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As recently described, adherence to the Mediterranean diet is associated with improved asthma control. However, evidence of how specific nutrients such as fatty acids and antioxidants may affect this relationship remains largely unknown. We aimed to examine the association between dietary intake of fatty acids and antioxidants and asthma control. A cross-sectional study was developed in 174 asthmatics, mean age of 40 (SD 15) years. Dietary intake was obtained by a FFQ, and nutritional content was calculated using Food Processor Plus? software (ESHA Research, Inc., Salem, OR, USA). Good asthma control was defined by the combination of forced expiratory volume during the first second, exhaled NO (eNO) and Asthma Control Questionnaire (ACQ) score (control: forced expiratory volume in the first second ≥80 %; eNO ≤35 ppb; ACQ <1·0, scale 0-6 score). Multiple linear and logistic regression models were performed to analyse the associations between nutrients and asthma outcomes, adjusting for confounders. A high n-6:n-3 PUFA ratio predicted high eNO, whereas high intakes of n-3 PUFA, a-linolenic acid (ALA) and SFA were associated with low eNO. Odds for controlled asthma improved along with an increased intake of n-3 PUFA (OR 0·14, 95% CI 0·04, 0·45; P for trend=0·001), SFA (OR 0·36, 95% CI 0·13, 0·97; P for trend=0·047) and ALA (OR 0·18, 95% CI 0·06, 0·58; P for trend=0·005). A high n-6:n-3 PUFA ratio increased the odds for uncontrolled asthma (OR 3·69, 95% CI 1·37, 9·94; P for trend=0·009), after adjusting for energy intake, sex, age, education and use of inhaled corticosteroids. Higher intakes of n-3 PUFA, ALA and SFA were associated with good asthma control, while the risk for uncontrolled asthma increased with a higher n-6:n-3 PUFA ratio. The present results introduce a protective effect of ALA in asthma control, independent of marine n-3 fatty acids, and provide a rationale to dietary intervention studies in asthma.  相似文献   

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Due to the anti-inflammatory properties of PUFA, it has been suggested that they may protect against kidney damage in adults. However, relatively few epidemiological studies have examined this hypothesis in human subjects. We investigated the association between dietary intakes of PUFA (n-3, n-6 and α-linolenic acid), fish and the prevalence of chronic kidney disease (CKD). A total of 2600 Blue Mountains Eye Study (1997-9) participants aged ≥?50 years were analysed. Dietary data were collected using a semi-quantitative FFQ, and PUFA and fish intakes were calculated. Baseline biochemistry including serum creatinine was measured. Moderate CKD was defined as an estimated glomerular filtration rate of 相似文献   

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Objective: To assess whether a diet containing foods enriched with β-glucans (3.6 g/d), folic acid (1600 μg/d), long-chain (800 mg/d) and short-chain (400 mg/d) n-3 fatty acids, and tocopherols (120 mg/d) is able to modulate positively the cardiovascular risk profile in people at slightly increased cardiovascular risk.

Methods: Sixteen subjects with mild plasma lipid abnormalities were studied according to a randomized crossover design. After a 2-week run-in period, they followed a diet containing baked products enriched with active nutrients (active diet) or a diet containing the same products but without active nutrients (control diet) for 1 month and then crossed over to the other diet. At the end of each period, a test meal of the same composition as the corresponding diet was administered, and plasma samples were obtained before and for 6 hours after the meal. Hunger and satiety were evaluated by the visual analog scale at fasting and after the meal.

Results: Fasting plasma triglycerides were significantly lower after the active versus the control diet (1.56 ± 0.18 vs 1.74 ± 0.16 mmol/l, p < 0.05), as was the postprandial level of chylomicron triglycerides and the insulin peak (p < 0.05). The active diet also reduced fasting homocysteine (8 ± 0.6 vs 10 ± 0.8 μmol/l, p < 0.05) and the feeling of hunger at the fifth and sixth hour (p < 0.05).

Conclusions: Baked functional products enriched with n-3 fatty acids, folates, β-glucans, and tocopherols within the context of a balanced diet lower fasting and postprandial plasma triglycerides, fasting homocysteinemia, and the postprandial insulin peak. They induce a greater feeling of satiety with possible beneficial implications on energy intake.  相似文献   

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This review is part of a series intended for nonspecialists that will summarize evidence relevant to the question of whether causal relations exist between micronutrient deficiencies and brain function. Here, we focus on experiments that used cognitive or behavioral tests as outcome measures in experimental designs that were known to or were likely to result in altered brain concentrations of the n-3 fatty acid docosahexaenoic acid (DHA) during the perinatal period of "brain growth spurt." Experimental designs reviewed include observational breastfeeding studies and randomized controlled trials in humans and studies in rodents and nonhuman primates. This review is based on a large number of expert reviews and commentaries and on some 50 recent studies in humans and animals that have not yet been included in published reviews. Expert opinion regarding the strengths and weaknesses of the major experimental systems and uncertainties associated with interpreting results is summarized. On the basis of our reading of this literature, we conclude that evidence from several types of studies, particularly studies in animals, suggests that, within the context of specific experimental designs, changes in brain concentrations of DHA are positively associated with changes in cognitive or behavioral performance. Additional experimental information required to conclude that a causal association exists is discussed, as are uncertainties associated with applying results from specific experimental designs to the question of whether infant formula should be supplemented with DHA.  相似文献   

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Cuprimine? and Syprine? are therapeutics approved by the USFDA to treat copper overload in Wilson Disease (a genetic defect in copper transport) by chelation and accelerated excretion of internally-deposited copper. These oral therapeutics are based on the respective active ingredients D-penicillamine (DPA) and N,N'-bis (2-aminoethyl) -1,2-ethanediamine dihydrochloride (Trien). Cuprimine is considered the primary treatment, although physicians are increasingly turning to Syprine as a first-line therapy. Both drugs exhibit oral systemic activity and low toxicity; their biological effects and safety are established. Previous in vivo studies using a rodent animal model established the decorporation potential of Cuprimine and Syprine for (60)Co and (210)Po. Currently these studies are being expanded to evaluate the in vivo decorporation efficacy of these drugs for several additional radionuclides. In this report, results of this investigation are discussed using the radionuclides (137)Cs, (60)Co, (192)Ir and (85)Sr. Short-term 48-h pilot studies were undertaken to evaluate DPA and Trien for their in vivo decorporation potential using male Wistar-Han rats. In these studies, a radionuclide solution was administered to the animals by intravenous (IV) injection, followed by a single IV dose of either DPA or Trien. Control animals received the radionuclide alone. Results show effective decorporation of (60)Co by DPA within the time frame evaluated. DPA and Trien were also modestly effective in decorporation of (137)Cs and (85)Sr, respectively. The study did not find DPA or Trien effective for decorporation of (192)Ir. Based on these encouraging findings, further studies to evaluate the dose-response profiles and timing of the chelator administration post exposure to radionuclides are warranted.  相似文献   

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Considerable research supports cardiovascular benefits of consuming omega-3 PUFA, also known as (n-3) PUFA, from fish or fish oil. Whether individual long-chain (n-3) PUFA have shared or complementary effects is not well established. We reviewed evidence for dietary and endogenous sources and cardiovascular effects on biologic pathways, physiologic risk factors, and clinical endpoints of EPA [20:5(n-3)], docosapentaenoic acid [DPA, 22:5(n-3)], and DHA [22:6(n-3)]. DHA requires direct dietary consumption, with little synthesis from or retroconversion to DPA or EPA. Whereas EPA is also largely derived from direct consumption, EPA can also be synthesized in small amounts from plant (n-3) precursors, especially stearidonic acid. In contrast, DPA appears principally derived from endogenous elongation from EPA, and DPA can also undergo retroconversion back to EPA. In experimental and animal models, both EPA and DHA modulate several relevant biologic pathways, with evidence for some differential benefits. In humans, both fatty acids lower TG levels and, based on more limited studies, favorably affect cardiac diastolic filling, arterial compliance, and some metrics of inflammation and oxidative stress. All three (n-3) PUFA reduce ex vivo platelet aggregation and DHA also modestly increases LDL and HDL particle size; the clinical relevance of such findings is uncertain. Combined EPA+DHA or DPA+DHA levels are associated with lower risk of fatal cardiac events and DHA with lower risk of atrial fibrillation, suggesting direct or indirect benefits of DHA for cardiac arrhythmias (although not excluding similar benefits of EPA or DPA). Conversely, EPA and DPA, but not DHA, are associated with lower risk of nonfatal cardiovascular endpoints in some studies, and purified EPA reduced risk of nonfatal coronary syndromes in one large clinical trial. Overall, for many cardiovascular pathways and outcomes, identified studies of individual (n-3) PUFA were relatively limited, especially for DPA. Nonetheless, the present evidence suggests that EPA and DHA have both shared and complementary benefits. Based on current evidence, increasing consumption of either would be advantageous compared to little or no consumption. Focusing on their combined consumption remains most prudent given the potential for complementary effects and the existing more robust literature on cardiovascular benefits of their combined consumption as fish or fish oil for cardiovascular benefits.  相似文献   

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The beneficial health effects of n-3 polyunsaturated fatty acids (PUFAs) from marine fish are widely recognized. However, concern exists about the safety of fish intake, since the water in which they live is often highly contaminated. In the present work we analyzed the n-3 PUFA and α- and γ-tocopherol composition of 12 fish species from an artificial lake located in an Italian region far from metropolitan and industrial sites, to evaluate whether the n-3 PUFA content could be comparable to that of marine fish, and whether the levels of the antioxidant tocopherols were enough to ensure a correct preservation of the fish after being caught. Moreover, we studied the chemical and physical features of the lake water and the levels of chemical pollutants present. The benthic macro-invertebrates representing the main food source for freshwater fish were also analyzed. The good chemical–physical quality of the water, as well as the n-3 PUFA and tocopherol levels in the fish, would constitute the basis for advising the dietary usage of these fish to increase intakes of these important nutrients. Pregnant or lactating women, and infants after weaning, in particular, could benefit from eating them, since safe and adequate n-3 PUFA dietary supplementation is required to guarantee the correct pre- and post-natal development of cerebral tissues in children.  相似文献   

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Objectives

According to the 2015 Quality of Death Index published by the Intelligence Unit of the Economist, Hong Kong is ranked 22nd in terms of quality of palliative care in the world, behind many other major developed countries in Asia, including Taiwan, Singapore, Japan, and South Korea. The objectives of the present study were to describe the knowledge, attitude, and preferences of the general Hong Kong adult population across different age groups regarding end-of-life (EOL) care decisions, place of care and death, as well as advance directive (AD).

Methods

This was a population-based cross-sectional survey conducted by telephone. A total of 1067 adults over 30 years old were contacted through residential telephone lines using a random sampling method and were interviewed. Information on sociodemographic factors, general health status, chronic diseases, knowledge, attitude and preferences of advance decisions, EOL care, and place of death were collected.

Results

A total of 85.7% had not heard of AD, but 60.9% would prefer to make their own AD if legislated after explanation; and for those who did not prefer to have an AD, the predominant concern was the possible change of mind afterward. Adjusted logistic regression suggested that female participants were less willing to make an AD, whereas those with prior knowledge of do-not-attempt-cardiopulmonary-resuscitation significantly increased the chance of making an AD. In terms of life-sustaining treatments, a predominant 87.6% preferred to receive appropriate palliative care that gives comfort rather than to prolong life if being diagnosed to be terminally ill; 43% disagreed that doctors should generally try to keep patients alive for as long as possible; and 86.2% agreed that the patient's own wishes should determine what treatment he/she should receive. Adjusted logistic regression showed that palliative care was more preferred by age groups 50 years or above but was less preferred by those who did not care for their family members with chronic diseases. Regarding place of death, 31.2% of the participants would choose to die at home, and among those, 19.5% would still prefer to die at home even if they did not have sufficient support. Adjusted logistic regression showed a decreased trend for all older age groups from 40–49 years to 80+ years, as well as having poor self-rated health, to prefer to die at home. Being a female participant and having education level of tertiary or above, however, had higher preference for death at home.

Conclusions

This is the first population-representative survey of the general Hong Kong adult population on the knowledge, attitude, and preferences of AD, EOL care, and place of care/death. The main implication of this study was that preferences to have autonomy over own EOL care, to receive palliative care, and to die at home were greater than the actual practice currently, highlighting the service gaps for better EOL care in the future.  相似文献   

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Dietary guidelines suggest consuming a mixed-protein diet, consisting of high-quality animal, dairy, and plant-based foods. However, current data on the distribution and the food sources of protein intake in a free-living, representative sample of US adults are not available. Data from the National Health and Nutrition Examination Survey (NHANES), 2007–2010, were used in these analyses (n = 10,977, age ≥ 19 years). Several US Department of Agriculture (USDA) databases were used to partition the composition of foods consumed into animal, dairy, or plant components. Mean ± SE animal, dairy, and plant protein intakes were determined and deciles of usual intakes were estimated. The percentages of total protein intake derived from animal, dairy, and plant protein were 46%, 16%, and 30%, respectively; 8% of intake could not be classified. Chicken and beef were the primary food sources of animal protein intake. Cheese, reduced-fat milk, and ice cream/dairy desserts were primary sources of dairy protein intake. Yeast breads, rolls/buns, and nuts/seeds were primary sources of plant protein intake. This study provides baseline data for assessing the effectiveness of public health interventions designed to alter the composition of protein foods consumed by the American public.  相似文献   

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OBJECTIVES: To establish the prevalence and distribution of witnesses, victims, and perpetrators of different types of violence in the general population and the proportion of victims consulting health services or reporting the incident to authorities. METHODS: Cross sectional survey of a random sample of 3007 inhabitants between the ages of 15 and 60 in the city of Bogotá, Colombia, in 1997, based on a face to face interview. RESULTS: Age adjusted past year prevalence of witnesses, victims, and perpetrators of physical aggression was 61%, 27%, and 27%, respectively, while lifetime prevalence of witnesses, victims, and perpetrators of assault with a weapon in this population reached 70%, 55%, and 5.8%. Between 11% and 67% of the victims consulted a health service and less than 32% reported the incident to an authority. Those involved in most types of physical violence tended to be young, male, from lower middle social classes, with some degree of secondary education, and single or divorced. CONCLUSIONS: Prevalence of witnesses and victims of violence in this sample appears to be high, while perpetrators constitute a small proportion. Violence is not equally distributed throughout the population suggesting the possibility of identifying a population at higher risk for the development of intervention programmes.  相似文献   

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The concentrations of iron, lead, cadmium, copper, manganese, mercury and arsenic were measured in water, sediment, five macrophytes (Typha angustifolia, Iris pseudacorus, Polygonum amphybium, Myriophyllum spicatum and Lemna gibba) and five fish species (Sander lucioperca, Abramis brama, Carassius gibelio, Silurus glanis and Arystichtys nobilis) in the Gru?a Reservoir, used for water supply and recreational fishing. The concentrations of all examined elements were higher in sediment than in water. The values of the ratio between element concentrations in the sediment and those in the water were the highest for Fe and As. Among the five plant species, the highest concentrations of Pb and Mn were observed in T. angustifolia, while the highest concentrations of Fe, Cu and Hg were in L. gibba. I. pseudacorus and P. amphybium had the highest concentrations of Cd and As, respectively. Among the fish species, C. gibelio showed the highest tendency of element accumulation (Fe, Cd, Cu), followed by S. lucioperca (Pb, Hg), A. brama (Mn) and A. nobilis (As). The average concentrations of elements in fish muscle, except for As in A. nobilis (2.635 ± 0.241 mg kg?1 ww), were below the limits that are considered safe for human consumption in accordance with the European Commission Regulation and Official Gazette of Serbia.  相似文献   

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There are disparities among older Caucasian and African American adults in many areas. The study used data from the National Health and Nutrition Examination Survey conducted from 1999 to 2002 and compared the self-reported dietary intakes, physical activity, and economic and health status of Caucasian (N = 1,398) and African American (N = 354) adults aged 65 years and older. Regression models and t-tests (α = 0.05) were used for comparisons. More African Americans than Caucasians lived in low-income households (40.4% vs. 21.3%), lived in households that were not fully food-secure (15.6% vs. 4.9%), watched five or more hours of television (34% vs. 20%), and were told that they had diabetes (10% vs. 4%) or high blood pressure (67 % vs. 52 %). They consumed 253 fewer calories than Caucasians. About 75 % of African American women were overweight. Our findings indicate that for those greater than 65 years of age, low-income African Americans are at a greater risk for poor nutrition and chronic health conditions than Caucasians.  相似文献   

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Physical, chemical, and bacteriological properties of municipally supplied water and well water in selected towns and the city centre (Ni?de, population 76,000) of the province of Ni?de, located in central Anatolia, in Turkey, were investigated in this study. A composition of 70 samples were collected, 31 from Ni?de city centre; 17 from Bor; 8 from Uluk??la; 6 from Altunhisar; 6 from Çiftlik and 2 from Çamard?. Analyses showed that all the samples collected were found to have been chemically safe to consume for domestic purposes. Twenty-three water samples were found potentially unsafe because of the existence of coliform bacteria in them, which was probably caused by the inexistence of sufficient chlorination. Physical tests indicated that 11 water samples were found to have deposit; therefore, the use of such water causes risks where human health is a concern, based upon Turkish national standards (TSE, 1984).  相似文献   

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Overweight-obesity and smoking are two main preventable causes of premature death. Because the relationship between smoking and body mass index (BMI) complicates the interpretation of associations between BMI and death risks, direct estimates of risks associated with joint exposures are helpful. We have studied the relationships of BMI and smoking to middle age (40–69 years) death risk—overall and by causes—in a Norwegian cohort of 32,727 women and 33,475 men who were 35–49 years old when baseline measurements and lifestyle information were collected in 1974–1988. Individuals with a history of cancer, cardiovascular disease or diabetes at baseline were excluded. Mortality follow-up was through 2009. The relationship between BMI and middle age death risk was U-shaped. Overall middle age death risks were 11 % in women and 21 % in men. The combination of obesity and heavy smoking resulted in fivefold increase in middle age death risks in both women and men: For women middle age death risk ranged from 6 % among never smokers in the 22.5–24.9 BMI group to 31 % (adjusted 28 %) in obese (BMI > 30 kg/m2) heavy smokers (≥20 cigarettes/day). The corresponding figures in men were 10 % and 53 % (adjusted 45 %). Obese never smokers and light (1–9 cigarettes/day) smokers in the 22.5–24.9 BMI groups both experienced a twofold increase in middle age risks of death. For women, cancer (56 %) was the most common cause of death followed by cardiovascular disease (22 %). In men, cardiovascular disease was most common (41 %) followed by cancer (34 %). Cardiovascular disease deaths were more strongly related to BMI than were cancer deaths.  相似文献   

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