Relationship between markers of HIV-1 disease progression and serum β-carotene concentrations in Kenyan women

Observational studies have suggested that low serum β-carotene concentrations may influence HIV-1 disease progression. However, randomized trials have not demonstrated beneficial effects of β-carotene supplementation. To understand this discrepancy, we conducted a cross-sectional study among 400 HIV-1-seropositive women in Mombasa, Kenya, to correlate serum β-carotene concentrations with several measures of HIV-1 disease severity. β-Carotene concentrations were significantly associated with biologic markers of HIV-1 disease progression (CD4 count, HIV-1 plasma viral load, serum C-reactive protein [CRP] concentration, and serum albumin level). In multivariate analysis, β-carotene concentrations below the median were associated with elevated CRP (>10mg/l, adjusted odds ratio [aOR] 3.32, 95% confidence interval [CI] 1.99–5.53, P <0.001) and higher HIV-1 plasma viral load (for each log10 copies/mL increase, aOR 1.38, 95% CI 1.01–1.88, P = 0.04). In the context of negative findings from randomized trials of β-carotene supplementation in HIV-1-seropositive individuals, these results suggest that low β-carotene concentrations primarily reflect more active HIV-1 infection rather than a deficiency amenable to intervention.

Micronutrient Deficiencies and Plasmodium vivax Malaria among Children in the Brazilian Amazon

Background

There is a growing body of evidence linking micronutrient deficiencies and malaria incidence arising mostly from P. falciparum endemic areas. We assessed the impact of micronutrient deficiencies on malaria incidence and vice versa in the Brazilian state of Amazonas.

Methodology/Principal Findings

We evaluated children <10 years old living in rural communities in the state of Amazonas, Brazil, from May 2010 to May 2011. All children were assessed for sociodemographic, anthropometric and laboratory parameters, including vitamin A, beta-carotene, zinc and iron serum levels at the beginning of the study (May 2010) and one year later (May 2011). Children were followed in between using passive surveillance for detection of symptomatic malaria. Those living in the study area at the completion of the observation period were reassessed for micronutrient levels. Univariate Cox-proportional Hazards models were used to assess whether micronutrient deficiencies had an impact on time to first P. vivax malaria episode. We included 95 children median age 4.8 years (interquartile range [IQR]: 2.3–6.6), mostly males (60.0%) and with high maternal illiteracy (72.6%). Vitamin A deficiencies were found in 36% of children, beta-carotene deficiency in 63%, zinc deficiency in 61% and iron deficiency in 51%. Most children (80%) had at least one intestinal parasite. During follow-up, 16 cases of vivax malaria were diagnosed amongst 13 individuals. Micronutrient deficiencies were not associated with increased malaria incidence: vitamin A deficiency [Hazard ratio (HR): 1.51; P-value: 0.45]; beta-carotene [HR: 0.47; P-value: 0.19]; zinc [HR: 1.41; P-value: 0.57] and iron [HR: 2.31; P-value: 0.16]). Upon reevaluation, children with al least one episode of malaria did not present significant changes in micronutrient levels.

Conclusion

Micronutrient serum levels were not associated with a higher malaria incidence nor the malaria episode influenced micronutrient levels. Future studies targeting larger populations to assess micronutrients levels in P. vivax endemic areas are warranted in order to validate these results.

Comparison of dietary intake between fixed orthodontic patients and control subjects

BACKGROUND

Adolescence is a period of rapid physiological and psychological development which is associated with an increased demand in nutritional requirements. Orthodontic therapy is also commonly initiated during this phase of life and nutritional intake may also change during treatment.

AIMS

To compare the nutrient intakes of adolescents wearing fixed orthodontic appliances and a control group matched for age and gender.

METHOD

A total of 180 patients aged between 15 and 17 years participated in this study (90 in the study group and 90 controls). Demographic data were collected by questionnaire and dietary intake was assessed using a 24-hour memory recall and was analysed using Dietplan6 software (Forestfield Software Ltd, UK). Comparisons between groups were assessed by the Independent sample t-test dnd the SPSS was used for statistical analysis.

RESULTS

Orthodontic patients consumed a similar number of total calories, protein and carbohydrate (p > 0.05); however, they had a greater intake of total fat, saturated fat, monosaturated fat, polysaturated fat, linolenic fat, linoleic fat and cholesterol and significantly lower intake of fibre, chromium and beta-carotene (p < 0.05) compared with the Control group. The intake of other macro- and micro-nutrients did not differ significantly between groups.

CONCLUSIONS

Adolescents receiving orthodontic treatment have an altered dietary intake that can be harmful to their health. As adolescents are at a critical stage of development and dietary intake is of particular importance, it is recommended that targeted nutritional guidance is provided to patients during orthodontic treatment.

Antioxidant vitamin levels in sickle cell disorders

BACKGROUND

Sickle cell disorder is a haemoglobinopathy prevalent in the Vidharbha region of Maharashtra, central India. With recent evidence of oxidative stress in sickle haemoglobinopathy, a possible deficiency of antioxidant vitamins was suspected.

METHODS

We measured plasma vitamin E, vitamin C and beta-carotene levels in persons with heterozygous (n=80) and homozygous sickle cell state (n=20), and suitable healthy controls for these groups (n=100 and 66, respectively) in a community-based study in the villages near our institution.

RESULTS

Subjects with heterozygous sickle cell trait had lower vitamin E levels than their respective controls (p < 0.05). Subjects with homozygous sickle cell disease had lower levels of all three vitamins (p < 0.05). Vitamins E and C levels showed a significant positive correlation in both forms of sickle cell disorder.

CONCLUSION

Our findings suggest that there is depletion of the antioxidant vitamins, particularly in severe forms of sickle cell disorder. A trial of administration of therapeutic doses of vitamin E in this condition is warranted.

Dietary modulation of lens zeaxanthin in quail

Although higher dietary intake of lutein/zeaxanthin has been associated with reduced risk for cataracts, the impact of dietary supplements on lens lutein (L) or zeaxanthin (Z) has not been examined. If higher lens carotenoids do reduce risk for cataract, it would be essential to know whether dietary carotenoids can elevate carotenoids in the adult vertebrate lens. In this study, a covey of Japanese quail were hatched and raised 6 months on carotenoid-deficient diet, then switched to deficient diet supplemented with low or high 3R,3R'-zeaxanthin (5 or 35 mgkg(-1) food) or beta-carotene (50 mgkg(-1) food). Controls included a group of covey-mates that remained on the deficient diet and another raised from birth on the high Z (35 mg Zkg(-1)) diet. At 1 year of age, carotenoids and tocopherols in the lens and in the serum were analysed by HPLC, and compared by analysis of variance. Serum Z was significantly elevated in deficient birds fed the lower or higher Z supplement for 6 months (P<0.0001 for each). Serum Z in birds maintained on the higher Z supplement for 1 year was much higher than that in deficient birds (P<0.0001), but not different from deficient birds given the higher Z supplement. As in humans, the predominant lens carotenoids were lutein (L) and zeaxanthin (Z), and the total carotenoid concentration was of lower magnitude than the concentration of alpha-tocopherol. Responses to Z supplementation were sex-related. Female quail had 5-10 times higher serum concentrations of both Z and L than males (P<0.0001, <0.001), and they also had higher lens Z concentrations than males (P<0.0006); possible effects of estrogen on lens carotenoids are discussed. Lens Z concentration was strongly and positively correlated with serum Z in females (r=0.77; P<0.002). Deficient adult females supplemented with the 35 mgkg(-1) dose of Z for 6 months had a mean lens Z concentration (0.252+/-0.06 microgg(-1) protein) close to that in females fed with the supplement from birth (0.282+/-0.15 microgg(-1) protein). Birds fed with the higher dietary Z supplement for 6 or 12 months had significantly higher lens Z than birds fed lower or no dietary Z (P<0.0001). Lens L was not altered by dietary supplementation with either Z or beta-carotene. beta-Carotene supplements did not result in detectable lens beta-carotene, and had no effect on lens Z. Neither Z nor beta-carotene supplementation had a significant effect on serum or lens tocopherol concentrations. These studies in quail provide the first experimental evidence that lens carotenoids in adult vertebrates can be manipulated by dietary Z supplements.

Micronutrient status of primary school girls in rural and urban areas of South Vietnam

Dietary habits, especially micronutrient intake, and nutritional status of Vietnamese primary school girls were investigated in a cross-sectional survey. We interviewed 284 girls aged 7 to 9 years old, randomly selected from three rural (N=148) and two urban (N=136) primary schools. Dietary data were calculated from the results of 24-h recall interviews over three consecutive days. The dietary micronutrient pattern of the rural group showed deficiency of iron, calcium, phosphorus, potassium, magnesium, beta-carotene, vitamin A and vitamin C. On the contrary, adequate consumption of these elements, except low beta-carotene, was observed in the urban group. Despite a low prevalence of anaemia, the prevalence of rural children with iron deficiency was close to the level regarded as being a public health problem. In contrast, 7.7% of urban children were found to have excessive iron status. Children with exhausted retinol stores (7.1%) requiring immediate retinol supplementation were only found in the rural group. Furthermore, the prevalence of children with marginal retinol stores in both the rural (35.7%) and urban (21.4%) groups was above the level of being a public health problem (20%). In both groups, more than 50% and 20% of children showed beta-carotene and tocopherol levels in the range of severe deficiency, respectively. Thus, nutritional education to improve the dietary habits of the two groups is necessary for Vietnamese primary school children.

Vitamin A and beta-carotene levels during pregnancy in Gaziantep, Turkey

Vitamin A levels during pregnancy have important influences on the health of pregnant women and the growing fetus. Therefore, plasma vitamin A and beta-carotene concentrations during pregnancy in Turkish women living in Gaziantep city were investigated in a prevalence study. Optimum sample size was determined as 252 for vitamin A deficiency and vitamin A and beta-carotene levels were examined in 427 pregnant women aged 14-44 years. Vitamin A and beta-carotene concentrations were measured spectrophotometrically by Neeld Pearson method. Vitamin A and beta-carotene concentrations in pregnant women were found as 1.14 +/- 0.44 micromol/L, and 1.80 +/- 0.66 micromol/L, respectively. Plasma vitamin A concentrations were found in low levels (<1.05 micromol/L) in 45.5% of pregnant women. Vitamin A deficiency (<0.7 micromol/L) was determined in 16.9% of pregnant women. A mild negative correlation was obtained between the vitamin A concentration and pregnancy period. Vitamin A levels of pregnant women were decreased significantly in the third trimester (p<0.05). The findings of present study suggest that vitamin A levels of pregnant women were poor in the region. Therefore, the intake of vitamin A with foods should be improved. Supplementation of vitamin A might benefit at improving maternal and child health especially in high-risk groups especially in developing countries. Monitoring vitamin A levels in pregnant women is very important for also determining low and high levels.

Zeaxanthin deficiency enhances the high light sensitivity of an ascorbate-deficient mutant of Arabidopsis

The ascorbate content of plants is usually increased in high light (HL), implying a function for ascorbate in the acclimation of plants to HL. Nevertheless, the importance of ascorbate in HL acclimation has not yet been tested directly. Here, we report on the acclimation process of an ascorbate-deficient Arabidopsis mutant to HL. The mutant vtc2 has only 10% to 30% of wild-type levels of ascorbate, and it is also slightly deficient in feedback de-excitation (qE), a photoprotective mechanism that causes the dissipation of excess light as heat. The vtc2 mutant was unable to acclimate to HL, when transferred from low light to HL. Its mature leaves bleached, and it showed an increased degree of lipid peroxidation and photoinhibition. In parallel, we tested the photosensitivity of an ascorbate-deficient xanthophyll cycle mutant, vtc2npq1, which also lacks zeaxanthin and nearly all qE. The double mutant bleached sooner and had higher degrees of lipid peroxidation and photoinhibition than the vtc2 mutant. This was in contrast to the npq1 single mutant that showed only slight deviations from the wild-type phenotype under the conditions used. These results demonstrate the antioxidant role of ascorbate in the acclimation process to HL and point to the relative importance of ascorbate in comparison with other photoprotective processes, such as specific xanthophylls or feedback de-excitation. The results also provide further support for the proposed role of zeaxanthin as an antioxidant and lipid stabilizer.

[The use of alimentary antioxidants in diet therapy of geriatric patients during the period of the surgical treatment]

Analysis of actual feeding of 277 geriatric patients suffering from urology disease. The patients had a combined deficient of vitamin A, vitamin C, vitamin of the B group, beta-capotene and mineral substances. Diets 1a, 1, 5, 7, 9, 15 could not provide daily needs for antioxidant nutrients. Antioxidant and antiinflammatory effects of the dietary supplement containing natural antioxidants in 122 oncourology patients after operation was indicated. So there was reason to fortify diets of patients with antioxidant dietary supplement during the period of surgical treatment.

[Use of the microalgae Spirulina platensis and its selenium-containing form in nutrition of patients with nonspecific ulcerative colitis]

The vitamin security and selenium status were measured in the patients with unspecific ulcerative colitis. There were used food microalgae Spirulina platensis and it's preparation enriched with selenium as auxiliary tools of dietetic treatment for these patients. It's shown that there is a combined deficiency of beta-carotene and selenium and occasionally some other micronutrients in a significant part of the patients. The doses used of said food supplements were not enough sufficient for a dietary correction of deficiency of micronutrients with antioxidative properties.

The age-related eye disease study: the results of the clinical trial

The Age-Related Eye Disease Study (AREDS) is a multi-center study sponsored by the National Eye Institute to determine the natural history and risk factors associated with both cataract and age-related macular degeneration (AMD). AREDS incorporated a clinical trial to determine what role micro nutrients may play in the development and progression of cataracts and AMD. The micro nutrients studied were the antioxidants vitamins E,C, beta-carotene and zinc with copper. Participants were randomized to either antioxidants, mineral, a combination of antioxidants and minerals or placebo. The participants were categorized, by the presence of drusen and diagnosis of AMD into one of four groups: no AMD, early AMD, intermediate AMD or advanced AMD. They were followed for an average of 6.3 years. There was no statistically significant difference in the cataract trial between treatment and placebo. In the AMD trial groups, those at high risk of developing advanced AMD lowered their risk by about 25% when treated with the mega dosages of the combination of antioxidants and minerals.

Long-term evaluation of a micronutrient-fortified biscuit used for addressing micronutrient deficiencies in primary school children

OBJECTIVE

To evaluate the long-term effect on micronutrient status of a beta-carotene-, iron- and iodine-fortified biscuit given to primary school children as school feeding.

DESIGN

Children receiving the fortified biscuit were followed in a longitudinal study for 2.5 years (n = 108); in addition, cross-sectional data from three subsequent surveys conducted in the same school are reported.

SETTING

A rural community in KwaZulu-Natal, South Africa.

SUBJECTS

Children aged 6-11 years attending the primary school where the biscuit was distributed.

RESULTS

There was a significant improvement in serum retinol, serum ferritin, haemoglobin, transferrin saturation and urinary iodine during the first 12 months of the biscuit intervention. However, when the school reopened after the summer holidays, all variables, except urinary iodine, returned to pre-intervention levels. Serum retinol increased again during the next 9 months, but was significantly lower in a subsequent cross-sectional survey carried out directly after the summer holidays; this pattern was repeated in two further cross-sectional surveys. Haemoglobin gradually deteriorated at each subsequent assessment, as did serum ferritin (apart from a slight increase at the 42-month assessment at the end of the school year).

CONCLUSIONS

This study has shown that fortification of a biscuit with beta-carotene at a level of 50% of the Recommended Dietary Allowance (RDA) was enough to maintain serum retinol concentrations from day to day, but not enough to sustain levels during the long school holiday break. Other long-term solutions, such as local food production programmes combined with nutrition education, should also be examined. The choice of the iron compound used as fortificant in the biscuit needs further investigation.

[Several parameters of the nutritional status of indigenous population of Far North]

Presented are the results of nutrition status of 803 inhabitants of Yakutia both sexes at the age from 20 to 50. 22 per cent of examined men and 42 per cent of examined women had redundant body mass. It relates to high caloric diet and unbalance between consumption and expense of energy. High caloric diet is a cause of hypercholesterinemia and hypertriglyceridemia among young and old people. The most part of residents had insufficiency of vitamin C and beta-carotene in winter. It relates to deficit of fruit and vegetables in diet. 8 per cent of examined men and 30 per cent of examined women had low level of hemoglobin. Thus, rational nutrition is necessary for prophylaxis diseases in the Far North.

Risk factors for coronary heart disease in different socioeconomic groups of Lithuania and Sweden--the LiVicordia Study

AIMS

Lithuanian middle-aged men have a fourfold higher risk for coronary heart disease (CHD) mortality compared with Swedish men. In Sweden, CHD mortality is twice as high in blue- compared with white-collar workers. Whether the same risk factors that characterized Lithuanian men, compared with Swedish men, could be found in low socioeconomic groups within the cities was investigated.

METHODS

The LiVicordia study compared both traditional and new possible risk factors for CHD among 150 50-year-old men in Linköping, Sweden and Vilnius, Lithuania. A comparison was made of the prevalence of these risk factors in high and low socioeconomic groups within the cities and, after controlling for the city, variations across socioeconomic groups in the total sample.

RESULTS

Small differences were found in traditional risk factors between cities. However, Vilnius men were shorter, had lower serum levels of antioxidant vitamins, more psychosocial strain, and lower cortisol response to a standardized laboratory stress test. These characteristics were also found among men in low social classes in both cities. In linear regression models, short stature, low serum beta-carotene, low social integration, coping and self-esteem, high vital exhaustion, high baseline and low cortisol response to stress were related to low social class.

CONCLUSIONS

The same set of risk factors, mainly relating to oxidative and psychosocial stress, that characterized Vilnius men was also found in men in low social classes within the cities. The results suggest that a common set of risk factors may help to explain health differences both between and within countries.

Low carotenoid concentration and the risk of HIV seroconversion in Pune, India

Low vitamin A and carotenoid levels could increase the risk of sexual HIV acquisition by altering the integrity of the genital epithelium or by immunologic dysfunction. We addressed this issue by measuring serum vitamin A and carotenoid levels in patients who were at risk of subsequent HIV infection. In a nested case-control study in individuals attending two sexually transmitted disease (STD) clinics in Pune, India, serum micronutrient levels were measured in 44 cases with documented HIV seroconversion (11 women and 33 men) and in STD patients matched for gender and length of follow-up with no subsequent HIV seroconversion (controls). STD patients in Pune had low vitamin A and carotenoid levels, and low serum beta-carotene levels were independently associated with an increased risk of subsequent HIV seroconversion. STD patients with beta-carotene levels less than 0.075 micromol/L were 21 times more likely to acquire HIV infection than those with higher levels (adjusted odds ratio = 21.1; p =.01). No such association was observed in case of other non-provitamin A carotenoids. This study reports the first evidence of an association between low serum provitamin A carotenoid levels and an increased risk for heterosexual HIV acquisition in STD patients in Pune, India.

Association of smoking with serum and dietary levels of antioxidants in adults: NHANES III, 1988-1994

OBJECTIVES

This study examined the association of smoking with serum levels and dietary intakes of antioxidants in a nationally representative sample.

METHODS

This study classified 7873 apparently healthy adults aged 17 to 50 years from National Health and Nutrition Examination Survey III (NHANES III) data as nonsmokers or as smokers if their serum cotinine levels were either lower than 14 ng/mL or 14 ng/mL or greater, respectively. SUDAAN software was used for the statistical analysis.

RESULTS

Smokers of both sexes had significantly (P < .001) lower serum levels of vitamin C, alpha-carotene, beta-carotene, beta-cryptoxanthin, and lutein/zeaxanthin. Reduction in the serum vitamin E, lycopene, and selenium levels in smokers was slight. Smokers also had significantly lower dietary intakes of vitamin C and beta-carotene. A significant (P < .001) inverse relation was found between serum vitamin C and beta-carotene levels and cotinine levels independent of diet effect, and a positive relation (P < .001) was found between serum levels and dietary intakes.

CONCLUSIONS

Antioxidants appear to have differing declines in serum levels as a result of reduced dietary intakes and the effects of smoking.

Nutrients and HIV: part one -- beta carotene and selenium

Micronutrient deficiencies are common in HIV/AIDS, resulting from both malabsorption and virally-caused depletion. Beta carotene and selenium deficiencies, two of the most common nutrient deficiencies, are important due to their dual function as nutrients necessary for immune modulation and as antioxidants. Beta carotene deficiencies are common in all stages of HIV/AIDS and may signal malabsorption. Supplementation has been shown to affect specific T lymphocyte populations and decrease markers of lipoperoxides. Selenium levels are highly significant in predicting AIDS-related mortality; and the HIV virus manufactures selenoproteins that are involved in the regulation of viral replication, possibly depleting host levels of selenium. Supplementation trials with individual antioxidants have shown improvement in immunological parameters and decreased evidence of lipid peroxidation.

Stomata from npq1, a zeaxanthin-less Arabidopsis mutant, lack a specific response to blue light

The Arabidopsis mutant npq1, which cannot accumulate zeaxanthin because of a defective violaxanthin deepoxidase, was used to investigate the role of zeaxanthin in the stomatal response to blue light. Neither dark-adapted nor light-treated guard cells or mesophyll cells of the npq1 mutant contained detectable zeaxanthin. In contrast, wild-type guard cells had a significant zeaxanthin content in the dark and accumulated large amounts of zeaxanthin when illuminated. The well-documented red light enhancement of blue light-stimulated stomatal opening, in which increasing fluence rates of background red light result in increased response to blue light, was used to probe the specific blue light response of Arabidopsis stomata. Stomata from the npq1 mutant did not have a specific blue light response under all fluence rates of background red light tested. On the other hand, stomata from leaves of hy4 (cry 1), an Arabidopsis mutant lacking blue light-dependent inhibition of hypocotyl elongation, had a typical enhancement of the blue light response by background red light. The lack of a specific blue light response in the zeaxanthinless npq1 mutant provides genetic evidence for the role of zeaxanthin as a blue light photoreceptor in guard cells.

Effect of iron-, iodine-, and beta-carotene-fortified biscuits on the micronutrient status of primary school children: a randomized controlled trial

BACKGROUND

Deficiencies of iron, iodine, and vitamin A are prevalent worldwide and can affect the mental development and learning ability of schoolchildren.

OBJECTIVE

The aim of this study was to determine the effect of micronutrient-fortified biscuits on the micronutrient status of primary school children.

DESIGN

Micronutrient status was assessed in 115 children aged 6-11 y before and after consumption of biscuits (fortified with iron, iodine, and beta-carotene) for 43 wk over a 12-mo period and was compared with that in a control group (n = 113) who consumed nonfortified biscuits. Cognitive function, growth, and morbidity were assessed as secondary outcomes.

RESULTS

There was a significant between-group treatment effect on serum retinol, serum ferritin, serum iron, transferrin saturation, and urinary iodine (P <0.0001) and in hemoglobin and hematocrit (P <0.05). The prevalence of low serum retinol concentrations (<0.70 micromol/L) decreased from 39.1% to 12.2%, of low serum ferritin concentrations (<20 microg/L) from 27.8% to 13.9%, of anemia (hemoglobin <120 g/L) from 29.6% to 15.6%, and of low urinary iodine concentrations (<100 microg/L) from 97.5% to 5.4%. There was a significant between-group treatment effect (P <0.05) in cognitive function with the digit span forward task (short-term memory). Fewer school days were missed in the intervention than in the control group because of respiratory- (P = 0.097) and diarrhea-related (P = 0.013) illnesses. The intervention had no effect on anthropometric status [corrected].

CONCLUSIONS

Fortified biscuits resulted in a significant improvement in the micronutrient status of primary school children from a poor rural community and also appeared to have a favorable effect on morbidity and cognitive function [corrected].

Selected vitamins in HIV infection: a review

In this article we review published studies on the role of serum micronutrient levels in the natural history of HIV infection. Specifically, we have focused on vitamins B12, E, A, and beta-carotene. Deficiencies of one or several of these vitamins have been associated with an accelerated progression of HIV infection to AIDS. Most investigators have used serum micronutrient levels as an indicator of vitamin nutriture. However, serum levels are not always the most sensitive or specific indicators of vitamin status. Nonetheless, serum vitamin levels are relatively easy to obtain and have been studied in various HIV-infected populations in individuals at different stages of disease. Low serum B12 levels have been associated with increased neurologic abnormalities, more rapid HIV disease progression, and increased AZT-related bone marrow toxicity. Low serum vitamin E levels have been associated with an increase in oxidative stress in HIV-infected individuals. However, early studies of vitamin E supplementation suggest that vitamin E may have important immunostimulatory properties. Studies of vitamin A deficiency in HIV-infected populations have shown that low serum vitamin A levels are associated with increased mortality, more rapid disease progression, and increased maternal-fetal transmission. However, there is little evidence that vitamin A supplementation, beyond the correction of deficiency, is beneficial in HIV infection. Finally, several clinical trials of beta-carotene supplementation have failed to show significant or sustained improvements in the immune response of patients with HIV infection or AIDS.

[Esophageal carcinoma]

After early rises, oesophageal cancer mortality rates have tended to level off in Italy over the last two decades, and are now intermediate on a European scale (4.7/100000 males, 0.8/100000 females, world standard). This reflects the trends in consumption of the major risk factors for the disease, tobacco and alcohol, particularly in men. Within Italy, there is also a substantial variation in oesophageal cancer rates, with high mortality areas in the North-East of the country. On the basis of a case-control study conducted in northern Italy, the relative risk (RR) of the disease was 4.3 in heavy smokers and 3.5 in heavy drinkers. A diet poor in fresh fruit and vegetables was also related to the risk of the disease (RR = 2.5). In terms of population attributable risk, 71% of cases in men and 32% in women were accounted for tobacco smoking, 45% in males and 10% in females by alcohol drinking, 40% in men and 29% in women by a diet poor in fresh fruit and vegetables (and hence in beta-carotene). These three factors together accounted for 90% of cases in Italian men, and 58% in women (83% in both sexes combined).

Vitamin supplementation in the elderly: a critical evaluation

Routine vitamin supplementation for the elderly has been advocated by many. Specific vitamin deficiencies are rare in free-living elderly, but are not uncommonly encountered in hospitalized and institutionalized patients. Deficiency may result from interactions with medications or overall poor dietary intake. Low blood or plasma vitamin concentration is not necessarily indicative of a deficient state. Specific vitamin supplements are useful in the treatment and prevention of a deficient state. However, there is little, if any benefit from supplementation for reasons other than replacement therapy. The incidence and clinical symptoms of thiamine (vitamin B1), riboflavin (B2), pyridoxine (vitamin B6), vitamin B12, C, D, folate, niacin, vitamin A, E, beta carotene, and K deficiency and their treatment and prevention in the elderly are discussed.

Serum beta-carotene deficiency in HIV-infected children

Representative levels of serum micronutrients specifically, beta-carotene and vitamins A and E, were studied in symptomatic human immunodeficiency virus (HIV)-infected children. The nutritional status of 23 symptomatic African-American and Hispanic HIV-infected children were compared with an appropriate control group comprised of 36 uninfected children matched for age and sex, using body mass index. Serum beta-carotene and vitamin A and E levels were randomly determined on 15 of the infected children. Beta-carotene concentration was 4.9-fold reduced in symptomatic HIV-infected children when compared with the control group. There was a 6.5-fold decrease in the serum level for children without acquired immunodeficiency syndrome (AIDS) and a 13-fold reduction in children with AIDS. No differences in the mean values for serum vitamins A and E were observed in the groups studied. Although the nutritional status of the symptomatic HIV-infected children was not different from that of the control population, their serum beta-carotene levels were profoundly deficient. This finding may have immunologic and clinical implications for children with rapidly progressing HIV disease.

The independent association of smoking and drinking with serum beta-carotene levels among males in Miyagi, Japan

BACKGROUND

Previous studies indicated that serum beta-carotene levels were low among smokers and drinkers. However these findings may result from the strong relationship between smoking and drinking.

METHODS

Data were collected from 1902 males randomly selected from participants of a cohort study. The effects of smoking on serum beta-carotene levels were assessed according to drinking status (non-drinker, ex-drinker and current drinker), and those of drinking were assessed according to smoking status (ex-smoker and current smoker) using general linear model including other factors (age, intake of green-yellow vegetables, intake of carrot or pumpkin, body mass index serum cholesterol levels.)

RESULTS

An inverse dose-response relationship between daily consumption of alcohol and beta-carotene levels was observed regardless of smoking status, and also between number of cigarettes smoked per day and beta-carotene levels regardless of drinking status.

CONCLUSION

These results suggest that cigarette smoking and alcohol drinking reduce beta-carotene levels independently.

Content of beta-carotene in blood serum of human papillomavirus infected women with cervical dysplasias

Studies were carried out in 528 women hospitalized in the Department of Obstetrics and Gynecology Medical Academy in Lublin. Besides the control group, patients were classified according to the observed histopathological changes in the cervix (CIN) and found infections with human papillomavirus (HPV). In all cases beta-carotene content in blood serum was examined. HPV infection was probably a cause of decrease of beta-carotene content. It was found that with increased advancement of cervical dysplasia the level of beta-carotene in serum decreased.