Assessment of sodium and iodine intake among university students in Casablanca,Morocco

IntroductionIodine deficiency is still a matter of public health concern despite salt fortification and especially with global recommendations to lower salt intake, this is mainly due to dietary habits. University students have a diet based on street food high in sodium and low in other micronutrients (i.e. iodine and potassium). In this study, we aim to measure sodium and iodine levels in university students to assess their risk of developing complications later in life.MethodologyA sample of 120 students aged between 18 and 25 years old was recruited and asked to collect their 24-hours urine samples in special containers containing. Samples were stored then analyzed for sodium, potassium, iodine and creatinine levels.ResultsThe average urinary excretion of sodium was 3066.8 ± 1196.0 mg/day. Overall, 72.6% of participants consume more than 2 g/day of sodium. Average potassium intake is 1805.9 ± 559.4 mg/day, and all participants consume less than the adequate amount. Daily urinary excretion of iodine is 135.6 ± 88.9 mg/day, and 69.2% of participants consume less than the recommended amount. Sodium, potassium and iodine intakes were higher in male participants (P-values = 0.008; 0.044 and 0.003, respectively). The lowest average iodine intake was observed in underweight participants (119.4 ± 31.4) with 87.5% of underweight participants and 80% of female participants below the recommended intake.ConclusionSodium intake is high while iodine intake is low in this studied population, especially in women.     

Sodium and potassium intakes assessed by 24-h urine among Moroccan University students in Casablanca,Morocco: Cross-sectional study

In Morocco, the high consumption of dietary sodium increases the risk of non-communicable diseases (NCDs) and predisposes to cardiovascular diseases (CVDs) and hypertension. This study aims to assess the dietary sodium and potassium intake in a random sample of Moroccan adult students as a benchmark informing a national strategy for reducing salt intake. This cross-sectional study was conducted with 103 adults aged 18 to 25 years recruited in Casablanca. The 24-hour urinary excretion was used to measure the sodium and potassium. Urine volume and creatinine excretion level were used to validate the completeness of the collected samples. The average urinary sodium excretion was 3.1 ± 0.1 g/day, 13.5% consumed less than 5 g/day, while 69% consumed more than 5 g/day of which 17.5% consumed more than twice the recommendations. For the average urinary potassium excretion was 1.83 ± 0.06 g/day, and more than 98% of the students consumed less than the adequate intake. The Na/K ratio is significantly higher than the recommended amounts. The results of this pilot study show that the population studied has a high sodium intake and low potassium intake which does not meet World Health Organization (WHO) recommendations, which requires implementing an action plan to reduce salt intake.     

Supplemental nutrition assistance program participation and sugar-sweetened beverage consumption,overall and by source

IntroductionThis paper examined patterns in adults' sugar-sweetened beverage (SSB) consumption and caloric intake by Supplemental Nutrition Assistance Program (SNAP) participation status and by source of purchases in the United States (US).MethodCross-sectional analysis of consumption of SSBs by source of purchases using 24-hour dietary recall data obtained from the US National Health and Nutrition Examination Survey 2003–2010 (N = 17,891). Bivariate analysis and multivariable regressions were used to examine the association between SNAP participation and SSB calories consumed overall and by source.ResultsSSBs account for approximately 12% of total daily caloric intake (258 kcal) among SNAP participants, higher than that of SNAP-eligible nonparticipants (9% total daily intake, 205 kcal) and SNAP-ineligible nonparticipants (6% total daily intake, 153 kcal). Among income-eligible adults, participating in SNAP is associated with 28.9 additional SSB calories, of which most were obtained from a store. From 2003–04 to 2009–10, SSB prevalence and caloric intake were flat among SNAP participants while it declined among both SNAP-eligible and SNAP-ineligible nonparticipants; this pattern held for all sources of SSBs except for those purchased from fast-food restaurants, which were not statistically reduced among nonparticipants.ConclusionSNAP participants consumed more SSB calories compared to SNAP-eligible nonparticipants; and their SSB prevalence and caloric intake trend was flat over the 2003–04 to 2009–10 period. SNAP-Education interventions that focus on improving access to healthy food in poor neighborhoods may benefit SNAP participants.     

Electrolyte intake and nonpharmacologic blood pressure control

PURPOSE: To characterize relationships between sodium and potassium intakes and blood pressure control.

METHODS: We analyzed repeated 24-hour diet recalls and 24-hour urine assays from 873 elderly participants with established hypertension in a 3-year clinical trial of lifestyle interventions. Pooled estimates of electrolyte intakes were developed using hierarchical measurement error models and related to nonpharmacologic blood pressure control.

RESULTS: Relative decreases in sodium and increases in potassium intakes each had graded relationships with better blood pressure control. After adjustment for measurement error, a 100 mmol/24-hour decrease in sodium intake was associated with an odds ratio of 2.93 [95% confidence interval: 1.83, 4.64] for maintaining nonpharmacologic blood pressure control throughout follow-up. A 50 mmol/24-hour increase in potassium intake was associated with an odds ratio of 2.00 [1.12, 3.55]. These relationships were independent of each other and of baseline levels of intakes. Blood pressure control was most strongly associated with sodium intake for participants with lower systolic blood pressures and longer duration of hypertension, and with potassium for those with elevated diastolic blood pressures.

CONCLUSIONS: Sodium and potassium intakes exert independent graded influences on nonpharmacologic blood pressure control. Correlated measurement error may spuriously introduce a dependency among these relationships.     

Short-term high dietary calcium intake during bedrest has no effect on markers of bone turnover in healthy men

ObjectiveImmobilization and space flight are causes of disuse osteoporosis. Increasing calcium intake may counteract this disuse-induced bone loss.MethodsWe conducted two bedrest experiments (crossover design: bedrest versus ambulatory control) in a metabolic ward, studying the effect of 1000 mg/d of calcium intake (study A, length of intervention 14 d) compared with that of a high calcium intake of 2000 mg/d (study B, 6 d) on markers of bone turnover. Both studies were randomized, controlled studies with the subjects staying under well-controlled environmental conditions (study A, 9 male subjects, age 23.6 ± 3.0 y; study B, 8 male subjects, age 25.5 ± 2.9 y). Blood was drawn to analyze serum calcium, parathyroid hormone, procollagen type I C-terminal propeptide, and bone alkaline phosphatase. Urine (24-h) was collected for analysis of calcium, C-terminal telopeptide of collagen type I, and N-terminal telopeptide of collagen type I.ResultsIn both studies, serum calcium levels remained unchanged. Procollagen type I C-terminal propeptide was lower (P = 0.03) in the bedrest phase than in the ambulatory phase in study A and tended to be lower (P = 0.08) in bedrest in study B, whereas bone alkaline phosphatase was not affected in either study. Urinary calcium excretion was greater during bedrest than during the ambulatory phase (study A, P = 0.005; study B, P = 0.002). C-terminal telopeptide of collagen type I excretion was also greater during bedrest in both studies (study A, P < 0.001; study B, P < 0.001).ConclusionDoubling calcium intake to 2000 mg/d does not prevent increased bone resorption induced by bedrest.     

Effect of nicotine patch on energy intake and weight gain in postmenopausal women during smoking cessation

IntroductionPost-cessation weight gain is a commonly cited barrier to smoking cessation. Some evidence suggests that nicotine replacement therapy may limit post-cessation weight gain by reducing energy intake. This project aims to assess differential changes in energy intake and body weight during smoking cessation in a sample of postmenopausal women randomized to receive 21 mg nicotine or placebo patch for 12 weeks.MethodsPostmenopausal women who smoked ≥ 10 cigarettes/day were enrolled in this double-blind randomized placebo-controlled study. Total energy intake (via four-day food diaries), body mass index (BMI; kg/m²), cigarettes/day and smoking status (self-report verified by exhaled carbon monoxide) were assessed at three time points: 2 weeks prior to quit date,12 weeks after quit date, and 12 months after smoking cessation treatment.ResultsParticipants (n = 119) were, on average, 55.8 ± 6.7 years old with a baseline BMI of 27.0 ± 5.2 and average cigarette/day was 21.1 ± 8.6. At Week 12, participants randomized to nicotine patch increased their mean caloric intake by 146.4 ± 547.7 kcal/day whereas those on placebo patch decreased their caloric intake by 175.3 ± 463.2 (f-value = 10.1, p-value = 0.002). Despite the differences in caloric intake, body weight remained similar between groups.ConclusionsThe results of this study indicate that nicotine patch may increase energy intake during treatment, and does not prevent post-cessation weight gain in postmenopausal smokers. Additional research is needed to replicate these findings and assess whether different forms of nicotine replacement therapy influence caloric intake and post-cessation weight gain in postmenopausal smokers.     

The evaluation of consumed food portions as a screening test for malnutrition in the older people living in a nursing home: A cross-sectional pilot study

IntroductionThe Self Evaluation of Food Intake (SEFI®) is a simple tool to assess food intake.AimsTo evaluate the validity of SEFI® to screen malnutrition compared to the Mini Nutritional Assessment (MNA)® as the reference method (primary) and other screening tools (secondary); to assess the feasibility of SEFI® (secondary) in older people living in a nursing home.MethodsQuantitative, non-interventional, cross-sectional, monocentric pilot study. Patients were included in a 143-beds nursing home. The SEFI® visual analogue scale (VAS) from 0 to 10, and the evaluation of consumed portions of served food by the general practioner (SEFI® consumed portions) were performed after the MNA®. Malnutrition was defined as MNA®<17.StatisticsYouden method and receiver operating characteristic (ROC) curves.ResultsOut of 128 patients, 93 were included: 72% women, mean age (±SD), 88 ± 7 yr, body mass index, 25.9 ± 6.1, MNA®<17, 26% (24/93), SEFI® consumed portions ≤50%, 29% (27/93) of patients. The feasibility of SEFI®  VAS and consumed portions were respectively 0 and 100% (93/93). The predictive performance of SEFI® consumed portions for the diagnosis of malnutrition was good: area under the curve = 0.81 [95% confidence interval (CI), 0.69–0.93]; sensitivity 75.0% (n = 18/24, 95%CI, 57.7–92.3), specificity 87.0% (n = 60/69, 77.0–94.9), positive predictive value 66.7% (n = 18/27, 48.9–84.4), and negative predictive value 90.9% (n = 60/66, 80.0–93.9).ConclusionsSEFI® is feasible and useful for detecting malnutrition in nursing home residents.     

Assessment of energy expenditure,physical activity and sleep pattern in patients with frequent symptomatic ventricular ectopic beats

BackgroundVentricular ectopic beats (VEBs) are considered as benign ventricular arrhythmias in patients without structural heart disease. However, symptomatic frequent VEBs can adversely affect energy metabolism. The present study aimed to determine the effect of symptomatic frequent VEBs on energy expenditure, physical activity and sleep pattern.MethodsThirty-seven patients with symptomatic frequent VEBs and no structural heart diseases were enrolled. Patients underwent simultaneous 24-hour-ambulatory Holter electrocardiogram monitoring and the BodyMedia armband device monitoring which measures energy expenditure. Data acquired from both devices were compared with the data acquired from healthy volunteers in the control group.ResultsTotal energy expenditure (TEE) was higher in the patient group than the control group (1470 ± 353 kcal vs 1125 ± 275 kcal, P < 0.001). Average metabolic equivalence (aMETs) (1.1 ± 0.2 vs. 1.3 ± 0.2, P = 0.028), physical activity duration (PAD) (0.35 vs. 0.48, P = 0.007) and sleep duration (SDN) (3.15 vs. 4.31, P = 0.004) were significantly lower in the patient group than control group. VEBs frequency was inversely correlated with only SDN (r = −0.374, P = 0.027).ConclusionTotal energy expenditure (TEE) is increased in patients with symptomatic frequent VEBs in comparison with healthy subjects while PAD, average metabolic equivalence (aMETs) and SDN are decreased. VEBs frequency was inversely correlated with SDN.     

Levels and daily intake of lead (Pb) and six essential elements in gari samples from Ondo State,Southwest Nigeria: A potential risk factor of health status

Gari, a staple food in most West African countries is a processed product of cassava plant. It supplies about 70% of the daily calorie intake in these countries. In this study, levels of lead (Pb), zinc (Zn), manganese (Mn), cobalt (Co), copper (Cu), calcium (Ca) and iron (Fe) in gari samples that were collected from four major Nigerian cities: Akure, Ondo, Isua and Ore – all located in Ondo State, Southwest, Nigeria were determined. The estimated daily intakes (EDI) of these elements were determined and compared to the recommended dietary intake limits or requirements. The mean concentrations of Pb in gari samples was 0.16 ± 0.09 mg/kg while for essential elements the concentrations were 4.13 ± 0.95, 0.00497 ± 0.00078, 12.98 ± 1.48, 1.01 ± 0.47, 512.6 ± 9.12 and 23.22 ± 2.32 mg/kg for Zn, Mn, Co, Cu, Ca and Fe, respectively. The mean estimated dietary intakes were 0.0333 ± 0.00443, 0.88 ± 0.21, 1.06 ± 0.36, 0.00278 ± 0.00068, 0.22 ± 0.04, 109.7 ± 4.22 and 4.97 ± 1.07 mg/day for Pb, Zn, Mn, Co, Cu, Ca and Fe respectively. The estimated mean Pb dietary intake from gari consumption alone was almost the same as the benchmark dose lower confidence limit (BMDL) for Pb, thus inferring that dietary route is a potential source of Pb contamination for gari consumers in Southwest Nigerian. Also, the data from this study indicated that gari is a good source of some essential elements like Mn, Co, and Cu but not exceptionally rich in Zn, Fe and Ca. It is therefore recommended that gari diets should be complemented with other food substances like beef, vegetables and low fat cheese that are good sources of the deficient elements.     

Multimodal-lifestyle intervention produces reduction of the fat mass rather than body weight loss in men with obesity: A prospective cohort study

Background and the objectiveBody composition changes throughout the multimodal-lifestyle intervention of obesity is underinvestigated. This study evaluated the effectiveness of the multimodal-lifestyle intervention in reduction of fat mass together with preservation of fat free mass.MethodsAdult male subjects with overweightness or obesity (n = 99) were enrolled in a prospective cohort study for 12 months. Patients were educated about healthy diet, physical activity, and some behavioral changes. Anthropometric measurements and body composition analysis by bioelectric impedance analysis (InBody-720) were reported before, during and after the study period.ResultsConcerning adherent subjects, the mean ± standard error of the mean (SEM) of percent weight loss, percent fat mass loss, percent fat free mass and total body water changes after 6 months were 7.24 ± 0.98, 16.28 ± 2.35, 0.76 ± 0.64 and 0.82 ± 0.65, respectively, and after 1 year they were 10.14 ± 0.78, 25.22 ± 3.59, 1.22 ± 1.06 and 1.27 ± 1.07, respectively. There were significant changes between before- and after-measurements of weight, BMI, waist circumference, fat mass and percent body fat (P < 0.05) for all studied intervals.ConclusionsMultimodal-lifestyle intervention might be effective in loss of fat mass rather than reduction of the total body weight together with preservation of the lean body mass.     

Sodium and Potassium Intake,the Sodium to Potassium Ratio,and Associated Characteristics in Older Adults,NHANES 2011-2016

BackgroundSodium, potassium, and the balance between these 2 nutrients are associated with hypertension and cardiovascular disease, and prevalence of these conditions increases with age. However, limited information is available on these intakes among older adults.ObjectiveOur aim was to explore the socioeconomic and health factors associated with usual sodium and potassium intakes and the sodium to potassium (Na:K) ratio of older adults.DesignThis was a cross-sectional, secondary analysis of the 2011-2012, 2013-2014, and 2015-2016 National Health and Nutrition Examination Survey.Participants/settingThis study included the data of 5,104 adults 50 years and older, with at least one reliable 24-hour dietary recall and an estimated glomerular filtration rate ≥60 mL/min/1.73 m².Main outcome measuresSodium and potassium intake, as absolute intake, density (per 1,000 kcal) and ratio of Na:K intake.Statistical analysesWe used t tests and χ² tests to examine significant differences in intakes on a given day by characteristics. Linear and logistic regression models were used to assess associations of socioeconomic and health characteristics with usual sodium and potassium intakes, determined using the National Cancer Institute method.ResultsOnly 26.2% of participants consumed <2,300 mg sodium (16.2% of men and 35.2% of women) and 36.0% of men and 38.1% of women consumed at least 3,400 mg and 2,600 mg of potassium, respectively. Fewer than one-third of participants consumed a Na:K ratio of <1.0. Women, those with lower blood pressure, and those with a lower body mass index were more likely to have a ratio <1.0.ConclusionsParticipants consumed too much sodium and not enough potassium, based on current recommendations. A higher Na:K ratio was significantly associated with established risk factors for cardiovascular disease. The study findings suggest that more research on cardiovascular health should include both sodium and potassium, as well as balance between these nutrients.     

Greater frequency of nut consumption is associated with lower prevalence of peripheral arterial disease

Nut consumption has been associated with lower risk of coronary heart disease and all-cause mortality. The association between nut intake and peripheral arterial disease (PAD) is uncertain.ObjectiveWe sought to investigate the association between nut consumption and presence of prevalent PAD in a large cross-sectional sample.MethodsSelf-referred participants at > 20,000 US sites who completed a medical and lifestyle questionnaire were evaluated by screening ankle brachial indices for PAD. Multivariable logistic regression analysis was used to estimate odds of PAD in different nut consumption categories.ResultsAmong 3,312,403 individuals, mean age was 63.6 ± 10.6 years and 62.8% were female. There were 219,527 cases of PAD. After multivariable adjustment there was an inverse association of nut intake with PAD. Compared to subjects with consumption of nuts < once/month, daily nut consumption was associated with a 21% (95% CI 20%–23%) lower odds of having PAD.ConclusionThese observations suggest the need for more rigorous testing evaluating the role of nuts in PAD prevention.     

Antioxidant components and antioxidant/antiradical activities of desert truffle (Tirmania nivea) from various Middle Eastern origins

Dried desert truffles from Bahraini, Iranian, Moroccan and Saudi origins were examined for their antioxidant and antiradical activities using four analytical methods: ferric reducing ability (FRAP), DPPH, deoxyribose, and nitric oxide (NO). Chemical constituents contributing towards these activities were also investigated. Generally, these truffles possessed varying concentration of antioxidant chemicals averaging 9.6 ± 0.15, 12.0 ± 8.34, 1860 ± 361, 1328 ± 167 and 293 ± 32 mg/100 g dw, for ascorbic, anthocyanins, total esterified phenolics, total free phenolics and total flavonoids, respectively; total carotenoids averaged 681 ± 245 g/100 g dw. Dried truffles also varied with regard to their antioxidant and antiradical activities. The FRAP value averaged 15.41 ± 3.51 mmol/100 g dw. Antiradical activity measured as percent inhibition of DPPH quenching averaged 30.6 ± 12.97% and EC₅₀ of 0.55 ± 0.38 mg. The average EC₅₀ of NO scavenging activity was 159.4 ± 69.3 μg, whereas the average percent inhibition of deoxyribose degradation was 55.9 ± 30.1%. The Iranian truffles yielded the highest in several variables, whereas the Moroccan truffles possessed the lowest values of many variables among the four tested samples. Significant correlation was established between total and free phenolics and FRAP values, and between flavonoids and percent radical inhibition using DPPH, NO and deoxyribose assays.     

Effect of pistachio diet on lipid parameters,endothelial function,inflammation, and oxidative status: A prospective study

ObjectiveRecent studies have suggested that nuts have favorable effects beyond lipid lowering. We aimed to investigate effect of the Antep pistachio (Pistacia vera L.) on blood glucose, lipid parameters, endothelial function, inflammation, and oxidation in healthy young men living in a controlled environment.MethodsA Mediterranean diet was administered to normolipidemic 32 healthy young men (mean age 22 y, range 21–24) for 4 wk. After 4 wk, participants continued to receive the Mediterranean diet but pistachio was added for 4 wk by replacing the monounsaturated fat content constituting ≈20% of daily caloric intake. Fasting blood samples and brachial endothelial function measurements were performed at baseline and after each diet.ResultsCompared with the Mediterranean diet, the pistachio diet decreased glucose (P < 0.001, ?8.8 ± 8.5%), low-density lipoprotein (P < 0.001, ?23.2 ± 11.9%), total cholesterol (P < 0.001, ?21.2 ± 9.9%), and triacylglycerol (P = 0.008, ?13.8 ± 33.8%) significantly and high-density lipoprotein (P = 0.069, ?3.1 ± 11.7%) non-significantly. Total cholesterol/high-density lipoprotein and low-density lipoprotein/high-density lipoprotein ratios decreased significantly (P < 0.001 for both). The pistachio diet significantly improved endothelium-dependent vasodilation (P = 0.002, 30% relative increase), decreased serum interleukin-6, total oxidant status, lipid hydroperoxide, and malondialdehyde and increased superoxide dismutase (P < 0.001 for all), whereas there was no significant change in C-reactive protein and tumor necrosis factor-α levels.ConclusionIn this trial, we demonstrated that a pistachio diet improved blood glucose level, endothelial function, and some indices of inflammation and oxidative status in healthy young men. These findings are in accordance with the idea that nuts, in particular pistachio nuts, have favorable effects beyond lipid lowering that deserve to be evaluated with prospective follow-up studies.     

The medication discrepancy detection service: A cost-effective multidisciplinary clinical approach

ObjectiveTo estimate the effectiveness of a Medication Discrepancy Detection Service (MDDS), a collaborative service between the community pharmacy and Primary Care.DesignNon-controlled before-and-after study.SettingBidasoa Integrated Healthcare Organisation, Gipuzkoa, Spain.ParticipantsThe service was provided by a multidisciplinary group of community pharmacists (CPs), general practitioners (GPs), and primary care pharmacists, to patients with discrepancies between their active medical charts and medicines that they were actually taking.OutcomesThe primary outcomes were the number of medicines, the type of discrepancy, and GPs’ decisions. Secondary outcomes were time spent by CPs, emergency department (ED) visits, hospital admissions, and costs.ResultsThe MDDS was provided to 143 patients, and GPs resolved discrepancies for 126 patients. CPs identified 259 discrepancies, among which the main one was patients not taking medicines listed on their active medical charts (66.7%, n = 152). The main GPs’ decision was to withdraw the treatment (54.8%, n = 125), which meant that the number of medicines per patient was reduced by 0.92 (9.12 ± 3.82 vs. 8.20 ± 3.81; p < .0001). The number of ED visits and hospital admissions per patient were reduced by 0.10 (0.61 ± .13 vs 0.52 ± 0.91; p = .405 and 0.17 (0.33 ± 0.66 vs. 0.16 ± 0.42; p = .007), respectively. The cost per patient was reduced by €444.9 (€1003.3 ± 2165.3 vs. €558.4 ± 1273.0; p = .018).ConclusionThe MDDS resulted in a reduction in the number of medicines per patients and number of hospital admissions, and the service was associated with affordable, cost-effective ratios.     

Varicella zoster virus infection of the central nervous system in a tertiary care center in Lebanon

ObjectiveTo describe the clinical manifestations and treatment outcomes of patients with VZV meningitis and encephalitis consulting at two medical centers in Lebanon.MethodsRetrospective study of patients with VZV meningitis and/or encephalitis confirmed by positive cerebrospinal fluid (CSF) VZV PCR.ResultsTwenty patients were identified (13 males). The average age was 49.7 ± 22.2 years. The most common complaint was headache (n = 17/20). Common comorbidities included hypertension (n = 7/20) and diabetes mellitus (n = 5/20). Immunosuppression was reported in two patients. Vesicles were only observed in eight patients. Altered mental status, focal neurological deficits, and fever were documented in six, two, and four patients respectively. All patients had CSF leukocytosis with lymphocytic predominance, normal CSF/serum glucose ratio, and high CSF protein. Eighteen patients had brain CT scans showing no relevant findings. Two of 12 patients with brain MRI had focal abnormalities. Unilateral temporal slow waves were observed in three of four patients who underwent electroencephalograms. Four patients had encephalitis and 16 had meningitis. Eighteen patients received an antiviral therapy. Treatment either included intravenous acyclovir or oral valacyclovir. The encephalitis and meningitis groups had comparable mean duration of treatment (13.5 ± 6.6 vs. 12.2 ± 5.4, respectively). All admitted patients showed clinical cure with no reported neurological sequelae.ConclusionVZV infection should be suspected in any patient with signs and symptoms of viral meningitis or encephalitis, irrespective of age, immune status, presence or absence of vesicles, fever, or neck stiffness.     

Dietary intake modification in response to a participation in a resistance training program for sedentary older adults with prediabetes: Findings from the Resist Diabetes study

Engagement in one type of health behavior change may exert a “spillover” effect resulting in other behavior changes. Few studies have examined dietary intake following prolonged training, and none have evaluated spontaneous dietary changes beyond alterations in energy or macronutrient intake following initiation of strength/resistance training (RT). The purpose of this observational investigation was to determine if spontaneous dietary intake modifications occur in response to initiation of an RT program, among older adults. Previously sedentary adults with prediabetes (n = 134, age = 59 ± 1 years) were enrolled in a supervised 12-week RT program. Participants were not given dietary advice or encouraged to change eating behaviors. Three non-consecutive 24-hour dietary recalls were collected at baseline and after 12 weeks of RT. Reductions in intake of energy (1914 ± 40 kcal vs. 1834 ± 427 kcal, p = 0.010), carbohydrate (211.6 ± 4.9 g vs. 201.7 ± 5.2 g, p = 0.015), total sugar (87.4 ± 2.7 g vs. 81.5 ± 3.1 g, p = 0.030), glycemic load (113.4 ± 3.0 vs. 108.1 ± 3.2, p = 0.031), fruits and vegetables (4.6 ± 0.2 servings vs. 4.1 ± 0.2 servings, p = 0.018), and sweets and desserts (1.1 ± 0.07 servings vs. 0.89 ± 0.07 servings, p = 0.023) were detected over time. No changes in other dietary intake variables were observed. Mode of exercise and disease state may be important factors in determining whether dietary modifications occur with exercise initiation, among previously sedentary adults. Successful initiation of RT may represent an opportunity for health care professionals to promote beneficial changes in dietary habits, among older adults with prediabetes.     

Vitamin D,cardio-inflammation,and endothelial dysfunction in older adults after orthopedic surgery: Results from an open-label trial to ameliorate cardiac function

ObjectivesAfter orthopedic surgery, clinical outcomes are affected by comorbid cardiovascular diseases (CVDs) and low 25-hydroxy-vitamin D (25-(OH)D). Myocardial function was suggested to be influenced by both the pro-inflammatory cytokine tumour necrosis factor alpha (TNFα) and the marker of endothelial dysfunction asymmetric dimethylarginine (ADMA).Material and methodsWe investigated TNFα and ADMA changes in association with serum levels of vitamin D and cardiac function in 47 older adults after major orthopedic surgery. Subjects were characterized for biochemical profiles and transthoracic echocardiographic measures. Assessments were done before and after the correction of hypovitaminosis D through a 6-month supplementation with calcifediol started at post-operative rehabilitation.ResultsThe means serum levels of both TNFα and ADMA reduced from 1.39 ± 0.47 pg/mL to 1.30 ± 0.37 pg/mL (P < 0.05) and from 0.69 ± 0.05 μmol/L to 0.68 ± 0.04 μmol/L (P < 0.05), respectively. Significant treatment effects were observed for systolic blood pressure (P < 0.05), left ventricular ejection function (P < 0.01), global longitudinal strain (P < 0.0001), 25-(OH)D (P < 0.001), and calcemia (P < 0.001).ConclusionAfter the normalization of low levels of vitamin D, we were able to observe a reduction of circulating TNFα and ADMA together with the amelioration of cardiac function. Even if our results suggest that vitamin D might exert cardiac effects indirectly through the decrease in cardio-inflammation and endothelial dysfunction, a better understanding of the precise molecular regulations should be better investigated.     

Economic challenges of using innovative medical devices in major public health pathologies: Example of acute ischemic stroke management by mechanical thrombectomy

BackgroundActivity-based Funding can induce financial imbalances for health institutions if innovative medical devices (MD) used to perform acts are included in Diagnosis Related Groups (DRG) tariff. To be reimbursed in addition to the DRG tariff, innovative MD must have received a favorable evaluation by the French National Authority for Health (Haute Autorité de Santé) and be registered on the positive list. The aim of this study was to evaluate the expenses and incomes generated by each scenario (before and after the reimbursement of MD), and the financial reports. This study concerned the management of ischemic stroke by mechanical thrombectomy devices, in high-volume French hospital.MethodsAll patients who have had an acute ischemic stroke and admitted to the interventional neuroradiology unit between January 2016 and December 2017 were included retrospectively in this monocentric study. They were divided into four subgroups based on the severity of the DRG. The cost study was carried out using the French National Cost Study Methodology adjusted for the duration of the stays and by micro-costing on MD.ResultsA total of 267 patients were included. Over the study period, the average cost of the hospital stay was €10,492 ± 6364 for a refund of €9838 ± 6749 per patient. The acts performed became profitable once the MD were registered on the positive list (€−1017 ± 3551 vs. €560 ± 2671; P < 0.05). Despite this reimbursement, this activity remained in deficit for DRG lowest severity (level 1) patients (€−492 ± 1244). Specific MD used for mechanical thrombectomy represented 37% of the total cost of stay.ConclusionThe time required to evaluate MD reimbursement files is too long compared to their development. As a result, practitioners are in difficulty to be able to carry out acts according to the consensual practices of their learned societies, without causing any financial deficit of their institutions.     

Mineral profile of raw and cooked leafy vegetables consumed in Southern Brazil

Butterhead lettuce, rucola, watercress, kale, chicory, cabbage, Chinese cabbage, and a spinach substitute (Tetragonia expansa) are widely consumed in Southern Brazil. Samples were collected five times during a year in food markets and analyzed for total potassium, sodium, calcium, magnesium, iron, manganese, copper, and zinc by flame atomic absorption spectrometry and for moisture content. All vegetables can contribute to diet in terms of potassium, calcium and magnesium. Kale offers the highest amounts of calcium (283±43 mg Ca/100 g) and Chinese cabbage, cabbage, and butterhead lettuce the lowest, with values from 33 to 58 mg Ca/100 g. The highest concentrations of magnesium were found in kale and in the spinach substitute and they were 52±4 and 55±16 mg Ca/100 g, respectively. Moisture content varied less among samples of the same vegetable than minerals did. Four of the vegetables (kale, chicory, Chinese cabbage, and cabbage) were cooked briefly during 3 min and analyzed for the same elements. The brief cooking did not cause appreciable losses for any of the minerals.