Search

Plasma lipoproteins and glucose homeostasis were evaluated after marked weight loss before and over 12 months following Roux-en-Y gastric-bypass (RYGBP) surgery in 19 morbidly obese women. Standard lipids, remnant-lipoprotein cholesterol (RLP-C); HDL-triglyceride (TG); apolipoproteins (apo) A-I, A-II, E, and A-I-containing HDL subpopulations; lecithin-cholesterol acyltransferase (LCAT) and cholesteryl ester transfer protein (CETP) mass and activity; plasma glucose and insulin levels were measured before and at 1, 3, 6, and 12 months after GBP surgery. Baseline concentrations of TG, RLP-C, glucose, and insulin were significantly higher in obese than in normal-weight, age-matched women, whereas HDL cholesterol (HDL-C), apoA-I, apoA-II, alpha-1 and alpha-2 levels were significantly lower. Over 1 year, significant decreases of body mass index, glucose, insulin, TG, RLP-C, HDL-TG, and prebeta-1 levels were observed with significant increases of HDL-C and alpha-1 levels (all P < 0.05). Changes of fat mass were correlated with those of LDL cholesterol (P = 0.018) and LCAT mass (P = 0.011), but not with CETP mass (P = 0.265). Changes of fasting plasma glucose concentrations were inversely correlated with those of CETP mass (P = 0.005) and alpha-1 level (P = 0.004). Changes of fasting plasma insulin concentrations were positively correlated with those of LCAT mass (P = 0.043) and inversely with changes of alpha-1 (P = 0.03) and alpha-2 (P = 0.05) concentrations. These results demonstrate beneficial changes in HDL remodeling following substantial weight loss induced by RYGBP surgery and that these changes are associated with improvement of glucose homeostasis in these patients.

Background. The objective of this study was to examine the association between 25-hydroxyvitamin D, 25(OH)D, and cognitive function. Methods. A cross-sectional investigation of 25(OH)D and cognition was completed in 377 black and 703 non-black (mainly Caucasian) elders (65-99 years) participating in the nutrition and memory in elders study. Participants underwent a comprehensive neuropsychological battery, and 25(OH)D concentrations were obtained. Results. More than 65% of elders had suboptimal 25(OH)D concentrations ([less than or equal to]20 ng/mL or [less than or equal to]50 nmol/L). Approximately 18% were deficient in 25(OH)D (< 10 ng/mL or 20 ng/mL were associated with better performance on tests of executive function, including trails A (80.5 vs 95, p < .05), trails B (205s vs 226s, p < .05), matrix reasoning (7.8 vs 7.0, p = .03), and digit symbol (31.5 vs 37, p < .01). There were no associations between 25(OH)D and memory tests. Factor analysis yielded factors for memory, executive function, and attention/ processing speed. Alter adjustment, 25(OH)D was associated with the executive function ([beta] = 0.01, p < 0.01) and attention/ processing speed factors ([beta] = 0.01, p = .03), but not the memory factor ([beta] = -0.001, p = 0.65). Conclusions. 25(OH)D was positively associated with cognitive performance, particularly with measures of executive function in this elderly population. Key Words: Cognitive function--Vitamin D--Elderly people--Dementia.

The proportion of the Latin American population above age 65 y is expected to rise substantially. To better define the prevalence of infectious diseases and micronutrient deficiencies, assess immunological status, and evaluate associations between nutritional status and infection, we performed a cross-sectional study of elderly Ecuadorians in a low-income peri-urban community in Quito, Ecuador. Culturally adapted questionnaires, delayed type hypersensitivity (DTH) skin response, micronutrient, and immunological assays were performed in randomly selected Ecuadorians aged [greater than or equal to] 65 y. Multiple linear and logistic regression models were developed to assess relationships between micronutrient concentrations and history of infection, DTH, and immune function. Participants (n = 352; mean age [+ or -] SD, 74.4 [+ or -] 6.4 y) recalled recent episodes of colds/influenza-like syndromes (62.8%), cough (61.0%), urinary tract infection (37.9%), diarrhea (32.2%), fever (24.1%), and pneumonia (3.5%). A prospective substudy of respiratory infections (RI) in 203 elderly revealed similar findings. Colds and pneumonia occurred in 42.8 and 7.9% of participants, respectively, during 737 person-weeks of observation (3.6 [+ or -] 1.1 wk per person). Anemia and micronutrient deficiencies, especially for vitamins C, D, B-6, and B-12 and folic acid and zinc, were common. Plasma vitamin C was associated with interferon-[gamma] (IFN[gamma]) (P < 0.01) and zinc with IFN[gamma] and interleukin-2 (each P < 0.0001). RI history was associated with any micronutrient deficiency (P < 0.001). The burden of infectious diseases, micronutrient deficiencies, and anemia was substantial in this elderly Ecuadorian population. Deficiencies of essential vitamins and minerals place these elderly adults at risk for infections through their negative impact on immune function.

Vitamin E supplementation on respiratory tract infections in elderly nursing home residents is studied. The test show that supplementation with 200 IU per day of vitamin E did not have significant effect on lower respiratory tract infections in elderly nursing home residents, but a protective effect of vitamin E supplementation on upper respiratory tract infections, particularly the common cold, merits further investigation.

Resting metabolic rate (RMR) and body composition were measured in 44 initially nonoverweight girls at three time points relative to menarche: premenarche (Tanner stage 1 or 2), menarche ([+ or -] 6 mo), and 4 yr after menarche. Mean absolute RMR was 1,167, 1,418, and 1,347 kcal/day, respectively. Absolute RMR was statistically significantly higher at menarche than at 4 yr after menarche despite statistically significantly less fat-free mass (FFM) and fat mass (FM), suggesting an elevation in RMR around the time of menarche. The pattern of change in RMR, adjusted for FFM, log transformed FM, age, race, parental overweight, and two interactions (visit by parental overweight, parental overweight by FFM), was also considered. Adjusted RMR did not differ statistically between the visits for girls with two normal-weight parents. For girls with at least one overweight parent, adjusted RMR was statistically significantly lower 4 yr after menarche than at premenarche or menarche. Thus parental overweight may influence changes that occur in RMR during adolescence in girls. parental overweight; puberty; adolescence; obesity; energy expenditure

Biological markers indicative of poor vitamin K status have been associated with a greater risk for hip fracture in older men and women. However, the dietary phylloquinone intake required to achieve maximal carboxylation of hepatic and extrahepatic vitamin K-dependent proteins is not known. In an 84-d study in a metabolic unit, 21 older (60-80 y) women were fed a phylloquinone-restricted diet (18 [micro]g/d) for 28 d, followed by stepwise repletion of 86, 200 and 450 [micro]g/d of phylloquinone. Plasma phylloquinone, urinary [gamma]-carboxyglutamic acid excretion and [gamma]-carboxylation of hepatic (prothrombin) and extrahepatic proteins (osteocalcin) decreased in response to phylloquinone restriction (P < 0.001), demonstrating the production of subclinical vitamin K deficiency. The [gamma]-carboxylation of prothrombin was restored to normal levels in response to phylloquinone supplementation at 200 [micro]g/d. In contrast, all other biochemical markers of vitamin K status remained below normal levels after short-term supplementation of up to 450 [micro]g/d of phylloquinone. These data support previous observations in rats that hepatic vitamin K-dependent proteins have preferential utilization of phylloquinone in response to phylloquinone dietary restriction. Moreover, our findings suggest that the current recommended Adequate Intake levels of vitamin K (90 [micro]g/d) in women do not support maximal osteocalcin [gamma]-carboxylation in older women. KEY WORDS: * vitamin K deficiency * undercarboxylated prothrombin * undercarboxylated osteocalcin * urinary [gamma]-carboxyglutamic acid * adequate intake

Objectives. 1) To establish with nationally representative US data whether menarche occurred earlier in the 1990s than it had 25 years before. 2) To assess whether the occurrence of menarche in relation to weight status and race had changed over this time period. Methods. Relative weight, race, and menarcheal status of girls in the National Health Examination Survey cycles II and III (1963-1970) were compared with results from the Third National Health and Nutrition Examination Survey (1988-1994). Probit analysis was used to determine the average age at menarche during the 2 survey periods. Logistic regression was used to assess the association of relative weight to likelihood of having reached menarche. Results. The average age at menarche dropped from 12.75 to 12.54 years, and the percentage of girls between 10 and 15 years old who were above the 85th percentile for body mass index increased from 16% to 27% over the 25 years between the 2 surveys. Higher relative weight was strongly associated with increased likelihood of having reached menarche after controlling for age and race. Black girls had a lower average age at menarche than did white girls, which was independent of the effect of relative weight. Conclusions. These analyses from 2 nationally representative samples of US girls suggest a drop of about 2 1/2 months in the average age of menarche during the time period between 1963-1970 and 1988-1994. This was paralleled by a concurrent shift in the population distribution of body mass index z-score toward higher relative weights. Pediatrics 2003;111:844-850; puberty, menarche, adolescents, obesity, overweight, body mass index, national surveys, ABBREVIATIONS. PROS, Pediatric Research in Office Settings; BMI, body mass index; NHES, National Health Examination Survey; NHANES III, Third National Health and Nutrition Examination Survey; CDC, Centers for Disease Control [...]

Studies that have compared the absorption of phylloquinone from green vegetables and oils have equivocal results. To address differences in approaches used to assess absorption of phylloquinone, a 24-h absorption study was conducted in 18 younger (20-40 y) and 18 older (60-80 y) men and women as part of a larger metabolic study that compared changes in vitamin K status in response to broccoli and phylloquinone-fortified oil (377 [+ or -] 46 and 417 [+ or -] 45 [micro]/d, respectively). Absorption was defined as the 24-h area under the curve (AUC) for plasma phylloquinone concentrations (both unadjusted and adjusted for triglyceride concentrations). The mean AUC for plasma phylloquinone concentrations (both unadjusted and adjusted) were significantly greater after consumption of the phylloquinone-fortified oil diet compared with the broccoli diet (P < 0.001). However, there were no differences between the two treatments in 24-h fasting plasma phylloquinone concentrations. Although there were no age differences in the AUC for plasma phylloquinone adjusted for triglycerides, older adults had significantly higher plasma phylloquinone concentrations (both unadjusted and adjusted) at 0 and 24 h than the younger adults (P < 0.001). These data emphasize that the use of different approaches for the assessment of vitamin K absorption can result in disparate conclusions. KEY WORDS: * vitamin K * absorption * phylloquinone * triglycerides * age

Previous studies of age-associated immune system changes revealed alterations in expressed immunoglobulin heavy chain variable domain repertoires, and variability in the fraction of expressed heavy chain variable domain genes with mutations. To test whether the latter finding reflected a variation in memory B-cell numbers, we measured circulating memory B cells of 11 healthy elderly subjects, 173 nursing-home residents, and 34 healthy young adults. A large fraction of old adults have low values for memory cells both as a percentage of all B cells and as an absolute memory B-cell concentration. The range of both values is much wider in old adults than in young adults, and it is much wider than the range of T-cell concentrations. Memory B-cell concentration, which was positively correlated with memory T-cell concentrations but inversely related to in vitro T-cell responses to mitogens, may reflect highly individual rates of immune senescence, and it may serve as an amplified marker of underlying T-cell function.

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 [...]