Estimation of salt intake assessed by urinary excretion of sodium over 24 h in Spanish subjects aged 7-11 years.

PURPOSE: High intake of salt is associated with early development of cardiovascular risk factors (e.g., hypertension, obesity). In "developed" countries, individuals frequently exceed dietary recommendations for salt intake. Taking into account the limited data on sodium intake by 24-h excretion in urine in schoolchildren, we wished to determine baseline salt intake in Spanish subjects aged 7-11 years. METHODS: The present study was an observational study involving 205 schoolchildren (109 boys and 96 girls) selected from various Spanish provinces. Sodium intake was ascertained by measuring sodium excretion in urine over 24 h. Creatinine was used to validate completeness of urine collections. The correlation between fat-free mass determined by anthropometry and that determined via urinary excretion of creatinine was calculated (r = 0.651; p < 0.001). RESULTS: Mean 24-h urinary excretion of sodium was 132.7 ± 51.4 mmol/24 h (salt equivalent: 7.8 ± 3.1 g/day). Hence, 84.5 % of subjects aged ≤10 years had intakes of >4 g salt/day, and 66.7 % of those aged >10 years had intakes of >5 g salt/day. Urinary excretion of sodium was correlated with systolic blood pressure and diastolic blood pressure (r = 0.1574 and r = 0.1400, respectively). Logistic regression analyses, adjusted by sex, showed that a high body mass index (odds ratio = 1.159; 95 % CI 1.041-1.290; p < 0.05) was associated with an increased likelihood of high urinary excretion of sodium. CONCLUSIONS: Sodium intake, as estimated by 24-h urinary excretion, was (on average) higher than recommended. Reducing the sodium content children's diet is a sound policy to reduce cardiovascular risk.

Selenium status in a group of schoolchildren from the region of Madrid, Spain.

BACKGROUND: To assess the selenium status of a group of schoolchildren from the Region of Madrid, Spain. METHODS: Study subjects comprised 483 children (216 boys and 267 girls) aged between 8 and 13 years. Selenium intake was determined using a 3-day food record. The foods consumed were transformed into energy and nutrients, and the selenium intake was compared with that recommended. Serum selenium levels were also recorded. RESULTS: Mean (SD) selenium intake [91.0 (25.2) µg day(-1) ] was above the recommended level in 99.4% of subjects; the main dietary sources were cereals, meats, fish and milk products. The serum selenium concentration [mean (SD) 71.1 (14.4) µg L(-1) ], however, was <60 µg L(-1) in 13.9% of subjects, and <45 µg L(-1) in 5.6%. The serum selenium concentration correlated with the selenium intake (r = 0.169; P < 0.05). Children with a serum selenium concentration of <75 µg L(-1) had significantly smaller selenium intakes than those with a serum concentration of ≥75 µg L(-1) . CONCLUSIONS: Although selenium intake was generally above that recommended, the serum selenium concentration of the children could be improved. This could be achieved by increasing the relative consumption of cereals and other selenium rich foods such as fish.

Dietary glycaemic load and odds of depression in a group of institutionalized elderly people without antidepressant treatment.

BACKGROUND: Depression is a very common disorder in elderly, especially in those institutionalized. Nutrition could play an important role in the onset and/or progression of depression, since the intake of carbohydrates with a high glycaemic index (GI) or diets with a high glycaemic load (GL) may increase the insulin-induced brain serotonin secretion. OBJECTIVE: The aim of our study was to analyse the association between dietary GI and GL and the odds of suffering depression in institutionalized elderly people without antidepressant treatment. METHODS: This cross-sectional study included 140 institutionalized elderly people from the Madrid region (Spain) (65-90 years of age) whose diets were recorded using a precise weighing method over seven consecutive days. Energy and nutrient intakes were recorded and the GI and GL calculated. The participants' affective capacity was assessed using the Geriatric Depression Scale (GDS). Subjects were grouped into non-depressed (GDS ≤ 5) and depressed (GDS > 5). Since GDS scores and gender were statistically associated (p < 0.01), the data were grouped considering this association. RESULTS: Dietary GI (51.09 ± 3.80) and GL (97.54 ± 13.46) were considered as medium. The dietary GL was significantly higher in the non-depressed (100.00 ± 12.13) compared with the depressed group (93.97 ± 14.04, p < 0.01). However, a similar GI was observed between non-depressed (51.50 ± 3.29) and depressed groups (50.52 ± 4.46). Additionally, participants with a dietary GL placed in the second and third tertiles had a 67.4 % and 65.3 %, respectively, less odds of suffering depression than those in the first tertile. GDS scores and dietary GL were inversely related; therefore, an increase in one unit in the dietary GL scale decreased the GDS score by 0.058 units. CONCLUSIONS: Glyaemic load is associated with a lower odd of depression.

Vitamin D intake and dietary sources in a representative sample of Spanish adults.

BACKGROUND: Vitamin D plays an essential role in bone mineralisation and its deficiency is associated with several chronic diseases. Some studies have reported a deficient status of vitamin D in Spanish and European population. The present study aimed to assess vitamin D intake, dietary sources of this nutrient and its adequacy with respect to the dietary reference intakes (DRI) in a representative sample of Spanish adults. METHODS: Four hundred and eighteen adults (aged 18-60 years) from 15 Spanish provinces were studied. They constituted a representative sample of the Spanish adult population. Energy and nutrient intake were determined using a 24-h dietary recall questionnaire for two consecutive days. Vitamin D intake was compared with the DRI for this vitamin. RESULTS: Mean (SD) vitamin D intake was 3.5 (4.0) µg day(-1) (69.5% of the DRI). Of the participants studied, 81.6% had vitamin D intakes below the DRI and 68.7% had intakes below 67% of the DRI. Of the vitamin D, 91.4% came from food sources and 8.6% came from dietary supplements. The main food sources of vitamin D were fish, eggs, dairy products, cereals, oils and meat. In addition, those subjects who met the DRI for vitamin D had a higher consumption of fish, vegetables and fruits and a lower consumption of meats than those subjects who did not meet the DRI. CONCLUSIONS: Vitamin D intake was inadequate in the sample of the adult Spanish population. Therefore, an increase in the consumption of oily fish, as well as fortified dairy products and cereals, might help to improve vitamin D intake.

Effects of omega 3 fatty acids supplementation in behavior and non-neurodegenerative neuropsychiatric disorders.

This work provides a systematic review of all published randomised, controlled clinical trials (RCT) investigating the effects of n-3 PUFA intake on the prevention and treatment of non-neurodegenerative neuropsychiatric disorders. Five databases (PubMed, EMBASE, LILACS, CINAHL and The Cochrane Database) were searched for RCT in this area published up to April 2011. The selected studies all involved human participants and included a comparison group. Thirty eight studies were identified, which examined the influence of n-3 PUFA supplementation on the prevention/treatment of depression (non-perinatal) (n 23), perinatal depression (n 6) and attention deficit hyperactivity disorder (ADHD) (n 9). Great heterogeneity was noticed in terms of study design, the doses of n-3 PUFA administered, and study duration. Some benefit was noted with respect to the treatment of hyperactivity and depression in over half the examined studies, although the evidence was not conclusive. For any firm conclusions to be drawn, further studies will be needed that take into account the initial n-3 PUFA status of the subjects. Excessive n-3 PUFA intakes might be associated with a greater risk of peroxidation events and therefore neuropsychiatric deterioration. Indeed, some studies only recorded benefits when lower doses were administered. It is therefore important that the dose required to achieve any potential benefit be determined.

Poor zinc status is associated with increased risk of insulin resistance in Spanish children.

Zn plays a key role in the synthesis and action of insulin. The aim of the present work was to determine whether a poorer Zn status was associated with insulin resistance in a group of 357 Spanish schoolchildren. Zn intake was determined by using a 3 d food record (i.e. Sunday to Tuesday). The body weight, height and waist and hip circumferences of all subjects were recorded and fasting plasma glucose, insulin and Zn concentrations were determined. Insulin resistance was determined using the homoeostasis model assessment (HOMA) marker. Children (11·5 %) with Zn deficiency (serum Zn concentration < 10·7 µmol/l) had higher HOMA values than those with a more satisfactory Zn status (1·73 (sd 0·93)) compared with 1·38 (sd 0·90; P < 0·05). An inverse correlation was found between the HOMA value and the serum Zn concentration (r - 0·149, P < 0·05). The risk of having a greater insulin resistance value (HOMA greater than the 75th percentile) increased with age (OR 1·438; 95 % CI 1·021, 2·027) and BMI (OR 1·448; 95 % CI 1·294, 1·619) and decreased as Zn serum levels increased (OR 0·908; 95 % CI 0·835, 0·987; P < 0·001). Moreover, an inverse relationship was observed between HOMA values and Zn dietary density (r - 0·122), and the Zn intakes of male children with a HOMA value of >3·16 made a significantly smaller contribution to the coverage of those recommended (59·7 (sd 14·7) %) than observed in children with lower HOMA values (73·6 (sd 18·2) %; P < 0·05). Taking into account that Zn intake was below than that recommended in 89·4 % of the children, it would appear that increasing the intake of Zn could improve the health and nutritional status of these children, and thus contribute to diminish problems of insulin resistance.

[Obesity, insulin resistance and increase in adipokines levels: importance of the diet and physical activity]. / Obesidad, resistencia a la insulina y aumento de los niveles de adipoquinas: importancia de la dieta y el ejercicio físico.

With obesity the amount of pro- and anti-inflammatory adipokines released is increased within the fat tissue. These molecules are implicated in many clinical manifestations of this pathology such as diabetes, arterial hypertension, or cardiovascular disease. At the first stage, the fat tissue of the obese patient becomes resistant to the action of insulin due to the effect of some of these adipokines such as tumour necrosis alpha (TNF-alpha) or interleukine-6 (IL-6). At a second stage, this resistance occurs at other tissues and glucose and insulin levels are increased. This increase, together with high adipokines levels that occur in diabetes, lead to the occurrence of different adverse events, such as the following: increase in oxidative stress, endothelial dysfunction, increase in blood pressure, and impairments in lipoprotein metabolism, all of which are harmful for health. Practising physical activity and following a balanced diet, similar to the Mediterranean pattern with low fat and salt consumption, would be helpful for improving insulin resistance and adipokines levels in obese people, thus helping improving their health status in the long run.

[Mother's age as a conditioning factor of food consumption and energy and nutrients intake of their offspring at pre-school age]. / La edad de la madre como condicionante del consumo de alimentos y la ingesta de energía y nutrientes de sus hijos en edad preescolar.

OBJECTIVES: The aim of this study was to analyse whether the mother's age at the offspring's birth may condition food consumption and energy and nutrients intake as well as the appropriateness of the diet of their offspring at pre-school age. MATERIALS AND METHODS: socio-economic, anthropometrical, and dietary data were collected from a group of 103 pre-school children from Madrid, and the population was divided according to the mother's age (= 26 years (percentile 25) or < 26 years) at birth. RESULTS: Twenty-two point five of the mothers of the preschool children studied had their offspring before 26 years of age and 6.8% before 18. Children from younger mothers consumed less sugars (p < 0.01) and alcohol-free beverages (p < 0.05), but also less fruits (p < 0.01) and others (p < 0.05). The energy from fats was lower (p < 0.05) and that from carbohydrates higher (p < 0.05) among children with older mothers. Besides, the lipid profile was also better in this children, with less caloric intake from polyunsaturated fats (p < 0.05). Besides, fibre (p < 0.05) and vitamin C (p < 0.001) intake was higher in children from older mothers. CONCLUSIONS: It seems that mother's age may have an influence on dietary habits of their children and be a protection factor against dietary inappropriateness of the offspring, so that younger mothers might need special counselling in this respect.

[Body weight perception and dieting behaviour in Spanish population]. / Percepción del peso corporal y medidas adoptadas para su control en población española.

INTRODUCTION: A high percentage of the population initiate or keep diets to lose weight independently of suffering or not overweight/obesity. Nevertheless, exists a great unknowledge on the more convenient guidelines to achieve this aim. OBJECTIVE: To analyze weight perception and types of behavior to control the corporal weight in Spanish adults in order to be able to start the campaigns most adapted to provide a correct nutritional information to the population. METHODS: 2,168 subjects (18 +/- 50 years) of 5 Spanish provinces were studied. Anthropometric and information about the worry about corporal weight data was obtained. RESULTS: 65.6% of subjects declare a desire to lose weight and 44.9% have followed diets with this purpose in some moment (especially in female population). 63.9% of subjects increase physical activity to control weight, 23.9% consumes dietetic products or medicinal herbs and 48.0% compensate the excesses when they try to lose weight. Sweets (24.5%), fats (15.4%), pastries (11.4%) and bread (11.4%) are avoided and fruits and vegetables consumption is increased (specially by women) when try to lose weight. CONCLUSIONS: Weight loss practices use to be inadequate due to the desire to lose weight quickly and to the unknowledge about the most adecuate diet to achieve this aim. It is necessary to avoid this type of practices and to improve the knowledge on nutrition in the population.

Vitamin B6 status improves in overweight/obese women following a hypocaloric diet rich in breakfast cereals, and may help in maintaining fat-free mass.

OBJECTIVE: To analyze the changes in vitamin B6 status in women following slightly hypocaloric diets based on the relative increase consumption of foods whose intakes are below those recommended, and to study how these changes influence the proportion of fat-free mass. DESIGN: Intervention study of two slightly hypocaloric diets: diet V (increased consumption of vegetables), or diet C (increased consumption of cereals, especially breakfast cereals). SUBJECTS: A total of 49 women with a body mass index (BMI) of 25-35 kg/m2. MEASUREMENTS: Dietetic, anthropometric and biochemical data were collected at the start of the study and at 2 and 6 weeks. RESULTS: Both the C and V subjects showed a reduction in their energy intake, body weight, BMI and fat mass. Pyridoxine intake increased in both groups and plasma pyridoxal phosphate (PLP) levels increased only with diet C. An association was found between the increase in plasma PLP at 6 weeks and the increase in pyridoxine intake (r=0.451; P<0.01). Multiple regression analysis showed a positive association between the increase in PLP at the end of the study and the increases in the pyridoxine intake, B6 density or B6/protein ratio. At the end of the study, and only in those women whose PLP levels were increased, the higher the increase in PLP level, the higher the increase in fat-free mass percentage (r=0.4426, P<0.05). CONCLUSIONS: Interventions aimed at weight control should also try to maintain or improve nutritional status. A diet rich in cereals (especially fortified breakfast cereals) appears to be useful in improving vitamin B6 status. Such an improvement could help maintain fat-free mass during periods of weight loss.

Changes in thiamin intake and blood levels in young, overweight/obese women following hypocaloric diets based on the increased relative consumption of cereals or vegetables.

OBJECTIVE: To analyse the changes in thiamin intake and blood levels of young, overweight/obese women following slightly hypocaloric diets based on the increased relative consumption of foods whose intakes were most removed from the ideal: cereals and vegetables. DESIGN: The women were randomly assigned to one of two slightly hypocaloric diets: diet V, in which the consumption of vegetables was increased, or diet C, in which the consumption of cereals (especially breakfast cereals) was increased. SUBJECTS: The study subjects were 67 young women with a body mass index of 24-35 kg/m2. INTERVENTIONS: Dietetic, anthropometrics and biochemical data were collected at the start of the study and again at 2 and 6 weeks. RESULTS: The reduction in energy intake was similar in both groups. However, diet C subjects lost significantly more weight. Blood thiamin concentration was higher in group C women than in group V women at 2 and 6 weeks. Compared to initial values, group C subjects showed a higher blood thiamin level at 2 weeks. The highest blood thiamin levels seen in group C women may have been due to their greater thiamin intake, their higher thiamin dietetic density, and a higher thiamin/carbohydrates ratio at both week 2 and 6 of the intervention period. CONCLUSIONS: Increasing the relative consumption of breakfast cereals within the context of a slightly hypocaloric diet can help in weight control and improve thiamine intake and blood levels.

Modification of iron status in young overweight/mildly obese women by two dietary interventions designed to achieve weight loss.

AIMS: To determine the modification of iron status in a group of overweight/mildly obese women following two different weight control programs. METHODS: The study subjects were 57 women who were assigned to one of two slightly hypocaloric diets: V (increased consumption of vegetables), or C (increased consumption of cereals, especially breakfast cereals). All data were determined at the start of the study and at 2 and 6 weeks into the dietary intervention period. RESULTS: Both diets led to a reduction in body weight and heme iron intake, and an increase in the intake of total and non-heme iron, at 2 and 6 weeks. At 6 weeks, a reduction in transferrin levels was seen in C subjects. Subjects with the worst initial iron status (hemoglobin

[Dietary habits and their relationship with the knowledge on the concept of a balanced diet in a group of young women with overweight/obesity]. / Hábitos alimentarios y su relación con los conocimientos, respecto al concepto de dieta equilibrada, de un colectivo de mujeres jóvenes con sobrepeso/obesidad.

OBJECTIVE: To know the dietary habits of a population of women with overweight/obesity and their knowledge on the concept of proper feeding in order to design nutrition educational campaigns focused on this population. MATERIALS AND METHODS: A group of 67 women, aged 20 to 35 years with body mass index 24-35 kg/m2 were asked about their frequency of food intake and what they thought to be correct to achieve a balanced diet. RESULTS: Studied women more frequently consumed oils (4.3 +/- 4.5 times/week) and sweets (2.5 +/- 3.6 times/week) and less frequently water (-19.1 +/- 22.7 times/week), vegetables (-4.3 +/- 5.7 times/week), fruits (-3.7 +/- 6.2 times/week), legumes (-1.3 +/- 2.0 times/week) and fish (-2.2 +/- 3.7 times/week) than what they thought they should consume. When comparing what they declare to consume to what has been established as minimal recommended intake for the different groups of foods it is observed that the intake of grains and legumes, fruits and vegetables, and slightly less that of fish and eggs, should de increased. CONCLUSIONS: given the incorrect dietary habits observed in a population of women with overweight/obesity, it should be convenient to carry out nutrition educational campaigns. This education could help improve the diet of all the population and the occurrence of overweight and obesity could be prevented in many cases. Besides, in those cases in which the pathology is already present, this could prevent following regimens that are harmful for the health and for weight management.

[Last will and testament: decision-making at the end of one's life]. / Testamento vital. La toma de decisiones en el final de la vida.

Current medical practice has made great progress over the past century which permits people to live longer and better than before. But this improvement has not been transferred to the field of death. To die with dignity today is a privilege only a few have. Those close to death claim their right to a death with dignity. Their petition usually goes unheard by the medical profession. The patients' autonomous law, which regulates last will and testaments or anticipated final wishes, is a step in this direction. The objective of this article is to publicize the current legal regulations related to last wills and testaments or last wishes by means of a critical review of the existing legislation.

Supplementation of grazing beef cows during gestation as a strategy to improve skeletal muscle development of the offspring.

The appropriate supply of nutrients in pregnant cows has been associated with the optimal development of foetal tissues, performance of their progeny and their meat quality. The aim of this study was to evaluate supplementation effects of grazing cows in different stages of gestation on skeletal muscle development and performance of the progeny. Thereby, 27 Nellore cows were divided into three groups (n=9 for each group) and their progeny as follows: UNS, unsupplemented during gestation; MID, supplemented from 30 to 180 days of gestation; LATE, supplemented from 181 to 281 days of gestation. The percentage composition of the supplement provided for the matrices was the following: ground corn (26.25%), wheat bran (26.25%) and soya bean meal (47.5%). The supplement was formulated to contain 30% CP. Supplemented matrices received 150 kg of supplement (1 and 1.5 kg/day for cows in the MID and LATE groups, respectively). After birth, a biopsy was performed to obtain samples of skeletal muscle tissue from calves to determine number and size of muscle fibres and for messenger RNA (mRNA) expression analysis. The percentage composition of the supplement provided for the progeny was the following: ground corn grain (30%), wheat bran (30%), soya bean meal (35%) and molasses (5%). The supplement was formulated to contain 25% CP and offered in an amount of 6 g/kg BW. Performance of the progeny was monitored throughout the suckling period. Means were submitted to ANOVA and regression, and UNS, MID and LATE periods of supplementation were compared. Differences were considered at P0.10). Similarly, no differences were observed between calves for nutrient intake (P>0.10). However, greater subcutaneous fat thickness (P=0.006) was observed in the calves of LATE group. The ribeye area (P=0.077) was greater in calves born from supplemented compared with UNS cows. The supplementation of pregnant cows did not affect the muscle fibre size of their progeny (P=0.208). On the other hand, calves born from dams supplemented at mid-gestation had greater muscle fibre number (P=0.093) compared with calves from UNS group. Greater mRNA expression of peroxysome proliferator-activated receptor α (P=0.073) and fibroblast growth factor 2 (P=0.003) was observed in the calves born from MID cows. Although strategic supplementation did not affect the BW of offspring, it did cause changes in carcass traits, number of myofibres, and mRNA expression of a muscle hypertrophy and lipid oxidation markers in skeletal muscle of the offspring.

[Response to a weight control program based on approximating the diet to its theoretical ideal]. / Respuesta ante un programa de control de peso basado en la aproximación de la dieta al ideal teórico.

UNLABELLED: Obesity is a risk factor for a number of degenerative diseases common in industrial societies and the number of overweight/obese people continues to grow. The control of body weight is therefore a priority public health objective. OBJECTIVE: To analyze the response to a weight loss program based on approximating the diet to the theoretical ideal (by increasing the consumption of recommended foods under-represented in the diet: cereals and vegetables). SUBJECTS: The study involved 67 women aged between 20 and 35 years with a body mass index (BMI) of between 24 and 35 kg/m2. These women were randomly assigned to two groups with the aim of improving weight control and of approximating the diet to the theoretical ideal. INTERVENTIONS: Both groups were advised to follow a slightly hypocaloric diet, but with one group increasing the intake of greens and vegetables (H) and the other increasing the intake of cereals (especially breakfast cereals) (C). Dietary data were obtained via the keeping of a daily food record over three days, including a Sunday. Anthropometric data were obtained at the start of the study and again 2 and 6 weeks later. RESULTS: Both treatments approximated the energy profile of the diets to the theoretical ideal. The amount of energy gained from lipids fell and that gained from carbohydrates increased (both at 2 and 6 weeks), significantly more so for group C. Fifty seven women completed the study and showed a mean reduction in body weight of 2.4 +/-1.4 kg. The weight lost by group C was significantly greater than that lost by group H (2.8 +/- 1.4 kg compared to 2.0 +/- 1.3 kg; p < 0.05). The women who followed diet C showed a greater number of skin folds of significantly reduced size, both at 2 and 6 weeks. More group C women completed the study (93.5% compared to 77.8% of group H women). CONCLUSION: In overweight or slightly obese women, approximating the diet to the theoretical ideal (by increasing the intake of vegetables of cereals) can help to control body weight and improve the quality of the diet (both in terms of the number and size of food rations, and the overall energy profile). The present results show that increasing the consumption of breakfast cereals may be of particular use owing to their high fiber, vitamin and iron contents.

Vitamin A status during the third trimester of pregnancy in Spanish women: influence on concentrations of vitamin A in breast milk.

We examined the relation between the vitamin A status of Spanish women during pregnancy and concentrations of vitamin A in breast milk. The subjects were 57 healthy, lactating women aged 18-35 y. Vitamin A intake was determined during the third trimester of pregnancy by using a 5-d dietary record that included a Sunday and by recording the quantities provided by supplements. HPLC was used to determine vitamin A concentrations in subjects' serum during the third trimester, in transitional breast milk (on days 13-14 of lactation), and in mature breast milk (on day 40). During the third trimester, 33.3% of subjects had vitamin A intakes from diet and supplements < 800 microg/d, the recommended value. These subjects had serum and breast milk vitamin A concentrations that were significantly lower than those of subjects who consumed greater quantities of the vitamin. Furthermore, subjects with serum vitamin A concentrations < 1.05 micromol/L during the third trimester (22.8%) had lower mean (+/- SD) concentrations of the vitamin in mature breast milk than did subjects with higher serum concentrations (1.8 +/- 1.2 micromol/L compared with 2.6 +/- 0.8 micromol/L; P < 0.05). These results show that vitamin A intake and serum vitamin A concentrations during pregnancy influence the composition of breast milk. Given that 12.3% of subjects had < 1.40 micromol vitamin A/L in mature breast milk, it seems advisable to follow and, if necessary, improve vitamin A status during pregnancy and lactation.

Influence of smoking on vitamin E status during the third trimester of pregnancy and on breast-milk tocopherol concentrations in Spanish women.

Concentrations of antioxidants in breast milk probably define the degree of protection it can offer against peroxidation. The aim of the present investigation was to determine the differences in vitamin E status of Spanish women smokers and nonsmokers in their third trimester of pregnancy and the concentrations of tocopherol in their milk. Vitamin E intake was determined during the third trimester of pregnancy by using a 5-d dietary record (including a Sunday) and by recording the quantities provided by supplements. HPLC was used to determine vitamin E concentrations in subjects' serum during the third trimester, in transitional breast milk on days 13-14 of lactation, and in mature breast milk on day 40 of lactation. Subjects also answered a questionnaire about their smoking habits during pregnancy. Subjects were grouped as nonsmokers (71.9%; n = 41) or smokers (28.1%; n = 16). Although vitamin E intake was somewhat greater in nonsmokers, the difference was not significant. Ratios of vitamin E to polyunsaturated fatty acids were practically the same in both groups. The use of vitamin E supplements was limited and did not modify the results of the study. No significant differences in these serum indexes were found between smokers and nonsmokers, and no subject had deficient serum vitamin E concentrations. However, vitamin E concentrations in mature milk were significantly lower in smokers than in nonsmokers. Although it is already known that maternal smoking favors peroxidation events in newborns, if the concentration of antioxidants (vitamin E) in smokers' breast milk is also lower, it might aggravate the peroxidation problems of their newborns.

Dietary intake and cognitive function in a group of elderly people.

Associations between dietary intake and cognitive performance were examined in 260 elderly people aged 65-90 y who were free of significant cognitive impairment. Dietary intake was monitored with a weighed-food record for 7 consecutive days. The subjects' cognitive capacity was tested by using Folstein et al's Mini-Mental State Examination (MMSE) and Pfeiffer's Mental Status Questionnaire (PMSQ). Subjects with adequate MMSE results (> or = 28 points) had lower intakes of monounsaturated fatty acids, saturated fatty acids, and cholesterol, and higher intakes of total food, fruit, carbohydrate, thiamine, folate, and vitamin C compared with those with less satisfactory results. Subjects who made no errors on the PMSQ had greater intakes of total food, vegetables, fruit, carbohydrate, fiber, folate, vitamin C, beta-carotene, iron, and zinc, and lower intakes of saturated fatty acids compared with those who made errors. Our results agree with those of other authors indicating that intakes of different nutrients or the consumption of a more satisfactory global diet is associated with better cognitive function in the elderly. However, more research is required to determine whether differences in intake of a particular nutrient are the result of or a conditioning factor for incipient impaired cognition. Unmeasured confounding factors may also affect both dietary intake and risk of cognitive impairment. A diet with less fat, saturated fat, and cholesterol, and more carbohydrate, fiber, vitamins (especially folate, vitamins C and E, and beta-carotenes), and minerals (iron and zinc) may be advisable not only to improve the general health of the elderly but also to improve cognitive function.

Is obesity worth treating in the elderly?

Obesity is associated with a range of health problems and affects an increasing number of people. However, the body mass index (BMI) that is associated with minimum mortality increases with age. Therefore, when a bodyweight loss programme is initiated, the possible benefits should be carefully measured against the potential risks. Elderly people with severe obesity, or those who have associated health risks such as hypertension or diabetes mellitus, are in greatest need of bodyweight control. The use of drugs may be advisable in some individuals, but the treatment duration should be short and administered under strict supervision. Many studies have shown that habitual, moderate physical activity and dietary improvement (i.e. moderating fat intake, avoiding micronutrient deficiencies and increasing fibre consumption) can be useful in achieving bodyweight control in the elderly. These measures are especially effective in improving nutritional status and may therefore be recommended in elderly individuals.