Zinc: dietary intake and impact of supplementation on immune function in elderly.

The diet in the elderly does not provide a sufficient level of nutrients needed to maintain an adequate healthy status leading to micronutrient deficiencies and impaired immune response with subsequent development of degenerative diseases. Nutrient "zinc" is a relevant micronutrient involved in maintaining a good integrity of many body homeostatic mechanisms, including immune efficiency, owing to its requirement for the biological activity of many enzymes, proteins and for cellular proliferation and genomic stability. Old people aged 60-65 years and older have zinc intakes below 50% of the recommended daily allowance on a given day. Many causes can be involved: among them, altered intestinal absorption, inadequate mastication, psychosocial factors, drugs interactions, altered subcellular processes (zinc transporters (Zip and ZnT family), metallothioneins, divalent metal transporter-1). Zinc supplementation may remodel the immune alterations in elderly leading to healthy ageing. Several zinc trials have been carried out with contradictory data, perhaps due to incorrect choice of an effective zinc supplementation in old subjects showing subsequent zinc toxic effects on immunity. Old subjects with specific IL-6 polymorphism (GG allele carriers; named C-) are more prone for zinc supplementation than the entire old population, in whom correct dietary habits with foods containing zinc (Mediterranean diet) may be sufficient in restoring zinc deficiency and impaired immune response. We summarise the main causes of low zinc dietary intake in elderly reporting an update on the impact of zinc supplementation upon the immune response also on the basis of individual IL-6 polymorphism.

Eating habits and total and abdominal fat in Spanish adolescents: influence of physical activity. The AVENA study.

OBJECTIVE: To evaluate the association between specific dietary habits and body fatness in Spanish adolescents, and to analyze the role of leisure-time physical activity (LTPA) in this association. METHODS: In this cross-sectional study, 1,978 adolescents (1,017 girls) aged 13.0-18.5 years from the AVENA (Alimentación y Valoración del Estado Nutricional en Adolescentes) study were included. Particular dietary habits (breakfast, mid-morning snack, lunch, afternoon snack, dinner, and nighttime snack, as well as time spent eating, number of meals, consumption of soft drinks, and ready-to-eat foods) and LTPA were self-reported and analyzed as dichotomic variables (yes/no). The sum of six skinfold thicknesses and waist circumference (WC) values were the main body fatness variables. RESULT: Skinfolds and WC values were lower in adolescents who reported consumption of mid-morning snack, afternoon snack, more than four meals per day, and an adequate speed of eating, independently of participation in LTPA. Moreover, a beneficial influence of breakfast consumption on skinfolds and WC values was observed in those adolescent boys who did not participate in LTPA (p for interactions = .044 and .040, respectively). CONCLUSIONS: In Spanish adolescents, certain healthy dietary habits (i.e., mid-morning snack, afternoon snack, > 4 meals per day, adequate eating speed) are associated with lower body fatness, independently of engaging in LTPA. In addition, among boys with non-LTPA, those who skipped breakfast showed the highest body fatness values, indicating a beneficial influence of daily breakfast on body fat in this particular group.

Combined influence of lifestyle risk factors on body fat in Spanish adolescents--the Avena study.

OBJECTIVE: To examine the combined influence of four lifestyle risk factors related to physical activity, television viewing, sleep duration, and meal frequency on body fat (BF) in adolescents. METHOD: This cross-sectional study comprised 1,310 Spanish adolescents (age 13-18.5 years). Lifestyle variables were self-reported and BF indicators (weight, height, six skinfold thicknesses, waist circumference) measured during the years 2000-2002. Lifestyle risk factors were: physically inactive, ≥ 3 h/day watching television, <8 h/day sleep duration, and <5 meals a day. The number of lifestyle risk factors was calculated for each participant, ranging from 0 to 4. RESULTS: The number of lifestyle risk factors was positively associated with sum of six skinfolds, %BF, waist circumference, and waist-height ratio (all p < 0.001). The odds ratios (95% confidence interval) of overweight (including obesity) for groups with 1, 2, and 3-4 lifestyle risk factors compared with those with 0 were 2.86 (1.77-4.62), 3.61 (2.16-6.04), and 5.81 (3.07-10.99), respectively (p for trend <0.001). All the observations were independent of age, gender, race, socioeconomic status, and fat free mass. CONCLUSION: The combined influence of four lifestyle risk factors is positively associated with BF and an approximately sixfold risk of overweight in adolescents.

Changes in cardiometabolic risk factors, appetite-controlling hormones and cytokines after a treatment program in overweight adolescents: preliminary findings from the EVASYON study.

OBJECTIVE: We investigated the effects of the EVASYON program on body fatness, cardiometabolic risk factors, gut appetite-controlling hormones and serum levels of cytokines in adolescents with overweight or obesity (OW/OB). METHODS: This study comprised 13 boys (10 obese) and 12 girls (8 obese), aged 13-16 years, from a Madrid Hospital. The EVASYON program was based on a calorie-restricted diet (10-40%), increased physical activity (at least 60 min/day 5 days a week), psychological therapy and nutritional education for 13 months. Anthropometric and blood pressure measurements were measured before and after intervention. Serum glucose, total cholesterol, high-density lipoprotein cholesterol, triglycerides, leptin, total peptide YY and insulin levels were determined before and after intervention. Serum levels of cytokines IL-1ß, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, and TNF-α were also assessed before and after intervention. RESULTS: A decrease in body mass index (BMI), BMI z-score, skinfolds (triceps, biceps, subscapular, thigh, and calf), sum of six skinfolds and body circumferences (arm relaxed and flexed, waist, hip, and proximal thigh) values were observed after the intervention program (all p < 0.05). In addition, diastolic blood pressure also decreased (p < 0.05). A decrease in serum leptin levels (-48.4%, p < 0.001) was observed after intervention without changes in total peptide YY and insulin levels. Levels of IL-8, IL-10, and TNF-α also decreased (all p < 0.05) after the intervention program. CONCLUSIONS: These preliminary results evidence that the EVASYON program may improve body fat, leptin, and some pro-inflammatory cytokines in adolescents with OW/OB.

Suggestive evidence of associations between liver X receptor ß polymorphisms with type 2 diabetes mellitus and obesity in three cohort studies: HUNT2 (Norway), MONICA (France) and HELENA (Europe).

BACKGROUND: The liver X receptors (LXR) α and ß regulate lipid and carbohydrate homeostasis and inflammation. Lxrß⁻/⁻ mice are glucose intolerant and at the same time lean. We aimed to assess the associations between single nucleotide polymorphisms (SNPs) in LXRß and risk of type 2 diabetes mellitus (T2DM), obesity and related traits in 3 separate cohort studies. METHODS: Twenty LXRß SNPs were identified by sequencing and genotyped in the HUNT2 adult nested case-control study for T2DM (n = 835 cases/1986 controls). Five tag-SNPs (rs17373080, rs2695121, rs56151148, rs2303044 and rs3219281), covering 99.3% of the entire common genetic variability of the LXRß gene were identified and genotyped in the French MONICA adult study (n = 2318) and the European adolescent HELENA cross-sectional study (n = 1144). In silico and in vitro functionality studies were performed. RESULTS: We identified suggestive or significant associations between rs17373080 and the risk of (i) T2DM in HUNT2 (OR = 0.82, p = 0.03), (ii) obesity in MONICA (OR = 1.26, p = 0.05) and (iii) overweight/obesity in HELENA (OR = 1.59, p = 0.002). An intron 4 SNP (rs28514894, a perfect proxy for rs17373080) could potentially create binding sites for hepatic nuclear factor 4 alpha (HNF4α) and nuclear factor 1 (NF1). The C allele of rs28514894 was associated with ~1.25-fold higher human LXRß basal promoter activity in vitro. However, no differences between alleles in terms of DNA binding and reporter gene transactivation by HNF4α or NF1 were observed. CONCLUSIONS: Our results suggest that rs17373080 in LXRß is associated with T2DM and obesity, maybe via altered LXRß expression.

Physical activity, exercise and low-grade systemic inflammation.

Prospective studies have shown that chronic low-grade inflammation may contribute to the pathogenesis of the most common chronic diseases and in particular CVD. Obesity has repeatedly been associated with moderately raised levels of inflammation, and this observation has led to the view that obesity is characterised by a state of chronic low-grade inflammation. There is now great interest in elucidating how physical activity and exercise modulate inflammation. This review summarises the current research addressing the influence of physical activity and exercise in mitigating the risks of obesity and diseases such as type-II diabetes and CVD, through its action on the low-grade inflammatory state. Most research on this topic hypothesised that the association between physical activity and inflammatory markers is independent of fatness, but very few studies have proven this. Given that physical activity and obesity are often inversely related, it is not clear as to whether the anti-inflammatory health benefits of a physically active lifestyle are due to exercise per se or result from favourable changes in the body composition.

Drinking pattern and socio-cultural aspects on immune response: an overview.

Social acceptance of drinking involves social and cultural roles and has important implications for public health. Since extensive evidence indicates that alcohol possesses immunomodulatory properties, scientists have recently debated the influence of alcohol consumption on the immune response, particularly in countries where drinking in a social setting is a part of cultural identity. Experimental and clinical data support the conclusion that alcohol is a potent immunomodulator. While high alcohol consumption suppresses a wide range of immune responses, leading to an increased incidence of a number of infectious diseases, moderate alcohol consumption may have a beneficial impact on the immune system, compared to alcohol abuse or abstinence, most likely due to the multiple components of polyphenol-rich alcoholic contributing to the protective effect seen for moderate alcohol consumption on CVD and the immune system. Despite this, the scientific literature appears to be concerned about the diseases associated with excessive drinking in some societies and cultures. Thus, the present review recognizes the importance to consider social and cultural aspects of drinking when examining the whole dimension of alcohol consumption (amount, beverage type, frequency and variability), in order to estimate global risk of consequences on host defence to better understand alcohol-related harm or benefit.

Haematological reference values in Spanish adolescents: the AVENA study.

OBJECTIVES: To provide reference values for haematological indices in Spanish adolescents according to age and gender. METHODS: A cross sectional study conducted in five Spanish cities was performed. Blood was drawn from a representative sample of 581 adolescents with age ranging from 13 to 17-18.5 yr. Age- and gender-specific means, standard deviations and percentiles were determined for the following parameters: total red blood cell counts (RBC), haemoglobin concentration (Hb), haematocrit percentage (Hct), mean corpuscular volume (MCV), mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration, red cell distribution width and total white blood cell (WBC) counts as well as counts and percentage of neutrophils, lymphocytes, monocytes, eosinophils and basophils; platelet count (PLT), mean platelet volume and plateletcrit percentage. RESULTS: Younger male subjects presented lower RBC, Hb, Hct and MCV means that their older counterpart. By contrast these differences were not observed in female subjects. As expected, RBC, Hb and Hct mean values in males were found significantly higher than in girls for all studied age groups. No significant differences were observed in WBC by age and gender. PLT values gradually decreased with age, except for females aged 17-18.5 yr. CONCLUSION: The present study provides reference data on the distribution of haematological indices of Spanish adolescents. These data can be useful biomarkers of the nutritional status in adolescents.

Lipoma arborescente de la bursa bicipital / Lipoma arborescens of the bicipital bursa

El lipoma arborescente (LA) es una entidad benigna caracterizada por la proliferación de tejido graso de morfología vellosa en la capa subsinovial, que afecta habitualmente a la rodilla. A continuación se presenta un caso de LA en la bursa bicipitorradial del codo en una mujer de 44 años. A pesar de la rara localización de la lesión, los hallazgos radiológicos en la ecografía y la resonancia magnética permitieron el diagnóstico (AU)

Lipoma arborescens is a rare benign entity characterized by proliferation of villous fat tissue in subsynovial layer that usually affects the knee joint. We report a case of lipoma arborescens in bicipitoradial bursa of the elbow in a 44 year-old female patient. In spite of this rare location, radiographic findings by ultrasonography and magnetic resonance imaging made diagnosis possible (AU)

Nutrition, inflammation, and cognitive function.

Inflammation, particularly low-grade chronic inflammation, appears to affect several brain functions, from early brain development to the development of neurodegenerative disorders and perhaps some psychiatric diseases. On the other hand, nutrition and dietary components and patterns have a plethora of anti- and pro-inflammatory effects that could be linked to cognitive function. Even a modest effect of nutrition on cognitive decline could have significant implications for public health. This paper summarizes the available evidence regarding inflammation as a key mechanism in cognitive function and nutritional pro- or anti-inflammatory effects with the purpose of linking the apparent disparate disciplines of nutrition, immunity, and neurology.

[Lipoma arborescens of the bicipital bursa]. / Lipoma arborescente de la bursa bicipital.

Lipoma arborescens is a rare benign entity characterized by proliferation of villous fat tissue in subsynovial layer that usually affects the knee joint. We report a case of lipoma arborescens in bicipitoradial bursa of the elbow in a 44 year-old female patient. In spite of this rare location, radiographic findings by ultrasonography and magnetic resonance imaging made diagnosis possible.

Neuroimmunomodulation by nutrition in stress situations.

Stress has long been suspected to play a role in the etiology of many diseases and may be detrimental to health. Nowadays, the communication between the neuroendocrine and the immune systems is well established and there is enough evidence that the magnitude of stress-associated immune dysregulation is large enough to have health implications. In stress conditions, modulation of the immune system by the central nervous system (CNS) is mediated by a complex network of signals, showing a relationship between stress and resistance to infection. On the other hand, an adequate balanced diet plays a crucial role in the management of stress, and nutrition seems to be a critical determinant in the interactions among CNS and the immune system under stress conditions. Thus, interactions among nutrition, CNS and the immune system could be a key to understand implications in physiological stress situations. The present article will briefly review nutrition approaches on stress-related immune response and CNS communication.

Comorbidity and prognosis in advanced hypopharyngeal-laryngeal cancer under combined therapy.

AIMS AND BACKGROUND: The success of combined treatment in head and neck cancer resides largely in its completion, which can be compromised when the patient's general health status is precarious. The objective of this investigation was to study the role of comorbidity as a prognostic factor in a large, homogeneous population affected by locally advanced pharyngeal-laryngeal cancer, under a combined protocol treatment. The a priori hypothesis is that comorbidity strongly conditions overall survival and specific overall survival in these patients and can aid in the selection and individualization of treatments. METHODS: After a 24-month follow-up, a univariate and multivariate retrospective analysis of survival and prognostic factors was performed using 14 clinical, pathological and molecular variables including the comorbidity index calculated following the Picarillo method. The settings were the Otolaryngology, Oncology and Pathology Departments of the Miguel Servet University Hospital, Zaragoza, Spain, a referral center of the National Health System. Of the original 114 patients selected, 15 were withdrawn because the tumor spread to maxillofacial areas, or due to the lack of attendance at the clinic, incomplete clinical data or coexistent primary tumors. The group under analysis consisted of the 99 remaining patients affected by stage III and IV laryngeal and/or hypopharyngeal cancers that had not received previous treatments. The main outcomes to analyze were overall survival, specific overall survival and relative risk. RESULTS: Overall survival at 2.5 years was 68.1% (95% CI, 57.7-78.5). Specific overall survival at 2.5 years was 74.8% (95% CI, 64.9-84.6). In the multivariate analysis, tumor staging, neoadjuvant chemotherapy response and comorbidity (RR = 1.55 and 1.44 for overall and specific overall survival, respectively) present themselves as three prognostic factors independent of overall and specific overall survival. CONCLUSIONS: The role of comorbidity as an independent prognostic factor in patients affected by laryngeal and/or hypopharyngeal cancer treated with chemo-radiotherapy should be taken into account in the tailoring of treatments and the improvement of therapeutic results.

Effects of moderate beer consumption on blood lipid profile in healthy Spanish adults.

BACKGROUND AND AIMS: To analyse the association of moderate beer consumption on the blood lipid profile in healthy Spanish adults. METHODS AND RESULTS: The study had an intervention longitudinal design in which each subject established their own control with a previous wash-out phase. After a 30-day alcohol abstinence period, 57 healthy volunteers were submitted to a daily moderate intake of beer for 30 days. Serum total cholesterol, HDL-cholesterol, triacylglycerols, GOT, GPT, GGT and glucose values, as well as blood erythrocytes, haemoglobin, haematocrit and MCV levels, together with anthropometric parameters were determined at the beginning of the study (baseline levels) (a), after 1 month of alcoholic abstinence (b) and after 1 month of moderate beer consumption (c). Dietary intake was assessed twice by a 7-day dietary record. HDL-cholesterol, erythrocytes, haematocrit and MCV levels increased significantly (p<0.05) after moderate beer consumption in women. In men, a decrease in HDL-cholesterol levels was observed after alcohol abstention. Haematocrit and MCV counts also increased significantly (p<0.05) in men after moderate beer consumption. There were no dietary changes during the study. CONCLUSION: In healthy Spanish adults, the effects of moderate beer consumption during 1 month were associated with favourable changes on the blood lipid profile.

Effects of moderate consumption of distilled and fermented alcohol on some aspects of neuroimmunomodulation.

Alcoholic beverages are characterized by their fermented versus distilled origin and also by their degree of alcohol. The toxic effects of chronic alcohol consumption have been widely studied. However, there is less evidence about possible beneficial effects of moderate alcohol intake. This work was aimed at evaluating the effects of moderate alcohol consumption (beer or ethanol) on plasma hormone concentrations, blood and thymus lymphocyte phenotypes and brain neurotransmitter levels. For this purpose, 40 adult Wistar male rats were administered ethanol or beer for 4 weeks (experimental groups). Age-matched rats were administered beer without alcohol or water to be used as controls. Rats were killed by decapitation and plasma from the trunk blood was collected to measure plasma prolactin, growth hormone and ACTH concentrations by homologous specific double antibody radioimmunoassays. Thymus and blood lymphocyte subsets were measured by flow cytometry. Neurotransmitter concentrations [dopamine, gamma-aminobutyric acid (GABA) and taurine] were measured by high pressure liquid chromatography in the median eminence and the pituitary. Blood and thymus lymphocyte subsets were not significantly changed by either ethanol or beer consumption, compared to controls. Plasma prolactin levels significantly decreased in ethanol-administered groups (p < 0.05) compared to control animals drinking water, although plasma levels of growth hormone and ACTH were not modified by either alcohol used. Dopamine and GABA concentrations in the median eminence or in the adenohypophysis remained unmodified by moderate beer or ethanol consumption. However, taurine concentration was significantly increased in the pituitary (p < 0.05) in the group drinking ethanol compared to those groups drinking beer with or without alcohol. These data suggest that moderate alcohol consumption may change the regulatory mechanism of prolactin secretion. Whether these modifications have a physiological significance deserves further research.

Moderate alcohol consumption and the immune system: a review.

Increasing evidence suggests that light to moderate amounts of polyphenol-rich alcoholic beverages like wine or beer could have health benefits. Scientists have long debated the effects of alcohol on immune function, showing on the one hand, that high doses of alcohol consumption can directly suppress a wide range of immune responses, and that alcohol abuse is associated with an increased incidence of a number of infectious diseases. On the other hand, moderate alcohol consumption seems to have a beneficial impact on the immune system compared to alcohol abuse or abstinence. Therefore, the link between alcohol consumption, immune response, as well as infectious and inflammatory processes remains not completely understood. With this in mind, it is important to realise that other factors, unrelated or indirectly related to immune function, like drinking patterns, beverage type, amount of alcohol, or gender differences, will affect the influence that alcohol consumption may have on the immune system. This review summarises published data describing the effects that light to moderate amounts of polyphenol-rich beverages like wine or beer seem to have on immunity in healthy adults.

Lifestyle-related determinants of inflammation in adolescence.

Inflammatory processes are involved in the pathogenesis of the most common chronic non-communicable diseases and may also play an important initiating role in their development. Only recently have inflammatory markers been included in epidemiological studies focusing on nutritional status, body composition and physical activity. We are just starting to understand how different lifestyles can determine basal levels of inflammatory biomarkers in early ages. This review aims to summarise what is known about the relationships between lifestyle-related determinants (focusing on overweight, physical activity and dietary habits) and inflammatory markers in apparently healthy young populations. Obesity is the most widely studied determinant. Several large-scale studies have now demonstrated that healthy young subjects with more body fat or higher BMI have moderately higher concentrations of inflammatory markers than their leaner peers, supporting the idea that obesity should be considered as a state of chronic low-grade inflammation. Less data is available to allow us to elucidate how physical activity/fitness or dietary patterns may have a direct effect on inflammation in apparently healthy, disease-free young populations.

Immunomodulatory effects of probiotics in different stages of life.

The immunomodulatory properties of lactic acid bacteria (LAB) and foods containing them (e.g., fermented milks) is a topic currently under investigation. Individuals could potentially benefit from the inclusion of LAB in the diet at different times during the life cycle. One of the most accepted specific uses of probiotic bacteria is the prevention of atopic eczema in infants with family history of the disease who receive the probiotic bacteria early, through supplementation of the gestating mother and orally after birth. Immune enhancing effects have also been suggested to be beneficial in diarrhoea treatment, especially in children infected with rotavirus and in malnourished patients, infants and adolescents, whose capacity to produce IFN-gamma can be increased after LAB-containing yoghurt intake. Regarding young people and adults, investigations have been conducted exploring the immunomodulation by LAB in subjects under stressful situations, in the prevention of urinary tract infections in fertile women and in the treatment of allergy. However, the beneficial effects of probiotics in these conditions remain controversial and the scientific evidence provided so far is not considered to be conclusive. The elderly population has been the focus of investigations aimed at identifying the capacity of probiotics to counteract the immunosenescence process by increasing phagocytic and natural killer (NK) cell activities and to protect against infection. The mechanisms involved in the different effects attributed to LAB remain to be clarified. Moreover, considering that the immunomodulatory properties are strain-specific, defining the optimal dose of a certain bacteria or combination of bacteria strains and the duration of treatment for a desired effect in a target population group is essential in order to substantiate health claims.

Changes in the immune system after moderate beer consumption.

BACKGROUND/AIM: Epidemiological studies have suggested that moderate alcohol consumption is associated with lower morbidity. However, intervention studies are needed to elucidate mechanisms involved. This study was aimed to determine the effects of moderate beer consumption on the immune function of healthy adults, taking into account gender differences. METHODS: After a 30-day alcohol abstinence period, 57 healthy volunteers consumed a moderate intake of beer (330 ml for women and 660 ml for men) for 30 days. Total leukocyte and lymphocyte counts; absolute values of T-lymphocyte CD3+, CD4+, and CD8+ subsets; delayed-hypersensitivity skin response (DHSR); absolute values of B lymphocytes (CD19+) and serum immunoglobulin concentrations (IgG, IgA, and IgM); and cytokine production (IL-2, IL-4, IL-6, IL-10, IFN-gamma, and TNF-alpha) were evaluated following the abstinence and alcohol consumption periods. RESULTS: After moderate beer consumption CD3+ cells increased only in women (p < 0.05). IgG, IgM, and IgA concentrations, as well as IL-2, IL-4, IL-10, and IFN-gamma cytokine production increased while IFN-gamma/IL-10 ratio decreased in both men and women (p < 0.05). The rest of the immunological parameters analyzed remained unchanged. CONCLUSION: Moderate beer consumption produced an immunomodulatory effect in a healthy adult Spanish population; this effect appears to be more relevant in women than in men.

Fibroblast growth factor receptor 3 mutations in epidermal nevi and associated low grade bladder tumors.

Epidermal nevi (EN) are benign lesions presenting at birth or in childhood. Based on the occurrence of fibroblast growth factor receptor 3 (FGFR3) mutations in seborrheic keratosis and urothelial carcinomas (UC), and the identification of two young patients with EN and UC, we hypothesized that mutations might occur in EN. The R248C mutation was found in 6/23 (26.1%) EN but it was absent from unaffected skin. In two patients with EN and UC, both lesions were FGFR3 wild type. Our findings indicate that: (1) FGFR3 mutations occur in mosaicism and can cause EN and (2) other genes are involved in EN.