Thermogenic response to an oral glucose load in man: comparison between young and elderly subjects

To investigate the effect of age and change in body composition on the increase in energy expenditure consecutive to the ingestion of a 75-g glucose load, respiratory exchange measurements were performed on 24 subjects, 12 elderly (mean +/- SEM, 73 +/- 1 yr) and 12 young (25 +/- 1 yr). The body weight was comparable, 62 +/- 2 kg in the elderly group vs 61 +/- 3 in the young, but the body fat content of the elderly group was significantly greater than that of the young (29 +/- 2% vs 19 +/- 2%, p less than 0.001). The elderly group presented a slight glucose intolerance according to the World Health Organization (WHO) criteria, with a 120-min plasma glucose of 149 +/- 9 mg/dl (p less than 0.005 vs young). The postabsorptive resting energy expenditure (REE) was 0.83 +/- 0.03 kcal/min in the elderly group vs 0.98 +/- 0.04 in the young (p less than 0.02); this decrease of 15% was mainly related to the decrease in fat free mass (FFM) in the elderly group, which averaged 14%. The difference was not significant when REE was expressed per kg FFM. The glucose-induced thermogenesis (GIT) expressed as percent of energy content of the load was 6.2 +/- 0.6% in the elderly group and 8.9 +/- 0.9% in the young (p less than 0.05). It is concluded that the glucose-induced thermogenesis is decreased in elderly subjects. However, when expressed per kg FFM, the increment in energy expenditure (EE), in response to the glucose load, is not different in elderly subjects, suggesting that the decrease of thermogenesis may be attributed to the age-related decrease in FFM.     

Reported dietary intakes of patients with insulin-dependent diabetes mellitus: limitations of dietary recall.

Reported dietary intakes were assessed in young patients with insulin-dependent diabetes mellitus (IDDM). We studied 44 IDDM patients (24 males, 20 females, mean +/- SD age 13.2 +/- 4.5 yr) and compared them with 44 healthy age- and sex-matched control subjects. Estimated intakes from 24-h dietary recall were analyzed in relation to body weight and degree of diabetes control. The reported energy intake of the IDDM patients with greater than 120% ideal body weight (IBW) for height was 66, 59/88% (where X = geometric mean, L1 = lower confidence limit/L2 = upper confidence limit) of recommended daily allowance (RDA), whereas those with IBW less than 120% reported 90, 67/120% (p less than 0.01). Patients with increased weights in comparison with IBW had higher hemoglobin A1c (HbA1c) levels (11.9 +/- 2.7%) than those with weights more appropriate for IBW (9.7 +/- 2.4%, p less than 0.025). IDDM patients reported overconsumption of protein and fat, but their carbohydrate intake was low. Analysis of dietary recalls revealed high protein intake (X +/- SD, 20.0 +/- 5.0% of total calorie intake), especially in older (27 +/- 4%) compared with younger (19 +/- 2%-19 +/- 4%, p less than 0.01) patients. Proportions of carbohydrate, protein, and fat did not correlate with variations in body weight and/or HbA1c. The reported intake of protein per kilogram body weight was not significantly different between appropriate-weight and overweight IDDM patients. There was no significant difference in reported total energy intakes of IDDM patients compared with their healthy control subjects.(ABSTRACT TRUNCATED AT 250 WORDS)     

Linoleate inhibits EPA incorporation from dietary fish-oil supplements in human subjects.

Thirty healthy male subjects were randomly allocated into one of two treatment groups: group H subjects were maintained on a high-linoleic acid (LA) diet with the saturated fatty acids kept low and those in group L were kept on a low-LA, low saturate diet. After a 3-wk run-in period, subjects consumed a fish-oil supplement containing 1.6 g eicosapentaenoic acid (EPA)/d and 0.32 g docosahexaenoic acid as triglycerides for a further 4 wk. The diets alone resulted in a significant change in neutrophil phospholipid LA (H = 12.7 +/- 2.9%, L = 9.0 +/- 0.9%; P less than 0.05). Dietary supplementation with fish oil resulted in a significant increase in EPA in neutrophil phospholipids that was greater in group L (mean 2.0 +/- 0.4%) than group H (mean 1.5 +/- 0.3%; P less than 0.005). Reductions in arachidonic acid concentrations in neutrophil membranes were not different, nor could differences in leukotriene B4 production be detected. Our study indicates that the ingestion of n-6 fatty acids within the diet is an important determinant of EPA incorporation into neutrophil membranes.     

Food intake measured by an automated food-selection system: relationship to energy expenditure.

Measuring food intake in a laboratory usually involves limited food choices. An automated food-selection system with two vending machines containing a large variety of foods was used to measure food intake in 10 male volunteers (31 +/- 6 y, 69.2 +/- 7.1 kg, 18 +/- 7% fat, mean +/- SD) on a metabolic ward. The effect of carbohydrate, fat, and protein intakes on 24-h energy expenditure (24EE) and substrate oxidations was measured in a respiratory chamber during day 4 of weight maintenance and day 7 of ad libitum intake. Ad libitum intake resulted in a 7-d overfeeding of 6468 +/- 3824 kJ/d above weight-maintenance requirements, leading to a 2.3 +/- 1.2-kg gain. The 10,975 +/- 3774 kJ excess energy intake on day 7 of ad libitum intake caused a 1205 +/- 920 kJ/d increase in 24EE (delta 24EE = 0.17 x delta intake - 695; r = 0.71, P less than 0.02). Of the excess carbohydrate intake, 74% was oxidized (r = 0.86, P less than 0.001), whereas excess fat intake was not. Carbohydrate and protein stores are regulated whereas excess fat intake is channeled to fat stores.     

Depression and adipose and serum cholesteryl ester polyunsaturated fatty acids in the survivors of the seven countries study population of Crete

BACKGROUND: Studies have shown that depression relates to biomarkers of both short- and long-term polyunsaturated fatty acid (PUFA) intake. However, it is not known which of these two biomarkers has the closest relationship to depression. OBJECTIVE: To examine the relationship of depression with both adipose tissue and serum cholesteryl ester PUFA and to assess the importance of each of these two biomarkers in relating to depression. DESIGN: Cross-sectional study of healthy elderly men from the island of Crete. SETTING: The Preventive Medicine and Nutrition Clinic, University of Crete, Greece. SUBJECTS: A total of 150 males, aged 80-96 years. The subjects were survivors of the Greek Seven Countries Study group. METHODS: Fatty acids were determined by gas chromatography in adipose tissue and serum cholesteryl esters. Information about depression was obtained through the use of the short form of the Geriatric Depression Scale (GDS-15). RESULTS: Regression analysis showed that depression related positively to age and serum cholesteryl ester arachidonic/docosahexaenoic fatty acid ratio. The only significant unadjusted correlation between depression and serum cholesteryl ester and adipose fatty acids was with adipose alpha-linolenic acid (ALA) (r = -0.31, P < 0.01). Depressed males (GDS-15 > 5) had lower adipose ALA and sum n-3 fatty acids than non-depressed ones. There were no significant differences between depressed and non-depressed males in serum cholesteryl ester fatty acids. When adipose tissue ALA was included as one of the independent measures in the regression model, the observed positive relation between GDS-15 depression and cholesteryl ester arachidonic/docosahexaenoic ratio failed to persist. Instead, there was a negative relationship between GDS-15 depression and adipose tissue ALA. CONCLUSIONS: It appears that the fatty acids of the adipose tissue are better predictors of depression than those of serum cholesteryl esters. This indicates that depression relates more strongly to long-term than to short-term fatty acid intake. The reason for this may be the reported slow rate of deposition of dietary PUFA to the brain.     

Effect of omega-3 fatty acid-containing phospholipids on blood catecholamine concentrations in healthy volunteers: a randomized, placebo-controlled, double-blind trial

OBJECTIVE: We previously reported that administration of fish oil rich in docosahexaenoic acid (DHA) increased the plasma ratio of epinephrine to norepinephrine (NE) at rest in young adults who were under chronic stress and that this effect was achieved mainly through depression of NE. However, not many reports have documented the effects of eicosapentaenoic acid (EPA) and DHA on blood catecholamine levels in healthy humans. Therefore, we performed another intervention study to test their effect on catecholamines with healthy subjects under no chronic stress. METHODS: Twenty-one healthy young adults (15 men and 6 women) were randomly assigned to an omega-3 group (n = 9) or a control group (n = 12) in a double-blind manner. Twenty capsules of shellfish-derived lipids containing 762 mg of EPA plus DHA per day were administered to the omega-3 group for 2 mo. The controls took the same amount of placebo capsules. Fasting blood samples after a 30-min rest with a catheter in a forearm vein were obtained at the start and the end of the study for catecholamine measurements. RESULTS: EPA but not DHA concentrations in red blood cells significantly increased in the omega-3 group compared with the control group (P < 0.001). Plasma NE concentrations were significantly decreased in the omega-3 group (from 1.49 +/- 0.39 nmol/L to 1.05 +/- 0.14 nmol/L) compared with the control group (from 1.12 +/- 0.24 nmol/L to 1.39 +/- 0.32 nmol/L) with analysis of covariance (P < 0.001). The differences remained significant (P = 0.01) even after deletion of three subjects in the omega-3 group who had the highest baseline NE values and one in the control group who had the lowest baseline NE value to nullify a significant baseline differences in NE between groups. CONCLUSION: This study demonstrated that EPA plus DHA supplementation lowered plasma NE concentrations in normal volunteers even at the small dose of 762 mg of EPA plus DHA per day. This effect of EPA plus DHA to lower plasma NE concentrations may be important to understand some of the effects of fish oils on diseases.     

Nutrition of the elderly in a Mediterranean city in Spain: effects of life-style patterns

We studied the food intake in a representative sample (121 males, 202 females) of the elderly people (greater than 60 years) of the city of Reus (Spain) living at home. The analysis of the consumption of nutrients revealed an energy intake lower than recommended but similar to that found in other surveys dealing with the same age group. We observed that in our elderly people, the major food sources of caloric intake were different in relation to those of adults of the same population. The distribution of energy percentage derived from several macronutrients is different in the elderly in relation to adults (35-64 yr) and children (3-4 yr) of the same population. In younger people there was a remarkably energy excess derived from lipids if compared with the recommended allowances, which does not occur in the elderly group. Among all the sociocultural characteristics of the individuals, the type of life-style is revealed as the major explanation of the differences in intake. The elderly males who live with younger people consume more energy (p less than 0.01), lipids (p less than 0.001) and carbohydrates (p less than 0.05) than those who live only with other old people. In elderly people living with younger ones, the energy sources become unbalanced in the same way as in the young people. We have not found any differences in the biotype of the elderly men in relation to the patterns of life-style which may explain the different intakes.(ABSTRACT TRUNCATED AT 250 WORDS)     

Evaluation of pyridoxine intake and pyridoxine status among aged institutionalised people

The vitamin B6 status of 60 institutionalised elderly subjects (group A: 31 men, mean age = 77 yr and 29 women, mean age = 84 yr) and 41 healthy young adults (group B or control group: 18 men, mean age = 30 yr and 23 women, mean age = 27 yr) was evaluated using erythrocyte aspartate aminotransferase activity coefficient (alpha EGOT) and plasma pyridoxal phosphate (PLP) level (vitamin B6-deficient subjects = alpha greater than 2.0 and PLP less than 80 nmol/l). The kilocalorie, protein and pyridoxine intakes were also estimated. Regarding calories and protein, the diets may be generally considered satisfactory in respect to the French 1981 RDA. The mean dietary intake of vitamin B6 was less than 2 mg/day in all groups. Ninety per cent of the aged, 80 per cent of females in group B in contrast to 56 per cent of males in group B consumed less than their individual vitamin B6 requirements as determined by a probability method. As the incidence of vitamin B6 biochemical deficiency was much higher in the group A (71% for males and 86% for females) than in the control group (11% for males and 30% for females), it is concluded that the high incidence of biochemical vitamin B6 deficiency noted in the aged appeared more relevant from an altered metabolism of the vitamin than from a too low energy intake. Supplements with high doses of vitamin B6 to aged subjects caused a significant decrease in alpha EGOT and a significant increase in PLP levels.     

Dietary zinc intake and sex differences in taste acuity in healthy young adults

BACKGROUND: Previous research suggests that adequate dietary zinc intake may be important in determining the sensory experience of food, appetite and consequently, dietary quality. The aim of this pilot study was to explore relationships between taste sensitivity and dietary zinc intake in healthy young adults (age 20-40 years: 24 male, mean age +/- SD = 27 +/- 4.86 years; 26 female, mean age +/- SD = 23 +/- 2.10). METHOD: A signal detection method was used to assess taste acuity for the four basic tastes: sweet (glucose), sour (citric acid), salt (sodium chloride) and bitter (quinine). A 4-day food diary was used to determine dietary intakes of zinc (mg day(-1)) and salt. RESULTS: Males reported a higher zinc intake than females (P=0.001). Higher dietary zinc intake was associated with better taste acuity for salt in females (P=0.017) but not in males. Acuity for bitter taste appeared to be related to zinc intake in males (P=0.007) but not females. Among those whose average daily zinc intake was below the RNI, males were less sensitive than females to sour (P=0.02) and bitter (P=0.014) taste. CONCLUSION: These findings suggest that zinc is more important for taste acuity in males than females and indicate the importance of taking sex differences into account when studying taste acuity.     

Serum calcidiol and calcitriol concentrations in elderly people: variations with age, sex, season and disease

The influence of age, sex, seasonal variations and vitamin D supplementation on serum concentrations (s-conc.) of calcidiol and calcitriol were studied in 311 hospitalized and 106 home-living people aged 70 years and over, residing at 60 degrees latitude. The serum calcidiol conc. (mean + SD, nmol/L) was reduced in the hospital group compared to the home-living group (males: 40.6 +/- 23.2 compared to 59.6 +/- 28.9; females: 37.3 +/- 22.6 compared to 48.5 +/- 20.3) and showed no seasonal variation. The home-living group showed highest levels in August-September (62.2 +/- 26), and lowest levels in January-March (42.9 +/- 21). Serum calcidiol declined with age, most prominent in the home group (males: r = -0.13, P = 0.036;females: r = -0.33, P = 0.001). A positive correlation was shown between s-calcitriol and s-calcidiol conc. (r = 0.26, P > 0.001). An increased s-conc. of calcidol was present in those with vitamin supplementation (home: 59.9 +/- 26; hospital: 43.4 +/- 22) compared to those without supplementation (home: 46.6 +/- 22; hospital: 36.2 +/- 22), but s-calcidiol conc. did not correlate to nutritional vitamin D intake. Vitamin D deficiency (s-calcidiol conc. < 30 nmol/L) was more common in old people recently admitted to hospital, compared to those living at home. Only the home-living group had the benefit of sunlight exposure, but both groups may benefit from vitamin supplementation.     

Relationship of vitamin A and vitamin E intake to fasting plasma retinol, retinol-binding protein, retinyl esters, carotene, alpha-tocopherol, and cholesterol among elderly people and young adults: increased plasma retinyl esters among vitamin A-supplement users

We studied the relationships of supplemental and total vitamin A and supplemental vitamin E intake with fasting plasma biochemical indicators of vitamin A and vitamin E nutritional status among 562 healthy elderly people (aged 60-98 y) and 194 healthy young adult (aged 19-59 y) volunteers. All subjects were nonsmokers. For the young adults, plasma retinol was significantly greater in males than in females (p less than 0.01); retinol was not related to supplemental vitamin A intake for either group. Fasting plasma retinyl esters demonstrated a significant increase with vitamin A supplement use. For supplemental vitamin A intakes of 5001-10,000 IU/d, a 2.5-fold increase over nonusers in fasting plasma retinyl esters was observed for elderly people (p less than 0.05) and a 1.5-fold increase for young adults (p greater than 0.20). For elderly people, greater fasting plasma retinyl esters were associated with long-term vitamin A supplement use (greater than 5 y) and biochemical evidence of liver damage. Elderly people who take vitamin A supplements may be at increased risk for vitamin A overload.     

Vitamin E, vitamin A and essential fatty acid status of patients hospitalized for anorexia nervosa

A group of 17 patients hospitalized for anorexia nervosa was assessed for nutritional status with respect to the essential fatty acids and vitamins E and A. Plasma aliquots available from blood drawn upon hospital admission were frozen and later extracted for total lipids. The total lipids were then fractionated by thin layer chromatography to isolate the phospholipids (PL). The fatty acid profile of both total plasma and PLs was determined by gas chromatography. High pressure liquid chromatography was used to quantitate the tocopherol isomers and retinol (vitamins E and A, respectively). The anorexic patients showed below normal weight-for-height, decreased percent body fat, and a high incidence of secondary amenorrhea. Of the four tocopherol isomers measured, only the beta + gamma fraction was significantly lower than the normal value (0.16 +/- .06 mg/dl vs 0.25 +/- 0.51 mg/dl, p less than .001). The essential fatty acids, linoleate and linolenate, were lower in the PL fraction of the anorexic group (linoleate, 19.35 +/- 5.65 vs 24.96 +/- 2.24, p less than .01); linolenate, none detected vs 0.16 +/- 0.13, p less than .05). Other indicators of essential fatty acid status differed from the normal group in the direction of deficiency (total omega 6, 31.44 +/- 7.41 vs 37.42 +/- 3.40, p less than .05; 20:4 omega 6/18:2 omega 6, 0.49 +/- 0.14 vs 40 +/- 0.02, mean +/- standard deviation, p less than .01). Eicosatrienoic acid, however, was not detected in either group.(ABSTRACT TRUNCATED AT 250 WORDS)     

6S]5-methyltetrahydrofolate or folic acid supplementation and absorption and initial elimination of folate in young and middle-aged adults

OBJECTIVES: To assess the effects of supplementation with the diastereoisomer of 5-methyltetrahydrofolate ([6S]5-methylTHF), as an alternative supplement for folic acid, on folate absorption and elimination, in two age groups. DESIGN: A randomized, double-blind intervention study. SUBJECTS: A total of 12 young (<30 y) and 12 middle-aged (> or =50 y) healthy volunteers were recruited. METHODS: Volunteers were randomized to receive daily supplementation with 400 mug folic acid or equimolar amounts of [6S]5-methylTHF during 5 weeks. Before and after supplementation, absorption and initial elimination were calculated following oral [(2)H(2)]folic acid test doses using isotope kinetics in plasma. RESULTS: Folic acid absorption was lower in the middle-aged as compared to the young adults, both before (P = 0.03) and after (P = 0.05) supplementation. In the young adults, absorption decreased by 22% after [6S]5-methylTHF and increased by 21% after folic acid (P = 0.02). In the other age group, no such changes were found. The folate rate constant of elimination increased after folic acid supplementation in the young (+50%; P = 0.05) but not in the middle-aged (+18%; P = 0.5) adults. CONCLUSIONS: Young adults show increased folate turnover after folic acid supplementation relative to the effect of [6S]5-methylTHF supplementation. Similar differences are not observed in middle-aged adults, in whom folic acid absorption was found to be lower as compared to the young adults.Sponsorship:Financial support was received from the European Union 5th Framework Programme (Grant QLRT-1999-00576).     

Carotid intima-media thickness in patients with Type 2 diabetes and hypercholesterolemia

Both patients with Type 2 diabetes mellitus (T2DM) and with hypercholesterolemia have a more extensive and accelerated atherosclerosis with higher common carotid artery intima-media thickness (CIMT) values than the general population. The aim of this study was to compare the CIMT in polygenic hypercholesterolemia (HP; n=41: 30 females and 11 males, aged 52+/-15 yr) and in T2DM (n=43: 22 females and 21 males, aged 59+/-11 yr), with a duration of disease less than 5 yr and no evidence of coronary heart disease. A control group (C) of 40 sex- and age-matched healthy subjects was studied. We evaluated the CIMT on the far wall of the distal segment of the common carotid arteries on sites free of plaque. The mean of the CIMT measurements (Tmean; 9 on each side) and the maximal CIMT measured (Tmax) were used as the representative values for each subject. Tmax values were 0.96+/-0.2 mm and 0.82+/-0.2 mm in T2DM and HP, respectively, which were significantly higher than C (0.74+/-0.1 mm). Corresponding values of Tmean were 0.8+/-0.1 mm and 0.71+/-0.2 mm, both significantly higher than C (0.68+/-0.1 mm). In HP, both Tmax and Tmean values were positively correlated to age (p=0.0001 and p=0.0001, respectively), body mass index (BMI; p=0.05 and p=0.05, respectively), presence of hypertension (p=0.003 and p=0.0008, respectively) and fibrinogen (p=0.0009 and p=0.001, respectively); Tmean was also correlated to apolipoprotein B (ApoB; p=0.03). The multiple "stepwise" regression analysis revealed fibrinogen and age as the only significant determinants of Tmax and Tmean. In T2DM Tmax and Tmean were positively correlated to age only (p=0.04 and p=0.01, respectively). In conclusion, T2DM patients have a more accelerated atherosclerosis than subjects with HP. This is evident after a short duration of disease, probably for a longer latency period of disease and the presence of multiple risk factors.     

A longitudinal study of the relationship between vitamin A supplementation and plasma retinol, retinyl esters, and liver enzyme activities in a healthy elderly population

This study examined the association between dietary supplementation with vitamin A and biochemical symptoms of toxicity in 116 healthy elderly volunteers (47 male, 69 female), aged 64-88 y. Plasma retinol and retinyl ester concentrations, seven liver-function tests, and dietary and supplemental vitamin A intakes were measured annually for 5 y. Supplemental intake range was 0-47,000 IU/d; dietary intake range was 2528-23,032 IU/d. Fasting retinol and retinyl ester concentrations were determined by HPLC and dietary intake was assessed by a 3-d food record. Supplemental vitamin A intake was highly correlated with retinyl ester concentrations (r = 0.74, P = 0.0001). Retinyl esters ranges from 3.4% to 10.2% of retinol concentrations. Retinyl ester concentrations did not increase over time, regardless of supplement amount. The association of retinyl esters and liver-function tests was significant only for aspartate aminotransferase activity in females (r = 0.47, P = 0.0001). The supplementation amount in this study was not associated with vitamin A toxicity.     

Body composition and nutrient intake of hypertensive elders and middle-aged men and women in Nigeria

Body composition of eighty hypertensive patients (43 middle-aged, 30-59 years and 37 elders, 60-80 years) was determined by anthropometry alongside their dietary intake. The mean body weight and height of female elders were 54.1 +/- 14.6 kg and 157.0 +/- 7.0 cm while that of male elders were 61.8 +/- 13.5 kg and 167.1 +/- 9.0 cm. Corresponding values for middle-aged subjects were also determined. The middle-aged subjects were heavier and taller than the elders in both sexes. Among the elders BMI values 21.7 (females) and 22.1 (males) were normal, but the female had higher percentage body fat (28.0 +/- 0.1%) than males (20.8 +/- 5.2%). Other body composition parameters determined included lean body mass, optimum body weight, body water, skin-fold thickness and arm muscle diameter. BMI was significantly correlated with high blood pressure. The mean energy and nutrient intake of the subjects were inadequate except for the female elders.     

Purified eicosapentaenoic and docosahexaenoic acids have differential effects on serum lipids and lipoproteins, LDL particle size, glucose, and insulin in mildly hyperlipidemic men

BACKGROUND: Regular consumption of n-3 fatty acids of marine origin can improve serum lipids and reduce cardiovascular risk. OBJECTIVE: This study aimed to determine whether eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids have differential effects on serum lipids and lipoproteins, glucose, and insulin in humans. DESIGN: In a double-blind, placebo-controlled trial of parallel design, 59 overweight, nonsmoking, mildly hyperlipidemic men were randomly assigned to receive 4 g purified EPA, DHA, or olive oil (placebo) daily while continuing their usual diets for 6 wk. RESULTS: Fifty-six men aged 48.8 +/- 1.1 y completed the study. Relative to those in the olive oil group, triacylglycerols fell by 0.45 +/- 0.15 mmol/L ( approximately 20%; P = 0.003) in the DHA group and by 0.37 +/- 0.14 mmol/L ( approximately 18%; P = 0.012) in the EPA group. Neither EPA nor DHA had any effect on total cholesterol. LDL, HDL, and HDL(2) cholesterol were not affected significantly by EPA, but HDL(3) cholesterol decreased significantly (6.7%; P = 0.032). Although HDL cholesterol was not significantly increased by DHA (3. 1%), HDL(2) cholesterol increased by approximately 29% (P = 0.004). DHA increased LDL cholesterol by 8% (P = 0.019). Adjusted LDL particle size increased by 0.25 +/- 0.08 nm (P = 0.002) with DHA but not with EPA. EPA supplementation increased plasma and platelet phospholipid EPA but reduced DHA. DHA supplementation increased DHA and EPA in plasma and platelet phospholipids. Both EPA and DHA increased fasting insulin significantly. EPA, but not DHA, tended to increase fasting glucose, but not significantly so. CONCLUSIONS: EPA and DHA had differential effects on lipids, fatty acids, and glucose metabolism in overweight men with mild hyperlipidemia.     

Comparison of the effects of fish and fish-oil capsules on the n 3 fatty acid content of blood cells and plasma phospholipids

BACKGROUND: n-3 Fatty acids (FAs) have been shown to be beneficial for cardiovascular health. Whether n-3 FAs from oily fish consumed weekly or from fish-oil capsules taken daily are equally bioavailable is not clear. OBJECTIVE: The purpose of this study was to compare the rate and extent of enrichment of blood cell membranes [ie, red blood cells (RBCs)] and plasma phospholipids with n-3 FAs from these 2 sources. DESIGN: Healthy premenopausal female volunteers were randomly assigned to consume a daily average of 485 mg eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids either from 2 servings of oily fish (ie, salmon and albacore tuna) per week or from 1-2 capsules/d. RESULTS: After 16 wk, EPA+DHA in RBCs in the fish group (n = 11) increased from 4.0 +/- 0.6% of total FAs to 6.2 +/- 1.4%, whereas it rose from 4.3 +/- 1.0% to 6.2 +/- 1.4% in the capsule group (P < 0.0001 for both; NS for group effect). Similar results were observed in plasma phospholipids. EPA+DHA stabilized in the latter after 4 wk but continued to rise through week 16 in RBCs. EPA in RBCs increased significantly (P = 0.01) more rapidly in the fish group than in the capsule group during the first 4 wk, but rates did not differ significantly between groups thereafter. Total FA variances were less in RBCs than in plasma phospholipids (P = 0.04). CONCLUSION: These findings suggest that the consumption of equal amounts of EPA and DHA from oily fish on a weekly basis or from fish-oil capsules on a daily basis is equally effective at enriching blood lipids with n-3 FAs.     

Efficacy of daily and weekly iron supplementation for the control of iron deficiency anaemia in infants in rural Vietnam

In Vietnam the high prevalence of iron deficiency anaemia in infants and young children speaks for implementing early interventions. This study aimed to evaluate the efficacy of the daily iron supplementation in infants given by their mothers and of the weekly iron supplementation. Two hundred and seventy infants aged 5 to 12 months, were divided into four groups. Group 1 received a placebo daily and group 2 a daily dose of 15 mg iron (2.0 +/- 0.3 mg iron/day/kg body weight) which was given by their mothers for three months. Group 3 received a daily dose of 15 mg iron and group 4 a weekly dose of 15 mg iron given during 6 months by health auxiliaries. The hemoglobin concentration (Hb) was measured before the intervention and after 3 months of supplementation in all groups, and again after 6 months of supplementation in groups 3 and 4. After 3 months of iron supplementation, the hemoglobin concentration increased significantly by 21.6 +/- 12.3 g/l and the prevalence of anaemia decreased from 81.3% to less than 9% in group 2. The weekly iron supplementation was significantly less effective than the daily supplementation: after 3 months, Hb increased by 15.4 +/- 13.3 g/l in group 3 and by 11.2 +/- 10.2 g/l in group 4 (p = 0.04) and the prevalence of anaemia was 17.9% and 41.5% in groups 3 and 4, respectively. After 6 months of supplementation, changes in Hb were not significantly different between group 3 (22.0 +/- 12.1 g/l) and group 4 (20.0 +/- 10.0 g/l, p = 0.30). However, the final hemoglobin concentration was significantly lower in group 4 (120.5 +/- 7.2 g/l) than in group 3 (123.6 +/- 7.8, p = 0.02). Moreover, nearly 8% of the children were still anemic in group 4 versus 0% in group 3. Since the early developmental period, when the brain and other specific organs are especially sensitive to iron deficiency, is critical, 3-month daily iron supplementation of infants from the age of 6 months has to be recommended, followed by a weekly iron supplementation until the age of 15 months. The community approach, where mothers informed on the importance of iron deficiency anaemia and on the consequences for the health of their infants gave the iron supplements, was shown to be effective. However, its sustainability would depend on the availability of low-cost iron supplements affordable by populations with limited economic resources. Other interventions, such as iron supplementation of women during fertile age, especially during pregnancy and lactation periods, and the use of complementary food to breast milk, fortified with micronutrients, should be associated.     

Very-long-chain omega-3 fatty acids as markers for habitual fish intake in a population consuming mainly lean fish: the EPIC cohort of Gipuzkoa. European Prospective Investigation into Cancer and Nutrition

OBJECTIVE: To assess the relationship between habitual fish intake and fatty acid levels in serum as well as in the LDL fractions of serum phospholipids and cholesteryl esters. DESIGN: Cross-sectional study. SETTING: Cohort of Gipuzkoa (Basque Country, northern Spain) included in the European Prospective Investigation into Cancer and Nutrition (EPIC) project. SUBJECTS: Random sample of 120 healthy volunteers of both sexes aged 35-65 y, divided into various consumption groups according to daily fish intake. METHODS: Data on habitual intake over the previous year was collected by trained interviewers by means of a computerized questionnaire based on the diet history method. Fasting venous blood samples were drawn and fatty acids were measured by gas-liquid chromatography. RESULTS: Lean fish accounted for 78% of all fish consumption in the highest consumption group (>115 g/day) and for 60% in the lowest (<31 g/day). The mean concentrations of omega-3 polyunsaturated fatty acids (PUFA), eicosapentaenoic acid (EPA, C20:5, omega-3), and docosahexaenoic acid (DHA, C22:6, omega-3) in serum and in the LDL fractions of serum phospholipids and cholesteryl esters increased significantly from the lowest to the highest fish consumption categories. Fish intake showed a statistically significant relationship with omega-3 PUFA, EPA and DHA in serum and in the LDL fractions of serum phospholipids and cholesteryl esters both in the simple linear regression analysis and in a multiple regression model adjusted by age, body mass index (BMI) and vegetable intake. CONCLUSIONS: Habitual fish intake is reflected in the content of EPA and DHA in serum and in the LDL phospholipid and cholesteryl esters fractions. The concentrations of very-long-chain omega-3 fatty acids are useful biomarkers for dietary fish intake, mainly lean fish. SPONSORSHIP: Europe Against Cancer Programme of the European Union (agreement SOC 97 200302 05F02); 'Fondo de Investigaciones Sanitarias', Spanish Ministry of Health (FIS grant 99/0024-05); Government of the Basque Country; and 'Fundación Científica de la Asociación Espa?ola contra el Cáncer'.