Adverse effects of homeopathy: a systematic review of published case reports and case series - comment by Tournier et al

Linked Comment: Jackson. Int J Clin Pract 2013; 67: 385. Linked Comment: Walach et al. Int J Clin Pract 2013; 67: 385–6. Linked Comment: Posadzki and Ernst. Int J Clin Pract 2013; 67: 386–7. Linked Comment: Grimes. Int J Clin Pract 2013; 67: 387. Linked Comment: Posadzki and Ernst. Int J Clin Pract 2013; 67: 389.

[Oncogenic osteomalacia: increased production of fibroblast growth factor 23 is not the unique actor]

The importance of fibroblast growth factor 23 (FGF 23) has been highlighted in the mechanism of urinary leakage of phosphate in the oncogenic osteomalacia (OO). It is now a component of diagnosis of this disease. We report a 58-year-old man who presented with osteomalacia and hypophosphatemia secondary to urinary leakage of phosphorus. Although serum FGF 23 was normal, the diagnosis of OO was obtained after another cause of acquired prolonged hypophosphatemia has been excluded (hyperparathyroidism and Fanconi syndrome in particular). The search for a deep tumor was performed, allowing the detection of a 12 mm hemangiopericytoma in the upper thigh. Its removal allowed the rapid resolution of clinical symptoms and laboratory abnormalities. The importance of functional sequelae in OO depends on prompt diagnosis. Tumorectomy remains the optimal treatment. Thus, the search for a secreting tumor is essential even in the absence of elevated serum FGF 23.

Effect of a fat-reduced dish in a meal on 24-h energy and macronutrient intake

A covertly fat-reduced and low-calorie dish was provided at lunchtime once a week to normal-weight human subjects. A normal-calorie version of the dish was served for the first 3 weeks, the low-calorie version for the following 4 weeks and the normal-calorie version again for the last 3 weeks. Participants did not compensate for the 840-kJ (201 kcal) fat reduction of their main dish during the lunchtime meal. This lack of compensation persisted after four successive weekly presentations. When the normal-caloric version was offered again, energy intake at lunch immediately recovered. There was 80% adjustment in 24-h energy intake from the first to the last test day on the low-calorie dish, and a return to the baseline level when the normal energy content of the dish was restored. No compensation specific to fat occurred after the consumption of the low-fat dish and so the proportion of energy intake derived from fat decreased from 39.6% in the period on the normal-caloric dish to 36.1% in the 4 weeks on the low-calorie dish. Thus, fat-reduced dishes seem a good means to improve the composition of the diet.

Effect of the physical state of a food on subsequent intake in human subjects

The effect of the physical state of food on further intake was studied. Human subjects were served two experimental foods at lunchtime 1 week apart. In a first experiment, the two-food meals had the same caloric content, weight, volume, composition and temperature but differed only in their physical form (solid or liquid). As compared to the solid meal, the 24-h total caloric intake following the liquid food was higher. This difference could be attributed to cognitive cues from the form of food or to the lack of masticatory movements while ingesting the liquid meal. The last hypothesis was tested in a second experiment. "In which the test-meals appeared absolutely identical to the senses and were composed of a liquid and a solid item; however, the major part of calories was either in the liquid or in the solid part. When most of the calories had to be drunk, the total subsequent caloric intake was higher than when the most of the calories had to be eaten. It seems that calories ingested in a liquid form are not well taken in account and could induce a subsequent overconsumption, at least until satiety was conditioned to the fluid.

Learned caloric adjustment of human intake

The time course of caloric compensation of food intake was studied in human subjects presented with a new calorically dilute snack food under naturalistic conditions. In a preliminary test, two versions of the snack food, normal in calories (NC) or low in calories (LC), were found equally palatable by the subjects (15 to 17-year-old boys). In the first part of the experiment two groups were presented with a 125g serving of either NC or LC version as an afternoon snack. Intakes during the subsequent dinner (1 h later) were measured. In the second part of the experiment, the same subjects were allowed to habituate to NC or LC, i.e. on five consecutive days, subjects were served NC or LC food ad libitum at afternoon snack-time; servings and left-overs were weighed. On the sixth day, the snack was a 125 g serving of the habitual food and dinner intakes were measured. It was shown that in these adolescent males a 200 kcal difference in the afternoon snack was not immediately compensated for by dinner intake. However, precise caloric adjustment occurred after habituation. This casts in question the value for weight control of such a use of food products having lower caloric content than conventional products.