Milk consumption throughout life and bone mineral content and density in elderly men and women.

UNLABELLED: Association between bone mineral density and bone mineral content in old age and milk consumption in adolescence, midlife, and old age was assessed. The association was strongest for milk consumption in midlife: those drinking milk daily or more often had higher bone mineral density and content in old age than those drinking milk seldom or never. INTRODUCTION: The role of lifelong milk consumption for bone mineral density (BMD) and bone mineral content (BMC) in old age is not clear. Here we assess the association between hip BMD and BMC in old age and milk consumption in adolescence, midlife, and current old age. METHODS: Participants of the Age, Gene/Environment Susceptibility-Reykjavik Study, aged 66-96 years (N = 4,797), reported retrospective milk intake during adolescence and midlife as well as in current old age, using a validated food frequency questionnaire. BMC of femoral neck and trochanteric area was measured by volumetric quantitative computed tomography and BMD obtained. Association was assessed using linear regression models. Differences in BMC, bone volume, and BMD in relation to milk intake were portrayed as gender-specific Z-scores. RESULTS: Men consuming milk ≥ once/day during midlife had 0.21 higher Z-scores for BMD and 0.18 for BMC in femoral neck (95 % confidence interval 0.05-0.39 and 0.01-0.35, respectively) compared with < once/week. Results were comparable for trochanter. For women the results were similar, with slightly lower differences according to midlife milk consumption. For current and adolescent milk consumption, differences in Z-scores were smaller and only reached statistical significance in the case of BMD for current consumption in men, while this association was less pronounced for BMC. CONCLUSIONS: Our data suggest that regular milk consumption throughout life, from adolescence to old age, is associated with higher BMC and BMD in old age, with no differences seen in bone volume. The strongest associations are seen for midlife milk consumption in both genders.

Faster increase in body mass index between ages 8 and 13 is associated with risk factors for cardiovascular morbidity and mortality.

BACKGROUND AND AIMS: Excess childhood weight is associated with cardiovascular disease (CVD) in adulthood. Whether this is mediated through adult body mass index (BMI) and associated risk factors such as metabolic derangements remains unclear. The aim was to examine whether childhood BMI velocity (Δkg m(-2) per year) was associated with adult CVD mortality and to examine how adult BMI and cardiometabolic risk factors contribute to the association. METHODS AND RESULTS: Subjects were 1924 Icelanders born between 1921 and 1935 and living in Reykjavik when recruited into a longitudinal study from 1967 to 1991. From ages 8-13 years, BMI velocity was calculated to quantify the association between childhood growth and adult CVD mortality. Deaths from recruitment to 31 December 2009 were extracted from the national register. There were 202 CVD deaths among men and 90 CVD deaths among women (mean follow-up: 25.9 years). Faster BMI velocity from ages 8-13 years was associated with CVD mortality when comparing those in the highest versus lowest tertile with corresponding hazard ratio (HR) (95% confidence interval (CI)): 1.49 (1.03, 2.15) among men and 2.32 (1.32, 4.08) among women after adjustment for mid-life BMI and CVD risk factors. Faster childhood BMI velocity was associated with elevated CVD risk factors among men at mid-life but these associations were less pronounced among women. CONCLUSION: Faster increase in BMI from ages 8-13 years was associated with an increased CVD mortality risk. Children with early growth spurts coupled with excess weight gain during this transition period from childhood into adolescence should be closely monitored to ensure better health in adulthood.

Effects of an isocaloric healthy Nordic diet on insulin sensitivity, lipid profile and inflammation markers in metabolic syndrome -- a randomized study (SYSDIET).

BACKGROUND: Different healthy food patterns may modify cardiometabolic risk. We investigated the effects of an isocaloric healthy Nordic diet on insulin sensitivity, lipid profile, blood pressure and inflammatory markers in people with metabolic syndrome. METHODS: We conducted a randomized dietary study lasting for 18-24 weeks in individuals with features of metabolic syndrome (mean age 55 years, BMI 31.6 kg m(-2) , 67% women). Altogether 309 individuals were screened, 200 started the intervention after 4-week run-in period, and 96 (proportion of dropouts 7.9%) and 70 individuals (dropouts 27%) completed the study, in the Healthy diet and Control diet groups, respectively. Healthy diet included whole-grain products, berries, fruits and vegetables, rapeseed oil, three fish meals per week and low-fat dairy products. An average Nordic diet served as a Control diet. Compliance was monitored by repeated 4-day food diaries and fatty acid composition of serum phospholipids. RESULTS: Body weight remained stable, and no significant changes were observed in insulin sensitivity or blood pressure. Significant changes between the groups were found in non-HDL cholesterol (-0.18, mmol L(-1) 95% CI -0.35; -0.01, P = 0.04), LDL to HDL cholesterol (-0.15, -0.28; -0.00, P = 0.046) and apolipoprotein B to apolipoprotein A1 ratios (-0.04, -0.07; -0.00, P = 0.025) favouring the Healthy diet. IL-1 Ra increased during the Control diet (difference -84, -133; -37 ng L(-1) , P = 0.00053). Intakes of saturated fats (E%, beta estimate 4.28, 0.02; 8.53, P = 0.049) and magnesium (mg, -0.23, -0.41; -0.05, P = 0.012) were associated with IL-1 Ra. CONCLUSIONS: Healthy Nordic diet improved lipid profile and had a beneficial effect on low-grade inflammation.

Predictors of dropping out in a weight loss intervention trial.

BACKGROUND/AIM: Dropouts in intervention trials can affect the statistical power of the study. The aim was to assess predictors of dropping out in a weight loss trial. METHODS: Each subject (n = 114) was instructed to follow a diet, energy-restricted by 30% from estimated energy expenditure (approximately 600 kcal/day), for 8 consecutive weeks. A detailed meal plan as well as recipe booklets and instructions were provided by a nutritionist. RESULTS: Antidepressants were used by 19.2% of the dropouts, compared with 1.8% of the completers (p < 0.001). Additionally, those dropping out consumed 35% more soft drinks in total and 44% more diet (artificially sweetened) soft drinks at baseline (habitual intake) than those completing the trial (p = 0.012). Dropouts (18.6%) were on average 1.9 years younger than those completing the study, but the difference was of borderline significance (p = 0.085). CONCLUSIONS: The use of antidepressants and heavy habitual soft drink consumption might be considered as exclusion criteria when preparing weight loss intervention trials including dietary restrictions.

Inclusion of fish or fish oil in weight-loss diets for young adults: effects on blood lipids.

OBJECTIVE: To assess the effects of fish (lean or oily) and fish oil consumption on blood lipid concentration during weight loss. DESIGN: Randomized, controlled 8-week trial of energy-restricted diet varying in fish and fish oil content. Subjects, 324 men and women, aged 20-40 years, body mass index 27.5-32.5 kg m(-2), from Iceland, Spain and Ireland, were randomized to one of four groups: (1) control (sunflower oil capsules, no seafood), (2) cod diet (3 x 150 g week(-1)), (3) salmon diet (3 x 150 g week(-1)), (4) fish oil (DHA/EPA capsules, no seafood). The macronutrient composition of the diets was similar between the groups and the capsule groups were single-blinded. MEASUREMENTS: Total cholesterol (TC), high-density lipoprotein (HDL) and low-density lipoprotein cholesterol, triacylglycerol (TG) and anthropometrics were measured at baseline and end point. RESULTS: The difference in logTG lowering between the control group and the cod diet, salmon diet and fish oil from baseline to end point was -0.036 (95% CI -0.079 to 0.006), -0.060 (-0.101 to -0.018) and -0.037 (-0.079 to 0.006), respectively. Reduction in TC was about 0.2 mmol l(-1) greater in the fish groups (cod and salmon) than in the control group, but only of borderline significance when adjusting for weight loss. HDL tended to decrease less in the diet groups consuming a significant amount of n-3 fatty acids (salmon and fish oil). CONCLUSION: Weight-loss diet including oily fish resulted in greater TG reduction than did a diet without fish or fish oil. Controlled trials using whole fish as a test meal are encouraged to be able to elucidate the role of different constituents of fish for human health.

Associations between Proportion of Plasma Phospholipid Fatty Acids, Depressive Symptoms and Major Depressive Disorder. Cross-Sectional Analyses from the AGES Reykjavik Study.

BACKGROUND: Deficits in n-3 fatty acids may be associated with depression. However, data are scarce from older adults who are at greater risk of poor dietary intake and of developing depression. OBJECTIVE: To investigate proportion of plasma phospholipid fatty acids with respect to depressive symptoms and major depressive disorder in community dwelling older adults. METHODS: Cross-sectional analyses of 1571 participants in the Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study aged 67-93 years. Depressive symptoms were measured using the 15-item Geriatric Depression Scale (GDS-15). Major depressive disorder was assessed according to Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria using the Mini-International Neuropsychiatric Interview (MINI). RESULTS: Depressive symptoms were observed in 195 (12.4%) subjects and there were 27 (1.7%) cases of major depressive disorder. Participants with depressive symptoms were less educated, more likely to be smokers, less physically active and consumed cod liver oil less frequently. Difference in GDS-15 scores by tertiles of n-3 fatty acid proportion was not significant. Proportion of long chain n-3 fatty acids (Eicosapentaenoic- + Docosahexaenoic acid) were inversely related to major depressive disorder, (tertile 2 vs. tertile 1) OR: 0.31 (95% CI: 0.11, 0.86); tertile 3 vs. tertile 1, OR: 0.45 (95% CI: 0.17, 1.21). CONCLUSION: In our cross sectional analyses low proportions of long chain n-3 fatty acids in plasma phospholipids appear to be associated with increased risk of major depressive disorder. However, the results from this study warrant further investigation in prospective setting with sufficiently long follow-up.

Association between healthy maternal dietary pattern and risk for gestational diabetes mellitus.

BACKGROUND/OBJECTIVES: Gestational diabetes mellitus (GDM) is associated with negative health effects for mother and child. The aim was to investigate the association between maternal dietary patterns and GDM. SUBJECTS/METHODS: Prospective observational study including 168 pregnant women aged 18-40 years, recruited at routine 20-week ultrasound. All participants kept a 4-day weighed food record following recruitment (commencement: gestational weeks 19-24). Principal component analysis was used to extract dietary patterns from 29 food groups. A Healthy Eating Index (HEI) was constructed. All women underwent an oral glucose tolerance test in weeks 23-28. RESULTS: One clear dietary pattern (Eigenvalue 2.4) was extracted with positive factor loadings for seafood; eggs; vegetables; fruits and berries; vegetable oils; nuts and seeds; pasta; breakfast cereals; and coffee, tea and cocoa powder, and negative factor loadings for soft drinks and French fries. This pattern was labeled a prudent dietary pattern. Explained variance was 8.2%. The prevalence of GDM was 2.3% among women of normal weight before pregnancy (n=86) and 18.3% among overweight/obese women (n=82). The prudent dietary pattern was associated with lower risk of GDM (OR: 0.54; 95% CI: 0.30, 0.98). When adjusting for age, parity, prepregnancy weight, energy intake, weekly weight gain and total metabolic equivalent of task the association remained (OR: 0.36; 95% CI: 0.14, 0.94). Similar results were found when only including overweight or obese women (OR: 0.31; 95% CI: 0.13, 0.75). CONCLUSIONS: Adhering to a prudent dietary pattern in pregnancy was clearly associated with lower risk of GDM, especially among women already at higher risk because of overweight/obesity before pregnancy.

Maternal body mass index, duration of exclusive breastfeeding and children's developmental status at the age of 6 years.

OBJECTIVE: To investigate whether the duration of exclusive breastfeeding and maternal body mass index (BMI) are associated with children's developmental status at the time of beginning elementary school. DESIGN AND SUBJECTS: The subjects in the sample came from a longitudinal study on infant nutrition in Iceland. Food records were made once a month from birth to the age of 12 months, from which duration of exclusive breastfeeding could be determined. Mothers filled in The Icelandic developmental inventory for evaluation of motor and verbal development close to their children's sixth birthday (n = 85). Maternal self-reported weight and height was recorded. Information on socioeconomic factors was gathered by a questionnaire. RESULTS: Duration of exclusive breastfeeding, in months, was positively related to children's motor component (B = 0.5+/-0.5, P = 0.054) and to the total developmental index (B = 1.0+/-0.5, P = 0.044) at 6 y, adjusting for gender and socioeconomic factors (maternal and paternal education, and family income). Children's learning score was negatively related to maternal BMI (B = -0.5+/-0.2, P=0.047). An inverse association also appeared between maternal BMI and two out of the three developmental composite scores, that is, verbal component and the total developmental index (B = -0.6+/-0.3, P=0.049) and (B = -0.4+/-0.2, P=0.057), respectively. In multiple regression the developmental indexes were most strongly independently associated with maternal BMI (negatively) and infants' birth weight (positively). CONCLUSION: Maternal BMI and duration of breastfeeding were associated with verbal and motor development of 6-y-old children, independent of socioeconomic factors. Birth weight was also an independent determinant for developmental scores.

Screening method evaluated by nutritional status measurements can be used to detect malnourishment in chronic obstructive pulmonary disease.

OBJECTIVE: To evaluate and develop a screening method for malnutrition among patients with chronic obstructive pulmonary disease (COPD). DESIGN: Findings from a screening sheet for malnutrition were compared with results from full nutritional assessment. The screening sheet included 7 questions regarding body mass index, anorexia, loss of weight, and other variables possibly affecting nutritional status. Each answer was assigned a point value, and a total of 4 and 5 points were tested as criterion for malnutrition. Full nutrition assessment included measurements of weight and height (body mass index), serum albumin and prealbumin, total lymphocyte count, triceps skinfold thickness, mid-arm muscle circumference or area, and information on unintentional weight loss. Malnutrition was defined by 3 or more values below reference values. SUBJECTS: Randomly selected patients (n = 34) with a clinical diagnosis of COPD, 15% of eligible patients admitted to the Department of Lung Medicine at National University Hospital, Reykjavik, Iceland, during the time of the study. STATISTICAL ANALYSIS: Sensitivity, specificity, and predictive values were calculated to evaluate the screening sheet. Each of the 7 parameters used in a full nutrition assessment was similarly evaluated as an indicator to predict malnutrition. RESULTS: Full nutrition assessment identified 13 of 34 patients (38%) as malnourished. Using 4 points as a criterion for malnutrition, the screening sheet to be used for patients with COPD resulted in sensitivity of 0.69 and specificity of 0.90. CONCLUSION: The results confirm the frequent finding of malnutrition among patients with COPD and show that a simple screening sheet can be used to identify which patients need further nutrition assessment and treatment.

Birth weight, growth and feeding in infancy: relation to serum lipid concentration in 12-month-old infants.

OBJECTIVE: To assess the effects of birth size, growth and feeding in infancy on serum lipids in 12-month-old infants. DESIGN: A longitudinal observation study on infants' consumption and growth. Food and growth records were made every month. At 6, 9 and 12 months, food records were weighed to calculate intake. Serum total cholesterol (TC), high-density lipoprotein-cholesterol (HDL), low-density lipoprotein (LDL) -cholesterol and triglyceride concentrations were analysed at 12 months. SETTINGS: Birth and growth information was gathered from maternity wards and healthcare centres in Iceland and food consumption data at home. SUBJECTS: Randomly selected newborns (n=180) according to the mother's domicile and 77% (n=138) participated, of them 75% (n=103), came in for blood sampling. RESULTS: Among boys, a 1 kg higher birth weight resulted in a 0.79 mmol/l higher TC (P=0.005), but nonsignificant after adjustment for growth. Duration of breastfeeding was related to LDL-cholesterol (B=0.06 +/-0.02, P=0.020, adj. R(2)=0.039), adjusting for gender. Independent of size at birth and breastfeeding, increase in length from 6 to 12 months and in weight from birth to 12 months were negatively related to TC (B=-0.455+/-0.156, P=0.008 and B=-1.086+/-0.474, P=0.032, respecitvely) in boys. PUFA was the strongest nutrient variable predicting TC (B=0.332, adj. R(2)=0.24, P>0.001). Cod liver oil consumption increased both TC and LDL-cholesterol in girls (B=0.141+/-0.051, P=0.008 and B=0.112+/-0.047, P=0.021, respectively). CONCLUSION: Slower growth of high birth weight infants and breastfeeding contributes to higher TC concentration at the age of 12 months. Nutrient intake in infancy also affects lipid profile. The effect of birth weight, growth and nutrient intake in infancy on lipid profile is different for boys and girls.