Calcium intake is weakly but consistently negatively associated with iron status in girls and women from six European countries. A cross-sectional study of over 1,000 girls and 500 women found that higher calcium intake was associated with lower levels of serum ferritin, a marker of iron stores, after adjusting for potential confounding factors. A consistent inverse association was seen between calcium intake and serum ferritin in both girls and women, regardless of whether calcium was consumed simultaneously with iron. The study suggests that higher dietary calcium intake is weakly negatively associated with blood iron status in girls and women.
Prevalence of Iron Deficiency Anaemia among Pregnant Women in Calabar, Cross ...IOSR Journals
Iron is a component of a number of proteins including haemoglobin, myoglobin, cytochromes and enzymes involved in redox reactions. Inadequate iron intake can lead to varying degrees of deficiency, from low iron stores to early iron deficiency and iron-deficiency anaemia and this is dangerous to both baby and mother. The objective of this study is to assess the prevalence of iron deficiency and iron deficiency anaemia among pregnant women in Calabar, Cross River State Nigeria. Seventy pregnant women within the age range of 15-45 years from University of Calabar Teaching Hospital were recruited as subjects in this study. The control consisted of fifty age-matched apparently healthy non-pregnant women . The tests that were carried out using standard method include include full blood count (packed cell volume, haemoglobin, mean cell haemoglobin, mean cell haemoglobin concentration and red cell count), serum iron, total iron binding capacity, transferrin saturation,serum ferritin and soluble transferrin recptor. The prevalence of anaemia and iron deficiency anaemia were found to be significantly higher (p<0.05)><0.01)><0.01) increased in pregnant than non-pregnant. It was also shown that pregnant women in their third trimesters and multigravidae had the highest prevalence of iron deficiency and iron deficiency anaemia while pregnant women in their second trimester had the highest prevalence of anaemia. In conclusion the study has shown that the prevalence of anaemia, iron deficiency and iron deficiency anaemia among pregnant women in the studied area were still high and can be considered public health problem.
Dietary iron intake was assessed using a food frequency questionnaire in a cohort of 58,615 Japanese adults with no history of cardiovascular disease or cancer. During follow up, 2,690 deaths from cardiovascular disease occurred. In men, higher dietary iron intake was associated with increased risk of death from total stroke, ischemic stroke, and total cardiovascular disease. Each of these associations showed a dose-response relationship with increasing quintiles of iron intake. Dietary iron intake was not associated with cardiovascular mortality in women. The results provide some support for the hypothesis that iron intake increases cardiovascular risk, at least in Japanese men.
This document summarizes an article that appeared in a journal published by Elsevier. The attached copy is provided to the author for non-commercial research and education purposes only. Other uses such as reproduction, distribution, selling, or posting to third party websites are prohibited without permission. Authors are allowed to post their version of the article to their personal or institutional websites for archiving purposes, and the document provides a link for authors to view Elsevier's full author rights and manuscript policies.
A study of serum Cadmium and lead in Iraqi postmenopausal women with osteopor...IOSR Journals
Postmenopausal status is an independent risk factor for osteoporosis. Several studies have reported that heavy metals, including lead, mercury, cadmium, and arsenic, have harmful effects on bone. The aim of this study was to evaluate the effect of heavy metals, including Cadmium and Lead on osteoporosis in postmenopausal Iraqi women. This prospective study included a total of 70 postmenopausal women divided as 40patients with osteoporosis compared to 30 apparently healthy women as controls during 2011. Serum levels of Cadmium and Lead were measured using atomic absorption while serum Calcium, Phosphorus and Alkaline phosphatase were measured by spectrophotometry.The results showed that there was no significant difference between patients and controls regarding age, Body Mass Index, Calcium, Phosphorous, and Alkaline phosphatase. Serum levels of Cadmium and Lead were higher in patients compared to controls, p < 0.001 and p< 0.01 respectively. It is concluded that increased serum levels of cadmium and lead maybe associated with higher risk of osteoporosis in postmenopausal women.
This study evaluated the effectiveness of a large-scale iron-fortified milk distribution program on anemia and iron deficiency in young children in Mexico. Researchers conducted a group-randomized trial assigning 12 milk distribution centers to provide either fortified or non-fortified milk to over 18,000 children aged 12-30 months. They found lower prevalences of anemia and iron deficiency in the fortified milk group compared to the non-fortified group at both 6 and 12 months. Fortified milk reduced the risk of mild-moderate anemia by 36% at 6 months and 57% at 12 months. The results suggest that fortifying milk provided through existing distribution programs can help reduce iron deficiency and anemia in low-
Objective: The aim of this research study is to compare ferrous fumarate and bovine lactoferrin as regard treatment of anemia in a pregnant patient with iron deficiency anemia.
Study design: A prospective open label randomized clinical trial which was conducted at Ain Shams University Maternity Hospital outpatient clinic in the period from 15 February 2016 to 15 August 2016. The study included 146 pregnant women suffering from iron deficiency anemia and divided in two groups.
This study examined the effects of lifelong weight cycling on lifespan in male mice. Mice were placed on either a low-fat diet, high-fat diet, or cycled diet that alternated between low-fat and high-fat every 4 weeks, causing weight fluctuations. The weight cycled mice experienced large fluctuations in body weight and fat mass over time. Surprisingly, the lifespan of weight cycled mice was not significantly different than mice on a low-fat diet, despite cycling between overweight and normal weight periods. In contrast, mice that remained on a high-fat diet had a significantly shorter lifespan than the other groups. This is the first controlled animal study to demonstrate that weight cycling itself did not decrease lifespan
Prevalence of Iron Deficiency Anaemia among Pregnant Women in Calabar, Cross ...IOSR Journals
Iron is a component of a number of proteins including haemoglobin, myoglobin, cytochromes and enzymes involved in redox reactions. Inadequate iron intake can lead to varying degrees of deficiency, from low iron stores to early iron deficiency and iron-deficiency anaemia and this is dangerous to both baby and mother. The objective of this study is to assess the prevalence of iron deficiency and iron deficiency anaemia among pregnant women in Calabar, Cross River State Nigeria. Seventy pregnant women within the age range of 15-45 years from University of Calabar Teaching Hospital were recruited as subjects in this study. The control consisted of fifty age-matched apparently healthy non-pregnant women . The tests that were carried out using standard method include include full blood count (packed cell volume, haemoglobin, mean cell haemoglobin, mean cell haemoglobin concentration and red cell count), serum iron, total iron binding capacity, transferrin saturation,serum ferritin and soluble transferrin recptor. The prevalence of anaemia and iron deficiency anaemia were found to be significantly higher (p<0.05)><0.01)><0.01) increased in pregnant than non-pregnant. It was also shown that pregnant women in their third trimesters and multigravidae had the highest prevalence of iron deficiency and iron deficiency anaemia while pregnant women in their second trimester had the highest prevalence of anaemia. In conclusion the study has shown that the prevalence of anaemia, iron deficiency and iron deficiency anaemia among pregnant women in the studied area were still high and can be considered public health problem.
Dietary iron intake was assessed using a food frequency questionnaire in a cohort of 58,615 Japanese adults with no history of cardiovascular disease or cancer. During follow up, 2,690 deaths from cardiovascular disease occurred. In men, higher dietary iron intake was associated with increased risk of death from total stroke, ischemic stroke, and total cardiovascular disease. Each of these associations showed a dose-response relationship with increasing quintiles of iron intake. Dietary iron intake was not associated with cardiovascular mortality in women. The results provide some support for the hypothesis that iron intake increases cardiovascular risk, at least in Japanese men.
This document summarizes an article that appeared in a journal published by Elsevier. The attached copy is provided to the author for non-commercial research and education purposes only. Other uses such as reproduction, distribution, selling, or posting to third party websites are prohibited without permission. Authors are allowed to post their version of the article to their personal or institutional websites for archiving purposes, and the document provides a link for authors to view Elsevier's full author rights and manuscript policies.
A study of serum Cadmium and lead in Iraqi postmenopausal women with osteopor...IOSR Journals
Postmenopausal status is an independent risk factor for osteoporosis. Several studies have reported that heavy metals, including lead, mercury, cadmium, and arsenic, have harmful effects on bone. The aim of this study was to evaluate the effect of heavy metals, including Cadmium and Lead on osteoporosis in postmenopausal Iraqi women. This prospective study included a total of 70 postmenopausal women divided as 40patients with osteoporosis compared to 30 apparently healthy women as controls during 2011. Serum levels of Cadmium and Lead were measured using atomic absorption while serum Calcium, Phosphorus and Alkaline phosphatase were measured by spectrophotometry.The results showed that there was no significant difference between patients and controls regarding age, Body Mass Index, Calcium, Phosphorous, and Alkaline phosphatase. Serum levels of Cadmium and Lead were higher in patients compared to controls, p < 0.001 and p< 0.01 respectively. It is concluded that increased serum levels of cadmium and lead maybe associated with higher risk of osteoporosis in postmenopausal women.
This study evaluated the effectiveness of a large-scale iron-fortified milk distribution program on anemia and iron deficiency in young children in Mexico. Researchers conducted a group-randomized trial assigning 12 milk distribution centers to provide either fortified or non-fortified milk to over 18,000 children aged 12-30 months. They found lower prevalences of anemia and iron deficiency in the fortified milk group compared to the non-fortified group at both 6 and 12 months. Fortified milk reduced the risk of mild-moderate anemia by 36% at 6 months and 57% at 12 months. The results suggest that fortifying milk provided through existing distribution programs can help reduce iron deficiency and anemia in low-
Objective: The aim of this research study is to compare ferrous fumarate and bovine lactoferrin as regard treatment of anemia in a pregnant patient with iron deficiency anemia.
Study design: A prospective open label randomized clinical trial which was conducted at Ain Shams University Maternity Hospital outpatient clinic in the period from 15 February 2016 to 15 August 2016. The study included 146 pregnant women suffering from iron deficiency anemia and divided in two groups.
This study examined the effects of lifelong weight cycling on lifespan in male mice. Mice were placed on either a low-fat diet, high-fat diet, or cycled diet that alternated between low-fat and high-fat every 4 weeks, causing weight fluctuations. The weight cycled mice experienced large fluctuations in body weight and fat mass over time. Surprisingly, the lifespan of weight cycled mice was not significantly different than mice on a low-fat diet, despite cycling between overweight and normal weight periods. In contrast, mice that remained on a high-fat diet had a significantly shorter lifespan than the other groups. This is the first controlled animal study to demonstrate that weight cycling itself did not decrease lifespan
PREDICT Study ASN Presentation June 2020Sara Gordon
Sarah Berry, Nicola Segata, Jose Ordovas and Tim Spector reveal novel findings from the world's largest ongoing nutrition study, PREDICT. The presentation shares learnings on how we metabolize food, the importance of food sequencing and combining, the gut microbiome and inflammation. These findings are some of the most cutting edge in the field of nutrition science, highlighting the need for precision nutrition. Learn more at www.joinzoe.com/science
A research article Fountain of Youth by Prof Dr Bashir Ahmed Dar Sopore KashmirProf Dr Bashir Ahmed Dar
Calorie restriction (CR) is as close to a real fountain of youth as any known technique is. Caloric restriction known to extend the human lifespan by up to five years has quietly become accepted among leading researchers. Even scientists who are cautious about anti-aging hype say it works
This study examined the association between serum albumin levels and muscle mass in 275 elderly men and women aged 60-95 years. The study found that after controlling for age, protein intake, physical activity, and comorbidities:
1) Serum albumin levels were significantly associated with muscle mass in both men and women, suggesting decreases in serum albumin with age are associated with sarcopenia.
2) This association between serum albumin and muscle mass was independent of other factors that could affect muscle mass or albumin levels.
3) The findings suggest that increased risk of disability seen in elderly people with low serum albumin may actually reflect an association with sarcopenia.
This document describes a study that aimed to determine if there is a relationship between insulin levels in the blood and various chemical and demographic variables using data from the National Health and Nutrition Examination Survey. The researchers analyzed relationships between insulin levels and urinary levels of iodine, creatinine, perchlorate, nitrate, and thiocyanate as well as demographic factors including gender, age, and household income. Initial models showed violations of assumptions that were addressed through data transformations, resulting in a log-transformed linear model that better fit the data.
Urinary iodine levels in the US population are declining according to national health surveys, potentially putting people at risk for thyroid problems. Monitoring of iodine through NHANES shows median levels dropping due to less iodine in salt. Continued decrease in iodization could lead to health issues if the downward trend is not addressed.
This document summarizes a presentation given by Md. Rejaul Islam on assessing the prevalence of dyslipidemia and fatty liver disease in overweight and obese children in the United Arab Emirates. The study found high rates of dyslipidemia (55.3%) and fatty liver disease (84% of those with elevated liver enzymes) in the obese children. Waist circumference was significantly associated with dyslipidemia. The study provides insight into metabolic health issues faced by obese children in the region where childhood obesity is prevalent.
This study examined the association between pre- and post-diagnostic recreational physical activity and BMI with colorectal cancer-specific and all-cause mortality in 1339 women from the Women's Health Initiative who were diagnosed with colorectal cancer. The study found that women who reported pre-diagnostic recreational physical activity of ≥18 MET-hours/week had significantly lower colorectal cancer-specific and all-cause mortality compared to women reporting no pre-diagnostic activity. Similar inverse associations were seen for post-diagnostic recreational physical activity. Neither pre- nor post-diagnostic BMI were associated with mortality after colorectal cancer diagnosis.
“Health implications of sugar and need for appropriate policy perspectives” by Nayanjeet Chaudhury.
- Paper presented at • Thirteenth International seminar on “Prevention of non-communicable diseases”, Madras Diabetes Research Foundation with University of Alabama at Birmingham, USA, and Florida International University (FIU), USA, 23-25 Jan, 2015, Chennai
The document discusses nutrition and injury rates among military recruits and personnel. Some key points:
1. A study found over 40% of US adults had inadequate intake of several important vitamins and minerals like vitamin D, calcium and magnesium.
2. Data from NHANES surveys showed high percentages of US adults with inadequate intake of vitamins A, C, D, E and minerals like magnesium.
3. Injury rates during basic combat training were high, especially for women, with most injuries being overuse injuries to the lower extremities. Proper nutrition, injury prevention programs and prehabilitation were shown to reduce injuries.
4. Studies demonstrated that iron and vitamin D supplementation, as well as increased calcium intake
Does the Mediterranean diet predict longevity in the elderly? A Swedish persp...Gianluca Tognon
My paper describing the association between adherence to a Mediterranean-like dietary pattern and longevity in 70 year-old men and women sampled in Gothenburg
The American Journal of Clinical Nutrition - ¿Sabemos todo sobre las bebidas ...claudiadelbosque
1) Recent studies have questioned whether sugar-sweetened beverages (SSBs) are solely responsible for obesity and related diseases, as evidence from randomized trials does not clearly support this.
2) Two new studies estimate that a proposed policy banning large SSB portions in the US would reduce calorie intake from SSBs by around 260 calories per day, but it is unclear if this reduction would be enough to see health benefits given limitations of the studies.
3) Many dietary and lifestyle factors beyond just SSBs are associated with health risks, and policies focusing only on SSBs may oversimplify their effects and interactions with other behaviors.
The document discusses how adopting a plant-based diet can promote both physical and environmental health. It notes that animal agriculture is unsustainable and is negatively impacting the environment, and that a plant-based diet can help address issues like water conservation, world hunger, and chronic diseases. Transitioning to a primarily plant-based food system that reduces consumption of meat and dairy would help create a more sustainable future for our environment and health.
Do fructose-containing sugars lead to adverse health consequences? Results of...Corn Refiners Association
At Experimental Biology 2014, the Sponsored Satellite Program “Sugars and Health Controversies: What Does the Science Say?” held in conjunction with the American Society for Nutrition’s Scientific Sessions took place on Saturday, April 26, 2014.
Panelist John L Sievenpiper, MD, PhD, presented science about sugars and their associated health outcomes.
20+ good health reasons to drink coffee2abdunatfah
There are good reasons to drink coffee and there are a few reasons not to. This article is for those that are looking for reasons to keep drinking it.
After all, you may have a caffeine-hater in your life. You know the type – they’re always telling you what’s bad for your health.
20+ good health reasons to drink coffee2
Here’s a list of some good reasons to drink coffee. Memorize this list – so the next time you encounter your favorite coffee-hater you can pull out one of these babies
Join Doc Andrew to see what's new in health research that supports plant based diet recommendations. Share your questions via @DenverWWAD or email FreemanA@njhealth.org
Andrew Freeman, MD, FACC, FACP is a cardiologist and Director of Clinical Cardiology and Operations at National Jewish Health in Denver, Colorado. He holds leadership roles in the American College of Cardiology at the local and national levels. Dr. Freeman founded Denver's chapter of the Walk with a Doc program and heads Walk with a Doc-Colorado.
Walk with a Doc-Denver is a cost-free empowerment initiative powered by people improving their health, local doctors, and other health professionals who prescribe exercise-as-medicine. The mission? To elevate community health--one walk at a time! The program's Saturday walks include expert talks, health screenings, refreshments, and motivational giveaways. For more info visit: http://walkwithadoc.org/our-locations/denver/
Nutrition: Biochemical correlates of anemia in Cambodian women of reproducti...IFSD14
1) The study examined biochemical correlates of anemia in Cambodian women of reproductive age, finding over 40% had a genetic hemoglobin disorder like heterozygous E trait or homozygous E.
2) Nearly 30% of women had anemia, most cases being microcytic, but few had biochemical evidence of iron, vitamin B12, folate, or vitamin A deficiencies. Iron deficiency was less than 1% based on ferritin and transferrin receptor.
3) Having a genetic hemoglobin disorder was associated with higher rates of anemia and tissue iron deficiency compared to those without a disorder, though iron deficiency anemia was still less than 1%.
This document summarizes the results of 5 randomized controlled trials lasting at least 2 years that compared low carbohydrate diets to low fat diets for weight loss. [1] The earliest trial from 2006 found equal weight loss after 3 years. [2] The first 2-year trial from 2008 found greater weight loss with low carb. [3] The second 2-year trial from 2009 found equal weight loss. [4] The third 2-year trial from 2010 also found equal weight loss. [5] The fourth 2-year trial from 2012 again found equal weight loss between groups. In conclusion, the short-term weight loss advantage of low carb diets was not sustained in these long-term trials of 2 years
The recovery and re-evaluation of the old data on Sydney Diet Heart Study uncovers unexpected outcomes. However, interpret with care because things have changed since 1970s.
Slides Rotily Urgences Ehpad - Présentation Michel Rotily
Prise en charge des résidents des maisons de retraite médicalisées (EHPAD) dans les services des services d'accueil des urgences; une enquête en région PACA
Adherence to treatment and quality of life during hepatitis C therapy:a prosp...Michel Rotily
Adherence to treatment and quality of life during hepatitis C therapy:a prospective, real-life, observational study by Patrick Marcellin, Michel Chousterman, Thierry Fontanges, Denis Ouzan, Michel Rotily, Marina Varastet,Jean-Philippe Lang, Pascal Melin and Patrice Cacoub, for the CheObs Study Group published in Liver Int 2011
PREDICT Study ASN Presentation June 2020Sara Gordon
Sarah Berry, Nicola Segata, Jose Ordovas and Tim Spector reveal novel findings from the world's largest ongoing nutrition study, PREDICT. The presentation shares learnings on how we metabolize food, the importance of food sequencing and combining, the gut microbiome and inflammation. These findings are some of the most cutting edge in the field of nutrition science, highlighting the need for precision nutrition. Learn more at www.joinzoe.com/science
A research article Fountain of Youth by Prof Dr Bashir Ahmed Dar Sopore KashmirProf Dr Bashir Ahmed Dar
Calorie restriction (CR) is as close to a real fountain of youth as any known technique is. Caloric restriction known to extend the human lifespan by up to five years has quietly become accepted among leading researchers. Even scientists who are cautious about anti-aging hype say it works
This study examined the association between serum albumin levels and muscle mass in 275 elderly men and women aged 60-95 years. The study found that after controlling for age, protein intake, physical activity, and comorbidities:
1) Serum albumin levels were significantly associated with muscle mass in both men and women, suggesting decreases in serum albumin with age are associated with sarcopenia.
2) This association between serum albumin and muscle mass was independent of other factors that could affect muscle mass or albumin levels.
3) The findings suggest that increased risk of disability seen in elderly people with low serum albumin may actually reflect an association with sarcopenia.
This document describes a study that aimed to determine if there is a relationship between insulin levels in the blood and various chemical and demographic variables using data from the National Health and Nutrition Examination Survey. The researchers analyzed relationships between insulin levels and urinary levels of iodine, creatinine, perchlorate, nitrate, and thiocyanate as well as demographic factors including gender, age, and household income. Initial models showed violations of assumptions that were addressed through data transformations, resulting in a log-transformed linear model that better fit the data.
Urinary iodine levels in the US population are declining according to national health surveys, potentially putting people at risk for thyroid problems. Monitoring of iodine through NHANES shows median levels dropping due to less iodine in salt. Continued decrease in iodization could lead to health issues if the downward trend is not addressed.
This document summarizes a presentation given by Md. Rejaul Islam on assessing the prevalence of dyslipidemia and fatty liver disease in overweight and obese children in the United Arab Emirates. The study found high rates of dyslipidemia (55.3%) and fatty liver disease (84% of those with elevated liver enzymes) in the obese children. Waist circumference was significantly associated with dyslipidemia. The study provides insight into metabolic health issues faced by obese children in the region where childhood obesity is prevalent.
This study examined the association between pre- and post-diagnostic recreational physical activity and BMI with colorectal cancer-specific and all-cause mortality in 1339 women from the Women's Health Initiative who were diagnosed with colorectal cancer. The study found that women who reported pre-diagnostic recreational physical activity of ≥18 MET-hours/week had significantly lower colorectal cancer-specific and all-cause mortality compared to women reporting no pre-diagnostic activity. Similar inverse associations were seen for post-diagnostic recreational physical activity. Neither pre- nor post-diagnostic BMI were associated with mortality after colorectal cancer diagnosis.
“Health implications of sugar and need for appropriate policy perspectives” by Nayanjeet Chaudhury.
- Paper presented at • Thirteenth International seminar on “Prevention of non-communicable diseases”, Madras Diabetes Research Foundation with University of Alabama at Birmingham, USA, and Florida International University (FIU), USA, 23-25 Jan, 2015, Chennai
The document discusses nutrition and injury rates among military recruits and personnel. Some key points:
1. A study found over 40% of US adults had inadequate intake of several important vitamins and minerals like vitamin D, calcium and magnesium.
2. Data from NHANES surveys showed high percentages of US adults with inadequate intake of vitamins A, C, D, E and minerals like magnesium.
3. Injury rates during basic combat training were high, especially for women, with most injuries being overuse injuries to the lower extremities. Proper nutrition, injury prevention programs and prehabilitation were shown to reduce injuries.
4. Studies demonstrated that iron and vitamin D supplementation, as well as increased calcium intake
Does the Mediterranean diet predict longevity in the elderly? A Swedish persp...Gianluca Tognon
My paper describing the association between adherence to a Mediterranean-like dietary pattern and longevity in 70 year-old men and women sampled in Gothenburg
The American Journal of Clinical Nutrition - ¿Sabemos todo sobre las bebidas ...claudiadelbosque
1) Recent studies have questioned whether sugar-sweetened beverages (SSBs) are solely responsible for obesity and related diseases, as evidence from randomized trials does not clearly support this.
2) Two new studies estimate that a proposed policy banning large SSB portions in the US would reduce calorie intake from SSBs by around 260 calories per day, but it is unclear if this reduction would be enough to see health benefits given limitations of the studies.
3) Many dietary and lifestyle factors beyond just SSBs are associated with health risks, and policies focusing only on SSBs may oversimplify their effects and interactions with other behaviors.
The document discusses how adopting a plant-based diet can promote both physical and environmental health. It notes that animal agriculture is unsustainable and is negatively impacting the environment, and that a plant-based diet can help address issues like water conservation, world hunger, and chronic diseases. Transitioning to a primarily plant-based food system that reduces consumption of meat and dairy would help create a more sustainable future for our environment and health.
Do fructose-containing sugars lead to adverse health consequences? Results of...Corn Refiners Association
At Experimental Biology 2014, the Sponsored Satellite Program “Sugars and Health Controversies: What Does the Science Say?” held in conjunction with the American Society for Nutrition’s Scientific Sessions took place on Saturday, April 26, 2014.
Panelist John L Sievenpiper, MD, PhD, presented science about sugars and their associated health outcomes.
20+ good health reasons to drink coffee2abdunatfah
There are good reasons to drink coffee and there are a few reasons not to. This article is for those that are looking for reasons to keep drinking it.
After all, you may have a caffeine-hater in your life. You know the type – they’re always telling you what’s bad for your health.
20+ good health reasons to drink coffee2
Here’s a list of some good reasons to drink coffee. Memorize this list – so the next time you encounter your favorite coffee-hater you can pull out one of these babies
Join Doc Andrew to see what's new in health research that supports plant based diet recommendations. Share your questions via @DenverWWAD or email FreemanA@njhealth.org
Andrew Freeman, MD, FACC, FACP is a cardiologist and Director of Clinical Cardiology and Operations at National Jewish Health in Denver, Colorado. He holds leadership roles in the American College of Cardiology at the local and national levels. Dr. Freeman founded Denver's chapter of the Walk with a Doc program and heads Walk with a Doc-Colorado.
Walk with a Doc-Denver is a cost-free empowerment initiative powered by people improving their health, local doctors, and other health professionals who prescribe exercise-as-medicine. The mission? To elevate community health--one walk at a time! The program's Saturday walks include expert talks, health screenings, refreshments, and motivational giveaways. For more info visit: http://walkwithadoc.org/our-locations/denver/
Nutrition: Biochemical correlates of anemia in Cambodian women of reproducti...IFSD14
1) The study examined biochemical correlates of anemia in Cambodian women of reproductive age, finding over 40% had a genetic hemoglobin disorder like heterozygous E trait or homozygous E.
2) Nearly 30% of women had anemia, most cases being microcytic, but few had biochemical evidence of iron, vitamin B12, folate, or vitamin A deficiencies. Iron deficiency was less than 1% based on ferritin and transferrin receptor.
3) Having a genetic hemoglobin disorder was associated with higher rates of anemia and tissue iron deficiency compared to those without a disorder, though iron deficiency anemia was still less than 1%.
This document summarizes the results of 5 randomized controlled trials lasting at least 2 years that compared low carbohydrate diets to low fat diets for weight loss. [1] The earliest trial from 2006 found equal weight loss after 3 years. [2] The first 2-year trial from 2008 found greater weight loss with low carb. [3] The second 2-year trial from 2009 found equal weight loss. [4] The third 2-year trial from 2010 also found equal weight loss. [5] The fourth 2-year trial from 2012 again found equal weight loss between groups. In conclusion, the short-term weight loss advantage of low carb diets was not sustained in these long-term trials of 2 years
The recovery and re-evaluation of the old data on Sydney Diet Heart Study uncovers unexpected outcomes. However, interpret with care because things have changed since 1970s.
Slides Rotily Urgences Ehpad - Présentation Michel Rotily
Prise en charge des résidents des maisons de retraite médicalisées (EHPAD) dans les services des services d'accueil des urgences; une enquête en région PACA
Adherence to treatment and quality of life during hepatitis C therapy:a prosp...Michel Rotily
Adherence to treatment and quality of life during hepatitis C therapy:a prospective, real-life, observational study by Patrick Marcellin, Michel Chousterman, Thierry Fontanges, Denis Ouzan, Michel Rotily, Marina Varastet,Jean-Philippe Lang, Pascal Melin and Patrice Cacoub, for the CheObs Study Group published in Liver Int 2011
A photo-shoot mesh-up of some of the events, people, times, places and things that have given myself so much to be thankful for. The tip of the iceberg on what seems a life's work; into our third year.
This study evaluated the impact of therapeutic education on adherence to treatment and outcomes in 674 patients with chronic genotype 2 or 3 hepatitis C virus infection. 370 patients received therapeutic education during the first 3 months of treatment, while 304 did not. Patients who received education had higher adherence to the combination of pegylated interferon and ribavirin treatment at 6 months (61% vs 47%). They also had slightly better sustained virological response and relapse rates. After adjusting for differences, therapeutic education was found to improve adherence to treatment.
Hiv testing in minorities and women 1999Michel Rotily
This study examined differences in HIV testing, knowledge, attitudes and practices between North African and French pregnant women in southeastern France. The study found that North African women were more likely to have lower socioeconomic status, receive care at public institutions, have less HIV knowledge, be tested without consent, and perceive themselves at lower risk than French women. Even after controlling for other factors, consent for HIV testing during pregnancy depended on a woman's North African origin. The results suggest routine prenatal screening is insufficient for ensuring adequate HIV testing and counseling of ethnic minority women, and culturally specific prevention programs are needed.
The Spring Conference 2010 document provides an update on the federal budget including $10 million for National Needs Fellowship Grants and $5 million for eXtension. It notes the president's budget would move Sec. 406 Integrated Activities funding lines to AFRI. The document also discusses county Extension budgets for 2010 ranging from $33,696 to $522,100 and notes all vacant Extension agent positions are filled on a 50/50 salary sharing basis with counties up to date on fiscal partnerships. Legislative reporting sessions were hosted between Nov. 24, 2009 to Apr. 23, 2010 by various county Extension offices.
Effects lapd or hfd urolithiasis kidney int 2000Michel Rotily
1) The document examines the effects of low protein and high fiber diets on urine composition and risk of calcium kidney stone recurrence in patients with idiopathic calcium kidney stones.
2) 96 patients were randomly assigned to a low protein diet, high fiber diet, or usual diet (control group) and their daily urine compositions were analyzed at baseline and 4 months.
3) While diets differed significantly between groups at 4 months, daily output of calcium and oxalate did not differ significantly within or between groups after adjusting for potential confounding factors. However, over a third of patients on the low protein diet achieved a significant decrease in urine urea and calcium excretion.
Tray is a 15-year-old ninth grade student with a history of aggressive behavior and inappropriate language. He often blurts out questions and answers during class instruction, distracting himself and other students. A functional behavior assessment was conducted and found that Tray blurts out to gain positive reinforcement and teacher attention, as the teacher would redirect him or tell him to stop blurting out. His blurting was not found to avoid work or escape tasks, or increase or decrease sensory stimulation.
The document summarizes the student's process for creating a music magazine as a media product. Key points covered include conventions used from real music magazines like unique titles, articles on the left side, and large background pictures. The intended audience is described as 14-19 year old females, and research was done using surveys to determine popular music genres and topics of interest. Technologies used included photo editing software and online surveys. Potential publishers mentioned are IPC, known for magazines like NME.
This document provides a list of components needed to construct a CPO including a .01 uF capacitor, 10K ohm resistor, 220 uF capacitor, variable resistor that may require bending, 47K ohm resistor, and connections for a battery.
This document provides information on preparing for deployment in an emergency communication role. It discusses the importance of having "jump kits" ready with necessary equipment, supplies, and documentation. Key points covered include:
- Considering the range of scenarios one might encounter and tailoring kits appropriately
- Dividing kits into categories for deployments under and over 24 hours
- Including items like radios, antennas, batteries, personal gear, food, water, forms, maps, and contact information
- Pre-planning tasks like check-in procedures, operating locations, and escape routes.
- Pursuing additional training through organizations like FEMA and ARRC to be better prepared.
Chronic Chlamydia pneumoniae infection inpatients with symptomatic atherothro...Michel Rotily
Chronic Chlamydia pneumoniae infection inpatients with symptomatic atherothrombosis by P. Halfon, N. Limal, G. Penaranda, H. Khiri, D. Sene ,M. Andreu, J.M. Feryn, M. Rotily, R. Serra,J.C. Piette, P. Cacoub in Journal of Infection 2005
This document provides guidance on effective communication techniques for emergency situations. It emphasizes the importance of brevity, clarity, and using plain language and standardized terminology to avoid potential misunderstandings. Specific tips covered include using tactical call signs instead of FCC call signs, employing prowords and phonetic alphabet, and following protocols for initiating and concluding communications concisely.
The document provides an overview of the Incident Command System (ICS). It describes ICS as a standardized management tool used to coordinate emergency response across agencies. It discusses the key components of ICS including its organizational structure, management by objectives approach, and use of an incident action plan. The document also describes how amateur radio groups can integrate with the ICS by establishing Amateur Radio Communication Teams to support communications needs during an incident.
The document provides guidance on choosing frequencies and resources for emergency communication operations. It recommends VHF/UHF FM and HF SSB bands for local operations depending on terrain and repeater availability. Operators should become familiar with the features and coverage of repeaters and digital systems in their area. The document also discusses stress management, generator safety, electrical safety, and ensuring RF safety compliance.
Reduced levels of some iron parameters of protein energyAlexander Decker
This document summarizes a study that assessed iron-related parameters in protein energy malnourished children in Calabar, Nigeria compared to healthy controls. The study found significantly lower levels of hemoglobin, packed cell volume, and serum ferritin in malnourished children, but higher serum iron and transferrin saturation. Serum ferritin levels decreased with age in malnourished children. There were no differences in iron parameters based on type of protein energy malnutrition. The results indicate reduced iron stores in malnourished children compared to controls.
Reduced levels of some iron parameters of protein energyAlexander Decker
This study assessed iron-related parameters in 100 protein-energy malnourished children aged 1-10 years in Calabar, Nigeria compared to 50 healthy controls. Key findings: Hemoglobin, packed cell volume, and serum ferritin levels were significantly lower in malnourished children, while serum iron and transferrin saturation were significantly higher. Serum ferritin levels decreased with age in malnourished children. Iron parameters did not differ by type of protein-energy malnutrition. Body mass index was lower in malnourished children. Poor diet and low socioeconomic status were implicated in the reduced iron stores seen in malnourished children.
This document summarizes a dissertation that aims to compare the effects of daily versus intermittent oral iron therapy on hemoglobin levels in non-anemic pregnant women. The study will involve randomly assigning 120 pregnant women between 14-20 weeks gestation to either a daily iron tablet group or a weekly intermittent group. Hemoglobin levels will be measured and compared between the two groups over the course of 1 month to assess differences in outcomes and compliance between the daily and intermittent supplementation regimens. The results of this study could help determine the most effective dosing schedule for iron supplementation during pregnancy.
This document summarizes a dissertation that compares the effects of daily versus intermittent oral iron therapy on hemoglobin levels in non-anemic pregnant women. The study aims to enroll 120 pregnant women between 14-20 weeks gestation and randomly assign them to a daily iron tablet group or weekly double-dose iron tablet group. Hemoglobin levels will be measured and compared between the two groups over the course of 1 month to assess differences in hemoglobin changes and side effect profiles between daily and intermittent iron supplementation regimens. The results of this study could help determine the most effective dosing schedule for iron supplementation during pregnancy.
ObesityNutritionObesity and iron deficiency a quantitati.docxcherishwinsland
Obesity/Nutrition
Obesity and iron deficiency: a quantitative
meta-analysis
L. Zhao1,2, X. Zhang3, Y. Shen3, X. Fang1, Y. Wang4 and F. Wang1,2,5
1Department of Nutrition, Nutrition Discovery
Innovation Center, Institute of Nutrition and
Food Safety, School of Public Health, School
of Medicine, Zhejiang University, Hangzhou,
Zhejiang, China; 2Collaborative Innovation
Center for Diagnosis and Treatment of
Infectious Diseases, Zhejiang University,
Hangzhou, Zhejiang, China; 3Department of
Epidemiology and Biostatistics, College of
Public Health, University of Georgia, Athens,
GA, USA; 4Department of Epidemiology and
Environmental Health, School of Public Health
and Health Professions, University at Buffalo,
State University of New York, Buffalo, NY,
USA; 5Department of Nutrition, Nutrition
Discovery Innovation Institute, College of
Public Health, Zhengzhou University,
Zhengzhou, China
Received 1 April 2015; revised 21 August
2015; accepted 21 August 2015
Address for correspondence: Professor F
Wang, Department of Nutrition, School of
Public Health, Zhejiang University, 866
Yuhangtang Road, Hangzhou 310058, China.
Email: [email protected];
[email protected]
Summary
Hypoferraemia (i.e. iron deficiency) was initially reported among obese individ-
uals several decades ago; however, whether obesity and iron deficiency are corre-
lated remains unclear. Here, we evaluated the putative association between obesity
and iron deficiency by assessing the concentration of haematological iron markers
and the risks associated with iron deficiency in both obese (including overweight)
subjects and non-overweight participants. We performed a systematic search in
the databases PubMed and Embase for relevant research articles published
through December 2014. A total of 26 cross-sectional and case–control studies
were analysed, comprising 13,393 overweight/obese individuals and 26,621 non-
overweight participants. Weighted or standardized mean differences of blood iron
markers and odds ratio (OR) of iron deficiency were compared between the
overweight/obese participants and the non-overweight participants using a
random-effects model. Compared with the non-overweight participants, the
overweight/obese participants had lower serum iron concentrations (weighted
mean difference [WMD]: −8.37 μg dL−1; 95% confidence interval [CI]: −11.38 to
−5.36 μg dL−1) and lower transferrin saturation percentages (WMD: 2.34%, 95%
CI: −3.29% to −1.40%). Consistent with this finding, the overweight/obese par-
ticipants had a significantly increased risk of iron deficiency (OR: 1.31; 95% CI:
1.01–1.68). Moreover, subgroup analyses revealed that the method used to diag-
nose iron deficiency can have a critical effect on the results of the association test;
specifically, we found a significant correlation between iron deficiency and obesity
in studies without a ferritin-based diagnosis, but not in studies that used a
ferritin-based diagnosis. Based upon these fin.
This document summarizes a study on iron deficiency anemia (IDA) in pregnant women in Iraq. The study evaluated serum levels of iron, copper, magnesium, manganese, calcium, sodium, and potassium in 3 groups: non-pregnant women (group 1), healthy pregnant women (group 2), and pregnant women with IDA (group 3). The results showed decreased serum iron and increased copper levels in group 2 compared to group 1. Groups 2 and 3 both had reductions in magnesium, manganese, calcium, and potassium compared to group 1. The findings indicate IDA affects levels of these elements in pregnant women, and they could serve as markers for assessing IDA during pregnancy.
Dietary Supplementation with Calcium in Healthy Rats Administered with Artemi...IOSR Journals
Reports on the role of calcium on predisposition to cardiovascular disease have been rather inconsistent while studies on its interaction with other medications are ongoing. We therefore investigated the effect of separate and combine administration of calcium supplement with artemisinin-based combination drug on hepatic and serum lipid profile. Thirty two male wistar rats were randomly assigned into four groups of eight rats each. The control (group A) received normal saline. Group B and D were placed on 10mg/Kg calcium twice daily for four weeks. On the thirtieth day, therapeutic dose of artemisinin-based combination was simultaneously administered to group C and group D twice daily for three days. All the rats were then sacrificed after 12 hours fasting, blood was withdrawn and the liver removed and homogenized in an appropriate buffer. Biochemical analysis showed no significant (p>0.05) variation in hepatic triaacylglycerol in all the treated groups whereas calcium supplementation was observed to induce a significant (p<0.05) reduction in hepatic cholesterol. Significant elevations due to calcium supplementation were also observed in serum total cholesterol, LDL cholesterol level and atherogenic risk index with a concomitant reduction in serum HDL cholesterol. No significant change was observed in serum total cholesterol, triacylglycerol and serum lipoproteins in all other treatment groups. Our study suggests that calcium supplementation may predispose to cardiovascular disease and that its co administration with ACT may not aggravate nor reduced the predisposition risk.
This study investigated the relationship between lactation and markers of folate and vitamin B12 deficiency in breastfeeding women over 9 months postpartum. The researchers found:
1) Homocysteine levels increased in exclusively breastfeeding women without vitamin supplementation from 3 weeks to 4 and 9 months postpartum, indicating potential folate deficiency.
2) Six women had elevated homocysteine levels, and four of these were unsupplemented and breastfeeding exclusively.
3) No overall depletion of folate or B12 stores was found during the lactation period in this population. However, folate-supplemented women had lower homocysteine levels, suggesting supplementation benefits lactating women.
Dietary iron status and health of third trimester pregnant women in kenyaAlexander Decker
1) The study aimed to assess dietary iron intake among third trimester pregnant women in Kenya through 24-hour dietary recalls and food frequency questionnaires.
2) The mean daily dietary iron intake was found to be 19.62mg, which meets the recommended daily intake of 21mg. However, 15.4% of women consumed less than 19.62mg of iron per day.
3) Education level was found to be associated with iron intake, as women with higher education levels generally consumed more iron-rich foods. It was also associated with uptake of iron supplements.
Anemia is a condition in which the number of red blood cells and/OR their oxy...Niranjan Chavan
Anemia is a condition in which the number of red blood cells and/OR their
oxygen-carrying capacity is insufficient to meet the body’s physiological needs.
Prevalence of anemia among teenage pregnant girls attending antenatal clinic ...Alexander Decker
The study found that the prevalence of anemia among teenage pregnant girls in Bungoma District, Western Kenya was 61%. Nearly half (48.3%) had mild anemia, 31.2% had moderate anemia, and 20.5% had severe anemia. Factors associated with anemia included parasitic infections like hookworm, which were linked to inadequate calcium intake, and malaria parasites, which affected folate intake. Food intake and socioeconomic factors also played a role, as iron intake was associated with perceived food shortage and over 65% of participants had a monthly income below $100. The high rates of anemia found indicate the need for deworming and anemia treatment programs for pregnant teenage girls in the region
Effects of Micronised Dispersible Ferric Pyrophosphate combined with Alpha-La...Antonio Simone Laganà
This study compared the effects of micronized dispersible ferric pyrophosphate combined with alpha-lactalbumin versus ferrous gluconate in treating iron deficiency anemia in pregnant women. Fifty pregnant women with anemia were randomly assigned to receive either 30 mg of ferric pyrophosphate plus 300 mg of alpha-lactalbumin or 80 mg of ferrous gluconate daily for 30 days. The combination treatment was more effective at increasing hemoglobin, ferritin, and serum iron levels with no reported side effects, while the ferrous gluconate group saw increases but also had a 24% side effect rate. The combination treatment was more effective at treating iron deficiency anemia in
treating anemia is a big challenge.oral iron therapy do not adequately treat IDA. IV ferric carboxy maltose (FCM)effectively treats IDA by circumventing the problem compliance of oral iron therapy.
Drug Consult ExampleDate and time requested September 23, 2013 .docxmadlynplamondon
Drug Consult Example
Date and time requested: September 23, 2013 at 10:00 AM
Date and time answered: September 27, 2013 at 5:00 PM
Pharmacy has been consulted re: Are calcium supplements associated with coronary heart disease in adult patients?
Background:
Calcium supplementation has long been recommended for promoting bone health and is often utilized for the prevention and treatment of osteoporosis.1 It has been reported that in the older population close to 50% of men and 70% of women are users of calcium supplements.1 In most adult patients, the recommended daily allowance (RDA) of elemental calcium is 1000 mg. In females aged 51 and greater, the RDA is slightly increased at 1200 mg.2 Calcium administration is generally well tolerated with the most commonly occurring adverse effects being gastrointestinal discomfort, constipation, flatulence and nausea.3 Recently, there has been speculation about a correlation between calcium supplementation and cardiovascular risk. While some studies have reported cardiovascular benefits such as improvements in blood pressure and lipid panels, some concerning data linking calcium supplementation to increased risk of stroke, myocardial infarction and cardiovascular death has also been published.1 It has been hypothesized that excess calcium intake via supplementation may lead to cardiac calcium phosphate deposits which are correlated with risk of atherosclerosis, coronary heart disease and death.1
Literature Search Strategy:
A search was conducted using Ovid MEDLINE (2009 to September week 2 2013). Terms searched included supplemental calcium, calcium supplement, coronary heart disease and cardiovascular disease. The Boolean operator OR was first used to combine the terms supplemental calcium and calcium supplement and then used again to combine the terms coronary heart disease and cardiovascular disease. The Boolean operator AND was subsequently utilized to combine the results from supplemental calcium, OR calcium supplement, with coronary heart disease OR cardiovascular disease. The search was limited to the English language and humans and yielded 13 results. Of the 13 articles, 9 were excluded for being review articles, 2 were excluded because they focused on dietary rather than supplemental calcium intake and 1 was excluded for being focused specifically on myocardial infarction and stroke. The article to be discussed was chosen because it is relevant to the topic as it looks specifically at cardiovascular risk related to calcium supplementation in both men and women.
Results/Literature Analysis:
A prospective study was conducted to determine if calcium intake was associated with risk of death from heart disease, cerebrovascular disease or cardiovascular disease.1 Included participants were male and female AARP members with ages ranging from 50 to 71 years. Participants were geographically located in 6 states (California, Florida, Louisiana, New
Jersey, North Carolina, and Pennsylvania) ...
Anemia and Iron Deficiency Anemia in Egyptiosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
The document summarizes a study that investigated the effects of iron supplementation alone and in combination with vitamins on hematological status, oxidative stress, and erythrocyte membrane fluidity in anemic pregnant women. 164 anemic pregnant women were randomly assigned to receive placebo, iron alone, iron with folic acid, or iron with folic acid, retinol, and riboflavin for 2 months. The study found that supplementation significantly increased hemoglobin and ferritin levels and decreased oxidative stress markers in all treatment groups compared to placebo. Erythrocyte membrane fluidity also increased with supplementation.
Knowledge of Postpartum Women's Toward Iron Deficiency Anemia at AlNasiriyah ...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care.
Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice
This study compared the efficacy of ferrous sulfate (divalent iron) and ferric polymaltose (trivalent iron) compounds for iron deficiency anemia (IDA) prophylaxis in exclusively breastfed infants. 112 exclusively breastfed infants were randomly assigned to receive either divalent or trivalent iron supplementation from 4-9 months of age. Both groups showed significant improvements in hematologic parameters and iron status after 5 months of supplementation. However, the divalent iron group had significantly higher hemoglobin, hematocrit, iron, and transferrin saturation levels. The prevalence of iron deficiency and IDA were not significantly different between groups. Both ferrous and ferric iron preparations were effective for IDA prophylaxis
— Aim of this study was to obtain knowledge on boron supplemented diet to mineral status of body fluids and feces in short term nutrition of dairy cattle. A total of 24 healthy Holstein dairy cows were used. The animals were fed with standard ration, and boron at three different doses was added to experimental' diets as boron compound: borax, for 10 days. Boron and other macro and trace minerals were determined in serum, milk, urine and feces samples taken on 0 and 11 st days. In this study, there were no overt signs of toxicosis, and a pivotal knowledge was obtained in dairy cattle fed with boron supplemented diet on boron absorption, excretion, and its interaction with other minerals. Boron could not completely absorb from gastrointestinal tract. Urine was the most important excretion way of boron. More less boron was also eliminated by milk. Boron levels in body fluids (serum and milk, p<0.000) were increasingly changed based on the dose. Boron, among minerals, provided a striking increase for Ca (p<0.003) and Mg (p<0.028) levels in serum by increasing absorption of these minerals. This topic is worth evaluating as an alternative approach in the prevention of hypocalcemia in transition cows.
The document summarizes a study on the antioxidant vitamin status of anemic and non-anemic Pakistani women in their third trimester of pregnancy. The study found that women who were anemic had lower levels of hemoglobin, iron, and antioxidant vitamins like vitamins A, C and E compared to non-anemic women. Specifically, the red blood cells of anemic women were smaller and paler due to iron deficiency and oxidative stress. The study concludes that to prevent anemia in late pregnancy, women should be supplemented not just with iron but also with antioxidant vitamins.
Similar to Calcium intake is weakly negatively associated with iron status j nutr 1999 (20)
A Prospective, Multicenter, Observational Study on Adherence With Viral Hepat...Michel Rotily
A Prospective, Multicenter, Observational Study on Adherence With Viral Hepatitis C Treatments (CHEOBS Study): Impact of Past Psychiatric Disorders on Sustained Virologic Response (SVR) by JP Lang, P Melin, D Ouzan, L Cattan, M Chousterman, M. Rotily, T Fontanges, P Marcellin, P Cacoub
Profils socio-médicaux des personnes détenues sous traitement de substitution Michel Rotily
Profils socio-médicaux des personnes détenues sous traitement de substitution : Résultats de l’étude RECAMS-LINSEARCH by Ivana Obradovic (OFDT), Jean-Noël Marzo (RECAMS), Michel Rotily (Clinsearch)
Présenté à THS 8, 26 octobre 2007
Orphan drugs - Le statut Orphan Drug: Une stratégie pour accélérer le dévelop...Michel Rotily
Orphan drugs - Le statut Orphan Drug: Une stratégie pour accélérer le développement de tout nouveau médicament? Présentation donnée dans le cadre du BioRezo et Euroboméditérannée à Sophia-Antipolis en 2009
DECLARATION OF HELSINKI - History and principlesanaghabharat01
This SlideShare presentation provides a comprehensive overview of the Declaration of Helsinki, a foundational document outlining ethical guidelines for conducting medical research involving human subjects.
Mercurius is named after the roman god mercurius, the god of trade and science. The planet mercurius is named after the same god. Mercurius is sometimes called hydrargyrum, means ‘watery silver’. Its shine and colour are very similar to silver, but mercury is a fluid at room temperatures. The name quick silver is a translation of hydrargyrum, where the word quick describes its tendency to scatter away in all directions.
The droplets have a tendency to conglomerate to one big mass, but on being shaken they fall apart into countless little droplets again. It is used to ignite explosives, like mercury fulminate, the explosive character is one of its general themes.
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2. 964 VAN DE VIJVER ET AL.
between calcium intake and iron status in the CALEUR study, mean level of 3.3 g/L and for analysis of serum iron the variation
a large cross-sectional study among girls and women in six coefficient was 1.8% at a mean value of 18 mol/L in the quality
European countries. (Kardinaal et al. 1999) control sample.
Blood samples were available for 1,083 girls and 525 women. In a
selection of samples with extremely high or low ferritin levels (ferritin
MATERIALS AND METHODS 3.0 or 10.0 g/L), duplicate measurement was performed. When
the second measurement was comparable to the first measurement,
The CALEUR study was conducted in Denmark, Finland, France, the first value was used. Samples of four subjects (three girls and one
Italy, The Netherlands and Poland, initially to study the association woman) were excluded from statistical analyses because of instability
between calcium intake and peak bone mass (Kardinaal et al. 1999). of the sample, leaving data for 1,080 girls and 524 women for analysis.
In each of the participating countries, girls aged 11–15 y and young Statistical analyses. Mean and SD of serum iron, serum ferritin,
adult women aged 20 –23 y with high and low calcium intake were serum transferrin and transferrin saturation and of dietary intake
selected from random population samples of about 750 girls and 375 levels were calculated. Pearson correlations between potential con-
women. All subjects were of Caucasian origin. In Finland (Oulu), founding factors and calcium intake and parameters for iron status
Denmark (Aarhus), Poland (Warsaw) and The Netherlands (Zeist), were calculated. As potential confounders, age, height, weight, men-
random samples from the local population registries were obtained ses, smoking, tea and coffee consumption, alcohol consumption,
and subjects invited to participate; response rates varied from 25.4 to energy intake, protein intake and vitamin C intake were considered.
51.5% for girls and from 28.6 to 62% for women. In France, girls and Variables associated with calcium intake and serum ferritin levels or
women were recruited via general practitioners and gynecologists in transferrin saturation were included as a covariable in the statistical
two geographical areas, Rhone-Alps and Marseille; in Italy, girls were models with serum ferritin or transferrin saturation as independent
recruited from all eight secondary schools in the town of Rende, and variables. Categorical variables were put into the model as dummy
women from the University of Calabria (response rates were 100%). variables. Though the covariables were not significantly associated
Of those selected, the participation rate varied between 64 and 84% with all the parameters of iron status, we choose to use a fixed set of
for girls and between 52 and 91% for women: data were collected for covariables in the statistical models. With analysis of covariance,
1,116 girls and 526 women. The study was approved by local medical- mean levels of the serum iron parameters were calculated per quartile
Downloaded from jn.nutrition.org by on February 21, 2009
ethical committees, and all participants (and their parents, if re- of calcium intake, adjusted for the covariables. Linear regression
quired) gave their informed consent. Subjects were excluded when analysis was used to calculate the effect of calcium intake on serum
indicating a chronic disease in general, diseases related to bone or levels overall and per country, unadjusted and adjusted for covari-
calcium metabolism in particular, use of corticosteroids, participating ables. The influence of the simultaneous intake of iron and calcium
in sports more than 7 h/wk, current or prior pregnancy, menstruation during a meal was measured by dividing calcium intake into calcium
at irregular intervals (for the women only), vegetarianism or macro- ingested simultaneously with iron and the remaining calcium. Simul-
biotism or a prescribed diet other than an energy-restricted diet. taneous intake of iron and calcium was defined as a moment of the
Dietary intake. To estimate calcium intake in a comparable way day when at least 20% of the total daily iron and at least 20% of the
in the six countries, a 3-d food record method was used. The subjects total daily calcium was consumed. For statistical analysis the BMDP
were asked to record everything they consumed during a consecutive statistical package was used (BMDP version 7.0; BMDP Statistical
Wednesday, Thursday and Friday, the week before their visit to the Software Inc., Los Angeles, CA). P values 0.05 were considered
institute. Time of day, food, quantity and recipes of composite dishes significant.
were recorded. The parent responsible for meal preparation was asked
to assist in completing the food records. At the visit to the institute,
the food records were checked by a dietitian for completeness; house- RESULTS
hold measures were verified by comparison with standard measures.
Daily consumption of food products in grams were converted to The study sample included girls with a mean age of 13.5
nutrient intake using local food composition tables. Mean intakes of 1.5 y (37.8% were premenarcheal) and women with a mean
calcium, iron and energy were calculated as the average over 3 d. age of 22.0 1.1 y. Use of oral contraceptives was reported by
Height and weight were measured with the subjects wearing light 1.0% of the girls and 48.1% of the women. Smoking was
clothing and no shoes. Subjects completed a self-administered ques-
tionnaire on menstrual function and use of oral contraceptives, smok-
reported by 7.0% of the girls and 29.4% of the women.
ing habits, alcohol use, time spent outdoors, height, weight and The ranges for (serum iron, serum ferritin, serum transferrin
education of parents and physical activity. Physical activity was and the transferrin saturation) the different countries were
determined for the previous month and covered activities at school, comparable (Table 1). For the pooled data, serum iron ranged
at work and in leisure time (sports and household activities). For the from 2.9 to 46.8 mmol/L for girls and from 2.1 to 45.1 mmol/L
girls, the questionnaire comprised 58 items, and for the women 88. for women. Ranges for serum ferritin and serum transferrin
The questionnaire was checked in an interview setting. were 2.3–161.1 g/L and 2.0 –5.3 g/L, respectively, for girls
A 10-mL blood sample was drawn from nonfasting subjects in a and 1.1–191.6 g/L and 2.1–5.5 g/L, respectively, for women.
10-mL tube with clot activator and cooled to 4°C. Serum was Transferrin saturation ranged from 3.4 to 60.3% for girls and
prepared within 2 h by centrifugation at 3000 g for 10 min. Serum from 3.0 to 63.3% for women, with the lowest levels in Italy
was stored at 20°C. Serum ferritin was measured as the main marker
for iron status. Serum ferritin levels reflect stored iron. Serum iron
and the highest in Denmark. The lowest levels of serum iron
and the main iron-binding protein, transferrin, reflect the iron in and serum ferritin were seen in Finland, both for girls and
transit and were used to calculate the transferrin saturation {(trans- women. Low-serum iron and ferritin levels were also seen in
ferrin saturation (%) iron (g/L)/[transferrin (g/L) 1.41)]} (Wick Italian women. Latent iron deficiency (ferritin 12 g/L) was
1996). Transferrin saturation can be used as a short-term marker of found in 4.3% of the girls and 7.4% of the women (Fig. 1).
iron concentration (Wick 1996). Serum iron, transferrin and ferritin Calcium intakes of both girls and women were lowest in
were measured with the Hitachi 911 (Boehringer Mannheim, Mann- Italy and highest in Finland (Table 2). Intakes in The Neth-
heim, Germany). Ferritin and transferrin were analyzed immunotur- erlands, Finland and Denmark were all relatively high. The
bidimetrically with a ferritin test kit (No. 1661400; Boehringer lowest iron intakes were in Italy, whereas girls and women in
Mannheim) and a transferrin test kit (No. 1360752; Boehringer Poland had the highest iron intakes.
Mannheim). Serum iron was analyzed after separation of Fe3 from
transferrin. After reduction, Fe2 forms colored complexes with To assess the association between calcium intake and serum
FerroZine™ (Hach Chemical Co., Ames, IA). The coefficient of iron levels, the potential confounders age, height, weight,
variation for the analysis of serum ferritin was 8.1 and 3.9% at mean menses, smoking, tea and coffee consumption, alcohol con-
values of 30 and 60 g/L in the quality control samples, respectively. sumption, energy intake, protein intake and vitamin C intake
The variation coefficient for analysis of transferrin was 2.5% at a were first considered. Inverse associations between serum fer-
3. CALCIUM INTAKE AND IRON STATUS 965
TABLE 1
Serum iron, ferritin and transferrin concentrations and transferrin saturation of girls and women from several European countries1
n Ferritin Iron Transferrin Transferrin saturation
g/L mol/L g/L %
Girls
The Netherlands 165 35.2 16.3 16.5 5.3 3.45 0.45 19.4 7.1
Finland 190 28.3 16.1 13.7 5.7 3.38 0.43 16.6 7.9
Denmark 165 38.2 21.3 17.6 6.3 3.31 0.40 21.5 8.2
Italy 197 33.4 21.4 15.2 6.1 3.78 0.51 16.4 7.1
France 167 36.4 19.6 15.4 5.7 3.36 0.43 18.6 7.5
Poland 196 36.1 17.9 16.6 6.4 3.51 0.43 19.1 7.8
Overall 1080 34.5 19.1 15.8 6.1 3.47 0.47 18.5 7.8
Women
The Netherlands 96 47.0 38.1 17.9 7.7 3.93 0.59 18.5 8.2
Finland 82 29.7 25.3 14.4 8.7 3.39 0.62 17.6 11.4
Denmark 77 50.2 36.4 19.4 7.8 3.67 0.66 21.5 9.2
Italy 99 33.1 19.2 14.4 5.8 3.47 0.51 16.9 7.1
France 74 39.6 30.2 17.3 7.7 3.69 0.53 19.1 8.5
Poland 96 42.2 26.9 18.0 6.4 3.43 0.49 21.1 7.5
Overall 524 40.2 30.5 16.9 7.5 3.59 0.60 19.1 8.8
1 Values are means SD.
Downloaded from jn.nutrition.org by on February 21, 2009
ritin and age and between serum transferrin and vitamin C women, respectively, P 0.05). After adjustment was made
intake were observed. Age, weight, height, protein intake and for the set of covariables, the adjusted linear regression coef-
energy intake were positively associated with serum trans- ficient for the pooled data was 0.57 0.20 for girls. This
ferrin. Calcium intake was positively associated with age, means that for every 100-mg/d increase of calcium intake the
height, energy intake, protein intake and vitamin C intake. ferritin level is reduced by 0.57 g/L. For an average ferritin
In Table 3 the mean levels of serum iron, ferritin, trans- level of 34.5 g/L, this means a reduction in ferritin level of
ferrin and transferrin saturation per quartile of calcium intake 1.6%. For women a linear regression coefficient of 1.37
are presented. The means were adjusted for a fixed set of 0.46 was found, i.e., a reduction in ferritin concentration of
covariables, age, country, tea, protein, vitamin C and iron 3.3% for every 100-mg/d increase in calcium intake at an
consumption and for menses (in girls only). Adjusted means average ferritin level of 40.2 g/L. Calculation of the associ-
differed significantly between quartiles of calcium intake for ation for each country separately revealed a consistent inverse
transferrin levels in girls and serum iron and transferrin satu- association between calcium intake and serum ferritin, even
ration in women. though in none of the countries this association reached
Linear regression modeling was used to assess the contribu- significance. When transferrin saturation as a measure of
tion of various independent variables of influence to serum short-term iron concentration was put in the model as the
iron status. Calcium intake was not associated with serum dependent variable, we found a significant adjusted inverse
levels of iron or transferrin. For the main indicator of iron regression coefficient for the girls of 0.18 0.08 per 100-
status, serum ferritin, the linear regression coefficients are mg/d increase of calcium. The regression coefficient calculated
presented for the separate countries and for all countries for the separate countries showed only a significant inverse
pooled (Table 4). Both for girls and for women a significant association in Denmark. For women, no association was ob-
inverse association was found between calcium intake and served between calcium intake and transferrin saturation.
serum ferritin level (r 0.09 and 0.07 for girls and Several studies suggest that only the simultaneous intake of
calcium and iron leads to an inhibitory effect (Gleerup et al.
1993). Our linear regression model, adjusted for iron intake,
age, menarche, country, protein intake and vitamin C intake,
did not reveal a difference in inhibition between calcium
taken simultaneously with iron and the remaining calcium.
The two linear models in which the calcium variables were
separated neither revealed a significant association with cal-
cium taken with iron nor with the remaining calcium. The
contribution of the two calcium sources independent of the
other source was assessed by putting both calcium variables in
one regression model. In the adjusted model with serum fer-
ritin as the dependent variable, the linear regression coeffi-
cients for calcium-consumed simultaneously with iron and for
the remaining calcium were 0.56 0.25 and 0.58 0.22,
respectively, in girls and 1.34 0.56 and 1.37 0.50,
respectively, in women (P 0.05 for all values).
The dose dependence of the association between calcium
FIG. 1. Percentage of women and girls in each country with latent intake and serum ferritin levels was checked over strata of
iron deficiency (ferritin 12 g/L). calcium intake levels. A division was made between intake
4. 966 VAN DE VIJVER ET AL.
TABLE 2
Daily intake of calcium, iron and energy among girls and women in the pooled data and per country1
Calcium Iron Energy intake
Girls Women Girls Women Girls Women
mg MJ
The Netherlands 1083 379 1139 458 10.9 4.4 10.5 3.5 9.5 2.1 9.4 2.0
Finland 1227 512 1265 545 11.3 9.6 10.3 5.7 7.8 2.0 7.6 2.0
Denmark 1133 499 1263 596 10.7 11.1 10.3 6.8 8.0 2.1 8.1 1.9
Italy 680 302 609 279 8.2 2.6 8.0 2.9 7.8 1.9 8.2 1.9
France 950 381 887 335 10.9 4.3 10.4 2.7 8.6 2.2 8.8 1.9
Poland 937 400 829 364 13.0 6.5 12.4 5.6 8.8 2.3 9.8 2.3
Overall 992 449 988 504 10.8 7.0 10.3 5.0 8.4 2.2 8.7 2.2
1 Values are means SD.
levels of 300, 300 – 600, 600 –900, 900 –1200, and 1200 prudence is called for when using these data as a measure of
mg/d. No indication of a threshold effect was seen. None of intake for a specific country. Also, blood was collected accord-
the linear regression coefficients in the strata showed a signif- ing to the same protocol, and all blood samples were analyzed
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icant association between calcium intake and serum ferritin centrally in one laboratory.
levels. In all strata an inverse association was observed except Dietary assessment took place on three consecutive days.
for a positive linear regression coefficient in women with a From the Dutch National Food Consumption Survey, it was
calcium intake lower than 300 mg. No trend could be de- calculated that the day-to-day variation in calcium intake in
tected. The Netherlands was small (Van Erp-Baart 1996). A 3-d
dietary record could thus give a representative estimate of
DISCUSSION usual calcium intake. Day-to-day variation in iron is expected
In this cross-sectional study, performed in six European to be more pronounced and consequently the 3-d record is not
countries, a weak but consistent inverse association was seen likely to accurately reflect habitual individual intake. On the
between calcium intake and serum ferritin status, irrespective other hand, measurement of serum iron parameters variable is
of whether calcium was ingested simultaneously with iron. also exposed to biological and analytical variances. The con-
Further, no dose-response relationship between calcium intake sequence of these factors is that whenever an association really
and serum ferritin was detected. exists, the association is either not found, or it seems to be
The study was conducted in six countries throughout Eu- weaker than in reality.
rope, which contributed to a wide variety in intakes of both In this study dietary information was collected at differ-
calcium and iron. In each country, two groups of subjects were ent periods over the year for the separate countries. There-
recruited, a group of girls and a group of young women. To fore, comparison of intakes between countries can give a
ensure comparability of the data between groups and among biased view. Blood collection took place in the same pe-
countries, all procedures were similar. Because the study pop- riod as the dietary assessment was made. Because blood
ulations are not necessarily representative for the countries, levels reflect intake, seasonality plays only a minor role in
TABLE 3
Serum iron, ferritin and transferrin concentrations and transferrin saturation of girls and women per quartile of calcium intake1
Quartile 1 2 3 4
Girls2
n 268 271 268 271
Calcium intake, mg 462.0 7.5 766.0 4.2 1031.9 6.2 1686.9 24.9
Iron, mol/L 15.5 0.6 15.2 0.4 16.0 0.4 16.5 0.7
Ferritin, g/L 34.0 1.8 32.0 1.3 34.0 1.2 37.8 2.1
Transferrin,* g/L 3.55 0.04 3.54 0.03 3.45 0.03 3.35 0.05
Transferrin saturation, % 17.8 0.7 17.4 0.5 18.9 0.5 19.9 0.9
Women3
n 129 130 130 131
Calcium intake, mg 482.9 10.8 798.2 6.9 1081.6 9.3 1597.9 27.8
Iron,* mol/L 15.4 1.1 17.9 0.7 15.8 0.7 18.4 1.2
Ferritin, g/L 41.2 4.5 40.8 3.0 42.9 2.7 36.4 5.1
Transferrin, g/L 3.57 0.09 3.56 0.06 3.59 0.05 3.67 0.10
Transferrin saturation,* % 17.3 1.3 20.1 0.9 18.0 0.8 21.0 1.5
1 Values are means SEM.
2 Adjusted for age, menses, country, protein, vitamin C, tea, iron.
3 Adjusted for age, country, protein vitamin C, tea, iron. * Significant difference among the means, P 0.05.
5. CALCIUM INTAKE AND IRON STATUS 967
TABLE 4
Linear regression coefficients for calcium intake (per 100 mg) as predictor of serum ferritin level
Crude Adjusted1 Multivariate adjusted2
( SD)
Girls
The Netherlands 0.37 0.28 0.46 0.29 0.88 0.46
Finland 0.06 0.22 0.20 0.23 0.44 0.42
Denmark 0.28 0.28 0.32 0.29 1.94 0.53**
Italy 0.30 0.55 0.53 0.58 0.49 0.79
France 0.01 0.46 0.08 0.48 0.43 0.58
Poland 0.62 0.35 0.72 0.36 0.58 0.50
Overall 0.25 0.12* 0.34 0.12** 0.57 0.20**
Women
The Netherlands 0.46 1.03 0.32 1.09 0.49 1.94
Finland 1.77 0.52 1.83 0.51 1.37 0.87
Denmark 0.55 0.85 0.59 0.85 1.87 1.37
Italy 0.29 0.65 0.15 0.69 0.43 1.05
France 0.82 0.93 0.66 0.99 1.99 1.22
Poland 1.03 0.68 0.85 0.74 1.33 0.94
Overall 0.60 0.30* 0.62 0.30* 1.37 0.46**
1 Adjusted for iron intake.
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2 Adjusted for iron intake, age, menarche (in girls only), protein, tea, vitamin C and country. * P 0.05, ** P 0.01.
the association between calcium intake levels and iron iron absorption is inhibited, Hallberg and colleagues (1992a)
status. argued that the mechanism must involve inhibition of iron
Several studies show an inhibitory effect of calcium intake extrusion from the enterocyte. Recent studies suggest that
on iron absorption (Deehr et al. 1990, Cook et al. 1991, Galan calcium competes for iron-binding sites on the intestinal iron-
et al. 1991, Hallberg et al. 1992a). In these intervention binding protein mobilferrin.
studies, calcium was provided via a supplement or added to the It can be argued whether the finding that higher calcium
meal (Hallberg et al. 1991, 1992a, 1992b). Some studies pro- intake is associated with reduced serum ferritin levels is of
vide extra yogurt or milk during the meal (Gleerup et al. 1993, biological relevance. The normal absorption of iron from the
1995). An effect of calcium on iron absorption was reported to diet is estimated to be 10% (about 1 mg/d). To maintain the
be most pronounced when calcium was provided during the iron balance, several mechanisms are involved. In case of an
same meal in which iron was consumed. Gleerup et al. (1993) iron deficiency, the uptake of iron may be increased by up to
showed that calcium given 2 or 4 h before a meal had no 20 –30% (Wick et al. 1996). Several studies showed that iron
inhibitory effect on iron absorption. Some studies, however, absorption is strongly and inversely associated with serum
did not find an inhibitory effect of milk on iron absorption ferritin level (Hulten et al. 1995). Therefore, reducing calcium
´
(Turnlund et al. 1990, Tidehag et al. 1995), and in a study intake does not necessarily lead to increased serum ferritin
among lactating Gambian women, no effect of calcium sup- levels. Because inadequate calcium intake may lead to other
plementation on serum ferritin level was observed (Yan et al. serious health problems such as osteoporosis (Heaney 1993), it
1996). seems inappropriate to advise strongly against the consump-
A far as we know, our study is the first to look at normal tion of calcium to prevent iron deficiency.
dietary intake levels instead of supplementation with calcium. From our results we conclude that dietary calcium intake is
Contrary to most studies which evaluate iron absorption, our weakly, inversely associated with the iron status of blood in
interest was the influence of calcium intake on iron status. girls and young women, irrespective of whether calcium was
This study, therefore, may yield a better assessment of the ingested simultaneously with iron.
long-term effect of calcium on iron absorption. Our study did
not reveal an effect of time of calcium consumption on iron ACKNOWLEDGMENTS
status. It may well be that the effect of simultaneous consump-
tion of calcium and iron is readily reflected in iron absorption, We thank all those who have contributed to data collection,
whereas the iron status of blood is a more long-term variable questionnaire development, data management, biochemical analysis
on which this effect is less clear. In our study we did not and technical and administrative support.
distinguish between heme and nonheme iron. However, be-
cause the inhibitory effect of calcium was observed in both LITERATURE CITED
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