Relationship between food polyamines and gross domestic product in association with longevity in Asian countries

doi:10.4236/health.2010.212206

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Vol.2, No.12, 1390-1396 (2010) Health

doi:10.4236/health.2010.212206

Relationship between food polyamines and gross

domestic product in association with longevity in Asian

countries

Phan Nguyen Thanh Binh1,2, Kuniyasu Soda3*, Chizuko Maruyama2, Masanobu Kawakami4

1Department of Community Nutrition, HCMC Nutrition Center, Ho Chi Minh City, Vietnam;

2Department of Food and Nutrition, Japan Women’s University, Tokyo, Japan;

3Department of Cardiovascular Research Institute, Saitama Medical Center, Jichi Medical University, Saitama, Japan;

*Corresponding Author: soda@jichi.ac.jp;

4Department of Internal Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.

Received 15 October 2010; revised 1 November 2010; accepted 5 November 2010

ABSTRACT

The relationship between gross domestic pro-

duct (GDP) and dietary profile, with a focus on

polyamine intake, was investigated in 35 Asian

countries. Data on food supply, GDP, and health

condition were collected from databases of the

United Nations, the International Monetary Fund,

and the World Health Organization, respectively.

The amount of polyamine intake from food was

estimated using polyamine concentrations listed

in published sources. The amounts of putrescine,

spermidine, spermine, and total polyamines in

1000 kcal of food in Asian countries were 39.07

± 17.98, 33.74 ± 14.35, 14.05 ± 6.60 and 86.85 ±

33.96 μmol/1000 kcal, respectively. Putrescine,

spermidine, and spermine constituted 44, 39,

and 17% of total polyamine, respectively. Vege-

tables contributed the largest amount of both

putrescine and spermidine and the second larg-

est amount of spermine (45.5%, 62.2% and 27.2%

of total putrescine, spermidine, and spermine,

respectively). Meat was the richest source of

spermine and contributed the greatest amount

(50%) of this polyamine. We showed a signifi-

cant positive association between GDP and the

amount of polyamine per 1000 kcal of food. Li-

fespan was associated with both GDP and the

amount of polyamine per energy quotient of

food. As several basic research studies have

shown that polyamines help prolong longevity,

it follows that polyamines may have a role in

determining the lifespan of humans.

Keywords: Polyamine; GDP; Longevity;

Cardiovascular Diseases; Food

1. INTRODUCTION

The polyamines putrescine, spermidine, and spermine,

not only play an essential role in the proliferation and

differentiation of mammalian cells but also have impor-

tant physiological roles on cellular function. In addition,

very recent studies have shown that exogenous polya-

mine suppresses the progression of age-associated pa-

thologies and increases the life span of cells and several

living organisms including mice [1,2]. On the other hand,

there is evidence that increased polyamine concentra-

tions are associated with several deteriorations in health

[3-6].

Food is one of the important sources of body polya-

mines which are absorbed by the intestinal lumen and

then distributed to all organs and tissues [7]. In fact, dif-

ferences in polyamine intake have been shown to influ-

ence blood polyamine concentration in both mice and

humans [8]. As most foods originate from plants or ani-

mals, almost all foods contain polyamines, but in widely

varying concentrations [9-12]. It is therefore very im-

portant to delineate the factors that may influence po-

lyamine intake.

Socioeconomic status is closely associated with fa-

vorable health status and prolonged lifespan [13-18].

Gross domestic product (GDP) is one of the representa-

tive indicators of socioeconomic status of countries, and

we have shown using an open database that individuals

living in European and Western countries with a high

GDP prefer foods containing abundant polyamines

compared to individuals living in countries with a lower

GDP [19]. This study aimed to examine the relationship

between the amount of food polyamine and GDP in

Asian countries. In addition, as polyamines have been

shown to have several roles on health status in experi-

mental models, we also examined the relationship be-

tween health status and polyamine intake in association

P. N. T. Binh et al. / Health 2 (2010) 1390-1396

1391

with GDP.

2. METHODS AND MATERIALS

2.1. Database

Data on food supply in 2002 were obtained from the

online database of the Statistics Division of the Food and

Agriculture Organization of the United Nations (FAOS-

TAT). The target populations were 35 Asian countries

that included Bangladesh, Brunei Darussalam, Cambo-

dia, China, Democratic People’s Republic of Korea, Fiji,

India, Indonesia, Islamic Republic of Iran, Japan, Jordan,

Kiribati, Kuwait, Kyrgyzstan, Lao People’s Democratic

Republic, Lebanon, Malaysia, Maldives, Mongolia, Myanmar,

Nepal, Pakistan, Philippines, Republic of Korea, Samoa,

Saudi Arabia, Solomon Islands, Sri Lanka, Syrian Arab

Republic, Thailand, Timor-Leste, United Arab Emirates,

Vanuatu, Viet Nam, and Yemen. The concentrations of

spermine, spermidine, and putrescine in foods were ob-

tained from published reports of concentrations meas-

ured in Japanese foods [9,10]. When these reports did

not show the polyamine content of certain foods, we

used additional data obtained from European studies

[11,12] (Table 1). All the food items were categorized

Table 1. Polyamine contents in Asian foods (nmol/g or

nmol/mL)†

Food items Putrescine Spermidine Spermine

Cereals

Barley 17 16 20

Maize 576 144 8

Millet 19 63 48

Oats 41 133 148

Rice (milled

equivalent) 8 7.5 1.5

Rye 41 133 148

Sorghum 14 12 0

Wheat 19 29.5 0.5

Other cereals 31.7 90 23.7

Vegetables

Cassava 0 0 0

Cloves 0 0 0

Onions 29.5 86.5 4.5

Potatoes 89 68 15.5

Pulses1 26 144 74

Roots & tuber

dry equiv2 118 109.3 19.8

Sweet pota-

toes 29 25.2 16.5

Tomatoes 146.3 22.5 2.5

Vegetables3 113.5 170.2 17.4

Yams 73 89.5 2

Aquatic plants118 109.3 19.8

Fruits

Apples 10 14 0.5

Bananas 160 50 1.5

Grapefruit 436 19.5 1.5

Grapes 106 87 0

Lemons, limes390.5 19 4.5

Oranges,

mandarins 432 15.5 0

Pineapples 46 30 0

Citrus, other4 460.2 26.5 0

Fruits, other5 74.5 55.4 4

Beans and

Nuts

Beans6 147 644.8 299.7

Groundnuts7 18 110 88

Peas8 367 341 32

Sesame seed 29 126 22

Soybean 297 909 235.5

Sunflower

seed 34 383 89

Tree nuts9 104.5 108.9 111.6

Seafoods

Cephalopods10 3.3 9.3 93.3

Crustaceans11 26.5 0 0

Fish12 27.2 37.1 53.1

Fish, oil 0 0 0

Molluscs13 19.7 143.5 383.5

Aquatic ani-

mals and

others14

26.3 55.1 87.2

Meat

Bovine meat 18.5 17.5 149

Mutton & goat

meat 8.2 39.7 131.3

Pig meat 4.5 9.5 165

Poultry meat15 13.3 48.5 3.5

Meat, other 11.5 26.7 194.2

Offal, edible16 63.8 188 825.8

Dairy prod-

ucts

Butter, ghee,

whey & milk 0 0 0

Cheese 0 15 3.5

Cream 0.3 0 0

P. N. T. Binh et al. / Health 2 (2010) 1390-1396

1392

Eggs 6.5 2.5 2.5

Vegetable oil and animal fat

Vegetable oil 0 0 0

Animal fat 0 0 0

Sugar &

Sweeteners

Sugar &

Sweeteners 3 0 0

Beverages and

stimulants

Beer 153.3 1 0

Wine 49 1.5 0

Tea leaf 49.5 96.3 72.8

Coffee 0 0 0

Other beve-

rages17 0 0 0

Pepper 621 80 45

Pimento &

Spices 0 0 0

† The average content of spermine, spermidine, and putres-

cine in each food item expressed as nmol/g or nmol/mL was

calculated using data for foods available in Japan reported

by K. Nishimura, et al., (Decrease in polyamines with aging

and their ingestion from food and drink. J Biochem 2006;

139: 81-90) and N. Nishibori, et al., (Amounts of

poly-amines in foods in Japan and intake by Japanese. Food

Chem 2007; 100: 433-872). 1Field pies; 2Burdock root and

lotus root; 3Asparagus, bean sprouts, beet, beetroot, brocco-

li, Brussel sprouts, butterbur, cabbage, carrot, cauliflower,

celery, Chinese cabbage, green cabbage, red cabbage, cher-

vil, chicory, cucumber, eggplant, escarole, green leek, leek,

lettuce, mushrooms, parsley, pumpkin, spinach, radish, sal-

sify, sorrel, watercress; 4Oranges, mandarins, and tangerines;

5Pear, strawberry, persimmon, fig, pomegranate, peach,

blueberry, melon, watermelon, cherry, prune, durian, pa-

paya, dragon fruit, kiwifruit, mango, and avocado; 6Adzuki

bean, cow pea, and soybean; 7Peanut; 8Green peas;

9Almond, cashew, and pistachio nuts; 10Squid and octopus;

11Shrimp and crab; 12Horse mackerel, Japanese needlefish,

mackerel, salmon, sardine, tuna, conger, angler, sweetfish,

alfonsino, saury, shark, scabbard fish, yellowtail, swordfish,

bonito, codfish, eel, and whitefish; 13Oyster, white scallop,

coral scallop, and clam; 14Fish and shellfish; 15Chicken and

duck; 16Beef liver, beef intestine, pork liver, chicken liver,

chicken gizzard, and chicken heart; 17Soft drink and cocoa.

the following 12 groups for further analysies; including

1) Cereals, 2) Vegetables and starchy roots, 3) Fruits, 4)

Beans, 5) Seafoods, 6) Meat, 7) Dairy products, 8) Eggs,

9) Vegetable oil and animal fat, 11) Sugar and sweeten-

ers, and 12) Beverages and stimulants. As the data on

food supply from the WHO does not necessarily indicate

the absolute amount consumed by each nation, and in

order to ascertain the features of dietary patterns, we

used a relative measure of the amount of various foods,

such as food consumption per energy quotient. GDP per

capita in 2002 was obtained from the International Mon-

etary Fund (IMF), and age-standardized mortality rates

(per 100,000 population) due to cardiovascular diseases

(CVD) and cancer in 2002 and life expectancy at birth in

2006 were derived from the World Health Organization

Statistical Information System (WHOSIS).

2.2. Statistics

The data were analyzed using the statistical package SPSS

for Windows (SPSS Inc., Chicago, IL, USA). Pearson’s

correlation coefficients were calculated to examine the

association between the relative amount of polyamine in

foods, GDP per capita, and life expectancy. A P-value <

0.05 was considered statistically significant.

3. RESULTS

3.1. Polyamine Contents in Asian Foods

The average content of the three polyamines, putrescine,

spermidine, and spermine in each food item is shown in

Table 1. Polyamine content ranged widely among the

foods, with several foods having increased polyamine

concentrations. The highest putrescine levels were found

in maize, citrus fruits, grapefruit, peas, soybeans, and

other beans. Spermidine concentrations were high in

soybeans, other beans, and vegetables, while spermine

concentrations were high in edible offal, molluscs, meats,

soybeans, and other beans. Generally, foods of plant ori-

gin tended to have higher contents of spermidine com-

pared to spermine, whereas foods of animal origin had

the opposite composition. The levels of all polyamines

were very low or undetectable in vegetable oil, animal fat,

sugar and sweeteners, eggs, and dairy products including

butter, cream, whey, cow milk and infant milk formulas.

3.2. Daily Amounts per capita and Amounts

per 1000 kcal of Polyamines

Table 2 shows the daily amounts per capita and Table 3

shows the daily amounts per 1000 kcal of the three po-

lyamines in Asian countries. The average estimated daily

intake of putrescine, spermidine, spermine, and total

polyamines in Asian countries were 106 μmol, 91 μmol,

38 μmol and 235 μmol, respectively. Putrescine, spermi-

dine, and spermine accounted for 44%, 39%, and 17% of

total polyamine intake, respectively. The amounts of

putrescine, spermidine, spermine, and the sum of the

three polyamines per 1000 kcal energy were 39, 34, 14,

and 87 μmol/day.

3.3. Sources of Polyamines

The proportions of the three polyamines provided by

each food group are shown in Figure 1. Overall, vegeta-

bles provided the largest amount of putrescine and sper-

P. N. T. Binh et al. / Health 2 (2010) 1390-1396

1393

Table 2. The daily amounts of polyamines in each food group.

c Amount Putrescine Spermidine Spermine

(g/day) (µmol/day) (µmol/day) (µmol/day)

Cereals 417.4 ± 101.2 26.04 ± 35.19 12.28 ± 8.63 0.92 ± 1.17

Vegetables and roots 497.6 ± 290.0 48.40 ± 30.81 59.70 ± 35.20 8.68 ± 4.90

Fruits 172.0 ± 116.3 23.85 ± 19.19 6.72 ± 5.06 0.32 ± 0.25

Beans 28.6 ± 30.9 2.24 ± 2.87 6.03 ± 9.24 2.33 ± 3.14

Seafoods 75.4 ± 97.4 1.86 ± 2.60 2.80 ± 3.65 4.64 ± 5.80

Meat 89.7 ± 67.5 1.30 ± 1.09 3.64 ± 3.34 21.34 ± 16.73

Dairy products 138.8 ± 136.5 0 0.04 ± 0.09 0.01 ± 0.02

Eggs 14.2 ± 13.8 0.09 ± 0.09 0.04 ± 0.03 0.01 ± 0.01

Vegetable oil 21.7 ± 14.3 0 0 0

Animal fat 5.1 ± 6.5 0 0 0

Sugar and sweeteners 63.2 ± 36.1 0.19 ± 0.11 0 0

Beverages and stimulants 34.6 ± 42.1 1.87 ± 2.84 0.11 ± 0.17 0.04 ± 0.01

Total 1558.2 ± 480.9 105.85 ± 52.48 91.36 ± 41.61 38.29 ± 19.61

Per-capita daily availability of amount of food and the amount of putrescine, spermidine, and spermine from each food group are expressed as the

mean ± standard deviation (SD). Values < 0.001 are expressed as 0.

Table 3. The daily amounts per 1000 kcal of polyamines in each food group.

Food groups Amount Putrescine Spermidine Spermine

(g/1000kcal) (µmol/1000kcal) (µmol/1000kcal) (µmol/1000kcal)

Cereals 158.7 ± 41.4 9.99 ± 13.26 4.64 ± 3.25 0.35 ± 0.42

Vegetables and roots 183.3 ± 104.3 17.68 ± 10.49 21.89 ± 12.01 3.22 ± 1.82

Fruits 62.7 ± 38.2 8.59 ± 6.24 2.46 ± 1.73 0.12 ± 0.09

Beans 10.2 ± 10.4 0.84 ± 1.17 2.32 ± 3.93 0.89 ±1.35

Seafoods 28.2 ± 36.8 0.70 ± 0.98 1.04 ± 1.37 1.72 ± 2.14

Meat 32.7 ± 24.9 0.47 ± 0.42 1.32 ± 1.26 7.74 ± 6.07

Dairy products 50.4 ± 47.7 0.0 ± 0.0 0.01 ± 0.03 0.003 ± 0.007

Eggs 5.1 ± 4.8 0.03 ± 0.03 0.01 ± 0.01 0.003 ± 0.002

Vegetable oil 7.9 ± 4.7 0 0 0

Animal fat 1.8 ± 2.3 0 0 0

Sugar and sweeteners 23.2 ± 12.5 0.07 ± 0.04 0 0

Beverages and stimulants 12.6 ± 14.6 0.69 ± 1.01 0.04 ± 0.06 0.01 ± 0.03

Total 576.8 ± 128.7 39.07 ± 17.98 33.74 ± 14.35 14.05 ± 6.60

Per-capita availability of the amount of food and the amount of putrescine, spermidine, and spermine per person are listed by food category.

The daily amounts per 1000 kcal are expressed as the mean ± SD. Values < 0.001 are expressed as 0

Figure 1. The contribution of each food group to the amount of putrescine (A), spermidine (B) and spermine (C).

P. N. T. Binh et al. / Health 2 (2010) 1390-1396

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midine, and also provided the second largest amount of

spermine (45.5% of putrescine, 62.2% of spermidine,

and 27.2% of spermine). Other important sources of

putrescine were cereals and fruits, which provided

24.0% and 22.3% of total putrescine, respectively. Cere-

als, fruits, and beans supplied 15.5%, 7.7%, and 6.6% of

total spermidine, respectively. Animal meats were the

biggest source of spermine, and provided 50% of total

spermine.

3.4. Associations between the Amounts of

Putrescine, Spermidine, and Spermine

per Total Energy and GDP per capita

The GDPs of the Democratic People’s Republic of Korea

and Timor-Leste could not be obtained. These two coun-

tries were therefore excluded from the analyses which

subsequently included 33 countries. The GDP data were

transformed to natural logarithms to approximate a nor-

mal distribution. Pearson’s correlation coefficients were

calculated to investigate the relationship between po-

lyamine amount per food energy (1000 kcal) and GDP.

As shown in Table 4, GDP per capita correlated posi-

tively with all three polyamines, with different levels of

correlation being observed. Although the correlation

coefficients between GDP and spermidine and putresine

per energy quotient were < 0.4 with p values < 0.05,

spermine per energy quotient showed a strong positive

correlation with GDP.

3.5. Correlation among the Amount of

Polyamine, GDP, and Health Status

GDP was associated positively with life expectancy (r =

0.890, p < 0.001) and negatively with mortality due to

cardiovascular diseases (r = –0.640, p < 0.001). Life

expectancy was associated negatively with CVD mortal-

ity (r = –0.674, p < 0.001). Although no significance

associations were found, the correlation coefficients be-

tween CVD mortality and spermine/energy, spermidine/

energy, putrescine/energy, spermine plus spermidine/

energy, and total amount of all three polyamines/energy

all had negative values (r = –0.276, –0.057, –0.035,

–0.154, and –0.103, respectively). No significant associ-

ation was found between life expectancy and cancer

mortality. As shown in Table 4, GDP and life expectancy

were associated positively with the total amount of food

polyamine per energy, with various levels of correlation

being observed.

4. DISCUSSION

Reference to our previous report on European foods [19]

showed that although there were many similarities in the

Table 4. Correlation between polyamine/energy and GDP and

life expectancy.

GDP Life expectancies

r P r P

Putrescine / energy 0.366 0.036 0.232 0.181

Spermidine / energy0.386 0.026 0.308 0.072

Sermine / energy 0.607 <0.001 0.585 < 0.001

Spermine plus

spermidine / energy0.532 0.001 0.453 0.006

Polyamine / energy 0.480 0.004 0.367 0.030

The correlation between each polyamine / energy and GDP (natural

logarithm) was examined in 33 countries, as the GDP of the Demo-

cratic People's Republic of Korea and Timor-Leste could not be

obtained. r indicates the correlation coefficient of the linear regres-

sion between polyamine/energy and GDP or life expectancy.

proportions of supplied foods, there were striking dif-

ferences in the higher amounts of dairy products and

animal-derived products consumed in European coun-

tries, whereas consumption of cereals was higher in

Asian countries. Similarly, polyamine concentrations in

Japanese foods [9,10] were similar to those in European

foods [11,12], whereas in some foods, especially cheese,

the concentrations were markedly different. These va-

ria-tions in polyamine content could be explained by the

effects of food processing and storage changes, and one

of the weaknesses of the present study was the inability

to comprehend these changes. However, the estimated

daily amount of food polyamines in Asian countries was

similar to those contained in a previous report on Japa-

nese foods [9] in which the daily amount of supplied

putrescine, spermidine, and spermine per person were

113, 82, and 39 μmol, respectively. In that study, putres-

cine, spermidine, and spermine accounted for 45%, 37%

and 18% of total daily polyamine supply in Japanese

diets, respectively. The daily amount of polyamine

availability from foods in Asian countries was consider-

ably lower than that reported in European countries, es-

pecially countries with a higher GDP (350-500 μmol/

day/person) [20,21]. However, the proportions of each of

the three polyamines relative to total polyamines were

similar to those in European countries [20,21]. The low-

er amount of total polyamine availability appeared to be

due to the lower amount of total food supply in Asian

countries, as the amounts of spermine and spermidine

per food energy in Asian countries were higher than

those in European countries, while the sum of the total

amount of the three polyamines per energy was similar

to European and Western countries with a lower GDP

[19].

The results of the present study using databases for

Asian countries were relatively similar to those reported

in earlier studies in European and Western countries in

which socio-economic status showed a close positive

association with longevity and a close negative associa-

P. N. T. Binh et al. / Health 2 (2010) 1390-1396

1395

tion with CVD mortality [13-18]. The results of the

present study also indicated that reducing the incidence

of CVD is very important for improving health status

and prolonging lifespan, even in Asian countries. Studies

using personal databases have shown decreases in CVD

incidence and increases in life span are often associated

with socioeconomic status [13-18]. Although the factors

affecting health condition according to socioeconomic

status are not fully understood, the present study showed

that the amount of polyamine in foods was associated

closely with GDP per capita. A very interesting finding

in our study was that the amount of food polyamine per

energy quotient was associated not only positively with

GDP but also negatively with CVD incidence. As the

current study was an ecological investigation, it would

therefore be expected there were potential confounding

factors in these associations. However, recent basic re-

search studies have shown that increased polyamine in-

take prolongs the longevity of some small organisms and

rodents [1,2], and therefore increased polyamine intake

may theoretically help maintain vascular health by in-

creasing the amount of arginine available for nitric oxide

(NO) synthesis [22-25]. These findings and those of the

present study suggest a possible role of food polyamines

on human health.

REFERENCES

[1] Eisenberg, T., Knauer, H., Schauer, A., Buttner, S.,

Ruckenstuhl, C., Carmona-Gutierrez, D., Ring, J.,

Schroeder, S., Magnes, C., Antonacci, L., Fussi, H.,

Deszcz, L., Hartl, R., Schraml, E., Criollo, A., Megalou,

E., Weiskopf, D., Laun, P., Heeren, G., Breitenbach, M.,

Grubeck-Loebenstein, B., Herker, E., Fahrenkrog, B.,

Frohlich, K.U., Sinner, F., Tavernarakis, N., Minois, N.,

Kroemer, G. and Madeo, F. (2009) Induction of autopha-

gy by spermidine promotes longevity. Nature Cell Biol-

ogy, 11 , 1305-1314.

[2] Soda, K., Dobashi, Y., Kano, Y., Tsujinaka, S. and Koni-

shi, F. (2009) Polyamine-rich food decreases age-associated

pathology and mortality in aged mice. Experimental

Gerontology, 44, 727-732.

[3] Quemener, V., Chamaillard, L., Brachet, P., Havouis, R.

and Moulinoux, J.P. (1994) Involvement of polyamines

in malignant proliferative processes: Antineoplastic ef-

fects of a polyamine deficiency. Bulletin de l'Academie

Nationale de Medecine, 178, 1591-1605.

[4] Quemener, V., Blanchard, Y., Chamaillard, L., Havouis,

R., Cipolla, B. and Moulinoux, J.P. (1994) Polyamine

deprivation: A new tool in cancer treatment. Anticancer

Research, 14, 443-448.

[5] Pegg, A.E. (1988) Polyamine metabolism and its impor-

tance in neoplastic growth and a target for chemotherapy.

Cancer Research, 48, 759-774.

[6] Marton, L.J. and Pegg, A.E. (1995) Polyamines as targets

for therapeutic intervention. Annual Review of Pharma-

cology and Toxicology, 35, 55-91.

[7] Bardocz, S., White, A., Grant, G., Brown, D.S., Duguid,

T.G. and Pusztai, A. (1996) Uptake and bioavailability of

dietary polyamines. Biochemical Society Transactions,

24, 226S.

[8] Soda, K., Kano, Y., Sakuragi, M., Takao, K., Lefor, A.

and Konishi, F. (2009) Long-term oral polyamine intake

increases blood polyamine concentrations. Journal Nu-

trition Science and Vitaminology (Tokyo), 55, 361-366.

[9] Nishibori, N., Fujihara, S. and Akatuki, T. (2007) Amounts of

polyamines in foods in Japan and intake by Japanese.

Food Chemistry, 100, 491-497.

[10] Nishimura, K., Shiina, R., Kashiwagi, K. and Igarashi, K.

(2006) Decrease in polyamines with aging and their in-

gestion from food and drink. Journal of Biochemistry,

139, 81-90.

[11] Cipolla, B.G., Havouis, R. and Moulinoux, J.P. (2007)

Polyamine contents in current foods: A basis for polya-

mine reduced diet and a study of its long term obser-

vance and tolerance in prostate carcinoma patients. Ami-

no Acids, 33, 203-212.

[12] Bardócz, S., Grant, G., Brown, D.S., Ralph, A. and Pusz-

tai, A. (1993) Polyamines in food—implications for

growth and health. Journal of Nutrition Biochemistry, 4,

66-71.

[13] Cooper, R., Cutler, J., Desvigne-Nickens, P., Fortmann, S.

P., Friedman, L., Havlik, R., Hogelin, G., Marler, J.,

McGovern, P., Morosco, G., Mosca, L., Pearson, T.,

Stamler, J., Stryer, D. and Thom, T. (2000) Trends and

disparities in coronary heart disease, stroke, and other

cardiovascular diseases in the United States: Findings of

the national conference on cardiovascular disease pre-

vention. Circulation, 102, 3137-3147.

[14] Kaplan, G.A. and Keil, J.E. (1993) Socioeconomic fac-

tors and cardiovascular disease: a review of the literature.

Circulation, 88, 1973-1998.

[15] Rooks, R.N., Simonsick, E.M., Miles, T., Newman, A.,

Kritchevsky, S.B., Schulz, R. and Harris, T. (2002) The

association of race and socioeconomic status with cardi-

ovascular disease indicators among older adults in the

health, aging, and body composition study. Journals of

Gerontology, 57, S247-256.

[16] Janssen, F., Kunst, A.E. and Mackenbach, J.P. (2006)

Association between gross domestic product throughout

the life course and old-age mortality across birth cohorts:

parallel analyses of seven European countries, 1950-1999.

Social Science & Medicine, 63, 239-254.

[17] Tresserras, R., Canela, J., Alvarez, J., Sentis, J. and Sal-

leras, L. (1992) Infant mortality, per capita income, and

adult illiteracy: an ecological approach. American Jour-

nal of Public Health, 82, 435-438.

[18] Beckfield, J. (2004) Does income inequality harm health?

New cross-national evidence. Journal of Health & Social

Behavior, 45, 231-248.

[19] Binh, P.N.T., Soda, K. and Kawakami, M. (2010) Gross

domestic product and dietary pattern among 49 Western

countries with a focus on polyamine intake. Health, 2, in

press.

[20] Bardocz, S., Duguid, T.J., Brown, D.S., Grant, G., Pusztai,

A., White, A. and Ralph, A. (1995) The importance of

dietary polyamines in cell regeneration and growth. Brit-

ish Journal of Nutrition, 73, 819-828.

[21] Zoumas-Morse, C., Rock, C.L., Quintana, E.L., Neuh-

P. N. T. Binh et al. / Health 2 (2010) 1390-1396

1396

ouser, M.L., Gerner, E. W. and Meyskens, F.L. (2007)

Development of a polyamine database for assessing die-

tary intake. Journal of the American Dietetic Association,

107, 1024-1027.

[22] Soda, K. (2010) Polyamine intake, dietary pattern, and

cardiovascular disease. Medica l H ypoth es es, 75, 299-301.

[23] Lefer, A.M. and Lefer, D.J. (1996) The role of nitric

oxide and cell adhesion molecules on the microcircula-

tion in ischaemia-reperfusion. Cardiovasc Research, 32,

743- 751.

[24] Drexler, H., Zeiher, A.M., Meinzer, K. and Just, H. (1991)

Correction of endothelial dysfunction in coronary micro-

circulation of hypercholesterolaemic patients by L-arginine.

Lancet, 338, 1546-1550.

[25] Cooke, J.P., Singer, A.H., Tsao, P., Zera, P., Rowan, R.A.,

and Billingham, M.E. (1992) Antiatherogenic effects of

L-arginine in the hypercholesterolemic rabbit. Journal of

Clinical Investigation, 90, 1168-1172.