Polyphenols and Human Health: The Role of Bioavailability

Polyphenols are a group of phytochemicals with potential health-promoting effects. They are classified as flavonoid (flavonols, flavanols, flavones, flavanones, isoflavones, and anthocyanins) and non-flavonoid molecules (phenolic acids, hydroxycinnamic acids, lignans, stilbenes, and tannins). Although an increasing number of trials have shown a correlation among polyphenol consumption and a reduction in risk factors for chronic diseases, discrepancies in explaining their positive effects have been found in terms of the bioavailability. In fact, polyphenols show a low bioavailability due to several factors: interaction with the food matrix, the metabolic processes mediated by the liver (phase I and II metabolism), intestine and microbiota. On the other hand, the biological activities of phenol compounds may be mediated by their metabolites, which are produced in vivo, and recent studies have confirmed that these molecules may have antioxidant and anti-phlogistic properties. This review discusses the studies performed in vivo, which consider the polyphenol bioavailability and their different food sources. Factors influencing the biological effects of the main classes of polyphenols are also considered.     

Trends in Vitamin C Consumption in the United States: 1999–2018

Low intakes of fruits and vegetables have resulted in suboptimal intakes of several micronutrients, including vitamin C. This cross-sectional study used data from 84,902 children/adults (≥1 y) who completed a 24-h dietary recall as part of the United States National Health and Nutrition Examination Survey (1999–2018). Mean vitamin C intakes from foods/beverages were calculated as were trends in major food/beverage sources of vitamin C. Percentages below the Estimated Average Requirement (EAR) were estimated. Overall, mean vitamin C consumption declined by 23% (97–75 mg/d; p-value for trend < 0.001). 100% fruit juice was the leading source of vitamin C (25.6% of total or 21.7mg/d), but this declined by 48% (25–13 mg/d; p-value for trend < 0.001). Whole fruit increased among children/adolescents (+75.8%;10–17 mg/d; p-value for trend < 0.001), but not adults, while the vegetable contribution was generally unchanged. The proportion of the population below the EAR increased by 23.8% on a relative scale or 9 percentage points on an absolute scale (38.3–47.4%). Declines in vitamin C intake is driven largely by decreases in fruit juice coupled with modest increases in whole fruit. Due to associations between vitamin C intake and numerous health outcomes these trends warrant careful monitoring moving forward.     

Determinants of the Consumption of Regular Soda,Sport, and Energy Beverages in Spanish Adolescents

Increasing sugar-sweetened beverages (SSB) consumption and associated health impacts warrant health-policy action. We assessed associations of socioeconomic and lifestyle variables with adolescents’ consumption of regular soda (RSD), sport (SD), and energy (ED) drinks. Cross-sectional study of 3930 Spanish adolescents (2089 girls, 1841 boys) aged 13–18 years). We compared frequency of consuming each SSB type (European Food Safety Authority questionnaire) with sociodemographic and lifestyle variables (standardized questions). RSD, SD, and ED were consumed at least weekly by 72.7%, 32.3%, and 12.3% of participants, respectively, and more frequently (p < 0.001) by boys, compared to girls. Multivariate ordinal logistic regression showed inverse association between RSD, SD, and ED consumption and parental occupation-based socioeconomic status (p < 0.01). Daily smoking was associated (p < 0.001) with higher ED (OR 3.64, 95% CI 2.39–5.55) and RSD (OR 2.15, 95% CI 1.56–2.97) consumptions. SD intake was associated inversely with smoking (OR 0.60, 95% CI 0.40–0.89, p = 0.012) and directly with physical activity (OR 2.93, 95% CI 2.18–3.95, p < 0.001). School performance was lower among ED (OR 2.14, 95% CI, 1.37–3.35, p = 0.001) and RSD (OR 1.81, 95% CI 1.24–2.64, p = 0.002) consumers, compared to SD. Maleness and low socioeconomic status predicted SSB consumption. Smoking and low school performance were associated with higher ED and RSD intakes.     

Marginal,Low, and Very-Low Food Security among Children Are Associated with Intake of Select Dietary Factors during Summer

BackgroundSchool meals are associated with improved food security status and dietary intake. Children receiving free and reduced-price school meals lose access to these meals during the summer. The association between food security status and dietary intake in these children during summer is unclear.ObjectiveTo examine the association between food security status (high, marginal, low, and very-low food security) among children and intake of select dietary factors during summer in children certified for free and reduced-price school meals by age group (3 to 4 years, 5 to 8 years, 9 to 12 years, and 13 to 17 years).DesignCross-sectional analysis.Participants/settingSecondary data from 11,873 children aged 3 to 17 years in the control group of the US Department of Agriculture Summer Electronic Benefit Transfer for Children Demonstration Project.Main outcome measuresConsumption of total fruits and vegetables; fruits and vegetables, excluding fried potatoes; whole grains; added sugars; added sugars, excluding cereals; added sugars from sugar-sweetened beverages; and dairy products assessed using questions from the 2009-2010 National Health and Nutrition Examination Survey Multifactor Diet Screener.Statistical analysisMultiple linear regression.ResultsFor the majority of age groups, marginal food security, low food security, and very-low food security were associated with lower fruit and vegetable consumption and low food security and very-low food security were associated with lower dairy consumption, with children from households with very-low food security having the lowest consumption. Children from households with very-low food security consumed 0.73 (95% CI –0.93 to –0.53) to 0.99 (95% CI –1.59 to –0.39) cup equivalents less per day of fruits and vegetables and 0.49 (95% CI –0.65 to –0.34) to 0.68 (95% CI –1.07 to –0.29) cup equivalents less per day of dairy compared with children from households experiencing high food security.ConclusionsLower food security was associated with reduced consumption of fruits and vegetables and dairy products during summer in children from low-income households.     

12~36月龄幼儿胃肠道功能情况及其影响因素研究

目的描述12~36月龄幼儿胃肠道功能情况,探讨潜在影响因素。方法2018年9月—2019年1月在北京市朝阳区某社区卫生服务中心招募12~36月龄幼儿385名,收集幼儿及母亲基本信息,采用简版《婴幼儿胃肠道症状问卷》评估幼儿胃肠道功能。问卷共10个问题,反映幼儿胃肠道症状(6个问题)和相关行为(4个问题)。胃肠道功能总评分为10~60分,其中胃肠道症状6~36分、胃肠道相关行为4~24分,评分越高提示胃肠功能越弱;将总评分等于或高于第二个三分位数(17分)定义为轻度胃肠不适。采用多因素logistic回归分析幼儿轻度胃肠不适的可能影响因素。结果幼儿胃肠道功能总评分、症状评分和相关行为评分的中位数(四分位数间距)分别为13.0(11.0~19.0)分、6.0(6.0~10.0)分和6.0(5.0~8.0)分。小月龄(12~17月龄14.5分,18~23月龄13.0分)比大月龄(24~29月龄12.0分,30~36月龄12.5分)、母亲为初产妇(14.0分)比经产妇(12.0分)的幼儿中位胃肠道功能总评分高(P<0.05)。轻度胃肠不适幼儿124名(32.2%),母亲为初产妇(36.8%)比母亲为经产妇(21.8%)的幼儿轻度胃肠不适发生率显著升高(P=0.004)。多因素logistic回归分析显示,12~17月龄幼儿与30~36月龄幼儿相比(调整OR,2.32;95%CI,1.14~4.71)、母亲为初产妇的幼儿与经产妇的幼儿相比(调整OR,2.05;95%CI,1.19~3.52),轻度胃肠不适风险显著升高。幼儿性别、分娩方式、母乳喂养时长和母亲分娩年龄对轻度胃肠不适发生风险无显著影响。结论幼儿胃肠道功能整体较好,幼儿月龄及母亲产次影响幼儿胃肠功能,小月龄及母亲为初产妇的幼儿易发生轻度胃肠不适。     

Continuity of primary care and prenatal care adequacy among women with disabilities in Ontario: A population-based cohort study

BackgroundWomen with disabilities experience elevated risks for pregnancy complications and report barriers accessing prenatal care. Emerging evidence highlights the significant role primary care providers play in promoting preventive services like prenatal care.ObjectiveTo examine the relationship between continuity of primary care (COC) and prenatal care adequacy among women with disabilities.MethodsWe conducted a population-based study using health administrative data in Ontario, Canada. The study population included 15- to 49-year-old women with physical (n = 106,555), sensory (n = 32,194), intellectual/developmental (n = 1515), and multiple (n = 6543) disabilities who had a singleton livebirth or stillbirth in 2003–2017 and ≥ 3 primary care visits < 2 years before conception. COC was measured using the Usual Provider of Care Index. Nominal logistic regression was used to compute adjusted odds ratios (aOR) for prenatal care adequacy, measured using the Revised-Graduated Prenatal Care Utilization Index, for women with low versus moderate/high COC, controlling for other social and medical characteristics.ResultsWomen with disabilities with low COC, versus those with moderate/high COC, had increased odds of no (aOR 1.42, 95% CI 1.29–1.56), inadequate (aOR 1.19, 95% CI 1.16–1.23), and intensive prenatal care (aOR 1.22, 95% CI 1.19–1.25) versus adequate. In additional analyses, women with low COC and no/inadequate prenatal care were the most socially disadvantaged among the cohort, and those with low COC and intensive prenatal care had the greatest medical need.ConclusionImproving primary care access for women with disabilities, particularly those experiencing social disadvantage, could lead to better prenatal care access.     

急性胰腺炎的螺旋CT双期动态扫描诊断

目的 通过螺旋CT双期动态扫描反映出急性胰腺炎不同的病理变化,认识螺旋CT在急性胰腺炎中的诊断价值。方法：使用螺旋CT对41例急性胰腺炎进行平扫和双期动态增强扫描,观察水肿型与坏死型胰腺炎的不同CT表现。结果：19例水肿型胰腺炎4例表现为动静脉期均匀强化,15例表现为动脉期轻度强化、静脉期明显强化;22例坏死型胰腺炎的坏死区于动、静脉期均未见强化。同时清晰显示炎症产生的胰周病变范围及周围脏器受累情况。还可发现产生胰腺炎的部分原因。结论：螺旋CT双期动态增强扫描可以提高急性胰腺炎的诊断准确度,有较高的临床诊断价值。     

三种血清肌酐测定方法的评价

目的：寻找一个简便,特异,准确的检测肌酐的方法,方法：使用三种方法Jaffe-FIXED,E-RATE,E-PAP进行方法学评价,包括准确度,精密度,线性范围,干扰试验,对比试验,结果：每各方法匀有自己的优,缺点,相比而言Jaffe-FIXE,E-RATE法更优于E－PAP,结论：根据实验室情况,使用试剂盒前进行方法学评价并选择方法,了解其性能,以便克服其缺陷。     

视神经管减压术治疗视神经挫伤20例分析

目的：报告视神经挫伤行视神经管减压术的治疗效果。方法：手术治疗限定于外伤后不超过1月且无严重颅脑损伤及无严重全身疾病者。采用局麻筛蝶窦入口法,手术前后常规用糖皮质激素及神经生长因子。结果：20例术前无光感16例,术后1周视力有光感及手动以上12例,占75％;术前视力在手动－0．04以内4例,术后视力均提高。术后随访3个月除2例外视力均有提高,最好达到0．3。结论：视神经挫伤病期不超过1月虽视力已无光感也不应放弃行视神经管减压术。     

喉部分切除术治疗喉癌30年回顾

目的：探讨30年间喉部分切除术在喉癌治疗中的应用。方法：30年间行喉部分切除术257例,将30年喉部分切除术后治疗喉癌分前10年、中间10年和后10年3个阶段,进行对比观察。前10年、中间10年和后10年喉癌手术中喉部分切除术分别占9．6％、52．3％和68．6％。结果：30年间喉部分切除术257例,前10年、后10年和后10年3年生存率分别为50．0％、63．0％和73．6％,5年生存率分别为37．5％、55．6％和71．8％;术后1－3月内拔管率分别为37．5％、50．6％和71．4％,术后咽瘘发生率分别为25．0％、12．3％和3．0％。结论：30年间喉部分切除术患者年龄有逐渐增高趋势;全喉切除术逐渐减少,喉部分切除术逐渐增加;3、5年生存率和术后拔管率有逐渐提高的趋势;术后咽瘘和逐渐减少的趋势。