Burger King and Subway: key nutrients, glycemic index, and glycemic load of nutritionally promoted items.

PURPOSE: The purpose of this investigation was to estimate the glycemic load (GL) of nutritionally promoted fast-food menu items and to compare menu items nutritionally. METHODS: Published glycemic index (GI) values and nutritional information from the Web sites of Subway and Burger King were used to calculate the GL of nutritionally promoted items. Menu items were compared based on calories, macronutrients, saturated fat, GI, and GL as basic items and as often served. RESULTS: Subway offered 7 low-fat (total/saturated fat: 3-5/1-2 g), low-calorie (230-330) sandwich options that had an average GL of 29. If the customer accepts the soda and baked potato chips, the total calories exceed 600 and the total/saturated fat becomes 13/4 g, with a doubling of the GL. The Burger King low-fat options contained 4.5 g total fat and 1.5 g saturated fat, with GLs of 53 to 54, and low-calorie options (265-310 calories) had low GLs (0-18.3). Adding fries and a soda brings the GL up from a 53 for just the sandwich to 123 for the meal. The bunless low-carb Whopper has the same fat content (total/saturated fat: 42/13g) as the original Whopper, but the GI and GL are zero. CONCLUSIONS: The nutritional information for meal options available at Burger King and Subway can help the patient with diabetes make choices. Accepting the fries or chips and soda can dramatically increase the calories, carbohydrate, fat, and GL of the nutritionally promoted fast-food meal.

Increased serum free light chains precede the presentation of immunoglobulin light chain amyloidosis.

PURPOSE: Patients with immunoglobulin light chain amyloidosis (AL amyloidosis) generally present with advanced organ dysfunction and have a high risk of early death. We sought to characterize monoclonal immunoglobulin (M-Ig) light chains before clinical presentation of AL amyloidosis. PATIENTS AND METHODS: We obtained prediagnostic sera from 20 cases with AL amyloidosis and 20 healthy controls matched for age, sex, race, and age of serum sample from the Department of Defense Serum Repository. Serum protein electrophoresis with immunofixation and serum free light chain (FLC) analysis were performed on all samples. RESULTS: An M-Ig was detected in 100% of cases and 0% of controls (P < .001). The M-Ig was present in 100%, 80%, and 42% of cases at less than 4 years, 4 to 11 years, and more than 11 years before diagnosis, respectively. The median FLC differential (FLC-diff) was higher in cases compared with controls at all time periods, less than 4 years (174.8 v 0.3 mg/L; P < .001), 4 to 11 years (65.1 v 2.2 mg/L; P < .001), and more than 11 years (4.5 v 0.4 mg/L; P = .03) before diagnosis. The FLC-diff was greater than 23 mg/L in 85% of cases and 0% of controls (P < .001). The FLC-diff level increased more than 10% per year in 84% of cases compared with 16% of controls (P < .001). CONCLUSION: Increase of FLCs, including within the accepted normal range, precedes the development of AL amyloidosis for many years.