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

Determination of trace and heavy metals in some commonly used medicinal herbs in Ayurveda

Traditionally, the herbal drugs are well established for their therapeutic benefits. Depending upon their geographical sources sometimes the trace and heavy metals’ content may differ, which may lead to severe toxicity. So, the toxicological and safety assessment of these herbal drugs are one of the major issues in recent days. Eight different plant species including Aloe vera, Centella asiatica, Calendula officinalis, Cucumis sativus, Camellia sinensis, Clitoria ternatea, Piper betel and Tagetes erecta were selected to determine their heavy and trace metals content and thereby to assure their safer therapeutic application. The trace and heavy metals were detected through atomic absorption spectrometry analysis. The selected medicinal plant materials were collected from the local cultivated regions of West Bengal, India, and were digested with nitric acid and hydrochloric acid as specified. Absorbance was measured through atomic absorption spectrometer (AA 303) and the concentration of different trace and heavy metals in the plant samples were calculated. The quantitative determinations were carried out using standard calibration curve obtained by the standard solutions of different metals. The contents of heavy metals were found to be within the prescribed limit. Other trace metals were found to be present in significant amount. Thus, on the basis of experimental outcome, it can be concluded that the plant materials collected from the specific region are safe and may not produce any harmful effect of metal toxicity during their therapeutic application. The investigated medicinal plants contain trace metals such as copper (Cu), chromium (Cr), manganese (Mn), iron (Fe) and nickel (Ni) as well as heavy metals such as arsenic (As), lead (Pb) and mercury (Hg), which were present within the permissible limit.

Vegetarian diets, low-meat diets and health: a review

OBJECTIVE

To review the epidemiological evidence for vegetarian diets, low-meat dietary patterns and their association with health status in adults.

DESIGN

Published literature review focusing primarily on prospective studies and meta-analyses examining the association between vegetarian diets and health outcomes.

RESULTS

Both vegetarian diets and prudent diets allowing small amounts of red meat are associated with reduced risk of diseases, particularly CHD and type 2 diabetes. There is limited evidence of an association between vegetarian diets and cancer prevention. Evidence linking red meat intake, particularly processed meat, and increased risk of CHD, cancer and type 2 diabetes is convincing and provides indirect support for consumption of a plant-based diet.

CONCLUSIONS

The health benefits of vegetarian diets are not unique. Prudent plant-based dietary patterns which also allow small intakes of red meat, fish and dairy products have demonstrated significant improvements in health status as well. At this time an optimal dietary intake for health status is unknown. Plant-based diets contain a host of food and nutrients known to have independent health benefits. While vegetarian diets have not shown any adverse effects on health, restrictive and monotonous vegetarian diets may result in nutrient deficiencies with deleterious effects on health. For this reason, appropriate advice is important to ensure a vegetarian diet is nutritionally adequate especially for vulnerable groups.

Sustainable diets for the future: Can we contribute to reducing greenhouse gas emissions by eating a healthy diet?

BACKGROUND

Food systems account for 18-20% of UK annual greenhouse gas emissions (GHGEs). Recommendations for improving food choices to reduce GHGEs must be balanced against dietary requirements for health.

OBJECTIVE

We assessed whether a reduction in GHGEs can be achieved while meeting dietary requirements for health.

DESIGN

A database was created that linked nutrient composition and GHGE data for 82 food groups. Linear programming was used iteratively to produce a diet that met the dietary requirements of an adult woman (19-50 y old) while minimizing GHGEs. Acceptability constraints were added to the model to include foods commonly consumed in the United Kingdom in sensible quantities. A sample menu was created to ensure that the quantities and types of food generated from the model could be combined into a realistic 7-d diet. Reductions in GHGEs of the diets were set against 1990 emission values.

RESULTS

The first model, without any acceptability constraints, produced a 90% reduction in GHGEs but included only 7 food items, all in unrealistic quantities. The addition of acceptability constraints gave a more realistic diet with 52 foods but reduced GHGEs by a lesser amount of 36%. This diet included meat products but in smaller amounts than in the current diet. The retail cost of the diet was comparable to the average UK expenditure on food.

CONCLUSION

A sustainable diet that meets dietary requirements for health with lower GHGEs can be achieved without eliminating meat or dairy products or increasing the cost to the consumer.

The role of minerals in food selection in a black howler monkey (Alouatta pigra) population in Belize following a major hurricane

As plants may contain low levels of some minerals including sodium, copper, and phosphorous, herbivores may become deficient in these nutrients. In 2001, Hurricane Iris hit the Monkey River Forest in Belize causing substantial damage to the food supply of the black howler monkey population (Alouatta pigra) living there. This included an 18-month absence in fruit production and a complete loss of figs that are high in calcium. In this article, we describe the post-hurricane diet of this monkey population and compare the mineral content of food items to each other and to recommendations for non-human primates [NRC 2003]. We also investigate food selection in relation to potentially limiting minerals. Behavioral data from four groups of howlers (2002-2006) and samples of all ingested food items were collected and a sample of 99 plant from 18 food species was analyzed for mineral content. Unexpectedly, the post-hurricane diet contained more mature leaves than new leaves despite the availability of new leaves. Leaves contained higher amounts of minerals than reproductive parts and with the exception of Cecropia peltata stems, plant parts were low in sodium. Cecropia peltata is a pioneer species that grows following habitat disturbance thus the ingestion of these stems may be a potential mechanism to avoid sodium deficiency in this damaged forest. Calcium and zinc were found above recommended values in most food items; however, both positively predicted food selection, which may reflect a difference between their abundance and their bioavailability. However, as mature leaves contained more calcium than other plant parts, their high post-hurricane consumption may also be a response to the absence of figs and the need to find an alternate calcium source. This study highlights how habitat disturbance may affect mineral abundance and the dietary choices of primates.

Reducing the environmental impact of dietary choice: perspectives from a behavioural and social change approach

Climate change is recognised as a significant public health issue that will impact on food security. One of the major contributors to global warming is the livestock industry, and, relative to plant-based agriculture, meat production has a much higher environmental impact in relation to freshwater use, amount of land required, and waste products generated. Promoting increased consumption of plant-based foods is a recommended strategy to reduce human impact on the environment and is also now recognised as a potential strategy to reduce the high rates of some chronic diseases such as cardiovascular disease and certain cancers. Currently there is a scant evidence base for policies and programs aiming to increase consumption of plant-based diets and little research on the necessary conditions for that change to occur and the processes involved in such a change. This paper reviews some of the environmental and health consequences of current dietary practices, reviews literature on the determinants of consuming a plant-based diet, and provides recommendations for further research in this area.

Proxy indicators for identifying iron deficiency among anemic vegetarians in an area prevalent for thalassemia and hemoglobinopathies

BACKGROUND AND AIMS

The study aimed to determine the proportion of iron deficiency (ID) anemia (IDA) among vegans in northeast Thailand and to explore whether mathematical formulas derived from red blood cell (RBC) indices are applicable for IDA screening in the study population.

METHODS

Blood samples from 234 individuals (age 6-45 years) living in a vegan community were taken. Complete blood cell count, serum ferritin, hemoglobin profiles and DNA analysis for α-thalassemia were determined. Anemia was defined using the WHO criteria adjusted for age and sex. Serum ferritin <15 ng/ml was considered as ID. A number of mathematical formulas derived from RBC indices were applied to screen ID among anemic individuals.

RESULTS

Anemia was found in 41.5% (95% CI = 35.1-48.1%) of the study participants. The overall proportion of thalassemia and hemoglobinopathies was 56.4% (95% CI = 49.8-62.9%). Of the anemic participants, 45.4% had ID. Based on the receiver-operating characteristic curve analysis, 4 formulas were applicable for predicting ID among anemic individuals (highest sensitivity of 86.4%).

CONCLUSIONS

The proposed formulas might be used as proxy indicators for the identification of ID among anemic children and adult vegans if more sophisticated laboratory determinations are not available due to limited financial resources.

Health Implications of a Vegetarian Diet

There is now a significant amount of research that demonstrates the health benefits of vegetarian and plant-based diets, which have been associated with a reduced risk of obesity, diabetes, heart disease, and some types of cancer as well as increased longevity. Vegetarian diets are typically lower in fat, particularly saturated fat, and higher in dietary fiber. They are also likely to include more whole grains, legumes, nuts, and soy protein, and together with the absence of red meat, this type of eating plan may provide many benefits for the prevention and treatment of obesity and chronic health problems, including diabetes and cardiovascular disease. Although a well-planned vegetarian or vegan diet can meet all the nutritional needs of an individual, it may be necessary to pay particular attention to some nutrients to ensure an adequate intake, particularly if the person is on a vegan diet. This article will review the evidence for the health benefits of a vegetarian diet and also discuss strategies for meeting the nutritional needs of those following a vegetarian or plant-based eating pattern.

Clinical practice: vegetarian infant and child nutrition

The aim of this review is to give insight on the benefits and risks of vegetarianism, with special emphasis on vegetarian child nutrition. This eating pattern excluding meat and fish is being adopted by a growing number of people. A vegetarian diet has been shown to be associated with lower mortality of ischaemic heart disease and lower prevalence of obesity. Growth in children on a vegetarian diet including dairy has been shown to be similar to omnivorous peers. Although vegetarianism in adolescents is associated with eating disorders, there is no proof of a causal relation, as the eating disorder generally precedes the exclusion of meat from the diet. A well-balanced lacto-ovo-vegetarian diet, including dairy products, can satisfy all nutritional needs of the growing child. In contrast, a vegan diet, excluding all animal food sources, has at least to be supplemented with vitamin B(12), with special attention to adequate intakes of calcium and zinc and energy-dense foods containing enough high-quality protein for young children. The more restricted the diet and the younger the child, the greater the risk for deficiencies.

Bio-available zinc in rice seeds is increased by activation tagging of nicotianamine synthase

We generated rice lines with increased content of nicotianamine (NA), a key ligand for metal transport and homeostasis. This was accomplished by activation tagging of rice nicotianamine synthase 2 (OsNAS2). Enhanced expression of the gene resulted in elevated NA levels, greater Zn accumulations and improved plant tolerance to a Zn deficiency. Expression of Zn-uptake genes and those for the biosynthesis of phytosiderophores (PS) were increased in transgenic plants. This suggests that the higher amount of NA led to greater exudation of PS from the roots, as well as stimulated Zn uptake, translocation and seed-loading. In the endosperm, the OsNAS2 activation-tagged line contained up to 20-fold more NA and 2.7-fold more zinc. Liquid chromatography combined with inductively coupled plasma mass spectrometry revealed that the total content of zinc complexed with NA and 2'-deoxymugineic acid was increased 16-fold. Mice fed with OsNAS2-D1 seeds recovered more rapidly from a zinc deficiency than did control mice receiving WT seeds. These results demonstrate that the level of bio-available zinc in rice grains can be enhanced significantly by activation tagging of OsNAS2.

A prospective study of intakes of zinc and heme iron and colorectal cancer risk in men and women

Although laboratory studies linked zinc and heme iron to colorectal cancer, epidemiologic evidence is limited. We prospectively examined these associations in the Nurses' Health Study and Health Professionals Follow-up Study. We used Cox proportional hazards regression analyses to calculate cohort-specific relative risks (RRs) and pooled results using a fixed-effects model. We documented 2,114 incident colorectal cancer cases during up to 22 years of follow-up. Compared highest to lowest quintile of dietary zinc intake, the pooled multivariable RRs (95% CIs) were 0.86 (0.73, 1.02) for colorectal cancer, 0.92 (0.76, 1.11) for colon cancer, and 0.68 (0.47, 0.99) for rectal cancer. The significant inverse association between dietary zinc intake and risk of rectal cancer was mainly driven by data in women, although the difference in the sex-specific results was not statistically significant. For the same comparison, the pooled multivariable RRs (95% CIs) for heme iron were 1.10 (0.93, 1.30) for colorectal cancer, 1.06 (0.88, 1.29) for colon cancer, and 1.20 (0.83, 1.75) for rectal cancer. These associations were not significantly modified by alcohol consumption, body mass index, physical activity, menopausal status, or postmenopausal hormone use. Total zinc intake, total iron intake, dietary iron intake, and zinc or iron supplement uses were largely not associated with colorectal cancer risk. Our study does not support strong roles of zinc and heme iron intake in colorectal cancer risk; however, a suggestive inverse association of dietary zinc intake with rectal cancer risk in women requires further study.

Hypothesis: zinc can be effective in treatment of vitiligo

Vitiligo is a common depigmenting skin disorder (prevalence 0.1-2%), still represents a cause of stigmatization and quality of life impairment in a large population. Several theories on vitiligo etiopathogenesis have been suggested including in trauma, stress, and autoimmune and genetic predisposition, accumulation of toxic compounds, altered cellular environment, imbalance in the oxidant-antioxidant system, impaired melanocyte migration and/or proliferation, infection, and psychological factors. Zinc, as a trace element, has many vital functions in human. It is antiapoptotic factor and needed as a cofactor for antioxidant defense system. It plays an important role in the process of melanogenesis. It may be effective in prevention and treatment of vitiligo via some mechanism. Herein, we suggested some probable protective mechanism for zinc in association with vitiligo.

Genetic and physiological analysis of iron biofortification in maize kernels

Background

Maize is a major cereal crop widely consumed in developing countries, which have a high prevalence of iron (Fe) deficiency anemia. The major cause of Fe deficiency in these countries is inadequate intake of bioavailable Fe, where poverty is a major factor. Therefore, biofortification of maize by increasing Fe concentration and or bioavailability has great potential to alleviate this deficiency. Maize is also a model system for genomic research and thus allows the opportunity for gene discovery. Here we describe an integrated genetic and physiological analysis of Fe nutrition in maize kernels, to identify loci that influence grain Fe concentration and bioavailability.

Methodology

Quantitative trait locus (QTL) analysis was used to dissect grain Fe concentration (FeGC) and Fe bioavailability (FeGB) from the Intermated B73 × Mo17 (IBM) recombinant inbred (RI) population. FeGC was determined by ion coupled argon plasma emission spectroscopy (ICP). FeGB was determined by an in vitro digestion/Caco-2 cell line bioassay.

Conclusions

Three modest QTL for FeGC were detected, in spite of high heritability. This suggests that FeGC is controlled by many small QTL, which may make it a challenging trait to improve by marker assisted breeding. Ten QTL for FeGB were identified and explained 54% of the variance observed in samples from a single year/location. Three of the largest FeGB QTL were isolated in sister derived lines and their effect was observed in three subsequent seasons in New York. Single season evaluations were also made at six other sites around North America, suggesting the enhancement of FeGB was not specific to our farm site. FeGB was not correlated with FeGC or phytic acid, suggesting that novel regulators of Fe nutrition are responsible for the differences observed. Our results indicate that iron biofortification of maize grain is achievable using specialized phenotyping tools and conventional plant breeding techniques.

Nutrition concerns and health effects of vegetarian diets

Vegetarians exhibit a wide diversity of dietary practices, often described by what is omitted from their diet. When a vegetarian diet is appropriately planned and includes fortified foods, it can be nutritionally adequate for adults and children and can promote health and lower the risk of major chronic diseases. The nutrients of concern in the diet of vegetarians include vitamin B(12), vitamin D, ω-3 fatty acids, calcium, iron, and zinc. Although a vegetarian diet can meet current recommendations for all of these nutrients, the use of supplements and fortified foods provides a useful shield against deficiency. A vegetarian diet usually provides a low intake of saturated fat and cholesterol and a high intake of dietary fiber and many health-promoting phytochemicals. This is achieved by an increased consumption of fruits, vegetables, whole-grains, legumes, nuts, and various soy products. As a result of these factors, vegetarians typically have lower body mass index, serum total and low-density lipoprotein cholesterol levels, and blood pressure; reduced rates of death from ischemic heart disease; and decreased incidence of hypertension, stroke, type 2 diabetes, and certain cancers than do nonvegetarians.

Dietary zinc and prostate cancer survival in a Swedish cohort

BACKGROUND

Zinc is involved in many essential cellular functions, including DNA repair and immune system maintenance. Although experimental evidence supports a role for zinc in prostate carcinogenesis, epidemiologic data are inconsistent; no data on cancer-specific survival have been reported.

OBJECTIVE

Our objective was to determine whether dietary zinc assessed near the time of prostate cancer diagnosis is associated with improved disease-specific survival.

DESIGN

This population-based cohort consists of 525 men aged <80 y from Örebro County, Sweden, with a diagnosis of prostate cancer made between 1989 and 1994. Study participants completed self-administered food-frequency questionnaires, and zinc intake was derived from nutrient databases. Cox proportional hazards regression was used to estimate multivariate hazard ratios (HRs) and 95% CIs for time to death from prostate cancer as well as death from all causes through February 2009 by quartile (Q) of dietary zinc intake. Models were also stratified by disease stage at diagnosis (localized or advanced).

RESULTS

With a median follow-up of 6.4 y, 218 (42%) men died of prostate cancer and 257 (49%) died of other causes. High dietary zinc intake was associated with a reduced risk of prostate cancer-specific mortality (HR(Q4 vs Q1): 0.64; 95% CI: 0.44, 0.94; P for trend = 0.05) in the study population. The association was stronger in men with localized tumors (HR: 0.24; 95% CI: 0.09, 0.66; P for trend = 0.005). Zinc intake was not associated with mortality from other causes.

CONCLUSION

These results suggest that high dietary intake of zinc is associated with lower prostate cancer-specific mortality after diagnosis, particularly in men with localized disease.

Nutrient intakes of rural Tibetan mothers: a cross-sectional survey

Background

Tibetan food intake is influenced by the region's high altitude and unique culture. Few published studies of nutrient intakes among Tibetan women are available. The present study of Tibetan mothers with young children explores dietary patterns, nutrient intakes, and differences between socio-demographic groups.

Methods

A cross-sectional survey of 386 women with a child aged less than 24 months was conducted in rural areas surrounding Lhasa, Tibet. All participants were recruited using simple random sampling and were interviewed face-to-face by trained investigators. Dietary information was collected via a food frequency questionnaire. Nutrient intakes were calculated using food composition tables. Non-parametric tests were used to compare nutrient intakes according to socio-demographic variables, and to compare results with the 2002 Chinese National Nutrition and Health Survey (2002 NNHS) and dietary reference intakes (DRIs).

Results

Median intakes of energy (p < 0.001), protein (p < 0.001), fat (p < 0.001), vitamin A (p < 0.001), vitamin B1 (p < 0.001), vitamin B2 (p < 0.001), vitamin C (p < 0.001), and vitamin E (p < 0.001) were lower than the average levels reported in 2002 NNHS. The median intakes of calcium (517 mg/d, p < 0.001), iron (35 mg/d, p < 0.001), and zinc (17.3 mg/d, p < 0.001) were higher than the average levels in 2002 NNHS. The highest education subgroup had significantly higher intakes of vitamins A and C than the lowest education subgroup.

Conclusion

Although the diet of Tibetan mothers with young children has been partially influenced by other factors, their dietary patterns are still mostly composed of Tibetan traditional foods. Compared with the 2002 NNHS, Tibetan women with young children appear to have insufficient intakes of many nutrients, which will affect their nutritional status.

Influence of dietary vitamin E and zinc on performance, oxidative stability and some blood measures of broiler chickens reared under heat stress (35 °C)

This study was conducted to determine the effects of vitamin E (αTA; dL-α-Tocopheryl acetate) and zinc (Zn; ZnCl2) on performance, oxidative stability and some blood measures of broiler chickens under normal and hot temperatures. One hundred sixty 10-day-old male chicks were assigned to four groups in four replicates. The birds received two diets, control and enriched with two levels of vitamin E and Zn (100 and 50 mg/kg of diet, respectively) under two ambient temperatures (22 °C and 35 °C). Although the diets enriched with the antioxidant vitamin and element compared with un-enriched diets resulted in the better performance of the birds, significant differences were related to temperature conditions, as the lowest feed conversion ratio (FCR) and the highest body weight (BW) were observed in the group fed the enriched diet under normal temperature. The serum malondialdehyde (MDA), cholesterol (C), triglycerides (TG), glucose (G), total protein (TP), and hematocrit and heterophil: lymphocyte ratio levels were significantly lower in birds reared under 22 °C compared with the group under 35 °C but the hematocrit was not significantly lower in groups fed enriched diets and exposed to normal conditions (P>0.05). It was concluded that a combination of 100 mg of vitamin E and 50 mg of Zn provides the better performance and the least blood C and TG levels accompanying the better oxidative stability in male broilers under normal temperature (22 °C) and that this combination can be considered as a protective strategy in broiler diets for reducing the negative effects of heat stress.

Innovative uses for zinc in dermatology

Severe zinc deficiency states, such as acrodermatitis enteropathica, are associated with a variety of skin manifestations, such as perioral, acral, and perineal dermatitis. These syndromes can be reversed with systemic zinc repletion. In addition to skin pathologies that are clearly zinc-dependent, many dermatologic conditions (eg, dandruff, acne, and diaper rash) have been associated and treated with zinc. Success rates for treatment with zinc vary greatly depending on the disease, mode of administration, and precise zinc preparation used. With the exception of systemic zinc deficiency states, there is little evidence that convincingly demonstrates the efficacy of zinc as a reliable first-line treatment for most dermatologic conditions. However, zinc may be considered as an adjunctive treatment modality. Further research is needed to establish the indications for zinc treatment in dermatology, optimal mode of zinc delivery, and best type of zinc compound to be used.

Dietary iron intake and risk of endometrial cancer: a population-based case-control study in Shanghai, China

Dietary red meat and animal fat have been linked to endometrial cancer (EC) risk, but the impact of bioavailable iron in animal-derived foods has been less well studied. Our objective was to investigate the effects of iron and fats on the risk of EC in a large, population-based, case-control study. The Shanghai Endometrial Cancer Study enrolled 1,204 EC cases and 1,212 controls who completed in-person interviews, including a food frequency questionnaire. Animal-derived iron and fat intakes were calculated from dietary intakes and food composition tables. Logistic regression models were used to evaluate independent and joint effects of iron and fat on EC risk. Animal-derived iron intake was positively associated with EC risk [adjusted OR = 1.9; 95% CI = 1.4-2.7, P(trend) < 0.01, highest vs. lowest quartile], predominantly after menopause (OR = 2.2; 95%CI = 1.4-3.4, P(trend) < 0.01) and in women with BMI >or= 25 kg/m(2)(OR = 3.2; 95% CI = 1.4-7.5 in postmenopausal obese women, P(trend) < 0.01). Animal-derived fat was also associated with postmenopausal EC risk (OR = 1.7; 95% CI = 1.2-2.5, P(trend) < 0.01). Multiplicative interactions between animal-derived iron and BMI or animal-derived fat intake were not observed. Animal-derived iron intake is associated with increased risk of EC after menopause and among obese women. Avoidance of animal-derived (heme) iron may reduce the risk of EC in these women.

Yogurt protects against growth retardation in weanling rats fed diets high in phytic acid

The purpose of this study was to determine the effects of adding yogurt to animal diets that were high in phytic acid (PA) and adequate in zinc (38 microg Zn/g). The PA:Zn molar ratio was 60:1. Zinc status was determined by documenting growth and measuring the zinc concentration in bone (tibia) and plasma. For 25 days, six groups (n=6) of Sprague-Dawley weanling rats were fed one of six AIN-76 diets. Half of the diets contained PA. Four of the diets contained yogurt with either active or heat-treated (inactive) cultures added at 25% of the diet. The diets were as follows: (a) AIN, (b) AIN with active yogurt, (c) AIN and inactive yogurt, (d) AIN with PA, (e) AIN with PA plus active yogurt and (f) AIN with PA plus inactive yogurt. Body weight, weight gain and zinc concentration in bone and plasma were measured, and food efficiency ratio was calculated. Rats fed diets with PA and yogurt had normal growth compared to the control group. Growth retardation was evident in the group fed the diet with PA and no yogurt. This group had significantly lower body weight compared to all other groups (P<.05). Rats fed diets with PA, with or without yogurt, had significantly lower zinc concentration in bone and plasma (P<.05). Adding yogurt to diets high in PA resulted in normal growth in weanling rats; however, zinc concentration in bone and plasma was still suboptimal.

Identification of biochemical changes in lactovegetarian urine using 1H NMR spectroscopy and pattern recognition

A vegetarian diet has been demonstrated to have a profound influence on human metabolism as well as to aid the prevention of several chronic diseases relative to an omnivorous diet. However, there have been no systematic metabolomic studies on all of the biochemical changes induced in human subjects by long-term vegetarianism. In this study, (1)H NMR spectroscopy in combination with multivariate statistical analysis was applied to explore the variability in the metabolic urinary profiles of healthy populations from four groups: lactovegetarian male (VEGMALE), lactovegetarian female (VEGFEMALE), omnivorous male (OMNMALE), and omnivorous female (OMNFEMALE). Differences in metabolic profiles were examined in relation to diet and gender by principal component analysis (PCA) and spectral integrals. It was found that the most influential low molecular weight metabolites responsible for the differences between the diet groups were N-acetyl glycoprotein (NAG), succinate, citrate, trimethylamine-N-oxide (TMAO), taurine, glycine, hippurate, phenylalanine, methylhistidine and formate, whereas for the differences in gender groups the most discriminatory metabolites were NAG, succinate, creatinine, arginine, TMAO, taurine, hippurate, mannitol, phenylalanine, and methylhistidine. The results from the PCA of all four groups indicated that diet plays a greater role in influencing metabolite differences than gender. As an exploration, this work shows the potential of metabolomics when applied to nutritional and physiological studies, and it will aid further studies.

A possible link between iron deficiency and gastrointestinal carcinogenesis

There is definitive evidence that iron overload induces oxidative stress and DNA damage, which can enhance carcinogenic risk. However, other evidence suggests that iron deficiency and anemia also increase oxidative stress and DNA damage, which might increase carcinogenesis risk, especially in the gastrointestinal (GI) tract. The aim of this review is to provide essential background information for the accurate interpretation of future research on iron deficiency and increased GI cancer risk. Based on clinical, epidemiological, and experimental evidence, we discuss how iron deficiency might contribute to increased cancer risk through the impairment of several iron-dependent metabolic functions that are related to genome protection and maintenance (e.g., immune responses against cancer-initiated cells, metabolism of toxic compounds, and redox regulation of DNA biosynthesis and repair). Some epidemiological studies have indicated increased risk of GI tumors among individuals with low iron intake or low somatic iron stores, and in vivo data from rodent cancer models indicates the early progression of GI tumors during iron deficiency. Given the preliminary but consistent evidence relating iron deficiency to cancer risk and the fact that iron deficiency affects about one third of the world's population, further studies are needed to define the extent to which iron deficiency might increase GI cancer risk.

Nutritional deficiencies in children on restricted diets

Pediatric nutritional deficiencies are associated not only with poverty and developing countries, but also in children in the developed world who adhere to restricted diets. At times, these diets are medically necessary, such as the gluten-free diet for management of celiac disease or exclusion diets in children with food allergies. At other times, the diets are self-selected by children with behavioral disorders, or parent-selected because of nutrition misinformation, cultural preferences, alternative nutrition therapies, or misconceptions regarding food tolerance. Health care providers must be vigilant in monitoring both growth and feeding patterns to identify inappropriate dietary changes that may result in nutritional deficiencies.

Position of the American Dietetic Association: vegetarian diets

It is the position of the American Dietetic Association that appropriately planned vegetarian diets, including total vegetarian or vegan diets, are healthful, nutritionally adequate, and may provide health benefits in the prevention and treatment of certain diseases. Well-planned vegetarian diets are appropriate for individuals during all stages of the life cycle, including pregnancy, lactation, infancy, childhood, and adolescence, and for athletes. A vegetarian diet is defined as one that does not include meat (including fowl) or seafood, or products containing those foods. This article reviews the current data related to key nutrients for vegetarians including protein, n-3 fatty acids, iron, zinc, iodine, calcium, and vitamins D and B-12. A vegetarian diet can meet current recommendations for all of these nutrients. In some cases, supplements or fortified foods can provide useful amounts of important nutrients. An evidence- based review showed that vegetarian diets can be nutritionally adequate in pregnancy and result in positive maternal and infant health outcomes. The results of an evidence-based review showed that a vegetarian diet is associated with a lower risk of death from ischemic heart disease. Vegetarians also appear to have lower low-density lipoprotein cholesterol levels, lower blood pressure, and lower rates of hypertension and type 2 diabetes than nonvegetarians. Furthermore, vegetarians tend to have a lower body mass index and lower overall cancer rates. Features of a vegetarian diet that may reduce risk of chronic disease include lower intakes of saturated fat and cholesterol and higher intakes of fruits, vegetables, whole grains, nuts, soy products, fiber, and phytochemicals. The variability of dietary practices among vegetarians makes individual assessment of dietary adequacy essential. In addition to assessing dietary adequacy, food and nutrition professionals can also play key roles in educating vegetarians about sources of specific nutrients, food purchase and preparation, and dietary modifications to meet their needs.

Lentils (Lens culinaris Medikus Subspecies culinaris): a whole food for increased iron and zinc intake

Micronutrient malnutrition, the hidden hunger, affects more than 40% of the world's population, and a majority of them are in South and South East Asia and Africa. This study was carried out to determine the potential for iron (Fe) and zinc (Zn) biofortification of lentils ( Lens culinaris Medikus subsp. culinaris ) to improve human nutrition. Lentils are a common and quick-cooking nutritious staple pulse in many developing countries. We analyzed the total Fe and Zn concentrations of 19 lentil genotypes grown at eight locations for 2 years in Saskatchewan, Canada. It was observed that some genetic variation exists for Fe and Zn concentrations among the lentil lines tested. The total Fe and Zn concentrations ranged from 73 to 90 mg of Fe kg(-1) and from 44 to 54 mg of Zn kg(-1). The calculated percentages of the recommended daily allowance (RDA) for Fe and Zn were within the RDA ranges from a 100 g serving of dry lentils. Broad-sense heritability estimates for Fe and Zn concentrations in lentil seed were 64 and 68%, respectively. It was concluded that lentils have great potential as a whole food source of Fe and Zn for people affected by these nutrient deficiencies. This is the first report on the genetic basis for Fe and Zn micronutrient content in lentils. These results provide some understanding of the genetic basis of Fe and Zn concentrations and will allow for the development of potential strategies for genetic biofortification.

Methods of assessment of zinc status in humans: a systematic review

BACKGROUND

Zinc is an essential micronutrient for human health and has numerous structural and biochemical roles. The search for a reliable, sensitive, and specific index of zinc status has been the subject of considerable research, which has resulted in the identification of a number of potentially useful biomarkers.

OBJECTIVE

The objective was to assess the usefulness of biomarkers of zinc status in humans.

DESIGN

The methods included a structured search strategy using Ovid MEDLINE, EMBASE (Ovid), and the Cochrane Library CENTRAL databases; formal inclusion and exclusion criteria; data extraction into an Access database; quality and validity assessment; and meta-analysis.

RESULTS

Data on 32 potential biomarkers from 46 publications were analyzed. Plasma zinc concentration responded in a dose-dependent manner to dietary manipulation in adults, women, men, pregnant and lactating women, the elderly, and those at low and moderate baseline zinc status. Urinary zinc excretion responded to zinc status overall and in all subgroups for which there were sufficient data. Hair zinc concentration also responded, but there were insufficient studies for subgroup analysis. Platelet, polymorphonuclear cell, mononuclear cell, and erythrocyte zinc concentration and alkaline phosphatase activity did not appear to be effective biomarkers of zinc status.

CONCLUSIONS

This systematic review confirms that in healthy individuals, plasma, urinary, and hair zinc are reliable biomarkers of zinc status. Further high-quality studies using these biomarkers are required, particularly in infants, adolescents, and immigrant population groups for whom there are limited data. Studies are also required to fully assess a range of additional potential zinc biomarkers.

Soybean ferritin: implications for iron status of vegetarians

Meeting the requirement for absorbed iron is difficult for vegetarians, and their iron status often is lower than that of nonvegetarians. Beans contain ferritin in low concentrations, but it is possible to enhance this content by plant breeding or by inserting the gene for ferritin into plants, eg, soybeans. Because each ferritin molecule can bind to thousands of iron atoms, this may be a sustainable means to increase the iron contents of plants. Before such efforts are launched, it is important to determine whether iron in ferritin is bioavailable. This has been assessed in vitro by using human intestinal (Caco-2) cells and in vivo by using radiolabeled ferritin and whole-body counting in human subjects. Dietary factors affecting iron absorption, eg, ascorbic acid, phytate, and calcium, had limited effect on iron uptake from intact ferritin by Caco-2 cells, which suggests that ferritin-bound iron is absorbed via a mechanism different from that of nonheme iron. In an in vitro digestion system, ferritin was shown to be relatively resistant to proteolytic enzymes. Binding of ferritin to Caco-2 cells was shown to be saturable, and the kinetics for binding were characteristic of a receptor-mediated process. In human subjects, iron from purified soybean ferritin given in a meal was as well absorbed as iron from ferrous sulfate. In conclusion, iron is well absorbed from ferritin and may represent a means of biofortification of staple foods such as soybeans.

Does physical exercise modify antioxidant requirements?

Physical training is known to induce a biochemical adaptive response which might require an increase in the ingestion and/or the absorption of micronutrients. A question that is still being raised is whether acute or chronic exercise modifies antioxidant requirements. First, the present review brings to light the most crucial studies on the topic. Second, it interprets the established relationships between antioxidant micronutrient intakes and the adaptive response of antioxidant systems. Finally, it exposes the major questions connected with antioxidant micronutrient requirements for athletes. To this effect, the training-load interaction with nutrition is taken into account. As oxidative stress cannot be avoided, the imbalance between oxidants and antioxidants can be alleviated to minimise oxidative damage and outcomes. There is growing evidence that one specific antioxidant cannot by itself prevent oxidative stress-induced damage, as direct adverse effects of supplementation are attributed to undesirable synergic effects. Other effects can be supposed that limit the endogenous adaptive effect of training. High doses of antioxidant supplements can minimise the effects of radical oxygen species themselves or generate pro-oxidant effects. Effects are only exhibited when nutritional status is deficient. There are no convincing effects of supplementation in well-trained athletes. Risk/benefit analysis emerges on evidence for an unknown risk of supranutritional intakes, a supposed impairment of adaptive effects and a still unknown long-term risk. Appropriate status can be achieved by a diversified and balanced diet, adapted to specific needs, by awareness of high-density food intakes (avoiding products containing a low density of micronutrients).

Indicators of zinc status at the population level: a review of the evidence

The role of zinc deficiency as an important cause of morbidity and impaired linear growth has prompted the need to identify indicators of population zinc status. Three indicators have been recommended - prevalence of zinc intakes below the estimated average requirement (EAR), percentage with low serum zinc concentrations, and percentage of children aged < 5 years who are stunted. This review outlines steps to estimate the prevalence of inadequate intakes, and confirm their validity based on the EARs set by International Zinc Nutrition Collaborative Group. Next, the appropriateness of serum zinc as a biochemical marker for population zinc status is confirmed by a summary of: (a) the response of serum zinc concentrations to zinc intakes; (b) usefulness of serum zinc concentrations to predict functional responses to zinc interventions; (c) relationship between initial serum zinc and change in serum zinc in response to interventions. Height- or length-for-age was chosen as the best functional outcome after considering the responses of growth, infectious diseases (diarrhoea, pneumonia), and developmental outcomes in zinc supplementation trials and correlation studies. The potential of other zinc biomarkers such as zinc concentrations in hair, cells, zinc-metalloenzymes, and zinc-binding proteins, such as metallothionein, is also discussed. Molecular techniques employing reverse transcriptase (RT)-polymerase chain reaction to measure mRNA in metallothionein and ZIP1 transporter hold promise, as do kinetic markers such as exchangeable zinc pools (EZP) and plasma zinc turnover rates. More research is needed to establish the validity, specificity, sensitivity, and feasibility of these new biomarkers, especially in community-settings.

Nutrigenomics and antioxidants

Since the complete sequencing of the human genome, the era of the ‘omics’ has appeared. Among them, a new discipline called ‘nutrigenomics’ emerged from the interface of nutrition research and genetics. Its aim is to understand how nutrients modulate gene expression. This powerful tool allows determinination of new biomarkers and the molecular pathways by which our diet may have a potential protective effect against degenerative diseases such as cancer. On one hand, cellular metabolism produces continuous oxidative stress and reactive oxygen species with mutagenic and oncogenic effects. On the other hand, diet provides natural antioxidants present in various fruits and vegetables that may prevent diseases. This review first reports the main antioxidants provided by diet and the main results from epidemiological studies of their role in health. Second, we describe how nutrigenomics could provide new insights into nutrition research and innovative developments through neutraceutical products and a personalized medicine.

Feeding the 1 to 7-year-old child. A support paper for the South African paediatric food-based dietary guidelines

Young children embark on a transitional nutritional journey, progressing from total reliance on caregivers to independence, autonomy and self-determination. Appropriate nutritional intake in young children is a diverse concept, incorporating suitable nutritional choices and feeding behaviours. Lessons learnt in childhood will have long-term effects on the individual and society overall. Since South African children are raised in a country where under- and over-nutrition exist simultaneously, a careful balance should be achieved in any national public health message. The South African paediatric food-based dietary guidelines for children younger than 7 years strive to facilitate the education of carers of young children in the adoption of healthy eating practices. The guidelines address issues regarding variety in the diet that has been shown to improve both micro- and macronutrient intakes. Specific reference is made to starchy foods, vegetables, fruit and water along with protein sources, which should be consumed regularly. Milk, has been emphasised in these guidelines because of the poor calcium intake in South African children. The only guideline that limits intake is the sweet treats or drinks message, because of public health concerns such as obesity and dental caries. Other messages pertaining to eating habits take cognisance of the child's physiological limitations in gastric capacity and suggest small regular meals. Clean, safe drinking water is the beverage of choice. Non-food-based guidelines are also included, which recognize the importance of active play, for developmental and health purposes, as well as regular clinic attendance.

Total zinc absorption in young women, but not fractional zinc absorption, differs between vegetarian and meat-based diets with equal phytic acid content

Zn bioavailability is often lower in vegetarian diets mainly due to low Zn and high phytic acid contents. The objective of the present study was to determine the fractional and total absorption of Zn from a vegetarian diet in comparison with meat diets with equal concentrations of phytic acid. A randomized crossover design, comprising three whole-day diet periods of 5 d each, with a vegetarian diet or diets containing Polish-produced meat or Danish-produced meat, was conducted. Twelve healthy female subjects completed the study. All diets had a high content of phytic acid (1250μlmol/d) and in the meat diets the main meals contained 60 g pork meat. All main meals were extrinsically labelled with the radioactive isotope 65Zn and absorption of Zn was measured in a whole-body counter. The mean Zn content of the whole-day diet was: Polish meat diet 9·9 (SE 0·14) mg, Danish meat diet 9·4 (SE 0·19) mg and vegetarian diet 7·5 (SE 0·18) mg. No difference was observed in the fractional absorption of Zn (Polish meat diet: 27 (SE 1·2) %, Danish meat diet: 27 (SE 1·9)% and vegetarian diet: 23 (SE 2·6) %). A significantly lower amount of total Zn was absorbed from the vegetarian diet (mean Zn absorption of Polish meat diet: 2·7 (SE 0·12) mg/d (P<,0·001), Danish meat diet: 2·6 (SE 0·17) mg/d (P=/4 0·006) and vegetarian diet: 1·8 (SE 0·20) mg/d). In conclusion, the vegetarian diet compared with the meat-based diets resulted in lower amounts of absorbed Zn due to a higher content of Zn in the meat diets, but no difference was observed in the fractional absorption of Zn.

Influence of habitual diet on antioxidant status: a study in a population of vegetarians and omnivores

BACKGROUND

Antioxidant status can be used as a biomarker to assess chronic disease risk and diet can modulate antioxidant defence.

OBJECTIVE

To examine effects of vegetarian diet and variations in the habitual intakes of foods and nutrients on blood antioxidants.

SUBJECTS AND SETTING

Thirty-one vegetarians (including six vegans) and 58 omnivores, non-smokers, in Northern Ireland.

DESIGN

A diet history method was used to assess habitual diet. Antioxidant vitamins, carotenoids, uric acid, zinc- and ferric-reducing ability of plasma (FRAP) were measured in fasting plasma and activities of glutathione peroxidase (GPX), superoxide dismutase (SOD) and glutathione S-transferase (GST) and level of reduced glutathione (GSH) were measured in erythrocytes.

RESULTS

Vegetarians had approximately 15% higher levels of plasma carotenoids compared with omnivores, including lutein (P< or =0.05), alpha-cryptoxanthin P< or =0.05), lycopene (NS), alpha-carotene (NS) and beta-carotene (NS). The levels/activities of all other antioxidants measured were similar between vegetarians and omnivores. Total intake of fruits, vegetables and fruit juices was positively associated with plasma levels of several carotenoids and vitamin C. Intake of vegetables was positively associated with plasma lutein, alpha-cryptoxanthin, alpha-carotene and beta-carotene, whereas intake of fruits was positively associated with plasma beta-cryptoxanthin. Intake of tea and wine was positively associated with FRAP value, whereas intake of herbal tea associated positively with plasma vitamin C. Intakes of meat and fish were positively associated with plasma uric acid and FRAP value.

CONCLUSIONS

The overall antioxidant status was similar between vegetarians and omnivores. Good correlations were found between intakes of carotenoids and their respective status in blood.

Zinc in skin pathology and care

OBJECTIVES

To assess the significance of zinc in the etiology of various dermatological conditions and examine the role of zinc as a mode of treatment for a wide range of dermatoses.

METHODS

Review of existing literature through searches using the PubMed site with zinc and the dermatosis in question as search words.

RESULTS

Severe zinc deficiency states such as acrodermatitis enteropathica are associated with a variety of skin manifestations, such as perioral, acral and perineal dermatitis. These syndromes can be reversed with systemic zinc repletion. In addition to skin pathologies which are clearly zinc-dependent, many dermatological conditions (e.g. dandruff, acne and diaper rash) have been associated and treated with zinc. Success rates for treatment with zinc vary depending on the disease, mode of application and zinc salt used. Usually, alternative modes of treatment are superior to zinc.

CONCLUSIONS

Generally, it seems that with the exception of systemic deficiency states, there is very little evidence to convincingly demonstrate the efficacy of zinc as a first-line treatment for any dermatological conditions. Further research is needed in order to establish the indications for zinc treatment in dermatology, optimal mode of delivery, type of compound and therapeutic indexes.

Dietas vegetarianas e desempenho esportivo

As evidências atuais apontam benefícios da dieta vegetariana para a saúde humana. Contudo, a partir da adoção de práticas vegetarianas mais restritivas, confirmam-se os riscos à saúde. As dietas vegetarianas são caracterizadas pelo elevado consumo de carboidratos, fibras, magnésio, potássio, folato e antioxidantes, podendo apresentar deficiências em aminoácidos e ácidos graxos essenciais, cálcio, zinco, ferro e cobalamina. Pesquisas experimentais em humanos indicam que vegetarianos e não-vegetarianos apresentam capacidade aeróbica semelhante. Em relação ao desempenho em atividades de força e potência muscular, as pesquisas são escassas, mas as existentes não apontam diferenças significativas. Situações de risco cardiovascular têm sido confirmadas, devido ao provável quadro de hiperhomocisteinemia, em decorrência da baixa ingestão de cobalamina. As dietas vegetarianas são isentas de creatina, o que resulta em estoques musculares mais baixos nessa população. Possivelmente ocorrem alterações hormonais e metabólicas em resposta às dietas vegetarianas, como baixos níveis de testosterona e androstenediona. A função imune parece não ser prejudicada. Dessa forma, a prática de dietas vegetarianas apresenta-se compatível com a prática esportiva cotidiana, desde que bem planejada para evitar deficiências nutricionais.