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Gruchy N, Bigot N, Jeanne Pasquier C, Read MH, Odent S, Galera P, Leporrier N. Involvement and alteration of the Sonic Hedgehog pathway is associated with decreased cholesterol level in trisomy 18 and SLO amniocytes. Mol Genet Metab 2014; 112:177-82. [PMID: 24742993 DOI: 10.1016/j.ymgme.2014.03.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 03/24/2014] [Accepted: 03/24/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Trisomy 18 and Smith-Lemli-Opitz syndrome are two polymalformative conditions in which a cholesterol defect has been noted. When they occur prenatally, they are associated with a decreased maternal unconjugated estriol (uE(3)) level. Cholesterol plays an essential role in the Sonic Hedgehog pathway, allowing Shh protein maturation leading to its maximal activity. Many malformations in these two syndromes occur in Shh dependent tissues. We thus sought to assess whether a cholesterol defect could affect the Shh pathway and explain some of the observed malformations. MATERIALS AND METHODS We selected 14 cases of trisomy 18 and 3 cases of SLO in which the maternal uE(3) level was decreased and reported malformations were observed after fetopathological examination. We correlated the number of malformations with maternal uE(3) level. We then carried out cholesterol concentrations in separate culture media consisting of trisomy 18, SLO and control amniocytes. Finally, we analyzed the Shh pathway by testing the gene expression of several Shh components: GLI transcription factors, BMP2, BMP4, TGFβ1, COL1A1 and COL1A2. RESULTS AND DISCUSSION There was an inverse correlation between phenotypic severity and maternal uE(3) levels in SLO and trisomy 18. The cholesterol levels in the amniocyte culture media were correlated with maternal uE3 levels and were significantly lower in T18 and SLO amniocytes, reflecting cholesterol defects. There was an alteration in the Shh pathway since expression of several genes was decreased in T18 and SLO amniocytes. However, these cholesterol defects were not solely responsible for the altered Shh pathway and the malformations observed.
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Affiliation(s)
- N Gruchy
- Laboratoire de cytogénétique prénatale, service de Génétique, avenue Côte de Nacre, CHU Caen, UFR médecine, 14033 Caen cedex 9, France.
| | - N Bigot
- Laboratoire "Microenvironnement cellulaire et pathologie" (MILPAT) EA 4652, UFR Médecine Caen, avenue Côte de Nacre, 14033 Caen cedex 9, France.
| | - C Jeanne Pasquier
- Service d'Anatomie pathologique, CHU Caen, UFR Médecine, 14033 Caen cedex 9, France.
| | - M H Read
- Service de biochimie métabolique, CHU Caen, UFR Médecine, 14033 Caen cedex 9, France.
| | - S Odent
- Génétique des pathologies liées au développement, CNRS, UMR6290, UFR Médecine, Rennes, France.
| | - P Galera
- Laboratoire "Microenvironnement cellulaire et pathologie" (MILPAT) EA 4652, UFR Médecine Caen, avenue Côte de Nacre, 14033 Caen cedex 9, France.
| | - N Leporrier
- Laboratoire de cytogénétique prénatale, service de Génétique, avenue Côte de Nacre, CHU Caen, UFR médecine, 14033 Caen cedex 9, France.
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Nota B, Struys E, Pop A, Jansen E, Fernandez Ojeda M, Kanhai W, Kranendijk M, van Dooren S, Bevova M, Sistermans E, Nieuwint A, Barth M, Ben-Omran T, Hoffmann G, de Lonlay P, McDonald M, Meberg A, Muntau A, Nuoffer JM, Parini R, Read MH, Renneberg A, Santer R, Strahleck T, van Schaftingen E, van der Knaap M, Jakobs C, Salomons G. Deficiency in SLC25A1, encoding the mitochondrial citrate carrier, causes combined D-2- and L-2-hydroxyglutaric aciduria. Am J Hum Genet 2013; 92:627-31. [PMID: 23561848 DOI: 10.1016/j.ajhg.2013.03.009] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 01/02/2013] [Accepted: 03/13/2013] [Indexed: 12/17/2022] Open
Abstract
The Krebs cycle is of fundamental importance for the generation of the energetic and molecular needs of both prokaryotic and eukaryotic cells. Both enantiomers of metabolite 2-hydroxyglutarate are directly linked to this pivotal biochemical pathway and are found elevated not only in several cancers, but also in different variants of the neurometabolic disease 2-hydroxyglutaric aciduria. Recently we showed that cancer-associated IDH2 germline mutations cause one variant of 2-hydroxyglutaric aciduria. Complementary to these findings, we now report recessive mutations in SLC25A1, the mitochondrial citrate carrier, in 12 out of 12 individuals with combined D-2- and L-2-hydroxyglutaric aciduria. Impaired mitochondrial citrate efflux, demonstrated by stable isotope labeling experiments and the absence of SLC25A1 in fibroblasts harboring certain mutations, suggest that SLC25A1 deficiency is pathogenic. Our results identify defects in SLC25A1 as a cause of combined D-2- and L-2-hydroxyglutaric aciduria.
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Mouadil A, Debout C, Read MH, Morello R, Allouche S, Chapon F. Blood metabolite data in response to maximal exercise in healthy subjects. Clin Physiol Funct Imaging 2012; 32:274-81. [PMID: 22681604 DOI: 10.1111/j.1475-097x.2012.01122.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Accepted: 01/05/2012] [Indexed: 11/30/2022]
Abstract
Maximal exercise test with gas exchange measurement evaluates exercise capacities with maximal oxygen uptake (VO(2) max) measurement. Measurements of lactate (L), lactate/pyruvate ratio (L/P) and ammonium (A) during rest, exercise and recovery enhance interpretative power of maximal exercise by incorporating muscular metabolism exploration. Maximal exercise test with gas exchange measurement is standardized in cardiopulmonary evaluations but, no reference data of blood muscular metabolites are available to evaluate the muscular metabolism. We determined normal values of L, L/P and A during a standardized maximal exercise and recovery in 48 healthy sedentary volunteers and compared with results obtained in four patients with exercise intolerance and a mitochondrial disease. In healthy subjects, L, L/P and A rose during exercise. In 98% of them L, L/P or A decreased between the fifth and the fifteenth minutes of recovery. In mitochondrial patients, VO(2) max was normal or low, and L, L/P and A had the same evolution as normal subjects or showed no decrease during recovery. We gave normal L, L/P and A values, which establish references for a maximal exercise test with muscular metabolism exploration. This test is helpful for clinicians in functional evaluation, management and treatment of metabolic myopathy and would be a useful tool in diagnosis of metabolic myopathy.
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Affiliation(s)
- Amèle Mouadil
- Department of Physiology, CHU de Caen, Caen, France.
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Coulbault L, Deslandes B, Herlicoviez D, Read MH, Leporrier N, Schaeffer S, Mouadil A, Lombès A, Chapon F, Jauzac P, Allouche S. A novel mutation 3090 G>A of the mitochondrial 16S ribosomal RNA associated with myopathy. Biochem Biophys Res Commun 2007; 362:601-5. [PMID: 17761147 DOI: 10.1016/j.bbrc.2007.08.040] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2007] [Accepted: 08/02/2007] [Indexed: 10/22/2022]
Abstract
We describe a young woman who presented with a progressive myopathy since the age of 9. Spectrophotometric analysis of the respiratory chain in muscle tissue revealed combined and profound complex I, III, II+III, and IV deficiency ranging from 60% to 95% associated with morphological and histochemical abnormalities of the muscle. An exhaustive screening of mitochondrial transfer and ribosomal RNAs showed a novel G>A substitution at nucleotide position 3090 which was detected only in urine sediment and muscle of the patient and was not found in her mother's blood cells and urine sample. We suggest that this novel de novo mutation in the 16S ribosomal RNA, a nucleotide which is highly conserved in different species, would impair mitochondrial protein synthesis and would cause a severe myopathy.
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Affiliation(s)
- L Coulbault
- Laboratoire de Biochimie, Centre Hospitalier et Universitaire de Caen, Avenue Côte de Nacre, 14033 Caen cedex, France
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Tiengou LE, Gloro R, Pouzoulet J, Bouhier K, Read MH, Arnaud-Battandier F, Plaze JM, Blaizot X, Dao T, Piquet MA. Semi-elemental formula or polymeric formula: is there a better choice for enteral nutrition in acute pancreatitis? Randomized comparative study. JPEN J Parenter Enteral Nutr 2006; 30:1-5. [PMID: 16387891 DOI: 10.1177/014860710603000101] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Jejunal nutrition is recommended during acute pancreatitis. The use of semi-elemental formulas presents several theoretical advantages over polymeric formulas, but their clinical value has been poorly documented. Our aim was to evaluate in patients with acute pancreatitis the effect of enteral nutrition by a semi-elemental formula compared with a polymeric formula. METHODS A randomized prospective pilot study, stratified according to severity, was performed in 30 consecutive patients with acute pancreatitis requiring jejunal nutrition. The semi-elemental group received 35 kcal/kg/d of Peptamen (n = 15), and the polymeric group received the same quantity of Sondalis-Iso (n = 15). Tolerance was evaluated after 7 days of enteral nutrition (D7) on visual analog scale (VAS), stool frequency, and 24-hour steatorrhea/creatorrhea. Outcome was evaluated by weight loss, length of hospital stay, and infection rate. RESULTS Results were calculated as mean +/- SEM, t-test, or chi2. Patients of the 2 groups were comparable in terms of age, gender, and severity. Tolerance was good in both groups (semi-elemental vs polymeric: VAS, 7.4 +/- 0.6 vs 7.1 +/- 0.6, not significant (NS); number of stools per 24 hours, 1.7 +/- 0.4 vs 1.8 +/- 0.4, NS). Steatorrhea and creatorrhea were lower than normal in both groups. In semi-elemental group, the length of hospital stay was shorter (23 +/- 2 vs 27 +/- 1, p = .006) and weight loss was less marked (1 +/- 1 vs 2 +/- 0, p = .01). One patient in semi-elemental group and 3 patients in polymeric group developed an infection (NS). CONCLUSIONS Semi-elemental and polymeric nutrition are very well tolerated in patients with acute pancreatitis. Nutrition with a semi-elemental formula supports the hypothesis of a more favorable clinical course than nutrition with a polymeric formula, but this conclusion needs to be established in larger adequately powered clinical trials.
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Coulbault L, Herlicoviez D, Chapon F, Read MH, Penniello MJ, Reynier P, Fayet G, Lombès A, Jauzac P, Allouche S. A novel mutation in the mitochondrial tRNAAsn gene associated with a lethal disease. Biochem Biophys Res Commun 2005; 329:1152-4. [PMID: 15752774 DOI: 10.1016/j.bbrc.2005.02.083] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2005] [Indexed: 10/25/2022]
Abstract
We describe a lethal mitochondrial disease in a 10-month-old child who presented with encephalomyopathy. Histochemical and electron microscopy examinations of skeletal muscle biopsy revealed abnormal mitochondria associated with a combined deficiency of complexes I and IV. After excluding mitochondrial DNA deletions and depletion, direct sequencing was used to screen for mutation in all transfer RNA (tRNA) genes. A T-to-C substitution at position 5693 in the tRNA(Asn) gene was found in blood and muscle. Microdissection of muscle biopsy and its analysis revealed the highest level of this mutation in cytochrome c oxidase (COX)-negative fibres. We suggest that this novel mutation would affect the anticodon loop structure of the tRNA(Asn) and cause a fatal mitochondrial disease.
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Affiliation(s)
- Laurent Coulbault
- Laboratoire de Biochimie A, Centre Hospitalier et Universitaire de Caen, Avenue Côte de Nacre, 14033 Caen cedex, France
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Nimubona L, Laloum D, Rolland MO, Read MH, Guillois B, Duhamel JF. An intestinal obstruction in an eight-month-old child suffering from mevalonic aciduria. Acta Paediatr 2003; 91:714-6. [PMID: 12162608 DOI: 10.1080/080352502760069179] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
UNLABELLED This report describes a case of mevalonate kinase deficiency diagnosed at 1 mo of age. Soon after delivery, symptoms were suggestive of congenital infection. An intestinal occlusion occurred towards the age of 8 mo. CONCLUSION Mevalonate kinase deficiency has variable clinical and biological signs which can lead to a delay in diagnosis. This is the first reported occurrence of bowel obstruction in this disease and the resemblance to a congenital infection in the neonatal period must be emphasized.
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Affiliation(s)
- L Nimubona
- Department of Neonatology, Caen University Hospital, France.
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Ducros V, Demuth K, Sauvant MP, Quillard M, Caussé E, Candito M, Read MH, Drai J, Garcia I, Gerhardt MF. Methods for homocysteine analysis and biological relevance of the results. J Chromatogr B Analyt Technol Biomed Life Sci 2002; 781:207-26. [PMID: 12450660 DOI: 10.1016/s1570-0232(02)00497-x] [Citation(s) in RCA: 80] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
It is now widely accepted that increased total plasma homocysteine (tHcy) is a risk factor for cardiovascular disease. Hyperhomocysteinemia can be caused by impaired enzyme function as a result of genetic mutation or vitamin B (B(2), B(6), B(9), B(12)) deficiency. A lot of methods are now available for tHcy determination. High-pressure liquid chromatography (HPLC) with fluorescence detection are at present the most widely used methods but immunoassays, easier to use, begin to supplant in-house laboratory methods. In order to help with the choice of a main relevant homocysteine analytical method, the characteristics, performances and limits of the main current methods are reviewed. One major drawback among all these available methods is the transferability which is not clearly established to date. The impact of both inter-method and inter-laboratory variations on the interpretation of the tHcy results are discussed.
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Affiliation(s)
- Véronique Ducros
- Département de Biologie Intégrée, CHU Grenoble, BP 217, 38043 Grenoble, France.
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Ducros V, Candito M, Caussé E, Couderc R, Demuth K, Diop ME, Drai J, Gerhardt MF, Quillard M, Read MH, Sauvant MP. [Comparison of plasma total homocysteine determinations in 9 French hospital laboratories by using 6 different methods]. Ann Biol Clin (Paris) 2002; 60:421-8. [PMID: 12147446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
A lot of methods are now available for total plasma homocysteine (tHcy) determination. Commercial kits using immunoassay, easier to use, begin to supplant in-house laboratory methods. Our aim is to evaluate the interchangeability of tHcy measurements in 9 French hospital laboratories. Six different method types were used: 2 gas chromatography-mass spectrometry (GC-MS), 2 HPLC with fluorescence detection subdivided in one in-house method and one commercial kit (Bio-Rad ), 3 fluorescence polarization immunoassays (FPIA), 1 enzyme immunoassay, 1 amino acid analyser, 1 capillary electrophoresis coupled with laser-induced fluorescence detection (EC-LIF). Each laboratory analysed 41 patient's plasma samples in which 8 samples contained added homocystine. Results were analysed for imprecision, recovery, and methodological differences. The mean among-laboratory imprecision (CV) ranged from 12.5 to 18% in function of plasma sample type and was identical to the mean among-method variation. In terms of recovery, we obtained underestimated results with immunoassays. The bias relative to the GC-MS method was less than 12.5% except for two laboratories, one using FPIA assay and the other EC-LIF. In conclusion, the interchangeability of tHcy results between laboratories is not satisfactory and does not allow us to evaluate cardiovascular risk linked to moderate increases of tHcy.
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Affiliation(s)
- V Ducros
- Département de biologie intégrée, CHU Grenoble
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Candito M, Caussé E, Couderc R, Demuth K, Drai J, Gachon AM, Garcia I, Gerhardt MF, Philippe-Bourgeois C, Quillard M, Read MH, Sauvant MP, Ducros V. [Determination of total plasma homocysteine: preanalytical parameters, method comparison and interchangeability]. Ann Biol Clin (Paris) 2002; 60:317-9. [PMID: 12050048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Affiliation(s)
- M Candito
- Département de biologie intégrée, CHRU, BP 217, 38043 Grenoble cedex, France
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Ducros V, Candito M, Caussé E, Couderc R, Demuth K, Diop ME, Drai J, Gachon AM, Garcia I, Gerhardt MF, Philippe-Bourgeois C, Read MH, Sauvant MP. [Plasma homocysteine measurement: a study of pre-analytical variation factors for conditions for total plasma homocysteine concentration]. Ann Biol Clin (Paris) 2001; 59:33-9. [PMID: 11174098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
An increase in homocysteine, a sulphur amino acid, is nowdays considered as a risk factor for cardiovascular diseases, and is independent of other risk factors. Reference range for total plasma homocysteine level in adults is usually 5-15 mmol/l. Hyperhomocysteinemia is defined as a fasting total plasma homocysteine level > 15 mmol/l. There may be also graded increased risks for subjects with homocysteinemia from 10 to 15 mmol/l. However, no threshold has been defined, partly because of the lack of standardization in pre-analytical and analytical steps. The aim of the present work was to evaluate three pre-analytical parameters on plasma homocysteine levels: i) the influence of three anticoagulants (EDTA, sodium citrate and lithium heparin); ii) the delay period of blood sample on ice before centrifugation; and iii) the advantages of strong acidic citrate at room temperature. The mean concentrations of total plasma homocysteine were different in function of the anticoagulant. These differences (EDTA minus lithium heparin or EDTA minus sodium citrate) were less than 10% however the used methods and could explain the good correlation between the results. However we recommend to keep the anticoagulant constant in the same study. When EDTA blood samples were immediately put on crushed ice, the maximum delay period before centrifugation could reach 4 hours. If ice is unavailable, strong acidic citrate at room temperature is a good alternative until for 4 hours.
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Affiliation(s)
- V Ducros
- Département de biologie intégrée, Hôpital Michallon, BP 217, 38043 Grenoble cedex 9
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Parks PS, Read MH. Adolescent male athletes: body image, diet, and exercise. Adolescence 1997; 32:593-602. [PMID: 9360733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The purpose of this study was to investigate and compare body image concerns, attitudes toward eating/weight control, and reasons for exercising between two groups of adolescent male athletes--football players (N = 44) and cross-country runners (N = 30). Subjects responded to surveys covering eating attitudes, weight concerns, physical traits, perceived and ideal body shape/size, and reasons for exercising. Significant differences were noted: Football players reported a more positive body image; cross-country runners indicated a greater degree of body dissatisfaction, more disordered eating patterns, and a greater degree of concern for weight control which identified this group as one in need of increased health education.
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Affiliation(s)
- P S Parks
- Dept. of Nutrition, University of Nevada, Reno 89557, USA
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Dahl BR, Read MH. Effect of a nutrition education program on the reduction of serum cholesterol level in Veterans Administration outpatients. J Am Diet Assoc 1995; 95:702-3. [PMID: 7759750 DOI: 10.1016/s0002-8223(95)00193-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- B R Dahl
- Special Supplemental Food Program for Women, Infants, and Children, Reno, Nev, USA
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Read MH, Jeor SS, Seymour K, Scott B. Supplementation practices of a group of patients with cancer. J Am Diet Assoc 1990; 90:278-9. [PMID: 2303668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Read MH, Fisher KA, Bendel R, Bhalla VJ, Bock MA, Harrill I, Mitchell M, Schutz H, Sheehan E, Standal B. Dietary fat intake: demographics. J Am Diet Assoc 1989; 89:830-1. [PMID: 2723309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- M H Read
- Department of Nutrition, University of Nevada-Reno 89557
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Read MH, McGuffin SL. The effect of B-complex supplementation on endurance performance. J Sports Med Phys Fitness 1983; 23:178-84. [PMID: 6632856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Read MH, Thomas DC. Nutrient and food supplement practices of lacto-ovo vegetarians. J Am Diet Assoc 1983; 82:401-404. [PMID: 6833687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Read MH, Graney AS. Food supplement usage by the elderly. J Am Diet Assoc 1982; 80:250-3. [PMID: 7056973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
A variety of food supplements were taken by 66 percent of the elderly persons in this study. Ascorbic acid and vitamin E were the most popular choices. Some supplements may have improved nutritional status, while others were probably inappropriate or unnecessary. The findings indicate that the elderly have a number of erroneous beliefs about the efficacy of food supplements. Reasons for supplementation were often inappropriate, and unreliable sources of information were used. In addition, substantial amounts of money were spent on food supplements by those already existing on a limited budget. Nutrition education is needed to demonstrate the relationship between adequate diet, good health, and appropriate versus inappropriate food supplement consumption.
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