Treatment with losartan causes an increase in urinary Zn excretion and induces Zn deficiency in patients with hypertension. The addition of hydrochlorothiazide has an additive effect. Magnesium and nitric oxide metabolism are not affected by either treatment.

Background: A recurring problem in medical institutions is patients not always receiving food meeting their nutritional and medical needs. A proposed contributing factor is non-inclusion of dietitians in food service staff. Recently, positions for food service dietitians in hospitals were created. For the newly defined role of "Food Service Dietitian", comprehensive training courses were developed (70 dietitians participated). Objective: To examine the impact of the addition of the role of a "Food Service Dietitian" in medical institutions on suitability of foods served, food costs and food waste.Methods: A three years (2014-2017) national case study to examine the new role's impact was carried out, in 18 hospitals, nine of which employ a food service dietitian (intervention), and 9 without (control). The number of nutritional analyses of menus was checked, as was the extent of kitchen staff training, and how often night meals were served for all patients. Data were gathered regarding food costs and waste with respect to food distributed to staff and patients. Food costs savings and waste reduction were calculated, based on reduction in provision of unnecessary meals, at a cost of 18 NIS per day per meal.

Drug combinations with thiazides (TZD) are common in the treatment of hypertension. We have previously shown that treatment with ACE inhibitors increased urinary Zinc (Zn) excretion, while TZD enhance urinary Zn and magnesium (Mg) losses. The effects of angiotensin receptor blockers on Zn and Mg metabolism are unknown. Sixteen Caucasian hypertensives (10 men, age 51±3 years,(SEM), body mass index 31±2 kg/m2), received losartan (LOS) 50mg (Ocsaar, MSD) for 4 weeks and LOS 50mg+hydrochlorothiazide (HCT) 12.5mg (Ocsaar plus, MSD) for the next 4 weeks. Serum, peripheral blood mononuclears (PBMC) and 24‐hour urinary Zn and Mg concentrations were determined at baseline, after LOS and after LOS+HCT treatments. LOS treatment significantly increased urinary Zn excretion (from 0.24±0.07 mcg/mg creatinine to 0.43±0.08 mcg/mg creatinine, p=0.01), and was associated with a significant decrease in PBMC Zn levels (from 13.8±0.8 mcg/mg protein to 12.4±0.8 mcg/mg protein, p=0.01). LOS+HCT further increased urinary Zn excretion (from 0.43±0.08 mcg/mg creatinine after LOS to 0.74±0.2 mcg/mg creatinine after LOS+HCT, p=0.04), but had no effect on PBMC Zn concentrations. Serum Zn concentrations remained unchanged after both treatments. Serum and PBMC Mg concentrations, and urinary excretion of Mg remained unchanged too. Treatment with LOS, induces increased urinary Zn excretion and Zn depletion in hypertensive patients. HCT has an additive effect. LOS and LOS+HCT had no effect on Mg metabolism. Clinical Pharmacology & Therapeutics (2004) 75, P12–P12; doi: