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Diet patterns and health problems: diet in southern Europe.

The diet of the populations in southern Europe, particularly those living in the Mediterranean areas, was characterized by a relatively higher consumption of fish, olive oil, vegetables and fruit and by a lower consumption of meat and animal fat. In terms of nutrients the most significant difference between the Mediterranean type of diet and the diet of continental and northern European populations was in the consumption of saturated and monounsaturated fatty acids and to a lesser degree in the intake of protein, sugar and alcohol, as well as in regard to the dietary fiber content. Since the Mediterranean populations have shown a lower total mortality rate as well as a specific mortality from coronary heart disease (CHD) which in part could be explained by their dietary habits, the Mediterranean diet has often been proposed as a prototype on which dietary measures for the prevention of CHD in populations should be developed. However, more recent data indicate that in the last 20 years the food pattern of the Mediterranean populations was subjected to substantial changes, particularly in regard to the increase in meat and dairy product consumption which in turn has resulted in an increase in the percentage of energy of saturated fats and which has also affected the ratio of monounsaturated to saturated fatty acids. These changes have also affected some of the risk factors of CHD in those populations.

Diet

The cumulative dose response effect of eicosapentaenoic and docosahexaenoic acid on blood pressure, plasma lipid profile and diet pattern in mild to moderate essential hypertensive black patients.

In this study eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) were given in a cumulative manner, every 6 weeks, starting with 10 mg, then 100 mg, 1000 mg and 10,000 mg EPA daily to mild to moderate essential hypertensive black patients. The corresponding DHA doses were 3, 33, 333 and 3333 mg. A control group was given olive oil as placebo for the entire 24 weeks. The placebo group had lower diastolic and systolic blood pressures after 24 weeks than the EPA and DHA group. No effect was seen on plasma triglycerides, cholesterol, HDL-cholesterol and gamma-glutamyltranspeptidase at any stage of the trial. In the EPA group plasma free-EPA increased significantly from 1000 mg onwards and plasma free-arachidonic acid (AA) decreased after 1000 mg EPA. No other plasma free essential fatty acid changed during the trial, although the HDL:cholesterol increased slightly but non-significantly with an increase in EPA and DHA. No significant changes in diet pattern or body mass was observed. It is therefore concluded that EPA and DHA supplementation had no beneficial effects in mild to moderate essential hypertensive black patients except for a lowering of plasma AA.

Adult

Effect of feeding amino acid mixtures on lipid transport from rat liver as measured by liver perfusion.

The present study examined lipid transport from the liver by application of a perfusion technique in situ in rats fed diets consisting of a low level Wheat- or Rice- or Miyazaki-pattern amino acid mixture. The net release of hepatic lipids was directly estimated from analysis of the perfusate continuously circulated through the liver. The net release of triacylglycerol from the liver into the perfusate was much more severely inhibited in the Wheat-pattern diet group, and more depressed in the Rice-pattern diet group than in the control group, and slightly reduced in the Miyazaki-pattern diet group compared with the control. For serum lipoproteins fractionated by the Quick-Disc electrophoresis method, there was a significant decrease in the serum pre-beta lipoprotein fraction in all the rats of the Wheat-, Rice- and Miyazaki-pattern diet groups compared with the control. These observations provide firm support for the hypothesis that in rats given diets consisting of a low level of the Wheat-, Rice- and Miyazaki-pattern amino acid mixture, fatty liver may be produced mainly by an impaired transport of triacylglycerols from the liver.

Amino Acids

Changes in diet and patterns of feeding activity of developing rats.

The purpose of this study was to determine the amount of milk and stock diet consumed by rats during postnatal development and the extent to which they feed in circadian rhythms when weaned naturally by their dams or when separated from their dams at age 21 days. One approach used in several experiments was to record feed bin weight losses at circadian intervals. The second approach was to analyze the stomach contents of rats killed at circadian intervals at representative ages. Contents were inspected, freeze-dried, weighed and assayed for fat by extraction with solvent. The difference in fat between rat milk solids and stock diet was the basis for estimating proportions of stock diet and milk. The results indicate that 1) natural weaning occurs progressively from 14 to 30 days after birth, with an accelerated phase between 18 and 25 days; 2) pups up to 8 days old and their dams feed mostly by light and darkness, respectively; 3) circadian variations in feeding are weak and inconsistent in 10 to 20 day old pups and their dams; 4) at 21 days pups and dams begin to feed mostly in darkness; 5) the proportions of food consumed by light and darkness approach those of the adult by age 29 days when rats are weaned naturally, and by 25 days when weaned at 21 days; and 6) progression into the nocturnal feeding pattern may be disturbed if larger litters are not provided with sufficient space.

Age Factors

Attained height of lacto-ovo vegetarian children and adolescents.

The relationship between diet and attained height was studied in children and adolescents in Southern California. Diet pattern was determined from an extensive food frequency questionnaire in 1765 Caucasian children of 7-18 years, attending state schools (452 m and 443 f) and Seventh-day Adventist schools (427 m and 443 f). The major difference in diet pattern between state and Adventist school children was in meat consumption. The Adventist children were split evenly between three categories of frequency in meat consumption (less than 1/week, 1/week-less than 1/d, and greater than or equal to 1/d), while 92 percent of state school children consumed meat daily. Vegetarians (those consuming meat less than 1/week) differed significantly in the consumption of other major food groups, such as fruit and vegetables. All school and diet subgroups were at or above the 50th percentile of the National Center for Health Statistics. Age-adjusted regression analysis showed that on average Adventist vegetarian children were taller than their meat-consuming classmates (2.5 and 2.0 cm for boys and girls, respectively). These results did not change materially when adjusting for other food groups. Nor did adjustment for parental height and socioeconomic factors in a sub-sample of 518 children. The results indicate that vegetarian children and adolescents on a balanced diet grow at least as tall as children who consume meat.

Adolescent

The influence of egg consumption on the serum cholesterol level in human subjects.

The influence of whole fresh eggs on the serum cholesterol level in men and women was studied independently in hospitalized patients in Sofia, Prague and Urbana-Champaign. The patients were fed two eggs or the equivalent of two eggs in a custard base or milk shake in addition to the foods that were consumed in their diet pattern. The serum cholesterol level was determined before and at periods varying from 5 hr to 54 days after the consumption of the eggs. The mixed fatty acid composition of the total lipids in the serum and the erythrocytes was also determined. In the majority of patients, the serum cholesterol level did not change significantly 5 hr after the consumption of 465 mg of cholesterol in an egg custard base or milk shake or after up to 54 days of continued consumption of two whole eggs per day. The serum cholesterol level of some subjects increased and others decreased at all three experimental sites. A comparison of the mixed fatty acid composition of the total serum lipids obtained from men and women who had received treatment for other reasons than cardiovascular disease with those that had been treated for cardiovascular disease indicated that the serum from both groups contained a substantial amount of polyunsaturated fatty acids. The lipids extracted from the red blood cells obtained from patients in Urbana-Champaign and Sofia did not differ significantly in linoleic and arachidonic acid content.

Adult

Nutritional concerns of addicts in treatment.

Some of the subcultural phenomena affecting diet patterns of methadone patients have been utilized to derive principles of treatment intervention. Attitudes and values related to time, treatment personnel, and group identification are important cultural determinants of beliefs and behaviors affecting nutrition. The proposed program of intervention is based on ethnographic observations. This suggested program emphasized the inclusion of cultural identity, sense of uniqueness and group information sharing and reinforcement. These characteristics are valued highly in the informants' subcultural group, and are important components of acceptable proprosals for change within this group.

Adult

Influence of a liquid diet and meal pattern on body weight and body fat in rats.

Rats weighing 110 to 150 g or 250 g initially were utilized in five experiments to determine the effect of the form of the diet (dry versus liquid) and the pattern of feeding (meal-feeding, force-feeding, nibbling, or ad libitum) on body weight gain and on body fat. A high-carbohydrate, 20% casein or 20% lactalbumin diet was fed for 4 to 8 weeks. Consumption of a diet mixed with an equal weight of water increased weight gain in one of three experiments. Body fat content of the rats was not influenced by addition of water to the diet. Neither force-feeding nor meal-feeding influenced body fat gain provided the respective control rats were pair-fed during the initial adaptation period. Likewise, when rats were pair force-fed to ad libitum fed rats without an initial adaptation meal frequency did not influence body fat gain. When meal-fed rats were switched to ad libitum intake their food intake increased to equal that of rats which had been continuously fed ad libitum; however, the rats which had been switched gained more body fat than did rats continuously fed ad libitum. These results suggest that meal frequency may have a minimal influence on body fat accumulation, but that a shift to a higher level of food intake may cause an increased food efficiency and greater rate of fat deposition than in rats continuously fed the higher level of intake.

Adipose Tissue

Effects of high-fat diet on the patterns of prostatic cancer induced in rats by N-nitrosobis(2-oxopropyl)amine and testosterone.

Controversial views exist on the link between prostatic cancer and consumption of high-fat (HF) diet. This topic was examined in experimental prostatic cancer induced in rats by N-nitrosobis(2-oxopropyl)amine (BOP). Groups of Wistar-derived MRC rats were fed a semipurified diet containing either 5% (low fat = LF) or 24.6% (HF) corn oil for life, beginning after weaning. In the short-term study, treatment with testosterone significantly increased the rate of cellular DNA synthesis (as determined by autoradiographs after tritiated thymidine injection) that was not influenced by the level of dietary fat. HF diet alone depressed the rate significantly in the dorsal lobe only. There was a significant increase in the plasma level of estradiol, a decrease in the level of luteinizing hormone, but no changes in the level of follicle-stimulating hormone (FSH) in rats treated with testosterone, with no differences between the HF and LF groups. However, HF in the absence of testosterone depressed the serum FSH level. In the carcinogenicity experiment, all rats fed HF or LF diet developed prostatic cancers (mostly adenocarcinomas). The incidence, however, was significantly higher in testosterone-treated rats. Dietary fat did not influence the incidence, histological patterns, or anatomical distribution of tumors, and there were no differences in the parameters between the HF- and LF-fed groups. Long-term administration of testosterone significantly lowered serum levels of luteinizing hormone but did not change the FSH level and affected estradiol levels to a variable extent. These values were not influenced by dietary fat. However, in the HF-BOP group, significantly higher levels of FSH were found compared with the values in the LF-BOP group. We concluded that (a) under the described experimental conditions, dietary fat, fed ad libitum, does not influence the patterns of prostatic cancer induced in rats by BOP; (b) testosterone alters the serum levels of estradiol and luteinizing hormone; and (c) both testosterone and estradiol could be involved in carcinogenesis.

Animals

Diet and activity patterns of male and female co-workers: should worksite health promotion programs assume homogeneity?

Worksite health promotion programs address the health education needs of the average employee. Anthropometric measurements and 24h diet and activity diaries collected from co-workers reveal that lifestyle and subsequently, health education needs of men and women working for the same employer, in the same environment and performing similar tasks, may be different. In this study, males were marginally overweight and obese; females were within recommended limits. Although job related workloads were comparable, females were more active (24hEE/FFM) outside the work place. Females spent more time engaged in moderate weight-bearing domestic activities than did males. These results question the effectiveness of worksite health promotion program which ignore the different health education needs of male and female employees.

Adult

Growth patterns and nutrition in Nepali children.

A growth survey of four groups of Nepali children from birth to 12 years was undertaken and the growth patterns related to diet. The patterns are those of children suffering from malnutrition in the second and third year and not those of a genetically small race. Diet histories showed inadequacies of diet, mostly preventable, occurring during the same period. Privileged children within the groups showed a different pattern and a significantly better growth.

Anthropometry

Diet and feeding patterns in high risk pre-school children.

A survey of 60 pre-school children both from Anglo-Saxon and Lebanese backgrounds collected detailed information on subjects' oral health status and dietary and feeding habits. Lebanese subjects had significantly higher caries experience (mean dmfs = 4.88) than Anglo-Saxon subjects (mean dmfs = 0.56). Subjects from the different backgrounds varied significantly also in the frequency of exposure to cariogenic agents and health practices. In each situation Lebanese children were exposed to higher risk factors than Anglo-Saxon children. Notwithstanding the association between variables, the best single predictor of variance in caries experience of subjects, explaining 23 per cent of the variance of dmfs, was the mother's level of education. Culturally relevant health education programmes need to address the specific requirements of high risk groups.

Animals

Multiple forms of acetylcholinesterase from rat erythrocytes. Effect of fat-free diet.

Electrophoretic patterns of acetylcholinesterase (acetylcholine hydrolase, EC 3.1.1.7) from rat erythrocyte were studied. The enzyme was solubilized by the following treatments: a) Triton X-100, b) sodium deoxycholate, or c) ultrasonic irradiation. When the erythrocyte membrane was solubilized by Triton X-100 at concentrations higher than 0.3%, by 10 mM sodium deoxycholate, or by ultrasonic irradiation for more than 5 min, a single band of acetylcholinesterase activity appeared in the gel. Two bands of activity were stained in the gel when the membrane was solubilized by Triton X-100 at concentrations between 0.1--0.2%, or by ultrasound for 5 min. Electrophoretic patterns of acetylcholinesterase from rats fed a fat-sufficient diet were similar to those for the enzyme from animals fed a fat-free diet. The recombination of lipids with the enzyme eluted from the gels confirmed the "phenotypic allosteric desensitization phenomenon".

Acetylcholinesterase

New approaches to the pathogenesis of peptic ulcer based on the protective action of saliva with special reference to roughage, vegetable fibre and fermented milk products.

Epidemiologic studies have shown differences in the prevalence of peptic ulcer disease among various communities to be related to variation in diet and eating patterns. Results of studies of the effect of diet and pattern of eating on saliva, on gastric juice, and on the amount of bile are reviewed. It is suggested that bile, and not hydrochloric acid, plays the causative role in pathogenesis of peptic ulceration. The role of saliva in the prevention of peptic ulcer is emphasized. The salivary mucus swallowed with food is protective because it decreases the flow rate of bile which, when held in the gall bladder longer, loses its alkalinity and therefore its ability to damage the mucous cells. Roughage, cellulose and vegetable fibres and fermented milk products act in a similar manner. When food is well masticated, containing plenty of vegetable fibres and fermented milk products such as ghee and yoghurt, resulting in an increase in the amount of salivary mucus, peptic ulceration may be prevented and cured and relapses may be prevented. This does not require a big change in the pattern of diet but only a change in the manner of eating so that hasty eating is avoided and good is chewed well. The pattern of diet, especially the relative dietary preponderance of short-chain fatty acids, such as those present in milk, yoghurt and other fermented milk products, have a protective action; the short-chain fatty acids retard gall bladder contraction and thus diminish the amount of bile entering the duodenal lumen.

Bile

A national nutrition policy: can we devise one?

The reasons for the success of the British food and nutritional policy of the second world war are discussed. Subsequent trends in Britain and elsewhere towards the affluent pattern of diet are described and the current views about diet and heart disease and diet and cancer are summarised. Conclusions are drawn about the need for public education on the modification of diet towards amore prudent pattern. The terms food policy and nutritional policy are distinguished.

Alcohol Drinking

Health implications of fibre-depleted diets.

In many different parts of the world the pattern of diseases has changed or is changing from one mainly of infections to one of degenerative diseases. Simultaneously, alterations in the pattern of diet have occurred or are occurring. A major alteration is depletion of fibre-containing foods of high bulk-forming capacity. Epidemiological evidence, short-term studies on man and experimental investigations on animals suggest that fibre-depleted diets are a major, or perhaps even the basic cause of the increasing prevalence of several degenerative diseases. Although much further research is essential, available evidence warrants recommending an increase in the intake of fibre-containing foods, especially those of cereal origin.

Black or African American

The amino acid pattern of the british diet.

The amounts of the essential amino acids in the average British household food supply have been calculated and compared with those recommended by FAO/WHO. There were large excesses of all essential amino acids, with threonine being the most limiting. When similar calculations were made ten years ago, the sulphur-containing amino acids were the most limiting. The change results not so much from the greater amounts of animal protein which are now eaten as from changes in the reference pattern of amino acids.

Amino Acids

Pregnancy diet based on ancestral patterns increases growth in subcortical fetal brain regions.

Evidence on the biological basis for maternal nutrition effects on fetal and newborn neurodevelopment remains limited. This randomized controlled trial in Ecuador tested a maternal dietary pattern-derived from empirical studies of nutrition in human evolution and adapted locally-on offspring growth and brain development. Pregnant women (n = 215) in their first trimester were randomized to: 1) control (n = 104); or 2) Mikhuna ("nourish" in Kichwa) intervention (n = 111). The intervention, from 12 wk gestation to birth, consisted of a weekly food delivery (8 eggs, 500 g fish, and a variety of sustainably sourced fruits and vegetables) and a behavior change communication strategy encouraging diet diversity and limiting highly processed foods. Longitudinal data collection occurred at 12 wk, 21 wk, 35 wk gestation, and 2 wk postpartum, and included ultrasound imaging of fetal bone and brain parameters, maternal dietary intakes, anthropometry, socioeconomic and demographic variables, and other biomarkers. At close of intervention, a significantly higher percentage of women met the minimum dietary diversity threshold in Mikhuna (74.5%) vs. control groups (55.8%) (P = 0.004). Generalized linear regression models showed significant differences in Mikhuna compared to control for: corpus callosum length 0.19 cm (95% CI [0.02, 0.35]), gangliothalamic ovoid height 0.15 cm (95% CI [0.03 to 0.26]), and femur length -0.10 cm (95% CI [-0.19, -0.02]) from 21 wk to 35 wk; and corpus callosum Z 0.56 (95% CI [0.03, 1.09]) and femur length Z -0.21 (95% CI [-0.42, 0.00]) at 35 wk. The Mikhuna intervention increased the growth of subcortical fetal brain structures, which have established roles in motor control, cognition, and signal transmission.

Female