Plasma n-6 and n-3 polyunsaturated fatty acids as biomarkers of their dietary intakes: a cross-sectional study within a cohort of middle-aged French men and women.

OBJECTIVE: To measure the correlations between habitual intakes of individual n-6 and n-3 polyunsaturated fatty acids (PUFA) and their percentages in total plasma fatty acids in a population of adult men and women. SUBJECTS/METHODS: Two hundred and seventy-six men and 257 women aged 45-60 (men) or 35-60 (women) at baseline, volunteers of the French SU.VI.MAX cohort. Fifteen 24-h record questionnaires were used to estimate the habitual intake of energy, total fat and linoleic, alpha-linolenic acid, arachidonic, eicosapentaenoic (EPA), n-3 docosapentaenoic (DPA) and docosahexaenoic (DHA) acids. Fatty acid composition of fasting plasma total lipids has been determined at baseline. RESULTS: Dietary intakes of linoleic acid, arachidonic acid, EPA and DHA were weakly but significantly correlated (0.16

Consumption of black, green and herbal tea and iron status in French adults.

OBJECTIVE: A number of potential health effects have lately been accorded to tea consumption. It is, however, not clear whether an increase in tea consumption increases the risk of iron depletion in a normal apparently healthy adult population. We have therefore evaluated this. DESIGN: Cross-sectional study. SUBJECTS: A total of 954 men (aged 52-68 years) and 1639 women (aged 42-68 years), who were participants of SU.VI.MAX Study, completed a detailed questionnaire on tea consumption. To determine the iron status of the participants, a venous blood sample was drawn and serum-ferritin was measured. Iron depletion was defined as a serum ferritin concentration <16 microg/l. Three 1-day food records were used to estimate the intake of other dietary enhancing or inhibiting factors of iron absorption, which were included in the logistic regression models. RESULTS: The mean serum-ferritin concentration was not related to black, green and herbal tea consumption in men, pre- or postmenopausal women. Also the risk of iron depletion was in the multivariate model not related to any kind of tea drinking or to the strength of tea, the infusion time or the time of tea drinking. CONCLUSIONS: The data suggest that normal apparently healthy adults are not at risk of iron depletion owing to any kind of tea drinking.

Dairy products, calcium and phosphorus intake, and the risk of prostate cancer: results of the French prospective SU.VI.MAX (Supplémentation en Vitamines et Minéraux Antioxydants) study.

Although dairy products have been found to be associated with an elevated risk of prostate cancer, studies investigating the potential effect of Ca are limited, and findings are inconsistent. The objective of the present study was to test the relationship between the risk of prostate cancer and consumption of dairy products and Ca. The analysis included 2776 men from the French SU.VI.MAX (Supplementation en Vitamines et Minéraux Antioxydants) prospective study, among whom sixty-nine developed prostate cancer during the follow-up period (median: 7.7 years). Food consumption was assessed at inclusion from repeated 24 h records and nutrient intake was calculated using a food composition table. A higher risk of prostate cancer was observed among subjects with higher dairy product (relative risk (RR; 95 % CI), 4th quartile v. 1st: 1.35 (1.02, 1.78), P = 0.04) and Ca intake (RR (95 % CI), 4th quartile v. 1st: 2.43 (1.05, 5.62), P = 0.04). Nevertheless, we identified a harmful effect of yoghurt consumption upon the risk of prostate cancer (RR (95 % CI), increment 125 g/d: 1.61 (1.07, 2.43), P = 0.02) independently of the Ca content. Our data support the hypothesis that dairy products have a harmful effect with respect to the risk of prostate cancer, largely related to Ca content. The higher risk of prostate cancer with linear increasing yoghurt consumption seems to be independent of Ca and may be related to some other component.

Serum selenium determinants in French adults: the SU.VI.M.AX study.

The objective of the present work was to assess the relationship between serum Se concentrations and environmental determinants (i.e. lifestyle, social activity, geographic region, urban status, education, familial status, physical activity, BMI, tobacco, and food and alcohol consumption). Baseline results from 13 017 subjects (7876 women aged 35-60 and 5141 men aged 45-60) who participated in the SU.VI.M.AX (Supplémentation en Vitamines et Minéraux Antioxydants) study were analysed. Fewer than 2 % of the volunteers had a serum Se status under 0.75 micromol/l, which has been quoted as the cut-off of biological Se sub-deficiency. Women had significantly lower serum Se concentrations than men (1.09 (sd 0.19) micromol/l (n 7423) and 1.14 (sd 0.20) micromol/l (n 4915), P<0.0001, respectively). Significant differences in serum Se concentrations were observed between geographic areas. In both sexes, the serum Se concentration increased with alcohol, meat and fish consumption, and decreased with smoking. In premenopausal women, the serum Se concentration was higher in contraceptive-pill users than in non-users. In women only, age was associated with increased serum Se concentrations, and obesity (BMI> or =30 kg/m2) was associated with decreased serum Se levels. In men, we observed a decrease in serum Se concentrations with increased consumption of vegetables and fruits. In conclusion, though few of the volunteers participating in the SU.VI.M.AX study had Se status in the sub-deficiency range, 83 % of women and 75 % of men had serum concentrations below the value considered optimal for glutathione peroxidase activity. The largest Se associations in both sexes were found with regions, smoking, alcohol, meat and fish consumption. Further studies are needed to understand the difference in Se status between genders.

Serum concentrations of beta-carotene, vitamins C and E, zinc and selenium are influenced by sex, age, diet, smoking status, alcohol consumption and corpulence in a general French adult population.

OBJECTIVE: To assess relationships between energy, nutrient and food intakes, alcohol consumption, smoking status and body mass index (BMI), and serum concentrations of beta-carotene, alpha-tocopherol, vitamin C, selenium and zinc. METHODS: Data on health status, alcohol consumption, smoking habits, anthropometric data and biochemical measurements were obtained in 1821 women aged 35-60 y and 1307 men aged 45-60 y, participant to the SU.VI.MAX Study. Data on dietary intake were available on a subsample who reported six 24-h dietary records during the first 18 months of the study. RESULTS: Women had higher baseline serum beta-carotene and vitamin C concentrations and lower concentration for serum vitamin E, zinc and selenium than men. In women, younger age was associated with lowered mean concentration of serum beta-carotene, vitamin E and selenium. In men, only differences were observed for serum zinc, which was lower in older men. Current smokers of both sexes had significantly lower concentrations of serum beta-carotene, vitamin C and selenium, and, only in women, of vitamin E, than nonsmokers. Alcohol consumers had lower concentrations of serum beta-carotene and higher selenium concentrations. Serum beta-carotene and vitamin C concentrations were lower in obese subjects. There were positive associations of dietary beta-carotene, vitamin C and E with their serum concentrations. Age, nutrient and alcohol intakes, serum cholesterol, BMI and smoking status explained 15.2% of the variance of serum beta-carotene in men and 13.9% in women, and 10.8 and 10.0% for serum vitamin C, and 26.3 and 28.6% for serum vitamin E, respectively. CONCLUSION: Serum antioxidant nutrient concentrations are primarily influenced by sex, age, obesity, tobacco smoking, alcohol consumption and especially dietary intake of those antioxidant nutrients.

Impact of musculoskeletal disorders on quality of life: an inception cohort study.

OBJECTIVE: To assess longitudinally the impact of new onset musculoskeletal (MSK) disorders on quality of life (QoL). METHODS: An inception cohort of 1202 subjects in France aged 45-60 years was determined to be free of MSK problems at baseline. Over 28 months of follow up between 1996 and 1998, 310 were diagnosed with MSK disorders and matched for age and sex with 620 healthy controls. The impact of the MSK disorder onset on QoL was assessed by the change in SF-36 dimension scores over time, using a linear mixed ANOVA model to compare the groups. RESULTS: The incidence of MSK disorder was 13.6% per person-year in the spine, 4.2% per person-year in a joint, and 4.6% per person-year at an extra-articular site. The greatest change in QoL was a 10 point drop in the 100 point SF-36 bodily pain dimension scale in the MSK group. Compared with controls, subjects with an MSK disorder had significantly greater reductions in the following dimensions: bodily pain (a -7.4 point difference in change), vitality (-2.7), general health (-1.8), and physical functioning (-1.3). Within the MSK group, chronic disorders had a greater impact than acute ones on the physical functioning (-2.1), role emotional (-8.4), and social functioning (-5.9) dimensions. CONCLUSION: New onset MSK disorders have a marked deleterious effect on QoL in the physical domain, with lesser effects on social and mental functioning. This evidence of an early significant impact on their QoL reinforces recent recommendations for early treatment and primary prevention.

Comparison of the diet of self-declared diabetics with non-diabetic patients in the SU.VI.MAX study: did the diabetics modify their nutritional behavior?

OBJECTIVE: Dietary recommendations, a pillar in the treatment of diabetes, form part of official guidelines. However, it is not known how well these recommendations are followed in the diabetic population in France. The purpose of this study was to compare the habitual diet of self-declared diabetics with non-diabetics and to evaluate whether recommendations are being followed. METHODS: The intakes of several nutrients and foods of 67 self-declared diabetic patients were compared to those of 4658 non-diabetics in the SU.VI.MAX study (a primary prevention trial evaluating the impact of antioxidant supplementation on chronic disease). All patients (aged 45 to 60 years) who had completed at least five 24-hr dietary records over the first 18 months of the SU.VI.MAX study were included. We excluded patients who had not declared a diagnosis of diabetes and those with plasma fasting glucose levels over 7 mmol/l. RESULTS: The diabetic patients who declared being diabetic reported lower carbohydrate intakes (185 +/- 10.4 vs 219 +/- 1.4 g/d for men [p=0.001], 137 +/- 9.6 vs 165 +/- 1.0 g/d for women [0.005]), with a 50% reduction in consumption of oligosaccharides. Lipid intakes were unchanged for men, but reduced for women (61 +/- 4.1 g/d vs 72 +/- 0.4 g/d [p=0.01] with a 20% reduction in saturated fatty acids. Protein consumption was higher in the diabetic than in the non-diabetic men, but comparable for the women. Energy intakes were only lower in the diabetic women (1458 +/- 81 vs 1665 +/- 9 Kcal/d for women [p=0.01]). Micronutrient intakes were similar to those of non-diabetics, but appeared to be inadequate, particularly for anti-oxidants. Diabetic men consumed more margarine and less alcohol than did the non-diabetics. CONCLUSION: Diabetic patients who declared being diabetic did modify their nutritional behaviour, as they reduced their carbohydrate intake (both men and women), increased their protein intake (men only), and decreased their lipid and energy intakes (women only). However, carbohydrate intakes were unbalanced and there was excess protein intake. So patients who declared being diabetic are not as non-compliant in nutrition as commonly thought; they try to modify their diet, but often inappropriately. This may be explained by the fact that dietary advice stems from different sources and may be contradictory. A diabetic education program requires standardised training of health professionals and the provision of unequivocal information to the mass media and the general public.

[The bank of biological material in the SU.VI.MAX study]. / La biothèque dans l'étude SU.VI.MAX.

The "SUpplémentation en VItamines et Minéraux AntioXydants" (SU.VI.MAX) study is a randomized double-blind, placebo-controlled, primary-prevention trial designed to test the efficacy of a daily supplementation with antioxidant vitamins and minerals at nutritional doses, in reducing several major health problems in industrialized countries, and especially the main causes of premature death (cancers and cardiovascular diseases). This 8-year cohort study started in 1994 in France; 13,535 eligible subjects (women aged 35 to 60, and men aged 45 to 60) were included in 1994 and will be followed up for 8 years. In this paper are described conditions and practical aspects for the realisation of the biological bank developped on the first sample (1994) and completed in 1996 and 1999. Biological material (buffy coat and plasma samples) are saved and stored at -196 degrees C, -80 degrees C and -20 degrees C for any further tests planned at later date (case-control studies and/or validation of new hypothesis).

Body mass index in 7-9-y-old French children: frequency of obesity, overweight and thinness.

OBJECTIVE: To assess the frequency of different grades of nutritional status (obesity, overweight and thinness) in French children aged 7-9 y using four current definitions based on body mass index (BMI). METHODS: Data were collected in 2000 in a randomly selected sample of French children following the protocol recommended by the European Childhood Obesity Group (ECOG). After computing the BMI (weight/height squared), four references were used to define grades of nutritional status: (1) the French references to define thinness and overweight (3rd and 97th percentiles respectively); (2) the Must et al references to define thinness, overweight and obesity (5th, 85th and 95th percentiles respectively); (3) the International Obesity Task Force cut-offs to define overweight and obesity; and (4) the Center for Disease Control 2000 references to define thinness, overweight and obesity (5th, 85th and 95th percentiles respectively). RESULTS: Age and gender standardized frequencies were estimated in 1582 children. According to the French, Must et al, IOTF and CDC references, overweight (including obesity) affected 16.3, 23.9, 18.1 and 20.6% of children, respectively; obesity affected 9.3, 3.8 and 6.4% of children according to the Must, IOTF and CDC references, respectively. Thinness was present in 3.9, 6.0 and 6.0% of children according to the French, Must and CDC references. Whatever the definition, little difference was observed between sexes. Through age classes, as a rule, overweight and obesity tended to decrease while thinness tended to increase. CONCLUSION: The present study revealed an increasing prevalence of overweight in comparison with previous French data and a trend for increasing prevalence of thinness. The IOTF-based prevalence of overweight (including obesity) in 2000 in France was similar with the prevalence recorded in the late 1980s in the USA and the prevalence of obesity in 2000 in France was similar to the prevalence of obesity in the late 1970s in the USA. Data in France are comparable to those reported in other studies conducted in Western Europe. This study provides baseline information for analysis of time trends and for geographical comparisons.

The use of computerised 24 h dietary recalls in the French SU.VI.MAX Study: number of recalls required.

OBJECTIVE: The 24 h dietary recall is a widely used method to estimate nutritional intakes in epidemiological studies. The objective of the present study was to estimate the number of recalls necessary for an accurate estimation of nutrient intake in French adults followed for 4 y. SUBJECTS AND METHODS: Participants of the SU.VI.MAX study (intervention study on the effects of antioxidant supplementation on chronic diseases) who completed a 24 h dietary recall every 2 months for at least 1 y. Inter- and intra-individual variance ratios (S(w)/S(b)) were calculated by analysis of variance for two time periods: year 1 and 2 (n=4955) and year 3 and 4 (n=1458). The number of recalls necessary was calculated using an accuracy of 0.9. RESULTS: The highest intra-individual/inter-individual variance ratio in the first period was seen for beta-carotene and the lowest for carbohydrate. The number of recalls necessary was five for carbohydrate and calcium intake and 16 for beta-carotene. For proteins, total and saturated fat, fibre, vitamin C and iron eight recalls were required, while nine, 11 and 10 recalls were necessary for mono- and polyunsaturated fat and vitamin E, respectively. The variance ratios in the second period were all lower and fewer recalls were therefore required. The same difference in number of recalls required between the two time periods was observed when only those subjects were included who completed at least 18 recalls (n=727). CONCLUSION: These results indicate that for an accurate estimation of carbohydrate intake only, already five recalls are necessary. Fewer recalls may be needed during long-time follow-up. SPONSORSHIP: The SU.VI.MAX Study has support from public and private sectors: Fruit d'Or Recherche, Candia, Lipton, Kellogg's, Céréal, CERIN, Estée Lauder, L'Oréal, Peugeot, Jet Service, RP Scherer, Sodexho, France Telecom, Santogen, Becton Dickinson, Fould Springer, Boehringer Diagnostic, Seppic Givaudan Lavirotte, Le grand Canal, Danone and Knorr.

[Syncope]. / Les syncopes.

Syncopes related to cerebral or cardio-vascular lesions, or resulting from a reflex or from a mixed origin should remain exceptional. Adequate knowledge of their possible etiology and of the curative and preventive measures to use, are very important. To avoid an irreversible issue every practitioner should master the resuscitation technics. Each office should have an adequate equipment for resuscitation and CPR courses should be taken every year.