[Healthy seniors with a normal nutritional level in the Mini-Nutritional Assessment (MNA) identified as at risk for status decline and impaired function]. / Gesunde Senioren zeigen auch bei normalem Ernährungszustand im Mini-Nutritional-Assessment (MNA) Risikobereiche und eingeschränkte Funktionen.

Older adults are potentially vulnerable for malnutrition, risk which can be assessed by the Mini-Nutritional Assessment (MNA). To answer the question, whether the MNA can also assess healthy, normal nourished seniors and to check for correlations on functional disabilities and risk factors for functional status decline, 58 independent living, healthy elderly persons with an MNA above 24 points were studied. Different clinical and laboratory exams were performed and a comprehensive geriatric assessment was carried out. There was a non age-dependent correlation for the number of risks in the Lachs' screening, for the number of drugs taken, for the hemoglobin concentration, the level of the g- GT and for mobility assessment tested by the "Timed Up and Go Test" and the "POMA". The MNA can also distinguish in the "normal" range from 24 to 30 points between persons at risk for functional status decline or persons with slightly impaired functions.

[Anti-aging with healthy nutrition. This you can recommend!]. / Anti-Aging durch gesunde Ernährung. Das können Sie empfehlen!

For a dietary anti-aging concept that "gives life to years and adds years to life" we recommend a low-fat, carbohydrate and fiber-rich diet containing plenty of fruits and vegetables and moderate amounts of protein (in particular of vegetable origin). Prolonging the fasting state by cancelling dinner is also of benefit. Five servings of fruits and vegetables (preferentially red, yellow and green) daily and whole-grain products provide sufficient amounts of vitamins C and E and the provitamin A beta-carotene, as well as secondary phytochemicals. Also to be recommended are low-fat dairy products, fish once or twice a week, little meat and eggs, and a maximum of 4-8 fl oz (1/8 to 1/4 liter) of red wine per day.

Hohenheim consensus workshop: copper.

Copper (Cu) is an essential trace element with many physiological functions. Homeostatic mechanisms exist to allow Cu to act as a cofactor in enzymatic processes and to prevent accumulation of Cu to toxic levels. The aim of this commentary is to better understand the role of dietary Cu supply in deficiency and under physiological and pathological conditions. The essentiality of Cu can be attributed to its role as a cofactor in a number of enzymes that are involved in the defence against oxidative stress. Cu, however, has a second face, that of a toxic compound as it is observed with accumulating evidence in hepatic, neurodegenerative and cardiovascular diseases. The destructive potential of Cu can be attributed to inherent physico-chemical properties. The main property is its ability to take part in Fenton-like reactions in which the highly reactive and extremely deleterious hydroxyl radical is formed. Diseases caused by dietary Cu overload could be based on a genetic predisposition. Thus, an assessment of risk-groups, such as infants with impaired mechanisms of Cu homeostasis regarding detoxification, is of special interest, as their Cu intake with resuspended formula milk may be very high. This implies the need for reliable diagnostic markers to determine the Cu status. These topics were introduced at the workshop by the participants followed by extensive group discussion. The consensus statements were agreed on by all members. One of the conclusions is that a re-assessment of published data is necessary and future research is required.

The relation between selenium, zinc and copper concentration and the trace element dependent antioxidative status.

An imbalance in the antioxidative system was connected with the development of a number of pathological processes. In order to receive values of a healthy group and to evaluate pathological changes of the trace element dependent antioxidative status in future, we investigated 99 healthy volunteers (45 male and 54 female, mean age 37.4 +/- 11.7 years). We determined the concentrations of Se, Cu and Zn, the concentrations of malondialdehyde (MDA) and the activities of the Se dependent glutathione peroxidase (GSH-Px) and the Zn/Cu dependent superoxide dismutase (SOD). The plasma concentrations (mean +/- SD) for Se, Cu and Zn were 0.84 +/- 0.10 micromol/l, 15.6 +/- 2.78 micromol/l and 12.6 +/- 1.80 micromol/l, resp., and for non protein-bound and protein bound MDA 0.27 +/- 0.07 micromol/l and 1.11 +/- 0.25 micromol/l, resp. The activity of GSH-Px in plasma and erythrocytes was 130 +/- 20.8 U/l and 19.8 +/- 4.18 U/mg Hb, resp. and of SOD in erythrocytes 3,159 +/- 847.2 U/g Hb. In plasma positive correlations have been found between Se concentrations and GSH-Px activities (p < 0.002, r = 0.31) and between GSH-Px activities and concentrations of non protein-bound MDA (p = 0.004, r = 0.28). A negative correlation has been observed between GSH-Px activities in plasma and in erythrocytes. The higher the concentrations of Cu in erythrocytes, the higher were the activities of SOD (p = 0.03, r = 0.22) and GSH-Px in erythrocytes (r = 0.26, p = 0.01), while an increasing activity of GSH-Px in these cells correlated with a decreasing concentration of non protein-bound MDA (r = -0,31, p = 0.002). An increase in BMI was connected with an increase in protein-bound MDA and a decrease in GSH-Px activities in pLasma (p = 0.002 and r = 0.23). As the results demonstrate, Se and Cu concentrations in erythrocytes can improve the trace element dependent antioxidative status.

Trace elements in diabetes mellitus. Peculiarities and clinical validity of determinations in blood cells.

Significantly more information about trace element status can be obtained by investigating concentrations in blood cells instead of only evaluating the concentrations in plasma. This can be explained by the fact that essential trace elements such as zinc, copper, chromium and selenium take part in a variety of enzymatic processes on a molecular cellular level. Ignoring these important biochemical roles, trace element concentrations determined in whole blood or plasma very often lead to conclusions contrary to the actual intracellular concentration. Especially in metabolic diseases like diabetes mellitus, conclusions drawn from trace element concentrations in blood cells usually offer more valuable clinical information about the metabolic state than trace element concentrations in plasma or whole blood. In the present investigation copper and zinc concentrations were increased in all blood fractions of diabetic patients (IDDM). In insulin-dependent diabetic children significantly higher values of zinc in erythrocytes were also found, and they were higher in patients with poor metabolic control (HbA1c>9%). When different blood fractions in diabetic patients (NIDDM) were compared with a control group, chromium was significantly increased in plasma and polymorphonuclear cells. Patients with IDDM had pronounced decreased selenium concentrations in erythrocytes as compared to controls.

Reference values for the trace elements copper, manganese, selenium, and zinc in the serum/plasma of children, adolescents, and adults.

Up to now few plasma or serum reference or serum reference values have been available for the assessment of the essential trace element supply status in different age groups covering the whole range of life range. In the present investigation, the concentrations of copper, manganese, selenium, and zinc were determined in the serum of 137 healthy children and in the plasma of 68 blood-donors. The age distribution within these groups ranged from 1 month to 18 years and from 22 to 75 years. The determinations were carried out directly by means of electrothermal atomic absorption spectrophotometry with Zeeman background compensation. The adult plasma reference values (mean +/- 2 SD) were 1.65 +/- 8.6 mumol/1 for copper, 14.3 +/- 11.4 nmol/1 for manganese, 0.80 +/- 0.36 mumol/1 for selenium, and 16.6 +/- mumol/1 for zinc. No correlation between concentration of elements and sex could be established. In the child and adolescent group, the manganese levels exhibited an age-dependent linear decrease (54% of the starting value, slope 0.92, r = 0.4, p < 0.001), the copper and the selenium concentrations, respectively, exhibited an exponential increase (107%, r = 0.59 and 174%, r = 0.61), with the highest value in the age group of 6 to 10 years. Reference ranges are established for 9 different age groups. The results reflect the known physiological data on the trace element content in the tissue of children and their diet. The present study is an important pre-requisite for diagnosis and therapy of trace element deficiencies in all age groups.

Isolation of corpuscular components of whole blood for the determination of selenium in blood cells.

Currently, the determination of trace elements in plasma or whole blood for the evaluation of adequate supply is unsatisfactory as it does not reflect exactly the biochemical processes in the human organism. A method of isolating cell fractions was developed in order to be able to analyze these elements in the corpuscular components of the blood. The separation, which is simple to perform, makes possible a high yield of erythrocytes, thrombocytes, and polymorphnuclear and mononuclear leucocytes, as well as a high purity of the cell fractions. For the first time a precise determination of trace elements in leucocytes has become possible. The concentration in erythrocytes was not calculated but measured directly, avoiding the danger of a compounding of errors by the combination of many steps. The highest relative selenium content of an investigated reference group (n = 25) was found in the erythrocytes (39.7%), followed by the plasma (29.9%) and the thrombocytes (24.9%). The leucocytes had the lowest concentration with < 1.9% in the polymorphonuclear and < 3.7% in the mononuclear cells. A comparison of these results with the distribution of selenium in the blood compartments will show whether the use of erythrocytes resp. thrombocytes for the analysis of this element is of greater value for diagnosis and therapy than currently employed procedures.