Bioavailability of iron, zinc, and other trace minerals from vegetarian diets

Integrating nutrient bioavailability and co-production links when identifying sustainable diets: How low should we reduce meat consumption?

Background

Reducing the consumption of meat and other animal-based products is widely advocated to improve the sustainability of diets in high-income countries. However, such reduction may impair nutritional adequacy, since the bioavailability of key nutrients is higher when they come from animal- vs plant-based foods. Meat reduction may also affect the balance between foods co-produced within the same animal production system.

Objective

The objective was to assess the impact of introducing nutrient bioavailability and co-production links considerations on the dietary changes needed − especially regarding meat ‒ to improve diet sustainability.

Methods

Diet optimization with linear and non-linear programming was used to design, for each gender, three modeled diets departing the least from the mean observed French diet (OBS) while reducing by at least 30% the diet-related environmental impacts (greenhouse gas emissions, eutrophication, acidification): i) in the nutrition-environment (NE) model, the fulfillment of recommended dietary allowances for all nutrients was imposed; ii) in the NE-bioavailability (NEB) model, nutritional adequacy was further ensured by accounting for iron, zinc, protein and provitamin A bioavailability; iii) in the NEB-co-production (NEB-CP) model, two links between co-produced animal foods (milk–beef and blood sausage–pork) were additionally included into the models by proportionally co-constraining their respective quantities. The price and environmental impacts of individual foods were assumed to be constant.

Results

‘Fruit and vegetables’ and ‘Starches’ quantities increased in all modeled diets compared to OBS. In parallel, total meat and ruminant meat quantities decreased. Starting from 110g/d women’s OBS diet (168g/d for men), total meat quantity decreased by 78%, 67% and 32% for women (68%, 66% and 62% for men) in NE, NEB and NEB-CP diets, respectively. Starting from 36g/d women’s OBS diet (54g/d for men), ruminant meat quantity dropped severely by 84% and 87% in NE and NEB diets for women (80% and 78% for men), whereas it only decreased by 27% in NEB-CP diets (38% for men). The share of energy and proteins of animal origin was similar for the 3 modeled diets (approximately 1/5 of total energy, and 1/2 of protein) and lower than in OBS diet (approximately 1/3 of total energy, and 2/3 of protein).

Conclusions

Decreasing meat content was strictly needed to achieve more sustainable diets for French adults, but the reduction was less severe when nutrient bioavailability and co-production links were taken into account.

Application of CE-ICP-MS and CE-ESI-MS/MS for identification of Zn-binding ligands in Goji berries extracts

The identification of groups of ligands binding metals is a crucial issue for the better understanding of their bioaccessibility. In the current study, we have intended an approach for identification of Zn-binding ligands based on using capillary electrophoresis combined with inductively coupled plasma mass spectrometry (CE-ICP-MS) and tandem electrospray ionization mass spectrometry (CE-ESI-MS/MS). The approach, which featured the use of the coupling of capillary electrophoresis with inductively coupled plasma mass spectrometry allows to separate and observe zinc ions present in complexes with respect to their size and charge and to identify nine compounds with zinc isotopic profile. CE-ICP-MS provides us with information about presence of zinc species and elemental information about zinc distribution. CE-ESI-MS/MS provide us with information about the most favorable Zn binding ligands: amino acids, flavonols, stilbenoids, fenolic acids and carotenoids. The presented work is the continuation of previous studies based on using LC-ESI-MS/MS, though, now we presented a new solutions with the possibility of changing detectors without changing the separation techniques, what is important without re-optimizing the method. The new presented method allows to identify the zinc-binding ligands in shorter time.

A multilateral investigation of the effects of zinc level on pregnancy

BACKROUND

The relationship between maternal zinc level and birth weight, birth week, delivery type, garvida, maternal age, etc., contribute to diagnosis and clinical follow-up.

METHOD

Multivariate investigated for data of 275 patients were obtained during their pregnancy periods until birth. 3 cc blood samples were centrifuged for 15 minutes at 2500 g within a period of 30 minutes and were stored at -80°C until the time of analysis. The zinc levels of the patients were found to be within the range of 49-129 μg/dL. Patients were divided into 8 groups according to their zinc levels (49-59, 60-69, …, 120-129) and the relationships of zinc level with the parameters related to the mode of delivery, week of delivery, birth weight, age, early membrane rupture, live-stillbirth, and gravid were statistically analyzed to determine differences between the groups.

RESULTS

There was a significant difference between the live births and stillbirths with a 95% confidence level regarding the zinc level. The zinc level affected the live-stillbirth status; patients with a zinc level of 49-59 μg/dL had stillbirths, the live birth rate for 59-69 μg/dL was approximately 50%, whereas it was approximately 88% for in the patients with a zinc level of 109-119 μg/dL. All patients with a zinc level of 119 μg/dL and above had live births.

CONCLUSION

Based on the results of this study, it is suggested that zinc supplementation may be an appropriate treatment for the pregnant women with low zinc levels to provide the realization of live births.

Determination of major and trace element variability in healthy human urine by ICP-QMS and specific gravity normalisation

Sixty five urine samples obtained during one or two non-consecutive days from 10 healthy individuals were analysed for major (Na, Mg, K, Ca) and trace (Co, Cu, Zn, As, Rb, Sr, Mo and Pb) element concentrations. Following microwave digestion, the analyses were carried out using ICP-QMS (inductively coupled plasma quadrupole mass spectrometry) incorporating a collision/reaction cell. Repeat analyses of quality control samples show that the procedure produces unbiased results and is well suited for routine urinalysis of the investigated elements. Concentrations were normalised using specific gravity (SG) and the resultant decrease in variability supports previous conclusions that SG-normalisation appropriately corrects for differences in urine dilution. The elemental concentrations of the individual urine samples show large differences in dispersion. Most variable are As, Co and Zn, with CVs (coefficients of variation) of >75%. The major elements as well as Rb, Sr and Mo display intermediate variability, whilst Cu and Pb have the least elemental dispersion with CV values of about 30%. A detailed assessment shows that the overall elemental variability is governed both by differences between individuals and variations for a single individual over time. Spot urine samples exhibit elemental concentrations that, on average, resemble the daily mean values to within about 30% for all elements except K and Rb. Diet-related changes in urinary element concentration are most prominent for Mg, K, Co, Rb and Pb. The concentrations of Co, As and Rb appear to vary systematically with gender but this may primarily reflect co-variance with specific diets.

Urinary element concentrations were quantified by ICP-QMS and variations over time, between individuals and with gender and diet were assessed.

Position paper on vegetarian diets from the working group of the Italian Society of Human Nutrition

BACKGROUND

Interest in vegetarian diets is growing in Italy and elsewhere, as government agencies and health/nutrition organizations are emphasizing that regular consumption of plant foods may provide health benefits and help prevent certain diseases.

METHODS AND RESULTS

We conducted a Pubmed search, up to September, 2015, for studies on key nutrients (proteins, vitamin B12, iron, zinc, calcium, vitamin D, and n-3 fatty acids) in vegetarian diets. From 295 eligible publications the following emerged: Vegetarians should be encouraged to supplement their diets with a reliable source of vitamin B12 (vitamin-fortified foods or supplements). Since the plant protein digestibility is lower than that of animal proteins it may be appropriate for vegetarians to consume more proteins than recommended for the general population. Vegetarians should also be encouraged to habitually consume good sources of calcium, iron and zinc - particularly vegetables that are low in oxalate and phytate (e.g. Brassicaceae), nuts and seeds, and calcium-rich mineral water. Calcium, iron, and zinc bioavailability can be improved by soaking, germination, and sour-dough leavening that lower the phytate content of pulses and cereals. Vegetarians can ensure good n-3 fatty acid status by habitually consuming good sources of a-linolenic acid (walnuts, flaxseeds, chia seeds, and their oils) and limiting linoleic acid intake (corn and sunflower oils).

CONCLUSIONS

Well-planned vegetarian diets that include a wide variety of plant foods, and a reliable source of vitamin B12, provide adequate nutrient intake. Government agencies and health/nutrition organizations should provide more educational resources to help Italians consume nutritionally adequate vegetarian diets.

Comparison of Sociodemographic and Nutritional Characteristics between Self-Reported Vegetarians, Vegans, and Meat-Eaters from the NutriNet-Santé Study

BACKGROUND

There is a growing trend for vegetarian and vegan diets in many Western countries. Epidemiological evidence suggesting that such diets may help in maintaining good health is rising. However, dietary and sociodemographic characteristics of vegetarians and vegans are not well known. The aim of this cross-sectional study was to describe sociodemographic and nutritional characteristics of self-reported, adult vegetarians and vegans, compared to meat-eaters, from the French NutriNet-Santé study.

METHODS

Participants were asked if they were following a specific diet. They were then classified into three self-reported diet groups: 90,664 meat-eaters, 2370 vegetarians, and 789 vegans. Dietary data were collected using three repeated 24-h dietary records. Multivariable polytomic logistic regression models were perfomed to assess the association between the sociodemographic characteristics and type of diet. The prevalence of nutrient intake inadequacy was estimated, by sex and age for micronutrients, as well as by type of self-reported diet.

RESULTS

Compared with meat-eaters, vegetarians were more likely to have a higher educational level, whereas vegans had a lower education level. Compared with meat-eaters, vegetarians were more likely to be women, younger individuals, and to be self-employed or never employed rather than managerial staff. Vegetarians and vegans substituted animal protein-dense products with a higher consumption of plant protein-dense products (e.g., soy-based products or legumes). Vegetarians had the most balanced diets in terms of macronutrients, but also had a better adherence to French dietary guidelines. Vegetarians exhibited a lower estimated prevalence of inadequacies for micronutrients such as antioxidant vitamins (e.g., for vitamin E, 28.9% for vegetarian women <55 years of age vs. 41.6% in meat-eaters) while vegans exhibited a higher estimated prevalence of inadequacies for some nutrients, in particular vitamin B12 (69.9% in men and 83.4% in women <55 years of age), compared to meat-eaters.

CONCLUSIONS

Our study highlighted that, overall, self-reported vegetarians and vegans may meet nutritional recommendations.

The effect of vegetarian diets on iron status in adults: A systematic review and meta-analysis

BACKGROUND

Vegetarian diets exclude meat, seafood, and products containing these foods. Although the vegetarian lifestyle could lead to a better health status in adults, it may also bear risks for certain nutritional deficiencies. Cross-sectional studies and narrative reviews have shown that the iron status of vegetarians is compromised by the absence of highly bioavailable haem-iron in meatless diets and the inhibiting effect of certain components present in plant foods on non-haem iron bioavailability.

METHODS

The databases Pubmed, Scopus, Embase, and Cochrane CentralRegister of Controlled Trials were searched for studies comparing serum ferritin, as the major laboratory parameter for iron status of adult vegetarians with non-vegetarian control groups. A qualitative review was conducted as well as an inverse-variance random-effects meta-analysis to pool available data. In addition the effect of vegetarian diets according to gender was investigated with a subgroup analysis. The results were validated using a sensitivity analysis.

RESULTS

A total of 27 cross-sectional studies and three interventional studies were selected for the systematic review. The meta-analysis which combined data of 24 cross-sectional studies showed that adult vegetarians have significantly lower serum ferritin levels than their non-vegetarian controls (-29.71 µg/L, 95% CI [-39.69, -19.73], p < 0.01). Inclusion of semi-vegetarian diets did not change the results considerably (-23.27 µg/L, 95% CI [-29.77, -16.76], p < 0.01). The effects were more pronounced in men (-61.88 µg/L, 95% CI [-85.59, -38.17], p < 0.01) than in both premenopausal women (-17.70 μg/L, 95% CI [-29.80, -5.60], p < 0.01) and all women (-13.50 μg/L, 95% CI [-22.96, -4.04], p < 0.01), respectively.

CONCLUSIONS

In conclusion our results showed that vegetarians are more likely to have lower iron stores compared with non-vegetarians. However, since high iron stores are also a risk factor for certain non-communicable diseases, such as type 2 diabetes, it is recommended that not only vegetarians but also non-vegetarians should regularly control their iron status and improve their diet regarding the content and bioavailability of iron by consuming more plants and less meat.

Are more environmentally sustainable diets with less meat and dairy nutritionally adequate?

Objective

Our current food consumption patterns, and in particular our meat and dairy intakes, cause high environmental pressure. The present modelling study investigates the impact of diets with less or no meat and dairy foods on nutrient intakes and assesses nutritional adequacy by comparing these diets with dietary reference intakes.

Design

Environmental impact and nutrient intakes were assessed for the observed consumption pattern (reference) and two replacement scenarios. For the replacement scenarios, 30 % or 100 % of meat and dairy consumption (in grams) was replaced with plant-based alternatives and nutrient intakes, greenhouse gas emissions and land use were calculated.

Setting

The Netherlands.

Subjects

Dutch adults (n 2102) aged 19–69 years.

Results

Replacing 30 % of meat and dairy with plant-based alternatives did not substantially alter percentages below the Estimated Average Requirement (EAR) for all studied nutrients. In the 100 % replacement scenario, SFA intake decreased on average by ~35 % and Na intake by ~8 %. Median Ca intakes were below the Adequate Intake. Estimated habitual fibre, Fe and vitamin D intakes were higher; however, non-haem Fe had lower bioavailability. For Zn, thiamin and vitamin B12, 10–31 % and for vitamin A, 60 % of adults had intakes below the EAR.

Conclusions

Diets with all meat and dairy replaced with plant-based foods lowered environmental impacts by >40 %. Estimated intakes of Zn, thiamin, vitamins A and B12, and probably Ca, were below recommendations. Replacing 30 % was beneficial for SFA, Na, fibre and vitamin D intakes, neutral for other nutrients, while reducing environmental impacts by 14 %.

Microelements and Heavy Metals Content in Frequently Utilized Medicinal Plants Collected from the Power Plant Area

The effectiveness of medicinal plants is mainly associated with their active constituents, but one of the major quality problems frequently encountered is their high trace metals content that can be associated to extensive pollution of the environment where medicinal plants grow. Therefore the aim of this research was to evaluate the content of Cd, Co, Cr, Cu, Fe, Mn, Ni, Pb, Zn and As in selected and frequently used medicinal plants, including chicory, broadleaf, common comfrey and dandelion. The plant material was collected from their wild habitats in the area of highly developed power plant activity during the summer of 2015. Plant analyses were done according to ICP methodology, using ICAP 6300 ICP optical emission spectrometer. The obtained results showed that the content of As, Cd, Co, Mn, Ni and Zn in the investigated medicinal plant species was below the maximum permissible concentration, while in all parts of all studied plants the concentration of Cr was toxic. The toxic concentrations of Cu were determined in root and aerial parts of chicory and common comfrey, and the toxic concentrations of Fe in root and aerial parts of dandelion and broadleaf plantain, and in aerial parts of common comfrey. However, high but not toxic content of Pb was found in aerial parts of chicory. It can be concluded that medicinal plants from the studied growing site are not appropriate for use in alternative medicine and that a determination of trace metals content in these plants must become a standard criterion for evaluation of their quality.

Diet and hair loss: effects of nutrient deficiency and supplement use

Patients presenting with hair loss should be screened by medical history, dietary history and physical exam for risk factors for nutrient deficiency. If warranted, laboratory studies may be performed. In patients with no risk factors, further laboratory evaluation searching for nutritional deficiencies is not warranted. For patients with nutritional deficiencies, it is clear that those deficiencies should be corrected. Further research is required to determine whether any benefit exists for nutrient supplementation in the absence of documented deficiency. At this time, patients must be informed that such research is lacking and that in fact some supplements carry the risk of worsening hair loss or the risk of toxicity.

Complementary Feeding: A Position Paper by the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) Committee on Nutrition

This position paper considers different aspects of complementary feeding (CF), focussing on healthy term infants in Europe. After reviewing current knowledge and practices, we have formulated these recommendations: Timing: Exclusive or full breast-feeding should be promoted for at least 4 months (17 weeks, beginning of the 5th month of life) and exclusive or predominant breast-feeding for approximately 6 months (26 weeks, beginning of the 7th month) is a desirable goal. Complementary foods (solids and liquids other than breast milk or infant formula) should not be introduced before 4 months but should not be delayed beyond 6 months.

CONTENT

Infants should be offered foods with a variety of flavours and textures including bitter tasting green vegetables. Continued breast-feeding is recommended alongside CF. Whole cows' milk should not be used as the main drink before 12 months of age. Allergenic foods may be introduced when CF is commenced any time after 4 months. Infants at high risk of peanut allergy (those with severe eczema, egg allergy, or both) should have peanut introduced between 4 and 11 months, following evaluation by an appropriately trained specialist. Gluten may be introduced between 4 and 12 months, but consumption of large quantities should be avoided during the first weeks after gluten introduction and later during infancy. All infants should receive iron-rich CF including meat products and/or iron-fortified foods. No sugar or salt should be added to CF and fruit juices or sugar-sweetened beverages should be avoided. Vegan diets should only be used under appropriate medical or dietetic supervision and parents should understand the serious consequences of failing to follow advice regarding supplementation of the diet.

METHOD

Parents should be encouraged to respond to their infant's hunger and satiety queues and to avoid feeding to comfort or as a reward.

A methodology to compile food metrics related to diet sustainability into a single food database: Application to the French case

The holistic approach required to assess diet sustainability is hindered by lack of comprehensive databases compiling relevant food metrics. Those metrics are generally scattered in different data sources with various levels of aggregation hampering their matching. The objective was to develop a general methodology to compile food metrics describing diet sustainability dimensions into a single database and to apply it to the French context. Each step of the methodology is detailed: indicators and food metrics identification and selection, food list definition, food matching and values assignment. For the French case, nutrient and contaminant content, bioavailability factors, distribution of dietary intakes, portion sizes, food prices, greenhouse gas emission, acidification and marine eutrophication estimates were allocated to 212 commonly consumed generic foods. This generic database compiling 279 metrics will allow the simultaneous evaluation of the four dimensions of diet sustainability, namely health, economic, social and environmental, dimensions.

Cardiorespiratory Fitness and Peak Torque Differences between Vegetarian and Omnivore Endurance Athletes: A Cross-Sectional Study

In spite of well-documented health benefits of vegetarian diets, less is known regarding the effects of these diets on athletic performance. In this cross-sectional study, we compared elite vegetarian and omnivore adult endurance athletes for maximal oxygen uptake (VO2 max) and strength. Twenty-seven vegetarian (VEG) and 43 omnivore (OMN) athletes were evaluated using VO2 max testing on the treadmill, and strength assessment using a dynamometer to determine peak torque for leg extensions. Dietary data were assessed using detailed seven-day food logs. Although total protein intake was lower among vegetarians in comparison to omnivores, protein intake as a function of body mass did not differ by group (1.2 ± 0.3 and 1.4 ± 0.5 g/kg body mass for VEG and OMN respectively, p = 0.220). VO2 max differed for females by diet group (53.0 ± 6.9 and 47.1 ± 8.6 mL/kg/min for VEG and OMN respectively, p < 0.05) but not for males (62.6 ± 15.4 and 55.7 ± 8.4 mL/kg/min respectively). Peak torque did not differ significantly between diet groups. Results from this study indicate that vegetarian endurance athletes’ cardiorespiratory fitness was greater than that for their omnivorous counterparts, but that peak torque did not differ between diet groups. These data suggest that vegetarian diets do not compromise performance outcomes and may facilitate aerobic capacity in athletes.

Association between predominantly plant-based diets and iron status in Chinese adults: a cross-sectional analysis

Current evidence of the relationship between diets and Fe status is mostly derived from studies in developed countries with Western diets, which may not be translatable to Chinese with a predominantly plant-based diet. We extracted data that were nationally sampled from the 2009 wave of China Health and Nutrition Survey; dietary information was collected using 24-h recalls combined with a food inventory for 3 consecutive days. Blood samples were collected to quantify Fe status, and log-ferritin, transferrin receptor and Hb were used as Fe status indicators. In total, 2905 (1360 males and 1545 females) adults aged 18–50 years were included for multiple linear regression and stratified analyses. The rates of Fe deficiency and Fe-deficiency anaemia were 1·6 and 0·7 % for males and 28·4 and 10·7 % for females, respectively. As red meat and haem Fe consumption differed about fifteen to twenty times throughout the five groups, divided by quintiles of animal protein intake per 4·2 MJ/d, only Fe status as indicated by log-ferritin (P=0·019) and transferrin receptor (P=0·024) concentrations in males was shown to be higher as intakes of animal foods increased. Log-ferritin was positively associated with intakes of red meat (B=0·3 %, P=0·01) and haem Fe (B=12·3 %, P=0·010) in males and with intake of non-haem Fe in females (B=2·2 %, P=0·024). We conclude that diet has a very limited association with Fe status in Chinese adults consuming a traditional Chinese diet, and a predominantly plant-based diet may not be necessarily responsible for poor Fe status.

Health Implications of Beef Intramuscular Fat Consumption

Despite several issues in relation to human health, beef is still a most popular meat product among large section of society due to the presence of high quality protein and other nutrients. The current paper reviews numerous studies that provide nutritional profiles and health implications of high marbled beef consumption. In relation to lipid content of beef, intramuscular fat contains high level of PUFA and MUFA compared to other beef fat. Level and composition of intramuscular fat varies depending on breed and feeding regime. Literature suggests that the marbling is more complex than the development of subcutaneous fat and marbling not only provides good fatty acids but also contributes to the higher eating quality of beef. Finally, the current work emphasize that meat plays a pivotal role in nutritious diets, high quality marbled beef is not only of excellent eating quality but also contain more beneficial fatty acids.

Iron in red meat-friend or foe

In developed countries, due to high content and bioavailability, red and processed meats are the main sources of iron in the diet. Adequate intake of this nutrient is essential for the proper development and functioning of the human body, and its deficiencies are associated mainly with the occurrence of anemia, which is one of the most widespread nutritional problems in the world. However, excessive intake of iron can be detrimental to health. Studies have shown that high consumption of red meat and its products, and thereby iron, particularly in the form of heme, increases the risk of non-communicable diseases, including cancers, type II diabetes and cardiovascular disease. Due to the high nutritional value, the presence of red meat in the diet is preferable, but according to World Cancer Research Fund International its consumption should not exceed 500g per week. Furthermore, there are several potential ways to suppress the toxic effects of heme iron in the diet.

Molecular speciation and tissue compartmentation of zinc in durum wheat grains with contrasting nutritional status

Low concentration of zinc (Zn) in the endosperm of cereals is a major factor contributing to Zn deficiency in human populations. We have investigated how combined Zn and nitrogen (N) fertilization affects the speciation and localization of Zn in durum wheat (Triticum durum). Zn-binding proteins were analysed with liquid chromatography ICP-MS and Orbitrap MS(2) , respectively. Laser ablation ICP-MS with simultaneous Zn, sulphur (S) and phosphorus (P) detection was used for bioimaging of Zn and its potential ligands. Increasing the Zn and N supply had a major impact on the Zn concentration in the endosperm, reaching concentrations higher than current breeding targets. The S concentration also increased, but S was only partly co-localized with Zn. The mutual Zn and S enrichment was reflected in substantially more Zn bound to small cysteine-rich proteins (apparent size 10-30 kDa), whereas the response of larger proteins (apparent size > 50 kDa) was only modest. Most of the Zn-responsive proteins were associated with redox- and stress-related processes. This study offers a methodological platform to deepen the understanding of processes behind endosperm Zn enrichment. Novel information is provided on how the localization and speciation of Zn is modified during Zn biofortification of grains.

Fermentation of food and feed: A technology for efficient utilization of macro and trace elements in monogastrics

Mineral deficiencies, especially of iron, zinc, and calcium, respectively, negatively affect human health and may lead to conditions such as iron deficiency anemia, rickets, osteoporosis, and diseases of the immune system. Cereal grains and legumes are of global importance in nutrition of monogastrics (humans and the respective domestic animals) and provide high amounts of several minerals, e.g., iron, zinc, and calcium. Nevertheless, their bioavailability is low. Plants contain phytates, the salts of phytic acid, chemically known as inositol-hexakisphosphate, which interact with several minerals and proteins. However, phytate may be hydrolysed by phytase. This enzyme is naturally present in plants and also widely distributed in microorganisms. Several food processing methods have been reported to enhance phytate hydrolysis, due to the activation of endogenous phytase activity or via the enzyme produced by microbes. In recent years, fermentation for food and feed improvement and preservation, respectively, has gained increasing interest as a promising method to degrade phytate and enhance mineral utilization in monogastrics. Indeed, several in vitro as well as in vivo studies confirm a positive effect on the utilization of minerals, such as P, Ca, Fe and Zn, using sourdough fermentation for baking or fermentation of legumes, mainly soybeans. This review summarizes the current knowledge regarding the potential of fermentation to enhance macro and trace element bioavailability in monogastric species.

A review on the elemental contents of Pakistani medicinal plants: Implications for folk medicines

ETHNOPHARMACOLOGICAL RELEVANCE

Substantially, plants produce chemicals such as primary and secondary metabolites, which have significant applications in modern therapy. Indigenous people mostly rely on traditional medicines derived from medicinal plants. These plants have the capacity to absorb a variety of toxic elements. The ingestion of such plants for medicinal purpose can have imperative side effects. Hence, with regard to the toxicological consideration of medicinal plants, an effort has been made to review the elemental contents of ethno medicinally important plants of Pakistan and to highlight the existing gaps in knowledge of the safety and efficacy of traditional herbal medications.

MATERIALS AND METHODS

Literature related to the elemental contents of ethno medicinal plants was acquired by utilizing electronic databases. We reviewed only macro-elemental and trace elemental contents of 69 medicinal plant taxa, which are traditionally used in Pakistan for the treatment of sundry ailments, including anemia, jaundice, cancer, piles, diarrhea, dysentery, headache, diabetes, asthma, blood purification, sedative and ulcer.

RESULTS

A majority of plants showed elemental contents above the permissible levels as recommended by the World health organization (WHO). As an example, the concentrations of Cadmium (Cd) and Lead (Pb) were reportedly found higher than the WHO permissible levels in 43 and 42 medicinal plants, respectively. More specifically, the concentrations of Pb (54ppm: Silybum marianum) and Cd (5.25ppm: Artemisia herba-alba) were found highest in the Asteraceae family.

CONCLUSIONS

The reported medicinal plants contain a higher amount of trace and toxic elements. Intake of these plants as traditional medicines may trigger the accumulation of trace and toxic elements in human bodies, which can cause different types of diseases. Thus, a clear understanding about the nature of toxic substances and factors affecting their concentrations in traditional medicines are essential prerequisites for efficacious herbal therapeutics with lesser or no side effects.

Plant-Based Diets: A Physician's Guide

Because of the ever-increasing body of evidence in support of the health advantages of plant-based nutrition, there is a need for guidance on implementing its practice. This article provides physicians and other health care practitioners an overview of the myriad benefits of a plant-based diet as well as details on how best to achieve a well-balanced, nutrient-dense meal plan. It also defines notable nutrient sources, describes how to get started, and offers suggestions on how health care practitioners can encourage their patients to achieve goals, adhere to the plan, and experience success.

ATSDR evaluation of potential for human exposure to zinc

As part of its mandate, the Agency for Toxic Substances and Disease Registry (ATSDR) prepares toxicological profiles on hazardous chemicals found at Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) National Priorities List (NPL) sites that have the greatest public health impact. These profiles comprehensively summarize toxicological and environmental information. This article constitutes the release of portions of the toxicological profile for zinc. The primary purpose of this article is to provide interested individuals with environmental information on zinc that includes production data, environmental fate, potential for human exposure, analytical methods and a listing of regulations and advisories. Toxicology and Industrial Health 2007; 23: 247—308

A cross-sectional study on nutrient intake and -status in inflammatory bowel disease patients

Background and aims

Inflammatory bowel disease (IBD) can be associated with nutritional problems. The aim of this study was to investigate diet and nutritional status of IBD patients.

Methods

A total of 78 participants (35 men and 43 women aged 18–74 years) were included in this cross-sectional study. The majority (80 %) of the participant received infliximab treatment. Participants filled out disease related questionnaires and 31 participants also a 3-day food record. Body composition was measured and blood samples analysed in order to estimate nutritional status.

Results

The majority (87 %) claimed that diet affects digestive tract symptoms and 72 % had changed diet accordingly. The most common foods restricted were dairy products (60 %), processed meat (55 %), soft drinks (46 %), alcohol (45 %) and fast food (44 %). Body mass index was mostly in the overweight range but 46 % of the participants had been diagnosed with some nutritional deficiency since IBD diagnosis (most common was iron deficiency: 39 %). Patients who restricted meat products had lower ferritin values (48 ± 39 vs. 95 ± 74 μg/L, P = 0.011). Intake of vitamin D and calcium were not adequate (65 % below recommeded intake for both) and 60 % had poor vitamin D status.

Conclusion

IBD patients often change their dietary intake in order to affect digestive tract symptoms. Many patients have a history of nutrient deficiency. Restriction of dairy and meat consumption is common and is negatively associated with intake or status of micronutrients like calcium and iron. Dietary advice by a dietitian and use of potentially helpful dietary supplements is indicated.

The chemical characteristics of organic iron sources and their relative bioavailabilities for broilers fed a conventional corn-soybean meal diet

Twenty-four organic Fe sources were evaluated by polarographic analysis and via solubility in buffers (pH 5 and 2) and deionized water. Organic Fe sources included 6 Fe-Met complexes (Fe-Met), 10 Fe-Gly complexes, 1 Fe-Lys complex, 4 Fe proteinates, and 3 Fe-AA complexes (Fe-AA). Sources varied considerably in chemical characteristics. Chelation strengths (quotient of formation [Q] values) ranged from weak (Q = 1.08) to extremely strong strength (Q = 8,590). A total of 1,170 1-d-old Arbor Acres male broilers were randomly allotted to 6 replicate cages (15 chicks/cage) for each of 13 treatments in a completely randomized design involving a 4 × 3 factorial arrangement of treatments (4 Fe sources × 3 added Fe levels) plus a control with no added Fe. Dietary treatments included a corn-soybean meal basal diet (control; 55.8 mg Fe/kg) and the basal diet supplemented with 20, 40, or 60 mg Fe/kg as iron sulfate (FeSO∙7HO); an Fe-Met with weak chelation strength (Fe-Met W; Q = 1.37; 14.7% Fe); an iron proteinate with moderate chelation strength (Fe-Prot M; Q = 43.6; 14.2% Fe); or an iron proteinate with extremely strong chelation strength (Fe-Prot ES; Q = 8,590; 10.2% Fe). The growth performance, Fe concentrations, hematological indices, and activities and gene expressions of 2 Fe-containing enzymes in tissues of broilers at 7, 14, and 21 d of age were determined in the present study. Transferrin saturation in plasma on 14 d; bone Fe on d 7 and 14; liver Fe on d 7, 14, and 21; kidney Fe on d 14; succinate dehydrogenase activities in the liver on d 21 and in the kidney on d 7 and 21; mRNA levels in the kidney and heart on d 14; and mRNA levels in the liver and kidney on d 21 linearly increased ( < 0.05) as added Fe levels increased. However, differences in bioavailabilities among Fe sources were detected ( < 0.05) only for the mRNA levels in the liver and kidney on d 21. Based on slope ratios from the multiple linear regression of mRNA level in the liver or kidney of broilers on d 21 on daily dietary analyzed Fe intake, the bioavailabilities of Fe-Met W, Fe-Prot M, and Fe-Prot ES relative to iron sulfate (100%) were 129 ( = 0.18), 164 ( < 0.003), and 174% ( < 0.001) or 102 ( = 0.95), 143 ( = 0.09), and 174% ( < 0.004), respectively. These results indicated that the relative bioavailabilities of organic Fe sources were closely related to their Q values and organic Fe sources with greater Q values showed higher Fe bioavailabilities.

Relationship of dietary factors with dialyzable iron and in vitro iron bioavailability in the meals of farm women

Sixty rural women with age varying between 25 and 35 were selected randomly to determine the role of dietary factors on bioavailability of iron in their diets. Food samples of selected subjects were collected for three major meals i.e. breakfast, lunch and dinner for three consecutive days. The samples were analyzed for meal constituents associated with iron absorption as well as for total and dialyzable iron. Based on dietary characteristics, the diets of the farm women were in the class of intermediate diets as per FAO/WHO classification with iron bioavailability of 8.11 %. The statistical analysis revealed that the meal constituents which were found to influence iron absorption positively were ascorbic acid and β-carotene in breakfast and only β-carotene in dinner. The meal constituents which affected iron absorption negatively were zinc and calcium in breakfast as well as lunch and phytates and NDF in dinner, however, polyphenols present in the meals of the subjects did not show any relationship with iron absorption.

Effect of inclusion of key foods on in vitro iron bioaccessibility in composite meals

The in vitro bioaccessibility of iron in context to fortification of key foods to cereal based diets was studied to optimize the meals for enhanced iron bioaccessibility to meet the needs of vegetarian and non-vegetarian adult women. Four individual food items and thirty six composite meals were selected to represent a wide spectrum of meal ingredients. The four individual foods: chapati, rice, dal and saag were choosen on the basis of data reported on meal pattern of surveyed households of north India. The basic meals were then fortified with key food ingredients which may influence in vitro iron bioaccessibility. Eight selected key foods were salad, orange, lemonade, milk, curd, chicken, egg and tea. The results revealed that inclusion of 200 g of chicken, 135 g of salad and 120 g of orange to the basic meals of rice or chapati with either dal or saag enhanced iron bioaccessibility by 1.6 fold to 5.0 fold; 5.2 to 28.9 % and 4.7 to 10.7 %, respectively. The best enhancer of iron absorption for vegetarians was lemonade (250 ml) which resulted in 70.2 and 61.0 % increase of in vitro bioaccessibility of iron to the rice based meals with dal and saag, respectively. The inclusion of lemonade resulted in 1.3 fold increase in iron bioaccessibility in chapati based meals. The major inhibitors of iron bioaccessibility were egg and tea, the percent reduction caused by egg being 16.1 to 50.2 % while by tea, it was between 21.5 to 55.3 %. The study recommends that those vulnerable to iron deficiency should be encouraged to increase overall intake of iron from iron rich foods. The increase should be coupled with efforts to combine appropriate foods in the diet to enhance the bioaccessibility of iron and reduce inhibitory factors.

Replacing electrolytic iron in a fortification-mix with NaFeEDTA increases both iron and zinc availabilities in traditional African maize porridges

While replacing electrolytic iron with NaFeEDTA in multi-micronutrient fortification-mixes is a popular option, there is no information about the effect on the iron and zinc availabilities in African staple foods. This study evaluated the effects of adding a multi-micronutrient fortification-mix, with no iron, electrolytic iron or NaFeEDTA on the availabilities of iron and zinc from thick and fermented special-grade maize porridges using a Caco-2 cell model. Replacing electrolytic iron with NaFeEDTA significantly (p ⩽ 0.05) increased iron and, importantly zinc, availabilities in both the thick (2.16% vs. 1.45% and 2.51% vs. 2.29%, respectively) and fermented (3.35% vs. 2.66% and 3.04% vs. 2.61%, respectively) porridges. Some of the NaFeEDTA complexes perhaps partially dissociated because of pH changes during simulated digestion, binding with zinc and increasing its availability. NaFeEDTA in a multi-micronutrient fortification-mix, added to less refined, high phytate maize meal, would be more effective than electrolytic iron in addressing both iron and zinc deficiencies in low socio-economic populations of sub-Saharan Africa.

Responses in Micro-Mineral Metabolism in Rainbow Trout to Change in Dietary Ingredient Composition and Inclusion of a Micro-Mineral Premix

Responses in micro-mineral metabolism to changes in dietary ingredient composition and inclusion of a micro-mineral premix (Fe, Cu, Mn, Zn and Se) were studied in rainbow trout. In a 2 x 2 factorial design, triplicate groups of rainbow trout (initial weight: 20 g) were fed over 12 weeks at 17°C a fishmeal-based diet (M) or a plant-ingredient based diet (V), with or without inclusion of a mineral premix. Trout fed the V vs. M diet had lower feed intake, growth, hepato-somatic index, apparent availability coefficient (AAC) of Fe, Cu, Mn and Zn and also lower whole body Se and Zn concentration, whereas whole body Fe and Cu and plasma Fe concentrations were higher. Feeding the V diet increased intestinal ferric reductase activity; at transcriptional level, hepatic hepcidin expression was down-regulated and ferroportin 1 was up-regulated. Transcription of intestinal Cu-transporting ATPases and hepatic copper transporter1 were higher in V0 compared to other groups. Among the hepatic metalo-enzyme activities assayed, only Se-dependent glutathione peroxidase was affected, being lower in V fed fish. Premix inclusion reduced the AAC of Fe, Cu and Zn; increased the whole body concentration of all micro- minerals; up-regulated hepatic hepcidin and down-regulated intestinal ferroportin 1 transcription; and reduced the transcription of Cu-transporting ATPases in the intestine. Overall, the regulation of micro-mineral metabolism in rainbow trout, especially Fe and Cu, was affected both by a change in ingredient composition and micro-mineral premix inclusion.

Major dietary patterns and risk of acute myocardial infarction in young, urban Pakistani population

Objective:

To investigate the role of dietary intake in the development of premature acute myocardial infarction (AMI) in a hospital-based Pakistani population in Karachi.

Methods:

In a case control study, 203 consecutive patients (146 males and 57 females) with their first AMI and age below 45 years were enrolled with informed consent. Similarly, 205 gender and age matched (within 3 years) healthy adults were also included as controls. Dietary intake of both cases and controls was assessed by using a simple 14-item food frequency questionnaire. Using factor analysis, 3 major dietary patterns- prudent dietary pattern, combination dietary pattern and western dietary pattern were identified. Fasting plasma/serum of both cases and controls were analyzed for homocysteine, folate, vitamin B₁₂, blood Pb, ferritin, cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides. ANOVA and conditional logistic regression were used to predict the association of dietary patterns with AMI.

Results:

Consumption of prudent diet, characterized by high consumption of legumes, vegetables, wheat, chicken and fruits, is protective against the risk of premature AMI. Moderate to high consumption of combination diet, characterized by high intake of eggs, fish, fruits, juices and coffee was associated with decreased risk of AMI. No association was observed between western diet, characterized by high intake of meat, fish and tea with milk and risk of AMI.

Conclusions:

Consumption of a prudent dietary pattern and a combination dietary pattern is protective against the risk of AMI in a Pakistani population.

A simplified determination of total concentrations of Ca, Fe, Mg and Mn in addition to their bioaccessible fraction in popular instant coffee brews

A direct analysis of instant coffee brews with HR-CS-FAAS spectrometry to determine the total Ca, Fe, Mg and Mn content has been developed and validated. The proposed method is simple and fast; it delivers good analytical performance; its accuracy being within -3% to 3%, its precision--2-3% and detection limits--0.03, 0.04, 0.004 and 0.01 mg l(-1) for Ca, Fe, Mg and Mn, respectively. In addition, Ca, Fe, Mg and Mn bioaccessibility in instant coffee brews was measured by means of the in vitro gastrointestinal digestion with the use of simulated gastric and intestinal juice solutions. Absorption of metals in intestinal villi was simulated by means of ultrafiltration over semi-permeable membrane with a molecular weight cut-off of 5 kDa. Ca, Fe, Mg and Mn concentrations in permeates of instant coffee gastrointestinal incubates were measured with HR-CS-FAA spectrometry.

Micronutrient status and intake in omnivores, vegetarians and vegans in Switzerland

PURPOSE

Vegetarian and vegan diets have gained popularity in Switzerland. The nutritional status of individuals who have adopted such diets, however, has not been investigated. The aim of this study was to assess the intake and status of selected vitamins and minerals among vegetarian and vegan adults living in Switzerland.

METHODS

Healthy adults [omnivores (OVs), n _OV = 100; vegetarians (VGs), n _VG = 53; vegans (VNs), n _VN = 53] aged 18-50 years were recruited, and their weight and height were measured. Plasma concentrations of the vitamins A, C, E, B1, B2, B6, B12, folic acid, pantothenic acid, niacin, biotin and β-carotene and of the minerals Fe, Mg and Zn and urinary iodine concentration were determined. Dietary intake was assessed using a three-day weighed food record, and questionnaires were issued in order to assess the physical activity and lifestyle of the subjects.

RESULTS

Omnivores had the lowest intake of Mg, vitamin C, vitamin E, niacin and folic acid. Vegans reported low intakes of Ca and a marginal consumption of the vitamins D and B12. The highest prevalence for vitamin and mineral deficiencies in each group was as follows: in the omnivorous group, for folic acid (58 %); in the vegetarian group, for vitamin B6 and niacin (58 and 34 %, respectively); and in the vegan group, for Zn (47 %). Despite negligible dietary vitamin B12 intake in the vegan group, deficiency of this particular vitamin was low in all groups thanks to widespread use of supplements. Prevalence of Fe deficiency was comparable across all diet groups.

CONCLUSIONS

Despite substantial differences in intake and deficiency between groups, our results indicate that by consuming a well-balanced diet including supplements or fortified products, all three types of diet can potentially fulfill requirements for vitamin and mineral consumption.

Dietary intake of iron, zinc, copper, and risk of Parkinson's disease: a meta-analysis

Although some studies have reported the associations between specific metal element intake and risk of Parkinson's disease (PD), the associations between specific metal element intake such as iron intake and PD are still conflicted. We aimed to determine whether intake of iron, zinc, and copper increases/decreases the risk of PD. PubMed, Embase, Web of Knowledge, and Google Scholar were searched. We pooled the multivariate-adjusted relative risks (RRs) or odds ratios using random effects. Study quality was evaluated by the Newcastle-Ottawa Scale. Five studies including 126,507 individuals remained for inclusion, pooled RRs of Parkinson's disease for moderate dietary iron intake was 1.08 (95 % CI 0.61-1.93, P = 0.787), and for high dietary iron intake was (1.03, 95 % CI 0.83-1.30, P = 0.766), respectively. The pooled RRs of Parkinson's disease for the highest compared with the lowest dietary iron intake were 1.47 (95 % CI 1.17-1.85, P = 0.001) in western population and in males (RR = 1.43, 95 % CI 1.01-2.01, P = 0.041). The pooled RRs of Parkinson's disease for moderate or high intake of zinc, and copper were not statistically different (P > 0.05). PD increased by 18 % (RR 1.18, 95 % CI 1.02-1.37) for western population by every 10-mg/day increment in iron intake. Higher iron intake appears to be not associated with overall PD risk, but may be associated with risk of PD in western population. Sex may be a factor influencing PD risk for higher iron intake. However, further studies are still needed to confirm the sex-selective effects.

Targeting specific nutrient deficiencies in protein-restricted diets: some practical facts in PKU dietary management

Among aminoacidopathies, phenylketonuria (PKU) is the most prevalent one. Early diagnosis in the neonatal period with a prompt nutritional therapy (low natural-protein and phenylalanine diet, supplemented with phenylalanine-free amino acid mixtures and special low-protein foods) remains the mainstay of the treatment. Data considering nutrient contents of cooked dishes is lacking. In this study, fourteen dishes specifically prepared for PKU individuals were analysed, regarding the lipid profile and iron and zinc contents. These dishes are poor sources of essential nutrients like Fe, Zn or n-3 fatty acids, reinforcing the need for adequate supplementation to cover individual patients' needs. This study can contribute to a more accurate adjustment of PKU diets and supplementation in order to prevent eventual nutritional deficiencies. This study contributes to a better understanding of nutrient intake from PKU patients' meals, showing the need for dietary supplementation.

Implications of compromised zinc status on bone loss associated with chronic inflammation in C57BL/6 mice

Compromised zinc status and chronic inflammation are independent factors that can contribute to bone loss. However, zinc’s role in regulating lymphoid and myeloid cell populations, combined with the interplay between the immune and skeletal systems raises the question as to the extent to which a low-grade inflammatory challenge in the context of marginal zinc deficiency would exacerbate bone loss. To address this question, young adult C57BL/6 male mice (n=32) were used in a 2×2 factorial design with dietary zinc (adequate or 35 ppm vs inadequate or −Zn =5 ppm) and lipopolysaccharide (LPS, 0 or 0.1 mg/kg body weight). Mice were fed their respective diets for 10 weeks. On the 6th week, mice had a slow release pellet implanted to induce a low-grade inflammation for the final 4 weeks of the study. −Zn induced a decrease in total white cell counts and peripheral lymphocytes, whereas LPS increased blood monocytes. LPS significantly reduced spine bone mineral density and trabecular bone volume and number of the vertebral body compared with both zinc adequate and inadequate without LPS groups. Likewise, the most pronounced effects on bone strength occurred with LPS, however, −Zn also had negative effects on the bone von Mises stresses. LPS induced an increase in TNF-α and this response was further increased with −Zn. Although the marginal zinc deficiency altered immune function, bone loss was not exacerbated with low-grade chronic inflammation in marginally zinc-deficient young adult mice. These findings demonstrate that in young adult animals an immune challenge modestly increases the inflammatory response and worsens bone biomechanics in the context of a marginal zinc deficiency, but not to the extent that more severe adverse outcomes are observed on bone structural parameters.

Zinc Status of Vegetarians during Pregnancy: A Systematic Review of Observational Studies and Meta-Analysis of Zinc Intake

Pregnant women are vulnerable to a low zinc status due to the additional zinc demands associated with pregnancy and foetal development. The present systematic review explores the relationship between habitual vegetarian diets and dietary zinc intake/status during pregnancy. The association between vegetarian diets and functional pregnancy outcome also is considered. A literature search was conducted of MEDLINE; PubMed; Embase; the Cochrane Library; Web of Science; and Scopus electronic databases up to September 2014. Six English-language observational studies qualified for inclusion in the systematic review. A meta-analysis was conducted that compared the dietary zinc intake of pregnant vegetarian and non-vegetarian (NV) groups; the zinc intake of vegetarians was found to be lower than that of NV (-1.38 ± 0.35 mg/day; p < 0.001); and the exclusion of low meat eaters from the analysis revealed a greater difference (-1.53 ± 0.44 mg/day; p = 0.001). Neither vegetarian nor NV groups met the recommended dietary allowance (RDA) for zinc. In a qualitative synthesis; no differences were found between groups in serum/plasma zinc or in functional outcomes associated with pregnancy. In conclusion; pregnant vegetarian women have lower zinc intakes than NV control populations and both groups consume lower than recommended amounts. Further information is needed to determine whether physiologic adaptations in zinc metabolism are sufficient to meet maternal and foetal requirements during pregnancy on a low zinc diet.

Potential contribution of African green leafy vegetables and maize porridge composite meals to iron and zinc nutrition

OBJECTIVES

The aim of this study was to determine the mineral nutritive value of different traditional African green leafy vegetable (GLV) dishes and their composite meals with fortified and unfortified maize porridge.

METHODS

The mineral (iron, zinc, and calcium) and antinutrient (phytate, total phenolics, and tannins) contents and in vitro bioaccessibility of iron and zinc were analyzed. The iron and zinc contents and bioaccessibilities were used to calculate contribution these dishes and meals could make toward the recommended daily requirements and absolute requirements of vulnerable populations.

RESULTS

It was found that the GLV dishes contained average amounts of zinc (2.8-3.2 mg/100 g, dry base [db]), but were high in both iron (12.5-23.4 mg/100 g, db) and antinutrients (phytate 1420-2089 mg/100 g, db; condensed tannins 105-203 mg/100 g, db). The iron bioaccessibility and amount of bioaccessible iron ranged between 6.7% and 45.2% and 0.9 and 5.11 mg/100 g, db, respectively. The zinc bioaccessibility and amount of bioaccessible zinc ranged between 6.4% and 12.7% and 0.63 and 1.63 mg/100 g, db, respectively.

CONCLUSION

Importantly, although compositing the GLV dishes with fortified maize porridges decreases the iron and zinc contents, because of the low antinutrient content of the maize meal, the amount of bioaccessible iron and zinc in the meal increases.