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Authors: MD James N. Parker,PH.D Philip M. Parker

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on your specific condition. To learn more about basic dietary guidelines, visit the Web site:
http://www.health.gov/dietaryguidelines/
. Based on these

guidelines, many foods are required to list the nutrition levels on the food’s packaging. Labeling Requirements are listed at the following site maintained

by the Food and Drug Administration:
http://www.cfsan.fda.gov/~dms/lab-

cons.html
. When interpreting these requirements, the government

recommends that consumers become familiar with the following

abbreviations before reading FDA literatur
e:49

·
DVs (Daily Values):
A new dietary reference term that will appear on the food label. It is made up of two sets of references, DRVs and RDIs.

·
DRVs (Daily Reference Values):
A set of dietary references that applies to fat, saturated fat, cholesterol, carbohydrate, protein, fiber, sodium, and

potassium.

49 Adapted from the FDA:
http://www.fda.gov/fdac/special/foodlabel/dvs.html
.

Researching Nutrition 141

·
RDIs (Reference Daily Intakes):
A set of dietary references based on the Recommended Dietary Allowances for essential vitamins and minerals

and, in selected groups, protein. The name “RDI” replaces the term “U.S.

RDA.”

·
RDAs (Recommended Dietary Allowances):
A set of estimated nutrient

allowances established by the National Academy of Sciences. It is

updated periodically to reflect current scientific knowledge.

What Are Dietary Supplements?
50

Dietary supplements are widely available through many commercial

sources, including health food stores, grocery stores, pharmacies, and by

mail. Dietary supplements are provided in many forms including tablets,

capsules, powders, gel-tabs, extracts, and liquids. Historically in the United States, the most prevalent type of dietary supplement was a

multivitamin/mineral tablet or capsule that was available in pharmacies,

either by prescription or “over the counter.” Supplements containing strictly

herbal preparations were less widely available. Currently in the United

States, a wide array of supplement products are available, including vitamin,

mineral, other nutrients, and botanical supplements as well as ingredients

and extracts of animal and plant origin.

The Office of Dietary Supplements (ODS) of the National Institutes of Health

is the official agency of the United States which has the expressed goal of

acquiring “new knowledge to help prevent, detect, diagnose, and treat

disease and disability, from the rarest genetic disorder to the common

cold.”
51 Ac
cording to the ODS, dietary supplements can have an important impact on the prevention and management of disease and on the

maintenance of health
.52 The O
DS notes that considerable research on the effects of dietary supplements has been conducted in Asia and Europe where

the use of plant products, in particular, has a long tradition. However, the

50 This discussion has been adapted from the NIH:

http://ods.od.nih.gov/whatare/whatare.html
.

51 Contact: The Office of Dietary Supplements, National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: (301) 435-2920, Fax: (301) 480-1845, E-mail:
[email protected]
.

52 Adapted from
http://ods.od.nih.gov/about/about.html
. The Dietary Supplement Health and Education Act defines dietary supplements as “a product (other than tobacco) intended to supplement the diet that bears or contains one or more of the following dietary ingredients: a vitamin, mineral, amino acid, herb or other botanical; or a dietary substance for use to supplement the diet by increasing the total dietary intake; or a concentrate, metabolite, constituent, extract, or combination of any ingredient described above; and intended for ingestion in the form of a capsule, powder, softgel, or gelcap, and not represented as a conventional food or as a sole item of a meal or the diet.”

142 Lupus Nephritis

overwhelming majority of supplements have not been studied scientifically.

To explore the role of dietary supplements in the improvement of health

care, the ODS plans, organizes, and supports conferences, workshops, and

symposia on scientific topics related to dietary supplements. The ODS often

works in conjunction with other NIH Institutes and Centers, other

government agencies, professional organizations, and public advocacy

groups.

To learn more about official information on dietary supplements, visit the

ODS site at
http://ods.od.nih.gov/whatare/whatare.html
. Or contact:

The Office of Dietary Supplements

National Institutes of Health

Building 31, Room 1B29

31 Center Drive, MSC 2086

Bethesda, Maryland 20892-2086

Tel: (301) 435-2920

Fax: (301) 480-1845

E-mail: [email protected]

Finding Studies on Lupus Nephritis

The NIH maintains an office dedicated to patient nutrition and diet. The

National Institutes of Health’s Office of Dietary Supplements (ODS) offers a

searchable bibliographic database called the IBIDS (International

Bibliographic Information on Dietary Supplements). The IBIDS contains over

460,000 scientific citations and summaries about dietary supplements and

nutrition as well as references to published international, scientific literature on dietary supplements such as v
itamins, minerals, and botanicals.53 IBID
S is available to the public free of charge through the ODS Internet page:

http://ods.od.nih.gov/databases/ibids.html
.

After entering the search area, you have three choices: (1) IBIDS Consumer

Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. We

recommend that you start with the Consumer Database. While you may not

find references for the topics that are of most interest to you, check back

periodically as this database is frequently updated. More studies can be

53 Adapted from
http://ods.od.nih.gov
. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

Researching Nutrition 143

found by searching the Full IBIDS Database. Healthcare professionals and

researchers generally use the third option, which lists peer-reviewed

citations. In all cases, we suggest that you take advantage of the “Advanced

Search” option that allows you to retrieve up to 100 fully explained

references in a comprehensive format. Type “lupus nephritis” (or synonyms)

into the search box. To narrow the search, you can also select the “Title”

field.

The following information is typical of that found when using the “Full

IBIDS Database” when searching using “lupus nephritis” (or a synonym):

·
Beneficial effect of prostaglandin E1 in three cases of lupus nephritis

with nephrotic syndrome.

Author(s): 2nd Department of Internal Medicine, Kyoto University

Hospital, Japan.

Source: Nagayama, Y Namura, Y Tamura, T Muso, R Ann-Allergy. 1988

October; 61(4): 289-95 0003-4738

·
Clinical implications of antineutrophil cytoplasmic antibody test in

lupus nephritis.

Author(s): Division of Nephrology, College of Medicine, Seoul National

University, Seoul, South Korea.

Source: Chin, H J Ahn, C Lim, C S Chung, H K Lee, J G Song, Y W Lee, H

S Han, J S Kim, S Lee, J S Am-J-Nephrol. 2000 Jan-February; 20(1): 57-63

0250-8095

·
Enhanced osteopontin expression and macrophage infiltration in MRL-

Fas(lpr) mice with lupus nephritis.

Author(s): Division of Nephrology, University Hospital, and Institute of

Physiology, University of Zurich-Irchel, Zurich, Switzerland.

[email protected]

Source: Wuthrich, R P Fan, X Ritthaler, T Sibalic, V Yu, D J Loffing, J

Kaissling, B Autoimmunity. 1998; 28(3): 139-50 0891-6934

·
Glucocorticoid receptor in patients with lupus nephritis: relationship

between receptor levels in mononuclear leukocytes and effect of

glucocorticoid therapy.

Author(s): Department of Internal Medicine, Keio University School of

Medicine, Tokyo, Japan.

Source: Tanaka, H Akama, H Ichikawa, Y Makino, I Homma, M J-

Rheumatol. 1992 June; 19(6): 878-83 0315-162X

·
Improvement in lupus nephritis following treatment with a Chinese

herbal preparation.

Author(s): Department of Pediatrics, National University of Singapore,

Singapore.

144 Lupus Nephritis

Source: Yap, H K Ang, S G Lai, Y H Ramgolam, V Jordan, S C Arch-

Pediatr-Adolesc-Med. 1999 August; 153(8): 850-2 1072-4710

·
Improvement in steroid and immunosuppressive drug resistant lupus

nephritis by intravenous prostaglandin E1 therapy.

Author(s): Department of Medical Research, Veterans General Hospital,

Taipei, Taiwan, Republic of China.

Source: Lin, C Y Nephron. 1990; 55(3): 258-64 0028-2766

·
Lupus nephritis in children.

Author(s): Department of Nephrology, Postgraduate Medical Institute of

Medical Education and Research, Chandigarh.

Source: Gupta, K L Indian-J-Pediatr. 1999 Mar-April; 66(2): 215-23 0019-

5456

·
Management of lupus nephritis at the Kenyatta National Hospital.

Author(s): Department of Medicine and Pathology, College of Health

Sciences, University of Nairobi, Kenyatta National Hospital.

Source: Otieno, L S McLigeyo, S O Kayima, J K Sitati, S East-Afr-Med-J.

1990 June; 67(6): 387-95 0012-835X

·
Physiologic role for enhanced renal thromboxane production in murine

lupus nephritis.

Author(s): Department of Medicine, Duke University, Durham, North

Carolina 27705.

Source: Spurney, R F Bernstein, R J Ruiz, P Pisetsky, D S Coffman, T M

Prostaglandins. 1991 July; 42(1): 15-28 0090-6980

·
Predictive value of clinical, laboratory, pathologic, and treatment

variables in steroid/immunosuppressive resistant lupus nephritis.

Author(s): Department of Medicine, UCLA School of Medicine.

Source: Wallace, D J Goldfinger, D Savage, G Nichols, S Goodman, D

Fichman, M Stewart, M Klinenberg, J R J-Clin-Apheresis. 1988; 4(1): 30-4

0733-2459

·
Pregnancy in lupus nephritis and related disorders.

Source: Bobrie, G Liote, F Houillier, P Grunfeld, J P Jungers, P Am-J-

Kidney-Dis. 1987 April; 9(4): 339-43 0272-6386

·
The effect of cyclophosphamide pulses on fertility in patients with

lupus nephritis.

Author(s): Department of Internal Medicine F, Chaim Sheba Medical

Center, Tel-Hashomer, Israel.

Source: Langevitz, P Klein, L Pras, M Many, A Am-J-Reprod-Immunol.

1992 Oct-December; 28(3-4): 157-8 1046-7408

Researching Nutrition 145

·
Thromboxane receptor blockade reduces renal injury in murine lupus

nephritis.

Author(s): Department of Medicine, Duke University, Durham, North

Carolina.

Source: Spurney, R F Fan, P Y Ruiz, P Sanfilippo, F Pisetsky, D S

Coffman, T M Kidney-Int. 1992 April; 41(4): 973-82 0085-2538

·
Treatment and outcome of lupus nephritis at the turn of the

millennium.

Source: Uppal, S S J-Assoc-Physicians-India. 1999 September; 47(9): 857-

61 0004-5772

Federal Resources on Nutrition

In addition to the IBIDS, the United States Department of Health and Human

Services (HHS) and the United States Department of Agriculture (USDA)

provide many sources of information on general nutrition and health.

Recommended resources include:

· healthfinder®, HHS’s gateway to health information, including diet and

nutrition:

http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

· The United States Department of Agriculture’s Web site dedicated to

nutrition information:
www.nutrition.gov

· The Food and Drug Administration’s Web site for federal food safety

information:
www.foodsafety.gov

· The National Action Plan on Overweight and Obesity sponsored by the

United States Surgeon General:

http://www.surgeongeneral.gov/topics/obesity/

· The Center for Food Safety and Applied Nutrition has an Internet site

sponsored by the Food and Drug Administration and the Department of

Health and Human Services:
http://vm.cfsan.fda.gov/

· Center for Nutrition Policy and Promotion sponsored by the United

States Department of Agriculture:
http://www.usda.gov/cnpp/

· Food and Nutrition Information Center, National Agricultural Library

sponsored by the United States Department of Agriculture:

http://www.nal.usda.gov/fnic/

· Food and Nutrition Service sponsored by the United States Department

of Agriculture:
http://www.fns.usda.gov/fns/

146 Lupus Nephritis

Additional Web Resources

A number of additional Web sites offer encyclopedic information covering

BOOK: The Official Patient's Sourcebook on Lupus
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