Сокращение потребления сахаросодержащих напитков и их неблагоприятного воздействия на здоровье населения в Эстонии: Аналитический обзор EVIPNet для формирования политики, номер 1

Потребление сахаросодержащих напитков связано с повышенной калорийностью рациона, набором веса, избыточным весом и ожирением в большей степени, чем потребление любых других продуктов питания или напитков. Потребление сахаросодержащих напитков также приводит к развитию ряда неинфекционных заболеваний и болезней полости рта. Уже сейчас более половины населения Эстонии имеет избыточный вес или страдает ожирением, и этот показатель быстро растет, особенно среди детей и подростков. Важное место в данном аналитическом обзоре занимают дети, поскольку предпочтения в отношении напитков и их потребления формируются уже в раннем детстве и могут сохраняться впоследствии.

В обзоре представлены четыре направления политики, которые позволят снизить потребление сахаросодержащих напитков и их неблагоприятное воздействие на здоровье: регулирование рекламы продуктов питания; маркировка сахаросодержащих напитков и повышение осведомленности об их влиянии на здоровье; меры вмешательства и политики в области питания в школах; введение налогов на сахаросодержащие напитки, субсидирование других групп продуктов и/или замена сахаросодержащих напитков другими безалкогольными напитками.

Основываясь на сделанных нами выводах, мы пришли к заключению о том, что эти четыре направления политики дополняют друг друга, и осуществление их в комплексе поможет улучшить показатели здоровья населения. Комплексные и многокомпонентные вмешательства позволят снизить потребление сахаросодержащих напитков и их неблагоприятное воздействие на здоровье.

Reducing the consumption of sugar-sweetened beverages and their negative health impact in Estonia: EVIPNet evidence brief for policy, number 1

The consumption of sugar-sweetened beverages is associated with increased energy intake, weight gain, overweight and obesity more than for any other food or beverage as well as with the development of several non-communicable diseases and poor oral health. Already, more than half of all Estonians are overweight or obese, and the numbers are rising rapidly, especially among children and adolescents. The brief focuses on children, as beverage preferences and consumption patterns develop early in childhood and can persist over time.

Four policy options were selected for reducing the consumption of sugar-sweetened beverages and their negative health effects: regulation of food advertising, labelling of sugar-sweetened beverages and raising awareness about their health effects, school interventions and nutrition policies, and imposing taxes on sugar-sweetened beverages, subsidizing other food groups and/or substituting alternative beverages.

Based on the findings it was concluded that the four policy options complement each other and, if implemented in combination, would help to reach the goal of better health outcomes. Comprehensive, multicomponent interventions will reduce the consumption of sugar-sweetened beverages and their negative health effects.

Suhkruga magustatud jookide tarbimise ja sellest põhjustatud tervisekahjude vähendamine Eestis: EVIPNet Tõenduspõhisuse ülevaade, number 1

Suhkruga magustatud jookide tarbimine on kehakaalu tõusuga tugevamini seotud kui ühegi muu toidu või joogi tarbimine, samuti on nende tarbimine seotud mitmetesse mittenakkushaigustesse haigestumisega ja halvenenud suuõõnetervisega. Juba praegu on üle poole Eesti elanikest ülekaalulised või rasvunud ja nende osatähtsus rahvastikus kasvab kiiresti, eriti laste ja noorukite seas. Tõenduspõhisuse ülevaade keskendub eelkõige just lastele ja noortele, sest joogieelistused ja tarbimismustrid kujunevad välja juba varases lapsepõlves ja need võivad püsida pikka aega.

Suhkruga magustatud jookide tarbimise ja nende negatiivse tervisemõju vähendamiseks käsitleti nelja poliitikavalikut: toiduturunduse meetmed, suhkruga magustatud jookide märgistus ja teadlikkuse tõstmine nende tervisemõjust, sekkumismeetmed koolides ja koolide toidupoliitika ning suhkruga magustatud jookide maksustamine, muude toidugruppide subsideerimine ja/või alternatiivsete jookidega asendamine.

Tulemuste põhjal järeldati, et neli poliitikavalikut on üksteist täiendavad ja nende kombineerimine aitab saavutada parema tervisetulemi eesmärki. Laiahaardelised, mitme komponendiga sekkumismeetmed vähendavad suhkruga magustatud jookide tarbimist ja nende negatiivset tervisemõju.

A two-site sandwich immunoradiometric assay of human lymphotoxin with monoclonal antibodies and its applications.

Three monoclonal antibodies (MoAbs L49-15, L81-11 and L238-14) were raised against recombinant human lymphotoxin (rLT) derived from E. coli containing the cDNA sequence specifying LT. MoAb L81-11 strongly neutralised the cytotoxicity of LT derived either from E. coli or the RPMI 1788 lymphoblastoid cell line, whilst the other two MoAbs were only weakly neutralising in this respect. L81-11 and L238-14 MoAbs bound to different antigenic determinants on the rLT molecule, but neither bound to other lymphokines such as the structurally related tumour necrosis factor (TNF). As such, these MoAbs were ideal reagents for immunoassay of LT and a very sensitive, highly specific immunoradiometric assay (IRMA) was developed. This assay was rapid to perform and was capable of detecting as little as 10 pg/ml of LT. Application of the LT IRMA in combination with previously developed human gamma-interferon (IFN-gamma) and human TNF-specific IRMA (Crane et al., 1985; Meager et al., 1987) permitted independent estimations of these three substances to be carried out in parallel. By these means, it was found that RPMI 1788 produced both LT and TNF, but not IFN-gamma. Extensive analyses on cytokine (monokine and lymphokine) preparations derived from a variety of activated lymphocytes are also reported. Co-production of LT, TNF and IFN-gamma was a common finding, even occurring in alloantigen-specific T helper cell clones.

Preparation and characterization of monoclonal antibodies directed against antigenic determinants of recombinant human tumour necrosis factor (rTNF).

A large number of monoclonal antibodies (McAb) binding to antigenic determinants of human tumour necrosis factor (TNF) were prepared from two fusions of mouse myeloma NSO cells with spleen cells from Balb/c mice immunized with highly purified recombinant (r)TNF. Several of these McAbs were highly neutralizing with respect to the biological activity (cytotoxicity) of TNF manifested in L-929 C1.10 cells. Antibody competition experiments suggested the presence of at least two antigenic determinants on the rTNF molecule through which binding of McAb effects neutralization of biological activity. Some of these McAbs were shown to be suitable for the development of immunoassays to quantify rTNF.

[Psychiatry in Emden--the 1st year]. / Psychiatrie in Emden--das erste Jahr.

The article reports on the first developmental stage of a psychiatric department in a location close to the place of residence of the majority of patients. This psychiatric clinic has at present 60 beds and facilities for 20 outpatients. The location of the clinic is in the area of a medium-sized town in a rural district classified as an area in which Public Health services are required to be active. First of all, the article gives a detailed description of the clinic itself and of the population and district it has to look after. Secondly, the article describes the present state and development of negotiations regarding the setting-up of an outpatient treatment ward. In this connection, it became unavoidable to point out the discrepancies between the need of the population to receive adequate psychiatric outpatient treatment on the one hand, and the policy followed by the relevant authorities on the other, the latter being unfortunately coloured by vested interests, both politically and by the class-consciousness of representatives of certain trade guilds and corporations. This is followed by a statistical evaluation of the patients treated on an inpatient, outpatient and consultant basis, together with an attempt to give a brief outline of the relevant epidemiology. Since the Social Psychiatric Service of Emden has close associations with the clinic--a fact which is rather untypical--the authors included a report on the starting-up phase and activity characteristics of that service.