Effects of a high fat or a balanced omega 3/omega 6 diet on cytokines levels and DNA damage in experimental colitis

Objective

High-fat diets have been shown to be a risk factor for ulcerative colitis (UC). Omega-6 polyunsaturated fatty acids are considered to increase lipid peroxidation, while the omega-3 polyunsaturated fatty acid exerts a chemopreventative effect. We evaluated the effect of high-fat diets (20%) enriched with fish or soybean oil on colonic inflammation and DNA damage in dextran sulfate sodium-induced colitis.

Methods

Male Wistar rats (28-30 days) were fed an American Institute of Nutrition (AIN)-93 diet for 47 days and divided into five groups: control normal fat non-colitic (C) or control colitis (CC), high soybean fat group (HS) colitis, high fish fat group colitis, or high-fat soybean plus fish oil colitis. UC was induced from day 35 until day 41 by 3% dextran sulfate sodium. On day 47, the rats were anesthetized; blood samples collected for corticosterone determination, and the distal colon was excised to quantify interleukin-4 (IL-4), IL-10, and interferon-gamma levels, myeloperoxidase activity, histological analyses, and DNA damage. The disease activity index was recorded daily.

Results

The disease activity index, histological analysis, myeloperoxidase activity, IL-4, interferon-gamma, and corticosterone levels did not differ among the colitic groups. IL-10 was significantly increased by the high fish fat group diet in relation to HS, but only the high soybean-fish fat diet increased the IL-10/IL-4 ratio (anti-inflammatory/pro-inflammatory) to levels closer to the C group and reduced DNA damage compared to the HS group (P < 0.05).

Conclusion

The data show that high-fat diets did not exacerbate UC and suggest that the soybean and fish oil mixture, more than the fish oil alone, could be a complementary therapy to achieve a cytokine balance in UC.     

IL-15 aggravates atherosclerotic lesion development in LDL receptor deficient mice

Background

Interleukin 15 (IL-15) is a pro-inflammatory cytokine involved in inflammatory diseases and IL-15 is expressed in atherosclerotic plaques.

Methods

To establish the role of IL-15 in atherosclerosis we studied the effect of IL-15 on atherosclerosis associated cells in vitro and in vivo by neutralizing IL-15 using a DNA vaccination strategy.

Results

Upon feeding a Western type diet LDLr^−/− mice do express higher levels of IL-15 within the spleen and the number of IL-15 expressing cells among blood leukocytes and spleen cells is increased. Addition of IL-15 to macrophages induces the expression TNF-α and CCL-2. After the mice were vaccinated against IL-15, we observe a reduction in plaque size of 75% plaque. Unexpectedly, the relative number of macrophages within the plaque was 2-fold higher in IL-15 vaccinated mice than in control mice. Vaccination against IL-15 leads to an increased cytotoxicity against IL-15 overexpressing target cells, resulting in a reduction in IL-15 expressing cells and macrophages in blood and spleen and a decreased CD4/CD8 ratio.

Conclusion

Hypercholesterolemia leads to upregulation of IL-15 within spleen and blood. DNA vaccination against IL-15 does markedly reduces atherosclerotic lesion size, but does not promote lesion stability.     

Randomized controlled trials of herbal interventions underreport important details of the intervention

Objective

To examine the quality of reporting and predictors of reporting in randomized clinical trials (RCTs) of herbal medicine interventions.

Study Design and Setting

We searched Medical Literature Analysis and Retrieval System Online, Excerpta Medica Database, and Academy of Microscope Enhanced Dentistry up to December 2007 for any English language RCT of 11 commonly used herbal medicine interventions. Two individuals separately and independently assessed all trials using the Consolidated Standards of Reporting Trials (CONSORT) checklist for herbal medicines interventions. We randomly selected 100 of these trials, extracted a set of potential predictor variables identified through a literature search and consultation with experts, and performed a conceptually driven stepwise elimination regression analyses for predictor variables.

Results

The 406 trials reported on average 38% of the information suggested in the checklist. Regression analyses revealed better overall reporting in trials with a participant flow diagram (P = 0.008), those of Panax quinquefolius (P = 0.018), and those published in more recent years (P = 0.02).

Conclusion

Our results indicate that RCTs of herbal medicine interventions frequently do not report important characteristics of the intervention. Trialists should refer to the CONSORT for herbal medicines when reporting their trials.     

Homophily and co-occurrence patterns shape randomized trials agendas: illustration in antifungal agents

Objective

To assess whether there are preferences and avoidances for specific comparisons in a clinical trials agenda.

Study Design and Setting

We tested for homophily (preference to compare agents against others in the same class) and co-occurrence (preference or avoidance of specific head-to-head comparisons) in the randomized trials agenda of antifungal agents. We searched MEDLINE and Cochrane Library databases for English language randomized trials evaluating systemic antifungals against Candida or Aspergillus in adults. We extracted data on compared regimens, sample size, publication year, indication (treatment/prophylaxis), and underlying disease.

Results

One hundred forty-four trials (74 treatments, 70 prophylaxes) were found (n = 27,497 patients). Among polyene and azole groups, agents were compared within the same class more often than across classes (homophily test P < 0.001). Lipid amphotericin was compared almost entirely against conventional amphotericin (18 trials), with only three comparisons against azoles. Head-to-head comparisons of newer agents were avoided. Only one of 14 trials for echinocandins compared head-to-head two different echinocandins (P < 0.001 for co-occurrence). Of 11 trials on newer azoles, only one compared a newer azole with an echinocandin (P < 0.001 for co-occurrence).

Conclusions

Trial networks for antifungals show that specific comparisons are preferred and others avoided, generating a potentially biased clinical research agenda.     

Residential fungal growth and incidence of acute respiratory illness during the first two years of life

Background

Whether or not indoor mold growth causes acute childhood respiratory illness is controversial.

Objective

To determine the influence of indoor fungus on the incidence of acute respiratory illness episodes during the first two years of life.

Methods

Fungal indicators were measured in homes of children followed by daily symptom diaries and twice monthly telephone contact up to two years.

Participants

357 children born in Prince Edward Island, Canada.

Results

Generally, fungal contamination was not excessive with a geometric mean mold surface area (MSA) of 1012 cm² (geometric standard deviation (GSD) 24.2). The annual mean illness episodes per child were 6.85 (Standard Deviation (SD) 2.80). The incidence of respiratory illness episodes was not significantly related to any of the mold indicators: Analysis of variance (ANOVA) derived F-statistic (p values) was 0.14 (0.7090) for mold surface area.

Conclusions

In homes not selected by degree of fungal contamination, fungal burden was generally not excessive and was not found to be a risk factor for acute respiratory illness episodes during the first two years of life.     

Viral interference induced by live attenuated virus vaccine (OPV) can prevent otitis media

Background

The goal of this study was to evaluate whether a live attenuated poliovirus vaccine (OPV) has clinically relevant interfering effect with non-polio infections causing otitis media in young children.

Methods

Open trial in which the intervention group (64 children) received OPV at the age of 2, 3, 6 and 12 months. The control group (250 children) received IPV (inactivated polio vaccine) at the age of 6 and 12 months. Clinical symptoms were recorded by a questionnaire at the age of 3, 6, 12, 18 and 24 months.

Results

Otitis media episodes were less frequent in the OPV than in the control group. A significant difference was seen at the age of 6-18 months (IRR = 0.76 [95% CI 0.59-0.94], P = 0.011) and was particularly clear among children, who attended daycare (IRR 0.37 [95% CI 0.19-0.71], P = 0.003).

Conclusions

OPV provides some protection against otitis media. This effect may be mediated by viral interference with non-polio viruses.     

Dietary pattern change and acculturation of Chinese Americans in Pennsylvania

Objective

To obtain information about dietary pattern change of Chinese Americans in Pennsylvania and its relationship with demographic characteristics and acculturation indicators.

Design

A cross-sectional self-administered survey.

Subjects

A convenience sample of 399 Chinese Americans.

Statistical analyses performed

t Tests, analysis of variance with Tukey post-hoc tests, Spearman rank correlation, and χ² test.

Results

After immigration, Chinese Americans increased consumption frequency of all seven food groups (grains, vegetables, fruits, meat/meat alternatives, dairy products, fats/sweets, and beverages) and Western foods while consumption frequency of traditional Chinese foods decreased. Dietary variety also increased after immigration. Higher education and higher income levels were associated with a larger increase in consumption frequency of grains, vegetables, and fruits. Persons who resided in the United States for a longer period of time shared a greater increase in their consumption frequencies of vegetables, fats/sweets, and beverages. Persons with better English proficiency had a greater increase in their consumption frequency of grains, fruits, meat/meat alternatives, and fats/sweets.

Conclusions

This study can help nutrition educators design appropriate educational programs for first-generation Chinese Americans that can facilitate the adoption of more healthful dietary practices. Nutrition educators should consider the dietary changes of Chinese-American participants, such as skipping breakfast and increased consumption frequency of fats, sweets, and soft drinks, which were observed in this study. For example, acculturated first-generation Chinese Americans should be encouraged to decrease fats, sweets, and soft-drink consumption. Less-acculturated persons should be encouraged to maintain their healthful dietary pattern and increase consumption of vegetables and fruits.     

Diet Based on the Japanese Food Guide Spinning Top and Subsequent Mortality among Men and Women in a General Japanese Population

Background

The Japanese Food Guide Spinning Top was developed by the Japanese Ministry of Health, Labor, and Welfare and the Ministry of Agriculture, Forestry, and Fishery to promote healthful diets.

Objective

Adherence to the Japanese Food Guide Spinning Top was evaluated in terms of future mortality in a prospective cohort study.

Design

A prospective cohort study among men and women in a general Japanese population.

Subjects/setting

The cohort consisted of 13,355 men and 15,724 women residing in Takayama, Japan, in 1992. At baseline, a food frequency questionnaire was administered, and adherence to the food guide was measured based on consuming the recommended number of servings of grains, vegetables, fish and meat, milk, and fruits, as well as total daily energy intake and energy from snacks and alcoholic beverages. Higher scores indicated better adherence to the recommendations on a scale of 0 to 70. Based on data obtained from the Office of the National Vital Statistics, deaths occurring among members of the cohort were prospectively noted from 1992 to 1999.

Statistical analyses performed

To assess the magnitude of association of adherence scores with subsequent mortality, a Cox proportional hazard model was applied to estimate hazard ratios (HRs) with 95% confidence intervals (CIs).

Results

Among women, the adherence score was significantly associated with a lower risk of mortality from all causes (comparing highest and lowest quartiles of the score, HR 0.78, 95% CI 0.65 to 0.94, P for trend 0.01) in a multivariate analysis; noncardiovascular, noncancer causes (HR 0.69, 95% CI 0.50 to 0.96, P for trend 0.04) and cardiovascular disease (HR 0.76, 95% CI 0.56 to 1.04, P for trend0.05). No statistically significant association was observed between the adherence score and mortality among men.

Conclusions

The results suggest that diets based on the food guide have the benefit of reducing future mortality in women.     

Lymph duct ligation during ischemia/reperfusion prevents pulmonary dysfunction in a rat model with ω-3 polyunsaturated fatty acid and glutamine

Objective

The release of injurious factors into the mesenteric lymph from the ischemic intestine has been shown to contribute to lung injury and systemic inflammation after severe injury. We studied the effects of lung injury and systemic inflammatory reaction after intestinal ischemia/reperfusion and mesenteric lymph duct ligation with different nutritional statuses.

Methods

Rats (n = 72) were fed with a normal diet or received one of three diets (enteral nutrition, glutamine, or ω-3 polyunsaturated fatty acid) that were isocaloric and isonitrogenous. After 7 d, rats were subjected to 60 min of intestinal ischemia, ischemia plus mesenteric lymph duct ligation, or sham procedures. After 3 d of ischemia, the lymph nodes, lung, intestinal, liver, and blood were harvested and analyzed.

Results

In the different groups, lung injury, including levels of myeloperoxidase, nitric oxide, nitric oxide synthase, and the index of alveolar apoptosis, were partly prevented by mesenteric lymph duct ligation (P < 0.05). Likewise, the rats with ischemia/reperfusion, but not those with duct ligation plus ischemia/reperfusion, had a significant increase in intestinal permeability and decreased mucosal thickness. The serum cytokine and endotoxin concentrations were also lower in the lymph duct ligation groups, although there was no significant difference between lymph duct ligation and sham procedure. The lung and intestinal injuries were attenuated in the groups fed with glutamine and ω-3 polyunsaturated fatty acid.

Conclusion

These results indicate that lymph duct ligation prevents lung injury, a systemic inflammation reaction, and gut-barrier dysfunction. Enteral glutamine and ω-3 polyunsaturated fatty acid modified the gut inflammation, prevented lung injury, and attenuated the systemic inflammation reaction.     

n-3 fatty acids and periodontitis in US adults

Background

Periodontitis is a common, chronic inflammatory disease. Although n-3 fatty acids have anti-inflammatory properties, it is unclear whether n-3 fatty acids can treat or prevent periodontitis.

Method

We studied 9,182 adults aged 20 years and older who participated in the National Health and Nutrition Examination Survey between 1999 and 2004. Periodontitis was assessed by dental exam and was defined as >4 mm pocket depth and >3 mm attachment loss in any one tooth. Intake of n-3 fatty acids was assessed by 24-hour dietary recall. We used multivariable logistic regression to estimate the associations between periodontitis and intakes of docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), and linolenic acid (LNA).

Results

The weighted prevalence and 95% confidence interval (CI) of periodontitis was 8.2% (95% CI 7.0 to 9.4). Compared with the lowest tertiles, the adjusted odds ratios for periodontitis associated with the highest tertiles of dietary n-3 intake were 0.78 (95% CI 0.61 to 1.00; P=0.009) for DHA, 0.85 (95% CI 0.67 to 1.08; P=0.10) for EPA, and 0.86 (95% CI 0.60 to 1.23; P=0.28) for LNA. The associations were little changed by multivariable adjustment or exclusion of individuals reporting use of dietary supplements containing DHA, EPA, or LNA.

Conclusions

In this nationally representative sample, higher dietary intakes of DHA and, to a lesser degree, EPA, were associated with lower prevalence of periodontitis. Interventional studies are needed to confirm the potential protective effects of n-3 fatty acids on periodontitis.     

Intraoperative placement of the Copper T-380 intrauterine devices in women undergoing elective cesarean delivery: a pilot study

Background

The purpose of this pilot project was to test the feasibility of a technique designed to place a copper intrauterine device (IUD) through the hysterotomy incision of an elective cesarean delivery to minimize possible contamination and to guarantee that tailstrings were visible in the vagina for easy removal should complications occur.

Study Design

Women were monitored in the hospital for signs of infection or excessive blood loss. At the time of hospital discharge and at 2 and 6 weeks postpartum, they were examined to determine the status of the tailstrings. The position of the IUD was assessed by ultrasound at week 6.

Results

All seven of the subjects had successful placement. The sutures tied to the IUD strings were visible on vaginal examination in each case. The original tailstrings were visible in the vagina at 6 weeks and each IUD was fundally positioned.

Conclusion

Successful intraoperative placement of Copper T-380A IUDs through incision at the time of cesarean birth is possible.     

Bone mineral density in a cohort of adolescents during use of norethisterone enanthate, depot-medroxyprogesterone acetate or combined oral contraceptives and after discontinuation of norethisterone enanthate

Background

Depot medroxyprogesterone acetate (DMPA), norethisterone enanthate (NET-EN) and combined oral contraceptives (COCs) have been shown to have a negative effect on bone mineral density (BMD) in adolescents. The aim of this study was to investigate BMD in 15- to 19-year-old new users of DMPA, NET-EN and COCs.

Study Design

This 5-year longitudinal study followed up new users of DMPA (n=115), NET-EN (n=115) and COCs (n=116) and 144 nonuser controls. BMD was measured at the distal radius using dual-energy X-ray absorptiometry.

Results

BMD increased in all groups (annual percent increase: nonusers, 1.49%; DMPA, 1.39%; NET-EN, 1.03%; COCs, 0.84%) during follow-up (p<.001). There was evidence for lower BMD increases per annum in NET-EN (p=.050) and COC (p=.010) users compared to nonusers but no difference between DMPA and nonusers (p=.76). In 14 NET-EN discontinuers, an overall reduction of 0.61% per year BMD was followed upon cessation by an increase of 0.69% per year (p=.066).

Conclusion

This study suggests that BMD increases in adolescents may be less in NET-EN and COC users; however, recovery of BMD in NET-EN users was found in the small sample of adolescents followed post-discontinuation.     

A systematic review of ETEC epidemiology focusing on colonization factor and toxin expression

Introduction

Vaccine development for enterotoxigenic Escherichia coli (ETEC) is dependent on in-depth understanding of toxin and colonization factor (CF) distribution. We sought to describe ETEC epidemiology across regions and populations, focusing on CF and toxin prevalence.

Methods

We conducted a systematic review of the published literature, including studies reporting data on ETEC CF and toxin distributions among those with ETEC infection. Point estimates and confidence intervals were calculated using random effects models.

Results

Data on 17,205 ETEC isolates were abstracted from 136 included studies. Approximately half of the studies (49%) involved endemic populations, and an additional 17% involved only travel populations. Globally, 60% of isolates expressed LT either alone (27%) or in combination with ST (33%). CFA/I-expressing strains were common in all regions (17%), as were ETEC expressing CFA/II (9%) and IV (18%). Marked variation in toxins and CFs across regions and populations was observed.

Discussion/conclusions

These results demonstrate the relative importance of specific CFs in achieving target product profiles for a future ETEC vaccine. However, heterogeneity across time, population, and region, confounded by variability in CF and toxin detection methodologies, obfuscates rational estimates for valency requirements.     

The quality of safety reporting in trials is still suboptimal: survey of major general medical journals

Objective

To evaluate whether the quality of reporting harms improved after the publication of the Extension of the Consolidated Standards of Reporting Trials (CONSORT) statement and predictors that influence the safety reporting in randomized controlled trials (RCTs)

Study Design and Setting

Systematic survey of published RCTs assessing drugs. In MEDLINE, we identified 228 RCTs published in Annals of Internal Medicine, British Medical Journal, Journal of American Medical Association, The Lancet, and The New England Journal of Medicine in 2003 and 2006.

Results

The reporting of harms have improved over time both in quality and extent of space. However, the mean score as an overall measure of adequacy in reporting harms was 0.58 in 2003 and increased to 0.67 in 2006, indicating a moderate safety reporting. Safety was more adequate in trials with statistically significant results for efficacy, private funding, primary harms outcome, and anti-infective, antineoplasmatic, or immunosuppressive agents.

Conclusion

The use of the Extension of the CONSORT statement may be associated with improving the quality of safety reporting in RCTs, but there are still deficiencies that need to be corrected to use quantitative objective evidence for harms in performing meta-analyses and making therapeutic decisions.     

Nutrient Adequacy and Diet Quality in Non-Overweight and Overweight Hispanic Children of Low Socioeconomic Status: The Viva la Familia Study

Objective

The role of diet quality and nutrient adequacy in the etiology of childhood obesity is poorly understood. The specific aims of these analyses were to assess overall diet quality and nutrient adequacy, and test for association between weight status and diet in children from low socioeconomic status (SES) Hispanic families at high risk for obesity.

Design

A cross-sectional study design was used to assess dietary intake in low-SES Hispanic children with and without overweight who were enrolled in the Viva la Familia Study. Multiple-pass 24-hour dietary recalls were recorded on two random, weekday occasions. Diet quality was evaluated according to the Dietary Guidelines for Americans. Nutrient adequacy was assessed using z scores based on estimated average requirement or adequate intake.

Subjects/setting

The study included 1,030 Hispanic children and adolescents, aged 4 to 19 years, in Houston, TX, who participated between November 2000 and August 2004.

Statistical analysis

STATA software (version 9.1, 2006, STATA Corp, College Station, TX) was used for generalized estimating equations and random effects regression.

Results

Diet quality did not adhere to the Dietary Guidelines for Americans for fat, cholesterol, saturated fatty acids, fiber, added sugar, and sodium. Although energy intake was significantly higher in children with overweight, food sources, diet quality, macro- and micronutrient composition were similar between non-overweight and overweight children. Relative to estimated average requirements or adequate intake levels, mean nutrient intakes were adequate (70% to 98% probability) in the children without and with overweight, except for vitamins D and E, pantothenic acid, calcium, and potassium, for which z scores cannot be interpreted given the uncertainty of their adequate intake levels.

Conclusions

Whereas the diets of low-SES Hispanic children with and without overweight were adequate in most essential nutrients, other components of a healthful diet, which promote long-term health, were suboptimal. Knowledge of the diets of high-risk Hispanic children will inform nutritional interventions and policy.     

Effects of two different oral contraceptives on total body water: a randomized study

Purpose

This open-label, randomized study evaluated the effect of two different oral contraceptives on body weight and composition during one cycle of treatment.

Method

Eighty women (mean age, 24.6 years) were randomized into three groups and given one of the following contraceptive methods: ethinylestradiol 15 μg/gestodene 60 μg (EE/GST, n=25), ethinylestradiol 30 μg/drospirenone 3 mg (EE/DRS, n=29) or male condom (control group, n=26). Bioelectric impedance analysis (BIA) was carried out on the first, 10th and 21st days during the use of oral contraceptives or in the menstrual cycle (control group), and total body water (TBW), fat mass (FM) and fat-free mass (FFM) were measured.

Results

No significant variations in TBW, FM or FFM were observed in the three groups during the cycle. Intergroup analysis showed no differences in TBW or FM; however, users of EE/GST showed a statistically significant increase in FFM compared to the control group.

Conclusion

The different doses of ethinylestradiol associated with gestodene or drospirenone showed no statistically significant effects on TBW or FM during one cycle of observation.