Nutrition
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Iron deficiency anemia (IDA) continues to be major public health problem in India. It is estimated that about 20% of maternal deaths are directly related to anemia and another 50% of maternal deaths are associated with it. The question, therefore, is why, despite being the first country to launch the National Nutritional Anemia Prophylaxis Programme in 1970, the problem of IDA remains so widespread. ⋯ Inadequate dietary intake of iron, defective iron absorption, increased iron requirements due to repeated pregnancies and lactation, poor iron reserves at birth, timing of umbilical cord clamping, timing and type of complementary food introduction, frequency of infections in children, and excessive physiological blood loss during adolescence and pregnancy are some of the causes responsible for the high prevalence of anemia in India. In addition, there are other multiple programmatic and organizational issues. This review, therefore, is an attempt to examine the current burden of anemia in India, its epidemiology, and the various issues regarding its prevention and control, as well as to offer some innovative approaches to deal with this major health problem.
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There is a significant amount of controversy related to the optimal amount of dietary carbohydrate. This review summarizes the health-related positives and negatives associated with carbohydrate restriction. On the positive side, there is substantive evidence that for many individuals, low-carbohydrate, high-protein diets can effectively promote weight loss. ⋯ LCDs that are high in saturated fat appear to raise low-density lipoprotein cholesterol and may exacerbate endothelial dysfunction. However, for the significant percentage of the population with insulin resistance or those classified as having metabolic syndrome or prediabetes, there is much experimental support for consumption of a moderately restricted carbohydrate diet (i.e., one providing approximately 26%-44 % of calories from carbohydrate) that emphasizes high-quality carbohydrate sources. This type of dietary pattern would likely lead to favorable changes in the aforementioned cardiovascular disease risk factors, while minimizing the potential negatives associated with consumption of the more restrictive LCDs.
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Increased fasting serum phosphate within the normal physiological range has been linked to increased cardiovascular risk in prospective epidemiology; increased production of fibroblast growth factor 23, and direct vascular effects of phosphate, may mediate this risk. Although dietary phosphate intake does not clearly influence fasting serum phosphate in individuals with normal renal function, increased phosphate intake can provoke a rise in fibroblast growth factor 23, and in diurnal phosphate levels, and hence may adversely influence vascular health. Dietary phosphate absorption can be moderated by emphasizing plant-based dietary choices (which provide phosphate in less bioavailable forms); avoidance of processed foods containing inorganic phosphate food additives; and by ingestion of phosphate-binder drugs, magnesium supplements, or niacin, which precipitate phosphate or suppress its gastrointestinal absorption. The propensity of dietary phosphate to promote vascular calcification may be opposed by optimal intakes of magnesium, vitamin K, and vitamin D; the latter should also counter the tendency of phosphate to elevate parathyroid hormone.
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This review provides the epidemiologic and research evidences documenting the effects of coffee consumption on type 2 diabetes mellitus (T2DM). We summarize the literature concerning the effects of coffee consumption on different mechanistic factors involving in pathogenesis of T2DM, such as glucose tolerance, insulin sensitivity, insulin resistance, glucose-6-phosphatase, intestinal glucose absorption, antioxidant activity, inflammatory biomarkers, nuclear factor-κB inhibition, glucose uptake, glucose homeostasis, glucose metabolism, and insulin secretion. ⋯ Overall, the experimental and epidemiologic evidences presented here elucidate the protective effects of coffee consumption on T2DM, involving multiple preventive mechanisms. Despite the firm evidences available through a growing literature base, it is still uncertain whether the use of coffee should be recommended to patients with diabetes and/or any patient who might be at the risk of T2DM as a supplementary therapy to prevent further progression of T2DM.
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Review
Can ω-3 fatty acids and tocotrienol-rich vitamin E reduce symptoms of neurodevelopmental disorders?
The incidence of childhood neurodevelopmental disorders, which include autism, attention-deficit hyperactivity disorders, and apraxia, are increasing worldwide and have a profound effect on the behaviors, cognitive skills, mood, and self-esteem of these children. Although the etiologies of these disorders are unclear, they often accompany genetic and biochemical abnormalities resulting in cognitive and communication difficulties. ⋯ The purpose of this review is to provide a scientific rationale based on cellular, experimental animal model, observational, and clinical intervention studies for incorporating the combination of ω-3 fatty acids and tocotrienol-rich vitamin E as complementary nutritional therapies in children with neurodevelopmental disorders. Should this nutritional combination correct key clinical or biochemical outcomes and/or improve behavioral patterns, it would provide a safe, complementary option for these children.