Cause Of Vascular Disease Research Articles

Awareness and compliance with the australian dietary guidelines: A descriptive study of Melbourne residents

A detailed questionnaire, designed to assess awareness, understanding and compliance with the Australian dietary guidelines was administered by mail to a random sample of Melbourne residents in June 1984. Seven hundred and thirty people responded, representing a response rate of 76%. Only one in ten respondents could name the three major causes of death of Australians in correct order; most considered excessive stress to be the major cause of vascular disease. Over-consumption of starch-carbohydrates, fat and salt, and lack of vitamins and minerals in the diet were seen as major nutritional problems. Lack of need to change and taste preferences were seen as principal barriers to dietary change. Ninety six percent of respondents had not heard of the term “Australian dietary guidelines”, although up to one third, mainly women and the tertiary educated, were currently attempting dietary activities recommended by the guidelines. It is concluded that, to date, the Australian dietary guidelines appear to have had a lesser effect on the population than traditional beliefs. Recommendations for nutrition education are indicated.

Influence of environmental chemicals on drug therapy in humans: studies with contraceptive steroids.

The effects have been studied of various environmental factors on the variability in response to oral contraceptive steroid therapy in women. Ten- to thirty-fold variations in plasma concentrations of norethisterone, L-norgestrel and ethinyloestradiol have been shown in samples taken 12 h after administration of oral contraceptives in mid-menstrual cycle. Factors shown to be responsible for this variation include passage into the enterohepatic circulation, a variable first-pass effect, and changes in metabolism in the gut wall or liver due to diet, disease, smoking or administration of drugs. Phenobarbitone and the antibiotic rifampicin increase both oestrogen and progestogen metabolism in women and in experimental animals by increasing hepatic and gut wall metabolism. In animals, other antibiotics (ampicillin, neomycin and lincomycin) suppress the gut flora that normally hydrolyse steroid conjugates excreted in bile; enterohepatic circulation or oral contraceptive steroids is thus reduced and their plasma concentrations lowered by up to 90%. In the human, ampicillin has a variable but less dramatic effect on elimination of oral contraceptives. Samples of gut wall mucosa obtained from patients with coeliac disease are defective in their ability to metabolize oral contraceptives. Cigarette smokers eliminate ethinyloestradiol more rapidly than non-smokers; an increased production of reactive steroid metabolites may thus be a cause of vascular disease in women who smoke and take contraceptive steroids.