Modalités de l’offre alimentaire (hors restauration scolaire) dans les collèges et lycées d’aquitaine: Évolution entre 2004 et 2005 en application de la loi de santé publique du 9 août 2004

Within the framework of the French National Programme on Nutrition and Health, a survey was conducted in middle and high schools of the French Aquitaine region with the aim of describing the food supply within middle and high schools in 2004-2005, before and after the application of regulation of snack machins in September 2005 of the recent French law of public health.The results show that:

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20 % of schools offered free snacks, specially bread (67 %) and fruit (39,3 %).

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63 % of the answering schools had food or drink sales, concerning pastries (74,6 %), chocolate bars (30 %) and soft drinks (25,4 %).

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In 2004-2005, 44 % of the high schools had snack machins. In Septembre 2005, each school (99 %) had removed on snack machines.

These results highlight the importance of the actions implemented in the programme of “Nutrition, prevention and health of children and teenagers in Aquitaine”, especially actions focussing on food supply within schools.     

Apport lipidique et prise de poids. Aspects quantitatifs - Un débat

From a quantitative point of view the role of dietary fat in weight gain apparently seems clear, but its accountability in obesity pathogenesis, for individuals or population, is not definitively established.This concern may be divided in four sections:

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On a physiopathological point of view, experimental data show that fats are able to increase energy density and food intake and to increase lipogenesis.

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On an epidemiological point of view the data are more conflicting. An higher fat intake was associated to the obesity epidemic, its decrease did not stopped it, and that suggest the role of others lifestyle patterns including physical activity.

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On a clinical point of view the studies are far from a consensus, but it is true that they focuse on the role of familial, educative and genetic factors. But really a fat excess can sensitive the effect of inactivity. Total energy intakes seem a main issue.

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The fat reduction is not sufficient to induce a weight loss or to prevent a weight gain. We must act on each component of energy balance. In insulin-resistant subjects the fat reduction without weight-loss does not seem favourable on cardiovascular risk.

Finally the total fat intakes cannot be considered as the cause of obesity but they may participate to the weight gain in some conditions. Qualitative aspects, and therefore fatty acids, must be also considered.     

Antibody response to the influenza vaccine in healthcare workers

People vaccinated against influenza develop hemagglutination inhibition (HAI) antibodies (Ab) that bind to the virus and neutralize it. Ab titer levels are variable depending on factors insufficiently studied, and tend to decrease over time.In the present study, we analyzed antibodies responses before and after influenza vaccination in nurses working in a hospital, with the aim of:

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identifying seroconversion rates to trivalent influenza vaccine one month after immunization;

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evaluating if, six months after vaccination, influenza HAI Ab titer fall comparing to one-month post vaccination HAI Ab titer;

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studying the association between the lack of HAI Ab response (seroconversion) assessed one month after immunization and:

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past influenza vaccinations,

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baseline (before vaccination) HAI Ab titer,

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baseline (before vaccination) HAI Ab titer ≥ 40 (considered as a protection titer).

Hemagglutination inhibition reaction was used to assess specific HAI Ab titers against influenza A(H₁N₁), A(H₃N₂) and B virus strains included in the influenza vaccine and we used progressive dilutions of two times, starting on 1:10 until 1:20.480.Seroconversion rates, one month after vaccination, were 66.7% for A(H₁N₁) strain, 63.2% for A(H₃N₂) strain and 56.3% for B strain. The most immunogenic strain used in 2007/08 influenza vaccine was A(H₁N₁). Seroconversion rates after one month were negatively associated with past influenza vaccinations, baseline HAI Ab titers ≥ 40 and baseline HAI Ab titers. Six months after vaccination, 50% of participants showed a drop in HAI Ab titers to an half, for each of the considered strains, but they remain high enough to protect against the disease.     

Direct and indirect effects of metal stress on physiology and life history variation in field populations of a lycosid spider

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Under stress, life history theory predicts reduced growth rates and adult sizes, reduced reproductive allocation, production of larger offspring and postponed reproduction. Both direct and indirect effects of metals can explain these trends, mainly linked to energetic constraints. Metallothionein-like proteins (MTLP’s) are believed to be an important defense mechanism against the adverse effects of metals and other stressors.

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We tested these predictions comparing six field populations of the wolf spider Pardosa saltans, three of which were on sites that are historically polluted with heavy metals.

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As expected for life histories evolving under energetic constraints, adult size and condition correlated negatively and egg mass positively with Cd concentrations for a subset of four populations. In the population that showed the highest cadmium and zinc body burdens, reproductive output and allocation were lowest and reproduction was postponed.

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Contrary to our expectation, for all six study populations MTLP concentrations did not increase in exposed populations, indicating that this defense mechanism cannot explain the observed variation in life histories.

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We conclude that indirect and synergistic effects of metal pollution may be more important than physiological defense mechanisms in shaping life history traits in field populations.

     

Mise au point d’un questionnaire d’analyse des pensées et sentiments autour de l’alimentation

Purpose

It was to construct a questionnaire in French on the thoughts and the feelings in the respect of the food in the general population. We also wished to detect some eating disorders.

Methods

Eight experts selected nine major subjects concerning the thoughts and the feelings around the food and elaborated a questionnaire including 8 to 10 questions by subject. Having twice been revised by the experts, the questionnaire was criticized by a sample group of 20 persons of different circles, then by 42 medical students in Nutrition. The questionnaire was then handed in 88 medical students (4^th year). These various stages allowed to suppress, to modify and to add different questions. The questionnaire was then sent to 114 medical students and 112 subjects from the general population.

Results

The percentage of returned and totally informed questionnaires (from a sending of 202 questionnaires) was very satisfying (>85%). The concordance of the answers to the redundant questions was very high (>90%). In this population (74% of women), we noted that fear towards the food and eating disorder were frequent: binge eating: 11%, bulimia nervosa: 4,2%, anorexia nervosa: 5%, “the glance of the other one when I eat frightens me”: yes, absolutely: 15%.

Conclusion

This questionnaire concerning thoughts and feelings around the food was validated by the interest which was carried to it, its reproducibility, its understanding by the interrogated persons and the behavioral aspects which it brings. It will be send to 3 000 unselected people of Dijon to judge its interest in the general population. It will be accompanied with a validated inventory to detect eating disorders in order to test its sensitivity and its reproducibility.     

Enteral Nutrition in Children with Short-Bowel Syndrome: Current Evidence and Recommendations for the Clinician

The optimal enteral feeding regimen in children with short-bowel syndrome (SBS) is debated by clinicians. The purpose of this article is to present an overview of published data on feeding strategies in children with SBS. A structured literature search (years 1966 through 2007) was done to identify human studies in children directly addressing nutrition (or specified nutrients) in relation to SBS. Eight relevant studies retrieved were graded by seven experts according to the Scottish Intercollegiate Guidelines Network criteria. This grading system is based on the study design and methodological quality of individual studies. Recommendations were made based on the outcome according to the Scottish Intercollegiate Guidelines Network if appropriate and on expert opinion otherwise. The most important recommendations are:

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Enteral nutrition should be initiated as soon as possible after bowel resection to promote intestinal adaptation.

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Enteral nutrition should be administered in a continuous fashion.

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Breast milk or standard polymeric formula (depending on the child's age) is recommended as preferred type of nutrition.

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Bottle-feeding (small volumes) should be started as soon as possible in neonates to stimulate the suck and swallow reflexes. Solid food can be introduced at the age of 4 to 6 months (corrected for gestational age if necessary) to stimulate oral motor activity and to avoid feeding aversion behavior.

The team of experts concluded that high-quality research on the preferred types of enteral and oral nutrition in children with SBS is scarce. Multicenter prospective studies on the effects of feeding strategies on bowel adaptation, fecal production, linear growth, and clinical outcome are required to find the optimal feeding regimen in children with SBS.     

The preparation of amoebic extracts and their testing by complement fixation against clinically proved sera

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1. A complement fixation technique for 60°C.-inactivated sera, suited to the diagnosis of amoebic disease, is described.