Gestational vitamin D concentration and other risk factors versus fetal femur length.

Introduction: Vitamin D plays a crucial role in the development of healthy fetal bone tissue. Analysis of fetal bone parameters versus maternal vitamin D status is necessary to shed some light on the matter. The aim of the study was to investigate the relationship between maternal and cord vitamin D concentrations and other factors which might affect fetal bone development and femur length.Material and methods: The study included 94 term pregnancies, delivered at the Department of Obstetrics, Gynecology and Oncology, Medical University of Warsaw. Fetal femur length was measured during an ultrasound examination on admission to the delivery unit. Total 25(OH)D concentrations were measured in maternal and cord blood. Direct interview with a dietician was used to collect lifestyle and nutrition data. Multiple regression analysis was used for statistical analysis.Results: No statistically significant relationship was found between vitamin D concentrations and fetal femur length, either in maternal (p = .7709) or cord (p = .7751) blood samples, despite the fact that low vitamin D concentrations, which might indicate aberrations in fetal bone development, were detected in 50.0% of the mothers and 28.7% of the newborns. Also, no relationship was confirmed for the remaining parameters, including nutritional factors (calcium or caffeine intake, vitamin/mineral supplements).Conclusion: Low vitamin D concentrations during pregnancy and lifestyle factors had no negative associations with fetal femur length.

Caffeine Intake During Pregnancy and Neonatal Anthropometric Parameters.

Caffeine is a psychoactive substance that may affect the normal course of pregnancy, therefore its intake during that time should not exceed 200 mg/day. The aim of this study was to evaluate caffeine intake among pregnant women from the Warsaw region. The study was conducted among 100 pregnant women who delivered at the Department of Obstetrics, Gynecology and Oncology, Medical University of Warsaw. Caffeine intake from coffee, tea, and energy drinks was measured using a questionnaire. Direct interviewing was used, with all interviews conducted by the same dietitian. Multiple regression analysis was used to investigate the relationship between caffeine intake and anthropometric measurements of the newborns. Mean caffeine intake among pregnant women was 68 ± 51 mg/day. Only 2% of the respondents exceeded the safe dose of 200 mg. Tea (mostly black) was the source of 63% of all caffeine. No relationships were found between caffeine intake and neonatal weight, length, or head and chest circumference (p > 0.05). Caffeine intake in our study population was relatively low and did not negatively affect fetal growth.

How is the process of setting micronutrients recommendations reflected in nutrition policies in Poland? The case study of folate.

INTRODUCTION AND OBJECTIVE: Ensuring the adequate intake of micronutrients by populations is an important aspect of public health. This study aims to elucidate the process of setting nutrition recommendations and the development of subsequent policies associated with micronutrients in Poland by using the case study of folate. MATERIAL AND METHODS: The study was based on 13 interviews conducted between October 2010 - February 2011, and desk research comprising a review of the associated scientific literature and relevant documents, such as scientific opinions and reports of the meetings of scientific committees. The interviews were conducted within the EURRECA (EURopean micronutrient RECommendations Aligned) Network of Excellence in the frame of the European Union's 6th Framework Programme. RESULTS: Since 1997, the Experts Group of the Ministry of Health recommended that all women of childbearing age should consume folic acid as a supplement to prevent neural tube defects in their offspring. The fortification of foodstuffs with folic acid is not obligatory. This study describes the revision of the folate nutrient recommendation and the process by which strategies to increase the intake of this vitamin by the Polish population were identified. The institution responsible for the choice and implementation of folate policy is the Ministry of Health and the National Food and Nutrition Institute is responsible for setting/updating the nutrient recommendations. CONCLUSIONS: The current Polish nutrition recommendations for folate are consistent with the levels set by most other countries. The constant improvement of nutritional knowledge on folate among consumers, especially young women, is necessary.

Dietary intake of DHA during pregnancy: a significant gap between the actual intake and current nutritional recommendations

Background: Docosahexaenoic acid (DHA) is indispensable to ensure proper development of the fetal central nervous system and pregnancy duration. Daily intake of DHA should be at least 100 mg higher as compared to the pre-pregnancy values. Objectives: The aim of the study was to evaluate DHA intake during pregnancy and compare it to the current recommendations. Material and methods: A total of 100 pregnant women presenting for labor at the Department of Obstetrics, Gynecology and Oncology, Medical University of Warsaw, were included in the study. DHA intake from the following sources: fish and eggs, and DHA preparations collected based on the questionnaire was investigated. Results: Low dietary DHA intake (median: 60 mg/day) was observed. The values were only slightly higher (median: 90 mg/day) after DHA preparations were taken into consideration because only 28% of the pregnant women used DHA preparations. Overall, 92% of the subjects consumed <200 mg of DHA a day, which was the result of insufficient fish consumption (mean: 15 g/day). Only 10% of the respondents ate fish twice a week, in which case the DHA dietary intake was statistically significantly higher (median: 160 mg/day) (p=0.0232). Total median dietary DHA and EPA intake in the study population was 79 mg/day. Conclusions: The diet of pregnant women is largely deficient as far as DHA intake is concerned. Importantly, it is not possible to comply with current recommendations without dietary supplementation.

Associations of vitamin D status with dietary intakes and physical activity levels among adults from seven European countries: the Food4Me study.

PURPOSE: To report the vitamin D status in adults from seven European countries and to identify behavioural correlates. METHODS: In total, 1075 eligible adult men and women from Ireland, Netherlands, Spain, Greece, UK, Poland and Germany, were included in the study. RESULTS: Vitamin D deficiency and insufficiency, defined as 25-hydroxy vitamin D3 (25-OHD3) concentration of <30 and 30-49.9 nmol/L, respectively, were observed in 3.3 and 30.6% of the participants. The highest prevalence of vitamin D deficiency was found in the UK and the lowest in the Netherlands (8.2 vs. 1.1%, P < 0.05). In addition, the prevalence of vitamin D insufficiency was higher in females compared with males (36.6 vs. 22.6%, P < 0.001), in winter compared with summer months (39.3 vs. 25.0%, P < 0.05) and in younger compared with older participants (36.0 vs. 24.4%, P < 0.05). Positive dose-response associations were also observed between 25-OHD3 concentrations and dietary vitamin D intake from foods and supplements, as well as with physical activity (PA) levels. Vitamin D intakes of ≥5 µg/day from foods and ≥5 µg/day from supplements, as well as engagement in ≥30 min/day of moderate- and vigorous-intensity PA were associated with higher odds (P < 0.05) for maintaining sufficient (≥50 nmol/L) 25-OHD3 concentrations. CONCLUSIONS: The prevalence of vitamin D deficiency varied considerably among European adults. Dietary intakes of ≥10 µg/day of vitamin D from foods and/or supplements and at least 30 min/day of moderate- and vigorous-intensity PA were the minimum thresholds associated with vitamin D sufficiency.

Vitamin D Concentration in Maternal and Umbilical Cord Blood by Season.

Summer is generally considered to be the season when the body is well-supplied with vitamin D. The aim of this study was to compare maternal and umbilical cord blood concentrations of vitamin D during two extreme seasons of the year in Poland-winter and summer. A total of 100 pregnant women with no history of chronic diseases before pregnancy were included in the study. Pre-delivery maternal venous blood and neonatal cord blood samples were collected and total 25(OH)D concentration was measured. Data on vitamin D consumption (collected with the use of Food Frequency Questionnaire) and lifestyle factors were taken. Both, maternal and umbilical cord blood concentrations of vitamin D were higher in the summer group as compared to the winter group (mean 22.2 ± 6.5 ng/mL vs. 16.5 ± 8.2 ng/mL (p < 0.001), respectively for the mothers and 31.3 ± 9.4 ng/mL vs. 22.7 ± 11.0 ng/mL (p < 0.0001), respectively for the neonates). However, only 16% of the pregnant women reached the optimal vitamin D concentration during summer. Therefore, summer improves the levels of vitamin D in the body but does not guarantee the recommended concentration and supplementation throughout the whole year is essential.

Psychosocial aspect of quality of life among working and unemployed nurses and midwives.

OBJECTIVE: The objective of the study was to explain differences in the subjective evaluation of the psychological and social aspects of quality of life in a group of working and unemployed nurses and midwives. MATERIAL AND METHODS: The survey was conducted in a group of 620 professionally-active and inactive people (315 nurses and 305 midwives), selected by random stratified-systematic sampling. The tool used to gather empirical material was the standardized questionnaire WHOQoL-100. RESULTS: Professionally-active nurses evaluated the mental domain less favourably (M=12.33), compared with unemployed nurses (M=12.73), and the difference between average values was statistically significant (p=.043). It is also worth noting that in the group of midwives there were significant differences in each discussed domain. The unemployed respondents evaluated more positively the overall quality of life (M=14.29; p=.005) and the mental domain (M=12.85; p=.009), while the social domain was evaluated less favourably by the professionally-active midwives (M=12.73; p=.022). CONCLUSIONS: Paradoxically, those who were unemployed made slightly more positive evaluations in comparison with the professionally active. Professional work is not a factor preferably affecting the quality of life and its psychosocial dimension. The higher quality of life of the unemployed respondents may result from the buffering impact of social support.

Assessing patients' attitudes towards dietary supplements.

BACKGROUND: There is currently many over the counter products on the market that exert nutritional or physiological effects on the human body. The differences between dietary supplements and non-prescription drugs are however poorly understood by the average consumer and may thus affect their expectations as to the desired effect produced on the body. OBJECTIVES: To evaluate patients' knowledge and attitudes towards dietary supplements as compared to non-prescription drugs. MATERIALS AND METHODS: Subjects were 335 patients of the Mazowiecki Voivodeship Hospital in Warsaw, Poland. The data were collected from a face-to-face interview using a single and multiple choice questionnaire with 10 questions on dietary supplements. Statistical analysis used the Chi-square (χ2) test. RESULTS: The majority of respondents were found to be familiar with the term 'dietary supplements', but had difficulties in classifying these products into appropriate categories. Over 55% do not consider dietary supplements to be foodstuffs and more than 40% considered such products to be drugs. Most respondents thought that the main purpose of taking dietary supplements is to improve nutrition, but over one third expected them to also treat disease. Over 70% declared taking notice to which category the non-prescription products they bought belongs to ie. whether non-prescription drugs (medicinal products) or dietary supplements. CONCLUSIONS: Many patients mistakenly believe that dietary supplements are drugs and can be used to treat disease and health disorders. KEY WORDS: dietary supplements, opinion on dietary supplements, nutrition, dietary supplement vs. medicinal product.

The influence of passive and active moral training on medical university on changes of students' moral competence index - results from randomized single blinded trial.

INTRODUCTION AND OBJECTIVES: Human's life as well as medical professions consist of many moral dilemmas. The aim of our study was to evaluate moral competences of midwifery students during their whole university education (3 year course) based on their moral competences C-index. MATERIAL AND METHOD: We performed randomized single blinded 3-year follow-up trial of 72 midwifery students. Standard Moral Judgment Test (MJT) By Georg Lind was used accompanied by own questionnaire. Moral competences were calculated (C-index) according to Lind's methodology. Subjects were also divided into active and passive ethics training to search for differences. RESULTS: C-index varied during studies insignificant (p=0.14). Randomized groups were equal at the beginning point, no significant differences were noticed. Active ethics teaching did not increase C-index compared to controls in all measuring points (P1-P4, respectively p=0,41 and p=0,38). CONCLUSIONS: During 3 year studies at medical university moral competences measured by C-index varied insignificantly, but simultaneously the change in C-index was dependent on its value at the beginning of the trial. There was not statistically significant influence of active ethic's teaching compared to controls. Among social factors parents have strongest influence on students' morality, but growing role of Medical University in this hierarchy raises hopes for improvement in effectiveness of training in ethics.

[Coffee drinking and risk of type 2 diabetes mellitus. Optimistic scientific data]. / Picie kawy a ryzyko cukrzycy typu 2. Optymistyczne doniesienia naukowe.

An alarming increase the prevalence of type 2 diabetes is forcing to constant analysis the lifestyle factors which can affect the risk of this illness. The research in the last ten years revealed new knowledge concerning the inverse association between habitual coffee drinking and risk of type 2 diabetes. The study indicate that people who drink at least 3 cups of coffee per day more seldom have diabetes and positive effect of coffee is rising along with the amount of the coffee in the diet. It is not clear what mechanism may be responsible for such association but the attention is focus mainly on caffeine, polyphenols, magnesium. Because of the fact that high coffee consumption can cause other adverse health effects coffee should not be treat as a public health strategy to prevent type 2 diabetes, but collected data have scientific character at the moment.

Iodine-deficiency prophylaxis and the restriction of salt consumption - a 21st century challenge.

The World Health Organization (WHO) issued a recommendation (Technical Consultation: Paris 2006, Luxembourg 2007) that salt consumption, as a risk factor for hypertension, atherosclerosis, myocardial infarction, stroke, and select cancers, should be restricted. The European Commission looked to adhere to this recommendation by creating the High Level Group on Nutrition and Physical Activity. According to WHO recommendations, a daily allowance of 5 g NaCl (i.e., 2 g Na) for individual salt consumption should not be exceeded. At present, mean individual salt consumption in Poland totals 13.5 g, of which salt used in household constitutes 8.8 g. In some regions of Poland, this number reaches upwards of 15.0 g/person. The Position Paper on Initiatives Aimed at Decreasing Salt Consumption in Poland, developed by an expert group at the National Food and Nutrition Institute, set the course for intervention, including changing recipes for massproduced food products and large-scale catering, improving oversight by food control agencies, and continuing legislative changes. These interventions should also include education directed towards consumers, food producers, public health professionals, healthcare workers, and media representatives. The Position Paper of the Polish Hypertension Society also sets the course for promoting restricted salt consumption and controlling hypertension on a population level. However, household salt is the main carrier of iodine in the Polish model of iodine prophylaxis. Thus, any interventions also require synchronized action with the Polish Council for Control of Iodine Deficiency Disorders. Current efforts aimed at preventing iodine-deficiency look to increase consumption of other iodine-rich products (e.g., milk, mineral water) with standardized levels of iodine. Once they achieve an iodine concentration of 0.1-0.2 mg, these products can easily supplement any decrease in physiological iodine levels resulting from reduced salt consumption. Also required are wide-ranging educational campaigns which will be coordinated by the new designated WHO Collaborating Centre for Nutrition at the Chair of Endocrinology at Jagiellonian University, Collegium Medicum in Kraków. (Pol J Endocrinol 2010; 61 (1): 135-140).

[Iodine-deficiency prophylaxis and the restriction of salt consumption--a 21st century challenge]. / Profilaktyka jodowa a ograniczenie spozycia soli--wyzwanie XXI wieku.

The World Health Organization (WHO) issued a recommendation (Technical Consultation: Paris 2006, Luxembourg 2007) that salt consumption, as a risk factor for hypertension, atherosclerosis, myocardial infarction, stroke, and select cancers, should be restricted. The European Commission looked to adhere to this recommendation by creating the High Level Group on Nutrition and Physical Activity. According to WHO recommendations, a daily allowance of 5 g NaCl (i.e., 2 g Na) for individual salt consumption should not be exceeded. At present, mean individual salt consumption in Poland totals 13.5 g, of which salt used in household constitutes 8.8 g. In some regions of Poland, this number reaches upwards of 15.0 g/person. The Position Paper on Initiatives Aimed at Decreasing Salt Consumption in Poland, developed by an expert group at the National Food and Nutrition Institute, set the course for intervention, including changing recipes for mass-produced food products and large-scale catering, improving oversight by food control agencies, and continuing legislative changes. These interventions should also include education directed towards consumers, food producers, public health professionals, healthcare workers, and media representatives. The Position Paper of the Polish Hypertension Society also sets the course for promoting restricted salt consumption and controlling hypertension on a population level. However, household salt is the main carrier of iodine in the Polish model of iodine prophylaxis. Thus, any interventions also require synchronized action with the Polish Council for Control of Iodine Deficiency Disorders. Current efforts aimed at preventing iodine-deficiency look to increase consumption of other iodine-rich products (e.g., milk, mineral water) with standardized levels of iodine. Once they achieve an iodine concentration of 0.1-0.2 mg, these products can easily supplement any decrease in physiological iodine levels resulting from reduced salt consumption. Also required are wide-ranging educational campaigns which will be coordinated by the new designated WHO Collaborating Centre for Nutrition at the Chair of Endocrinology at Jagiellonian University, Collegium Medicum in Kraków.

Anthocyanin-rich Aronox extract from Aronia melanocarpa E protects against 7beta-hydroxycholesterol-induced apoptosis of endothelial cells.

AIMS: It has been previously reported that dietary polyphenolic compounds have a positive effect in cardiovascular diseases, although the underlying mechanisms remain unknown. In this study, the effects of Aronox, an anthocyanin-rich extract from Aronia melanocarpa E, on human umbilical vein endothelial cell (HUVEC) apoptosis was investigated. METHODS: Apoptosis was measured in HUVEC pretreated with Aronox and than treated with 7beta-hydroxycholesterol (20 microg/ml). For the evaluation of apoptosis we used the cell binding of annexin V, the propidium iodide uptake method and the TUNEL assay. We also measured the generation of reactive oxygen species (ROS) in the cells, using fluorescent probe 2',7'-dichlorofluorescein acetate. Moreover, alteration of the mitochondrial membrane potential with subsequent cytochrome c release, activation of caspase-3, and the level of anti-apoptotic Bcl-2 were investigated. RESULTS: Aronox significantly decreased 7beta-hydroxycholesterol-induced apoptosis and ROS generation, and ameliorated the collapse of the mitochondrial transmembrane potential with subsequent inhibition of cytochrome c release. Furthermore, down-regulation of Bcl-2 and up-regulation of caspase-3 activation were reversed by Aronox. CONCLUSION: The protective action of the extract against apoptosis in endothelial cells may contribute to the potential benefits drawn from consumption of plant polyphenols.