Examining the role of different weakness categories for mobility and future falls in older Americans.

BACKGROUND: Recently developed absolute and body size normalized handgrip strength (HGS) cut-points could be used individually and collectively to predict mobility problems and falls. AIMS: We examined the associations of (1) each absolute and normalized weakness cut-point, (2) collective weakness categories, and (3) changes in weakness status on future falls in older Americans. METHODS: The analytic sample included 11,675 participants from the 2006-2018 waves of the Health and Retirement Study. Falls were self-reported. Men were classified as weak if their HGS was < 35.5-kg (absolute), < 0.45 kg/kg (body mass normalized), or < 1.05 kg/kg/m2 (body mass index normalized). While, women were considered weak if their HGS was < 20.0-kg, < 0.337 kg/kg, or < 0.79 kg/kg/m2. Collective weakness categorized those below 1, 2, or all 3 cut-points. The collective weakness categories were also used to observe changes in weakness status over time. RESULTS: Older Americans below each absolute and normalized cut-point had greater odds for future falls: 1.23 (95% confidence interval (CI): 1.15-1.32) for absolute weakness, 1.20 (CI 1.11-1.29) for body mass index normalized weakness, and 1.26 (CI 1.17-1.34) for body mass normalized weakness. Persons below 1, 2, or all 3 weakness cut-points had 1.17 (CI 1.07-1.27), 1.29 (CI 1.18-1.40), and 1.36 (CI 1.24-1.48) greater odds for future falls, respectively. Those in some changing weakness categories had greater odds for future falls: 1.26 (CI 1.08-1.48) for persistent and 1.31 (CI 1.11-1.55) for progressive. DISCUSSION: Collectively using these weakness cut-points may improve their predictive value. CONCLUSION: We recommend HGS be evaluated in mobility and fall risk assessments.

The estimated prevalence of no reported dementia-related diagnosis in older Americans living with possible dementia by healthcare utilization.

BACKGROUND: Screening for dementia in relevant healthcare settings may help in identifying low cognitive functioning for comprehensive cognitive assessments and subsequent dementia treatment after diagnosis. AIMS: This study sought to estimate the prevalence of no reported dementia-related diagnosis in a nationally-representative sample of older Americans with a cognitive impairment consistent with dementia (CICD) by healthcare utilization. METHODS: The unweighted analytical sample included 1514 Americans aged ≥ 65 years that were identified as having a CICD without history of stroke, cancers, neurological conditions, or brain damage who participated in at least one-wave of the 2010-2016 waves of the Health and Retirement Study. An adapted Telephone Interview of Cognitive Status assessed cognitive functioning. Those with scores ≤ 6 had a CICD. Dementia-related diagnosis was self-reported. Respondents indicated if they visited a physician, received home healthcare, or experienced an overnight nursing home stay in the previous two years. RESULTS: The prevalence of no reported dementia-related diagnosis in persons with a CICD who visited a physician was 89.9% (95% confidence interval (CI): 85.4%-93.1%). Likewise, the prevalence of no reported diagnosis in those with a CICD who received home healthcare was 84.3% (CI: 75.1-90.5%). For persons with a CICD that had an overnight nursing home stay, the prevalence of no reported dementia-related diagnosis was 83.0% (CI: 69.1-91.4%). DISCUSSION: Although the prevalence of no reported dementia-related diagnosis in individuals with a CICD differed across healthcare settings, the prevalence was generally high nonetheless. CONCLUSIONS: We recommend increased awareness and efforts be given to dementia screenings in various clinical settings.

Alzheimer's Disease Warning Signs: Gender and Education Influence Modifiable Risk Factors-A Pilot Survey Study.

OBJECTIVE: The aim of this research was to determine the relationships among diabetes, Alzheimer's disease warning signs, and lifestyle factors such as fruit and vegetable intake and physical activity. METHOD: Adults over the age of 50 (N = 147) responded to a survey about their health, family history, and experience of Alzheimer's warning signs in the previous year. RESULTS: Pearson's correlation revealed significant relationships between fruit and vegetable intake and education, gender, and physical activity. Alzheimer's warning signs were associated with relatives having an Alzheimer's disease diagnosis. Other results were nonsignificant. CONCLUSIONS: Diabetes impacts one-third of older adults in the United States and increases the risk of Alzheimer's disease. This survey revealed that women, who are more at risk for Alzheimer's disease, are less likely to engage in physical activity, a behavior that could decrease their risk. Similarly, those with higher education were more likely to consume colorful fruits and vegetables, potentially decreasing their risk of Alzheimer's disease.

Flaxseed Effects on Inflammation Regulatory Gene Expressions in an Obese Animal Model.

Obesity is known to be partially influenced by low-grade inflammation caused by pro-inflammatory cytokines and excess adipose tissue. Flaxseed contains secoisolariciresinol diglucoside (SDG) and α-linolenic acid (ALA) that have been shown to prevent pro-inflammatory cytokine production and secretion. This study determined flaxseed effects on inflammation regulatory gene expressions and their relationships with weight gain in an obese animal model. C57BL/6J mice were fed with whole flaxseed, defatted flaxseed, or flaxseed oil supplemented high-fat diet for eight weeks. After eight weeks of dietary treatment, NF-κB, IκBα, IKKß, IL-6, TNF-α, Akt2, and adiponectin gene expressions were measured. The result shows how health-promoting compounds in flaxseed assist in alleviating and preventing obesity-induced low-grade inflammation by actively working against IKKß/NF-κB pathway.

Does Nutrition Education with Fruit and Vegetable Supplementation Increase Fruit and Vegetable Intake and Improve Anthropometrics of Overweight or Obese People of Varying Socioeconomic Status?

Fruit and vegetable (F/V) intake is inadequate and obesity is more prevalent among adults of lower socioeconomic status (SES) in the United States. The effect of nutrition education and F/V supplementation on F/V intake and anthropometrics of overweight or obese adults of varying SES was determined. F/V intake was not different between the nutrition education and F/V supplementation groups. Individuals with a graduate degree had significant improvements in fruit intake. Few of the improvements in anthropometrics seen were significant. Future research should focus on specific barriers to F/V intake and include information on total energy intake and expenditure.

Nutrition education effective in increasing fruit and vegetable consumption among overweight and obese adults.

Despite the benefits of fruit and vegetable consumption on weight and decreased risk for chronic disease, Americans' intake of fruits and vegetables is well below the recommended daily servings. While previous studies have assessed fruit and vegetable consumption and the influence of educational interventions on fruit and vegetable intake, no studies to date have examined the effects of nutrition education combined with provision of fruits and vegetables on changes in fruit and vegetable consumption among overweight and obese adults. The objectives of this study were to evaluate fruit and vegetable consumption patterns, including intake of antioxidant-rich fruits and vegetables, provide education about benefits of consuming fruits and vegetables, expose participants to different varieties of fruits and vegetables, and improve fruit and vegetable consumption. Fifty-four adults (19 men/35 women; 44.7 ± 12.1 y) were randomly assigned to one of three intervention groups. The control group received no intervention, the education group attended weekly nutrition lessons focused on benefits of fruit and vegetable consumption, and the fruit and vegetable group attended weekly nutrition lessons and received one serving of fruits and two servings of vegetables per day for 10 weeks. Intake of fruits and vegetables was assessed using semi-quantitative food frequency questionnaires and three-day food records. Findings suggested that while the majority of participants failed to consume the recommended number of servings of fruits and vegetables per day, nutrition education was helpful in improving the consumption frequency of antioxidant-rich fruits and vegetables among overweight and obese adults.

Collective Weakness and Fluidity in Weakness Status Associated With Basic Self-Care Limitations in Older Americans.

Aims: To examine the associations of 1) absolute and normalized weakness cut-points, 2) collective weakness categories, and 3) changes in weakness status on future activities of daily living (ADL) limitations in older Americans. Methods: The analytic sample included 11,656 participants aged ≥65-years from the 2006-2018 waves of the Health and Retirement Study. ADL were self-reported. A handgrip dynamometer measured handgrip strength (HGS). Males were classified as weak if their HGS was <35.5-kg (absolute), <0.45-kg/kg (body mass normalized), or <1.05-kg/kg/m2 (body mass index (BMI) normalized); females were considered weak if their HGS was <20.0-kg, <0.337-kg/kg, or <0.79-kg/kg/m2. Collective weakness categorized those below 1, 2, or all 3 absolute and normalized cut-points. These collective categories were also used to classify observed changes in weakness status over time (onset, persistent, progressive, recovery). Results: Older Americans below absolute and normalized weakness cut-points had greater future ADL limitations odds: 1.34 (95% confidence interval (CI): 1.22-1.47) for absolute, 1.36 (CI: 1.24-1.50) for BMI normalized, and 1.56 (CI: 1.41-1.73) for body mass normalized. Persons below 1, 2, or 3 cut-points had 1.36 (CI: 1.19-1.55), 1.60 (CI: 1.41-1.80), and 1.70 (CI: 1.50-1.92) greater odds for future ADL limitations, respectively. Those in each changing weakness classification had greater future ADL limitation odds: 1.28 (CI: 1.01-1.62) for onset, 1.53 (CI: 1.22-1.92) for persistent, 1.72 (CI: 1.36-2.19) for progressive, and 1.34 (CI: 1.08-1.66) for recovery. Conclusions: The presence of weakness, regardless of cut-point and change in status over time, was associated with greater odds for future ADL limitations.

Prevalence and Trends of Basic Activities of Daily Living Limitations in Middle-Aged and Older Adults in the United States.

BACKGROUND: Population-level surveillance of the prevalence and trends of basic self-care limitations will help to identify the magnitude of physical disablement in the rapidly growing older American demographic. We sought to evaluate the prevalence and trends of activities of daily living (ADL) limitations in the United States. METHODS: The analytic sample included 30,418 Americans aged ≥50 years from the 2006-2018 waves of the Health and Retirement Study. ADLs were self-reported. Weighted prevalence estimates were presented, and trends analyses were performed. RESULTS: Although overall ADL disability prevalence was 16.5% (95% confidence interval: 15.8-17.2) in 2018, there were no changes in limitations during the study period (p = 0.52). Older adults had a greater ADL disability prevalence than middle-aged adults (p < 0.001). While older persons experienced a declining trend of ADL limitations (p < 0.001), middle-aged persons had an increasing trend (p < 0.001). Males had a lower ADL limitation prevalence than females (p < 0.001). Hispanic and non-Hispanic Black had a higher ADL disability prevalence than non-Hispanic White (p < 0.001). CONCLUSIONS: This investigation revealed that while the estimated prevalence of ADL limitations in the United States was substantial, changes in such limitations were not observed. Our findings can help guide ADL screening, target sub-populations with an elevated ADL limitation prevalence, and inform interventions.

The Role of Different Weakness Cut-Points for Future Cognitive Impairment in Older Americans.

OBJECTIVES: New absolute and normalized handgrip strength (HGS) cut-points may not yield similar predictive value for cognitive performance. We sought to determine the associations of (1) each absolute and normalized weakness cut-point, and (2) compounding weakness on future cognitive impairment in older Americans. DESIGN: Longitudinal panel. SETTING AND PARTICIPANTS: The analytic sample included 11,116 participants aged ≥65 years from the 2006 to 2018 waves of the Health and Retirement Study. Participants from the Health and Retirement Study completed detailed interviews that included physical measures and core interviews. METHODS: The modified Telephone Interview of Cognitive Status assessed cognitive function and persons scoring <11 were classified as having a cognitive impairment. A handgrip dynamometer measured HGS. Men were considered weak if their HGS was <35.5 kg (absolute), <0.45 kg/kg (body mass normalized), or <1.05 kg (body mass index normalized), whereas women were classified as weak if their HGS was <20.0 kg, <0.337 kg/kg, or <0.79 kg. Compounding weakness included those below 1, 2, or all 3 cut-points. Generalized estimating equations quantified the associations. RESULTS: Persons considered weak under the absolute cut-point had 1.62 (95% CI 1.34-1.96) greater odds for future cognitive impairment, but no significant associations were observed for those classified as weak under the body mass [odds ratio (OR) 1.12, CI 0.91-1.36] and body mass index normalized (OR 1.17, CI 0.95-1.43) cut-points. Older Americans below all 3 weakness cut-points had 1.47 (CI 1.15-1.88) greater odds for future cognitive impairment, but no significant associations were found for persons classified as weak under 1 (OR 1.08, CI 0.83-1.42) or 2 (OR 1.19, CI 0.91-1.55) cut-points. CONCLUSIONS AND IMPLICATIONS: Our findings suggest that each weakness cut-point has differential prognostic value for future cognitive impairment, and aggregating weakness cut-points may improve their predictive utility. Consideration should be given to how weakness categories are uniquely linked to cognitive function.

The Prevalence and Trends of Instrumental Activities of Daily Living Impairments in the United States from 2008-2018.

Background: Instrumental activities of daily living (IADL) are neuropsychological-driven tasks that are linked to cognitive dysfunction. Examining population-based IADL deficits may reveal insights for the presence of these impairments in the United States. Objective: This investigation sought to evaluate the prevalence and trends of IADL impairments in Americans. Methods: A secondary analysis of data from the 2006-2018 waves of the Health and Retirement Study was conducted. The overall unweighted analytic sample included 29,764 Americans aged≥50 years. Respondents indicated their ability to perform six IADLs: manage money, manage medications, use a telephone, prepare hot meals, shop for groceries, and use a map. Persons reporting difficulty or an inability to complete an individual IADL were considered as having a task-specific impairment. Similarly, those indicating difficulty or an inability to perform any IADL were classified as having an IADL impairment. Sample weights were utilized to generate nationally-representative estimates. Results: Having an impairment in using a map (2018 wave: 15.7% (95% confidence interval (CI): 15.0-16.4) had the highest prevalence in individual IADLs regardless of wave examined. The overall prevalence of IADL impairments declined during the study period (p < 0.001) to 25.4% (CI: 24.5-26.2) in the 2018 wave. Older Americans and women had a consistently higher prevalence of IADL impairments compared to middle-aged Americans and men, respectively. The prevalence of IADL impairments was also highest among Hispanics and non-Hispanic Blacks. Conclusion: IADL impairments have declined over time. Continued surveillance of IADLs may help inform cognitive screening, identify subpopulations at risk of impairment, and guide relevant policy.

Sleep and diet patterns of college students during the COVID-19 pandemic lockdowns.

Introduction: College students experience high levels of depression, anxiety, and stress during the academic year as they juggle the competing demands of young adulthood and their studies. The COVID-19 pandemic heightened this experience. Healthful diets and sleep patterns are associated with improved physical and mental well-being. Purpose: The goal of this study was to identify if there was a relationship between changes in sleep and diet during the COVID-19 pandemic. Methods: A group of college students was surveyed online using Qualtrics software during the first two months of lockdown restrictions at a large, midwestern university in the United States. Results: More participants reported no changes in diet and increased hours of sleep than reported declines or improvements in diet, or reductions or retained sleep patterns. Participants who maintained their diet were likely to maintain their current sleep pattern. Conclusion: College students demonstrated resilience in healthful behaviors during the first two months of COVID-19 lockdown.

Undiagnosed Dementia Is Associated with Poor Physical Function in Older Adults.

BACKGROUND: Older adults with a cognitive impairment, including those not yet diagnosed, may have deficits in their physical function. OBJECTIVE: We sought to determine the associations of cognitive impairment consistent with dementia (CICD) diagnosis status on handgrip strength, gait speed, and functional disability in older adults. METHODS: The analytical sample included 8,383 adults aged ≥65-years without history of stroke, cancers, neurological conditions, or brain damage who participated in at least one-wave of the 2010-2016 waves of the Health and Retirement Study. A handgrip dynamometer measured handgrip strength. Men with handgrip strength <26 kg and women <16 kg were weak. Gait speed was timed across a 2.5-m course and those with slowness had gait speed <0.8 m/s. Participants with difficulty or an inability in completing any basic activities of daily living had a functional disability. The adapted Telephone Interview of Cognitive Status evaluated cognitive function. Persons with scores <7 had a CICD. Healthcare provider dementia-related diagnosis was self-reported. Undiagnosed CICD was defined as no reported dementia-related diagnosis but had CICD, while diagnosed CICD was classified as reporting a dementia-related diagnosis. Covariate-adjusted logistic models were used for the analyses. RESULTS: Persons with undiagnosed CICD had 1.37 (95% confidence interval (CI): 1.04-1.80) greater odds for weakness and 2.02 (CI: 1.39-2.94) greater odds for slow gait speed. Older adults with diagnosed CICD had 2.29 (CI: 1.32-3.97) greater odds for slowness and 1.85 (CI: 1.19-2.90) greater odds for functional disability. CONCLUSION: Screening for CICD could be recommended when defects in physical function are observed in older adults.

Flaxseed supplementation improved insulin resistance in obese glucose intolerant people: a randomized crossover design.

BACKGROUND: Obesity leads to an increase in inflammation and insulin resistance. This study determined antioxidant activity of flaxseed and its role in inflammation and insulin resistance in obese glucose intolerant people. METHODS: Using a randomized crossover design, nine obese glucose intolerant people consumed 40 g ground flaxseed or 40 g wheat bran daily for 12 weeks with a 4-week washout period. Plasma inflammation biomarkers (CRP, TNF-α, and IL-6), glucose, insulin, and thiobaribituric acid reactive substance (TBARS) were measured before and after of each supplementation. RESULTS: Flaxseed supplementation decreased TBARS (p = 0.0215) and HOMA-IR (p = 0.0382). Flaxseed or wheat bran supplementation did not change plasma inflammatory biomarkers. A positive relationship was found between TBARS and HOMA-IR (r = 0.62, p = 0.0003). CONCLUSIONS: The results of the study weakly support that decreased insulin resistance might have been secondary to antioxidant activity of flaxseed. However, the mechanism(s) of decreased insulin resistance by flaxseed should be further determined using flaxseed lignan.

Handgrip Weakness and Asymmetry Independently Predict the Development of New Activity Limitations: Results from Analyses of Longitudinal Data from the US Health and Retirement Study.

OBJECTIVES: Examining strength asymmetries in assessments of muscle function may improve screenings for limitations in independent living tasks such as instrumental activities of daily living (IADL). We sought to determine the associations between handgrip strength (HGS) asymmetry and future IADL limitations in aging Americans. DESIGN: Longitudinal panel. SETTING AND PARTICIPANTS: Secondary analyses of data from participants aged at least 50 years from the 2006-2016 waves of the Health and Retirement Study. The analytic sample included 18,235 Americans who identified hand dominance and had measures of HGS for both hands in a single wave. METHODS: Hand dominance was self-reported, and a handgrip dynamometer measured HGS on each hand. The highest HGS values on each hand were used to calculate the HGS asymmetry ratio: (nondominant HGS/dominant HGS). Individuals with HGS asymmetry ratio <0.80 or >1.20 had HGS asymmetry. Persons with HGS asymmetry ratio <0.80 had dominant HGS asymmetry, whereas participants with HGS asymmetry ratio >1.20 had nondominant HGS asymmetry. Persons with HGS asymmetry ratio <1.0 also had their ratio inversed to make all HGS asymmetry ratios ≥1.0. IADL were self-reported. Covariate-adjusted generalized estimating equations were used for the analyses. RESULTS: Participants with HGS asymmetry had 1.12 [95% confidence interval (CI): 1.03-1.20] greater odds for future IADL limitations. Each HGS asymmetry dominance group also had greater odds for future IADL limitations: 1.09 (CI: 1.01-1.18) for individuals with dominant HGS asymmetry and 1.29 (CI: 1.09-1.52) for persons with nondominant HGS asymmetry. Every 0.10 increase in inverted HGS asymmetry ratio was associated with 1.30 (CI: 1.07-1.57) greater odds for future IADL limitations. CONCLUSIONS AND IMPLICATIONS: Assessing HGS asymmetry, as another potential biomarker of impaired muscle function, may provide novel insights for predicting IADL limitations. Future research should continue examining how strength asymmetries, and other aspects of muscle function beyond maximal strength, factor into the disabling cascade.

Differences in dietary patterns among college students according to body mass index.

OBJECTIVE AND PARTICIPANTS: The authors surveyed 557 undergraduate students aged 18-56 years to assess weight status, health behaviors, and dietary variety. METHODS: They used body mass index (BMI) to divide students into 4 weight categories: underweight (BMI < 19 kg/m2), healthy weight (19 kg/m2 to 24.99 kg/m2), over-weight (25 kg/m2 to 29.99 kg/m2), and obese (> 30 kg/m2). RESULTS: Approximately 33% of respondents were overweight or obese, and 8% were underweight. Among the weight categories, the authors observed significant differences in diet (eg, cheese, pork, lamb, veal and game, fish, green leafy vegetables, other vegetables, and the cumulative total of all meats). Overall, 33% of the students consumed 1 fruit in 3 days. The authors found no differences among the weight categories related to eating fatty, sugary snacks. CONCLUSIONS: College administrators should create health promotion and skill-building programs to improve students' diet variety.

Flaxseed- and Buckwheat-Supplemented Diets Altered Enterobacteriaceae Diversity and Prevalence in the Cecum and Feces of Obese Mice.

Dietary intake may cause variable bacterial prevalence in the gastrointestinal tract. The objective of this research was to determine the prevalence of Enterobacteriaceae in the cecum and feces and its relationship to weight changes following flaxseed-, health-promoting compounds of flaxseed-, or buckwheat-supplemented diets. Seventy-two C57BL/6J male mice were randomly assigned to a diet group and fed for 8 weeks: high fat (45% kcal fat); 10% whole flaxseed (45% kcal fat); 6% defatted flaxseed (45% kcal fat); 4% flaxseed oil (45% kcal fat); 10% buckwheat (45% kcal fat); and low fat (16% kcal fat) diet groups. Significant differences in the prevalence of Enterobacteriaceae in the cecum (p < .0348) and feces at posttreatment (p < .0033) were observed. The prevalence of Enterobacteriaceae affected posttreatment weight (p < .0001). Our results indicate that there may be a relationship between an increase in Enterobacteriaceae prevalence and weight gain.

Plasma and electrolyte changes in exercising humans after ingestion of multiple boluses of pickle juice.

CONTEXT: Twenty-five percent of athletic trainers administer pickle juice (PJ) to treat cramping. Anecdotally, some clinicians provide multiple boluses of PJ during exercise but warn that repeated ingestion of PJ may cause hyperkalemia. To our knowledge, no researchers have examined the effect of ingesting multiple boluses of PJ on the same day or the effect of ingestion during exercise. OBJECTIVE: To determine the short-term effects of ingesting a single bolus or multiple boluses of PJ on plasma variables and to characterize changes in plasma variables when individuals ingest PJ and resume exercise. DESIGN: Crossover study. SETTING: Laboratory. PATIENTS OR OTHER PARTICIPANTS: Nine euhydrated men (age = 23 ± 4 years, height = 180.9 ± 5.8 cm, mass = 80.7 ± 13.8 kg, urine specific gravity = 1.009 ± 0.005). INTERVENTION(S): On 3 days, participants rested for 30 minutes, and then a blood sample was collected. Participants ingested 0 or 1 bolus (1 mL · kg(-1) body weight) of PJ, donned sweat suits, biked vigorously for 30 minutes (approximate temperature = 37 °C, relative humidity = 18%), and had a blood sample collected. They either rested for 60 seconds (0- and 1-bolus conditions) or ingested a second 1 mL · kg(-1) body weight bolus of PJ (2-bolus condition). They resumed exercise for another 35 minutes. A third blood sample was collected, and they exited the environmental chamber and rested for 60 minutes (approximate temperature = 21 °C, relative humidity = 18%). Blood samples were collected at 30 and 60 minutes postexercise. MAIN OUTCOME MEASURE(S): Plasma sodium concentration, plasma potassium concentration, plasma osmolality, and changes in plasma volume. RESULTS: The number of PJ boluses ingested did not affect plasma sodium concentration, plasma potassium concentration, plasma osmolality, or changes in plasma volume over time. The plasma sodium concentration, plasma potassium concentration, and plasma osmolality did not exceed 144.6 mEq · L(-1) (144.6 mmol · L(-1)), 4.98 mEq · L(-1) (4.98 mmol · L(-1)), and 289.5 mOsm · kg(-1)H2O, respectively, in any condition at any time. CONCLUSIONS: Ingesting up to 2 boluses of PJ and resuming exercise caused negligible changes in blood variables. Ingesting up to 2 boluses of PJ did not increase plasma sodium concentration or cause hyperkalemia.

Effects of chromium and copper depletion on lymphocyte reactivity to mitogens in diabetes-prone BHE/cdb rats.

OBJECTIVE: The purpose of this study was to measure effects of chromium (Cr) and copper (Cu) depletion on lymphocyte reactivity to mitogens in diabetes-prone BHE/cdb rats. METHODS: A 2 x 2 factorial research design was used, and 40 BHE/cdb rats were fed with Cr- and/or Cu-depleted diets or adequate Cr and/or Cu diets for 21 wk. Cr and Cu concentrations in diets and mineral concentrations of tissues of BHE/cdb rats were measured by using flame and graphite furnace atomic absorption spectrometry. Three glucose tolerance tests were performed to monitor the development of diabetes or glucose intolerance at weeks 12, 18, and 21. Splenocytes (2 x 10(6)) were incubated with phytohemagglutinin-l (PHA-L), concanavalin A (ConA), and lipopolysaccharides (LPSs), respectively, for 72 h. Four hours before the end of the incubation, splenocytes were pulsed with 3H-thymidine. The 3H-thymidine uptake by lymphocytes was used to calculate a stimulation index. RESULTS: According to glucose tolerance tests, these rats did not develop diabetes or impaired glucose tolerance throughout the study. Average Cr concentrations were 0.98 to 1.03 mg Cr/kg of diet in adequate Cr diets and 8.2 to 14 micrograms Cr/kg of diet in Cr-depletion diets. Average Cu concentrations were 3.6 to 6.4 mg Cu/kg of diet in adequate Cu diets and 1.1 to 1.3 mg Cu/kg of diet in Cu-depletion diets. Organ weights did not differ significantly among treatment groups at the end of the study. Cr or Cu depletion significantly affected iron, zinc, and magnesium concentrations in the liver. A significant interactive effect of Cr and Cu was observed on lymphocyte proliferation with PHA-L stimulation at 25 micrograms/mL (P < 0.006). However, there were no significant effects of dietary treatment on lymphocyte proliferation with 10 micrograms/mL of PHA-L, ConA, or LPS stimulations. CONCLUSIONS: When Cr and Cu were adequate in the diets, there was an enhanced effect of Cu or Cr on lymphocyte proliferation. However, when Cr was depleted in the diet, there was a suppressive effect of Cu on lymphocyte proliferation. This result indicates that adequate amounts of Cr and Cu in the diet support the immune system.

Decreased consumption of sugar-sweetened beverages improved selected biomarkers of chronic disease risk among US adults: 1999 to 2010.

Consumption of sugar-sweetened beverages (SSBs) increased greatly from the late 1970s to the early part of this decade. Although recent data show that consumption of SSB may now be declining, consumption levels still remain much higher than recommended. Using data from the National Health and Nutrition Examination Survey, we assessed trends in intakes of SSB and levels of chronic disease biomarkers from 1999 to 2010 and examined the associations of SSB intake and biomarkers of chronic disease risk. We hypothesized that SSB intake will decrease and biomarkers of chronic disease risk will improve, therefore indicating that high intake of SSB is associated with greater chronic disease risk. Univariate analysis showed that from 1999 to 2010, SSB consumption decreased (P for trend = .0026), high-density lipoprotein increased (P for trend < .0001), low-density lipoprotein decreased (P for trend = .0007), and C-reactive protein decreased (P for trend = .0096). Using multivariate analysis, we showed that higher intakes of SSB were associated with lower high-density lipoprotein (P for trend < .0001), in an unadjusted model and all models with increasing numbers of covariates, and higher C-reactive protein (P for trend < .05), in an unadjusted model and in models with age, race/ethnicity, sex, education level, and poverty income ratio adjustments. We conclude that SSB consumption is associated with biomarkers of chronic disease risk, independent of demographic and lifestyle factors.

Grade III Liver Laceration in a Female Volleyball Player.

A 20-year-old female collegiate volleyball athlete (body mass, 74.8 kg; height, 177.8 cm), with no previous history of abdominal injury, dove for a ball during a match and was struck in the anterolateral abdominal region by a teammate's knee. She experienced a solar plexus spasm, shortness of breath, and nausea. On-site evaluation revealed sharp pain in the right upper quadrant and epigastric area, pallor, continued nausea, and excessive sweating. Upon arrival to the emergency department, an abdominal/pelvic computed tomography (CT) scan with intravenous contrast showed a small amount of fluid along the posteromedial surface of the liver indicating a subcapsular hematoma. A trace amount of free fluid in the right paracolic gutter and pelvis was also noted, suggesting a hemoperitoneum. The athlete was diagnosed with a grade III laceration (> 3 cm parenchymal depth) on the right lobe of the liver. She was hemodynamically stable and vital sign values were normal ~2.5 hours postinjury (blood pressure, 118/76 mm Hg; heart rate, 68 beats per minute; respiratory rate, 16 breaths per minute; tympanic temperature, 36.3°C). The athlete was admitted into the intensive care unit for observation, and the attending physician decided on a conservative, nonoperative approach to treatment. Forty-eight hours postinjury, a second abdominal/pelvic CT scan was ordered and revealed no increased bleeding or extensive damage to the liver. Two days later, after being discharged from the hospital, she was prohibited from practicing until a third abdominal/pelvic CT scan was performed and showed no residual injury to the liver (5 weeks postinjury). The athlete returned to play 6 weeks postinjury without complications; however, she continued performing rehabilitation focusing on cardiorespiratory endurance.