Calcium intake and blood pressure in elderly women.

The authors studied the relative importance of calcium intake as a correlate of blood pressure in a cross-sectional analysis of 6,517 nonblack women aged > or = 65 years from Portland, Oregon; Minneapolis, Minnesota; Baltimore, Maryland; and the Monongahela Valley near Pittsburgh, Pennsylvania, who enrolled in the Study of Osteoporotic Fractures in 1986. Dietary calcium intake was measured by using a modified food frequency questionnaire. There were weak associations between total calcium intake and blood pressure, such that each 1,000 mg/day increase in calcium intake was associated with a 1.5 mmHg decrease in systolic blood pressure (95% confidence interval -2.2 to -0.8, p < 0.0001) and a 0.5 mmHg decrease in diastolic pressure (95% confidence interval -0.8 to -0.20, p < 0.004). After adjustment for confounding variables, total calcium intake continued to have a weak inverse association only with diastolic blood pressure. The multivariate models revealed several stronger independent risk factors for blood pressure, including age, body mass index, alcohol consumption, and level of education (all p < 0.01). The small size of the inverse association between calcium intake and blood pressure limits its biological importance in this population of elderly women.     

徐州市高血压患者食盐摄入量与血压控制的现况研究

目的了解食盐摄入量与高血压患者血压控制达标情况的关系。方法采用多阶段整群随机抽样的方法,使用自行设计的问卷进行调查,对徐州市2 502例≥18岁高血压患者进行问卷调查和体格检查,运用logistic回归分析探索食盐摄入量与血压控制之间的关系。结果高血压患者血压控制达标率33.53%,调查对象平均食盐摄入量(9.81±6.28)g/d,不同文化程度、BMI、女性腰围、冠心病史、糖尿病史、高血压家族史患者高血压控制达标率差异均有统计学意义(P值均0.05);农村高血压患者食盐摄入量高于城市,差异有统计学意义(P0.05);调整混杂因素前后,食盐摄入量6g/d调查对象血压未达标风险的OR值及其95%CI分别为2.564(2.147~3.062),2.279(1.882~2.761)。结论控制每日食盐摄入量是高血压患者血压控制的有利因素。     

Association of lifestyle and personality characteristics with blood pressure and hypertension: a cross-sectional study in the elderly.

The association between certain lifestyle and personality characteristics and blood pressure in the elderly was assessed in a cross-sectional study of 843 independent living 60-87 year old volunteers. They comprised 338 women and 505 men of whom 35 and 30% respectively were being treated with antihypertensive drugs. Among untreated volunteers, 28% of women and 28% of men had systolic blood pressure greater than 160 or diastolic blood pressure greater than 95. Isolated systolic hypertension was found in 20% of untreated women and 14% of untreated men. Lifestyle factors and personality characteristics associated with blood pressure were similar to those described in younger adult populations, although there were some differences related to gender and whether subjects were being treated for hypertension. Stepwise multiple regression showed that higher blood pressure was associated with greater body mass index (BMI), alcohol intake and coffee drinking and measures of irritability. Increased physical activity, and high values for measures of suspicion and extraversion were negatively related to blood pressure. Age was positively related to systolic, but not to diastolic blood pressure. The presence of hypertension was significantly associated with self-reports of raised cholesterol, diabetes or angina, as well as past history of heart failure, heart attack or stroke. Thus, in this elderly free-living population blood pressures are still significantly associated with behavioural characteristics which could be further investigated as an alternative or adjunct to antihypertensive therapy.     

Longitudinal study of soy food intake and blood pressure among middle-aged and elderly Chinese women

BACKGROUND: Several small-scale clinical trials have suggested a potential beneficial effect of short-term soy consumption on blood pressure (BP). Data are scanty on long-term effects of the usual intake of soy foods on BP in general populations. OBJECTIVE: Our aim was to examine the association between usual intake of soy foods and BP. DESIGN: The usual intake of soy foods was assessed at baseline, and BP was measured 2-3 y after the baseline survey among 45 694 participants of the Shanghai Women's Health Study aged 40-70 y who had no history of hypertension, diabetes, or cardiovascular disease at recruitment. Multiple regression models were used to estimate mean differences in BP associated with various intakes of soy foods. RESULTS: Soy protein intake was inversely associated with both systolic BP (P for trend = 0.01) and diastolic BP (P for trend = 0.009) after adjustment for age, body mass index, and lifestyle and other dietary factors. The adjusted mean systolic BP was 1.9 mm Hg lower (95% CI: -3.0, -0.8 mm Hg) and the diastolic BP was 0.9 mm Hg lower (-1.6, -0.2 mm Hg) in women who consumed > or =25 g soy protein/d than in women consuming <2.5 g/d. The inverse associations became stronger with increasing age (P for interaction < 0.05 for both BPs). Among women >60 y old, the corresponding differences were -4.9 mm Hg (95% CI: -8.0, -1.9 mm Hg) for systolic BP and -2.2 mm Hg (95% CI: -3.8, -0.6 mm Hg) for diastolic BP. CONCLUSION: Usual intake of soy foods was inversely associated with both systolic and diastolic BPs, particularly among elderly women.     

Effects of vitamin C on high-density lipoprotein cholesterol and blood pressure.

Diet has been linked to cardiovascular disease risk by its influence on low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and blood pressure (BP). Recent evidence suggests that vitamin C may play a role in regulation of cholesterol and BP. The cross-sectional relationships of plasma ascorbic acid (PAA) with cholesterol and BP are described in three Boston area samples: 1) 249 males and 447 females (aged 60-100 years), 2) 100 Chinese-American males and 159 Chinese-American females (aged 60-96 years), and 3) 225 male and 192 female participants (aged 20-60 years) in a randomized field trial of vitamin C supplementation. Results indicate 3.7-9.5% higher levels of HDL-C, 4.1% lower levels of LDL-C, and 1.9-5.5% lower levels of BP with each 30 mumol/L increment in PAA. These relationships may be stronger at lower levels of PAA.     

The cause and correction of low blood vitamin C concentrations in the elderly

Chronically sick elderly women had low intakes and low blood concentrations of vitamin C. Small dietary supplements of vitamin C increased the concentration of vitamin C in their plasma and leucocytes to those found in both the active elderly and the young. These findings confirm that low concentrations of vitamin C in the institutionalized and chronically sick elderly are primarily due to poor intake and can be easily corrected by dietary changes. The case for increasing the intake of vitamin C in these patients is discussed.     

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.     

Dietary vitamin D intake and muscle mass in older women. Results from a cross-sectional analysis of the EPIDOS study

Objectives

Vitamin D intake may prevent physical performance decline through prevention of muscle mass loss. Our objective was to determine whether low dietary intakes were associated with low muscle mass (MM).

Design and participants

Cross-sectional analysis of 1989 community-dwelling women (mean age 80.5±3.8years) from the EPIDémiologie de l’OStéoporose (EPIDOS) study were assessed at baseline.

Measurements

Low intakes of vitamin D (<70µg/week) were estimated from the weekly dietary vitamin D intakes (self-administered food frequency questionnaire). Low MM was defined according to the appendicular skeletal muscle mass index assessed using Dual Energy X-ray Absorptiometry, divided by square height of less than 5.45 kg/m². Usual gait speed defined physical performance. Age, sun exposure, co-morbidities, education level, living arrangements, recreational physical activity, dietary protein and calcium intakes, bone mineral density, handgrip strength, and body mass index were considered as potential confounders. Multivariate logistic regression analyses assessed the association between low vitamin D intakes and low MM.

Results

Two-hundred and nine (10.5%) women with low MM were compared to 1,780 women with normal MM. In final model, obesity/overweight (Adjusted Odds Ratios, aOR=0.09; 95%CI [0.05–0.17]), malnutrition (aOR=3.90; 95%CI [2.74–5.54]) and low handgrip strength (aOR=2.33; 95%CI [1.44–3.77]; p<0.001) were statistically associated with a low MM status.

Conclusion

No association with low MM has been reported regarding low dietary intakes of vitamin D.     

A cross-sectional study of vitamin C and cognitive function in older adults: the differential effects of gender

Previous studies have suggested that vitamin C status may be associated with cognitive function in community-dwelling populations. However, this has not been consistent across all studies due to methodological differences. This cross-sectional study assessed the association between vitamin C and cognitive function in 544 community-dwelling older adults aged 65 or older who participated in both the Cardiovascular Health Study (CHS) and the CLUE II study in 1989. Three percent of the subjects had low plasma vitamin C concentrations (< 40 mg/dL) and 15% had low total vitamin C intake (< 60 mg/day). Most participants (96.7 percent) had normal cognitive function. In the unadjusted analyses, the highest fifth of plasma vitamin C concentration was associated with better Digit Symbol Substitution Test (DSST) scores and marginally associated with Mini-Mental State Examination (MMSE) compared to the lowest fifth. Total vitamin C intake, measured by Block's food frequency questionnaire, was generally associated with higher MMSE scores, though it was not significant. Adjusting for numerous factors did not substantially change results. In a stratified analysis by gender, higher plasma concentrations or intake were associated with higher MMSE scores for men but not for women. These mixed results do not provide strong evidence of an association between vitamin C concentrations or intake and cognitive function.     

Dietary vitamin K intake and anticoagulation in elderly patients

PURPOSE OF REVIEW: Vitamin K is an essential co-factor for the synthesis of several coagulation factors. Oral anticoagulants competitively inhibit enzymes that participate in vitamin K metabolism. The purpose of this review is to evaluate the potential interaction of dietary vitamin K and coagulation stability, particularly in the elderly patient. RECENT FINDINGS: Recent prospective evidences suggest that dietary vitamin K plays an essential role in anticoagulation stability. Vitamin K intake of more than 250 microg/day was shown to decrease warfarin sensitivity in anticoagulated patients consuming regular diets. In a randomized crossover study, brief periods of changes on vitamin K intake also had significant effects on coagulation parameters. Patients that were allocated to an 80% decrease of intake increased International Normalized Ratio (INR) by almost 30% 7 days after the intervention. Similarly, it was estimated by dietary records that for each increase in 100 microg of vitamin K intake, the INR would be reduced by 0.2. A recent study also demonstrated that over-the-counter multivitamin supplements contain enough vitamin K1 to significantly alter coagulation parameters. SUMMARY: Contemporary data strengthen the concept that the interaction between dietary vitamin K and coumarin derivatives is clinically relevant and plays a major role in INR fluctuations in chronic anticoagulated patients.     

Modification of the nutrition questionnaire for elderly to increase its ability to detect elderly people with inadequate intake of energy, calcium, vitamin C and vitamin D.

OBJECTIVE: To validate the Nutrition Questionnaire for Elderly (NQE) aimed at health care personnel -and develop and validate a modified version of the questionnaire (MNQE) to improve its sensitivity in detecting elderly people with inadequate intake of specific nutrients and energy. DESIGN: The NQE was used to rank the nutrient intake of participants as 'acceptable' (OK-->) or 'at risk' (OBS-->) with respect to energy, calcium, vitamin C and vitamin D--nutrients with a high risk of deficiency, especially among the homebound or institutionalised elderly. The sensitivity, specificity and predictive capacity were calculated by means of a 4 d estimated record (study 1). Based on the results minor adjustments of the NQE was made, and the already obtained information was used to assess the theoretical validity of the MNQE (study 2). Finally the MNQE was validated in a new population (study 3). SETTING AND SUBJECTS: Ninety-five old people ( > 65 y) living in nursing-homes (Bagsvaerd or Havdrup), or at home in the same home-care district (Valby) or in the same preventive home-visit district (R?dovre) were recruited. Excluded were those who declined to participate or who were in a terminal condition (n = 3). RESULTS: The sensitivity of the NQE regarding the intakes of energy, calcium, vitamin C and vitamin D was quite low (respectively 0.46, 0.08, 0.05 and 0.38) (study 1). However minor adjustments of the NQE increased the sensitivity both in theory (energy: 0.64, calcium: 0.95, vitamin C: 1.00 and vitamin D: 0.84) (study 2) and in practice (energy: 1.00, calcium: 0.40, vitamin C: 0.86 and vitamin D: 0.85) (study 3). Modification of the NQE did not reduce the high specificity and predictive capacity of the original version. CONCLUSIONS: Modifications of the NQE resulted in a questionnaire with a high sensitivity, specificity and predictive capacity for detecting inadequate intake of energy, calcium, vitamin C and vitamin D in elderly people.     

Calcium from dairy products, vitamin D intake, and blood pressure: the Tromso Study

BACKGROUND: The present epidemiologic study was conducted in Tromso, Northern Norway, in 1994-1995. OBJECTIVE: The objective was to evaluate the relation between calcium intake from dairy products and the intake of vitamin D on systolic and diastolic blood pressure. DESIGN: Subjects who were taking drugs for hypertension or heart disease, those taking calcium tablets, subjects reporting cardiovascular disease, and pregnant women were excluded, leaving 7543 men and 8053 women aged 25-69 y for analysis. Calcium and vitamin D intakes were calculated from a food-frequency questionnaire. RESULTS: After correction for age, body mass index, alcohol and coffee consumption, physical activity, cigarette smoking, and vitamin D intake, there was a significant linear decrease in systolic and diastolic blood pressure with increasing dairy calcium intake in both sexes (P < 0.05). However, the difference in blood pressure between subjects with the highest and those with the lowest calcium intake was 相似文献   

Effects of different levels of vitamin C intake on the vitamin C concentration in human milk and the vitamin C intakes of breast-fed infants

The influence of maternal intake of vitamin C on the vitamin C concentration in human milk and on the vitamin C intakes of breast-fed infants has not been demonstrated conclusively. This study examined these influences of diet and supplementation in 25 lactating women administered 90 mg of ascorbic acid for 1 day followed by 250, 500 or 1000 mg/day for 2 days or unsupplemented for 1 day followed by either 0 or 90 mg ascorbic acid supplement for 2 days. Vitamin C content in milk and urine was determined by the 2,4-dinitrophenylhydrazine method. Vitamin C intakes of infants were calculated from milk volume, as determined by the test-weighing method and from vitamin C levels in milk samples obtained at each feeding. Total maternal intakes of vitamin C, which exceeded 1000 mg/day or 10-fold the RDA for lactation (100 mg/day), did not significantly influence the vitamin C content in milk or the vitamin C intakes of infants. However, maternal vitamin C intake was positively correlated (r = 0.7) with maternal urinary excretion. These differences in milk and urine response to vitamin C intake suggest a regulatory mechanism for vitamin C levels in milk.     

High vitamin C intake is associated with lower 4-year bone loss in elderly men

Vitamin C is essential for collagen formation and normal bone development. We evaluated associations of total, supplemental, and dietary vitamin C intake with bone mineral density (BMD) at the hip [femoral neck, trochanter], spine, and radial shaft and 4-y BMD change in elderly participants from the Framingham Osteoporosis Study. Energy-adjusted vitamin C intakes were estimated from the Willett FFQ in 1988-89. Mean BMD and 4-y BMD change was estimated, for men and women, by tertile/category of vitamin C intake, adjusting for covariates. We tested for interaction with smoking, calcium, and vitamin E intake. Among 334 men and 540 women, the mean age was 75 y and mean vitamin D intake was 8.25 mug/d (women) and 8.05 mug/d (men). We observed negative associations between total and supplemental vitamin C intake and trochanter-BMD among current male smokers (P-trend = 0.01). Among male nonsmokers, total vitamin C intake was positively associated with femoral neck BMD (P-trend = 0.04). Higher total vitamin C intake was associated with less femoral neck and trochanter-BMD loss in men with low calcium (all P-trend 相似文献