Nutrition reviews
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Evidence has established the protective effect of folic acid (FA) fortification and periconceptional supplementation on neural tube defects (NTDs). Folic acid fortification and periconceptional supplementation of women may reduce the risk of certain childhood cancers in their offspring. ⋯ Future debates and decisions regarding FA fortification should take into consideration all potential adverse effects and dose-responses of such a measure because it may be associated with very serious consequences for many generations. In addition to careful monitoring of adverse effects, preclinical and population-based studied are warranted in order to determine the efficacy, safety, and potential deleterious effects of FA fortification and supplementation on cancer risk and other health outcomes.
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The prevalence of vitamin B12 deficiency increases in the elderly, mainly because atrophic gastritis decreases the production of the acid and digestive enzymes needed to cleave protein-bound vitamin B12 from the natural chemical form of vitamin B12 found in meat, poultry, fish, and dairy foods. Depending on the biochemical criterion that is used, 5% to more than 20% of older adults have marginal or frank vitamin B12 deficiency. Adults over 50 years of age should meet the Recommended Dietary Allowance by consuming vitamin B12 in the crystalline form, which does not require gastric acid or enzymes for initial digestion. A recent clinical trial suggests that an oral dose of 500 microg/d of crystalline vitamin B12 is needed to reverse biochemical signs of vitamin B12 deficiency in older adults.
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Review
The FOOD Trial Collaboration: nutritional supplementation strategies and acute stroke outcome.
Results from three large, randomized, multicenter FOOD (Feed or Ordinary Food) Collaboration Trials showed no reduction in death or poor outcome with routine oral protein-energy supplementation of stroke patients who were primarily well nourished upon admission to the hospital. Nasogastric tube feeding was favored over percutaneous endoscopic gastrostomy as the early route of feeding in dysphagic stroke patients.
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Mensink and Katan showed in 1990 that trans fats reduce high- and increase low-density lipoprotein cholesterol. Unilever aided this study because the company considered knowledge on trans fats incomplete in spite of their long history of safe use. ⋯ Over the next 14 years, manufacturers worldwide followed suit. This experience illustrates that food companies need to know about the health effects of their products and how to apply that knowledge.