencias de fumar, sin embargo, los estudiantes de 4to año están más concientes de los peligros que envuelve el fumar. La actitud hacia el tabaco depende en gran escala de si el encuestado fuma o no; los no fumadores como podría predecirse están más en contra del uso del tabaco. A pesar de que existen diferencias culturales entre los profesionales de la salud en Puerto Rico y Estados Eunidos, ambos grupos tienen conocimiento y actitudes similares hacia el uso del tabaco

Dietary analysis of meals served in the breakfast and lunch programs of Puerto Rican schools

BACKGROUND: Nutritional analysis of meals in the Federally-sponsored Breakfast and Lunch Programs in Stateside Schools has recently been completed. However due to ethnic and cultural differences, the findings may not be directly applicable to similar nutrition programs in Puerto Rico. It is our aim to carry out an analysis of meals served in Federal programs in Puerto Rico and to compare results to the stateside study. METHODS: Twenty eight different breakfast meals and 96 different lunch meals being cycled in elementary, middle and secondary schools throughout the entire island of Puerto Rico were analyzed for content using the Minnesota Nutrition Data System 32 and compared with: 1) compliance to meal pattern requirements of federal programs, 2) dietary guidelines for Americans (DG) and 3) recommended dietary allowances (RDA's). RESULTS: Breakfasts and lunches served in Puerto Rican Schools satisfy federal meal pattern requirements however most frequently offered foods different from programs in the mainland, reflecting ethnic and cultural food preferences. In terms of DG's adequate protein waspresent, cholesterol content was satisfactory but meals had excess percent energy from fat as well as excess energy from saturated fat, high sodium and a lower than recommended level of energy from carbohydrate. In terms of RDA's meals had prescribed levels of vitamin A, vitamin B12, vitamin C, calcium, folacin, magnesium, phosphorus and potassium. Below prescribed levels included vitamin B6, copper, vitamin E, energy, fiber, iron, niacin and zinc. CONCLUSIONS: While differences in food preferences exist between foods available in the Breakfast and Lunch Programs in Puerto Rican and U.S., schools, they have similar strengths and weaknesses when compared to compliance with U.S. Dietary Guidelines and with recommended dietary allowances

Glycation of blood proteins during pregnancy and lactation in the rat

Non-enzymatic glycation of blood proteins is a time and concentration dependent process and has been used clinically to monitor carbohydrate metabolism during human pregnancy. Since gestation in rats is of much shorter duration than in humans (3 weeks vs 9 mos) the question was raised whether similar differences in glycated proteins could be observed. Therefore, levels of glucose, glycated hemoglobin and fructosamine were measured during normal pregnancy and lactation in rats. Glucose levels during late pregnancy were significantly lower than in non pregnant and early pregnant rats. During lactation glucose levels return to normal. Glycated hemoglobin paralleled glucose decrease during late pregnancy and increased during lactation. Fructosamine followed a similar pattern. Therefore glycated hemoglobin and fructosamine appear to be reliable indicators of glucose status during gestation and lactation similar to humans and may have value as predictors of gestational diabetes mellitus once a suitable rat model is developed