RESUMO
Lactose is a unique component of breast milk, many infant formulas and dairy products, and is widely used in pharmaceutical products. In spite of that, its role in human nutrition or lactose intolerance is generally not well-understood. For that reason, a 2-day-long lactose consensus meeting with health care professionals was organized in Mexico to come to a set of statements for which consensus could be gathered. Topics ranging from lactase expression to potential health benefits of lactose were introduced by experts, and that was followed by a discussion on concept statements. Interestingly, lactose does not seem to induce a neurological reward response when consumed. Although lactose digestion is optimal, it supplies galactose for liver glycogen synthesis. In infants, it cannot be ignored that lactose-derived galactose is needed for the synthesis of glycosylated macromolecules. At least beyond infancy, the low glycemic index of lactose might be metabolically beneficial. When lactase expression decreases, lactose maldigestion may lead to lactose intolerance symptoms. In infancy, the temporary replacing of lactose by other carbohydrates is only justified in case of severe intolerance symptoms. In those who show an (epi)genetic decrease or absence of lactase expression, a certain amount (for adults mostly up to 12 g per portion) of lactose can still be consumed. In these cases, lactose shows beneficial intestinal-microbiota-shaping effects. Avoiding lactose-containing products may imply a lower intake of other important nutrients, such as calcium and vitamin B12 from dairy products, as well as an increased intake of less beneficial carbohydrates.
Assuntos
Dieta , Intolerância à Lactose , Lactose , Adulto , Criança , Consenso , Microbioma Gastrointestinal , Humanos , Lactente , Lactase , México , Ciências da Nutrição/organização & administraçãoRESUMO
Umbilical veins (UV) and arteries (UA) of preeclamptic women in Curaçao harbor lower long-chain polyunsaturated fatty acids (LCP). The present aim was to test these findings in Mwanza (Tanzania), whose inhabitants have high LCPomega3 and LCPomega6 intakes from Lake Victoria fish. Women with preeclampsia (n=28) in Mwanza had lower PUFA and higher 20:0 in UV and UA, compared with normotensive/non-proteinuric controls (n=31). Their UV 22:6omega3, 22:4omega6, LCPomega6, omega6, and LCPomega3+omega6 were lower, while saturated FA, potentially de novo synthesized FA (Sigmade novo) and (Sigmade novo)/(LCPomega3+omega6) ratio were higher. Their UA had higher 16:1omega7, omega7, 18:0, and 16:1omega7/16:0. Umbilical vessels in Mwanza had higher 22:6omega3, LCPomega3, omega3, and 16:0, and lower 22:5omega6, 20:2omega6, 18:1omega9, and omega9, compared to those in Curaçao. Preeclampsia in both Mwanza and Curaçao is characterized by lower LCP and higher Sigmade novo. An explanation of this might be placental dysfunction, while the similarity of umbilical vessel FA-abnormalities in preeclamptic and diabetic pregnancies suggests insulin resistance as a common denominator.
Assuntos
Ácidos Graxos Ômega-3/análise , Ácidos Graxos Ômega-6/análise , Ácidos Graxos/análise , Produtos Pesqueiros , Pré-Eclâmpsia/metabolismo , Cordão Umbilical/química , Adolescente , Adulto , Gorduras Insaturadas na Dieta/metabolismo , Ácidos Graxos Insaturados/análise , Feminino , Humanos , Antilhas Holandesas , Gravidez , Tanzânia , Artérias Umbilicais/química , Veias Umbilicais/química , Adulto JovemRESUMO
This study investigated the relationship between platelet (PLT) serotonin (5-HT) and intestinal permeability in children with pervasive developmental disorders (PDD). Differential sugar absorption and PLT 5-HT were determined in 23 children with PDD. PLT 5-HT (2.0-7.1 nmol/10(9) PLT) was elevated in 4/23 patients. None exhibited elevated intestinal permeability (lactulose/mannitol ratio: 0.008-0.035 mol/mol). PLT 5-HT did not correlate with intestinal permeability or GI tract complaints. PLT 5-HT correlated with 24 h urinary 5-hydroxyindoleacetic acid (5-HIAA; p = .034). Also urinary 5-HIAA and urinary 5-HT were interrelated (p = .005). A link between hyperserotonemia and increased intestinal permeability remained unsupported. Increased PLT 5-HT in PDD is likely to derive from increased PLT exposure to 5-HT. Longitudinal studies, showing the (in)consistency of abnormal intestinal permeability and PLT 5-HT, may resolve present discrepancies in the literature.
Assuntos
Plaquetas/metabolismo , Transtornos Globais do Desenvolvimento Infantil/fisiopatologia , Absorção Intestinal/fisiologia , Serotonina/sangue , Criança , Transtornos Globais do Desenvolvimento Infantil/diagnóstico , Diarreia/fisiopatologia , Feminino , Humanos , Ácido Hidroxi-Indolacético/urina , Síndrome do Intestino Irritável/diagnóstico , Síndrome do Intestino Irritável/fisiopatologia , Lactulose/metabolismo , Masculino , Manitol/metabolismo , Fatores de Risco , Sacarose/metabolismo , Venezuela , Vômito/diagnóstico , Vômito/fisiopatologiaRESUMO
We determined optimal folate, vitamin B12 and vitamin B6 dosages in 21 sickle cell disease (SCD) patients (11 HbSS, 10 HbSC; mean 7 years, range 7-16), using plasma homocysteine (Hcy) as functional marker. They received daily 400 g (0-3 weeks), 700 g (3-6) and 1000 g (6-70) folate; 1 (0-21), 3 (21-45 and 5 RDA (45-70) vitamin B12; and 1 RDA vitamin B6 (0-70). Blood was taken at baseline (P0) and after 3 (PI), 6 (P2), 9 (P3), 21 (P4), 33 (P5), 45 (P6), 57 (P7) and 70 (P8) weeks for measurement of erythrocyte (RBC), serum folate, plasma vitamin B12, whole blood vitamin B6 and plasma Hcy. Vitamin B6 increased from P0 to P1 and P1 to P2; vitamin B12 from P4 to P8; serum folate from P0 to P1 and P1 to P2; RBC folate from P0 to P1, P1 to P2 and P2 to P3. Hcy decreased from P1 to P2 and P4 to P6. Most pronounced Hcy decreases occurred from P0 to P1 (43 percent of patients), P1 to P2 (14 percent) and P4 to P5 (24 percent). Haematological indices did not change. Patients with HbSS had higher RBC folate at P1, P2 and P8. The entire group exhibited inverse relations between RBC folate and haemoglobin on P1, P2, P3, P6, P7 and P8. We conclude that RBC folate is less valuable for folate status assessment in SCD patients. The optimal daily supplement is 700 g folate (3.5-7 RDA vitamin B12 (4.2-6.0 g) and 1 RDA vitamin B6 (1.4-2.0 mg). This combination causes Hcy levels that do not decrease further upon higher dosages and may reduce by simple and relatively inexpensive means their inherently high risk of endothelial damage.(Au)
Assuntos
Criança , Humanos , Anemia Falciforme/sangue , Deficiência de Vitamina B 12/dietoterapia , Deficiência de Vitamina B 6/dietoterapia , Ácidos Pteroilpoliglutâmicos/deficiência , Coleta de DadosRESUMO
Recently, several reports have shown endothelial activation to play an important role in the pathophysiology of sickle cell vaso-occlusion. We measured serum soluble VCAM-1 and soluble ICAM-I levels in steady state paediatric sickle cell patients. TNF, an endothelial activating cytokine, was also measured. sVCAM-I levels were increased as compared to age, sex and race-matched controls (p=0.002), whereas sICAM-I levels were not significantly enhanced. TNF levels were also elevated in paediatric sickle cell patients as compared to controls (p=0.01). These results show that endothelial activation is already manifest at a very young age in sickle cell patients, probably resulting from enhanced endothelial activating cytokines, such as TNF.(AU)
Assuntos
Criança , Pré-Escolar , Lactente , Humanos , Anemia Falciforme/sangue , Anemia Falciforme/fisiopatologiaRESUMO
Trinidadian Indians and Africans have different coronary artery disease (CAD) incidences. We determined apolipoprotein-E (apo-E) genotypes, and umbilical plasma cholesterol, triglycerides, apo-A1, apo-B and lipoprotein(a) [Lp(a) in 294 consecutive newborns in Trinidad. We calculate the apo-B/apo-A1 ratio and an adapted "lipid tetrad index" (i.e cholesterol*triglycerides*Lp(a)/apo-A1). Apo-E genotype distributions of Trinidadian Africans (allele frequencies: apo-e2:e3:e4=10.4:66.4:23.2 percent) and Indians(e2:e3:e4=3.5:83.1:13.4 percent) were different. The apo-E genotype distribution of Trinidadian Africans resembles to a certain extent that of their counterpart in Curacao and Sudan, but not that of cuonterparts in Nigeria and the USA.(AU)
Assuntos
Humanos , Apolipoproteínas E/genética , Doença das Coronárias/genética , Trinidad e Tobago , Fatores de RiscoRESUMO
We investigated whether paediatric patients with sickle cell disease (9ñ4 years; 27 HbSS; 19 HbSC) have different folic acid status compared with age-, sex-and race-matched HbAA controls (n=20), and whether their folic acid status can be improved by folic acid supplementation. The patients were supplemented with vitamins B6 and B12 during one week and with folic acid during the next week. Circulating folic acid, homocysteine, vitamin B6 and vitamin B12 levels were measured at baseline (patients and controls), after 1 and 2 weeks (patients). The patients had similar folic acid, vitamin B6 and vitamin B12, but higher homocysteine levels, compared with HbAA controls (12.7ñ4.5 vs 10.9ñ3.5 mmol/l;p=0.04). Vitamin B6 and B12 supplementation did not change their homocysteine levels, but folic acid supplementation caused a 52 percent reduction (to 5.7ñ1.6). We conclude that patients with sickle cell disease have adequate vitamin B6 and B12 status, but suboptimal folic acid status. They may benefit from folic acid supplementation to reduce their high risk for endothelial damage.(AU)
Assuntos
Criança , Humanos , Anemia Falciforme/fisiopatologia , Deficiência de Ácido Fólico , Deficiência de Vitamina B 12 , Deficiência de Vitamina B 6 , Deficiência de RiboflavinaRESUMO
We determined the fatty acid compositions of maternal and umbilical platelets (PLT), and of the umbilical arteries (UA) and veins (UV) of 27 preeclamptic pregnancies and 24 normotensive controls, mostly of Afro-Caribbean descents. Between-group differences were analyzed with the Kruskal-Wallis test or with analysis of convariance with gestational age as covariate. PLT of preeclamptic women contained lower 20:5 w3, and a higher 20.4 w6/20:5 w3 ratio. Linear discriminant analysis revealed higher 20:4 w6. Major differences were found in UV and especially UA fatty acid compositions. UA and UV of preeclamptic pregnancies contained lower long chain polyunsaturated fatty acids of the w3-series (LCPUFA w3), LCPUFA w6 and 20:3 w6. UA had lower 20:4 w6 higher 20:3 w9 and 20:3 w9/20:4 w6. We conclude that the low LCPUFA w3 and LCPUFA w6 levels in umbilical vessels of preeclamptic women with adequate w6 status may indicate insufficient LCPUFA transplacental transfer. The low 20:4 w6, high 20:3 w9 and high 20:3 w9/20:4 w6 ratio in UA may unfavourably affect local prostacylin production and cause other 20:3 w9 related adverse effects. Low 20:3 w6 in UV and UA, and low 20:5 w3 in maternal PLT, may contribute to the dominance of 20:4 w6 derived eicosanoids.(AU)
Assuntos
Artérias Umbilicais/fisiologia , Veias Umbilicais/fisiologia , Pré-Eclâmpsia/fisiopatologia , Ácidos Graxos InsaturadosRESUMO
We studied lipids, apolipoprotein-E (apo-E) genotypes and other coronary artery disease (CAD) risk factors of 67 CAD patients (male/female ratio 5) in Curacao. Compared with 57 controls, male CAD patients had higher cholesterol, triglycerides, LDL-cholesterol, apo-B and decreased HDL-cholesterol and HDL-cholesterol/cholesterol concentrations. Other CAD risk factors were: increased fasting glucose and Hba concentration, decreased creatinine clearance, and increased prevalences of lipoprotein (a) concentration > 500 mg/l, renal disease, hyperhomcysteinaemia, diabetes mellitus type II (DM-II), positive CAD family history and cigarette smoking. Male CAD patients had higher plasma Ó-tocopherol. Compared with 29 female controls, female CAD patients had higher fasting plasma glucose with HbA concentrations, and prevalence of DM-II. Predicting factors for CAD development in the whole CAD group were: DM-II, cigarette smoking, apo-E/E and apo-E/E Apo-E was associated with lower HDL-and higher LDL-cholesterol concentrations. There is a need for local studies on improvement of diabetic control, reference values of lipoprotein (a) and homocysteine concentrations, on apolipoprotein (a) phenotypes, causes of hyperhomocysteinaemia, and dietary influences on CAD development in subject who carry the apo-E allele.
Assuntos
Adulto , Feminino , Humanos , Apolipoproteínas E/genética , Doença das Coronárias/genética , Lipídeos/genética , Estudos de Casos e Controles , Fatores Sexuais , Fatores de Risco , Doença das Coronárias/etiologia , Suscetibilidade a Doenças , Alelos , GenótipoRESUMO
Patients with coronary artery diseases are advised to augment their dietary linoleic acid intakes at the expense of saturated fatty acids. We investigated whether the dietary linoleic acid intake of 57 patients with coronary artery disease (47 males, 10 females; ages 61 ñ 10 years) in Curacao is higher as compared with 77 controls (51 males, 26 females; ages 56 ñ 7 years). For this, we measured plasma cholesterol ester fatty acids, which reflect the dietary fatty acid composition of the preceeding weeks. Patients with coronary artery disease and controls had minor differences in cholesterol ester fatty acids. Their cholesterol ester linoleic acid content suggests that the dietary polyunsaturated/saturated fatty acid ratio is far below 1. Comparison with data reported for the the Netherlands, Greenland and Crete showed that the dietary fatty acid composition in Curacao is typically Western with a high intake of saturated fatty acids, a low intake of monounsaturated fatty acids and the consumption of linoleic acid as the predominant polyunsaturated fatty acid. Intake of long chain polyunsaturated fatty acids from fatty fish is low. Reduction of dietary saturated fatty acids, augmentation of fish consumption, and an increase of the Ó-linolenic/linoleic acid ratio are likely to be of benefit to both primary and secondary prevention from coronary artery disease in Curaco.