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PubMed1986

Impact of hormonal contraceptives vis-à-vis non-hormonal factors on the vitamin status of malnourished women in India and Thailand. World Health Organization: Special Programme of Research, Development and Research Training in Human Reproduction. Task Force on Oral Contraceptives.

The effects of combined oral contraceptives containing 30 or 50 micrograms ethinyl oestradiol and 150 micrograms levonorgestrel or a 3-monthly injectable preparation depo-medroxyprogesterone acetate (DMPA) on the vitamin status of low-income group women from two urban centres in India (Bombay and Hyderabad) and one rural centre in Thailand (Chiang Mai) were examined in a follow-up study over a period of 1 year. The magnitude of malnutrition in the study population vis-à-vis a middle-income reference group was assessed by comparing the baseline data on the two groups. Effects of time-related variables such as lactation and season were also examined by a cross-sectional analysis of the baseline data on the study population. In all three centres the majority of the study population suffered from biochemical riboflavin and/or pyridoxine deficiency even before initiating contraception. Lactation appeared to have an effect on the vitamin status, which varied among the different populations. Seasonal effects were seen, but showed inconsistent trends in the three centres. Both the oral contraceptive pills and DMPA tended to increase serum vitamin A and blood folate. The thiamin, riboflavin and pyridoxine status of the women who were already deficient did not deteriorate further with the use of hormonal contraception, as judged by enzyme saturation tests. Some deterioration in the riboflavin status of the normal women of Hyderabad was seen with the use of oral pills. Women who were biochemically deficient prior to the use of oral contraceptives tended to show some improvement in B-vitamin status, over the 1-year period of hormonal contraception.

Adolescent↗
PubMed1986

Nutrition, immune response, and outcome.

The immune system plays a key role in the body's ability to fight infection and reduce the risk of developing tumors, autoimmune and degenerative disease. Nutritional deficiencies and excesses influence various components of the immune system. Early studies investigating the association between nutrition and immunity focused on generalized protein-energy malnutrition, particularly in children in developing countries. The extent of immunological impairment depends not only on the severity of malnutrition but on the presence of infection and on the age of onset of nutritional deprivation, among other factors. In industrialized nations, immune function has been shown to be compromised in many malnourished hospitalized patients, small-for-gestational age infants, and the elderly. Obesity also may adversely influence immune function. Imbalances of single nutrients are relatively uncommon in humans, and investigations of protein and amino acids and specific vitamins, minerals, and trace elements generally are carried out in experimental animals. Deficiencies of protein and some amino acids, as well as vitamins A, E, B6 and folate, are associated with reduced immunocompetence. In contrast, excessive intake of fat, in particular polyunsaturated fatty acids (e.g. linoleic and arachidonic acids), iron, and vitamin E are immunosuppressive. Trace elements modulate immune responses through their critical role in enzyme activity. Both deficiency and excess of trace elements have been recognized. Although dietary requirements of most of these elements are met by a balanced diet, there are certain population groups and specific disease states which are likely to be associated with deficiency of one or more of these essential elements. The role of trace elements in maintenance of immune function and their causal role in secondary immunodeficiency is increasingly being recognized. There is growing research concerning the role of zinc, copper, selenium, and other elements in immunity and the mechanisms that underlie such roles. The problem of interaction of trace elements and immunity is a complex one because of the frequently associated other nutritional deficiencies, the presence of clinical or subclinical infections which in themselves have a significant effect on immunity, and finally the altered metabolism due to the underlying disease. There are many practical applications of our recently acquired knowledge regarding nutritional regulation of immunity.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗
PubMed1986

[Alimentary, metabolic and toxic osteopathies in adults].

Skeletal changes in deficient or badly balanced nutrition (alimentary osteopathies) and osseous changes accompanying chronic disease of internal organs and metabolic disorders (metabolic osteopathies) are discussed. Basically, the classical generalised skeletal changes such as osteoporosis, osteomalacia, fibroosteoclacia and sclerosis of the bone can occur in their pure form or as a combination of two ore more of these disorders. Finally the exogenic toxic osteopathies are discussed, nowadays fluorosis being the most important. Other external factors may be drugs such as methotrexate and antiepileptic medications.

Adult↗
PubMed1986

Complications of parenteral nutrition.

There have been no controlled studies that clearly document a beneficial effect of TPN on neonatal mortality and morbidity. Beneficial effects such as reducing the time required to achieve some targeted weight and enhancing positive nitrogen balance are used in support of TPN. The positive opinion about TPN is strongly supported by the experience in surgical patients with GI disorders. It is not surprising that use of TPN is a complex therapy in newborn patients. It is an essential therapy in many patients if nutrition is to be maintained that permits growth and promotes resolution of other chronic problems. Accurate determination of the requirements for TPN is difficult, while complications are not always preventable by simply monitoring blood chemistries. Because of the acute or long-term and potentially lethal complications, there is need for further understanding in parenteral nutrition.

Avitaminosis↗
PubMed1987

[8 cases of African noma. The therapeutic importance of nutrition].

Eight cases of noma observed in black Africa included five children examined during the first few days of the affection. They were aged between 4 and 5 years and had energy, protein and vitamin (pre-kwashiorkor) deficiency. Spontaneous recovery is possible if the nutritional lack is corrected immediately.

Adolescent↗
PubMed1988

Common nutritional disorders in the elderly: atypical manifestations.

Nutritional problems are commonly seen in elderly persons living in both community and institutional settings. Multiple interacting medical problems, age-related physiological changes, and low socio-economic status are just some of the factors placing the older person at greater risk for nutritional problems. Nutritional inadequacies often have a slow and insidious onset; many of the presenting features mimic changes of normal aging. Absence of clear-cut signs and symptoms may easily lead to a delay in the diagnosis of these potentially serious yet easily reversible conditions. Practicing physicians need to keep in mind the atypical presentation nutritional deficiencies may have in old age.

Aged↗
PubMed1987

[Malnutrition and the immune system].

The immune system is governed by a large number of influences. An important support of the nutritional dependent changes of the reaction to immunity is represented by the prostaglandin and leukotriene system. The basis are essential and non-essential highly unsaturated fatty acids which are transformed by the body's own enzyme system in oxidative steps. As coenzyme and cosubstrate, for instance Vitamin B6 and zinc, are needed--tests show the influence of pyridoxine and folic acid on the immune system. The significance of minerals, especially zinc, iron and selenium, for the immune metabolism will be demonstrated. Selenium deficiency leads, evidently, to a reduction in the ability to stimulate the lymphocytes and decreases the phagocytosis index of the macrophages--some risk groups, responsible for the appearance of the state of malnutrition, will be pointed out and pharmaco-therapeutic prevention measures will be described.

Avitaminosis↗
PubMed1985

Nutritional deficiencies in institutionalized mentally retarded and physically disabled individuals.

The folic acid, riboflavin, and vitamin A status of 150 individuals in a hospital for mentally retarded persons was examined. Because many of the subjects were incontinent, it was necessary to use blood samples. Folic acid deficiency was determined from plasma levels and from examination of stained peripheral blood smears for megaloblastic changes in the leucocytes. Riboflavin deficiency was determined from estimation of erythrocyte glutathione reductase and vitamin A in plasma by a colorimetric method. Twenty percent of the subjects had evidence of folic acid deficiency, 17% had evidence of riboflavin deficiency, and none had vitamin A deficiency.

Adolescent↗
PubMedDate not supplied

Association of esophageal cytological abnormalities with vitamin and lipotrope deficiencies in populations at risk for esophageal cancer.

Esophageal brush cytological screening was undertaken and blood concentrations of micronutrients (vitamin A, E, B12, folic acid and methionine) determined from adults at risk for esophageal carcinoma (EC) in Transkei and Ciskei, Southern Africa. Age-standardised EC rates per 100,000 per annum for both sexes in high, intermediate and low risk districts in Transkei were 74, 51 and 34, respectively. Corresponding rates in high and low EC risk districts in Ciskei were 129 and 9, respectively. Esophageal cytological changes including esophagitis, signs of folic acid deficiency, cellular atypia, dysplasia and cancer, were more prevalent in patients from high than from low EC risk areas. Dietary questionnaires revealed that corn was the main dietary staple in all populations, but that lower intakes of green vegetables, fruits and animal protein occurred in the high risk areas. Significantly lower concentrations of vitamins A, E, B12 and folic acid were present in the blood of patients presenting with cellular dysplasia or malignancy than in cytologically normal patients and in patients from low risk areas. Concentrations of red cell and plasma folate were significantly lower in patients presenting with cytological signs of folic acid deficiency or cellular atypia. The association of vitamin A, vitamin E and folic acid deficiencies with specific esophageal cytological abnormalities in populations at risk for EC is reported for the first time.

Adult↗