Early docosahexaenoic acid supplementation of mothers during lactation leads to high plasma concentrations in very preterm infants

Very preterm infants are vulnerable to deficiency in DHA. In a longitudinal study, 10 mothers who delivered ≤29 wk gestation and planned to breast-feed received DHA (1200 mg/d) until 36 wk after conception. The plasma DHA status was assessed in their 12 infants (including 2 pairs of twins) from birth to d 49. Fatty acid profiles were measured weekly in breast milk, and in plasma of mothers and infants at baseline and at d15 and 49. Plasma and breast milk fatty acid concentrations in the DHA-supplemented group at d 49 were compared with a reference group of very preterm infants (n = 24, including triplets) whose mothers (n = 22) did not receive DHA during lactation. The infants' plasma DHA concentration tended to be greater in the DHA group than in the reference group (P = 0.10) and was greater when expressed as a percentage of total fatty acids (P = 0.009). At d 49, maternal milk DHA in the DHA group (1.92 ± 1.10 mmol/L) was ~12 times higher than in the reference group (0.15 ± 0.27 mmol/L) (P < 0.001). The amount of DHA provided to the infants increased from wk 1 through wk 7 in the DHA group (P < 0.001). Although enteral intake at wk 7 did not differ between the DHA group [119 ± 51 mL/(kg·d)] and the reference group [113 ± 66 mL/(kg·d)], DHA group infants received 55 ± 38 mg/(kg·d) of DHA, and the reference group infants received 7 ± 11 mg/(kg·d) (P < 0.001). Early supplementation with DHA to lactating mothers with low dietary DHA intake successfully increased the plasma DHA status in very preterm infants.     

Dietary magnesium intake in a national sample of US adults

Despite the role of magnesium in maintaining health, much of the U.S. population has historically not consumed adequate amounts of magnesium. Furthermore, significant racial or ethnic disparities in magnesium intake exist. Our objective was to provide more recent data about magnesium intake in the U.S. population. We analyzed the 24-h dietary recall data from 4257 participants aged >or=20 y from the National Health and Nutrition Examination Survey 1999-2000. The median intake of magnesium was 326 mg/d (mean 352 mg/d) among Caucasian men, 237 mg/d (mean 278 mg/d) among African American men, 297 mg/d (330 mg/d) among Mexican American men, 237 mg/d (mean 256 mg/d) among Caucasian women, 177 mg/d (mean 202 mg/d) among African American women, and 221 mg/d (mean 242 mg/d) among Mexican American women. Among men and women, Caucasians had significantly higher mean intakes of dietary magnesium than African Americans but not Mexican Americans. Magnesium intake decreased with increasing age (P for linear trend = 0.035 for Caucasians; P for linear trend <0.001 for African Americans and Mexican Americans). Men had higher intakes of magnesium than women for each of the three race or ethnic groups (P < 0.001 in each group). Caucasian men, African American men and Caucasian women who used vitamin, mineral or dietary supplements consumed significantly more magnesium in their diets than did those who did not. Substantial numbers of U.S. adults fail to consume adequate magnesium in their diets. Furthermore, racial or ethnic differences in magnesium persist and may contribute to some health disparities.     

Dietary arachidonic acid dose-dependently increases the arachidonic acid concentration in human milk

Lactation hampers normalization of the maternal arachidonic acid (AA) status, which is reduced after pregnancy and can further decline by the presently recommended increased consumption of (n-3) long-chain PUFA [(n-3) LCPUFA]. This may be unfavorable for breast-fed infants, because they also require an optimum supply of (n-6) LCPUFA. We therefore investigated the LCPUFA responses in nursing mothers upon increased consumption of AA and (n-3) LCPUFA. In a parallel, double-blind, controlled trial, lactating women received for 8 wk no extra LCPUFA (control group, n = 8), 200 (low AA group, n = 9), or 400 (high AA group, n = 8) mg/d AA in combination with (n-3) LCPUFA [320 mg/d docosahexaenoic acid (DHA), 80 mg/d eicosapentaenoic acid, and 80 mg/d other (n-3) fatty acids], or this dose of (n-3) LCPUFA alone [DHA + eicosapentaenoic acid group, n = 8]. Relative concentrations of AA, DHA, and sums of (n-6) and (n-3) LCPUFA were measured in milk total lipids (TL) and erythrocyte phospholipids (PL) after 2 and 8 wk and changes were compared by ANCOVA. The combined consumption of AA and (n-3) LCPUFA caused dose-dependent elevations of AA and total (n-6) LCPUFA concentrations in milk TL and did not significantly affect the DHA and total (n-3) LCPUFA increases caused by (n-3) LCPUFA supplementation only. This latter treatment did not significantly affect breast milk AA and total (n-6) LCPUFA concentrations. AA and DHA concentrations in milk TL and their changes were strongly and positively correlated with their corresponding values in erythrocyte PL (r(2) = 0.27-0.50; P 相似文献   

Magnesium and Calcium in Hypertension and Ischemic Heart Disease

Objective: We previously demonstrated that choline and folate are interrelated and that African American women have lower folate nutriture than Caucasian and Mexican American women under conditions of controlled folate intake. The present study sought to examine the influences of ethnicity and controlled folate intake on choline status.

Methods: Forty-two women of Mexican American (n = 14), African American (n = 14), and Caucasian American (n = 14) descent consumed a folate restricted diet (135 μg DFE/d) for 7 weeks, followed by 7 weeks of folate treatment with either 400 or 800 μg DFE/d. Total choline intake remained unchanged throughout the study at approximately 350 mg/d. Plasma choline and its derivatives were measured by LC-MS/MS at weeks 0, 7, and 14.

Results: Plasma phosphatidylcholine declined during folate restriction (P < 0.001) and tended to increase in response to 800 μg DFE/d (week × folate, P = 0.099) in Mexican American and Caucasian women. For African American women, however, phosphatidylcholine continued to decline (week × race, P = 0.056). Plasma betaine was modified by ethnicity and level of folate intake (week × race × folate, P = 0.039) however no clear patterns emerged.

Conclusions: The phosphatidylcholine data suggest that the lower folate status observed in African American women may also be associated with lower choline status. In turn, diseases linked to folate may also be linked to choline.     

Human milk as a source of ascorbic acid: no enhancing effect on iron bioavailability from a traditional complementary food consumed by Bangladeshi infants and young children

BACKGROUND: Iron bioavailability from traditional complementary foods based on cereals and legumes can be expected to be low unless ascorbic acid-rich foods are incorporated into the diet. OBJECTIVE: We evaluated human milk as a source of ascorbic acid for enhancing iron bioavailability from khichuri, a complementary food based on rice and lentils. DESIGN: Erythrocyte incorporation of stable iron isotopes 14 d after administration was used as a proxy for iron bioavailability. Children aged 8-18 mo (n = 31) were breastfed (32-90 mg ascorbic acid/kg human milk) immediately after intake of 4 servings of khichuri labeled with (57)Fe (test meal B) and were offered water after intake of 4 servings of khichuri labeled with (58)Fe (test meal A). Test meals were fed twice daily during 4 d in the order of AABBAABB or BBAABBAA. RESULTS: The mean intakes of human milk and ascorbic acid were 274 g (range: 60-444 g) and 14 mg (range: 4-28 mg, respectively). The mean molar ratio of ascorbic acid to iron was 2.3 (range: 0.7-4.6). The geometric mean iron bioavailability from khichuri fed with or without human milk was 6.2% and 6.5%, respectively (P = 0.76, paired Student's t test). CONCLUSIONS: Although human milk contributed significant quantities of ascorbic acid, no significant difference in iron bioavailability was found between khichuri consumed with water and that consumed with human milk. These results indicate either that the molar ratio of ascorbic acid to iron was not sufficiently high to overcome the inhibitory effect of phytic acid in khichuri (30 mg/serving) or that components of human milk modified the influence of ascorbic acid on iron bioavailability.     

Fatty acid absorption in preterms on formulas with and without long-chain polyunsaturated fatty acids and in terms on formulas without these added

BACKGROUND/OBJECTIVE: Long chain polyunsaturated fatty acids have beneficial effects in preterm neurophysiological development and are semi-essential. Their levels and variation in plasma and red cells in term and preterms are better known than their intestinal absorption. In this paper the absorption of supplemented arachidonic acid (AA) and docosahexaenoic acid (DHA) is evaluated in a preterm group. DESIGN: Four newborn randomized groups were studied. Group T comprised 11 terms on regular formula. Preterms: group P (n=9) was on a classic preterm formula. Intervention: groups PA (n=9) and PB (n=13) were on the same formula but PB contained AA and DHA in similar proportion to breast milk. At 20 days a 3 day metabolic balance was taken for Ca, P(i), Mg, total fat and individual fatty acids (C8-C24, saturated unsaturated). RESULTS: Calcium absorption was (mean+/-s.d.) 51+/-13% in terms. In preterms it was respectively 45+/-18, 38+/-11 and 37+/-21%. Total fat absorption was 92.0+/-8.0% in terms, and from 95.0+/-2.0 to 91.0+/-8.0% in preterms. Absorption of 8:0, 10:0 and 12:0 showed a very high and constant rate despite significant intake differences (715-33 mg/kg/day). Linoleic acid and alpha-linolenic acid were absorbed in the three groups at around 94% regardless of a greater LA intake in group P. Details of absorption (mg/kg/day) were: for AA, intake 17+/-7, fecal excretion 5+/-4, net retention 12+/-5 (75.0+/-18%); for DHA, intake 10+/-3, fecal excretion 3+/-2, net retention 6+/-4 (62.3+/-30%). CONCLUSION: Intestinal absorption of fatty acids is high and is comparable in terms and preterms as regards the studied acids. Longer acids were less well absorbed. The supplemented amounts of AA and DHA were less well absorbed and probably not impairing calcium absorption. SPONSORSHIP: University of Alicante, University of Miguel Hernández.     

A 1-y walking program and increased dietary calcium in postmenopausal women: effects on bone

The effects of a supervised 1-y walking program and increased dietary calcium (milk supplement, 831 mg/d, vs placebo drink, 41 mg/d) on bones were examined in 36 postmenopausal women (60.2 +/- 6.5 y). Trabecular bone-mineral density (BMD) of the lumbar spine (L1-L3), measured by computed tomography, increased by 0.5% in exercising women (n = 18) and decreased by 7.0% in sedentary women (n = 18; P = 0.02). Femoral-neck BMD measured by dual-photon absorptiometry (DPA) increased by 2.0% in women consuming high dietary calcium (n = 18) and decreased by 1.1% in those on moderate calcium intake (n = 18; P = 0.001). Neither exercise nor dietary calcium had an effect on lumbar spine (L2-L4) measured by DPA, distal radius measured by single-photon absorptiometry, or total body calcium measured by in vivo neutron activation. The varying proportions and rates of turnover of trabecular and cortical bone from one site to another suggest that exercise and high dietary calcium may preferentially alter bone density at different skeletal sites.     

Increasing habitual protein intake accentuates differences in postprandial dietary nitrogen utilization between protein sources in humans

It is appropriate to characterize the nutritional value of dietary proteins in humans through the specific study of dietary nitrogen metabolism during the postprandial period. However, the influence of the habitual protein intake on this variable has not been studied. We aimed to describe the influence of prior protein intake on the specific metabolic utilization of dietary nitrogen in humans. Healthy men and women were adapted for 7 d to two diets with a normal [NP, 1 g/(kg x d)] and high protein content [HP, 2 g/(kg x d)]. After each period, they were studied for an 8-h postmeal period after ingesting a single (15)N-labeled mixed meal (0.41 g/kg protein) containing either milk (n = 12) or soy protein (n = 8). The HP diet reduced the peak of dietary N incorporation into free serum amino acids in the soy group but had no effect in the milk group. The incorporation of dietary N into plasma protein was higher after soy than after milk protein, but habitual protein level had no effect. The postprandial retention of milk protein was reduced by the HP diet compared with the NP diet by only 5% and that of soy protein was diminished by 13% (protein source: P < 0.0001, protein level: P < 0.0001, interaction: P < 0.001). In conclusion, the efficiency of the meal N postprandial retention was lower after HP adaptation, but this decrease was much more pronounced for soy than for milk protein, indicating that increasing the habitual protein intake accentuates differences in metabolic utilization among dietary proteins.     

High intakes of skimmed milk, but not meat, increase serum IGF-I and IGFBP-3 in eight-year-old boys

OBJECTIVE: To examine whether a high protein intake (PI) from either milk or meat, at a level often seen in late infancy, could increase s-IGF-I and s-IGF-I/s-IGFBP-3 in healthy, prepubertal children. IGF-I levels are positively associated with growth velocity in children and some studies suggest that a high animal PI can stimulate growth. During protein deprivation IGF-I decrease, but it is unknown whether a high PI can increase s-IGF-I in well-nourished children. DESIGN: In all, 24 8-y-old boys were asked to take either 1.5 l of skimmed milk (n = 12) or the same amount of protein as 250 g low fat meat (n = 12) daily for 7 days. The remaining diet they could choose freely. At baseline and after 7 days, anthropometrical variables were measured, diet was registered (3-day weighed records), and s-IGF-I and s-IGFBP-3 (RIA) were determined after fast. RESULTS: PI increased by 61% in the milk group to 4.0 g/kg/day (P < 0.0001) and by 54% in the meat group to 3.8 g/kg/day (P = 0.001). The high milk intake increased s-IGF-I by 19% (P = 0.001) and s-IGF-I/s-IGFBP-3 by 13% (P < 0.0001). There were no increases in the meat group. CONCLUSIONS: High intake of milk and not meat, increased concentrations of s-IGF-I and s-IGF-I/s-IGFBP-3 significantly. Compounds in milk and not a high PI as such seem to stimulate IGF-I. This might explain the positive effect of milk intake on growth seen in some studies.     

Changes in caffeine intake and long-term weight change in men and women

BACKGROUND: The long-term effects of caffeine intake on weight have not been examined prospectively. OBJECTIVE: The objective was to assess the relation between caffeine intake and 12-y weight change. DESIGN: We conducted a prospective study of 18 417 men and 39 740 women, with no chronic diseases at baseline, who were followed from 1986 to 1998. Caffeine intake was assessed repeatedly every 2-4 y. Weight change was calculated as the difference between the self-reported weight in 1986 and in 1998. RESULTS: The participants reported a change in caffeine intake that varied across quintiles, from decreases of 296 and 342 mg/d to increases of 213 and 143 mg/d in men and women, respectively. Age-adjusted models showed a lower mean weight gain in participants who increased their caffeine consumption than in those who decreased their consumption, but the differences between extreme quintiles were small: -0.43 kg (95% CI: -0.17, -0.69) in men and -0.41 kg (95% CI: -0.20, -0.62) in women. After adjustment for potential confounders and baseline and change in total energy intake and other nutrients and foods, the differences remained similar for men and diminished slightly for women (men: -0.43 kg; 95% CI: -0.17, -0.68; women: -0.35; 95% CI: -0.14, -0.56). An increase in coffee and tea consumption was also associated with less weight gain. In men, the association between caffeine intake and weight was stronger in younger participants (P for interaction < 0.001); in women, the association was stronger in those who had a body mass index (in kg/m2) > or = 25, who were less physically active, or who were current smokers (P for interaction < 0.001). CONCLUSION: Increases in caffeine intake may lead to a small reduction in long-term weight gain.     

The nitrogen and energy metabolism of lactating cows given abomasal infusions of casein

1. Four cows in early lactation were given continuous infusion into the abomasum of 0, 200, 400 or 600 g lactic casein/d according to a Latin-square design. Each period was of 14 d and the Latin square was followed by 7 d in which an infusion of 800 g glucose/d was given. The basal diet was given at a level which provided sufficient nitrogen and energy for 10 kg milk yield/d. 2. Infusion of casein resulted in significant increases in milk yield, milk N yield and milk energy yield; milk N increased progressively but milk energy reached a maximum at 400 g casein/d. Milk yields and composition when glucose was infused resembled those seen on the zero casein treatment. 3. N-balance measurements indicated a severe deficit (-20 g/d) on the zero casein treatment and a progressive increase to +7 g/d as casein increased; N equilibrium was achieved at about 400 g casein/d. The regression of net productive N on N intake (P less than 0.001) indicated that the efficiency of utilization of dietary N did not differ between treatments. 4. Heat production increased with increase in casein infused (P less than 0.05) but remained a constant proportion of the metabolizable energy (ME) intake. Energy balances were negative and did not differ significantly between treatments but calculation of the protein and fat components indicated a threefold increase in body fat mobilization in response to the first increment of casein. Milk yield adjusted to zero energy balance was significantly related to ME intake (P less than 0.001) but the efficiency of energy utilization was not affected by the level of casein infusion. 5. The concentrations of glucose, beta-hydroxybutyrate and non-esterified fatty acids in plasma did not differ between treatments but the concentration of urea in plasma increased markedly (P less than 0.05) at the highest level of casein addition. Insulin concentrations increased and growth hormone decreased (both P less than 0.05) with increase in casein infusion. 6. The concentration of total amino acids (AA) in plasma increased up to 400 g casein/d and then declined. Changes in concentration and in the ratio of essential:total AA indicated a very high extraction rate of essential AA at the lower levels of casein infusion. 7. The observed lactational responses are discussed in relation to the ratio of protein:energy in the absorbed nutrients.(ABSTRACT TRUNCATED AT 400 WORDS)     

Ascorbic acid and erythorbic acid metabolism in nonpregnant women

Ascorbic acid (AA) metabolism and requirements were studied in 11 adult nonpregnant women maintained in a metabolic unit and fed a formula diet devoid of AA for 54 d. After depletion for 24 d, the subjects received increasing supplements of AA in the presence or absence of 600 mg/d of erythorbic acid (EA). Various analytical procedures were used to measure AA concentrations in blood components. The depletion period resulted in a marked decrease in AA in all blood indices. During the study scorbutic signs developed in some of the subjects. AA supplements of 30 mg/d for 10 d failed to increase plasma ascorbate concentrations; 60 mg/d for 10 d produced a small increase; 90 mg/d resulted in a mean AA concentration of 29 mumol/L. EA did not present any adverse effects, but rather had a small sparing effect. Vitamin C requirements for adult nonsmoking, nonpregnant women would be marginally met by an intake of 60 mg/d of AA whereas 90 mg/d would provide an allowance for body storage.     

Dairy products do not lead to alterations in body weight or fat mass in young women in a 1-y intervention

BACKGROUND: Previous results suggested that increased intake of dairy calcium is associated with reduced weight and fat mass. OBJECTIVE: The purpose of this study was to determine whether long-term increases in consumption of dairy calcium alter body weight and fat mass in young, healthy women. DESIGN: We used a randomized, 1-y intervention for dairy calcium. Subjects were 155 young (aged 18-30 y), healthy, normal-weight women with intake of dietary calcium < 800 mg/d and energy intake 相似文献   

Cultured milk, yogurt, and dairy intake in relation to bladder cancer risk in a prospective study of Swedish women and men

BACKGROUND: Findings from epidemiologic studies of the effect of dairy foods (mainly milk) on the risk of bladder cancer have been inconsistent. OBJECTIVE: We aimed to examine the association between the intake of cultured milk and other dairy foods and the incidence of bladder cancer in a prospective, population-based cohort. DESIGN: We prospectively followed 82,002 Swedish women and men who were cancer-free and who completed a 96-item food-frequency questionnaire in 1997. Incident cases of bladder cancer were identified in the Swedish cancer registries. RESULTS: During a mean follow-up of 9.4 y, 485 participants (76 women and 409 men) were diagnosed with bladder cancer. Total dairy intake was not significantly associated with risk of bladder cancer [> or =7.0 servings/d compared with < 3.5 servings/d: multivariate rate ratio (RR) = 0.87; 95% CI: 0.66, 1.15; P for trend = 0.33]. However, a statistically significant inverse association was observed for the intake of cultured milk (sour milk and yogurt). The multivariate RRs for the highest category of cultured milk intake (> or =2 servings/d) compared with the lowest category (0 serving/d) were 0.62 (95% CI: 0.46, 0.85; P for trend = 0.006) in women and men combined, 0.55 (95% CI: 0.25, 1.22; P for trend = 0.06) in women, and 0.64 (95% CI: 0.46, 0.89; P for trend = 0.03) in men. The intake of milk or cheese was not associated with bladder cancer risk. CONCLUSION: These findings suggest that a high intake of cultured milk may lower the risk of developing bladder cancer.     

Variation in fat,lactose and protein in human milk over 24 h and throughout the first year of lactation

Fat in human milk is extremely variable and can represent up to 50 % of infant energy intake. To accurately determine milk composition and infant intake at 1 (n 17), 2 (n 17), 4 (n 17), 6 (n 15), 9 (n 6) and 12 (n 5) months of lactation, samples of fore- and hind-milk were collected from each breast at each feed over 24 h periods from an initial group of seventeen women. The content of fat in milk varied over 24 h, with a mean CV of 47.6 (se 2.1) % (n 76) and 46.7 (se 1.7) % (n 76) for left and right breasts respectively. The 24 h amounts of fat, lactose and protein in milk differed between women (P=0.0001), but were consistent between left and right breasts. Daily milk production differed between breasts (P=0.0001) and women (P=0.0001). Accordingly, amounts of fat (P=0.0008), lactose (P=0.0385) and protein (P=0.0173) delivered to the infant over 24 h also differed between breasts and women (P=0.0001). The energy content of milk and the amount of energy delivered to the infant over 24 h were the same between breasts, but differed between women (P=0.0001). The growth rate of a group of only six infants in the present study was not related to either the concentrations or amounts of fat, lactose, protein and energy in milk over the first 6 months of life. These results show the individuality of milk composition and suggest that only a rigorous sampling routine that takes into account all levels of variation will allow the accurate determination of infant intake of fat, lactose, protein and energy.     

Ascorbic acid from lime juice does not improve the iron status of iron-deficient women in rural Mexico

BACKGROUND: Although ascorbic acid (AA) increases dietary iron bioavailability, there has been no food-based community trial of its efficacy in improving iron status. OBJECTIVE: The objective was to assess the efficacy of 25 mg AA as agua de limón (limeade), consumed with each of 2 daily meals, in improving the iron status of iron-deficient women. DESIGN: Two rural Mexican populations were randomly assigned to an AA or a placebo group, each with 18 iron-deficient women. The AA group was given 500 mL limeade containing 25 mg AA twice a day, 6 d/wk, for 8 mo. The placebo group was given a lime-flavored beverage free of AA or citric acid. Beverages were consumed within 30 min of 2 main daily meals. Data were collected on morbidity (3 times/wk), dietary intake (on 6 d), socioeconomic status, parasites (twice), medical history, and response to treatment. Blood samples at 0, 2, 4, 6, and 8 mo were analyzed for hemoglobin, plasma AA, plasma ferritin, transferrin receptors, and C-reactive protein. RESULTS: AA intake was significantly (P < 0.0001) higher in the AA group, but nonheme iron, heme iron, and phytic acid intakes did not differ significantly. Plasma AA was significantly (P < 0.01) higher in the AA group at 2, 4, 6, and 8 mo. There were no final differences between groups in hemoglobin, plasma ferritin, or transferrin receptor concentrations or in the ratio of transferrin receptors to plasma ferritin after control for initial concentrations. CONCLUSION: Increasing dietary AA by 25 mg at each of 2 meals/d did not improve iron status in iron-deficient women consuming diets high in phytate and nonheme iron.     

Contribution of dietary and newly formed arachidonic acid to human milk lipids in women eating a low-fat diet

BACKGROUND: Polyunsaturated fatty acids in milk are derived from direct intestinal absorption, endogenous synthesis, or maternal body stores. Arachidonic acid (AA) intake is frequently low in undernourished women, but milk secretion of this fatty acid is similar to that in well-nourished women. OBJECTIVE: The objective was to evaluate the contribution of dietary and endogenously synthesized AA to its total secretion in the milk of women eating a low-fat diet. DESIGN: Ten lactating women who habitually ate a low-fat diet (17% of energy) received 2.5 mg [(13)C]linoleic acid (LA)/kg body wt orally 5 mo postpartum. LA and AA concentrations and (13)C enrichment were measured in milk samples collected before and after the tracer application. Total lipid, LA, and AA contents were determined in diet composites. Fatty acids were assessed by gas chromatography and (13)C enrichment by isotope ratio mass spectrometry. RESULTS: The cumulative 72-h recovery of [(13)C]LA in milk was 16.3 +/- 6.4% of the dose; only 0.01% of the label was found as [(13)C]AA. The calculated transfer of dietary LA and AA into milk was 32.8 +/- 18.0% and 11.8 +/- 6.6%, respectively. AA originating from conversion of dietary LA contributed only 1.1% to the total milk AA secreted. CONCLUSIONS: Little milk AA originates from conversion of LA; 70% of LA and 90% of AA secreted in milk were not derived from direct intestinal absorption. Our results suggest that maternal body stores are the major source of milk LA and AA in these women.     

Prevalence of obesity and dyslipidemia in middle-aged men and women in Tanzania,Africa: relationship with resting energy expenditure and dietary factors

The prevalence of obesity and dyslipidemia and the mean frequency of intake of selected dietary factors were studied in 545 participants aged 46-58 y and living in three areas in Tanzania. The prevalence of obesity (body mass index of > or = 30 kg/m2) was 22.5% among women and 5.4% among men, p < 0.001. Higher rates of obesity were observed in both men and women in an urban (U) area of Dar. The prevalence of dyslipidemia [(TC-HDL-C)/HDL-C > 5] among men was higher in a pastoralists (P) population of the Maasai in Monduli (22.6%) than in Dar (9.6%) and rural (R) Handeni (7.3%, p < 0.05). The mean resting energy expenditure (REE) was higher in subjects from the rural and pastoralists populations than in urban dwellers (0.024 kcal/min/kg, p < 0.001). The three areas showed different dietary patterns with subjects from the urban area consuming coconut milk (4 d/wk, p < 0.001) and meat (2.5 d/wk, p < 0.05), more often than the rural population of Handeni which had the highest consumption of green vegetables (4.2 d/wk, p < 0.001). Participants from Monduli had the highest consumption of milk per day (1,219 mL/d, p < 0.001). A simple correlation analysis showed that body mass index (BMI) correlated positively with the frequency of intake of coconut milk, fish and meat, and negatively with REE and milk consumption. Total cholesterol (TC) was negatively correlated with the frequency of intake of green vegetables, fish and the REE, and correlated positively with meat consumption and BMI in both genders. Independent of other factors, important contributors to obesity and dyslipidemia in this population were dietary factors such as meat (p < 0.001) and fish (p < 0.05), and a lower REE (p < 0.05). These findings suggest that unhealthy diet and lower energy expenditure are important contributors to obesity and dyslipidemia in Tanzania.     

Maternal plasma phospholipid polyunsaturated fatty acids in pregnancy with and without gestational diabetes mellitus: relations with maternal factors.

BACKGROUND: The fatty acids arachidonic acid (AA; 20:4n-6) and docosahexaenoic acid (DHA; 22:6n-3) are essential for fetal growth and development, but their metabolism may be altered in insulin resistance. OBJECTIVES: The objectives were to determine maternal plasma phospholipid polyunsaturated fatty acid concentrations in pregnant women receiving dietary therapy for gestational diabetes mellitus (GDM) and to identify maternal factors associated with plasma phospholipid AA and DHA concentrations in the third trimester. DESIGN: Fasting plasma phospholipid fatty acids were determined in women with GDM (n = 15) receiving dietary therapy only and in healthy, pregnant women without GDM (control group, n = 15) at 27-30, 33-35, and 36-39 wk gestation. RESULTS: Maternal plasma phospholipid (as % by wt of total fatty acids and mg/L) linoleic acid (18:2n-6), AA, and 22:5n-6 concentrations did not differ significantly between women with GDM and control subjects. The other n-6 long-chain polyunsaturated fatty acids (% by wt) were lower in GDM subjects than in control subjects. Plasma phospholipid (expressed as % by wt and mg/L) linolenic acid (18:3n-3) and summed precursors of DHA were lower and DHA (% by wt and mg/L), adjusted for dietary DHA intake, was 13% higher in GDM subjects than in control subjects. Maternal blood hemoglobin A1C was inversely related to plasma phospholipid AA (% by wt) (r = -0.56, P = 0.03) in control subjects and positively associated with plasma phospholipid AA (% by wt) in women with GDM (r = 0.76, P = 0.001). Pregravid body mass index was negatively associated with plasma phospholipid DHA (% by wt) in control subjects (r = -0.55, P = 0.04) and in women with GDM with a body mass index (in kg/m2) <30 (r = -0.76, P = 0.007). CONCLUSIONS: This is the first report documenting alterations in maternal plasma phospholipid PUFAs in pregnant women receiving dietary therapy for GDM. In pregnant woman, both with and without GDM, maternal glycemic control and pregravid BMI appear to be significant predictors of plasma phospholipid AA and DHA, respectively, during the third trimester. Additionally, dietary DHA significantly affects phospholipid DHA concentrations.