Vitamins, selenium, iron, and coronary heart disease 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 partly because of differences in antioxidants (vitamins A, C, and E, and selenium) and pro-oxidants (iron). DESIGN: Cross sectional study of the general population. SETTING: Singapore. PARTICIPANTS: Random sample of 941 persons aged 30 to 69 years. MAIN RESULTS: There were moderate correlations between vitamin A and vitamin E, and between these vitamins and selenium. Mean plasma vitamins A and E were similar by ethnic group. Vitamin A concentration for Indians were (men 0.66 and women 0.51 mg/l), Malays (men 0.67 and women 0.54 mg/l), and Chinese (men 0.68 and women 0.52 mg/l). Vitamin E concentrations for Indians were (men 12.9 and women 12.8 mg/l), Malays (men 13.6 and women 13.3 mg/l), and Chinese (men 12.6 and women 12.6 mg/l). In contrast, mean plasma vitamin C concentrations were lower in Indians (men 5.7 and women 6.9 mg/l) and Malays (men 5.1 and women 6.4 mg/l) than Chinese (men 6.3 and women 8.4 mg/l). Mean serum selenium was lower in Indians (men 117 and women 115 micrograms/l) than Malays (men 122 and women 122 micrograms/l) and Chinese (men 126 and women 119 micrograms/l). Mean serum ferritin was much lower in Indians (men 132 and women 50 micrograms/l) than Malays (men 175 and women 85 micrograms/l) and Chinese (men 236 and women 92 micrograms/l). MAIN CONCLUSIONS: Lower vitamin C and selenium in Indians, particularly in combination, could play a part in their increased risk of CHD. Vitamins A and E, and ferritin (iron) have no such role. Lower vitamin C in Indians and Malays is probably because of its destruction by more prolonged cooking. In Indians, lower selenium is probably because of a lower dietary intake and the much lower ferritin to a lower dietary intake of iron and its binding by phytates.

 

     

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.     

Water,sanitation, and hygiene in schools: Status and implications of low coverage in Ethiopia,Kenya, Mozambique,Rwanda, Uganda,and Zambia

Adequate access to water, sanitation, and hygiene (WaSH) in schools impacts health, educational outcomes, and gender disparities. Little multi-country research has been published on WaSH in rural schools in Sub-Saharan Africa. In this multi-national cross-sectional WaSH study, we document WaSH access, continuity, quality, quantity, and reliability in 2270 schools that were randomly sampled in rural regions of six Sub-Saharan African countries: Ethiopia, Kenya, Mozambique, Rwanda, Uganda, and Zambia. Data collection included: school WaSH surveys containing internationally established WaSH indicators, direct observation, and field- and laboratory-based microbiological water quality testing. We found 1% of rural schools in Ethiopia and Mozambique to 23% of rural schools in Rwanda had improved water sources on premises, improved sanitation, and water and soap for handwashing. Fewer than 23% of rural schools in the six countries studied met the World Health Organization’s recommended student-to-latrine ratios for boys and for girls. Fewer than 20% were observed to have at least four of five recommended menstrual hygiene services (separate-sex latrines with doors and locks, water for use, waste bin). The low access to safe and adequate WaSH services in rural schools suggest opportunities for WaSH interventions that could have substantive impact on health, education, and gender disparities.     

Schistosomiasis japonica, anemia, and iron status in children, adolescents, and young adults in Leyte, Philippines 1

BACKGROUND: Observational and interventional evidence supports a relation between human schistosomiasis and anemia; however, the exact causal mechanisms remain unclear. Eggs translocating across the intestinal or bladder wall may result in extracorporeal blood loss with subsequent iron deficiency. Alternatively, anemia may result from cytokine-mediated dyserythropoiesis, as seen in anemia of inflammation. OBJECTIVES: By evaluating the cross-sectional relation between the intensity of Schistosoma japonicum infection, hemoglobin concentration, and iron status in 7-30-y-old persons from S. japonicum-endemic rice-farming villages in the province of Leyte, Philippines, we assessed the relative contribution of iron deficiency and anemia of inflammation to schistosomiasis-associated anemia. DESIGN: We enrolled 627 S. japonicum-infected and 111 S. japonicum-uninfected persons. We obtained stool samples to quantify S. japonicum infection and venous blood samples for hemograms and measures of iron status and inflammation. RESULTS: Intensity of S. japonicum infection was independently associated with hemoglobin (beta = -0.24; 95% CI: -0.31, -0.17). Persons with high-intensity infection had a greater risk of iron deficiency anemia (adjusted prevalence odds ratio: 6.6; 95% CI: 2.9, 14.7), but there was no evidence of this relation in low-intensity infections. In contrast, anemia without iron deficiency was prevalent across all intensities (adjusted prevalence odds ratio: 3.8; 95% CI: 1.5, 9.5). CONCLUSIONS: Storage iron deficiency is a major contributor to anemia in high-intensity S. japonicum infection. A high prevalence of anemia without iron deficiency, exclusion of other mechanisms of anemia, and the evidence of low bioavailable iron suggest that anemia of inflammation contributes to S. japonicum-associated anemia at all infection intensities.     

Psychological distress, gender, and health lifestyles in Belarus, Kazakhstan, Russia, and Ukraine

This paper examines the relationship between psychological distress, gender, and health lifestyles in Belarus, Kazakhstan, Russia, and Ukraine. These countries have been subjected to highly stressful and extensive social change associated with the transition out of communism. Data were collected by face-to-face interviews (n = 10,406) in November 2001. Distress was measured by 12 psychological distress symptoms. Health lifestyles focused on measures of alcohol consumption, smoking and diet. We found that females carried a much heavier burden of psychological distress than males, but this distress did not translate into greater alcohol consumption and smoking for these women or for men. The greatest influence of distress on health lifestyle practices was on daily diets in that both less distressed females and males consumed a more balanced diet than more distressed persons. Our findings suggest that it is the normative demands of a particular lifestyle, rather than distress, that principally shapes the pattern of heavy male drinking. This is an important finding as some sources indicate heavy drinking is largely responsible for the health crisis in the former socialist states.     

Arsenic,cadmium, cobalt,copper, lead,mercury, molybdenum,selenium and zinc concentrations in liver,kidney and muscle in Australian sheep

Matched muscle, liver and kidney samples from 152 sheep in different states of Australia were analysed for trace elements. Mean levels found in muscle, livers and kidneys were 0.010, 0.010 and 0.011 mg kg⁻¹ (fresh weight) for arsenic; 0.0035, 0.280 and 0.853 mg kg⁻¹ for cadmium; 0.006, 0.060 and 0.044 mg kg⁻¹ for cobalt; 0.74, 66.0 and 2.72 mg kg⁻¹ for copper; 0.007, 0.040 and 0.057 mg kg⁻¹ for lead; 0.0025, 0.0034 and 0.0061 mg kg⁻¹ for mercury; 0.014, 1.05 and 0.44 mg kg⁻¹ for molybdenum; 0.09, 0.31 and 0.95 mg kg⁻¹ for selenium; and 40.4, 37.2 and 20.8 mg kg⁻¹ for zinc. The lead, mercury and arsenic concentrations in meat and organs may be regarded as low, but the concentrations of cadmium in kidney and livers are sometimes relatively high. Apart from cadmium, lead and selenium, tissue trace element concentrations were not related to the age of the investigated animals. Differences in essential and non-essential trace element accumulation in sheep reared in different regions (states and territories) of Australia were also evaluated. Cadmium, lead and selenium were the only elements that appeared to show significant regional differences. Overall the results show that concentrations of the elements considered are within current acceptable ranges.     

Gender,play, language,and creativity in preschoolers

This study explored the effects of a child's gender and school setting on preschoolers' language abilities (receptive vocabulary), creativity, and social play. The participants were primarily European-American children who spoke English as a primary language (nine children were bilingual), and were from middle income socioeconomic backgrounds. There were 20 girls and 33 boys. Ages ranged from 3.11 to 6.60 years with a mean age of 4.66 years. On separate occasions, children individually completed the Goodenough-Harris Draw-a-Person Test and the Peabody Picture Vocabulary Test-IV. We also recorded the children's social play using Howes and Matheson's [1992. Sequences in the development of competent play with peers: Social and social pretend play. Developmental Psychology, 28, 961–974] scale. We employed a time sampling approach and also notated the area in which the child was playing. We found that gender and school setting influenced children's language abilities and social play. For example, children in the preschool that engaged in pretend play with greater frequency performed well on the receptive vocabulary test. We also found that certain classroom areas generated different types of social play. We discuss the applied value of our findings as these relate to future research.     

Passive smoking in bars, restaurants, and discotheques in Florence, Italy

BACKGROUND: "Environmental Tobacco Smoke (ETS) exposure in a sample of European cities" is the first European multicentre project intended to measure ETS exposure in public places in a number of European cities. OBJECTIVES: To present results of measurements of nicotine concentration in a number of bars, restaurants and discotheques in Florence, Italy. METHODS: The ETS marker was vapour-phase nicotine sampled by passive monitors. At least two monitors were placed in each of seven bars (five in hospitals; one at an airport; one at a railway station), and seven restaurants (three with smoking and non-smoking sections), and left in place for several days. In each of four discotheques two nicotine passive monitors were used as personal samplers. RESULTS: The average nicotine concentration in discotheques, restaurants and bars was respectively 26.78 micro/m3, 2.32 microg/m3 and 0.83 microg/m3. In the smoking section of restaurants with separated areas for smokers and non-smokers the average nicotine concentration was 2.54 microg/m3, which was similar to that measured in non-smoking sections (2.14 microg/m3).     

Fruit, vegetable, and antioxidant intake and all-cause, cancer, and cardiovascular disease mortality in a community-dwelling population in Washington County, Maryland

Higher intake of fruits, vegetables, and antioxidants may help protect against oxidative damage, thus lowering cancer and cardiovascular disease risk. This Washington County, Maryland, prospective study examined the association of fruit, vegetable, and antioxidant intake with all-cause, cancer, and cardiovascular disease death. CLUE participants who donated a blood sample in 1974 and 1989 and completed a food frequency questionnaire in 1989 (N = 6,151) were included in the analysis. Participants were followed to date of death or January 1, 2002. Compared with those in the bottom fifth, participants in the highest fifth of fruit and vegetable intake had a lower risk of all-cause (cases = 910; hazard ratio (HR) = 0.63, 95% confidence interval (CI): 0.51, 0.78; p-trend = 0.0004), cancer (cases = 307; HR = 0.65, 95% CI: 0.45, 0.93; p-trend = 0.08), and cardiovascular disease (cases = 225; HR = 0.76, 95% CI: 0.54, 1.06; p-trend = 0.15) mortality. Higher intake of cruciferous vegetables was associated with lower risk of all-cause mortality (HR = 0.74, 95% CI: 0.60, 0.91; p-trend = 0.04). No statistically significant associations were observed between dietary vitamin C, vitamin E, and beta-carotene intake and mortality. Overall, greater intake of fruits and vegetables was associated with lower risk of all-cause, cancer, and cardiovascular disease death. These findings support the general health recommendation to consume multiple servings of fruits and vegetables (5-9/day).     

Cd and Zn in atmospheric deposit, soil, wheat, and milk

Continuous air quality monitoring in the Vojvodina district of Serbia and Montenegro has shown high levels of Cd, especially in the outskirts of large towns such as Kikinda. The construction and metal processing industries located in Kikinda have been emitting significant amounts of heavy metals into the environment. The levels of Cd and Zn were monitored in the region of Kikinda and compared to their concentrations detected in Novi Sad, the capital of Vojovodina, where emission of heavy metals originated mostly from vehicle traffic. The study was performed during the economic sanctions when industrial production decreased drastically. The consequence of that was a significant decrease of the concentration of Cd and Zn in atmospheric deposits. Data collected during 3 years indicated a direct influence of atmospheric deposits on heavy metal distribution in the chain soil-cattle feed-milk. Decreased Cd concentrations of 93% in atmospheric deposits in the Kikinda region resulted in decreased Cd concentrations of 17% in cattle feeds and 13% in milk. Decreased Zn concentrations of 58% in atmospheric deposits caused reduced Zn concentrations of 30% in soil, 17% in cattle feeds, and 17% in milk.     

Occupation and bladder cancer in Boston, USA, Manchester, UK, and Nagoya, Japan.

Relations between occupational history and the development of cancer of the lower urinary tract ("bladder cancer") were evaluated in Boston, Massachusetts, USA, Manchester, UK, and Nagoya, Japan. Population-based series of incident cases and controls were identified and interviewed in each area. The present analysis was limited to men and was based on 430 cases and 397 controls in Boston, 399 cases and 493 controls in Manchester, and 226 cases and 443 controls in Nagoya. In Boston, elevated risk of bladder cancer was associated with employment related to dyes (relative risk = 2 X 1; 90% confidence interval, 0 X 9-5 X 1), leather (1 X 7; 1 X 1-2 X 6), paint (1 X 5; 0 X 9-2 X 4), or organic chemicals (1 X 6; 1 X 1-2 X 5). In Manchester, elevated risk was associated with 0 X 9-3 X 6). No clear association was observed between occupation and risk in Nagoya. Elevations in risk related to occupation generally were stronger in men under 65 years of age compared to older men. Differences from place to place in associations between occupation and risk may be the result of differences in the exposures to hazardous agents that jobs with the same title involve.     

Physical and ergonomic hazards in the textile, chemical, food, metal products, and woodworking industries in Turkey

Questionnaires were administered in 272 textile, chemical, food, metal products and woodworking firms in ten cities in industry-dense areas to assess the general OHS situation in Turkey. This paper explores the portion related to exposures of workers to physical and ergonomic hazards. OHS experts where available, firm owners, partners, or engineers responsible for safety were asked to answer structured questions regarding percentages of workers exposed to specific hazards. About 65% of respondents reported exposures to noise risks among at least some percentage of employees; 26.3% reported more than 50% of employees were so exposed. In more than 60% of the firms employees were exposed to ergonomic risks related to the need to meet production quotas and the need to maintain constant posture. The most prevalent risk factors in five industries and the relative frequencies of exposed employees are described.     

Molybdenum, nickel, cobalt, vanadium, and strontium in total diets

The 234 foods from a 1984 collection of the Food and Drug Administration's Total Diet Study were analyzed for the trace elements molybdenum, nickel, cobalt, vanadium, and strontium by plasma emission spectrometry. Daily intakes of these elements were then estimated for eight age-sex groups on the basis of results from national food consumption surveys. The contribution of food commodity groups to the daily intake of the five elements and the distribution of the elements in the 234 foods were also determined. Results from this study were compared with those reported earlier from other laboratories.