Metales en algas comestibles: Evaluación y estudio comparativo / Metals in edible algae: evaluation and comparative study

Los contenidos de 4 macroelementos (Na, K, Ca, Mg), 13 elementos traza (B, Ba, Co, Cr, Cu, Fe, Mn, Mo, Li, Zn, Ni, Sr, V) y 3 metales tóxicos (Al, Cd, Pb) se determinaron por espectrometría de emisión atómica por plasma acoplado inductivamente (ICP-OES) en 27 muestras de 7 especies de algas comestibles deshidratadas (Porphyra spp., Chondrus crispus, Palmaria palmata, Laminaria spp., Undari pinnatífica, Hilmanthia elongata, Ulva lactuca), procedentes de dos orígenes diferentes (la costa asiática y la Unión Europea) y comercializadas en la isla de Tenerife (Islas Canarias, España). Las concentraciones medias (mg/kg) fueron: 4281 (Na), 7179 (K), 3222 (Ca), 2458 (Mg), 38,14 (B), 2,72 (Ba), 0,11 (Co), 0,26 (Cr), 1,98 (Cu), 106 (Fe), 8,21 (Mn), 0,11 (Mo), 2,33 (Li), 10,63 (Zn), 1,02 (Ni), 1,47 (Sr), 1,54 (V), 48,71 (Al), 0,30 (Cd) y 0,17 (Pb). El consumo de algas (4 g/día) podría contribuir a las ingestas dietéticas de metales esenciales y elementos traza principalmente Mg (4,13% de la IDR en mujeres adultas y 3,54% de la IDR en hombres adultos) y Fe (2,36% de la IDR en mujeres adultas y 4,71% de la IDR en hombres adultos). Las ingestas de metales tóxicos (195 μg Al/día 1,18 μg Cd/día y 0,68 μg Pb/día) derivada del consumo de 4 g/día de las algas analizadas no representan riesgo toxicológico para los consumidores (AU)

The content of 4 macroelements (Na, K, Ca, Mg), 13 trace elements (B, Ba, Co, Cr, Cu, Fe, Mn, Mo, Li, Zn, Ni, Sr, V) and 3 toxic metals (Al, Cd, Pb) were quantified by inductively coupled plasma optical emission spectrometry (ICP-OES) in 27 samples of 7 dehydrated edible seaweed species (Porphyra spp., Chondrus crispus, Palmaria palmata, Laminaria spp., Undari pinnatífica, Hilmanthia elongata, Ulva lactuca), from two different production origins (Asian coast and European Union) and purchased in Tenerife island (Canary Islands, Spain). Mean concentrations (mg/kg) were: 4281 (Na), 7179 (K), 3222 (Ca), 2458 (Mg), 38.14 (B), 2.72 (Ba), 0.10 (Co), 0.26 (Cr), 1.98 (Cu), 106 (Fe), 8.21 (Mn), 0.11 (Mo), 2.33 (Li), 10.63 (Zn), 1.02 (Ni), 1.47 (Sr),1.54 (V), 48.71 (Al), 0.30 (Cd) and 0.17 (Pb). Daily consumption of seaweed (4 g/day) contributes to the dietary intake of metals, mainly Mg (4.13% of the RDA for adult women, and 3.54% of the RDA for adult men) and Fe (2.36% of the RDA for adult women, and 4.71% of the RDA in adult men). The estimated intakes of toxic metals derived from a daily seaweed consumption of 4 g (195 μg Al/day, 1.18 μg Cd/day and 0.68 μg Pb/day) did not reveal toxicological risks for consumers (AU)

Nutritional deficiencies in children on restricted diets.

Pediatric nutritional deficiencies are associated not only with poverty and developing countries, but also in children in the developed world who adhere to restricted diets. At times, these diets are medically necessary, such as the gluten-free diet for management of celiac disease or exclusion diets in children with food allergies. At other times, the diets are self-selected by children with behavioral disorders, or parent-selected because of nutrition misinformation, cultural preferences, alternative nutrition therapies, or misconceptions regarding food tolerance. Health care providers must be vigilant in monitoring both growth and feeding patterns to identify inappropriate dietary changes that may result in nutritional deficiencies.

Caracterización y evaluación nutricional de las dietas macrobióticas Ma-Pi / Characterization and nutritional evaluation of the Ma-Pi macrobiotic diets

Existe desconocimiento y confusión general sobre la alimentación macrobiótica. En el Instituto Finlay se están realizando, desde hace siete años, diferentes ensayos clínicos con las dietas macrobióticas Ma-Pi, desarrolladas por Mario Pianesi, fundador y presidente de "Un Punto Macrobiótico", Italia, con el objetivo de comprobar su seguridad nutricional y los efectos terapéuticos atribuidos. Estas dietas se basan en el consumo de alimentos naturales, integrales y ecológicos. Predominan los cereales integrales, los vegetales y las leguminosas. Este trabajo ofrece información sobre estas dietas, su caracterización, principios básicos, contenido y evaluación nutricional. Se determinó el contenido nutricional de cinco ejemplos de patrones alimentarios correspondientes al mismo número de dietas Ma-Pi y se comparó con las recomendaciones propuestas por grupos de expertos. Las dietas se destacaron por ser bajas en grasas, proteínas de origen animal y carbohidratos simples y altas en carbohidratos complejos, fibra dietética y antioxidantes. Las dietas Ma-Pi evaluadas fueron seguras nutricionalmente. Sus principios tienen un fuerte aval científico, por lo que pueden ser utilizadas para promover salud, prevenir y tratar enfermedades crónicas, ya que están compuestas por una gran cantidad de alimentos funcionales con poder terapéutico reconocido. Las investigaciones sobre su potencialidad terapéutica están en desarrollo(AU)

There exist lack of knowledge and general confusion on macrobiotic feeding. During 7 years, different clinical tests have been made at the "Finlay" Institute with the Ma-pi macrobiotic diets, developed by Mario Pianesi, founder and president of "A Macrobiotic Point", Italy, in order to check its nutritional safety and the therapeutic effects attributed to it. These diets are based on the consumption of natural, integral and ecological foods, with a predominance of the integral cereals, vegetables and legumes. This work offers information on these diets, their characterization, basic principles, content and nutritional evaluation. The nutritional content of 5 examples of alimentary patterns corresponding to the same number of Ma-pi diets was determined and compared with the recommendations proposed by experts' groups. The diets proved to have a low fat content, proteins of animal origin, simple carbohydrates, a high content of complex carbohydrates, dietary fiber and antioxidants. The evaluated Ma-pi diets were nutritionally safe. Their principles have a strong scientific support; therefore, they can be used to promote health and to prevent and treat chronic diseases, since they are composed of a great number of functional foods with recognized therapeutic power. The investigations about their therapeutic potentiality are under development(AU)

Caracterización y evaluación nutricional de las dietas macrobióticas Ma-Pi / Characterization and nutritional evaluation of the Ma-Pi macrobiotic diets

Existe desconocimiento y confusión general sobre la alimentación macrobiótica. En el Instituto Finlay se están realizando, desde hace siete años, diferentes ensayos clínicos con las dietas macrobióticas Ma-Pi, desarrolladas por Mario Pianesi, fundador y presidente de "Un Punto Macrobiótico", Italia, con el objetivo de comprobar su seguridad nutricional y los efectos terapéuticos atribuidos. Estas dietas se basan en el consumo de alimentos naturales, integrales y ecológicos. Predominan los cereales integrales, los vegetales y las leguminosas. Este trabajo ofrece información sobre estas dietas, su caracterización, principios básicos, contenido y evaluación nutricional. Se determinó el contenido nutricional de cinco ejemplos de patrones alimentarios correspondientes al mismo número de dietas Ma-Pi y se comparó con las recomendaciones propuestas por grupos de expertos. Las dietas se destacaron por ser bajas en grasas, proteínas de origen animal y carbohidratos simples y altas en carbohidratos complejos, fibra dietética y antioxidantes. Las dietas Ma-Pi evaluadas fueron seguras nutricionalmente. Sus principios tienen un fuerte aval científico, por lo que pueden ser utilizadas para promover salud, prevenir y tratar enfermedades crónicas, ya que están compuestas por una gran cantidad de alimentos funcionales con poder terapéutico reconocido. Las investigaciones sobre su potencialidad terapéutica están en desarrollo.

There exist lack of knowledge and general confusion on macrobiotic feeding. During 7 years, different clinical tests have been made at the "Finlay" Institute with the Ma-pi macrobiotic diets, developed by Mario Pianesi, founder and president of "A Macrobiotic Point", Italy, in order to check its nutritional safety and the therapeutic effects attributed to it. These diets are based on the consumption of natural, integral and ecological foods, with a predominance of the integral cereals, vegetables and legumes. This work offers information on these diets, their characterization, basic principles, content and nutritional evaluation. The nutritional content of 5 examples of alimentary patterns corresponding to the same number of Ma-pi diets was determined and compared with the recommendations proposed by experts' groups. The diets proved to have a low fat content, proteins of animal origin, simple carbohydrates, a high content of complex carbohydrates, dietary fiber and antioxidants. The evaluated Ma-pi diets were nutritionally safe. Their principles have a strong scientific support; therefore, they can be used to promote health and to prevent and treat chronic diseases, since they are composed of a great number of functional foods with recognized therapeutic power. The investigations about their therapeutic potentiality are under development.

Problemática nutricional del vegetarianismo en el embarazo, la lactancia y la edad infantil / Nutritional concerns regarding vegetarianism during pregnancy, breast-feeding and chilhood

La dieta vegetariana está siendo adoptada por un porcentaje creciente de población. En sus variedades lacto u ovolactovegetariana, el riesgo nutricional puede ser minimizado mediante una buena combinación de alimentos. Sin embargo, una dieta vegetariana estricta puede tener repercusiones negativas sobre todo en periodos de rápido crecimiento, y afectar el desarrollo físico y psicomotor. Deben controlarse de forma especial los requerimientos mínimos de ácidos grasos polinsaturados de larga cadena (PLC), hie-o, cinc y vitamina B 12 (AU)

The macrobiotic diet in cancer.

Macrobiotics is one of the most popular alternative or complementary comprehensive lifestyle approaches to cancer. The centerpiece of macrobiotics is a predominantly vegetarian, whole-foods diet that has gained popularity because of remarkable case reports of individuals who attributed recoveries from cancers with poor prognoses to macrobiotics and the substantial evidence that the many dietary factors recommended by macrobiotics are associated with decreased cancer risk. Women consuming macrobiotic diets have modestly lower circulating estrogen levels, suggesting a lower risk of breast cancer. This may be due in part to the high phytoestrogen content of the macrobiotic diet. As with most aspects of diet in cancer therapy, there has been limited research evaluating the effectiveness of the macrobiotic diet in alleviating suffering or prolonging survival of cancer patients. The few studies have compared the experience of cancer patients who tried macrobiotics with expected survival rates or assembled series of cases that may justify more rigorous research. On the basis of available evidence and its similarity to dietary recommendations for chronic disease prevention, the macrobiotic diet probably carries a reduced cancer risk. However, at present, the empirical scientific basis for or against recommendations for use of macrobiotics for cancer therapy is limited. Any such recommendations are likely to reflect biases of the recommender. Because of its popularity and the compelling evidence that dietary factors are important in cancer etiology and survival, further research to clarify whether the macrobiotic diet or similar dietary patterns are effective in cancer prevention and treatment is warranted.

Risk of persistent cobalamin deficiency in adolescents fed a macrobiotic diet in early life.

BACKGROUND: Cobalamin deficiency has been described in children consuming macrobiotic diets. OBJECTIVE: We investigated whether moderate consumption of animal products is sufficient for achieving normal cobalamin function in 73 adolescents who had received a macrobiotic diet until 6 y of age and had then switched to a lactovegetarian, lactoovovegetarian, or omnivorous diet (macrobiotic adolescents). DESIGN: Hematologic indexes and serum concentrations of methylmalonic acid (MMA), total homocysteine (tHcy), and folate were measured. Current consumption frequency of animal products and cobalamin intake from dairy products were assessed by questionnaire. Data from 94 age-matched adolescents who received an omnivorous diet from birth were used as a reference. RESULTS: Serum cobalamin concentrations were significantly lower and concentrations of MMA and folate and mean corpuscular volume (MCV) were significantly higher in macrobiotic adolescents than in control adolescents: of macrobiotic adolescents, 21% had abnormal MMA concentrations (>0.41 micromol/L), 37% had abnormal cobalamin concentrations (<218 pmol/L), 10% had abnormal tHcy concentrations (> 12.8 micromol/L), and 15% had abnormal MCV (> 89 fL). In macrobiotic adolescents, dairy products (200 g milk or yogurt and 22 g cheese/d) supplied on average 0.95 microg cobalamin/d; additionally, these adolescents consumed fish, meat, or chicken 2-3 times/wk. In girls, meat consumption contributed more to cobalamin status than the consumption of dairy products, whereas in boys these food groups were equally important. CONCLUSIONS: A substantial number of the formerly strict macrobiotic adolescents still had impaired cobalamin function. Thus, moderate consumption of animal products is not sufficient for restoring normal cobalamin status in subjects with inadequate cobalamin intake during the early years of life.

Reduced bone mass in Dutch adolescents fed a macrobiotic diet in early life.

This study investigated the effect of a macrobiotic (vegan-type) diet, low in calcium and vitamin D, consumed in early life, on bone mineral during adolescence. Bone mineral content (BMC) and bone area were measured in 195 adolescents (103 girls, 92 boys) aged 9-15 years, using dual-energy X-ray absorptiometry. Ninety-three adolescents (43 girls, 50 boys) had followed a macrobiotic diet in childhood, and 102 (60 girls, 42 boys) were control subjects. After adjustment for bone area, weight, height, percent body lean, age, and puberty, BMC was significantly lower in macrobiotic subjects, in boys and girls, respectively, at the whole body, -3.4% and -2.5%, spine, -8.5% and -5.0%, femoral neck, -8.0% and -8.2%, midshaft radius, -6.8% and -5.6%, and also in girls, at the trochanter, -5.8% (p < 0.05). No group differences were observed at the wrist. Group differences were not explained by current calcium adjusted bone mass at age 9-15 years, observations which may hold important implications for fracture risk in later life.

A rare cause of rickets in a young child.

We present a case of nutritional rickets in a young child due to a macrobiotic diet. The child presented with important thoracic deformation and breathing difficulties. Plain radiographs appeared to be an excellent method for the diagnosis and follow-up of the bony lesions in this disorder. We describe the typical bony abnormalities related to this relative rare disease.

Methylmalonic acid and homocysteine in plasma as indicators of functional cobalamin deficiency in infants on macrobiotic diets.

Methylmalonic acid and total homocysteine in plasma and serum have previously been used as indicators of intracellular cobalamin function in adults. To assess the usefulness of quantitation of these metabolites in the diagnosis of dietary cobalamin deficiency in infants, they were determined in plasma from 41 infants (aged 10-20 mo) on a macrobiotic diet and in 50 healthy group-matched omnivorous controls. In the macrobiotic infants, both methylmalonic acid and total homocysteine were markedly increased compared with controls (8-fold and 2-fold, respectively). Both metabolites showed an inverse relation to the plasma cobalamin level. The very low cobalamin content of the macrobiotic diet and low plasma cobalamin in macrobiotic infants makes an impaired cobalamin function likely in these infants. We therefore used dietary group as an independent indicator of cobalamin status. Different test parameters for cobalamin status were evaluated by comparing their ability to discriminate between the two dietary groups. Logistic regression analysis showed that methylmalonic acid followed by total homocysteine and cobalamin, in that order, were the strongest predictors of dietary group. Mean corpuscular volume and Hb had low discriminative power. We conclude that the determination of methylmalonic acid and total homocysteine represents a sensitive and specific test for the diagnosis and follow-up of nutritional cobalamin deficiency in infants. Furthermore, the finding of high methylmalonic acid and total homocysteine in plasma of most macrobiotic infants demonstrates a functional cobalamin deficiency in these subjects.

Macrobiotic nutrition and child health: results of a population-based, mixed-longitudinal cohort study in The Netherlands.

A population-based study on the nutritional status of children consuming macrobiotic diets was carried out in The Netherlands. Participants followed a macrobiotic diet based mainly on whole-grain cereals, pulses, and vegetables. Studies in children aged 0-10 y suggested that growth was retarded mainly between 6 and 18 mo. This was confirmed in a subsequent mixed-longitudinal study (including data on diet, anthropometry, blood chemistry, and pediatric examination) in 4-18 mo-old macrobiotic infants and a matched omnivorous control group. Ubiquitous deficiencies of energy, protein, vitamin B-12, vitamin D, calcium, and riboflavin were detected in macrobiotic infants, leading to retarded growth, fat and muscle wasting, and slower psychomotor development. Breast milk from macrobiotic mothers contained less vitamin B-12, calcium, and magnesium. Supplementation of the macrobiotic diet with fat (minimum 20-25 g/d), fatty fish (minimum 100-150 g/wk), and dairy products (minimum 150-250 g/d) is recommended.

Nutrients and contaminants in human milk from mothers on macrobiotic and omnivorous diets.

The effect of alternative dietary habits and prolonged lactation on the nutrient and contaminant concentrations in human milk was studied. The study sample consisted of mothers on macrobiotic diets, containing little or no diary products and meat, at 2-3 months postpartum (n = 9) and 9-13 months postpartum (n = 12), and mothers on omnivorous diets at 2-3 months postpartum (n = 10). Protein and zinc concentrations in breast-milk from macrobiotic mothers decreased with stage of lactation. After adjustment for stage of lactation, milk from macrobiotic mothers contained less calcium, magnesium and saturated fatty acids C15:0-C20:0, and more polyunsaturated fatty acids. Observed tendencies for lower protein and fat and higher lactose concentrations in the macrobiotic group were not statistically significant. Concentrations of vitamin B12, HCB and polychlorinated biphenyls (PCB 118, PCB 138, PCB 153 and PCB 180) were lower in the macrobiotic group. After adjustment for confounding variables, meat and fish consumption, but not dairy products, contributed to vitamin B12 concentrations. Meat and diary products strongly contributed to breast-milk concentrations of dieldrin and PCBs, fish to PCB 118, and smoking to DDT and dieldrin. Our findings suggest that breast-milk contamination could be reduced by abstinence from smoking and a moderate intake of animal products. However, risk of nutritional deficiencies rules out complete avoidance of meat, fish or diary products. Quantitative research on the effects of a reduced consumption of animal products, as well as smoking, on breast-milk contamination is warranted.

[Diet peculiarities. Vegetarianism, veganism, crudivorism, macrobiotism]. / Les particularités diététiques. Végétarisme, végétalisme, crudivorisme, macrobiotisme.

People who refuse to eat meat animal products mostly adhere to vegetarianism, veganism, crudivorism or macrobiotism, But these food habits are only one part of life-style chosen for spiritual, ethic or hygienic and healthy motivations. Except vitamin B12 deficiencies these regimens do not produce other deficiencies if they are correctly followed and if the energy intake is in agreement with the RDA'S. They reduce the risks of metabolic diseases, coronaropathies, arterial hypertension, colon cancer, diverticular disease of the colon, kidney and gallstones. Nevertheless crudivorism and macrobiotism are associated with high risks of deficiencies especially in children and pregnant women.

Stunting and nutrient deficiencies in children on alternative diets.

Studies in children fed alternative diets showed that anthropometric parameters and the intake of energy and nutrients by macrobiotic children deviated most from current norms. Therefore weaning practice, growth and haematological status were investigated in 3 age-cohorts of macrobiotic fed infants between 4 and 18 months of age and a control group. A mixed longitudinal design was used for this study. Main findings were a growth retardation which was strongest in the second cohort (8-14 months of age) and related to a diet low in energy density, fat and protein. Haematological data revealed very low vitamin B12 concentrations with consequently low values of haematocrit and red blood cell count and higher values of mean corpuscular volume and mean corpuscular haemaglobin mass in the macrobiotic group. High folate concentrations also seemed to be a consequence of Vitamin B12 deficiency. Iron deficiency was found in 15% of the macrobiotic group vs. no infants in the control group. Nutritional recommendations acceptable within the macrobiotic philosophy are discussed.

High prevalence of rickets in infants on macrobiotic diets.

The vitamin D status of 53 Caucasian infants aged 10-20 mo on a macrobiotic diet and 57 matched control infants on omnivorous diets was studied. In late summer (August-November) physical symptoms of rickets were present in 28% of the macrobiotic group; these infants had lower average plasma 25(OH)D concentrations (34.0 +/- 15.3 nmol/L) (mean +/- SD) than did the macrobiotic infants without such symptoms (49.7 +/- 21.9 nmol/L, p less than 0.02). Follow-up of a subsample of 25 macrobiotic infants in March-April revealed physical symptoms of rickets in 55% of the macrobiotic infants. All concentrations in blood were considerably below those in the preceding summer; the average 25(OH)D concentration was 12.3 +/- 4.3 nmol/L. Further analysis indicated that the low availability of calcium in the macrobiotic diet was an independent factor in causing the high prevalence of rickets in summer. Avoidance of milk products in combination with a high fiber intake may damage bone development in young children.