Fifty years ago. Archives of Diseases in Childhood 1933. A nutritional disease of childhood associated with a maize diet

Starvation-resistant cavefish reveal conserved mechanisms of starvation-induced hepatic lipotoxicity

Starvation causes the accumulation of lipid droplets in the liver, a somewhat counterintuitive phenomenon that is nevertheless conserved from flies to humans. Much like fatty liver resulting from overfeeding, hepatic lipid accumulation (steatosis) during undernourishment can lead to lipotoxicity and atrophy of the liver. Here, we found that although surface populations of Astyanax mexicanus undergo this evolutionarily conserved response to starvation, the starvation-resistant cavefish larvae of the same species do not display an accumulation of lipid droplets upon starvation. Moreover, cavefish are resistant to liver atrophy during starvation, providing a unique system to explore strategies for liver protection. Using comparative transcriptomics between zebrafish, surface fish, and cavefish, we identified the fatty acid transporter slc27a2a/fatp2 to be correlated with the development of fatty liver. Pharmacological inhibition of slc27a2a in zebrafish rescues steatosis and atrophy of the liver upon starvation. Furthermore, down-regulation of FATP2 in Drosophila larvae inhibits the development of starvation-induced steatosis, suggesting the evolutionarily conserved importance of the gene in regulating fatty liver upon nutrition deprivation. Overall, our study identifies a conserved, druggable target to protect the liver from atrophy during starvation.

Starvation resistant cavefish reveal conserved mechanisms of starvation-induced hepatic lipotoxicity

Starvation causes the accumulation of lipid droplets in the liver, a somewhat counterintuitive phenomenon that is nevertheless conserved from flies to humans. Much like fatty liver resulting from overfeeding, hepatic lipid accumulation (steatosis) during undernourishment can lead to lipotoxicity and atrophy of the liver. Here, we found that while surface populations of Astyanax mexicanus undergo this evolutionarily conserved response to starvation, the starvation-resistant cavefish larvae of the same species do not display an accumulation of lipid droplets upon starvation. Moreover, cavefish are resistant to liver atrophy during starvation, providing a unique system to explore strategies for liver protection. Using comparative transcriptomics between zebrafish, surface fish, and cavefish, we identified the fatty acid transporter slc27a2a/fatp2 to be correlated with the development of fatty liver. Pharmacological inhibition of slc27a2a in zebrafish rescues steatosis and atrophy of the liver upon starvation. Further, down-regulation of FATP2 in drosophila larvae inhibits the development of starvation-induced steatosis, suggesting the evolutionary conserved importance of the gene in regulating fatty liver upon nutrition deprivation. Overall, our study identifies a conserved, druggable target to protect the liver from atrophy during starvation.

Dietary Manipulation of Amino Acids for Cancer Therapy

Cancer cells cannot proliferate and survive unless they obtain sufficient levels of the 20 proteinogenic amino acids (AAs). Unlike normal cells, cancer cells have genetic and metabolic alterations that may limit their capacity to obtain adequate levels of the 20 AAs in challenging metabolic environments. However, since normal diets provide all AAs at relatively constant levels and ratios, these potentially lethal genetic and metabolic defects are eventually harmless to cancer cells. If we temporarily replace the normal diet of cancer patients with artificial diets in which the levels of specific AAs are manipulated, cancer cells may be unable to proliferate and survive. This article reviews in vivo studies that have evaluated the antitumor activity of diets restricted in or supplemented with the 20 proteinogenic AAs, individually and in combination. It also reviews our recent studies that show that manipulating the levels of several AAs simultaneously can lead to marked survival improvements in mice with metastatic cancers.

Nutritional Assessment of the Symptomatic Patient on a Plant-Based Diet: Seven Key Questions

Plant-based diets, both vegan and vegetarian, which emphasize grains, vegetables, fruits, legumes, nuts, and seeds are increasingly popular for health as well as financial, ethical, and religious reasons. The medical literature clearly demonstrates that whole food plant-based diets can be both nutritionally sufficient and medically beneficial. However, any person on an intentionally restrictive, but poorly-designed diet may predispose themselves to clinically-relevant nutritional deficiencies. For persons on a poorly-designed plant-based diet, deficiencies are possible in both macronutrients (protein, essential fatty acids) and micronutrients (vitamin B12, iron, calcium, zinc, and vitamin D). Practitioner evaluation of symptomatic patients on a plant-based diet requires special consideration of seven key nutrient concerns for plant-based diets. This article translates these concerns into seven practical questions that all practitioners can introduce into their patient assessments and clinical reasoning. Ideally, persons on plant-based diets should be able to answer these seven questions. Each serves as a heuristic prompt for both clinician and patient attentiveness to a complete diet. As such, these seven questions support increased patient nutrition knowledge and practitioner capacity to counsel, refer, and appropriately focus clinical resources.

Dietary restriction of amino acids for Cancer therapy

Biosyntheses of proteins, nucleotides and fatty acids, are essential for the malignant proliferation and survival of cancer cells. Cumulating research findings show that amino acid restrictions are potential strategies for cancer interventions. Meanwhile, dietary strategies are popular among cancer patients. However, there is still lacking solid rationale to clarify what is the best strategy, why and how it is. Here, integrated analyses and comprehensive summaries for the abundances, signalling and functions of amino acids in proteomes, metabolism, immunity and food compositions, suggest that, intermittent dietary lysine restriction with normal maize as an intermittent staple food for days or weeks, might have the value and potential for cancer prevention or therapy. Moreover, dietary supplements were also discussed for cancer cachexia including dietary immunomodulatory.

Nutritional, inflammatory, and ecological correlates of maternal retinol allocation to breast milk in agro-pastoral Ariaal communities of northern Kenya

OBJECTIVES

Vitamin A (VA) is an essential micronutrient required for a range of biological functions throughout life. VA deficiency (VAD) claims an estimated 1 million preschool children's lives annually. Human milk is enriched with VA (retinol) from the maternal blood, which originates from the hepatic reserve and dietary intake. Secreting retinol into milk will benefit the nursing infant through breast milk, but retaining retinol is also important for the maternal health. Previous studies found that the public health intervention of high-dose VA supplementation to lactating mothers did not significantly lower child mortality. The World Health Organization (WHO) recently acknowledged that our understanding about the principle of VA allocation within the maternal system and the secretion into milk is too incomplete to devise an effective intervention.

METHODS

We present a secondary analysis of data collected among lactating mothers in VAD endemic northern Kenya (n = 171), examining nutritional, inflammatory, and ecological factors that might associate with maternal retinol allocation. Regression models were applied using the outcome milk-retinol allocation index: milk retinol/(milk retinol + serum retinol).

RESULTS

Ten percent of the sample was identified as VAD. The average milk retinol concentration was 0.1 μmo/L, grossly below what is considered minimally necessary for an infant (1 μmol/L). VAD mothers and mothers with inflammation did not seem to compromise their milk retinol even though their serum retinol was lower than non-VAD and noninflammation mothers. Breast milk fat concentration positively correlated with milk retinol but not with serum retinol.

CONCLUSIONS

This exploratory study contributes toward an understanding of maternal retinol allocation.

Vitamin A dynamics in breastmilk and liver stores: a life history perspective

OBJECTIVES

Newborns are dependent on breastmilk vitamin A for building hepatic stores of vitamin A that will become critical for survival after weaning. It has been documented that vitamin A concentrations in breastmilk decline across the first year postpartum in both well-nourished and malnourished populations. The reason for this decline has been assumed to be a sign of concurrently depleting maternal hepatic stores. This study investigates this assumption to clarify why the decline occurs, drawing on life history theory.

METHODS

A cross sectional survey was conducted among lactating mothers in Kenya in 2006. Data were used to examine (1) the relationship between liver vitamin A and time, (2) if the relationship between milk and liver vitamin A varies by time, and (3) by maternal parity.

RESULTS

The relationship between liver vitamin A and time fits the quadratic pattern with marginal significance (P = 0.071, n = 192); the liver vitamin A declined during early postpartum then recovered in late postpartum time, controlling covariates. The milk-liver vitamin A relationship varied by postpartum time periods (P = 0.03) and by maternal parity (P = 0.005). Mothers in earlier postpartum or higher parity had a stronger positive relationship between milk and liver vitamin A than mothers in later postpartum or lower parity.

CONCLUSIONS

Our observations are consistent with life history tradeoffs and negate the assumption that maternal hepatic and milk vitamin A decline together. Rather, maternal liver vitamin A has a dynamic relationship with milk vitamin A, particularly depending on postpartum time and maternal parity.

Chapter 50: history of tropical neurology

Tropical neurology began less than two centuries ago. Consumption of dietary toxins predominated at the beginning and gave birth to the geographic entity. The story moved from lathyrism through Jamaican neuropathy to cassava-induced epidemic neuropathy, which was contrasted with Konzo, also associated with cassava. Other tropical diseases enumerated with chronological details include: Chaga's diseases, kwashiorkor, Madras type of motor neuron disease, atlanto-axial dislocation, Burkitt's lymphoma and Kuru, associated with cannibalism among the Fore linguistic group in New Guinea. More recent documentation includes the Cuban neuropathy in 1991 with an epidemic of visual loss and neuropathy, Anaphe venata entomophagy in Nigeria presenting as seasonal ataxia, and neurological aspects of the human immunodeficiency virus infection complete the picture. With time, professional associations were formed and the pioneers were given prominence. The World Federation of Neurology featured Geographic Neurology as a theme in 1977 and Tropical Neurology was given prominence at its 1989 meeting in New Delhi, India. The situation remains unchanged with regards to rare diseases like Meniere's, multiple sclerosis, hereditary disorders. However, with westernization and continued urbanization, changing disease patterns are being observed and tropical neurology may depart from dietary toxins to more western world-type disorders.

Withdrawal behavior and depression in infancy

This paper describes the history of the concept of infant depression, which has been at the beginning of the discipline of infant mental health, and reviews classification and diagnosis issues, along with some animal models. Several diagnostic criteria have yielded different prevalence rates, and some being unrealistic, but we still do not know when infant depression begins, what its outcome is, and what are its different aspects. It is suggested that infant depression needs a certain amount of emotional and cognitive development to unfold, and that it might not exist before 18-24 months of age, a crossover during which major autoreflexive, cognitive, and emotional abilities emerge. Depression could be an outcome of attachment disorganization in infancy, as depression and disorganization seem to share the same learned helpnessness psychopathological process. Developmental psychopathology considers trouble more from a dimensional point of view rather than from a categorical one, and more as the result of several factors with a sequential action rather than the effect of a genetic disorder with direct expression. Before the limit of 18-24 months, the concept of relational withdrawal seems more applicable and useful.