A nutritional survey in the elderly: blood and urine vitamin levels.

In this survey of vitamin levels in 93 acute geriatric admissions to hospital, none had a completely normal nutritional profile. Twenty-two patients had over 50% of test abnormal and for all patients the average % of abnormal tests was 29%. The most common abnormalities were albumin, leucocyte vitamin C, vitamin E, carotene and nicotinic acid where over 50% of patients had abnormal results. Transferrin and vitamin A levels were abnormal in over 30% of patients while there was little evidence for riboflavin or thiamine malnutrition. It is postulated that an inadequate dietary intake, due to disease or to physical and mental deterioration was the most likely cause of these multiple nutritional abnormalities.     

上海市卢湾区老年公寓老人饮食营养状况调查

随着人类平均寿命的增长 ,2 1世纪人口老年化浪潮将席卷全球。人口老龄化与老年人的健康问题越来越受到社会广泛关注。而老年人的健康状况与膳食营养因素密切相关 ,一些老年常见疾病在很大程度上受到营养素摄入的影响。近年来 ,随着老年公寓的兴起 ,越来越多的老年人在那颐养天年 ,故研究老年公寓对老人的营养供给情况 ,分析影响营养质量的因素 ,探讨老年人营养与健康关系 ,对提高老年人生活质量和减少老年人营养相关疾病的发生至关重要 ,同时亦为进一步对老年公寓开展有效的配膳管理与干预提供科学依据。为此我们于2 0 0 3年 3～ 5月对上海…     

An international haematological survey.

Haematological surveys of adult population samples were conducted simultaneously in 12 countries, all but one of which are in Europe. Haematological estimations on samples from nine of the countries were made in one central laboratory. Differences between countries in the mean levels of haemoglobin (and haematocrit and red cell count) were found to be relatively small, and the prevalence of levels below the arbitrary WHO levels for anaemia were, on the whole, low. In males, the evidence suggests a fall in haemoglobin level throughout adult life, which increases slightly in advanced age. In females, there is no evidence of any important relationship between age and haemoglobin level.     

A nutritional survey among day-school pupils

A comprehensive nutritional survey conducted in Chengdu, 1986 among 488 day-school pupil aged 6 to 12 years showed that definite improvement in the dietary intake of heat energy, protein, iron, thiamin, niacin and ascorbic acid and other nutrients as compared with 1982, apparently the result of improved living standards. Nevertheless, the intake of energy food in breakfast meals were still inadequate. The findings revealed that 38.3% of the pupils suffered mild anemia. Special attention should be paid to the pupils' nutritional status during the adolescent growth spurt.     

Pre-operative nutritional assessment in the elderly

Nutritional depletion has been frequently documented in adult surgical patients admitted to hospital with nutritional status being known to deteriorate over the course of the hospital stay. In the elderly in particular, undernutrition has serious implications for health and for recovery from illness or surgery. This, in turn, has cost implications for the health service and the efficient distribution of health care. Because nutritional depletion is often insidious, nutritional problems frequently go unrecognised and untreated. Nutritional screening and assessment of nutritional status should therefore form an essential part of the health care of any elderly patient who requires surgical intervention. This paper aims to review the screening and assessment techniques currently available and their applicability to the elderly surgical patient.     

A survey of nutritional��immunological interactions

There is some evidence to show that the immune response is suppressed in malnutrition but the mechanism is not entirely clear. A more complete understanding of nutritional—immunological relationships is important, especially for child health in developing countries. This memorandum discusses a general approach to the problem and proposes specific methods for investigating the effects of malnutrition on the immune response. Several field studies incorporating these proposals are now in progress.     

Negev nutritional studies: nutritional deficiencies in young and elderly populations.

The importance of nutrition to public health and preventive medicine is evident. Undernutrition is a main nutritional risk factor in the elderly and has been established as a cause of excess morbidity and mortality in different segments of the older population. In the infant population, inadequate nutrition is one of the causes of iron-deficiency anemia, which is associated with impaired physical and cognitive development and lowered immunity. The aim of this paper was to estimate the nutritional pattern and micronutrient deficiencies in elderly and young populations in the Negev. In southern Israel, 351 subjects over 64 years old reported mean dietary intake that was lower than that in younger persons and was independent of the presence of chronic diseases. Current data from southern Israel on healthy Jewish children revealed anemia prevalence of 15% in the second year of life. Data from recent prospective study on Bedouin children showed that anemia affected one quarter of children at age one year. Thus, infants in this area are at high risk for iron deficiency. The findings require the attention of public health authorities and food manufacturers, and should result in a range of activities including publicity and educational programs, fortification of foods, and supplementation programs in high risk-groups.     

Selenium and cancer: some nutritional aspects

The level of selenium in cancer patients is lower than that in control subjects. However, low selenium levels in body fluids can be due to the malnutrition observed in these patients. There is evidence from epidemiologic studies that high dietary selenium intakes and high selenium status in people are associated with lower cancer mortality. However, contradictory information has been found in some prospective studies. The presence of other nutrients in selenium-rich foods can influence the role of the selenium in cancer etiology. Therefore, there are selenium antagonistic elements that inhibit the anticarcinogenic effects of selenium and other antioxidant micronutrients such as ascorbic acid, retinol, beta-carotene, alpha-tocopherol, and some other elements have a synergistic effect on the prevention of cancer.     

Urolithiasis - nutritional aspects

The progressive increase in the incidence of calcium oxalatephosphate calculi of the upper urinary tract during the 20th century in Western Europe and North America appears associated with affluence. Changes in diet over that time period have produced changes in urinary solutes which would increase the probability of calculus formation. Increased ingestion of animal protein produces a significant increase in the urinary excretion of calcium, oxalate and uric acid. Dietary calcium, oxalate and purine increase the excretion of calcium, oxalate and uric acid directly. Urine oxalate also increases with an increased ingestion of calcium but, paradoxically, also increases with severe dietary calcium restriction. Oral carbohydrate loading increases urinary calcium and magnesium excretion. Changes in urinary calcium excretion induced by dietary fiber appears related to the phytate content. A rational, though not of proven efficacy, dietary approach to urolithiasis therapy includes restriction of animal protein, avoidance of excess oxalate ingestion, a normal calcium intake, and water intake sufficient to generate 2 liters of urine per day.     

Myopathies in critical illness: characterization and nutritional aspects

Myopathies related to critical illness have received increasing recognition over the past decade and are common in patients even after a brief period in the intensive care unit. Recent studies have revealed that myopathies in the critically ill may in fact be more prevalent than neuropathies and that morbidity and mortality may be greater. Protein catabolism, an increase in urinary nitrogen loss, and muscle wasting are observed in critical illness myopathy. Muscle biopsies in critically ill patients demonstrate low glutamine levels, low protein/DNA levels, and high concentrations of extracellular water. The increased flux of glutamine in muscle in these patients is thought to be insufficient to meet the body's requirement for glutamine, and thus in critical illness this amino acid may be classified as "conditionally essential." Three subtypes of critical illness myopathy have been described that are often grouped together as acute quadriplegic myopathy: thick-filament myopathy, critical illness myopathy, and necrotizing myopathy. These can be differentiated based on clinical features and muscle biopsy. Treatments for critical illness myopathies range from primary prevention, i.e., avoiding myopathy-inducing drugs, to novel nutritional therapies, such as glutamine and glutathione supplementation. One should be particularly vigilant for the development of myopathies in critically ill alcoholic patients, who may have a chronic alcoholic myopathy at baseline. In the past decade, advances have been made in characterizing and identifying patients with myopathies due to critical illness. However, additional studies must be performed in order to develop appropriate therapies for this potentially devastating disorder.     

城市居民维生素A营养状况调查

目的评价城市居民维生素A营养状况。方法在浙江2城市按多阶段整群随机抽样方法,抽取400名居民,通过问卷调查和3天24小时膳食调查法、体格检查和血样采集检测血清维生素A水平,采用维生素A每日推荐摄入量(RNI)来评价维生素A膳食摄入状况,分析城市居民维生素A营养状况及其影响因素。结果城市居民维生素A水平中位数为0.463(0.213)μg/m L,维生素A高度缺乏的占0.25%、缺乏的占0.50%、不足的占6.75%、充足的占92.50%。299人参与了膳食调查,每日维生素A摄入量的中位数为350.5(351.5)μgRE;平均每日维生素A摄入量低于60%RNI的占61.87%,仅有25.42%的人摄入量在80%RNI以上。男性、大城市、年龄较大、血清甘油三酯水平较高及膳食胆固醇摄入较高的居民其血清维生素A水平较高。结论城市居民血清维生素A较为充足,但维生素A膳食摄入状况仍有待改善。年龄、性别、地区等因素影响血清维生素A水平。     

Alcohol and cancer: genetic and nutritional aspects

Chronic alcohol consumption is a major risk factor for cancer of upper aero-digestive tract (oro-pharynx, hypopharynx, larynx and oesophagus), the liver, the colo-rectum and the breast. Evidence has accumulated that acetaldehyde is predominantly responsible for alcohol-associated carcinogenesis. Acetaldehyde is carcinogenic and mutagenic, binds to DNA and protein, destroys the folate molecule and results in secondary cellular hyper-regeneration. Acetaldehyde is produced by mucosal and cellular alcohol dehydrogenase, cytochrome P450 2E1 and through bacterial oxidation. Its generation and/or its metabolism is modulated as a result of polymorphisms or mutations of the genes responsible for these enzymes. Acetaldehyde can also be produced by oral bacteria. Smoking, which changes the oral bacterial flora, also increases salivary acetaldehyde. Cigarette smoke and some alcoholic beverages, such as Calvados, contain acetaldehyde. In addition, chronic alcohol consumption induces cytochrome P450 2E1 enxyme activity in mucosal cells, resulting in an increased generation of reactive oxygen species and in an increased activation of various dietary and environmental carcinogens. Deficiencies of riboflavin, Zn, folate and possibly retinoic acid may further enhance alcohol-associated carcinogenesis. Finally, methyl deficiency as a result of multiple alcohol-induced changes leads to DNA hypomethylation. A depletion of lipotropes, including methionine, choline, betaine and S-adenosylmethionine, as well as folate, results in the hypomethylation of oncogenes and may lead to DNA strand breaks, all of which are associated with increased carcinogenesis.     

A preliminary validation of a nutritional risk measure for the elderly

We used data from a two-stage random sample of 401 noninstitutionalized elderly individuals residing in 18 census tracts in south-central metropolitan St. Louis to establish the reliability and validity of a 16-item nutritional risk measure. Reliability analysis yielded a Cronbach's alpha of 0.603. Concurrent predictive validity was demonstrated by the prediction of physician, emergency room, and hospital use. Individuals with high scores displayed a consistent pattern of higher rates of known nutrition-related problems and their sequelae than did those with low scores, providing evidence of known groups validity. Statistical correlations with components of an established theoretical model of the elderly's health and illness behavior demonstrate preliminary support for construct validity. The advantages of our nutritional risk measure include its ease of administration and telephone portability.     

Dose-response relationships regarding vitamin B-6 in elderly people: a nationwide nutritional survey (Dutch Nutritional Surveillance System)

The dietary intake and biochemical status of vitamin B-6 in 476 apparently healthy Dutch elderly people (aged 65-79 y), who were not using drugs known to affect vitamin B-6 metabolism, were evaluated. Intake of vitamin B-6 per gram protein was related to biochemical data, namely plasma pyridoxal 5'-phosphate (PLP) and cofactor stimulation of aspartate aminotransferase in erythrocytes (AST-AC). Based on a cutoff point of 2.02 for AST-AC, approximately 9% of the elderly people not using vitamin B-6 supplements had a marginal vitamin B-6 status. About 7% were using vitamin B-6 supplements. Dietary intake of vitamin B-6 per gram protein was negatively related to AST-AC. Vitamin B-6 intakes per gram protein higher than 0.020 mg were necessary to ensure an AST-AC value less than 2.02. At high PLP values AST-AC hardly varied. The results seem to indicate a higher requirement of vitamin B-6 in elderly people than in younger adults.