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Background/Objectives To clarify the effects of intake of legumes and isoflavones on all-cause mortality in middle-aged and older Japanese. Subject/Methods The subjects were 2136 randomly chosen community-dwelling Japanese men and women aged 40-79 years who participated in a first-wave survey (1997-2000; baseline). The subjects were followed from baseline to December 31, 2017 (mean period of 16.6 [plus or minus] 4.2 years). Intake of legumes, soybeans, and isoflavones at baseline was assessed using a 3-day dietary record with photographs. The relationships of intake amounts of legumes and isoflavones to mortality were assessed using Cox proportional hazards regression controlling for age, sex, education, employment, body mass index, smoking habits, medical histories, drinking, and energy intake. Results There were 491 deaths during the follow-up period. We found inverse associations of the intake of total soy products and intake of each of the isoflavones with all-cause mortality (p for trend < 0.05) in subjects aged < 60 years: the multivariate-adjusted hazard ratios (95% confidence intervals) for all-cause mortality in the highest intake group (third tertile) of total soy products and total isoflavones were 0.32 (0.13-0.78) and 0.35 (0.17-0.73), respectively, compared with the reference group (first tertile). In contrast, there were no significant associations of intake amounts of legumes, soybeans, and isoflavones with all-cause mortality in subjects aged 60 years or older. Conclusions The findings suggest that a higher intake of isoflavones might decrease the risk of all-cause mortality, especially in middle-aged Japanese., Author(s): Mariko Nakamoto [sup.1] [sup.2] , Rei Otsuka [sup.2] , Chikako Tange [sup.2] , Yukiko Nishita [sup.3] , Makiko Tomida [sup.2] , Tomoko Imai [sup.2] [sup.4] , Tohru Sakai [sup.1] [...]

Objective Type 2 diabetes mellitus (T2D) prevalence continues to increase, and age of incidence continues to decrease. More information is needed to target interventions to the ages where they can be most effective. The objective of this study was to explore the degree to which the association between diet and T2D incidence changes through adulthood. Methods Participants were a large number (N = 2818) of community living adults in Canberra and Queanbeyan, Australia across three cohorts; young (20-24 followed to 32-36), mid-life (40-44 followed to 52-56) and late-life (60-64 followed to 72-76). Self-report dietary pattern scores at baseline and diabetes incidence across 12 years follow-up were measured, alongside confounders of caloric intake, sex, smoking status, years of education, hypertension, BMI and physical activity. Results Cox proportional hazards indicated that neither Western nor Prudent dietary pattern scores were significantly associated with T2D incidence when confounders were included in the model. Unadjusted estimates suggested a positive association between Western dietary pattern scores and subsequent diabetes incidence (HR = 1.40, 95% CI [1.18, 1.64]). Compared with the mid-life cohort, a higher Western dietary pattern score posed a lower risk for incident T2D in the young cohort (unadjusted HR = 0.46, 95% CI [0.22, 0.96]), who also had significantly lower BMI and higher physical activity. No such significant effects were found for the late-life cohort. Conclusions Our findings indicate that mid-life may be a period of heightened vulnerability to the effects of an unhealthy diet on diabetes risk, but this effect is attenuated when risk factors related to diet, such as adiposity, are taken into account., Author(s): Erin I. Walsh [sup.1] [sup.2] , Felice N. Jacka [sup.3] , Peter Butterworth [sup.1] [sup.4] , Kaarin J. Anstey [sup.1] [sup.5] [sup.6] , Nicolas Cherbuin [sup.1] Author Affiliations: (1) [...]

Background/objectives: For decades, the Mediterranean diet has been in focus regarding healthy eating as it has been associated with reduced risk of non-communicable diseases. Less interest has been given to health benefits of other regional diets. The aim of the present study was to assess whether adherence to a healthy Nordic food index was associated with lower risk of myocardial infarction (MI) among middle-aged Danes. Subjects/methods: Data were obtained from the Danish Diet, Cancer and Health cohort study of 57 053 men and women aged 50-64 years recruited between 1993 and 1997. The healthy Nordic food index comprised healthy Nordic food items selected a priori (fish, cabbage, rye bread, oatmeal, apple and pears and root vegetables). Information on incident MI was ascertained through linkage with national registries. Hazard ratios (HR) with 95% confidence intervals (CI) were estimated from sex-specific Cox proportional hazard models. Results: In total, 1669 men and 653 women developed MI during follow-up (13.6 median years). In adjusted models, those with an index score of 5-6 points (highest scores) had significantly lower MI risk (men: HR=0.77, 95% CI=0.62, 0.97; women: HR=0.55, 95% CI=0.37, 0.82) relative to those scoring 0 points in the index (lowest score). A significantly lower MI risk was found per 1-point increment in the index in both men (HR=0.95, 95% CI=0.92, 0.99) and women (HR=0.93, 95% CI=0.88, 0.98). Conclusions: A healthy Nordic diet is associated with lower MI risk among middle-aged Danes, suggesting that Nordic diets should be considered in recommendations for dietary changes in the promotion of coronary health., Author(s): V B Gunge [sup.1] , I Andersen [sup.2] , C Kyrø [sup.1] , C P Hansen [sup.3] , C C Dahm [sup.3] , J Christensen [sup.4] , A Tjønneland [...]

OBJECTIVES: The relationships between local food environments and dietary patterns are important for older adults and could be different in men and women. We examined associations between exposure to neighbourhood food sources and food consumption and the moderating role of diet knowledge separately among older women and men living in Montreal in 2003-2005 (n =722). METHODS: The proportion of fast-food outlets relative to all restaurants (%FFO) and the proportion of healthy food stores relative to all stores (%HFS) were estimated for 500 m buffers around participants' homes. Two dietary patterns, designated 'Western' and 'prudent', reflecting lower- and higher-quality diets respectively, were identified from food frequency questionnaire data. The unique and interactive effects of diet knowledge and food-source exposure on diet scores were tested with separate linear regression models for women and men. RESULTS: For men, greater %FFO exposure was related to lower prudent diet scores ([beta] = -0.18, p = 0.02), but no effect of %HFS exposure was observed and no interactions were statistically significant. For women, an inverse relationship between %FFO and prudent diet scores was strongest among those with low diet knowledge ([beta] = -0.22, p < 0.01). No other associations were statistically significant. CONCLUSION: Older men's diet patterns may reflect unhealthy cues associated with fast-food outlets. Among women, diet knowledge potentiated both negative and positive relationships with the food environment. In the absence of consistent main effects of the food environment on diet scores, subgroup analysis is a promising avenue for research. KEY WORDS: Diet; older adults; urban population; food supply; effect modifier OBJECTIFS: Les liens entre les environnements alimentaires locaux et les habitudes alimentaires sont importants pour les personnes agees et pourraient differer selon le sexe. Nous avons examine separement pour des femmes et des hommes ages vivant a Montreal en 2003-2005 (n = 722) les associations entre l'exposition aux commerces alimentaires du quartier, la consommation d'aliments et le role moderateur des connaissances en nutrition. METHODE: Nous avons estime la proportion de debits de restauration rapide (DRP) par rapport a l'ensemble des restaurants et la proportion de magasins d'alimentation pouvant offrir des aliments sains (MAS) par rapport a l'ensemble des magasins dans un rayon de 500 m autour du domicile des participants. Deux types d'habitudes alimentaires, qualifiees d' << occidentales >> et de << prudentes >> pour indiquer les regimes de qualite inferieure et superieure, respectivement, ont ete cernes a partir des donnees de questionnaires sur la frequence de consommation des produits alimentaires. Les effets uniques et interactifs des connaissances en nutrition et de l'exposition aux commerces alimentaires sur les scores des habitudes alimentaires ont ete analyses selon des modeles de regression lineaire distincts selon le sexe. RESULTATS: Chez les hommes, un pourcentage superieure d'exposition aux DRP etait lie a des notes plus faibles pour le regime << prudent >> ([beta] = -0,18, p = 0,02), mais nous n'avons observe aucun effet du pourcentage d'exposition aux MAS, et aucune interaction n'etait significative. Chez les femmes, la relation inverse entre le %DRP et le regime << prudent >> etait la plus forte chez les participantes dont les connaissances en nutrition etaient faibles ([beta] = -0,22, p < 0,01). Aucune autre association n'etait significative. CONCLUSION: Les habitudes alimentaires des hommes peuvent s'expliquer par des reperes malsains associes aux debits de restauration rapide. Chez les femmes, les connaissances en nutrition peuvent entraIner a la fois des relations negatives et positives avec l'environnement alimentaire. En l'absence d'effets principaux coherents de l'environnement alimentaire sur les scores des habitudes alimentaires, l'analyse par sous-groupe est une piste de recherche prometteuse. MOTS CLES: regime alimentaire; personne agee; population urbaine; approvisionnement en nourriture; effets modificateurs La traduction du resume se trouve a la fin de l'article. Can J Public Health 2016;107(Suppl. 1):eS34-eS41 doi: 10.17269/CJPH.107.5309, Nutrition plays a major role in successful aging and in the prevention and management of chronic diseases. (1) However, national surveys highlight concerns regarding inadequate intakes of several foods and [...]

Objectives: To describe the contribution of highly processed foods to total diet, nutrient intakes and patterns among 27 redefined centres in the 10 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC). Methods: Single 24-hour dietary recalls were collected from 36 034 individuals (aged 35-74 years) using a standardized computerized interview programme (EPIC-SOFT). Centre-specific mean food intakes (g/day) were computed according to their degree of food processing (that is, highly, moderately and non-processed foods) using a specifically designed classification system. The contribution (%) of highly processed foods to the centre mean intakes of diet and 26 nutrients (including energy) was estimated using a standardized nutrient database (ENDB). The effect of different possible confounders was also investigated. Results: Highly processed foods were an important source of the nutrients considered, contributing between 61% (Spain) and 78-79% (the Netherlands and Germany) of mean energy intakes. Only two nutrients, b-carotene (34-46%) and vitamin C (28-36%), had a contribution from highly processed foods below 50% in Nordic countries, in Germany, the Netherlands and the United Kingdom, whereas for the other nutrients, the contribution varied from 50 to 91% (excluding alcohol). In southern countries (Greece, Spain, Italy and France), the overall contribution of highly processed foods to nutrient intakes was lower and consisted largely of staple or basic foods (for example, bread, pasta/rice, milk, vegetable oils), whereas highly processed foods such as crisp bread, breakfast cereals, margarine and other commercial foods contributed more in Nordic and central European centres. Conclusions: Highly industrially processed foods dominate diets and nutrient patterns in Nordic and central European countries. The greater variations observed within southern countries may reflect both a larger contribution of non/moderately processed staple foods along with a move from traditional to more industrialized dietary patterns. doi: 10.1038/ejcn.2009.82 Keywords: 24-h dietary recall; standardisation; processed foods; industrial foods; nutrient patterns; EPIC-SOFT, Introduction Two major historical periods have introduced profound changes in human diet and other lifestyle factors. The introduction of agriculture and animal husbandry in the neolithic period (~10 000 years [...]

Background: Dietary flaxseed may have beneficial cardiovascular effects. An aged population has a higher incidence of cardiovascular disease, but they may react differently to flaxseed in the diet. Objective: To investigate the response, over a period of 4 weeks, of subjects aged 18-29 or 45-69 years to a diet containing the same amount of [alpha]-linolenic acid (ALA) (6 g) introduced in the form of ground flaxseed (30 g) or flaxseed oil. Results: All subjects who received flaxseed oil showed a significant increase in plasma ALA and eicosapentaenoic acid (EPA) concentrations over the course of this study. Subjects who received ground flaxseed in the 18-29-year-old group showed a statistically significant increase in their plasma ALA levels, and although there was a trend in the same direction for the 45-69-year-old subjects, this did not achieve statistical significance. The diets induced no major changes in platelet aggregation, plasma total cholesterol, low-density lipoprotein or high-density lipoprotein cholesterol levels in any of the groups. Younger subjects showed a decrease in triglyceride (TG) values compared with older subjects. There were no significant side effects that caused compliancy issues. Conclusion: Subject age does not seem to be a major determining factor in influencing ALA absorption from a flaxseed- supplemented diet nor in the metabolism of ALA to EPA in the groups fed flaxseed oil. Concerns about side effects in older subjects administered a higher fiber load in a flaxseed-supplemented diet are not justified. However, younger but not older subjects showed a beneficial decrease in circulating TGs due to flaxseed supplementation. doi:10.1038/ejcn.2009.41; published online 8 July 2009 Keywords: omega-3 fatty acid; polyunsaturated fatty acids (PUFAs); platelet aggregation; linseed; cardiovascular disease; aging, Introduction Flaxseed contains one of the richest plant sources of the [omega]-3 polyunsaturated fatty acid, [alpha]-linolenic acid (ALA). ALA is believed to be one of the dietary factors responsible for [...]

Background/Objectives: Few studies have investigated dietary patterns among French adults. We aimed to identify dietary patterns and their relation with nutrient intakes, sociodemographic, lifestyle and other health indicators in a large population of middle-aged subjects living in France. Subjects/Methods: Dietary patterns were identified using factor analysis in 5194 women and men aged 45-60 years enrolled in the SU.VI.MAX (Supplementation en Vitamines et Mineraux Antioxydants) study. Dietary data were based on repeated 24-h dietary records (at least six records during 2 years). Results: Four patterns were identified: (1) &apos;alcohol and meat products&apos;; (2) &apos;prudent diet&apos;; (3) &apos;convenience foods&apos;; and (4) &apos;starch, sauces, and vegetables&apos;. The first pattern was positively associated with low education, smoking and overweight in both genders, as well as with abdominal obesity in women and treated hyperlipidaemia and/or hypertension in men. The second pattern was positively correlated with high education and being older than 55 years and negatively correlated with current smoking. This pattern was also associated with overweight and low waist circumference in women and with hyperlipidaemia treatment in men. The third pattern was inversely related to age and positively related to higher education in both genders. In men, higher scores were related to living alone and an urban residence. The fourth pattern was associated with high education and an urban residence in men only. Conclusions: Our study identified four dietary patterns in this population of French middle-aged adults. Associations with sociodemographic, behavioural and health-related factors were found to differ according to dietary patterns. Sex-specific relationships were also found. doi:10.1038/sj.ejcn.1602978; published online 23 January 2008 Keywords: dietary patterns; factor analysis; lifestyles; nutrient intakes; health factors, Introduction Epidemiological studies investigating the relationships between nutritional factors and health have traditionally focused on the effect of one or a few individual dietary factors such as nutrients and food [...]

We examined whether the adherence to major dietary patterns at baseline of 5824 nondiabetic Danes (30-60 y) enrolled in the nonpharmacological Inter99 intervention predicted changes in fasting plasma glucose (FPG) and postchallenge 2-h plasma glucose (2h-PG) concentrations during a 5 y period and whether a potential association was dependent on baseline glucose tolerance status. Through principal component analysis, a score for a traditional dietary pattern (characterized by higher intakes of high-fat sandwich spreads, red meat, potatoes, butter and lard, low-fat fish, sandwich meat, and sauces) and a score for a modern dietary pattern (characterized by higher intakes of vegetables, fruit, vegetable oil/vinegar dressing, poultry, pasta, rice, and cereals) were estimated for each person at baseline. Random effect models adjusting for relevant confounders were used to estimate changes in repetitive measures of FPG and 2h-PG. A higher modern score (of 1 SD) predicted an annual decrease in 2h-PG of 0.015 mmol/L (P < 0.01) regardless of glucose tolerance status. For individuals with isolated impaired glucose tolerance, a higher traditional score (of 1 SD) predicted an annual increase in 2h-PG of 0.083 mmol/L (P < 0.0001). In conclusion, glucose tolerance status did not, in general, affect the predictive effect of the dietary patterns. The study suggests that the risk of worsening 2h-PG concentrations may be smaller for individuals with a high modern dietary pattern score characterized by high intakes of vegetables, fruit, vegetable oil/vinegar dressing, poultry, pasta, rice, and cereals.

Background Numerous studies support the protective effect of high fruit and vegetable consumption on chronic disease risk, mainly against cancer and cardiovascular diseases. The increase of fruit and vegetable intake has become a public health priority in many countries. Objective The aim of the study was to investigate the relationships of socioeconomic, demographic, and behavioral factors with both quantity and variety of fruit and vegetable consumption. Design/subjects Fruit and vegetable intake was assessed using repeated 24-hour dietary records collected during a 2-year period from 4,282 French subjects (2,373 men and 1,909 women), aged 45 to 62 years, who participated in a large prospective study. Statistical analysis Both education level and occupation categories were used as socioeconomic indicators. Logistic regression models were applied to assess factors related to meeting the 5 A Day fruit and vegetable recommendation. Covariance analyses were performed to compare the fruit and vegetable variety scores and the contributions of fruit and vegetables to the total daily diet cost across socioeconomic indicators within each sex. Results Meeting the 5 A Day recommendation was more likely in subjects aged 50 years and older, higher education levels, nonsmokers, moderate alcohol drinkers and in women engaging in regular physical activity. The odds ratio (95% confidence interval) for the lower vs higher education level was 0.70 (0.54 to 0.92) in men and 0.65 (0.48 to 0.85) in women. No significant difference was observed between occupation categories. A positive relationship between vegetable variety and education level was found in both sexes. Fruit variety was positively associated with both education and occupation categories, but only in men. The contribution of fruits to the total daily diet cost increased with occupation (P<0.02) and education (P<0.0001) in men, but decreased with occupation in women (P<0.05). Conclusions Although cost constraints may explain the lower fruit and vegetable intake in lower socioeconomic groups, the relative influence of budgetary resources, nutrition knowledge, and social and environmental barriers in socioeconomic disparities need further investigation.

Objective: To assess the effects of zinc supplementation on vitamin status in middle-aged and older volunteers. Subjects/Methods: Three hundred and eighty-seven healthy middle-aged (55-70 years) and older (70-85 years) men and women, randomly allocated to three groups to receive 15 or 30 mg Zn/day or placebo for 6 months. Dietary intake was assessed by means of a validated 4-day recall record. Fasting blood samples were simultaneously analysed for levels of plasma retinol and [alpha]-tocopherol by high-performance liquid chromatography. Erythrocyte folates were measured by a competitive immunoassay with direct chemiluminescence detection on an automatized immunoanalyser. Biochemical measurements were performed at baseline and after 3 and 6 months of zinc supplementation. Results: Plasma vitamin A levels were significantly increased proportionally with zinc dose and period of treatment, particularly at 6 months (for 15 mg Zn/day, P Conclusions: Our results show that a long-term zinc supplementation increases plasma vitamin A levels in middle-aged and older people of similar characteristics to those involved in this study. Moreover, supplementation influences serum zinc levels but does not affect erythrocyte zinc concentration and both plasma vitamin E and erythrocyte folate status. doi:10.1038/sj.ejcn.1602844; published online 11 July 2007 Keywords: elderly; zinc supplementation; vitamin A; vitamin E; folates, Introduction Zinc is an essential component of a large number of enzymes participating in the synthesis and degradation of carbohydrates, lipids, proteins and nucleic acids as well as in the [...]

Objective: To measure the correlations between habitual intakes of individual n-6 and n-3 polyunsaturated fatty acids (PUFA) and their percentages in total plasma fatty acids in a population of adult men and women. Subjects/Methods: Two hundred and seventy-six men and 257 women aged 45-60 (men) or 35-60 (women) at baseline, volunteers of the French SU.VI.MAX cohort. Fifteen 24-h record questionnaires were used to estimate the habitual intake of energy, total fat and linoleic, [alpha]-linolenic acid, arachidonic, eicosapentaenoic (EPA), n-3 docosapentaenoic (DPA) and docosahexaenoic (DHA) acids. Fatty acid composition of fasting plasma total lipids has been determined at baseline. Results: Dietary intakes of linoleic acid, arachidonic acid, EPA and DHA were weakly but significantly correlated (0.16< r Conclusions: The percentages of linoleic acid, arachidonic acid, EPA and DHA in plasma total fatty acids, but not that of alinolenic acid, are acceptable markers of their habitual levels of intake. The plasma levels of long-chain n-6 and n-3 PUFA are not influenced by the intake levels of their precursors, linoleic and a-linolenic acids. doi:10.1038/sj.ejcn.1602836; published online 11 July 2007 Keywords: omega-3 fatty acids; plasma; biomarkers; linoleic; a-linolenic; arachidonic, Introduction Essential fatty acids (EFA) are nutrients of primary importance for health, and many research works in the last decades have shown the role of an adequate intake of n-6 [...]

Background/Objectives: Little is known about relation of overall breakfast quality with cardiometabolic risk factors. Therefore, this study aimed to explore sex-specific associations between breakfast quality and cardiometabolic risk profiles in a sample of an upper middle-aged German population. Subjects/Methods: Cardiometabolic profiles of 339 men and 329 women were cross-sectionally assessed using an overall biomarker score (BScore), glycated hemoglobin (HbA1[sub.c]), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), blood pressure, body mass index (BMI) and waist circumference (WC). Overall breakfast quality was assessed by using (i) an a-priori defined breakfast quality score (BQS) and (ii) data-driven breakfast patterns based on principal component analysis (PCA). Multiple linear regression models for association of breakfast quality with all outcomes were adjusted for all potential confounders including overall diet quality. Results: After adjustment for all potential confounders the BQS was inversely associated with the BScore (regression beta with 95% Confidence Interval: -0.29 (052-0.06)) and HbA1c (-0.12 (-0.21, -0.04)) in men; whereas no such associations were observed in women. Four breakfast (B) patterns were identified: B-processed-food pattern, B-cereal pattern, B-high fat pattern and B-dairy & cereal pattern. The B-processed-food pattern was positively associated with HbA1c (0.09(0.01, 0.18)), BMI (0.16 (0.06, 0.26)), and WC (0.17 (0.8, 0.26)) in men, and BMI (0.13 (0.1, 0.25)) and WC (0.11(0.01.0.22)) in women. The B-cereal pattern was inversely associated with BScore (-0.23 (-0.45, -0.01)) and BMI (-0.11 (-0.20, -0.01)) in men and WC(-0.16 (-0.27, -0.05)) in women. The B-dairy & cereal pattern was also inversely associated with BScore (-0.26 (-0.48, -0.04)) in men but not in women. Conclusions: The overall breakfast quality was cross-sectionally associated with a healthier cardiometabolic profile, especially in upper-middle age men, independent of overall dietary quality. Such analyses should be supplemented by studies investigating the circadian sequence of food intake and metabolic consequences including hard disease endpoints. European Journal of Clinical Nutrition (2017) 71, 1312-1320; doi: 10.1038/ejcn.2017.116; published online 26 July 2017, Author(s): K Iqbal [1]; L Schwingshackl [1]; M Gottschald [1]; S Knüppel [1]; M Stelmach-Mardas [1, 2]; K Aleksandrova [1, 3]; H Boeing [1] Introduction Breakfast is considered an important [...]

Objective The goal of this study was to examine the purported effects of calcium on modulating body weight. Design Retrospective data was used to assess the relationship between calcium intake and weight change over an 8- to 12-year period among middle-aged adults. Subjects Participants were 10,591 men and women aged 53 to 57 years recruited during 2000-2002. Statistical analysis Linear regression was used to model associations of 10-year weight change and calcium intake, adjusted for weight at age 45 years, energy intake, physical activity, and other factors. Results Calcium intake was associated with 10-year weight change only in women. Women with current calcium supplement dose of >500 mg/day had a 10-year weight gain of 5.1 kg (95% confidence interval 4.7 to 5.5) compared to 6.9 kg (95% confidence interval 6.5 to 7.4) among nonusers (P for trend=0.001). Trends were similar for total calcium intake from diet plus supplements (P for trend=0.001). Dietary calcium alone had no significant effect on 10-year weight change. Conclusions Increasing total calcium intake, in the form of calcium supplementation, may be beneficial to weight maintenance, especially in women during midlife.

Objective To assess dietary supplement use and its association with micronutrient intakes and adequacy among 2,195 US men and women aged 40 to 59 years from eight diverse population samples surveyed by the International Population Study on Macronutrients and Blood Pressure. Design Four 24-hour dietary recalls were collected, including information on dietary supplements. The Nutrition Data System (NDS) was used for nutrient analyses. Supplements not in NDS were classified separately (non-NDS). Intake of non-NDS supplements was documented. Participants were classified as not supplement users and supplement users, subclassified--due to concerns about nutritional value--as users of NDS supplements only (mostly vitamins and minerals) and users of non-NDS supplements (eg, botanicals, animal products, and enzymes). To assess effects of supplement use on micronutrient intake and adequacy, mean intakes from supplements, foods, and foods plus supplements were compared with Dietary Reference Intakes. Participants Two thousand one hundred ninety-five US participants; 1,136 used supplements. Statistical analyses [chi square] tests, multivariate logistic regression, and means were used to assess differences in and factors related to supplement use and to determine dietary adequacy. Results Supplement use was more common among women, older participants, more educated participants, and Asian Americans. Body mass index and current cigarette smoking were significantly and inversely associated with supplement use; past smoking and education were significantly and positively associated with supplement use. Intake from foods plus supplements was considerably higher than from foods alone for vitamins A, C, and E; niacin; folate; and iron. Conclusions Supplement use is common among middle-aged Americans and sizably increases daily intakes of several micronutrients. These data underscore the importance of dietary supplement assessment. J Am Diet Assoc. 2005;105:1106-1114.

This study assessed the effect of oral pinitol supplementation on oral and intravenous glucose tolerances and on skeletal muscle insulin receptor content and phosphorylation in older people. Fifteen people (6 men, 9 women; age 66 [+ or -] 8 y; BMI 27.9 [+ or -] 3.3 kg/[m.sup.2]; hemoglobin A1c 5.39 [+ or -] 0.46%, mean [+ or -] SD) completed a 7-wk protocol. Subjects were randomly assigned to groups that during wk 2-7 consumed twice daily either a non-nutritive beverage (Placebo group, n = 8) or the same beverage with 1000 mg pinitol dissolved into it (Pinitol group, n = 7, total dose = 2000 mg pinitol/d). Testing was done at wk 1 and wk 7. In the Pinitol group with supplementation, 24-h urinary pinitol excretion increased 17-fold. The fasting concentrations of glucose, insulin, and C-peptide, and the 180-min area under the curve for these compounds, in response to oral (75 g) and intravenous (300 mg/kg) glucose tolerance challenges, were unchanged from wk 1 to wk 7 and were not influenced by pinitol. Also, pinitol did not affect indices of hepatic and whole-body insulin sensitivity from the oral glucose tolerance test and indices of insulin sensitivity, acute insulin response to glucose, and glucose effectiveness from the intravenous glucose tolerance test, estimated using minimal modeling. Pinitol did not differentially affect total insulin receptor content and insulin receptor phosphotyrosine 1158 and insulin receptor phosphotyrosine 1162/1163 activation in vastus lateralis samples taken during an oral-glucose-induced hyperglycemic and hyperinsulinemic state. These data suggest that pinitol supplementation does not influence whole-body insulin-mediated glucose metabolism and muscle insulin receptor content and phosphorylation in nondiabetic, older people. KEY WORDS: * D-chiro-inositol * C-peptide * oral glucose tolerance test * intravenous glucose tolerance test

This study delineates demographic, lifestyle, dietary and health factors associated with the use of supplements at varying levels. Data are from a population-based cohort of 2,152 middle- to older-age adults living in Beaver Dam, Wisconsin. Information was collected by in-person interviews between 1988-1990. Associations were adjusted for gender and age. Use of supplements was more prevalent among women, persons with more than 12 years of education, those with relatively low body mass indices, persons with active lifestyles, and persons who never smoked as compared to current smokers (P [greater than or equal to] 0.05). Supplement users had higher intakes of most of the micronutrients from food that were examined in this study, including the antioxidant vitamins C and E and certain carotenoids (P [greater than or equal to] 0.05). Intakes of dairy products and also foods that are important sources of vitamin C and carotenoids were higher among users of supplements, but relationships differed by gender and by the type and level of supplement intake. These findings suggest that several factors need to be considered potential confounders in observational studies that examine the etiologic role of supplements in the occurrence of chronic disease. KEY WORDS: * ascorbic acid * carotene * humans * supplements * vitamin E

Objective Age-related deficits in salt taste perception are said to increase preferences for salty foods, thereby leading potentially to greater sodium consumption. This study examined the link between salt taste perceptions and preferences and sodium intakes as a function of age and gender. Design We studied 24 young adults (aged 20 to 30 years) and 24 healthy older adults (aged 60 to 75 years). The subjects tasted and rated five sodium chloride solutions and eight samples of salted chicken broth containing from 0.04 to 0.64 mol/L sodium. Food intakes were assessed using a 24-hour food recall and 14 consecutive days of diet records. Results Older and younger subjects did not differ in their sensory evaluations of chicken broth, including ratings of the intensity of saltiness. Older subjects preferred less salty soups than did young adults. Hedonic response profiles for salt in soup were not related to daily sodium intakes as assessed by diet records. Applications Salt taste perceptions and preferences were unrelated to sodium intakes in young adults and in older respondents. Factors other than taste may influence dietary sodium consumption. J Am Diet Assoc. 1996; 96:471-474., Age-related deficits in taste and smell are thought to affect food preferences and may have an adverse effect on nutrition and health (1,2). Diminished perception of saltiness in old age [...]

The energy requirements of older people may be higher than the present recommendations. This does not mean however, that energy intake must be raised. This only shows that energy intake and expenditure of older individuals may be greater than what was expected. Health and lifestyle are also found to be more important than age in determining energy requirements for older people.

Intake of macronutrients and micronutrients was estimated from a diet history questionnaire in a population-based sample of persons (n = 2152), 43-86 y of age. Men and women 65 y of age or older consumed less protein, fat, cholesterol, niacin, riboflavin, calcium, iron, zinc and lycopene than their middle-aged counterparts. After including nutrient intake from supplements, age differences in intake were no longer significant for zinc in women or for niacin and iron in men. After further adjusting for energy intake, only protein, cholesterol, and lycopene mean intakes were lower in older compared with middle-aged men and women. Regular use of supplements was most prevalent among older men and women (40 and 48%, respectively). Supplement use was greater in the current time period compared with retrospective reports of supplement use 10 y before interview. The impact of supplement intake on median values of intake was greatest in women, particularly for vitamins A, C and E, riboflavin and calcium. The high prevalence of supplement use emphasizes the importance of considering this source of nutrients in future investigations in which dietary intake is measured.

Dietitians, physicians, the government, and the press have repeatedly told the public that intake of dietary fat and cholesterol is associated with heart disease and should therefore be reduced. The [...]

Diabetes, a common chronic disease associated with aging, affects about 20% of persons 65 years of age or older in the United States (1). Diet is an essential part of [...]

Objective: To compare the effects of two energy-restricted healthy diets, one with a low GI and one with a high GI, on heart disease risk factors and weight loss in subjects at risk of heart disease. Design: A 12-week randomized parallel study of low and high GI, healthy eating diets was carried out. Setting: The study was carried out at the Hammersmith Hospital. Subjects: Eighteen subjects were recruited by advertisement and randomized to one of the two diets. Fourteen completed the study but one was excluded from the final analysis. Methods: At randomization, subjects were advised to follow the intervention diet for 12 weeks. Before randomization and on completion of the study, anthropometrics, fasting cholesterol and glucose blood tests and 24-h glucose measurements were taken using a continuous glucose monitoring system (CGMS). Statistical analysis was carried out using non-parametric tests. Median (IQR) are presented. Results: A significantly different dietary GI was achieved in the low GI (median: 51.3 (IQR: 51.0-52.0) compared to the high GI (59.3 (59.2-64.0) (P=0.032) group. By week 12, both groups reduced their energy intake by: low GI group: [sup.-]167 ([sup.-]312-[sup.-]123) kcal/day (P=0018) vs high GI group: [sup.-]596 ([sup.-]625-[sup.-]516) (P=0.018) kcal/day, the difference between the groups being significant (P=0.010). However, only the low GI group lost weight ([sup.-]4.0 ([sup.-]4.4-[sup.-]2.4) kg (P=0.018) whereas the high GI group did not significantly change in weight ([sup.-]1.5 ([sup.-]3.6-0.8) kg (P=0.463). By week 12, the low GI group also had a significantly lower 24-h area under the curve (AUC) (7556 (7315-8434) vs 8841 (8424-8846) mmol-h/l (P=0.045) and overnight AUC (2429 (2423-2714) vs 3000 (2805-3072) mmol-h/l (P=0.006) glucose as measured by CGMS. There were no differences in the other heart disease risk factors assessed. Conclusions: This pilot study provides some evidence that consuming a low GI diet in addition to weight loss and healthy eating may reduce cardiovascular risk. Other potential benefits of GI might have been masked by weight loss in the low GI group. Larger-scale studies need to follow. Sponsorship: The study was funded by the British Heart Foundation. European Journal of Clinical Nutrition (2008) 62, 145-149; doi: 10.1038/sj.ejcn.1602688; published online 21 February 2007 Keywords: glycaemic index, glycaemic load, glycaemic response, weight loss, coronary heart disease, Author(s): E Philippou [1]; B M C McGowan [2]; A E Brynes [1]; A Dornhorst [2]; A R Leeds [3]; G S Frost [4] Introduction Coronary heart disease (CHD) is [...]

!!! BEGIN AUTH ABST Objective To describe the snack consumption of older people from several European towns. Subjects with similar snack patterns are clustered into groups to explore the contribution [...]

Objectives. This study examined whether weight gain with age could be prevented through the use of a low-intensity intervention. Methods. Participants, 228 men and 998 women recruited from diverse sources, were randomized to one of the following groups: (l) no-contact control, (2) education through monthly newsletters, or (3) education plus incentives for participation. All participants were weighed and completed questionnaires about behaviors and attitudes related to weight at baseline and annually for 3 years thereafter. Results. Individuals in intervention groups reported favorable changes over time in frequency of weighing and healthy dieting practices relative to those in the control group. These behavior changes were in turn related to a reduced rate of weight gain over time. However, weight gain over 3 years did not differ significantly by treatment group. Conclusions. This low-intensity educational approach to weight gain prevention sustained interest over a lengthy time period and was associated positively with behavior change, but it was not strong enough to significantly reduce weight gain with age. (Am J Public Health. 1999;89:747-751)

An evaluation of research studies on energy requirements for older people is given. Changes in basal metabolism and levels of physical activity may not necessarily be consistent with the standards set for energy requirement changes for older individuals. There is a need for data that represents values for different physical activity levels (PAL) in older people. Proposed energy requirements must also be embodied into a PAL system for adults of different ages.