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Immigration almost always involves major cultural changes in dietary, social and health-related beliefs and behaviour. Two years after the arrival of the earliest Yemenite immigration wave to Israel, about 30 years ago, the prevalence rate of diabetes in that population was almost nonexistent (approximately 0.06%), increasing to approximately 12% 25 years later. Obesity and hyperlipoproteinemia were not always correlated with diabetes. Ethiopians, mainly from the northern regions, first immigrated to Israel ten years ago. At that time, their prevalence rate of diabetes was 0-0.4%. Though it is too early to determine the overall prevalence rate in this population, 5-8% rates have been reported after up to 5 years in Israel. The objective of the present work was to study the effect of the diversity of ethnic food patterns and adaptability on the nutritional status of Ethiopian immigrants. Two groups were studied--teenagers and adults. After 2 and 18 months in Israel, adult Ethiopians who arrived in Israel in 1991 (n = 426) had an average body mass index (BMI) of 20-22 kg/m2, which was below western values; a waist:hip ratio (WHR) of 0.9 suggested abdominal fat accumulation. Fasting serum- glucose levels were within the norm, whereas insulin levels were high (24 micrograms/mL). Plasma triglycerides (TG) increased with age, from about 100 to 150 mg/dL, whereas cholesterol and lipoprotein levels remained stable and normal. The BMI of Ethiopian teenagers (n = 15) 5-7 years in Israel was similar to that found in adults. Fasting serum insulin levels were significantly lower in boys than in girls (approximately 16.6 vs approximately 18.6 microU/mL, respectively). Cholesterol values were significantly higher in girls than in boys (approximately 184 vs approximately 150 mg/dL); TG, high density and low density lipoprotein values were normal. These data indicate the existence of early signs of risk factors for diabetes, which may not manifest itself clinically unless provoked. Several causes, rendered detrimental by progress, could be setting the stage for early manifestation of risk factors for cardiovascular disease and diabetes. Of these, two are of pertinence to this work: a genetic endowment for low-energy output and the thrifty genotype, and maternal undernutrition.

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PURPOSE: To study the distribution, prevalence, determinants, and association between substance use (e.g., cigarettes, alcohol, and illegal drugs) and eating attitudes and behavior of high school students in the Negev region of Israel in order to provide an improved basis for prevention and health services. METHODS: An anonymous questionnaire regarding attitudes and behavior related to substance use and eating (e.g., breakfast before school, a snack or meal during school time, and three meals a day) was answered by 1,513 high school age youth. RESULTS: The study participants were at greater risk of poor eating behavior if they: (1) used cigarettes, alcohol, and/or illicit substances (p < .01); and (2) were female (p < .01). It was found that girls who used cigarettes were more likely than other young people studied not to eat properly and not to know about the relation between proper eating behavior and personal health (p < .05). Regardless whether cigarettes, alcohol, or illicit substances were used or not used, more than 50% of the youth reported not eating breakfast and 30% indicated they did not eat three meals daily. CONCLUSIONS: There are many concerns about the use and abuse of both licit and illicit substances among adolescents. More attention, however, needs to be given to the relationship between substance use and the attitudes and behavior of young people toward their health, including proper eating habits. The results support the need to develop drug prevention and health programs that are more comprehensive in terms of addressing the broad range of factors associated with adolescent growth and development.

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Experimental dietary studies of human colorectal carcinogenesis are usually based on the AIN-76A diet, which is dissimilar to human food in source, preparation, and content. The aims of this study were to examine the feasibility of preparing and feeding rats the diet of a specific human population at risk for colorectal neoplasia and to determine whether changes in the colonic morphology and metabolic contents would differ from those resulting from a standard rat diet. The mean daily food intake composition of a previously evaluated adenoma patient case-control study was used for the "human adenoma" (HA) experimental diet. Foods were prepared as for usual human consumption and processed by dehydration to the physical characteristics of an animal diet. Sixty-four female Sprague-Dawley rats were randomized and fed ad libitum the HA or the AIN-76A diet. Every eight weeks, eight rats from each group were sacrificed, and the colons and contents were examined. Analysis of the prepared food showed no significant deleterious changes; food intake and weight gain were similar in both groups. Compared with the controls, the colonic contents of rats fed the HA diet contained significantly less calcium, concentrations of neutral sterols, total lipids, and cholic and deoxycholic acids were increased, and there were no colonic histological changes other than significant epithelial hyperproliferation. This initial study demonstrated that the HA diet can be successfully processed for feeding to experimental animals and is acceptable and adequate for growth but induces significant metabolic and hyperproliferative changes in the rat colon. This dietary model may be useful for studies of human food, narrowing the gap between animal experimentation and human nutritional research.

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BACKGROUND: This study explored eating habits, nutrient intake, and blood vitamin and mineral levels to determine whether severely obese subjects (BMI 40-50kg m(2)) post-vertical banded gastroplasty (VBG) or gastric bypass Roux-en-Y (GBR) are at risk of developing compounded under-nutrition. METHODS: A dietary follow-up of 36 VBG and. 19 GBR was maintained for 18 months via 7-day food intake diaries and 24-h recalls. Food intake was analyzed for energy and nutrient composition and for its relative amount to recommended dietary allowances (RDA). RESULTS: Weight loss was greatest during the first 6 months, continued at a slower rate for the next 6 months, nearly ceasing thereafter. The results following GBR were not substantially different from those following VBG 18 months postoperatively. The median weight loss at 1 year postoperatively was 48, 46, 48 and 36 kg; expressed as residual excess body weight: 0.2, 16, 13 and 22% for GBR Men, Women, VBG Men, Women, respectively. According to the classification proposed by Reinhold, all subjects achieved excellent treatment outcomes 18 months postoperatively. Despite the relatively low reported energy intake (2050% below RDA), no correlation was found between rate of weight loss and energy intake at 6 months postoperatively. The intake of most vitamins and minerals was below 50% of RDA during the 18 months follow-up. The increase in energy intake did not improve the level of the nonenergy-contributing nutrients. Compliance to multivitamin and mineral supplement intake deteriorated with time. CONCLUSION: The low to within-normal range of blood vitamin and mineral levels 12 months postoperatively suggests the slow development of subclinical nutritional deficiency which could jeopardize the subjects' long-term health status.

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OBJECTIVE: To investigate the interrelationships between satiety feelings, abdominal perception, energy intake and weight loss, related to the presence of an intragastric balloon. DESIGN: Randomized double blind study. SUBJECTS: 20 severely obese subjects, BMI > 40 kg/m2, randomly assigned either to receive an air filled balloon (n = 11) or to have a sham procedure (n = 9). All subjects had dietary counselling to help them follow a relatively low energy diet (60% of individual spontaneous intake). MEASUREMENTS: During biweekly visits, body weight was recorded, visual analogic scales for stomach distension, hunger and feeling of balloon presence were completed. Blood chemistry profiles were monitored once every 4 weeks. RESULTS: In the balloon group, the sensations related to the presence of the balloon and to abdominal distension dramatically increased after insertion, and plateaued during the next 4 weeks. Both feelings of presence and distension decreased thereafter, and after 10 weeks they were not significantly different from those of the sham balloon group. Hunger dramatically decreased to about 30% of initial rating in the first week, but slowly returned to the initial value by the 12th week. Hunger feelings were highly and negatively correlated with feelings of distension. During the same period, the sham balloon group continued to maintain the low energy intake, and did not register any feelings of distension or presence; hunger level did not differ from initial levels throughout the whole study. The energy intake and the rate of weight loss (8-9 kg) was similar in the two groups during the study, and were not correlated with the feelings of distension. CONCLUSION: This study showed that in severely obese subjects submitted to a restrictive diet, an intragastric balloon has a measurable but transient effect on the sensation of epigastric distension and is able to decrease feelings of hunger. Unfortunately, these effects were not associated with a lower energy intake or a higher rate of weight loss than the sham situation. Thus, the present study does not support the interest of such a balloon (500 ml, air filled) in the treatment of severe obesity.

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BACKGROUND: vertical banded gastroplasty (VBG) and gastric bypass Roux-en-Y (GBP) are adjunctive to lifelong commitment to energy restricted diet in the attempt by the severely obese to lose weight and maintain weight loss. METHODS: the outcome of 48 subjects (36 VBG and 12 GBP) is presented. RESULTS: 18 months nutritional counseling and follow-up indicated VBG and GBP to be equally effective in maintaining appreciable weight loss. Achievement of 'functional weight', such as minimum 50% loss of excess body weight for at least 12 months Post-operatively occurred in the majority of patients. Excess weight loss by GBP and VBG was 77% and 54% respectively during the first 6 months, with 7-15% additional loss during the next 12 months. BMI decreased from an average 43 to 27 kg m(2) after 12 months. During the first 3 months, energy intake was approximately 2930 kJ, increasing to;4605 kJ at 6 months, to; 5860 kJ at 12 months and then stabilizing. Intake of;50% of the Recommended Daily Allowance (RDA) for most vitamins and minerals was reached. Hemoglobin, iron, folic acid and thiamin values were in the normal range for the entire 18 months follow-up, while serum vitamin B12 levels decreased to deficiency levels during the same period. The pre-operative moderately elevated triglycerides, cholesterol, glucose and insulin levels returned to normal range, thereby alleviating the need for medication and reducing the risk of obesity-related morbidity. Most subjects were quickly satiated with small amounts of solid foods and did not report hunger feelings for the first 6 months post-operatively. The main significant changes in food preferences in the first 6 months were the decrease in starch-based products and the increase in semi-solid milk products and eggs. CONCLUSION: taken together these observations suggest that the subjects should be strongly advised to partake in structured counseling for an extended period of time.

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Based on a lower reported incidence of breast cancer in the Arab population in Israel, nutritional levels were evaluated in a case-control study of 33 Jewish and 10 Arab patients with breast cancer all matched with a first-degree family-related control. Demographic, gynecologic, obstetric, anthropometric, genetically tumor-related, and nutritional data were ascertained through interviews, tests, and questionnaires. Food consumption, calories, protein, fat, and fiber intake, and anthropomorphic measures were calculated. The following results were obtained: 1. Calories of food consumption were significantly higher in Jewish and Arab patients than in their controls. 2. Jewish patients consumed significantly higher levels of monounsaturated fat; Arab patients consumed significantly higher levels of dietary fiber. 3. Animal protein intake was elevated in patients of both ethnic origins as compared with controls. 4. Vegetable fat and monounsaturated fatty acids were elevated in Arab patients as compared with Jewish patients. 5. Body weight of both Arab and Jewish patients was not significantly higher when compared with their controls. 6. Energy consumption and obesity were higher in breast cancer patients than in the controls. This supporting evidence suggests an association between obesity and breast cancer occurrence.

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The objective of this study was to evaluate the effect of gland cottonseed dietary fiber (CSDF) containing 86% dietary fiber (mainly cellulose) on serum glucose levels in diabetic rats and in non-insulin-dependent diabetes mellitus (NIDDM) patients. A diet containing 15% CSDF given to streptozotocin-induced diabetic rats for 30 d tended to reduce the postprandial plasma glucose level curve. Alternatively, CSDF significantly increased fecal weight (15 +/- 3 vs. 5 +/- 2 g; P less than 0.01) and shortened transit time (20 +/- 2.24 vs. 11.2 +/- 0.8 h). CSDF had no effect on body weight and serum lipid levels. Twelve NIDDM subjects were given a meal tolerance test (MTT) with or without CSDF before and after daily supplementation of CSDF (16.5 g) in pita twice a day for a month. Incremental glucose levels were significantly (P less than 0.05) lower at 30, 60 and 180 min after the MTT containing CSDF than in subjects consuming a meal without CSDF. The insulin levels also tended to be lower. The NIDDM subjects tolerated the CSDF well. No flatulence or other side effects were exhibited. Plasma lipid levels remained unchanged. We therefore concluded that CSDF may have a potential benefit in the management of NIDDM.

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The metabolic response to different periods of fasting, ranging from 3 to 7 days, was studied in eight nonobese subjects. Blood ketones rose progressively to 5.07 nmol/l with the prolongation of the fast. The concentrations of glucose and alanine decreased significantly. Valine and leucine rose during fasting but the rise was not statistically significant. Serum triiodothyronine (T3) and insulin decreased, while the urinary excretion of 17-hydroxycorticosteroids (OHCS) doubled. Urea nitrogen decreased in those who fasted 5 to 7 days. Total urinary nitrogen excretion did not change significantly. Excretion of 3-methylhistidine (3-MH) rose during fasting and in some subjects more than doubled when compared with the fed state. The discrepancy between the loss of body protein (calculated by comparing excretion of urinary nitrogen) and the loss of muscle protein (calculated from the excretion of 3-MH) suggests a high rate of recycling of nitrogen during fasting in our subjects.

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The low-insulin responding spiny mice (Acomys cahirinus), maintained on a 50% sucrose diet vs isocaloric regular diet, responded with an impressive increase in the activity of hepatic enzymes of glycolysis and lipogenesis and in hyperlipidemia. There was no hyperinsulinemia or hyperglycemia and spiny mice did not gain weight on sucrose due to loss of adipose tissue. Serum T3 levels rose 1.8 fold and the activity of the hepatic mitochondrial FAD-glycerol-3-phosphate oxidase became induced 2.6 fold representing the enhancement of multiple, T3-dependent, energy-consuming metabolic cycles. An increased TG lipolysis in adipose tissue was also observed. C57BL/6J ob/ob mice were markedly hyperinsulinemic and gained weight on sucrose almost as much as those on regular diet, without changes in serum glucose or insulin. Serum triglyceride level decreased, whereas liver triglycerides accumulated markedly. The extent of the increase in hepatic enzyme activities related to lipogenesis was much lower both in the ob/ob mice and their lean siblings, than in spiny mice, but the basal enzyme activities in ob/ob mice were remarkably elevated. Serum T3 level was also elevated already on the regular diet and rose only slightly on sucrose. Basal glycerol phosphate oxidase activity in ob/ob mice exceeded that in spiny mice and rose only marginally on sucrose. Adipose tissue lipolysis was not increased. Thus, sucrose diet by enhancing the T3 production appeared to activate protective mechanism against weight gain in normoinsulinemic spiny mice, whereas the full expression of these mechanisms appeared to be precluded by the hyperinsulinemia of ob/ob mice.(ABSTRACT TRUNCATED AT 250 WORDS)

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Muscles of genetically-obese animals exhibit decreased binding of and metabolic responses to insulin. Muscle protein catabolism was investigated by measuring the activity of alkaline, myofibril-bound protease in male (ob/ob) mice, fed ad libitum, or fasted for 5 d. Enzyme activity in the isolated myobrillar fraction was determined by the degradation of 14C-globin. Compared to the lean siblings, protease activity in the obese mice was 2.0, 1.5 and 1.3-fold higher in gastrocnemius, diaphragm and soleus muscle respectively, but without change in heart. The higher protease activity in gastrocnemius, diaphragm and soleus was associated with a parallel decrease in the weight and protein mass of the muscles. The muscles of obese mice also showed a 3 to 4-fold increase in triglyceride and a 2-fold increase in glycogen content. After 5-d starvation, the activity of protease rose in the gastrocnemius of obese mice only 1.5 fold, while it increased as much as 4 and 2 fold in gastrocnemius and diaphragm, respectively, in the lean mice. There was no significant change in heart enzyme activity. After 5-d starvation, serum insulin in obese mice fell markedly but remained still higher than that in ad libitum fed lean mice. Insulin-dependent serum metabolites, as well as adipose tissue lipoprotein lipase and hepatic enzymes related to lipogenesis and gluconeogenesis were consequently much less affected in obese mice and the prevalence of adequate insulin supply appeared to be the cause for lack of significant effect on muscle protease activity in fasting obese mice. It is suggested, therefore, that the induction of myofibrillar protease in obesity is linked to the decrease in cellular responsiveness to insulin and may also be interrelated with the intracellular metabolic adjustments to the enhanced muscle lipid availability.

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(1) The effect of thiamine deficiency during pregnancy and lactation on lipogenesis in the brain of rat pups was determined. (2) Acetate incorporation to brain lipids in thiamine-deficient rats in vivo was no less than in pair fed control rats, apart from slightly reduced fatty acid synthesis in the cerebrum. (3) Glucose incorporation to brain lipids in vivo was considerably reduced in thiamine-deficient pups. (4) The inducible NADP dependent malic enzyme activity was increased in thiamine-deficient pup brains. (5) The synthesis of acetyl-CoA appears to be the rate limiting step in lipogenesis in thiamine-deficient pup brains.

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Milk composition was determined in rats maintained on a thiamine deficient diet from the 10th day of pregnancy. Percentage of thiamine transfer was reduced after the 14th postpartum day. Milk composition of thiamine deficient dams 18 days postpartum revealed similar protein and amino acid levels in both thiamine deficient and control rats, whereas milk protein fractions showed some differences. Milk lactose levels were depressed in thiamine deficient rats. Fatty acid content was higher in milk of thiamine deficient than in pair fed and adlibitum controls. The supply of a larger proportion of calories from lipids rather than carbohydrates may have clinical significance.

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The site and extent of absorption of thiamin hydrochloride was determined in rats using 51Cr-EDTA as a non-absorbed reference substance. The main site of absorption of thiamin was found to be the proximal 22 cm of the small intestine with relatively little absorption occurring distally, particularly at low dietary thiamine levels. Concentration of thiamin in the intestinal contents increased along the intestine reaching maximum levels in the distal small intestine. The results are compatible with two concurrent mechanisms of thiamin absorption with the active absorptive process being saturated at 0.5 to 1.0 muM.

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In an attempt to create a model of human infantile beriberi, pregnant rats were fed, from the 10th day of pregnancy through lactation, a low-thiamine diet. Controls were either pair-fed or offered a nutritionally complete diet ad libitum. Dams exhibited symptoms of thiamine deficiency after 30 days on the experimental diet, whereas the their pups displayed signs of thiamine deficiency from the 14th postnatal day. Brain transketolase activity was depressed in day-old thiamine-deficient pups, and brain pyruvic acid levels were elevated after the 7th postnatal day. From the 14th postnatal day, brains of thiamine-deficient pups contained less phospholipids, cerebrosides and cholesterol than those of both controls. On the 21st day, weight and lipid content of brains of thiamine-deficient and of pair-fed pups were lower than those of normal controls. In some rats rehabilitation with thiamine was begun on the 19th day, and after 23 days, brain cerebroside content was still lower in the experimental group than in both controls. Since cerebrosides are an essential component of myelin, this finding may suggest damage of the myelin sheath.

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