BackgroundThe possibility that lifestyle factors such as diet, specifically potassium intake, may modify the risk of stroke has been suggested by several observational cohort studies, including some recent reports. We performed a systematic review and meta‐analysis of existing studies and assessed the dose–response relation between potassium intake and stroke risk.Methods and ResultsWe reviewed the observational cohort studies addressing the relation between potassium intake, and incidence or mortality of total stroke or stroke subtypes published through August 6, 2016. We carried out a meta‐analysis of 16 cohort studies based on the relative risk (RR) of stroke comparing the highest versus lowest intake categories. We also plotted a pooled dose–response curve of RR of stroke according to potassium intake. Analyses were performed with and without adjustment for blood pressure. Relative to the lowest category of potassium intake, the highest category of potassium intake was associated with a 13% reduced risk of stroke (RR=0.87, 95% CI 0.80–0.94) in the blood pressure–adjusted analysis. Summary RRs tended to decrease when original estimates were unadjusted for blood pressure. Analysis for stroke subtypes yielded comparable results. In the spline analysis, the pooled RR was lowest at 90 mmol of potassium daily intake (RRs=0.78, 95% CI 0.70–0.86) in blood pressure–adjusted analysis, and 0.67 (95% CI 0.57–0.78) in unadjusted analysis.ConclusionsOverall, this dose–response meta‐analysis confirms the inverse association between potassium intake and stroke risk, with potassium intake of 90 mmol (≈3500 mg)/day associated with the lowest risk of stroke.
In Vietnam, nutrition interventions do not target school children despite a high prevalence of micronutrient deficiencies. The present randomised, placebo-controlled study evaluated the impact of providing school children (n 403) with daily multiple micronutrient-fortified biscuits (FB) or a weekly Fe supplement (SUP) on anaemia and Fe deficiency. Micronutrient status was assessed by concentrations of Hb, and plasma ferritin (PF), transferrin receptor (TfR), Zn and retinol. After 6 months of intervention, children receiving FB or SUP had a significantly better Fe status when compared with the control children (C), indicated by higher PF (FB: geometric mean 36·9 (95 % CI 28·0, 55·4) mg/l; SUP: geometric mean 46·0 (95 % CI 33·0, 71·7) mg/l; C: geometric mean 34·4 (95 % CI 15·2, 51·2) mg/l; P,0·001) and lower TfR concentrations (FB: geometric mean 5·7 (95 % CI 4·8, 6·52) mg/l; SUP: geometric mean 5·5 (95 % CI 4·9, 6·2) mg/l; C: geometric mean 5·9 (95 % CI 5·1, 7·1) mg/l; P¼ 0·007). Consequently, body Fe was higher in children receiving FB (mean 5·6 (SD 2·2) mg/kg body weight) and SUP (mean 6·1 (SD 2·5) mg/kg body weight) compared with the C group (mean 4·2 (SD 3·3) mg/kg body weight, P, 0·001). However, anaemia prevalence was significantly lower only in the FB group (1·0 %) compared with the C group (10·4 %, P¼ 0·006), with the SUP group being intermediate (7·4 %). Children receiving FB had better weight-for-height Z-scores after the intervention than children receiving the SUP (P¼0·009). Vitamin A deficiency at baseline modified the intervention effect, with higher Hb concentrations in vitamin A-deficient children receiving FB but not in those receiving the SUP. This indicates that vitamin A deficiency is implicated in the high prevalence of anaemia in Vietnamese school children, and that interventions should take other deficiencies besides Fe into account to improve Hb concentrations. Provision of biscuits fortified with multiple micronutrients is effective in reducing anaemia prevalence in school children.Key words: School-aged children: Anaemia: Iron: Vitamin A: Zinc: Fortification: Pharmaceutical supplementation Anaemia and Fe-deficiency anaemia (IDA) have a negative impact (1) on physical and cognitive development of children, on immune status and resistance to infection and on work capacity. Fe deficiency (ID) affects nearly 3·5 billion people throughout the world, mainly women of reproductive age, infants and young children (2) . It is estimated that in developing countries, more than 40 % of preschool children and women of reproductive age are affected by anaemia (3) .Vietnam has experienced considerable economic growth in the last 10 years (4) and the living standard of the population has gradually increased, mainly in urban areas (5) . Malnutrition including micronutrient deficiencies remains a serious problem among vulnerable groups, in particular those living in rural or mountainous zones. In 2000, 34 % of the children aged , 5 years were underweight, and this has fallen to , 20 % over the last...
Following a request from the European Commission, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked to deliver an opinion on pyrroloquinoline quinone disodium salt (PQQ), trade name BioPQQ TM , as a novel food pursuant to Regulation (EC) No 258/97. PQQ is produced by fermentation using Hyphomicrobium denitrificans CK-275 and purification process. PQQ has a minimum purity of 99.0%. The information provided on the composition, specifications, batch-to-batch variability, stability and production process of PQQ is sufficient and does not raise safety concerns. The applicant intends to market PQQ for use in food supplements for healthy adults, except pregnant and lactating women, at a maximum proposed level of consumption of 20 mg/day (corresponding to 0.29 mg/kg bw per day for a 70-kg person). The proposed level of consumption is at least 250 times higher than the estimated background intake of PQQ occurring naturally in foods. Information on the absorption, distribution, metabolism and excretion of PQQ in animals and humans is limited. Considering the no-observed-adverse-effect-level (NOAEL) of 100 mg/kg bw per day from a 90-day repeated dose oral toxicity study with BioPQQ TM , and the maximum proposed level of consumption, the Panel concludes that the margin of exposure (of 344) is sufficient. The Panel concludes that the novel food, pyrroloquinoline quinone disodium salt (BioPQQ TM ), is safe under the intended conditions of use as specified by the applicant. This is an open access article under the terms of the Creative Commons Attribution-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited and no modifications or adaptations are made.The EFSA Journal is a publication of the European Food Safety Authority, an agency of the European Union. SummaryFollowing a request from the European Commission, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) was asked to deliver an opinion on the safety of pyrroloquinoline quinone disodium salt (PQQ), trade name BioPQQ TM , as a novel food (NF) pursuant to Regulation (EC) No 258/97. The assessment, which follows the methodology set out in Commission Recommendation 97/618/EC, is based on the data supplied in the original application, the initial assessment by the competent authority of Ireland, the concerns and objections of a scientific nature raised by the other Member States and the responses of the applicant.PQQ is produced by fermentation using Hyphomicrobium denitrificans CK-275 and purification process. The final form of the PQQ is a reddish-brown powder with a minimum purity of 99.0%. The source organism does not have a history of use in food. Notwithstanding the limited knowledge on the bacterial strain, neither the live bacteria nor the DNA are present in the NF above the detection limits of the analytical techniques applied. H. denitrificans is included in the microbiological specifications of the NF. The Panel therefore considers that the use of H. deni...
This review aims to describe approaches used to estimate bioavailability when deriving dietary reference values (DRV) for iron and zinc using the factorial approach. Various values have been applied by different expert bodies to convert absorbed iron or zinc into dietary intakes, and these are summarised in this review. The European Food Safety Authority (EFSA) derived zinc requirements from a trivariate saturation response model describing the relationship between zinc absorption and dietary zinc and phytate. The average requirement for men and women was determined as the intercept of the total absorbed zinc needed to meet physiological requirements, calculated according to body weight, with phytate intake levels of 300, 600, 900 and 1200 mg/d, which are representative of mean/median intakes observed in European populations. For iron, the method employed by EFSA was to use whole body iron losses, determined from radioisotope dilution studies, to calculate the quantity of absorbed iron required to maintain null balance. Absorption from the diet was estimated from a probability model based on measures of iron intake and status and physiological requirements for absorbed iron. Average dietary requirements were derived for men and pre- and post-menopausal women. Taking into consideration the complexity of deriving DRV for iron and zinc, mainly due to the limited knowledge on dietary bioavailability, it appears that EFSA has made maximum use of the most relevant up-to-date data to develop novel and transparent DRV for these nutrients.
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