Nutrition and behavioral characteristics and determinants of plasma cholesterol levels in men and women.

The National Cholesterol Education Program advocates dietary interventions in persons with high and moderate blood cholesterol levels and in the general population as a preventive measure for coronary heart disease. For these efforts to be successful, it is necessary to understand consumer characteristics and behaviors, including nutrient intake and dietary patterns. We studied the relationship of plasma cholesterol levels to consumer characteristics and dietary behaviors by examining 127 men (aged 20 through 71 years) and 187 women (aged 18 through 67 years) as part of a cholesterol screening project in the administrative offices and academic departments of Boston University from March 1988 through June 1988. Our results showed that specific consumer characteristics and dietary behaviors significantly differentiated male and female groups with low, moderate, and high cholesterol levels. Factors that should be considered in planning dietary interventions aimed at cholesterol reduction in men include spouse involvement and support in lipid-lowering interventions; weight reduction; increase in exercise; reduction in beef intake; and increases in dietary fiber and carbohydrates, particularly fruits. For women, recommendations include weight reduction; possible interventions aimed at reducing blood pressure (ie, behavioral modification aimed at reducing stress, increasing exercise, and cooking low-salt meals); reduction in beef intake, dietary fat, and saturated fat; and increases in carbohydrates and dietary fiber.


Oat bran lowers plasma cholesterol levels in mildly hypercholesterolemic men.

The effects of oat bran and wheat bran on plasma lipid concentrations were compared in a crossover study. Each bran (123 g oat bran or 54 g wheat bran) added nearly 18 g of nonstarch polysaccharide to a background diet containing about 10 g nonstarch polysaccharide. Twenty-three men (average plasma cholesterol level = 5.84 mmol/L, and low-density-lipoprotein (LDL) cholesterol level = 4.11 mmol/L) were randomly assigned to either the oat or wheat bran diet for 4 weeks and then changed to the alternate bran diet for a similar period. The oat bran diet produced significantly lower levels of plasma total cholesterol and LDL cholesterol: 5.65 +/- 0.16 and 3.88 +/- 0.15 mmol/L (mean +/- standard error) for oat bran vs 5.89 +/- 0.16 and 4.11 +/- 0.16 mmol/L for wheat bran. Food intake diaries showed that average consumption of total fat and saturated fat was identical during the two test periods, which excluded displacement of fat as an explanation for lowering of plasma cholesterol by oat bran. Our results indicate that in mildly hypercholesterolemic men, a diet high in soluble oat fiber can significantly lower plasma total cholesterol and LDL cholesterol and thus potentially lower the risk of coronary heart disease.


Efficacy of hydrated sodium calcium aluminosilicate in reducing the toxicity of dietary zearalenone to mink.

Ovariectomized mink were fed diets containing zearalenone (ZEN) at concentrations of 0, 10 or 20 ppm with or without 0.5% hydrated sodium calcium aluminosilicate (HSCAS) for 24 days. Zearalenone at 10 and 20 ppm caused a significant increase in uterine weights, while 20 ppm ZEN resulted in significantly higher vulva swelling scores when compared to controls. The presence of HSCAS in the diet did not alter these hyperestrogenic effects of ZEN. In a second experiment, female mink were provided diets containing 20 ppm ZEN, 20 ppm ZEN plus 0.5% HSCAS or a control diet from 1 January 1989 through whelping (25 April to 15 May 1989). The females were given an opportunity to mate with untreated proven breeder males beginning on 1 March (day 59 of exposure). ZEN did not have an effect on the number of females whelping but there was a significant increase in gestation length, a decrease in litter size and an increase in kit mortality from birth to 3 weeks of age when compared to the control group and the group receiving the combination of ZEN and HSCAS. These results suggest that HSCAS can alleviate some of the reproductive effects of ZEN which are not related to its estrogenic action.


Cytomegalovirus-associated perianal ulcerations in AIDS.

We report two patients with the acquired immune deficiency syndrome and cytomegalovirus associated perianal ulcerations. Both complained of chronic, painful, nonhealing ulcers that required surgical intervention for diagnosis and palliation. One patient developed diffuse cytomegalovirus infection and both had poor response to gancyclovir therapy. We review the pertinent clinical and pathologic findings of this serious manifestation of cytomegalovirus infection.


Cytomegalovirus as a cause of isolated severe ileal bleeding.

A 66-year-old man with squamous cell carcinoma of the tongue and vallecula had massive lower gastrointestinal hemorrhage. Colonoscopy examination results were normal, but angiography revealed a 3 x 6-cm hypervascular mass in the right lower quadrant. Persistent bleeding required resection of a large ileal ulcer, which proved to be an isolated ulcer containing cells with cytomegalovirus (CMV) inclusion bodies. Massive gastrointestinal hemorrhage due to an isolated CMV ileal ulcer in adults without acquired immunodeficiency syndrome has not been previously reported. This case illustrates that hemorrhage due to CMV infection of the ileum may occur in the absence of endoscopic evidence of colonic involvement.


Essential hypertension: a disorder of growth with origins in childhood?

To review evidence that essential hypertension is a growth-related disorder with origins in childhood and manifestations in adult life. Blood pressure rises with age in children and adults. In children, the rise closely relates to growth and to skeletal and sexual maturation. Adolescents with highest pressure are heavier and had as children grown fastest; as adults, they show the greatest increase of pressure with age and are more likely to develop hypertension and coronary heart disease. In adults, the rate of increase of pressure relates to earlier pressure. One interpretation of this is that a self-perpetuating mechanism is at work. Genetic and environmental factors influence these events. Most forms of secondary hypertension have two pressor mechanisms; a primary cause, e.g. renal clip, and a second process, which is slow to develop, capable of maintaining hypertension after removal of the primary cause, and probably self-perpetuating in nature. We suggest that essential hypertension also has two mechanisms, both based upon cardiovascular hypertrophy: (1) a growth-promoting process in children (equivalent to the primary cause in secondary hypertension); and (2) a self-perpetuating mechanism in adults.


Effect of acute NaCl depletion on NaCl-sensitive hypertension in borderline hypertensive rats.

The borderline hypertensive rat (BHR) is the first generation offspring of a mating between a female spontaneously hypertensive rat and a male normotensive Wistar-Kyoto rat. With increased dietary NaCl intake, the BHR develops hypertension and augmented cardiovascular and renal responses to acute environmental stress. This investigation sought to examine the role of extracellular fluid volume (ECFV) in these changes. Three groups of 16-week-old BHR were studied: (1) rats on a 1% NaCl diet for 12 weeks; (2) rats on an 8% NaCl diet for 12 weeks; and (3) rats on an 8% NaCl diet for 12 weeks plus furosemide (50 mg/kg, i.p., twice daily) for the preceding 2 days. Rats were chronically instrumented for the measurement of mean arterial pressure (MAP), heart rate and renal hemodynamic, excretory and sympathetic nerve activity responses to acute environmental stress (acute air jet stress). ECFV was measured as inulin space. BHR fed an 8% NaCl diet had increased MAP, urinary sodium excretion and ECFV compared with those fed a 1% NaCl diet; they also exhibited augmented pressor, tachycardic, renal sympathetic nerve excitatory and antinatriuretic responses to acute environmental stress. When 8% NaCl-diet BHR were treated with furosemide for 2 days, arterial pressure, urinary sodium excretion, ECFV and cardiovascular and renal responses to acute environmental stress returned to values seen in 1% NaCl-diet BHR. The hypertension and increased cardiovascular and renal responses to acute environmental stress produced by increased dietary NaCl intake in BHR derive from a central nervous system site of action via a mechanism(s) related to ECFV and/or sodium.