The present study gives further evidence for the recently found association between variants of the fatty acid desaturase 1 fatty acid desaturase 2 (FADS1 FADS2) gene cluster and PUFA in blood ...phospholipids and explores this association for cellular fatty acids in erythrocyte membranes. In a subgroup of adults participating in the Bavarian Nutrition Survey II, a cross-sectional population-based study conducted in Bavaria, Germany, allelic variation in three selected loci of the FADS1 FADS2 gene cluster was analysed and used for haplotype construction. Associations with plasma phospholipid PUFA (n 163) and PUFA in erythrocyte membranes (n 535) were investigated by regression analysis. All haplotypes of the original five-loci haplotypes of our previous study could be replicated. In addition, associations with serum phospholipid PUFA were confirmed in the present data set. Although less pronounced, associations between FADS1 FADS2 haplotypes and PUFA in erythrocyte membranes, particularly arachidonic and dihomo-γ-linolenic acid, could be established. We provide the first replication of the association of the FADS1 FADS2 gene cluster with PUFA in blood phospholipids. For the first time, such associations were also shown for PUFA in cell membranes.
The relative contribution of nutrition-related chronic diseases to the total disease burden of the society and the health care costs has risen continuously over the last decades. Thus, there is an ...urgent necessity to better exploit the potential of dietary prevention of diseases. Carbohydrates play a major role in human nutrition – next to fat, carbohydrates are the second biggest group of energy-yielding nutrients. Obesity, type 2 diabetes mellitus, dyslipoproteinaemia, hypertension, metabolic syndrome, coronary heart disease and cancer are wide-spread diseases, in which carbohydrates could have a pathophysiologic relevance. Correspondingly, modification of carbohydrate intake could have a preventive potential. In the present evidence-based guideline of the German Nutrition Society, the potential role of carbohydrates in the primary prevention of the named diseases was judged systematically. The major findings were: a high carbohydrate intake at the expense of total fat and saturated fatty acids reduces the concentrations of total, LDL and HDL cholesterol. A high carbohydrate consumption at the expense of polyunsaturated fatty acids increases total and LDL cholesterol, but reduces HDL cholesterol. Regardless of the type of fat being replaced, a high carbohydrate intake promotes an increase in the triglyceride concentration. Furthermore, a high consumption of sugar-sweetened beverages increases the risk of obesity and type 2 diabetes mellitus, whereas a high dietary fibre intake, mainly from whole-grain products, reduces the risk of obesity, type 2 diabetes mellitus, dyslipoproteinaemia, cardiovascular disease and colorectal cancer at varying evidence levels. The practical consequences for current dietary recommendations are presented.
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Dietary fiber may be partly responsible for the lower bioavailability of carotenoids from food than from purified supplements. Due to the lack of detailed information available, we investigated the ...effects of different kinds of dietary fiber on the absorption of carotenoids and alpha-tocopherol. Six healthy young women received an antioxidant mixture consisting of beta-carotene, lycopene, lutein, canthaxanthin and alpha-tocopherol together with a standard meal. The meal did not contain additional dietary fiber or was enriched with pectin, guar, alginate, cellulose or wheat bran (0. 15 g. kg body weight(-1)). The increases in plasma carotenoid and alpha-tocopherol concentrations were followed over 24 h, and the areas-under-curves (AUC(24h)) were calculated. The mean AUC(24h) of beta-carotene was significantly (P < 0.05) reduced by the water-soluble fibers pectin, guar and alginate with a mean decrease of 33-43%. All tested fibers significantly reduced the AUC(24h) of lycopene and lutein by 40-74% (P < 0.05). The dietary fiber effect on the AUC(24h) of canthaxanthin was almost significant (P = 0.059) and there was no effect on the AUC(24h) of alpha-tocopherol. We conclude that the bioavailability of beta-carotene, lycopene and lutein given within a mixed supplement is markedly reduced by different kinds of dietary fiber.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Subjective parameters such as quality of life or patient satisfaction gain importance as outcome parameters and benchmarks in health care. In many countries hospitals are now undergoing accreditation ...as mandatory or voluntary measures. It is believed but unproven that accreditations positively influence quality of care and patient satisfaction. The present study aims to assess in a defined specialty (cardiology) the relationship between patient satisfaction (as measured by the recommendation rate) and accreditation status.
Consecutive patients discharged from 25 cardiology units received a validated patient satisfaction questionnaire. Data from 3,037 patients (response rate > 55%) became available for analysis. Recommendation rate was used as primary endpoint. Different control variables such as staffing level were considered.
The 15 accredited units did not differ significantly from the 10 non-accredited units regarding main hospital (i.e. staffing levels, no. of beds) and patient (age, gender) characteristics. The primary endpoint "recommendation rate of a given hospital" for accredited hospitals (65.6%, 95% Confidence Interval (CI) 63.4 - 67.8%) and hospitals without accreditation (65.8%, 95% CI 63.1-68.5%) was not significantly different.
Our results support the notion that - at least in the field of cardiology - successful accreditation is not linked with measurable better quality of care as perceived by the patient and reflected by the recommendation rate of a given institution. Hospital accreditation may represent a step towards quality management, but does not seem to improve overall patient satisfaction.
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CEKLJ, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background/Aims: To assess dietary and nondietary determinants of serum undercarboxylated osteocalcin (ucOC) as a measure of vitamin K status. Methods: UcOC and total intact osteocalcin (iOC) ...concentrations were determined by specific ELISA tests in serum samples of 231 male and 320 female participants (18–81 years) of the representative, cross-sectional Bavarian Food Consumption Survey II. Determinants of ucOC were investigated by analysis of variance, Spearman’s rank correlation coefficients and logistic regression models. Results: Mean ucOC serum concentration was 2.46 ng/ml in men and 2.34 ng/ml in women. Corresponding means of the ratio of ucOC to iOC (ucOC/iOC) were 0.28 and 0.29. Concentrations of ucOC and iOC, as well as the ratio of ucOC/iOC, strongly depended on the participant’s age. UcOC was influenced by smoking status, sports activity, and the season when blood was collected. Dietary intake of the dominant vitamin K sources, green leafy vegetables and dairy products, as well as the plasma concentration of the carotenoid lutein were inversely associated with serum ucOC values. Conclusions: In studies using serum ucOC as a measure of vitamin K supply, determinants, especially age, need to be taken into account.
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Dietary flavonoids, especially flavonols, are discussed as potentially preventive agents in the etiology of diseases such as coronary heart disease, stroke, and cancer. However, their consideration ...in epidemiologic studies is hampered by difficulties in exposure assessment.
By comparison with dietary intake estimates, fasting plasma flavonoid concentrations should be evaluated as possible biomarkers of the ordinary dietary intake.
7-d dietary records were completed by 48 healthy female students. Flavonoid intake was estimated by means of available literature data on the flavonoid content of foods. Fasting plasma samples were taken at the end of the record period for flavonoid determination (HPLC).
The mean intake estimates (7-d period) of quercetin, kaempferol, naringenin, and hesperetin amounted to 17.9, 4.7, 12.1, and 17.4 mg/d, respectively; the corresponding mean plasma concentrations were 22.9, 10.7, 8.2, and 22.2 nmol/l. For all four flavonoids significant correlations between 7d-intake results and fasting plasma concentrations (r = 0.30-0.46, p < 0.05) existed. As expected from the known short elimination half-life of some plasma flavonoids, distinctly higher correlation coefficients were found for the relationship between intake estimates for the last day before blood sampling and the fasting plasma concentrations (r = 0.42-0.64; p < 0.01). The intraindividual variation in fasting plasma flavonoid concentrations during ad libitum intake was found to be rather high (mean coefficient of variation between 82 and 91 %; n = 4).
The flavonoid content in fasting plasma samples seems to be a suitable biomarker of short-term intake and a possible biomarker of the medium-term intake. Due to the high intraindividual variation the combined use of plasma flavonoid concentrations and dietary intake estimates may be the best choice in epidemiologic studies.
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DOBA, EMUNI, FIS, FSPLJ, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, SIK, UILJ, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Adequate physical activity (PA) is considered as a key factor in the fight against the obesity epidemic. Therefore, detailed description of the actual PA and its components in the population is ...necessary. Additionally, this study aims to investigate the association between PA and obesity risk in a representative population sample in Bavaria, Germany.
Data from 893 participants (age 13-80 years) of the Bavarian Food Consumption Survey II (BVS II) were used. In each participant, three computer-based 24-hour recalls were conducted by telephone assessing type and duration of PA in the domains occupation, sports, other strenuous leisure time activities (of mostly moderate intensity) as well as TV/PC use in leisure time and duration of sleeping. After assigning metabolic equivalents (METs) to each activity, estimates of energy expenditure (MET*h) and total daily PA level (PALest.) were calculated. In a subgroup of adults (n = 568) with anthropometric measurements logistic regression models were used to quantify the impact of PA on obesity risk.
Estimated average PA in women and men was 38.5 +/- 5.0 and 40.6 +/- 9.3 MET*h/d, respectively, corresponding to PALest. values of 1.66 +/- 0.22 and 1.75 +/- 0.40. Obese subjects showed lower energy expenditure in the categories sports, occupation, and sleeping, while the time spent with TV/PC during leisure time was highest. This is confirmed in logistic regression analyses revealing a statistically significant association between obesity and TV/PC use during leisure time, while sports activity was inversely related to obesity risk. Overall, less than 1/3 of the study participants reached the recommended PAL of >or= 1.75. Subjects within the recommended range of PA had an about 60 % (odds ratio = 0.43; 95% CI: 0.21-0.85) reduced risk of obesity as compared to inactive subjects with a PALest. <1.5.
Based on the results of short-term PA patterns, a major part of the Bavarian adult population does not reach the recommendations (PAL>1.75; moderate PA of > 30 min/d). Despite the limitations of the study design, the existing associations between sports activity, TV/PC use and obesity risk in this population give further support to the recommendation of increasing sports activity and reducing sedentary behaviour in order to prevent rising rates of obesity.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
The habitual intake of the conjugated linoleic acid (CLA) isomer C18:2 c9t11 (rumenic acid, RA) was assessed and compared with plasma biomarkers.
The newly developed food-frequency questionnaire ...(FFQ) comprised 46 food items and was validated by means of a 7-day estimated record (7-d ER). Additionally, the dietary intake results of the FFQ, 7-d ER, the last day (1-d ER) and the last two days (2-d ER) before blood sampling of the 7-d ER were compared to the content of C18:2 c9t11 in plasma phospholipids (PL) and triglycerides (TG) as possible biomarkers.
Metabolic unit of a university institute.
Fifty-seven students completed both dietary instruments. From all participants fasting blood samples were taken.
Mean daily intake of rumenic acid was 246 mg day(-1) and 323 mg day(-1) as measured by the FFQ and the 7-d-ER, respectively. The degree of correspondence between both assessment methods was acceptable; this is indicated by a total kappa value of kappa = 0.31 (P < 0.01) and a Pearson correlation coefficient of r = 0.46 (P < 0.01). Rumenic acid content in plasma triglycerides was twice as high as found in phospholipids. The correlation between the intake results gained with the 7-d ER and the plasma PL contents of C18:2 c9t11 was statistically significant; this was also true for the C18:2 c9tl 1 values in plasma TG compared with the intake results of one or two days before blood sampling.
Regarding RA intake, the FFQ data revealed an acceptable degree of correspondence with the 7-d ER data but failed to show significant correlations to the potential biomarkers. However, with respect to the results of the 7-d ER, the RA content in plasma PL and TG are possible biomarkers of short-term and medium-term intake, respectively.
Epidemiological data suggests a role of dietary cholesterol in the etiology of lung cancer without having a clear biological
hypothesis. Although smoking as the outstanding risk factor for lung ...cancer may enhance lipid peroxidation reactions, this
study was planned to assess smoking-independent associations between the extent of cholesterol oxidation and the risk for
lung cancer. In the frame of a nested case-control study in European Prospective Investigation on Cancer-Heidelberg, six cholesterol
oxidation products (COPs) were determined in plasma samples of 20 incident lung cancer patients obtained 1.9 ± 0.6 years before
diagnosis and in 40 matched (including smoking habits) controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were
calculated by conditional logistic regression. Among all COP compounds tested, plasma 7β-hydroxycholesterol was associated
with lung cancer risk. The high crude risk estimate (OR ∼ 5) became significant after adjustment for sports activity (OR =
6.83, CI = 1.08–43.01, 3rd versus 1st tertile). For the independent effect of 7β-hydroxycholesterol, i.e. , adjusted for other COP compounds, an OR of 8.08 (CI = 1.12–58.54, 3rd versus 1st tertile) was calculated ( P = 0.04 for trend). Lung cancer risk adjusted for sports activity significantly increased by 26% (CI = 1.050–1.506, P = 0.01) per unit (1 nmol/mmol plasma cholesterol) of 7β-hydroxycholesterol. No dietary factor had a significant effect in
the regression model, but the dietary intake of meat, eggs, animal fat, cholesterol, and fruits (inversely) correlated with
plasma COP concentrations. In this small study, plasma 7β-hydroxycholesterol appeared to be a smoking-independent predictor
of lung cancer risk and might therefore be used as a biomarker. Because of the rather high-risk estimate, research on possible
intrinsic biological effects of this compound should be encouraged.
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