Bioavailability of Oral Curcumin in Systematic Reviews: A Methodological Study.

Curcumin is a natural compound found in turmeric that exhibits diverse biological activities. However, its poor bioavailability limits its therapeutic application, which has led to the development of various bioavailability-improved formulations. In this methodological study, we analyzed whether systematic reviews on curcumin considered the bioavailability of systemic oral curcumin formulations when synthesizing evidence from human clinical trials. A total of 171 systematic reviews published between 2003 and 2022 were included in the study. From the included studies, we extracted data on study characteristics; type of curcumin; methods; and reporting regarding bioavailability, funding, and conflict of interest. Our results show that systematic reviews rarely consider the variable bioavailability of tested curcumin formulations. Relevant statistical subgroup and/or sensitivity analyses were reported in the methods and results of only 3.5% and 6.4% of reviews, respectively. However, more reviews mentioned bioavailability in their discussion (57%) or conclusion (13%). The detailed analysis of the included systematic reviews suggests that there is broad recognition of product bioavailability as a crucial factor affecting the health effects of curcumin, which is not accompanied by adequate evidence synthesis. Therefore, the results of most systematic reviews on orally administered curcumin should be taken with caution.

Functional biotransformation of phytoestrogens by gut microbiota with impact on cancer treatment.

The human gut is a host for trillions of microorganisms, divided into more than 3,000 heterogeneous species that is called the gut microbiota. The gut microbiota composition can be altered by many different endogenous and exogenous factors, especially diet and nutrition. A diet rich in phytoestrogens, a variable group of chemical compounds similar to 17-ß-estradiol (E2), the essential female steroid sex hormone is potent to change the composition of gut microbiota. However, the metabolism of phytoestrogens also highly depends on the action of enzymes produced by gut microbiota. Novel studies have shown that phytoestrogens could play an important role in the treatment of different types of cancers, such as breast cancer in women, due to their potential to decrease estrogen levels. This review aims to summarize recent findings about the lively dialogue between phytoestrogens and gut microbiota and to address their possible future application, especially in treating patients with diagnosed breast cancer. A potential therapeutic approach for the prevention and improving outcomes in breast cancer patients could be based on targeted probiotic supplementation with the use of soy phytoestrogens. A positive effect of probiotics on the outcome and survival of patients with breast cancer has been established. However, more in vivo scientific studies are needed to pave the way for the use of probiotics and phytoestrogens in the clinical practice of breast cancer treatment.

Methods Used for Enhancing the Bioavailability of Oral Curcumin in Randomized Controlled Trials: A Meta-Research Study.

It is unknown how randomized controlled trials (RCTs) approach the problem related to curcumin bioavailability. We analyzed methods and reporting regarding the bioavailability of systemic oral curcumin used in RCTs. We searched PubMed on 12 September 2020, to find articles reporting RCTs that used curcumin as an intervention. We extracted data about trial characteristics, curcumin products used, methods for improving curcumin bioavailability, and mentions of curcumin bioavailability. We included 165 RCTs. The most common category of intervention was simply described as "curcumin" or "curcuminoids" without a commercial name. There were 107 (64%) manuscripts that reported that they used methods to enhance the oral bioavailability of curcuminoids used in their intervention; 25 different methods were reported. The most common method was the addition of piperine (23%). Phospholipidated curcumin, a combination of curcumin and turmeric oils, nanomicellar curcumin, and colloidal dispersion of curcumin were the next most common methods. Fourteen trials (8.4%) compared more than one different curcumin product; nine (7.9%) trials compared the bioavailability/pharmacokinetics of curcumin products. In conclusion, a high number of diverse methods were used, and very few trials compared different curcumin products. More studies are needed to explore the comparative bioavailability and efficacy of different curcumin products.

Optimization of MAE for the Separation of Nicotine and Phenolics from Tobacco Waste by Using the Response Surface Methodology Approach.

This study intends to valorize by-products of the industrial processing of tobacco to obtain nicotine and phenolics as value-added compounds. Three influential parameters of the microwave-assisted extraction-MAE (temperature, treatment time, and solvent/solid ratio) were studied for the optimization of the extraction protocol for tobacco leaves and three types of waste-scrap, dust, and midrib, respectively. Nicotine was the dominant bioactive compound in all extracts, ranging from 1.512 to 5.480% in leaves, 1.886 to 3.709% in scrap, 2.628 to 4.840% dust, and 0.867 to 1.783% in midrib extracts. Five phenolic compounds were identified and quantified, predominated by chlorogenic acid and rutin. Additionally, total phenol content and antioxidant activity were determined using spectrophotometric assays. Optimization was performed in two aspects: to obtain a maximum extraction yield with minimum nicotine content and to obtain a maximum extraction yield with maximum nicotine content. These findings demonstrate that tobacco waste is a valuable source of bioactive compounds and MAE can be a promising alternative technique to obtain extracts rich in targeted bioactive compounds, especially nicotine.

Changes in dietary habits of patients with chronic pain represent contributing factors to decreased pain intensity and improved quality of life. Pilot study from Croatia / Los cambios en los hábitos alimenticios de los pacientes con dolor crónico representan factores que contribuyen a la disminución de la intensidad del dolor y a una mejor calidad de vida. Estudio piloto de Croacia

INTRODUCTION: chronic pain is a complex entity with immense individual and societal burden. OBJECTIVES: to assess the effectiveness of specifically designed nutrition education for the management of chronic pain and whether any change in dietary habits contribute to decrease in pain intensity. Objectives and methods: 40 patients were enrolled in the 4-week intervention study. Patients filled-in questionaires regarding their basic characteristics, pain intensity, quality of life, and dietary habits at baseline and post-intervention. Intervention consisted of 1 individual and 2 group counselings based on the nutrition education specifically designed for the chronic pain management. RESULTS: post-intervention, pain intensity decreased in 67.5 % of patients while quality of life improved significantly (from 42.9 ± 31.3 to 70.1 ± 26.2 points, p = 0.015). All patients responded to nutrition education by increasing the number of meals per day (p < 0.001), improving regularity of breakfast (p = 0.005) and by less frequently skipping meals (p = 0.027). Fewer meal skipping (OR = 0.037, 95 % CI (0.003-0.482), p = 0.012) and lower consumption of foods with negative effect on chronic pain (OR = 0.008, 95 % CI (0.000-0.444), p = 0.019) were found to modestly, but independently contribute to decrease in pain intensity. Still, patients with higher BMI and several diagnoses had low response. CONCLUSIONS: the developed nutrition education is fit for the management of chronic pain. The main benefits are improved meal consumption pattern along with reduced consumption of foods with pro-inflammatory effect and food cravings. The complexity of chronic pain is obvious in low responsiveness among patients with higher BMI and several conditions

INTRODUCCIÓN: el dolor crónico es una entidad compleja con una inmensa carga individual y social. OBJETIVO: verificar si la educación nutricional diseñada específicamente para el tratamiento del dolor crónico y si algún cambio en los hábitos alimenticios contribuyen a disminuir la intensidad del dolor. MATERIAL Y MÉTODOS: se incluyeron 40 pacientes en el estudio observacional intervencionista de 4 semanas. Los pacientes completaron cuestionarios sobre las características básicas: la intensidad del dolor, la calidad de vida y los hábitos alimenticios al inicio y después de la intervención. La intervención consistió en 1 asesoramiento individual y 2 grupales basados en la educación nutricional diseñada específicamente para el tratamiento del dolor crónico. RESULTADOS: después de la intervención, la intensidad del dolor disminuyó en el 67,5 % de los pacientes al tiempo que mejoró significativamente la calidad de vida (de 42,9 ± 31,3 a 70,1 ± 26,2 puntos, p = 0,015). Todos los pacientes respondieron a la educación nutricional: aumentaron el número de comidas por día (p < 0,001), mejoraron la regularidad del desayuno (p = 0,005) y omitieron las comidas con menos frecuencia (p = 0,027). Menos saltos de comida (OR = 0,037, IC 95 % [0,003-0.482], p = 0,012) y menor consumo de alimentos con efecto negativo sobre el dolor crónico (OR = 0,008, IC 95 % [0,000-0,444], p = 0.019) se encontraron que modestamente, pero, de formma independiente, contribuyen a disminuir la intensidad del dolor. Sin embargo, los pacientes con mayor BMI y varios diagnósticos tuvieron baja resonancia. CONCLUSIÓN: la educación nutricional desarrollada es adecuada para el manejo del dolor crónico. Los mejores beneficios son un patrón mejorado de consumo de comida junto a un consumo reducido de alimentos con efecto proinflamatorio y antojos de alimentos. La complejidad del dolor crónico es visible en baja respuesta entre pacientes con mayor BMI y varios diagnósticos

Changes in dietary habits of patients with chronic pain represent contributing factors to decreased pain intensity and improved quality of life. Pilot study from Croatia.

INTRODUCTION: Objectives: to assess the effectiveness of specifically designed nutrition education for the management of chronic pain and whether any change in dietary habits contribute to decrease in pain intensity. Objectives and methods: 40 patients were enrolled in the 4-week interventional observational study. Patients filled-in questionaires regarding their basic characteristics, pain intensity, quality of life, and dietary habits at baseline and post-intervention. Intervention consisted of 1 individual and 2 group counselings based on the nutrition education specifically designed for the chronic pain management. Results: post-intervention, pain intensity decreased in 67.5 % of patients while significantly improving quality of life (from 42.9 ± 31.3 to 70.1 ± 26.2 points, p = 0.015). All patients responded to nutrition education by increasing the number of meals per day (p < 0.001), improving regularity of breakfast (p = 0.005) and by less frequently skipping meals (p = 0.027). Fewer meal skipping (OR = 0.037, 95 % CI (0.003-0.482), p = 0.012) and lower consumption of foods with negative effect on chronic pain (OR = 0.008, 95 % CI (0.000-0.444), p = 0.019) were found to modestly, but independently contribute to decrease in pain intensity. Still, patients with higher BMI and several diagnoses had low resonse. Conclusions: the developed nutrition education is fit for the management of chronic pain. The main benefits are improved meal consumption pattern along with reduced consumption of foods with pro-inflammatory effect and food cravings. The complexity of chronic pain is obvious in low responsiveness among patients with higher BMI and several conditions.

INTRODUCCIÓN: Introducción: el dolor crónico es una entidad compleja con una inmensa carga individual y social. Objetivo: verificar si la educación nutricional diseñada específicamente para el tratamiento del dolor crónico y si algún cambio en los hábitos alimenticios contribuyen a disminuir la intensidad del dolor. Material y métodos: se incluyeron 40 pacientes en el estudio observacional intervencionista de 4 semanas. Los pacientes completaron cuestionarios sobre las características básicas: la intensidad del dolor, la calidad de vida y los hábitos alimenticios al inicio y después de la intervención. La intervención consistió en 1 asesoramiento individual y 2 grupales basados en la educación nutricional diseñada específicamente para el tratamiento del dolor crónico. Resultados: después de la intervención, la intensidad del dolor disminuyó en el 67,5 % de los pacientes al tiempo que mejoró significativamente la calidad de vida (de 42,9 ± 31,3 a 70,1 ± 26,2 puntos, p = 0,015). Todos los pacientes respondieron a la educación nutricional: aumentaron el número de comidas por día (p < 0,001), mejoraron la regularidad del desayuno (p = 0,005) y omitieron las comidas con menos frecuencia (p = 0,027). Menos saltos de comida (OR = 0,037, IC 95 % [0,003-0.482], p = 0,012) y menor consumo de alimentos con efecto negativo sobre el dolor crónico (OR = 0,008, IC 95 % [0,000-0,444], p = 0.019) se encontraron que modestamente, pero, de formma independiente, contribuyen a disminuir la intensidad del dolor. Sin embargo, los pacientes con mayor BMI y varios diagnósticos tuvieron baja resonancia. Conclusión: la educación nutricional desarrollada es adecuada para el manejo del dolor crónico. Los mejores beneficios son un patrón mejorado de consumo de comida junto a un consumo reducido de alimentos con efecto proinflamatorio y antojos de alimentos. La complejidad del dolor crónico es visible en baja respuesta entre pacientes con mayor BMI y varios diagnósticos.

Efficacy and safety of oral and inhalation commercial beta-glucan products: Systematic review of randomized controlled trials.

BACKGROUND & AIMS: Beta-glucans are advertised as biologically active compounds, with various health claims. We aimed to summarize results about efficacy and safety of commercial oral and inhalation beta-glucan products on human health from randomized controlled trials (RCTs). METHODS: We conducted systematic review of RCTs. We searched MEDLINE, CENTRAL and ClinicalTrials.gov. Any commercial product, any types of participants and any health-related outcomes were eligible. Two authors independently screened studies and extracted data. Cochrane risk of bias tool was used. This review did not have any extramural funding. Registration: PROSPERO record no. 42016043539. RESULTS: We included 30 RCTs that were conducted on healthy or ill participants. Most of the trials reported beneficial effect of beta-glucan, but among the 105 different outcome domains and measures that were used, only three could be considered clinically relevant, while others were various biomarkers and surrogate outcomes such as complete blood count. Included studies on average had 33 participants per study arm, high or unclear risk of bias of at least one domain, and only half of them reported data for safety. More than half of trials that reported source of funding indicated commercial sponsorship from producers of beta-glucan. Only five RCTs reported trial registration. CONCLUSIONS: Commercial beta-glucan products were studied in a number of RCTs whose results can be considered only as preliminary, as they used small number of participants and surrogate outcomes. The quality of many studies was poor and further research and trials on bigger population should be performed before a final conclusion can be made.

Traditional Herbal Medicines for Diabetes Used in Europe and Asia: Remedies From Croatia and Sri Lanka.

Diabetes is a global pandemic where alternative means of combating the disease have been the focus of research in recent years. Herbal remedies for diabetes have proven to be a valuable alternative therapy given the fact that many of the existing synthetic drugs are incapable of curbing the disease progression. This review article serves as an appraisal of highlighting the variety and diversity of herbal remedies that are present around the world by looking at only 2 countries-Croatia and Sri Lanka-located in Europe and Asia, respectively. The following herbs were selected for review: from Croatia: (1) Cichorium intybus, (2) Olea europaea, (3) Taraxacum campylodes, (4) Urtica dioica, and (5) Vaccinium myrtillus; and from Sri Lanka: (1) Acacia catechu, (2) Allium sativum, (3) Aloe vera, (4) Cinnamomum zeylanicum, (5) Gymnema sylvestre, and (6) Zingiber officinale. The botanical origins, bioactive compounds, evidence-based studies on antidiabetic properties, as well as uses and applications of these herbs in various ailments, are included herein. A plethora of scientific evidence on the antidiabetic potency of these herbs exists to date, through which it is apparent that they could be promoted as alternative therapies for diabetes.

Optimization of Ultrasound-Assisted Extraction of Some Bioactive Compounds from Tobacco Waste.

This is the first study on ultrasound-assisted extraction (UAE) of bioactive compounds from different types of tobacco industry wastes (scrap, dust, and midrib). The obtained results were compared with starting raw material (tobacco leaves) to see the changes in bioactive compounds during tobacco processing. Results suggested that tobacco waste extracts possess antioxidant activity and considerable amounts of targeted bioactive compounds (phenolics and solanesol). The content of chlorogenic acid varied between 3.64 and 804.2 µg/mL, caffeic acid between 2.34 and 10.8 µg/mL, rutin between 11.56 and 93.7 µg/mL, and solanesol between 294.9 and 598.9 µg/mL for waste and leaf extracts, respectively. There were noticeable differences between bioactive compounds content and antioxidant activity in extracts related to applied UAE conditions and the used type of tobacco waste. Results show that optimal UAE parameters obtained by response surface methodology (RSM) were different for each type of material, so process optimization proved to be necessary. Considering that tobacco waste is mostly discarded or not effectively utilized, the results clearly show that tobacco waste could be used as a potential source of some bioactive compounds.

Bioactive Profile of Various Salvia officinalis L. Preparations.

Salvia officinalis L., also known as the "Salvation Plant", has been long used and well-documented in traditional medicine around the globe. Its bioactive compounds, and especially its polyphenol profile, have been extensively researched and reviewed. However, sage's beneficial effects reach much further, and nowadays, with a range of new extraction techniques, we are discovering new components with new therapeutic effects, especially in the context of neurodegenerative diseases and various carcinomas. This review describes the bioactive profile of various sage preparations depending on the extraction techniques and extraction parameters, and this review lists the newest research findings on its health effects.

Forestalling the Epidemics of Parkinson's Disease Through Plant-Based Remedies.

Parkinson's disease (PD) as the second leading neurodegenerative disease, imposes a heavy burden among individuals as well as economies worldwide. The main characteristics of PD is a progressive loss of dopaminergic neurons resulting in the loss of motor function, the occurrence of non-motor symptoms, and cognitive decline. Similar to many other chronic diseases, complementary and alternative therapies (CAT) are very popular for the treatment of this disease. This review evaluates six plants, three each from European and Asian traditional medicinal systems: (1) Atropa belladonna, (2) Hyoscyamus niger, (3) Lepidium meyenii, (4) Aspargus racemosus, (5) Mucuna pruriens L., and (6) Gingko biloba. Atropa belladonna, and Hyoscyamus niger in particular, are better known for their poisonous and narcotic effects than as potentially effective plants for the treatment of neurodegenerative diseases. Ginkgo biloba is one of the most widely cultured plants in Traditional Chinese Medicine with high antioxidant potential which contributes to its neuroprotective/ anti-apoptotic activity. The bioactive compounds, anti-neurodegenerative effects and other neuroprotective effects of all six plants are discussed herein.

Body Mass Index and the Literacy on Obesity in Relation to Media Following.

BACKGROUND: The aim of this study was to investigate the effects of TV, magazines, radio, and internet following on body mass index (BMI) and obesity-related literacy among adults. METHODS: In this cross-sectional study, the subjects were recruited from an outpatient center in the city of Sombor, Serbia during Mar-Apr 2013. We collected data by a questionnaire from 657 (397 women; 59%) subjects, aged from 18 to 87 yr (Mean = 45; SD =14). The questionnaire consisted of personal data, body height and weight, frequency of television, radio, magazines and internet following and personal opinion on the impact of smoking, alcohol consumption, stress and physical inactivity on obesity. RESULTS: Spearman's rank correlation analysis showed that BMI increased with longer TV viewing with a very weak strength of the correlation (r=0.104; P=0.009) and decreased with more internet following with a weak strength of the correlation (r=-0.200: P<0.001). Multiple linear regression analysis revealed that only internet use had a significant independent effect on BMI. The frequency rise of internet following from "rare" to "often" and "every day" decreased BMI by 0.5 per each grade. Internet followers showed a significantly better knowledge of the importance of smoking (P = 0.003), alcohol consumption (P<0.001) and physical inactivity (P=0.004) for obesity in comparison to non-followers. CONCLUSION: Internet is the only media that independently and positively influence weight control and the literacy on obesity among adults.

Dietary intake of vitamin B12 in relation to diet and lifestyle characteristics in a population at high risk for colorectal cancer.

OBJECTIVE: Besides irreplaceable role in health, vitamin B12 is proposed to have cytoprotective role in colorectal cancer (CRC). So far, studies are inconclusive on the role dietary intake of vitamin B12 has in CRC. The aim of this study was to determine whether total dietary intake of vitamin B12 and contribution from its food sources relates to a low-risk diet and lifestyle in a population at high risk for CRC. METHODS: An observational study on 200 healthy adults from Eastern Croatia was conducted during April-May 2013. A typical diet of this population in this region is characterized with all known major dietary risk factors for CRC placing the population at high risk for CRC, yet the incidence of CRC remains relatively low. RESULTS: Diet and lifestyle characteristics of 52.2% of participants can be classified as the high-risk for CRC. Women, people in lower BMI category, and urban residents have significantly lower risk of the high-risk diet and lifestyle. Higher intake of vitamin B12 shows positive association with the low-risk diet and lifestyle. Intake of vitamin B12 from milk, dairy and fish represent independent factors for the low-risk diet and lifestyle in this population at high-risk for CRC. CONCLUSIONS: Higher intake of vitamin B12, especially intake from milk, dairy and fish are associated with the low-risk diet and lifestyle in a population at high risk for CRC. Further studies should focus on interplay between vitamin B12 and other nutrients that share the same food sources to elucidate their role in the aetiology and pathology of CRC.

Comparison of various techniques for the extraction of umbelliferone and herniarin in Matricaria chamomilla processing fractions.

Chamomile, a well-known medicinal plant, is a rich source of bioactive compounds, among which two coumarin derivatives, umbelliferone and herniarin, are often found in its extracts. Chamomile extracts have found a different uses in cosmetic industry, as well as umbelliferone itself, which is, due to its strong absorption of UV light, usually added to sunscreens, while herniarin (7-methoxycoumarin) is also known for its biological activity. Therefore, chamomile extracts with certain herniarin and umbelliferone content could be of interest for application in pharmaceutical and cosmetic products. The aim of this study was to compare the extracts of different chamomile fractions (unprocessed chamomile flowers first class, processed chamomile flowers first class, pulvis and processing waste) and to identify the best material and method of extraction to obtain herniarin and umbelliferone. Various extraction techniques such as soxhlet, hydrodistillation, maceration and supercritical CO2 extraction were used in this study. Umbelliferone and herniarin content was determined by high performance liquid chromatography (HPLC). The highest yield of umbelliferone (11.80 mg/100 g) and herniarin (82.79 mg/100 g) were obtained from chamomile processing waste using maceration technique with 50% aqueous ethanol solution and this extract has also proven to possess antioxidant activity (61.5% DPPH scavenging activity). This study shows a possibility of potential utilization of waste from chamomile processing applying different extraction techniques.

Antidiabetic Effects of Aronia melanocarpa and Its Other Therapeutic Properties.

Diabetes is a global pandemic which warrants urgent attention due to its rising prevalence and economic burden. Thus, many alternative therapies are being researched for antidiabetic properties, given the inefficacy of current medicinal treatments. From this perspective, Aronia melanocarpa or black chokeberry has been investigated for its therapeutic properties in many studies, especially for its ability to combat hyperglycemia-induced oxidative stress and the macrovascular complications of diabetes including cardiovascular disease. Though A. melanocarpa is native to the eastern areas of North America, it has been planted extensively in Europe and Asia as well. Several in vivo studies have displayed the antioxidant properties of A. melanocarpa berry juice and plant extract in rat models where oxidative stress markers were observed to have significant reductions. Some of the potent bioactive compounds present in the fruits and other parts of the plant were identified as (-)-epicatechin, chlorogenic acid, neochlorogenic acid, and cyanidin-3-galactoside. Overall, A. melanocarpa could be considered a good source of antioxidants which is effective in combating hyperglycemia-induced oxidative stress.

COMPARISON OF DIET IN WOMEN OF REPRODUCTIVE AGE WITH AND WITHOUT DIAGNOSED POLYCYSTIC OVARY SYNDROME - PILOT STUDY.

INTRODUCTION: This study was aimed at comparing diets, dietary patterns and lifestyle habits of women with polycystic ovary syndrome and controls in Croatia. MATERIAL AND METHODS: In this pilot, matched pair study, the participants were women of reproductive age: 12 with Polycystic Ovary Syndrome and 16 healthy (between the ages of 18 and 41 years). The following data sets were collected and a,nalysed:.nutrient intake, dietary habits and physical activity, polycystic ovary syndrome symptoms, anthropometry and biochemical records. RESULTS: The analyses of dietary habits showed a significantly (p=0.030) higher score for the controls (92.4?8.7 points) compared to the women with polycystic ovary syndrome (83.3?12.2 points). There was a significant correlation between the age and intake of total carbohydrates, and intake of plant protein in the women with polycystic ovary syndrome. A significant correlation was found between the age and total fats intake, as well as intake of different types of fats, and energy intake in the controls. The free time activity index showed a significant difference (t-test: p=0.043, ANOVA: p=.004) in favour of the control group of women who were more active. CONCLUSIONS: This study has shown that Croatian women with polycystic ovary syndrome compared to the controls have significantly poorer dietary habits characterised by high Glycaemic Index diets, they are less physically active during free time. and have positive significant correlation between the age and carbohydrate intake whereas the controls have positive significant correlation between the age and fat intake.

Nutritional knowledge and dietary habits survey in high school population.

During adolescence, young people are in a sensitive transition period when they gradually take over the responsibility for their own eating habits, health attitudes and behaviours and create lifelong habits so it is essential that they adopt healthy habits according to dietary recommendations. Knowledge is one of the factors necessary for the changes in dietary habits. The'objective of this study was to gain insight in nutritional knowledge and dietary habits of adolescents. The sample included 117 adolescents aged 17-19 years. Self-administered, anonymous questionnaire, representing modified version of General Nutrition Knowledge Questionnaire was used to assess general characteristics, nutritional knowledge about nutrients, dietary recommendations, sources of nutrients, diet-disease relationship, and dietary habits. Less than one third of adolescents showed satisfactory knowledge, but boys, adolescents from rural environment and overweight adolescents showed significantly lower knowledge unlike others. Meal skipping was present habit, especially for breakfast consumption. Especially high consumption of meat and meat products was noted for boys, while fruit and vegetables for girls. Fad dieting was quite practiced habit, especially in girls and overweight adolescents. Among girls, high consumption of sweets was confirmed, while boys showed high consumption of soft drinks. Television presents the main source of infor- mation about nutrition for adolescents. Collected data shows similarity with other research in Europe and North America that confirm strong influence of globalization and fast spread of unhealthy habits. The results pointed out weak spots in nutritional knowledge and revealed unhealthy eating habits. This information is necessary for the development of new approaches to modulate their knowledge and consequently act on their behaviour. Behavioral changes would include higher number of meals per day, regular breakfast consumption, higher intake of fish, lower consumption of meat and meat products, sweetened foods and drinks etc. The final outcome would result in longterm positive impact on dietary habits.

Cluster analysis as a prediction tool for pregnancy outcomes.

Considering specific physiology changes during gestation and thinking of pregnancy as a "critical window", classification of pregnant women at early pregnancy can be considered as crucial. The paper demonstrates the use of a method based on an approach from intelligent data mining, cluster analysis. Cluster analysis method is a statistical method which makes possible to group individuals based on sets of identifying variables. The method was chosen in order to determine possibility for classification of pregnant women at early pregnancy to analyze unknown correlations between different variables so that the certain outcomes could be predicted. 222 pregnant women from two general obstetric offices' were recruited. The main orient was set on characteristics of these pregnant women: their age, pre-pregnancy body mass index (BMI) and haemoglobin value. Cluster analysis gained a 94.1% classification accuracy rate with three branch- es or groups of pregnant women showing statistically significant correlations with pregnancy outcomes. The results are showing that pregnant women both of older age and higher pre-pregnancy BMI have a significantly higher incidence of delivering baby of higher birth weight but they gain significantly less weight during pregnancy. Their babies are also longer, and these women have significantly higher probability for complications during pregnancy (gestosis) and higher probability of induced or caesarean delivery. We can conclude that the cluster analysis method can appropriately classify pregnant women at early pregnancy to predict certain outcomes.

What Is the Real Public Health Significance of Iron Deficiency and Iron Deficiency Anaemia in Croatia? A Population-Based Observational Study on Pregnant Women at Early Pregnancy from Eastern Croatia.

AIM: Studies imply that significance of iron deficiency (ID) and iron deficiency anaemia (IDA) for pregnancy outcomes is especially highlighted in the early pregnancy. Prevalence around the world varies widely, however, no data is available up to date for Croatia or neighbouring countries. Therefore, the objective was to determine the prevalence of ID and IDA among pregnant women from Croatia at the first trimester. Also, the aim was to compare two criterions; the World Health Organization (WHO) one and the clinical one. METHODS: Randomised observational population based study was set up and 265 pregnant women at the first trimester were enrolled. RESULTS: Based on the WHO criteria, 17.7% on haemoglobin basis and 18.5% on haematocrit basis had either ID or IDA. Clinical criteria showed that even 32.8% had either ID or IDA (transferrin saturation <20.0%). The WHO criterion shows less sensitivity, especially in detecting less severe stages of IDA. CONCLUSIONS: Regardless of the criteria used, ID and IDA present a mild to moderate public health problem in pregnant women population. This high share of pregnant women who are starting their pregnancy as iron deficient, presents a potentially high risk for the pregnancy outcomes, especially in terms of a newborn, and it is fully justified to treat them as diseases of public health significance.

The question is whether intake of folic acid from diet alone during pregnancy is sufficient.

UNLABELLED: PREGNANCY AND FOLIC ACID: Pregnancy is the most important period in life of every woman, partially for the number of physiological adaptations she is going through, partially for the expectance of new life. In addition, pregnancy is the "critical window" for development later in childhood, as a period of foetal programming during which nutrition plays one of crucial roles. Despite the general belief that nutrition through pregnancy is adequate and characterized by better nutritional habits, a number of studies do not corroborate this belief. ROLE OF FOLIC ACID: An adequate folate blood level is necessary for normal cell growth, synthesis of several compounds including deoxyribonucleic acid and ribonucleic acid, proper brain and neurologic functions; it is included in the regulation of homocysteine level, and closely related to the vitamin B12 metabolism. Folate deficiency in pregnancy is related to neural tube defects, other neurological disorders, preterm delivery and low birth weight. FOOD SOURCES: A correlation between folate and the prevention of broad spectrum of chronic diseases has been confirmed. Emerging evidence from the epigenetic studies is now bringing even more light on the level of significance of folic acid. A wide range of plant and animal foods are the natural sources of folate; liver, yeast, mushrooms, and green leafy vegetables being the most significant. Different ways of food preparation influence the folate stability and its bioavailability varies from 25 to 50% from foods, 85% from enriched foods or 100% from supplements. CONCLUSION: A great amount of scientific results has led to official recommendations for folic acid supplementation in pregnant women as well as in a number of obligatory or voluntary fortification programmes in order to prevent the folate deficiency on the level of different population groups. Nevertheless, there must be a certain level of precaution for elderly because folate can mask the vitamin B12 deficiency with possible fatal outcomes.