Are sleep duration, midpoint of sleep and sleep quality associated with dietary intake among Bavarian adults?

BACKGROUND/OBJECTIVES: Only few epidemiologic studies examined sleep characteristics in relation to dietary behaviour. Our aim was to analyse associations of sleep duration, midpoint of sleep and sleep quality with dietary intake among the Bavarian population. SUBJECTS/METHODS: Within the cross-sectional Bavarian Food Consumption Survey II, 1050 subjects aged 13-81 years were recruited. Dietary intake was assessed with three 24-h dietary recalls by telephone (EPIC-Soft). In our study, 814 participants aged 18 years or older, who completed at least two 24-h dietary recalls and who had complete and plausible information on sleep characteristics were analysed. Dietary intake was described by the consumption of main food groups, energy-proving nutrients and energy intake. Sleep was measured by the Pittsburgh Sleep Quality Index Questionnaire, from which categories of self-reported usual sleep duration in half-h-steps per night, midpoint of sleep and overall sleep quality were derived. RESULTS: Sleep duration was associated with intake of non-alcoholic beverages (P<0.01), carbonated beverages (P=0.04), water (P=0.04) and coffee/black tea (P=0.01) with higher intake among short duration sleepers. No association was found between the consumption of other main food groups, energy-proving nutrients or total daily energy intake and sleep duration. Midpoint of sleep was associated with intake of carbonated beverages (P=0.02, highest intake among subjects with early midpoint of sleep). No association between sleep quality and dietary intake was detected. CONCLUSIONS: Our findings demonstrate only specific associations between sleep characteristics and dietary intake, and mainly sleep duration was associated with beverage intake.

[Development and first results of fast and cost-effective examination methods for an ophthalmological screening within the National Cohort]. / Entwicklung und erste Anwendungserfahrungen einer schnellen und kostengünstigen ophthalmologischen Untersuchung für die Nationale Kohorte.

BACKGROUND: For an implemented ophthalmological screening within a German long-term cohort study (National Cohort) simple and effective methods for an examination of visual acuity and for non-mydriatic retina photografies should be evaluated. Furthermore standard operating-procedures (SOP) should be developed. METHODS: In the years 2011 and 2012 pinhole visual acuity measurements and automated retina photographies (DRS, CenterVue S. p. a., Padua, Italy) were made at three different epidemiological study centers within Germany. Furthermore, anterior segment images were taken by the camera. Standard operating procedures (SOP) regarding the ophthalmological screening were developed and evaluated within the study. The main question was whether it is possible to implement the screening methods within the National Cohort. Further main outcomes were quality and interpretability of the taken images. RESULTS: 457 subjects (914 eyes) were examined within the investigation. Median VA was 0.8 for right and left eyes (p > 0.42). Image quality of the photographies was good in 491 cases (54 %), fair in 239 cases (26 %) and bad in 179 cases (20 %). The usability of the images was without limitations in 686 cases (75 %), limited in 152 cases (17 %) and not given in 71 cases (8 %). Increasing age of the subjects was slightly correlated with decreasing image quality (r = 0.26) and decreasing image usability (r = 0.2). Anterior segment photographies were usable in 176 eyes (56 %). CONCLUSION: The developed screening method fulfilled the specifications of the National Cohort. The used pinhole visual acuity examination was fast and cheap. Image quality and usability of the retina photographies could be improved with prolonged pupil recovery times. The quality of the anterior segment images could not fulfill the expectations and were taken out of the further examinations of the ophthalmological screening. The written SOP showed good acceptance within the investigators' daily routine. The ophthalmological screening within the National Cohort generates information (e. g., pathologies of the vessels or of the retina) which are useful not only from an ophthalmological point of view.

[Carbohydrate intake and prevention of nutrition-related diseases]. / Kohlenhydratzufuhr und Prävention ausgewählter ernährungsmitbedingter Krankheiten.

The relative contribution of nutrition-related chronic diseases to the total disease burden of the society and the healthcare costs have risen continuously over the last decades. This challenge requires to explore and use the potential of dietary prevention of diseases such as obesity, type 2 diabetes, dyslipidaemia, cardiovascular disease and cancer. This evidence-based guideline systematically assessed the potential role of carbohydrates in the primary prevention of these diseases. The major findings were: a high consumption of sugar-sweetened beverages increases the risk of obesity and type 2 diabetes (strength of evidence: probable), whereas a high dietary fibre intake, mainly from whole-grain products, reduces the risk of obesity, type 2 diabetes, dyslipidaemia, hypertension, coronary heart disease and colorectal cancer (strength of evidence: probable and convincing, respectively). The practical consequences for current dietary recommendations are presented.

Dietary beta-carotene, vitamin C and E intake and breast cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC).

So far, studies on dietary antioxidant intake, including beta-carotene, vitamin C and vitamin E, and breast cancer risk are inconclusive. Thus, we addressed this question in the European Prospective Investigation into Cancer and Nutrition. During a median follow-up time of 8.8 years, 7,502 primary invasive breast cancer cases were identified. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI). All analyses were run stratified by menopausal status at recruitment and, additionally, by smoking status, alcohol intake, use of exogenous hormones and use of dietary supplements. In the multivariate analyses, dietary intake of beta-carotene, vitamin C and E was not associated with breast cancer risk in premenopausal [highest vs. lowest quintile: HR, 1.04 (95% CI, 0.85-1.27), 1.12 (0.92-1.36) and 1.11 (0.84-1.46), respectively] and postmenopausal women [0.93 (0.82-1.04), 0.98 (0.87-1.11) and 0.92 (0.77-1.11), respectively]. However, in postmenopausal women using exogenous hormones, high intake of beta-carotene [highest vs. lowest quintile; HR 0.79 (95% CI, 0.66-0.96), P (trend) 0.06] and vitamin C [0.88 (0.72-1.07), P (trend) 0.05] was associated with reduced breast cancer risk. In addition, dietary beta-carotene was associated with a decreased risk in postmenopausal women with high alcohol intake. Overall, dietary intake of beta-carotene, vitamin C and E was not related to breast cancer risk in neither pre- nor postmenopausal women. However, in subgroups of postmenopausal women, a weak protective effect between beta-carotene and vitamin E from food and breast cancer risk cannot be excluded.

Variation in intakes of calcium, phosphorus, magnesium, iron and potassium in 10 countries in the European Prospective Investigation into Cancer and Nutrition study.

BACKGROUND/OBJECTIVES: Adequate mineral intake is important for the maintenance of bone health, cellular function and general metabolism, and possibly in the aetiology of cancer and other chronic diseases. This study aimed at investigating variation in intakes of selected minerals across 10 European countries participating in the EPIC (European Prospective Investigation into Cancer and Nutrition) study. METHODS: Nutrient intakes for 36 034 subjects, aged between 35 and 74 years, in 27 centres were obtained using standardized 24-h dietary recall software (EPIC-SOFT). Mean intakes of calcium, phosphorus, magnesium, iron and potassium were calculated by centre and weighted by season and day of the week and were also stratified by age group. The contribution of food groups to total nutrient intake was calculated. RESULTS: There was clear geographical variability in intakes, with differences ranging from 35% for magnesium to 90% for iron in men and 36% for potassium to 75% for calcium in women, and a twofold difference in sources of haem iron (meat and fish). There was a geographical gradient in iron intake, with higher intakes in Southern than in Northern Europe and also around a twofold north-south gradient in the contribution of fruits and vegetables to potassium intake. Compared with reference intakes, the majority of age groups and centres had intakes above the recommended levels. Dairy foods and products contributed the most to calcium and phosphorus intake in almost all centres. Cereals and cereal products contributed the most to magnesium and iron intakes, except in Greece and Germany. CONCLUSIONS: Intakes of minerals vary substantially throughout Europe, with some geographical variability in their food sources.

Use of dietary supplements in the European Prospective Investigation into Cancer and Nutrition calibration study.

BACKGROUND: Dietary supplement use is increasing, but there are few comparable data on supplement intakes and how they affect the nutrition and health of European consumers. The aim of this study was to describe the use of dietary supplements in subsamples of the 10 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). METHODS: Specific questions on dietary supplement use were asked as a part of single 24-h recalls performed on 36,034 men and women aged 35-74 years from 1995 to 2000. RESULTS: Between countries, the mean percentage of dietary supplement use varied almost 10-fold among women and even more among men. There was a clear north-south gradient in use, with a higher consumption in northern countries. The lowest crude mean percentage of use was found in Greece (2.0% among men, 6.7% among women), and the highest was in Denmark (51.0% among men, 65.8% among women). Use was higher in women than in men. Vitamins, minerals or combinations of them were the predominant types of supplements reported, but there were striking differences between countries. CONCLUSIONS: This study indicates that there are wide variations in supplement use in Europe, which may affect individual and population nutrient intakes. The results underline the need to monitor consumption of dietary supplements in Europe, as well as to evaluate the risks and benefits.

Plasma phyto-oestrogens and prostate cancer in the European Prospective Investigation into Cancer and Nutrition.

We examined plasma concentrations of phyto-oestrogens in relation to risk for subsequent prostate cancer in a case-control study nested in the European Prospective Investigation into Cancer and Nutrition. Concentrations of isoflavones genistein, daidzein and equol, and that of lignans enterolactone and enterodiol, were measured in plasma samples for 950 prostate cancer cases and 1042 matched control participants. Relative risks (RRs) for prostate cancer in relation to plasma concentrations of these phyto-oestrogens were estimated by conditional logistic regression. Higher plasma concentrations of genistein were associated with lower risk of prostate cancer: RR among men in the highest vs the lowest fifth, 0.71 (95% confidence interval (CI) 0.53-0.96, P trend=0.03). After adjustment for potential confounders this RR was 0.74 (95% CI 0.54-1.00, P trend=0.05). No statistically significant associations were observed for circulating concentrations of daidzein, equol, enterolactone or enterodiol in relation to overall risk for prostate cancer. There was no evidence of heterogeneity in these results by age at blood collection or country of recruitment, nor by cancer stage or grade. These results suggest that higher concentrations of circulating genistein may reduce the risk of prostate cancer but do not support an association with plasma lignans.

Dietary phytoestrogen intake and mammographic density -- results of a pilot study.

The influence of dietary phytoestrogens provided by Western diets on mammographic density is not well established. Soy and soy products as source of isoflavones were found to be inversely associated with high mammographic density, a marker for breast cancer risk. Another class of phytoestrogens, the lignans, which are more frequent in Western diets, are rarely investigated. Within the European Prospective Investigation into Cancer and Nutrition cohort in Heidelberg (EPIC-Heidelberg) we explored the feasibility of mammogram collection and measurement of mammographic density in order to investigate the association between dietary phytoestrogen intake and breast density patterns. Wolfe classification was used to summarize mammographic density. Dietary habits were assessed by means of a validated food frequency questionnaire. - Out of the 505 randomly selected women, 317 (63%) returned the questionnaire and 310 (61.4%) women provided informed consent to collect mammograms. Dietary intake of seven women with dense patterns (DY) was compared with 47 women without dense patterns. A high dietary intake of fibre (p-value = 0.008) and secoisolariciresinol (p-value = 0.043) is inversely associated with non-dense breast patterns. This is also observed for a high dietary intake of soy-products (p-value = 0.004) and, in tendency, genistein (p-value = 0.069). After adjustment for energy intake and age the groups of dense and non-dense mammographic patterns were different regarding the intake of carbohydrate (p = 0.032), soy-products (p = 0.020), fibre (p = 0.046), and secoisolariciresinol (p = 0.027). - Our results suggest an inverse association between dietary lignan intake and breast density, similar to the findings for isoflavones. To our knowledge this is the first report on this association, but due to the risk of chance finding, this has to be confirmed in a study with sufficient statistical power.

Allergic sensitisation and allergic rhinitis are associated with n-3 polyunsaturated fatty acids in the diet and in red blood cell membranes.

OBJECTIVE: Due to inconsistent results based on dietary intake data, unsaturated fatty acids in red blood cell (RBC) membranes and diet were used to investigate their association with allergic sensitisation and allergic rhinitis. DESIGN: Cross-sectional, population-based study. SETTING: Bavarian Nutrition Survey II (2002-03), Germany. SUBJECTS: A total of 568 adult participants, 325 women and 243 men. METHODS: By means of logistic regression models, the relation of fatty acids to (i) allergic sensitisation as defined by means of specific serum immunoglobulin E analysis (CAPSX1 class > or = 2), and (ii) self-reported allergic rhinitis was examined. RESULTS: A high cell membrane level of eicosapentaenoic acid (EPA, 20:5 n-3) was inversely associated with allergic sensitisation, the adjusted odds ratio (OR) and 95% confidence interval (95% CI) were 0.52 (0.30-0.90) for the highest (vs lowest) quartile. A similar effect was observed for allergic rhinitis with an OR (95% CI) of 0.50 (0.24-1.03; P = 0.027 for trend). A higher dietary intake of alpha-linolenic acid (ALA, 18:3 n-3) was associated with a decreased risk of allergic sensitisation and allergic rhinitis with ORs (95% CIs) of 0.51 (0.28-0.93) and 0.43 (0.20-0.93), respectively, in the highest quartiles. No other dietary or cell membrane unsaturated fatty acid was significantly associated with the outcome variables, nor was the n-6/n-3 ratio. The strongest effects were observed among subjects under the age of 40 y. CONCLUSIONS: In this cross-sectional study among adults, a high content of n-3 fatty acids in RBC membranes (EPA) or in the diet (ALA) is associated with a decreased risk of allergic sensitisation and allergic rhinitis.

n6/n3 hypothesis and allergies: biologically plausible, but not confirmed.

The dietary intake of certain fatty acids might contribute to the development of atopic diseases like allergic rhinitis and asthma. We investigated the association between the ratio of n-6 and n-3 fatty acids in serum phospholipids and hay fever or allergic sensitisation in adults. Data from a population based cross-sectional study on respiratory health including measurement of fatty acids in serum phospholipids of 740 adults between 20 and 64 years of age were analysed. We could not find any significant association between n6/n3-ratio of fatty acids in serum phospholipids and hay fever or allergic sensitisation neither in the total population nor in the sub-population stratified by sex. Since no previous study on fatty acid intake confirmed the n6/n3-ratio hypothesis and this study did not find any association between the n6/n3-ratio in serum-phospholipids and hay fever or allergic sensitization, we conclude that the n6/n3- ratio hypothesis is not confirmed although biological plausible.

Antioxidant status of surgical patients receiving TPN with an omega-3-fatty acid-containing lipid emulsion supplemented with alpha-tocopherol.

BACKGROUND: LCT lipid emulsions and even more fish oil-containing lipid emulsions are under debate regarding their tocopherol and PUFA content as well as their effect on the antioxidative status especially in patients with oxidative stress. METHODS: Thirty-three patients undergoing major abdominal surgery were randomly assigned to receive either an alpha-tocopherol-supplemented (562 micromol/l) MCT/LCT/omega-3-acid triglycerides (MLF, 5/4/1 w/w/w, 20%) emulsion or a soybean oil-based LCT emulsion (20%). The TPN regimen continuously provided 1.4 g fat kg bw(-1)d(-1)over 5 days. RESULTS: Plasma antioxidant concentrations were strongly reduced by surgical treatment. Following 5 days of TPN with the MLF emulsion, mean plasma alpha-tocopherol increased by 20.0 micromol/l (1.98 micromol/mmol lipid), while nearly no change was observed in the LCT emulsion group. In both groups, plasma concentrations of all non-supplemented antioxidants (vitamin C, carotenoids, selenium) as well as serum total antioxidant capacity further decreased during TPN. The concentrations of plasma cholesterol oxidation products as a measure of in vivo lipid peroxidation revealed no changes over the TPN period in either group. CONCLUSION: In contrast to the LCT emulsion, administration of the a-tocopherol supplemented MLF lipid emulsion normalized a-tocopherol plasma concentrations. Despite its high long-chain PUFA content, no hint for increased lipid peroxidation was found.

Some dietary fibers reduce the absorption of carotenoids in women.

Dietary fiber may be partly responsible for the lower bioavailability of carotenoids from food than from purified supplements. Due to the lack of detailed information available, we investigated the effects of different kinds of dietary fiber on the absorption of carotenoids and alpha-tocopherol. Six healthy young women received an antioxidant mixture consisting of beta-carotene, lycopene, lutein, canthaxanthin and alpha-tocopherol together with a standard meal. The meal did not contain additional dietary fiber or was enriched with pectin, guar, alginate, cellulose or wheat bran (0. 15 g. kg body weight(-1)). The increases in plasma carotenoid and alpha-tocopherol concentrations were followed over 24 h, and the areas-under-curves (AUC(24h)) were calculated. The mean AUC(24h) of beta-carotene was significantly (P < 0.05) reduced by the water-soluble fibers pectin, guar and alginate with a mean decrease of 33-43%. All tested fibers significantly reduced the AUC(24h) of lycopene and lutein by 40-74% (P < 0.05). The dietary fiber effect on the AUC(24h) of canthaxanthin was almost significant (P = 0.059) and there was no effect on the AUC(24h) of alpha-tocopherol. We conclude that the bioavailability of beta-carotene, lycopene and lutein given within a mixed supplement is markedly reduced by different kinds of dietary fiber.

Acute effects of LDL-apheresis on cholesterol oxidation products and antioxidants in plasma and lipoproteins of patients with familial hypercholesterolemia.

Regular LDL-apheresis treatment of hypercholesterolemic patients has proven to reduce the formation of atherosclerotic lesions. Regarding the underlying mechanisms, cholesterol oxidation products (COP) may play a detrimental role. Therefore, COP levels were determined before and after regular LDL-apheresis treatment in ten patients with familial hypercholesterolemia. - The patients had approximately twofold elevated plasma and LDL COP concentrations on the average as compared to healthy subjects. LDL-apheresis treatment efficiently removed COP from the circulation. As a consequence of a smaller reduction of the COP content (- 52 %) than of the total cholesterol content (-71 %) in LDL, the LDL COP:cholesterol ratio increased. Lipid-soluble antioxidants in the plasma of the hypercholesterolemics decreased to a comparable extent as did plasma lipids. In contrast to nearly stable vitamin C concentrations, plasma selenium concentrations also decreased, resulting altogether in a decreased but still normal serum total antioxidant capacity. - In conclusion, LDL-apheresis treatment effectively reduced potentially atherogenic COP from the plasma. With normal plasma antioxidant concentrations before LDL-apheresis in long-term treated hypercholesterolemics, the observed acute decrease in lipid-soluble antioxidants and selenium by treatment seems not to be as meaningful. The higher LDL COP:cholesterol ratio after treatment needs further elucidation.

Dietary fiber reduces the antioxidative effect of a carotenoid and alpha-tocopherol mixture on LDL oxidation ex vivo in humans.

BACKGROUND: Antioxidant concentrations in low density lipoproteins (LDL) are an important determinant for their susceptibility to oxidation and can be modulated by dietary intake. AIM OF THE STUDY: In the present study, the influence of dietary fiber on the antioxidant enrichment and the oxidation resistance of LDL after antioxidant supplementation is investigated. METHOD: An antioxidant supplement consisting of beta-carotene, lycopene, lutein, canthaxanthin and alpha-tocopherol was given to six young women together with a standard meal. Using a cross-over study design, each subject received the standard meal without additional dietary fiber and enriched with pectin, guar, or cellulose in a random order. To determine the resistance of LDL against copper ion-induced oxidation, the formation of conjugated dienes was measured. RESULTS: Eight, 10, and 24 hours after antioxidant supplementation the isolated LDL revealed significantly (p < 0.05) increased antioxidant concentrations; addition of pectin, guar, or cellulose to the meal depressed this increase. Concomitantly, the observed increase in the resistance of LDL against oxidation (measured as lag phase) was lower with dietary fiber supplementation than that found without. On average, pectin, guar, and cellulose reduced the increase of the lag phase (measured without addition of dietary fiber) by 38%, 22%, and 18%, respectively. CONCLUSIONS: These results indicate that dietary fiber supplementation decreases the antioxidative effect of a supplement consisting of carotenoids and alpha-tocopherol in LDL, an effect that is likely to be mediated by a reduced bioavailability of these antioxidants in the gut.

Effect of a single oral dose of antioxidant mixture (vitamin E, carotenoids) on the formation of cholesterol oxidation products after ex vivo LDL oxidation in humans.

During oxidation of LDL not only polyunsaturated fatty acids and apolipoproteins but also cholesterol is affected. To test the preventive effect of vitamin E and carotenoids against metal ion-induced oxidative modification of the cholesterol moiety, LDL of five females (age 25-30 years) were enriched by single oral supplementation with a mixture of alpha-tocopherol, beta-carotene, lycopene, canthaxanthin, and lutein. LDL was isolated from blood samples before as well as 10 and 24 hours after supplement intake. In the 10 and 24 hours samples, total concentration of the supplemented antioxidants increased significantly to 127% and 125% of the initial value, respectively. As a consequence, the lag phase until beginning of oxidative modification of fatty acids--measured in terms of lag phase time till diene production--significantly increased by 13% (10 h and 24 h). After stopping the oxidation process in all LDL samples (0 h, 10 h, 24 h) of one person when the maximal absorbance value of diene production in the 10 h sample was reached, a statistically significant reduction in the formation of cholesterol oxidation products (COP) could be measured. In the average, 10 h and 24 h after supplementation the COP concentration reached 84% and 86% of the 0 h-value, respectively. Except for 7 beta-hydroxycholesterol, all COP measured decreased by 10-20%. The results of the in vitro-model demonstrate that an antioxidant enrichment of LDL has the potential to protect also cholesterol (besides unsaturated fatty acids) against oxidative modification.

Efficacy of different triglycerides in total parenteral nutrition for preventing atrophy of the gut in traumatized rats.

BACKGROUND: The efficacy of different fat emulsions as components of a total parenteral nutrition (TPN) regimen on the integrity of the gut was assessed in traumatized rats. With the release of the short-chain fatty acids butyric or propionic acid during the hydrolysis of a structured triglyceride containing butyric acid (C4-L-C4-TG) or the beta-oxidation of nonanoic acid from trinonanoin (C9TG), respectively, the infusion of these two triglycerides was supposed to reveal positive effects against the TPN-induced atrophy of the intestine. METHODS: After 3 days of fiber-free liquid diet, rats were traumatized (laparotomy) and catheterized. Afterwards they received equicaloric TPN that delivered 1008 kJ (241 kcal)/kg of body weight per day and 30% nonprotein calories as fat emulsion. The four fat emulsions tested in four groups of six animals contained either long-chain triglycerides (LCT), medium-chain triglycerides (MCT)-LCT (1:1), C9TG/LCT (1:1) or C4-L-C4-TG. Animals of a control group were infused with isovolemic 0.9% NaCl solution and were offered oral standard chow. RESULTS: After 7 days of MCT/LCT administration, the mass-to-length ratio of the total small bowel as well as the masses of mucosa/submucosa and muscularis/serosa in 10-cm segments of the distal half of the small bowel were significantly higher than that found in the other TPN groups or not different from controls. Histometric measurement of the villus height in the ileum revealed no statistically significant differences from controls for the rats of the MCT/LCT and C4-L-C4-TG groups. In the colon, no statistically significant differences between TPN groups were found for either parameter. CONCLUSIONS: Within the tested fatty substrates the MCT/LCT fat emulsion revealed less structural impairments in the distal half of the small bowel regarding mucosa/submucosa (mass and villus height), but also muscularis/ serosa (mass).

Influence of knowledge on iodine content in foodstuffs and prophylactic usage of iodized salt on urinary iodine excretion and thyroid volume of adults in southern Germany.

Thyroid volume, urinary iodine excretion as well as personal nutritional knowledge and individual iodine prophylaxis were determined during a health education program on iodine deficiency and prophylaxis in 1992. Participants were 472 male and 568 female (mean age 27.7 years) students and employees of five universities in the southern part of Germany. The study aimed to clarify the relationship between personal knowledge on iodine, individual iodine prophylaxis and parameters of iodine deficiency (thyroid volume, iodine excretion) in a well known iodine deficient area. Mean thyroid volume (mean +/- SD) was 19.7 +/- 8.3 ml in males and 15.8 +/- 7.1 ml in females. 25.5% of females and 19.9% of males showed thyroid volume above the upper normal values. Total mean urinary iodine excretion was 70.7 +/- 42 micrograms I/g creatinine reflecting WHO-grade-I iodine deficiency. 80.8% of total subjects used iodized salt and 43.2% stated to consume salt-water fish to meet their iodine requirement. The female non-users had significantly lower iodine excretion (no iodized salt, no salt-water fish: 61.4 +/- 31.3 vs. +iodized salt, +salt-water fish: 83.9 +/- 47.6 micrograms I/g creatinine; p < 0.05), however, thyroid volume was identical in these groups. The area of residence over the last 10 years did not significantly influence the thyroid volume. The goiter incidence increased with age. Although our study population was highly educated (81.8% students) and the subjects were provided with educational brochures immediately prior to the study, knowledge about iodine content of food was poor. We conclude that despite a high degree of voluntary iodine prophylaxis and educational programs the iodine intake is insufficient. The use of iodized salt in households, cafeterias, and also in food manufacturing must be increased for sufficient iodine prophylaxis.

Dietary habits and serum lipids of a group of German amateur body-builders.

Dietary intake, nutrient supplementation, and serum lipids were investigated in 13 German male amateur body-builders during a non-competitive period. Dietary information was collected with weighted food records during 14 consecutive days. Daily energy intake was 17.1 +/- 3 MJ including 22 +/- 5% protein, 26 +/- 6% fat, and 49 +/- 4% carbohydrates. "Breads and cereals" and "milk and dairy products" revealed to be the most important food groups. Protein supplements contributed 13% of total protein intake. With food alone the average supply of the vitamins A, D, E and B1 was < 3/4 of the recommended amounts (DGE). Due to the high consumption of supplement preparations, total daily intake of most of the selected minerals and vitamins--particularly of vitamins of the B-group--increased far above recommended dietary intake. Mean fasting serum triglyceride, phospholipid and total cholesterol concentrations were in a normal range, while high-density lipoprotein cholesterol levels were reduced. The serum cholesterol ester fatty acids analysis confirmed a rather low intake of essential fatty acids (linoleic acid) found by dietary assessment. In conclusion, with a few corrections in food selection patterns of the body-builders, a well balanced diet would be achieved and the use of nutrient supplementation products would become totally superfluous.

Odd-numbered medium-chain triglycerides (trinonanoin) in total parenteral nutrition: parameters of carbohydrate and protein metabolism.

To investigate the metabolic effects of intravenously administered odd-numbered medium-chain triglycerides in healthy non-stressed animals, trinonanoin/long-chain triglyceride (LCT) (7/3) fat emulsions were given in a high dose (46.5% energy) to rabbits (n = 8) for 11 days within a total parenteral nutrition regimen. In comparison with medium-chain triglyceride (MCT)/LCT fat emulsions, higher plasma glucose (day 4), plasma lactate and pyruvate (day 11) and liver glycogen concentrations were found for the test group, indicating a glucogenic effect of the trinonanoin/LCT emulsion. With the present study design, nitrogen balance of the rabbits was not significantly influenced by the kind of fat emulsion administered.