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Influence of fish oil on blood lipids in coronary artery disease.

The low incidence of coronary artery disease in Greenland Eskimos may be due to their intake of seafood with a high content of n-3 polyunsaturated fatty acids which may have a hypolipidaemic effect. Results of previous studies have been controversial, depending on the dosage of fish oil and the phenotypic cause of the hyperlipoproteinaemia. In this placebo-controlled, double-blind, cross-over study, patients (n = 32) with coronary artery disease and dyslipidaemia received firstly 2.4 g eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids. Thereafter in the open study the same study group received 3.6 g EPA/DHA. Fish oil had no significant effect on serum cholesterol or high density lipoprotein (HDL) cholesterol. Low doses of fish oil (2.4 g EPA/DHA) reduced serum triglyceride level significantly (P less than 0.05) and more significantly (P less than 0.01) with 3.6 g EPA/DHA. The results indicated that the therapeutic effect of n-3 fatty acids as hypolipidaemic agents is greatest in patients with severe hypertriglyceridaemia (greater than 3.00 mmol/l).

Aged↗

Blood pressure during pregnancy in Canadian Inuit: community differences related to diet.

OBJECTIVE: To assess a possible relation between the incidence of hypertension during pregnancy and the consumption of fatty acids found in fish and sea mammals. DESIGN: Retrospective survey of pregnancy-induced hypertension; prospective diet survey. SETTING: Inuit women from seven communities in the Keewatin region of the Northwest Territories. PATIENTS: All women from Arviat (formerly Eskimo Point), Baker Lake, Chesterfield Inlet, Coral Harbour, Repulse Bay, Sanikiluaq and Whale Cove who gave birth between Sept. 1, 1984, and Aug. 31, 1987. MAIN OUTCOME MEASURES: All blood pressure measurements recorded during the pregnancy, incidence of pregnancy-induced hypertension in the seven communities, harvest of country food (food obtained from the land or sea rather than bought in a store) for six of the communities, self-reported consumption of fish, sea mammals and terrestrial mammals by a subgroup of the subjects and levels of phospholipid fatty acids in cord serum samples from a subgroup of the infants. MAIN RESULTS: Significantly lower mean diastolic blood pressure values during the last 6 hours of pregnancy were noted for the women from the three communities with a higher consumption of fish and sea mammals (78.2 [95% confidence limits (CL) 76.6 and 79.9] mm Hg) than for those from the four communities with a lower consumption of such food (81.5 [95% CL 80.1 and 82.9] mm Hg) (p less than 0.005). The relation between community diet type and blood pressure was independent of other factors. Correspondingly, the women from communities with a lower consumption of marine food were 2.6 times more likely to be hypertensive during the pregnancy than those from communities with a higher consumption of marine food (p less than 0.007). Parity (p less than 0.05) and prepregnancy weight (p less than 0.005) were also significantly associated with pregnancy-induced hypertension; however, the relation between hypertension and community diet type remained significant in logistic regression analysis (odds ratio 2.56, p = 0.03). The differences between the community groups were substantiated by the results of the diet survey, the levels of eicosapentaenoic acid (EPA) in the cord serum phospholipids and the harvest data. CONCLUSIONS: Increased consumption of fish may be beneficial for women at risk for hypertension during pregnancy. A prospective randomized trial of fish or EPA supplementation during pregnancy is warranted.

Animals↗

Gamma-linolenic acid, arachidonic acid, and eicosapentaenoic acid as potential anticancer drugs.

Several in vitro studies and limited in vivo investigations showed that some cis-unsaturated fatty acids (c-UFAs) such as gamma-linolenic acid, arachidonic acid, and eicosapentaenoic acid have selective tumoricidal actions. This cytotoxic action of c-UFAs is produced by augmentation of free-radical generation and lipid peroxidation in tumor cells but not in normal cells. Moreover, lymphokines such as interferon and tumor necrosis factor seem to produce their antitumor effects by inducing the release of c-UFAs from the cell-membrane lipid pool and free-radical generation, and several anticancer drugs, especially doxorubicin and vincristine, have the capacity to augment free-radical generation and promote lipid peroxidation. Tumor cells are known to contain low amounts of c-UFAs, have decreased capacity to generate free radicals and lipid peroxides, and are highly susceptible to free radical-induced cytotoxicity compared with normal cells. In addition, c-UFAs and their products can modulate the immune response, augment the respiratory burst of neutrophils and free-radical generation by macrophages, and modify genetic damage induced by mutagens and carcinogens. These evidences, coupled with the observation that the cancer incidence is low in Eskimos on traditionally high-c-UFA diets, suggests that c-UFAs can be exploited as possible anticancer agents either alone or in combination with lymphokines and cancer chemotherapy.

Animals↗

Dental amalgam--the possible contribution to mercury burden in Greenland Inuit.

The possible contribution to the total mercury burden by dental amalgam among Greenland Eskimos has been studied in Nanortalik Health District. A total of 40 individuals have been tested, and no significant differences in whole blood mercury have been found between individuals with and without experience of dental amalgam. Higher values than previously reported for South-West Greenland have been found, mercury (Hg) concentrations reaching a median of 53 microgram Hg/l in males and 42.5 microgram Hg/l in females. A tendency towards covariation with the relative amount of local food items in the diet did not reach significance at a 5% level.

Body Burden↗

[An evolutionary hypothesis on the absence of the Diego antigen (Di-a) in Chibcha Amerindians].

Diego blood group was studied in 141 Amerindian and Eskimo tribes from Alaska and Canada. Twenty six tribes (18%) did not show the Di-a antigen and 20 tribes (77%) were of the Chibcha linguistic Phyla. In the past, the Di-a absence has been related to several ecological factors such as climate and the presence of clines. I advance an alternative explanation regarding the loss of the Di-a allele in the Chibcha genetic divergence which occurred 6000-7000 years ago, as a consequence of random processes and not of natural selection. It is postulated that the Di-a allele is absent in this Amerindian groups only, and that the presence of the antigen in four tribes (Boruca, Ica, Kuna and Sumo) is due to gene flow across neighboring groups of different languages which carry the Di-a antigen.

Blood Group Antigens↗

Immunogenicity of a new Haemophilus influenzae type b conjugate vaccine (meningococcal protein conjugate) (PedvaxHIB).

Haemophilus influenzae type b is responsible for an estimated 15,000 to 20,000 cases of meningitis per year in the United States, mainly in children 2 months to 5 years old. The mortality rate from meningitis due to H influenzae type b infections ranges from 5% to 10%. Despite antibiotic treatment, up to 35% of survivors have permanent neurologic sequelae. In addition to meningitis, H. influenzae type b is responsible for other invasive infections, including epiglottitis, septicemia, cellulitis, septic arthritis, osteomyelitis, pneumonia, pericarditis, and otitis media; approximately 30,000 cases H influenzae diseases occur annually in the United States. The diseases peak in incidence between 6 and 12 months of age, with almost one half of the cases occurring before 1 year of age. About 75% of disease caused by H influenzae type b occurs in children younger than 24 months old. The incidence of disease is higher in children of certain groups, including blacks, Hispanics, Eskimos and Native Americans, young children attending day-care facilities, patients with asplenia or antibody-deficiency syndromes, and children of lower socioeconomic status. There is considerable evidence that antibody to the capsular polysaccharide (polyribosylribitol-phosphate [PRP] of H influenzae type b is protective.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Undifferentiated carcinoma with lymphoid stroma of the major salivary glands.

Undifferentiated carcinoma with lymphoid stroma or lymphoepithelial carcinoma of the major salivary glands is a demographically and histopathologically unique malignancy. Although whites may have the disease, it is preponderantly a carcinoma of North American Eskimos and native Greenlanders. The carcinoma shares many features with undifferentiated nasopharyngeal carcinomas, from which it must be distinguished: histologic appearance, putative relationship with Epstein-Barr virus, predilection for mongoloid races, and response to therapy. In some cases, the carcinoma appears to have evolved from a lymphoepithelial lesion.

Adult↗

Molecular epidemiology of Haemophilus influenzae type b.

Ninety-five percent of systemic Haemophilus influenzae infections in childhood are caused by serotype b organisms. The high risk for mortality and serious sequelae and the increase in antibiotic resistance of H influenzae type b are strong arguments for vaccination. Incidences and age distribution of disease caused by H influenzae type b vary considerably among countries. Compiled data for meningitis show the highest incidences to be among Alaskan Eskimos, Navajo and White Mountain Indians, and aboriginals in Australia. High incidences coincide with a peak incidence in a younger age group. This differs from Finland, where 95% of the cases of disease caused by H influenzae type b occur in children older than 7 months of age. In general, incidences are low in industrial and high in nonindustrial areas. For example, in Gambia the highest age-specific incidence is at 4 to 5 months after birth (H.A.B., unpublished data, 1988). This implies that a vaccine and regimen similar to that used in Finland would not be as efficacious if used in Gambia because of differences in demographics and incidence. Vaccines that confer protection at 3 to 4 months of age are, therefore, strongly desired. Outer membrane proteins and lipopolysaccharides of H influenzae type b have been suggested as alternative vaccine candidates in conjugation with the capsular polysaccharide because they apparently can contribute to the virulence of H influenzae type b. The occurrence and immunogenicity of various outer membrane proteins and lipopolysaccharides among H influenzae type b in industrial and nonindustrial countries and their significance as epidemiologic markers for the spread of disease, the type of disease, the age of acquisition, and their association with antibiotic resistance will be reviewed in this article.(ABSTRACT TRUNCATED AT 250 WORDS)

Bacterial Typing Techniques↗

[Omega-3-fatty acids: their value in nutrition and prevention].

Based on epidemiological, experimental and physiological evidence, this review examines whether omega-3 fatty acids (omega-3-PUFA) are cardioprotective and whether they are therefore relevant to the primary prevention of cardiovascular diseases. The high intake of omega-3-PUFA among Greenlandic Eskimos has been supposed to be a key factor for their low mortality rate of coronary heart disease (CHD). Other ecological studies from Norway and Japan suggest that higher fish consumption might be cardioprotective. Three cohort studies have shown an unequivocal inverse relation between fish-intake and CHD mortality, while two others--possibly for methodological reasons--have not shown clear overall associations. Several biological effects of omega-3-PUFA are known which may moderate and influence positively the pathogenesis of atherosclerosis. However, double-blind trials with clinical endpoints are not yet available to confirm these effects. For the time being, fish oil capsules should not be recommended as cardioprotective dietary supplementation, because some uncertainty about their long-term safety and dosage remains. Fish consumption is safe and modifies the FA-pattern of the diet favourably. From the point of view of prevention, rising fish intake up to twice or three times weekly can therefore be recommended for people residing in Switzerland.

Coronary Disease↗

Botulism among Alaska Natives. The role of changing food preparation and consumption practices.

Alaska Natives have one of the highest rates of food-borne botulism worldwide. All outbreaks have been associated with the consumption of native foods, but in recent years outbreaks have occurred in previously unaffected areas and have involved new food items. Five botulism outbreaks occurred between 1975 and 1985 in an area of southwestern Alaska without previous confirmed outbreaks and among one ethnic group, the Yupik Eskimo. Of the 5 outbreaks, 3 were associated with fermented beaver tail, a nontraditional native food recently introduced into the region. Preparation techniques vary widely within villages and among ethnic groups. Traditional fermentation techniques have changed over the past 50 years; current preparation methods used by some families and ethnic groups may be more favorable for Clostridium botulinum growth. Prevention efforts should be targeted at high-risk subgroups of Alaska Natives who appear to have modified traditional practices and increased their risk of food-borne botulism.

Adult↗

An epidemiological study of the ocular and visual profiles of Oklahoma Cherokees and Minnesota Chippewas.

Over the last three decades some American Indian tribes in North America have received attention in the literature as a minority group with unique visual characteristics. Studies on the refractive status of Indians have shown an increase of refractive errors and particularly an abnormally high prevalence, and amount of, with-the-rule astigmatism. These changes appear to have taken place over the last 40 years. Eskimos, on the other hand, have recently showed an astoundingly high incidence of myopia. Other Native American tribes do not show dramatic changes in myopia or astigmatism. The Public Health Service-Indian Health Service, as an ongoing aspect of their responsibilities to Native Americans, perform screenings on children. This study reports the results of visual screenings primarily of Oklahoma Cherokee and Minnesota Chippewa children.

Astigmatism↗

The paleopathology of the liver.

Paleopathology, the study of disease in ancient remains, adds the dimension of time to our study of health and disease. The oldest finding relating the liver to disease is indirect skeletal evidence of hypervitaminosis A in an early human fossil owing to the ingestion of excessive amounts of animal liver. The earliest evidence of pathologic change in the liver is an example of schistosomal cirrhosis in a 3200 year old Egyptian mummy. Lipofuscin pigment has been identified in the liver of a 1600 year old Eskimo mummy. An experimental study suggests that the potential exists for identifying a wide range of hepatic pathology in mummified remains.

History, Ancient↗

Associations of early childhood infections and reduced hemoglobin levels in a historic cohort of Alaska Native infants.

A retrospective study was carried out to determine the effect of common childhood infectious diseases on the hemoglobin level of a cohort of Alaskan Eskimo children born between 1960 and 1962. Hemoglobin and health records were available on 308 children between 6-11 and 12-17 months of age. Additional records were available on 187 of these children at 18-23 months of age. Episodes of chickenpox, measles, pertussis, and lower respiratory infections were reviewed. Between 38 and 50% of infants between 6 and 23 months of age had hemoglobin levels below 11.0 g/dl. The mean hemoglobin level of infants 6-11 and 12-17 months of age decreased with increasing number of total infectious episodes occurring within the 3 months before hemoglobin measurement. This trend was not apparent for infants in the 18-23 months age interval nor were low hemoglobins predictive of illness during the 3 months after the hemoglobin determination. At the 6-11 and 12-17 month age interval the number of lower respiratory infectious were most significantly associated with a decreased hemoglobin value. These observations are consistent with more recent reports that document iron deficiency anemia among children with antecedent infections and again emphasize the role of infection in the development and maintenance of anemia in children about 1 year of age.

Alaska↗

Low prevalence of psoriasis in Norwegian lapps.

The prevalence of psoriasis was found to be 0.6% in 2 000 pure Lapps from Kautokeino. Similar low prevalences have been found in Mongolians and Eskimos. HL-A studies have suggested a common origin for these populations.

Female↗

[Three-dimensional measurement of the maxillary first molar in Australian whites].

The occlusal surfaces of upper first molars of Australian Whites were measured in three dimensions with the aid of moiré contourography. The dental casts had been collected from Australian White twins who were considered to be of European stock and the casts housed in the Department of Dentistry, The University of Adelaide, South Australia. In the present study, our first aim was to describe the three-dimensional features of occlusal surfaces of molars in Australian whites. One cast was selected from each monozygotic twin pair at random. A total of 24 males and 15 females were photographed. The results obtained in the present study were compared with those of other human populations previously reported. Cusp height of Australian Whites showed intermediate mean values among 8 populations, but mean intercuspal distances were smaller. This feature, such as small size of occlusal surface but relatively high cusps, also found in Dutch and Asiatic Indian. Mean cusp heights in this population of showed similar values between sexes. Mean differences were insignificant as in Asiatic Indian, Australian Aboriginals, and Bantu unlike the Mongoloid, Japanese and Eskimo populations, where there were significant sex differences in cusp heights. This sexual dimorphism in cusp height among human populations is discussed phylogenetically and functionally.

Australia↗

Cyclooxygenase and lipoxygenase pathways in anterior uvea and conjunctiva.

It has been demonstrated that normal, uninflamed, anterior uvea and conjunctiva of different species have the capacity to synthesize cyclooxygenase and lipoxygenase products. Cyclooxygenase activity is greater than lipoxygenase activity in both anterior uvea and conjunctival tissues. Other ocular tissues such as cornea, lens, and retina were found to have much lesser capacity than the conjunctiva and anterior uvea to synthesize cyclooxygenase and lipoxygenase products from arachidonic acid. In our preliminary studies, we also observed that human retina have considerably less ability to metabolize AA into cyclooxygenase and lipoxygenase activity. The finding that the anterior uvea of all species studied has a high capacity to synthesize PGs and other cyclooxygenase products maybe of particular physiological significance since several investigators have demonstrated that PGE2 and PGF2 alpha in low doses, lower intraocular pressure in all species studied, including the human eye. Additionally, PGE2 can be shown to have some anti-inflammatory effects. In light of these observations, we must consider that the high endogenous cyclooxygenase activity in normal conjunctiva and anterior uvea may play a role in maintaining normal intraocular pressure and in preventing the development of inflammation in response to normal environmental stimuli. Arachidonic acid is also metabolized into biologically active compounds by cytochrome P450 in corneal endothelium. It is not yet known whether or not other ocular tissues also have the ability to metabolize arachidonic acid via this pathway and whether these compounds, when synthesized from endogenous arachidonic acid stores in vivo have any biological effects on the eye. Studies on omega-3 fatty acid metabolism were done for two main reasons: (1) PGE3 and PGD3 lowered intraocular pressure without causing ocular inflammation in rabbit; and (2) some surveys demonstrated that in Greenland Eskimos whose marine diet is enriched with omega-3 substrate eicosapentaenoic acid, have a lower incidence of open-angle glaucoma as compared to Caucasians, whose diet is rich in arachidonic acid. The ability of anterior uvea to synthesize PGE3 and PGD3 in human, monkey, and rabbit anterior uvea warrants further investigation to determine whether or not these omega-3 PGs play a role in lowering intraocular pressure.

Animals↗

[Effects of omega-3-fatty acids on the prostaglandin system in healthy probands].

Epidemiological comparisons of Greenland Eskimos and mainland Danes suggested that a diet rich in marine lipids mainly containing polyunsaturated fatty acids may be associated with a reduction in the incidence of occlusive vascular disease. Fish oils contain the Omega-3 polyunsaturated fatty acid eicosapentaenoate (timnodonic acid, EPA, 20:5n-3), which is incorporated into the platelet membrane after dietary intake instead of arachidonic acid (20:4n-6), the main substrate for prostaglandin synthesis. After incorporation of the fatty acids into the platelet membrane the overall effect of prostanoids with three double bonds derived from EPA proves to be less atherogenic. Since only TxA2 is a potent vasoconstrictor and platelet agonist whilst TxA3 is virtually biologically inert.

Adult↗

Genetic epidemiology of Greenland.

The Inuit (Eskimo) gene pool is in many respects similar to that of East Asian populations. Some polymorphisms imply frequent occurrence of disorders comparatively rare in Western Europe (e.g. lactose and sucrose malabsorptions). Low frequencies of alleles for slow isoniazid acetylation and sparteine/debrisoquine oxidation indicate slow elimination of a multitude of drugs. Autoimmune disorders (e.g. rheumatoid arthritis, insulin dependent diabetes mellitus, Graves' disease and psoriasis) are rare, possibly explained by the associations of these disorders with HLA-alleles rare in Inuit (e.g. HLA-B8). Correspondingly high incidence of reactive arthritis may be explained by a frequent HLA-B27 allele. Prevalence of disorders due to instability of mesenchymal tissues (e.g. spondylolisthesis, osteoarthrosis, hernia, heart block) are still in want of a biochemical explanation. Attention is drawn to the urgency of genetic studies in the Arctic because of the accelerating hybridization of Inuit in all circumpolar areas.

Genetic Diseases, Inborn↗