Homocysteine, folate, vitamin B12, and cardiovascular risk in Indians, Malays, and Chinese in Singapore

OBJECTIVE: To examine the hypothesis that the higher rates of coronary heart disease (CHD) in Indians (South Asians) compared with Malays and Chinese is partly attributable to differences in blood concentrations of homocysteine, and related blood concentrations of folate and vitamin B12. DESIGN: Cross sectional study of the general population. SETTING: Singapore. PARTICIPANTS: Random sample of 726 fasting subjects aged 30 to 69 years. MAIN RESULTS: Mean plasma total homocysteine concentrations did not show significant ethnic differences; values were Indians (men 16.2 and women 11.5 mumol/l), Malays (men 15.0 and women 12.5 mumol/l), and Chinese (men 15.3 and women 12.2 mumol/l). Similarly, the proportions with high plasma homocysteine (> 14.0 mumol/l) showed no important ethnic differences being, Indians (men 60.0 and women 21.9%), Malays (men 53.9 and women 37.8%), and Chinese (men 56.6 and women 30.6%). Mean plasma folate concentrations were lower in Indians (men 8.7 and women 10.9 nmol/l) and Malays (men 8.5 and women 10.8 nmol/l), than Chinese (men 9.7 and women 13.8 nmol/l). Similarly, the proportions with low plasma folate (< 6.8 nmol/l) were higher in Indians (men 44.9 and women 36.6%) and Malays (men 45.3 and women 24.5%) than Chinese (men 31.4 and women 12.6%). Mean plasma vitamin B12 concentrations were lowest in Indians (men 352.5 and women 350.7 pmol/l), then Chinese (men 371.1 and women 373.7 pmol/l), and then Malays (men 430.5 and women 486.0 pmol/l). CONCLUSION: While there were ethnic differences for plasma folate and vitamin B12 (in particular lower levels in Indians), there was no evidence that homocysteine plays any part in the differential ethnic risk from CHD in Singapore and in particular the increased susceptibility of Indians to the disease.     

Association between the intake of vitamins and trace elements from supplements and C-reactive protein: results of the MONICA/KORA Augsburg study

OBJECTIVE: To examine the association between plasma concentrations of C-reactive protein (CRP) and the intake of vitamins and trace elements from supplements possibly related to inflammation such as vitamin C, vitamin E, carotenoids, selenium and zinc. DESIGN: Cross-sectional study using data from the Monitoring of Trends and Determinants in Cardiovascular Disease/Cooperative Health Research in the Region of Augsburg (MONICA/KORA) Survey 1994/95. SETTING: Region of Augsburg, Southern Germany. SUBJECTS: Population-based sample of 2045 women and 2172 men, aged 25-74 years. RESULTS: Intake of dietary supplements containing vitamins and trace elements was associated with lower CRP levels in women. Especially vitamin E in combination with other vitamins like vitamin C, vitamin B(1), B(2), B(6), B(12), niacin, folic acid, pantothenic acid and selenium, was significantly associated with lower CRP levels. Odds ratios for elevated CRP levels (>3.0 mg/l) after multivariable adjustment were 0.57 (95% confidence interval (CI): 0.37, 0.89) for the intake of vitamin E and 0.57 (95% CI: 0.35, 0.91) for the intake of multivitamins, defined as taking three or more different vitamins. These associations were not seen in men. Intake of vitamin C, carotenoids or zinc was not significantly associated with levels of CRP in both men and women. CONCLUSIONS: Our data indicate that the intake of certain vitamins and trace elements from supplements is associated with lower CRP concentrations in women. Thus, intake of these micronutrients could influence the inflammatory process underlying the pathogenesis of atherosclerosis. Specific dose response relationships and the best combinations of vitamins and trace elements have to be determined in further studies.     

Omega-3 fatty acids and selenium as coronary heart disease risk modifying factors in Asian Indian and Chinese males

OBJECTIVE: Asian Indian men are reported to have a higher incidence of coronary heart disease than men of other ethnic groups worldwide. Among the many hypotheses, one possible risk factor may be related to their dietary habits. This study estimated the plasma concentrations of fatty acids, antioxidant vitamins, and selenium in Indians and Chinese of Singapore. METHODS: The study population consisted of 145 Indian men and 147 Chinese men ages 26 to 79 y from a cross-sectional survey, the National University of Singapore Heart Study. RESULTS: Our findings indicated that Indians had lower plasma concentrations of docosahexanoic acid (3.07% versus 3.54%, P < 0.001), alpha-linolenic acid (0.48% versus 0.57%, P < 0.001), and total omega-3 fatty acids (4.71% versus 5.27%, P < 0.001) than did the Chinese. Arachidonic acid was higher in Indians (4.83%) than in the Chinese (4.51%, P = 0.007). The ratio of omega-3 acid to omega-6 fatty acid was also lower in Indians (0.15) than in the Chinese (0.16, P = 0.007). There were no significant differences in the concentrations of monounsaturated fatty acids, but saturated fatty acids were higher in Indians (39.17%) than in the Chinese (38.28%, P < 0.001). Analysis of vitamins A, C, and E showed no significant differences between Indians (0.67, 5.72, and 13.04 mg/L, respectively) and Chinese (0.68, 6.48, and 12.71 mg/L, respectively); however, serum concentration of selenium in Indians (117.49 microg/L) was significantly lower than in the Chinese (126.72 microg/L, P < 0.001). CONCLUSION: The results suggest that lower plasma concentrations of omega-3 fatty acids and selenium and higher concentrations of arachidonic acid and saturated fatty acids in Indians may reflect lower intakes of marine foods and, as a consequence, higher susceptibility to coronary heart disease.     

Central obesity, insulin resistance, syndrome X, lipoprotein(a), and cardiovascular risk in Indians, Malays, and Chinese in Singapore.

STUDY OBJECTIVE: To examine the hypothesis that the higher rates of coronary heart disease (CHD) in Indians (South Asians) compared with Malays and Chinese is at least partly explained by central obesity, insulin resistance, and syndrome X (including possible components). DESIGN: Cross sectional study of the general population. SETTING: Singapore. PARTICIPANTS: Random sample of 961 men and women (Indians, Malays, and Chinese) aged 30 to 69 years. MAIN RESULTS: Fasting serum insulin concentration was correlated directly and strongly with body mass index (BMI), waist-hip ratio (WHR), and abdominal diameter. The fasting insulin concentration was correlated inversely with HDL cholesterol and directly with the fasting triglyceride concentration, blood pressures, plasminogen activator inhibitor 1 (PAI-1), and tissue plasminogen activator (tPA), but it was not correlated with LDL cholesterol, apolipoproteins B and A1, lipoprotein(a), (Lp(a)), fibrinogen, factor VIIc, or prothrombin fragment (F)1 + 2. This indicates that the former but not the latter are part of syndrome X. While Malays had the highest BMI, Indians had a higher WHR (men 0.93 and women 0.84) than Malays (men 0.91 and women 0.82) and Chinese (men 0.91 and women 0.82). In addition, Indians had higher fasting insulin values and more glucose intolerance than Malays and Chinese. Indians had lower HDL cholesterol, and higher PAI-1, tPA, and Lp(a), but not higher LDL cholesterol, fasting triglyceride, blood pressures, fibrinogen, factor VIIc, or prothrombin F1 + 2. CONCLUSIONS: Indians are more prone than Malays or Chinese to central obesity with insulin resistance and glucose intolerance and there are no apparent environmental reasons for this in Singapore. As a consequence, Indians develop some but not all of the features of syndrome X. They also have higher Lp(a) values. All this puts Indians at increased risk of atherosclerosis and thrombosis and must be at least part of the explanation for their higher rates of CHD.     

Selenium status and cardiovascular risk factors in healthy Dutch subjects.

To provide further insight into the possible role of selenium in cardiovascular disease, we examined the relationship between cardiovascular risk factors, some nutritional parameters, and short- and long-term selenium status. A total of 82 healthy Dutch volunteers, 59 men and 23 women, aged 40-75 years, were studied. Means and standard deviations of selenium parameters were: plasma selenium 106.4 +/? 23.7 micrograms/L, erythrocyte selenium 0.59 +/? 0.19 microgram/g Hb, toenail selenium 0.78 +/? 0.17 ppm, and erythrocyte glutathione peroxidase activity 28.0 +/? 8.1 U/g Hb. No association was found between selenium status and gender, age, serum total-, LDL-, and HDL-cholesterol, systolic and diastolic blood pressure, alcohol intake, and body mass index. A significantly lower plasma selenium level was observed among smokers compared to nonsmokers (101.0 micrograms/L, SE = 3.9 vs 112.0 micrograms/L, SE = 3.6, p = 0.04). A significant negative association was found between erythrocyte selenium and serum levels of vitamin A and ferritin. No relevant relationship was observed between selenium status and serum fatty acid composition, vitamin E, vitamin B6, and iron. Apart from an association between smoking and short-term selenium status, we found no indications that a possible effect of selenium on cardiovascular disease may operate through the known risk factors.     

Selenium status and cardiovascular risk factors in healthy Dutch subjects

To provide further insight into the possible role of selenium in cardiovascular disease, we examined the relationship between cardiovascular risk factors, some nutritional parameters, and short- and long-term selenium status. A total of 82 healthy Dutch volunteers, 59 men and 23 women, aged 40-75 years, were studied. Means and standard deviations of selenium parameters were: plasma selenium 106.4 +/- 23.7 micrograms/L, erythrocyte selenium 0.59 +/- 0.19 microgram/g Hb, toenail selenium 0.78 +/- 0.17 ppm, and erythrocyte glutathione peroxidase activity 28.0 +/- 8.1 U/g Hb. No association was found between selenium status and gender, age, serum total-, LDL-, and HDL-cholesterol, systolic and diastolic blood pressure, alcohol intake, and body mass index. A significantly lower plasma selenium level was observed among smokers compared to nonsmokers (101.0 micrograms/L, SE = 3.9 vs 112.0 micrograms/L, SE = 3.6, p = 0.04). A significant negative association was found between erythrocyte selenium and serum levels of vitamin A and ferritin. No relevant relationship was observed between selenium status and serum fatty acid composition, vitamin E, vitamin B6, and iron. Apart from an association between smoking and short-term selenium status, we found no indications that a possible effect of selenium on cardiovascular disease may operate through the known risk factors.     

Differences and trends in antioxidant dietary intake in smokers and non-smokers, 1980-1992: the Minnesota Heart Survey

PURPOSE: Differences and secular trends in dietary antioxidant vitamin intake (vitamins E, C, and beta-carotene) in current non-smokers, light smokers, and heavy smokers were examined as part of the Minnesota Heart Survey. METHODS: Three cross-sectional surveys were conducted in adults ages 25-74 years in 1980-82 (N = 1682), 1985-87 (N = 2326), and 1990-92 (N = 2487). Dietary information was obtained from a 24-hour dietary recall. Smoking was assessed through self-report. Intakes were adjusted for age, energy intake, body mass index, education level, and exercise level (vitamins E, C and beta-carotene). RESULTS: Antioxidant vitamin intakes were significantly higher in non-smokers than in light (1-20 cig/day) and heavy smokers (>20 cig/day) when all three survey periods were combined. In men, mean vitamin E intake was 9.2 mg, 8.6 mg, and 7.8 mg for non-smokers, light smokers, and heavy smokers, respectively. Results were similar in men for beta-carotene (non-smokers 1408 microg, light smokers 1287 microg, and heavy smokers 1064 microg), and vitamin C (non-smokers 81 mg, light smokers 67 mg, and heavy smokers 56 mg). Women had results of similar magnitude and direction. From 1980-92, secular trends in men showed non-significant increases from 1980-82 to 1990-92 in beta-carotene (+6.1%), while decreases were observed in vitamins E (-1.1%) and C (-2.6%). In contrast, women had large decreases in all antioxidant vitamin intakes: vitamin E (-13%), vitamin C (-18.6%), and beta-carotene (-16.2%). CONCLUSIONS: Light and heavy smokers had a significantly lower overall mean dietary antioxidant vitamin intake than non-smokers. Over the decade, antioxidant dietary intake remained relatively stable in men and decreased in women in Minneapolis-St. Paul, despite improvements in access to antioxidant rich fruits and vegetables.     

Intake of nutrients associated with an increased risk of cardiovascular disease in a Spanish population

The daily intake of nutrients associated with increased risk of cardiovascular disease was assessed in Spain to provide current data on adequance to the Spanish nutritional objectives and recommendations. The energy and nutrient distribution throughout the day was also determined. Nutrient intake data of 100 people (24 males and 76 females) aged 20-40 years living in Ponferrada (León, northwest Spain) were calculated from seven non-consecutive daily dietary records using Spanish food composition tables. The survey was carried out in the autumn of 2001. The average energy (E) intake was 2906.67 kcal (12.16 MJ)/day among men and 2106.95 kcal (8.82 MJ)/day among women, with total fat accounting for 39.21 E% (men) and 38.96 E% (women). Average saturated fatty acids (SFA), monounsaturated fatty acids (MUFA) and polyunsaturated fatty acids (PUFA) were 13.03, 15.51 and 6.22 E% (men), and 12.20, 15.58 and 7.10 E% (women). The SFA:MUFA:PUFA ratios were 2.1:2.5:1.0 (men) and 1.7:2.2:1.0 (women), with adequate essential fatty acids (FA) amounts. PUFA n-3 FA daily intake (2.46 g and 1.68 g for men and women, respectively) was adjusted to the recommended levels, with a n-6/n-3 ratio of 7.14 (men) and 8.33 (women). Low trans-FA levels were reported both among male (3.10 g/day) and female (2.21 g/day) populations. High daily cholesterol intakes were found (440.87 mg for men and 359.14 mg for women). Average daily intakes of dietary fibre, alcohol, vitamin A, vitamin C and vitamin E, selenium and sodium were 20.14 and 15.68 g, 7.00 and 4.11 g, 736.00 and 739.28 retinol equivalents, 103.45 and 95.24 mg, 8.73 and 7.84 mg, 83.26 and 45.93 micrograms, and 3777.21 and 2488.12 mg for men and women, respectively. The vitamin E (mg):PUFA (g) ratios were 0.44 (male) and 0.46 (female). Dinner (10.00 p.m. approximately) showed the highest densities (g/1000 kcal) of fat and cholesterol, while breakfast had the highest densities of SFA and trans-FA, both in men and women. Our results advise a decrease in total fat, SFA, n-6 FA, cholesterol and sodium amounts. In contrast, energy intake and consumption of dietetic fibre, vitamins A and E (both sexes) and selenium (women) should be increased in the study population.     

Antioxidant status and risk of cancer in the SU.VI.MAX study: is the effect of supplementation dependent on baseline levels?

The SUpplementation en VItamines et Mineraux AntioXydants (SU.VI.MAX) study, a randomised double-blind, primary-prevention trial showed that after 7.5 years, low-dose antioxidant supplementation lowered the total cancer incidence in men, but not in women. To explain this difference in the impact of antioxidant supplementation in men and women, we hypothesised that the effect of supplementation is dependent on initial antioxidant status; 12 741 French adults (7713 females aged 35--60 years; 5028 males aged 45--60 years) received daily antioxidant supplementation (120 mg vitamin C, 30 mg vitamin E, 6 mg beta-carotene, 100 microg Se, 20 mg Zn daily) or a matching placebo. Cut-off limits for baseline serum concentrations of the different antioxidant vitamins and minerals were defined as follows for both men and women: 0.3 micromol/l for beta-carotene, 11.4 micromol/l for vitamin C, 15 micromol/l for vitamin E, 0.75 micromol/l for Se and 10.7 micromol/l for Zn. The percentage of men with serum concentrations under cut-off limits was higher for vitamins C and E and beta-carotene in those who developed a cancer than in those who did not. The risk of cancer was higher in men with baseline concentrations of serum vitamin C or vitamin E under cut-off limits, but not in women. The effect of supplementation was greater in men with baseline serum concentrations of vitamin C, vitamin E and beta-carotene below the cut-off limits compared with those above it. This effect was maintained only for vitamin E after adjustment for age, tobacco, and alcohol consumption and BMI. No effect of supplementation could be seen in women. Baseline antioxidant status is related to the risk of cancer in men but not in women and therefore does not entirely explain the differences observed in the effect of antioxidant supplementation on cancer risk between sexes in the SU.VI.MAX study.     

Epidemiology of vitamins A, E, D and C in rural villages in Finland: biochemical, nutritional and socioeconomical aspects.

We carried out an extensive health profile analysis in spring-winter 1986 in four Eastern Finnish rural villages as a part of the Healthy Village Study. Altogether, 793 people at working age (20-64 years of age, 427 men and 366 women) participated (80%). Serum lipids (total cholesterol, HDL-cholesterol and triglycerides) and plasma vitamins (vitamin A, D, E and C) were measured as biochemical indicators of health. The dietary habits were reflected in high serum total cholesterol, and in low plasma vitamin C (ascorbic acid, mean 34.4 mumol/l in men, and 51.2 mumol/l in women). The plasma levels of the other vitamins studied were, in general, satisfactory. The mean plasma concentration of vitamin A (retinol) was 2.70 mumol/l in men, and 2.23 mumol/l in women. The gender, high body weight and the use of animal fats had the strongest association to apparent plasma retinol concentrations. The corresponding plasma concentrations of vitamin D (25-hydroxy-D) were 34.1 nmol/l and 35.4 nmol/l, and vitamin E (d-alpha-tocopherol) 22.1 mumol/l and 22.2 mumol/l. Vitamin D deficiency (plasma 25-OHD less than 12.5 nmol/l) was seen in 5% of the subjects. A good vitamin D status was correlated with the use of vitamin supplements, and, surprisingly, with the frequent consumption of alcohol.     

Cardiovascular diseases in Chinese, Malays, and Indians in Singapore. II. Differences in risk factor levels.

STUDY OBJECTIVE--The aim of the study was to examine cardiovascular risk factors to see how these might explain differences in cardiovascular disease mortality among Chinese, Malays, and Indians in the Republic of Singapore. DESIGN--The study was a population based cross sectional survey. Stratified systematic sampling of census districts, reticulated units, and houses was used. The proportions of Malay and Indian households were increased to improve statistical efficiency, since about 75% of the population is Chinese. SETTING--Subjects were recruited from all parts of the Republic of Singapore. SUBJECTS--2143 subjects aged 18 to 69 years were recruited (representing 60.3% of persons approached). There were no differences in response rate between the sexes and ethnic groups. MEASUREMENTS AND MAIN RESULTS--Data on cardiovascular risk factors were collected by questionnaire. Measurements were made of blood pressure, serum cholesterol, low and high density lipoprotein cholesterol, fasting triglycerides and plasma glucose. In males the age adjusted cigarette smoking rate was higher in Malays (53.3%) than in Chinese (37.4%) or Indians (44.5%). In both sexes, Malays had higher age adjusted mean systolic blood pressure: males 124.6 mm Hg v 121.2 mm Hg (Chinese) and 121.2 mm Hg (Indians); females 122.8 mm Hg v 117.3 mm Hg (Chinese) and 118.4 mm Hg (Indians). Serum cholesterol, low density lipoprotein cholesterol and triglyceride showed no ethnic differences. Mean high density lipoprotein cholesterol in males (age adjusted) was lower in Indians (0.69 mmol/litre) than in Chinese (0.87 mmol/litre) and Malays (0.82 mmol/litre); in females the mean value of 0.95 mmol/litre in Indians was lower than in Chinese (1.05 mmol/litre) and Malays (1.03 mmol/litre). Rank prevalence of diabetes for males was Indians (highest), Malays and then Chinese; for females it was Malays, Indians, Chinese. CONCLUSIONS--The higher mortality from ischaemic heart disease found in Indians in Singapore cannot be explained by the major risk factors of cigarette smoking, blood pressure and serum cholesterol; lower high density lipoprotein cholesterol and higher rates of diabetes may be part of the explanation. The higher systolic blood pressures in Malays may explain their higher hypertensive disease mortality.     

Selected Vitamins and Essential Elements in Meat from Semi-Domesticated Reindeer (Rangifer tarandus tarandus L.) in Mid- and Northern Norway: Geographical Variations and Effect of Animal Population Density

Meat samples (n = 100) were collected from semi-domesticated reindeer originating from 10 grazing districts in Norway. We aimed at studying concentrations, correlations, geographical variations and the effect of animal population density on vitamins A, B3, B7, B12 and E, and calcium, iron, zinc, selenium, chromium and cobalt. Mean concentrations of vitamins A, B3, B7; B12 and E were <5 μg, 6.6 mg, <0.5 μg, 4.7 μg and 0.5 mg/100 g wet weight, respectively. Concentrations of calcium, iron, zinc, selenium, chromium and cobalt were 4.7 mg, 2.8 mg, 6.4 mg, 19.4 μg, 1.7 μg and 0.5 μg/100 g wet weight, respectively. Vitamin E and selenium were the nutrients that exhibited the largest geographical variations (p < 0.05), although no geographical gradient was observed for any of the studied nutrients. Age had a significant effect on zinc and selenium concentrations. Iron was significantly positive correlated with calcium (r = 0.3416, p < 0.01) and vitamin B12 with zinc (r = 0.35, p < 0.05). Reindeer from districts with low animal population density had significantly higher selenium concentration than those from districts with medium and high population densities (p < 0.01). Reindeer meat contained higher vitamin B12, iron, zinc and selenium concentrations when compared to Norwegian beef, lamb, mutton, pork and chicken meat.     

Ethnicity is an independent correlate of biomarkers of micronutrient intake and status in American adults

Diet may be among the factors that mediate the acknowledged ethnicity and socioeconomic differentials in health. Biomarkers of nutritional exposure avoid reliance on biased self-reports of diet and allow an objective assessment of dietary differentials associated with ethnicity and socioeconomic position. We used data from the NHANES III (n = 13113) and NHANES 1999-2002 (n = 7246) to examine ethnic, education, and income differentials in serum concentrations of nutrients of putative public health importance (vitamins C, D, and E, folate, carotenoids, selenium, and ferritin) in U.S. adults. Multiple regression methods were used to adjust for covariates and complex survey design to examine these associations. The serum beta-cryptoxanthin and lutein + zeaxanthin concentrations, adjusted for education and income, were higher in nonwhites (P < 0.0001) relative to non-Hispanic whites. Non-Hispanic blacks had lower serum vitamins C and D, folate, and selenium concentrations relative to non-Hispanic-whites. The biomarker profile (except vitamin D, and folate and ferritin in women) of Mexican-Americans was comparable or better relative to non-Hispanic-whites. Ethnicity associations with mean biomarker concentrations generally paralleled these associations with the proportion of the population at risk of marginal concentrations. Education was an independent positive predictor of serum concentrations of several carotenoids and vitamin C (P 相似文献   

Dietary Intake and Supplement Use of Vitamins C and E and Upper Respiratory Tract Infection

Objective: Antioxidants are regulators of immune function and may play a role in upper respiratory tract infections (URTI). We investigated the potential effects of dietary intake from food and supplement use of vitamins C and E on the risk of self-reported URTI.

Methods: We conducted a population-based cohort study of 1509 Swedish men and women ages 20 to 60 with a follow-up period of 4 months. Participants reported a total of 1181 occurrences of URTI. Poisson regression model was used to control for age, sex, and other confounding factors.

Results: Among women, we found that the incidence rate ratio (IRR) for high intake of vitamin C (>200 mg/d) from food was 0.69 (95% CI 0.49–0.98) compared with low intake (<100 mg/d). This association was not seen among men, for whom the IRR was 1.16 (95% CI 0.79–1.70) for high intake of vitamin C (>150 mg/d) compared with low intake (<50 mg/d). We saw no protective effect of vitamin E from food among either men or women, but a possible protective effect of vitamin C and E supplement use among men (vitamin C, 0.69 [95% CI 0.47–1.02]; vitamin E, 0.56 [95% CI 0.33–0.95]), although not among women.

Conclusion: The present study is the first observational study to suggest that intake of vitamin C from food is sufficient to lower the risk of URTI among women. In addition, it appears that supplement use of vitamin E and vitamin C may reduce the risk of URTI among men, who overall had a lower intake of vitamin C from food than women.     

Blood micronutrients in Algeria, relationships with sex and age

Despite trace elements and vitamins are major public health problems in some African countries, there are few studies reporting micronutrient status in North Africa. Therefore, it could be interesting to evaluate plasma concentrations of vitamin A, E and beta-cartene, along with zinc, copper, selenium erythrocyte glutathione peroxidase and superoxide dismutase in Algeria. Volunteers were randomly recruited in Constantine, Batna and Mila. Vitamins, trace elements and enzymes were measured in the University Hospital of Grenoble. 455 persons were included in the study. Subjects were divided in 3 groups: group I: 15 girls and 12 boys who were 6 to 12.9 years old, group II: 190 women and 192 men 13 to 49.9 years old, group III: 24 women and 24 men 50 to 65 years old. Plasma concentrations of micronutrients and enzymes are close to those commonly observed in Europe, except for vitamin A concentrations. Indeed, retinol levels are 30-35% lower than those reported in European countries, moreover almost 8% of the population showed retinol concentrations less than 1.05 mumol/l. beta-Carotene levels were also lower than in the French average population. Ten per cent of the population had plasma zinc levels lower than 10.6 mumol/l. Vitamin E, copper and selenium status seems satisfactory in Algeria. Vitamin A is not a public health problem, however a significant percentage of residents exhibits impaired vitamin A levels and may benefit from retinol supplementation. Larger studies are needed, and particularly in children, to detect possible higher prevalence of vitamin A deficiency in poor socio-economical classes and in inner geographic areas.     

Dietary intakes and vitamin status of a sample of homeless people in Paris

OBJECTIVE: To determine nutritional intake and vitamin status in a sample of homeless people who had been on the streets of Paris for more than 2 y. DESIGN: The nutritional status was evaluated by a 24 h recall questionnaire and by assay of circulating levels of vitamins A, B1, B6, B12, C and E. SETTING: The study was conducted in four accommodation centres of the SAMU Social of Paris (CHUSI units) from July 1999 to May 2000. SUBJECTS: A total of 329 homeless people were interviewed. Only 87 subjects, aged 26-76 y, were recruited based on seven selection criteria (over 18 y old, being homeless for more than 2 y, interviewed before taking a meal in the CHUSI units, good understanding of French, in a calm state, not coming from hospital or another CHUSI units, without any acute condition that might affect usual dietary habits), and completed the dietary questionnaire. Out of these 87, 71 agreed to blood sampling. RESULTS: In all 84% of the subjects declared that they drank alcoholic beverages regularly (175+/-167 g/day of alcohol), and 75.5% of the subjects also declared that they smoked. The mean total energy intake was 2111+/-1482 kcal/day for the men (8823.98+/-6194.76 kJ/day) and 1523+/-531 kcal/day for the women (6366.14+/-2219.58 kJ/day). Alcohol accounted for 44+/-30% and 19+/-17% of the total energy intakes (TEI) for the men and women, respectively. Proteins, lipids and carbohydrates accounted for 21+/-9, 23+/-14 and 57+/-16%, respectively, of the energy intake without alcohol for men, and 15+/-5, 22+/-11 and 62+/-14% EIWA for women. For all micronutrients, except for iron in the men, more than 50% of the population studied had intakes below the French recommendations for the adult population. All the women had calcium, vitamin E and vitamin B1 intakes below the recommendations for French women (900, 12 and 1.3 mg/day, respectively) in the general population. For the men, 98.7, 96.1 and 93.5% of the subjects had vitamin E, B1 and C intakes below the recommendations for French males in the general population (12, 1.5 and 80 mg/day, respectively). It is of note that subjects who ate in the CHUSI units more than once a day per week had significantly (P=0.018) higher intakes of vitamin C (27+/-38 mg/day) than did the subjects who ate in the CHUSI units less than once a day (8+/-12 mg/day). Measurement of serum vitamin levels demonstrated a deficiency in 95% of the subjects, mainly for vitamin C. The mean concentration in serum was 16+/-8 micromol/l, although 72% of the subjects had levels of 6 micromol/l. In contrast, 50.7, 42.2 and 35.2% of the subjects had high levels of vitamin B6, B12 and B1, respectively (100 nmol/l, 420 pmol/l and 40 micromol/l). CONCLUSION: Alcohol takes a high place in the diet of these homeless people. Although the total energy intake was too low, macronutrient intakes seem to be satisfactory in quality (well-balanced). However, calcium and vitamin C intakes were too low, and these deficiencies favour the development of disease (scurvy, asthenia, ecchymosis), in addition to alcohol-linked disease. Furthermore, the overexposure to vitamin B6, among the other B vitamins, is a matter of concern since it has been shown to be toxic in high doses.     

Iron status in a group of long-stay mentally handicapped menstruating women: some dietary considerations

As part of a longitudinal study aimed at assessing the dietary intakes and nutritional status of a group of long-stay mentally handicapped subjects, 15 women of menstruating age were considered for a substudy to assess the influence of intake levels of dietary iron, energy, tea, coffee and vitamin C on their iron status. The assessment comprised a week-long weighed dietary survey and the measurement of a number of haematological indices that included serum ferritin concentration. Information on duration of menses was also collected and included in the assessment. Two-fifths of the subjects assessed had a serum ferritin concentration less than 12 micrograms/l indicating iron deficiency, including one who was considered anaemic as suggested by a haemoglobin level less than 12 g/dl. Duration of menses showed a negative significant correlation with serum ferritin concentration. The mean iron intake in the group was 9.5 +/- 1.5 mg/day. Energy intakes were low and positively correlated with iron intake. Although serum ferritin showed no correlation with iron intake, it showed significant negative correlations with the daily and meal-time intakes of tea and a significant positive correlation with the meal-time intakes of vitamin C. The six iron-depleted subjects were assessed as a separate group (Group I) in comparison with the other nine subjects who had a serum ferritin concentration greater than 12 micrograms/l. The results of this assessment showed that, while there were no significant differences in duration of menses or the mean daily intakes of iron and energy between the two groups. Group I subjects had significantly higher daily and meal-time intakes of tea and significantly lower meal-time intakes of vitamin C compared to Group II subjects. The study provides some evidence suggestive of an association between the iron deficiency states observed and tea intake in adversely affecting iron status, particularly in the absence of adequate meal-time intakes of vitamin C. The findings from the study also suggest that long-stay mentally handicapped women of menstruating age, in addition to their handicap and dependency states which may often predispose them to a low dietary intake, are at particular risk of iron deficiency.     

Changes in thiamin, riboflavin, niacin, beta-carotene, vitamins, C, A, D and E status of French Elderly Subjects during the first year of institutionalization

Vitamin status was assessed in 26 recently institutionalized elderly subjects by combining dietary and biochemical measurements of thiamin, riboflavin, niacin, beta-carotene, vitamins C, A, D and E at admission (P1), and 1.5 (P2), 3.0 (P3), 4.5 (P4), 6.0 (P5), 12 (P6) months later. At admission, except for vitamin A, mean vitamin intakes were lower than the 1992 French Recommended Dietary Allowance. Thiamin, vitamins C, A and E status seemed nearly satisfactory as less than one-fourth of the population sample had blood values lower than the cut-off point for thiamin (erythrocyte thiamin pyrophosphate < 0.17 mumol/l), vitamin A (serum retinol < 1.05 mumol/l), vitamin C (serum vitamin C < 11.3 mumol/l) and vitamin E (serum alpha-tocopherol < 9.3 mumol/l) or higher than the cut-off point for thiamin (erythrocyte transketolase activity coefficient > 1.19). Almost half of the subjects for riboflavin, and almost all non supplemented subjects for vitamin D were in risk of vitamin deficiency (46% had an erythrocyte glutathione reductase activity coefficient > 1.19 and 72% had a plasma 25(OH)D3 < 25 nmol/l). During the study, vitamins status remained unchanged for riboflavin, niacin, vitamins A, D and E, improved for vitamin C (P = 0.004) or impaired for thiamin (P = 0.008). Thus, institutionalization seemed to have no effect on riboflavin, niacin, vitamins A, D and E status and a slight effect on thiamin and vitamin C status.     

Biochemical and anthropometric evaluation of the nutritional status of 35-year-old Dutch men with reference to smoking and drinking habits

In 1986, sixty 35-year-old Dutch men (response 87%) provided information on medications, alcohol consumption and smoking habits. Length, body weight and blood pressure were determined. A blood sample was taken to determine serum cholesterol, HDL cholesterol and biochemical parameters of the vitamin, iron and trace element status (hematology, ferritin, vitamins A, B6, B12, folate, Zn, Se). Prevalence of overweight (body mass index greater than 27 kg/m2) was 15%, whereas 12% had high-risk cholesterol levels (greater than 6.4 mmol/l). Except for possibly selenium, no marginal values for the vitamin, iron and trace element status were found. Smokers had a higher hematocrit reading and mean corpuscular volume and lower mean corpuscular hemoglobin concentration (p less than 0.05). The nutritional status was not negatively influenced by (predominantly moderate) alcohol consumption (mean = 21 g/day). Positive associations with alcohol consumption were found for plasma folic acid (p less than 0.01) and plasma pyridoxal-5'-phosphate (p less than 0.001). This study shows that the most important nutritional risks in 35-year-old Dutch men are related to cardiovascular disease.     

Strong negative association between intake of tofu and anemia among Chinese adults in Jiangsu, China

BACKGROUND: Anemia is prevalent in China. Tofu made from soybean is a popular food. Soybean is shown to have an affect on iron status. No study has examined the relation between tofu and iron status. OBJECTIVE: To investigate the association between tofu intake and anemia among Chinese adults. DESIGN: A cross-sectional household survey of 2,849 men and women aged 20 years and older (mean age 47.0+/-14.5 years), from a nationally representative random sample in Jiangsu province undertaken in 2002 (response rate 89%). Tofu intake was assessed by food frequency questionnaire. Nutrient intake was measured by 3-day weighed food records. Serum ferritin and hemoglobin were measured. RESULTS: The prevalence of anemia was 18.3% in men and 31.5% in women. Mean hemoglobin values increased by quartiles of tofu intake (men: 14.1, 14.0, 14.5, and 14.8 mg/dL [141, 140, 145, and 148 g/L]; women: 12.4, 12.5, 12.6 and 13.3 g/dL [124, 125,126, and 133 g/L]), and the prevalence of anemia decreased concomitantly. Comparing first and fourth quartiles of tofu intake, the prevalence of anemia was 23.9% vs 10.7% in men, and 38.1% vs 16.8% in women. Tofu intake was inversely associated with serum ferritin levels in women. In multivariate analyses, the odds ratio of anemia for men in fourth compared to first quartile of tofu intake was 0.30 (95% confidence interval 0.17 to 0.50), and the corresponding odds ratio for women was 0.31 (95% confidence interval 0.20 to 0.47). The association between tofu intake and anemia was independent of iron intake. CONCLUSIONS: Tofu intake was associated with lower risk of anemia among Chinese adults in both sexes.