Nutritional profiles in a public health perspective: a critical review.

Nutritional profiling is defined as 'the science of categorizing foods according to their nutritional composition' and it is useful for food labelling and regulation of health claims. The evidence for the link between nutrients and health outcomes was reviewed. A reduced salt intake reduces blood pressure, but only a few randomized controlled trials have verified the effect of salt on overall and cardiovascular mortality. Evidence linking a reduced fat intake with cardiovascular mortality and obesity is generally non-significant. Studies that have examined the relationship between obesity and diet have produced contrasting results. A simulation exercise that demonstrated that the impact of a reduced salt and fat intake on overall mortality would be negligible in the European population was carried out. Consideration of the literature and the results of this simulation exercise suggest that the introduction of nutritional profiles in Europe would be expected to have a very limited impact on health outcomes.

A celebration of wine: wine IS medicine.

Wine describes a diverse commodity class composed of the yeast fermentation products of the must, or juice, pressed from grapes, the fruit of genus Vitis, but both in animal and human studies, wine demonstrates beneficial properties that are independent from the presence of alcohol. These benefits for health are mostly associated with polyphenols, and are absorbable from wine but poorly from unfermented grape juice. Dealcoholised wine is providing all the benefits without the toxicity, and is very affordable; improvements in the organoleptic quality of dealcoholised wine(s) as well as massive distribution are current challenges.

Unique phospholipid metabolism in mouse heart in response to dietary docosahexaenoic or alpha-linolenic acids.

Diet and fatty acid metabolism interact in yet unknown ways to modulate membrane fatty acid composition and certain cellular functions. For example, dietary precursors or metabolic products of n-3 fatty acid metabolism differ in their ability to modify specific membrane components. In the present study, the effect of dietary 22:6n-3 or its metabolic precursor, 18:3n-3, on the selective accumulation of 22:6n-3 by heart was investigated. The mass and fatty acid compositions of individual phospholipids (PL) in heart and liver were quantified in mice fed either 22:6n-3 (from crocodile oil) or 18:3n-3 (from soybean oil) for 13 wk. This study was conducted to determine if the selective accumulation of 22:6n-3 in heart was due to the incorporation of 22:6n-3 into cardiolipin (CL), a PL most prevalent in heart and known to accumulate 22:6n-3. Although heart was significantly enriched with 22:6n-3 relative to liver, the accumulation of 22:6n-3 by CL in heart could not quantitatively account for this difference. CL from heart did accumulate 22:6n-3, but only in mice fed preformed 22:6n-3. Diets rich in non-22:6n-3 fatty acids result in a fatty acid composition of phosphatidylcholine (PC) in heart that is unusually enriched with 22:6n-3. In this study, the mass of PC in heart was positively correlated with the enrichment of 22:6n-3 into PC. The increased mass of PC was coincident with a decrease in the mass of phosphatidylethanolamine, suggesting that 22:6n-3 induced PC synthesis by increasing phosphatidylethanolamine-N-methyltransferase activity in the heart.

Gustatory Evaluation of Still and Carbonated Waters: A Preference Rating Study.

We studied the sensory preference for six still waters and four carbonated waters, nonflavored, by 11 tasting experts (4 women and 7 men). Five tasters rated the still waters, four tasters rated the carbonated water, and seven tasters rated twice on each of the still waters when evaluated with a dry red wine. All ratings were performed through answering a set of questions regarding the specific taste and/or smell of the waters. All tasters and the statistician were blinded to the water brands during rating and analysis. Multidimensional preference analysis and correspondence analysis were used to portray the underlying sensory preference. Still waters with higher mineral content tended to be less favorable for drinking purposes. On the other hand, carbonated waters with more minerals (but not over a certain limit) were favorable, and still waters with higher mineral content were preferable as mouth cleaners for red wine. The methodology can be carried to the food and beverage industries, to the functional foods industry, and to medical research where the preference of patients toward certain medications is of interest.

Anti-inflammatory effects of a stabilized lipid extract of Perna canaliculus (Lyprinol).

A lipid-rich extract, prepared by supercritical fluid (CO2) extraction of freeze-dried stabilized NZ green-lipped mussel powder (Lyprinol) has shown significant anti-inflammatory (AI) activity when given to animals and humans. When treated p.o. with Lyprinol, Wistar and Dark Agouti rats developed neither adjuvant-induced polyarthritis or collagen(II)-induced auto-allergic arthritis. This was achieved with doses < NSAIDs, and 200 times < of other seed or fish oils. Lyprinol subfractions inhibited LTB4 biosynthesis by PMN in vitro, and PGE2 production by activated macrophages. Much of this AI activity was associated with omega-3 PUFAs and natural antioxidants [e.g. carotenoids]. In contrast to NSAIDs, Lyprinol is non-gastro toxic in disease-stressed rats at 300 mg/kg p.o., and does not affect platelet aggregation [human, rat]. Clinical studies, either controlled or randomized, have demonstrated very significant AI activity in patients with osteoarthritis (OA), rheumatoid arthritis (RA), asthma, and other inflammatory conditions. Lyprinol is a reproducible, stable source of bioactive lipids with much greater potency than plant/marine oils currently used as nutritional supplements to ameliorate signs of inflammation.

The scientific rediscovery of an ancient Chinese herbal medicine: Cordyceps sinensis: part I.

This review presents Cordyceps sinensis (Berk.) Sacc., a fungus highly valued in China as a tonic food and herbal medicine. The extant records show the continued use of C. sinensis is now centuries old. The major chemical, pharmacological, and toxicological studies on C. sinensis and the various derived, cultured, fermented mycelial products currently in use are reviewed from the English and Chinese literature. Preclinical in vitro and in vivo studies and clinical blinded or open-label trials in to date over 2000 patients are reviewed. These studies show the main activities of the fungus in oxygen-free radical scavenging, antisenescence, endocrine, hypolipidemic, antiatherosclerotic, and sexual function-restorative activities. The safety of the fungus, its effects on the nervous system, glucose metabolism, the respiratory, hepatic, cardiovascular, and immune systems, immunologic disease, inflammatory conditions, cancer, and diseases of the kidney will be reviewed in the second part of this article to be published in the winter issue of this journal.

The scientific rediscovery of a precious ancient Chinese herbal regimen: Cordyceps sinensis: part II.

Cordyceps sinensis (Berk.) Sacc. is a time-honored tonic food and herbal medicine in China, where recent research has shown that many of its traditional uses may be viewed from the basis of pharmacological activities. The ongoing exploration of C. sinensis in its wild form and cultured, fermented mycelial products derived from it, are reviewed from English and Chinese literature. Part II concludes the series with a review of C. sinensis in preclinical in vitro and in vivo studies, and open-label and double-blinded clinical trials on the respiratory, renal, hepatic, cardiovascular, immunologic, and nervous systems, and its effects on cancer, glucose metabolism, inflammatory conditions, and toxicological studies. In Part I, which appeared in the Fall 1998 issue of this journal (4(3):289-303), we discussed the effects of C. sinensis on antisenescence, endocrine and sexual functions, atherosclerosis, hyperlipidemia, and free radicals.

Anti-neutrophil cytoplasmic antibodies in patients with chromomycosis.

OBJECTIVE: Antineutrophil cytoplasmic antibodies (ANCA) are a family of antibodies that react to proteins within neutrophil granules and monocyte lysosomes, and occur prominently in sera from patients with systemic necrotizing vasculitis. The cytoplasmic staining pattern (c-ANCA) is very sensitive and specific for Wegener's granulomatosis (WG), and most commonly results from reactivity with proteinase 3 (PR3). The features of tissue damage in the fungal infection chromomycosis, in particular polymorphonuclear neutrophil (PMN) infiltration and granuloma formation, bear a resemblance to that seen in WG. METHODS: We tested sera from 25 patients with clinical and histologic diagnosis of chromomycosis for the presence of ANCA by indirect immunofluorescence. These same sera were analyzed for reactivity to neutrophil primary granule extracts and PR3 by ELISA. RESULTS: Five of the 25 patients (20%) had detectable c-ANCA, without central accentuation, at serum dilutions of at least 1:40. Three of these 5 ANCA-positive patients reacted with neutrophil primary granule extracts by ELISA; however, none of them reacted with PR3. CONCLUSIONS: These results demonstrate that fungal infection should be included among the conditions, unrelated to necrotizing vasculitis, that can trigger autoreactivity against myeloid lysosomal antigens.

Treatment of irritable bowel syndrome with Lacteol Fort: a randomized, double-blind, cross-over trial.

OBJECTIVE: To assess the efficacy of Lacteol Fort, an antidiarrheal drug, in patients suffering from the chronic intestinal disease known as irritable bowel syndrome (IBS). DESIGN: The randomized, double-blind, cross-over trial versus placebo was carried out from 1992 to 1994. This trial consisted of administering a 6-wk treatment with a first drug (Lacteol Fort or placebo), followed by a wash-out period of 2 wk, and then the administration of a second drug for a further 6 wk (placebo or Lacteol Fort). Among the 29 patients eligible after recruitment, 18 adults with well documented IBS fulfilled the inclusion criteria. Four patients were dropped for loss of materials used in the study and seven for lack of compliance. The patient's initial state was assessed using a questionnaire relating to six criteria: abdominal pain, bloating or gas, daily number of stools, consistency, mucus content, and general physical state. During the treatment, these criteria were evaluated daily by the patients themselves. RESULTS: All investigated criteria were scored, and then a daily mean index was calculated. The statistical analysis of the daily mean index values showed that the number of patients (nine cases) obtaining better results with Lacteol Fort than with placebo was statistically significant (p = 0.018). CONCLUSIONS: This double-blind, placebo-controlled, cross-over trial demonstrated that Lacteol Fort leads to a statistically significant therapeutic benefit in 50% of patients, when taking into consideration all of the six selected clinical criteria considered representative of IBS.

Serum silicon levels are elevated in women with silicone gel implants.

The metabolic fate of silicone gel leaked into the body from an implant is unknown. In this study, serum from 72 women with silicone gel breast implants and 55 control women was blindly assayed by inductively coupled plasma atomic emission spectroscopy (ICP-AES) for elemental silicon. Samples were processed using materials free of silicon. The mean silicon level in controls was 0.13 +/- 0.07 mg/l (range 0.06-0.35 mg/l), while in implant patients, the mean was significantly higher at 0.28 +/- 0.22 mg/l (range 0.06-0.87 mg/l) (P < 0.01, Student's t-test with correction for unequal variances). Using the mean of the control group + 2 SD as a cutoff for normal range (0.27 mg/l), 25/72 (34.7%) implant patients exceeded this value, compared with 2/55 (3.6%) controls. There was no significant correlation between past rupture of one or both implants, current rupture at the time of the blood draw or the number of years with implants and silicon levels. The results suggest that elevations of serum silicon are seen in many women with silicone gel breast implants. The kinetics of this elevation and the actual chemical species of the measured silicon remain to be determined.

Elevated serum silicon levels in women with silicone gel breast implants.

The metabolic fate of silicone gel leaked from an intact or ruptured prosthesis is unknown. In this study, serum was blindly assayed by inductively coupled plasma atomic emission spectroscopy (ICP-AES) for elemental silicon in 72 women with silicone gel breast implants and 55 control women (mean age 48 yr, both groups). Blood was drawn and processed using silicon-free materials. The mean silicon level in controls was 0.13 +/- 0.07 mg/L (range 0.06-0.35 mg/L), whereas in implant patients, the mean was significantly higher at 0.28 +/- 0.22 mg/L (range 0.06-0.87 mg/L) (P < 0.01, Student's t-test with correction for unequal variances). Using the mean of the control group + 2 SD as a cutoff for normal range (0.27 mg/L), 25/72 (34.7%) implant patients exceeded this value, compared with 2/55 (3.6%) controls. There was no significant correlation between past rupture of one or both implants, current rupture at the time of the blood draw, or the number of years with implants and silicon levels. The results suggest that serum silicon levels are elevated in many women with silicone gel breast implants. The chemical species involved and kinetics of this elevation remain to be determined.

Pseudoasthma in a case of asthma.

The respiratory system, which is composed of the upper and lower airways performs varied and distinct functions. These can also be the sites of various pathological processes. Asthma is one of the major conditions involving the lower airways whereas laryngeal dysfunction due to various conditions has also been known to occur. Isolated laryngeal dysfunction with abnormal vocal cord movements has been shown to occur both in various organic and non-organic conditions. The non-organic laryngeal dysfunction with a functional component is being increasingly recognized, the symptoms of which can be easily confused with those of asthma. We describe a patient who is believed to have both asthma and functional laryngeal dysfunction with paradoxical motion of the vocal cords on inspiration, observed on direct laryngoscopy. It is also believed that her laryngeal dysfunction is an isolated clinical entity not related to her underlying asthma, which has been shown, at times, to be associated with non-compensatory adduction of the vocal cords on inspiration. The patient described is known to have an anxious and hysterical personality and was also diagnosed to have a major depression. Episodes of paradoxical motion of the vocal cords on inspiration are acute and are usually precipitated by an emotional event and the shortness of breath may or may not be associated with stridor. Treatment of this condition, which can be mistaken for asthma, involves speech/vocal cord exercises to be used at the advent of an attack. It is thus important to recognize this condition so that appropriate treatment can be given.(ABSTRACT TRUNCATED AT 250 WORDS)

Odor-associated idiopathic anaphylaxis. A case report.

A 44 year old woman is described who appears to have idiopathic anaphylaxis triggered by chemical odors. Her case and a general discussion of anaphylaxis are presented. The known causes of anaphylaxis and a discourse on idiopathic anaphylaxis are given. The treatment of idiopathic anaphylaxis is discussed.

Uses, adverse effects of abuse of corticosteroids. Part I.

While no one seems to doubt the importance of corticosteroids as potent anti-inflammatory and immunomodular agents, view about the dreaded complications are also rampant. There appears to be a wide variation in their use among various physicians depending on their individual beliefs, but generally there is a consensus in regard to their use in certain autoimmune/connective tissue disorders such as SLE, various vasculitides, etc., where no acceptable alternative medications exist. In these conditions relatively high doses of corticosteroids are needed until the disease activity is controlled and thereafter attempts should be made to taper down the dose to the lowest possible maintenance dose. In some situations such an attempt may not be successful because of exacerbation in disease activity. In such cases supplemental steroid sparing agents such as azathioprine and others should be considered. Other measures such as alternate day therapy should be considered if shown to be affective in controlling disease activity. Alternate day therapy has been shown to be associated with fewer side effects, notably HPA axis suppression, incidence of infection, myopathy and glucose intolerance. Pulsed i.v. Solumedrol has also been shown to be effective in certain situations such as rapidly progressive glomerulonephritis and renal transplant rejection. Steroids should not be used when an equally effective alternative medication is available such as NSAIDS and disease modifying agents in various inflammatory arthritis. Much of reported side effects in the literature are based on case reports and uncontrolled studies and there appears to be considerable individual variation in susceptibility. Some of the side effects are expected regardless of the size of the dose and cumulative dose whereas others are related to the dose. Certain side effects of steroids use, notably osteoporosis, have been shown to be significantly associated with long term use of corticosteroids whereas in others such as peptic ulcer disease, the association is tenuous with other variables playing a significant role. Potential for abuse/misuse also exists both by the physicians and patients. This, however, is relatively small here in the U.S. compared to developing countries where corticosteroids have been used irrationally and inappropriately in a wide variety of conditions, in high dosages.

Building components contributors of the sick building syndrome.

The sick building syndrome has been widely discussed from epidemiological perspectives. Although there is considerable difference in opinion regarding the concrete and objective evidence to support a distinct sick building syndrome and/or building-related illness, much data indicates that numerous variables within buildings can potentially influence human health. In this paper, we discuss in detail not only the potential and unique infectious diseases caused by Legionella, Pontiac fever, Q fever, and influenza, but also the data implicating noninfectious etiologies of sick building syndrome and building-related illnesses. In addition, the role of psychological factors, mass hysteria, and indoor pollution is discussed with respect to the nature of associations between exposure and symptoms. Finally, comparisons are made in different building construction types of old versus new buildings to highlight changes in modern construction that may have led to a putative increase in work-related symptomatology.

A linoleate-enriched cheese product reduces low-density lipoprotein in moderately hypercholesterolemic adults.

OBJECTIVE: To test the effect of substituting a modified-fat cheese product into the diets of hypercholesterolemic adults. DESIGN: A 4-month, randomized, double-blind, crossover substitution trial. SETTING: General community outpatient study. PARTICIPANTS: Twenty-six healthy adult volunteers (17 men, 9 women) with moderate hypercholesterolemia (total cholesterol > 5.69 mmol/L but < 7.24 mmol/L). INTERVENTION: Daily substitution of 100 g of cheese, either partial skim-milk mozzarella or modified-fat (vegetable oil) mozzarella cheese product, into participants' normal diets. Participants consumed an assigned cheese for 2 months, at which time they crossed over to consume the other study cheese. MAIN OUTCOME MEASURES: Plasma lipid and apolipoprotein levels were measured at baseline and at 2 and 4 months after initiation of the study. Compliance was assessed by body weight and by biweekly dietary records and interviews. RESULTS: No differences in weight or in the amount or type of calories consumed were found during the study. No statistically significant changes in lipid values resulted from consumption of mozzarella cheese. Modified-fat cheese substitution resulted in a decreased low-density lipoprotein cholesterol level when compared with levels at both baseline (-0.28 mmol/L; 95% Cl, -0.14 to -0.42 mmol/L) and during consumption of the skim-milk mozzarella cheese (-0.38 mmol/L; 95% Cl, -0.2 to -0.70 mmol/L). Findings for total cholesterol were similar. High-density lipoprotein cholesterol, plasma triglyceride, and apolipoprotein A-l and B-100 levels were unaltered. Both sexes responded similarly. CONCLUSIONS: A linoleate-enriched cheese product, in the absence of any other changes in diet or habits, substituted into the normal diets of hypercholesterolemic adults reduced low-density lipoprotein and plasma cholesterol levels.