Barley Intake Research Articles

High barley intake in non-obese individuals is associated with high natto consumption and abundance of butyrate-producing bacteria in the gut: a cross-sectional study.

Barley, abundant in β-glucan, a soluble dietary fiber, holds promise in obesity prevention. Given the microbial metabolism of dietary fiber in the gastrointestinal tract, we investigated the role of gut microbiota in non-obese individuals consuming high levels of barley. Our study enrolled 185 participants from "The cohort study on barley and the intestinal environment (UMIN000033479)." Comprehensive physical examinations, including blood tests, were conducted, along with separate assessments of gut microbiome profiling and dietary intake. Participants were categorized into high and low barley consumption groups based on the median intake, with non-obese individuals in the high intake group identified as barley responders while participants with obesity were designated as non-responders. We compared the relative abundance of intestinal bacteria between these groups and used multivariate analysis to assess the association between intestinal bacteria and barley responders while controlling for confounding factors. Among the fermented food choices, responders exhibited notably higher consumption of natto (fermented soybeans) than non-responders. Moreover, after adjusting for confounders, Butyricicoccus and Subdoligranulum were found to be significantly more prevalent in the intestines of responders. Given natto's inclusion of Bacillus subtilis, a glycolytic bacterium, and the butyrate-producing capabilities of Butyricicoccus and Subdoligranulum, it is hypothesized that fiber degradation and butyrate production are likely to be enhanced within the digestive tract of barley responders.

Grazing camels under semi-extensive production system: selectivity, feed intake capacity, digestion and energy expenditure

BackgroundIt was proposed that camels are more effective than other livestock species in selecting plants for their nutritional value. They may self-regulate their voluntary feed intake to satisfy their nutritional needs. This study was designed to investigate camels’ feeding selectivity and ability to cover nutritional requirements when grazing alfalfa (high in protein) and/ or barley (high in energy) in a desert climate.MethodsEighteen lactating camels were equally divided into three feeding treatments. They grazed daily on alfalfa, barley, or a mixed pasture of both, for two periods of one month each. The concentrate supplement was individually administered at 40 g/kg BW0.75, divided into two equal parts, in the morning and in afternoon. Total energy expenditure (EE) was estimated by heart rate (HR) monitors for 48 h after being calibrated by oxygen consumption using an upgraded face mask open-circuit respiratory system.ResultsDuring the first period, camels had a greater forage intake and digestibility when they grazed barley rather than alfalfa, while those grazing mixed pasture performed intermediately. In the second period, camels had a similar forage intake and digestibility among treatments due to a decline in barley intake and digestibility compared to the first period, which was expected since the preferred plant part gradually shifted from barley grains to predominantly straw as a function of time. Similar HR and EE were found across periods and treatments. As a result of greater gross and digestible energy intake in period 1, a better energy balance in period 1 was observed compared to period 2. Camels better utilize barley than alfalfa. Grazing on barley had a higher energy balance than grazing alfalfa alone or in combination with barley. However, camels grazing barley produced lower milk yield and energy than those grazing alfalfa alone or in combination with barley, with no interaction detected between period and treatment.ConclusionsLactating camels are able to self-regulate their voluntary intake to cover their energy requirements when they are grazing barley and/or alfalfa supplemented with a concentrate supplement at 40 g/kg BW0.75. Grazing barley is better utilized by camels than alfalfa. The chemical and physical properties of plant species play an important role in the selectivity of foraging camels. It also impacts their intake and digestibility, which is negatively associated with the proportion of cell wall content consumed.

Beneficial Effects of Dietary Intake of Soybean and Barley on Hyperlipidemic Albino Rats

Beneficial Effects of Dietary Intake of Soybean and Barley on Hyperlipidemic Albino Rats

Barley consumption under a high-fat diet suppresses lipogenic genes through altered intestinal bile acid composition

We evaluated whether barley flour consumption in a high-fat environment affects lipid metabolism through signals mediated by bile acids. Four-week-old mice were fed a high-fat diet supplemented with cellulose (HC) or β-glucan-rich barley flour (HB) for 12 weeks. Bile acid composition in the intestinal tract and feces was measured by GC/MS. Gene expression levels involved in bile acid metabolism in the liver and intestinal tract were determined by RT-PCR. Similar parameters were measured in mice treated with antibiotics (antibiotics-cellulose [AC] and antibiotics-barley [AB]) to reduce the activity of intestinal bacteria. The Results showed that the HB group had lower liver blood cholesterol and triglyceride levels than the HC group. The HB group showed a significant decrease in primary bile acids in the gastrointestinal tract compared to the HC group. On the other hand, the concentration of secondary bile acids relatively increased in the cecum and feces. In the liver, Fxr activation suppressed gene expression levels in synthesizing bile acids and lipids. Furthermore, in the gastrointestinal tract, Tgr5 was activated by increased secondary bile acids. Correspondingly, AMP levels were increased in the HB group compared to the HC group, AMPK was phosphorylated in the liver, and gene expression involved in lipid synthesis was downregulated. A comparison of the AC and AB groups treated with antibiotics did not confirm these effects of barley intake. In summary, our results suggest that the prevention of lipid accumulation by barley consumption involves signaling through changes in bile acid composition in the intestinal tract.

Characteristic Gut Bacteria in High Barley Consuming Japanese Individuals without Hypertension.

Barley, a grain rich in soluble dietary fiber β-glucan, is expected to lower blood pressure. Conversely, individual differences in its effects on the host might be an issue, and gut bacterial composition may be a determinant. Using data from a cross-sectional study, we examined whether the gut bacterial composition could explain the classification of a population with hypertension risks despite their high barley consumption. Participants with high barley intake and no occurrence of hypertension were defined as "responders" (n = 26), whereas participants with high barley intake and hypertension risks were defined as "non-responders" (n = 39). 16S rRNA gene sequencing revealed that feces from the responders presented higher levels of Faecalibacterium, Ruminococcaceae UCG-013, Lachnospira, and Subdoligranulum and lower levels of Lachnoclostridium and Prevotella 9 than that from non-responders. We further created a machine-learning responder classification model using random forest based on gut bacteria with an area under the curve value of 0.75 for estimating the effect of barley on the development of hypertension. Our findings establish a link between the gut bacteria characteristics and the predicted control of blood pressure provided by barley intake, thereby providing a framework for the future development of personalized dietary strategies.

Awareness of Physicians on Celiac Disease and the Effect of Education

Celiac disease is a genetic in origin, systemic autoimmune disease that can be occur at any stage of life. The onset of the disease is triggered by dietary intake of wheat, barley and rye containing gluten prolamins. The prevalence of the disease is around 1% and this rate is expected to increase as awareness increases. Due to celiac disease mimicking the symptoms of other diseases and being known as a rare disease, the diagnosis rate is low, and patients are often diagnosed late. In this study, we evaluated the awareness rates of physicians and investigated the effect of celiac training on awareness rate. Our research is a pre-test and post-test compatibility study prepared in cross-sectional style. Family physicians who participated in the meeting on May 9, 2019, Celiac Day were included in our study. The pre-test was distributed to physicians just before the meeting. A training module on celiac disease was presented to the participants and a final test was performed afterwards. When the pre-test and post-test were matched, the questionnaires of 88 physicians were analyzed. Kappa coefficient was calculated for nominal scale information and Kendall’s tau-b correlation coefficient for ordinal scale questions were calculated. A binary logistic regression model was created according to the situation of encountering celiac patients in the study environment. In the whole study, type-I error value was taken as 5% and p<0.05 value was accepted as statistically significant. The mean age of the participants was 30.91±6.69 years. The mean number of patients suspected of celiac disease was 3.13 in the participants who stated that they had seen 767 patients in a month. The mean for patients diagnosed with celiac disease was 1.56 in the last year. When celiac-related conditions are evaluated, the states with the highest awareness are chronic diarrhea (100%), weight loss (98.9%), and anemia (96.6%), respectively, while the least common conditions were genetic syndromes (14.8-20.5%) and gynecological problems and infertility (39.8-42%). In the last test after the training, it was found that almost all the awareness was around 90%. The change between pre-test and post-test was significant for most statements (p<0.001). When the comparisons between the pre-test and post-test on the self-sufficient visual scale provided to the physicians were made, the difference was observed as significant in both (Wilcoxon test, p <0.001). Chronic diarrhea, weight loss, anemia, and dyspepsia were the most well-known conditions related to celiac disease in our study, while gynecological problems and genetic syndromes were the least known. It was determined that typical celiac disease is known more, and atypical celiac disease is less known. At the end of the training, it was observed that the awareness rate increased in all findings. The results of the study support that reminding of celiac disease with in-service training given both in residency training and in primary care can increase the diagnosis rates.

Explainable Artificial Intelligence in the Early Diagnosis of Gastrointestinal Disease

This study reviews the recent progress of explainable artificial intelligence for the early diagnosis of gastrointestinal disease (GID). The source of data was eight original studies in PubMed. The search terms were "gastrointestinal" (title) together with "random forest" or "explainable artificial intelligence" (abstract). The eligibility criteria were the dependent variable of GID or a strongly associated disease, the intervention(s) of artificial intelligence, the outcome(s) of accuracy and/or the area under the receiver operating characteristic curve (AUC), the outcome(s) of variable importance and/or the Shapley additive explanations (SHAP), a publication year of 2020 or later, and the publication language of English. The ranges of performance measures were reported to be 0.70-0.98 for accuracy, 0.04-0.25 for sensitivity, and 0.54-0.94 for the AUC. The following factors were discovered to be top-10 predictors of gastrointestinal bleeding in the intensive care unit: mean arterial pressure (max), bicarbonate (min), creatinine (max), PMN, heart rate (mean), Glasgow Coma Scale, age, respiratory rate (mean), prothrombin time (max) and aminotransferase aspartate (max). In a similar vein, the following variables were found to be top-10 predictors for the intake of almond, avocado, broccoli, walnut, whole-grain barley, and/or whole-grain oat: Roseburia undefined, Lachnospira spp., Oscillibacter undefined, Subdoligranulum spp., Streptococcus salivarius subsp. thermophiles, Parabacteroides distasonis, Roseburia spp., Anaerostipes spp., Lachnospiraceae ND3007 group undefined, and Ruminiclostridium spp. Explainable artificial intelligence provides an effective, non-invasive decision support system for the early diagnosis of GID.

Classification of the Occurrence of Dyslipidemia Based on Gut Bacteria Related to Barley Intake

Barley is a grain rich in β-glucan, a soluble dietary fiber, and its consumption can help maintain good health and reduce the risk of metabolic disorders, such as dyslipidemia. However, the effect of barley intake on the risk of dyslipidemia has been found to vary among individuals. Differences in gut bacteria among individuals may be a determining factor since dietary fiber is metabolized by gut bacteria and then converted into short-chain fatty acids with physiological functions that reduce the risk of dyslipidemia. This study examined whether gut bacteria explained individual differences in the effects of barley intake on dyslipidemia using data from a cross-sectional study. In this study, participants with high barley intake and no dyslipidemia were labeled as “responders” to the reduced risk of dyslipidemia based on their barley intake and their gut bacteria. The results of the 16S rRNA gene sequencing showed that the fecal samples of responders (n = 22) were richer in Bifidobacterium, Faecalibacterium, Ruminococcus 1, Subdoligranulum, Ruminococcaceae UCG-013, and Lachnospira than those of non-responders (n = 43), who had high barley intake but symptoms of dyslipidemia. These results indicate the presence of certain gut bacteria that define barley responders. Therefore, we attempted to generate a gut bacteria-based responder classification model through machine learning using random forest. The area under the curve value of the classification model in estimating the effect of barley on the occurrence of dyslipidemia in the host was 0.792 and the Matthews correlation coefficient was 0.56. Our findings connect gut bacteria to individual differences in the effects of barley on lipid metabolism, which could assist in developing personalized dietary strategies.

Consumption of barley flour increases gut fermentation and improves glucose intolerance via the short-chain fatty acid receptor GPR43 in obese male mice.

Barley consumption is expected to increase insulin sensitivity by increasing the level of short-chain fatty acids (SCFAs) and promoting the secretion of GLP-1. However, the involvement of GPR43, a receptor for SCFAs, has not been investigated. Therefore, we evaluated whether the inhibitory effect of β-glucan-rich barley intake on blood glucose rise is mediated by GPR43 signalling via an increase of SCFAs. C57BL/6J mice and GPR43-knockout mice were fed high-fat diets with either cellulose (HC) or β-glucan-rich barley flour (HB) for 12 weeks. The level of SCFAs in cecum contents was measured and the concentration of GLP-1 in the portal vein was determined. The supernatant of the cecum contents of C57BL/6J mice was added to GLUTag cells, and then the changes to GLP-1 and intracellular Ca2+ concentrations determined. The same parameters were measured using cells in which GPR43 was knocked down by siRNA. C57BL/6J mice fed HB diets showed a suppressed glucose rise compared to those on the HC diet. Cecum SCFAs and GLP-1 concentration in the portal vein were also increased by the HB diet. When an aqueous solution from the cecum content of mice fed a HB diet was added to GLUTag cells, GLP-1 secretion and intracellular Ca2+ concentration were increased. These phenomena were not observed in cells with knockdown of GPR43. In GPR43 knockout mice an increase of GLP-1 in the portal vein and suppression of blood glucose elevation was attenuated, despite increased SCFAs brought on by the HB diet. In conclusion, GPR43 activation in the intestinal tract via increased SCFAs is required for the glucose intolerance-improving effect of barley consumption.

Development of the Diabetic Kidney Disease Mouse Model Culturing Embryos in α-Minimum Essential Medium In Vitro, and Feeding Barley Diet Attenuated the Pathology.

Diabetic kidney disease (DKD) is a critical complication associated with diabetes; however, there are only a few animal models that can be used to explore its pathogenesis. In the present study, we established a mouse model of DKD using a technique based on the Developmental Origins of Health and Disease theory, i.e., by manipulating the embryonic environment, and investigated whether a dietary intervention could ameliorate the model’s pathology. Two-cell embryos were cultured in vitro in α-minimum essential medium (MEM; MEM mice) or in standard potassium simplex-optimized medium (KSOM) as controls (KSOM mice) for 48 h, and the embryos were reintroduced into the mothers. The MEM and KSOM mice born were fed a high-fat, high-sugar diet for 58 days after they were 8 weeks old. Subsequently, half of the MEM mice and all KSOM mice were fed a diet containing rice powder (control diet), and the remaining MEM mice were fed a diet containing barley powder (barley diet) for 10 weeks. Glomerulosclerosis and pancreatic exhaustion were observed in MEM mice, but not in control KSOM mice. Renal arteriolar changes, including intimal thickening and increase in the rate of hyalinosis, were more pronounced in MEM mice fed a control diet than in KSOM mice. Immunostaining showed the higher expression of transforming growth factor beta (TGFB) in the proximal/distal renal tubules of MEM mice fed a control diet than in those of KSOM mice. Pathologies, such as glomerulosclerosis, renal arteriolar changes, and higher TGFB expression, were ameliorated by barley diet intake in MEM mice. These findings suggested that the MEM mouse is an effective DKD animal model that shows glomerulosclerosis and renal arteriolar changes, and barley intake can improve these pathologies in MEM mice.

Effects of barley intake on glycemic control in Japanese patients with type 2 diabetes mellitus undergoing antidiabetic therapy: a prospective study.

Barley reportedly reduces postprandial hyperglycemia in healthy individuals. However, its effects in patients with type 2 diabetes mellitus (T2DM) undergoing antidiabetic therapy remains unclear. This study aimed to clarify the effects of barley intake on postprandial hyperglycemia in T2DM patients who use metformin or acarbose. T2DM patients who were undergoing dietary therapy without medications (naive), with metformin, or with acarbose (n = 10/group) were recruited. They were instructed to eat white rice twice per day for 5 days, followed by barley-mixed rice twice per day for 6 or 7 days. Subsequently, blood glucose fluctuations in the interstitial fluid glucose were measured using a continuous glucose monitoring device. Meal tolerance tests were performed using test diets containing white rice and barley-mixed rice before and after the trial, respectively. Postprandial hyperglycemia was lower in patients taking barley-mixed rice than in those taking white rice in each group. However, the AUC of blood glucose concentration in the acarbose-treated patients showed only a trend. Mean amplitude of glycemic excursions (MAGEs) decreased in patients who consumed barley-mixed rice. Additionally, although MAGEs in the naive decreased, it did not in the metformin- (P = 0.098) and acarbose-treated (P = 0.29) patients. Barley-mixed rice lowers postprandial glucose concentrations in treatment-naive and metformin-treated T2DM patients, and shows a trend in acarbose-treated patients. Therefore, using barley-containing diets as dietary therapy may be useful in improving glycemic control in diabetes patients. UMIN000028623. The online version contains supplementary material available at 10.1007/s13340-021-00552-z.

Fiber-Rich Barley Increases Butyric Acid-Producing Bacteria in the Human Gut Microbiota.

Butyric acid produced in the intestine by butyric acid-producing bacteria (BAPB) is known to suppress excessive inflammatory response and may prevent chronic disease development. We evaluated whether fiber-rich barley intake increases BAPB in the gut and concomitantly butyric acid in feces. Eighteen healthy adults received granola containing functional barley (BARLEYmax®) once daily for four weeks. Fecal DNA before intake, after intake, and one month after intake was analyzed using 16S rRNA gene sequencing to assess microbial diversity, microbial composition at the order level, and the proportion of BAPB. Fecal butyric acid concentration was also measured. There were no significant differences in diversities and microbial composition between samples. The proportion of BAPB increased significantly after the intake (from 5.9% to 8.2%). However, one month after stopping the intake, the proportion of BAPB returned to the original value (5.4%). Fecal butyric acid concentration increased significantly from 0.99 mg/g feces before intake to 1.43 mg/g after intake (p = 0.028), which decreased significantly to 0.87 mg/g after stopping intake (p = 0.008). As BAPB produce butyric acid by degrading dietary fiber, functional barley may act as a prebiotic, increasing BAPB and consequently butyric acid in the intestine.

Transition Characteristics and Risk Assessment of Heavy Metal(loid)s in Barley (Hordeum vulgare L.) Grown at the Major Producing Districts in Korea

Transition Characteristics and Risk Assessment of Heavy Metal(loid)s in Barley (<italic>Hordeum vulgare</italic> L.) Grown at the Major Producing Districts in Korea-Barley,Heavy Metal(loid)s,Lead,Monitoring,Risk Assessment

Mice derived from in vitro αMEM-cultured preimplantation embryos exhibit postprandial hyperglycemia and higher inflammatory gene expression in peripheral leukocytes.

We examined whether peripheral leukocytes of mice derived from in vitro αMEM-cultured embryos and exhibiting type 2 diabetes had higher expression of inflammatory-related genes associated with the development of atherosclerosis. Also, we examined the impact of a barley diet on inflammatory gene expression. Adult mice were produced by embryo transfer, after culturing two-cell embryos for 48 h in either α minimal essential media (α-MEM) or potassium simplex optimized medium control media. Mice were fed either a barley or rice diet for 10 weeks. Postprandial blood glucose and mRNA levels of several inflammatory genes, including Tnfa and Nox2, in blood leukocytes were significantly higher in MEM mice fed a rice diet compared with control mice. Barley intake reduced expression of S100a8 and Nox2. In summary, MEM mice exhibited postprandial hyperglycemia and peripheral leukocytes with higher expression of genes related to the development of atherosclerosis, and barley intake reduced some gene expression.

Birth weight modifies the association between a healthy Nordic diet and office blood pressure in old age.

A healthy diet reduces risk for high blood pressure. A small body size at birth increases risk for high blood pressure. Our aim was to study whether birth weight modifies the association between a healthy Nordic diet, characterized by high intake of Nordic vegetables, fruits, and berries, whole-grain rye, oat, and barley, and rapeseed oil, and blood pressure. Finnish men and women (n = 960) born in 1934-1944 attended clinical visits including clinical measurements, and questionnaires in 2001-2004 and 2011-2013. Linear regression was applied to investigate the interactions between birth weight and Nordic diet (measured by the Baltic sea diet score (BSDS)) on blood pressure change during the 10-year follow-up. Baseline Nordic diet and birth weight showed a significant interaction on systolic blood pressure (SBP) (p = 0.02), and pulse pressure (PP) (p < 0.01) over a 10-year follow-up. In the lowest birth weight category (women < 2951 g, men < 3061 g), predicted SBP decreased across BSDS thirds (lowest (T1): 155 mmHg, highest (T3): 145 mmHg, p for linearity = 0.01) as did predicted PP (T1: 71 mmHg, T3: 63 mmHg, p < 0.01). In the middle birth weight category, predicted SBP increased across BSDS thirds (T1: 151 mmHg, T3: 155 mmHg, p = 0.02) as did predicted PP (T1: 67 mmHg, T3: 71 mmHg, p < 0.01). In the highest birth weight category, no associations were found. Higher adherence to a healthy Nordic diet was associated with lower SBP and PP in individuals with low birth weight but with higher SBP and PP in those with average birth weight.

Hulless Barley: A new era of research for food purposes

Barley (Hordeum vulgare L.) is included in the family of grasses and is the fourth highly significant crop after maize, wheat, and rice. Barley is considered as an important food ingredient because of the presence of vital biochemical constituents viz. β-glucan, starch, amylose, protein etc. Barley is usually classified as hulless or hulled types (absence or presence of hull adhering to grain). Hulless barley needs negligible processing and preserves the maximum of the endosperm and germ, which is once in a while lost during the time spent for dehulling. As a result, it is highly suitable for human utilization, as the entire grain can be specifically utilized to form a meal or processed into flour. Interest in the use of hulless barley as a food grain has expanded primarily due to its stated health benefits. The regular intake of hulless barley contributes to the maintenance of normal blood cholesterol level, beneficial in preventing certain types of cancer like colon cancer and also provides better glucose and insulin responses. Hulless barley has high β-glucan content which helps in lowering of glycemic index and also causes the stimulation of bowel health. For this reason, the food industry is anxious about expanding the utilization of these cereals as nourishment fixings and henceforth more research is merited here. DOI.org/10.25174/2249-4065/2019/83719

Association of Lifelong Intake of Barley Diet with Healthy Aging: Changes in Physical and Cognitive Functions and Intestinal Microbiome in Senescence-Accelerated Mouse-Prone 8 (SAMP8).

Barley intake reportedly reduces the risk of cardiovascular disease, but effects on the systemic phenotypes during healthy aging have not yet been examined. Therefore, we examined the effects of barley on the lifespan; behavioral phenotypes, such as locomotor activity, and cognitive functions, and intestinal microbiome in the senescence-accelerated mouse-prone 8 (SAMP8) mouse. We prepared two mild high-fat diets by adding lard, in which the starch components of AIN-93G were replaced by rice or barley “Motchiriboshi.” SAMP8 (four weeks old, male) mice were fed AIN-93G until eight weeks old, and then rice (rice group) or barley diet (rice: barley = 1:4, barley group) until death. Changes in aging-related phenotypes, object and spatial recognition, locomotor and balancing activities, and the intestinal microbiome were recorded. Moreover, plasma cholesterol levels were analyzed at 16 weeks old. Barley intake prolonged the lifespan by approximately four weeks, delayed locomotor atrophy, and reduced balancing ability and spatial recognition. Barley intake significantly increased the medium and small particle sizes of high-density lipoprotein (HDL) cholesterol, which is associated with a reduced risk of total stroke. The Bacteroidetes to Firmicutes ratio in the barley group was significantly higher than that in the rice group during aging. Thus, lifelong barley intake may have positive effects on healthy aging.

Intensification of production, low emission pathways and sustainable strategies for backyard, layer and broiler chickens

Meat and eggs produced by chickens represent an important economic resource in many economies. In future, global greenhouse gas (GHG) emissions produced by chickens will increase due to greater food demand. This study analyses the GHG emissions of chickens and identifies sustainable policy strategies for production intensification and GHG reduction. It advances beyond previous studies by combining GHG reduction and improving meat and egg production rather than reporting mitigation options only, and can thus provide low-emission pathways. The contemporaneous intensification of chicken production and GHG emission reduction are feasible for broiler, layer and backyard chickens in Moldova. For farmers, this important goal can be achieved by using feeds of good quality and high digestibility. An efficient utilization of feeds for backyard chickens (by a dietary replacement of 10% dry matter (DM) intake of fresh grass with 10% DM intake of barley) had the effect of reducing the total emissions to 78179, 79682 and 81238 tons of carbon dioxide-equivalent/year (t CO2-eq/year), increasing meat production to 2376, 2422 and 2469 t carcass weight/year and increasing egg production (in shell) to 47846, 48793, and 49741 t eggs/year with an increase of chickens of 2%, 6% and 10% per year, respectively. Policymakers can do a great deal to support the abatement of chicken emissions by developing long-term strategies, and regulations that are aimed towards mitigation targets and technologies. To effectively maximize emission reduction and increase production, however, policymakers must overcome the existing national barriers.Keywords: feed, greenhouse gas, manure, mitigation, policy

Associations between socioeconomic status and blood cadmium levels in Korea.

OBJECTIVESAlthough smoking is associated with both low socioeconomic status and blood cadmium (Cd) levels, the association between socioeconomic status and Cd levels remains unclear. Therefore, our study aimed to examine this association and to clarify whether smoking is a confounding or mediating variable in this relationship.METHODSData (n=7,734) were drawn from the Korea National Health and Nutrition Examination Survey (KNHANES, 2008- 2011), including years that contained data on blood Cd and urinary cotinine levels. We investigated the associations of income, education, and occupation with blood Cd levels. Smoking was investigated by categorizing participants by smoking status (never, former, and current) and pack-years into quartiles. The weekly frequency of rice and barley intake was analyzed to gain insights into participants’ dietary patterns. Additionally, urinary cotinine levels were used to ensure the validity of the smoking variables.RESULTSParticipants earning a low income and with less formal education had higher blood Cd levels. After controlling for smoking, the association between income and Cd levels substantially weakened. Further controlling for education, the association between income and Cd levels disappeared. However, there was a strong negative association between education and Cd levels, even after controlling for smoking history, pack-years, and urinary cotinine levels.CONCLUSIONSIn cross-sectional data from the KNHANES, blood Cd levels were significantly higher among those with a low income and less formal education. Smoking history contributed to, but did not fully explain, these associations.

CELIAC DISEASE

Background: Celiac disease (CD) is an immune-mediated enteropathy stimulatedby intake of gluten, rye and barley in genetically prone persons. In children, gastrointestinalsymptoms are usual if disease is diagnosed in first two years of life but as the age at onset of theillness advances to late years, extra-intestinal manifestations have been increasingly recognizedaffecting almost all organ systems. Objectives: To determine the prevalence of varied clinicalmanifestations of CD in children. To assess classical and non-classical features in patients withCD. Study Design: Cross sectional study. Setting: Nishtar Hospital Multan. Period: July 2016to July 2017. Material &amp; Methods: Ninety-six patients with celiac disease were analyzed. Thediagnosis was confirmed by serological antibodies and positive biopsy wherever needed. Allthe cases were evaluated for different intestinal or extra-intestinal features. Also the cases werecategorized based on their primary clinical features into two groups. The classical group hadCD patients with usual symptoms. The non-classical group had atypical symptoms. Results:The mean age of CD patients at the time of diagnosis was 5.98 ± 3.19 years. Median valuefor duration of clinical symptoms was 24 months. The common typical clinical presentationsincluded failure to thrive 86 (89.6%), short stature 86 (89.6%), diarrhea 78 (81.3%), unexplainedanemia 78 (81.3%) and clubbing 41 (42.7%). The atypical features noted in our study wereconstipation 21 (21.9%), hypertransaminasemia 38 (39.6 %) and neurological symptoms likeirritability/ behavioral changes 41 (42.7%). Family history of gluten allergy or other autoimmunediseases was present in 29 (30.2%) of patients. Children presented with non-classical symptomswere older than 2 years of age and they showed high prevalence of associated immune andnon immune diseases compared to those in classical group. Conclusion: The knowledge ofvaried behavior of CD may prevent delay in diagnosis. CD must be particularly screened inpatients with unexpected anemia, rickets, clubbing, short stature and in cases with positivehistory in family.