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Preliminary results from this program showed that PHN home visitation (control and intervention groups) positively affects the birth outcomes of adolescent mothers and their infants.

1,3-Butadiene’s (BD’s) major electrophilic metabolites 1,2-epoxy-3-butene (EB), 1,2-dihydroxy-3,4-epoxybutane (EBD), and 1,2,3,4-diepoxybutane (DEB) are responsible for both its mutagenicity and carcinogenicity. EB, EBD, and DEB are DNA reactive, forming a variety of adducts. All three metabolites are genotoxic in vitro and in vivo, with relative mutagenic potencies of DEB >> EB > EBD. DEB also effectively produces gene deletions and chromosome aberrations. BD’s greater mutagenicity and carcinogenicity in mice over rats as well as its failure to induce chromosome-level mutations in vivo in rats appear to be due to greater production of DEB in mice. Concentrations of EB and DEB in vivo in humans are even lower than in rats. Although most studies of BD-exposed humans have failed to find increases in gene mutations, one group has reported positive findings. Reasons for these discordant results are examined. BD-related chromosome aberrations have never been demonstrated in humans except for the possible production of micronuclei in lymphocytes of workers exposed to extremely high levels of BD in the workplace. The relative potencies of the BD metabolites, their relative abundance in the different species, and the kinds of mutations they can induce are major considerations in BD’s overall genotoxicity profile.

OBJECTIVE -High-viscosity hydroxypropylmethylcellulose (HV-HPMC) is a modified cellulose fiber that produces a viscous gel in the gastrointestinal tract. Clinical trials demonstrate that consumption of HV-HPMC significantly lowers cholesterol, but limited information has been available on the influence of HV-HPMC on postprandial insulin and glucose responses. The objective of this investigation was to assess the influence of HV-HPMC on postprandial glucose and insulin responses in overweight and obese men and women.RESEARCH DESIGN AND METHODS -Participants were 31 overweight or obese men and women without diabetes who underwent three breakfast meal tests in random order, separated by Ն72 h. Test meals containing 75 g carbohydrate plus 4 or 8 g HV-HPMC or control meals containing 8 g cellulose were delivered in a double-blind fashion.RESULTS -Peak glucose was significantly lower (P Ͻ 0.001) after both HV-HPMCcontaining meals (7.4 mmol/l [4 g] and 7.4 mmol/l [8 g]) compared with the control meal (8.6 mmol/l). Peak insulin concentrations and the incremental areas for glucose and insulin from 0 to 120 min were also significantly reduced after both HV-HPMC doses versus control (all P Ͻ 0.01).CONCLUSIONS -These findings indicate that HV-HPMC consumption reduces postprandial glucose and insulin excursions, which may favorably alter risks for diabetes and cardiovascular disease. Diabetes Care 30:1039 -1043, 2007I nsulin resistance and compensatory hyperinsulinemia are believed to play important pathophysiological roles in the development of a number of conditions, including diabetes, coronary heart disease, and hypertension (1,2). Insulin resistance is a state in which a given circulating concentration of insulin produces subnormal clearance of glucose from the blood (2).In the presence of insulin resistance, the pancreas will increase insulin secretion to maintain normal glucose tolerance (2). However, the resulting excessive demand on the pancreatic ␤-cells may, over an extended period, lead to pancreatic exhaustion and the eventual development of glucose intolerance (1,2). Furthermore, insulin resistance may not be present to the same degree for all tissues and actions of insulin. Therefore, the hyperinsulinemia required to maintain normal glucose tolerance may produce undesirable physiological effects, including increased synthesis of VLDL, enhanced renal sodium reabsorption, and remodeling of vascular and cardiac tissues (1-3).Slowing the absorption of digestible dietary carbohydrates shows promise as a way to reduce hyperinsulinemia and its unwanted consequences on pancreatic function and the development of hemodynamic disturbances (1,4 -6). One class of medication, the ␣-glucosidase inhibitors, slows glucose absorption by reducing the rate of enzymatic digestion of starch, thereby delaying the release of glucose molecules for absorption. These agents reduce postprandial glucose and insulin levels (7). A Cochrane Review of five trials (2,360 participants) concluded that there is evidence that acarbose reduced the ...

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