Primary adult lactose malabsorption in Italy: regional differences in prevalence and relationship to lactose intolerance and milk consumption.

A study of regional differences in prevalence of primary adult lactose malabsorption in Italy was conducted on 205 subjects. Their origin was determined by their grandparents' birthplace, 89 from northern, 65 from central, and 51 from southern areas of Italy. Lactose malabsorption was diagnosed with standard oral lactose tolerance test and blood glucose determinations. Lactose malabsorbers showed symptoms more frequently than absorbers after the test load of lactose (p less than 0.01) they also reported milk intolerance more frequently (p less than 0.01). Prevalence of lactose malabsorption is significantly lower in the central sample (19%) than in the northern (52%) and southern (41%) samples (p less than 0.01). This finding contrasts with the hypothesis of a continuous increase in frequency of lactose malabsorption from northern to southern Europe and is probably due to the complex genetic history of the Italian population.

Abnormal lipid metabolism in treated hypertensive patients with non-insulin-dependent diabetes mellitus.

Plasma lipid, lipoprotein, and apoprotein concentrations were measured in 169 patients with non-insulin-dependent diabetes mellitus (NIDDM), 78 with normal blood pressure, and 91 diagnosed and receiving drug treatment for hypertension. Plasma triglyceride, cholesterol, low-density lipoprotein-cholesterol, and apoprotein B concentrations were significantly higher (p = less than 0.05 to less than 0.001) in the hypertensive group. In addition, the ratios of high-density to low-density lipoprotein-cholesterol and of apoprotein A-1 to apoprotein B were significantly reduced (p less than 0.01) in patients with hypertension. The changes noted were independent of differences in sex distribution, degree of obesity, and level of glycemic control. These results indicate that substantial differences in plasma lipid, lipoprotein, and apoprotein concentrations are seen when normotensive patients with NIDDM are compared with patients who are also being treated for hypertension, and that all of the changes noted would increase the risk of coronary artery disease in the hypertensive group. Since all patients with hypertension were receiving anti-hypertensive medications, it is not clear if it is hypertension per se, or its treatment, that is responsible for the observed changes in lipid metabolism.

Chenodeoxycholic acid and ursodeoxycholic acid effects in endogenous hypertriglyceridemias. A controlled double-blind trial.

A double-blind controlled trial was carried out to compare the effects of chenodeoxycholic acid (CDCA), ursodeoxycholic acid (UDCA), and placebo on cholesterol and triglyceride levels in patients with endogenous hypertriglyceridemias. The dose of both bile acids was four 150-mg capsules day. Total serum cholesterol levels did not show appreciable changes with any of the treatments. HDL cholesterol was significantly increased after CDCA but not after UDCA or placebo. CDCA feeding was associated with a significant decrease in serum triglyceride levels, whereas the other treatments failed to show an effect. It is concluded that UDCA does not affect serum lipid levels, whereas CDCA lowers serum triglycerides and may be useful in the treatment of endogenous hypertriglyceridemia.

Effectiveness of long-term treatment with pantethine in patients with dyslipidemia.

A one-year clinical trial with pantethine was conducted in 24 patients with established dyslipidemia of Fredrickson's types II A, II B, and IV, alone or associated with diabetes mellitus. The treatment was well tolerated by all patients with no subjective complaints or detectable side effects. Blood lipid assays repeated after 1, 3, 6, 9, and 12 months of treatment revealed consistent and statistically significant reductions of all atherogenic lipid fractions (total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B) with parallel increases of high-density lipoprotein cholesterol and apolipoprotein A. The results were equally good in patients with uncomplicated dyslipidemia and in those with associated diabetes mellitus. The authors conclude that pantethine (a drug entity related to the natural compound, pantetheine) represents a valid therapeutic support for patients with dyslipidemia not amenable to satisfactory correction of blood lipids by diet alone.

[Nutritional principles for the pregnant diabetic]. / Principi di nutrizione della gravida diabetica.

After a short account on alimentation in pregnant women, the authors examine in detail the correct alimentation in pregnant women affected by different types of diabetes. As general lines for a correct nutritional approach, a total caloric intake of 2200-2500 kcal daily (9196-10450 Kj) (which enclose 35-40 kcal/pro/kg ideal weight and a caloric surplus for pregnancy) is recommended. In over-weight women the caloric intake will be reduced till 1500 kcal (6270 Kj) checking constantly metabolic situation (increase of weight should be for the first ten weeks of 100 g weekly, than of 300 g weekly). Altogether weight increase should be from 9 to 12 kg. 15-20% of caloric intake should be represented for proteins, very important for pregnancy and good growth of fetus. Carbohydrate intake should be 55-60% of caloric intake represented for 75-80% by complex glucides and for 20-25% simple glucides to support a suitable amount of dietary fibres (25-30%). The lipid intake recommended should be 25-30% of the daily calories with a third of monounsaturated fat acids, a third of polyunsaturated fat acids and a third of saturated fat acids, with a cholesterol amount under 300 mg/die. In additional the nutritional plan should consist of a adequate amount of "non energetic nutrients" (minerals and vitamins), particularly the calcium intake must be 1200 mg/die and 18 mg/die that of iron and folic acid, vitamin A, D and B intake must be increased. Finally, the authors advise against alcoholic beverages and recommend a regular subdivision of the meals.(ABSTRACT TRUNCATED AT 250 WORDS)

[Clinical research on a new microcrystalline cellulose dietetic supplement]. / Ricerca clinica su un nuovo integratore a base di cellulosa microcristallina. Effetti sul transito intestinale in obesi sottoposti a restrizioni dietetiche.

BACKGROUND: Obesity dietetic treatment produces a residual bulk reduction that is easily responsible of constipation. Fiber addiction improves bowel transit. To avoid some unpleasant effects of high molecular weight fibers, a research was made on a colloidal cellulose microfibers (MCC) product, that for its low molecular weight and its phytic acid lack, can limit these problems. Influence on constipation, blood and chemical analysis and satiation has been studied. METHODS: Research was made on obese patients. One group (studied for 4 weeks) of 30 subjects, 25 affected by simple obesity, and 5 obese, with hyperlipemia and non insulin dependent diabetes. The other group (studied for 8 weeks) of 10 subjects affected by simple obesity. The product was in tablets containing MCC 0.600 mg each, to be taken daily in dose of 4/6. Weight, BMI, total and fractionated cholesterol, triglycerides, A and B lipoproteins, uric acid, glucose and glycosylated hemoglobin (in diabetic patients), blood count and plasma iron level (in the second group of patients) had been determined. Each subject reported on a record evacuations, collaterals symptoms, sense of satiation. RESULTS: 83% in the first group of patients and 90% in the second group showed defecation improvement. No changes were found in controlled parameters. MCC effect has been constipation correction. CONCLUSIONS: This fiber can be suggested in obese subjects when diet caused a slow bowel transit. Supplement can be protracted because it doesn't interfere with iron absorption.

Dietary treatment of dyslipidaemias.

Detailed and personalized dietary guidance must be given to subjects recognized as dyslipidaemic and to the parents of high-risk individuals. The diets should be hypolisocaloric with reduced intake of fats (30%) and cholesterol (250-300 mg/day) and with high intake of carbohydrate (55-60%), preferably complex. Dietary fibre intake should be at least 25 g/day.

Lipoprotein(a) and exercise.

Plasma levels of lipoprotein(a), total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, apoprotein A1 and apoprotein B were assessed in 10 healthy, untrained volunteers subjected to a bicycle ergometric exercise equal to 50% of individual VO2max, followed by increasing loads until muscular exhaustion. Blood samples were taken before the exercise, immediately afterwards and then at 12-hourly intervals for a 72 hours period. Subsequently, the same parameters were evaluated for 8 long-distance runners during the XXIII New York Marathon, with blood samples being taken before and after the race, and then after one month of detraining. After the exercise, lipoprotein(a) in untrained subjects began to decrease significantly from the 24th hour on and remained lower than baseline levels up till the 72nd hour. After detraining, lipoprotein(a) in marathon runners increased significantly both with respect to basal values and especially to post-race values. Modifications of the other metabolic parameters evaluated in both tests were negligible and predictable. In the two groups of subjects examined, no correlation was found between lipoprotein (a) and the anthropometrical data and metabolic parameters considered.

[Clinical experience on a new substance with high fibre content (author's transl)]. / Esperienze cliniche su un nuovo preparato ad elevato contenuto in fibre.

After a brief reference on the so-called diseases of "civilisation" and on their correlations with a diet rich in refined high caloric carbohydrate having poor gastric filling capacity and therefore lacking in fibre, the authors present their experience on a new product, MF/D/80, which is an association of cereal and acid fruit fibres. 25 patients (3 men and 22 women) were treated, 22 of them suffered from chronic constipation and 3 from colitis. The experiment was carried out without the use of control drugs. The aim of the research was that of verifying the efficacy and tolerability of the product. The efficacy was optimal in 88%, good in 4% and modest in 2 cases (8%) of the entire number of cases while the tolerability has been optimal in all the cases. The Authors conclude the retaining that MF/D/80 is a product that can be used with enormous advantages in chronic constipation for its efficacy, optimal tolerability and for its mechanism of action. The Authors finally underline its usefullness as an "alimentary integrator" in all those diseases (obesity, diabetes, atherosclerosis etc.) which among the various etiopathogenetic moments, also count in refined alimentation.

Double-blind study on the tolerance of four types of milk in lactose malabsorbers and absorbers.

Eighty Italian adults (53 females, 18-69 years, and 27 males, 18-60 years) underwent double-blind tests involving the intake of increasing amounts (125, 250, 500, 1000 ml/d) of four types of milk with normal or low lactose and/or fat content. The tests were completed satisfactorily by 71 subjects. Forty were lactose malabsorbers (LMs) and 31 were absorbers (LAs), according to a standard oral lactose tolerance test. Each subject reported on a questionnaire whether he/she experienced symptoms during the 24 h after milk intake, and the intensity of the symptoms, adopting a score of 0 to 12, according to an already tested procedure. The aim of the study was to investigate the relationship between lactose malabsorption or absorption and intolerance to milk in Italian adults, relative to lactose and fat contents, dose of milk and individual sensitivity. LMs reported symptoms overall more frequently and with greater intensity than LAs (P less than 0.001). The amount of milk ingested was positively associated with the frequency of symptoms both in LMs and LAs. Contrary to earlier findings, fat seemed to contribute to milk intolerance in LMs rather than to reduce it. According to analysis of variance individual differences accounted for 40 per cent of total variation in symptom frequency.

[Retrospective study on 778 patients with acute myocardial infarct: relation between sex, age and blood lipid picture]. / Indagine retrospettiva su 778 pazienti con infarto miocardico acuto: rapporti tra sesso, età e quadro lipemico.

To evaluate the relationship between myocardial infarction and serum lipid levels, 778 patients admitted to the Fidenza Coronary Unit were studied. These patients were divided by sex and into groups by age decade and the frequency of hyperlipidemia was investigated. In the first place the association between myocardial infarction (MI) with hypercholesterolemia, second with hypertriglyceridemias was considered. In addition the population was subdivided in respect to the 3 more frequent types of hyperlipidemia (hypercholesterolemia, hypercholesterolemia and hypertriglyceridemia, hypertriglyceridemia). The results show the presence at a positive correlation between MI and hypercholesterolemia in the younger groups in both sexes, but mainly in female. Similar results are obtained when the correlation between MI and hypertriglyceridemia was considered, but at a lower statistical significance. The statistical analysis of the different types of hyperlipidemia confines the important pathogenetic role of hypercholesterolemia by itself and in association with hypertriglyceridemia. On the other hand hypertriglyceridemia does not show any primary influence on MI, but it acts synergistically with hypercholesterolemia. The strong association of hyperlipidemia and MI in the younger group and in female, documented in this study, confirms the importance of hypercholesterolemia and hypertriglyceridemia as a risk factor in the early development of coronary heart disease.