What stresses adolescents? A qualitative study on perceptions of stress, stressors and coping mechanisms among urban adolescents in India.

Background: In India, stress levels are increasing steadily among youth. We aimed to explore the factors that contribute to psychological stress and coping strategies among adolescents in Mysore, India to inform the development of an intervention. Methods: We recruited 16 volunteers in Mysore, India including 6 younger (12-15 years; 3 girls) and 10 older adolescents/ young adults (17-25 years; 5 girls) using a purposive sampling technique. Older adolescents were recruited from ongoing birth cohort study, and the younger adolescents by word-of-mouth from the community. Individual in-depth interviews were carried out based on a semi-structured interview guide comprising open-ended questions. The interviews were analysed to derive themes and emerging constructs related to stress and coping strategies.  Results: Adolescents generally perceived stress in their daily lives. Family conflicts and academic pressures were the main triggers for increased stress. Issues around peer relationships, and social position were also important contributors. Adolescents reported that they had robust coping strategies. These included stress release through rationalising and acceptance of the situation, distraction activities, spirituality, and self-comforting methods. However, they felt the need for further support from their family, and the society in general. In particular they expressed the need for a space to share their concerns and obtain guidance through healthy discussions with adults.      Conclusions: Our study indicates that adolescents in India are exposed to a wide range of stressors in their daily lives. The conflict between 'traditional' society's opinions of what adolescents should do and the new age adolescents' aspirations for autonomy to find 'informed' solutions for their issues may hinder the stress management efforts. Moving forward, we propose to develop a culturally acceptable intervention tool that accommodates adolescents' perspectives and psychosocial context.

'I should be disease free, healthy and be happy in whatever I do': a cross-country analysis of drivers of adolescent diet and physical activity in different low- and middle-income contexts.

OBJECTIVE: To explore perceptions of how context shapes adolescent diet and physical activity in eight low- and middle-income (LMIC) sites at different stages of societal and economic transition. DESIGN: Novel qualitative secondary analysis of eight data sets generated as part of the international Transforming Adolescent Lives through Nutrition (TALENT) collaboration. SETTING: Diverse sites in India and Sub-Saharan Africa. PARTICIPANTS: Fifty-two focus group discussions with 491 participants (303 adolescents aged 10-17 years; 188 caregivers). RESULTS: Analysis of pooled qualitative data identified three themes: (1) transitions in generational nutrition education and knowledge; (2) transition in caregiver-adolescent power balance and (3) the implications of societal and economic transition for diet and physical activity. Adolescents in urban and peri-urban areas could readily access 'junk' food. Diets in rural settings were determined by tradition, seasonality and affordability. Physical activity was inhibited by site-specific factors including lack of space and crime in urban settings, and the prioritisation of academic performance. Gender influenced physical activity across all sites, with girls afforded fewer opportunities. CONCLUSIONS: Interventions to improve adolescent diet and physical activity in LMIC need to be complex, context-specific and responsive to transitions at the individual, economic and societal levels. Moreover, solutions need to acknowledge gender inequalities in different contexts, as well as structural and cultural influences on diet and physical activity in resource-limited settings. Programmes need to be effective in engaging and reconciling adolescents' and caregivers' perspectives. Consequently, there is a need for action at both the community-household level and also through policy.

Anthropometric nutritional status, and social and dietary characteristics of African and Indian adolescents taking part in the TALENT (Transforming Adolescent Lives through Nutrition) qualitative study.

OBJECTIVE: To describe the anthropometry, socioeconomic circumstances, diet and screen time usage of adolescents in India and Africa as context to a qualitative study of barriers to healthy eating and activity. DESIGN: Cross-sectional survey, including measured height and weight and derived rates of stunting, low BMI, overweight and obesity. Parental schooling and employment status, household assets and amenities, and adolescents' dietary diversity, intake of snack foods, mobile/smartphone ownership and TV/computer time were obtained via a questionnaire. SETTING: Four settings each in Africa (rural villages, West Kiang, The Gambia; low-income urban communities, Abidjan, Cote D'Ivoire; low/middle-class urban communities, Jimma, Ethiopia; low-income township, Johannesburg, South Africa) and India (rural villages, Dervan; semi-rural villages, Pune; city slums, Mumbai; low-middle/middle-class urban communities, Mysore). PARTICIPANTS: Convenience samples (n 41-112 per site) of boys and girls, half aged 10-12 years and another half aged 15-17 years, were recruited for a qualitative study. RESULTS: Both undernutrition (stunting and/or low BMI) and overweight/obesity were present in all settings. Rural settings had the most undernutrition, least overweight/obesity and greatest diet diversity. Urban Johannesburg (27 %) and Abidjan (16 %), and semi-rural Pune (16 %) had the most overweight/obesity. In all settings, adolescents reported low intakes of micronutrient-rich fruits and vegetables, and substantial intakes of salted snacks, cakes/biscuits, sweets and fizzy drinks. Smartphone ownership ranged from 5 % (West Kiang) to 69 % (Johannesburg), higher among older adolescents. CONCLUSIONS: The 'double burden of malnutrition' is present in all TALENT settings. Greater urban transition is associated with less undernutrition, more overweight/obesity, less diet diversity and higher intakes of unhealthy/snack foods.

Fruit Polyphenols: A Review of Anti-inflammatory Effects in Humans.

Underlying etiological factors in the development of obesity-related chronic diseases are long-term imbalances of oxidative and inflammatory stress leading to tissue dysfunction, damage, and ultimately failure. Poor dietary quality contributes significantly to the oxidative and inflammatory status of an individual. Conversely, various dietary approaches, including specific dietary factors can mitigate or prevent the occurrence of these risk-conferring imbalances brought about by modern lifestyle. Plant-derived polyphenolic compounds are well known for their antioxidant properties. Recent evidence indicates these compounds may confer anti-inflammatory and/or inflammatory response stabilizing activities, which would have important implications in health maintenance and disease risk reduction. Commonly consumed fruits, such as grapes, berries, and oranges/orange juice, contain polyphenolic compounds that have been studied for their effects on inflammation, but the nature and extent of their effects in humans remain unclear. Therefore, this article aims to provide a comprehensive overview of human clinical trials investigating the acute and chronic (feeding) effect of polyphenols from commonly consumed fruits or their derived products on inflammation.

Berries: anti-inflammatory effects in humans.

A sustained pro-inflammatory state is a major contributing factor in chronic disease development, progression, and complication, including the most commonly known diseases: cardiovascular disease, Alzheimer's, and type 2 diabetes. Fruits, such as berries, contain polyphenol compounds purported to have anti-inflammatory activity in humans. Among the most notable polyphenols in berries are anthocyanins, responsible for their distinctive colors of red, blue, and purple. Berries have been studied widely for their antioxidant properties; however, preclinical data suggest important effects on inflammatory pathways. Correspondingly, the effects of berries, including extracts and purified anthocyanins, have been the subject of a number of human trials. This review aims to evaluate the current state of the human science on berry (products) as a source of dietary polyphenols, particularly anthocyanins, to modulate inflammatory status. Identifying dietary strategies that manage the modern-day inflammatory burden has important implications for chronic disease risk reduction and informing dietary guidelines aimed at achieving and maintaining health.

High dose trans-10,cis-12 CLA increases lean body mass in hamsters, but elevates levels of plasma lipids and liver enzyme biomarkers.

The current study examined the efficacy of graded doses of c9,t11 and t10,c12 CLA isomers on body composition, energy expenditure, hepatic and serum lipid liver biomarkers in hamsters. Animals (n = 105) were randomized to seven treatments (control, 1, 2, 3% of c9,t11; 1, 2, 3% of t10,c12) for 28 days. After 28 days treatment, 1-3% of t10,c12 lowered (p < 0.05) body fat mass compared to the control group. The 1-3% t10,c12 and 3% c9,t11 fed groups showed higher (p < 0.05) lean mass compared to other groups. We observed unfavorable changes in plasma total cholesterol and non-HDL cholesterol levels in animals fed with 3% t10,c12 CLA isomers. The 2%, 3% t10,c12 groups presented elevated (p < 0.05) ALT levels. The present data suggest that a diet enriched with more than 2% t10, c12 led to liver malfunction and poses unfavorable changes on plasma lipid profiles. The 1% t10,c12 CLA lowered (p < 0.05) body fat mass and increased (p < 0.05) lean body mass. The c9,t11 CLA has less potent actions than t10,c12 CLA. We conclude that the actions of CLA on energy and lipid metabolism are form and dose dependent in the hamster model.

Conjugated linoleic acid supplementation for 8 weeks does not affect body composition, lipid profile, or safety biomarkers in overweight, hyperlipidemic men.

The usefulness of conjugated linoleic acid (CLA) as a nutraceutical remains ambiguous. Our objective was, therefore, to investigate the effect of CLA on body composition, blood lipids, and safety biomarkers in overweight, hyperlipidemic men. A double-blinded, 3-phase crossover trial was conducted in overweight (BMI ≥ 25 kg/m(2)), borderline hypercholesterolemic [LDL-cholesterol (C) ≥ 2.5 mmol/L] men aged 18-60 y. During three 8-wk phases, each separated by a 4-wk washout period, 27 participants consumed under supervision in random order 3.5 g/d of safflower oil (control), a 50:50 mixture of trans 10, cis 12 and cis 9, trans 11 (c9, t11) CLA:Clarinol G-80, and c9, t11 isomer:c9, t11 CLA. At baseline and endpoint of each phase, body weight, body fat mass, and lean body mass were measured by DXA. Blood lipid profiles and safety biomarkers, including insulin sensitivity, blood concentrations of adiponectin, and inflammatory (high sensitive-C-reactive protein, TNFα, and IL-6) and oxidative (oxidized-LDL) molecules, were measured. The effect of CLA consumption on fatty acid oxidation was also assessed. Compared with the control treatment, the CLA treatments did not affect changes in body weight, body composition, or blood lipids. In addition, CLA did not affect the ß-oxidation rate of fatty acids or induce significant alterations in the safety markers tested. In conclusion, although no detrimental effects were caused by supplementation, these results do not confirm a role for CLA in either body weight or blood lipid regulation in humans.

Milk enriched with conjugated linoleic acid fails to alter blood lipids or body composition in moderately overweight, borderline hyperlipidemic individuals.

BACKGROUND: Dietary conjugated linoleic acid (CLA) represents a group of positional and geometric isomers of conjugated dienoic derivatives of linoleic acid. The effects of dietary CLA on blood lipids and body composition in humans remain controversial. OBJECTIVE: To examine whether consumption of milk enriched naturally or synthetically with cis 9, trans 11 (c-9, t-11) and trans 10, cis 12 (t-10, c-12) CLA isomers alters blood lipid indices, including concentrations of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triacyglycerol; indices of liver function including plasma alanine transaminase and total bilirubin; C-reactive protein; tumor necrosis factor-alpha; and body weight and composition in moderately overweight, borderline hyperlipidemic humans. DESIGN: A randomized, 3-phase, crossover, single-blind clinical trial was carried out in moderately overweight, borderline hyperlipidemic individuals who consumed (1) milk naturally enriched in CLA (4.2%) containing c-9, t-11 only providing 1.3 g/d of CLA; (2) milk enriched with a 4.2% synthetic mixture of t-10, c-12 and c-9, t-11 CLA isomers providing 1.3 g/d of CLA; or (3) untreated milk as a control providing 0.2 g/d CLA. Dietary phases were each 8 weeks in duration and were separated by 4-week washout periods. Plasma lipid levels were measured in blood samples collected at the beginning and end of each dietary phase. Magnetic resonance imaging was carried out at the beginning and end of each dietary phase to assess any changes in regional body fat composition. RESULTS: Compared with the control intervention, consumption of the two CLA-enriched milks failed to alter plasma total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, or triacyglycerol concentrations; body weight; or fat composition. CLA consumption did not significantly affect plasma alanine transaminase, total bilirubin, C-reactive protein, or tumor necrosis factor-alpha concentrations. CONCLUSION: Results from this study fail to support the role of milk enriched naturally with CLA containing c-9, t-11 or synthetically with c-9, t-11 and t-10, c-12 CLA isomers in modulation of lipid profiles or body composition in moderately overweight, borderline hyperlipidemic individuals.

Trans-8, cis-10+ cis-9, trans-11-conjugated linoleic acid mixture alters body composition in Syrian golden hamsters fed a hypercholesterolaemic diet.

The effectiveness of conjugated linoleic acid (CLA) as a weight-loss nutraceutical continues to be debatable, suggesting that there may be value in exploring the physiological effects of the lesser-known isomers. The effects of the minor isomer, trans-8, cis-10 (t8, c10)-CLA, in the form of an equimolar mixture with the cis-9, trans-11 (c9, t11) isomer, on body weight and body composition, circulating glucose and lipid concentrations, and liver weights were studied in sixty male Syrian golden hamsters. Animals were randomised to receive for 28 d a semi-purified, hypercholesterolaemic diet (5% dietary fat and 0.25% cholesterol) supplemented at the 2% level with either the t8, c10+c9, t11-CLA mixture, c9, t11-CLA or trans-10, cis-12 (t10, c12)-CLA replacing lard and safflower-seed oil (control). Results show that compared with control, the t8, c10+c9, t11-CLA mixture and t10, c12-CLA-fed animals had lower (P < 0.0001) fat mass following supplementation. Animals consuming t10, c12-CLA also possessed higher lean mass compared with control and c9, t11-CLA groups (P < 0.001). However, the livers of these animals were larger (P < 0.0001) compared with those in the control and other CLA groups. Body weights of the hamsters did not differ across the experimental groups. CLA treatments had no effect on serum glucose or lipid profile, except for inducing higher (P < 0.05) non-HDL-cholesterol concentration with t10, c12-CLA compared with the c9, t11 isomer. Overall, these results indicate that in male hamsters fed a hypercholesterolaemic diet, the t8, c10+c9, t11-CLA mixture does not have an impact on blood lipid profile, but is able to effectively reduce fat mass, without incurring an accompanying liver enlargement.

Effect of trans8, cis10+cis9, trans11 conjugated linoleic acid mixture on lipid metabolism in 3T3-L1 cells.

Evidence suggests that minor isomers of conjugated linoleic acid (CLA), such as trans8, cis10 CLA, can elicit unique biological effects of their own. In order to determine the effect of a mixture of t8, c10+c9, t11 CLA isomers on selected aspects of lipid metabolism, 3T3-L1 preadipocytes were differentiated for 8 days in the presence of 100 microM linoleic acid (LA); t8, c10+c9, t11 CLA; t10, c12+c9, t11 CLA or purified c9, t11 CLA. Whereas supplementation with c9, t11 and t10, c12+c9, t11 CLA resulted in cellular triglyceride (TG) concentrations of 3.4 +/- 0.26 and 1.3 +/- 0.11 microg TG/microg protein, respectively (P < 0.05), TG accumulation following treatment with CLA mixture t8, c10+c9, t11 was significantly intermediate (2.5 +/- 0.22 microg TG/microg protein, P < 0.05) between the two other CLA treatments. However, these effects were not attributable to an alteration of the Delta(9) desaturation index. Adiponectin content of adipocytes treated with t8, c10+c9, t11 mixture was similar to the individual isomer c9, t11 CLA, and both the t8, c10+c9, t11 and c9, t11 CLA groups were greater (P < 0.05) than in the t10, c12+c9, t11 CLA group. Overall, these results suggest that t8, c10+c9, t11 CLA mixture affects TG accumulation in 3T3-L1 cells differently from the c9, t11 and t10, c12 isomers. Furthermore, the reductions in TG accumulation occur without adversely affecting the adiponectin content of these cells.

CCR3 and CXCR3 as drug targets for allergy: principles and potential.

Atopic disorders include a range of conditions such as allergic asthma, -rhinitis, -conjunctivitis, -dermatitis, food and drug allergies and anaphylaxis. Induction of T helper (Th)-2 immune response with consequent IgE dependent eosinophil, basophil and mast cell mediated tissue damage is the characteristic feature of allergies. The mechanism underlying this unique and long appreciated feature of allergy is being elucidated at the molecular level with advances in our knowledge of the chemokine system. Thus, chemokines that target CCR3 in concert with Th2 cytokines appear to play a pathogenic role in allergy. In contrast, chemokines that target CXCR3 in concert with Th1 cytokine appear to play a beneficial role. Accordingly, inhibiting CCR3/Th2 pathway using CCR3 antagonists is viewed as a potentially useful strategy for anti-allergy drug development. In contrast, the idea of using CXCR3 agonists to inhibiting allergic response by promoting CXCR3/Th1 pathway faces serious concerns of their potential pro-inflammatory activities in vivo. In this article we have critically evaluated the literature examining the principle and potential of this anti-allergy drug development strategy including a summary of various compounds that are under investigation.