The consumption of breakfast cereals appears to have a positive impact on nutritional status regardless of age.
Au cours des dernieres annees, un certain nombre de travaux fondamentaux et cliniques ont mis en evidence le role des derives actives de l’oxygene, les radicaux libres, dans le determinisme des processus d’atherogenese et l’effet protecteur ou preventif de certains nutriments antioxydants tels que le b-carotene, la vitamine E, la vitamine C, le zinc et le selenium. De nombreux travaux epidemiologiques, developpes au cours des dernieres annees (etudes ecologiques, etudes cas-temoins et etudes prospectives), suggerent l’existence d’une relation entre les apports (ou le statut biologique) en vitamines antioxydantes et le risque de maladies cardiovasculaires. Cependant, la nature meme des etudes epidemiologiques realisees ne permet pas d’affirmer l’existence d’un lien de causalite entre ces deux facteurs. La piste est, cependant, suffisamment serieuse pour que soient developpes de grands essais d’intervention visant a tester, dans le cadre d’etudes randomisees en double aveugle, l’impact d’un apport supplementaire en vitamines antioxydantes sur l’incidence des pathologies cardiovasculaires et la mortalite qui leur est consecutive.
Our findings suggest that selenium may protect against goiter. Selenium was related to thyroid echostructure, suggesting it may also protect against autoimmune thyroid disease.
Our results indicate that a short-term supplementation with physiological doses of antioxidant vitamins, carotenoids and trace elements during alcohol rehabilitation clearly improves micronutrient status indicators. Heavy smokers in particular seem to respond to vitamin C supplementation.
Jusqu’a une periode recente, les relations entre l’alimentation et la sante ont ete percues au travers des grandes maladies de carence nutritionnelle. L’evidence de cette relation reposait sur les grands tableaux cliniques qui accompagnaient les famines et les deficits alimentaires majeurs, ou les carences specifiques qui ont emaille l’histoire de l’humanite. Le manque de proteines etait responsable des formes cliniques evidentes du Kwashiorkor ; le manque d’energie de celles du marasme ; les carences en vitamine C du scorbut ; celles en vitamine B1, du beri-beri,… Au cours des dernieres decennies, en France comme dans l’ensemble des autres pays industrialises, une situation d’abondance s’est developpee (excepte pendant la duree des deux guerres mondiales), favorisant la disparition des grandes maladies de carence encore presentes en Europe et en Amerique du Nord au debut de ce siecle, et toujours largement repandues dans les pays en voie de developpement. C’est ainsi que les aspects les plus evidents de la relation entre l’alimentation et la sante se sont apparemment estompes dans les pays industrialises, alors qu’ils demeurent dramatiquement presents dans de nombreuses parties du monde. Les enjeux de sante publique qui resultent des relations entre nutrition et sante et auxquels doit faire face un pays comme la France, en cette fin du 20eme siecle sont d’une tout autre nature : l’inadaptation des apports alimentaires ne peut en regle generale etre consideree comme la cause directe des maladies qui y sont aujourd’hui les plus repandues, mais l’alimentation (et l’etat nutritionnel qui en resulte) participe de facon active au determinisme de ces affections. Le caractere multifactoriel de ces pathologies (cancers, maladies cardio-vasculaires, osteoporose, obesite,...), qui representent un poids considerable en termes de sante publique, est en effet parfaitement etabli aujourd’hui. Des facteurs physiologiques, genetiques et de nombreux facteurs d’environnement interviennent dans leur initiation, leur developpement ou leur expression clinique. Parmi les facteurs d’environnement, l’alimentation est aujourd’hui consideree comme jouant un role essentiel. S'il est difficile de mesurer precisement le poids relatif des facteurs alimentaires dans le determinisme des maladies, de nombreux arguments suggerent qu’il est important. Ainsi, dans le cas des cancers, une analyse realisee par Doll et Peto au debut des annees 80 suggerait que l'alimentation contribuait pour 30 a 40 % des cancers chez l’homme et pour 60 % des cancers chez la femme (Doll et Peto, 1981). Cette estimation peut certes etre discutee, mais ces chiffres permettent de prendre conscience de la place importante des facteurs alimentaires dans le determinisme des maladies chroniques. Ce point est d’autant plus essentiel que l’alimentation est un phenomene sur lequel les possibilites d'intervention existent en termes de sante publique et de prevention. Au cours des 30 dernieres annees se sont accumules, au niveau international, de tres nombreux travaux scientifiques de type mecanistique, clinique et epidemiologique qui ont permis d’identifier et de documenter un certain nombre de facteurs de risque et de protection lies a la nutrition intervenant dans le determinisme de diverses maladies chroniques qui constituent aujourd’hui des problemes majeurs de sante publique. L’ensemble de ces recherches a permis d’aboutir aujourd’hui a de veritables consensus internationaux sur l’implication de ces facteurs et sur la necessite, selon les cas, de chercher a les reduire ou de favoriser leur promotion. Ce rapport dresse tout d’abord un etat des lieux de la situation actuelle, en analysant notamment : les enjeux majeurs de sante publique que representent les maladies chroniques dans lesquelles sont impliques les facteurs nutritionnels ; les specificites des habitudes alimentaires et de l’etat nutritionnel de la population vivant en France ; les determinants de la consommation alimentaire (sans toutefois approfondir toutes les dimensions comportementales), les preuves scientifiques concernant les relations entre nutrition et sante. Puis sur la base de ce constat sont formulees des recommandations pour la mise en place d’une politique nutritionnelle de sante publique pour la France. Ce rapport se limite aux aspects nutritionnels et n’integre pas les aspects concernant la securite alimentaire, notamment les problemes microbiologiques et toxicologiques, qui se situent hors du champ de la saisine ministerielle.
Many epidemiologic studies based on an observational approach indicate that a high dietary intake or high blood concentrations of some antioxidant micronutrients are associated with a reduced risk of cardiovascular diseases and cancer at several common sites. Inconsistent results of intervention trials suggest that low risk of pathologies may be related to multiple nutrients consumed, at nutritional doses, and in combination. This hypothesis was the rationale of the SU.VI.MAX. study, a randomized double-blind, placebo-controlled, primary-prevention trial designed to test the efficacy of a daily supplementation with antioxidant vitamins and minerals at nutritional doses in reducing the major health problems in industrialized countries, and especially the main causes of premature death (cancers and cardiovascular diseases).
Read moreThe iron status of 22 children and adolescents with Crohn's disease (mean age: 13 years) was evaluated. Eleven patients were suffering from active disease with inflammation, identified by at least one abnormal value for serum orosomucoid, C-reactive protein or sedimentation rate (group I). Eleven patients were in clinical remission and showed no biological evidence of inflammation (group II). Hemoglobin and red cell indices, erythrocyte protoporphyrin, serum iron, transferrin, serum ferritin and basic red cell ferritin were determined in all patients. The usual indicators of iron status, particularly serum ferritin, were affected by the inflammatory processes, but basic red cell ferritin appeared to be independent of inflammation. Basic red cell ferritin can therefore be considered to be a reliable indicator of iron status in children and adolescents with Crohn's disease.
Read moreSerum ferritin, serum iron, total iron-binding capacity (TIBC) and erythrocyte protoporphyrin were measured in a group of 69 children (6.4 +/- 3.6 years) living in a rural area of Mauritania. The predictive value of low serum ferritin was calculated for each iron parameter. A serum ferritin value above 12 micrograms/l was present in 50.2% of children with abnormal serum iron, in 59.0% of those with abnormal TIBC, in 60.3% of those with abnormal transferrin saturation and in 60.0% of those with abnormal erythrocyte protoporphyrin. The percentages varied from 88.0 to 94.8% for a predictive value of serum ferritin of less than 50 micrograms/l. Nearly 35% of children had biochemical evidence of iron deficiency, i.e. 2 abnormal independent iron parameters or more, including serum ferritin of less than 12 micrograms/l. Nearly 32% had probable iron deficiency, i.e. 2 abnormal independent iron parameters, with a serum ferritin value between 13 and 50 micrograms/l.
Read moreDuring the last years, a large number of surveys have suggested than some fractions of the French population, as in other industrialized countries, presented dietary iron intake below the recommended dietary allowances. Iron deficiency is widespread in children, menstruating women, and particularly pregnant women. Iron deficiency is enough severe to be responsible of anemia in some groups of population. Aside the classical risk of anemia (with its well-known consequences on health), the effects of iron deficiency by itself, taking into consideration the role of iron in numerous metabolic functions, needs to be more documented to assess the potential deleterious consequences upon health.
Read moreThe aim of our study was to investigate the relationship between dietary fibre intake and some clinical indices, blood biochemical variables and the incidence of cardiovascular disease and cancers in France, taking advantage of an ongoing cohort, the Supplementation en Vitamines et Minéraux AntioXydants (SU.VI.MAX) intervention study. This preliminary report provides data on dietary fibre intake in this French adult population group of 4080 subjects (2168 men and 1912 women) aged 45-65 years at inclusion. The data obtained for fibre intake indicate that most men and women have low to moderate intakes of total dietary fibre (mean 21.0 and 17.1 g/d respectively), with only 21 % of the men and 7 % of the women having total dietary fibre intakes at the recommended level (i.e. > 25 g/d) and soluble fibre accounting for 19 % of the total dietary fibre intake for both genders. The main food sources of dietary fibre are cereals (30-35 % total), vegetables (20-24 % total) and fruit (19-22 % total). No marked regional differences were observed within France. The highest dietary fibre intakes have been found to be associated with a lower BMI, blood systolic pressure, plasma triacylglycerols and plasma glucose in men and lower BMI in women. Overall, these data support the concept of a beneficial effect of a high dietary fibre intake on cardiovascular disease risk.
Read moreTo determine the impact of a trace element and vitamin supplementation on infectious morbidity, a double-blind controlled trial was performed on 81 elderly subjects in a geriatric center during a 2-year period. Subjects were randomly assigned to one of four treatment groups, and received daily: placebo; trace elements/zinc 20 mg; selenium 100 micrograms); vitamins (vitamin C 120 mg; beta-carotene 6 mg; alpha-tocopherol 15 mg); or a combination of trace elements and vitamins at equal doses. (1) Before supplementation, low serum values in vitamin C, folate, zinc and selenium were observed in more than two thirds of the patients. (2) After 6 months of supplementation, a significant increase in vitamin and trace element serum levels was obtained in the corresponding treatment groups: a plateau was then observed for the whole study. (3) Subjects who received trace elements (zinc and selenium) alone or associated with vitamins had significantly less infectious events during the 2 years of supplementation. These results indicate that supplementation with low doses of vitamins and trace elements is able to rapidly correct corresponding deficiencies in the institutionalized elderly. Moreover, zinc and selenium reduced infectious events.
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