Dietary and serum vitamins and minerals as predictors of myocardial infarction and stroke in elderly subjects.

BACKGROUND AND AIM: According to a widespread hypothesis, antioxidative vitamins and trace elements may protect the body against atherosclerotic diseases, especially in the elderly. We assessed dietary and serum vitamins and minerals for prediction of acute myocardial infarction (AMI) and stroke in elderly subjects. METHODS AND RESULTS: In a population-based health survey with special emphasis on the diet, subjects aged 65-99 years were followed up for up to 10 years. The study population consisted of 361 men and 394 women. Information on individual food consumption was elicited by means of dietary history interviews. Serum vitamins and mineral elements were analysed utilizing commonly applied biochemical methods. Prediction analyses were based on 130 cases accumulated in the AMI group, 70 subjects in the stroke group, and corresponding control subjects. The cases were determined on the basis of revised information from the National Register of Cases of Death, and from the National Hospital Discharge Register. Low intake of vitamin D (p = 0.011) and low serum levels of 1,25-dihydroxy-vitamin D (p = 0.0053) were significantly predictive of stroke when adjusted for age, gender, smoking and functional capacity. On the other hand, high dietary intakes of two flavonoids, luteolin (p = 0.0096) and kaempferol (p = 0.002) were associated with lowered risk of AMI. Furthermore, low serum levels of iron predicted both AMI (p = 0.013) and stroke (p = 0.019). The results remained essentially unchanged when adjusted for additional major risk factors of atherosclerosis. CONCLUSIONS: From the items in the dietary interview, low intakes of vitamin D and certain flavonoids emerged as the sole predictors of AMI and stroke. In biochemical analyses, on the other hand, these disorders were predicted only by low levels of 1,25-dihydroxy-vitamin D and iron in the serum.

Children with functional motor limitations: the effects on family strengths.

Sixty children with functional motor limitations (age range from 15 months to 7 years 3 months) and their parents participated in the study. The objective was to explore the relationship of the severity of their restrictions on family strengths. Functional motor abilities of the children were assessed using Autti-Ramo's Scale. Cognitive functions were assessed using the Swedish standardized version of the Griffiths Scales of Mental Development. Family strengths were indexed using the Family Functioning Style Scale. The social-economical status, children's age and caretakers' age were taken into account. Overall, the results indicated that family strengths were rather strong. Only families rearing a child with severe participation limitations (functional motor limitations and cognitive difficulties) showed less strengths concerning family identity and internal coping relative to families with a child with milder participation limitations.

Botulinum toxin treatment of spastic equinus in cerebral palsy: a randomized trial comparing two injection sites.

OBJECTIVE: To explore the clinical relevance of injection site by comparing two different injection techniques in children with cerebral palsy who have spastic equinus gait. DESIGN: A total of 19 children (13 boys, 6 girls; range, 1 yr 6 mos to 7 yrs; nine hemiplegics, eight diplegics, two quadriplegics; levels I to IV with the Gross Motor Function Classification System) participated in the study. The children were randomized into two groups: the proximal group received a botulinum toxin A injection into the proximal part of both heads of the gastrocnemius, and the distal group received a botulinum toxin A injection into the mid-belly of the muscle bulks. A single-point injection of BOTOX, 3 units/kg per site, was used. Assessments of active and passive range of motion, dynamic muscle length (modified Tardieu scale), calf tone (modified Ashworth scale), and video gait analysis (Observational Gait Scale) were performed before treatment and 3, 8, and 16 wks posttreatment. RESULTS: Active and passive dorsiflexion and calf tone in both groups and Observational Gait Scale total scores in the distal group improved at all time points. The median change from baseline values in Observational Gait Scale initial foot contact and total scores at 8 wks showed a significant difference favoring the distal group, but the clinical relevance remained tenuous. CONCLUSIONS: Using the methods described, no major changes in main outcome measures were associated with changing the injection site.

Effects of diet on the neurologic development of children at 5 years of age: the STRIP project.

OBJECTIVES: To evaluate the effects of diet, serum cholesterol concentrations, and apolipoprotein E phenotype on neurodevelopment of 5-year-old children. STUDY DESIGN: Prospective, 4.4-year cohort study in 496 children. Fat-modified diet was introduced to intervention families of 7-month-old infants. Control children consumed an unrestricted diet. Nutrient intakes, serum cholesterol, and neurodevelopment were studied. The groups were combined in univariate and stepwise multivariate logistic regression analyses. RESULTS: In 13-month-old boys (girls), energy intake was 996 (938) kcal, fat intake 26.6 (26.4) percent of energy (E%), and protein intake 17.2 (17.4) E%. In 5-year-old boys (girls), the intakes were 1484 (1364) kcal, 32.1 (31.9) E%, and 15.5 (15.9) E%, respectively. The intakes of total fat and saturated fat and serum cholesterol were not associated with neurodevelopment. In boys, high intake of protein at 5 years, high intakes of protein at 4 years and cholesterol at 2 years, and high intake of polyunsaturated fatty acids at 3 years predicted favorable outcomes in the tests of speech and language skills, gross motor function and perception, and visual motor skills, respectively. Apolipoprotein E phenotype did not influence the test performance. CONCLUSIONS: Moderate restriction of dietary fat has no unfavorable effects on neurodevelopment in early childhood. However, the quality of fat and the relative intake of protein may influence neurodevelopment of the boys.