Alexandr Parlesak | University College Copenhagen (original) (raw)

Papers by Alexandr Parlesak

Nutrients

Low-carbon diets can counteract climate change and promote health if they are nutritionally adequ... more Low-carbon diets can counteract climate change and promote health if they are nutritionally adequate, affordable and culturally acceptable. This study aimed at developing sustainable diets and to compare these with the EAT-Lancet diet. The Swedish national dietary survey Riksmaten Adolescents 2016–2017 was used as the baseline. Diets were optimized using linear programming for four dietary patterns: omnivores, pescatarians, vegetarians and vegans. The deviation from the baseline Riksmaten diet was minimized for all optimized diets while fulfilling nutrient and climate footprint constraints. Constraining the diet-related carbon dioxide equivalents of omnivores to 1.57 kg/day resulted in a diet associated with a reduction of meat, dairy products, and processed foods and an increase in potatoes, pulses, eggs and seafood. Climate-friendly, nutritionally adequate diets for pescatarians, vegetarians and vegans contained fewer foods and included considerable amounts of fortified dairy and ...

World Journal of Gastroenterology, 2007

To investigate the role of cytochrome P450 (CYP) in the carcinogenesis of squamous-cell carcinoma... more To investigate the role of cytochrome P450 (CYP) in the carcinogenesis of squamous-cell carcinoma (SCC) in human esophagus by determining expression patterns and protein levels of representative CYPs in esophageal tissue of patients with SCC and controls. mRNA expression of CYP2E1, CYP2C, CYP3A4, and CYP3A5 was determined using RT-PCR in both normal and malignant esophageal tissues of patients with untreated esophageal SCC (n = 21) and in controls (n = 10). Protein levels of CYP2E1, CYP2C8, CYP3A4, and CYP3A5 were measured by Western blot. Within the group of SCC patients, mRNA expression of CYP 3A4 and CYP2C was significantly lower in malignant tissue (-39% and -74%, respectively, P < 0.05) than in normal tissue. Similar results were found in CYP3A4 protein levels. Between groups, CYP3A4, CYP3A5, and CYP2C8 protein concentration was significantly higher in non-malignant tissue of SCC patients (4.8-, 2.9-, and 1.9-fold elevation, P < 0.05) than in controls. In contrast, CYP2E1 protein levels were significantly higher in controls than in SCC patients (+46%, P < 0.05). Significant differences exist in protein levels of certain CYPs in non-malignant esophageal tissue (e.g. CYP2C8, CYP3A4, CYP3A5, and CYP2E1) between SCC patients and healthy subjects and may contribute to the development of SCC in the esophagus.

This chapter discusses the effects of alcohol on gut permeability and endotoxins. Chronic alcohol... more This chapter discusses the effects of alcohol on gut permeability and endotoxins. Chronic alcohol abuse is the leading cause of progressive liver disease in Western countries. The more advanced stages of Alcoholic Liver Disease (ALD) are associated with both hepatic infiltration and activation of leukocytes, findings that support the assumption that the unspecific immune system may play an important role in the pathogenesis of ALD. Besides other factors such as changes associated with the metabolism of ethanol and genetic susceptibility, strong evidence has accumulated during the last two decades that bacterial toxins of intestinal origin—namely, endotoxins can be considered to be important inducers of hepatic damage after chronic alcohol abuse. In alcoholics, elevated plasma levels of endotoxin were suggested to occur already at early stages of ALD. In chronic alcoholics, this increase was found to be paralleled by both bacterial overgrowth of the small intestine and increased permeability to macromolecules. Several studies revealed a close correlation between the plasma endotoxin concentration and several laboratory markers of ALD, both of which improved after alcohol withdrawal. The reduction of bacterial toxin concentration in the intestine by oral administration of broad spectrum antibiotics resulted nearly in the prevention of ALD.

Alkohol und Alkoholfolgekrankheiten, 2005

Sowohl akute als auch chronische Zufuhr groserer Mengen alkoholischer Getranke konnen zu vielfalt... more Sowohl akute als auch chronische Zufuhr groserer Mengen alkoholischer Getranke konnen zu vielfaltigen Storungen der Funktion und auch zu morphologischen Anderungen der Dunndarmschleimhaut fuhren. Funktionelle Storungen betreffen die Absorption wichtiger Energielieferanten sowie von Vitaminen und einigen Spurenelementen. Eine besondere Beachtung verdient die Anderung der Permeabilitat der Darmmukosa fur grosere Molekule durch Alkohol, die zu einer vermehrten Aufnahme bakterieller und anderer Toxine fuhren kann. Letzteres tragt wahrscheinlich zur Entstehung alkoholbedingter Lebererkrankungen und anderer Organschaden bei.

Der Gastroenterologe, 2011

Zusammenfassung Übergewicht und Adipositas im Kindes- und Jugendalter haben in den letzten beide... more Zusammenfassung Übergewicht und Adipositas im Kindes- und Jugendalter haben in den letzten beiden Jahrzehnten stark an Häufigkeit zugenommen. In Deutschland sind 15% der 3- bis 17-Jährigen übergewichtig, 6,3% adipös. Kindliche Adipositas führt zu hohen psychosozialen Belastungen und beeinträchtigt ernsthaft Lebensqualität und Lebenserwartung. Die Therapiemöglichkeiten bei kindlicher Adipositas sind derzeit alles andere als zufriedenstellend. Medikamente kommen bei kindlicher Adipositas kaum zum Einsatz,

Nutrition Journal

Background School meals hold considerable potential to shape children’s diets and reduce food-rel... more Background School meals hold considerable potential to shape children’s diets and reduce food-related greenhouse gas emissions (GHGE)—in the short and long term. This study applied linear optimization to develop a GHGE-reduced, nutritionally adequate, and affordable school lunch menu. The effects on food waste, consumption and pupils’ satisfaction with the meals were evaluated. Methods A pre-post design was employed to assess the effects of implementing an optimized lunch menu on daily food waste, consumption, and pupils’ school meal satisfaction in three schools (grades 0–9) from one Swedish municipality. A food list containing amounts, prices, nutrient content, and GHGE-values of all foods used for a previously served (baseline) four-week lunch menu was created. Using linear programming, this food list was optimized for minimum deviation and constrained to ensure nutritional adequacy and a reduced climate impact. The optimized food list was developed into a new (intervention) four...

Introducing children to sustainable and healthy school meals can promote a long-term dietary shif... more Introducing children to sustainable and healthy school meals can promote a long-term dietary shift to lower climate impact and improve population health. The aim of the OPTIMAT study was to optimize meals for minimum deviation from the current food supply while reducing greenhouse gases and ensuring nutritional adequacy without increasing cost. Optimized menus were tested in four primary schools in Sweden and effects on daily food consumption and waste evaluated. Pupils received their usual menu plan for three weeks and then the isocaloric optimized menu plan for another three weeks. Nutritional recommendations for a school lunch and a maximum of 500 grams of CO2eq/meal were applied as constraints during linear programming. Pulses, Cereals, Meat and Eggs increased, while Fats and Oils, Dairy, Sauces and Seasonings decreased. The amount of ruminant meat was reduced in favor of other meat products. The new menu was 28% lower in greenhouse gas emissions and slightly less costly than th...

Nutrients

Although low socioeconomic groups have the highest risk of noncommunicable diseases in Estonia, n... more Although low socioeconomic groups have the highest risk of noncommunicable diseases in Estonia, national dietary guidelines and nutrition recommendations do not consider affordability. This study aims to help develop nutritionally adequate, health-promoting, and culturally acceptable dietary guidelines at an affordable price. Three food baskets (FBs) were optimised using linear programming to meet recommended nutrient intakes (RNIs), or Estonian dietary guidelines, or both. In total, 6255 prices of 422 foods were collected. The Estonian National Dietary Survey (ENDS) provided a proxy for cultural acceptability. Food baskets for a family of four, earning minimum wage, contain between 73 and 96 foods and cost between 10.66 and 10.92 EUR per day. The nutritionally adequate FB that does not follow Estonian dietary guidelines deviates the least (26% on average) from ENDS but contains twice the sugar, sweets, and savoury snacks recommended. The health-promoting FB (40% deviation) contains...

Nutrients

The high prevalence of undernutrition, especially stunting, in Ethiopia hampers the country’s eco... more The high prevalence of undernutrition, especially stunting, in Ethiopia hampers the country’s economic productivity and national development. One of the obstacles to overcome undernutrition is the relatively high cost of food for low economic groups. In this study, linear programming was used to (i) identify urban and rural nutritionally adequate food baskets (FBs) with the highest affordability for an Ethiopian family of five and (ii) create urban and rural FBs, optimized for cultural acceptability, which are affordable for a family with the lowest income. Nutritionally adequate rural and urban FBs with highest affordability cost as little as Ethiopian Birr (ETB) 31 and 38 (~USD 1.07 and 1.31), respectively, but have poor dietary diversity (16 and 19 foods). FBs that cost ETB 71.2 (~USD 2.45) contained 64 and 48 foods, respectively, and were much more similar to the food supply pattern reported by FAO (15% and 19% average relative deviation per food category). The composed FBs, whi...

Minimizing greenhouse gas emissions (GHGE) from public sector meals harbours considerable potenti... more Minimizing greenhouse gas emissions (GHGE) from public sector meals harbours considerable potential to reduce climate impact. This paper aimed at finding the best possible strategy for reducing GHGE in the Swedish school food supply without compromising its nutritional adequacy, affordability, and cultural acceptability. Prices, amounts, and GHGE of all foods and drinks supplied to three schools over one year were optimized by linear programming. Three models were developed: Model 1 minimized GHGE while constraining relative deviation (RD) from observed food supply; Model 2 minimized total RD while imposing stepwise GHGE reductions; and Model 3 additionally constrained RD to -75% and +200% of the observed value. Model 1 reduced GHGE by 89-95% with an average RD (ARD) from observed food supply of 480-887%. In Model 2, comparable GHGE reductions (80%-95%) at lower ARD (78%-459%) were achieved but with high RDs for individual foods. Model 3 excluded no foods, avoided high RDs, and redu...

Public Health Nutrition

Objective Breast-feeding is an important determinant of health of mothers and their offspring. Th... more Objective Breast-feeding is an important determinant of health of mothers and their offspring. The present study aimed to compare breast-feeding rates across Europe disaggregated by maternal education and establish what proportion achieves at least 50 % exclusive breast-feeding (EBF) at 6 months. Design/Setting Secondary analysis of national or sub-national studies’ breast-feeding data for EU Member States plus Norway and Iceland, published in 2006–2016. Nineteen EU Member States plus Norway reported rates of EBF and any breast-feeding disaggregated by maternal education, of which only thirteen could be matched to the International Standard Classification of Education. Participants Mothers and their infants aged 0–12 months. Results Data on EBF rates at 6 and 4 months were found in only four and six countries, respectively. At 6 months, EBF rates of 49 % in Slovakia and 44 % in Hungary were closest to WHO’s target of at least 50 % EBF. At 4 months, mothers with high education level ...

BMJ open, Jan 21, 2016

To model food group consumption and price of diet associated with achieving UK dietary recommenda... more To model food group consumption and price of diet associated with achieving UK dietary recommendations while deviating as little as possible from the current UK diet, in order to support the redevelopment of the UK food-based dietary guidelines (now called the Eatwell Guide). Optimisation modelling, minimising an objective function of the difference between population mean modelled and current consumption of 125 food groups, and constraints of nutrient and food-based recommendations. The UK. Adults aged 19 years and above from the National Diet and Nutrition Survey 2008-2011. Proportion of diet consisting of major foods groups and price of the optimised diet. The optimised diet has an increase in consumption of 'potatoes, bread, rice, pasta and other starchy carbohydrates' (+69%) and 'fruit and vegetables' (+54%) and reductions in consumption of 'beans, pulses, fish, eggs, meat and other proteins' (-24%), 'dairy and alternatives' (-21%) and 'foods...

Maternal & Child Nutrition, 2016

In her recent editorial, Dr. de Pee (2015) states there are two main ways to provide additional n... more In her recent editorial, Dr. de Pee (2015) states there are two main ways to provide additional nutrients during complementary feeding: fortification and supplementation. She illustrates some problems associated with these ‘solutions’, including lack of compliance (Kodish et al., 2016). Rather than conclude that lipid‐based nutrient supplements (LNS) and ready‐to‐use therapeutic foods (RUTFs) may thus be ineffective, de Pee advocates research to improve compliance, assuming effectiveness has been demonstrated. We highlight four additional problems: inappropriateness, cost, lack of sustainability and potential adverse effects. First, RUTFs were designed for therapeutic use under medical prescription. Indeed Briend et al. (2015) state these are not optimized to maximize linear growth, vitamin and mineral status, nor functional outcomes; have problems related to quality and content and are expensive. Second, De Pee states that linear programming (LP) states a healthy diet is not affordable by many households in low and middle income countries (LMICs). However, at least two examples, Mozambique (Parlesak et al., 2014) and Kenya (Termote et al., 2014), illustrated how a low‐cost diverse diet can be designed using locally available foods. Interestingly, LP's ability to model these appears to depend on which cost‐efficient micronutrient‐dense local foods are selected. These LP diets, modelled for LMICs, were relatively affordable compared with the cost of 150 sachets of LNS weighing 92 g each which cost approximately US$55 in 2013. Moreover, Segrè et al. (2015) found that only 25% of Ethiopian consumers appeared willing to pay for LNS and could afford them. Third, de Pee states that distribution of LNS is sustainable and lists the practical constraints associated with feeding young children. However, investigators, e.g. in Bangladesh (Bogard et al., 2015), Ecuador, Kenya (Waswa et al., 2015) and Tanzania (Kuyper et al., 2014), have shown how to overcome these constraints using cost‐effective, culturally acceptable and locally available diverse foods. In addition, mothers are empowered by being able to earn income (Jones et al., 2015), which has spin‐off benefits. Both Johns et al. (2013) and Powell et al. (2015) demonstrate the economic importance of how local production improves dietary diversity, can be sustainable, cost‐effective, and culturally acceptable and helps to reduce rates of chronic undernutrition. Indeed the majority of young children in LMICs who do not consume LNS or RUTF are not undernourished.

Alcoholism Clinical and Experimental Research, Mar 1, 2003

ABSTRACT Der Zusammenhang zwischen übermäßigem Alkoholkonsum und dem Auftreten von Krebserkrankun... more ABSTRACT Der Zusammenhang zwischen übermäßigem Alkoholkonsum und dem Auftreten von Krebserkrankungen wird bei den malignen Erkrankungen der Speiseröhre und des Mund-Rachen-Raumes besonders deutlich. Weitere Organe, die eine signifikant erhöhte Inzidenz für Krebserkrankungen bei Alkoholabusus aufweisen, sind die Leber und die weibliche Brust. Für den Zusammenhang zwischen Alkoholmissbrauch und Dickdarmkrebs gibt es Hinweise, während der Einfluss von Alkoholabusus auf maligne Entartungen anderer Organe als unwahrscheinlich gilt. Ethanol selbst kann keine direkte krebserzeugende Wirkung zugeschrieben werden. Als mögliche Mechanismen, die bei übermäßigem Alkoholkonsum zur Zellentartung führen, werden eine erhöhte, durch die Löseeigenschaften von Alkohol hervorgerufene Migration von (Pro-)Kanzerogenen in die Zelle und eine Störung der Funktion von Leukozyten diskutiert, die an der Bekämpfung entarteter Zellen beteiligt sind. Des Weiteren werden die Induktion von Enzymen (Zytochrom P450), deren Aktivierung eine Giftung von Prokarzinogenen zur Folge hat und die Bildung von Azetaldehyd, dem ersten Stoffwechselprodukt von Ethanol, als wichtige Ursachen der Krebsentstehung angesehen. Eine aktuelle Hypothese berücksichtigt die Interferenzen zwischen dem Ethanol- und Retinoidstoffwechsel als mögliche Ursache der Zellentartung. Der bei Alkoholikern beobachtbare signifikant niedrigere Plasmaspiegel an Vitaminen und Spurenelementen (vor allem die Vitamine Folsäure, B 1 , B 6 und Zink) kann zu einer Einschränkung bei der Methylierung von DNA führen, die gleichfalls mit einer Risikoerhöhung für maligne Erkrankungen in Verbindung gebracht wird. Dies kann auf eine Störung der intestinalen Absorption zurückgeführt werden, die auch einen Mangel an antioxidativ wirksamen Vitaminen und Spurenelementen (Tocopherol, Vitamin C, Zink, Selen) zur Folge haben kann.

Nutrients

Low-carbon diets can counteract climate change and promote health if they are nutritionally adequ... more Low-carbon diets can counteract climate change and promote health if they are nutritionally adequate, affordable and culturally acceptable. This study aimed at developing sustainable diets and to compare these with the EAT-Lancet diet. The Swedish national dietary survey Riksmaten Adolescents 2016–2017 was used as the baseline. Diets were optimized using linear programming for four dietary patterns: omnivores, pescatarians, vegetarians and vegans. The deviation from the baseline Riksmaten diet was minimized for all optimized diets while fulfilling nutrient and climate footprint constraints. Constraining the diet-related carbon dioxide equivalents of omnivores to 1.57 kg/day resulted in a diet associated with a reduction of meat, dairy products, and processed foods and an increase in potatoes, pulses, eggs and seafood. Climate-friendly, nutritionally adequate diets for pescatarians, vegetarians and vegans contained fewer foods and included considerable amounts of fortified dairy and ...

World Journal of Gastroenterology, 2007

To investigate the role of cytochrome P450 (CYP) in the carcinogenesis of squamous-cell carcinoma... more To investigate the role of cytochrome P450 (CYP) in the carcinogenesis of squamous-cell carcinoma (SCC) in human esophagus by determining expression patterns and protein levels of representative CYPs in esophageal tissue of patients with SCC and controls. mRNA expression of CYP2E1, CYP2C, CYP3A4, and CYP3A5 was determined using RT-PCR in both normal and malignant esophageal tissues of patients with untreated esophageal SCC (n = 21) and in controls (n = 10). Protein levels of CYP2E1, CYP2C8, CYP3A4, and CYP3A5 were measured by Western blot. Within the group of SCC patients, mRNA expression of CYP 3A4 and CYP2C was significantly lower in malignant tissue (-39% and -74%, respectively, P < 0.05) than in normal tissue. Similar results were found in CYP3A4 protein levels. Between groups, CYP3A4, CYP3A5, and CYP2C8 protein concentration was significantly higher in non-malignant tissue of SCC patients (4.8-, 2.9-, and 1.9-fold elevation, P < 0.05) than in controls. In contrast, CYP2E1 protein levels were significantly higher in controls than in SCC patients (+46%, P < 0.05). Significant differences exist in protein levels of certain CYPs in non-malignant esophageal tissue (e.g. CYP2C8, CYP3A4, CYP3A5, and CYP2E1) between SCC patients and healthy subjects and may contribute to the development of SCC in the esophagus.

This chapter discusses the effects of alcohol on gut permeability and endotoxins. Chronic alcohol... more This chapter discusses the effects of alcohol on gut permeability and endotoxins. Chronic alcohol abuse is the leading cause of progressive liver disease in Western countries. The more advanced stages of Alcoholic Liver Disease (ALD) are associated with both hepatic infiltration and activation of leukocytes, findings that support the assumption that the unspecific immune system may play an important role in the pathogenesis of ALD. Besides other factors such as changes associated with the metabolism of ethanol and genetic susceptibility, strong evidence has accumulated during the last two decades that bacterial toxins of intestinal origin—namely, endotoxins can be considered to be important inducers of hepatic damage after chronic alcohol abuse. In alcoholics, elevated plasma levels of endotoxin were suggested to occur already at early stages of ALD. In chronic alcoholics, this increase was found to be paralleled by both bacterial overgrowth of the small intestine and increased permeability to macromolecules. Several studies revealed a close correlation between the plasma endotoxin concentration and several laboratory markers of ALD, both of which improved after alcohol withdrawal. The reduction of bacterial toxin concentration in the intestine by oral administration of broad spectrum antibiotics resulted nearly in the prevention of ALD.

Alkohol und Alkoholfolgekrankheiten, 2005

Sowohl akute als auch chronische Zufuhr groserer Mengen alkoholischer Getranke konnen zu vielfalt... more Sowohl akute als auch chronische Zufuhr groserer Mengen alkoholischer Getranke konnen zu vielfaltigen Storungen der Funktion und auch zu morphologischen Anderungen der Dunndarmschleimhaut fuhren. Funktionelle Storungen betreffen die Absorption wichtiger Energielieferanten sowie von Vitaminen und einigen Spurenelementen. Eine besondere Beachtung verdient die Anderung der Permeabilitat der Darmmukosa fur grosere Molekule durch Alkohol, die zu einer vermehrten Aufnahme bakterieller und anderer Toxine fuhren kann. Letzteres tragt wahrscheinlich zur Entstehung alkoholbedingter Lebererkrankungen und anderer Organschaden bei.

Der Gastroenterologe, 2011

Zusammenfassung Übergewicht und Adipositas im Kindes- und Jugendalter haben in den letzten beide... more Zusammenfassung Übergewicht und Adipositas im Kindes- und Jugendalter haben in den letzten beiden Jahrzehnten stark an Häufigkeit zugenommen. In Deutschland sind 15% der 3- bis 17-Jährigen übergewichtig, 6,3% adipös. Kindliche Adipositas führt zu hohen psychosozialen Belastungen und beeinträchtigt ernsthaft Lebensqualität und Lebenserwartung. Die Therapiemöglichkeiten bei kindlicher Adipositas sind derzeit alles andere als zufriedenstellend. Medikamente kommen bei kindlicher Adipositas kaum zum Einsatz,

Nutrition Journal

Background School meals hold considerable potential to shape children’s diets and reduce food-rel... more Background School meals hold considerable potential to shape children’s diets and reduce food-related greenhouse gas emissions (GHGE)—in the short and long term. This study applied linear optimization to develop a GHGE-reduced, nutritionally adequate, and affordable school lunch menu. The effects on food waste, consumption and pupils’ satisfaction with the meals were evaluated. Methods A pre-post design was employed to assess the effects of implementing an optimized lunch menu on daily food waste, consumption, and pupils’ school meal satisfaction in three schools (grades 0–9) from one Swedish municipality. A food list containing amounts, prices, nutrient content, and GHGE-values of all foods used for a previously served (baseline) four-week lunch menu was created. Using linear programming, this food list was optimized for minimum deviation and constrained to ensure nutritional adequacy and a reduced climate impact. The optimized food list was developed into a new (intervention) four...

Introducing children to sustainable and healthy school meals can promote a long-term dietary shif... more Introducing children to sustainable and healthy school meals can promote a long-term dietary shift to lower climate impact and improve population health. The aim of the OPTIMAT study was to optimize meals for minimum deviation from the current food supply while reducing greenhouse gases and ensuring nutritional adequacy without increasing cost. Optimized menus were tested in four primary schools in Sweden and effects on daily food consumption and waste evaluated. Pupils received their usual menu plan for three weeks and then the isocaloric optimized menu plan for another three weeks. Nutritional recommendations for a school lunch and a maximum of 500 grams of CO2eq/meal were applied as constraints during linear programming. Pulses, Cereals, Meat and Eggs increased, while Fats and Oils, Dairy, Sauces and Seasonings decreased. The amount of ruminant meat was reduced in favor of other meat products. The new menu was 28% lower in greenhouse gas emissions and slightly less costly than th...

Nutrients

Although low socioeconomic groups have the highest risk of noncommunicable diseases in Estonia, n... more Although low socioeconomic groups have the highest risk of noncommunicable diseases in Estonia, national dietary guidelines and nutrition recommendations do not consider affordability. This study aims to help develop nutritionally adequate, health-promoting, and culturally acceptable dietary guidelines at an affordable price. Three food baskets (FBs) were optimised using linear programming to meet recommended nutrient intakes (RNIs), or Estonian dietary guidelines, or both. In total, 6255 prices of 422 foods were collected. The Estonian National Dietary Survey (ENDS) provided a proxy for cultural acceptability. Food baskets for a family of four, earning minimum wage, contain between 73 and 96 foods and cost between 10.66 and 10.92 EUR per day. The nutritionally adequate FB that does not follow Estonian dietary guidelines deviates the least (26% on average) from ENDS but contains twice the sugar, sweets, and savoury snacks recommended. The health-promoting FB (40% deviation) contains...

Nutrients

The high prevalence of undernutrition, especially stunting, in Ethiopia hampers the country’s eco... more The high prevalence of undernutrition, especially stunting, in Ethiopia hampers the country’s economic productivity and national development. One of the obstacles to overcome undernutrition is the relatively high cost of food for low economic groups. In this study, linear programming was used to (i) identify urban and rural nutritionally adequate food baskets (FBs) with the highest affordability for an Ethiopian family of five and (ii) create urban and rural FBs, optimized for cultural acceptability, which are affordable for a family with the lowest income. Nutritionally adequate rural and urban FBs with highest affordability cost as little as Ethiopian Birr (ETB) 31 and 38 (~USD 1.07 and 1.31), respectively, but have poor dietary diversity (16 and 19 foods). FBs that cost ETB 71.2 (~USD 2.45) contained 64 and 48 foods, respectively, and were much more similar to the food supply pattern reported by FAO (15% and 19% average relative deviation per food category). The composed FBs, whi...

Minimizing greenhouse gas emissions (GHGE) from public sector meals harbours considerable potenti... more Minimizing greenhouse gas emissions (GHGE) from public sector meals harbours considerable potential to reduce climate impact. This paper aimed at finding the best possible strategy for reducing GHGE in the Swedish school food supply without compromising its nutritional adequacy, affordability, and cultural acceptability. Prices, amounts, and GHGE of all foods and drinks supplied to three schools over one year were optimized by linear programming. Three models were developed: Model 1 minimized GHGE while constraining relative deviation (RD) from observed food supply; Model 2 minimized total RD while imposing stepwise GHGE reductions; and Model 3 additionally constrained RD to -75% and +200% of the observed value. Model 1 reduced GHGE by 89-95% with an average RD (ARD) from observed food supply of 480-887%. In Model 2, comparable GHGE reductions (80%-95%) at lower ARD (78%-459%) were achieved but with high RDs for individual foods. Model 3 excluded no foods, avoided high RDs, and redu...

Public Health Nutrition

Objective Breast-feeding is an important determinant of health of mothers and their offspring. Th... more Objective Breast-feeding is an important determinant of health of mothers and their offspring. The present study aimed to compare breast-feeding rates across Europe disaggregated by maternal education and establish what proportion achieves at least 50 % exclusive breast-feeding (EBF) at 6 months. Design/Setting Secondary analysis of national or sub-national studies’ breast-feeding data for EU Member States plus Norway and Iceland, published in 2006–2016. Nineteen EU Member States plus Norway reported rates of EBF and any breast-feeding disaggregated by maternal education, of which only thirteen could be matched to the International Standard Classification of Education. Participants Mothers and their infants aged 0–12 months. Results Data on EBF rates at 6 and 4 months were found in only four and six countries, respectively. At 6 months, EBF rates of 49 % in Slovakia and 44 % in Hungary were closest to WHO’s target of at least 50 % EBF. At 4 months, mothers with high education level ...

BMJ open, Jan 21, 2016

To model food group consumption and price of diet associated with achieving UK dietary recommenda... more To model food group consumption and price of diet associated with achieving UK dietary recommendations while deviating as little as possible from the current UK diet, in order to support the redevelopment of the UK food-based dietary guidelines (now called the Eatwell Guide). Optimisation modelling, minimising an objective function of the difference between population mean modelled and current consumption of 125 food groups, and constraints of nutrient and food-based recommendations. The UK. Adults aged 19 years and above from the National Diet and Nutrition Survey 2008-2011. Proportion of diet consisting of major foods groups and price of the optimised diet. The optimised diet has an increase in consumption of 'potatoes, bread, rice, pasta and other starchy carbohydrates' (+69%) and 'fruit and vegetables' (+54%) and reductions in consumption of 'beans, pulses, fish, eggs, meat and other proteins' (-24%), 'dairy and alternatives' (-21%) and 'foods...

Maternal & Child Nutrition, 2016

In her recent editorial, Dr. de Pee (2015) states there are two main ways to provide additional n... more In her recent editorial, Dr. de Pee (2015) states there are two main ways to provide additional nutrients during complementary feeding: fortification and supplementation. She illustrates some problems associated with these ‘solutions’, including lack of compliance (Kodish et al., 2016). Rather than conclude that lipid‐based nutrient supplements (LNS) and ready‐to‐use therapeutic foods (RUTFs) may thus be ineffective, de Pee advocates research to improve compliance, assuming effectiveness has been demonstrated. We highlight four additional problems: inappropriateness, cost, lack of sustainability and potential adverse effects. First, RUTFs were designed for therapeutic use under medical prescription. Indeed Briend et al. (2015) state these are not optimized to maximize linear growth, vitamin and mineral status, nor functional outcomes; have problems related to quality and content and are expensive. Second, De Pee states that linear programming (LP) states a healthy diet is not affordable by many households in low and middle income countries (LMICs). However, at least two examples, Mozambique (Parlesak et al., 2014) and Kenya (Termote et al., 2014), illustrated how a low‐cost diverse diet can be designed using locally available foods. Interestingly, LP's ability to model these appears to depend on which cost‐efficient micronutrient‐dense local foods are selected. These LP diets, modelled for LMICs, were relatively affordable compared with the cost of 150 sachets of LNS weighing 92 g each which cost approximately US$55 in 2013. Moreover, Segrè et al. (2015) found that only 25% of Ethiopian consumers appeared willing to pay for LNS and could afford them. Third, de Pee states that distribution of LNS is sustainable and lists the practical constraints associated with feeding young children. However, investigators, e.g. in Bangladesh (Bogard et al., 2015), Ecuador, Kenya (Waswa et al., 2015) and Tanzania (Kuyper et al., 2014), have shown how to overcome these constraints using cost‐effective, culturally acceptable and locally available diverse foods. In addition, mothers are empowered by being able to earn income (Jones et al., 2015), which has spin‐off benefits. Both Johns et al. (2013) and Powell et al. (2015) demonstrate the economic importance of how local production improves dietary diversity, can be sustainable, cost‐effective, and culturally acceptable and helps to reduce rates of chronic undernutrition. Indeed the majority of young children in LMICs who do not consume LNS or RUTF are not undernourished.

Alcoholism Clinical and Experimental Research, Mar 1, 2003

ABSTRACT Der Zusammenhang zwischen übermäßigem Alkoholkonsum und dem Auftreten von Krebserkrankun... more ABSTRACT Der Zusammenhang zwischen übermäßigem Alkoholkonsum und dem Auftreten von Krebserkrankungen wird bei den malignen Erkrankungen der Speiseröhre und des Mund-Rachen-Raumes besonders deutlich. Weitere Organe, die eine signifikant erhöhte Inzidenz für Krebserkrankungen bei Alkoholabusus aufweisen, sind die Leber und die weibliche Brust. Für den Zusammenhang zwischen Alkoholmissbrauch und Dickdarmkrebs gibt es Hinweise, während der Einfluss von Alkoholabusus auf maligne Entartungen anderer Organe als unwahrscheinlich gilt. Ethanol selbst kann keine direkte krebserzeugende Wirkung zugeschrieben werden. Als mögliche Mechanismen, die bei übermäßigem Alkoholkonsum zur Zellentartung führen, werden eine erhöhte, durch die Löseeigenschaften von Alkohol hervorgerufene Migration von (Pro-)Kanzerogenen in die Zelle und eine Störung der Funktion von Leukozyten diskutiert, die an der Bekämpfung entarteter Zellen beteiligt sind. Des Weiteren werden die Induktion von Enzymen (Zytochrom P450), deren Aktivierung eine Giftung von Prokarzinogenen zur Folge hat und die Bildung von Azetaldehyd, dem ersten Stoffwechselprodukt von Ethanol, als wichtige Ursachen der Krebsentstehung angesehen. Eine aktuelle Hypothese berücksichtigt die Interferenzen zwischen dem Ethanol- und Retinoidstoffwechsel als mögliche Ursache der Zellentartung. Der bei Alkoholikern beobachtbare signifikant niedrigere Plasmaspiegel an Vitaminen und Spurenelementen (vor allem die Vitamine Folsäure, B 1 , B 6 und Zink) kann zu einer Einschränkung bei der Methylierung von DNA führen, die gleichfalls mit einer Risikoerhöhung für maligne Erkrankungen in Verbindung gebracht wird. Dies kann auf eine Störung der intestinalen Absorption zurückgeführt werden, die auch einen Mangel an antioxidativ wirksamen Vitaminen und Spurenelementen (Tocopherol, Vitamin C, Zink, Selen) zur Folge haben kann.