Showing papers in "European Journal of Clinical Nutrition in 1992"

Classification and measurement of nutritionally important starch fractions

Abstract: For nutritional purposes, starch in foods may be classified into rapidly digestible starch (RDS), slowly digestible starch (SDS) and resistant starch (RS). RS may be further divided into three categories according to the reason for resistance to digestion. A method is reported for the measurement of total starch, RDS, SDS, RS and three RS fractions in starchy foods, using controlled enzymic hydrolysis with pancreatin and amyloglucosidase. The released glucose is measured by colorimetry, using a glucose oxidase kit. Values for RDS and SDS in foods obtained by the method reflect the rate of starch digestion in vivo. Values for RS are similar to the amounts of starch escaping digestion in the small intestine of ileostomates, and are a guide to the amounts of starch likely to enter the colon for fermentation. Results are given for a number of starchy foods.

Physical characteristics of starch granules and susceptibility to enzymatic degradation.

Abstract: Starch, the most abundant component of the diet, is characterized by its variety as well as the versatility of its derivatives in foods. This paper is an overview of the main physical characteristics of the native starch granule. Three different levels of organization are presented: macromolecular structure, crystalline organization and ultrastructure. Starch consists of amylose and amylopectin. Amylose is an essentially linear polymer composed of alpha-1,4-linked D-anhydroglucose units (AGU); amylopectin is a branched polymer clustering a large amount of short linear chains by the linkage of alpha-1,6-bonds, constituting about 5% of the total glycosidic bonds. In the native starch granules, a large number of the macromolecular chains are organized in crystalline structures. Three forms have been found, the A, B and C patterns. So far only A and B starch crystals have been modelled. There is a variation in the susceptibility of the starch granules to enzymatic digestion. This is explained by variation in the morphology of the granules and their crystalline organization.

An in vitro procedure based on chewing to predict metabolic response to starch in cereal and legume products.

Abstract: A new method for measuring the rate of in-vitro starch digestion in products with a structure 'as eaten' is introduced. An equivalent amount of potentially available starch from each product was chewed by subjects, expectorated into a beaker and incubated with pepsin. The incubate was thereafter transferred to a dialysis tubing and incubated with pancreatic alpha-amylase for 3 h. Samples were removed from the dialysate at time intervals and the degree of hydrolysis was calculated as the proportion of the potentially available starch degraded to maltose. A hydrolysis index (HI) was calculated as the area under the hydrolysis curve with the product as a percentage of the corresponding area with white wheat bread. The method was applied to 21 cereal and legume products, chosen to cover as wide a range as possible with respect to metabolic response, and to include several of the proposed mechanisms to differences in metabolic behaviour of starch. The accuracy of the in-vitro method was evaluated versus the metabolic responses obtained with the same products in healthy subjects. A significant correlation between HI and glycaemic index (GI) was obtained in cereal as well as in legume products. A significant correlation was also obtained between HI and insulin index (II) with pooled data from all products. However, in the case of II no correlation was obtained with the legume products only. It is concluded that the presently described in-vitro procedure offers a good potential to predict the metabolic behaviour of starchy foods.

A simplified approach of assessing adult chronic energy deficiency.

Abstract: Body mass index (BMI) in conjunction with indices of energy turnover, e.g. physical activity levels (PAL), was recently proposed for classifying adult chronic energy deficiency (CED). Three deprived populations in Africa and Asia were chosen to assess the classification system. Repeated monitoring showed that the combined indicator was affected by instability in PALs and produced implausible discontinuities in the prevalence of different grades of CED. The use of BMI alone produced coherent data with changing BMI distributions, and only 5% of the population would have been wrongly classified as being malnourished, because of being thin but active. The risk of misclassification would be even smaller for populations with BMI distribution shifted towards the right. The prevalence of CED was consistently related within each country to indices of socio-economic status. Yet in Zimbabwe 18% of women and 6% of men had Grade I obesity compared with 11% and 14%, respectively, with CED. Less than 1% Indian and Ethiopian adults were obese but 61% of women and 70% of men were classified as CED in India and 57% and 50%, respectively, in Ethiopia. We propose that adult BMI alone is sufficient to provide important new insights into the problems of food availability and its control in less developed countries.

Limiting factors of starch hydrolysis.

Abstract: Foods appear as complex structures, in which starch may be present in different forms. These, including the molecular characteristics and the crystalline organization, depend on processing conditions and compositions of ingredients. The main changes in starch macro- and microstructures are the increase of surface area to volume ratio in the solid phase, the modification of the crystallinity as affected by gelatinization and gelation, and the depolymerization of amylose and amylopectin. Starch modification may be estimated by different methodologies, which should be selected according to the level of structure considered. When amylose and amylopectin are in solution, rapid and total hydrolysis leads to the formation of a mixture of linear oligosaccharides and branched alpha-limit dextrins. However, starch usually occurs in foods as solid structures. Structural factors of starchy materials influence their enzymic hydrolysis. A better understanding of the enzymatic process enables the identification of the structural factors limiting hydrolysis: diffusion of enzyme molecules, porosity of solid substrates, adsorption of enzymes onto solid substrates, and the catalytic event. A mechanistic modelling should be possible in the future.

Calcium and iron absorption: mechanism of action and nutritional importance.

Abstract: We investigated the inhibitory effect of calcium on iron absorption in 57 human subjects. Three studies suggested that the effect is not located in the gastrointestinal tract. The presence of phytate in a meal and formation of calcium-iron-phytate complexes is not a prerequisite for the inhibition. The relative increase in iron absorption by ascorbic acid was the same in meals with and without calcium, suggesting that calcium did not influence the balance between enhancing and inhibiting ligands in the gastrointestinal lumen. No inhibiting effect on iron absorption was seen when adding 3 mg calcium to 0.01 mg iron (molar ratio Ca/Fe = 420). Previous studies showing a marked inhibition by calcium had a lower molar ratio, but greater amounts of calcium were given. This suggests that a minimal concentration of calcium is needed to achieve an effect. The present results indirectly support our original hypothesis that the inhibitory effect of calcium on iron absorption is situated within the intestinal mucosal cells. The practical nutritional implications of the inhibitory effect of calcium are considerable since addition of milk, milkshake or cheese to common meals such as pizza or hamburger meals reduced iron absorption by 50-60%. It is recommended to reduce the intake of dairy products with the main meals providing most of the dietary iron, especially for those having the highest iron requirements i.e. children, teenagers and women at childbearing age.

Metabolic responses to starch in bread containing intact kernels versus milled flour.

Abstract: In the present study, the potential of including intact kernels from different cereals was evaluated as a means of developing bread with 'lente' characteristics. Postprandial glucose and insulin responses to bread products were studied in healthy subjects. In parallel, the in-vitro enzymic starch availability was investigated. Also studied were the contents of in-vitro indigestible starch. Coarse bread (CB) products composed of 80% pre-boiled kernels from wheat, rye, oats or barley and 20% white wheat flour were baked. In the case of barley, two forms for pre-treatments was used, boiling and scalding. A bread with 80% wholemeal barley flour and 20% white wheat flour (WMB) was also included and a white wheat bread (WWB) was used as reference. The glycaemic and insulinaemic indexes (GI and II, respectively) were calculated from the 95 and 120 min incremental blood glucose and insulin areas. The GIs were significantly lower with CB from wheat, rye and barley than with WWB. In contrast, the GIs with CB from oats and WMB from barley were similar to that with WWB. The GIs and IIs were generally closely correlated. However, the II with CB from oats was significantly lower than with WWB despite similar GI. The GIs, and in particular IIs, were closely correlated with the hydrolysis rate index (HI) obtained in vitro, and this procedure can be recommended as a tool for ranking of starchy food. It is concluded that the botanical structure is an important determinant of the enzymic availability and hence of the metabolic responses. The in-vitro indigestible starch content was highest in CB from barley (1.2% dry weight basis) and lowest in CB from oats (0.5%).

Accuracy of a quantitative food frequency questionnaire applied in elderly Norwegian women.

Abstract: The accuracy (reproducibility and relative validity) of a self-administered quantitative food frequency questionnaire including 180 food items was evaluated. A total of 38 elderly women kept multiple weighed diet records for a total of 14 days over a 6-week period and filled in the questionnaire both before and after this period. Spearman rank correlations between the nutrient intakes from the two questionnaires varied from 0.43 for carbohydrate to 0.88 for energy percentage from alcohol. The median correlation was 0.70. Seven women whose recorded average energy intake was less than 1.17 times their measured basal metabolic rate were excluded from the analysis comparing the questionnaire and the diet records. The first questionnaire gave on the average 10% higher nutrient median values than the records, while the second questionnaire did not in general produce higher values. Unadjusted correlation coefficients comparing intakes measured by the two methods ranged from 0.31 for vitamin C to 0.79 for energy percentage from carbohydrate, the median coefficient being 0.61. On the average 77% of the subjects were classified in the same (+/- 1) quintile in the first food frequency questionnaire and the diet records. The present study indicates that the self-administered quantitative food frequency questionnaire is useful for measuring individual or group intakes for a variety of nutrients.

Diet, body size and micronutrient status in Parkinson's disease.

Abstract: Nutritional status was assessed in a group of patients with Parkinson's disease. Weight loss since the onset of disease occurred in 52% of the patients and 22% had lost more than 12.8 kg. Although 67% of patients experienced eating difficulties of some kind, dietary intakes of protein and energy were not significantly lower than recommended intakes. Plasma levels of albumin (44.2 g/l vs 45.7 g/l), vitamin A (2.61 vs 2.94 mumol/l), vitamin E (22.0 vs 32.0 mumol/l), iron (15.3 vs 18.3 mumol/l) and zinc (14.2 vs 18.7 mumol/l) were significantly lower (P < 0.05) in the patients than in healthy controls. Levels of ferritin, total iron-binding capacity and copper were similar between groups. The potential significance of low levels of vitamin E and zinc are discussed in relation to oxidative stress in the pathogenesis of this disease.

The fetal origins of diseases of old age.

Abstract: In this paper I am going to describe the evidence that diseases of old age, including heart disease, stroke, the associated conditions hypertension and diabetes, and obstructive lung disease are substantially determined during fetal life and infancy. The phenomenon underlying this is called 'programming', which is the process whereby permanent alterations in physiology and metabolism result from insults or stimuli during critical early periods of development. Programming occurs because different systems and organs of the body develop in fetal life and infancy during critical and sometimes brief periods. There are windows of time during which maturation has to be achieved, and failure of maturation is to some extent irrecoverable.

Body composition assessment: dual-energy X-ray absorptiometry (DEXA) compared to reference methods.

Abstract: The use of dual energy X-ray absorptiometry (DEXA) for the assessment of body composition was examined in 55 adults (26 male & 29 female) ranging in age from 19 to 65 years. DEXA measures of bone mineral content (BMC, g), bone mineral density (BMD, g/cm2) and soft tissue (ST) were based on differential energy attenuation at dual energy levels of 40 and 70 keV. The ratio of the low- to high-energy attenuation in ST was used to quantify fat (%FatDEXA) and fat-free mass minus the bone component (FFMDEXA). BMC and BMD were significantly correlated (r = 0.82 and 0.60) with densitometric fat-free mass (FFMD). No significant differences were observed between the sum of FFMDEXA + BMC versus FFMD for either the males or females (males: FFMDEXA + BMC = 61.7 kg; FFMD = 59.1 kg; females: FFMDEXA + BMC = 43.8 kg; FFMD = 42.8 kg). Percentage body fat from DEXA for the women was equivalent to percentage fat from density (%FatDEXA = 30.8 versus %FatD = 32.2); however, significant differences were observed for the men (%FatDEXA = 19.4 versus %FatD = 23.5). Percentage fat differences for the men may be due to classification of individual soft tissue pixels. DEXA is reliable, easy to use, and appears to give accurate values for the estimation of FFM for both men and women. Additional research is needed to ascertain the cause of the differences in the estimation of percent body fat for men.

Determination of resistant starch in foods and food products: interlaboratory study.

Abstract: A collaborative study was conducted to compare methods of determining resistant starch (RS) in various foods and food products. Principally, two methods derived from Berry (1986, Journal of Cereal Science, 4, 301-314) (method A) and Bjorck et al. (1986, Journal of Cereal Science, 4, 1-11) (method B) were used to analyse four samples containing various forms of RS. Several methods were also used to determine total starch. The RS yield by method A compared to method B was higher in all samples except unmilled bean flakes. When the starch was a raw B-type (potato starch), method B failed to detect any RS because of its initial heating step, whereas method A yielded 48% RS on an 'as is' basis.

Diminishing or increasing contrasts? Social class variation in Finnish food consumption patterns, 1979-1990.

Abstract: The study examines whether social-class-based food consumption patterns changed in Finland during 1979-1990. The data were compiled by the National Public Health Institute in connection with a programme entitled 'Monitoring Health Behaviour among the Finnish Adult Population'. A questionnaire was sent annually to a random sample of Finns (N = 3400-5100, response rate 68-86%). This study was restricted to respondents 25-54 years old. Social class was defined by level of education (low, middle, high). Trends and variations in consumption patterns were studied by cross-tabulations and by fitting logistic regression models. The results show that the proportions of users of butter, high-fat milk and coffee sugar decreased during the study eriod whereas that of regular users of vegetables increased. Since the mid-1980s the shift towards 'healthier' food choices has accelerated among men, yet women are consistently more health-oriented. Social class appears to be a significant determinant of food consumption patterns. Men and women of lower social class follow trends set by upper social classes with a time lag of about ten years. Along with an overall shift towards observance of dietary recommendations, social class differences in Finnish food consumption patterns have diminished, without, however, disappearing altogether.

Determination of resistant starch in vitro with three different methods, and in vivo with a rat model

Abstract: Thomasset (Lyon Medicine (1962): 207, 107-118; (1963): 209, 1325-1350; (1965): 214, 131-143) and others suggested that low-frequency impedance measurements could be used to estimate extracellular fluid and that high-frequency measurements could be used for the assessment of total body water. It was the purpose of this study to examine the relationship between body fluid compartments and multi-frequency bioelectrical impedance analysis (MF-BIA). Total body water (TBW) and extracellular fluid (ECF) were measured using deuterium and sodium bromide dilution procedures. Intracellular fluid volume (ICF) was calculated as the difference between TBW and ECF. A tetrapolar arrangement of surface electrodes was used to measure whole-body resistance (R), reactance (Xc), impedance (Z), and phase angle (P) at 25 frequencies ranging from 1 kHz to 1.35 MHz. Subjects (n = 60; 40 male and 20 female) were between the ages of 19 and 65 years. Mean ratios (+/- SEM) of ECF/ICF and ECF/TBW were 0.83 +/- 0.021 and 0.45 +/- 0.011, respectively. Individuals with the largest fat-free mass (FFM) had the highest ECF value. Whole-body resistive index values most correlated to ECF were at 224, 300, 400, 548 and 1 kHz with correlations ranging from 0.93 to 0.84. All possible subset regression analysis was used to develop a prediction equation for ECF: R2 = 0.924 and SEE = 1.061: ECF = 5.17753 + (0.09989*RI224) + (0.09322*WT) - (1.3962*SEX), where RI = resistive index (HT2/R) at the specific frequency of 224kHz; WT = weight in kilograms; sex was dummy-coded, males = 0, females = 1.

The influence of tissue depth and composition on the performance of the Lunar dual-energy X-ray absorptiometer whole-body scanning mode.

Abstract: To assess the performance of the Lunar dual-energy X-ray absorptiometer (DPX) whole-body scanning mode (software version 3.1), a simple phantom was devised. This had known but variable amounts of lard to represent fat, and water to represent fat-free tissue. The bone mineral content of the phantom remained constant and consisted of the Lunar spine phantom to represent the spine/trunk and a slab of aluminium to represent the head. This phantom was scanned using the whole-body mode by the Lunar DPX to determine bone mineral content (BMC), area, bone mineral density (BMD), and body composition in terms of fat and fat-free tissue. The determinations of total tissue mass were very accurate and precise but fat tissue mass was slightly overestimated (103% of calculated value) and lean tissue mass slightly underestimated (98% of calculated value). The spine and head sections of the phantom were scanned individually using the spine mode and hence by addition the total BMC, area, and BMD of the whole phantom were determined. These results were compared to the bone mineral results obtained using the whole-body mode. The whole-body mode gave higher values for BMC and area than spine-mode measurements (at depths above 10 cm). This discrepancy increased with increasing depths of water (140% and 170% respectively of spine-mode value at soft-tissue depths of 22 cm and 15% fat). The values for BMD of the whole phantom tended to decrease with increasing depths of water and were lower than spine-mode values at tissue depths above 12cm.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood vitamin and lipid levels in overweight and obese women.

Abstract: The study was carried out on 102 obese and overweight women, average age 41.5 years, and 33 control non-obese women matched for age. Fasting venous blood vitamins (ascorbic acid, tocopherol, retinol, carotenes, thiamin, riboflavin, folic acid, pyridoxine), lipids (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, total lipids) and haematological indices were determined. Significantly lower serum antioxidant vitamin levels and a higher prevalence of vitamin deficiency were found in the study group. The study confirmed the high risk of dyslipoproteinaemia and the high frequency of elevated blood pressure in obese women. A correlation between ascorbic acid status, degree of obesity and the incidence of elevated blood pressure was demonstrated.

Glycaemic index of foods.

Abstract: From the mid-1970s several groups realized progressively that the same amounts of carbohydrates in different foods produce quite different blood glucose curves after ingestion. The glycaemic index (GI) was introduced by Jenkins to express the rise of blood glucose after eating a food against a standard blood glucose curve after glucose (or white bread) in the same subject. The GI ranges from about 20 for fructose and whole barley to about 100 for glucose and baked potato. A table is given of representative GI values. There appears to be no general correlation between GI and per cent resistant starch in foods. Questions about methodology for GI are discussed and the factors in food that affect glycaemic response are briefly reviewed. The GI is affected by the physical form of a food, by processing and by associated fat in the food, which reduces the GI, presumably by delayed gastric emptying. As a rule the degree of insulin response to carbohydrate-containing foods is similar to the glycaemic response. Most investigators have found that the GI of a meal of mixed foods can be predicted from the (weighted) GI of its constituent foods. The GI concept is proving useful in dietary design for the management of diabetes mellitus, especially the non-insulin-dependent type. It may prove useful for prevention of diabetes and perhaps also in pre-event meals for athletes, as a factor in dental cariogenesis, in determining satiety, and conceivably regular low GI foods could delay ageing by reducing glycosylation of body proteins.

The Scottish Heart Health Study. Dietary intake by food frequency questionnaire and odds ratios for coronary heart disease risk. II. The antioxidant vitamins and fibre.

Abstract: High serum antioxidant vitamins are increasingly being associated with reduced risk of coronary heart disease (CHD). Previous studies have not addressed the relationship between dietary antioxidant vitamins and risk of CHD although diet is a key factor which modifies blood antioxidant vitamin levels. In prospective studies, high-fibre diets have also been associated with reduced CHD incidence. In this analysis CHD-diagnosed, -undiagnosed and non-CHD controls were selected from 10,359 men and women aged 40-59 who participated in a cross-sectional study of CHD risk factors. Diet was assessed by food frequency questionnaire, odds ratios were adjusted for the classical CHD risk factors (+/- social class) and calculated relative to the first quintile for each vitamin and total fibre. The antioxidant vitamins were further combined in a principal component analysis and the odds ratios for undiagnosed and diagnosed CHD were again calculated. For undiagnosed CHD, risk was significantly lower in the highest quintiles of beta-carotene, fibre and vitamin C, E and A for men, but only lower for fibre in women. Opposite trends were observed in the odds ratios for vitamin C and E and fibre for male-diagnosed CHD which possibly indicates changes in diet as a result of diagnosis. Principal component analysis showed significantly reduced risk of undiagnosed CHD in the top three quintiles for men (odds ratios 0.66, 0.67 and 0.64; P less than 0.05 in each case). A similar trend occurred for women but was non-significant. The results suggest that high dietary intake of the antioxidant vitamins may reduce risk of CHD, particularly in men, and that fibre may be equally cardio-protective in both sexes.

Tetrapolar body impedance is influenced by body posture and plasma sodium concentration.

Abstract: Tetrapolar body impedance measures body resistance, which is highly correlated to total body water and fat-free mass. We investigated the change in resistance measured with tetrapolar impedance, resulting from fluid shifts, following an altered body posture and changes in resistance following an altered electrolyte composition of the extracellular fluid during hypertonic saline and mannitol infusion. An increase in body resistance was measured during recumbency, which was positively correlated with the calculated shift of interstitial fluid to the intravascular space. This effect was completely abolished after 5 min in the upright position. During infusion of 5% saline or 20% mannitol the change in resistance and the change in plasma sodium concentration were inversely correlated. Therefore the measurement of resistance is essentially influenced by alterations in the amount and composition of extracellular fluids. Using the resistance measurements standardization is obligatory for posture and plasma sodium concentration. This is particularly important when repeated measurements are performed.

Loss of total body water and extracellular water assessed by multifrequency impedance.

Abstract: Fat-free mass (FFM), total body water (TBW), extracellular water (ECW) and bioelectrical impedance at 15 selected frequencies, ranging from 1 kHz to 1350 kHz, were determined in 12 subjects before and 3 h after the use of a diuretic drug to induce loss of ECW. Weight loss and urine loss were recorded, and these were assumed to be equal to loss of FFM and TBW, respectively. From the excretion of sodium the amount of excreted ECW was calculated. Prediction formulae at all frequencies were developed for FFM, TBW and ECW from impedance data before the use of the diuretic drug. With these formulae the changes in FFM, TBW and ECW were predicted and compared with the losses of body weight, urine and ECW. At all frequencies FFM, TBW and ECW could be well predicted, with comparable values of explained variance and standard errors of estimate. However, the losses in FFM and TBW were significantly overestimated using the low-frequency impedance formulae. At higher frequencies the predicted losses were no longer significantly different from the weight and urine losses, respectively. The change in ECW was only adequately predicted at 1 kHz. Prediction formulae for ECW at higher frequencies underestimated the loss of ECW. It is concluded that multifrequency impedance offers the possibility of distinguishing between body fluid compartments and of assessing changes in body fluid compartments with a reasonable error.

Feeding problems in children with congenital heart disease: the impact on energy intake and growth outcome.

Abstract: Cross-sectional data on growth outcome, upper-arm measurements and energy intake have been analysed according to the presence or absence of early feeding problems and poor appetite in 40 children (0.9-13 years) with congenital heart disease (CHD). At the time of study, refusal to eat or poor appetite was reported as a significant problem in 19 children and subnormal height and/or weight were recorded in 11 children. The children ate considerably less calories than recommended for healthy children. The cross-sectional analyses showed that children with poor appetite had significantly (P less than 0.05 and P less than 0.01) lower outcome values of growth and upper-arm measurements than their disabled counterparts with no feeding problems and good appetite. Children with feeding problems also tended to eat less than children without feeding problems. For most parents (65%) feeding of infants and children with CHD involves difficulties, time and anxiety. This study has shown that the parents' experience about feeding problems may be a good predictor for low growth outcome and low voluntary food intake of the child. Whenever feeding problems are reported, nutritional intervention should be offered in order to increase the caloric intake of the child and to develop a sound feeding relationship in the family.

Effects of an oat bran concentrate on serum lipids in free-living men with mild to moderate hypercholesterolaemia.

Abstract: An oat bran concentrate was prepared by removing non-fibre components by cold-water wet-milling, resulting in a 2- to 3-fold concentration of soluble fibre, with beta-D-glucan as its main component. The concentrate was baked in bread which was consumed for 8 weeks by free-living men with mild to moderate hypercholesterolaemia. The effects on serum lipids were assessed in a randomized, double-blind, placebo-controlled trial. Despite the large daily dose (11.2 g) of beta-glucan, the beta-glucan-enriched bread had only a small and statistically non-significant effect on serum lipid concentrations. Probable reasons for the weakness of the effect could be the poor solubility of beta-glucan in the preparation, its enzymatic hydrolysis after ingestion, and the consequently low viscosity in the intestine.

An eight-month controlled study of a low-fat high-fibre diet: effects on blood lipids and blood pressure in healthy young subjects.

Abstract: The effects on blood lipids and blood pressure of a diet corresponding to present Nordic Nutrition Recommendations, i.e. less than 30% of energy from fat and with a fibre content exceeding 3 g/MJ, were studied in 18 men and 12 women (mean age, 24 years) under strict dietary control over 8 months. Blood sampling, blood pressure and body weight measurement were performed at four occasions on their habitual diet and once a month during the intervention period. An age-matched control group (17 men, 8 women) was followed with monthly measurements parallel to the intervention group. The habitual diets, assessed by 7-day records, showed an average fat content corresponding to 36% of energy. Initial levels of total cholesterol and HDL cholesterol (X +/- SD) were 4.21 +/- 0.61 and 1.23 +/- 0.23 mmol/l for the men in the intervention group; 4.35 +/- 0.79 and 1.21 +/- 0.26 mmol/l for the male controls; 4.61 +/- 0.59 and 1.46 +/- 0.31 mmol/l for the women in the intervention group and 4.48 +/- 0.64 and 1.48 +/- 0.29 mmol/l for the female controls. Significantly decreased levels of total cholesterol and HDL cholesterol throughout the experimental period were seen for both sexes in the intervention group. Total cholesterol fell 0.49 mmol/l (95% CI: 0.41-0.56) in the male subjects and 0.49 mmol/l (95% CI: 0.39-0.59) in the female subjects. The fall in HDL cholesterol was 0.16 mmol/l (95% C: 0.13-0.18) and 0.18 mmol/l (95% CI: 0.12-0.23), respectively. Total cholesterol changes were independent of initial values. All subjects were normotensive at the start of the study with an average blood pressure of 122/68 mmHg for men and 112/68 mmHg for the women. Systolic blood pressure dropped gradually and significantly in the male subjects of the intervention group. A minimum of 6 mmHg below initial values was noted after six months of dietary intervention. No significant changes in dietary intake and blood lipids were observed in the control group. Thus, changes of present dietary habits of young healthy Danish subjects to an intake in accordance with the Nordic Nutrition Recommendations 1989 will favourably affect suggested risk factors for disease.

Variation in dietary fibre, beta-glucan, starch, protein, fat and hull content of oats grown in Sweden 1987-1989.

Abstract: Samples of oat groat from cultivars grown in Sweden during 3 years (1987-1989, 50 samples/year) were investigated On an average, the kernels contained 159% protein, 70% fat, 97% dietary fibre and 632% starch (% of dry matter) The coefficient of variation was highest for fat (26%) and lowest for starch (7%) The thousand kernel weight was on average 347 g The content of dietary fibre and fat was significantly negatively correlated and the starch positively correlated with the thousand kernel weight The samples contained mean (and range) 97% (50-134) total dietary fibre, 35% (20-50) soluble dietary fibre, and 46% (35-57) beta-glucan The beta-glucan content was significantly positively correlated with insoluble and total dietary fibre as well as with the fat content, and significantly negatively correlated with starch

Nutrients and contaminants in human milk from mothers on macrobiotic and omnivorous diets.

Abstract: The effect of alternative dietary habits and prolonged lactation on the nutrient and contaminant concentrations in human milk was studied. The study sample consisted of mothers on macrobiotic diets, containing little or no diary products and meat, at 2-3 months postpartum (n = 9) and 9-13 months postpartum (n = 12), and mothers on omnivorous diets at 2-3 months postpartum (n = 10). Protein and zinc concentrations in breast-milk from macrobiotic mothers decreased with stage of lactation. After adjustment for stage of lactation, milk from macrobiotic mothers contained less calcium, magnesium and saturated fatty acids C15:0-C20:0, and more polyunsaturated fatty acids. Observed tendencies for lower protein and fat and higher lactose concentrations in the macrobiotic group were not statistically significant. Concentrations of vitamin B12, HCB and polychlorinated biphenyls (PCB 118, PCB 138, PCB 153 and PCB 180) were lower in the macrobiotic group. After adjustment for confounding variables, meat and fish consumption, but not dairy products, contributed to vitamin B12 concentrations. Meat and diary products strongly contributed to breast-milk concentrations of dieldrin and PCBs, fish to PCB 118, and smoking to DDT and dieldrin. Our findings suggest that breast-milk contamination could be reduced by abstinence from smoking and a moderate intake of animal products. However, risk of nutritional deficiencies rules out complete avoidance of meat, fish or diary products. Quantitative research on the effects of a reduced consumption of animal products, as well as smoking, on breast-milk contamination is warranted.

Lactation performance of rural Mesoamerindians.

Abstract: Anthropometry, body composition and dietary intake of 30 lactating Otomi Indians of Capulhuac, Mexico, were studied to identify maternal factors which potentially limit lactation and thereby infant growth. Human milk production, milk composition, and maternal dietary intake, body weight, skinfold thicknesses, and body composition were measured at 4 and 6 months postpartum. The 2H2O dose-to-mother method was used to estimate milk production and maternal total body water (TBW). Fat-free mass (FFM) was calculated as TBW/0.73. Body fat was computed as body weight minus FFM. Human milk samples were analyzed for energy, nitrogen, lactose and fat using standard analytical methods. Maternal diet was assessed by three 24-h intake recalls. Mean (SD) milk production was 885 (146) and 869 (150) g/d at 4 and 6 months, respectively. Milk concentrations of protein nitrogen (1.23 (0.17) mg/g) and lactose (66.6 (2.8) mg/g) were comparable to, but the concentrations of fat (22.2 (6.7) mg/g) and energy (0.54 (0.06) kcal/g) were lower than, values observed in economically privileged populations. Maternal height, weight, and BMI were 1.47 (0.06) m, 50.3 (6.0) kg, and 23.4 (3.1) kg/m2, respectively. Maternal TBW, FFM and body fat were 55.8 (4.6)%, 76.4 (6.3)%, and 23.6 (6.4)%, expressed as a percentage of body weight, respectively. Maternal energy and protein intakes averaged 1708 (338) kcal/d and 40 (10) g/d, respectively. Milk production was negatively correlated with maternal body fat (P = 0.006). Energy and fat concentrations in the milk of the Otomi women were positively related to their weight (P = 0.002), BMI (P = 0.05), and body fat (P = 0.004). Energy concentrations in milk were not related to rates of milk production (r = 0.24; P = 0.23). Nor was milk production or composition significantly associated with maternal dietary intake. Lactation performance of these Otomi women correlated significantly with maternal body size and composition, but not current dietary intake.

Do beans and oat bran add to the effectiveness of a low-fat diet?

Abstract: The effects of consuming an increased amount of soluble fibre as oat bran or beans were examined in 40 free-living hypercholesterolaemic men and women. The subjects were initially established on a low-fat background diet (29% of energy from fat) and then 55 g low-fibre oat bran, 55 g high-fibre oat bran or 80 g mixed cooked beans were added to their diet in random order for 6 week periods. Body weight and overall composition of the diet did not change. Plasma cholesterol and low-density lipoprotein cholesterol (LDL-C) were unchanged. High-density lipoprotein cholesterol (HDL-C) was significantly higher on all three intervention diets than on the lower fibre run-in diet. Supplementation of a moderately low-fat diet with palatable quantities of oat bran or beans without changing the overall fat intake does not appear to significantly lower cholesterol but may have a benefit by increasing HDL-C and reducing the ratio of LDL-C to HDL-C.

Platelet phospholipid fatty acid composition and function in vegans compared with age- and sex-matched omnivore controls.

Abstract: Platelet function and phospholipid composition, plasma lipids and dietary intakes were assessed in 20 vegan subjects and 20 age- and sex-matched omnivore controls. The intakes of saturated fat were lower in the vegans and those of linoleic and linolenic acids were greater. Eicosapentaenoic and docosahexaenoic acids were absent from the diets of the vegans. Plasma total cholesterol and low-density lipoprotein concentrations were lower in the male vegan subjects and those of carotene were greater compared with their controls. The platelet phospholipids of the vegans contained higher proportions of linoleic (18:2n-6) and adrenic (22:4n-6) acids and lower proportions of arachidonic (20:4n-6), eicosapentaenoic (20:5n-3), docosapentaenoic (22:5n-3) and docosahexaenoic (22:6n-3) acids. Template bleeding times, platelet aggregation induced by adenosine diphosphate, compound U44619 and collagen were similar in both groups.