Cancer, vitamins, and plasma lipids: prospective Basel study.

In the Basel study (BS) (1960-73) on cardiovascular and peripheral arterial diseases, a mortality follow-up was completed for the period 1965-80. Of the 4,224 men at risk for these diseases, 531 died. The causes of death were established from the death certificates and classified into 8 groups. For each case 2 age- and sex-matched controls were selected and compared with the corresponding cases with regard to the various variables obtained at the three examinations (1960, 1965, 1971). This report dealth with cancer mortality, plasma lipids, plasma vitamins, alcohol and cigarette consumption, and intake of milk and citrus fruits. The results were all obtained at the second follow-up examination (BS III, 1971-73). Cancer of the lung, stomach, large bowel, and all other sites were treated separately. The average follow-up from BS III until death varied from 3.7 years (other sites) to 4.9 years (cancer of the lung). Of 129 cancer deaths, the highest incidence was found for cancer of the lung (38) followed by stomach (19) and large bowel, (15) and the remainder (57) was for other sites. Plasma lipids did not differ significantly among cases and controls. However, the lowest values were observed in colorectal cancer and gastric carcinoma (mean cholesterol, 213 mg/dl). beta-Carotene was significantly lower in cancer cases of the lung than in controls (14.8 micrograms/dl vs. 23.7; P less than .05). It was also low in gastric cancer cases (13.0 micrograms/dl). Vitamin A was below average only in cases with gastric cancer (difference due to the small number not significant). Vitamin C was consistently lower in cancer cases than in controls. The lowest value was found for cancer of the stomach and corresponded to a below-average consumption of citrus fruits. Vitamin E was low in cancer of the colon. Plasma lipids correlated strongly with vitamin E (tau = 0.5) and to a lesser extent with vitamin A (tau = 0.25). beta-Carotene correlated poorly with beta-lipoproteins (low-density and very low-density lipoproteins) but significantly with total cholesterol. Smoking was inversely related, as was alcohol consumption, to the beta-carotene level. From these results, the conclusion was that vitamins influence carcinogenesis in humans.

Biotin deficiency in chicks fed a wheat-based diet.

A wheat-based diet produced severe biotin deficiency symptoms appearing at the age of ten to fourteen days and becoming very severe in the third and fourth week (group 1). Biotin supplementation with 50 mug/kg (group 2) reduced the symptoms almost completely, but did not restore completely growth compared to chicks receiving the diet supplemented with 300 mug biotin/kg compared to chicks receiving the diet supplemented with 300 mug biotin/kg (group 3). The plasma level of biotin was about, or lower than, 100 ng/100 ml plasma in groups 1 and 2, indicating biotin deficiency. In group 3, plasma biotin was above 200 ng/100 ml. Liver biotin, after two weeks, was low in group 1 (less than 600 ng/g), medium in group 2 (1000 to 1500 ng/g) and in group 3 above 2000 ng/g. Plasma and liver biotin levels are found to be suitable parameters for diagnosis of subclinical biotin deficiency in chicks.

The vitamin status of Viennese school children aged 11-12 years.

In 830 Viennese school children of both sexes, aged 11-12 years, plasma carotene, retinol and alpha-tocopherol, erythrocyte transketolase activity (alpha ETK), erythrocyte glutathione-reductase (alpha EGR) and erythrocyte glutamic acid oxalacetic acid transaminase (alpha EGOT) were determined. The mean alpha ETK value indicated inadequate thiamine supply. The vitamin status was better in boys and in children of higher socio-economic classes than in girls and in the low income group, with respect to beta-carotene, retinol, tocopherol, thiamine and riboflavin. The opposite situation was true in the case of pyridoxine where the girls and the children of lower socio-economic status showed lower values for alpha EGOT indicating a better vitamin B6 status. Eating habits of the children did not seem to affect the vitamin status, but in children with overweight higher values for retinol and thiamine were more frequent and a positive correlation was found between tocopherol values and serum cholesterol.

The vitamin A activity of beta-carotene.

In rats (parameters: growth, epithelial protection and liver storage), and in chicks (liver storage), it has been demonstrated that the conversion of beta-carotene to vitamin A diminishes inversely to the intake of beta-carotene, as long as the dosages are higher than 1-2 times the daily requirements. The decrease in the biopotency of beta-carotene follows a Michaelis Menten kinetic. In the dosage range of the daily requirements molecular ratio applies. Based on these findings, the following guidelines for the conversion of retinol in man are proposed: (Table: see text). For beta-carotene in oily solutions, a conversion factor of 1:3.33 should be accepted for the dosage range of 1,500 to 4,000 micrograms. For higher doses, this factor should be decreased according to the results with laboratory animals: For beta-carotene in vegetables, the conversion factor of 1:6.0 should be accepted for intakes between 1,500 and 4,000 micrograms. A higher factor should be chosen for smaller intakes, and a smaller factor for higher intakes.

The effects of riboflavin administration on iron metabolism parameters in a school-going population.

The effect of riboflavin administration on iron metabolism was studied in a group of riboflavin-deficient children with Erythrocyte Glutathione Reductase (EC 1.6.4.2) reactivation above 1.20. The results have shown that the administration of riboflavin has resulted in a decrease of serum iron as well as in transferrin saturation which was accompanied by an increase in blood hemoglobin in subjects with initially lower hemoglobin values (less than or equal to 13.5 g/100 ml). There was, however, no change in blood hemoglobin in the group with initially higher hemoglobin values (greater than or equal to 14.0 g/100 ml). The results suggest that inadequate riboflavin intake may affect the iron utilization. The possible mechanism of riboflavin action on iron utilization is discussed.

Nutritional status of the elderly. III. Vitamin nutriture of elderly pensioners in Perugia.

The thiamin, riboflavin, vitamin C, vitamin A, folacin, and vitamin B12 nutriture was assessed in a longitudinal study in 206 aged pensioners of the city of Perugia. The prevalence of thiamin and riboflavin malnutrition, particularly in men, was rather high. Unexpectedly low values of plasma vitamin C were not uncommon among men. For folacin there were a large number of individuals with low plasma levels, while the plasma levels of vitamin A and B12 is in general satisfactory. As in other studies, no significant correlation between vitamin nutriture and intake was found.

Vitamin C status and physical working capacity in adolescents.

The effect of ascorbic acid supplementation on physical working capacity was studied in young adolescent boys in which the concomitant biochemical riboflavin and pyridoxin deficiencies were corrected by medicamentous prophylaxis. After daily administration for two months of 70 mg ascorbic acid, the mean plasma vitamin C in the experimental group (n = 49) rose from 0.33 to 1.49 mg/dl (p less than 0.001) and the prevalence of deficient plasma vitamin C values (less than 0.20 mg/dl) decreased from 52.3 percent to zero. The improvement in vitamin C biochemical status was also accompanied by a statistically significant increase in VO2 max. (p less than 0.01). There were no significant changes neither in the mean plasma vitamin C values nor in the mean VO2 max. in the control group subjects (n = 42). The increase in VO2 max. in the experimental group was primarily the result of an increase of VO2 max. in subjects with initially lower values. When data from both experimental and control groups were pooled together, a positive and significant association was found between VO2 max. and the increase of plasma vitamin C values below 1.0 mg/dl. No further increase in VO2 max. was observed when vitamin C plasma values reached 1.0 mg/dl or more. The two regression lines crossed at X = 0.86 mg/dl. This cut off point of plasma vitamin C level corresponds to a dietary intake of about 80 mg of ascorbic acid per day. The results of this study are in agreement with the suggested optimal ascorbic acid daily intake obtained by kinetic studies with (1-14C) ascorbic acid.

Blood vitamin and mineral levels in 7-17 years old Turkish children.

Blood vitamin (thiamin, riboflavin, vitamins B6, B12, C, A, and E, folate and beta-carotene), mineral (iron and zinc), alkaline phosphatase and cholesterol levels and hematocrit were assessed in 960 school-age children selected by random sampling from urban and rural regions of Turkey. Nutritional statuses of the children according to each index were compared with respect to age, sex, area and type of settlement. A biochemical deficiency was observed in 20.1% of the children for thiamin, in 89.9% for riboflavin, in 83.4% for vitamin B6, in 23.3% for folate, in 5.9% for vitamin B12, in 43.0% for vitamin C, in 11.6% for vitamin A, in 3.5% for beta-carotene, in 21.8% for vitamin E, in 6.1% for iron, and in 15.7% for zinc. Hematocrit was low in 54.3%. Alkaline phosphatase and cholesterol levels were found to be above normal in 54.6% and 4.9% of the children respectively. It is surmised that a major cause of the deficiencies was an ignorance of good dietary practice. Although the children were found to be relatively short according to the National Center for Health Statistics standards, their normalised weights were within acceptable limits, which suggested a prevalence of stunting but not wasting in this population.

Nutritional status, grip strength, and immune function in institutionalized elderly.

The effects of vitamin supplementation on grip strength and immune function was studied in a group of institutionalized elderly with a relatively higher prevalence of low and below acceptable biochemical parameters of vitamin C, pyridoxine, folic acid, riboflavin, iron and zinc nutriture. The vitamin supplementation has resulted in a statistically significant increase in the level of biochemical parameters related to added vitamins, and the number of subjects with inadequate vitamin values was reduced to zero. The improved vitamin status had a positive and statistically significant effect on the delayed cutaneous hypersensitivity one of the parameters of cellular immunity. The calculation of multiple correlation after inclusion of all biochemical parameters into the stepwise regression analysis has shown that the coefficient of multiple regression between examined biochemical parameters of nutrition status and delayed cutaneous hypersensitivity was R = .599 (p less than 0.001) which indicates that about 36% of the variability in the cellular immunity would be affected by the vitamin and mineral nutrition status.

[Relationship between vitamin status (A, B1, B2, B6, and C), clinical features and nutritional habits in a population of old people (author's transl)]. / Beziehungen zwischen dem Vitaminstatus (Vitamin A, B1, B2, B6 und C), klinischen Befunden und den Ernährungsgewohnheiten in einer Gruppe von alten Leuten in Wien.

112 patients in a medical ward were examined clinically and biochemically with regard to their vitamin status (plasma vitamin A, plasma vitamin C, blood glutathione reductase, vitamin B1, vitamin B2, N-methyl nicotinic acid amide and pyridoxic acid excretion). The nutritional habits were assessed by means of a questionnaire. The results of these two examinations were correlated with the clinical findings. The assessment of the vitamin B2 status showed a deficiency in 8 cases and a marginal vitamin B2 supply in a further 4 cases. The thiamine intake was insufficient in 43 cases and marginal in 42 cases. The biochemical assessment of vitamins C, B1 and PP indicated a deficiency of these vitamins. Dermatological signs pointed to a deficiency of vitamins A and B2. There was a significant correlation between the plasma vitamin A level and the serum iron level. The importance of milk and vegetables in the diet is stressed and also the association between milk consumption and the serum cholesterol level.

[Biochemical markers of vitamin supply]. / Marqueurs biochimiques d'apport vitaminique.

The biochemical indicators to assess the nutritional status of individuals may be divided into 4 categories: methods which measure body stores e.g. plasma vitamin C or urinary excretion of thiamine, methods related to the rate of conversion of vitamins to metabolites e.g. thiamine pyrophosphate content of blood or urinary excretion of pyridoxic acid, methods based on the coenzymatic or hormonal function of vitamin metabolites, e.g., erythrocyte transketolase in the case of vitamin B1 or plasma concentration of 1,25 dihydroxycholecalciferol in the case of vitamin D. Finally, methods derived from true biochemical impairment of the metabolism, e.g., elevated blood pyruvate in borderline vitamin B1 deficiency or prolonged blood clotting time in the case of vitamin K deficiency. The results of all of these methods are for a certain vitamin related to each other and also to the daily intake of the vitamin in question as long as the daily vitamin intake remains stationary and no confounding variables such as disease, smoking or drinking habits interfere. Otherwise the estimation of vitamin intake by measuring biochemical parameters becomes questionable, since biochemical parameters are indicators of nutritional status and not so much of nutrient intake.

[Should dietary recommendations be revised?]. / Müssen die Ernährungsempfehlungen revidiert werden?

The dietary recommendations of the Second Swiss Nutrition Report are in part based on incomplete knowledge about nutritional patterns of the Swiss population and on controversial results of relations between nutritional status and health, thus do not fulfill completely the WHO requirements for dietary guidelines. A new set of recommendations would not be based on better knowledge. However, efforts to prevent the widespread chronical diseases, e.g. by dietary measures are understandable. We therefore recommend to apply dietary guidelines never without considering their controversial incomplete scientific basis and to prevent by this a possible negative impact of dietary guidelines.

[A nutritional survey of 38 single elderly persons with free choice of food]. / Ernährungserhebung bei 38 alleinstehenden Betagten mit freier Nahrungswahl

The nutritional habits of 38 randomly selected single aged people with free choice of food have been investigated by the precise weighing method. Blood serum levels of the vitamins A, C, and E and of beta-carotene and biotin were analyzed, and the nutritional status with respect to the vitamins B1, B2, and B6 was examined by the transketolase-test, the glutathione-reductase-test, and the glutamic-acid-oxalo-acetic-transaminase-test. In relation to the desirable daily supply of nutrients and other dietary components the food was deficient in the vitamins B1, and B6 and in magnesium. For women an additional calcium-deficiency was demonstrated. The dietary fat content, however, was found to be high (44% of total calorie intake). The results of the blood analyses suggest an insufficient dietary supply of vitamin B1, partly also of the vitamins B6 and C. The total caloric intake was found to be rather low with respect to the age.

[Slight variations of vitamin A in blood levels and their effect on visual perception]. / Petites variations du taux sanguin de vitamine A et leurs incidences sur la perception visuelle.

The purpose of this study was to find out a simple perceptual visual test that gives the possibility to detect the visual incidence of slight variations of the vitamin A blood rate. The visual function was tested in 30 young subjects without refraction problems at the same time as blood concentration of vitamin A was measured. Visual tests comprised visual acuity at high and low luminance level, contrast sensitivity, glare sensitivity as well as attenuation characteristics of the eye toward flickering stimuli. Among all these tests, only the flicker test showed some relation with the plasma vitamin A levels, which were situated between 35 and 75 mcg/100 ml.

[Basle family study. Organization and 1st results]. / Basler Familienstudie Organisation und erste Resultate.

The organisation of the Basle Family Study and preliminary results outlining the data analysis are presented. The study investigates in 500 families the familial influence on risk factors for cardiovascular diseases. In addition the distribution of hemostatic variables is studied. Analysis of the data according to age, sex and intrafamilial relations in 211 families demonstrate the influence of the mother on the development of the life style of the children.