Pregnant women who eat sugary or highly processed food such as white bread and cornflakes face double the risk of having malformed babies, according to new research.
  Scientists made the discovery after comparing the diets of mothers whose babies had so-called neural tube defects such as spina bifida with those of mothers with normal babies.
   The study, involving almost 1,000 women, found that the risk of such birth defects was substantially greater among those who consumed higher levels of sugar and the highly refined carbohydrates found in potatoes, white bread and rice and many popular breakfast cereals.
  University researchers at the California birth defects monitoring programme in Berkeley said such foods may double the risk of neural tube defects in unborn babies, increasing to a fourfold risk among mothers with obesity.
  The new findings, reported in the latest issue of the American Journal of Clinical Nutrition, add to the growing concern over food products with a high glycemic index (GI). By producing a surge in blood sugar, the foods trigger the release of a large amount of insulin, high levels of which have already been implicated in birth defects.
  Dr Ross Welch, a specialist in foetal medicine at Arrowe Park Hospital, Wirral, Cheshire, said: "Assuming these results have a sound statistical basis, then this is important. The question we have to ask is what do we do about it?" Most mothers did not realise the crucial importance of diet in the first days of pregnancy, Dr Welch said.
  "High blood sugar levels have already been linked with foetal abnormality in diabetes, and this new research seems to be in line with that." He added: "Preconceptual folic acid is, however, still likely to be more important."
  The findings come amid mounting evidence that high GI foods may pose a significant threat to health. Earlier this year, high GI diets were linked to 50 to 80 per cent increases in risk of oral and ovarian cancer by researchers at the Centre for Cancer Research in Aviano, Italy.
  Most concern focuses on the role of such food in obesity. Research published earlier this month by scientists at Oxford Brookes University found that children given a high GI breakfast of cornflakes, Coco-Pops or white bread consumed many more calories at lunchtime than those given a low-GI alternative, such as bran flakes or porridge.
  Professor Jeya Henry, who led the research, said that the results supported evidence that high-GI foods boost appetite while cutting satiety - the "full" feeling that normally follows a meal. Both are thought to play important roles in developing obesity.
  "It is time we got away from the idea that it is all just a matter of a lack of self-control and exercise," said Prof Henry. "Every measure to reduce food intake must be explored. If we are serious about this issue, we need the Government and the food industry to get together to fund more research as a matter of urgency."
  Within the scientific world there is mounting anger over what is being seen as foot-dragging by the food industry over its role in the increase in obesity, which according to official figures is responsible for 30,000 premature deaths a year in Britain.
  Neville Rigby, the policy director of the London-based international obesity task force, said: "The food industry is the solution - they have to be, but they are not doing enough." However,the food industry insists that the issues involved are complex. A spokesman for Kellogg's, which makes many high GI cereals, said: "The science is relatively new and in some areas controversial. For instance, simply adding milk to cornflakes lowers their GI, while adding a banana lowers it even further. There is very clear evidence that foods such as Kellogg's Corn Flakes, which are high in carbohydrate and low in fat, play an important role in helping people reduce fat intakes, maintain weight levels and possibly help their bodies to better control blood sugar levels."
  Parents with children suffering from spina bifida welcomed the research. Su Scurr, from Tiverton, Devon, whose three-year-old daughter Briony has spina bifida, said last night: "If these foods are a significant factor then women need to be made aware of this research. I wouldn't wish what happened to me on anyone. It was awful. We found out that I was carrying a child with spina bifida in a scan at about 22 weeks.
  "I took folic acid in the two months before I got pregnant and I made sure I ate lots of fruit and salads but in the past I had eaten quite a bit of sugar. Who doesn't eat cereals? We need more research into spina bifida."
  Mrs Scurr, a full-time mother, who lives with her husband Peter, a chiropodist, Briony and two other - healthy - children, said abortion was not an option. "I have no regrets. Briony is lovely."
  Tanni Grey-Thompson OBE, who was born with spina bifida and has become Britain's best-known paralympic athlete, said last night: "These findings are interesting but you have to put them into context. Living in areas with heavy industry is also a factor, for example. It is really useful to encourage women to eat a better diet but there are also financial reasons why women eat what they do."
  Ms Grey-Thompson, who has won 14 paralympic medals and eight medal placings in the London Marathon, added: "There are a huge number of scary things that women are told when they become pregnant that can put a lot of guilt on mothers. Sometimes disability is no one's fault and there is nothing you can do about it."

     Here's the Medline abstract:

Am J Clin Nutr. 2003 Nov;78(5):972-8.
Neural tube defects associated with maternal periconceptional dietary intake of simple sugars and glycemic index.
Shaw GM, Quach T, Nelson V, Carmichael SL, Schaffer DM, Selvin S, Yang W.
March of Dimes Birth Defects Foundation, California Birth Defects Monitoring Program, Berkeley, CA 94710, USA. gsh@cbdmp.org

  BACKGROUND: Maternal diabetes, prepregnancy obesity, hyperinsulinemia, and intakes of sweets have been associated with increased risks of neural tube defects (NTDs). The interdependence of these factors suggests a common pathogenesis via altered glycemic control and insulin demand.
  OBJECTIVE: We investigated whether maternal periconceptional dietary intakes of sucrose, glucose, fructose, and foods with higher glycemic index values influence the risk of having NTD-affected pregnancies.
  DESIGN: In a population-based case-control study, all hospitals in 55 of the 58 counties in California participated. In-person interviews were conducted with the mothers of 454 NTD cases (including fetuses and infants who were electively terminated, stillborn, or born alive) and with the mothers of 462 nonmalformed controls within an average of 5 mo from the term delivery date. The risk of having an NTD-affected pregnancy was the main outcome measure.
  RESULTS: Risks of having an NTD-affected pregnancy were not substantially elevated in relation to periconceptional intakes of glucose or fructose [fruit sugar - ljf]. Elevated risks of approximately 2-fold were observed for higher intakes of sucrose and foods with higher glycemic index values. Elevated risks were observed for high sucrose intake irrespective of whether adjustment was made for other covariates such as maternal folic acid intake. For higher glycemic index values, adjusted elevated risks of >/= 4-fold were observed in women whose body mass index (in kg/m(2)) was > 29.
  CONCLUSION: Our observed associations support observations that potential problems in glucose control are associated with NTD risk even among nondiabetic women.

PMID: 14594784

  BACKGROUND: Natural selection has had < 1% of hominid evolutionary time to eliminate the inevitable maladaptations consequent to the profound transformation of the human diet resulting from the inventions of agriculture and animal husbandry.
  OBJECTIVE: The objective was to estimate the net systemic load of acid (net endogenous acid production; NEAP) from retrojected ancestral preagricultural diets and to compare it with that of contemporary diets, which are characterized by an imbalance of nutrient precursors of hydrogen and bicarbonate ions that induces a lifelong, low-grade, pathogenically significant systemic metabolic acidosis.
  DESIGN: Using established computational methods, we computed NEAP for a large number of retrojected ancestral preagricultural diets and compared them with computed and measured values for typical American diets.
  RESULTS: The mean (+/- SD) NEAP for 159 retrojected preagricultural diets was -88 +/- 82 mEq/d; 87% were net base-producing. The computational model predicted NEAP for the average American diet (as recorded in the third National Health and Nutrition Examination Survey) as 48 mEq/d, within a few percentage points of published measured values for free-living Americans; the model, therefore, was not biased toward generating negative NEAP values. The historical shift from negative to positive NEAP was accounted for by the displacement of high-bicarbonate-yielding plant foods in the ancestral diet by cereal grains and energy-dense, nutrient-poor foods in the contemporary diet-neither of which are net base-producing.
  CONCLUSIONS: The findings suggest that diet-induced metabolic acidosis and its sequelae in humans eating contemporary diets reflect a mismatch between the nutrient composition of the diet and genetically determined nutritional requirements for optimal systemic acid-base status.

PMID: 12450898

  BACKGROUND: Zinc deficiency in children is an important public health concern in the developing world, and the consumption of predominantly cereal-based diets with a high phytate content may contribute to the risk. The gastrointestinal tract plays a central role in absorbing and conserving zinc, yet it has not been carefully studied in such children.
  OBJECTIVE: This study investigated zinc homeostasis in healthy, free-living Malawian children with habitually high-phytate diets to better understand the role of the gastrointestinal tract.
  DESIGN: We evaluated zinc homeostasis in 10 children aged 2-5 y who were consuming a maize-based diet (phytate:zinc molar ratio of 23:1). Zinc stable isotopes were administered orally and intravenously. The tracer and tracee were measured in urine and feces.
  RESULTS: Endogenous fecal zinc was high in comparison with results for this measure in previous studies. Typical correlations seen in subjects consuming a low-phytate diet between total absorbed zinc, the size of the exchangeable zinc pool, and endogenous fecal zinc were not observed. Fractional absorption of zinc was 0.24.
  CONCLUSIONS: Zinc homeostasis was perturbed, particularly by large, endogenous fecal zinc losses, in this vulnerable population. The effects of interventions to improve zinc status, including dietary phytate reduction, on zinc homeostasis merit further study.

PMID: 12036813

  A sudden increase in dietary carbohydrate invariably increases the plasma levels of very low density lipoprotein (VLDL) and triglyceride. The present studies were designed to test the hypothesis that dietary carbohydrate-induced hypertriglyceridemia need not occur. In the first study we fed gradually increasing amounts of carbohydrate and gradually decreasing amounts of fat to eight subjects. The usual American diet (40% fat, 45% carbohydrate, and 15% protein) was followed in sequence by four diets in a phased regimen, the carbohydrate increasing by 5% of total calories and the fat content decreasing by 5% for each dietary period. In the last dietary period (phase 4), 20% of the energy was in the form of fat and 65% in the form of carbohydrates; the cholesterol content was 100 mg/day. Throughout the study, plasma triglyceride and VLDL triglyceride levels did not change significantly. The plasma total and low density lipoprotein (LDL) cholesterol levels were greatly reduced, by 15% and 22%, respectively (p = 0.004). Plasma high density lipoprotein (HDL) cholesterol levels decreased concomitantly. In the second study, after a washout period six of the subjects were initially fed the phase 4 high-carbohydrate diet for a 10-day period. The plasma triglyceride concentration increased over baseline levels by 47%, and VLDL triglyceride levels increased by 73%. We conclude that although a sudden increase in dietary carbohydrate increases the plasma triglyceride level, patients gradually introduced to a high-carbohydrate, low-fat diet may achieve a significant reduction of plasma total and LDL cholesterol without developing carbohydrate-induced hypertriglyceridemia.

PMID: 2065027

  Two levels of dietary carbohydrate (40% and 60% of calories) were incorporated into typical US diets and fed for 15 days each to eight patients with endogenous hypertriglyceridemia. Fasting blood samples were drawn on days 13, 14, and 15 of each dietary period, and analyzed for glucose, insulin, cholesterol, and triglyceride concentrations, as well as for triglyceride and cholesterol content of the various lipoprotein classes. In addition, these same measurements were made before and for three hours after the noon meal on days 14 and 15. Fasting plasma triglyceride (TG) and very-low-density lipoprotein (VLDL)-TG concentrations were significantly increased (P less than 0.005) on the low-fat-high-carbohydrate diet. In addition, integrated postprandial insulin, TG, and VLDL-TG responses to the noon meal were significantly (P less than 0.01-0.001) elevated on the low-fat-high-carbohydrate diet. No dietary-induced changes were noted in either the fasting or postprandial values of glucose cholesterol, chylomicron-TG, low-density lipoprotein-cholesterol, high-density lipoprotein (HDL)-cholesterol, HDL2-cholesterol, or HDL3-cholesterol. These results indicate that low-fat-high-carbohydrate diets accentuate the metabolic risk factors for coronary artery disease that are already present in patients with endogenous hypertriglyceridemia.

PMID: 6346001

  Postprandial plasma cholesterol and triglyceride (TG) levels were measured after the consumption of a relatively low-fat (35% of calories) diet in 41 subjects. Plasma cholesterol levels did not change appreciably during the postprandial state. In 34 subjects a biphasic plasma TG response curve was noted, with an initial peak occurring 1 to 3 hr after feeding and a secondary TG peak 4 to 7 hr after the meal. The primary peak was greater than 90%, accounted for by chylomicrons, whereas the secondary peak represented very low-density lipoproteins (greater than 82%). Furthermore, the heights of the primary and secondary peaks were closely correlated to the fasting TG level (r = 0.61 and 0.72, respectively) indicating that the fasting TG concentration is an important determinant of the postprandial TG response. Because low-fat (high-carbohydrate) diets are known to raise fasting TG levels in patients who do not have fasting hyperchylomicronemia, and because relatively few patients have chylomicrons in the fasting state, these data suggest that such diets may lead to day long increases in plasma TG levels in the majority of subjects.

PMID: 178167

  We have studied the effects of moderate dietary fat restriction on plasma triglyceride, cholesterol, glucose, and insulin response in 27 subjects. Compared with a control diet (45% fat, 40% carbohydrate [CHO], 15% protein) the low fat (higher CHO) diet (30% fat, 55% CHO, 15% protein) produced a 41% increase in fasting triglyceride level (155 +/- 17 to 219 +/- 23 mg%) with no change in fasting plasma cholesterol level. Furthermore, this increase in triglyceride levels; induced by the higher CHO content of the low fat diet, was seen in 26 out of 27 subjects. Postprandial triglyceride, glucose, and insulin levels were also higher on the low fat (higher CHO) diet. Since hypertriglyceridemia is a significant risk factor for the development of coronary heart disease, and since our data indicate that the moderate increase in dietary CHO associated with a low fat diet will elevate plasma triglyceride levels, we believe that more caution is necessary before recommending the wide-spread use of low fat diets for heart disease prevention.

[NOTE: first of all, this study uses the intentionally deceptive "% calories as xxx" concept.  Then it suggests that the only way to decrease fat intake is to increase carbohydrate (CHO) drastically; however, abandoning the cultural diet, which contains highly-excessive quantities of both proteins and carbohydrates, and adopting a fruit and vegetable-oriented diet, which is much closer to the diet of our ape-ancestors, will reduce both excess protein and excess CHO, in absolute quantities.  The study does point out that excess starches will produce high serum triglycerides.  Most excessive CHO's in cultural diets come from grains and grain products, and these are relatively recent human inventions that were most certainly not in our evolutionary diet - ljf]

PMID: 1262445

Persorbed Particles/Fibers

Pathologe 1993 Sep;14(5):247-52
[Persorption of microparticles]. [Article in German]
Volkheimer G.

  Solid, hard microparticles, such as starch granules, pollen, cellulose particles, fibres and crystals, whose diameters are well into the micrometre range, are incorporated regularly and in considerable numbers from the digestive tract. Motor factors play an important part in the paracellular penetration of the epithelial cell layer. From the subepithelial region the microparticles are transported away via lymph and blood vessels. They can be detected in body fluids using simple methods: only a few minutes after oral administration they can be found in the peripheral blood-stream. We observed their passage into urine, bile, cerebrospinal fluid, the alveolar lumen, the peritoneal cavity, breast milk, and transplacentally into the fetal blood-stream. Since persorbed microparticles can embolise small vessels, this touches on microangiological problems, especially in the region of the CNS. The long-term deposit of embolising microparticles which consist of potential allergens or contaminants, or which are carriers of contaminants, is of immunological and environmental-technical importance. Numerous ready-made foodstuffs contain large quantities of microparticles capable of persorption.

PMID: 8415433

  Intact starch granules in food can pass through the intestinal wall and enter the circulation. They remain intact if they have not been cooked for long enough in the presence of water. Some of these granules embolise arterioles and capillaries. In most organs the collateral circulation suffices for continued function. In the brain, however, neurones may be lost. Over many decades the neuronal loss could be of clinical importance. To test this hypothesis, there is a need to examine brains for the presence of embolised starch granules. Examining tissues polariscopically clearly distinguishes starch granules from other objects of similar appearance.

PMID: 1890981

  Seidemann J. The problems arising in using microcrystalline cellulose in the food industry are outlined. Like starch granules, microcrystalline cellulose is also persorbed by the human and animal organism. As long as the problem persists whether persorption is a normal, everyday process or a process which is detrimental in the long run, the statement that the use of greater amounts of microcrystalline cellulose for foods and pharmaceutical products is absolutely safe should be carefully examined.

PMID: 785264

  More than 150 years ago the foundations were laid for the so-called HERBST effect which was subsequently forgotten. In the sixties the phenomenon was rediscovered by VOLKHEIMER at the Charite Hospital in Berlin and then reviewed through many experiments and publications. What is meant by the HERBST effect? If an experimental animal or even human being is given a larger amount of maize starch or also biscuits or some other products containing starch, starch bodies can be detected rapidly in venous blood already after minutes or half an hour later and in the urine after one hour and later. The term "persorption" has been coined for this interesting phenomenon. It is indeed surprising that it has met with so little attention. As a matter of fact, it constitutes the basis for our understanding of peroral immunization and of allergies. In the same way, feeding of carbon particles results in their appearance and detection in blood, kidney and urine. The same result is obtained by the intake of diatoms and what is even more important with meat fibres. I hope you are aware of the implications. When Professor NAGAI stayed in Berlin, we tried to receive the phenomenon. Since only a few cell nuclei are necessary for "genetic fingerprinting" we thought that after intake of 200 or 400 g of raw meat the type of food eaten could be determined from the urinary sediment by means of the fingerprint method which would be of forensic significance. Therefore, we eat meat and raw liver and examined the urinary sediment..(ABSTRACT TRUNCATED AT 250 WORDS)

PMID: 2273756