Probiotics and prebiotics: prospects for public health and nutritional recommendations

Probiotics and prebiotics are useful interventions for improving human health through direct or indirect effects on the colonizing microbiota. However, translation of these research findings into nutritional recommendations and public health policy endorsements has not been achieved in a manner consistent with the strength of the evidence. More progress has been made with clinical recommendations. Conclusions include that beneficial cultures, including probiotics and live cultures in fermented foods, can contribute towards the health of the general population; prebiotics, in part due to their function as a special type of soluble fiber, can contribute to the health of the general population; and a number of challenges must be addressed in order to fully realize probiotic and prebiotic benefits, including the need for greater awareness of the accumulated evidence on probiotics and prebiotics among policy makers, strategies to cope with regulatory roadblocks to research, and high-quality human trials that address outstanding research questions in the field.

Manipulation of lipids in animal-derived foods: can it contribute to public health nutrition?

Foods derived from animals are an important source of nutrients for humans. Concerns have been raised that due to their SFA content, dairy foods may increase the risk of cardiometabolic disease. Prospective studies do not indicate an association between milk consumption and increased disease risk although there are less data for other dairy foods. SFA in dairy products can be partially replaced by cis-MUFA through nutrition of the dairy cow although there are too few human studies to conclude that such modification leads to reduced chronic disease risk. Intakes of LCn-3 FA are sub-optimal in many countries and while foods such as poultry meat can be enriched by inclusion of fish oil in the diet of the birds, fish oil is expensive and has an associated risk that the meat will be oxidatively unstable. Novel sources of LCn-3 FA such as kirll oil, algae, and genetically modified plants may prove to be better candidates for meat enrichment. The value of FA-modified foods cannot be judged by their FA composition alone and there needs to be detailed human intervention studies carried out before judgements concerning improved health value can be made. Practical applications: The amount and FA composition of dietary lipids are known to contribute to the risk of chronic disease in humans which is increasing and becoming very costly to treat. The use of animal nutrition to improve the FA composition of staple foods such as dairy products and poultry meat has considerable potential to reduce chronic risk at population level although judgements must not be based simply on FA composition of the foods.

Talking AIDS in Hong Kong: Cultural models in public health discourse

This paper explores issues of cultural models in the discourse of public health in a multicultural, multilingual context through a 'frame analysis' of 20 AIDS awareness campaigns aired in both English and Cantonese in Hong Kong from 1987 to 1994. Using a methodology derived from the work of Goffman (1974), and Gee (1990), it examines how the authors of AIDS awareness messages in Hong Kong project cultural models on several different levels of "framing" and how these models both reflect and validate dominant ideologies within the society.

Design and formative evaluation of an information kiosk on cattle health for landless cattle owners

This paper describes and analyses the experience of designing, installing and evaluating a farmer-usable touch screen information kiosk on cattle health in a veterinary institution in Pondicherry. The contents of the kiosk were prepared based on identified demands for information on cattle health, arrived at through various stakeholders meetings. Information on these cattle diseases and conditions affecting the livelihoods of the poor was provided through graphics, text and audio back-up, keeping in mind the needs of landless and illiterate poor cattle owners. A methodology for kiosk evaluation based on the feedback obtained from kiosk facilitator, critical group reflection and individual users was formulated. The formative evaluation reveals the potential strength this ICT has in transferring information to the cattle owners in a service delivery centre. Such information is vital in preventing diseases and helps cattle owners to present and treat their animals at an early stage of disease condition. This in turn helps prevent direct and indirect losses to the cattle owners. The study reveals how an information kiosk installed at a government institution as a freely accessible source of information to all farmers irrespective of their class and caste can help in transfer of information among poor cattle owners, provided periodic updating, interactivity and communication variability are taken care of. Being in the veterinary centre, the kiosk helps stimulate dialogue, and facilitates demand of services based on the information provided by the kiosk screens.

The effects of conjugated linoleic acid on human health-related outcomes

Conjugated linoleic acid (CLA) is a collective term for a mixture of positional and geometric isomers of conjugated dienoic derivatives of linoleic acid. CLA has received considerable attention as a result of animal experiments that report anti-carcinogenic, anti-atherogenic and anti-diabetic properties, and modulation of body composition and immune function. Several studies of CLA supplementation in human subjects have now been published, but in contrast to animal studies there has been marked variation between reports on the health-related outcomes. The consensus from seventeen published studies in human subjects is that CLA does not affect body weight or body composition. Some detrimental effects of the trans-10,cis-12 CLA isomer have also been reported in terms of altered blood lipid composition and impaired insulin sensitivity. Finally, CLA has only limited effects on immune functions in man. However, there have been reports of some interesting isomer-specific effects of CLA on the blood lipid profile, but not on immune function. These isomer-specific effects need further investigation. Until more is known, CLA supplementation in man should be considered with caution.

UK Food Standards Agency workshop report: the effects of the dietary n-6 : n-3 fatty acid ratio on cardiovascular health

This report summarises a workshop convened by the UK Food Standards Agency (FSA) on 11 September 2006 to review the results of three FSA-funded studies and other recent research on effects of the dietary n-6:n-3 fatty acid ratio on cardiovascular health. The objective of this workshop was to reach a clear conclusion on whether or not it was worth funding any further research in this area. On the basis of this review of the experimental evidence and on theoretical grounds, it was concluded that the n-6:n-3 fatty acid ratio is not a useful concept and that it distracts attention away from increasing absolute intakes of long-chain n-3 fatty acids which have been shown to have beneficial effects on cardiovascular health. Other markers of fatty acid intake, that more closely relate to physiological function, may be more useful.

Impact of the quantity and flavonoid content of fruits and vegetables on markers of intake in adults with an increased risk of cardiovascular disease: the FLAVURS Trial

Purpose Limited robust randomised controlled trials investigating fruit and vegetable (F&V) intake in people at risk of cardiovascular disease (CVD) exist. We aimed to design and validate a dietary strategy of increasing flavonoid-rich versus flavonoid-poor F&V consumption on nutrient biomarker profile. Methods A parallel, randomised, controlled, dose–response dietary intervention study. Participants with a CVD relative risk of 1.5 assessed by risk scores were randomly assigned to one of the 3 groups: habitual (control, CT), high-flavonoid (HF) or low-flavonoid (LF) diets. While the CT group (n = 57) consumed their habitual diet throughout, the HF (n = 58) and LF (n = 59) groups sequentially increased their daily F&V intake by an additional 2, 4 and 6 portions for 6-week periods during the 18-week study. Results Compliance to target numbers and types of F&V was broadly met and verified by dietary records, and plasma and urinary biomarkers. Mean (±SEM) number of F&V portions/day consumed by the HF and LF groups at baseline (3.8 ± 0.3 and 3.4 ± 0.3), 6 weeks (6.3 ± 0.4 and 5.8 ± 0.3), 12 weeks (7.0 ± 0.3 and 6.8 ± 0.3) and 18 weeks (7.6 ± 0.4 and 8.1 ± 0.4), respectively, was similar at baseline yet higher than the CT group (3.9 ± 0.3, 4.3 ± 0.3, 4.6 ± 0.4, 4.5 ± 0.3) (P = 0.015). There was a dose-dependent increase in dietary and urinary flavonoids in the HF group, with no change in other groups (P = 0.0001). Significantly higher dietary intakes of folate (P = 0.035), non-starch polysaccharides (P = 0.001), vitamin C (P = 0.0001) and carotenoids (P = 0.0001) were observed in both intervention groups compared with CT, which were broadly supported by nutrient biomarker analysis. Conclusions The success of improving nutrient profile by active encouragement of F&V intake in an intervention study implies the need for a more hands-on public health approach.

Children of the golden minster: St. Oswald's Priory and the impact of industrialisation on child health.

This study explores the disease experience of children buried within the cemetery of St. Oswald’s Priory, Gloucester from AD1153 to 1857. Evidence for ages-at-death, infant mortality, and the prevalence of stress indicators, trauma, and pathology were compared between the early and postmedieval periods. The skeletal remains of these children provide evidence for child health spanning the economic expansion of Gloucester at St. Oswald’s, from a mostly rural parish to a graveyard catering for families from the poorer northern part of the town and the workhouse. Results showed that the children from the postmedieval period in Gloucester suffered higher rates of dental caries (38%) and congenital conditions (17.3%) than their counterparts from the early and later medieval period. This paper serves to highlight the value of nonadult skeletal material in the interpretation of past human health in transitional societies and illustrates the wide variety of pathological conditions that can be observed in nonadult skeletons.

Comparison of in vivo and in vitro digestion on polyphenol composition in lingonberries: potential impact on colonic health

The composition of polyphenols in ileal fluid samples obtained from an ileostomy subject after lingonberry intake was compared with lingonberry extracts obtained after simulated in vitro digestion (IVDL) and subsequent faecal fermentation (IVFL). HPLC-PDA-MS/MS analysis confirmed similar patterns of lingonberry (poly)phenolic metabolism after the in vivo and in vitro digestion, with reduced recovery of anthocyanins and a similar pattern of recovery for proanthocyanidins observed for both methods of digestion. On the other hand, the IVFL sample contained none of the original (poly)phenolic components but was enriched in simple aromatic components. Digested and fermented extracts exhibited significant (P < 0.05) anti-genotoxic (Comet assay), anti-mutagenic (Mutation Frequency assay), and anti-invasive (Matrigel Invasion assay) effects in human cell culture models of colorectal cancer at physiologically-relevant doses (0-50 μg/mL gallic acid equivalents). The ileal fluid induced significant anti-genotoxic activity (P < 0.05), but at a higher concentration (200 μg/mL gallic acid equivalents) than the IVDL. Despite extensive structural modification following digestion and fermentation, lingonberry extracts retained their bioactivity in vitro. This reinforces the need for studies to consider the impact of digestion when investigating bioactivity of dietary phytochemicals.

Children’s perspectives on their working lives and on public action against child labour in Burkina Faso

The majority of children in Burkina Faso undertake work and, compared to other West African countries, it has the highest rate of children involved in hazardous work (Diallo 2008; NISD 2008), which is one working child out of two. Based on a qualitative survey, this chapter presents the perspectives of Burkinabe children working in two of the hazardous sectors: a quarry and an artisanal mine. The findings show that children acknowledge very difficult working conditions in these sites. However a variety of reasons maintain them in work, which they perceive as a solution and thus challenging action against child labour in Burkina Faso.