Attention-deficit hyperactivity disorder is associated with disordered eating in adolescents.

AIM: Attention-deficit hyperactivity disorder (ADHD) and disordered eating (DE) are both highly prevalent among adolescents, but their relationship is understudied. This study examines their possible association in a nationally representative sample of adolescents. METHODS: Participants in the Israeli Youth Health and Nutrition Survey (2015-2016), a cross-sectional, school-based study, completed self-administered questionnaires, including the SCOFF questionnaire, and underwent anthropometric measurements. An affirmative reply to at least two SCOFF items was considered a DE case. Multivariable logistic regression evaluated the ADHD-DE association and the associations between ADHD and individual SCOFF items, controlling for age, sex, socioeconomic status, and body mass index. RESULTS: Of 4616 participants (12-18 years, 50.2% male), 654 reported an ADHD diagnosis. DE prevalence among ADHD adolescents was significantly higher than the non-ADHD group (50.2% vs. 43.9%, p = 0.003). Controlling for potential covariates, the association between ADHD and DE remained significant (OR = 1.409; 95% CI: 1.170-1.697), as did associations between ADHD and three SCOFF items. No difference in DE prevalence was found between stimulant-treated (n = 287) and untreated (n = 326) adolescents with ADHD. CONCLUSION: Adolescents with ADHD are more likely to experience DE. As DE can herald an imminent eating disorder, early identification is crucial. Further studies are needed to determine the ADHD-DE relationship's causality. IMPACT: Disordered eating (DE) and attention-deficit hyperactivity disorder (ADHD) are common among adolescents, and significantly affect health and well-being. This study examined the association between ADHD and DE in adolescents using the SCOFF questionnaire. Following adjustment for sociodemographic variables and BMI z-score, ADHD was associated with a 41% increased odds for DE. This study established the association between ADHD and DE, using a well-known questionnaire, in a large, nationally representative sample of adolescents. Monitoring eating behaviors and attitudes among adolescents with ADHD should be a priority, to minimize the risk of developing an eating disorder and its harmful consequences.

Rapid Weight Loss in Competitive Judo and Taekwondo Athletes: Attitudes and Practices of Coaches and Trainers.

Fasting, skipping meals, and dehydration are common methods of rapid weight loss used prior to competition in weight category sports. This study examines coaches' attitudes, perceptions, and practices regarding rapid weight loss among judo and taekwondo athletes. A convenience sample of experienced coaches and trainers (n = 68) completed structured questionnaires. Participants in this study were 33.8 ± 9.3 years old; 57 were males and 11 were females; and 59% were certified coaches, with 71% reporting over 20 years of involvement in sports and 68% having more than 10 years of teaching experience. The majority (90%) reported that they usually supervised athletes through the weight loss process. Interventions for weight loss began at 12.7 ± 1.9 years of age, with a recommended precompetition weight loss duration of 16.2 ± 8.2 days and an average reduction of 1.5 ± 0.7 kg. The majority of the responders (92%) recommended that their athletes practice gradual weight loss methods using a combination of dehydration or increased physical activity (80.3%), sweat suits (50.8%), restricted fluid intake (39.3%), training in heated rooms (27%), and sauna (26.2%). Recommendations of spitting (27.8%) or using laxatives, diuretics, diet pills, or vomiting (21.3%) were also reported. Coaches and trainers often encouraged athletes to cut weight before competition. The methods recommended are potentially harmful with severe health risks, including compromised nutritional status and diminished athletic performance. This is of particular concern in young athletes who are still growing and developing physically. Enhancing knowledge and awareness for coaches, athletes, and parents regarding potential dangers, along with improved nutrition education, is critical for reducing the magnitude and misuse of rapid weight loss methods.

A New System of Documentation to Improve Dietitian-Physician Crosstalk.

BACKGROUND: Standardization of the dietetic care process allows for early identification of malnutrition and metabolic disorders, interdisciplinary collaboration among the medical team, and improved quality of patient care. Globally, dietitians are adopting a nutrition care model that integrates national regulations with professional scope of practice. Currently, Israel lacks a standardized dietetic care process and documentation terminology. OBJECTIVES: To assess the utilization of a novel sectoral documentation system for nutrition care in Israel. METHODS: Seventy dietitians working in 63 geriatric facilities completed an online training program presenting the proposed patient-sectoral-model. Training was followed by submission of sample case studies from clinical practice or completion of a case simulation. Application of the proposed model was assessed by measuring the frequency participants implemented different sections of the model and responses to an approval questionnaire. RESULTS: Fifty-four participants (77%) provided completed cases. Over 80% of participants reported each step of the proposed dietary care process with 100% reporting the "nutrition diagnosis". Fifty-one dietitians (72.8%) completed the approval survey with the section on nutrition diagnosis receiving a highly favorable response (95%), indicating that the new documentation system was beneficial. Over 80% of participants rated the model useful in clinical practice. CONCLUSIONS: A sectoral approach for documenting dietetic care may be the ideal model for dietitians working in specific patient populations with the potential for improving interdisciplinary collaboration in patient care.

Past and Present Insights on Alpha-linolenic Acid and the Omega-3 Fatty Acid Family.

Alpha-linolenic acid (ALA) is the parent essential fatty acid of the omega-3 family. This family includes docosahexaenoic acid (DHA), which has been conserved in neural signaling systems in the cephalopods, fish, amphibian, reptiles, birds, mammals, primates, and humans. This extreme conservation, in spite of wide genomic changes of over 500 million years, testifies to the uniqueness of this molecule in the brain and affirms the importance of omega-3 fatty acids. While DHA and its close precursor, eicosapentaenoic acids (EPA), have received much attention by the research community, ALA, as the precursor of both, has been considered of little interest. There are many papers on ALA requirements in experimental animals. Unlike humans, rats and mice can readily convert ALA to EPA and DHA, so it is unclear whether the effect is solely due to the conversion products or to ALA itself. The intrinsic role of ALA has yet to be defined. This paper will discuss both recent and historical findings related to this distinctive group of fatty acids, and will highlight the physiological significance of the omega-3 family.

Menarche at an Earlier Age: Results from Two National Surveys of Israeli Youth, 2003 and 2016.

STUDY OBJECTIVE: To assess emergent changes in the age at menarche and investigate associated factors in Israeli adolescents in 2003 and 2016. DESIGN: Cross-sectional study. SETTING: Two national representative school-based surveys (first and second "Mabat Youth"). PARTICIPANTS: Both surveys included female students in 7th-12th grades (ages 11-19 years). The first (N = 3328) was conducted between the years 2003 and 2004, and the second (N = 2535) from 2015 to 2016. INTERVENTIONS: The survey questionnaire was self-administered and anthropometric measurements were performed by trained personnel. MAIN OUTCOME MEASURES: The current age at menarche in Israeli girls was determined and independent factors (demographic, clinical, and lifestyle) examined. Changes that occurred since the past national survey more than a decade ago were documented. RESULTS: The estimated median age at menarche declined from 13.0 (interquartile range, 12.0-14.0) years in 2003-2004 to 12.5 (interquartile range, 12.0-13.0) years in 2015-2016 (P < .0001). Jewish girls reached menarche earlier than Arab girls, but both populations experienced a similar downward trend in the past approximately 14 years. Greater body mass index, higher socioeconomic status, and immigrant status were associated with younger menarche onset (P < .001). Age at menarche remained lower in 2015-2016 vs 2003-2004, even after adjustment for these potential confounders, with a high hazard ratio (HR), which decreased as a function of survival time (t): HRt = 15.417 × 0.813t. CONCLUSION: This study confirms the decline in age at menarche in Israel. Findings were associated with body mass index and population group but also indicated that other factors are likely involved.

Update on alpha-linolenic acid.

Consumption of omega 3 fatty acids is known to have health benefits. For many years, the importance of the only member of the omega 3 family considered to be essential, alpha-linolenic acid (ALA), has been overlooked. Current research indicates that ALA, along with its longer chain metabolites, may play an important role in many physiological functions. Potential benefits of ALA include cardioprotective effects, modulation of the inflammatory response, and a positive impact on both central nervous system function and behavior. Recommended levels for ALA intake have been set, yet the possible advantages of its consumption are just being revealed.

Dietary intake of pilots in the Israeli Air Force.

The purpose of this study was to evaluate the dietary intake of pilots in the Israeli Air Force and to determine whether reported consumption met the Military Dietary Reference Intakes. Thirty-one pilots completed a 24-hour dietary recall and physical activity questionnaire. Blood parameter values were collected from medical records. Results showed that energy-adjusted sample mean intakes of nutrients met the military recommendations with the exceptions of dietary fiber (53% of the recommended level) and calcium (84% of the recommended level). Macronutrient distribution of energy was 17% from protein, 47% from carbohydrate, and 36% from fat. Although saturated fat consumption was not more than 10% of energy, cholesterol consumption was well above the 300 mg/d presently recommended. For all pilots, blood parameter values were in the normal range. Overall, the diet of Israeli pilots was found to be well balanced, but negative dietary patterns (i.e., high cholesterol intake and low fiber intake) characteristic of the general population were observed in this group.

Impact of Community-Based Nutrition Education on Geophagic Behavior and Dietary Knowledge and Practices among Rural Women in Nakuru Town, Kenya: A Pilot Study.

OBJECTIVE: Geophagia, the deliberate consumption of rocks, soil, or clay, is prevalent in developing countries, particularly sub-Saharan Africa. Health risks associated with this behavior include parasitosis, heavy metal poisoning, nutrient deficiencies, and poor birth outcomes. This pilot study was designed to reduce geophagic practices and improve nutrition among rural Kenyan women. METHODS: The researchers used snowball sampling to recruit participants (n = 135; aged 15-49 years) from low socioeconomic areas who consumed geophagic materials. Interviews were carried out before and after a nutrition intervention implemented by trained community health volunteers. RESULTS: Nutrition education focusing on geophagia significantly (P < .001) decreased the practice in 77% of participants. Postintervention interviews also demonstrated substantial improvement in understanding the concept of making half the plate vegetables using the healthy plate model. CONCLUSIONS AND IMPLICATIONS: Nutrition education can be useful for reducing geophagia (a largely ignored, unsafe dietary behavior) and enhancing nutritional knowledge in African women.

"Practice What You Teach" Public Health Nurses Promoting Healthy Lifestyles (PHeeL-PHiNe): Program Evaluation.

Healthy lifestyle programs are essential for meeting the challenge of noncommunicable diseases. The Public Health Nurses Promoting Healthy Lifestyles (PHeeL-PHiNe) program engaged nurses from family health clinics in Jerusalem District and included physical activity, healthy nutrition, and motivational skills. Questionnaires were completed at baseline, postintervention, and at 18 months. Results showed a marked effect on health practices. The proportion of nurses consuming a balanced diet and the use of food labels significantly increased and were maintained over time. Short-term improvements in physical activity were also observed. Nurses who practiced a healthy lifestyle were significantly more likely to provide guidance and counseling to families on healthy behaviors.

Online training introduces a novel approach to the Dietetic Care Process documentation.

AIM: Nutrition professionals in Israel are developing a system to document the Dietetic Care Process (DCP) tailored for specific patient sectors and compliant with national health guidelines. The ultimate goal is to achieve uniform documentation and improve nutrition care. Israeli dietetic practitioners work in specific patient sectors; therefore, a patient population-specific reporting system is proposed instead of the typical singular format applied across all patient populations. The purpose of this project was to evaluate learning outcomes and attitudes among registered dietitians (RDs) after online training of a novel DCP documentation system. METHODS: A total of 80 Israeli RDs working in geriatric practice completed an eight-week online educational program learning documentation that is compatible for use with electronic health records and compliant with Israeli standards of practice. A paired sample t-test and McNemar test were used to analyse pre- to post-test performance, while Pearson's r, point-biserial, Spearman's and ANOVA were used to assess relationships among variables. RESULTS: Post-test knowledge scores increased significantly, t (67) = -9.007, P = 0.000; 95% CI (-26.713, -17.019). Age, education, geographic location and previous experience with online courses were not correlated with academic performance, suggesting that demographic characteristics did not impact training. Overall, RDs (>80%) responded positively to the training model and were highly interested in future proficiency online learning opportunities (98%). CONCLUSIONS: A sectoral DCP online training program significantly improved knowledge and was rated favourably by Israeli RDs. DCP training for clinical practitioners may be optimised when standardised nutrition care and reporting systems are adapted to specific patient populations.

Grapefruit and oroblanco enhance hepatic detoxification enzymes in rats: possible role in protection against chemical carcinogenesis.

Citrus fruits are considered to be functional foods that promote good health. This study was carried out to assess the effect of oroblanco and grapefruit consumption on hepatic detoxification enzymes. Male Sprague-Dawley rats were provided with either regular drinking water (control) or experimental treatments of oroblanco juice, grapefruit juice, or a sugar mix for 6 weeks. After 1 week of treatment, half the animals in each group were injected with the procarcinogen 1,2-dimethylhydrazine. Grapefruit juice significantly increased activity and expression of the hepatic phase I enzyme, cytochrome P450 CYP1A1, with a marked trend toward enhanced NAD(P)H:quinone reductase (QR) activity. Oroblanco juice significantly increased glutathione S-transferase phase II enzyme activity along with CYP1A1 expression and a notable trend toward increased activity of both CYP1A1 and QR. These results suggest that these citrus fruits are bifunctional inducers, modulating both phase I and phase II drug-metabolizing enzymes to enhance hepatic detoxification.

Natural compounds derived from foods modulate nitric oxide production and oxidative status in epithelial lung cells.

The effects of natural antioxidants on nitric oxide (NO) modulation and oxidative status were determined in rat epithelial lung cells (L-2). Cells were stimulated with cytokines and treated with one of the following: resveratrol, soybean saponin group B (SSB), quercetin, genistein, olive leaf polyphenol concentrate (OLPC), or N-acetyl-L-cystein (NAC). NAC had no effect on NO levels, whereas resveratrol and OLPC were found to be effective in reducing nitrite levels, modifying iNOS mRNA, and decreasing free radical production. OLPC affected the levels of MnSOD while resveratrol did not, indicating that they act via different pathways. Quercetin and genistein reduced nitrite levels without affecting iNOS levels, presumably by scavenging NO. SSB did not affect nitrite levels, but exposure did reduce iNOS mRNA expression and protein levels, possibly due to antioxidant activity. Naturally occurring antioxidants, in particular resveratrol and OLPC, may have therapeutic potential in the treatment of inflammatory diseases.

Nutrition targeting by food timing: time-related dietary approaches to combat obesity and metabolic syndrome.

Effective nutritional guidelines for reducing abdominal obesity and metabolic syndrome are urgently needed. Over the years, many different dietary regimens have been studied as possible treatment alternatives. The efficacy of low-calorie diets, diets with different proportions of fat, protein, and carbohydrates, traditional healthy eating patterns, and evidence-based dietary approaches were evaluated. Reviewing literature published in the last 5 y reveals that these diets may improve risk factors associated with obesity and metabolic syndrome. However, each diet has limitations ranging from high dropout rates to maintenance difficulties. In addition, most of these dietary regimens have the ability to attenuate some, but not all, of the components involved in this complicated multifactorial condition. Recently, interest has arisen in the time of day foods are consumed (food timing). Studies have examined the implications of eating at the right or wrong time, restricting eating hours, time allocation for meals, and timing of macronutrient consumption during the day. In this paper we review new insights into well-known dietary therapies as well as innovative time-associated dietary approaches for treating obesity and metabolic syndrome. We discuss results from systematic meta-analyses, clinical interventions, and animal models.

α-Linolenic acid (ALA) is an anti-inflammatory agent in inflammatory bowel disease.

Studies suggest that consumption of omega-3 (n-3) polyunsaturated fatty acids (PUFA) plays a protective role in inflammatory bowel disease; however, the use of plant-derived oils rich in α-linolenic acid (ALA) has not been widely investigated. The aims of this study were to test the effects of two different sources of (n-3) PUFA, fish and plant-derived oils, in two animal models of experimental colitis and to determine whether the (n-3) PUFA-enriched diets could ameliorate the inflammatory status. Rats were fed diets rich in corn, fish or sage oil with or without vitamin A supplementation for 3weeks then colitis was induced by adding dextran sodium sulfate to the drinking water or by injecting 2,4,6-trinitrobenzene sulfonic acid. We show that colitic rats fed the sage oil diets had a lower inflammatory response, improved histological repair and had less necrotic damage in the mucosa when compared to the corn and fish oil groups. Colonic damage and myeloperoxidase activity were significantly lower. Colonic mRNA levels of pro-inflammatory genes including interleukin IL-6, cyclooxygenase 2 and tumor necrosis factor α were markedly down-regulated in rats fed fish and sage oils compared to control. These results were supported by experiments in the human colonic epithelial cell line Caco-2, where ALA supplementation was shown to be effective in inhibiting inflammation induced by IL-1ß by down-regulating mRNA levels of pro-inflammatory genes including IL-8, COX2 and inducible nitric oxide synthase. Taken together, these results suggest that plant-derived oil rich in ALA could ameliorate the inflammatory damage in colitis.

Olive oil as a functional food: epidemiology and nutritional approaches.

Olive oil is an integral ingredient of the Mediterranean diet and accumulating evidence suggests that it may have health benefits that include reduction of risk factors of coronary heart disease, prevention of several varieties of cancers, and modification of immune and inflammatory responses. Olive oil appears to be an example of a functional food, with varied components that may contribute to its overall therapeutic characteristics. Olive oil is known for its high levels of monounsaturated fatty acids and is also a good source of phytochemicals including polyphenolic compounds, squalene, and alpha-tocopherol.

Nutrition knowledge, attitudes, and behaviors of israeli female combat recruits participating in a nutrition education program.

The objective of this study was to assess the impact of a pilot nutrition intervention program on knowledge, attitudes, and behaviors of female combat soldiers in basic training serving in the Israeli army and to determine changes in nutrient intake. Seventy recruits participated in the intervention. Anthropometric measurements and food frequency questionnaires were completed at 3 time points: at enlistment, at 2 months, and at 4 months. Additional questionnaires to assess nutrition knowledge, attitudes, and behaviors were administered preintervention and postintervention. Baseline results indicated that intakes of calcium, vitamin E, and vitamin D were below recommended levels. After 2 months (8 weeks), suboptimal consumption of many nutrients was observed. At this time point, a nutrition education program was initiated and activities were carried out for the final 2 months of basic training. Following completion of the intervention, a marked improvement in nutrient intake was reported, accompanied by significant changes in attitudes toward healthy eating and increased nutrition knowledge. One-year follow-up evaluation indicated that approximately 20% of participants had made long-term dietary changes. In conclusion, nutrition education increased knowledge, modified attitudes, and led to dietary changes in female recruits. Programs of this type should be considered for implementation in the military.

A high-fat diet has a tissue-specific effect on adiponectin and related enzyme expression.

OBJECTIVE: This study was designed to test whether adiponectin plays a role in diet-induced obesity and insulin resistance and acts as a mediator to induce or inhibit specific metabolic pathways involved in lipid metabolism RESEARCH METHODS AND PROCEDURES: Forty C57BL/6J male mice were fed either a high-fat (HF) or control diet for 4 months, and adiponectin, its receptors, and enzyme expression in liver and muscle tissue were measured. RESULTS: Mice fed the HF diet exhibited significantly greater weight gain, abnormal oral glucose tolerance test curves, and elevated homeostasis model assessment of insulin resistance (5.3 +/- 0.89 vs. 2.8 +/- 0.39). A significant reduction of adiponectin RNA expression (51%) and protein levels (15%) was observed in the adipose tissue of HF animals; however, serum adiponectin levels did not differ between groups (7.12 +/- 0.34 mug/mL vs. 6.44 +/- 0.38 microg/mL). Expression of hepatic mRNA of AdipoR1 and AdipoR2 was reduced by 15% and 25%, respectively, in animals fed the HF diet. In contrast, receptor mRNA expression of AdipoR1 and AdipoR2 increased by 25% and 30%, respectively, in muscle tissue. No effect was found on hepatic adenosine monophosphate-activated protein kinase expression; however, a significant reduction of phosphoadenosine monophosphate kinase levels in muscles was observed. Hepatic acetyl-coenzyme A carboxylase was similar between groups, but in muscles, the inactive form phosphoacetyl-coenzyme A carboxylase was significantly reduced (p < 0.05). DISCUSSION: The HF diet led to decreased insulin sensitivity accompanied by impaired activity of adiponectin-related enzymes in skeletal muscles but not in the liver. These results suggest that the HF diet has a tissue-specific effect on adiponectin and associated enzyme expression.

Inducible nitric oxide synthase activity and expression in liver and hepatocytes of diabetic rats.

Inducible nitric oxide synthase (iNOS) is expressed by the liver in a number of physiological and pathophysiological conditions. The aim of this study was to investigate the relationship between the diabetic state, iNOS and oxidative stress in the rat liver and isolated hepatocytes. Hepatic iNOS expression and activity was measured in both healthy and streptozotocin-induced diabetic rats and determined in hepatocytes in the presence and absence of insulin. Cu/Zn superoxide dismutase (SOD) and phosphatidylinositol-3-kinase (PI3K) were also measured. In a separate experiment lasting 3 weeks, diabetic rats received either no treatment, two daily injections of insulin or aminoguanidine in the drinking water. Diabetes led to increased activity (45%) and expression (70%) of liver iNOS, an effect that was attenuated by insulin treatment both in vitro and in whole animals. Hepatocyte iNOS expression increased by 56%. Hepatic SOD expression was elevated in the diabetic state, but activity levels were similar to healthy controls. Insulin treatment in vivo led to increased enzyme activity but expression was not modified. Levels of PI3K protein were significantly lower in diabetic rats while insulin treatment markedly increased expression. Aminoguanidine did not inhibit hepatic iNOS in this study. Glycemic control via insulin administration was able to downregulate enhanced hepatic iNOS activity and expression in the liver observed in the diabetic state and improve SOD activity, responses that can potentially reduce the free radical damage associated with diabetes.

Interactions between nitric oxide and arachidonic acid in lung epithelial cells: possible roles for peroxynitrite and superoxide.

This study investigated interactions between nitric oxide synthesis and phospholipase A2 (PLA2) activation in lung epithelial cells. Nitrite formation, inducible nitric oxide synthase expression, and [3H]arachidonic acid (AA) release were determined following treatment with: (1) the nitric oxide synthase inhibitors N(G)-nitro-L-arginine methyl esther (L-NAME) and aminoguanidine; (2) arachidonyl trifluoromethyl ketone (AACOCF3), a specific cytosolic PLA2 inhibitor; (3) S-morpholinosydnonimine (SIN-1), a nitric oxide donor which provokes peroxynitrite formation; (4) trolox, a free radical scavenger, and (5) the AA release agonists calcium ionophore, phorbol 12-myristate 13-acetate, and sodium vanadate. The results demonstrated that (1) L-NAME and aminoguanidine inhibited agonist-induced AA release by 40 and 65%, respectively; (2) AACOCF3 inhibited nitrite formation and inducible nitric oxide synthase expression in a dose-dependent manner; (3) SIN-1, together with AA release agonists, significantly increased the AA output, and (4) trolox counteracted the SIN-1 effects. Our results demonstrate cross talk between nitric oxide synthase and PLA(2) pathways, with a possible intermediary role for peroxynitrite and superoxide.

Plasma carotenoid and vitamins a and e concentrations in older African American women after wheat bran supplementation: effects of age, body mass and smoking history.

OBJECTIVE: This study investigated the relationships of plasma vitamins A, E, and carotenoids with age, BMI and former/non-smoking history after adjusting for wheat bran supplementation. METHODS: All 39 African American women in the church-based, volunteer sample, 40-70 years old, supplemented their daily diets for 5-6 wks. with 1/2 cup of a riboflavin-spiked wheat bran cereal. RESULTS: Urinary riboflavin concentrations increased from 0.8 +/- 0.1 mg/day at baseline to 7.5 +/- 0.5 mg/day after supplementation, confirming the 99.2 +/- 10.5% self-reported adherence. Plasma nutrient concentrations did not change significantly with supplementation nor was never/former smoking history related to diet. Plasma retinol and serum cholesterol were significantly higher (p < 0.0002) in persons older than 55 years compared to younger adults. Plasma retinol (microg/dL) but not serum cholesterol was associated significantly with menopausal status and hormone replacement therapy (HRT; p = 0.05); progressive increases in retinol concentrations were found in the women after adjusting for pre/post supplementation: lowest in pre-menopause (47.7 +/- 4.8); intermediate concentrations in post-menopause on HRT (54.6 +/- 3.0); highest level in post-menopause without HRT (61.1 +/- 3.0). Similarly, a progressive increase was found in lipid-unadjusted alpha-tocopherol concentrations and menopausal status with or without HRT. Vitamin A and cholesterol intakes were not significantly different by age group. Plasma carotenoids were not significantly different by age or fiber supplementation, but alpha- and beta-carotene and beta-cryptoxanthin were significantly lower with BMI > or = 30. In contrast to carotenoids, both plasma levels of gamma-tocopherol and lipid-adjusted gamma-tocopherol were significantly higher with obesity compared to those with BMI < 30. CONCLUSION: Plasma alpha- and beta-carotene and beta-cryptoxanthin were negatively associated with obesity, whereas gamma-tocopherol measures were consistently elevated with high BMI. The increase in age-associated plasma retinol in postmenopausal women was likely related to decreased estrogen concentrations in the African American women. Smoking history was not influential in this study.