Biomarkers of oxidative stress in patients with wet age related macular degeneration

Objective

The aim of this study was to analyze biomarkers of oxidative stress in patients with wet age related macular degeneration (AMD).

Participants and Measurements

Case-control study that includes 163 patients with wet AMD (age group of 55–82 years with the mean age of 71 years and 170 age-matched healthy controls in the age group of 55–78 years with the mean age of 71 years. The following parameters were determined: reduced and oxidized Glutathione (GSH/GSSH), protein carbonyl groups, total antioxidant activity in plasma and the activity of endogenous antioxidant enzymes, such as, gluthatione peroxidase, gluthatione reductase and superoxide dismutase.

Results

We observed total antioxidant activity higher in control group (CG) compared with patients with wet AMD (7.1 ± 1.2 μM Trolox vs 5.8 ± 1.1 μM Trolox). Values of superoxide dismutase activity (SOD), gluthatione reductase (GR) and gluthatione peroxidase (GPx) are higher in control group than in patients with wet AMD. According to the GSH/GSSH results, average values were higher in the CG than in patients with wet AMD and data were not significantly different.. Values of protein carbonyl groups were higher in patients with wet AMD than in CG and significant differences were found.

Conclusions

The finding of the present study suggests that the patients with wet AMD are an altered metabolic state of oxidation-reduction and that it is convenient to give therapeutic interventions with antioxidants. We have demonstrated that systematic oxidative stress, measured by different biomarkers is closely associated with the wet AMD.     

Which health professionals are most at risk for cardiovascular disease? Or do not be a manager

Objectives

Health care workers constitute a high-risk occupational category owing to the character of their work that includes high-risk environment, shift work and mental as well as physical stress. In occupational medicine, caring for their health condition should be a priority and include measures aimed at preventing cardiovascular diseases. The study aimed at determining the prevalence of cardiovascular disease (CVD) risk factors in employees of a large hospital and assessing their effect on the incidence of cardiovascular events.

Materials and Methods

The group comprised 3124 employees with a mean age of 36.1 years (SD = 11.4), out of whom 562 were males (mean age of 37.1 years, range: 18–72; SD = 12.26) and 2562 were females (mean age of 35.9 years, range: 18–68; SD = 11.24). At their initial examination, the employees filled in a questionnaire on basic CVD risk factors (according to valid recommendations). This was supplemented with objective data to determine the risk of CVD using valid charts. From this group, a subset of persons at a high or intermediate risk was selected, comprising 247 individuals with a mean age of 54.1 years (SD = 5.73). After 5–9 years (mean 7.24±1.38 years), they either underwent another examination or their health status was ascertained by phone or in a computer database. The end point was the incidence of cardiovascular events (sudden death, acute myocardial infarction, unstable angina pectoris, percutaneous coronary intervention, cardiac failure, stroke or transient ischemic attack).

Results

The end point was noted in a total of 15 males (6.07%) and 6 females (2.42%), being statistically significantly present in managers (males p < 0.00007, females p < 0.00001), male physicians/surgeons (p < 0.025), tertiary-educated males (p < 0.0095), female smokers (p < 0.015), male ex-smokers (p < 0.007), overweight or obese males (p < 0.02) and those with the waist-to-hip ratio above 1.0 (p < 0.005).

Conclusions

Cardiovascular events are most likely to occur in obese male physicians/surgeons holding managerial positions and in female managers.     

Vitamin B-12 supplementation improves arterial function in vegetarians with subnormal vitamin B-12 status

Objective

Vegetarians are more vascular-healthy but those with subnormal vitamin B-12 status have impaired arterial endothelial function and increased intima-media thickness. We aimed to study the impact of vitamin B-12 supplementation on these markers, in the vegetarians.

Design

Double-blind, placebo controlled, randomised crossover study.

Setting

Community dwelling vegetarians.

Participants

Fifty healthy vegetarians (vegetarian diet for at least 6 years) were recruited. Intervention: Vitamin B-12 (500??g/day) or identical placebo were given for 12 weeks with 10 weeks of placebo-washout before crossover (n=43), and then open label vitamin B-12 for additional 24 weeks (n=41).

Measurement

How-mediated dilation of brachial artery (FMD) and intima-media thickness (IMT) of carotid artery were measured by ultrasound.

Results

The mean age of the subjects was 45+9 years and 22 (44%) were male. Thirty-five subjects (70%) had serum B-12 levels <150pmol/l. Vitamin B-12 supplementation significantly increased serum vitamin B-12 levels (p<0.0001) and lowered plasma homocysteine (p<0.05). After vitamin B-12 supplementation but not placebo, significant improvement of brachial FMD (6.3±1.8% to 6.9±1.9%; p<0.0001) and in carotid IMT (0.69±0.09mm to 0.67±0.09 mm, p<0.05) were found, with further improvement in FMD (to 7.4±1.7%; p<0.0001) and IMT (to 0.65±0.09mm; p<0.001) after 24 weeks open label vitamin B-12. There were no significant changes in blood pressures or lipid profiles. On multivariate analysis, changes in B-12 (??=0.25; p=0.02) but not homocysteine were related to changes in FMD, (R=0.32; F value=3.19; p=0.028).

Conclusions

Vitamin B-12 supplementation improved arterial function in vegetarians with subnormal vitamin B-12 levels, proposing a novel strategy for atherosclerosis prevention.     

Neck circumference is not associated with dysphagia but with undernutrition in elderly individuals requiring long-term care

Objectives

The purpose was to assess the association between neck circumference, dysphagia, and undernutrition in elderly individuals requiring long-term care.

Design

Cross-sectional study.

Setting

Geriatric health services facilities, acute hospitals, and the community.

Participants

Elderly individuals ≥65 years of age with dysphagia or possible dysphagia (N=385).

Measurements

Neck circumference, the Dysphagia Severity Scale (DSS) and the Mini Nutritional Assessment Short Form (MNA-SF).

Results

Participants included 130 males and 255 females with a mean age (± standard deviation) of 83 ± 8.0 years. Sixty-six were in acute hospitals, 195 were in geriatric health services facilities, and 124 were community-dwelling. The mean neck circumference in males and females was 37.1 ± 3.0 cm and 33.3 ± 3.3 cm, respectively. Based on the DSS, 81 participants were within normal limits, 137 had dysphagia without aspiration, and 167 had dysphagia with aspiration. The MNA-SF revealed that 173 were malnourished, 172 were at risk of malnutrition, and 40 had a normal nutritional status. Neck circumference was not significantly correlated with the DSS (r=?0.080) but was significantly correlated with the MNA-SF (r=0.183) in the Spearman rank correlation analysis. In the logistic regression, neck circumference was not independently associated with the DSS after adjusting for the MNA-SF, the Barthel Index, age, sex, setting, and cerebrovascular disorders. However, the multiple regression analysis showed that neck circumference had an independent effect on the MNA-SF after adjusting for the Barthel Index, age, sex, setting and cerebrovascular disorders.

Conclusions

Neck circumference is not associated with dysphagia but with undernutrition in elderly individuals requiring long-term care.

     

Heart rate variability (HRV) analysis in radio and TV broadcasting stations workers

Objectives

The aim of the study was to assess the mechanism of cardiovascular impairments in workers exposed to UHF-VHF radio frequency electromagnetic fields (EMF).

Materials and Methods

Heart rate variability (HRV) was analysed using 512 normal heart beats registered at rest. The analysis concerned time-domain (STD R-R) and frequency-domain (VLF, LF, HF) parameters of HRV. Fifty nine workers (group I) with low-level and 12 workers (group II) with high-level exposure were examined. The mean age of the subjects was 47±9 years and 41±14 years, and mean exposure duration 19.1±8.8 years and 13±4 years, in groups I and II, respectively. The groups were divided according to: E_max, E_dose, E_mean for frequencies UHF, VHF and UHF+VHF: The control group consisted of 42 non-exposed subjects, aged 49±8 years. Statistical analysis comprised one-way analysis of variance, covariance analysis and logistic regression models.

Results

In the exposed groups, the heart rate was higher than in the control one. Standard deviation of R-R intervals (STD R-R) was found to be significantly (p = 0.0285) lower in group I (42.5±24.7 ms) compared to the control group (62.9±53.5 ms). The risk of lowered STD R-R was significantly increased (OR = 2.37, p = 0.023) in group II. Both exposed groups presented significantly higher VLF and LF values than the control group (p = 0.005 and p = 0.0025, respectively). The EMF-exposed groups were characterised by the dominance of the sympathetic system (LF/HF 1.3±0.35).

Conclusions

The results indicate that exposure to radiofrequency EMF may affect the neurovegetative regulation.     

The effect of antioxidant vitamins E and C on cognitive performance of the elderly with mild cognitive impairment in Isfahan,Iran: a double-blind,randomized, placebo-controlled trial

Purpose

This study was carried out to investigate the effect of vitamins E and C on cognitive performance among the elderly in Iran.

Methods

About 256 elderly with mild cognitive impairment, aged 60–75 years, received 300 mg of vitamin E plus 400 mg of vitamin C or placebo daily just for 1 year.

Background

Demographic characteristics, anthropometric variables food consumption, cognitive function by Mini-Mental State Examination (MMSE), and some of the oxidative stress biomarkers were examined.

Results

Antioxidant supplementation reduced malondialdehyde level (P < 0.001) and raised total antioxidant capacity (P < 0.001) and glutathione (P < 0.01). The serum 8-hydroxydeoxyguanosine remained unchanged (P < 0.4). After adjusting for the covariates effects, MMSE scores following 6- (25.88 ± 0.17) and 12-month antioxidant supplementation (26.8 ± 0.17) did not differ from control group (25.86 ± 0.18 and 26.59 ± 0.18, respectively).

Conclusion

Despite significant improvement in most of the oxidative stress biomarkers, antioxidants’ supplementation was not observed to enhance cognitive performance. A large number of kinetic and/or dynamic factors could be suspected.     

Relationship between use of proton pump inhibitors and IGF system in older subjects

Objectives

to investigate the effects of proton pump inhibitors (PPIs) on the insulin-like-growth factor 1(IGF-1) system in the elderly.

Design

cross-sectional.

Setting

InCHIANTI study.

Participants

938 older subjects (536 women, 402 men, mean age 75.7±7.4 years).

Measurements

complete data on age, sex, BMI, liver function, medications, dietary intake, IGF-1, IGF-binding protein-1 and -3 (IGFBP-1, IGFBP-3).

Results

Participants were categorized by PPI use, identifying 903 PPI non users and 35 users. After adjusting for age, male PPI users (107.0 ± 69.6 vs 127.1 ± 55.8, p<0.001) and female PPI users (87.6 ± 29.1 vs 107.6 ± 52.3, p=0.03) had lower IGF-1 levels than non-users. IGFBP-1 levels were similar in the two groups in both sexes. In whole population, after adjustment for age and sex, PPI users had lower IGF-1 levels 81.9 [61.1–113.8] than nonusers 110 [77.8–148.6], p=0.02. After further adjustment for BMI, albumin, liver function, C-reactive protein, Interleukin-6, number of medications, ACE-inhibitors use, caloric intake, protein intake, physical activity, glycemia, and IGFBP-1, the use of PPIs remained significantly and negatively associated with IGF-1 levels (β±SE=?19.60±9.83, p=0.045).

Conclusion

Use of PPIs was independently and negatively associated with IGF-1 levels.     

Investigation of oxidative stress and dietary habits in Mongolian people, compared to Japanese people

Background

The average life span of Mongolians is 62 years for males and 69 years for females. This life span is about 16 years shorter than that of Japanese. Mongolian people generally eat meat, fat and diary products but less vegetables or fruit. Thus, we investigated the state of oxidative stress and dietary habits of Mongolians.

Methods

The investigation was performed in Murun city in the northwest area of Mongolia. A total of 164 healthy subjects (24–66 y) were enrolled. As a marker of reactive oxygen species, the levels of reactive oxygen metabolites (ROM) were measured using the d-ROM test. Interviews about dietary habits were performed using the Food Frequency Questionnaire established by the Kagawa Nutrition University.

Results

ROM levels were 429.7 ± 95.2 Carr U for Murun subjects, whereas Japanese people (n = 220, 21–98 y) showed 335.3 ± 59.8 (p < 0.001). The levels of serum malondialdehyde-modified low-density lipoprotein-cholesterol and urinary 8-hydroxydeoxyguanosine were also high. ROM levels correlated with body fat ratio and inversely correlated with handgrip strength. Handgrip strength in the subjects over 45 years decreased more rapidly than that of age-matched Japanese. Murun subjects ate larger amounts of meat, fat, milk and flour and dairy products than Japanese, but less vegetables or fruit. Serum vitamin A and E levels were the same as Japanese references, but vitamin C levels were lower.

Conclusion

Murun subjects may be in high oxidative stress, which may have a relationship with early ageing and several diseases, ultimately resulting in their short life span. In order to increase antioxidant capacity and suppress overproduction of ROM, antioxidant food intake is recommended.     

Garlic intake is an independent predictor of endothelial function in patients with ischemic stroke

Objetives

To investigate the effects of garlic on endothelial function in patients with ischemic stroke (ISS). Design: Cross-sectional study.

Participants

125 Chinese patients with prior ISS due to athero-thrombotic disease were recruited from the outpatient clinics during July 2005 to December 2006.

Measurements

Daily allium vegetable intake (including garlic, onions, Chinese chives and shallots) was ascertained by means of a validated food frequency questionnaire for Chinese and brachial artery flow-mediated dilatation (FMD) was measured using high-resolution ultrasound in all subjects.

Results

The mean age of the study population was 65.9±11.1 years and 69% were males. Mean allium vegetable intake and garlic intake of the study population was 7.5±12.7g/day and 2.9±8.8g/day respectively. Their mean FMD was 2.6±2.3%. Daily intake of total allium vegetable (r=0.36, P<0.01) and garlic (r=0.34, P<0.01) significantly correlated with FMD. Using the median daily allium intake as cut-off (3.37g/day), patients with a low allium intake <3.37g/day was noted to have a lower FMD compared to those with a normal allium intake (2.1±2.1% versus 3.0±2.4%, P<0.05). After adjusting for confounding factors, multi-variate analysis identified that daily allium vegetable (B=0.05, 95% confidence interval: 0.02, 0.09, P<0.01) and garlic (B=0.07, 95% confidence interval: 0.02, 0.12, P<0.01) intake, but not onions, Chinese chives and shallots were independent predictors for changes in FMD in patients with ISS.

Conclusions

Daily garlic intake is an independent predictor of endothelial function in patients with ISS and may play a role in the secondary prevention of atherosclerotic events.     

Child labor in a rural Egyptian community: an epidemiological study

Objectives

Estimating the burden of child labor in a rural community of El-Minia governorate, Egypt and exploring its determinants and health impact.

Methods

One hundred and ninety nine children randomly participated from a randomly selected village; 147 (73.9 %) males and 52 (26.1 %) females, whose ages ranged from 6 to 17 years (mean age 12.1 ± 2.9). All children were subjected to interview questionnaire, and medical examination.

Results

Ninety (45.2 %) of the children reported that they are engaged in a work. The working children belonged to 65.6 and 85.6 % of illiterate fathers and mothers, respectively. The majority of the working children were engaged in jobs at quarries (58.9 %), followed by farming (21.1 %), then small proportions of children were working in other jobs. Poverty, big families and insufficient family’s income were the most frequently reported reasons for starting to work (80 %). There was a significant higher prevalence of the reported health complaints among working children.

Conclusions

Working children are at high risk of many health problems. Poverty, parents’ illiteracy, large family size and fathers’ absence are the driving force for child labor in the rural community of Eastern Minia.     

The impact of supplemental N-3 long chain polyunsaturated fatty acids and dietary antioxidants on physical performance in postmenopausal women

Objectives

Identify relationships and evaluate effects of long chain polyunsaturated fatty acids (LCPUFA) on frailty and physical performance. Design: Randomized, double blind pilot study.

Setting

University General Clinical Research Center.

Participants

126 postmenopausal women.

Intervention

2 fish oil (1.2g eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) or 2 placebo (olive oil) capsules per day for 6 months. All participants received calcium and vitamin D supplements.

Measurements

Fatty acid levels, frailty assessment, hand grip strength, 8 foot walk, body composition, medical history and co-morbidities, nutrient intake, and inflammatory biomarkers taken at baseline and 6 months.

Results

At baseline, those with greater red blood cell (RBC) DHA and DHA/arachidonic acid (AA) presented with less frailty (r=?0.242, p=0.007 and r=?0.254, p=0.004, respectively). Fish oil supplementation resulted in higher RBC DHA and lower AA compared to baseline and placebo (p<0.001) and an improvement in walking speed compared to placebo (3.0±16 vs. ?3.5±14, p=0.038). A linear regression model included age, antioxidant intake (selenium and vitamin C), osteoarthritis, frailty phenotype, and tumor necrosis factor alpha (TNFα). The model explained 13.6% of the variance in the change in walking speed. Change in DHA/AA (p=0.01) and TNFα (p=0.039), and selenium intake (p=0.031) had the greatest contribution to change in walking speed.

Conclusion

Physical performance, measured by change in walking speed, was significantly affected by fish oil supplementation. Dietary intake of antioxidants (selenium and vitamin C) and changes in TNFα also contributed to change in walking speed suggesting LCPUFA may interact with antioxidants and inflammatory response to impact physical performance.     

Antioxidant effect of zinc supplementation on both plasma and cellular red-ox status markers in a group of elderly Italian population

Objectives

The aim of this work was to evaluate the effect of long term supplementation with two moderate dose of Zn on plasma and cellular red-ox status markers in elderly volunteers.

Design, setting and subjects

In a double blind study 108 healthy volunteers, aged 70–85 years, were enrolled. They were randomly divided in 3 groups of treatment, receiving placebo, 15 mg/day and 30 mg/day of Zn for 6 months. Red-ox status markers were assessed at baseline and after 6 months evaluating carotenoids, vitamin A and E in plasma; glutathione (GSH), thiol groups (RSH), malondialdehyde (MDA), percentage of haemolysis and methemoglobin in erythrocytes.

Results

Zn supplementation had no significant effects on red-ox status markers except for vitamin A levels (from 1.94±0.44 to 2.18±0.48 μM in volunteers receiving 15 mg of Zn and from 1.95±0.46 to 2.26±0.56 μM in volunteers receiving 30 mg of Zn), which increased proportionally to zinc dose.

Conclusions

It appears that, differently from unhealthy populations, long-term supplementation with two moderate doses of Zn in a healthy elderly population, with an adequate Zn nutritive status and macro and micronutrients intakes in the range of normality, is an inefficient way to increase antioxidant defences.     

The chronic effects of fish oil with exercise on postprandial lipaemia and chylomicron homeostasis in insulin resistant viscerally obese men

Background

The purpose of this study was to determine the effects of the pre-workout supplement Assault? (MusclePharm, Denver, CO, USA) on upper and lower body muscular endurance, aerobic and anaerobic capacity, and choice reaction time in recreationally-trained males. Subjective feelings of energy, fatigue, alertness, and focus were measured to examine associations between psychological factors and human performance.

Methods

Twelve recreationally-trained males participated in a 3-week investigation (mean +/- SD, age: 28 +/- 5 y, height: 178 +/- 9 cm, weight: 79.2 +/- 15.7 kg, VO_2max: 45.7 +/- 7.6 ml/kg/min). Subjects reported to the human performance laboratory on three separate occasions. All participants completed a baseline/familiarization day of testing that included a maximal graded exercise test for the determination of aerobic capacity (VO_2max), one-rep maximum (1-RM) for bench and leg press to determine 75% of 1-RM, choice reaction tests, and intermittent critical velocity familiarization. Choice reaction tests included the following: single-step audio and visual, one-tower stationary protocol, two-tower lateral protocol, three-tower multi-directional protocol, and three-tower multi-directional protocol with martial arts sticks. Subjects were randomly assigned to ingest either the supplement (SUP) or the placebo (PL) during Visit 2. Subjects were provided with the cross-over treatment on the last testing visit. Testing occurred 20 min following ingestion of both treatments.

Results

Significant (p < 0.05) main effects for the SUP were observed for leg press (SUP: 13 ± 6 reps, PL: 11 ± 3 reps), perceived energy (SUP: 3.4 ± 0.9, PL: 3.1 ± 0.8), alertness (SUP: 4.0 ± 0.7, PL: 3.5 ± 0.8), focus (SUP: 4.1 ± 0.6, PL: 3.5 ± 0.8), choice reaction audio single-step (SUP: 0.92 ± 0.10 s, PL: 0.97 ± 0.11 s), choice reaction multi-direction 15 s (SUP: 1.07 ± 0.12 s, PL: 1.13 ± 0.14 s), and multi-direction for 30 s (SUP: 1.10 ± 0.11 s, PL: 1.14 ± 0.13 s).

Conclusions

Ingesting the SUP before exercise significantly improved agility choice reaction performance and lower body muscular endurance, while increasing perceived energy and reducing subjective fatigue. These findings suggest that the SUP may delay fatigue during strenuous exercise.     

Normal values for finger systolic blood pressures in males and females

Objective

To compare finger systolic blood pressures in males and females and in younger and older persons and provide normal values for all four fingers in younger and older males and females.

Methods

Eighty healthy subjects participated in the study: 20 males and 20 females aged 20–30 years, and 20 males and 20 females aged 55–65 years. Finger systolic blood pressures (FSBPs) were measured using strain-gauge plethysmography following local cooling at 30 and 10°C in accord with International Standard 14835-2. The FSBPs were measured simultaneously in the thumb and the four fingers of the dominant hand and the percentage changes in finger systolic blood pressures (%FSBPs) due to the cold provocation were calculated.

Results

The median finger systolic blood pressures increased with increasing age in both females and males, with the increase highly significant at 30°C but not at 10°C. The %FSBPs were not significantly affected by the age of males, but were significantly lower in older females than younger females. The FSBPs were lower in females than in males at 30°C but there was no significant difference between genders at 10°C. The %FSBPs were higher in younger females than younger males, but only significantly higher in the middle finger and there were no significant differences between the genders in the older age group. There were only minor differences between the four fingers in the FSBPs at 30 and 10°C. The %FSBPs across the four fingers were similar in the younger subjects and in the older females, but varied with finger in the older males.

Conclusion

Although there are some differences in the %FSBPs associated with age, gender, and finger, the differences may be sufficiently small to use a single value criterion when deciding on abnormalities in FSBP associated with cold provocation for persons aged 20–65 years.

     

Health-related quality of life among hemodialysis patients at El-Minia University Hospital, Egypt

Background

Hemodialysis results in significant change in daily living, physical and psychological impairments, disruption of marital, family, and social life. Health-related quality of life (HRQOL) assessment helps to plan individual treatment strategies, and determine the efficacy, quality of medical and social care provided.

Aim

The focus of the study was to assess HRQOL of hemodialysis patients attending El-Minia University Hospital dialysis unit, determine the relation between HRQOL and some sociodemograghic factors and clinical disorders and also to compare HRQOL between patients performing hemodialysis for less than and more than 5 years.

Subjects and methods

The study is a cross-sectional hospital-based study that included 170 hemodialysis patients; 81 males and 89 females, mean age 46.6?±?14.6 years. In all 59.4 % were rural residents. Data were collected by a questionnaire which included, demographic, social and medical data. Kidney Disease Quality of Life-36 (KDQOL-36) health survey was used for assessment of HRQOL.

Results

About two thirds (64 %) of the studied hemodialysis patients had physical and mental quality of life (QOL) scores below average level. HRQOL was lower in old, female, married, illiterate and non-worker hemodialysis patients. Hepatitis C positive (HCV), diabetic and anemic patients had decreased QOL scores. A longer duration of hemodialysis treatment was associated with reduced physical QOL.

Conclusion

The most important sociodemographic factors affecting HRQOL were age, sex, education, occupation and marital status. The most important clinical disorders affecting QOL were anemia, HCV infection, sleep disturbances and diabetes. Increase awareness of hemodialysis patients and their caregivers about disabilities associated with hemodialysis treatment and educational programs to decrease the problems which the patients face and to increase the QOL.     

Measuring health-related quality of life among adults in Singapore: population norms for the EQ-5D

Purpose

To provide population norms for the Euro-QoL-5D (EQ-5D) according to age, sex, ethnicity and language version using a representative sample of adults aged 18 years and above in the Singapore population.

Methods

A total of 5,594 respondents who completed the self-administrated paper-based EQ-5D in the Singapore Mental Health Study were included in this study. Socio-demographic characteristics were captured using a structured questionnaire.

Results

The mean age of the sample was 40 years, females comprised 52.2 % of the sample and 78 % were of Chinese descent. Pain/discomfort was the most frequently reported problem (15.3 %) followed by anxiety/depression (8.2 %), whilst self-care (0.5 %) was the least frequently reported problem in the Singapore population. Multiple linear regression analysis revealed that younger age, higher income, those employed and those administered English version of the questionnaire were significantly associated with higher EQ-5D index.

Conclusions

This article provides important population norms for the EQ-5D for measuring health-related quality of life (HRQOL) both in clinical settings and in the research context. Our results suggest that socio-demographic factors should be taken into account when assessing HRQOL among adults in Singapore.     

Glycaemic index of meals affects appetite sensation but not energy balance in active males

Background

Foods with low glycaemic index (LGI) are reported to suppress appetite mainly in overweight population but have not been investigated in athletic adults.

Objective

The aim of this study was to compare the short-term effects of LGI and high GI (HGI) meals over a day on subsequent subjective appetite sensation, energy intake, energy expenditure, energy balance and resting metabolic rate in physically active males.

Methods

This cross-sectional randomized crossover study included 14 active males (mean ± SD; age 34.5 ± 8.9 years, body mass index 22.8 ± 2.1 kg m^?2) to consume LGI and HGI meals on two separate days. On each trial day, participants consumed a breakfast in the laboratory and then left with a packed lunch, dinner and snacks. Appetite scores, energy intake and expenditure were assessed.

Results

The area under the curve for appetite scores of the HGI trial was significantly smaller than that of the LGI trial during the laboratory period (p = 0.027) and throughout the day (p = 0.009). No significant differences in energy intake, energy expenditure, energy balance and resting metabolic rate were found between groups, between the trial days and between the corresponding post-trial days.

Conclusions

These results show that frequent ingestion of the HGI meals, contrary to the previous reports, suppresses appetite more than that of LGI meals, but did not affect energy balance in physically active normal-weight males.     

Effects of 12-week supplementation of <Emphasis Type="Italic">Citrus bergamia</Emphasis> extracts-based formulation CitriCholess on cholesterol and body weight in older adults with dyslipidemia: a randomized,double-blind,placebo-controlled trial

Backgrounds

Recent experiments suggest that Citrus bergamia extracts could benefit people with dyslipidemia and obesity but this needs to be further validated.

Methods

A total of 98 people age-matched older adults (65 years) with elevated blood lipids were enrolled to receive 12-week supplementation of a Citrus bergamia extracts-based formulation (CitriCholess)(n?=?48) and placebo (n?=?50).

Results

No group differences were found in baseline bodyweight, body mass index (BMI), blood cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C) and glucose levels. CitriCholess supplementation resulted in lower levels than placebo in TG (1.83?±?0.92 vs. 1.95?±?1.34 mmol/L, P?=?0.612), TC (5.14?±?0.98 vs. 5.44?±?0.77 mmol/L, P?=?0.097), and LDL-C (3.13?±?0.74 vs. 3.43?±?0.62 mmol/L, P?=?0.032). Compared to placebo, CitriCholess also resulted in greater reductions in body weight (?0.604?±?0.939 vs. 0.06?±?0.74 kg, P?<?0.01), waist circumferences (?0.60?±?1.349 cm vs. -0.16?±?1.503 cm, P?<?0.01) and BMI (?0.207?±?0.357 vs. 0.025?±?0.274, P?<?0.01). Additionally, females had a significantly higher level of HDL-C than males. TC was significantly correlated with LDL-C, and to a less degree, with TG. TG was inversely correlated with HDL-C. Body weight and waist circumference were negatively correlated with HDL-C and positively correlated with glucose.

Conclusion

12-week supplementation of CitriCholess could benefit lipid metabolism and weight management in old adults with dyslipidemia.

     

Simple kcal/kg formula is comparable to prediction equations for estimating resting energy expenditure in older cognitively impaired long term care residents

Objective

Assessment of energy needs is a critical step in developing the nutrition care plan, especially for individuals unable to modulate their own energy intakes. The purpose of this study was to assess precision and accuracy of commonly used prediction equations in comparison to measured resting energy expenditure in a sample of “oldest old” adults residing in long term care (LTC).

Subjects and Design

Resting energy expenditure (mREE) was measured by indirect calorimetry in 45 residents aged 86.1 ± 7.3 years, and compared to frequently used prediction equations (pREE): Mifflin St.Jeor, Harris Benedict, World Health Organization and Owen. Precision and accuracy were determined by concordance correlation coefficients and number of individuals within ± 10% of mREE. Bland Altman plots with linear dependence trends were constructed to visualize agreement. To complete analyses, the common 25 kcal/kg formula was assessed and alternative formulas were determined for best fit by regressing adjusted mREE on body weight.

Results

mREE averaged 976.2 ± 190.3 kcal/day for females and 1260.0 ± 275.9 kcal/d for males. The strength of the relationships between pREE and mREE were only moderate (r = 0.41–0.72). In examining linear trends in the Bland Altman plots, significant systematic deviation from mREE was detected for all pREE. Two kcal/kg formulas were generated: 20.6 kcal/kg for females and 22.7 kcal/kg for males, which were not significantly different.

Conclusion

None of the prediction equations adequately estimated energy needs in this sample of the “oldest old.” A simple formula using 21–23 kcal/kg may be a more practical and reliable method to determine energy needs in the LTC setting.     

Tocotrienol rich fraction supplementation improved lipid profile and oxidative status in healthy older adults: A randomized controlled study

Background

Vitamin E supplements containing tocotrienols are now being recommended for optimum health but its effects are scarcely known. The objective was to determine the effects of Tocotrienol Rich Fraction (TRF) supplementation on lipid profile and oxidative status in healthy older individuals at a dose of 160 mg/day for 6 months.

Methods

Sixty-two subjects were recruited from two age groups: 35-49 years (n = 31) and above 50 years (n = 31), and randomly assigned to receive either TRF or placebo capsules for six months. Blood samples were obtained at 0, 3^rd and 6^th months.

Results

HDL-cholesterol in the TRF-supplemented group was elevated after 6 months (p < 0.01). Protein carbonyl contents were markedly decreased (p < 0.001), whereas AGE levels were lowered in the > 50 year-old group (p < 0.05). Plasma levels of total vitamin E particularly tocopherols were significantly increased in the TRF-supplemented group after 3 months (p < 0.01). Plasma total tocotrienols were only increased in the > 50 year-old group after receiving 6 months of TRF supplementation. Changes in enzyme activities were only observed in the > 50 year-old group. SOD activity was decreased after 3 (p < 0.05) and 6 (p < 0.05) months of TRF supplementation whereas CAT activity was decreased after 3 (p < 0.01) and 6 (p < 0.05) months in the placebo group. GPx activity was increased at 6 months for both treatment and placebo groups (p < 0.05).

Conclusion

The observed improvement of plasma cholesterol, AGE and antioxidant vitamin levels as well as the reduced protein damage may indicate a restoration of redox balance after TRF supplementation, particularly in individuals over 50 years of age.