Development and validation of a Brief Diet Quality Assessment Tool in the French-speaking adults from Quebec.

BACKGROUND: The objective of this study was to develop and validate a short, self-administered questionnaire to assess diet quality in clinical settings, using the Alternative Healthy Eating Index (AHEI) as reference. METHODS: A total of 1040 men and women (aged 44.6 ± 14.4 y) completed a validated web-based food frequency questionnaire (webFFQ) and had their height and weight measured (development sample). Participants were categorized arbitrarily according to diet quality (high: AHEI score ≥ 65/110, low: AHEI score < 65/110) based on dietary intake data from the webFFQ. The Brief Diet Quality Assessment Tool was developed using a classification and regression tree (CART) approach and individual answers to the webFFQ among participants considered to have a plausible energy intake (ratio of reported energy intake to basal metabolic rate ≥ 1.2 and < 2.4; n = 1040). A second sample of 3344 older adults (aged 66.5 ± 6.4 y) was used to test the external validity of the Brief Diet Quality Assessment Tool (external validation sample). RESULTS: The decision tree included sequences of 3 to 6 binary questions, yielding 21 different pathways classifying diet quality as being high or low. In the development sample, the area under the receiver operating characteristic (ROC) curve of the predictive model was 0.92, with sensitivity, specificity and agreement values of 89.5, 83.9 and 87.2%. Compared with individuals having a low-quality diet according to the Brief Diet Quality Assessment Tool (mean AHEI 56.7 ± 11.4), individuals classified as having a high-quality diet (mean AHEI 71.3 ± 11.0) were significantly older, and had lower BMI, percent body fat and waist circumference, and had lower blood pressure, triglycerides, cholesterol/HDL ratio and fasting insulin as well as higher HDL-cholesterol concentrations (all P < 0.05). Similar results were observed in the external validation sample, although overall performance of the Brief Diet Quality Assessment Tool was slightly lower than in the development sample, with an area under the ROC curve of 0.79 and sensitivity, specificity and agreement values of 73.0, 69.0 and 71.3%, respectively. CONCLUSION: The CART approach yielded a simple and rapid Brief Diet Quality Assessment Tool that identifies individuals at risk of having a low-quality diet. Further studies are needed to test the performance of this tool in primary care settings.

Dietary patterns: a novel approach to examine the link between nutrition and cognitive function in older individuals.

Cognitive decline may lead to dementia whose most frequent cause is Alzheimer's disease (AD). Among the many potential risk factors of cognitive decline and AD, diet raises increasing interest. Most studies considered diet in the frame of a single nutrient approach with inconsistent results. A novel approach to examine the link between nutrition and cognitive function is the use of dietary patterns. The aim of the present review was to update and complete the body of knowledge about dietary patterns in relationship with various cognitive outcomes in the elderly. Two approaches can be used: a priori and a posteriori patterns. A priori patterns are defined by the adhesion to a pre-defined healthy diet using a score such as the Mediterranean diet (MeDi) score, the Healthy Eating Index, the Canadian Healthy Eating Index, the French National Nutrition and Health Programme (Programme National Nutrition Santé) Guideline Score (PNNS-GS), the Recommended Food Score (RFS) and Dietary Approaches to Stop Hypertension (DASH). MeDi score, RFS, PNNS-GS and DASH have been associated with lower risks of cognitive impairment, cognitive decline, and dementia or AD. Principal components analysis, reduced rank regression and clustering methods allow the identification of 'healthy' patterns associated with lower risk of cognitive decline. However, some studies did not report any associations with cognitive outcomes and results are discordant especially regarding MeDi and the risk of dementia. Several methodological challenges should be overcome to provide a higher level of evidence supporting the development of nutritional policies to prevent cognitive decline and AD.

Induction of antiviral cytotoxic T cells by plasmacytoid dendritic cells for adoptive immunotherapy of posttransplant diseases.

Virus-associated hematologic malignancies (EBV lymphoproliferative disease) and opportunistic infections (CMV) represent a major cause of hematopoietic stem cell and solid organ transplantation failure. Adoptive transfer of antigen-specific T lymphocytes appears to be a major and successful immunotherapeutic strategy, but improvements are needed to reliably produce high numbers of virus-specific T cells with appropriate requirements for adoptive immunotherapy that would allow extensive clinical use. Since plasmacytoid dendritic cells (pDCs) are crucial in launching antiviral responses, we investigated their capacity to elicit functional antiviral T-cell responses for adoptive cellular immunotherapy using a unique pDC line and antigens derived from Influenza, CMV and EBV viruses. Stimulation of peripheral blood mononuclear cells from HLA-A*0201(+) donors by HLA-A0201 matched pDCs pulsed with viral-derived peptides triggered high levels of multi-specific and functional cytotoxic T-cell responses (up to 99% tetramer(+) CD8 T cells) in vitro. Furthermore, the central/effector memory cytotoxic T cells elicited by the pDCs strongly display antiviral activity upon adoptive transfer into a humanized mouse model that mimics a virus-induced malignancy. We provide a simple and potent method to generate virus-specific CTL with the required properties for adoptive cellular immunotherapy of post-transplant diseases.

[GENiusVac, a novel antitumor vaccine strategy based on allogeneic plasmacytoid dendritic cells]. / GENiusVac, une stratégie vaccinale antitumorale innovante basée sur des cellules dendritiques plasmocytoïdes allogéniques.

The development of effective vaccines against cancer and viruses still remains a challenge. Many immunotherapeutic strategies have been developed but without sufficient therapeutic success. Plasmacytoid dendritic cells (pDC) play a crucial role in antitumor and antiviral responses. Despite their outstanding functional properties, their therapeutic potential has not yet been worked out. We propose a new immunotherapeutic strategy based on a pDC cell line irradiated and pulsed with tumor or viral antigens. GENiusVac allows the induction of multispecific and highly functional cytotoxic cell responses directed against viral or tumor targets. We demonstrated the potential of this strategy in vitro, its therapeutic efficacy in vivo in a humanized mouse model, and its clinical relevance ex vivo from melanoma patients' cells. GENiusVac highlights pDCs as potent vector of immunotherapy and provide a way to exploit them in cell therapy to fight cancer or chronic viral infections.

Physical activity and risk of cognitive impairment and dementia in elderly persons.

CONTEXT: Dementia is common, costly, and highly age related. Little attention has been paid to the identification of modifiable lifestyle habits for its prevention. OBJECTIVE: To explore the association between physical activity and the risk of cognitive impairment and dementia. DESIGN, SETTING, AND SUBJECTS: Data come from a community sample of 9008 randomly selected men and women 65 years or older, who were evaluated in the 1991-1992 Canadian Study of Health and Aging, a prospective cohort study of dementia. Of the 6434 eligible subjects who were cognitively normal at baseline, 4615 completed a 5-year follow-up. Screening and clinical evaluations were done at both waves of the study. In 1996-1997, 3894 remained without cognitive impairment, 436 were diagnosed as having cognitive impairment-no dementia, and 285 were diagnosed as having dementia. MAIN OUTCOME MEASURE: Incident cognitive impairment and dementia by levels of physical activity at baseline. RESULTS: Compared with no exercise, physical activity was associated with lower risks of cognitive impairment, Alzheimer disease, and dementia of any type. Significant trends for increased protection with greater physical activity were observed. High levels of physical activity were associated with reduced risks of cognitive impairment (age-, sex-, and education-adjusted odds ratio, 0.58; 95% confidence interval, 0.41-0.83), Alzheimer disease (odds ratio, 0.50; 95% confidence interval, 0.28-0.90), and dementia of any type (odds ratio, 0.63; 95% confidence interval, 0.40-0.98). CONCLUSION: Regular physical activity could represent an important and potent protective factor for cognitive decline and dementia in elderly persons.

Past exposure to vaccines and subsequent risk of Alzheimer's disease.

BACKGROUND: It has been suggested that changes to the immune system could be a factor in age-related conditions such as Alzheimer's disease. Our objective was to examine the association between past exposure to conventional vaccines and risk of Alzheimer's disease. METHODS: We analyzed data from a representative community sample of subjects 65 years of age or older participating in the Canadian Study of Health and Aging, a prospective cohort study of dementia. Screening and clinical evaluations were done at both baseline and follow-up. Past exposure to vaccines was assessed at baseline by means of a self-administered questionnaire. RESULTS: Of the 4392 eligible subjects who were cognitively unimpaired and for whom vaccine information was available at baseline (in 1991-1992) and who completed follow-up 5 years later (in 1996-1997), 527 were diagnosed as having cognitive impairment or dementia other than Alzheimer's disease and were excluded from these analyses. Of the remaining subjects, 3682 were cognitively unimpaired at follow-up and 183 were newly diagnosed as having Alzheimer's disease. After adjustment for age, sex and education, past exposure to vaccines against diphtheria or tetanus, poliomyelitis and influenza was associated with lower risk for Alzheimer's disease (odds ratio [OR] 0.41, 95% confidence interval [CI] 0.27-0.62; OR 0.60, 95% CI 0.37-0.99; and OR 0.75, 95% CI 0.54-1.04 respectively) than no exposure to these vaccines. INTERPRETATION: Past exposure to vaccines against diphtheria or tetanus, poliomyelitis and influenza may protect against subsequent development of Alzheimer's disease.

Diacylglycerol molecular species in plasma membrane and microsomes change transiently with endothelin-1 treatment of glioma cells.

Agonist-induced intracellular signal transduction often involves activation of protein kinase C by diacylglycerol (DAG) released from membrane phospholipids by phospholipases. Using either DAG kinase or HPLC assays to quantitatively determine DAG mass, we observed a time-dependent increase in DAG accumulation upon incubation of rat C6 glioma cells with 200 nM endothelin-1 (ET-1). Total cell DAG rapidly increased by 25-35% from a basal level of 4.5 +/- 0.3 nmol/mg protein during one min of ET-1 treatment and remained constant or slightly decreased between 1 and 2 min. Thereafter, DAG increased to a maximum (1.6-fold above basal) by 5-10 min. and remained elevated to 30 min. Resolution of DAG molecular species by HPLC after incubation of cells with ET-1 revealed that accumulation of DAG species differed in total cell lysate and subcellular compartments. In plasma membrane, major DAG species increased at 1 min. followed by a decrease at 10 min. whereas in microsomes DAG species did not change at 1 min. and decreased at 10 min. Although phospholipid sources of DAG species were not identified specifically, there was preferential hydrolysis of molecular species of phospholipid for DAG production. We propose that molecular species of DAG produced at the plasma membrane may be transferred to the endoplasmic reticulum so that phospholipid resynthesis can replenish molecular species initially utilized in signal transduction.

Prosthetic relining and dietary counselling in elderly women.

A reduced consumption of hard-textured fibrous foods may promote the development of digestive disturbances in more susceptible elderly people who wear prostheses having deficient masticatory function. The purpose of this study was to evaluate the effects of a program combining denture relining and dietary counselling on the masticatory performance, fibre intake, and prevalence of digestive symptoms in elderly women with low chewing efficiency. This program was provided to 55 women between 55 and 74 years of age. Chewing ability was assessed quantitatively with the Swallowing Threshold Test Index (STTI), and qualitatively according to the participants' experience in chewing five specific foods. Nutritional data were collected using a food frequency questionnaire. The mean value of the STTI was significantly increased at three weeks and at six to nine months after completion of relining by 37 and 31 per cent, respectively. Subjects included one more food in their diet at the end of the six- to nine-month period only. Fibre intake from vegetables was significantly increased by 18 per cent, while colonic and gastrointestinal symptoms were both reduced. Prosthetic relining increased the masticatory performance of elderly women, but not to a functional level. In addition, dietary counselling stimulated subjects to eat foods that had previously been avoided. These observations suggest that the improvement of chewing efficiency, combined with dietary counselling, could reduce the presence of digestive symptoms.

Fibre intake in elderly individuals with poor masticatory performance.

The effects of masticatory performance on food selection and nutrient intake in non-institutionalized elderly subjects wearing dental prostheses were investigated. A poor masticatory performance was associated with significantly lower intakes of insoluble and dietary fibre for both sexes (as compared to subjects with a good masticatory performance) and with lower intakes of vitamin A in women only. Further, 37 per cent of subjects with low masticatory performance were taking gastrointestinal drugs, as compared to 20 per cent of subjects with good performance. A reduced consumption of hard-textured fibrous foods due to the deficient masticatory performance of elderly people wearing prostheses may promote the development of gastrointestinal disorders in susceptible individuals.

Nutrient intake and gastrointestinal disorders related to masticatory performance in the edentulous elderly.

The effects of chewing efficiency on nutrient intake and the prevalence of gastrointestinal disorders were determined in edentulous elderly subjects. Three hundred sixty-seven noninstitutionalized individuals aged 60 years and over were interviewed. Denture masticatory performance and the collection of dietary information were assessed with the "Swallowing Threshold Test Index" and a food-frequency questionnaire. Approximately half (47%) of the participants exhibited a low masticatory performance classification. Thirty-nine percent used the same prosthesis for more than 10 years and 28% were taking some medication for gastrointestinal disorders. Lower intakes of fruits and vegetables for both sexes and of vitamin A by women were observed in subjects with poor masticatory performance. Furthermore, subjects with poor masticatory performance took significantly more drugs (37%) than those with superior performance (20%). A reduced consumption of high-fiber foods could therefore induce the development of gastrointestinal disorders in edentulous elderly subjects with a deficient masticatory performance.

Factors affecting insulin responsiveness of triglyceride synthesis in incubated chicken hepatocytes.

A technique was developed to isolate and incubate hepatocytes from 4-day-old chickens. Hepatocytes incubated in serum-free medium containing 1 ng chicken insulin/ml had greater rates of triglyceride (TG) synthesis than insulin-unexposed cells. Greater concentrations of insulin enhanced TG synthesis. Addition to medium of a supplement containing several hormones greatly improved insulin responsiveness of TG synthesis in hepatocytes compared with cells not incubated in supplemented medium. The medium supplement did not affect TG synthesis in hepatocytes incubated in the absence of insulin. The presence, compared with the absence, of triiodothyronine in the medium supplement improved insulin responsiveness of TG synthesis. In hepatocytes incubated in supplemented medium, increasing chicken insulin concentrations augmented malic enzyme activity. Hepatocytes incubated in supplemented medium containing bovine insulin had lesser rates of TG synthesis than cells incubated with similar concentrations of chicken insulin. To determine whether insulin responsiveness of TG synthesis is affected by age of chicken, hepatocytes from 4-, 11-, and 74-day-old chickens were incubated in supplemented medium. Responsiveness of TG synthesis to chicken insulin progressively decreased in hepatocytes from older chickens. Results indicate that hepatocytes isolated from 4-day-old chickens and incubated in supplemented medium are responsive to dilute insulin concentrations and may be useful to investigate the biochemical effects of this hormone.

Nutritional deficiencies and gastrointestinal disorders in the edentulous elderly: a literature review.

Many factors influence the food selection and nutritional status of elderly individuals. In this brief review, it is hypothesized that the functional status of dental prostheses is a prime determinant in the food selection, dietary fibre intake and prevalence of gastrointestinal disorders in edentulous elderly subjects.

Influence of diets containing cow's milk or soy protein beverage on plasma lipids in children with familial hypercholesterolemia.

The present article summarizes the effects of diets containing either cow's milk or soy protein beverage on plasma lipids and lipoproteins in children with familial hypercholesterolemia. After a stabilization period of 6 weeks without any hypolipemic medication, 10 subjects aged 6-12 years were randomly assigned to either cow's milk or soy protein beverage with subsequent crossover after a washout period, each of 4 weeks duration. During the experimental periods, subjects were fed diets containing 20% of energy as protein, of which 35% was from cow's milk protein or soy protein isolate, 28% of energy as fat with a polyunsaturated:monounsaturated:saturated fat ratio of 1:3:3, and less than 200 mg/day of cholesterol. The soy protein beverage, compared to cow's milk, induced significant reductions in plasma triglycerides and very-low-density lipoprotein cholesterol, as well as a significant increase in high-density lipoprotein cholesterol, indicating that consumption of soy protein beverage may be beneficial for the prevention of coronary heart disease in children with familial hypercholesterolemia.

Localized dual-wavelength fiber-optic polarimeter for the measurement of structural strain and orientation.

A single-ended, all-fiber polarimetric strain sensor with wide dynamic range and linearized response is described. Linear response is achieved by using a dual-wavelength technique, with modified pseudoheterodyne signal recovery. Single-valued, multiple-fringe phase tracking is obtained by using a binary signal division technique. An average strain sensitivity of 0.050 +/- 0.02 deg microepsilon(-1) cm(-1) is found for sensors that are surface adhered to cantilever beams. The sensor system is applied successfully to the measurement of the local orientation of a 1-m structural beam, with an accuracy of +/-0.02 deg of beam slope. Limitations on the applicability of this sensing technique are discussed.

Effects of a soy-protein beverage on plasma lipoproteins in children with familial hypercholesterolemia.

The effects of soy protein (35% of protein energy) given as a beverage and those of cow-milk proteins were investigated on plasma lipoprotein concentrations in children with familial hypercholesterolemia (FH). Subjects were randomly assigned to either the soy-protein or cow-milk-protein experimental period, with subsequent crossover after a washout period, each period lasting 4 wk. Diets were planned to provide 20% energy as protein, 28% as fat (polyunsaturated:monounsaturated:saturated fatty acids, 1:3:3) and less than 200 mg cholesterol/d. No changes were observed in either plasma cholesterol, low-density-lipoprotein cholesterol, or apolipoprotein concentrations. However, the soy beverage significantly reduced the concentrations of triglyceride and very-low-density-lipoprotein cholesterol (P less than 0.05) and significantly increased the concentrations of high-density-lipoprotein cholesterol (HDL-C) and HDL3-C (P less than 0.04 and P less than 0.03, respectively). These results indicate that the administration of soy protein may induce clinically beneficial effects in children with FH.

Roles of synthesis and degradation in the regulation of metallothionein accretion in a chicken macrophage-cell line.

Metallothionein (MT) is a metal-binding protein rapidly accreted in many tissues in response to trace elements or hormones. To gain an understanding of the regulation of MT accretion, rates of MT synthesis and degradation were determined by using a decay-kinetics technique. A chicken macrophage-cell line (HD11) that rapidly accretes incremental amounts of MT when stimulated with increasing concentrations of Zn2+ or Cd2+ was studied. The maximum rate of MT accretion occurred at 50 microM-Zn2+ or 20 microM-Cd2+. The absolute rate of MT accretion was less in macrophages incubated with 25 microM- as compared with 50 microM-Zn2+, owing to decreased and increased rates of MT synthesis and degradation respectively. The absolute rate of MT accretion was less in macrophages incubated with 10 microM- as compared with 20 microM-Cd2+, owing to a decreased rate of MT synthesis with no change in degradation. Compared with macrophages continually incubated with 50 microM-Zn2+, removal of Zn2+ from medium previously containing 50 microM-Zn2+ decreased the absolute rate of MT accretion, owing to decreased and increased rates of MT synthesis and degradation respectively. Removal of Cd2+ from medium previously containing 20 microM-Cd2+ also decreased the absolute rate of MT accretion in macrophages. Unlike Zn2+ removal, the decrease in MT accretion was due to a decreased rate of MT synthesis with no change in degradation. When macrophages incubated with 50 microM-Zn2+ were subsequently incubated with 20 microM-Cd2+, rates of MT synthesis and accretion were decreased as compared with cells continually incubated with 50 microM-Zn2+ or 20 microM-Cd2+. When macrophages incubated with 20 microM-Cd2+ were subsequently incubated with 50 microM-Zn2+, rates of MT synthesis and accretion were increased as compared with cells continually incubated with 50 microM-Zn2+ or 20 microM-Cd2+. Switching the metal in the incubation medium did not influence the rate of MT degradation. Our results indicate that the rate of MT accretion is determined by variations in the rates of MT synthesis and degradation, depending upon the inducing metal and the concentration of the metal.

Rates of metallothionein synthesis, degradation and accretion in a chicken macrophage cell line.

To understand the regulation of metallothionein (MT) accretion in a chicken-macrophage cell line, fractional rates of MT synthesis (FRS) and degradation (FRD) were measured by following decay kinetics of [35S]cysteine in MT. To obtain valid measurements, we added various amounts of cysteine to medium to ensure that the isotope tracer was adequately diluted after MT was labeled in the presence of various levels of zinc. We also demonstrated that the measured fractional rate of MT accretion closely approximated the difference between FRS and FRD. All fractional rates were similar for the two MT isoforms isolated. FRD did not change during the 27-hr decay period, but FRS and fractional rate of MT accretion changed over time. FRS of MT was 0.097 and 0.012 hr-1 from 0 to 9 and 9 to 27 hr, respectively, after cells were incubated in medium supplemented with 50 microM zinc. FRD of MT was 0.020 hr-1. Addition of 1100 microM unlabeled cysteine to medium supplemented with 50 microM zinc increased FRD and decreased FRS and fractional rate of MT accretion, as compared with not adding cysteine. Overall, these results indicate that rates of MT synthesis and degradation can both regulate MT accretion. Further experiments with various amounts of zinc and cysteine added to medium suggested that the effect of added cysteine on MT fractional rates was due to chelation of unbound zinc. Elimination of the cysteine effect on MT fractional rates was accomplished by adding more zinc to cysteine-supplemented medium. Thus, the concentration of unbound zinc affects the rates of MT synthesis and degradation.

Immunologically mediated growth depression in chicks: influence of feed intake, corticosterone and interleukin-1.

The effects of an immune response on growth and feed efficiency in chicks and the role of interleukin-1 (IL-1) and corticosterone (Cort) as mediators of the response were investigated. Daily injections of either sheep red blood cells or the inflammatory agent Sephadex resulted in significantly (P less than 0.05) lower rates of weight gain, feed intake and efficiency of feed utilization than controls fed ad libitum, indicating an immunologically mediated stress. Feeding control chicks the same amount of diet as that consumed by immunologically challenged chicks did not completely equalize rates of weight gain. Injections of a crude preparation of IL-1, but not Cort, resulted in weight gain, feed intake and efficiency of feed utilization that were similar to those of immunologically challenged chicks. The concentrations of IL-1 and Cort, measured by bioassay and radioimmunoassay, respectively, in serum from immunologically challenged chicks were significantly higher than in nonchallenged chicks. To determine the influence of IL-1 and Cort on protein accretion in skeletal muscles, the extensor digiti communus and ulnaris lateralis were incubated in the presence of these two hormones at concentrations similar to that seen in serum after an immunologic challenge. Cort did not affect the rate of protein degradation but resulted in rates of protein synthesis that were significantly lower than controls. IL-1 did not affect the rate of protein synthesis but resulted in rates of protein degradation that were about 24% greater than controls.

Presence of acute phase changes in zinc, iron, and copper metabolism in turkey embryos.

Acute phase changes in trace mineral metabolism were examined in turkey embryos. An endotoxin injection resulted in increased concentrations of serum copper and liver zinc and decreased concentrations of serum zinc in embryos incubated either in ovo or ex ovo. Changes in zinc and copper metabolism occurred when endotoxin either was injected intramuscularly, into the amnionic fluid, or administered onto the chorioallantoic membrane. Unlike poults, embryos did not respond to an inflammatory challenge with decreased serum iron concentrations. Acute phase changes in embryo serum zinc and copper as well as liver zinc concentrations were similar to those in poults. Increased liver zinc concentrations were associated with increased zinc in metallothionein (MT). An injection of a crude interleukin 1 preparation into embryos resulted in similar increases in hepatic zinc and MT concentrations as an endotoxin injection, suggesting a role for this cytokine in mediating the acute phase changes in embryonic zinc metabolism.