Pork and Chicken Meals Similarly Impact on Cognitive Function and Strength in Community-Living Older Adults: A Pilot Study.

A pilot quasi-experimental study investigated whether provision of pork, a rich source of thiamin, as the main protein source in meals four times/week for 12 weeks resulted in improved muscle mass, body strength, and cognitive function in community-living older adults compared to similar meals containing chicken. Retirement villages were randomized to receive pre-prepared frozen meals containing either pork or chicken. Dietary intake was assessed by three-day food records and cognitive domains assessed using validated tests. Hand grip strength was measured and lower extremity performance assessed by the sit-to-stand test, get-up-and-go test and six-minute walk test. Forty-eight volunteers participated (78.2 ± 6.2 y). In linear mixed models, controlling for baseline physical activity and dietary protein and energy intake, no differences were found between pork (n = 19) and chicken (n = 12) groups. The chicken group had improved Rey Auditory Verbal Learning test scores (verbal learning and memory) at six weeks (p < 0.001). Provision of four pork meals a week did not result in improvements in cognitive function, nor measures of strength or physical function, compared to those receiving chicken meals in healthy older adults. This suggests that merely changing the type of dietary protein provided by meat does not impact physical or cognitive function.

Lean Body Mass Associated with Upper Body Strength in Healthy Older Adults While Higher Body Fat Limits Lower Extremity Performance and Endurance.

Impaired strength adversely influences an older person's ability to perform activities of daily living. A cross-sectional study of 117 independently living men and women (age = 73.4 ± 9.4 year; body mass index (BMI) = 27.6 ± 4.8 kg/m²) aimed to assess the association between body composition and: (1) upper body strength (handgrip strength, HGS); (2) lower extremity performance (timed up and go (TUG) and sit to stand test (STS)); and (3) endurance (6-minute walk (SMWT). Body composition (% fat; lean body mass (LBM)) was assessed using bioelectrical impedance. Habitual physical activity was measured using the Minnesota Leisure Time Physical Activity Questionnaire (MLTPA) and dietary macronutrient intake, assessed using 24 h recalls and 3-day food records. Regression analyses included the covariates, protein intake (g/kg), MLTPA, age and sex. For natural logarithm (Ln) of right HGS, LBM (p < 0.001) and % body fat (p < 0.005) were significant (r² = 46.5%; p < 0.000). For left LnHGS, LBM (p < 0.000), age (p = 0.036), protein intake (p = 0.015) and LnMLTPA (p = 0.015) were significant (r² = 0.535; p < 0.000). For SMW, % body fat, age and LnMLTPA were significant (r² = 0.346; p < 0.000). For STS, % body fat and age were significant (r² = 0.251; p < 0.000). LBM is a strong predictor of upper body strength while higher % body fat and lower physical activity are associated with poorer outcomes on tests of lower extremity performance.

Review of patient satisfaction with services provided by general practitioners in an antenatal shared care program.

BACKGROUND: Antenatal shared care (ANSC) is a model of care in Australia whereby pregnant women are managed by their general practitioner (GP) and an obstetrician at a public antenatal clinic throughout the pregnancy. The aim of this study was to assess pregnant women's satisfaction with the ANSC program and the adequacy of advice provided to pregnant women. METHODS: Women participating in ANSC in the Illawarra region of NSW were invited to complete a satisfaction survey, which included questions on relevant topics discussed with their GP. RESULTS: Most women reported being highly satisfied with the ANSC service. Over half of the women had not received any information about breastfeeding and nutritional supplementation of iodine.

Antenatal shared care: are pregnant women being adequately informed about iodine and nutritional supplementation?

OBJECTIVES: To assess nutrition-related knowledge and practices, including supplement use, of both pregnant women and healthcare providers that participate in antenatal shared care (ANSC). METHODS: Pregnant women enrolled in ANSC (n = 142) completed a knowledge and practices survey and a validated iodine-specific Food Frequency Questionnaire. General practitioners (GP) and nurses (N = 61) participating in the ANSC program completed a short survey which assessed their knowledge about nutrition for pregnancy, focussing on iodine. RESULTS: Both groups had poor knowledge about the importance and roles of iodine during pregnancy. Most women (82%) reported taking a supplement during their current pregnancy, and 70% were taking a supplement containing iodine. Only 26% of GPs discussed iodine supplementation with pregnant patients. The median (IQR) iodine intake of pregnant women was 189 (129-260) µg/day which meets the estimated average requirement (160 µg/day). Half (52%) of women's dietary iodine was provided by dairy foods, and only 7% came from fish and seafood. Most healthcare providers (74%) expressed interest in receiving ongoing professional education about iodine in pregnancy. CONCLUSION AND IMPLICATIONS: Ongoing nutrition education for ANSC health practitioners is required to ensure that women receive sufficient dietary advice for optimal pregnancy outcomes. Further research is required to address reasons behind dietary choices of Australian pregnant women.

Identification and evaluation of models of antenatal care in Australia--a review of the evidence.

BACKGROUND: Antenatal care has been routine practice throughout the world since early in the 20th century, and in most developed countries, antenatal care consists of a scheduled program of individual consultations with a healthcare practitioner, using a doctor or midwife. Women seek antenatal care that provides a physical review of the health and development of their unborn baby, the reassurance and ability to be listened to and the opportunity for their partner to be involved in their care. AIMS: To identify the types of antenatal care services that are available to Australian women and investigate the views and opinions of Australian women related to these services. MATERIALS AND METHODS: A systematic literature review using Scopus and Medline databases was used to find appropriate journal articles in January 2013. Articles were restricted to those in the Australian setting from the past 10 years with a focus on different models of antenatal care and the views and experiences of women during their antenatal care. RESULTS: Eighteen relevant peer-reviewed journal articles were included. Emerging forms of antenatal care that are showing increasing levels of satisfaction from Australian women include continuity of carer, the midwifery-led care and group- or community-led care. These approaches are proving to be safe and successful. CONCLUSION: Newer models of antenatal care in Australia may offer benefits over standard practice.

Improvement in iodine status of pregnant Australian women 3 years after introduction of a mandatory iodine fortification programme.

INTRODUCTION: In order to address population-level mild iodine deficiency in Australia, a mandatory iodine fortification programme of salt used in bread was introduced in late 2009. METHODS: A before-after study was conducted to assess changes in median urinary iodine concentration (MUIC) measurements, according to supplement use, in convenience samples of pregnant women attending a public antenatal clinic in a regional area of New South Wales, Australia in 2008 (n=139), 2011 (n=147) and 2012 (n=114). Knowledge and practices related to iodine nutrition were investigated in 2012, using self-administered questionnaires. RESULTS: The mild iodine deficiency confirmed pre-fortification (MUIC (IQR)=87.5 (62-123.5; n=110)) has steadily improved to 145.5 µg/L (91-252) in 2011 (n=106) and 166 (97-237) in 2012 (n=95) (sufficiency ≥ 150 µg/L). However, only women taking supplements containing iodine had MUIC indicative of sufficiency in both years surveyed post fortification (2011: 178 µg/L vs. 109 µg/L, P<0.001; 2012: 202 µg/L vs. 124 µg/L, P<0.05). Despite bread being the vehicle for iodine fortification, dairy foods remained major contributors to total iodine intake (58%). Overall knowledge regarding health implications of iodine deficiency was poor. CONCLUSIONS: Iodine status of women has improved since the introduction of mandatory iodine fortification; however supplementation is indicated during pregnancy.

Nuclear targeting of 6-phosphofructo-2-kinase (PFKFB3) increases proliferation via cyclin-dependent kinases.

The regulation of metabolism and growth must be tightly coupled to guarantee the efficient use of energy and anabolic substrates throughout the cell cycle. Fructose 2,6-bisphosphate (Fru-2,6-BP) is an allosteric activator of 6-phosphofructo-1-kinase (PFK-1), a rate-limiting enzyme and essential control point in glycolysis. The concentration of Fru-2,6-BP in mammalian cells is set by four 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatases (PFKFB1-4), which interconvert fructose 6-phosphate and Fru-2,6-BP. The relative functions of the PFKFB3 and PFKFB4 enzymes are of particular interest because they are activated in human cancers and increased by mitogens and low oxygen. We examined the cellular localization of PFKFB3 and PFKFB4 and unexpectedly found that whereas PFKFB4 localized to the cytoplasm (i.e. the site of glycolysis), PFKFB3 localized to the nucleus. We then overexpressed PFKFB3 and observed no change in glucose metabolism but rather a marked increase in cell proliferation. These effects on proliferation were completely abrogated by mutating either the active site or nuclear localization residues of PFKFB3, demonstrating a requirement for nuclear delivery of Fru-2,6-BP. Using protein array analyses, we then found that ectopic expression of PFKFB3 increased the expression of several key cell cycle proteins, including cyclin-dependent kinase (Cdk)-1, Cdc25C, and cyclin D3 and decreased the expression of the cell cycle inhibitor p27, a universal inhibitor of Cdk-1 and the cell cycle. We also observed that the addition of Fru-2,6-BP to HeLa cell lysates increased the phosphorylation of the Cdk-specific Thr-187 site of p27. Taken together, these observations demonstrate an unexpected role for PFKFB3 in nuclear signaling and indicate that Fru-2,6-BP may couple the activation of glucose metabolism with cell proliferation.