Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 42
Filtrar
Más filtros

Medicinas Complementárias
Métodos Terapéuticos y Terapias MTCI
Bases de datos
Tipo del documento
Intervalo de año de publicación
1.
Osteoporos Int ; 24(5): 1567-77, 2013 May.
Artículo en Inglés | MEDLINE | ID: mdl-23229471

RESUMEN

UNLABELLED: On September 29, 2011, acknowledged experts in the field of vitamin D, mainly European, were brought together in order to discuss the recent scientific advances in relation to vitamin D: the current requirements and associations with various health outcomes. In this article, the discussions resulting from the meeting are summarized. INTRODUCTION: Several groups at risk for developing vitamin D insufficiency have been identified. Accordingly, reviews indicate that a significant percentage of the population worldwide have serum 25-hydroxyvitamin D levels below 50 nmol/l. In addition to the role of vitamin D in bone health, recent studies suggest that it may play a pivotal role in other systems, e.g., the cardiovascular system, pancreas, muscle, immune system and brain. Most evidence, however, is obtained from observational studies and yet inconclusive. METHODS: To exchange and broaden knowledge on the requirements for vitamin D and its effect on various health outcomes, a workshop entitled "Vitamin D Expert Meeting: Do we get enough?", was organized. RESULTS: Despite low vitamin D levels worldwide, consensus on the definition of deficiency is not yet reached. In order to define cut-off points for vitamin D whilst taking into account extraskeletal health effects, randomized controlled trials in these fields are warranted. The experts do emphasize that there is evidence to suggest an important role for vitamin D in the maintenance of optimal bone health at all ages and that vitamin D supplementation, in most studies co-administered with calcium, reduces fracture risk in the senior population. CONCLUSION: To reach a serum 25-hydroxyvitamin D level of 50 nmol/l older adults aged ≥65 years are therefore recommended to meet a mean daily vitamin D intake of 20 µg (800 IU), which is best achieved with a supplement.


Asunto(s)
Dieta/normas , Suplementos Dietéticos , Deficiencia de Vitamina D/diagnóstico , Vitamina D/administración & dosificación , Europa (Continente) , Medicina Basada en la Evidencia/métodos , Salud Global , Humanos , Valores de Referencia , Luz Solar , Vitamina D/análogos & derivados , Vitamina D/sangre , Deficiencia de Vitamina D/sangre
2.
J Nutr Health Aging ; 15(10): 912-7, 2011 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-22159782

RESUMEN

OBJECTIVE: Aging and oxidative stress may lead to enhanced cellular damage and programmed cell death. To study the association of intrinsic apoptosis with age and the effect of antioxidant supplementation on intrinsic and UV-induced apoptosis in children, young and elderly people. METHODS: The study was a 2 months, double-blind, randomized trial. Three age groups were studied: children, young adults and elderly people. A total of 274 healthy subjects were allocated to a group supplemented with moderate amounts of retinol, ß-carotene, α-tocopherol, ascorbic acid and selenium or placebo. Plasma oxidative stress parameters were detected and apoptosis of lymphocytes was evaluated with TUNEL staining. RESULTS: At baseline, percentages of intrinsic apoptosis were 13.8% and 11.1% in elderly and young people, respectively, both significantly higher than children (6.3%). A decrease of 1.7% and 2.3% in intrinsic apoptosis of lymphocytes was found in the supplemented groups of young and elderly people compared with their control groups (all p values <0.001), but no significant decrease in children. Moreover, percentages UV-induced apoptosis significantly decreased by 1.4%, 1.9% and 3.1% in children, young and elderly people, respectively, compared with control groups after the trial. There were considerable increments in concentrations of plasma ß-carotene, retinol, tocopherol, ascorbic acid and selenium in all three treated groups after the supplementation. CONCLUSIONS: Young and elderly people have a higher intrinsic apoptosis than children, which was improved by antioxidant supplementation. UV-induced damage was attenuated by the supplementation in all three age groups.


Asunto(s)
Antioxidantes/farmacología , Apoptosis/efectos de los fármacos , Suplementos Dietéticos , Linfocitos/efectos de los fármacos , Micronutrientes/farmacología , Estrés Oxidativo/efectos de los fármacos , Rayos Ultravioleta , Adolescente , Adulto , Anciano , Antioxidantes/metabolismo , Ácido Ascórbico/sangre , Ácido Ascórbico/farmacología , Niño , Método Doble Ciego , Femenino , Humanos , Etiquetado Corte-Fin in Situ , Recuento de Linfocitos , Linfocitos/efectos de la radiación , Masculino , Micronutrientes/metabolismo , Persona de Mediana Edad , Selenio/sangre , Selenio/farmacología , Vitamina A/sangre , Vitamina A/farmacología , Adulto Joven , beta Caroteno/sangre , beta Caroteno/farmacología
3.
J Nutr Health Aging ; 14(5): 347-51, 2010 May.
Artículo en Inglés | MEDLINE | ID: mdl-20424800

RESUMEN

OBJECTIVES: Age-related hearing loss is a common social and health problem in the older adult population. Up until now, very little scientific attention has been given to the potential role of fatty acids in age-related hearing loss. In this study we investigated whether plasma very long-chain n-3 polyunsaturated fatty acids (PUFAs) are associated with age-related hearing loss over three years. DESIGN: Cross-sectional and 3-year longitudinal analyses. SETTING: Wageningen, the Netherlands. PARTICIPANTS: 720 men and postmenopausal women (50-70 years of age) without middle ear dysfunction or unilateral hearing loss. MEASUREMENTS: Fatty acid proportions were measured in plasma cholesteryl esters. Hearing thresholds (in decibels, dB) at baseline and after three years were measured with pure-tone audiometry. Hearing loss was calculated as the increase in mean hearing thresholds in the low (0.5-kHz, 1-kHz, and 2-kHz) and high (4-kHz, 6-kHz, and 8-kHz) frequencies over three years. RESULTS: Subjects in the highest quartile of plasma very long-chain n-3 PUFA had less hearing loss in the low frequencies over three years than subjects in the lowest quartile (p < 0.01, ANCOVA, difference in mean adjusted hearing thresholds= -1.2 dB). There were no significant differences between the quartiles of plasma very long-chain n-3 PUFA in hearing loss in the high frequencies (p=0.49, ANCOVA). These associations are adjusted for baseline mean hearing thresholds, age, sex, level of education and alcohol consumption. CONCLUSION: This study is the first to show an inverse association between plasma very long-chain n-3 PUFAs and age-related hearing loss. These results are encouraging, but require confirmation from future studies.


Asunto(s)
Envejecimiento/fisiología , Umbral Auditivo/fisiología , Ácidos Grasos Omega-3/sangre , Presbiacusia/sangre , Anciano , Audiometría , Estudios Transversales , Ácidos Grasos Omega-3/fisiología , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Presbiacusia/etiología
4.
J Nutr Health Aging ; 13(9): 769-75, 2009 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-19812866

RESUMEN

BACKGROUND: Elderly people may benefit from sensory stimulation to increase food intake since anorexia of ageing is prevalent among them. An optimal MSG concentration may increase the palatability of foods but this depends on the food and chemosensory status of the taster. Currently, the results on taste enhancing to increase intake are inconsistent. OBJECTIVE: To find an optimal preferred MSG concentration in mashed potatoes, spinach and ground beef and to determine whether this concentration increases consumption of these foods among institutionalized elderly people. DESIGN: Single blind within subject cross-over study performed at the laboratory and in the residents' own apartments. PARTICIPANTS: 33 elderly and 29 young people in the sensory study and 53 elderly people in the intake study. MEASUREMENTS: Pleasantness of the foods was rated of the foods each with 0, 0.5, 0.8, 1.3 and 2.0 g of MSG/100g. Intake was measured by weighing back leftovers of 2 meals with MSG (0.5% in mashed potatoes, 2% in spinach and ground meat) and without MSG. RESULTS: 0.5% MSG (p < 0.05) was preferred in mashed potatoes but no optimal preferred concentration was found for spinach and ground beef, possibly because of their complex taste. Intake was not different between the foods with and without MSG or the total meal (all p > 0.68). CONCLUSION: MSG (0.5% and 2%) does not guarantee a higher intake among elderly. The chemosensory heterogeneity of the elderly population requires more individual flavor enhancement to improve the dietary intake and sensory experience.


Asunto(s)
Ingestión de Energía/efectos de los fármacos , Aditivos Alimentarios/farmacología , Glutamato de Sodio/farmacología , Gusto/efectos de los fármacos , Anciano de 80 o más Años , Envejecimiento , Anorexia , Estudios Cruzados , Relación Dosis-Respuesta a Droga , Femenino , Aditivos Alimentarios/administración & dosificación , Hogares para Ancianos , Humanos , Masculino , Productos de la Carne/análisis , Casas de Salud , Método Simple Ciego , Glutamato de Sodio/administración & dosificación , Solanum tuberosum/química , Spinacia oleracea/química , Adulto Joven
5.
Neurology ; 71(6): 430-8, 2008 Aug 05.
Artículo en Inglés | MEDLINE | ID: mdl-18678826

RESUMEN

BACKGROUND: High intake of n-3 polyunsaturated fatty acids may protect against age-related cognitive decline. However, results from epidemiologic studies are inconclusive, and results from randomized trials in elderly subjects without dementia are lacking. OBJECTIVE: To investigate the effect of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) supplementation on cognitive performance. METHODS: Double-blind, placebo-controlled trial involving 302 cognitively healthy (Mini-Mental State Examination score > 21) individuals aged 65 years or older. Participants were randomly assigned to 1,800 mg/d EPA-DHA, 400 mg/d EPA-DHA, or placebo capsules for 26 weeks. Cognitive performance was assessed using an extensive neuropsychological test battery that included the cognitive domains of attention, sensorimotor speed, memory, and executive function. RESULTS: The mean age of the participants was 70 years, and 55% were male. Plasma concentrations of EPA-DHA increased by 238% in the high-dose and 51% in the low-dose fish oil group compared with placebo, reflecting excellent compliance. Baseline scores on the cognitive tests were comparable in the three groups. Overall, there were no significant differential changes in any of the cognitive domains for either low-dose or high-dose fish oil supplementation compared with placebo. CONCLUSIONS: In this randomized, double-blind, placebo-controlled trial, we observed no overall effect of 26 weeks of eicosapentaenoic acid and docosahexaenoic acid supplementation on cognitive performance.


Asunto(s)
Trastornos del Conocimiento/prevención & control , Cognición , Ácido Eicosapentaenoico/administración & dosificación , Ácidos Grasos Insaturados/administración & dosificación , Aceites de Pescado/administración & dosificación , Anciano , Cápsulas , Suplementos Dietéticos , Método Doble Ciego , Femenino , Humanos , Masculino
6.
J Hum Hypertens ; 20(8): 571-80, 2006 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-16673011

RESUMEN

Calcium plays a role in blood pressure (BP) regulation, but the importance of supplemental calcium intake for the prevention of hypertension is still debated. We conducted a meta-analysis of randomized controlled trials to determine the effect of calcium supplementation on BP. A systematic search for randomized trials of calcium supplementation and BP in non-pregnant subjects was performed in Medline from 1966 to June 2003. Seventy-one trials were identified, 40 of which met the criteria for meta-analysis (total of 2492 subjects). Two persons independently extracted data from original publications on changes in calcium intake and BP. In addition, data were collected on subjects' characteristics, that is, age, gender, initial BP and initial calcium intake. A random effects model was used to obtain the effect of calcium supplementation on BP, overall and in predefined population subgroups. Calcium supplementation (mean daily dose: 1200 mg) reduced systolic BP by -1.86 mm Hg (95% confidence interval: -2.91 to -0.81) and diastolic BP by -0.99 mm Hg (-1.61 to -0.37). In people with a relatively low calcium intake (< or =800 mg per day) somewhat larger BP estimates were obtained, that is, -2.63 (-4.03 to -1.24) for systolic BP and -1.30 (-2.13 to -0.47) for diastolic BP. Our study suggests that an adequate intake of calcium should be recommended for the prevention of hypertension. More research on BP in people with calcium-deficient diets is warranted.


Asunto(s)
Presión Sanguínea/efectos de los fármacos , Presión Sanguínea/fisiología , Calcio de la Dieta/administración & dosificación , Calcio de la Dieta/farmacología , Suplementos Dietéticos , Ensayos Clínicos Controlados Aleatorios como Asunto , Adolescente , Adulto , Anciano , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad
7.
J Hum Hypertens ; 17(7): 471-80, 2003 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-12821954

RESUMEN

The objective of the study was to assess the blood pressure response to changes in sodium and potassium intake and examine effect modification by age, gender, blood pressure, body weight and habitual sodium and potassium intake. Randomised trials of sodium reduction or potassium supplementation and blood pressure were identified through reference lists of systematic reviews and an additional MEDLINE search (January 1995-March 2001). A total of 40 sodium trials and 27 potassium trials in adults with a minimum duration of 2 weeks were selected for analysis. Data on changes in electrolyte intake and blood pressure during intervention were collected, as well as data on mean age, gender, body weight, initial electrolyte intake and initial blood pressure of the trial populations. Blood pressure effects of changes in electrolyte intake were assessed by weighted metaregression analysis, overall and in strata of trial population characteristics. Analyses were repeated with adjustment for potential confounders. Sodium reduction (median: -77 mmol/24 h) was associated with a change of -2.54 mmHg (95% CI: -3.16, -1.92) in systolic blood pressure and -1.96 mmHg (-2.41, -1.51) in diastolic blood pressure. Corresponding values for increased potassium intake (median: 44 mmol/24 h) were -2.42 mmHg (-3.75, -1.08) and -1.57 mmHg (-2.65, -0.50). Blood pressure response was larger in hypertensives than normotensives, both for sodium (systolic: -5.24 vs -1.26 mmHg, P < 0.001; diastolic: -3.69 vs -1.14 mmHg, P < 0.001) and potassium (systolic: -3.51 vs -0.97 mmHg, P=0.089; diastolic: -2.51 vs -0.34 mmHg, P=0.074). In conclusion, reduced intake of sodium and increased intake of potassium could make an important contribution to the prevention of hypertension, especially in populations with elevated blood pressure.


Asunto(s)
Presión Sanguínea/fisiología , Potasio en la Dieta/farmacología , Sodio en la Dieta/farmacología , Presión Sanguínea/efectos de los fármacos , Femenino , Humanos , Hipertensión/fisiopatología , Masculino , Persona de Mediana Edad , Análisis de Regresión
8.
Br J Nutr ; 89(5): 673-8, 2003 May.
Artículo en Inglés | MEDLINE | ID: mdl-12720587

RESUMEN

Zn is an essential mineral. The role of Zn in atherosclerosis is not clear. Epidemiological studies, which have reported contradictory results, are limited by the use of serum Zn levels as a marker of intake. We assessed the association of toenail Zn, which integrates dietary Zn intake over 3 to 12 months, with the risk of a first myocardial infarction. Toenail Zn concentrations were determined by neutron activation analysis in the European multi-centre case-control study on antioxidants, myocardial infarction and breast cancer. This multi-centre case-control study included 684 cases and 724 controls from eight European countries and Israel. Toenail Zn levels of controls (adjusted for age and study centre) were positively associated with age, alpha-tocopherol and Se, but not with additional dietary variables or with classical risk factors for CHD. Average toenail Zn was 106.0 mg/kg in cases (95 % CI 103.1, 108.9) and 107.5 mg/kg in controls (95 % CI 104.5, 110.7). After controlling for cardiovascular risk factors and for centre, the adjusted odds ratios of myocardial infarction for quintiles 2-5 of toenail Zn with respect to the first quintile were 0.97 (95 % CI 0.59, 1.58), 1.15 (95 % CI 0.72, 1.85), 0.91 (95 % CI 0.56, 1.50), and 0.85 (95 % CI 0.52, 1.39). The P for trend was 0.45. In conclusion toenail Zn levels (reflecting long-term dietary intake) were not significantly associated with acute myocardial infarction.


Asunto(s)
Infarto del Miocardio/metabolismo , Uñas/química , Zinc/análisis , Tejido Adiposo/química , Anciano , Envejecimiento , Biomarcadores/análisis , Estudios de Casos y Controles , Europa (Continente) , Humanos , Israel , Masculino , Persona de Mediana Edad , Infarto del Miocardio/etiología , Análisis de Activación de Neutrones , Oportunidad Relativa , Riesgo , Selenio/análisis , Dedos del Pie , alfa-Tocoferol/análisis
9.
Br J Sports Med ; 36(2): 126-31, 2002 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-11916896

RESUMEN

OBJECTIVE: To examine the effects of 17 weeks of physical exercise and micronutrient supplementation on the psychological wellbeing of 139 independently living, frail, elderly subjects (inactive, body mass index < or =25 or experiencing weight loss). METHODS: Participants (mean (SD) age 78.5 (5.7)) were randomly assigned to: (a) comprehensive, moderate intensity, group exercise; (b) daily micronutrient enriched foods (25-100% recommended daily amount); (c) both; (d) neither. A social programme and identical regular foods were offered as attention control and placebo. RESULTS: At baseline, moderate to low but significant correlations were found between general wellbeing scores and physical fitness (r = 0.28), functional performance (r = 0.37), and blood concentrations of pyridoxine (r = 0.20), folate (r = 0.25), and vitamin D (r = 0.23) (all p values < or =0.02), but not with physical activity levels and other blood vitamin concentrations. General wellbeing score and self rated health were not responsive to 17 weeks of exercise or nutritional intervention. CONCLUSION: Psychological wellbeing in frail elderly people was not responsive to 17 weeks of intervention with exercise and/or micronutrient enriched foods. The moderate but significant correlations between wellbeing and physical fitness and several blood vitamin concentrations at baseline suggest that changes in wellbeing may occur after long term interventions.


Asunto(s)
Anciano/fisiología , Anciano/psicología , Terapia por Ejercicio/métodos , Anciano Frágil/psicología , Micronutrientes/administración & dosificación , Actividades Cotidianas , Anciano de 80 o más Años , Suplementos Dietéticos , Femenino , Estado de Salud , Humanos , Masculino , Salud Mental , Estado Nutricional , Aptitud Física/fisiología , Aptitud Física/psicología
10.
Arch Phys Med Rehabil ; 82(6): 811-7, 2001 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-11387588

RESUMEN

OBJECTIVE: To examine the effects of an exercise program and an enriched food regimen on physical functioning of frail elderly persons. DESIGN: A 17-week randomized, placebo-controlled trial. SETTING: Community. PARTICIPANTS: One hundred fifty-seven independently living frail elderly (mean age, 78.7 +/- 5.6yr). INTERVENTION: Thirty-nine subjects participated in a twice weekly group exercise designed to improve daily functioning; 39 subjects daily ate foods enriched with vitamins and minerals (at 25%-100% of the recommended daily allowances); 42 subjects exercised and ate enriched foods; and 37 subjects served as controls. Nonexercising groups followed a social program; nonsupplement groups received the same food products without the micronutrients. MAIN OUTCOME MEASURES: Functional performance based on 6 performance tests, physical fitness based on 7 fitness tests, and disabilities based on the self-reported ability to perform 16 daily activities. RESULTS: Performance sum scores were significantly enhanced in trained (+8%) compared with nontrained subjects (-8%) (difference in change: 1.9 points, p < .001, adjusted for baseline scores). Fitness sum scores were significantly enhanced as well (+3% in trained vs -2% in nontrained) (difference in change: 0.9 points, p = .05, adjusted for baseline scores). No exercise effects on the disability score were observed. Consumption of enriched products did not affect performance, fitness, or disability scores. CONCLUSION: Our comprehensive exercise program, designed for widespread applicability, enhanced physical performance and fitness in a population of frail elderly. Daily consumption of micronutrient enriched foods showed no functional benefits within 17 weeks.


Asunto(s)
Actividades Cotidianas , Ejercicio Físico , Alimentos Fortificados , Anciano Frágil , Aptitud Física , Anciano , Fenómenos Biomecánicos , Femenino , Humanos , Masculino , Estadísticas no Paramétricas
11.
Am J Clin Nutr ; 73(2): 338-46, 2001 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-11157333

RESUMEN

BACKGROUND: Frail elders are at risk of suboptimal micronutrient status, functional decline, and neurologic disorders. The influence of oral multimicronutrients in physiologic doses and of moderately intense physical exercise on homocysteine (Hcy), methylmalonic acid (MMA), and neurologic functioning have not yet been investigated. OBJECTIVE: Our goal was to determine the effects of enriched foods and exercise on blood vitamins, Hcy, MMA, and neuropsychological functioning in the frail. DESIGN: A 17-wk randomized controlled intervention trial was used to study 1) enriched foods plus a social program, 2) regular foods plus exercise, 3) enriched foods plus exercise, and 4) regular foods plus a social program. Enriched foods contained multiple micronutrients (25-100% of the Dutch recommended dietary allowances); exercises focused on strength, coordination, flexibility, and endurance. Vitamin (cobalamin, red blood cell folate, and pyridoxal 5'-phosphate), Hcy, and MMA concentrations were measured and 2 neuropsychological tests were conducted. RESULTS: Vitamin concentrations were higher in the supplemented groups than in the unsupplemented groups (P < 0.001; total n = 130). Compared with baseline, cobalamin in the supplemented groups was increased by 22%, plasma folate by 101%, red blood cell folate by 87%, and pyridoxal 5'-phosphate by 68%. Concentrations in the unsupplemented groups changed by -2%, -6%, 1%, and -13%, respectively. Hcy decreased by 25% and MMA by 30% in the supplemented groups, compared with a small increase in Hcy (2%) and decrease in MMA (9%) in the unsupplemented groups. Exercise did not significantly affect vitamin, Hcy, or MMA concentrations. No significant effect of either intervention was observed on the neuropsychological tests. CONCLUSIONS: The decrease in Hcy and MMA in frail elders confirms a subclinical metabolic deficiency state. Enriched foods containing physiologic amounts of micronutrients have a beneficial effect on these metabolites. No effects of B vitamins on mental health were identified.


Asunto(s)
Ejercicio Físico/fisiología , Alimentos Fortificados , Anciano Frágil , Homocisteína/sangre , Ácido Metilmalónico/sangre , Fenómenos Fisiológicos del Sistema Nervioso , Complejo Vitamínico B/sangre , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Estudios Transversales , Suplementos Dietéticos , Femenino , Humanos , Masculino , Enfermedades del Sistema Nervioso/prevención & control , Países Bajos , Pruebas Neuropsicológicas , Política Nutricional , Estado Nutricional , Valor Nutritivo , Socialización , Encuestas y Cuestionarios
12.
Med Sci Sports Exerc ; 32(12): 2005-11, 2000 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-11128843

RESUMEN

OBJECTIVE: To examine the effects of 17-wk physical exercise and enriched foods on cellular immune response (CIR) in frail elderly. METHODS: A total of 112 independently living, frail elderly men and women (mean age 79.2 +/- 5.9) received: twice weekly comprehensive, moderate intensity, progressive group exercise (group A, N = 26); daily enriched foods (group B, N = 31); both (group C, N = 29); or neither (group D, N = 26). Exercises focused on skills training. Foods were enriched with micronutrients with a high prevalence of deficiency in older people (at 25-100% the RDA). A social program and identical regular foods were offered as a control. CIR was measured by delayed-type hypersensitivity skin test response (DTH) against seven recall antigens expressed as the total number of positive responses and sum of diameters of all positive responses. RESULTS: No independent or interactive effect of enriched foods was observed. Therefore, exercise (groups A + C) was compared with no exercise (groups B + D). Nonexercising subjects showed an average decline of 0.5 responses compared with an unchanged responsiveness among exercising subjects (difference = 0.5, 95% CI: 0.04-0.89, P = 0.03 adjusted for baseline DTH, activity level, and micronutrient status). Nonexercising subjects had a larger decline in the sum of diameters of all positive responses than exercising subjects but the difference did not reach significance (adjusted difference = 2.1 mm, 95% CI:-1.0-4.8). CONCLUSION: Exercise may prevent or slow the age-related decline in immune response. Micronutrient enriched foods showed no effect. As infectious diseases can have debilitating or even fatal consequences for the elderly, prevention of the age-related decline in CIR could significantly improve their quality of life.


Asunto(s)
Ejercicio Físico/fisiología , Alimentos Fortificados , Anciano Frágil , Inmunidad Celular , Fenómenos Fisiológicos de la Nutrición , Anciano , Femenino , Humanos , Masculino
13.
J Clin Epidemiol ; 53(7): 707-14, 2000 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-10941948

RESUMEN

We studied the associations between the common carotid-intima-media thickness (IMT), as a marker of atherosclerosis, and smoking characteristics and antioxidant vitamins among 158 male life-long cardiovascular disease (CVD)-free smokers. An "increased" carotid IMT was defined as the upper 25%. The prevalence of increased IMT was 2.5 times (odds ratio (OR) = 2.5; 95% CI: 1.1, 5.6) higher among smokers inhaling smoke deeply into the lungs than among moderate and non-inhalers. This association decreased when adjusted for other CVD risk factors. Smokers with an increased carotid IMT did not differ significantly in mean antioxidant vitamin intake and status with the remaining group. However, classical CVD risk factors contributed importantly to increased carotid IMT. In our study, depth of inhalation was the only smoking characteristic associated with carotid IMT although attenuated after adjustment for traditional risk factors for CVD. Furthermore, in these life-long smokers not using any vitamin supplements, no associations were found for antioxidant vitamins.


Asunto(s)
Antioxidantes/uso terapéutico , Arterias Carótidas/patología , Enfermedades de las Arterias Carótidas/epidemiología , Fumar/patología , Túnica Íntima/patología , Túnica Media/patología , Anciano , Enfermedades de las Arterias Carótidas/patología , Humanos , Masculino , Persona de Mediana Edad , Ensayos Clínicos Controlados Aleatorios como Asunto , Factores de Riesgo
14.
Am J Epidemiol ; 151(10): 999-1006, 2000 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-10853639

RESUMEN

Fish consumption seems to protect against death from coronary heart disease (CHD). If this association is due to n-3 polyunsaturated fatty acids, especially fatty fish may be responsible for this protective effect. The association between total, lean, and fatty fish consumption and the risk of CHD mortality was examined in 1,088 Finnish, 1,097 Italian, and 553 Dutch men participants in the Seven Countries Study who were aged 50-69 years and free of CHD around 1970. After 20 years of follow-up, 242 (22.2%) men in Finland, 116 (10.6%) men in Italy, and 105 (19.0%) men in the Netherlands had died of CHD. Cox proportional hazards analysis showed no association between total fish consumption and CHD mortality. After adjustments were made for age, body mass index, smoking, energy intake, and relevant dietary variables, the pooled relative risk for the highest quartile of total fish compared with no fish consumption in the three countries was 1.08 (95% confidence interval: 0.76, 1.53). Lean fish consumption also was not associated with CHD mortality in any country. Fatty fish compared with non-fatty-fish consumption was associated with lower CHD mortality; the adjusted, pooled relative risk for fatty fish consumers was 0.66 (95% confidence interval: 0.49, 0.90). These data suggest that especially fatty fish is protective against CHD mortality.


Asunto(s)
Enfermedad Coronaria/mortalidad , Enfermedad Coronaria/prevención & control , Dieta/estadística & datos numéricos , Peces , Adulto , Anciano , Animales , Enfermedad Coronaria/etiología , Encuestas sobre Dietas , Ácidos Grasos Omega-3/fisiología , Finlandia/epidemiología , Estudios de Seguimiento , Humanos , Italia/epidemiología , Masculino , Metaanálisis como Asunto , Persona de Mediana Edad , Países Bajos/epidemiología , Vigilancia de la Población , Modelos de Riesgos Proporcionales , Factores de Riesgo
15.
J Nutr ; 129(11): 2028-36, 1999 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-10539780

RESUMEN

A decline in dietary intake due to inactivity and, consequently, development of a suboptimal nutritional status is a major problem in frail elderly people. However, benefits of micronutrient supplementation, all-round physical exercise or a combination of both on functional biochemical and hematologic indicators of nutritional and health status in frail elderly subjects have not been tested thoroughly. A 17-wk randomized controlled trial was performed in 145 free-living frail elderly people (43 men, 102 women, mean age, 78 +/- 5.7 y). Based on a 2 x 2 factorial design, subjects were assigned to one of the following: 1) nutrient-dense foods, 2) exercise, 3) both (1) and (2) or 4) a control group. Foods were enriched with micronutrients, frequently characterized as deficient [25-100% of the recommended daily allowance (RDA)] in elderly people. Exercises focused on skill training, including strength, endurance, coordination and flexibility. Dietary intake, blood vitamin levels and nutritional and health indicators, including (pre)albumin, ferritin, transferrin, C-reactive protein, hemoglobin and lymphocytes were measured. At baseline, 28% of the total population had an energy intake below 6.3 MJ, up to a maximum of 93% having vitamin intakes below two thirds of the Dutch RDA. Individual deficiencies in blood at baseline ranged from 3% for erythrocyte glutathione reductase-alpha to 39% for 25-hydroxy vitamin D and 42% for vitamin B-12. These were corrected after 17 wk in the two groups receiving the nutrient-dense foods, whereas no significant changes were observed in the control or exercise group. Biochemical and hematologic indicators at baseline were within the reference ranges (mean albumin, 46 g/L; prealbumin, 0.25 g/L; hemoglobin, 8.6 mmol/L) and were not affected by any of the interventions. The long-term protective effects of nutrient supplementation and exercise, by maintaining optimal nutrient levels and thereby reducing the initial chance of developing critical biochemical values, require further investigation. Other indicative functional variables for suboptimal nutritional status, in addition to those currently selected, should also be explored.


Asunto(s)
Suplementos Dietéticos , Ejercicio Físico , Anciano Frágil , Micronutrientes/uso terapéutico , Vitaminas/administración & dosificación , Anciano , Anciano de 80 o más Años , Antropometría , Avitaminosis/tratamiento farmacológico , Avitaminosis/epidemiología , Dieta , Ingestión de Energía , Femenino , Humanos , Masculino , Países Bajos/epidemiología , Política Nutricional , Estado Nutricional , Valores de Referencia , Vitaminas/sangre
16.
Am J Clin Nutr ; 69(6): 1273-81, 1999 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-10357750

RESUMEN

BACKGROUND: It has been suggested that vitamin E can counteract the age-associated decline in cellular immune responsiveness (CIR). Particularly, T helper cell type 1 (Th1) activity, ie, interferon (IFN) gamma-producing Th1 activity and, hence, delayed-type hypersensitivity (DTH) would be enhanced by vitamin E supplementation. OBJECTIVE: Our aim was to study the effects of 6 mo supplementation with 50 and 100 mg vitamin E on CIR in the elderly. DESIGN: A double-blind, placebo-controlled trial was conducted in 161 healthy elderly subjects aged 65-80 y. CIR was measured in vivo by means of DTH skin tests and in vitro by assessing the production of interleukin (IL) 2, IFN-gamma (a typical Th1 cytokine), and IL-4 (a typical Th2 cytokine) by peripheral blood mononuclear cells after stimulation with phytohemagglutinin. RESULTS: Both DTH and IL-2 production showed a trend toward increased responsiveness with increasing dose of vitamin E. However, IFN-gamma production decreased whereas IL-4 production increased in the groups receiving vitamin E. Only the change in the number of positive DTH reactions was borderline significantly larger in the 100-mg vitamin E group than in the placebo group (P = 0.06, Bonferroni adjusted). Subjects receiving 100 mg vitamin E with low baseline DTH reactivity or who were physically less active had a significantly larger increase in the cumulative diameter of the skin induration resulting from the DTH test than did the placebo group (P = 0.03), although this difference was not significant after Bonferroni correction (P = 0.07). CONCLUSION: Possible beneficial effects of 100-mg vitamin E supplementation may be more pronounced in particular subgroups of elderly subjects.


Asunto(s)
Hipersensibilidad Tardía/tratamiento farmacológico , Inmunidad Celular/efectos de los fármacos , Vitamina E/farmacología , Anciano , Anciano de 80 o más Años , Índice de Masa Corporal , Relación Dosis-Respuesta a Droga , Método Doble Ciego , Femenino , Humanos , Interleucinas/biosíntesis , Masculino , Países Bajos , Vitamina E/administración & dosificación , Vitamina E/sangre
17.
Arterioscler Thromb Vasc Biol ; 19(4): 1111-8, 1999 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-10195943

RESUMEN

Omega-3 fatty acids have potential antiatherogenic, antithrombotic, and antiarrhythmic properties, but their role in coronary heart disease remains controversial. To evaluate the association of omega-3 fatty acids in adipose tissue with the risk of myocardial infarction in men, a case-control study was conducted in eight European countries and Israel. Cases (n=639) included patients with a first myocardial infarction admitted to coronary care units within 24 hours from the onset of symptoms. Controls (n=700) were selected to represent the populations originating the cases. Adipose tissue levels of fatty acids were determined by capillary gas chromatography. The mean (+/-SD) proportion of alpha-linolenic acid was 0.77% (+/-0.19) of fatty acids in cases and 0.80% (+/-0.19) of fatty acids in controls (P=0.01). The relative risk for the highest quintile of alpha-linolenic acid compared with the lowest was 0.42 (95% confidence interval [CI] 0.22 to 0.81, P-trend=0.02). After adjusting for classical risk factors, the relative risk for the highest quintile was 0.68 (95% CI 0.31 to 1.49, P-trend=0.38). The mean proportion of docosahexaenoic acid was 0.24% (+/-0.13) of fatty acids in cases and 0.25% (+/-0.13) of fatty acids in controls (P=0. 14), with no evidence of association with risk of myocardial infarction. In this large case-control study we could not detect a protective effect of docosahexaenoic acid on the risk of myocardial infarction. The protective effect of alpha-linolenic acid was attenuated after adjusting for classical risk factors (mainly smoking), but it deserves further research.


Asunto(s)
Tejido Adiposo/metabolismo , Ácidos Grasos Omega-3/metabolismo , Infarto del Miocardio/epidemiología , Infarto del Miocardio/metabolismo , Anciano , Estudios de Casos y Controles , Europa (Continente)/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Distribución Aleatoria , Factores de Riesgo
18.
Br J Nutr ; 80 Suppl 1: S77-112, 1998 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-9849355

RESUMEN

This paper assesses critically the science base that underpins the argument that oxidative damage is a significant causative factor in the development of human diseases and that antioxidants are capable of preventing or ameliorating these disease processes. The assessment has been carried out under a number of headings, and some recommendations for future research are made based on the present day knowledge base. The knowledge database (1) Consideration of the basic science that underlies understanding of the role of free radicals in causing cellular pathologies, and the role of antioxidants in preventing this, shows that an imbalance of reactive oxygen species and antioxidant defence systems may lead to chemical modifications of biologically relevant macromolecules. This imbalance provides a logical pathobiochemical mechanism for the initiation and development of several disease states. Experimental data obtained in vivo provide evidence that antioxidants function in systems that scavenge reactive oxygen species and that these are relevant to what occurs in vivo. The relevance in vivo of these observations depends inter alia on knowledge of the uptake and distribution of the antioxidant within the human body, and on what tissue levels of the antioxidant may be expected in relation to dietary levels. (2) There is some way to go until validated precise methods are available for measuring biomarkers of oxidative damage in human subjects in vivo under minimally invasive conditions. With respect to oxidative damage in DNa, HPLC and GC-mass spectrophotometry methods have both merits and limitations. Lipid oxidation products in plasma are best measured as isoprostanes or as lipid hydroperoxides using specific HPLC techniques. Development of isoprostane measurement will advance specificity and precision. The measurement of oxidative damage to proteins has some potential but such methods have not been effectively exploited. (3) Epidemiological studies support the hypothesis that the major antioxidant nutrients vitamin E and vitamin C, and beta-carotene (which may or may not be acting as an antioxidant in vivo), may play a beneficial role in prevention of several chronic disorders. More research is needed on the impact of other non-nutrient compounds, such as other carotenoids and flavonoids, on human health. In general, human intervention studies using hard end-points are the gold standard. Trials are restricted mainly to the major antioxidants and do not allow firm conclusions because of inconsistent findings, an insufficient number of studies and the use of varying doses. There is evidence that large doses of beta-carotene may be deleterious to the health of certain subgroups of the population such as heavy habitual smokers. (4) With respect to the safety of administration of supplementary vitamins, vitamin C is safe at levels of supplementation up to 600 mg/d, and higher levels, up to 2000 mg/d, are without risk. Vitamin E has a very low human toxicity and an intake of 1000 mg/d is without risk; 3200 mg/d has been shown to be without any consistent risk. Large intakes of beta-carotene must be viewed with caution because they have been shown to confer detriment to a population at high risk of lung cancer when administered after many years of high risk (smoking) behaviour. Until further work clarifies the situation in heavy smokers with respect to taking supplements, larger doses should be avoided by such individuals. There is little reliable information about the human toxicology of flavonoids and related non-nutrient antioxidant constituents of the diet. (5) The food industry has long experience in the control of oxidative damage in foods and this experience can be used to advantage for the protection of food antioxidants which are beneficial. Some of these, such as vitamins C and E and beta-carotene, are well known, and strategies for their protection in foods are already exploited by food technologies. (ABSTRACT TRUNCATED)


Asunto(s)
Antioxidantes/administración & dosificación , Alimentos , Fenómenos Fisiológicos de la Nutrición/fisiología , Especies Reactivas de Oxígeno , Enfermedades Cardiovasculares/prevención & control , Catarata/prevención & control , Tecnología de Alimentos , Humanos , Neoplasias/prevención & control , Enfermedades del Sistema Nervioso/prevención & control , Investigación
19.
Am J Clin Nutr ; 68(1): 134-41, 1998 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-9665107

RESUMEN

The strongest evidence that monunsaturated fat may influence breast cancer risk comes from studies of southern European populations, in whom intake of oleic acid sources, particularly olive oil, appears protective. No previous study has examined the relation of adipose tissue fatty acid content to breast cancer in such a population. We used adipose biopsies with diverse fat intake patterns gathered in 5 European centers, including southern Europe (Malaga, Spain), to test the hypothesis that stores of oleic acid or other monounsaturates are inversely associated with breast cancer. Gluteal fat aspirates were obtained from 291 postmenopausal incident breast cancer patients and 351 control subjects, frequency-matched for age and catchment area. Logistic regression was used to model breast cancer by monounsaturates, with established risk factors controlled for. Oleic acid showed a strong inverse association with breast cancer in the Spanish center. The odds ratio for the difference between 75th and 25th percentiles was 0.40 (95% CI: 0.28, 0.58) in Malaga and 1.27 (0.88, 1.85) in all other centers pooled, with a peak at 2.36 (1.01, 5.50) for Zeist. Palmitoleic and myristoleic acids showed evidence of an inverse association outside Spain, and cis-vaccenic acid showed a positive association in 3 centers. These data do not support the hypothesis that increasing tissue stores of oleic acid are protective against breast cancer in non-Spanish populations. This finding implies that the strong protective associations reported for olive oil intake in dietary studies may be due to some other protective components of the oil and not to the direct effect of oleic acid uptake. Alternatively, high olive oil intake may indicate some other protective aspect of the lifestyle of these women.


Asunto(s)
Tejido Adiposo/química , Neoplasias de la Mama/epidemiología , Ácidos Grasos Monoinsaturados/análisis , Anciano , Biopsia , Neoplasias de la Mama/metabolismo , Grasas Insaturadas en la Dieta/administración & dosificación , Europa (Continente)/epidemiología , Ácidos Grasos Monoinsaturados/administración & dosificación , Ácidos Grasos Monoinsaturados/metabolismo , Femenino , Humanos , Modelos Logísticos , Persona de Mediana Edad , Oportunidad Relativa , Ácido Oléico/administración & dosificación , Ácido Oléico/análisis , Aceite de Oliva , Aceites de Plantas/administración & dosificación , Posmenopausia , España/epidemiología
20.
Am J Epidemiol ; 147(4): 342-52, 1998 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-9508101

RESUMEN

The fatty acid content of adipose tissue in postmenopausal breast cancer cases and controls from five European countries in the European Community Multicenter Study on Antioxidants, Myocardial Infarction, and Cancer (EURAMIC) breast cancer study (1991-1992) was used to explore the hypothesis that fatty acids of the omega-3 family inhibit breast cancer and that the degree of inhibition depends on background levels of omega-6 polyunsaturates. Considered in isolation, the level of omega-3 or omega-6 fat in adipose tissue displayed little consistent association with breast cancer across study centers. The ratio of long-chain omega-3 fatty acids to total omega-6 fat showed an inverse association with breast cancer in four of five centers. In Malaga, Spain, the odds ratio for the highest tertile relative to the lowest reached 0.32 (95% confidence interval 0.13-0.82). In this center, total omega-6 fatty acid was strongly associated with breast cancer. With all centers pooled, the odds ratio for long-chain omega-3 to total omega-6 reached 0.80 for the second tertile and 0.65 for the third tertile, a downward trend bordering on statistical significance (p for trend = 0.055). While not definitive, these results provide evidence for the hypothesis that the balance between omega-3 and omega-6 fat may play a role in breast cancer.


Asunto(s)
Tejido Adiposo/química , Neoplasias de la Mama/epidemiología , Grasas Insaturadas en la Dieta/análisis , Ácidos Grasos Omega-3/análisis , Ácidos Grasos Insaturados/análisis , Anciano , Neoplasias de la Mama/química , Estudios de Casos y Controles , Europa (Continente)/epidemiología , Ácidos Grasos Omega-6 , Femenino , Humanos , Incidencia , Modelos Logísticos , Persona de Mediana Edad , Posmenopausia , Factores de Riesgo
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA