The Role of Nutritional Status in Elderly Patients with Heart Failure.

Evidence indicates that malnutrition very frequently co-occurs with chronic heart failure (HF) and leads to a range of negative consequences. Studies show associations between malnutrition and wound healing disorders, an increased rate of postoperative complications, and mortality. In addition, considering the increasing age of patients with HF, a specific approach to their treatment is required. Guidelines proposed by the European Society of Cardiology (ESC) for treating acute and chronic HF refer to the need to monitor and prevent malnutrition in HF patients. However, the guidelines feature no strict nutritional recommendations for HF patients, who are at high nutritional risk as a group, nor do they offer any such recommendations for the poor nutritional status subgroup, for which high morbidity and mortality rates have been observed. In the context of multidisciplinary healthcare, recommended by the ESC and proven by research to offer multifaceted benefits, nutritional status should be systematically assessed in HF patients. Malnutrition has become a challenge within healthcare systems and day-to-day clinical practice, especially in developed countries, where it affects the course of disease and patients' prognosis.

Development, reproducibility and validity of the food frequency questionnaire in the Poland arm of the Prospective Urban and Rural Epidemiological (PURE) study.

BACKGROUND: A food frequency questionnaire (FFQ) is the most commonly used method in large epidemiological studies. The validation of an FFQ is essential for specific populations because foods are culture-dependent. The present study aimed to develop an FFQ and evaluate its validity and reproducibility in estimating the intake of nutrients in urban and rural areas of Poland. METHODS: Adult participants (n = 146) in the Polish arm of the ongoing Prospective Urban and Rural Epidemiological (PURE) study completed FFQs on two occasions, as well as four 24-h dietary recalls (DRs) during a 12-month period. Correlation coefficients (r) and de-attenuated correlation coefficients between dietary recalls and both FFQs were calculated for selected macro- and micronutrients. Agreement between the two methods was evaluated by classification into quartiles and the Bland-Altman method. Reproducibility was assessed by the intra-class correlation coefficient (ICC). RESULTS: The final food list contained 134 food items. For urban participants, FFQ2 generally underestimated energy, protein and fat compared to the FFQ1 and mean of DRs. In rural areas, compared to DRs, both FFQs overestimated energy and macronutrients. For both urban and rural settings, de-attenuated correlation exceeded 0.4 for almost all nutrients and the exact agreement in quartile categorisation was >66%. When assessing repeatability, ICC varied from 0.39-0.63 in an urban setting and 0.19-0.45 in a rural setting. CONCLUSIONS: This 134-item FFQ has good validity and reproducibility in relation to the reference method and can be used to rank individuals based on their macro- and micronutrient intake.

Weight reduction in renal transplant recipients program: the first successes.

INTRODUCTION: Overweight and obesity in kidney graft recipients, both at transplantation and further on, are connected with the development of complications of metabolic syndrome. Hypertension, diabetes, and atherosclerosis are risk factors for chronic allograft nephropathy, shortened graft function, and lower recipient life expectancy. The aim of this study was to present the initial results from a weight reduction in renal transplant recipients program. MATERIAL: Thirty-four overweight and obese kidney transplant recipients were enrolled in the study: 9 overweight (26%), 19 obese (55.8%), and 6 morbidly obese (17.6%). The control group encompassed 418 kidney transplant recipients, in whom fluctuations in body mass and body mass index (BMI) were monitored for 56 months. METHODS: During the first visit, we performed an account of dietary habits and anthropometric measurements. At the second visit following a 6-month interval, patients received dietary guidelines based on an analysis of diet questionnaires. RESULTS: Six months after enrollment, despite not having received dietary guidelines during the first visit, only 27% of study subjects and 80% of controls experienced weight gain. CONCLUSIONS: Patients enrolled in the first step of the weight reduction program had no weight nor BMI increase after 6 months. Recipients having experienced body mass increase constituted only 27% of the study group, whereas increase in body mass occurred in 80% of controls. Reducing body mass accretion in kidney transplant recipients should be the target of preventive measures and nonpharmacological therapeutic interventions conducted by qualified personnel. Greater interest by medical personnel in the issue of body mass increase in recipients may be a strong motivating factor for them to undertake weight loss measures.

[Level of cadmium and lead in vegetables, fruit, cereal and soil from areas differing in the degree of industrial pollution and from greenhouses]. / Zawartosc kadmu i olowiu w warzywach, zbozach, owocach i glebie pochodzacych z terenów o zróznicowanym zanieczyszczeniu przemyslowym oraz ze szklarni.

The content of cadmium and lead was measured in vegetables, fruit, cereals and soil from areas exposed and non-exposed to industrial pollution and in vegetables and soil from greenhouses. The elements were measured after dry mineralization by atomic absorption spectrophotometry following extraction of complexes from APDS into the organic phase (MIBK). Lead and cadmium were determined in 482 samples of vegetables, 101 fruit samples, 132 cereal samples and 297 soil samples. In the vegetables from the areas not exposed to industrial pollution lead content was below the detectability range (< d.r.) to 576.1 micrograms/kg, and cadmium was from < d.r. to 73.5 micrograms/kg. In the vegetables from areas exposed to industrial pollution lead was from 9.3 to 1044.0 micrograms/kg and cadmium from < d.r. to 552.3 micrograms/kg and cadmium from 2.3 to 132.5 micrograms/kg. In the soil from greenhouses lead was found in amounts from 17.5 to 212.0 mg/kg of air dry mass (adm), and cadmium from 125 to 750 micrograms/kg of adm. In soil from vegetable gardens lead was from 3.3 to 15.3 mg/kg of adm., and cadmium from < d.r. to 385.0 mu/kg adm. In soil from orchards lead was from 2.8 to 141.3 mg/kg adm, and cadmium from < d.r. to 810.0 micrograms/kg adm. In the soil from fields of cereals lead was from 3.0 to 67.5 mg/kg amd, and cadmium from < d.r. to 295.0 micrograms/kg adm. In fruit lead was present in amounts from 12.8 to 144.0 micrograms/kg and cadmium from < d.r. to 42.0 micrograms/kg. In cereals lead was found in amounts from < d.r. to 760.0 micrograms/kg and cadmium from < d.r. to 200 micrograms/kg.

[Levels of copper and zinc in vegetables, fruit and cereal from areas differing in the degree of industrial pollution and from greenhouses]. / Zawartosc miedzi i cynku w warzywach, owocach i zbozach pochodzacych z terenów o zróznicowanym zanieczyszczeniu przemyslowym oraz ze szklarni.

The content of copper and zinc was determined in vegetables, fruit and cereals derived from areas exposed or non-exposed to industrial pollution and from greenhouses. The elements were determined after dry mineralization by atomic absorption spectrometry immediately from mineral solution. Copper and zinc were measured in 506 samples of vegetables, 101 fruit samples and 117 cereal samples. In the vegetables from areas not exposed to industrial pollution the copper content was from 0.10 to 6.69 mg/kg, and zinc content was from 1.10 to 27.90 mg/kg. In the vegetables from areas exposed to this pollution copper was found in amounts from 0.10 to 3.26 mg/kg and zinc from 0.88 to 27.90 mg/kg. In the vegetables from green-houses copper amounted to 0.14-1.20 mg/kg and zinc from 1.00 to 10.60 mg/kh. In fruit samples copper was found in amounts from 0.04 to 7.01 mg/kg and zinc from 0.60 to 17.30 mg/kg. In cereals copper ranged from 1.14 to 11.68 mg/kg and zinc from 7.20 to 72.07 mg/kg. Table I. Copper in vegetables, fruit and cereals from areas differing in the degree of industrial pollution and from greenhouses copper amounted to 0.14-1.20 mg/kg and zinc from 1.00 to 10.60 mg/kh. In fruit samples copper was found in amounts from 0.04 to 7.01 mg/kg and zinc from 0.60 to 17.30 mg/kg. In cereals copper ranged from 1.14 to 11.68 mg/kg and zinc from 7.20 to 72.07 mg/kg. Table I. Copper in vegetables, fruit and cereals from areas differing in the degree of industrial pollution and from greenhouses.