Acid Intake In Women Research Articles

The Importance of Medical Student Advocacy in Global Neurosurgery: The Example of Folate Fortification

Folic acid, also known as Vitamin B9, is a water soluble vitamin used by pregnant women to reduce the risk of spina bifida and anencephaly (SBA) in their children.1 Neurosurgeons are experts in diagnosing, assessing, and surgically treating NTDs. Pediatric neurosurgeons recognize that their role spans beyond these aspects, to include advocacy for children with neurosurgical conditions.2 Neurosurgeons are well positioned to engage in advocacy related to pediatric neurosurgery, given their expertise in the field, the importance of primary prevention, and substantial social and professional networks that allow them to collaborate with individuals in other fields and take leadership roles.3,4
 
 Despite clear evidence demonstrating the effectiveness of increasing folic acid intake in women of childbearing age, the formulation and adoption of effective policy has been challenging. Currently, only 23% of all folate-preventable cases of spina bifida and anencephaly are being prevented.5Although mandatory food fortification with folic acid is associated with markedly reduced birth prevalence of SBA, hospitalization rates, and deaths after discharge, only 56 countries have instituted mandatory folate fortification.3,5 The efficacy of folate supplementation is variable, dependent on patient knowledge and adherence.3 Greater well-coordinated advocacy efforts are necessary to facilitate the implementation of effective folate policy.

Serum fatty acid synthase levels and n-3 fatty acid intake in patients with breast cancer.

Fatty acid synthase (FASN) is a key enzyme in fatty acid biosynthesis that is usually over-expressed in patients with breast cancer, but its relationship with the patient's dietary habit is not clear. A higher intake of n-3 polyunsaturated fatty acids is related to reduced breast carcinogenesis invitro and invivo. The aim of this study was to clinically investigate the association between serum FASN levels and fatty acid intake in women newly diagnosed with breast cancer. In a case-control cross-sectional study, with 18 breast cancer patients and 29 controls, we evaluated nutritional status, dietary intake, and serum FASN levels. Statistical analyses were carried out with parametric and non-parametric tests, according to the sample's normality distribution. The mean age of breast cancer group (n=18) and control group (n=29) was 46.8±9.7y and 44.4.±8.6y, respectively. Mean serum concentration of FASN in breast cancer group was significantly higher (132.51±95.05ng/mL) than in control group (36.88±20.87ng/mL) (p<0.0001). Among breast cancer group, serum FASN levels of premenopausal women were significantly higher than those of postmenopausal women (p=0.026). There was no significant difference between the early and late disease stages in regard to serum FASN levels in breast cancer group. Mean nutrient intake was similar and n-3 docosahexaenoic acid intake was low in both groups. We observed no association regarding fatty acid intake and serum FASN levels. These data suggest that dietary n-3 fatty acid has no association with serum FASN levels among newly diagnosed breast cancer patients.

Modelling the impact of mandatory folic acid fortification of bread or flour in Ireland on the risk of occurrence of NTD-affected pregnancies in women of childbearing age and on risk of masking vitamin B12 deficiency in older adults

The rate of neural tube defects (NTDs) in Europe has remained similar since the 1990s despite folic acid supplement recommendations (400µg/day) for women of childbearing age. Mandatory folic acid fortification of staple foods has proved effective for reducing the prevalence of NTDs in over 80 countries. This study estimated the impact of addition of folic acid to bread or flour in the Republic of Ireland on reducing the risk of occurrence of NTD-affected pregnancies and the possible risk of masking (undiagnosed) vitamin B12 deficiency in older adults. Analyses were based on the Irish National Adult Nutrition Survey (2008-2010). Folic acid fortification was modelled using DaDiet© software. Estimates were made of the increase in average daily folic acid intake in women (18-50years) and the risk of exceeding the tolerable upper intake level (UL) of 1000µg for folic acid in adults over 50years of age. The fortification scenarios examined would reduce the risk of NTD-affected pregnancies by 8-32%, corresponding to an increase of 39-152μg in the mean daily folic acid intake of WCBA. The risk of masking anaemia associated with vitamin B12 deficiency in older adults would be negligible as the probability of exceeding the UL for folic acid, even by a small amount, is very low (≤ 0.2%). These levels of addition of folic acid to bread or flour would effectively reduce the risk of NTDs while allowing safe consumption of folic acid at current levels from other fortified foods and supplements.

Prevention of spina bifida: folic acid intake during pregnancy in Gulu district, northern Uganda.

IntroductionThe intake of folic acid before conception and during the first trimester of pregnancy can prevent spina bifida. This paper describes folic acid intake in women in Gulu district in northern Uganda.MethodsStructured interviews were held with 394 women attending antenatal care (ANC), 15 mothers of children with spina bifida, and 35 health workers in 2012 and 2013. SPSS16 was used for data analysis.Results1/4 mothers of children with spina bifida took folic acid during late pregnancy, none preconception. None had knowledge about folic acid and spina bifida prevention. 33.5% of women attending ANC had ever heard about spina bifida, 1% knew folic acid intake can prevent spina bifida. 42.4% took folic acid supplements in late pregnancy, 8.1% during the first trimester, none preconception. All women said to have eaten food rich in folic acid. None were aware about fortified foods. 7% of health workers understood the importance of early folic acid intake. All health workers recommended folic acid intake to women attending ANC. 20% of the health workers and 25% of the women said folic acid supplements are not always available.ConclusionFolic acid intake is limited in northern Uganda. This is attributed to limited education and understanding of women and health workers about the importance of early folic acid intake, late presentation of women at ANC, poor supply chain and dilapidated health services caused by war and poverty. A combination of food fortification, sensitization of health workers, women, and improving folic acid supply is recommended.

Impact of a preconception counselling resource (DVD) on preconception folic acid intake in women with diabetes

Impact of a preconception counselling resource (DVD) on preconception folic acid intake in women with diabetes

Lipoprotein subfractions and dietary intake of n-3 fatty acid: the Genetics of Coronary Artery Disease in Alaska Natives study

Few studies have compared lipoprotein composition with dietary intake. The lipoprotein subfraction profile was evaluated in relation to diet in Alaska Eskimos at high cardiovascular risk but with a low frequency of hyperlipidemia and high intake of n-3 (omega-3) fatty acids. A population-based sample (n = 1214) from the Norton Sound Region of Alaska underwent a physical examination and blood sampling. Analyses were from 977 individuals who did not have diabetes or use lipid-lowering medications and had complete dietary information (food-frequency questionnaire) and a lipoprotein subfraction profile (nuclear magnetic resonance spectroscopy). After adjustment for age, BMI, total energy intake, and percentage of energy from fat, the intake of n-3 fatty acids was significantly associated with fewer large VLDLs (P = 0.022 in women, P = 0.064 in men), a smaller VLDL size (P = 0.018 and P = 0.036), more large HDLs (P = 0.179 and P = 0.021), and a larger HDL size (P = 0.004 and P = 0.001). After adjustment for carbohydrate and sugar intakes, large VLDLs (P = 0.042 and 0.018) and VLDL size (P = 0.011 and 0.025) remained negatively associated with n-3 fatty acid intake in women and men, and large HDLs (P = 0.067 and 0.005) and HDL size (P = 0.001 in both) remained positively associated with n-3 fatty acid intake in women and men. In addition, large LDLs (P = 0.040 and P = 0.025) were positively associated in both sexes, and LDL size (P = 0.006) showed a positive association in women. There were no significant relations with total LDL particles in either model. Dietary n-3 fatty acids, independent of the reciprocal changes in carbohydrate and sugar intakes, are associated with an overall favorable lipoprotein profile in terms of cardiovascular risk. Because there are no relations with total LDL particles, the benefit may be related to cardiovascular processes other than atherosclerosis.

The Role of Dietary Cholesterol and Transfatty Acids in the Aetiology of Gallstones. A UK Prospective Cohort Study (EPIC-Norfolk) Using 7-Day Food Diaries

Introduction Dietary cholesterol may prevent gallstone formation by upregulating the enzyme cholesterol 7-α hydroxlase (Cyp7A1), which converts cholesterol to primary bile acids and prevents biliary cholesterol supersaturation, a prerequisite for cholesterol stone formation. Trans fatty acids promote hyperinsulinaemia which inhibits Cyp7A1 and could promote gallstone disease. This study investigated dietary cholesterol and trans fatty acid intake on the risk of developing symptomatic gallstones, for the first time using 7-day food diaries (7-DFDs), the most accurate feasible method of estimating food intake in large studies. Methods 25 639 participants (56% women), aged 40–74 years were recruited into the European Prospective Investigation into Cancer-Norfolk (EPIC-Norfolk) with 23 658 completing 7-DFDs at enrolment. The cohort was monitored for 14 years for new symptomatic gallstones, with diagnoses confirmed by review of the clinical notes. The 7-DFDs recorded 1 week9s diet including food types, frequency of consumption, quantities and cooking methods. A representative sample of 3 970 and those with gallstone disease had their 7-DFDs coded by nutritionists using a computer program containing nutrient information on 11 000 food and 55 000 portion sizes. A cohort analysis used Cox regression to estimate sex specific HRs for developing gallstones for fifths of dietary cholesterol and trans fatty acid intake, adjusted for known risk factors: age, body mass index, energy, alcohol and physical activity in men and also parity and hormone replacement therapy use in women. Results 177 women (mean age of diagnosis 66.5 years SD 9.5 years) and 90 men (64.2 years SD 9.2 years) developed symptomatic gallstones. In women, increased dietary cholesterol was associated with a decreased risk of disease (highest vs lowest fifth, HR 0.52, 95% CI 0.31 to 0.86, per fifth increase HR 0.83, 95% CI 0.74 to 0.93, p for trend=0.002), with no effect in men (trend across fifths HR 0.92, 95% CI 0.78 to 1.08). Increased trans fatty acid intake in women increased the risk of disease (highest vs lowest fifth, HR 2.18, 95% CI 1.21 to 3.92, per fifth increase HR 1.17, 95% CI 1.02 to 1.35, p=0.023), with no effect in men (trend across fifths HR 1.01, 95% CI 0.84 to 1.23). Conclusion In women, low dietary cholesterol and high trans fatty acid intake increased the risk of developing symptomatic gallstones, for which there are plausible biological mechanisms. No effects were found in men, though this could be due to a lack of power with only half the number of cases diagnosed. Dietary cholesterol and trans fatty acids should be measured in future aetiological studies of gallstones.

The role of dietary cholesterol and transfatty acids in the aetiology of gallstones: a uk prospective cohort study (EPIC-Norfolk) using 7-day food diaries

IntroductionDietary cholesterol may prevent gallstone formation by upregulating the enzyme cholesterol 7-α hydroxlase (Cyp7A1), which converts cholesterol to primary bile acids and prevents biliary cholesterol supersaturation, a prerequisite for cholesterol...

Race-ethnicity differences in folic acid intake in women of childbearing age in the United States after folic acid fortification: findings from the National Health and Nutrition Examination Survey, 2001–2002

Race-ethnicity differences in folic acid intake in women of childbearing age in the United States after folic acid fortification: findings from the National Health and Nutrition Examination Survey, 2001–2002

Race-ethnicity differences in folic acid intake in women of childbearing age in the United States after folic acid fortification: findings from the National Health and Nutrition Examination Survey, 2001–2002

Background: Neural tube defects are serious birth defects of the brain and spinal cord. Up to 70% of neural tube defects can be prevented by the consumption of folic acid by women before and early during pregnancy.Objective: The objective was to examine folic acid intake in women of childbearing age in the United States.Design: We analyzed nutrient intake data reported by 1685 nonpregnant women aged 15–49 y who participated in the National Health and Nutritional Examination Survey, 2001–2002.Results: The adjusted geometric mean consumption of folic acid from fortified foods was 128 μg/d (95% CI: 123, 134 μg/d) in nonpregnant women. Eight percent (95% CI: 5.8%, 11.0%) of nonpregnant women reported consuming ≥400 μg folic acid/d from fortified foods. This proportion was lower among non-Hispanic black women (5.0%) than among non-Hispanic white (8.9%) or Hispanic (6.8%) women. A smaller percentage of non-Hispanic black (19.1%) and Hispanic (21%) women than of non-Hispanic white women (40.5%) consumed ≥400 μg folic acid from supplements, fortified foods, or both, in addition to food folate, as recommended by the Institute of Medicine to reduce the frequency of neural tube defects.Conclusions: Most nonpregnant women of childbearing age in the United States reported consuming less than the recommended amount of folic acid. The proportion with low daily folic acid intake was significantly higher in non-Hispanic black and Hispanic women than in non-Hispanic white women. At the present level of folic acid fortification, most women need to take a folic acid–containing dietary supplement to achieve the Institute of Medicine recommendation.

Strategies to increase folate/folic acid intake in women: an overview

Summary Supplementation with folic acid reduces the risk of neural tube defects (NTDs) and may also be associated with other health benefits in relation to cancer and vascular disease. There is strong support around the world for public health policies that encourage increased folic acid intake by women of childbearing age, especially daily intake of supplemental folic acid, to reduce the incidence of NTDs. Campaigns promoting the use of folic acid supplements are useful but many women remain unaware and many pregnancies are unplanned. They have therefore had a limited impact in the primary target group, namely women around the time of conception and in the early weeks of pregnancy. Studies suggest that only about 30% of women aged 18–45 years use folic acid periconceptionally, and among younger, less educated and poorer women, use is even less. It is estimated that the majority of women who take folic acid don’t start until they know they are pregnant, and so miss the critical window (first 12 weeks) for the prevention of NTDs. It is therefore important that routes other than supplementation are considered. A European Union‐funded programme of work, ‘Folate: from food to functionality and optimal health’ (FolateFuncHealth, QLRT1‐1999‐00576 &amp; QLRT‐2001‐2740), has contributed to this work and the findings were presented at a conference in Warsaw in 2004.

Addressing environmentally caused human birth defects.

1. Robert L. Brent, MD, PhD, DSc* 1. 2. *Distinguished Professor of Pediatrics, Radiology, and Pathology, Anatomy, and Cell Biology; Louis and Bess Stein Professor of Pediatrics; Emeritus Chairman, Department of Pediatrics, Jefferson Medical College, Philadelphia, PA; Head, Laboratory of Clinical and Environmental Teratology, Research Department, Alfred I. DuPont Hospital for Children, Wilmington, DE. Objectives After completing this article, readers should be able to: 1. List the environmental drugs, chemicals, and physical agents that have been documented to result in congenital malformations and have reproductive effects. 2. List the requirements for a teratogenic exposure. 3. Describe the importance of dose when evaluating the risk of exposures. 4. Describe the most important advances in embryology, teratology, reproductive biology, genetics, and epidemiology in the past 50 years. When I was a medical student at the University of Rochester, I was fortunate to have James G. Wilson, an embryologist, as one of my teachers in the anatomy course. He was working on the effects of radiation on the embryo, which is how I became interested in congenital malformations. Many of the faculty members discouraged me from pursuing the study of the causes of birth defects as an academic goal, “Because we are never going to solve that problem.” In 1955, when I had completed medical school and graduate school, the scientific world did not even have the correct figure for the number of human chromosomes. Gregg had recently described the teratogenicity of rubella virus infection during pregnancy. The teratogenic risk of the folic acid antagonists was established, and there were experimental studies indicating that nutritional deficiencies could produce birth defects in animals. What have we learned and accomplished in the past 50 years? Thousands of previously unknown genetic diseases have been described, and many of their genes have been identified. The fields of prenatal intrauterine diagnoses, intervention, and treatment have been created. Metabolic and biochemical screening have become standard care for pregnant women and newborns. More than 50 teratogenic environmental drugs, chemicals, and physical agents have been described by using modern epidemiologic tools and the superb talents of clinical dysmorphologists. The basic science and clinical rules for evaluating teratogenic risks have …

Omega-3 Fatty Acid Intakes in Midwestern Women of Child-Bearing Age from Different Income and Education Levels

Omega-3 fatty acids are required for normal fetal development. Low intakes have been documented among low income pregnant women in certain areas of the United States. The purpose of this project was to assess the omega-3 fatty acid intake in women of child-bearing age from the Midwestern United States. Three-day food records were obtained from women (n=67) of different income and education levels. Food intake records were analyzed using the Food Processor Plus Computer Program. Mean daily intakes of omega-3 fatty acids were determined. Analysis of variance and LS Means were used to test for differences in omega-3 fatty acid consumption among two income and three education levels. Mean daily consumption of omega-3 fatty acids for the entire population was 0.59±0.38g/day. The Canadian Recommended Nutrient Intakes (RNI, 1990) recommend an omega-3 fatty acid intake of 1.1-1.2g/day for women between the ages of 19 and 49 years. Women in the low and mid/high income groups consumed 0.74 ± 0.07g/day and 0.51±0.06 g/day, respectively (p<.01). Women with a Bachelor's Degree or higher consumed 0.89±0.09 g/day of omega-3 fatty acids, compared with women with a high school education or lower (0.39±0.07 g/day, p<.01). Food sources providing omega-3 fatty acids were fats, oils, salad dressings, whole milk, ice cream, fish and chicken. We conclude that mean intakes of omega-3 fatty acids of Midwestern women of child-bearing age are 54% of the Canadian RNI and are influenced by income and education levels.