Trace element concentrations in hair of subjects from two South Pacific Islands, Atafu (Tokelau) and Kitava (Papua New Guinea).

The concentrations of trace elements in hair were measured in 108 healthy subjects (60 males and 48 females, mean age 46-years) resident on Atafu (Tokelau) and in 83 subjects (63 males and 20 females, mean age 26-years) living on Kitava island (Papua New Guinea). On Kitava, a traditional subsistence lifestyle uninfluenced by Western dietary habits is still maintained, but on Atafu the dietary habits have been modified by the inclusion of such imported foods as rice, flour, sugar and canned meat and fish. The concentrations of zinc and magnesium in hair were significantly higher in the Kitava than in the Atafu subjects, whereas those of copper were similar in both groups, and those of selenium, mercury, lead and cadmium were higher in Atafu subjects. The levels of serum copper, magnesium and selenium concentrations in Kitava subjects were not so low as to indicate any trace element deficiency. The higher hair content of mercury, lead and cadmium found among Atafu subjects might be due to consumption of marine foods contaminated with metals, consumption of canned foods, or frequent cigarette smoking, though it is difficult to single out any specific factor.

The effects of a 2-year switch from a mixed to a lactovegetarian diet on trace element status in hypertensive subjects.

Trace element status of 20 hypertensive subjects (14 women and 6 men, mean age 52 years) was compared to that of normotensives. The changes in trace element status, body weight and blood pressure after a 2-year switch from a mixed to a lactovegetarian diet were also compared between these groups. The concentration of copper in plasma and that of lead in hair were higher in hypertensive subjects than in normotensives, but the concentrations of zinc, magnesium and selenium in plasma, urine and hair were similar to those of normotensives. In the hypertensive subjects, 3 months after the diet shift there was a decrease in the concentrations of zinc in plasma, hair and urine, that of copper in plasma and hair, of magnesium in urine, of selenium in plasma and hair, and an increase in the magnesium content in plasma and hair. Also the concentrations of mercury, lead and cadmium in hair decreased after the diet switch. Among the hypertensives, the relative increase of magnesium in plasma was greater than that of normotensives; their relative decreases of selenium and lead in hair were lower, that of cadmium greater and that of copper in urine was lower. Four years after the start of the experiment when most subjects had resumed a mixed diet, mineral and trace element concentrations in plasma, hair and urine were similar to their baseline levels. Three months after the diet switch the relative decrease in body weight was more marked among hypertensive women (5%) than in female normotensives (3%), but similar among men of both groups (5%).(ABSTRACT TRUNCATED AT 250 WORDS)

Trace element status in healthy subjects switching from a mixed to a lactovegetarian diet for 12 mo.

The consequences of a change from a mixed to a lactovegetarian diet for 12 mo on trace element concentrations in plasma, hair, urine, and feces were studied in 16 women and 4 men. After the diet shift, intakes of zinc and magnesium did not change but that of selenium decreased by 40%. Three months after the diet shift, plasma and hair concentrations of zinc, copper, and selenium had decreased but those of magnesium had increased and the concentrations of mercury, lead, and cadmium in hair were lower. Also, the excretion of zinc, copper, and magnesium in urine, and that of selenium in urine and feces had decreased. Only small changes occurred during the remaining lactovegetarian-diet period. Three years later trace element concentrations had reverted towards baseline concentrations; copper values were similar to baseline concentrations but data for magnesium were slightly higher, and more complex patterns were observed for zinc and selenium. It is concluded that a shift to a lactovegetarian diet changes trace element status.

Trace element alterations in infectious diseases.

Trace elements like copper, zinc, iron and selenium have a significant influence on the function of the immune system. We studied plasma levels of trace elements in 53 patients with acute bacterial and viral infections. In bacterial infections (septicaemia, pneumonia, erysipelas and meningitis) the plasma concentrations of selenium, iron and zinc were decreased. Plasma copper was unchanged in patients with erysipelas, but increased in other types of bacterial infections. Although the patients with viral infections showed similar shifts of the trace elements as were observed in patients with bacterial infections, the changes were not as pronounced. A plasma selenium value below 0.8 mumol/l was found in only 6% of the patients with viral infections in contrast to 63% of the patients with septicaemia or 57% of the patients with pneumonia. Furthermore, in viral infections 60% of the zinc values were below the mean level of 12.8 mumol/l observed in healthy controls as compared with 90% of the values in patients with sepsis or 92% of the values in patients with pneumonia. The onset of change in trace elements occurred within a few days and persisted for several weeks. These changes seem to be non-specific and are independent of the agent causing infection. The different types of infections were followed by changes in most of the plasma proteins which are known to be associated with an inflammatory reaction. The changes in plasma proteins were most pronounced in patients with sepsis and pneumonia. Patients with sepsis having a high degree of inflammation did not show a positive correlation between the severity of the disease--as judged by plasma proteins--and the alterations of trace elements.

Nutritional status in girls with juvenile chronic arthritis.

Nutritional status, with emphasis on nutrients involved in inflammatory processes, was investigated in 26 girls with juvenile chronic arthritis (JCA) and in healthy controls. Children with JCA had decreased plasma selenium compared to controls. Glutathione peroxidase activity in plasma was similar in both groups but the activity in blood was slightly depressed in JCA. The decrease in blood glutathione peroxidase was more pronounced in patients with high to medium disease activity. Ascorbic acid was measured in plasma, platelets, mononuclear cells and granulocytes. A slight decrease in granulocyte ascorbic acid was observed in patients but in plasma, platelets and mononuclear cells no difference was observed. Serum alpha-tocopherol, blood folate and serum cobalamine was the same in both groups. Several patients, especially in the youngest group, exhibited impaired growth. Serum creatinine and arm muscle circumference were lower in the arthritic patients indicating a lower muscle mass. These changes were more pronounced in patients with systemic or polyarticular onset of the disease. The possibility that the changes in nutritional status in patients with JCA can be corrected by dietary supplementation needs further investigation.

Selenium status in vegans and lactovegetarians.

Plasma and urinary selenium were determined among vegans, lactovegetarians and several groups of omnivorous subjects, using gas-liquid chromatography. Plasma Se was lower among lactovegetarians (0.80 (SD 0.18) mumol/l) than in the other groups (0.98 (SD 0.15) mumol/l). This was not related to Se intake, since the vegans had a lower and the lactovegetarians a higher intake of Se than omnivorous subjects in Sweden. Urinary Se was 0.36 (SD 0.10) mumol/d for controls, 0.17 (SD 0.10) mumol/d for vegans and 0.16 (SD 0.07) mumol/d for lactovegetarians. No relation between dietary Se and urinary Se was observed. Among vegetarians, plasma Se and urinary Se were correlated (r 0.51; P less than 0.05).

Vegan regimen with reduced medication in the treatment of bronchial asthma.

Thirty-five patients who had suffered from bronchial asthma for an average of 12 yr, all receiving long-term medication, 20 including cortisone, were subject to therapy with vegan food for 1 yr. In almost all cases, medication was withdrawn or drastically reduced. There was a significant decrease in asthma symptoms. Twenty-four patients (69%) fulfilled the treatment. Of these, 71% reported improvement at 4 months and 92% at 1 yr. There was a significant improvement in a number of clinical variables; for example, vital capacity, forced expiratory volume at one sec and physical working capacity, as well as a significant change in various biochemical indices as haptoglobin, IgM, IgE, cholesterol, and triglycerides in blood. Selected patients, with a fear of side-effects of medication, who are interested in alternative health care, might get well and replace conventional medication with this regimen.

A vegan regimen with reduced medication in the treatment of hypertension.

Twenty-nine patients who had suffered from essential hypertension for an average of 8 years, all receiving long-term medication for hypertension, were subject to therapy with vegan food for 1 year. In almost all cases medication was withdrawn or drastically reduced. There was a significant decrease in systolic and diastolic blood pressure. A number of reported symptoms disappeared. There was a significant improvement in a number of clinical variables as well as a significant change in various biochemical indices such as urea, haptoglobin, cholesterol and triglyceride concentrations in blood. Subjectively all patients reported improvement. Selected patients, with a fear of side-effects of medication, who are interested in alternative health care might replace conventional medication with this dietary regimen.

Vegetarian fasting of obese patients: a clinical and biochemical evaluation.

The effects of vegetarian fasting were evaluated in 14 grossly obese patients who participated in a program comprising 5 weeks' fasting in a lactovegetarian health center. Before and after the fasting period the patients were hospitalized and put on a standardized weight-maintaining diet; at the health center they consumed vegetable juices containing less than 1 MJ and 3 g of protein per day. The weight reduction (mean +/- S.D.) was 13.4 +/- 5.0 kg (from 132.0 +/- 27.2 to 118.6 +/- 16.1 kg). Except for the first few days the patients had no severe hunger sensations. No severe adverse clinical effects were noted. The laboratory status--comprising serum or plasma levels of minerals, protein, and lipids; hematological data; and variables reflecting liver and thyroid function--revealed abnormal group mean values only for ferritin and the acute-phase reactants haptoglobin, C-reactive protein, and anti-chymotrypsin in the obese. The levels of potassium, retinol-binding protein, and haptoglobin decreased, and aminotransferase and lactate dehydrogenase activities and free fatty acid and glycerol concentrations increased as a result of the fasting. The most striking effect of the weight reduction was an increase in the HDL cholesterol levels. Fasting according to the described regimen thus seems to provide a safe method for treatment of obese patients.

Content of trans-octadecenoic acid in vegetarian and normal diets in Sweden, analyzed by the duplicate portion technique.

The intake of trans fatty acids by subjects adhering to the normal Swedish diet or to different vegetarian regimes was studied, using chemical analysis of duplicate portions. Trans-octadecenoic acid was 5.0, 3.9, and 1.8% of dietary fatty acid in the normal, lactovegetarian, and vegan diets, respectively, corresponding to 2.0, 1.3, and 0.5% of energy intake. The results are related to the content of trans-octadecenoic acid in some edible fats.

Nutrient intake and health status of vegans. Chemical analyses of diets using the duplicate portion sampling technique.

A strict vegetarian diet [vegan diet (VD)] was investigated. Six middle-aged vegans (three men and three women) collected copies of 24-h diets using the duplicate portion sampling technique. By chemical analyses, the nutrient composition was determined in detail and compared with corresponding figures of a normal mixed Swedish diet. In the VD 30% of the energy originated from fat compared with 40% in normal Swedish mixed diet (MD). Linoleic acid was the dominant fatty acid (60% of total fat in VD versus 8% in MD). The VD contained 24 g protein/1000 kcal compared to 30 g/1000 kcal in MD, but the intake of essential amino acids by the vegans exceeded the recommendations. Dietary fiber was about 5 times higher in the vegan diet (29 versus 6 g/1000 kcal) and sucrose similar to MD (18 versus 21 g/1000 kcal). Among the inorganic nutrients the concentration of calcium (351 versus 391 mg/1000 kcal) and sodium (53 versus 49 mmol/1000 kcal) were similar in both types of diets but the amount of potassium (56 versus 30 mmol/1000 kcal, magnesium (300 versus 110 mg/1000 kcal), iron (9 versus 6.5 mg/1000 kcal), zinc (6.5 versus 4.7 mg/1000 kcal), and copper (2 versus 0.7 mg/1000 kcal) were nearly doubled. Iodine (39 versus 156 micrograms/1000 kcal and selenium (5 versus 17 micrograms/1000 kcal) were much lower in the VD, selenium even being undetectable in several 24-h diets. The VD was rich in folic acid (301 versus 90 micrograms/1000 kcal in MD) but the intake of vitamin B12 was only 0.3 to 0.4 microgram/day (MD: 3 to 4 micrograms/day). No clinical signs of nutritional deficiency were observed in the vegans. Serum protein levels of the vegans as well as their serum lipoproteins were near the lower range of the reference group. In addition, none of the vegans was overweight and their blood pressures were low for their age.

Acid hydrolases in serum from patients with lysosomal disorders.

The activity of acid hydrolases was studied in serum from patients with mucolipidosis (II and III) and other lysosomal disorders. In mucolipidosis II and III all hydrolases examined except alpha-glucosidase, beta-glucosidase and acid phosphatase were greatly increased. High values for beta-galactosidase were seen in mucopolysaccharidosis types I and II, Gaucher's disease, juvenile amaurotic idiocy and metachromatic leucodystrophy. N-Acetyl-beta-glucosaminidase activity was high in mucopolysaccharidosis types I, II, III and Gaucher's disease. The activity of beta-glucuronidase was increased in mucopolysaccharidosis types I, II and III, Gaucher's disease, juvenile amaurotic idiocy and metachromatic leucodystrophy. Acid phosphatase had increased activity only in Gaucher's disease. In several lysosomal storage disorders no increased values could be found. It is suggested that high values in serum from patients with lysosomal storage disorders (not including mucolipidosis II and III) may depend upon liver cell damage, which disturbs the clearing of acid hydrolases from serum.

A new N-acetyl-beta-D-hexosaminidase disease with late onset of progressive neurological symptoms.

Clinical data are presented on a 30-year-old male with normal early development (4-5 years) but subsequent progressive impairment of psychomotor functions. He has marked kyphoscoliosis and talipes calcaneo-valgus. The organs appear normal and the patient can walk unaided and feed himself although he does not recognize his parents. He has normal fundi oculi. Biochemical data show an absence of mucopolysacchariduria and very low but detectable levels of N-acetyl-beta-D-hexosaminidase in serum and leucocytes. The clinical symptoms are much milder than would normally be expected from such a profound enzyme deficiency (Sandhoff disease).

Urinary abnormalities in fucosidosis. Characterization of a disaccharide and two glycoasparagines.

The urinary excretion of fucose-containing material was found to be highly increased in a patient with fucosidosis type 2. Three structurally related compounds, a disaccharide and two glycoasparagines, were isolated from the urine. The isolation procedure included ultrafiltration, gel chromatography on Sephadex G-25, preparative zone electrophoresis and paper chromatography. From structural studies including optical rotation, sugar analysis, methylation analysis, ninhydrin degradation, reduction with lithium aluminium hydride and partial hydrolysis, the following structures were deduced: formula (see text), where Fucp is fucopyranose, Manp is mannopyranose, Galcp is galactopyranose, GlcNAcp is 2-acetamido-2-deoxyglucopyranose and Asn is asparagine. The yields of these compounds were 1.7, 40, and 6 mg/l, respectively. The origin of the disaccharide and the two glycoasparagines is probably the core region of glycoprotein carbohydrate chains.