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Information on the macronutrient composition of the diet is needed in doubly labeled water studies to convert measured rates of carbon dioxide production into values for total energy expenditure. There is no general consensus, however, about the best method to determine food intake for this purpose. Four common methods of measuring food intake (7-day weighed food intake, 24-hour recall, and Fred Hutchinson Cancer Research Center/Block and Willett food frequency questionnaires) were tested for their ability to provide comparable food quotient and total energy expenditure data in doubly labeled water studies in 10 young and 10 older women. All methods gave mean values for total energy expenditure that were within 1% of each other. Individual values obtained using the 24-hour recall and food frequency questionnaires were within +3% (standard deviation) of values determined using data from the 7-day weighed food record. These results suggest that it is not necessary to use time-consuming and expensive 7-day food records in doubly labeled water studies; instead, food intake data obtained more easily by 24-hour recall or food frequency questionnaire can provide comparable data. J Am Diet Assoc. 1998; 98:1015-1020., The doubly labeled water method is an isotopic method for determination of total energy expenditure (TEE) in free-living subjects (1,2). The method is based on measurement of the differential rates [...]

Blood glucose regulation in the fasting and fed states has important implications for health. In addition, the ability to maintain normal blood glucose homeostasis may be an important determinant of an individual's capacity to regulate food intake. We tested the hypothesis that aging is associated with an impairment in the ability to maintain normal blood glucose homeostasis following the consumption of large meals but not small ones, a factor that could help to explain age-related impairments in the control of food intake and energy regulation. The subjects were eight healthy younger women (25 f [+ or -] years, SD) and eight healthy older women (72 [+ or -] 2 years) with normal body weight and glucose tolerance. Following a 36-h period when diet and physical activity were controlled, subjects consumed test meals containing 0, 1046, 2092, and 4184 kJ (simulating extended fasting, and consumption of a snack, a small meal, and a moderately large meal), with 35% of energy from fat, 48% from carbohydrate, and 17% from protein. Each subject consumed each of the test meals on a separate occasion. Serial blood samples were collected at baseline and during 5 h after consumption of the meals. Measurements were made of circulating glucose, insulin, glucagon, free fatty acids, and triglycerides. There was no significant difference between young and older women in their hormone and metabolite responses to fasting and consumption of the 1046-kJ meal However, following consumption of 2092 and 4148 kJ, older individuals showed exaggerated responses and a delayed return to premeal values for glucose (p = .023), insulin (p = .010), triglycerides (p = .023), and the ratio of insulin to glucagon (p = .026). In conclusion, these results suggest an impairment in the hormonal and metabolite responses to large meals in older women.

Objective. To determine the association among aging, inflammation, and cytokine production by peripheral blood mononuclear cells. Population and Methods. We examined production of interleukin- 1 [Beta] (1L- 1 [Beta]), tumor necrosis factor-[Alpha] (TNF-[Alpha]), ILl receptor antagonist (IL-IRa), and IL-6 in 711 elderly participants in the Framingham Heart Study (mean age, 79 y) and 21 young healthy volunteers (mean age, 39 y). The elderly subjects were categorized by serum C-reactive protein (CRP) concentration, a marker of systemic inflammation. Results. Production of IL-6 (p < .00001) and IL-IRa (p < .00001) was higher in the elderly subjects than in the control group. IL-6 production increased with increasing CRP, whereas IL-IRA was uniformly elevated in elderly subjects regardless of CRP. However, we found no difference in the production of IL-113 or TNF-[Alpha] between the young and elderly groups, regardless of CRP status. IL-6 population correlated with IL-1[Beta] (r = .36, p < .0001) and TNF-[Alpha] production (r = .25, p < .0001), but IL-1Ra production did not. Conclusion. Production of IL-6 and IL- 1Ra - but not IL- 1 [Beta] or TNF-[Alpha] - was increased in the elderly compared to healthy, young subjects. The increase in IL-6 also correlated with increased production of CRP, a marker of inflammation. However, IL-IRa was increased in the elderly independently of CRP production. Although limited by the small control group, these data suggest that dysregulation of some inflammatory cytokines occurs with age, but the role of inflammation in aging remains unclear.

Elderly people who take calcium and vitamin D supplements may reduce their risk of fractures by increasing their bone density. A total of 176 men and 213 women 65 years old or older took either calcium and vitamin D or a placebo for three years. Those taking calcium and vitamin D increased their bone density at the hip and spine significantly compared to those taking a placebo, who experienced a decline in bone density at the hip. Of the 37 people who fractured a bone at some time during the study, 26 were in the placebo group and 11 were in the vitamin D and calcium group.

Objective To evaluate the Nutrition Screening Initiative (NSI) checklist as a screening and an awareness/educational tool in an elderly population. Design Epidemiologic follow-up study. Information similar to the questions of the NSI checklist was collected by the Nutrition Status Survey of Boston elders between 1981 and 1984. Vital status of volunteers was obtained during 8 to 12 years of follow-up. Subjects/setting Community-dwelling men (n=200) and women (n=381) aged 60 years and older who participated in the survey. Statistical analyses performed Multivariate analysis was used to assess the association between mortality and each of the NSI-similar questions and the cumulative score, which is the sum of the values assigned to each question. Attributable risk percent, a measure of association, was calculated to measure the percentage of deaths that could potentially be prevented if the risk factors or their consequences were eliminated. Results Eating meals alone, problems biting or chewing, difficulties with shopping or cooking, and taking more than three medications per day were positively associated with mortality (P, Adequate nutritional status has been recognized as an important factor in the prevention and treatment of chronic disease (1,2). The elderly population is particularly prone to inadequate nutritional status because [...]

Background. Bioelectrical impedance analysis (BIA) can potentially be used to estimate body composition in large populations studied at multiple sites. However, it is not clear whether age-specific BIA equations are necessary for accurate application of BIA to research on elderly subjects. Methods. We compared a published equation designed to predict fat-free mass (FFM) that had been derived in a young healthy population (mean age 27 y; mean BM123.9 kg/[m.sup.2]), with equations that we developed for the elderly by using data from 455 participants in the Framingham Heart Study (78 y; 27.3 kg/[m.sup.2]), using dual-energy x-ray absorptiometry (DXA) as a reference technique. The BIA equations were then compared in an independent sample of 283 participants in the New Mexico Aging Process Study (76 y, 25.5 kg/[m.sup.2]), who also underwent BIA and DXA. Results. When the young-population equation was applied to Framingham, it caused an overestimation of FFM in heavier subjects that was eliminated by use of the age-specific equation. However, when the two equations were tested in the New Mexico population, the published equation gave estimates of FFM that were closer to DXA than the Framingham equations did. Conclusions. The accuracy of a BIA equation depends on the body composition of the population and the validation method rather than on age per se. Application of BIA to elderly populations requires uniform validation procedures in the actual study population, rather than reliance on age-specific equations.

Dietary intakes of retinol equivalents, [Alpha]-tocopherol equivalents, vitamin D and phylloquinone were estimated from three sets of 4-d weighed diet records and compared to three corresponding fasting plasma concentrations of retinol, 25-hydroxyvitamin D, [Alpha]-tocopherol, and phylloquinone measured in 34 healthy adults over 20 wk. The magnitude of the correlation between dietary vitamin intake and its corresponding biochemical measure is in part determined by the reproducibility of each of the measures, so within-to-between subject variance ratios were calculated for both dietary intakes and plasma concentrations. Phylloquinone was the only fat-soluble vitamin with a significant correlation between dietary intake and fasting plasma concentration (r = 0.51, P = 0.004). This correlation improved with an increase in both the number of independent diet records and independent plasma measures. Of the dietary intake measures, all the fat-soluble vitamins had greater within than between subject variance, with the highest measured for phylloquinone (6.86:1). Of the plasma measures, only phylloquinone had a within-to-between subject variance ratio greater than one (5.36:1). Comparisons across age and sex for dietary intake and plasma concentrations differed in pattern among the fat-soluble vitamins. KEY WORDS: * vitamin A * vitamin D * vitamin E * vitamin K * humans

Relatively little is known about the influence of age on energy regulation during energy imbalance. We compared the effects of underfeeding on changes in energy expenditure, substrate oxidation, and body energy loss between young men (age 22.0 [+ or -] 0.9 [SEM] years) and older men (age 66.0 [+ or -] 1.8) who were leading unrestricted lives. Changes in total energy expenditure (TEE), resting energy expenditure (REE), the thermic effect of feeding (TEF), respiratory quotient, and body energy loss were determined in response to undereating by 3.17 [+ or -] 0.16 Megajoule (MJ)/day for 21 days in 19 healthy subjects consuming a typical diet. No significant effects of age were observed in changes in TEE, REE, TEF, or body energy loss in response to underfeeding. Thus, older men do not appear to have any impairment of energy conservation during negative energy balance compared to young men. This normal pattern of energy conservation during undereating together with the previously demonstrated reduction in energy dissipation during overeating can be predicted to promote body fat deposition in older men during the cycles of positive and negative energy balance that occur during normal life. This finding may help to explain the increased body fat mass in older individuals.

Relatively little is known about the influence of age on energy regulation during energy imbalance. We compared the effects of overfeeding on changes in energy expenditure, substrate oxidation, and energy deposition between young men (age 23.7 [+ or -] 1.1 [SEM] years) and older men(age70.0 [+ or -] 7.0) of normal body weight who were leading unrestricted lives. Changes in total energy expenditure, resting energy expenditure (REE), the thermic effect of feeding (TEF), respiratory quotient(RQ), and body energy content were determined in response to overeating by 4.09 [+ or -] 0.07 Megajoule (MJ)/day for 21 days in 16 healthy subjects consuming a typical diet. After excluding data from one young subject with unusual results and adjusting for individual differences in excess energy intake, there was a tendency towards a smaller increase in REE in older men compared to the young men (p = .07) which was accounted for by their lower fat-free mass (p = .016). There was also a significantly smaller increase in resting energy expenditure averaged over fasting and fed states (i.e, REE [+ or -] TEF) with overfeeding in order men than in young men (p < .01). Combined, these smaller increases in energy expenditure with overfeeding in the older subjects averaged an estimated 365 kilojoule (kj)/day (8.9% of the excess energy intake) (p

An Athletic Image Scale including female physiques with and without muscular definition is currently in the developmental phase. With shading, contouring, and three-dimensionality not offered previously on figure-rating scales, this instrument was designed to examine an apparent growing interest on the part of women in athletic body-image ideals. The athletic level of each figure on the scale was based on responses of a group of college women. The 30-figure pilot scale was then tested by rating current and ideal body-shape preferences of two groups of first-year college women, 65 who exercised regularly and 45 who engaged in no regular exercise. Analysis showed no relationship between current and ideal physique choice and exercise status. Most exercising and nonexercising women chose a mesomorphic ideal physique with upper-body muscularity unlikely to occur without substantial amounts of physical activity. The associations among exercise status, figure choice, subscale scores on the Eating Disorder Inventory, and Self-esteem Scale scores were also examined. Women choosing moderately mesomorphic figures as their current shape had the lowest Body Dissatisfaction scale scores on the Eating Disorder Inventory irrespective of exercise status. Current- and ideal-shape preferences were not related to self-esteem scores. The pilot Athletic Image Scale offered several figures which seemed to be relevant to women although it must be noted that the scale purposely emphasized particular physiques. Even so, it is important to recognize that greater than sixty percent of the women preferred images with athletic physiques which are not offered on figure-rating scales presently in use.

Identifying dietary patterns of older Americans is important for relating diet to nutritional status and disease, identifying groups at risk of underconsumption or overconsumption of specific nutrients, and creating appropriate [...]

Individuals who are overweight during adolescence may have a higher risk of developing certain diseases later in life, regardless of their weight as adults. Among 181 individuals interviewed in 1988 who had participated in the Harvard Growth Study of 1922 to 1935, 85 had been classified as overweight and 96 had been classified as lean during adolescence. The risk of death from all causes was twice as high among men classified as overweight during adolescence than among those classified as lean. Women who had been overweight during adolescence did not have an increased risk of death, compared to those who had been lean. Both men and women who were overweight during adolescence had a higher risk of developing coronary heart disease and atherosclerosis than those who had been lean. Men who were overweight had a higher risk of developing gout than those who had been lean. Women who were overweight had a higher risk of developing arthritis than those who had been lean.

Abstract Background Central adiposity is related to chronic disease risk in adolescents. Racial differences in waist circumference have been identified using cross-sectional data from this age group. We tested for racial differences in age-related growth in waist circumference in a longitudinal cohort of black and white adolescent girls. Methods We analyzed 9 years of publicly available data from the National Heart, Lung, and Blood Institute Growth and Health Study, for 2379 girls (1213 black and 1166 white) enrolled at age 9-10 years in 1987-1988 and followed annually. Individual growth trajectories of waist circumference were constructed for girls with >3 annual measures. Mixed models were used to compare changes in waist circumference during adolescence between black and white females. BMI and age at menarche were included in the models. Results At each age, black females had significantly higher waist circumference. Mean annual increase in waist circumference was significantly higher for black females compared to white females (1.46 cm/yr vs. 1.36 cm/yr, respectively). After adjusting for BMI, the mean annual increase in waist circumference for white females was significantly higher than for black females (0.08 cm/yr vs. -0.07 cm/yr, respectively). These relationships remained significant after adjusting for age at menarche. Conclusions Black females had significantly steeper increases in waist circumference over adolescence than white females. After adjusting for BMI and age at menarche, however, the annual increase in waist circumference for black females was significantly shallower than for their white peers. These data suggest racial differences in the deposition of fat over the adolescent period.