Cuticular and Suberin Polymers of Edible Plants. Analysis by Gas Chromatographic-Mass Spectrometric and Solid State Spectroscopic Methods

Cutin and suberin are structural and protective polymers of plant surfaces. The epidermal cells of the aerial parts of plants are covered with an extracellular cuticular layer, which consists of polyester cutin, highly resistant cutan, cuticular waxes and polysaccharides which link the layer to the epidermal cells. A similar protective layer is formed by a polyaromatic-polyaliphatic biopolymer suberin, which is present particularly in the cell walls of the phellem layer of periderm of the underground parts of plants (e.g. roots and tubers) and the bark of trees. In addition, suberization is also a major factor in wound healing and wound periderm formation regardless of the plants’ tissue. Knowledge of the composition and functions of cuticular and suberin polymers is important for understanding the physiological properties for the plants and for nutritional quality when these plants are consumed as foods. The aims of the practical work were to assess the chemical composition of cuticular polymers of several northern berries and seeds and suberin of two varieties of potatoes. Cutin and suberin were studied as isolated polymers and further after depolymerization as soluble monomers and solid residues. Chemical and enzymatic depolymerization techniques were compared and a new chemical depolymerization method was developed. Gas chromatographic analysis with mass spectrometric detection (GC-MS) was used to assess the monomer compositions. Polymer investigations were conducted with solid state carbon-13 cross polarization magic angle spinning nuclear magnetic resonance spectroscopy (13C CP-MAS NMR), Fourier transform infrared spectroscopy (FTIR) and microscopic analysis. Furthermore, the development of suberin over one year of post-harvest storage was investigated and the cuticular layers from berries grown in the North and South of Finland were compared. The results show that the amounts of isolated cuticular layers and cutin monomers, as well as monomeric compositions vary greatly between the berries. The monomer composition of seeds was found to differ from the corresponding berry peel monomers. The berry cutin monomers were composed mostly of long-chain aliphatic ω-hydroxy acids, with various mid-chain functionalities (double-bonds, epoxy, hydroxy and keto groups). Substituted α,ω-diacids predominated over ω-hydroxy acids in potato suberin monomers and slight differences were found between the varieties. The newly-developed closed tube chemical method was found to be suitable for cutin and suberin analysis and preferred over the solvent-consuming and laborious reflux method. Enzymatic hydrolysis with cutinase was less effective than chemical methanolysis and showed specificity towards α,ω-diacid bonds. According to ₁₃C CP-MAS NMR and FTIR, the depolymerization residues contained significant amounts of aromatic structures, polysaccharides and possible cutan-type aliphatic moieties. Cultivation location seems to have effect on cuticular composition. The materials studied contained significant amounts of different types of biopolymers that could be utilized for several purposes with or without further processing. The importance of the so-called waste material from industrial processes of berries and potatoes as a source of either dietary fiber or specialty chemicals should be further investigated in detail. The evident impact of cuticular and suberin polymers, among other fiber components, on human health should be investigated in clinical trials. These by-product materials may be used as value-added fiber fractions in the food industry and as raw materials for specialty chemicals such as lubricants and emulsifiers, or as building blocks for novel polymers.

Interactions between Polyunsaturated Fatty Acids and Probiotics

The prevalence of inflammatory based diseases has increased in industrialized countries over the last decades. For allergic diseases, two primary hypotheses have been proposed to explain this phenomenon, namely the hygiene and dietary evolution based hypothesis. Particularly, the reduced early exposure to microbes and an increase in the amount of polyunsaturated fatty acids (especially n-6 PUFA) in the diet have been discussed. Often, these two factors have been studied independently, even though both factors have been shown to possess potential health benefits and their mode of action to share similar mechanisms. The hypothesis of the present study was that demonstrate that PUFA and probiotics are not separate entities as such but do interact with each other. In the present study, we investigated whether maternal diet and atopic status influence the PUFA composition of breast milk and serum fatty acids of infants, and whether the fatty acid absorption and utilization of infant formula fatty acids is affected by supplementation of infant formula with probiotic bacteria (Lactobacillus GG and Bifidobacterium lactis Bb-12). Moreover, we investigated the mechanisms by which different PUFA influence the physicochemical and functional properties of probiotics as well as functionality of epithelial cells in vitro. We demonstrated a carry-over effect of dietary fatty acids from maternal diet via breast milk into infants’ serum lipid fatty acids. Our data confirmed the previously shown allergy –related PUFA level imbalances, though it did not fully support the impaired desaturation and elongation capacity hypothesis. We also showed that PUFA incorporation into phospholipids of infants was influenced by probiotics in infant formula in a strain dependent manner. Especially,Bifidobacterium lactis Bb-12 in infant formula promoted the utilization of n-3 PUFA. Mechanistically, we demonstrated that probiotics (Lactobacillus GG, Lactobacillus casei Shirota and Lactobacillus bulgaricus) did incorporate and interconvert exogenous free PUFA in the growth medium into bacterial fatty acids strain and PUFA dependently. In general, high concentrations of free PUFA inhibited the growth and mucus adhesion of probiotics, whereas low concentrations of specific long chain PUFA were found to promote the growth and mucus adhesion of Lactobacillus casei Shirota. These effects were paralleled with only minor alterations in hydrophobicity and electron donor – electron acceptor properties of lactobacilli. Furthermore, free PUFA were also demonstrated to alter the adhesion capacity of the intestinal epithelial cells; n-6 PUFA tended to inhibit the Caco-2 adhesion of probiotics, whereas n-3 PUFA had either no or minor effects or even promote the bacterial adhesion (especially Lactobacillus casei Shirota) to PUFA treated Caco-2 cells. The results of this study demonstrate the close and bilateral interactions between dietary PUFA and probiotics. Probiotics were shown to influence the absorption and utilization of dietary PUFA, whereas PUFA were shown to alter the functional properties of both probiotics and mucosal epithelia. These findings suggest that a more thorough understanding of interactions between PUFA and intestinal microbiota is a prerequisite, when the beneficial effects of new functional foods containing probiotics are designed and planned for human intervention studies.

Identifying and Characterizing New Ingredients in vitro for Prebiotic and Synbiotic use

The endogenous microbiota, constituting the microbes that live inside and on humans, is estimated to outnumber human cells by a factor of ten. This commensal microbial population has an important role in many physiological functions, with the densest microbiota population found in the colon. The colonic microbiota is a highly complex and diverse bacterial ecosystem, and a delicate balance exists between the gut microbiota and its host. An imbalance in the microbial ecosystem may lead to severe symptoms in and also beyond the gastrointestinal tract. Due to the important role of the gut microbiota in human health, means of its modification have been introduced in the dietary concepts of pro-, pre- and synbiotics. Prebiotics, which are usually carbohydrates, strive to selectively influence beneficial microbes resident in the colon with the aim of modifying the composition and functionality of the commensal microbial population towards a purportedly healthier one. The study of prebiotic effects on colonic micro-organisms is typically done by using human faecal material, though this provides relatively little information on bacterial populations and metabolic events in different parts of the colon. For this reason, several in vitro models have been developed to investigate the gut microbiota. The aim of this doctoral thesis was to screen through some of the promising prebiotic candidates, characterize their effects on the microbiota through the use of two in vitro methods (pure microbial cultures and a colon simulator model) and to evaluate their potential as emerging prebiotics or synbiotics when combined with the probiotic Bifidobacterium lactis . As a result of the screening work and subsequent colon simulation studies, several compounds with promising features were identified. Xylo-oligosaccharides (XOS), which have previously already shown promise as prebiotic compounds, were well fermented by several probiotic Bifidobacterium lactis strains in pure culture studies and in the following simulation studies utilizing the complex microbiota by endogenous B. lactis Another promising compound was panose, a trisaccharide belonging to isomalto-oligosaccharides (IMO) that also was also able to modify the microbiota in vitro by increasing the number of beneficial microbes investigated. Panose has not been widely studied previously and therefore, this thesis work provided the first data on panose fermentation in mixed colonic microbiota. Galacto-oligosaccharide (GOS) is an established prebiotic, and it was studied here in conjunction with another potential polygosaccharide polydextrose (PDX) and probiotic B. lactis Bi-07. In this final study, the synbiotics including GOS were more effective than the constituting pro- or prebiotics alone in modulating the microbiota composition, thus indicating a synergy resulting from the combination. The results obtained in this in vitro work can be, and have already been, utilized in product development aimed at the nutritional modification of the human colonic microbiota. Some of the compounds have entered the human clinical intervention phase to nvestigate in more detail the prebiotic and synbiotic properties seen in these in vitro studies.

Uusintamurtumien ehkäisy kaatumisen aiheuttaman yläraajamurtuman kokeneilla yli 50-vuotiailla henkilöillä

Tarkoitus: Tarkoituksena oli selvittää murtumien tehostetun ehkäisyohjelman vaikutuksia yläraajamurtuman saaneiden yli 50-vuotiaiden henkilöiden elämäntapoihin, murtumien riskitekijöihin, kaatumisiin, kaatumisvammoihin ja elämänlaatuun. Aineisto: 219 yli 50-vuotiasta kotona asuvaa, kaatumisen seurauksena yläraajamurtuman saanutta henkilöä satunnaistettiin koe- (n = 105) ja kontrolliryhmiin (n = 114). Menetelmä: Koeohjelma sisälsi yksilöllisen, yhdessä lääkärin, terveydenhoitajan ja tutkittavan kanssa laaditun hoito- ja kuntoutussuunnitelman sekä kutsun murtumien ehkäisyn koulutusohjelmaan. Kontrolliryhmän tutkittavat saivat kehotuksen hakeutua murtumahoitajan ohjaukseen. Seuranta-aika oli 14 kuukautta. Tulokset analysoitiin ryhmissä tapahtuneina muutoksina alkuja loppumittausten välillä sekä ryhmien välisenä erona muutoksissa. Tulokset: Keskimääräinen luun tiheys lannerangassa lisääntyi koeryhmässä (p<0,001) ja kontrolliryhmässä (p = 0,038), ryhmien välinen ero ei ollut tilastollisesti merkitsevä (p = 0,134). Reisiluun kaulassa luun tiheys ei muuttunut kummassakaan ryhmässä. Päivittäinen kalsiumin saanti lisääntyi koeryhmässä keskimäärin 167 mg (p<0,001) ja kontrolliryhmässä 30 mg (p = 0,475), ryhmien välinen ero oli tilastollisesti merkitsevä (p = 0,031). Kala-ateriat ja päivittäinen D-vitamiinilisä sekä kenkien liukuesteiden säännöllinen käyttö liukkaalla lisääntyivät molemmissa ryhmissä, mutta ryhmien välillä ei ollut eroa. Viiteen tuolilta nousukertaan käytetty aika vähentyi koeryhmässä keskimäärin 0,49 sekuntia (p = 0,185) ja lisääntyi kontrolliryhmässä 0,39 (p = 0,475), ero ryhmien välillä oli tilastollisesti merkitsevä (p = 0,02). Kymmenen metrin kävelyssä ei tapahtunut tulosten keskiarvossa muutoksia kummassakaan ryhmässä. Ortostatismi vähentyi kontrolliryhmässä (p = 0,049), ja masentuneisuus vähentyi koeryhmässä (p = 0,041), mutta ryhmien välillä ei näissä ollut merkitsevää eroa. Osteoporoosilääkkeiden käyttö lisääntyi molemmissa ryhmissä, ryhmien välillä ei ollut eroa. Alkoholin käytössä oli vähäisiä mutta ei merkittäviä muutoksia. Muissa testatuissa muuttujissa, kuten liikunnan viikoittainen määrä, tupakointi, näkökyky, tasapaino ja elämänlaatu, ei ollut merkitseviä muutoksia ryhmissä tai ryhmien välillä. Kaatumisten (koeryhmä 33, kontrolliryhmä 35) ja murtumien (koeryhmä 5 ja kontrolliryhmä 3) määrissä ei myöskään ollut merkitseviä eroja ryhmien välillä. Johtopäätökset: Noin neljällä viidestä kaatumisen seurauksena yläraajamurtuman saaneista, yli 50 vuotta täyttäneistä henkilöistä oli alentunut luun tiheys, ja noin joka toisella oli lisääntynyt kaatumisriski. Kaatumisen riskitekijöiden kliiniset mittaukset olivat nopeita toteuttaa ja auttoivat ehkäisytoimenpiteiden suunnittelussa. Murtuman saaneet olivat motivoituneita murtumien riskitekijöiden selvittämiseen ja myös toteuttamaan annettua lääkehoitoa. Elämäntavoissa helpoimmin toteutuivat muutokset ruokailutottumuksissa. Liikuntatottumuksien muuttaminen sen sijaan onnistui melko huonosti. Ryhmien välillä oli merkitsevä ero ainoastaan kalsiumin päivittäisessä käytössä ja tuolilta nousutestissä. Murtumariskien tunnistaminen, niiden syiden selvittäminen ja toimenpiteiden käynnistäminen riskien vähentämiseksi tulisi kuulua jokaisen pienienergisen murtuman saaneen potilaan kokonaisvaltaiseen hyvään hoitoon.

Astringent Food Compounds and Their Interactions with Taste Properties

Astringency is traditionally thought to be induced by plant tannins in foods. Because of this current research concerning the mechanism of astringency is focused on tannin‐protein interactions and thus on precipitation, which may be perceived by mechanoreceptors. However, astringency is elicited by a wide range of different phenolic compounds, as well as, some non‐phenolic compounds in various foods. Many ellagitannins or smaller compounds that contribute to astringent properties do not interact with salivary proteins and may be directly perceived through some receptors. Generally, the higher degree of polymerization of proanthocyanidins can be associated with more intense astringency. However, the astringent properties of smaller phenolic compounds may not be directly predicted from the structure of a compound, although glycosylation has a significant role. The astringency of organic acids may be directly linked to the perception of sourness, and this increases along with decreasing pH. Astringency can be divided into different sub‐qualities, including even other qualities than traditional mouth‐drying, puckering or roughing sensations. Astringency is often accompanied by bitter or sour or both taste properties. The different sub‐qualities can be influenced by different astringent compounds. In general, the glycolysation of the phenolic compound results in more velvety and smooth mouthdrying astringency. Flavonol glycosides and other flavonoid compounds and ellagitannins contribute to this velvety mouthdrying astringency. Additionally, they often lack the bitter properties. Proanthocyanidins and phenolic acids elicit more puckering and roughing astringency with some additional bitter properties. Quercetin 3‐O‐rutinoside, along with other quercetin glycosides, is among the key astringent compounds in black tea and red currants. In foods, there are always various other additional attributes that are perceived at the same with astringency. Astringent compounds themselves may have other sensory characteristics, such as bitter or sour properties, or they may enhance or suppress other sensory properties. Components contributing to these other properties, such as sugars, may also have similar effects on astringent sensations. Food components eliciting sweetness or fattiness or some polymeric polysaccharides can be used to mask astringent subqualities. Astringency can generally be referred to as a negative contributor to the liking of various foods. On the other hand, perceptions of astringent properties can vary among individuals. Many genetic factors that influence perceptions of taste properties, such as variations in perceiving a bitter taste or variations in saliva, may also effect the perception of astringency. Individuals who are more sensitive to different sensations may notice the differences between astringent properties more clearly. This may not have effects on the overall perception of astringency. However, in many cases, the liking of astringent foods may need to be learned by repetitive exposure. Astringency is often among the key sensory properties forming the unique overall flavour of certain foods, and therefore it also influences whether or not a food is liked. In many cases, astringency may be an important sub‐property suppressed by other more abundant sensory properties, but it may still have a significant contribution to the overall flavour and thus consumer preferences. The results of the practical work of this thesis show that the astringent phenolic compounds are mostly located in the skin fractions of black currants, crowberries and bilberries (publications I–III). The skin fractions themselves are rather tasteless. However, the astringent phenolic compounds can be efficiently removed from these skin fractions by consecutive ethanol extractions. Berries contain a wide range of different flavonol glycosides, hydroxycinnamic acid derivatives and anthocyanins and some of them strongly contribute to the different astringent and bitterness properties. Sweetness and sourness are located in the juice fractions along with the majority of sugars and fruit acids. The sweet and sour properties of the juice may be used to mask the astringent and bitterness properties of the extracts. Enzymatic treatments increase the astringent properties and fermented flavour of the black currant juice and decrease sweetness and freshness due to the effects on chemical compositions (IV). Sourness and sweetness are positive contributors to the liking of crowberry and bilberry fractions, whereas bitterness is more negative (V). Some astringent properties in berries are clearly negative factors, whereas some may be more positive. The liking of berries is strongly influenced by various consumer background factors, such as motives and health concerns. The liking of berries and berry fractions may also be affected by genetic factors, such as variations in the gene hTAS2R38, which codes bitter taste receptors (V).

Rural Food System Change in Tanzania during the Post-Ujamaa Era. A Case Study from Western Bagamoyo District

Food systems in Sub-Saharan Africa have been rapidly transforming during the recent decades with diverse outcomes on human development and environment. This study explores the food system change in rural villages in eastern Tanzania where subsistence agriculture has traditionally been the main source of livelihood. The focus is on the salient changes in the spatial dimensions and structural composition of the food system in the context of economic liberalization that has taken place after the end of the socialist ujamaa era in the mid-1980s. In addition, the linkages of the changes are examined in relation to food security, socio-economic situation, livelihoods, and local environment. The approach of the study is geographical, but also involves various multi-disciplinary elements, particularly from development studies. The research methods included thematic and questionnaire interviews, participatory tools, and the analysis of land use/ cover data and official documents. Several earlier studies that were made in the area during the late 1970s and 1980s provided an important reference base. The study shows that subsistence farming has lost its dominant role in food provisioning due to the declining productivity of land, livestock losses, and the increasing shift of labour to non-farm sectors. Also rapid population growth has added to the pressure on land and other natural resources. Despite the increasing need for money for buying marketed foods and other necessities, the nutritional situation shows improvement and severe malnutrition has diminished. However, the long-term sustainability of this transformation raises concerns. Firstly, the food security situation continues to be fragile and prone to shocks such as adverse climatic conditions, crop failures and price hikes. Secondly, the commodification of the food system and livelihoods in general is linked to rapid environmental degradation in the area, particularly the loss of soil fertility and deforestation. The situation calls for efforts that take more determined and holistic approaches towards sustainable development of the rural food system with particular focus on the role and viability of small-scale farming.

Andean indigenous food crops: nutritional value and bioactive compounds

The Andean area of South America is a very important center for the domestication of food crops. This area is the botanical origin of potato, peanut and tomato. Less well- known crops, such as quinoa (Chenopodium quinoa), kañiwa (Chenopodium pallidicaule) and kiwicha (Amaranthus caudatus), were also domesticated by ancient Andean farmers. These crops have a long history of safe use with the local populations and they have contributed to the nutrition and wellbeing of the people for centuries. Several studies have reported the nutritional value of Andean grains. They contain proteins with a balanced essential amino acid composition that are of high biological value, good quality oil and essential minerals, for example iron, calcium and zinc. They are potential sources of bioactive compounds such as polyphenols and dietary fiber. The main objective of the practical work was to assess the nutritional value of Andean native grains with a special emphasis on the bioactive components and the impact of processing. The compounds studied were phenolic acids, flavonoids, betalains and dietary fiber. The radical scavenging activity was measured as well. Iron, calcium and zinc content and their bioavailability were analyzed as well. The grains were processed by extrusion with the aim to study the effect of processing on the chemical composition. Quinoa, kañiwa and kiwicha are very good sources of dietary fiber, especially of insoluble dietary fiber. The phenolic acid content in Andean crops was low compared with common cereals like wheat and rye, but was similar to levels found in oat, barley, corn and rice. The flavonoid content of quinoa and kañiwa was exceptionally high. Kiwicha did not contain quantifiable amounts of these compounds. Only one variety of kiwicha contained low amounts of betalains. These compounds were not detected in kañiwa or quinoa. Quinoa, kañiwa and kiwicha are good sources of minerals. Their calcium, zinc and iron content are higher than the content of these minerals in common cereals. In general, roasting did not affect significantly mineral bioavailability. On the contrary, in cooked grains, there was an increase in bioavailability of zinc and, in the case of kañiwa, also in iron and calcium bioavailability. In all cases, the contents of total and insoluble dietary fiber decreased during the extrusion process. At the same time, the content of soluble dietary fiber increased. The content of total phenolics, phytic acid and the antioxidant activity decreased in kiwicha varieties during the extrusion process. In the case of quinoa, the content of total phenolic compounds and the radical scavenging activity increased during the extrusion process in all varieties. Taken together, the studies presented here demonstrate that the Andean indigenous crops have excellent potential as sources of minerals, flavonoids and dietary fiber. Further studies should be conducted to characterize the phenolic compound and antioxidant composition in processed grains and end products. Quinoa, kañiwa and kiwicha grains are consumed widely in Andean countries but they also have a significant, worldwide potential as a new cultivated crop species and as an imported commodity from South America. Their inclusion in the diet has the potential to improve the intake of minerals and health-promoting bioactive compounds. They may also be interesting raw materials for special dietary foods and functional foods offering natural sources of specific health-promoting components.

Composition of Hawthorn (Crataegus spp.) Fruits and Leaves and emblic Leafflower (Phyllanthus emblica) Fruits

Hawthorn (Crataegus sp.) is widely distributed in the northern hemisphere (Asia, Europe and North America). It has been used as a medicinal material and food for hundreds of years both in Europe and in China. Clinical investigations and other research suggest that extracts of hawthorn fruits and leaves have multiple health effects including hypolipidaemic, anti-atherosclerotic, hypotensive, cardioprotective and blood vessel relaxing activities. Hawthorn fruit extracts have also displayed antioxidant and radical scavenging activities. Emblic leafflower fruit (Phyllanthus emblica) is widely used in Chinese and Indian traditional medicine. It has been found to have anti-cancer, hypoglycaemic and hypolipidaemic activities as well as cardioprotective effects and antioxidant activity. The fruit is currently used as a functional food targeted at obese people in China. Phenolic compounds, procyanidins (PCs), flavonols and C-glycosyl flavones in hawthorn and hydrolysable tannins in emblic leafflower fruits are considered among the major bioactive compounds in these berries. Moreover, hawthorn and emblic leafflower fruits are rich in vitamin C, triterpenoids, fruit acids, sugar alcohols and some other components with beneficial effects on the health of human beings. The aim of the thesis work was to characterise the major phenolic compounds in hawthorn fruits and leaves and emblic leafflower fruits as well as other components contributing to the nutritional profile and sensory properties of hawthorn fruits. Differences in the content and compositional profile of the major phenolic compounds, sugars, acids and sugar alcohols within various origins and species of hawthorn were also investigated. Acids, sugars and sugar alcohols in the fruits of different origins/cultivars belonging to three species (C. pinnatifida, C. brettschneideri and C. scabrifolia) of hawthorn were analysed by gas chromatography (GC-FID) and mass spectrometry (Publication I). Citric acid, quinic acid, malic acid, fructose, glucose, sorbitol and myo-inositol were found in all the subspecies. Sucrose was present only in C. scabrifolia and three cultivars of C. pinnatifida var. major. Forty-two phenolic compounds were identified/tentatively identified in fruits of C. pinnatifida var. major by polyamide column chromatography combined with high-performance liquid chromatograph-electrospray ionisation mass spectrometry (HPLC-ESI-MS) (Publication II). Ideain, chlorogenic acid, procyanidin (PC) B2, (-)-epicatechin, hyperoside and isoquercitrin were the major phenolic components identified. In addition, 35 phenolic compounds were tentatively identified based on UV and mass spectra. Eleven major phenolic compounds (hyperoside, isoquercitrin, chlorogenic acid, ideain, (-)-epicatechin, two PC dimers, three PC trimers and a PC dimer-hexoside) were quantified in the fruits of 22 cultivars/origins of three species of Chinese hawthorn by HPLC-ESI-MS with single ion recording function (SIR) (Publication III). The fruits of the hawthorn cultivars/origins investigated fell into two groups, one rich in sugars and flavonols, the other rich in acids and procyanidins. Based on the compositional features, different biological activities and sensory properties may be expected between cultivars/origins of the two groups. The results suggest that the contents of phenolic compounds, acids, sugars and sugar alcohols may be used as chemotaxonomic information distinguishing the hawthorn species from each other. Phenolic compounds in fruits and leaves of C. grayana and their changes during fruit ripening/harvesting were investigated using HPLC-UV-ESI-MS (Publication IV). (-)-Epicatechin, PC B2 and C1, hyperoside and a quercetin-pentoside were the major phenolic compounds in both fruits and leaves. Three C-glycosyl flavones (a luteolin-C-hexoside, a methyl luteolin-C-hexoside and an apigenin-C-hexoside) were present in leaves in abundance, but only at trace levels in fruits. Ideain and 5-O-caffeoylquinic acid were found in fruits only. Additionally, eleven phenolic compounds were identified/tentatively identified in both leaves and fruits (three B-type PC trimers, two B-type PC tetramers, a quercetin-rhamnosylhexoside, a quercetin-pentoside, a methoxykaempferol-methylpentosylhexoside, a quercetin-hexoside acetate, a methoxykaempferol-pentoside, chlorogenic acid and an unknown hydroxycinnamic acid derivative). The total content of phenolic compounds reached the highest level by the end of August in fruits and by the end of September in leaves. The compositional profiles of phenolic compounds in fruits and leaves of C. grayana were different from those of C. pinnatifida, C. brettschneideri, C. scabrifolia, C. pinnatifida. var. major, C. monogyna, C. laevigata and C. pentagyna. Phenolic compounds in emblic leafflower fruits were characterised by Sephadex LH-20 column chromatography combined with HPLC-ESI-MS (Publication V). A mucic acid gallate, three isomers of mucic acid lactone gallate, a galloylglucose, gallic acid, a digalloylglucose, putranjivain A, a galloyl-HHDP-glucose, elaeocarpusin and chebulagic acid represented the major phenolic compounds in fruits of emblic leafflower. In conclusion, results of this study significantly increase the current knowledge on the key bioactive and nutritional components of hawthorn and emblic leafflower fruits. These results provide important information for research on the mechanism responsible for the health benefits of these fruits.

Leiomiossarcoma de jejuno

We describe a case of leiomyosarcoma of the jejunum in which abdominal computed tomography showed an intestinal tumor with a "sui generis" metalic artefact inside, which made us think of a benign disease (foreign body granuloma), because the patient lived in the rural area and he had a manioc flour mill, which is one the basic foods of the majority of the population of the north in Brazil. Because of the aspect of the tumor, we decided on a large scale resection, considering the possibility of a malignant tumor since we don't have frozen sections. This assured us of an adequate treatment for the tumor. This type of pathology should be remembered even though it only accounts for 0,2-2% of the intestinal tract tumors.

An Infant with Food Allergy and Eczema in the Family – The Mental and Economic Burden of Caring

Allergic diseases including food allergy and eczema in an infant in combination with the everyday activities of caring for a family will pose challenges to parents. Only fragments of these challenges are revealed to health care professionals. Families have varying mental, social and economic resources to help them care for an allergic infant, and all such resources are important in determining how families succeed in meeting these challenges and the quality of the infant’s care. This study evaluated the whole burden to the family caused by an infant's allergic disease during the first 24 months of life. As the primary caregiver during this period is usually the mother, her perspective was considered important. Ecocultural theory, which considers families as capable of modifying the positive and negative forces facing them, was taken as the frame of reference. Data were collected as part of an ongoing prospective mother-infant study, and the methods included severity scoring of atopic dermatitis, dietary records, health-related quality of life measurements and assessments of the use of health care services and medications for treating the infant’s eczema, food allergy and asthma. Interviews with mothers were analysed by deductive content analysis on the basis of ecocultural theory and the family empowerment model. The theme “Living an ordinary family life” guided the organization of family activities essential for treating the infant's food allergy and eczema. These activities were sources of both strain and support for the mothers, the allergy-related supporting factors being the mother’s own knowledge of the allergy, hopes for an improvement in the infant’s condition, social support and work. An infant’s food allergy at the age of one year caused considerable strain for the mother in cases where the introduction of new foods into the child’s diet was delayed. This delay was still causing the mother additional strain when the child was 24 months of age. The infants waking at night at the ages of 12 and 24 months because of itching related to eczema caused strain for the mothers. The infants’ health-related quality of life was impaired at ages of 6 and 12 months compared with healthy infants. The principal reasons for impairments were itching, scratching and sleep disturbances at 6 and 12 months and treatment difficulties at 6 months. Problems with getting to sleep were reported at all stages irrespective of eczema and were also present in healthy infants. The economic impact of the treatment of allergic diseases on families during the first 24 months was 131 EUR (2006 value) in cases of eczema and 525 EUR in cases of food allergy. From the societal perspective, the costs of food allergy were a median of 3183 EUR (range 628–11 560 EUR) and of eczema a median of 275 EUR (range 94–1306 EUR). These large variations in costs in food allergy and eczema indicate that disease varies greatly . In conclusion, food allergy and eczema cause extra activities and costs to families which arrange these disease-related activities in such a way that they support the leading family theme “Living an ordinary family life”. Health care professionals should consider this thematic character of family life and disease-related activities in order to ensure that new treatments are sustainable, meaningful and tailored to daily activities. In addition, those mothers who are experiencing difficulties with food allergic infants or infants with eczema should be recognized early and provided with individual encouragement and support from health clinics. In the light of the present results, early detection of symptoms and effective parental guidance can contribute to the well-being and health-related quality of life of the child and family.

Risk factors and presence of antibodies to Toxoplasma gondii in dogs from the coast of São Paulo State, Brazil

Toxoplasmosis is caused by the obligate intracellular protozoan parasite Toxoplasma gondii and affects warm-blooded vertebrates, including pets and man. Dogs are epidemio-logically important since they act as sentinels for the infection in humans. The present study aimed to determine the presence of antibodies to T. gondii in 205 serum samples from dogs in Ubatuba, Sao Paulo state, Brazil, through indirect immunofluorescence reaction (IFAT), as well as the risk factors related to toxoplasmosis in the animals such as breed, age, sex, access to outdoors, homemade food ingestion, access to untreated water, and contact with rodents. Toxoplasmosis-positive samples accounted for 52/205 (25.4%), with titers ranging from 16 to 256. The serological results presented significant association (P<0.05) with homemade food ingestion (45/118; 38.1%; CI95% 29.9%-47.2%) (OR=7.0; CI95% 3.0-16.6), and with access to outdoors where those that do not have access to the street were prevalent (37/121; 30.6%; CI95% 23.1%-39.3%) (OR=0.5; CI95% 0.2-1.0). These results show that toxoplasmosis in this region is related to problems of sanitary education, mainly concerning the appropriate cooking of foods, since most positive animals did not show significant association with the presence of rodents or untreated water consumption but showed, instead association with ingestion of homemade food. Thus, toxoplasmosis is a public health problem in the studied region, and sanitary measures are needed to control the infection due to the strict relationship between man and dog and the presented risk factors

Pre- and postnatal nutrition – target for allergy risk reduction

A rapid increase in allergic diseases in Western societies has led to the conclusion that our modern lifestyle is a risk factor for immune dysregulation. Potential culprits and benefactors are searched among early dietary and microbial exposures, which may act to program later allergic disease. The aim of this thesis was to investigate the role of early maternal and child nutrition in reducing the risk of child allergy. The study population comprised of 256 mother – child pairs from families with a history of allergy participating in a randomized controlled dietary counseling and probiotic intervention (Lactobacillus rhamnosus GG and Bifidobacterium lactis Bb12) study from early pregnancy onwards. The dietary counseling aimed for a diet complying with dietary recommendations for pregnant and lactating women, with special attention to fat quality. Maternal dietary counseling was reflected in cord blood fatty acids suggesting better essential fatty acid status in infants in the counseling group. Dietary counseling with probiotics or placebo had no effect on child allergy risk, but associations between maternal diet during pregnancy and breastfeeding and child allergic outcomes were found in secondary analyses. During pregnancy, milk intake was related to decreased and cheese intake to increased risk of child atopic eczema. During breastfeeding, intake of vitamin C was related to increased risk of asthma and intake of egg was related to decreased risk of atopic eczema. The timing of introduction of complementary foods to infant’s diet was not associated with risk of atopic eczema, when adjusted with parental opinion of child allergic symptoms (i.e., potential reverse causality). In conclusion, the results demonstrate that infant fatty acid supply can be modified via maternal dietary changes. In addition, interesting associations of maternal diet with child allergy risk were discovered. However, no difference in the incidence of allergic diseases with dietary counseling was observed. This suggests that more potent dietary interventions might be necessitated to induce clinical risk reduction of allergy. Highrisk families can safely adhere to dietary recommendations for pregnant and lactating women, and the results support the current conception that no additional benefit is gained with delaying introduction of complementary feeding.