Using gas chromatography and mass spectrometry to determine 25-hydroxyvitamin D levels for clinical assessment of vitamin D deficiency

Vitamin D is responsible for multiple metabolic functions in humans. Rickets are the most common disease caused by vitamin D deficiency. It is caused by poor calcium intake resulting in poor serum-ionized calcium. The purpose of this study is to develop a rapid, sensitive, and feasible method to determine the 25-hydroxy-vitamin D3 (25(OH)D3) levels in blood samples for clinical assessment. In this study, gas chromatography coupled mass spectrometry with trimethylsilyl derivatization (TMS-GC-MS) is the most suitable protocol for quantitative analyses of 25(OH)D3. Performance of method was evaluated and compared with liquid chromatography and immunoassay. Method validation has been carried out with plasma specimens. The limit of quantitation of TMS-GC-MS method is 1.5 ppb with good linear correlation. Furthermore, the dietary intake and nutritional status of vegetarian and non-vegetarians in Taiwan were assessed by our validated method. As a result, this vitamin D nutrition survey demonstrates that most Taiwanese people have insufficient vitamin D. Due to dietary habits; the male vegans may have the highest risk of vitamin D deficiency.     

Knowledge and attitudes of registered dietitians concerning vegetarian diets

Registered Dietitians' (RD) knowledge and attitudes about the safety, adequacy and health benefits of vegetarian diets were estimated. A questionnaire was developed with demographic, knowledge, and attitude questions and was completed by 182 RDs from Washington, Nebraska and Vermont. The results showed that RDs in Vermont had significantly higher attitude scores regarding vegetarian diets than RDs in Nebraska (63% vs. 52% of questions answered correctly, respectively) and that RDs in Washington had significantly higher knowledge scores concerning vegetarian diets than RDs in Nebraska (73% vs. 67% of questions answered correctly, respectively). A significantly higher percentage of the RDs from Vermont, 52%, reported having followed some type of vegetarian diet compared to only 28% of the RDs from Washington or 12% of the RDs from Nebraska. Results also showed that RDs who had followed vegetarian diets at the time of the study or at some time in the past had significantly higher overall knowledge and attitude scores when compared with those RDs who had never followed vegetarian diets. There was a significant positive correlation between overall knowledge and overall attitude score for individual subjects. This suggests that increasing the knowledge base of RDs concerning vegetarian diets may lead them to consider meatless diets in a more positive light. In addition, average overall knowledge and attitude scores suggested that RDs are not up to date with current research in the field of vegetarian nutrition.     

Factors affecting adherence to a raw vegan diet

The purpose of this study was to evaluate adherence and identify predictors of adherence to a raw vegan diet (i.e., uncooked plant foods) following a stay at a raw vegan institute. In this cohort study of guests at a raw vegan institute, subjects completed written questionnaires upon arrival and 12 weeks later. Of 107 eligible guests, 84 participated. Mean age was 54 years, 23 were male, and 73 white. Fifty-one completed the 12-week follow-up. Eight (16%) reported their diet to be 80% raw vegan at baseline and 14 (28%) at follow-up. Based on a raw vegan dietary adherence score (range 0-42) created for this study, mean adherence (SD) increased from 15.1 (5.4) to 17.0 (5.8) over 12 weeks (p=0.03). Baseline predictors of adherence included: education (beta=0.95), severity of disease (beta=0.98), and self-efficacy to adhere (beta=0.72). Future interventions that evaluate this diet should address self-efficacy, an important, potentially remediable predictor of adherence.     

食草动物食性研究方法的评价

目的分析近30年草食性动物食性研究方法及其进展。方法查阅国内外有关大型草食性动物食性的文献,对主要研究方法进行评价。结论目前国内外常见的大型草食性动物食性研究方法主要包括宏观和微观两大类:宏观分析法主要包括直接观察法(direct observation method)、利用法(utilization method),微观分析法主要包括粪便显微分析法(fecal microscopic analysis method)、胃容物分析法(rumen analysis)。宏观分析法和微观分析法通常共同运用于食性研究过程。20世纪90年代前多采用直接观察法和胃分析法,到20世纪90年代后对有蹄类的食性研究多采用粪便显微分析法,并以其易于取样和对动物干扰小等优点在食性研究中得到了广泛应用,逐步地实现了由胃分析法为主向以粪便显微分析法为主的转变。     

Severe hypoalbuminemia and steatohepatitis leading to death in a young vegetarian female, 8 months after mini gastric bypass: A case report

BackgroundHypoalbuminemia is an important complication after Mini Gastric Bypass (MGB) and is more frequent in vegetarians, diabetic nephropathy, and alcoholic and liver disease patients. The patients must be followed in regular intervals and serum albumin must be checked in every visit after MGB. Hypoalbuminemia must be prevented by good protein regimes.Case summaryA 29 years old female was admitted 8 month after Laparoscopic Mini Gastric Bypass with malaise, dyspnea, icter, nausea, vomiting, diarrhea and edema of extremities from 2 weeks before admission. She had become vegetarian autonomously and had not participated in routine postop follow up, and also discontinued her high protein regimen. In para clinictest results, she had severe hypoalbuminemia, anemia, elevated liver enzymes and direct bilirubinemia, metabolic acidosis in Arterial Blood Gas (ABG), and in Core Needle Biopsy (CNB) marked Steatohepatitis was shown. Unfortunately, the patient did not respond to medical care and died.ConclusionRegular follow up after Mini Gastric Bypass is very important for many reasons such as early diagnosis and treatment of hypoalbuminemia.     

Vegetarian vs. conventional diabetic diet – A 1-year follow-up

ObjectiveOur previous 6-month, randomized study demonstrated the beneficial effect of a vegetarian (V) compared to a conventional diet (C) with similar caloric restriction on cardiovascular risk factors for patients with type 2 diabetes (T2D), namely increased insulin sensitivity, reduced body weight, reduced volume of visceral and subcutaneous fat, decreased LDL-cholesterol and improved oxidative stress markers and chosen adipokines. We conducted post-trial monitoring to determine whether the improved outcomes persisted 1 year after the end of the study.Methods62 subjects with T2D who completed the study were asked to come for a 1-year follow-up to measure weight, waist circumference, HbA1c and blood lipids. No attempts were made to maintain their previously assigned diets.Results44 patients (71%) attended the post-trial monitoring. Hypoglycemic agents were increased by 14% in V and by 26% in C; insulin therapy was introduced in 5% in V and in 13% in C one year after the end of the intervention. Neither weight nor waist circumference changed significantly in either group. HbA1c increased (p ≤ 0.05) similarly in both groups (+0.49 ± 1.04% in V vs. +0.42 ± 0.8% in C). Blood lipids did not change in either group.ConclusionOne year after the end of the intervention, the positive effects of a vegetarian diet on cardiovascular risk factors compared to a conventional diet were partially maintained.     

Effects of a dietary intervention with Mediterranean vs lacto-ovo vegetarian diets on HDL function: Results from the CARDIVEG study

Background and aimHDL-cholesterol efflux capacity (CEC) has been shown to be a better cardiovascular (CVD) risk marker than serum HDL concentration. Several foods and nutrients have been shown to improve HDL functions, however no effective dietetic nor pharmacological strategy is available to increase CEC. This study aims to evaluate the possible effect of Mediterranean diet (MD) and lacto-ovo-vegetarian diet (VD) on HDL function in a group of clinically healthy subjects at low-to-moderate CVD risk.Methods and resultsThirty apparently healthy subjects with a low-to-moderate cardiovascular risk profile (21 F; mean age: 51.3 ± 9.7 years) were randomly assigned to a 3-month MD or VD diet and then crossed.Participants on VD showed a reduction in total HDL CEC by 8.99% (p < 0.001) as well as a reduction in ABCA1 mediated-CEC by 18.62% (p < 0.001) compared to participants on MD. Regarding CEC mediated by aqueous diffusion, no significant changes were observed after treatment with either diet. Finally, a significant positive association between CEC mediated by the ABCA1 transporter and adiponectin was found (r = 0.462; p = 0.010).ConclusionThe results of this study suggest that HDL activity in promoting cholesterol efflux and thereby reducing the concentration of pro-atherogenic lipoproteins was more effective in participants undergoing MD than VD. Based on these findings, the MD could be considered a better therapeutic strategy for cardiovascular prevention than VD.Clinical Trial registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT02641834.