Eur J Clin Nutr

Low cereal intake in Estonian infants: the possible explanation for the low frequency of coeliac disease in Estonia.

Year 1998
Mitt K. Uibo O.
Department of Pediatrics, University of Tartu, Estonia.
OBJECTIVE: The aim of this study was to analyse the intake of coeliac disease (CD) inducing, gluten containing cereals (wheat, rye, barley and oats) in Estonian infants diet and compare these results with neighbouring countries with different CD incidence rate. DESIGN: Study group consisted of 32 healthy full term infants of Estonian origin. SETTINGS: Study was carried out in Tartu University Women's Hospital and in Tartu University Children's Hospital. These are both primary care facilities. SUBJECTS: Infants were recruited to the study group according to their health parameters and parents agreement to take part of this study. Material of this article is based on one part of Estonian infants dietary habits investigation. RESULTS: The total amount of gluten containing cereals in Estonian infants diet was lower than in Sweden and Finland. We found that there is a certain parallelism between CD incidence and cereal intake. Wheat intake of Estonian infants was very close to Finnish infants, but almost twice lower than in Swedish infants. CONCLUSION: Data from the study is consistent with the hypothesis that gluten intake during infancy play role in development of CD. The quality of gluten-containing cereals may have important part in the development of the disease.

Effects of intrauterine growth retardation on mortality and morbidity in infants and young children.

Year 1998
Ashworth A.
Centre for Human Nutrition, London School of Hygiene and Tropical Medicine, UK.
This review aims to quantify the risks of mortality and morbidity associated with intrauterine growth retardation (IUGR). Twenty-nine data sets with birth-weight-specific mortalities are examined to determine whether consistent patterns of risk emerge when data from different populations are compared. Measures of mortality risk are also made with birth weight as a dichotomous variable. Twelve data sets are presented. From the data available, it is estimated that for term infants weighing 2000-2499 g at birth, the risk of neonatal death is 4 times higher than for infants weighing 2500-2999 g, and 10 times higher than for infants weighing 3000-3499 g. The risk of postneonatal death in term infants weighing 2000-2499 g is estimated to be 2 times higher than for infants 2500-2999 g, and 4 times that of infants weighing 3000-3499 g. Estimates of risk for IUGR infants are less consistent than for preterm infants. This could be due to methodological differences, particularly smaller sample sizes in the studies in developing countries, or may reflect real variation in risk. The latter may be associated with the heterogeneity of IUGR across populations, or to varying risks depending, for example, on which infections predominate or infant age at peak prevalence. IUGR is most prevalent in developing countries and the review therefore focuses on morbidity from diarrhoeal and respiratory infections. Data from nine studies are presented. There is an increased risk of diarrhoea in term infants < 2500 g and an increased risk of pneumonia. The risks of morbidity and mortality appear to differ depending on whether infants are wasted or stunted at birth. Stunted infants of low birth weight have higher neonatal mortality than wasted newborns, but this could be due to inclusion of infants with congenital anomalies who are often stunted. Wasted infants are more prone than stunted infants to neonatal morbidity. No comparative postneonatal data were located.

A review of associations between Crohns disease and consumption of sugars.

Year 1998
Riordan AM. Ruxton CH. Hunter JO.
Addenbrookes Hospital, Cambridge.
OBJECTIVES: To critically review the available literature reporting associations between the onset of Crohn's disease and intakes of sugars or sugar-containing foods. To evaluate published evidence on the use of dietary manipulation of sugars in the treatment of Crohn's disease. DESIGN: All publications from refereed journals which reported intakes of sugars and sugar-containing foods in the context of Crohn's disease onset or treatment were selected. CONCLUSION: Evidence suggesting a relationship between sugars and onset of Crohn's disease was inconsistent and subject to important methodological limitations. There was a clear lack of distinction between reporting of current, as opposed to, retrospective intakes. There appeared to be no clinical advantage to the use of reduced sugar diets in Crohn's disease treatment.

Malignant epithelial tumours in the upper digestive tract: a dietary and socio-medical case-control and survival study.

Year 1998
Freng A. Daae LN. Engeland A. Norum KR. Sander J. Solvoll K. Tretli S.
Department of Otorhinolaryngology, Ulleval University Hospital, Oslo, Norway.
OBJECTIVE: The aim of the present study was to elucidate the influence of social, dietary and environmental factors on the incidence of malignant epithelial tumours in the upper digestive tract and on the prognosis of patients with these cancers. DESIGN: A population-based case-control study was carried out, and the patients in the study were included in a survival analysis. SETTING: The study was carried out at the Department of Otorhinolaryngology at Ulleval University Hospital, Oslo, Norway. SUBJECTS: In the case-control study, 84 patients and 89 controls were included. Only the patients were included in the survival analysis. RESULTS: Smoking showed the highest odds ratio (OR) for morbidity (OR = 29). The patients had in general a lower social status, and a higher alcohol intake (OR = 6.6). For both beta-carotene and vitamin C, the ORs decreased with increasing intake (OR = 0.2 and 0.3, respectively). Increased ORs were associated with low values for haemoglobin, iron, TIBC, folic acid, magnesium and especially for albumin (OR = 14), and with high values for ferritin, vitamin B12 and thiocyanate (a marker for smoking). Stage of the disease was an important prognostic factor. The relative risk (RR) of dying for disseminated vs localised tumours being 3.2. A poorer prognosis was linked to higher age, to smoking vs no smoking (RR = 2.3), and to lower levels of haemoglobin, albumin, magnesium and thiocyanate. CONCLUSIONS: Strong beer, liquor, consumption of milk and table fat, low social status and smoking seemed to have a negative impact on both disease and survival. Fruit and vegetables might, however, reduce the risk. Whereas low serum albumin, iron and magnesium indicated a high OR for cancer, vitamin C and beta-carotene had the opposite implication. No significant implications on survival could be detected in blood chemistry beyond the stage of disease.