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Cohen PA, Avula B, Katragunta K, Khan I. Recalls, Availability, and Content of Dietary Supplements Following FDA Warning Letters. JAMA 2022; 328:393-395. [PMID: 35881132 PMCID: PMC9327580 DOI: 10.1001/jama.2022.9734] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
This study examines the frequency of product recalls and the presence of FDA-prohibited drugs in supplements after FDA warning letters.
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von Mutius E, Smits HH. Primary prevention of asthma: from risk and protective factors to targeted strategies for prevention. Lancet 2020; 396:854-866. [PMID: 32910907 DOI: 10.1016/s0140-6736(20)31861-4] [Citation(s) in RCA: 110] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/03/2020] [Accepted: 07/10/2020] [Indexed: 12/15/2022]
Abstract
Asthma is a complex disease that often starts in childhood. Genomic and environmental factors as well as aberrant immune maturation early in life can contribute to the onset of disease, with great disparity over time and geographical regions. Epidemiological studies have scrutinised environmental exposures and attempted to translate these exposures into prevention strategies. Some approaches for patients with asthma have been successful (eg, smoking ban, the Finnish Asthma Programme), and primary prevention of wheeze in pre-school children (age 0-5 years) by the supplementation of vitamin D or fish oil, or both, to pregnant women seems promising. Several recent prevention initiatives are based on strong asthma-protective environmental microbial exposures associated with traditional rural lifestyles. Preclinical studies with various bacterial lysates, bacterial and dietary metabolites, or helminthic compounds have yielded promising results that await translation into clinical practice. Given the immense societal and individual burden of asthma, there is an urgent need to further develop novel strategies to eradicate the disease.
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Affiliation(s)
- Erika von Mutius
- Department of Pediatrics, Dr von Hauner Children's Hospital, Ludwig Maximilians University, Munich, Germany; Helmholtz Zentrum Muenchen-German Research Center for Environmental Health, Institute for Asthma and Allergy Prevention, Neuherberg, Germany; Comprehensive Pneumology Center Munich, German Center for Lung Research, Neuherberg, Germany.
| | - Hermelijn H Smits
- Department of Parasitology, Center of Infectious Diseases, Leiden University Medical Center, Leiden, Netherlands
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Paolantonio L, Kim SY, Ramirez J, Roberts-Eversley N, Li Y, Melnic I, Wu M, Jutagir DR, Smith J, Oladele M, Gany F. Food Purchasing Behavior of Food Insecure Cancer Patients Receiving Supplemental Food Vouchers. Support Care Cancer 2020; 28:3739-3746. [PMID: 31828492 PMCID: PMC8054702 DOI: 10.1007/s00520-019-05183-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 11/07/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE Food insecure cancer patients experience worse health outcomes and poorer quality of life than food secure patients. There has been little research in programs to alleviate food insecurity in cancer patients. The objective of this paper is to report on the food purchasing behaviors of cancer patients enrolled in a supplemental food voucher program. METHODS This paper utilized data from a three-arm randomized controlled trial investigating the impact of food interventions on alleviating food insecurity in cancer patients receiving chemotherapy and/or radiation therapy. In one arm, patients received a monthly $230 voucher with which to purchase food. Receipts were collected for items purchased with the voucher and were coded to analyze purchasing behaviors. RESULTS Thirty-three patients provided receipts for more than 11,000 individual items. Patients spent 50% of voucher funds on animal protein, fruits, and vegetables. Patients spent, on average, 77% of voucher funds on items categorized as "healthy." CONCLUSIONS Patients who received a food voucher purchased more fruits and vegetables than national averages would suggest. They also spent less on sweetened beverages than national samples. Patients who were born outside of the United States or who were limited English proficient purchased significantly more healthy foods than English-speaking and American-born study patients. Supplemental food vouchers for food insecure cancer patients resulted in the purchase of healthy food items.
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Affiliation(s)
- Luke Paolantonio
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
| | - Soo Young Kim
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
| | - Julia Ramirez
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
| | - Nicole Roberts-Eversley
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
| | - Yuelin Li
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
| | - Irina Melnic
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
| | - Minlun Wu
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
| | - Devika R Jutagir
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
| | - Julia Smith
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
| | - Modupe Oladele
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
| | - Francesca Gany
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Department of Medicine, and Department of Public Health, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY, USA.
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Al Khawli F, Pateiro M, Domínguez R, Lorenzo JM, Gullón P, Kousoulaki K, Ferrer E, Berrada H, Barba FJ. Innovative Green Technologies of Intensification for Valorization of Seafood and Their by-Products. Mar Drugs 2019; 17:E689. [PMID: 31817754 PMCID: PMC6950251 DOI: 10.3390/md17120689] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 12/03/2019] [Accepted: 12/03/2019] [Indexed: 02/01/2023] Open
Abstract
The activities linked to the fishing sector generate substantial quantities of by-products, which are often discarded or used as low-value ingredients in animal feed. However, these marine by-products are a prominent potential good source of bioactive compounds, with important functional properties that can be isolated or up-concentrated, giving them an added value in higher end markets, as for instance nutraceuticals and cosmetics. This valorization of fish by-products has been boosted by the increasing awareness of consumers regarding the relationship between diet and health, demanding new fish products with enhanced nutritional and functional properties. To obtain fish by-product-derived biocompounds with good, functional and acceptable organoleptic properties, the selection of appropriate extraction methods for each bioactive ingredient is of the outmost importance. In this regard, over the last years, innovative alternative technologies of intensification, such as ultrasound-assisted extraction (UAE) and supercritical fluid extraction (SFE), have become an alternative to the conventional methods in the isolation of valuable compounds from fish and shellfish by-products. Innovative green technologies present great advantages to traditional methods, preserving and even enhancing the quality and the extraction efficiency, as well as minimizing functional properties' losses of the bioactive compounds extracted from marine by-products. Besides their biological activities, bioactive compounds obtained by innovative alternative technologies can enhance several technological properties of food matrices, enabling their use as ingredients in novel foods. This review is focusing on analyzing the principles and the use of UAE and SFE as emerging technologies to valorize seafoods and their by-products.
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Affiliation(s)
- Fadila Al Khawli
- Department of Preventive Medicine and Public Health, Food Science, Toxicology and Forensic Medicine, Faculty of Pharmacy, Universitat de València, Avda. Vicent Andrés Estellés, s/n 46100 Burjassot, València, Spain;
| | - Mirian Pateiro
- Centro Tecnológico de la Carne de Galicia, Rúa Galicia No 4, Parque Tecnológico de Galicia, San Cibrao das Viñas, 32900 Ourense, Spain; (M.P.); (R.D.); (P.G.)
| | - Rubén Domínguez
- Centro Tecnológico de la Carne de Galicia, Rúa Galicia No 4, Parque Tecnológico de Galicia, San Cibrao das Viñas, 32900 Ourense, Spain; (M.P.); (R.D.); (P.G.)
| | - José M. Lorenzo
- Centro Tecnológico de la Carne de Galicia, Rúa Galicia No 4, Parque Tecnológico de Galicia, San Cibrao das Viñas, 32900 Ourense, Spain; (M.P.); (R.D.); (P.G.)
| | - Patricia Gullón
- Centro Tecnológico de la Carne de Galicia, Rúa Galicia No 4, Parque Tecnológico de Galicia, San Cibrao das Viñas, 32900 Ourense, Spain; (M.P.); (R.D.); (P.G.)
| | - Katerina Kousoulaki
- Department of Nutrition and Feed Technology, Nofima AS, 5141 Bergen, Norway;
| | - Emilia Ferrer
- Department of Preventive Medicine and Public Health, Food Science, Toxicology and Forensic Medicine, Faculty of Pharmacy, Universitat de València, Avda. Vicent Andrés Estellés, s/n 46100 Burjassot, València, Spain;
| | - Houda Berrada
- Department of Preventive Medicine and Public Health, Food Science, Toxicology and Forensic Medicine, Faculty of Pharmacy, Universitat de València, Avda. Vicent Andrés Estellés, s/n 46100 Burjassot, València, Spain;
| | - Francisco J. Barba
- Department of Preventive Medicine and Public Health, Food Science, Toxicology and Forensic Medicine, Faculty of Pharmacy, Universitat de València, Avda. Vicent Andrés Estellés, s/n 46100 Burjassot, València, Spain;
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Bharadva K, Mishra S, Tiwari S, Yadav B, Deshmukh U, Elizabeth KE, Banapurmath CR. Prevention of Micronutrient Deficiencies in Young Children: Consensus Statement from Infant and Young Child Feeding Chapter of Indian Academy of Pediatrics. Indian Pediatr 2019; 56:577-586. [PMID: 31333213] [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: 06/10/2023]
Abstract
JUSTIFICATION Micronutrient deficiencies have significant impact on the overall health and well-being of society and potential targets for supplementations. It is important to formulate a consensus statement in view of current evidence, and put in place strategies to meet targets. OBJECTIVE To formulate by endorsement or adoption and disseminate a consensus statement for prevention of micronutrients deficiencies in young children for office practices from an Indian perspective. PROCESS A National Consultative Meeting was convened by Infant and Young Child Feeding Chapter (IYCF) of Indian Academy of Pediatrics (IAP) on 17 December, 2016 at Mumbai. IYCF chapter, IAP, United Nations Children Fund, National Institute of Nutrition and Government of India were the participating agencies; and participants representing different parts of India were included. CONCLUSIONS Micronutrient deficiencies are widespread. For its prevention proper maternal and infant-young child feeding strategies need to be practiced. Encourage delayed cord clamping, dietary diversification, germinated foods, soaking and fermentation processes. Existing Iron, Vitamin A, Zinc supplementation and universal salt iodization programs need to be scaled up, especially in high risk groups. Universal vitamin D supplementation need to be in place; though, the dose needs more research. Vitamin B12 deficiency screening and supplementation should be practiced only in high-risk groups. Availability of appropriately fortified foods needs to be addressed urgently.
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Affiliation(s)
- Ketan Bharadva
- Department of Pediatrics Masoom Children's Hospital, Surat, Gujarat. India
| | - Sudhir Mishra
- Department of Pediatrics, Tata Main Hospital, Jamshedpur, Rajasthan, India
| | - Satish Tiwari
- Department of Pediatrics, Dr PDM Medical College Amravati, Maharashtra, India. Correspondence to: Dr Satish Tiwari, Professor and Head, Department of Pediatrics, Dr PDM Medical College, Amravati Yashodanagar No. 2, Maharashtra 444 606, India.
| | - Balraj Yadav
- Department of Pediatrics, Smt Santra Devi Health and Educational Trust Gurgram, India
| | - Urmila Deshmukh
- Department of Pediatrics, Biotrak Research Foundation Akola, Maharashtra, India
| | - K E Elizabeth
- Department of Pediatrics, Sree Mookambika Institute of Medical Sciences, Kulasekharam, Kanyakumari, Tamilnadu, India
| | - C R Banapurmath
- Department of Pediatrics, JJM Medical College, Davangere, Karnataka, India
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Pritchard L, Lewis S, Hickson M. Comparative effectiveness of vitamin D supplementation via buccal spray versus oral supplements on serum 25-hydroxyvitamin D concentrations in humans: a systematic review protocol. JBI Database System Rev Implement Rep 2019; 17:487-499. [PMID: 30520774 DOI: 10.11124/jbisrir-2017-003907] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
REVIEW QUESTIONS The questions of this review are.
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Affiliation(s)
- Lucy Pritchard
- Department of Nutrition and Dietetics, University Hospitals Plymouth NHS Trust, Plymouth, UK
- School of Health Professions, Faculty of Health and Human Sciences, University Hospitals Plymouth, UK
- The University of Plymouth Centre for Innovations in Health and Social Care: a Joanna Briggs Institute Centre of Excellence
| | - Stephen Lewis
- Department of Gastroenterology, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Mary Hickson
- School of Health Professions, Faculty of Health and Human Sciences, University Hospitals Plymouth, UK
- The University of Plymouth Centre for Innovations in Health and Social Care: a Joanna Briggs Institute Centre of Excellence
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Lybbert TJ, Vosti SA, Adams KP, Guissou R. Household demand persistence for child micronutrient supplementation. J Health Econ 2018; 62:147-164. [PMID: 30368033 PMCID: PMC6277815 DOI: 10.1016/j.jhealeco.2018.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 09/05/2018] [Accepted: 09/27/2018] [Indexed: 06/08/2023]
Abstract
Addressing early-life micronutrient deficiencies can improve short- and long-term outcomes. In most contexts, private supply chains will be key to effective and efficient preventative supplementation. With established vendors, we conducted a 60-week market trial for a food-based micronutrient supplement in rural Burkina Faso with randomized price and non-price treatments. Repeat purchases - critical for effective supplementation - are extremely price sensitive. Loyalty cards boost demand more than price discounts, particularly in non-poor households where the father is the cardholder. A small minority of households achieved sufficient supplementation for their children through purely retail distribution, suggesting the need for more creative public-private delivery platforms informed by insights into household demand persistence and heterogeneity.
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Zadka K, Pałkowska-Goździk E, Rosołowska-Huszcz D. The State of Knowledge about Nutrition Sources of Vitamin D, Its Role in the Human Body, and Necessity of Supplementation among Parents in Central Poland. Int J Environ Res Public Health 2018; 15:ijerph15071489. [PMID: 30011906 PMCID: PMC6068672 DOI: 10.3390/ijerph15071489] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 07/09/2018] [Accepted: 07/11/2018] [Indexed: 12/16/2022]
Abstract
The percentage of children with vitamin D deficiency in Poland is alarming. The aim of the study was to assess the knowledge about sources of food and the function of vitamin D, as well as the frequency of its supplementation. A survey was conducted among the parents of children from Central Poland attending primary schools, and a questionnaire containing mainly open-ended questions was used to collect the data. Most mothers knew at least one of the functions of vitamin D in the body but had a low level of knowledge about its dietary sources. Only a small group of respondents supplemented themselves and their children with vitamin D. Statistically significant influences on the level of knowledge about the functions and sources of vitamin D were place of residence (i.e., better knowledge in the countryside) and mothers’ level of education (i.e., the better educated, the greater knowledge). In the case of monthly income level, such impact was observed only in relation to the knowledge of vitamin D functions. Concerning the frequency of supplementation, only maternal level of education had a statistically significant effect (i.e., the higher the education level, the higher the frequency of supplementation). In addition, mothers who were aware of functions of vitamin D and nutritional sources, significantly more frequently supplemented vitamin D.
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Affiliation(s)
- Katarzyna Zadka
- Department of Dietetics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences WULS-SGGW, 159c Nowoursynowska ST., 02-776 Warsaw, Poland.
| | - Ewelina Pałkowska-Goździk
- Department of Dietetics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences WULS-SGGW, 159c Nowoursynowska ST., 02-776 Warsaw, Poland.
| | - Danuta Rosołowska-Huszcz
- Department of Dietetics, Faculty of Human Nutrition and Consumer Sciences, Warsaw University of Life Sciences WULS-SGGW, 159c Nowoursynowska ST., 02-776 Warsaw, Poland.
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Rao N, Spiller HA, Hodges NL, Chounthirath T, Casavant MJ, Kamboj AK, Smith GA. An Increase in Dietary Supplement Exposures Reported to US Poison Control Centers. J Med Toxicol 2017; 13:227-237. [PMID: 28741126 PMCID: PMC5570731 DOI: 10.1007/s13181-017-0623-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Revised: 06/13/2017] [Accepted: 06/21/2017] [Indexed: 02/02/2023] Open
Abstract
INTRODUCTION The objective of this study was to investigate the epidemiology of dietary supplement exposures in the USA. METHODS A retrospective analysis was conducted of out-of-hospital dietary supplement exposures reported to the National Poison Data System from 2000 through 2012. RESULTS There were 274,998 dietary supplement exposures from 2000 through 2012. The annual rate of dietary supplement exposures per 100,000 population increased by 46.1% during 2000-2002, decreased 8.8% during 2002-2005, and then increased again by 49.3% from 2005 to 2012. These trends were influenced by the decrease in ma huang exposures starting in 2002. Miscellaneous dietary supplements accounted for 43.9% of all exposures, followed by botanicals (31.9%), hormonal products (15.1%), and other supplements (5.1%). The majority of dietary supplement exposures (70.0%) occurred among children younger than 6 years old and were acute (94.0%) and unintentional (82.9%). Serious medical outcomes accounted for 4.5% of exposures and most (95.0%) occurred among individuals 6 years and older. Ma huang products, yohimbe, and energy products were the categories associated with the greatest toxicity. CONCLUSIONS There was an overall increase in the rate of dietary supplement exposures from 2000 through 2012. Although the majority of these exposures did not require treatment at a health care facility or result in serious medical outcomes, exposures to yohimbe and energy products were associated with considerable toxicity. Our results demonstrate the success of the FDA ban on ma huang products and the need for FDA regulation of yohimbe and energy products in the USA.
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Affiliation(s)
- Nisha Rao
- Center for Injury Research and Policy of the Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Henry A Spiller
- The Ohio State University College of Medicine, Columbus, OH, USA
- Central Ohio Poison Center, Columbus, OH, USA
| | - Nichole L Hodges
- Center for Injury Research and Policy of the Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - Thiphalak Chounthirath
- Center for Injury Research and Policy of the Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA
| | - Marcel J Casavant
- Center for Injury Research and Policy of the Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA
- The Ohio State University College of Medicine, Columbus, OH, USA
- Central Ohio Poison Center, Columbus, OH, USA
| | - Amrit K Kamboj
- Center for Injury Research and Policy of the Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA
- Mayo Clinic, Division of General Internal Medicine, Rochester, MN, USA
| | - Gary A Smith
- Center for Injury Research and Policy of the Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.
- The Ohio State University College of Medicine, Columbus, OH, USA.
- Child Injury Prevention Alliance, Columbus, OH, USA.
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Gross U, Valle C, Diaz MM. Effectiveness of Distribution of Multimicronutrient Supplements in Children and in Women and Adolescent Girls of Childbearing Age in Chiclayo, Peru. Food Nutr Bull 2016; 27:S122-9. [PMID: 17455398 DOI: 10.1177/15648265060274s403] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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: 11/15/2022]
Abstract
Background There is a need to better understand the coverage of scaled-up multimicronutrient supplementation programs. Objective The coverage of the distribution of multimicronutrient supplements in 26 urban communities among women and adolescent girls 12 through 44 years of age and children under 5 years of age was evaluated for purposes of scaling-up. Methods Formative research and descriptive statistics were used to analyze the distribution of supplements. Results Despite a delayed memorandum of understanding with the health sector and delayed delivery by the producer of the supplement, a high coverage rate of supplement distribution to the children (88% on average during the 3 months of supplementation) was still achieved as a result of the strong commitment of the community and the Integrated Food Security Program. The lower coverage rate among women and adolescent girls (47% on average) was the result of too short a period of enrollment in the program. There was no decrease of coverage during the 3 months of supplementation in both groups. Conclusions Effective, sustainable, large-scale micronutrient supplementation programs require broad partnerships with commitments of governmental and nongovernmental organizations, communities, and the private sector. Availability of the supplements and communication materials must be secured well ahead of the supplementation campaign and distribution of the supplement.
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Affiliation(s)
- Ursula Gross
- Agencia Internacional de Seguridad Alimentaria (AISA), Lima, Peru.
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Avigan MI, Mozersky RP, Seeff LB. Scientific and Regulatory Perspectives in Herbal and Dietary Supplement Associated Hepatotoxicity in the United States. Int J Mol Sci 2016; 17:331. [PMID: 26950122 PMCID: PMC4813193 DOI: 10.3390/ijms17030331] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 02/16/2016] [Accepted: 02/16/2016] [Indexed: 01/06/2023] Open
Abstract
In the United States (US), the risk of hepatotoxicity linked to the widespread use of certain herbal products has gained increased attention among regulatory scientists. Based on current US law, all dietary supplements sold domestically, including botanical supplements, are regulated by the Food and Drug Administration (FDA) as a special category of foods. Under this designation, regulatory scientists do not routinely evaluate the efficacy of these products prior to their marketing, despite the content variability and phytochemical complexity that often characterizes them. Nonetheless, there has been notable progress in the development of advanced scientific methods to qualitatively and quantitatively measure ingredients and screen for contaminants and adulterants in botanical products when hepatotoxicity is recognized.
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Affiliation(s)
- Mark I Avigan
- Office of Pharmacovigilance and Epidemiology, Center for Drug Evaluation and Research, Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD 20993, USA.
| | - Robert P Mozersky
- Office of Dietary Supplement Products, Center for Food Safety and Applied Nutrition, 5100 Paint Branch Parkway, College Park, MD 20740, USA.
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Affiliation(s)
- Katharine Jamieson
- Department of Community Paediatrics, Camden Community, Kentish Town Health Centre, , London, UK
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Weenen TC, Ramezanpour B, Pronker ES, Commandeur H, Claassen E. Food-pharma convergence in medical nutrition- best of both worlds? PLoS One 2013; 8:e82609. [PMID: 24358214 PMCID: PMC3865102 DOI: 10.1371/journal.pone.0082609] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Accepted: 11/04/2013] [Indexed: 12/17/2022] Open
Abstract
At present, industries within the health and life science sector are moving towards one another resulting in new industries such as the medical nutrition industry. Medical nutrition products are specific nutritional compositions for intervention in disease progression and symptom alleviation. Industry convergence, described as the blurring of boundaries between industries, plays a crucial role in the shaping of new markets and industries. Assuming that the medical nutrition industry has emerged from the convergence between the food and pharma industries, it is crucial to research how and which distinct industry domains have contributed to establish this relatively new industry. The first two stages of industry convergence (knowledge diffusion and consolidation) are measured by means of patent analysis. First, the extent of knowledge diffusion within the medical nutrition industry is graphed in a patent citation interrelations network. Subsequently the consolidation based on technological convergence is determined by means of patent co-classification. Furthermore, the medical nutrition core domain and technology interrelations are measured by means of a cross impact analysis. This study proves that the medical nutrition industry is a result of food and pharma convergence. It is therefore crucial for medical nutrition companies to effectively monitor technological developments within as well as across industry boundaries. This study further reveals that although the medical nutrition industry’s core technology domain is food, technological development is mainly driven by pharmaceutical/pharmacological technologies Additionally, the results indicate that the industry has surpassed the knowledge diffusion stage of convergence, and is currently in the consolidation phase of industry convergence. Nevertheless, while the medical nutrition can be classified as an industry in an advanced phase of convergence, one cannot predict that the pharma and food industry segments will completely converge or whether the medical industry will become an individual successful industry.
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Affiliation(s)
- Tamar C. Weenen
- Erasmus University Rotterdam, Faculty of Economics, Rotterdam, The Netherlands
- Department of Virology, Erasmus Medical Center, Rotterdam, The Netherlands
- * E-mail:
| | | | | | - Harry Commandeur
- Erasmus University Rotterdam, Faculty of Economics, Rotterdam, The Netherlands
- Nyenrode Business University, Breukelen, The Netherlands
| | - Eric Claassen
- Department of Virology, Erasmus Medical Center, Rotterdam, The Netherlands
- Athena Institute, Vrije Universiteit, Amsterdam, The Netherlands
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Adarme-Vega TC, Thomas-Hall SR, Schenk PM. Towards sustainable sources for omega-3 fatty acids production. Curr Opin Biotechnol 2013; 26:14-8. [PMID: 24607804 DOI: 10.1016/j.copbio.2013.08.003] [Citation(s) in RCA: 158] [Impact Index Per Article: 14.4] [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: 06/25/2013] [Revised: 08/01/2013] [Accepted: 08/05/2013] [Indexed: 11/18/2022]
Abstract
Omega-3 fatty acids eicosapentaenoic acid (EPA) and docohexaenoic acid (DHA), provide significant health benefits for brain function/development and cardiovascular conditions. However, most EPA and DHA for human consumption is sourced from small fatty fish caught in coastal waters and, with depleting global fish stocks, recent research has been directed towards more sustainable sources. These include aquaculture with plant-based feeds, krill, marine microalgae, microalgae-like protists and genetically-modified plants. To meet the increasing demand for EPA and DHA, further developments are needed towards land-based sources. In particular large-scale cultivation of microalgae and plants is likely to become a reality with expected reductions in production costs, yield increasese and the adequate addressing of genetically modified food acceptance issues.
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Affiliation(s)
- T Catalina Adarme-Vega
- Algae Biotechnology Laboratory, School of Agriculture and Food Sciences, The University of Queensland, Brisbane, Queensland 4072, Australia
| | - Skye R Thomas-Hall
- Algae Biotechnology Laboratory, School of Agriculture and Food Sciences, The University of Queensland, Brisbane, Queensland 4072, Australia
| | - Peer M Schenk
- Algae Biotechnology Laboratory, School of Agriculture and Food Sciences, The University of Queensland, Brisbane, Queensland 4072, Australia.
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Abstract
BACKGROUND Moderate acute malnutrition, also called moderate wasting, affects around 10% of children under five years of age in low- and middle-income countries. There are different approaches to addressing malnutrition with prepared foods in these settings; for example, providing lipid-based nutrient supplements or blended foods, either a full daily dose or in a low dose as a complement to the usual diet. There is no definitive consensus on the most effective way to treat children with moderate acute malnutrition. OBJECTIVES To evaluate the safety and effectiveness of different types of specially formulated foods for children with moderate acute malnutrition in low- and middle-income countries, and to assess whether foods complying or not complying with specific nutritional compositions, such as the WHO technical specifications, are safe and effective. SEARCH METHODS In October 2012, we searched CENTRAL, MEDLINE, LILACS, CINAHL, BIBLIOMAP, POPLINE, ZETOC, ICTRP, mRCT, and ClinicalTrials.gov. In August 2012, we searched Embase. We also searched the reference lists of relevant papers and contacted nutrition-related organisations and researchers in this field. SELECTION CRITERIA We planned to included any relevant randomised controlled trials (RCTs), controlled clinical trials (CCTs), controlled before-and-after studies (CBAs), and interrupted time series (ITS) that evaluated specially formulated foods for the treatment of moderate acute malnutrition in children aged between six months and five years in low- and middle-income countries. DATA COLLECTION AND ANALYSIS Two authors assessed trial eligibility and risk of bias, and extracted and analysed the data. We summarised dichotomous outcomes using risk ratios (RR) and continuous outcomes using mean differences (MD) with 95% confidence intervals (CI). Where appropriate, we combined data in meta-analyses using the random-effects model and assessed heterogeneity. The quality of evidence was assessed using GRADE methods. MAIN RESULTS Eight randomised controlled trials, enrolling 10,037 children, met our inclusion criteria. Seven of the trials were conducted in Africa. In general, the included studies were at a low risk of bias. There may have been a risk of performance bias as trial participants were aware which intervention group they were in, but we did not consider this likely to have biased the outcome measurement. We were unable to assess the risk of reporting bias in half of the trials and two trials were at high risk of attrition bias. Any specially formulated food versus standard care - the provision of food increased the recovery rate by 29% (RR 1.29, 95% CI 1.20 to 1.38; 2152 children, two trials; moderate quality evidence), decreased the number dropping out by 70% (RR 0.30, 95% CI 0.22 to 0.39; 1974 children, one trial; moderate quality evidence), and improved weight-for-height (MD 0.20 z-score, 95% CI 0.03 to 0.37; 1546 children, two trials; moderate quality evidence). The reduction in mortality did not reach statistical significance (RR 0.44; 95% CI 0.14 to 1.36; 1974 children, one trial; low quality evidence). Lipid-based nutrient supplements versus any blended foods (dry food mixtures, without high lipid content), at full doses - there was no significant difference in mortality (RR 0.93, 95% CI 0.54 to 1.62; 6367 children, five trials; moderate quality evidence), progression to severe malnutrition (RR 0.88, 95% CI 0.72 to 1.07; 4537 children, three trials; high quality evidence), or the number of dropouts from the nutritional programme (RR 1.14, 95% CI 0.62 to 2.11; 5107 children, four trials; moderate quality evidence). However, lipid-based nutrient supplements significantly increased the number of children recovered (RR 1.10, 95% CI 1.04 to 1.16; 6367 children, five trials; moderate quality evidence), and decreased the number of non-recovering children (RR 0.53, 95% CI 0.40 to 0.69; 4537 children, three trials; high quality evidence). LNS also improved weight gain, weight-for-height, and mid-upper arm circumference, although for these outcomes, the improvement was modest (moderate quality evidence). One trial observed more children with vomiting in the lipid-based nutrient supplements group compared to those receiving blended food (RR 1.43, 95% CI 1.11 to 1.85; 2712 children, one trial; low quality evidence). Foods at complementary doses - no firm conclusion could be drawn on the comparisons between LNS at complementary dose and blended foods at complementary or full dose (low quality evidence). Lipid-based nutrient supplements versus specific types of blended foods - a recently developed enriched blended food (CSB++) resulted in similar outcomes to LNS (4758 children, three trials; moderate to high quality evidence). Different types of blended foods - in one trial, CSB++ did not show any significant benefit over locally made blended food, for example, Misola, in number who recovered, number who died, or weight gain (moderate to high quality evidence). Improved adequacy of home diet - no study evaluated the impact of improving adequacy of local diet, such as local foods prepared at home according to a given recipe or of home processing of local foods (soaking, germination, malting, fermentation) in order to increase their nutritional content. AUTHORS' CONCLUSIONS In conclusion, there is moderate to high quality evidence that both lipid-based nutrient supplements and blended foods are effective in treating children with MAM. Although lipid-based nutrient supplements (LNS) led to a clinically significant benefit in the number of children recovered in comparison with blended foods, LNS did not reduce mortality, the risk of default or progression to SAM. It also induced more vomiting. Blended foods such as CSB++ may be equally effective and cheaper than LNS. Most of the research so far has focused on industrialised foods, and on short-term outcomes of MAM. There are no studies evaluating interventions to improve the quality of the home diet, an approach that should be evaluated in settings where food is available, and nutritional education and habits are the main determinants of malnutrition. There are no studies from Asia, where moderate acute malnutrition is most prevalent.
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Affiliation(s)
- Marzia Lazzerini
- Unit for Health Services Research and International Health, WHO Collaborating Centre for Maternal and Child Health, Institutefor Maternal and Child Health, Trieste, Italy.
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Lenihan-Geels G, Bishop KS, Ferguson LR. Alternative sources of omega-3 fats: can we find a sustainable substitute for fish? Nutrients 2013; 5:1301-15. [PMID: 23598439 PMCID: PMC3705349 DOI: 10.3390/nu5041301] [Citation(s) in RCA: 125] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 03/29/2013] [Accepted: 04/02/2013] [Indexed: 02/06/2023] Open
Abstract
Increasing demand for eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) containing fish oils is putting pressure on fish species and numbers. Fisheries provide fish for human consumption, supplement production and fish feeds and are currently supplying fish at a maximum historical rate, suggesting mass-scale fishing is no longer sustainable. However, the health properties of EPA and DHA long-chain (LC) omega-3 polyunsaturated fatty acids (PUFA) demonstrate the necessity for these oils in our diets. EPA and DHA from fish oils show favourable effects in inflammatory bowel disease, some cancers and cardiovascular complications. The high prevalence of these diseases worldwide indicates the requirement for alternative sources of LC-PUFA. Strategies have included plant-based fish diets, although this may compromise the health benefits associated with fish oils. Alternatively, stearidonic acid, the product of α-linolenic acid desaturation, may act as an EPA-enhancing fatty acid. Additionally, algae oils may be a promising omega-3 PUFA source for the future. Algae are beneficial for multiple industries, offering a source of biodiesel and livestock feeds. However, further research is required to develop efficient and sustainable LC-PUFA production from algae. This paper summarises the recent research for developing prospective substitutes for omega-3 PUFA and the current limitations that are faced.
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Affiliation(s)
- Georgia Lenihan-Geels
- Discipline of Nutrition, Faculty of Medical & Health Sciences, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand; E-Mail:
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +64-9-9234471; Fax: +64-9-3035962
| | - Karen S. Bishop
- Auckland Cancer Society Research Center, Faculty of Medical & Health Sciences, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand; E-Mail:
| | - Lynnette R. Ferguson
- Discipline of Nutrition, Faculty of Medical & Health Sciences, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand; E-Mail:
- Auckland Cancer Society Research Center, Faculty of Medical & Health Sciences, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand; E-Mail:
- Nutrigenomics New Zealand, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
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Obican SG, Jahnke GD, Soldin OP, Scialli AR. Teratology public affairs committee position paper: iodine deficiency in pregnancy. Birth Defects Res A Clin Mol Teratol 2012; 94:677-82. [PMID: 22903940 PMCID: PMC3637994 DOI: 10.1002/bdra.23051] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Revised: 06/05/2012] [Accepted: 06/05/2012] [Indexed: 11/08/2022]
Abstract
Iodine deficiency is an important nutritional deficiency, with more than 2 billion people worldwide estimated to be at risk. The developing fetus and young children are particularly at risk. During pregnancy and lactation, iodine requirements increase, whether in iodine-poor or iodine-sufficient countries, making the mother and the developing fetus vulnerable. The American Thyroid Association (ATA) recommends 250 micrograms per day of iodine intake for pregnant and lactating women. The thyroid gland is able to adapt to the changes associated with pregnancy as long as sufficient iodine is present. Dietary intake is the sole source of iodine, which is essential to the synthesis of thyroid hormones. Iodine is found in multiple dietary sources including iodized salt, dairy products, seaweed, and fish. Prenatal vitamins containing iodine are a good source of iodine, but iodine content in multivitamin supplements is highly variable. Congenital hypothyroidism is associated with cretinism. Clinical hypothyroidism has been associated with increased risk of poor perinatal outcome including prematurity, low birth weight, miscarriage, preeclampsia, fetal death, and impaired fetal neurocognitive development. Subclinical hypothyroidism is also associated with poor pregnancy outcomes and potential fetal neurocognitive deficits, but the data are more variable than those for clinical hypothyroidism. We concur with the ATA recommendation that all pregnant and lactating women should ingest (through diet and supplements) 250 micrograms of iodine daily. To achieve this goal, we recommend that all pregnant and lactating women take daily iodine supplementation of 150 micrograms.
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Affiliation(s)
- Sarah G Obican
- Department of Obstetrics and Gynecology, George Washington University, Washington, DC, USA.
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Pantha S, Hutter S, Gartoulla P. Experiences from nutritional rehabilitation among under 5 children from a remote mountain area of Nepal. Rural Remote Health 2012; 12:1-3. [PMID: 22624570] [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: 06/01/2023] Open
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Don't be starstruck by supplements. Celebrity endorsements: who's selling what. Consum Rep 2012; 77:12. [PMID: 22420061] [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: 05/31/2023]
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Hackett M, Melgar-Quiñonez H, Taylor CA, Alvarez Uribe MC. Factors associated with household food security of participants of the MANA food supplement program in Colombia. Arch Latinoam Nutr 2010; 60:42-47. [PMID: 21090176] [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: 05/30/2023]
Abstract
The objective of this study was to explore demographic and economic characteristics associated with household food security of 2,784 low-income households with pre-school aged children receiving food supplements from the Colombian Plan for Improving Food and Nutrition in Antioquia - MANA (Mejoramiento Alimentario y Nutricional de Antioquia) in the Department of Antioquia, Colombia. Included in the study was a 12-item household food security survey was collected from a cross-sectional, stratified random sample of MANA participants in which households were characterized as food secure, mildly food insecure, moderately food insecure, and severely food insecure. It was hypothesized that household food security status would be strongly associated with demographic characteristics, food expenditure variables, and food supplement consumption by children in MANA. Food insecure households were characterized by more members, older parents, and lower income (p < 0.0001). Rural residence and female head of households had higher rates of food insecurity (p < 0.01). Food insecure households had the lowest monthly expenditures food (p < 0.0001). Severely food insecure households saved the highest percentage of per capita food expenditure from consuming MANA supplements (p < 0.0001), similarly, MANA food supplement intakes were greatest in households reporting the most food insecurity (p < 0.001). The results of this study are important to describe characteristics of the population benefiting from the MANA nutrition intervention by their unique level of household food security status.
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Affiliation(s)
- Michelle Hackett
- Department of Human Nutrition, The Ohio State University, School of Allied Medical Professions, USA
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Nazni P, Pradheepa S, Hasan A. Effects of weaning biscuits on the nutritional profile and the cognitive development in preschool children. Ital J Pediatr 2010; 36:18. [PMID: 20167064 PMCID: PMC2830220 DOI: 10.1186/1824-7288-36-18] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2009] [Accepted: 02/18/2010] [Indexed: 11/29/2022] Open
Abstract
AIM To study the effect of weaning biscuits supplementation of the nutritional parameters and cognitive performance of the selected children. METHODS Three primary schools situated in Salem District, Tamilnadu, India were selected. A total number of 150 school children, 61 from primary school I, 46 from primary school II and 43 from primary school III comprised the study sample. About 80 primary school children with Grade II malnutrition were selected for the experimental study. Home diet without any supplementation was followed by Group I (n=20, control group), potato flour biscuit was supplemented to Group II (n=20), wheat biscuits was given to Group III (n=20) and ragi biscuits were given to Group IV (n=20) for the period of 3 months. Parameters like anthropometric measurements, hemoglobin content clinical picture and cognitive performance were analyzed before and after supplementation. RESULTS Results about Group I (control group) showed no significant difference in height, weight and clinical picture and cognitive performance after three months on their home diet. In Group II, III and IV significant increase in all the above parameters was noticed. More increase was found in Group II children supplemented with potato flour biscuits for a period of 3 months. About cognitive performance better results was obtained in Group II followed by Group III (supplemented with wheat biscuits) and Group IV (supplemented with ragi biscuits). Least was obtained by control group children who are in their home diet. CONCLUSION All these observations evident that if such weaning biscuits made with potato flour, wheat and Ragi can form a daily ingredient in their diets, it will bring out better all round development of the children.
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Affiliation(s)
- Peerkhan Nazni
- Department of Food Science, Periyar University, Salem, Tamilnadu, India
| | | | - Abul Hasan
- Consultant Pediatric Surgeon, City hospital, Erode, Tamilnadu, India
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Rahman M. Micronutrient profile of children and women in rural Bangladesh: study on available data for iron and vitamin A supplementation. East Afr J Public Health 2009; 6:102-107. [PMID: 20000073 DOI: 10.4314/eajph.v6i1.45758] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Micronutrient deficiencies are so important to public health outcomes, particularly in the developing world, that a series of global goals have been established, and significant amounts of donor and national funds have been directed at them. OBJECTIVES This paper makes an attempt to compile the micronutrient profile of children and mothers (available data on vitamin A and iron supplementation) in rural Bangladesh and to identify the factors influencing with respect to these micronutrients intake. METHODOLOGY To reach our goal Bangladesh Demographic and Health Survey of 2004 data for last five years (N = 3329) has been used. Descriptive and multivariate logistic regression methods were employed in analyzing the data. RESULTS It is observed that only 64% of targeted children had received vitamin A dose in the six months preceding the survey and overall, 14% and 45% mothers received a postpartum vitamin A dose and iron tablets. The study elucidates that the rate of receiving vitamin A dose by children lower in Barisal division than among other five divisions. Inequalities were observed in receiving vitamin A and iron supplementation, regarding household quality and assets index. The proportion of receiving vitamin A dose by children and intake of iron by mothers was found higher living in the upper quality houses. Middle aged mothers more received iron tablet and vitamin A dose and less sufferer form from difficulty with night blindness and day light vision during pregnancy than among the adolescence and older aged mothers. Multivariate logistic regression analysis considering mothers vitamin "A" dose and iron supplementation as a dependent variable shows that higher educated women were approximately two times higher probability of receiving vitamin "A" supplement of their child than women with no education. Women whose husbands had a lower status of job were less likely to receive vitamin A dose and iron supplements. The other main contributing factors likely to affect micronutrients intake among women were mass media, mother's age at last birth, mother's and husband's education and husband occupation. CONCLUSIONS The results indicate several policy options: (a) there is need to ensure availability of iron and vitamin a supplements; (b) there is also the need for creation of awareness regarding micronutrient intake among mothers and children through programmes like mass media campaign; (d) The high-risk group such as adolescents and higher aged women need special care and the existing health management system may be strengthened to create awareness among mothers of these groups for micronutrient intake from the beginning of pregnancy; (c) it is equally important that education for women and increased cash incomes is emphasized to bring about a lasting impact on the overall nutrition status of women and children.
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Affiliation(s)
- Mosiur Rahman
- Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh.
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Saper RB, Phillips RS, Sehgal A, Khouri N, Davis RB, Paquin J, Thuppil V, Kales SN. Lead, mercury, and arsenic in US- and Indian-manufactured Ayurvedic medicines sold via the Internet. JAMA 2008; 300:915-23. [PMID: 18728265 PMCID: PMC2755247 DOI: 10.1001/jama.300.8.915] [Citation(s) in RCA: 258] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
CONTEXT Lead, mercury, and arsenic have been detected in a substantial proportion of Indian-manufactured traditional Ayurvedic medicines. Metals may be present due to the practice of rasa shastra (combining herbs with metals, minerals, and gems). Whether toxic metals are present in both US- and Indian-manufactured Ayurvedic medicines is unknown. OBJECTIVES To determine the prevalence of Ayurvedic medicines available via the Internet containing detectable lead, mercury, or arsenic and to compare the prevalence of toxic metals in US- vs Indian-manufactured medicines and between rasa shastra and non-rasa shastra medicines. DESIGN A search using 5 Internet search engines and the search terms Ayurveda and Ayurvedic medicine identified 25 Web sites offering traditional Ayurvedic herbs, formulas, or ingredients commonly used in Ayurveda, indicated for oral use, and available for sale. From 673 identified products, 230 Ayurvedic medicines were randomly selected for purchase in August-October 2005. Country of manufacturer/Web site supplier, rasa shastra status, and claims of Good Manufacturing Practices were recorded. Metal concentrations were measured using x-ray fluorescence spectroscopy. MAIN OUTCOME MEASURES Prevalence of medicines with detectable toxic metals in the entire sample and stratified by country of manufacture and rasa shastra status. RESULTS One hundred ninety-three of the 230 requested medicines were received and analyzed. The prevalence of metal-containing products was 20.7% (95% confidence interval [CI], 15.2%-27.1%). The prevalence of metals in US-manufactured products was 21.7% (95% CI, 14.6%-30.4%) compared with 19.5% (95% CI, 11.3%-30.1%) in Indian products (P = .86). Rasa shastra compared with non-rasa shastra medicines had a greater prevalence of metals (40.6% vs 17.1%; P = .007) and higher median concentrations of lead (11.5 microg/g vs 7.0 microg/g; P = .03) and mercury (20,800 microg/g vs 34.5 microg/g; P = .04). Among the metal-containing products, 95% were sold by US Web sites and 75% claimed Good Manufacturing Practices. All metal-containing products exceeded 1 or more standards for acceptable daily intake of toxic metals. CONCLUSION One-fifth of both US-manufactured and Indian-manufactured Ayurvedic medicines purchased via the Internet contain detectable lead, mercury, or arsenic.
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Affiliation(s)
- Robert B Saper
- Department of Family Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA 02118-2317, USA.
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Affiliation(s)
- S Jay Olshansky
- Division of Epidemiology and Biostatistics, University of Illinois, Chicago, 1603 W Taylor St, Room 885, Chicago, IL 60612, USA.
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Affiliation(s)
- Evan Taylor
- Southern Illinois University School of Law, Carbondale, Illinois 62901, USA
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Garton L. Children's bone health, calcium and vitamin D--how much do nurses and health visitors know? J Fam Health Care 2008; 18:175-177. [PMID: 18973090] [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: 05/27/2023]
Abstract
Two focus groups of health visitors, practice nurses and community nursery nurses were held to find out how much health visitors and nurses know about children's bone nutrition, and whether they are able to identify dietary sources of these nutrients. Results showed that these professionals spend a significant part of their time giving nutritional advice about children and young people and answering questions on a range of dietary matters. They were well informed about the importance for bone health of calcium, vitamin D, exercise and a healthy, balanced diet. The biggest misconception was that dairy products in the UK contain vitamin D. Most of the professionals knew that bone strength develops quickly during childhood, and some that it does so in adolescence but few were aware that 90% of the full genetic potential for bone strength is achieved before adulthood. The groups reported confusion over the Government's initiatives for vitamin D supplements, and lack of guidance from Primary Care Trusts on making Healthy Start vitamins available at clinics for mothers and babies. Overall, health visitors and nurses have a good knowledge of bone health but there are gaps and more educational resources are needed, including on dietary sources of vitamin D. The Government needs to give clear guidelines about its initiatives for vitamin D supplements for mothers and children aged under five years. It is disappointing that the Dairy Council's 3-a-Day message on meeting essential calcium needs through three daily servings of dairy foods has not got through.
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Martins MC, Santos LMP, Santos SMCD, Araújo MDPN, Lima AMP, Santana LAA. Avaliação de políticas públicas de segurança alimentar e combate à fome no período 1995-2002. 3 - o Programa Nacional de Controle da Deficiência de Vitamina A. CAD SAUDE PUBLICA 2007; 23:2081-93. [PMID: 17700943 DOI: 10.1590/s0102-311x2007000900016] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2006] [Accepted: 01/23/2007] [Indexed: 11/22/2022] Open
Abstract
A distribuição de vitamina A em Dias Nacionais de Vacinação ocorre desde 1983; o Brasil foi pioneiro nesse tipo de intervenção. O estudo avaliou o programa no período de 1995-2002 na perspectiva de estrutura-processo-resultado. A metodologia envolveu pesquisa documental, entrevistas com gestores e estudo de caso em 44 municípios da Bahia, resultando em 1.344 questionários domiciliares. Em relação à estrutura, o programa operou sem instrumento normativo a partir de 1998, decorrente da extinção do Instituto Nacional de Alimentação e Nutrição. Melhorias nos processos de aquisição e distribuição do suplemento impactaram positivamente na sua cobertura; em 2002, foram distribuídas 3,5 milhões de cápsulas (cobertura 72%). Nas 2.546 crianças estudadas na Bahia, não houve regularidade na distribuição e a cobertura anual variou de 8% a 26%. As limitações de tempo e recursos humanos, informadas pelos gestores, corroboram a hipótese de que essa estratégia não contribui para esclarecer a população sobre a importância da vitamina. Os achados mostram ser necessária a articulação sistemática entre esferas de governo para que o programa seja executado e monitorado em sua plenitude.
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Affiliation(s)
- Maisa Cruz Martins
- Agencia Nacional de Saúde Suplementar, Ministério da Saúde, Rio de Janeiro, Brasil
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Abstract
The UK's Food Standards Agency recently recommended mandatory folic acid fortification of some foods. Nicholas Wald and Godfrey Oakley argue that it's a safe effective way of preventing spina bifida and anencephaly—but Richard Hubner and colleagues say that more research into the harms is needed
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Affiliation(s)
- Nicholas J Wald
- Wolfson Institute of Preventive Medicine, Barts and The London, Queen Mary's School of Medicine and Dentistry, University of London, London EC1M 6BQ.
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Abstract
The UK's Food Standards Agency recently recommended mandatory folic acid fortification of some foods. Nicholas Wald and Godfrey Oakley argue that it's a safe effective way of preventing spina bifida and anencephaly—but Richard Hubner and colleagues say that more research into the harms is needed
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Affiliation(s)
- Richard A Hubner
- Institute of Cancer Research, Section of Cancer Genetics, Sutton SM2 5NG.
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Bendech MA, Cusack G, Konaté F, Touré A, Ba M, Baker SK. National vitamin A supplementation coverage survey among 6-59 months old children in Guinea (West Africa). J Trop Pediatr 2007; 53:190-6. [PMID: 17463012 DOI: 10.1093/tropej/fmm007] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Vitamin A deficiency (VAD) is a major contributor to child mortality in sub-Saharan Africa. Sustained control of VAD is essential to meet the Millennium Development Goal (MDG) for reduction of child mortality in Guinea. Since, twice yearly vitamin A supplementation (VAS), either coupled with National Immunization Days or stand-alone has been adopted as a key strategy to combat VAD in 6-59 months old children. OBJECTIVES The objectives of this survey were to describe national VAS coverage rates and related factors affecting VAS coverage among 6-59 months old Guinean children. METHODS In July 2003, a VAS coverage survey was implemented in Guinea. A cross-sectional random cluster survey was conducted to select Guinean children (n = 1950, 390 mother-child pairs per zone) aged 6-59 months. The country was divided into four agro-ecological zones with 30 clusters chosen per zone. Within each cluster, a random selection of 13 households with at least one child was carried out with random selection of one child per household. Data on characteristics of children, receipt of VAS, caregivers' socio-economic characteristics, vitamin A knowledge and practices of caregivers were collected by questionnaire. RESULTS The national coverage rate of 68% is much lower than the official coverage rate of 93%. Middle Guinea, the region most affected by VAD, had the lowest coverage rate (58%). CONCLUSION In order to increase overall VAS coverage and reduce regional disparities, it is suggested that mass VAS be organized on a regional level, prioritizing rural regions (Middle and Upper Guinea) and the city of Conakry.
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Malasanos T, Chaudhari M, Selman-Almonte A, Pino S, Previti M, Braverman L, Rosenbloom A. Iodine deficiency, iodine content of salt and knowledge of iodine supplementation in the Dominican Republic. J Trop Pediatr 2007; 53:214-6. [PMID: 17329322 DOI: 10.1093/tropej/fmm001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Sharpe PA, Granner ML, Conway JM, Ainsworth BE, Dobre M. Availability of weight-loss supplements: Results of an audit of retail outlets in a southeastern city. ACTA ACUST UNITED AC 2007; 106:2045-51. [PMID: 17126636 DOI: 10.1016/j.jada.2006.09.014] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2005] [Indexed: 11/28/2022]
Abstract
The sale of nonprescription weight-loss products accounts for millions of dollars spent by Americans trying to lose weight, yet there is little evidence for effectiveness and there are multiple safety concerns. The purpose of this study was to determine what products, and ingredients within products, were available at retail outlets in a metropolitan area. A purposive sampling strategy identified 73 retail outlets. An audit form was used to collect information from product labels. The audit identified 402 products containing 4,053 separate ingredients. The mean number of ingredients per product was 9.9+/-8.96 (range = 1 to 96). A database search was conducted regarding evidence for effectiveness, safety precautions, and side effects for the 10 ingredients that appeared most often across products. Modest evidence of effectiveness exists for green tea (Camellia sinensis), chromium picolinate, and ma huang (Ephedra major). For the remaining seven (ginger root [Zingiber officinale], guarana [Paullinia cupana], hydroxycitric acid [Garcinia cambogia], white willow [Salix alba], Siberian ginseng [Eleutherococcus senticosus], cayenne [Capsicum annuum], and bitter orange/zhi shi [Citrus aurantium]), inadequate or negative evidence exists. Although precautions and contraindications were found for all 10 ingredients, the strongest concerns in the literature appear for ma huang, bitter orange, and guarana. Our audit revealed numerous weight-loss products available to consumers, yet there is little evidence to support the effectiveness of the top 10 ingredients identified and many potential adverse reactions; therefore, food and nutrition professionals should discuss dietary supplement use with their clients.
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Affiliation(s)
- Patricia A Sharpe
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, 921 Assembly St, Columbia, SC 29208, USA.
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Abstract
A 25-year-old woman presented with abdominal pain after taking an imported herbal weight-loss product. A urinary toxicology screen was positive for amphetamine, which the patient denied taking. On further investigation, the neutraceutical was found to contain an amphetamine derivative banned by the US Food and Drug Administration (FDA). Although the patient had discontinued use of the supplement before hospitalization and her symptoms steadily improved with appropriate treatment, a report was made to the FDA. Similar reports from cities across the United States prompted the FDA to confiscate shipments of the product before it could be distributed further nationally while they investigate claims against the product.
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Affiliation(s)
- Minh H Nguyen
- Department of Internal Medicine, Santa Clara Valley Medical Center, 751 S Bascom Ave, San Jose, CA 95128, USA.
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Masanja H, Schellenberg JA, Mshinda HM, Shekar M, Mugyabuso JKL, Ndossi GD, de Savigny D. Vitamin A supplementation in Tanzania: the impact of a change in programmatic delivery strategy on coverage. BMC Health Serv Res 2006; 6:142. [PMID: 17078872 PMCID: PMC1635705 DOI: 10.1186/1472-6963-6-142] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2006] [Accepted: 11/01/2006] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Efficient delivery strategies for health interventions are essential for high and sustainable coverage. We report impact of a change in programmatic delivery strategy from routine delivery through the Expanded Programme on Immunization (EPI+) approach to twice-yearly mass distribution campaigns on coverage of vitamin A supplementation in Tanzania METHODS We investigated disparities in age, sex, socio-economic status, nutritional status and maternal education within vitamin A coverage in children between 1 and 2 years of age from two independent household level child health surveys conducted (1) during a continuous universal targeting scheme based on routine EPI contacts for children aged 9, 15 and 21 months (1999); and (2) three years later after the introduction of twice-yearly vitamin A supplementation campaigns for children aged 6 months to 5 years, a 6-monthly universal targeting scheme (2002). A representative cluster sample of approximately 2,400 rural households was obtained from Rufiji, Morogoro Rural, Kilombero and Ulanga districts. A modular questionnaire about the health of all children under the age of five was administered to consenting heads of households and caretakers of children. Information on the use of child health interventions including vitamin A was asked. RESULTS Coverage of vitamin A supplementation among 1-2 year old children increased from 13% [95% CI 10-18%] in 1999 to 76% [95%CI 72-81%] in 2002. In 2002 knowledge of two or more child health danger signs was negatively associated with vitamin A supplementation coverage (80% versus 70%) (p = 0.04). Nevertheless, we did not find any disparities in coverage of vitamin A by district, gender, socio-economic status and DPT vaccinations. CONCLUSION Change in programmatic delivery of vitamin A supplementation was associated with a major improvement in coverage in Tanzania that was been sustained by repeated campaigns for at least three years. There is a need to monitor the effect of such campaigns on the routine health system and on equity of coverage. Documentation of vitamin A supplementation campaign contacts on routine maternal and child health cards would be a simple step to facilitate this monitoring.
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Affiliation(s)
- Honorati Masanja
- Ifakara Health Research & Development Center, Ifakara, Morogoro, Tanzania
- Department of Epidemiology, Swiss Tropical Institute, Basel, Switzerland
| | - Joanna Armstrong Schellenberg
- Ifakara Health Research & Development Center, Ifakara, Morogoro, Tanzania
- Department of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, Keppel Street, London, UK
| | - Hassan M Mshinda
- Ifakara Health Research & Development Center, Ifakara, Morogoro, Tanzania
| | - Meera Shekar
- Human Development Network (HDNHE), The World Bank, 1818 H Street, NW, Washington DC 20433, USA
| | | | | | - Don de Savigny
- Department of Epidemiology, Swiss Tropical Institute, Basel, Switzerland
- Tanzania Essential Health Interventions Project, Dar es Salaam, Tanzania
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Abstract
The purpose of this study was to analyze the composition of 103 dietary supplements bought on the internet. The supplements were dispatched in four different categories according to their announced contents [creatine, prohormones, "mental enhancers" and branched chain amino acids (BCAA)]. All the supplements were screened for the presence of stimulants and main anabolic steroids parent compounds. At the same time, the research was focused on the precursors and metabolites of testosterone and nandrolone. The study pointed out three products containing an anabolic steroid, metandienone, in a very high amount. The ingestion of such products induced a high quantity of metandienone metabolites in urines that would be considered as a positive antidoping test. The results have also shown that one creatine product and three "mental enhancers" contained traces of hormones or prohormones not claimed on the labels and 14 prohormone products contained substances other than those indicated by the manufacturer. The oral intake of the creatine product revealed the presence of the two main nandrolone metabolites (19-norandrosterone and 19-noretiocholanolone) in urine.
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Affiliation(s)
- N Baume
- Laboratoire Suisse d'Analyse du Dopage, Institut Universitaire de Médecine Légale, Département Universitaire de Médecine et Santé Communautaire, Lausanne, Switzerland.
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Chełchowska M, Laskowska-Klita T, Ambroszkiewicz J, Leibschang J. [The effect of tobacco smoking during pregnancy on concentration of vitamin A and beta-carotene in matched-maternal cord pairs]. Przegl Lek 2006; 63:966-9. [PMID: 17288195] [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: 05/13/2023]
Abstract
Tobacco smoking causes oxidant stress in pregnant women and may have a similar effect in fetus. Vitamin A and beta-carotene are natural factors protecting cells from damaging influence of free oxygen species.Therefore the aim of the study was to estimate the effect of tobacco smoking during pregnancy on concentration of vitamin A and beta-carotene in blood of mother and newborn. Healthy women in III trimester of pregnancy were divided into non-smoking (n = 40) and smoking group (n = 35) according to the concentration of cotinine in serum and urine. Level of carotenoids was measured by HPLC (high pressure liquid chromatography) method in plasma of matched-maternal cord pairs. We observed that, in smoking women group concentration of vitamin A was lower in plasma of mothers as well as in cord blood of newborn (p < 0.001) and amounted respectively only 80% and 70% of that observed in non-smoking mother and their child. In smoking group plasma level of beta-carotene was significantly lower (by 30%; p < 0.0001) as compared with non-smoking matched-maternal cord pairs. Plasma level of vitamin A was significantly correlated with concentration of pcarotene both in smoking and non-smoking pregnant women (r = 0.70, p < 0.001; r = 0.57, p < 0.001). The similar correlation was observed in umbilical cord blood in both groups (r = 0.81 and r = 0.82; p < 0.001). Reduced concentration of vitamin A and beta-carotene in matched-maternal cord pairs suggest that consumption of this antioxidant for neutralization of free radicals present in cigarette smoking is enhanced.
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Abstract
BACKGROUND: The Internet is a popular tool for marketing and purchasing herbal dietary supplements (DS). Various Web sites sell these products purely for recreational use. Objective: To describe the content of Web sites that advertise and market herbal DS for recreational use (ie, for the purpose of altering mood/behavior/or perception, “getting high,” or as a substitute for a drug of abuse). METHODS: Four major search engines and the search terms “buy herbal high” and “buy legal high” were used to identify Web sites selling herbal DS for recreational use. Web sites were evaluated for their country of origin and for compliance with the Dietary Supplement Health and Education Act (DSHEA). Products were evaluated for their ingredient lists, effect claims, comparisons with illicit drugs, adverse effects, drug interactions, and contraindications. RESULTS: Twenty-eight unique Web sites with 119 products were evaluated. Most sites were in the US (54%) and were in compliance with DSHEA. Forty-seven percent of the products were likened to illicit drugs, typically marijuana (48%) or 3-,4-methylene dioxyamphetamine (Ecstasy; 23%). The most common product ingredients were ephedra alkaloids (27%), Salvia divinorum (17%), kava (10%), guarana (10%), Acorus calamus (10%), and damiana (10%). Effect claims frequently involved the products' use as a hallucinogen (51%) or stimulant (39%). Sixty-four percent of the sites mentioned adverse effects, and 54% mentioned drug interactions. CONCLUSIONS: This study demonstrates that herbal DS are being marketed for use as legal alternatives to illicit drugs of abuse. Healthcare professionals need to be aware of this trend and the products that are involved.
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Affiliation(s)
- Cathi E Dennehy
- School of Pharmacy, University of California, San Francisco, CA 94143-0622, USA.
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Coren C. Vitamin A supplementation erases gender disparities in child mortality in Nepal. Int Fam Plan Perspect 2005; 31:42-3. [PMID: 15997497] [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: 05/03/2023]
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Bishai D, Kumar K C S, Waters H, Koenig M, Katz J, Khatry SK, West KP. The impact of vitamin A supplementation on mortality inequalities among children in Nepal. Health Policy Plan 2005; 20:60-6. [PMID: 15689431 DOI: 10.1093/heapol/czi007] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [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: 11/14/2022] Open
Abstract
OBJECTIVE This paper examines gender, caste and economic differentials in child mortality in the context of a cluster-randomized trial of vitamin A distribution, in order to determine whether or not the intervention narrowed these differentials. DESIGN The study involved secondary analysis of data from a placebo-controlled randomized field trial of vitamin A supplements. The study took place between 1989-1991 in rural Sarlahi District of Nepal, with 30,059 children age 6 to 60 months. The main outcome measures were differences in mortality between boys and girls, between highest Hindu castes and others, and between the poorest quintile and the four other quintiles. RESULTS Without vitamin A, girls in rural Nepal experience 26.1 deaths per 1000, which is 8.3 deaths more than the comparison population of boys. With vitamin A the mortality disadvantage of girls is nearly completely attenuated, at only 1.41 additional deaths per 1000 relative to boys. Vitamin A supplementation also narrowed mortality differentials among Hindu castes, but did not lower the concentration of mortality across quintiles of asset ownership. The vitamin A-related attenuation in mortality disadvantage from gender and caste is statistically significant. CONCLUSIONS We conclude that universal supplementation with vitamin A narrowed differentials in child death across gender and caste in rural Nepal. Assuring high-coverage vitamin A distribution throughout Nepal could help reduce inequalities in child survival in this population.
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Affiliation(s)
- David Bishai
- Department of Population and Family Health Sciences, Johns Hopkins University, Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA.
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Meadows M. Use caution buying medical products online. FDA Consum 2005; 39:28-34. [PMID: 15803594] [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: 05/02/2023]
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Celec P, Ostatníková D, Cagánová M, Zuchová S, Hodosy J, Putz Z, Bernadic M, Kúdela M. Endocrine and cognitive effects of short-time soybean consumption in women. Gynecol Obstet Invest 2004; 59:62-6. [PMID: 15528926 DOI: 10.1159/000081895] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [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: 05/03/2004] [Accepted: 08/19/2004] [Indexed: 11/19/2022]
Abstract
BACKGROUND Soy phytoestrogens are known to influence the hormonal status acting as partial estrogen agonists. Soy-derived food supplements are advised for hormone replacement therapy, prevention of atherosclerosis, age-related cognitive decline and even hormone-dependent cancer, although results from clinical studies are controversial. Whether increased soybean intake can affect the endocrine status and cognitive abilities is largely unknown. AIM To observe the effects of 1 week of increased soybean intake on sex hormone levels and spatial cognitive abilities in women. SUBJECTS AND METHODS 16 young healthy female volunteers were asked to eat 900 g of soybeans within 1 week. Salivary testosterone (T), free and total plasma T, salivary and plasma estradiol (E) were measured by radioimmunoassay before and after the study period. Mental rotation (MR) and spatial visualization (SV) psychological tests were done at the days of sampling. RESULTS Soybean intake increased total plasma T levels (p < 0.02) while decreasing salivary T (p < 0.01) and not altering free plasma T levels. Salivary and plasma E levels were not changed. The results of MR and SV tests were improved after the study period. CONCLUSION Short-time increased soybean intake alters the level of total plasma and salivary T and improves spatial cognition in women. Whether this effect is mediated by modulation of estrogen receptors, changes in sex hormone-binding globulin production or changes in activity of steroid-competent enzymes needs further study.
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Affiliation(s)
- Peter Celec
- Institute of Pathophysiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia.
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Meadows M. Ensuring the safety of dietary supplements. FDA Consum 2004; 38:10-1. [PMID: 15346577] [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: 04/30/2023]
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Abstract
CONTEXT Passage of the Dietary Supplement Health and Education Act in 1994 restricted the Food and Drug Administration's control over dietary supplements, leading to enormous growth in their promotion. The Internet is often used by consumers as a source of information on such therapies. OBJECTIVE To assess the information presented and indications claimed on the Internet for the 8 best-selling herbal products. DATA SOURCES We searched the Internet using the 5 most commonly used search engines. For each, we entered the names of the 8 most widely used herbal supplements (ginkgo biloba, St John's wort, echinacea, ginseng, garlic, saw palmetto, kava kava, and valerian root). We analyzed the health content of all Web sites listed on the first page of the search results. STUDY SELECTION We analyzed all accessible, English-language Web sites that pertained to oral herbal supplements. A total of 522 Web sites were identified; of these, 443 sites met inclusion criteria for the analysis. DATA EXTRACTION The nature of the Web site (retail or nonretail), whether it was a sponsored link, and all references, indications, claims, and disclaimers were recorded. Two reviewers independently categorized medical claims as disease or nondisease according to Food and Drug Administration criteria. DATA SYNTHESIS Among 443 Web sites, 338 (76%) were retail sites either selling product or directly linked to a vendor. A total of 273 (81%) of the 338 retail Web sites made 1 or more health claims; of these, 149 (55%) claimed to treat, prevent, diagnose, or cure specific diseases. More than half (153/292; 52%) of sites with a health claim omitted the standard federal disclaimer. Nonretail sites were more likely than retail sites to include literature references, although only 52 (12%) of the 443 Web sites provided referenced information without a link to a distributor or vendor. CONCLUSIONS Consumers may be misled by vendors' claims that herbal products can treat, prevent, diagnose, or cure specific diseases, despite regulations prohibiting such statements. Physicians should be aware of this widespread and easily accessible information. More effective regulation is required to put this class of therapeutics on the same evidence-based footing as other medicinal products.
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Affiliation(s)
- Charles A Morris
- Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass 02120, USA.
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Kauflin S. Dietary supplements: is availability worth the risks? Proposed alternatives to the present DSHEA scheme. Seton Hall Law Rev 2003; 33:411-46. [PMID: 12715805] [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: 03/02/2023]
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Katz J, West KP, Khatry SK, Christian P, LeClerq SC, Pradhan EK, Shrestha SR. Risk factors for early infant mortality in Sarlahi district, Nepal. Bull World Health Organ 2003; 81:717-25. [PMID: 14758431 PMCID: PMC2572324] [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: 04/28/2023] Open
Abstract
OBJECTIVES Early infant mortality has not declined as rapidly as child mortality in many countries. Identification of risk factors for early infant mortality may help inform the design of intervention strategies. METHODS Over the period 1994-97, 15,469 live-born, singleton infants in rural Nepal were followed to 24 weeks of age to identify risk factors for mortality within 0-7 days, 8-28 days, and 4-24 weeks after the birth. FINDINGS In multivariate models, maternal and paternal education reduced mortality between 4 and 24 weeks only: odds ratios (OR) 0.28 (95% confidence interval (CI) = 0.12-0.66) and 0.63 (95% CI = 0.44-0.88), respectively. Miscarriage in the previous pregnancy predicted mortality in the first week of life (OR = 1.98, 95% CI = 1.37-2.87), whereas prior child deaths increased the risk of post-neonatal death (OR = 1.85, 95% CI 1.24-2.75). A larger maternal mid-upper arm circumference reduced the risk of infant death during the first week of life (OR = 0.88, 95% CI = 0.81-0.95). Infants of women who did not receive any tetanus vaccinations during pregnancy or who had severe illness during the third trimester were more likely to die in the neonatal period. Maternal mortality was strongly associated with infant mortality (OR = 6.43, 95% CI = 2.35-17.56 at 0-7 days; OR = 11.73, 95% CI = 3.82-36.00 at 8-28 days; and OR = 51.68, 95% CI = 20.26-131.80 at 4-24 weeks). CONCLUSION Risk factors for early infant mortality varied with the age of the infant. Factors amenable to intervention included efforts aimed at maternal morbidity and mortality and increased arm circumference during pregnancy.
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Affiliation(s)
- Joanne Katz
- Division of Disease Prevention and Control, Center for Human Nutrition, Sight & Life Research Institute, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
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Thomson C, Diekman C, Fragakis AS, Meerschaert C, Holler H, Devlin C. Guidelines regarding the recommendation and sale of dietary supplements. J Am Diet Assoc 2002; 102:1158-64. [PMID: 12171465 DOI: 10.1016/s0002-8223(02)90257-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Galloway R, Dusch E, Elder L, Achadi E, Grajeda R, Hurtado E, Favin M, Kanani S, Marsaban J, Meda N, Moore KM, Morison L, Raina N, Rajaratnam J, Rodriquez J, Stephen C. Women's perceptions of iron deficiency and anemia prevention and control in eight developing countries. Soc Sci Med 2002; 55:529-44. [PMID: 12188461 DOI: 10.1016/s0277-9536(01)00185-x] [Citation(s) in RCA: 162] [Impact Index Per Article: 7.4] [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: 11/28/2022]
Abstract
The World Health Organization estimates that 58% of pregnant women in developing countries are anemic. In spite of the fact that most ministries of health in developing countries have policies to provide pregnant women with iron in a supplement form, maternal anemia prevalence has not declined significantly where large-scale programs have been evaluated. During the period 1991-98, the MotherCare Project and its partners conducted qualitative research to determine the major barriers and facilitators of iron supplementation programs for pregnant women in eight developing countries. Research results were used to develop pilot program strategies and interventions to reduce maternal anemia. Across-region results were examined and some differences were found but the similarity in the way women view anemia and react to taking iron tablets was more striking than differences encountered by region, country or ethnic group. While women frequently recognize symptoms of anemia, they do not know the clinical term for anemia. Half of women in all countries consider these symptoms to be a priority health concern that requires action and half do not. Those women who visit prenatal health services are often familiar with iron supplements, but commonly do not know why they are prescribed. Contrary to the belief that women stop taking iron tablets mainly due to negative side effects, only about one-third of women reported that they experienced negative side effects in these studies. During iron supplementation trials in five of the countries, only about one-tenth of the women stopped taking the tablets due to side effects. The major barrier to effective supplementation programs is inadequate supply. Additional barriers include inadequate counseling and distribution of iron tablets, difficult access and poor utilization of prenatal health care services, beliefs against consuming medications during pregnancy, and in most countries, fears that taking too much iron may cause too much blood or a big baby, making delivery more difficult. Facilitators include women's recognition of improved physical well being with the alleviation of symptoms of anemia, particularly fatigue, a better appetite, increased appreciation of benefits for the fetus, and subsequent increased demand for prevention and treatment of iron deficiency and anemia.
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Katz J, West KP, Wu L, Khatry SK, Pradhan EK, Christian P, LeClerq SC, Shrestha SR. Determinants of maternal vitamin A or beta-carotene supplementation coverage: village-based female distributors in Nepal. Am J Public Health 2002; 92:1105-7. [PMID: 12084690 PMCID: PMC1447196 DOI: 10.2105/ajph.92.7.1105] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Joanne Katz
- Department of International Health, Center for Human Nutrition, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD 21205-2103, USA.
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