Biological effects of drinking-water mineral composition on calcium balance and bone remodeling markers.

OBJECTIVE: To compare the effects of 2 drinking waters containing similar calcium (Ca) concentration in order to analyze the role of ions other than Ca on bone metabolism. These mineral drinking-waters differed by their mineral composition primarily concerning the concentration of bicarbonate (HCO3-), high in the HB, and sulfate, high in HS water. DESIGN: Of 60 included women, 39 completed the study. Patients were randomly assigned to an intake of 1 liter per day of mineral water HB or HS for 28 d, followed by cross-over to the alternative drinking-water for a further 28 d. At baseline and after each period of one month, Ca metabolism parameters, acid-base status, and bone remodeling markers were measured. RESULTS: Changes in Ca metabolism were significant in the HB group where the ionized Ca increased and the PTH decreased. Serum pH showed a similar increase whatever the used drinking water compared to baseline. In the HB group, significant increase in urine pH, and significant decrease in AT-HCO3- and NH4+ were observed. Bone resorption markers, urinary CTx/Cr, Pyr/Cr, and D-Pyr/Cr, significantly decreased in the HB group compared to baseline, and were not significantly modified in the HS group. CONCLUSIONS: These results showed a beneficial effect of the bicarbonaterich HB water on bone metabolism. This may account for a better bioavailability of the Ca, a greater alkalinization, and a larger decrease in PTH level secondary to a higher ionized Ca level. The higher content of silica in HB water may have also participated to the positive action on bone balance that was observed. In this short term study, these data underlined the potential role of the mineral drinking water composition on bone metabolism.

Who should be educated? Education strategies: could children educate their parents?

The International Obesity Task Force (IOTF) concluded that the prevention of weight gain is easier, less expensive and more effective than treating obesity after it has fully developed. The objective of prevention programmes is to reduce the exposure of populations to the environmental causes of obesity. Public health prevention is based on education and behavioural changes aiming at promoting physical activity and a less energy dense diet. Effective management of overweight in children proved to reduce the number who carry their weight problems into adulthood. It has been proposed that school could play an important role in encouraging healthy eating habits. School-based prevention strategies consider the child as the target of the education programme. A complementary approach considers that the child could play an active role in the transmission of the message of prevention. It is the hypothesis of a prospective intervention study in northern France, the 'Fleurbaix-Laventie-Ville-Santé' Study, that nutritional education of children aged 6-12y at school may not only improve their nutritional knowledge but also influence the dietary habits of the family. Preliminary results indicate that the education programme resulted in encouraging changes in dietary habits, mainly a decreased intake of lipid-rich foods in the family. The effects on body weight evolution remain to be evaluated. The study is in progress with a 10-year follow-up.

Food and nutritional data for a population from northern France: the Fleurbaix Laventie Ville Santé (FLVS) Study.

BACKGROUND: This paper describes nutritional characteristics and eating habits of the participants of the Fleurbaix Laventie Ville Santé study. METHODS: One-day dietary records for children (under 14 years of age) and three-day records for adolescents and adults provided nutritional data for 2,364 people between the ages of 2 and 70. RESULTS: Daily energy intake increased up to the age of 18 (9038 +/- 2620 kJ in women and 11,659 +/- 2146 kJ in men) and decreased thereafter. In parallel, the contribution of fat and protein to energy intake increased with age (respectively 42% and 18% in people older than 40) whereas the contribution of carbohydrates decreased (40% in people older than 40). The daily distribution of energy intake indicated increased contributions of lunch and dinner with age, and decreased contributions of breakfast and of afternoon snacks. Consumption of potatoes and processed meat far exceeded that of fruit, bread and fish. In comparison to recommended intakes and to other French nutritional studies, total energy intake in our study was similar, whatever the sex and age range. In contrast, the contribution of fat and protein to energy intake was always higher while that of carbohydrates was lower. This was especially true for the adults. CONCLUSIONS: These differences cannot be entirely explained by the differences in methodologies used and are undoubtedly due to the regional eating habits in the area studied.

Obstructive sleep apnea syndrome: a frequent complication of obesity.

Obstructive sleep apnea syndrome (OSAS) is a major health problem, not only because of its consequences in terms of morbidity and mortality, but also because of its social impact in the form of car accidents and industrial accidents. These facts stress the necessity of screening OSAS among the population, particularly in patients suffering from obesity or hypertension, diseases frequently associated with OSAS. This review will focus on the epidemiology and the pathophysiology of this syndrome, its clinical features with a view to screening OSAS, and the main examination used to confirm the diagnosis. The management of OSAS will be discussed.

[Gonadotropic adenoma. Clinical and hormonal characteristics]. / Adénomes gonadotropes. Caractéristiques cliniques et hormonales.

The main clinical and hormonal features of gonadotropin secreting adenomas (GSA) are reviewed through the literature and our personal data. There is still no agreement about their definition and frequency. The most classical clinical presentation is that of men aged 50 years or more, bearing a large pituitary adenoma, the only biological expression of which is a moderately elevated serum FSH level. Female cases are less recognised and are underestimated because the serum LH and/or FSH elevated levels are not informative in menopausal women. The assay of the alpha subunit may help in these cases. In premenopausal women, few of them having been described so far, the GSA may be revealed by an amenorrhea-galactorrhea syndrome with a mild hyperprolactinaemia which may result from different mechanisms. The absence of gonadal hyperactivity, and, conversely, the frequent hypogonadism associated with GSA lead the clinician to raise some questions: are all GSA able to secret gonadotropins? How is the bioactivity of the LH and/or FSH secreted by GSA? How reliable are the radioimmunoassays routinely used for measurement of LH and FSH in patient's serum? Furthermore, therapeutical management of GSA is still impaired by the lack of documented medical treatments which could control their growth and prevent their recurrence.