Environmental Parameters Affecting the Concentration of Iodine in New Zealand Pasture.

Iodine (I) is an essential trace element commonly deficient in agricultural systems. Whereas there is much information on I in food crops, there is a lacuna of knowledge on the environmental factors that affect pasture I concentrations. We aimed to identify the most important environmental factors affecting the concentration of I in New Zealand pastures, and the consequences to agricultural systems. Soil and pastoral samples were collected throughout the country and analyzed for I and other elements. The soils contained 1.1 to 86 mg I kg, with 0.005 to 1.4 mg kg in the pasture. In 26% of pastures, I concentrations were insufficient for sheep nutrition, whereas 87% contained insufficient I for cattle nutrition. Pasture I concentrations were negatively correlated with the distance from the sea, and the concentration of oxalate-extractable amorphous Al, Fe, and Si oxides, which immobilize soil I. Soil organic C and clay increased I retention in soil but did not significantly affect pasture I concentrations. Future work should investigate how soil properties affect pasture I uptake in inland areas.

Energy drink consumption and impact on caffeine risk.

The impact of caffeine from energy drinks occurs against a background exposure from naturally occurring caffeine (coffee, tea, cocoa and foods containing these ingredients) and caffeinated beverages (kola-type soft drinks). Background caffeine exposure, excluding energy drinks, was assessed for six New Zealand population groups aged 15 years and over (n = 4503) by combining concentration data for 53 caffeine-containing foods with consumption information from the 2008/09 New Zealand Adult Nutrition Survey (ANS). Caffeine exposure for those who consumed energy drinks (n = 138) was similarly assessed, with inclusion of energy drinks. Forty-seven energy drink products were identified on the New Zealand market in 2010. Product volumes ranged from 30 to 600 ml per unit, resulting in exposures of 10-300 mg caffeine per retail unit consumed. A small percentage, 3.1%, of New Zealanders reported consuming energy drinks, with most energy drink consumers (110/138) drinking one serving per 24 h. The maximum number of energy drinks consumed per 24 h was 14 (total caffeine of 390 mg). A high degree of brand loyalty was evident. Since only a minor proportion of New Zealanders reported consuming energy drinks, a greater number of New Zealanders exceeded a potentially adverse effect level (AEL) of 3 mg kg(-1) bw day(-1) for caffeine from caffeine-containing foods than from energy drinks. Energy drink consumption is not a risk at a population level because of the low prevalence of consumption. At an individual level, however, teenagers, adults (20-64 years) and females (16-44 years) were more likely to exceed the AEL by consuming energy drinks in combination with caffeine-containing foods.

Predictive modelling of interventions to improve iodine intake in New Zealand.

OBJECTIVE: The potential effects of four interventions to improve iodine intakes of six New Zealand population groups are assessed. DESIGN: A model was developed to estimate iodine intake when (i) bread is manufactured with or without iodized salt, (ii) recommended foods are consumed to augment iodine intake, (iii) iodine supplementation as recommended for pregnant women is taken and (iv) the level of iodization for use in bread manufacture is doubled from 25-65 mg to 100 mg iodine/kg salt. SETTING: New Zealanders have low and decreasing iodine intakes and low iodine status. Predictive modelling is a useful tool to assess the likely impact, and potential risk, of nutrition interventions. SUBJECTS: Food consumption information was sourced from 24 h diet recall records for 4576 New Zealanders aged over 5 years. RESULTS: Most consumers (73-100 %) are predicted to achieve an adequate iodine intake when salt iodized at 25-65 mg iodine/kg salt is used in bread manufacture, except in pregnant females of whom 37 % are likely to meet the estimated average requirement. Current dietary advice to achieve estimated average requirements is challenging for some consumers. Pregnant women are predicted to achieve adequate but not excessive iodine intakes when 150 µg of supplemental iodine is taken daily, assuming iodized salt in bread. CONCLUSIONS: The manufacture of bread with iodized salt and supplemental iodine for pregnant women are predicted to be effective interventions to lift iodine intakes in New Zealand. Current estimations of iodine intake will be improved with information on discretionary salt and supplemental iodine usage.

Subgroups of advanced cancer patients clustered by their symptom profiles: quality-of-life outcomes.

BACKGROUND: Symptom cluster analysis is a new frontier of research in symptom management. This study clustered patients by their symptom profiles to identify subgroups that may be at higher risk for poor quality of life (QOL) and that may, therefore, benefit most from targeted interventions. METHODS: Longitudinal study of metastatic cancer patients using the Edmonton Symptom Assessment Scale (ESAS). We generated two-, three-, and four-cluster subgroups and examined the relationship of cluster membership with patient outcomes. To address the problem of missing longitudinal data, we developed a novel outcome variable (QualTime) that measures both QOL and time in study. RESULTS: Two hundred and twenty-one patients with a mean Palliative Performance Scale (PPS) of 59.1 were enrolled. The three-cluster model was chosen for further analysis. The low-burden subgroup had all low severity symptom scores. The intermediate subgroup separates from the low-burden group on the "debility" profile of fatigue, drowsiness, appetite, and well-being. The high-burden group separates from the intermediate-burden group on pain, depression, and anxiety. At baseline, PPS (p=0.0003) and cluster membership (p<0.0001) contributed significantly to global QOL. In univariate analysis, cluster membership was related to the longitudinal outcome, QualTime. In a multivariate model, the relationship of PPS to QualTime was still significant (p=0.0002), but subgroup membership was no longer significant (p=0.1009). CONCLUSION: PPS is a stronger predictor of the longitudinal variable than cluster subgroups; however, cluster subgroups provide a target for clinical interventions that may improve QOL.

Physicochemical properties of oat ß-glucan influence its ability to reduce serum LDL cholesterol in humans: a randomized clinical trial.

BACKGROUND: Consumption of 3 g oat ß-glucan/d is considered sufficient to lower serum LDL cholesterol, but some studies have shown no effect. LDL cholesterol lowering by oat ß-glucan may depend on viscosity, which is controlled by the molecular weight (MW) and amount of oat ß-glucan solubilized in the intestine (C). OBJECTIVES: Our 2 primary objectives were to determine whether consumption of 3 g high-MW oat ß-glucan/d would reduce LDL cholesterol and whether LDL cholesterol lowering was related to the log(MW × C) of oat ß-glucan. DESIGN: In a double-blind, parallel-design, multicenter clinical trial, subjects with LDL cholesterol ≥3.0 and ≤5.0 mmol/L (n = 786 screened, n = 400 ineligible, n = 19 refused, n = 367 enrolled, and n = 345 completed) were randomly assigned to receive cereal containing wheat fiber (n = 87) or 3 g high-MW (2,210,000 g/mol, n = 86), 4 g medium-MW (850,000 g/mol, n = 67), 3 g medium-MW (530,000 g/mol, n = 64), or 4 g low-MW (210,000 g/mol, n = 63) oat ß-glucan/d (divided doses, twice daily) for 4 wk. RESULTS: LDL cholesterol was significantly less with 3 g high-MW, 4 g medium-MW, and 3 g medium-MW oat ß-glucan cereals than with the wheat-fiber cereal by 0.21 (5.5%; 95% CI: -0.11, -0.30; P = 0.002), 0.26 (6.5%; 95% CI: -0.14, -0.37; P = 0.0007), and 0.19 (4.7%; 95% CI: -0.08, -0.30; P = 0.01) mmol/L, respectively. However, the effect of 4 g low-MW oat ß-glucan/d (0.10 mmol/L) was not significant (2.3%; 95% CI: 0.02, -0.20). By analysis of covariance, log(MW × C) was a significant determinant of LDL cholesterol (P = 0.003). Treatment effects were not significantly influenced by age, sex, study center, or baseline LDL cholesterol. CONCLUSIONS: The physicochemical properties of oat ß-glucan should be considered when assessing the cholesterol-lowering ability of oat-containing products; an extruded breakfast cereal containing 3 g oat ß-glucan/d with a high-MW (2,210,000 g/mol) or a medium-MW (530,000 g/mol) lowered LDL cholesterol similarly by ≈0.2 mmol/L (5%), but efficacy was reduced by 50% when MW was reduced to 210,000 g/mol. This trial was registered at www.clinicaltrials.gov as NCT00981981.

Nutritional modelling: distributions of salt intake from processed foods in New Zealand.

The salt content of processed foods is important because of the high intake of Na by most New Zealanders. A database of Na concentrations in fifty-eight processed foods was compiled from existing and new data and combined with 24 h diet recall data from two national nutrition surveys (5771 respondents) to derive salt intakes for seven population groups. Mean salt intakes from processed foods ranged from 6.9 g/d for young males aged 19-24 years to 3.5 g/d for children aged 5-6 years. A total of > or = 50 % of children aged 5-6 years, boys aged 11-14 years and young males aged 19-24 years had salt intakes that exceeded the upper limit for Na, calculated as salt (3.2-5.3 g/d), from processed foods only. Bread accounted for the greatest contribution to salt intake for each population group (35-43 % of total salt intake). Other foods that contributed 2 % or more and common across most age groups were sausage, meat pies, pizza, instant noodles and cheese. The Na concentrations of key foods have changed little over the 16-year period from 1987 to 2003 except for corned beef and whole milk that have decreased by 34 and 50 % respectively. Bread is an obvious target for salt reduction but the implication on iodine intake needs consideration as salt is used as a vehicle for iodine fortification of bread.

Dietary exposure and trends of exposure to nutrient elements iodine, iron, selenium and sodium from the 2003-4 New Zealand Total Diet Survey.

The mean dietary exposure to the nutrient elements iodine, Fe, Se and Na by eight age-sex groups of the New Zealand population was estimated from foods purchased and prepared as for consumption. A total of 968 samples comprising 121 foods were collected and analysed. Mean daily exposures were calculated from mean concentration levels of the selected nutrients in each food combined with simulated diets for a 25+-year-old male and female, a 19-24-year-old male, a 11-14-year-old boy and girl, a 5-6-year-old child, a 1-3-year-old toddler and a 6-12-month-old infant. Food concentrations and dietary exposures are reported and compared with nutrient reference values (for example, recommended daily intakes, adequate intakes or upper limits). Dietary iodine exposures for all age-sex groups were well below recommended levels and have steadily decreased since 1982, raising concern especially for the physical and mental development of infants and young children. Fe exposures meet the recommended daily intake for the average male and 11-14 year olds but are only about half that recommended for adult females. Se exposure is about 20 % less than optimal for females. Na exposures, excluding discretionary salt, are above the acceptable exposure level for all age-sex groups, and exceed the upper intake limits for 25+-year-old males, 19-24-year-old young males, and 11-14-year-old boys and girls by up to 125 % for an average consumer.

Recombinant human luteinizing hormone, lutropin alfa, for the induction of follicular development and pregnancy in profoundly gonadotrophin-deficient women.

OBJECTIVE: To provide evidence of efficacy and safety for use of lutropin alfa in inducing follicular development and pregnancy in hypogonadotrophic hypogonadal women with profound gonadotrophin deficiency. DESIGN: An open-label, noncomparative extension of a randomized, double-blind, placebo-controlled study PATIENTS: A total of 31 hypogonadotrophic hypogonadal women with profound gonadotrophin deficiency in 23 medical centres in four countries were studied. INTERVENTIONS: Lutropin alfa 75 IU and follitropin alfa (75-225 IU), individually based on each patient's response as is consistent with usual medical practice. MEASUREMENTS: Follicular development as defined by (i) at least one follicle >or= 17 mm; (ii) preovulatory serum oestradiol level >or= 109 pg/ml on the day of hCG administration; and (iii) midluteal phase P(4) level >or= 7.9 ng/ml. Pregnancy and over-response leading to cycle cancellation were considered treatment successes. Pregnancy rates were assessed. RESULTS: In a total of 54 cycles, 27 of 31 (87.1%) profoundly gonadotrophin-deficient patients achieved follicular development within three cycles. Twenty of 27 patients (74.1%) who achieved follicular development and received hCG became pregnant; 16 (59.3%) continued to clinical pregnancy. One patient was hospitalized for severe ovarian hyperstimulation syndrome. Lutropin alfa was well tolerated. CONCLUSIONS: Coadministration of lutropin alfa 75 IU and follitropin alfa is safe and effective in inducing follicular development and pregnancy in hypogonadotrophic hypogonadal women with profound gonadotrophin deficiency in a setting consistent with established medical practice.

Estrogenicity of pyrethroid insecticide metabolites.

There is concern that insecticides are able to mimic the action of 17beta-estradiol by interaction with the human estrogen receptor. Pyrethroids are commonly used insecticides and several have been assessed for potential endocrine disrupting activity by various methods. It has been noted that some metabolites of pyrethroids, in particular, permethrin and cypermethrin, have chemical structures that are more likely to interact with the cellular estrogen receptor than the parent pyrethroid. For this study permethrin and cypermethrin metabolites 3-(4-hydroxy-3-phenoxy)benzyl alcohol, 3-(4-hydroxy-3-phenoxy)benzoic acid, and N-3-(phenoxybenzoyl)glycine were synthesised, and together with the commercially available 3-phenoxybenzyl alcohol, 3-phenoxybenzaldehyde, and 3-phenoxybenzoic acid, were studied in a recombinant yeast assay expressing human estrogen receptors (YES). Three metabolites, 3-phenoxybenzyl alcohol, 3-(4-hydroxy-3-phenoxy)benzyl alcohol, and 3-phenoxybenzaldehyde, showed estrogenic activity of approximately 10(5) less than that of 17beta-estradiol. No activity was observed in the yeast assay for 3-phenoxybenzoic acid, 3-(4-hydroxy-3-phenoxy)benzoic acid, and N-3-(phenoxybenzoyl)glycine. The results from this study show that pyrethroid metabolites are capable of interacting with the human estrogen receptor, and so might present a risk to human health and environmental well being. The impact would be expected to be small, but still add to the overall environmental xenoestrogen load.

Population structure inferred by local spatial autocorrelation: an example from an Amerindian tribal population.

Spatial autocorrelation (SA) methods were recently extended to detect local spatial autocorrelation (LSA) at individual localities. LSA statistics serve as useful indicators of local genetic population structure. We applied this method to 15 allele frequencies from 43 villages of a South American tribe, the Yanomama. Based on a network of links

A new protocol for evaluating putative causes for multiple variables in a spatial setting, illustrated by its application to European cancer rates.

We introduce a statistical protocol for analyzing spatially varying data, including putative explanatory variables. The procedures comprise preliminary spatial autocorrelation analysis (from an earlier study), path analysis, clustering of the resulting set of path diagrams, ordination of these diagrams, and confirmatory tests against extrinsic information. To illustrate the application of these methods, we present incidence and mortality rates of 31 organ- and sex-specific cancers in Europe; these rates vary markedly with geography and type of cancer. Additionally, we investigated three factors (ethnohistory, genetics, and geography) putatively affecting these rates. The five variables were correlated separately for the 31 cancers over European reporting stations. We analyzed the correlations by path analysis, k-means clustering, and nonmetric multidimensional scaling; coefficients of the 31 path diagrams modeling the correlations vary substantially. To simplify interpretation, we grouped the diagrams into five clusters, for which we describe the differential effects of the three putative causes on incidence and mortality. When scaled, the path coefficients intergrade without marked gaps between clusters. Ethnic differences make for differences in cancer rates, even when the populations tested are ancient and complex mixtures. Path analysis usefully decomposes a structural model involving effects and putative causes, and estimates the magnitude of the model's components. Smooth intergradation of the path coefficients suggests the putative causes are the results of multiple forces. Despite this continuity of the path diagrams of the 31 cancers, clustering offers a useful segmentation of the continuum. Etiological and other extrinsic information on the cancers map significantly into the five clusters, demonstrating their epidemiological relevance.

Bioactive isoflavones in functional foods: the importance of gut microflora on bioavailability.

Isoflavones present in soy may have risk and benefits to human health. Human gut microflora have been shown to exert metabolic activities on isoflavones, which influences bioavailability and bioactivity. Absorption of isoflavones is likely to occur in the small intestine where there is a diverse range of microfloral species able to hydrolyze conjugated isoflavones, releasing the bioactive aglycone for absorption or further metabolism and reconjugation. The identification of gut microbes that metabolize isoflavone aglycones is not well established. Such information may lead to a better understanding of the bioavailability of isoflavones in functional foods.

Dietary exposure to xenoestrogens in New Zealand.

Continuing evidence of the feminising effects of xenoestrogens on a range of wildlife species increases the need to assess the human health risk of these estrogen mimics. We have estimated the exposure of New Zealand males, females and young men to a range of naturally occurring and synthetic xenoestrogens found in food. Only estrogenic compounds that act by interaction with the estrogen receptor have been included. Theoretical plasma estrogen activity levels were derived from estrogen exposure estimates and estrogenic potency data. Theoretical plasma levels were compared with published data for specific xenoestrogens. There was surprisingly close agreement. Xenoestrogenicity from dietary intake was almost equally attributed to naturally occurring and synthetic xenoestrogens. Relative contributions for a male, for example were isoflavones (genistein and daidzein) (36%) and bisphenol A (34%) with smaller contributions from alkyl phenols (18%) and the flavonoids (phloretin and kaempferol) (12%). It is suggested that dietary xenoestrogens might have a pharmacological effect on New Zealand males and postmenopausal women, but are unlikely to be significant for pre-menopausal women.

A Comparison of Risk and Protective Factors for Colorectal Cancer in the Diet of New Zealand Maori and non-Maori.

By international standards New Zealand (population 3.8 x 10(6)) has a high rate of colorectal cancer, with approximately 2000 new cases occurring and approximately 1000 deaths each year. But within the New Zealand population, a lower incidence of colorectal cancer is reported for Maori than for non-Maori New Zealanders (22.2 and 43.7 per 100,000 respectively). Information from the New Zealand National Nutrition Survey 1997 shows that in comparison to non-Maori, Maori eat more in total, eat more red meat, drink more alcohol, consume more saturated fat, have a higher prevalence of obesity and have a lower proportion of individuals consuming a given level of fruit and vegetables per day. All these factors would be expected to increase colorectal cancer risk. Puha (sow thistle; Sonchus sp.) and watercress (Nasturtium officinale, N.aquaticum) are foods with plausible cancer protective properties which are components of the Maori, but not the non-Maori diet.

Reduction in organochlorine levels in the milk of New Zealand women.

In this study, the authors investigated whether measures taken to reduce exposures subsequent to 1988 led to detectable reductions in levels of persistent organochlorine compounds in milk samples of New Zealand women collected in 1998-1999. The procedures and selection criteria used in a 1987-1988 study were replicated. Participants (n = 53) completed a questionnaire and provided a milk sample, which the authors analyzed for polychlorinated dibenzo-p-dioxins and dibenzofurans, polychlorinated biphenyl congeners, and organochlorine pesticides. Levels of most compounds measured in this study declined approximately 70% from their 1987-1988 values. Levels were low, compared with those found in similar studies from other countries. These results provide evidence that exposure of New Zealand women to organochlorine substances has substantially declined, suggesting that policy measures to reduce exposures have been effective.