Estimating the burden of disease attributable to iron deficiency anaemia in South Africa in 2000

OBJECTIVES To estimate the extent of iron deficiency anaemia (IDA) among children aged 0 - 4 years and pregnant women aged 15 - 49 years, and the burden of disease attributed to IDA in South Africa in 2000. DESIGN The comparative risk assessment (CRA) methodology of the World Health Organization (WHO) was followed using local prevalence and burden estimates. IDA prevalence came from re-analysis of the South African Vitamin A Consultative Group study in the case of the children, and from a pooled estimate from several studies in the case of the pregnant women (haemoglobin level < 11 g/dl and ferritin level < 12 microg/l). Monte Carlo simulation-modelling was used for the uncertainty analysis. SETTING South Africa. SUBJECTS Children under 5 years and pregnant women 15 - 49 years. OUTCOME MEASURES Direct sequelae of IDA, maternal and perinatal deaths and disability-adjusted life years (DALYs) from mild mental disability related to IDA. Results. It is estimated that 5.1% of children and 9 - 12% of pregnant women had IDA and that about 7.3% of perinatal deaths and 4.9% of maternal deaths were attributed to IDA in 2000. Overall, about 174,976 (95% uncertainty interval 150,344 - 203,961) healthy years of life lost (YLLs), or between 0.9% and 1.3% of all DALYs in South Africa in 2000, were attributable to IDA. CONCLUSIONS This first study in South Africa to quantify the burden from IDA suggests that it is a less serious public health problem in South Africa than in many other developing countries. Nevertheless, this burden is preventable, and the study highlights the need to disseminate the food-based dietary guidelines formulated by the National Department of Health to people who need them and to monitor the impact of the food fortification programme.

Folate Content of Asian Vegetables

Folates are one of the most nutritionally significant vitamins. Natural sources of folate are reportedly more effective than supplementation or fortification with folic acid. Green leafy vegetables are excellent sources of folates which occur naturally in many forms or vitamers. With an expanding range of Asian vegetables and increasing consumer awareness and acceptance, it is timely to present information on the health attributes of these vegetables.

A mobile app offering distractions and tips to cope with cigarette craving: A qualitative study

Background Despite considerable effort, most smokers relapse within a few months after quitting due to cigarette craving. The widespread adoption of mobile phones presents new opportunities to provide support during attempts to quit. Objective To design and pilot a mobile app "DistractMe" to enable quitters to access and share distractions and tips to cope with cigarette cravings. Methods A qualitative study with 14 smokers who used DistractMe on their mobiles during the first weeks of their quit attempt. Based on interviews, diaries, and log data, we examined how the app supported quitting strategies. Results Three distinct techniques of coping when using DistractMe were identified: diversion, avoidance, and displacement. We further identified three forms of engagement with tips for coping: preparation, fortification, and confrontation. Overall, strategies to prevent cravings and their effects (avoidance, displacement, preparation, and fortification) were more common than immediate coping strategies (diversion and confrontation). Tips for coping were more commonly used than distractions to cope with cravings, because they helped to fortify the quit attempt and provided opportunities to connect with other users of the application. However, distractions were important to attract new users and to facilitate content sharing. Conclusions Based on the qualitative results, we recommend that mobile phone-based interventions focus on tips shared by peers and frequent content updates. Apps also require testing with larger groups of users to assess whether they can be self-sustaining.

Silencing of toxic gene expression by Fis

Bacteria and bacteriophages have evolved DNA modification as a strategy to protect their genomes. Mom protein of bacteriophage Mu modifies the phage DNA, rendering it refractile to numerous restriction enzymes and in turn enabling the phage to successfully invade a variety of hosts. A strong fortification, a combined activity of the phage and host factors, prevents untimely expression of mom and associated toxic effects. Here, we identify the bacterial chromatin architectural protein Fis as an additional player in this crowded regulatory cascade. Both in vivo and in vitro studies described here indicate that Fis acts as a transcriptional repressor of mom promoter. Further, our data shows that Fis mediates its repressive effect by denying access to RNA polymerase at mom promoter. We propose that a combined repressive effect of Fis and previously characterized negative regulatory factors could be responsible to keep the gene silenced most of the time. We thus present a new facet of Fis function in Mu biology. In addition to bringing about overall downregulation of Mu genome, it also ensures silencing of the advantageous but potentially lethal mom gene.

Silencing of toxic gene expression by Fis

Bacteria and bacteriophages have evolved DNA modification as a strategy to protect their genomes. Mom protein of bacteriophage Mumodifies the phage DNA, rendering it refractile to numerous restriction enzymes and in turn enabling the phage to successfully invade a variety of hosts. A strong fortification, a combined activity of the phage and host factors, prevents untimely expression of mom and associated toxic effects. Here, we identify the bacterial chromatin architectural protein Fis as an additional player in this crowded regulatory cascade. Both in vivo and in vitro studies described here indicate that Fisacts as a transcriptional repressor of mom promoter. Further, our data shows that Fis mediates its repressive effect by denying access to RNA polymerase at mom promoter. We propose that a combined repressive effect of Fis and previously characterized negative regulatory factors could be responsible to keep the gene silenced most of the time. We thus present a new facet of Fis function in Mu biology. In addition to bringing about overall downregulation of Mu genome, it also ensures silencing of the advantageous but potentially lethal mom gene.

Morar e trabalhar: a pesca artesanal e o seu elo com o lugar

Este trabalho busca realizar uma discussão de grande relevância para o entendimento do que é ser pescador artesanal em tempos em que a modernização do espaço se faz pujante e intende a subjugar suas formas de trabalho e de vida. Em decorrência disto, pretende-se aqui estimular reflexões em torno da relação existente entre trabalho e moradia para estes sujeitos, os quais vivem em pleno contexto metropolitano. Para tal tarefa, serão elucidadas questões centrais que abrangem o cotidiano dos pescadores artesanais que vivem no bairro de Pedra de Guaratiba, localizado na Zona Oeste do município do Rio de Janeiro (RJ), às margens da Baía de Sepetiba. Sendo assim, realizaremos uma tentativa de compreensão analítica dos agentes de base popular, suas experiências de vida e seus conflitos no que se refere à produção social da metrópole. Veremos que os pescadores artesanais representam uma categoria de extrema complexidade e que não é compreendida sequer parcialmente pelas instituições públicas que regem o seu ordenamento. Complexidade esta que se inscreve também na relação entre moradia e trabalho na vida desses sujeitos, se tornando assim, um dos pilares de sustentação de suas existências e, consequentemente, do seu próprio resistir. Para a percepção dessas relações e dos sentidos (valores) que animam a vida desses homens e mulheres, buscamos a realização de uma metodologia em que o pesquisador torna o seu olhar sensível ao reconhecimento dos elos que unem esses sujeitos aos seus lugares de trabalho e de vida, entendendo assim as dinâmicas responsáveis por construir as peculiaridades que os diferenciam (mas não os excluem) dos demais trabalhadores urbanos. Por fim, chegaremos ao entendimento de que morar e trabalhar para os pescadores artesanais são pares indissociáveis, os quais contribuem para a fortificação da categoria em tempos de grande adversidade

Protein concentrate from shark

A simple method of leaching the minced muscle with water repeatedly followed by cooking, pressing, drying the cake and powdering has been described for the preparation of fish protein concentrate (FPC) from shark without the use of solvents. The FPC thus prepared had high protein content and was completely free of urea. It contained all the essential amino acids in a balanced proportion with high lysine content and had a storage life up to 12 months. This product can be used for the fortification of bread, biscuits and chappathis respectively at 10, 5 and 2% levels.

Studies on arsenical creosote as a wood preservative for marine structures. Part 1. Incorporation of arsenic in creosote at various temperatures

A detailed study of the fortification of normal creosote and low temperature creosote with As sub(2) O sub(3) at 40°C, 50°C, 60°C, 70°C, 80°C and 90°C was carried out. When compared to normal creosote, low temperature creosote has been found to combine more easily with As sub(2) O sub(3) when temperature was . raised from 40 to 90°C. The incorporated arsenic values obtained shows that low temperature creosote with high phenolic content, retains considerably more As sub(2) O sub(3) and a maximum of 0.2180% w/w can be incorporated in low temperature creosote at 90°C.

Exploring the physicochemical basis of cheese texture, rheology and functionality, with emphasis on cation-casein interactions

The physicochemical properties of cheese and milk gels are greatly influenced by molecular interactions between the casein proteins involving calcium. Novel experiments were designed to investigate the relationship between insoluble caseinbound cations and rheological properties of Cheddar cheese and rennet-induced milk gels. Cheddar cheese and rennet-induced milk gels were supplemented with Mg2+ or Sr2+ to compare their effects on their rheological properties to those previously reported in literature for Ca2+ supplementation. Sr2+ displayed behaviour similar to Ca2+ as observed by its ability to increase the rigidity of cheese and rennet milk gels and also decrease cheese meltability. Mg+2 had no influence on cheese rheological properties and was greatly inferior to Ca2+ and Sr2+ in its ability to increase rennet milk gel elasticity. Cheddar cheese was supplemented with the calcium-chelating salts trisodium citrate, disodium hydrogen phosphate or disodium EDTA, in an attempt to reduce the CCP content of cheese and thereby modify its rheological and functional properties. TSC and EDTA were successful in decreasing cheese CCP, whereas DSP caused an initial increase in CCP content. Cheddar cheese was supplemented with chlorides of iron, copper and zinc at salting to investigate the effects of concentrations of these elements in excess of those found innately or commonly in fortification studies, with emphasis on mineral equilibria changes and resultant alteration of rheological properties. Zinc addition was the only added metal that significantly influenced cheese rheological properties, leading to an increase in cheese rigidity and decreased cheese melt at elevated temperatures. Gum tragacanth was used as a fat-replacer in the manufacture of reduced-fat Cheddar cheese, in an attempt to improve the rheological, functional and sensory properties of reduced-fat Cheddar. Overall, the experimental work reported in this thesis generated new knowledge and theories about how casein-mineral interactions influence rheological properties of casein systems.

Studies on the texture, functionality, rheology and sensory properties of Cheddar and Mozzarella cheeses

The effect of fortification of skim milk powder and sodium caseinate on Cheddar cheeses was investigated. SMP fortification led to decreased moisture, increased yield, higher numbers of NSLAB and reduced proteolysis. The functional and texture properties were also affected by SMP addition and formed a harder, less meltable cheese than the control. NaCn fortification led to increased moisture, increased yield, decreased proteolysis and higher numbers of NSLAB. The functional and textural properties were affected by fortification with NaCn and formed a softer cheese that had similar or less melt than the control. Reducing the lactose:casein ratio of Mozzarella cheese by using ultrafiltration led to higher pH, lower insoluble calcium, lower lactose, galactose and lactic acid levels in the cheese. The texture and functional properties of the cheese was affected by varying the lactose:casein ratio and formed a harder cheese that had similar melt to the control later in ripening. The flavour and bake properties were also affected by decreased lactose:casein ratio; the cheeses had lower acid flavour and blister colour than the control cheese. Varying the ratio of αs1:β-casein in Cheddar cheese affected the texture and functionality of the cheese but did not affect insoluble calcium, proteolysis or pH. Increasing the ratio of αs1:β-casein led to cheese with lower meltability and higher hardness without adverse effects on flavour. Using camel chymosin in Mozzarella cheese instead of calf chymosin resulted in cheese with lower proteolysis, higher softening point, higher hardness and lower blister quantity. The texture and functional properties that determine the shelf life of Mozzarella were maintained for a longer ripening period than when using calf chymosin therefore increasing the window of functionality of Mozzarella. In summary, the results of the trials in this thesis show means of altering the texture, functional, rheology and sensory properties of Mozzarella and Cheddar cheeses.

Impaired functioning of thermolabile methylenetetrahydrofolate reductase is dependent on riboflavin status: implications for riboflavin requirements.

BACKGROUND: Methylenetetrahydrofolate reductase (MTHFR; EC 1.7.99.5) supplies the folate needed for the metabolism of homocysteine. A reduction in MTHFR activity, as occurs in the homozygous state for the 677C-->T (so-called thermolabile) enzyme variant (TT genotype), is associated with an increase in plasma total homocysteine (tHcy). OBJECTIVE: In vitro studies suggest that the reduced activity of thermolabile MTHFR is due to the inappropriate loss of its riboflavin cofactor. We investigated the hypothesis that MTHFR activity in the TT genotype group is particularly sensitive to riboflavin status. DESIGN: We studied tHcy and relevant B-vitamin status by MTHFR genotype in a cross-sectional study of 286 healthy subjects aged 19-63 y (median: 27 y). The effect of riboflavin status was examined by dividing the sample into tertiles of erythrocyte glutathionine reductase activation coefficient, a functional index of riboflavin status. RESULTS: Lower red blood cell folate (P = 0.0001) and higher tHcy (P = 0.0082) concentrations were found in the TT group than in the heterozygous (CT) or wild-type (CC) groups. However, these expected relations in the total sample were driven by the TT group with the lowest riboflavin status, whose mean tHcy concentration (18.09 micromol/L) was almost twice that of the CC or CT group. By contrast, adequate riboflavin status rendered the TT group neutral with respect to tHcy metabolism. CONCLUSIONS: The high tHcy concentration typically associated with homozygosity for the 677C-->T variant of MTHFR occurs only with poor riboflavin status. This may have important implications for governments considering new fortification policies aimed at the prevention of diseases for which this genotype is associated with increased risk.

Micronutrients: dietary intake v. supplement use

Whilst clinical deficiency of micronutrients is uncommon in the developed world, a suboptimal intake of certain micronutrients has been linked with an increased risk of chronic diseases such as CVD and cancer. Attention has therefore focused on increasing micronutrient status in order to theoretically reduce chronic disease risk. Increasing micronutrient status can involve a number of approaches: increasing dietary intake of micronutrient-rich foods; food fortification; use of supplements. Observational cohort studies have demonstrated an association between high intakes of micronutrients such as vitamin E, vitamin C, folic acid and beta-carotene, and lower risk of CHD, stroke and cancer at various sites. However, randomised intervention trials of micronutrient supplements have, to date, largely failed to show an improvement in clinical end points. The discordance between data from cohort studies and the results so far available from clinical trials remains to be explained. One reason may be that the complex mixture of micronutrients found, for example, in a diet high in fruit and vegetables may be more effective than large doses of a small number of micronutrients, and therefore that intervention studies that use single micronutrient supplements are unlikely to produce a lowering of disease risk. Studies concentrating on whole foods (e.g. fruit and vegetables) or diet pattern (e.g. Mediterranean diet pattern) may be more effective in demonstrating an effect on clinical end points. The present review will consider the clinical trial evidence for a beneficial effect of micronutrient supplements on health, and review the alternative approaches to the study of dietary intake of micronutrients.

Confirmatory method for the determination of various acetylgestagens in animal kidney fat using liquid chromatography-tandem mass spectrometry

A confirmatory method has been developed and validated that allows for the simultaneous detection of medroxyprogesterone acetate (MPA), megestrol acetate (MGA), melengestrol acetate (MLA), chlormadinone acetate (CMA) and delmadinone acetate (DMA) in animal kidney fat using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The compounds were extracted from kidney fat using acetonitrile, defatted using a hexane wash and subsequent saponification. Extracts were then purified on Isolute CN solid-phase extraction cartridges and analysed by LC-MS/MS. The method was validated in animal kidney fat in accordance with the criteria defined in Commission Decision 2002/657/EC. The decision limit (CC) was calculated to be 0.12, 0.48, 0.40, 0.63 and 0.54 g kg-1, respectively, for MPA, MGA, MLA, DMA and CMA, with respective detection capability (CC) values of 0.20, 0.81, 0.68, 1.07 and 0.92 g kg-1. The measurement uncertainty of the method was estimated at 16, 16, 19, 27 and 26% for MPA, MGA, MLA, DMA and CMA, respectively. Fortifying kidney fat samples (n = 18) in three separate assays showed the accuracy of the method to be between 98 and 100%. The precision of the method, expressed as % RSD, for within-laboratory reproducibility at three levels of fortification (1, 1.5 and 2 g kg-1 for MPA, 5, 7.5 and 10 g kg-1 for MGA, MLA, DMA and CMA) was less than 5% for all analytes.

Detection of 3-amino-2-oxazolidinone (AOZ), a tissue-bound metabolite of the nitrofuran furazolidone, in prawn tissue by enzyme immunoassay

Furazolidone, a nitrofuran antibiotic, is banned from use in food animal production within the European Union. Increasingly, compliance with this ban is monitored by use of analytical methods to detect a stable tissue-bound metabolite, 3-amino-2-oxazolidinone (AOZ). Widespread use of furazolidone in poultry and prawns imported into Europe highlighted the urgent need for development of nitrofuran immunoassay screening tests. The first enzyme-linked immunoabsorbant assay for detection of AOZ residues in prawns (shrimps) is now described. Prawn samples were derivatized with o-nitrobenzaldehyde, extracted into ethyl acetate, washed with hexane and applied to a competitive enzyme immunoassay based on a rabbit polyclonal antiserum. Assay limit of detection (LOD) (mean+3 s) calculated from the analysis of 20 known negative cold and warm water prawn samples was 0.1 mug kg(-1). Intra- and interassay relative standard deviations were determined as 18.8 and 38.2%, respectively, using a negative prawn fortified at 0.7 mug kg(-1). The detection capability (CCbeta), defined as the concentration of AOZ at which 20 different fortified samples yielded results above the LOD, was achieved at fortification between 0.4 and 0.7 mug kg(-1). Incurred prawn samples (n=8) confirmed by liquid chromatography coupled with tandem mass spectrometry detection to contain AOZ concentrations between 0.4 and 12.7 mug kg(-1) were all screened positive by this enzyme-linked immunoabsorbant assay. Further data are presented and discussed with regard to calculating assay LOD based on accepting a 5% false-positive rate with representative negative prawn samples. Such an acceptance improves the sensitivity of an ELISA and in this case permitted an LOD of 0.05 mug kg(-1) and a CCbeta of below 0.4 mug kg(-1).

Folate and vitamin B-12: friendly or enemy nutrients for the elderly

In the UK vitamin B-12, deficiency occurs in approximately 20% of adults aged >65 years. This incidence is significantly higher than that among the general population. The reported incidence invariably depends on the criteria of deficiency used, and in fact estimates rise to 24% and 46% among free-living and institutionalised elderly respectively when methylmalonic acid is used as a marker of vitamin B-12 status. The incidence of, and the criteria for diagnosis of, deficiency have drawn much attention recently in the wake of the implementation of folic acid fortification of flour in the USA. This fortification strategy has proved to be extremely successful in increasing folic acid intakes pre-conceptually and thereby reducing the incidence of neural-tube defects among babies born in the USA since 1998. However, in successfully delivering additional folic acid to pregnant women fortification also increases the consumption of folic acid of everyone who consumes products containing flour, including the elderly. It is argued that consuming additional folic acid (as 'synthetic' pteroylglutamic acid) from fortified foods increases the risk of 'masking' megaloblastic anaemia caused by vitamin B-12 deficiency. Thus, a number of issues arise for discussion. Are clinicians forced to rely on megaloblastic anaemia as the only sign of possible vitamin B-12 deficiency? Is serum vitamin B-12 alone adequate to confirm vitamin B-12 deficiency or should other diagnostic markers be used routinely in clinical practice? Is the level of intake of folic acid among the elderly (post-fortification) likely to be so high as to cure or 'mask' the anaemia associated with vitamin B-12 deficiency?.