Search

Milk is a widely consumed beverage that is essential to the diet of several millions of people worldwide because it provides important macro- and micronutrients. Milk is recognized as being useful during childhood and adolescence because of its composition; however, its relatively high saturated fat proportion raises issues of potential detrimental effects, namely on the cardiovascular system. This review evaluates the most recent literature on dairy and human health, framed within epidemiologic, experimental, and biochemical evidence. As an example, the effects of milk (notably skimmed milk) on body weight appear to be well documented, and the conclusions of the vast majority of published studies indicate that dairy consumption does not increase cardiovascular risk or the incidence of some cancers. Even though the available evidence is not conclusive, some studies suggest that milk and its derivatives might actually be beneficial to some population segments. Although future studies will help elucidate the role of milk and dairy products in human health, their use within a balanced diet should be considered in the absence of clear contraindications.

Background: Obesity dietetic treatment produces a residual bulk reduction that is easily responsible of constipation. Fiber addiction improves bowel transit. To avoid some unpleasant effects of high molecular weight fibers, a research was made on a colloidal cellulose microfibers (MCC) product, that for its low molecular weight and its phytic acid lack, can limit these problems. Influence on constipation, blood and chemical analysis and satiation has been studied., Methods: Research was made on obese patients. One group (studied for 4 weeks) of 30 subjects, 25 affected by simple obesity, and 5 obese, with hyperlipemia and non insulin dependent diabetes. The other group (studied for 8 weeks) of 10 subjects affected by simple obesity. The product was in tablets containing MCC 0.600 mg each, to be taken daily in dose of 4/6. Weight, BMI, total and fractionated cholesterol, triglycerides, A and B lipoproteins, uric acid, glucose and glycosylated hemoglobin (in diabetic patients), blood count and plasma iron level (in the second group of patients) had been determined. Each subject reported on a record evacuations, collaterals symptoms, sense of satiation., Results: 83% in the first group of patients and 90% in the second group showed defecation improvement. No changes were found in controlled parameters. MCC effect has been constipation correction., Conclusions: This fiber can be suggested in obese subjects when diet caused a slow bowel transit. Supplement can be protracted because it doesn't interfere with iron absorption.

In this paper the presence of a correlation between plasma Lp(a) levels and peripheral vascular disease (PVD) and/or coronary heart disease (CHD) was investigated in 20 dyslipidaemic patients (10 males and 10 females, well matched for age, type of hyperlydaemia and other CVD risk factors). Lp(a) plasma levels, ECG and carotid and femoral arteries duplex ultrasonography were performed in all the patients. No difference in plasma Lp(a) levels between patients without and with carotid and femoral arteries stenotic lesions was observed. On the contrary Lp(a) was significantly higher in patients with ECG signs of coronary ischaemic heart diseases than in patients with normal ECG. These observations confirm the importance of Lp(a) as a risk factor for coronary heart disease in dyslipidaemic patients.

Objectives: To see if the cluster of metabolic and haemodynamic variables defined as comprising Syndrome X varied as a function of urinary albumin excretion (UAE) rate in a healthy population., Design: A cross-sectional, population-based study., Setting: A factory in Italy., Subjects: Two hundred and twenty-five healthy volunteers, 115 men and 110 women. OUTCOME MEASURES. Measurements were made of the plasma glucose and insulin responses to oral glucose, fasting triglyceride (TG) and high density lipoprotein (HDL)-cholesterol concentrations, blood pressure, and UAE rates., Results: Only five of the 225 volunteers had micro-albuminuria, defined as a UAE rate > 2 micrograms min-1, and the UAE rate was < 5 micrograms min-1 in 80% of the volunteers. Significant variations in the metabolic and haemodynamic variables measured were not associated with any differences in UAE. Finally, significant relationships were found between various measures of plasma insulin concentration and plasma glucose response to oral glucose, plasma TG and HDL-cholesterol concentrations, and mean arterial blood pressure, independent of variations in age, body mass index, ratio of waist-to-hip girth, and UAE rates., Conclusion: The widespread variability in plasma glucose and insulin responses, plasma TG and HDL-cholesterol concentrations, and blood pressure that are seen in the population at large cannot be attributed to variations in UAE rate.

Plasma levels of lipoprotein(a), total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, apoprotein A1 and apoprotein B were assessed in 10 healthy, untrained volunteers subjected to a bicycle ergometric exercise equal to 50% of individual VO2max, followed by increasing loads until muscular exhaustion. Blood samples were taken before the exercise, immediately afterwards and then at 12-hourly intervals for a 72 hours period. Subsequently, the same parameters were evaluated for 8 long-distance runners during the XXIII New York Marathon, with blood samples being taken before and after the race, and then after one month of detraining. After the exercise, lipoprotein(a) in untrained subjects began to decrease significantly from the 24th hour on and remained lower than baseline levels up till the 72nd hour. After detraining, lipoprotein(a) in marathon runners increased significantly both with respect to basal values and especially to post-race values. Modifications of the other metabolic parameters evaluated in both tests were negligible and predictable. In the two groups of subjects examined, no correlation was found between lipoprotein (a) and the anthropometrical data and metabolic parameters considered.

After a short account on alimentation in pregnant women, the authors examine in detail the correct alimentation in pregnant women affected by different types of diabetes. As general lines for a correct nutritional approach, a total caloric intake of 2200-2500 kcal daily (9196-10450 Kj) (which enclose 35-40 kcal/pro/kg ideal weight and a caloric surplus for pregnancy) is recommended. In over-weight women the caloric intake will be reduced till 1500 kcal (6270 Kj) checking constantly metabolic situation (increase of weight should be for the first ten weeks of 100 g weekly, than of 300 g weekly). Altogether weight increase should be from 9 to 12 kg. 15-20% of caloric intake should be represented for proteins, very important for pregnancy and good growth of fetus. Carbohydrate intake should be 55-60% of caloric intake represented for 75-80% by complex glucides and for 20-25% simple glucides to support a suitable amount of dietary fibres (25-30%). The lipid intake recommended should be 25-30% of the daily calories with a third of monounsaturated fat acids, a third of polyunsaturated fat acids and a third of saturated fat acids, with a cholesterol amount under 300 mg/die. In additional the nutritional plan should consist of a adequate amount of "non energetic nutrients" (minerals and vitamins), particularly the calcium intake must be 1200 mg/die and 18 mg/die that of iron and folic acid, vitamin A, D and B intake must be increased. Finally, the authors advise against alcoholic beverages and recommend a regular subdivision of the meals.(ABSTRACT TRUNCATED AT 250 WORDS)

Detailed and personalized dietary guidance must be given to subjects recognized as dyslipidaemic and to the parents of high-risk individuals. The diets should be hypolisocaloric with reduced intake of fats (30%) and cholesterol (250-300 mg/day) and with high intake of carbohydrate (55-60%), preferably complex. Dietary fibre intake should be at least 25 g/day.

Our objective was the checking of clinical data obtainable from the assay of some parameters in NID diabetic individuals. To this end, we studied 133 patients--57 males and 76 females, average age 74.36 +/- 1.01 years, 72.6% of which were above 65 years of age. The control population was subdivided as follows: 50 subjects, 26 F and 24 M; average age 71.25 +/- 1.32 years, with normal glucidic tolerance as assessed by OGTT. Current glycemia, average glycemia, fructosamine, glycosylated hemoglobin, triglycerides, LDL-cholesterol and apolipoprotein B were obviously much higher than normal in the individuals admitted to the study. A statistically significant correlation was found between average glycemia, glycosylated hemoglobin, LDL-cholesterol and blood triglycerides (p less than 0.05). No correlation was found between current glycemia, fructosamine and glycosylated hemoglobin. Similarly, serum fructosamine was unrelated to the parameters studied. In our study, fructosamine, glycosylated hemoglobin and current glycemia offered unrelatable data. Hence, in our opinion it is necessary to assay these three parameters contemporaneously for a reliable assessment of metabolic compensation.

A one-year clinical trial with pantethine was conducted in 24 patients with established dyslipidemia of Fredrickson's types II A, II B, and IV, alone or associated with diabetes mellitus. The treatment was well tolerated by all patients with no subjective complaints or detectable side effects. Blood lipid assays repeated after 1, 3, 6, 9, and 12 months of treatment revealed consistent and statistically significant reductions of all atherogenic lipid fractions (total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B) with parallel increases of high-density lipoprotein cholesterol and apolipoprotein A. The results were equally good in patients with uncomplicated dyslipidemia and in those with associated diabetes mellitus. The authors conclude that pantethine (a drug entity related to the natural compound, pantetheine) represents a valid therapeutic support for patients with dyslipidemia not amenable to satisfactory correction of blood lipids by diet alone.

Iodide-induced hypothyroidism has been observed in subjects treated with compounds with mild antithyroid activity. The hypoglycemic agent tolbutamide belongs to the aminoheterocyclic group, a class of compounds with antithyroid effect. Thus it was thought interesting to study the effect of large doses of iodide on thyroid function in diabetics chronically treated with tolbutamide. Basal thyroid function as assessed by clinical examination and iodothyronine and TSH concentrations was normal in all patients. Furthermore, in diabetics treated with tolbutamide, hormone concentrations were not different from those of patients treated with insulin or diet. Serum T4, T3 and TSH did not show any significant variation throughout the investigation period. Our results suggest that thyroid function is not affected by chronic treatment with tolbutamide even when large doses of iodide are administered.

The lack of fiber in the western diet may contribute to the development of several diseases including gastrointestinal disorders; the clinical effects of a new substance (AGIOLAX) made from plantago seeds and senna pods were studied. 100 patients of both sexes, aged from 40 to 60 years (30 with diabetes mellitus, 40 with obesity and 30 with hyperlipidemia) were treated; everyone complained a slowness, of different degree, of normal intestinal transit time or chronic constipation. The experiment was carried out without the use of a control group. Aim of the present study was to investigate the efficacy and tolerability of the product. In addition to the clinical evaluation of the symptoms, laboratory tests were performed. The patients were treated for 3 months with a daily dose of 2 teaspoons every evening. In the majority of the subjects a good clinical response was obtained; 88% of the patients presented a normalization of the gastrointestinal transit time; only 12% of them did not respond satisfactorily to the substance. Further the drug was well tolerated by 86% of the patients. In conclusion the authors report a good efficacy and tolerability of the product; thus they recommend its use in those disorders characterized by slow intestinal transit time and/or constipation.

Recent investigations have confirmed the effectiveness and the excellent tolerability of pantethine, a derivative of pantetheine, an essential part of the acetylation coenzyme CoA, administered P.O., in normalizing the blood lipid concentrations of patients with hyperlipidemias. A group of 18 patients with hyperlipidemias (9 M, 9 F), with an average age of 52.6 years, was submitted to pantethine parenteral treatment. After a 20 days wash-out, pantethine (400 mg/day; BID) was administered intramuscularly, for 20 days. Total cholesterol, triglycerides, HDL-cholesterol, apo A-1 and B lipoprotein, uric acid in serum, glycemia, CBC, B.U.N., creatininemia, E.S.R., SGOT, SGPT, bilirubinemia, cardiac frequency, blood pressure and body weight were controlled before and after treatment. The drug showed to have a therapeutic effectiveness by a rapid and significant improvement in the blood lipid pattern with reduction of total cholesterol, triglycerides and apo-B lipoprotein and increase of HDL-cholesterol and apo A-1 lipoprotein. The tolerability of pantethine at the stated dosage and mode of administration was invariably excellent, with non complaints or visible side effects imputable to the test drug. BUN, creatininemia, glycemia, SGOT, SGPT, bilirubinemia, E.S.R., CBC, cardiac frequency and blood pressure readings showed no noteworthy changes throughout the study.

A double-blind controlled trial was carried out to compare the effects of chenodeoxycholic acid (CDCA), ursodeoxycholic acid (UDCA), and placebo on cholesterol and triglyceride levels in patients with endogenous hypertriglyceridemias. The dose of both bile acids was four 150-mg capsules day. Total serum cholesterol levels did not show appreciable changes with any of the treatments. HDL cholesterol was significantly increased after CDCA but not after UDCA or placebo. CDCA feeding was associated with a significant decrease in serum triglyceride levels, whereas the other treatments failed to show an effect. It is concluded that UDCA does not affect serum lipid levels, whereas CDCA lowers serum triglycerides and may be useful in the treatment of endogenous hypertriglyceridemia.

The authors compared sequential HbA1 levels with the results obtained by oral glucose tolerance test (O.G.T.T.) with the purpose of detecting the confidence limit of each test regarding the glucose control in pregnant women. HbA1 detection showed more sensitivity than O.G.T.T. in detecting maternal impaired glucose control and in distinguishing between a metabolic or a genetic feto-neonatal macrosomia.

The AA. describe an unusual form of severe grahm negative bacterial infection of the renal parenchima that occurs infrequently in adult patients, most of whom are diabetics. During the acute phase, the kidney becomes smoothly enlarged, with marked impairment of contrast material excretion. The urographic and echographic findings simulated a renal neoplasm; on the contrary the selective renal angiography excluded the presence of a neoplastic blood circulation. This bacterial infection produces an inflammatory infiltrate surrounding and occluding the interlobular arteries in the cortex, with secondary ischemy. A precious and appropriate antibiotic therapy causes a rapid return of renal function; on the contrary this process may produce a globally small kidney in the long run.

Gallstone disease has been recognized to be linked to others metabolic disorders such as obesity, atherosclerosis, hyperlipidemia and diabetes. Previous studies demonstrated a close relationship between abnormal eating habits and gallstone disease. The total caloric intake should be calculated on each individual energy requirement and should be restricted in over-weight patients. The diet should contain approximately 15-20% of the daily calories from proteins, 30-35% from fat (mainly vegetable fat for the higher content in polyunsaturated fat) and 40-55% from carbohydrate (especially complex carbohydrate). In addition the nutritional plan should consist of adequate amount of minerals and vitamins and the fiber consumption should be increased to 30-40 g/day. Finally, at last the Authors recommends (6279-8372 Kj- a regular subdivision of the meals (small and frequent) dressed in the very natural wag.

The Authors have studied an experimental product (L. G. 140/S), based on GUAR GUM, to establish its effectiveness and tolerability as a dietetic support in the treatment of obesity. The clinical research work has been conducted on 21 obese subjects (18 females and 3 males) aged 17 to 58 and treated with a hypocaloric and hypoglycemic diet. This preparation has proved useful in helping the patients to conform to the dietary restrictions and/or in normalizing their intestinal transit. No objective or subjective symptoms certainly referable to this preparation have been observed. The administration of the product has been interrupted for precautionary reasons in some cases, since it was not indispensable. Considering the good results they have obtained in terms of tolerability and agreeableness of this product, the Authors conclude that it can be considered a useful support to the restrictive dietary regimen, which is still considered - together with physical activity - the only sound and effective remedy in the treatment of obesity.

The hypolipidemizing effects of Pantethine were investigated by the Authors in 37 hypercholesterolemic and/or hypertriglyceridemic patients. Of these, 21 were also diabetic, in a satisfying glucidic compensation, in order to verify the action of this drug also in this metabolic condition. The study was carried out for three months and during this period the patients were given Pantethine at the dose of 600 mg/die orally. At the 30th, the 60th, the 90th day of treatment the following parameters were controlled: cholesterolemia, HDL cholesterol, apolipoproteins A and B, triglyceridemia, systolic and diastolic arterial pressure, uricemia, body weight. Thirty days after suspending the treatment, the parameters were controlled again to detect a possible "rebound" effect. The results were analyzed on the whole case-record, subdividing the patients in dislipidemic and diabetic-dislipidemic, and on the basis of the Fredrickson's classification. Pantethine induced in all groups a quick and progressive decrease of cholesterolemia, triglyceridemia, LDL cholesterol and Apolipoproteins B with increased HDL cholesterol and Apolipoproteins A. After suspending the treatment, there is a clear inversion of the state of these parameters. The Authors conclude that the present work shows that Pantethine, a natural and atoxic substance, an important component of Coenzyme A, is efficacious in determining a clear tendency towards normalization of the lipidic values.

The present paper reports some aspects of glycolipid metabolism observed during and after dialysis of varying duration, and the effects of glucose content in dialysis fluid. Some substances used in dialysis interfere with glycolipid metabolism: heparin (Robinson and French, 1960; Wolff and Wolff, 1960); sodium acetate (Bloch, 1947; Ghosal et al, 1969; Mion et al, 1964); and glucose in high (Leonards et al, 1961; Mendelssonhn et al, 1967) or low concentrations (Drukker et al, 1964; Hagstam et al, 1969) or, more recently, completely eliminated (Alwall et al, 1970; Hubner et al, 1971).

A method has been devised for the analysis of tolerance curves, and tested on data collected for the diagnosis of lactose malabsorption with lactose tolerance tests. Two different models were fitted to over 100 experimental curves; the need to allow small changes over time in the glucose baseline level became evident, indicating that a model allowing a time trend is preferable. The results are briefly discussed and the biological significance of the quantities estimated by the method is discussed.

Tests of thyroid function in 493 obese patients were compared with thyroid function in 3076 non-obese patients. No differences in 131I uptake by the thyroid were observed at 6 h or 24 h; the frequency distribution was gaussian or normal in both populations; the frequencies of normal, high or low T3 and T4 values in the two populations were likewise comparable. Further, no correlation was found in the obese subjects between 131I uptake (6 h and 24 h), T3, T4 and overweight; on the other hand, there was a significant negative correlation between 131I uptake (6 h and 24 h) and age. It would appear that thyroid function is normal in obesity.

We have studied metabolic, circulatory and vascular parameters in a group of 57 diabetics (37 affected by IDDM, 20 affected by NIDDM; 35 were males, 22 were females). Goals of present study were: 1) quantitative evaluation of the blood retinal barrier; 2) influence of the metabolic state, blood pressure, sex, type and duration of the diabetes on the ocular conditions; 3) relationship between ophthalmoscopic appearance of the retina and vitreous fluorophotometric recordings. We concluded that: a) ocular alterations depend by lipidic metabolism, blood pressure, sex, type and duration of the diabetes; b) vitreous fluorophotometry has proved a good device for early detection of retinal damages in the diabetic retinopathy.

To evaluate the relationship between myocardial infarction and serum lipid levels, 778 patients admitted to the Fidenza Coronary Unit were studied. These patients were divided by sex and into groups by age decade and the frequency of hyperlipidemia was investigated. In the first place the association between myocardial infarction (MI) with hypercholesterolemia, second with hypertriglyceridemias was considered. In addition the population was subdivided in respect to the 3 more frequent types of hyperlipidemia (hypercholesterolemia, hypercholesterolemia and hypertriglyceridemia, hypertriglyceridemia). The results show the presence at a positive correlation between MI and hypercholesterolemia in the younger groups in both sexes, but mainly in female. Similar results are obtained when the correlation between MI and hypertriglyceridemia was considered, but at a lower statistical significance. The statistical analysis of the different types of hyperlipidemia confines the important pathogenetic role of hypercholesterolemia by itself and in association with hypertriglyceridemia. On the other hand hypertriglyceridemia does not show any primary influence on MI, but it acts synergistically with hypercholesterolemia. The strong association of hyperlipidemia and MI in the younger group and in female, documented in this study, confirms the importance of hypercholesterolemia and hypertriglyceridemia as a risk factor in the early development of coronary heart disease.

After a brief reference on the so-called diseases of "civilisation" and on their correlations with a diet rich in refined high caloric carbohydrate having poor gastric filling capacity and therefore lacking in fibre, the authors present their experience on a new product, MF/D/80, which is an association of cereal and acid fruit fibres. 25 patients (3 men and 22 women) were treated, 22 of them suffered from chronic constipation and 3 from colitis. The experiment was carried out without the use of control drugs. The aim of the research was that of verifying the efficacy and tolerability of the product. The efficacy was optimal in 88%, good in 4% and modest in 2 cases (8%) of the entire number of cases while the tolerability has been optimal in all the cases. The Authors conclude the retaining that MF/D/80 is a product that can be used with enormous advantages in chronic constipation for its efficacy, optimal tolerability and for its mechanism of action. The Authors finally underline its usefullness as an "alimentary integrator" in all those diseases (obesity, diabetes, atherosclerosis etc.) which among the various etiopathogenetic moments, also count in refined alimentation.

After having stressed the importance of fibres in the nutritional field, pointing out the inverse relationship between vegetal fibres consumption in various populations and diffusion of many diseases of the so-called "industrialized" societies (such as obesity, diabetes, dyslipidemias, atherosclerosis, cholelithiasis, cancer of the colon, etc.), the Authors report their experiment on a new experimental product based on glucomannane purified (PRL). The present study was carried out on 24 obese subjects (5 males and 19 females). The patients, normoglycemics in their basic condition, were submitted to OGTT with 75 g of glucose in the morning before eating and were subdivided into two groups, the first (Group A) characterized by the sequence OGTT + placebo; after a few days, by another OGTT + experimental product; the second characterized by the inverse sequence. Four tablets (glucomannane purified 5,2 g) and four tablets of placebo was the posology employed. The evaluation of the possible action of the product in reducing or slowing down the intestinal absorption of glucose was the aim of the research. The results obtained show that the administration of the product under study has led to a sharp decrease of the average glycemic values with variations per cent ranging from 13% to 16% in Group A, from 10% to 11% in Group B and from 7% to 12% in the two groups considered on the whole. In conclusion, the Authors wish an increased diffusion of dietary fibres and particularly of the glucomannanes in all those dysmetabolic forms having at their bases an unbalanced, hypercaloric alimentation, rich in refined aliments and poor in fibres.

Epidemiological aspects of obesity have been the object of few studies in Italy, and the results of these are reviewed and compared with those obtained in other developed countries. The prevalence of obesity has been investigated in pre-school and school-age children, in young conscripts and in workers at the Riuniti Hospital in Parma, and the results show that the problem of obesity in Italy is a serious one. More than 2000 obese subjects, attending the First Medical Clinic of Parma University, have been studied to establish how far overweight is responsible for pathological and disabling complications. Obesity was implicated as a major contributing factor in diabeties, atherosclerosis, hypertension, arthritis and many other disabling diseases. The social aspects of the problems of obesity are discussed, together with possible preventive and curative measures.

Eighty Italian adults (53 females, 18-69 years, and 27 males, 18-60 years) underwent double-blind tests involving the intake of increasing amounts (125, 250, 500, 1000 ml/d) of four types of milk with normal or low lactose and/or fat content. The tests were completed satisfactorily by 71 subjects. Forty were lactose malabsorbers (LMs) and 31 were absorbers (LAs), according to a standard oral lactose tolerance test. Each subject reported on a questionnaire whether he/she experienced symptoms during the 24 h after milk intake, and the intensity of the symptoms, adopting a score of 0 to 12, according to an already tested procedure. The aim of the study was to investigate the relationship between lactose malabsorption or absorption and intolerance to milk in Italian adults, relative to lactose and fat contents, dose of milk and individual sensitivity. LMs reported symptoms overall more frequently and with greater intensity than LAs (P less than 0.001). The amount of milk ingested was positively associated with the frequency of symptoms both in LMs and LAs. Contrary to earlier findings, fat seemed to contribute to milk intolerance in LMs rather than to reduce it. According to analysis of variance individual differences accounted for 40 per cent of total variation in symptom frequency.

A study of regional differences in prevalence of primary adult lactose malabsorption in Italy was conducted on 205 subjects. Their origin was determined by their grandparents' birthplace, 89 from northern, 65 from central, and 51 from southern areas of Italy. Lactose malabsorption was diagnosed with standard oral lactose tolerance test and blood glucose determinations. Lactose malabsorbers showed symptoms more frequently than absorbers after the test load of lactose (p less than 0.01) they also reported milk intolerance more frequently (p less than 0.01). Prevalence of lactose malabsorption is significantly lower in the central sample (19%) than in the northern (52%) and southern (41%) samples (p less than 0.01). This finding contrasts with the hypothesis of a continuous increase in frequency of lactose malabsorption from northern to southern Europe and is probably due to the complex genetic history of the Italian population.

Referring to the results of a "pilot" nutritional investigation carried out in a representative mixed sample of a small community of Parma district (Langhirano), the AA. underline the clinical and metabolic implications resulting from the not quite correct nutritional behaviour observed. In fact, in agreement with the national average data reported for italian population from ISTAT, caloric excess, particularly of dietary fat and proteins, was confirmed in this community too. Nevertheless, want of vitamins (D, B1, B2), and minerals (Ca) was paradoxically found. Considering in detail the results some immediate clinical and metabolic consequences come out: namely, want of Ca is prevailing in women and just in the critical age classes (20-40 and 50-59 years, that is in fertile and climacteric ages). When the recommended intake levels are higher. Ferthermore in male-populations, in the class aged 30-50 (that is more vulnerable as to atherosclerosis), was found the highest caloric intake besides in fat and particularly in cholesterol, as to the recommended safety levels. The A.A. conclude pointing out the importance and the necessity of a nutritional notions wide spreading, involving the various responsible public health and social politic organisation of the Country.

Plasma lipid, lipoprotein, and apoprotein concentrations were measured in 169 patients with non-insulin-dependent diabetes mellitus (NIDDM), 78 with normal blood pressure, and 91 diagnosed and receiving drug treatment for hypertension. Plasma triglyceride, cholesterol, low-density lipoprotein-cholesterol, and apoprotein B concentrations were significantly higher (p = less than 0.05 to less than 0.001) in the hypertensive group. In addition, the ratios of high-density to low-density lipoprotein-cholesterol and of apoprotein A-1 to apoprotein B were significantly reduced (p less than 0.01) in patients with hypertension. The changes noted were independent of differences in sex distribution, degree of obesity, and level of glycemic control. These results indicate that substantial differences in plasma lipid, lipoprotein, and apoprotein concentrations are seen when normotensive patients with NIDDM are compared with patients who are also being treated for hypertension, and that all of the changes noted would increase the risk of coronary artery disease in the hypertensive group. Since all patients with hypertension were receiving anti-hypertensive medications, it is not clear if it is hypertension per se, or its treatment, that is responsible for the observed changes in lipid metabolism.