J.W.T. Dickerson

Obesity in Bahraini Adults

In this study the prevalence of obesity and the demographic factors associated with it were analysed on 290 adult Bahraini individuals, of whom 137 were males and 153 were females. The overweight and obesity prevalence rates, using the Body Mass Index (BMI) as a criterion, were 26% and 16% in males and 29% and 31% in females, respec tively. The prevalence of underweight (BMI< 20) was 16.8% and 11.8% in the males and females respectively. The mean body fat percentage of females, calculated from the skinfold measurements, was 35%; the fat percentage of males was 18.6%. Bahraini women had greater fat deposition in the subscapular region than the amount reported for American women. Females and males living in urban areas had a greater tendency to be obese than those residing in rural areas. Marriage, ownership of a car as well as a large family (> 7 mem bers) were positively associated with obesity; unmarried women were more likely to be underweight than married women. The educational level was not associated with obesity in either the males or females. The age of adult females was not found to be associated with obesity, whereas in males the incidence of obesity was more frequent among those who were 50 years of age and above than under 50 years of age. Family monthly income was not asso ciated with the incidence of obesity. The high prevalence of overweight and obesity in the women reported in this study and the difference in the distribution of body fat suggest that genetics may be a determinant factor of this disorder in Bahrainis but certainly social fac tors are also important.

Potato starch and caecal hypertrophy in the rat

Raw and milled potato starch caused caecal enlargement of up to 800% when fed to rats as the sole carbohydrate source in synthetic diets containing 16–24% protein and 71-63% carbohydrate. Control animals received maize starch in the diet. Caecal enlargement was dose-related. The hypertrophy was reversible and caeca approached control size within 11 days of the replacement of potato starch by maize starch. Some deaths occurred in groups of animals receiving raw potato starch at dietary levels of 30% or more. A total of 21% of the animals receiving these levels of raw potato starch died, while no deaths were observed in control animals. There were no significant differences between test and control animals in potassium concentrations and osmolalities of caecal contents, or in serum electrolyte and urea concentrations. Activities of serum glutamic-pyruvic transaminase and alkaline phosphatase were significantly higher in test animals but the histology of the liver, gastrointestinal tract and kidney were apparently normal. Caecal distension resulted in pressure on the diaphragm and impaired respiratory function, as indicated by a higher arterial blood pCO2 and lower pO2 and an increase in lactate concentration in venous blood. It is suggested that impaired respiratory function may have played an important role in the deaths associated with dietary potato starch and caecal enlargement.

Plasma and erythrocyte membrane long chain polyunsaturated fatty acids in endogenous depression.

Patients suffering from endogenous depression had significantly greater proportions of long chain polyunsaturated fatty acids (LCP), docosahexaenoic acid (22:6?3) and eicosapentaenoic acid (20:5?3), and a reduced proportion of linoleic acid (18:2?6) in their plasma choline phosphoglycerides (CPG) compared with age-sex-matched healthy controls. Patients suffering from reactive depression or from other psychiatric disorders did not differ significantly from matched controls. Changes in the fatty acid composition of the major erythrocyte membrane phospholipids were in the same direction but were less marked. The importance and possible reasons for the elevated LCP in endogenous depression are discussed.

Preoperative and postoperative levels of plasma protein and amino acid in esophageal and lung cancer patients

The metabolic changes following thoracic surgery in three groups of patients (esophageal cancer, lung cancer, and hiatus hernia) have been studied. Before operation patients with esophageal cancer, but not those with lung cancer, had significantly lower plasma total protein and albumin than patients with hiatus hernia. After surgery plasma albumin and total protein fell in both esophageal cancer and hiatus hernia patients, a development attributed to poor nutrition and restricted calorie diet in these two groups of patients respectively. With the exception of alanine and arginine in lung cancer patients, and free tryptophan in lung and esophageal cancer patients, the preoperative concentrations of all plasma amino acids were similar in both groups of cancer patients and in those with hiatus hernia. After operation the concentrations of glutamine, total tryptophan, alanine, glycine, and arginine fell sharply, whereas those of phenylalanine, lysine, valine, and leucine were slightly or not at all affected by surgery. The immediate postoperative fall of plasma free amino acids is thought to be due to the increased rate of gluconeogenesis. The rise of free fraction of plasma tryptophan after surgery is related to the raised level of plasma free fatty acids and increased secretions of catecholamines, which is believed to follow surgery.

Haematological studies on vegans.

1. The concentrations of vitamin B12 and folate in the serum and folate in the erythrocytes were determined and full blood counts made on a series of caucasian vegans and omnivore controls. 2. The blood counts and films were normal in all the vegans and no subject had a haemoblobin concentration below the lower limit of normality. 3. Although within the normal range, male but not female vegans had lower values for erythrocyte counts and higher values for mean corpuscular volume and mean corpuscular haemoglobin than their controls regardless of whether they were taking vitamin B12 supplements or not. 4. The mean serum vitamin B12 concentration was lower in the vegans not taking vitamin B12 supplements and in those using foods supplemented with the vitamin than in the controls, but in no subject was it below 80 ng/1. 5. The serum folate concentrations were higher in the vegans than in their controls. The mean value for erythrocyte folate tended to be greater in the vegans not taking vitamin B12 supplements. No subject had an erythrocyte folate concentration of less than 100 microgram/1. 6. It is concluded that megaloblastic anaemia is very rare in caucasian vegans and that a diet consisting entirely of plant foods is generally adequate to promote normal blood formation providing it is composed of a mixture of unrefined cereals, pulses, nuts, fruit and vegetables and is supplemented with vitamin B12.

Short-Term Effect of Zinc Sulphate on Plasma and Hepatic Concentrations of Vitamins A and E in Normal Weanling Rats

In normal weanling male rats, the intraperitoneal administration of zinc sulphate (ZnSO4) resulted in a decreased hepatic and an increased plasa concentration of vitamin A after 2 h. In an in vitro study, the vitamin A concentrations of liver homogenates were markedly increased when homogenized livers were treated with ZnSO4, ZnSO4, however, did not show any effect on plasma and liver concentrations of vitamin E. These results indicate that zinc may be specifically involved in mobilizing vitamin A from liver to the circulation of normal animals within a short period. The trace element, therefore, could be used only to treat cases of depressed vitamin A in plasma but also to treat hepatic toxicity from hypervitaminosis A.

Malignant disease: nutritional implications of disease and treatment

Protein-energy malnutrition (PEM) is common in cancer patients and may develop into the syndrome known as ‘cancer cachexia’. This is characterised by complex disturbances in carbohydrate, lipid, protein, and electrolyte metabolism. The actiology is equally complex, with host and therapeutic factors contributing to the reduced food intake and effects on host tissues. Anorexia is of prime importance, differing in its cause from one patient to another and often presenting a barrier to successful nutritional support. Further research is necessary to elucidate the interaction of central and peripheral factors that may be involved in the aetiology of anorexia. Because of the interplay of biochemical, physiological, and psychological consequences of cancer, the nutritional support of the patient presents a considerable challenge to the caring professions.

Plasma and erythrocyte membrane fatty acids in oral contraceptive users

The fatty acid composition of the plasma choline phosphoglycerides (CPG) and erythrocyte phospholipids were determined in women using oral contraceptive agents and age-matched female controls. Those using oestrogen and progestogen combined preparations had higher concentrations of palmitic acid (16:0) and linoleic acid (18:2 omega 6) and lower concentrations of stearic acid (18:0) and long chain polyunsaturated fatty acids (LCP), in particular arachidonic acid (20:4 omega 6) and eicosapentaenoic acid (20:5 omega 3), in their plasma CPG than controls. These differences were reflected in the erythrocyte phospholipids. The progestogen-only group had similar concentrations to matched controls. It is suggested that the lower concentrations of LCP in combined pill users may affect membrane function and prostaglandin synthesis and may relate to their increased risk of thrombosis.

The effects of exclusion of dietary egg and milk in the management of asthmatic children: a pilot study:

Current understanding of the use of exclusion diets in the management of asthma in children is limited and controversial. The aim of this study was to examine the effects of excluding eggs and milk on the occurrence of symptoms in children with asthma and involved 22 children aged between three and 14 years clinically diagnosed as having mild to moderate disease. The investigation was single blind and prospective, and parents were given the option of volunteering to join the ‘experiment’ group, avoiding eggs, milk and their products for eight weeks, or the ‘control’ group, who consumed their customary food. Thirteen children were recruited to the experimental group and nine to the control group. A trained paediatrician at the beginning and end of the study period assessed the children. A seven-day assessment of food intake was made before, during and immediately after the period of dietary intervention in both groups. A blood sample was taken from each child for determination of food specific antibodies and in those children who could do so, the peak expiratory flow rate (PEFR) was measured. Based on the recommended nutrient intake (RNI), the mean percentage energy intake of the children in the experimental group was significantly lower (p<0.05) in the experimental group. After the eight-week study period and compared with baseline values, the mean serum anti-ovalbumin IgG and anti-beta lactoglobulin IgG concentrations were statistically significantly reduced (p<0.05) for both in the experimental group. In contrast, the values for anti-ovalbumin IgG in the control group were significantly increased and those for anti-beta lactoglobulin IgG were practically unchanged. The total IgE values were unchanged in both groups. Over the study period, the PEFR in those children in the experimental group able to perform the test was significantly increased, but no such change was noted in the children in the control group who could do the test. These results suggest that even over the short time period of eight weeks, an egg- and milk-free diet can reduce atopic symptoms and improve lung function in asthmatic children.

POLYAMINES OF THE HUMAN BRAIN DURING NORMAL FETAL AND POSTNATAL GROWTH AND DURING POSTNATAL MALNUTRITION

Abstract— The concentrations of the polyamines and putrescine were measured in the brains of human infants during fetal and early postnatal development. The concentrations of the amines were also measured in the brains of children who were malnourished during the first 2 years of life. In the brains of the adequately‐nourished infants there were differences in the developmental profiles of the amines between different regions of the brain, and the changes in polyamine concentrations paralleled changes in nucleic acid accumulation. The concentration of putrescine was much higher than that of the polyamines in all regions of the brain, and in the brain stem there were marked increases in putrescine concentration at the time of most rapid rate of myelination. Putrescine also increased markedly in the forebrain at the time of neuroblast multiplication in the fetus. In children malnourished during the first year of life there were reductions in the concentrations of spermidine and putrescine in the forebrain and brainstem, but spermine was unaffected. Malnutrition had no effect on the concentration of any of the amines in the cerebellum.