Effects of An Oral Mixture Containing Glycine,Glutamine and Niacin on Memory,GH and IGF-I Secretion in Middle-aged and Elderly Subjects

Abstract

Aging is associated with declining activity of the growth hormone-insulin-like growth factor-I (GH-IGF-I) axis and with a decrease in cognitive function. The stimulatory effect of an orally administered nutritional supplement, mainly containing glycine, glutamine and niacin on the GH-IGF-I axis and on mood and cognition was investigated. Forty-two healthy subjects (14 men and 28 women, aged 40-76 years) were enrolled in a randomised, double blind, placebo-controlled trial. They received 5 g of a nutritional supplement or placebo, twice daily orally for a period of 3 weeks. At baseline and after 3 weeks, blood was collected for measurement of serum GH and IGF-I levels and mood and cognitive function were tested. The nutritional supplement ingestion for 3 weeks was found to increase serum GH levels with 70% relatively to placebo, whereas circulating IGF-I levels did not change. Mean GH (±SD) increased in this group from 3.23 (±4.78) to 4.67 mU/l (±5.27) (p=0.03). GH increase was not associated with improvement in mood or memory. Correlation analyses, however, revealed that individual increases in IGF-I, but not GH, were associated with improved memory and vigour. It is concluded that an oral mixture of glycine, glutamine and niacin can enhance GH secretion in healthy middle-aged and elderly subjects.     

EFFECTS OF ALCOHOL AND LIVER CIRRHOSIS ON THE GH-IGF-I AXIS

Decreased serum insulin-like growth factor (IGF-I) levels havebeen shown in malnutrition and liver diseases. To analyse whichof them is the main cause of GH-IGF-I axis alterations, serumlevels of growth hormone (GH), growth-hormone releasing factor(GHRH), IGF-I and its binding protein IGFBP-3 were measuredin 85 hospitalized alcoholics (51 without cirrhosis, 15 withcompensated cirrhosis and 19 with cirrhosis with ascites) andin 25 healthy controls. Liver function tests and objective nutritionalassessment were also performed. Serum IGF-I and IGFBP-3 levelswere lower in alcoholics, particularly in those with liver cirrhosis.Serum GH was raised in cirrhotics with ascites but GHRH levelswere not significantly altered. Although these patients werefrequently malnourished there was no relationship between dataderived from GH-IGF-I axis and nutritional parameters. However,there was a significant positive correlation between serum GHconcentrations and impaired liver function and a significantnegative correlation between serum IGF-I and IGFBP-3 and impairedliver function. This suggests that, in this population, serumIGF-I and IGFBP-3 levels reflect liver dysfunction rather thanmalnutrition.     

Change of the growth hormone-insulin-like growth factor-I axis in patients with gastrointestinal cancer: related to tumour type and nutritional status

Changes in the growth hormone (GH)-insulin-like growth factor-I (IGF-I) axis, especially acquired GH resistance, develop in many severe illnesses, including cachexia. To study changes in the GH-IGF-I axis in patients with cancer cachexia, biochemical markers and body composition parameters were measured in eighty-eight gastric cancer patients, thirty colorectal cancer patients (subclassified according to the presence or absence of cachexia) and twenty-four healthy control subjects. Fifty-nine patients were defined as cachectic, based on the percentage of weight loss compared with their previous normal weight. The remaining fifty-nine patients were defined as non-cachectic. Measurements were repeated in twenty-seven patients (sixteen with gastric cancer and eleven with colorectal cancer) 3 months after radical operation. Compared with the controls, the cachectic gastric cancer patients had high GH levels (1.36 v. 0.32 ng/ml; P=0.001), a trend towards high IGF-I levels (223.74 v. 195.15 ng/ml; P=0.128 compared with non-cachectic patients) and a low log IGF-I/GH ratio (2.55 and 2.66 v. 3.00; P=0.002), along with a decreased BMI; the cachectic colorectal cancer patients showed the biochemical characteristics of acquired GH resistance: high GH (0.71 v. 0.32 ng/ml; P=0.016), a trend towards decreased IGF-I levels (164.18 v. 183.24 ng/ml; P=0.127) and a low log IGF-I/GH ratio (2.54 v. 2.99; P=0.005), with increased IGF-I levels following radical surgery (200.49 v. 141.91 ng/ml; P=0.046). These findings suggest that normal GH reaction and sensitivity occur in gastric cancer patients, controlled by nutritional status, whereas acquired GH resistance develops in cachectic colorectal cancer patients, which may be caused by tumour itself.     

谷氨酰胺和生长激素对术后病人肌肉代谢的影响

目的许多研究表明,给予生长激素和谷氨酰胺能减少手术后肌肉蛋白的分解(术后肌蛋白分解表现在肌蛋白合成减少、谷氨酰胺水平降低和氮丢失增加)。本研究目的是联合使用生长激素和胰岛素样生长因子((IGF-I,一种能解释生长激素部分作用效果的生长因子)及添加生长激素和谷氨酰胺对术后肌肉代谢的影响。     

Long-term effects of early postnatal food restriction on growth hormone secretion in rats

BACKGROUND: Malnutrition in early life retards growth permanently in both humans and rats, but the underlying mechanism is unclear. The purpose of this study was to test the hypothesis that early postnatal food restriction induces long-term changes in the growth hormone-insulin-like growth factor I (GH-IGF-I) axis. METHODS: We examined the effect of increasing litter size to 20 during lactation [food restriction (FR)] on growth and spontaneous GH secretion and serum IGF-I levels in 14- to 15-week-old rats. RESULTS: No catch up in body weight (BW; p < .05), total length (TTL; p < .001), or tail length (TL; females, p < .02; males, p < .001) was observed in the adult female and male FR rats. Spontaneous 6-hour rat GH (rGH) secretory profiles showed significantly increased (p < .05) mean baseline rGH plasma concentrations in the male adult FR versus control (CON) rats (38.0 +/- 3.6 versus 26.4 +/- 2.5 ng/mL). Serum IGF-I levels in the male adult FR rat were significantly (p < .01) reduced (751.3 +/- 50.3 versus 985 +/- 55.5 ng/mL) compared with male controls. rGH secretory pattern in the adult female FR rat and serum IGF-I concentrations were not different from female controls. CONCLUSIONS: FR during lactation leads to incomplete catch-up growth in adult female and male rats. In the adult male FR rat, increased baseline rGH secretion and reduced serum IGF-I concentrations might explain the slow growth.     

The insulin-like growth factor system in critical illness: pathophysiology and therapeutic potential

Insulin-like growth factor-I (IGF-I) mediates at least some of the anabolic actions of growth hormone (GH). Most IGF-I in the circulation is held in a 150 kD complex with IGF binding protein-3 (IGFBP-3). In critical illness there is GH resistance which results in low serum levels of IGF-I, although its bioavailability may initially be maintained by serum proteases which modify the IGFBP-3 and reduce its affinity for IGF-I. Attempts to treat the protein catabolism associated with critical illness by hyperalimentation have had only limited success. The use of recombinant human GH combined with nutritional support increases protein synthesis, but the GH resistance necessitates high doses and GH has adverse direct metabolic effects including insulin resistance and impaired glucose tolerance. Treatment with recombinant human IGF-I inhibits proteolysis but may cause hypoglycaemia if administered intravenously. Its effects are often transient and show tachyphylaxis. A combination of GH and IGF-I with nutritional support may be the most effective treatment to counter the catabolism associated with critical illness. The costs of such therapy could be offset by shorter hospital stays. Further controlled studies are necessary to establish the clinical effectiveness of growth factor treatment.     

The influence of soy-derived phosphatidylserine on cognition in age-associated memory impairment

Phosphatidylserine (PS) is a phospholipid widely sold as a nutritional supplement. PS has been claimed to enhance neuronal membrane function and hence cognitive function, especially in the elderly. We report the results of a clinical trial of soybean-derived PS (S-PS) in aging subjects with memory complaints. Subjects were 120 elderly (> 57 years) of both sexes who fulfilled the more stringent criteria for age-associated memory impairment (AAMI); some also fulfilled the criteria for age-associated cognitive decline. Subjects were allocated at random to one of the three treatment groups: placebo, 300mg S-PS daily, or 600mg S-PS daily. Assessments were carried out at baseline, after 6 and 12 weeks of treatment, and after a wash-out period of 3 weeks. Tests of learning and memory, choice reaction time, planning and attentional functions were administered at each assessment. Delayed recall and recognition of a previously learned word list comprised the primary outcome measures. No significant differences were found in any of the outcome variables between the treatment groups. There were also no significant interactions between treatment and 'severity of memory complaints'. In conclusion, a daily supplement of S-PS does not affect memory or other cognitive functions in older individuals with memory complaints.     

IGF-I, marqueur nutritionnel

Many of the anabolic effects of growth hormone (GH) are mediated by insulin-like growth factor-I (IGF-I), which is a mitogenic polypeptide with structural similarities to insulin. Plasma levels of IGF-I are modulated by nutritional and metabolic factors and disease status. Although the liver is the principal source of circulating IGF-I, the ubiquity of the sites of secretion and action led to the concept that IGF-I may function as autocrine/paracrine growth factor as well as a classic endocrine hormone. In humans, the majority of the IGFs circulate bound to IGF binding proteins (IGFBPs), particularly IGFBP-3, and less than 5% is free. This binding prolongs the metabolic half-life of IGF-I in the circulation and serves as a metabolic reserve of IGFs. Evidences are accumulating to support a model of the GH/IGF-I/IGFBP-3 axis that is closely regulated by the metabolic and nutritional status of the individual, which thereby controls bioavailability of IGF-I. The regulation of IGF-I by nutrients connects diet intake and growth, brings an interface between nutrients and hormones acting in concert to stimulate growth, and illustrates the significant role of the nutrients in the control of gene expression. Understanding the mechanisms linking nutrient intake and IGF-I synthesis and action to stimulate growth, should permit the formulation of strategies for treatment of catabolic disorders and wiser uses of anabolic agents.     

Effects of a diet integration with an oily emulsion of DHA-phospholipids containing melatonin and tryptophan in elderly patients suffering from mild cognitive impairment

Age-related changes in nutritional status can play an important role in brain functioning. Specific nutrient deficiencies in the elderly may exacerbate pathological processes in the brain. Consequently, the potential of nutritional intervention to prevent or delay cognitive impairment and the development of dementia is an important topic. A randomized, double-blind, placebo-controlled trial has been performed in 25 elderly subjects (86 ± 6 years, 20 females, 5 males) with mild cognitive impairment (MCI). These subjects were randomly assigned to supplement their diet with either an oily emulsion of docosahexaenoic acid (DHA)-phospholipids containing melatonin and tryptophan (11 subjects) or a placebo (14-matched subjects) for 12 weeks. The main aim of this study was to evaluate the efficacy of the dietary supplement on cognition, by the assessment at the start and after 12 weeks of: (1) Orientation and other cognitive functions: Mini-Mental State Examination (MMSE); (2) Short-term memory: digit, verbal, and spatial span (digit span; verbal span; Corsi's test); (3) Long-term memory: Rey's auditory-verbal learning test; 'short story' test; Rey-Osterrieth complex figure (recall); (4) Attentional abilities: attentive matrices; (5) Executive functions: Weigl's sorting test; phonological fluency 'FAS'; (6) Visuo-constructional and visuo-spatial abilities: copy of simple drawings; Rey-Osterrieth complex figure (copy); (7) Language: semantic fluency; (8) Mood: Geriatric Depression Scale (GDS). Moreover, Sniffin' Sticks olfaction test and Mini Nutritional Assessment (MNA) have been performed. After 12 weeks, a significant treatment effect for the MMSE (P < 0.001) and a positive trend for the semantic verbal fluency was found in the supplement group (P < 0.06). A significant treatment effect was found out for the olfactory sensitivity assessment (P < 0.009). As regards the nutrition evaluation, after 12 weeks of treatment the supplemented group showed an improvement in the MNA score with a significant difference relative to placebo (P < 0.005). Older adults with MCI had significant improvements in several measures of cognitive function when supplemented with an oily emulsion of DHA-phospholipids containing melatonin and tryptophan for 12 weeks, compared with the placebo.     

Vitamin C,Mood and Cognitive Functioning in the Elderly

The present study examined the effects of anti-oxidant vitamin supplementation on mood and cognitive functioning in 205 volunteers (110 females, 95 males; age range: 60–80 years). In this randomised, double-blind, placebo-controlled study, the volunteers received either anti-oxidant supplementation (daily dosage 12mg/d β-carotene, 400 mg/d α-tocopherol and 500mg/d ascorbic acid) or placebo. The volunteers were followed up for 12 months. Vitamin levels were assessed from plasma samples. The primary outcome measures were subjective mood, self-reported cognitive failures, and measures of intelligence. These were measured at 4, 8 and 12 months. There were very few significant differences between the placebo and vitamin groups. Analysis of the effects of changes in vitamin levels on mood and cognition revealed significant effects of changes in vitamin C but not the other anti-oxidants. Increases in vitamin C were associated at 12 months with more positive mood, greater improvements in global assessments of intellectual functioning and a reduction in everyday errors of memory, attention and action. These effects were greatest for those volunteers who had a more negative mood and lower levels of cognitive function at baseline. Overall, results support earlier findings based on examination of dietary intake.     

Effects of breakfast-size on short-term memory, concentration, mood and blood glucose

Effects of breakfast size on blood glucose, mood, short-term memory and concentration were assessed in 319 adolescents (age 13-20 years) in real-life setting. Mean energy increase of 63% over habitual breakfast had no effect on blood glucose or late morning mood. High energy intake from breakfast had a beneficial effect on immediate recall in short-term memory evaluated on the whole sample. However, concentration appeared to be impaired by a high caloric breakfast. There were no differences in the studied parameters according to energy supplement size. The present results are consistent with suggestions that meal size supplement has an effect on cognitive function.     

Effects of dietary supplements on depressive symptoms in older patients: a randomised double-blind placebo-controlled trial

BACKGROUND & AIMS: The effect of nutritional supplements on mental health in older patients has received little attention so far. The aims of this trial were therefore to test the effect of nutritional support on older patient's depressive symptoms and cognitive function. METHODS: In this prospective, double-blind, placebo-controlled study, we randomly assigned 225 hospitalised acutely ill older patients to receive either normal hospital diet plus 400 mL oral nutritional supplements (106 subjects) or normal hospital diet plus a placebo (119 subjects) daily for 6 weeks. The composition of the supplement was such as to provide 995 kcal for energy and 100% of the Reference Nutrient Intakes for a healthy old person for vitamins and minerals. Outcome measures were 6 weeks and 6 months changes in nutritional status, depressive symptoms and cognitive state. RESULTS: Randomisation to the supplement group led to a significant increase in red-cell folate and plasma vitamin B12 concentrations, in contrast to a decrease seen in the placebo group. There were significant differences in symptoms of depression scores in the supplement group compared with the placebo group at 6 months (p = 0.021 for between groups difference). The effect of supplement was seen in all patient groups including those with no symptoms of depression, mild depression and those with severe depression (p = 0.007). There was no evidence of a difference in cognitive function scores at 6 months. CONCLUSION: Oral nutritional supplementation of hospitalised acutely ill older patients led to a statistically significant benefit on depressive symptoms.     

Gincosan (a combination of Ginkgo biloba and Panax ginseng): the effects on mood and cognition of 6 and 12 weeks' treatment in post-menopausal women

As memory and concentration impairments are a frequent complaint in post-menopausal women, this well-defined population was selected to investigate the effect on mood and cognition of chronic treatment with Gincosan. In a double-blind placebo controlled study, post-menopausal women aged 51-66 were randomly assigned to 12 weeks' treatment with Gincosan (320mg/day), containing 120mg Ginkgo biloba, and 200mg Panax ginseng (n = 30), or matched placebo (n = 27). They were given measurements of mood, somatic anxiety, sleepiness, and menopausal symptoms and a battery of cognitive tests before treatment and after 6 and 12 weeks of treatment. There were no significant effects of Gincosan treatment on ratings of mood, bodily symptoms of somatic anxiety, menopausal symptoms, or sleepiness or on any of the cognitive measures of attention, memory or frontal lobe function. Thus, after chronic administration, Gincosan appeared to have no beneficial effects in post-menopausal women.     

Primary empty sella and GH deficiency: prevalence and clinical implications

Primary empty sella (PES) is a particular anatomical condition characterized by the herniation of liquor within the sella turcica. The pathogenesis of this alteration, frequently observed in general population, is not yet completely understood. Recently reports demonstrated, in these patients, that hormonal pituitary dysfunctions, specially growth hormone (GH)/insulin- like growth factor (IGF-I) axis ones, could be relevant. The aim of this paper is to evaluate GH/IGF-I axis in a group of adult patients affected by PES and to verify its clinical relevance. We studied a population of 28 patients with a diagnosis of PES. In each patient we performed a basal study of thyroid, adrenal and gonadal - pituitary axis and a dynamic evaluation of GH/IGF-I after GH-releasing hormone (GHRH) plus arginine stimulation test. To evaluate the clinical significance of GH/IGF-I axis dysfunction we performed a metabolic and bone status evaluation in every patients. We found the presence of GH deficit in 11 patients (39.2%). The group that displayed a GH/IGF-I axis dysfunction showed an impairment in metabolic profile and bone densitometry. This study confirms the necessity to screen the pituitary function in patients affected by PES and above all GH/IGF-I axis. Moreover the presence of GH deficiency could be clinically significant.     

Correlation between the components of the insulin-like growth factor I system, nutritional status and visceral leishmaniasis

The role of the insulin-like growth factor I (IGF-I) system and nutritional status was studied in 241 children from a Brazilian area endemic for visceral leishmaniasis (VL). Thirty-nine children had the active form, 20 were oligosymptomatic, 38 were asymptomatic and 144 were not infected. Serum concentrations of growth hormone (GH), total and free IGF-I and IGF binding-protein 3 (IGFBP3) were measured by radioimmunoassay. Nutritional status was evaluated by anthropometric indicators and biochemical measurements. Total and free IGF-I and IGFBP3 were significantly reduced in the active form. Z scores for total and free IGF-I and for IGFBP3 were found to be significantly lower for active VL and oligosymptomatic individuals than for asymptomatic individuals, but never reached values 相似文献   

Effects of a diet integration with an oily emulsion of DHA-phospholipids containing melatonin and tryptophan in elderly patients suffering from mild cognitive impairment

Abstract

Age-related changes in nutritional status can play an important role in brain functioning. Specific nutrient deficiencies in the elderly may exacerbate pathological processes in the brain. Consequently, the potential of nutritional intervention to prevent or delay cognitive impairment and the development of dementia is an important topic. A randomized, double-blind, placebo-controlled trial has been performed in 25 elderly subjects (86 ± 6 years, 20 females, 5 males) with mild cognitive impairment (MCI). These subjects were randomly assigned to supplement their diet with either an oily emulsion of docosahexaenoic acid (DHA)-phospholipids containing melatonin and tryptophan (11 subjects) or a placebo (14-matched subjects) for 12 weeks. The main aim of this study was to evaluate the efficacy of the dietary supplement on cognition, by the assessment at the start and after 12 weeks of: (1) Orientation and other cognitive functions: Mini-Mental State Examination (MMSE); (2) Short-term memory: digit, verbal, and spatial span (digit span; verbal span; Corsi's test); (3) Long-term memory: Rey's auditory-verbal learning test; ‘short story’ test; Rey-Osterrieth complex figure (recall); (4) Attentional abilities: attentive matrices; (5) Executive functions: Weigl's sorting test; phonological fluency ‘FAS’; (6) Visuo-constructional and visuo-spatial abilities: copy of simple drawings; Rey-Osterrieth complex figure (copy); (7) Language: semantic fluency; (8) Mood: Geriatric Depression Scale (GDS). Moreover, Sniffin' Sticks olfaction test and Mini Nutritional Assessment (MNA) have been performed. After 12 weeks, a significant treatment effect for the MMSE (P < 0.001) and a positive trend for the semantic verbal fluency was found in the supplement group (P < 0.06). A significant treatment effect was found out for the olfactory sensitivity assessment (P < 0.009). As regards the nutrition evaluation, after 12 weeks of treatment the supplemented group showed an improvement in the MNA score with a significant difference relative to placebo (P < 0.005). Older adults with MCI had significant improvements in several measures of cognitive function when supplemented with an oily emulsion of DHA-phospholipids containing melatonin and tryptophan for 12 weeks, compared with the placebo.     

Gincosan (A Combination of Ginkgo biloba and Panax ginseng ): The Effects on Mood and Cognition of 6 and 12 Weeks' Treatment in Post-menopausal Women

Abstract

As memory and concentration impairments are a frequent complaint in post-menopausal women, this well-defined population was selected to investigate the effect on mood and cognition of chronic treatment with Gincosan. In a double-blind placebo controlled study, post-menopausal women aged 51-66 were randomly assigned to 12 weeks' treatment with Gincosan (320 mg/day), containing 120 mg Ginkgo biloba , and 200 mg Panax ginseng ( n =30), or matched placebo ( n =27). They were given measurements of mood, somatic anxiety, sleepiness, and menopausal symptoms and a battery of cognitive tests before treatment and after 6 and 12 weeks of treatment. There were no significant effects of Gincosan treatment on ratings of mood, bodily symptoms of somatic anxiety, menopausal symptoms, or sleepiness or on any of the cognitive measures of attention, memory or frontal lobe function. Thus, after chronic administration, Gincosan appeared to have no beneficial effects in post-menopausal women.     

Growth hormone and IGF-I in diabetic children with and without microalbuminuria

In order to evaluate the relationship between urinary GH, urinary IGF-I and plasma IGF-I levels and presence of incipient diabetic nephropathy in paediatric age, we studied fifty (25 male and 25 female) prepubertal patients with insulin-dependent diabetes mellitus (T1DM). The patients were subdivided into two groups according to the presence of persistent microalbuminuria defined as albumin excretion rate (AER) >20 microg/min in at least 5 urine collections in the 6 months prior to the beginning of the study: Group A: 18 patients with microalbuminuria; Group B: 32 patients without microalbuminuria. A group of 20 healthy subjects, sex-, age- and pubertal stage-matched, served as control. No difference was observed between the urinary output of IGF-I and GH and plasma IGF-I values between normoalbuminuric and control subjects (normoalbuminuric vs controls: urinary GH: mean+/-SD 7.9+/-0.7 ng/day vs 8.1+/-0.6; urinary IGF-I: 178.3+/-19.7 ng/day vs 175.5+/-20.3; plasma IGF-I: 203.9+/-31.2 ng/ml vs 199.4+/-43.2), but a significant difference was observed between the urinary output of IGF-I and GH and plasma IGF-I levels between microalbuminuric patients and normoalbuminuric and controls (microalbuminuric subjects: urinary GH: 13.1+/-1.4 p<0.01; urinary IGF-I: 451.3+/-45.9 p<0.001; plasma IGF-I: 326.5+/-63.2 p<0.01). Moreover, plasma IGF-I, urinary GH and urinary IGF-I were not significantly associated with microalbuminuria, while plasma IGF-I levels were positively related to glomerular filtration rate (GFR) (p<0.05). In conclusion, our study demonstrates that microalbuminuric patients have higher levels of urinary IGF-I, urinary GH, plasma IGF-I than normoalbuminuric diabetic subjects. These data support the hypothesis that IGF-I can have a role in the changes of renal function observed in patients with persistent microalbuminuria.     

Changes in serum insulin-like growth factors, not leptin, are associated with postnatal weight gain in preterm neonates

BACKGROUND: Serum concentrations of conventional nutrition-related proteins, such as albumin, prealbumin, transferrin, and retinol-binding protein, are usually inconsistent with changes in anthropometric measurements in the postnatal period. The aim of this study was to evaluate how reliable growth hormone (GH), insulin-like growth factors (IGFs), IGF-binding proteins (IGFBPs), and leptin, the proteins known to be involved in the regulation of growth, are in reflecting postnatal growth and nutritional status in preterm neonates. METHODS: Blood samples and anthropometric measurements were collected from 55 preterm neonates (chronological age 30.4 +/- 2.8 weeks) for 4 continuous weeks (weeks 0 to 3). RESULTS: After adjusting for chronological age, body weights and serum IGF-II concentrations were significantly greater and serum transferrin concentrations were significantly lower in weeks 2 and 3 than in week 0 (repeated-measures analysis of variance (ANOVA) and Bonferroni test, p < .05). Forward stepwise multivariate regression analysis showed that change in total IGF-I (week 0 to week 3) was a positive predictor, and changes in insulin and prealbumin were negative predictors of postnatal weight gain. In addition, daily fat intake was a positive predictor of postnatal length increases, and changes in prealbumin, insulin, and GH were negative predictors of postnatal changes in the ponderal index (weight x length(-3)). Changes in GH and IGFBP-2 were negative predictors of changes in head circumference and triceps skinfold thickness, respectively. CONCLUSIONS: Serial measurements of serum IGF-I and IGF-II may be useful adjuncts to anthropometric measurements for monitoring postnatal growth and nutritional status in preterm neonates.     

Effect of vitamin and trace-element supplementation on cognitive function in elderly subjects

OBJECTIVE: To determine whether supplementation with vitamins and trace elements in modest amounts influences cognitive function in apparently healthy, elderly subjects. METHODS: The study was designed as a randomized, double-blind, placebo-controlled trial. Ninety-six, apparently healthy, independent men and women older than 65 y of age were recruited and randomized to receive a supplement of trace elements and vitamins or a placebo daily for 12 mo. Blood-nutrient levels were estimated at baseline and at the end of the study. The major outcome measure assessed was cognitive function consisting of immediate and long-term memory, abstract thinking, problem-solving ability, and attention. RESULTS: Eighty-six subjects completed the 1-y trial. The supplemented group showed a significant improvement in all cognitive tests (P < 0.001 to 0.05) except long-term memory recall (P > 0.1). Those whose blood-nutrient levels were below the reference standard showed lower responses on cognitive tests. There was no significant correlation between individual nutrient levels and performance on various cognitive function tests. CONCLUSIONS: Cognitive functions improved after oral supplementation with modest amounts of vitamins and trace elements. This has considerable clinical and public health significance. We recommend that such a supplement be provided to all elderly subjects because it should significantly improve cognition and thus quality of life and the ability to perform activities of daily living. Such a nutritional approach may delay the onset of Alzheimer's disease.