Intake of fruits and vegetables in relation to 10-year weight gain among Spanish adults.

OBJECTIVE: Despite the alarming increase in the prevalence of obesity, epidemiologic studies that prospectively examine the fruit and vegetable consumption and other lifestyle factors in relation to weight gain (WG) are still insufficient. We explored the associations between fruit and vegetable intake and WG over a 10-year period in an adult Mediterranean population. METHODS AND PROCEDURES: We performed a 10-year follow-up study with healthy participants (n = 206) aged 15-80 years at baseline in 1994, who participated in a nutrition survey in Valencia, Spain. Data on diet, lifestyle factors, and body weight were obtained in 1994 and 2004 using a food frequency questionnaire (FFQ) and direct measurements. RESULTS: The average WG over the study period was 3.41 (s.d. 6.9) kg. In multivariate analyses, participants in the third quartile of fruit intake at baseline in 1994 had lower risk of WG> or =3.41 kg compared to those in the lowest quartile (oddsratio (OR) = 0.31, 95% confidence interval (CI), 0.11-0.85; P trend = 0.044). Regarding vegetable intake, the risk of WG was lowest in participants of the fourth quartile (>333 g/day), which had an 84% reduced risk of gaining 3.41 kg weight (OR = 0.18, 95% CI, 0.05-0.66; P trend = 0.017). When the intake of fruits and vegetables was combined, the risk of WG decreased across quartiles, with the lowest risk among those in the fourth quartile (OR = 0.22, 95% CI, 0.06-0.81; P trend = 0.022). Further adjustment for an increased intake of fruits and vegetables over the past 10 years reported by participants in 2004 did not appreciably alter the observed ORs. DISCUSSION: Dietary patterns associated with a high intake of fruits and vegetables in Mediterranean populations may reduce long-term risk of subsequent WG and obesity among adults.

Plasma concentrations of carotenoids and vitamin C are better correlated with dietary intake in normal weight than overweight and obese elderly subjects.

Carotenoid and vitamin C intakes, assessed by FFQ, have been positively associated with plasma concentrations in different populations. However, the influence of BMI on these associations has not been explored in detail. We explored in a cross-sectional study the relation between dietary carotenoid and vitamin C intakes, using a 135-item FFQ, with their plasma concentrations by BMI categories in 252 men and 293 women, 65 years and older. For men and women combined, significant (P < 0.05) Pearson correlations were observed between energy-adjusted dietary intakes and plasma concentrations (carotenoids adjusted for cholesterol) for: alpha-carotene 0.21, beta-carotene 0.19, lycopene 0.18, beta-cryptoxanthin 0.20 and vitamin C 0.36. Multiple linear regression analyses showed that the intake of carotenoids and vitamin C were significant predictors of their respective plasma concentration (P<0.01), and that BMI was inversely associated with plasma concentration of carotenoids (P< or =0.01) but not with plasma vitamin C. In addition, we observed significant interactions between BMI and the intakes of alpha-carotene and lutein + zeaxanthin, and to a lower extent beta-carotene, suggesting that these intakes in subjects with high BMI were not good predictors of their plasma concentration. The present data suggest that plasma carotenoids and vitamin C may be good markers of dietary intake in elderly subjects, but not so for alpha-carotene, beta-carotene and lutein + zeaxanthin in obese subjects.

Estimation of height and body mass index from demi-span in elderly individuals.

BACKGROUND: Obtaining accurate height and, consequently, body mass index (BMI) measurements in elderly subjects can be difficult due to changes in posture and loss of height during ageing. Measurements of other body segments can be used as an alternative to estimate standing height, but population- and age-specific equations are necessary. OBJECTIVE: Our objectives were to validate existing equations, to develop new simple equations to predict height in an elderly Spanish population and to assess the accuracy of the BMI calculated by estimated height from the new equations. METHODS: We measured height and demi-span in a representative sample of 592 individuals, 271 men and 321 women, 65 years and older (mean +/- SD, 73.8 +/- 6.3 years). We suggested equations to predict height from demi-span by multiple regression analyses and performed an agreement analysis between measured and estimated indices. RESULTS: Height estimated from demi-span correlated significantly (p < 0.001) with measured height (men: r = 0.708, women: r = 0.625). The best prediction equations were as follows: men, height (in cm) = 77.821 + (1.132 x demi-span in cm) + (-0.215 x 5-year age category); women: height (in cm) = 88.854 + (0.899 x demi-span in cm) + (-0.692 x 5-year age category). No significant differences between the mean values of estimated and measured heights were found for men (-0.03 +/- 4.6 cm) or women (-0.02 +/- 4.1 cm). The BMI derived from measured height did not differ significantly from the BMI derived from estimated height either. CONCLUSION: Predicted height values from equations based on demi-span and age may be acceptable surrogates to derive accurate nutritional indices such as the BMI, particularly in elderly populations, where height may be difficult to measure accurately.

Alcohol consumption is directly associated with circulating oxidized low-density lipoprotein.

Findings on the association of alcohol consumption and oxidation of low-density lipoprotein (LDL), which is thought to play a crucial role in the generation of atherosclerotic lesion, are inconsistent. The aim of the present study was to investigate the association of total alcohol consumption and type of alcoholic beverage with circulating plasma LDL oxidation. This cross-sectional study included data of circulating oxidized LDL (ox-LDL) from a subpopulation of 587 men and women enrolled in a population-based survey conducted in 2000 in Girona (Spain). Multivariate analysis was performed to describe the independent association of alcohol consumption and ox-LDL. Increasing alcohol consumption was associated with high in vivo ox-LDL levels in the present population. The consumption of 10 g of alcohol was associated with an increase of 2.40 U/L of ox-LDL (p = 0.002). Adjustment for dietary variables, leisure-time physical activity, educational level, smoking, LDL-cholesterol, high-density lipoprotein-cholesterol, glycemia, triglycerides, diabetes, body mass index, waist circumference, and systolic and diastolic blood pressures only slightly modified this association (p = 0.003). In this full adjusted model the consumption of 10 g of alcohol per day was associated with an increase of 2.11 U/L of ox-LDL. Consumption of wine (ml/day) was associated with increasing ox-LDL levels (p = 0.029), however, attenuated after controlling for alcohol. No significant relationship of ox-LDL with alcohol-independent consumption of wine, beer, and spirits was observed. Alcohol consumption was independently and directly associated with circulating ox-LDL in the present population.

Postprandial LDL phenolic content and LDL oxidation are modulated by olive oil phenolic compounds in humans.

Olive oil phenolic compounds are potent antioxidants in vitro, but evidence for antioxidant action in vivo is controversial. We examined the role of the phenolic compounds from olive oil on postprandial oxidative stress and LDL antioxidant content. Oral fat loads of 40 mL of similar olive oils, but with high (366 mg/kg), moderate (164 mg/kg), and low (2.7 mg/kg) phenolic content, were administered to 12 healthy male volunteers in a cross-over study design after a washout period in which a strict antioxidant diet was followed. Tyrosol and hydroxytyrosol, phenolic compounds of olive oil, were dose-dependently absorbed (p<0.001). Total phenolic compounds in LDL increased at postprandial state in a direct relationship with the phenolic compounds content of the olive oil ingested (p<0.05). Plasma concentrations of tyrosol, hydroxytyrosol, and 3-O-methyl-hydroxytyrosol directly correlated with changes in the total phenolic compounds content of the LDL after the high phenolic compounds content olive oil ingestion. A 40 mL dose of olive oil promoted a postprandial oxidative stress, the degree of LDL oxidation being lower as the phenolic content of the olive oil administered increases. In conclusion, olive oil phenolic content seems to modulate the LDL phenolic content and the postprandial oxidative stress promoted by 40 mL olive oil ingestion in humans.

Circulating oxidized LDL is associated with increased waist circumference independent of body mass index in men and women.

BACKGROUND: Obesity is associated with oxidative stress, and the oxidation of LDL is thought to play a crucial role in the generation of atherosclerotic lesions. OBJECTIVE: The objective was to describe the association of waist circumference (WC) and body mass index (BMI; in kg/m2) with plasma circulating oxidized LDL (ox-LDL) and C-reactive protein (CRP). DESIGN: This cross-sectional study included data for circulating ox-LDL and CRP from a subpopulation of 586 men and women enrolled in a population-based survey conducted in 2000 in Girona, Spain. Multivariate analysis was performed to describe the independent association of WC and BMI with ox-LDL and CRP. RESULTS: Multivariate logistic regression analysis adjusted for lifestyle, educational level, and dietary confounders showed a direct association of WC (quartile distribution) and BMI categories with ox-LDL (P for linear trend = 0.002) and CRP (P for linear trend = 0.004). Subjects in the top quartile of WC and with a BMI > 29.9 were at high risk of elevated circulating concentrations of ox-LDL and CRP. Further adjustment for cardiovascular disease risk factors did not substantially modify these associations. The risk of high ox-LDL concentrations in overweight (BMI = 25.0-29.9) or obese (BMI > or = 30) subjects with a WC < 102 cm (men) or < 88 cm (women) was not significantly different from that in normal-weight subjects with these WCs. In contrast, overweight or obese subjects with higher WCs (WC > or = 102 cm for men and > or = 88 cm for women) were at significantly higher risk of increased ox-LDL. CONCLUSION: High WC was associated with high concentrations of ox-LDL independently of BMI in the study population.

Olive oils high in phenolic compounds modulate oxidative/antioxidative status in men.

The aim of the present study was to evaluate whether olive oils high in phenolic compounds influence the oxidative/antioxidative status in humans. Healthy men (n = 12) participated in a double-blind, randomized, crossover study in which 3 olive oils with low (LPC), moderate (MPC), and high (HPC) phenolic content were given as raw doses (25 mL/d) for 4 consecutive days preceded by 10-d washout periods. Volunteers followed a strict very low-antioxidant diet the 3 d before and during the intervention periods. Short-term consumption of olive oils decreased plasma oxidized LDL (oxLDL), 8-oxo-dG in mitochondrial DNA and urine, malondialdehyde in urine (P < 0.05 for linear trend), and increased HDL cholesterol and glutathione peroxidase activity (P < 0.05 for linear trend), in a dose-dependent manner with the phenolic content of the olive oil administered. At d 4, oxLDL after MPC and HPC, and 8-oxo-dG after HPC administration (25 mL, respectively), were reduced when the men were in the postprandial state (P < 0.05). Phenolic compounds in plasma increased dose dependently during this stage with the phenolic content of the olive oils at 1, 2, 4, and 6 h, respectively (P < 0.01). Their concentrations increased in plasma and urine samples in a dose-dependent manner after short-term consumption of the olive oils (P < 0.01). In conclusion, the olive oil phenolic content modulated the oxidative/antioxidative status of healthy men who consumed a very low-antioxidant diet.

Antioxidant paraoxonase 1 activity in the metabolic syndrome.

Paraoxonase (PON1) is an antioxidant enzyme closely associated with high-density lipoproteins. Low PON1 has been shown in oxidative stress-associated processes such as dyslipidemia, diabetes mellitus, advancing age, and smoking. Indeed, oxidative stress is related to the degree of insulin resistance, a key component of the metabolic syndrome. Therefore, the possible relationship between PON1 activity and the metabolic syndrome was investigated. From 1364 randomly recruited subjects, 285 were found to have the metabolic syndrome, according to the guidelines published by the National Cholesterol Education Program, Adult Treatment Panel III. PON1 activity, lipid peroxides, and PON1 codon 192 genotypes, which strongly modulate PON1 activity, were determined. Serum PON1 activity levels were found to be significantly lower, and lipid peroxide concentrations significantly higher, in subjects with the metabolic syndrome compared with unaffected subjects (P = 0.033 and < 0.001, respectively). Study subjects showed a significant decreasing trend in PON1 activity levels and a significant increasing trend in lipid peroxide concentrations, with the increase in the number of metabolic disturbances. No differences in the prevalence of PON1 codon 192 genotypes were found among the categories of metabolic abnormalities. In conclusion, a greater degree of severity of the metabolic syndrome is associated with a progressively worse antioxidant/oxidant balance, which is consistent with increased oxidative stress and lower antioxidant PON1 enzymatic capacity.

Hydroxytyrosol disposition in humans.

BACKGROUND: Animal and in vitro studies suggest that phenolic compounds in virgin olive oil are effective antioxidants. In animal and in vitro studies, hydroxytyrosol and its metabolites have been shown to be strong antioxidants. One of the prerequisites to assess their in vivo physiologic significance is to determine their presence in human plasma. METHODS: We developed an analytical method for both hydroxytyrosol and 3-O-methyl-hydroxytyrosol in plasma. The administered dose of phenolic compounds was estimated from methanolic extracts of virgin olive oil after subjecting them to different hydrolytic treatments. Plasma and urine samples were collected from 0 to 12 h before and after 25 mL of virgin olive oil intake, a dose close to that used as daily intake in Mediterranean countries. Samples were analyzed by capillary gas chromatography-mass spectrometry before and after being subjected to acidic and enzymatic hydrolytic treatments. RESULTS: Calibration curves were linear (r >0.99). Analytical recoveries were 42-60%. Limits of quantification were <1.5 mg/L. Plasma hydroxytyrosol and 3-O-methyl-hydroxytyrosol increased as a response to virgin olive oil administration, reaching maximum concentrations at 32 and 53 min, respectively (P <0.001 for quadratic trend). The estimated hydroxytyrosol elimination half-life was 2.43 h. Free forms of these phenolic compounds were not detected in plasma samples. CONCLUSIONS: The proposed analytical method permits quantification of hydroxytyrosol and 3-O-methyl-hydroxytyrosol in plasma after real-life doses of virgin olive oil. From our results, approximately 98% of hydroxytyrosol appears to be present in plasma and urine in conjugated forms, mainly glucuronoconjugates, suggesting extensive first-pass intestinal/hepatic metabolism of the ingested hydroxytyrosol.

High oxidative stress in patients with stable coronary heart disease.

Oxidized low density lipoprotein (oxLDL) plays a pivotal role in the development of atherosclerosis. The aim of the study was to investigate the relationship between oxLDL and other oxidative stress biomarkers with stable coronary heart disease (CHD). We compared the degree of oxidative stress in patients with CHD and sex-matched healthy control subjects in a case-control study. The study included 64 male subjects: 32 patients with stable CHD and 32 normal control subjects. Levels of circulating oxLDL were measured by a monoclonal antibody 4E6-based competition ELISA. Comparison of oxidative stress marker levels between cases and controls, adjusted for age, revealed significantly higher plasma oxLDL levels (63.32+/-25.49 vs. 37.73+/-20.58 U/l, P=0.001), lower serum levels of autoantibodies against oxLDL (341.53+/-350.46 vs. 796.45+/-1034.2 mU/ml, P=0.021), higher activities of the antioxidant enzymes superoxide dismutase in erythrocytes (951+/-70.2 vs. 771.6+/-191.2 U/g, P=0.032) and glutathione peroxidase in whole blood (GSH-Px: 10714.4+/-3705.4 vs. 5512.2+/-1498.1 U/l, P<0.001). The risk of having CHD was 20.6-fold greater (95% CI, 1.86-228.44, P=0.014) in the highest tertile of the oxLDL distribution than in the lowest, determined by logistic regression analysis on the combined study population after adjustment for age and other potential confounding factors. When the risk associated with GSH-Px levels was calculated, the odds ratio was 305.3 (95% CI, 5.07-18369.95, P=0.006) in the highest tertile compared with the lowest. Our results showed that an oxidative stress occurs in patients with CHD despite being clinically stable and under medical treatment. The combination of oxLDL levels and GSH-Px activity may be useful for the identification of patients with stable CHD.