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PubMedDate not supplied

Explaining sex differences in dental caries prevalence: saliva, hormones, and "life-history" etiologies.

When dental caries rates are reported by sex, females are typically found to exhibit higher prevalence rates than males. This finding is generally true for diverse cultures with different subsistence systems and for a wide range of chronological periods. Exceptions exist, but are not common. In this paper, we present new data for sex differences in dental caries rates among the Guanches (Tenerife, Canary Islands), summarize results of meta-analyses of dental caries prevalence, and emphasize new research that stresses the critical role of female hormones and life-history events in the etiology of dental caries. Among the Guanches, corrected tooth-count caries rates for females (8.8%, 158/1,790) are approximately twice the frequency of caries among males (4.5%, 68/1,498). Higher caries prevalence among females is often explained by one of three factors: 1) earlier eruption of teeth in girls, hence longer exposure of girls' teeth to the cariogenic oral environment, 2) easier access to food supplies by women and frequent snacking during food preparation, and 3) pregnancy. Anthropologists tend to favor explanations involving behavior, including sexual division of labor and women's domestic role in food production. By contrast, the causal pathways through which pregnancy contributes to poorer oral health and higher caries rates are deemphasized or discounted. This paper presents recent research on physiological changes associated with fluctuating hormone levels during individual life histories, and the impact these changes have on the oral health of women. The biochemical composition of saliva and overall saliva flow rate are modified in several important ways by hormonal fluctuations during events such as puberty, menstruation, and pregnancy, making the oral environment significantly more cariogenic for women than for men. These results suggest that hormonal fluctuations can have a dramatic effect on the oral health of women, and constitute an important causal factor in explaining sex differences in caries rates.

Anthropology, Physical↗

PubMed1994

Joint protection behavior in patients with rheumatoid arthritis following an education program: a pilot study.

PURPOSE: Joint protection (JP) education is a common feature in rheumatoid arthritis (RA) treatment programs. However, no objective studies have been published demonstrating patients' behavior changes following such education. This study evaluated whether RA patients' hand movement patterns altered following a JP education program. METHODS: An assessment procedure was constructed to assess application of four JP principles related to altering patterns of hand use during common everyday activities (making a hot drink and snack meal). RESULTS: Eleven RA patients were assessed. There was no significant behavioral change at 6 weeks post-JP education (t = 10; P > 0.1). In contrast, follow-up interviews of self-perceived JP behavior showed all subjects considered JP relevant for them and seven believed they had changed to using these techniques. CONCLUSIONS: This suggests education led to attitudinal change but that behavioral change requires longer and more targeted input than is currently normally provided.

Activities of Daily Living↗

PubMedDate not supplied

Diabetes management in the new millennium using insulin pump therapy.

Current goals of therapy of type 1 and 2 diabetes are to achieve near normal glycemia, minimize the risk of severe hypoglycemia, limit excessive weight gain, improve quality of life and delay or prevent late vascular complications. As discussed in this review, insulin pump or continuous subcutaneous insulin infusion (CSII) therapy provides a treatment option that can dramatically aid in achieving all of these goals. In comparison to multiple daily injections (MDI), CSII uses only rapid-acting insulin, provides greater flexibility in timing of meals and snacks, has programmable basal rates to optimize overnight glycemic control, can reduce the risk of exercise-induced hypoglycemia, and enhances patients' ability to control their own diabetes. Most important, in adults and adolescents with type 1 diabetes, CSII has been shown to lower HbA(1c) levels, reduce the frequency of severe hypoglycemia and limit excessive weight gain versus MDI without increasing the risk of diabetic ketoacidosis. Similarly positive results are being seen with CSII in adults with type 2 diabetes. The effectiveness of CSII and improvements in pump technology have fueled a dramatic increase in the use of this therapy. Practical guidelines are presented for selection of patients, initiation of treatment, patient education, follow-up assessments and troubleshooting. The recent introduction of methods for continuous glucose monitoring provides a new means to optimize the basal and bolus capabilities of CSII and offers the hope of the development of a feedback-controlled artificial pancreas.

Adolescent↗

PubMed2007

Metformin prolongs the postprandial fall in plasma ghrelin concentrations in type 2 diabetes.

BACKGROUND: Weight loss is difficult to achieve in type 2 diabetes and many therapies are associated with weight gain, an effect attenuated by metformin. We studied the effects of metformin on energy expenditure, appetite and the regulation of PYY and ghrelin in type 2 diabetes. METHODS: Plasma peptide YY (PYY), ghrelin, resting metabolic rate (RMR), postprandial thermogenesis (PPTG), and appetite ratings were measured at baseline and following a mixed meal in 11 type 2 diabetic subjects treated with diet alone (T2D) and 10 treated with metformin monotherapy (T2MF). The groups were similar in age, gender and adiposity. RESULTS: There were no differences in baseline anthropometric, or metabolic variables between the groups. Postprandially, plasma ghrelin fell equally in both groups (23% versus 24.5%, p < 0.05 versus baseline, p = NS between groups) but were reduced for longer in T2MF (below baseline 60-240 min T2MF versus 60-180 min T2D) coincidentally with a prolonged sensation of fullness and suppression of hunger in the metformin-treated group. There were no differences in PYY concentrations, RMR or PPTG. CONCLUSIONS: Metformin prolongs the postprandial fall in ghrelin concentrations. These effects may prolong the inter-meal interval, thereby decreasing snack intake and daily energy intake, promoting weight loss.

Adult↗

PubMed2004

Effect of SULT1A1 and NAT2 genetic polymorphism on the association between cigarette smoking and colorectal adenomas.

Cigarette smoke contains polycyclic hydrocarbons and arylamines that may both be activated by sulfotransferase, encoded by SULT1A1. A genetic polymorphism leads to an Arg213His substitution, thereby decreasing enzyme activity and stability and might thus modify the association between smoking and colorectal adenomas. We investigated this in a Dutch case-control study. Additionally, we evaluated potential roles of epoxide hydrolase (EPHX), N-acetyltransferases (NAT1 and NAT2) and glutathione S-transferases (GSTM1 and GSTT1). The data analysis included 431 adenoma cases and 432 polyp-free controls (54% women; mean age, 54.6 years) enrolled at endoscopy in 8 Dutch hospitals between 1997 and 2000. All participants provided data on smoking habits and blood for DNA isolation. Genotyping was performed using appropriate polymerase chain reaction-restriction fragment length polymorphism procedures. Multivariate models included age, sex, endoscopy indication, consumption of snacks and alcohol and, if appropriate, daily smoking dose or smoking duration. Smoking increased colorectal adenoma risk, most importantly by duration. Smoking for more than 25 years more than doubled adenoma risk (OR = 2.4, 95% CI = 1.4-4.1) compared to never smoking. Combinations of SULT1A1 fast sulfation (*1/*1) and of NAT2 slow acetylation with smoking resulted in a 4 times higher risk of adenomas compared to never smokers with other inherited gene variants, although there was no statistically significant effect modification. We found no clear effects of the other genetic polymorphisms on the association between smoking and adenomas. We conclude that smoking increases risk of colorectal adenomas and that SULT1A1 and NAT2 only modestly modify this association.

Acetyltransferases↗

PubMed2004

Food groups and colon cancer risk in African-Americans and Caucasians.

The disparities in colon cancer incidence between African-Americans and other U.S. ethnic groups are largely unexplained. This report examines associations of various food groups with colon cancer in African-Americans and Caucasians from a case-control study. Incident cases of histologically confirmed colon cancer, age 40-80 years, (n = 613) and matched controls (n = 996) were interviewed in-person to ascertain potential colon cancer risk factors. Diet over the year before diagnosis or interview date was assessed using a validated food frequency questionnaire adapted to include regional foods. Multivariate logistic regression models estimated energy-adjusted and non-energy adjusted odds ratios (OR). Controls generally reported higher consumption (daily amount and weekly frequency) of fruits, vegetables and dark green, deep yellow fruits/vegetables, whereas cases consumed more refined carbohydrates and fats, oils and snacks. Regardless of ethnic group or energy adjustment, high and frequent vegetable consumption (particularly dark green vegetables) was protective, consistent with 20-50% reductions in risk. In Caucasians, high refined carbohydrate and red meat consumption (amount and frequency) was associated with a statistically significant 2-fold increased risk in non-energy adjusted models. In African-Americans, frequent intake of dairy foods was associated with a doubling in risk (OR = 1.9, 95% CI = 1.1-3.4) in non-energy-adjusted models, whereas frequent fruit consumption correlated with a non-significant 30% lower risk. These findings add to growing evidence that plant foods may protect against colon cancer; however, the effects of the other food groups varied by ethnic group and energy adjustment. These results may also explain some of the ethnic differences in colon cancer incidence.

Adult↗

PubMed1990

Diet, living conditions and nasopharyngeal carcinoma in Tunisia--a case-control study.

We conducted a case-control study of nasopharyngeal carcinoma (NPC) in Tunisia, on diet, dietary patterns and life style, the characteristics of which had been defined by an anthropological study. Eighty incident cases, diagnosed in Tunisia between November 1986 and November 1987, were each matched for sex, age and place of residence to 2 controls. The subjects were asked for dietary data referring to the year preceding the diagnosis of NPC and, with help of their families, during childhood and after weaning. After adjustment for an empirical living conditions score, the following food items were found to be associated with an increased risk for NPC: preserved spiced meat (quaddid), basic stewing preparation (mixture of red and black pepper, garlic, oil, caraway and coriander), and harissa (red pepper, olive oil, garlic, caraway, salt) taken with bread as a snack during childhood and youth. Moreover, subjects who had been directly weaned from mother's milk on to an adult diet were found to be at higher risk for NPC.

Adolescent↗

PubMed1995

Brain serotonin, carbohydrate-craving, obesity and depression.

Serotonin-releasing brain neurons are unique in that the amount of neurotransmitter they release is normally controlled by food intake: Carbohydrate consumption--acting via insulin secretion and the "plasma tryptophan ratio"--increases serotonin release; protein intake lacks this effect. This ability of neurons to couple neuronal signaling properties to food consumption is a link in the feedback mechanism that normally keeps carbohydrate and protein intakes more or less constant. However, serotonin release is also involved in such functions as sleep onset, pain sensitivity, blood pressure regulation, and control of the mood. Hence many patients learn to overeat carbohydrates (particularly snack foods, like potato chips or pastries, which are rich in carbohydrates and fats) to make themselves feel better. This tendency to use certain foods as though they were drugs is a frequent cause of weight gain, and can also be seen in patients who become fat when exposed to stress, or in women with premenstrual syndrome, or in patients with "winter depression," or in people who are attempting to give up smoking. (Nicotine, like dietary carbohydrates, increases brain serotonin secretion; nicotine withdrawal has the opposite effect.) It also occurs in patients with normal-weight bulimia. Dexfenfluramine constitutes a highly effective treatment for such patients. In addition to producing its general satiety-promoting effect, it specifically reduces their overconsumption of carbohydrate-rich (or carbohydrate-and fat-rich) foods.

Animals↗

PubMed1999

The impact of a shipboard weight control program.

OBJECTIVE: The specific aim was to determine whether a multifaceted approach to weight loss and physical readiness could be implemented onboard a deployed combatant ship of the U.S. Navy. RESEARCH METHODS AND PROCEDURES: Thirty-nine men (31+/-6 years old, mean+/-standard deviation) assigned to the USS ENTERPRISE (CVN 65) during a 6-month Mediterranean deployment who had failed their previous Physical Readiness Test due to excessive body weight (108+/-11 kg overweight) were randomly assigned to nutrition, cognitive-behavioral obesity treatment plus exercise or to the Navy's usual treatment (control), which is exercise alone. RESULTS: Outcomes for the treatment group were significantly better than the controls, with 8.6+/-5.0 vs. 5.0+/-4.1 kg weight loss, 8% vs. 5% reduction in original body weight, and body fat loss of 7% vs. 5%. Triglycerides declined significantly greater in the treatment group than the controls (145 mg/dL to 109 mg/dL vs. 146 mg/dL to 145 mg/dL, p<0.05), whereas depression and eating behaviors significantly improved among treated men. Problematic environmental factors were the limited variety of heart healthy foods in the galley, short meal breaks, and long mess hall lines that led to eating snacks from vending machines and frequent port calls. DISCUSSION: Although greater weight loss than would be expected of a Navy usual care group diluted the treatment effect, the treated men still fared significantly better. The physical readiness implication of this research has the potential to impact Navy health promotion programs and policy, the health and well-being of its personnel, and the Navy's ability to meet mission requirements.

Absorptiometry, Photon↗

PubMed1999

Comparison of high-calorie, low-nutrient-dense food consumption among obese and non-obese adolescents.

OBJECTIVE: The purpose of this study was to determine whether obese adolescents eat more high-calorie low-nutrient-dense foods than non-obese adolescents. RESEARCH METHODS AND PROCEDURES: Using a cross-sectional design, 22 non-obese and 21 obese adolescents kept 14-day food records. Records provided estimates of total daily energy intake and caloric intake from five categories of high-calorie, low-nutrient-dense (HC) foods: candy, chips, soda, baked goods, and ice cream. Body composition was determined by 18O dilution and daily energy expenditure by doubly labeled water. Percentage of energy intake reported (%report) was calculated as the ratio of reported energy intake to measured energy expenditure (x 100%). RESULTS: Both groups underreported energy intake, but the percentage reported was significantly greater in the non-obese group (78.2+/-20.5% non-obese vs. 55.5+/-21.8% obese, p<0.001). Consumption of calories from chips and soda was similar among non-obese and obese adolescents. However, total energy intake from all HC foods was higher in the non-obese group than among the obese (617+/-356 kcal/day vs. 362+/-223 kcal/day; p<0.01) and represented 27.2+/-10.5% and 19.9+/-9.6% of reported energy intake in the non-obese and obese groups, respectively. After adjustment for under-reporting, the percentage of calories provided by each of the HC foods was similar in the obese and non-obese groups except for ice cream, which remained significantly greater in the non-obese group (p<0.05). DISCUSSION: Our findings suggest that both non-obese and obese adolescents consume a substantial portion of reported calories from HC foods and that obese adolescents do not consume more calories from these foods than non-obese adolescents. These data offer no evidence to support the widespread notion that obese adolescents eat more "junk food" than non-obese adolescents. Health professionals who treat obese adolescents must be aware that the excess calories in their diets may come from a variety of food sources and not solely from high-calorie snack foods.

Adipose Tissue↗

PubMed1997

A frequency survey of sugary foods and drinks consumption in school children and adolescents in a West Indian island--Antigua.

In 1991, the pattern of sugar consumption in samples of 172 12-year-old children and 231 15-19-year-old adolescents was studied. Twenty-four hour dietary records of five consecutive days were obtained from each subject. The frequency of total sugary food and drink episodes for children was 3.16 and 3.71 for adolescents. This was mainly accounted for by the consumption of sugary items at meals for both age groups. Students mostly consumed sweetened drinks at meals, especially at breakfast and ate sugary foods between meal times, particularly between lunch and dinner. Sweetened tea and juice were the most popular drinks and confectionery was the most popular snack food.

Adolescent↗

PubMed1995

Physicochemical effects of a new slow-release potassium phosphate preparation (UroPhos-K) in absorptive hypercalciuria.

A new slow-release, neutral potassium phosphate salt (UroPhos-K) has been formulated in order to minimize gastrointestinal side effects and avoid sodium-induced calciuria. It was tested in a prospective randomized, double-blind trial in a group of 21 kidney stone patients with absorptive hypercalciuria type I (AH). Twelve patients allocated to the UroPhos-K group received four tablets twice daily with breakfast and an evening snack providing 1240 mg of phosphorus and 63.5 mEq of potassium daily. Nine patients assigned to the placebo group received placebo tablets of the same appearance containing excipient only. Subjects were studied during a 3-day period in the hospital while consuming a constant metabolic diet containing 400 mg Ca, 100 mEq Na, and 800 mg P per day before and after 3 months of treatment. Treatment with UroPhos-K did not cause any significant gastrointestinal side effects; nor did it raise fasting serum K or phosphorus, or reduce hemoglobin or creatinine clearance. It was associated with a rise in urinary K from 46 +/- 7 to 98 +/- 9 mEq per day and phosphorus from 744 +/- 185 to 1535 +/- 112 mg per day (p < 0.001 each). UroPhos-K treatment reduced urinary Ca from 288 +/- 63 to 171 +/- 49 mg/day (p < 0.001), without altering oxalate excretion. It reduced the urinary saturation of calcium oxalate without altering that of brushite. Moreover, by increasing urinary excretion of inhibitors (citrate and pyrophosphate), it reduced the propensity for spontaneous nucleation of brushite (increased formation product of brushite) and inhibited crystal agglomeration of calcium oxalate.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗

PubMed1993

Gender and age differences in food cognition.

Results from three studies relevant to a model of food cognition based on the evaluative dimensions pleasure, health, and convenience are reported. In the first study, discriminant analyses of the evaluative ratings (n = 248) of 35 meals and snacks yielded significant gender and age differences on the pleasure and health dimensions. Separate factor analyses of the pleasure and health ratings revealed that males and females grouped foods differently on these criteria. The factor analysis of convenience ratings suggested that males and females perceive the meaning of convenience differently. In the second study, 336 college students rated 27 meals on the three evaluative dimensions and also indicated their preferences for each meal. Multiple regression analyses showed that preferences could be significantly predicted, and other results showed that as compared to males, females give higher health, pleasure and convenience ratings to healthy meals. The third study employed a modified free association technique to investigate gender and age differences in the meanings of nine familiar foods. Data from 96 males and females aged 18 to 86 revealed a substantial variety of significant age and gender differences for specific foods. It is suggested that taken together, these results indicate important cognitive and affective sources for gender and age-related food attitudes.

Adolescent↗

PubMed1994

Relations between parental mealtime practices and children's food intake.

The food intake of children aged 3-7 years was related to selected parental and child mealtime behaviours from video recordings of meals in 50 Swedish families and a 7-day weighed record of dietary intake from 39 of these. The children's mean intakes of fat and sucrose were relatively high (23% of energy from sugar-rich snacks) and their energy intake and number of meals were evenly distributed over the day. No relationship between energy intake and overweight was found. Children spent 50% of the total mealtime eating. One-third of all child mealtime behaviours were verbal. Most parental behaviours were verbal with negative, non-eating statements about the child being very common and negatively correlated with child energy intake. The child's energy intake was positively correlated with the child taking food on recommendation by the parent. The results indicate parental influences on children's eating which may have implications for the development of food preferences and overweight in childhood.

Adult↗

PubMed1994

Diets for disease? Intraurban variation in reported food consumption in Glasgow.

A recent official report on the Scottish Diet reviews evidence for poor health and poor diets among the Scots, and makes extensive and specific recommendations about dietary change. This paper examines the extent to which reported consumption of fifteen of the food groups discussed in that report vary among four neighbourhoods in Glasgow City. Some foods appear to be typical of a wider Glaswegian (or Scottish) diet and show little variation among neighbourhoods (e.g. semi-skimmed milk, white fish, confectionery, cakes and pastries, savoury snacks). Other foods however show marked differences between neighbourhoods after controlling for sex, age and social class; these include fruit, vegetables, meat (particularly processed meat products), bread, spreading fats, sugar, natural fruit juice and alcohol. This suggests that such intraurban variations in food consumption cannot be explained simply by socio-demographic or socio-economic factors in individuals and that cultural and supply factors also need to be taken into account.

Adult↗

PubMed1994

Effect of meal macronutrient and energy content on human performance.

The effects of planned meals, varying in carbohydrate (CHO), fat and caloric content, on psychomotor performance by male subjects with unrestricted access to commercially-available foods was investigated in two residential studies. In the first study, two groups of three subjects (n = 6) completed psychomotor tasks before and after consuming a lunch consisting of 431 or 844 kcal, with caloric differences produced through covert changes in either fat or CHO content. The effects of each of four lunch conditions (low-fat, high-fat, low-CHO, high-CHO) were determined for three consecutive days. In the second study, two groups of three subjects (n = 6) received breakfast, lunch and an afternoon snack and completed psychomotor tasks after breakfast and lunch. Cumulative caloric content of the three eating occasions was approximately 700, 1200 or 1700 kcal (low, medium or high), again with differences resulting from covert changes primarily in either fat or CHO content. The effects of each of six food conditions were determined for two consecutive days. While changes in some aspects of performance were altered after meals, the effects were not related to the CHO, fat or caloric content of the meal. When subjects have unrestricted access to commercially-available foods, neither calories nor the relative fat or CHO content of normal meals influence human psychomotor task performance.

Adult↗

PubMed1996

Effect of exercise and dietary restraint on energy intake of reduced-obese women.

Self-selected food intake of 15 reduced-obese women living in a metabolic ward was studied for 14 consecutive days to determine the effect of exercise and other metabolic and behavioral variables on energy intake. A choice of prepared food items were offered at breakfast, lunch and dinner, and a variety of additional food items were available continuously 24 h/day. Subjects performed either moderate intensity aerobic exercise (A-EX) (n = 8) expending 354 +/- 76 kcal/session or low intensity resistance weight training (R-EX)(n =7) expending 96 +/- kcal/session, 5 days/week. Mean energy intakes (kcal/day, +/- SEM) of the exercise groups were similar: 1867 +/- 275 for A-EX, 1889 +/- 294 for R-EX. Mean energy intakes of individuals ranged from 49 to 157% of the predetermined level required for weight maintenance. Resting metabolic rate per kg 0.75 and the Eating Inventory hunger score contributed significantly to the between subject variance in energy intake, whereas exercise energy expenditure did not. Regardless of exercise, eight women consistently restricted their energy intake (undereaters), and seven other consumed excess energy (overeaters). Overeaters were distinguished by higher Eating Inventory disinhibition (P = 0.023) and hunger (p = 0.004) scores. The overeaters' diet had a higher fat content 34 +/- 1% (p = 0.007). Also, overeaters took a larger percentage of their daily energy, than that of undereaters, 27 +/- 1 energy intake in the evening, 13 +/- 2%, compared to undereaters, 7 +/- 1% (p = 0.005). We conclude that the Eating Inventory is useful for identifying reduced-obese women at risk of overeating, and these individuals may benefit from dietary counseling aimed at reducing fat intake and evening snacking.

Adult↗

PubMed1996

Effects of weight and energy content of preloads on subsequent appetite and food intake.

This study was done to determine the relative effects of energy content and weight of ingested food on subsequent satiety and food intake. The weight/volume and the energy content of nine preloads were manipulated, in a 3 x 3 factorial design, to give three weight levels, 250, 500 and 750 g, and three energy levels 0, 1.26 and 2.51 MJ (0, 300 and 600 kcal). The weights were varied by the addition of water, while the energy levels were varied by using yogurt and cream. Each of the 1.26 and 2.51 MJ preloads contained 27 g of protein and 31 g of carbohydrates. The 1.26 MJ preloads contained 8 g of fat and the 2.51 MJ preloads had 41 g of fat. Each of the nine preloads was presented as a lunch to 21 female and 16 male subjects. Two hours after the preloads, subjects consumed sweet and savory snacks and various drinks ad libitum from a buffet. The weight of the preload had a small but statistically significant effect on feelings of hunger and satiety between preload and buffet, and on energy intake during the buffet (5.34, 5.05 and 5.04 MJ after 250, 500 and 750 g preloads). There was a large difference between 0 and 1.26 MJ, but little difference in effect between 1.26 and 2.51 MJ preloads. Mean energy intakes in the buffet after the 0, 1.26 and 2.51 MJ preloads were 6.17, 4.83 and 4.42 MJ. These results suggest that the weight or amount of food affects subsequent appetite and food intake, but the effect of energy is stronger.

Adult↗