Vitamins, lipids and lipoproteins in a healthy elderly population

Vitamin status may be related to serum lipid-lipoprotein levels. We tested this hypothesis in a group of 270 healthy elderly men and women over 60 years of age. Vitamin status was determined from dietary intakes and biochemical analysis of plasma. Fasting lipid profile included triglycerides, total cholesterol, low-density lipoprotein-cholesterol (LDL-C), and high-density lipoprotein-cholesterol (HDL-C). Correlations have been adjusted by partial correlation for age, physical activity, body mass index, and alcohol consumption. Neither vitamin E intake nor ascorbic acid intake nor ascorbic acid plasma levels correlated with any lipids measured. HDL-C levels did not correlate with any vitamin parameters. In men, vitamin A blood levels correlated with LDL-C, triglyceride, and total cholesterol levels. In women, total cholesterol levels correlated inversely with thiamine and riboflavin blood status and with dietary intake of vitamins B6, D, and niacin. LDL-C plasma values were also inversely correlated with both intake and plasma vitamin D levels and intakes of riboflavin and vitamin B12 in women.     

Effect of nutrition education on the nutritional status of low-income pregnant women of Mexican descent.

Low-income pregnant women of Mexican descent were studied to determine whether their food habits could be improved by nutrition education. Biochemical indices of nutritional status were also investigated. Twenty-four-hour dietary recalls were obtained at an initial interview and again at a final interview after a nutrition education program, which was offered to a randomly selected treatment group. At the initial interview, the mean nutrient intakes that were most often below two-thirds of the Recommended Dietary Allowance (RDA) were iron, vitamin A, thiamin, and calcium. The mean energy value of the diets was also frequently below the RDA. At the final intakes, although the mean energy values and the calcium and carbohydrate of both the control and treatment groups increased significantly, the following improvements in dietary intakes were seen only within the treatment group: 1) there were significant increases in the mean intake of protein, ascorbic acid, niacin, riboflavin, and thiamin, 2) there were significant decreases in the percentage of intakes below two-thirds of the RDA for ascorbic acid and riboflavin, and 3) there was a significant decrease in the incidence of multiple low nutrient intakes. These dietary improvements, which occurred only in the treatment group, suggest the effectiveness of the nutrition education program. The most common biochemical deficiencies were of folic acid, thiamin, and riboflavin. Except for an improvement in mean serum folate levels, the biochemical indices for the treatment group did not appear to be influenced by the nutrition education. It is possible that the vitamin and mineral supplements which were taken by 80% of the women could have obscured improvements in biochemical indices which may have been due to the education program.     

Habitual alcohol consumption and nutritional status of the elderly

The interrelationship between habitual alcohol consumption, dietary intakes and vitamin status was examined in 393 elderly subjects (188 men, 205 women, age range 65-90 years) resident in seven retirement homes throughout Italy. Individual food intake was assessed by the 7-day precise weighing method. Fasting blood was tested for riboflavin (erythrocyte glutathione reductase activity coefficient), thiamine (erythrocyte transketolase activity), retinol (fluorimetry) and folic acid status. Alcohol contributed on average 12 per cent of total energy intake in men, and 6 per cent in women. Forty-eight per cent of males and 39 per cent of females were classified as heavy drinkers (HD) with 48 and 28 g/d average alcohol intakes respectively. There was a general tendency for women to add alcohol to their habitual diet, as revealed by the positive correlation between total energy intake and alcohol intake. The higher energy intakes of HD women were also reflected in their higher body weights. Men tended to displace food energy partially by alcohol. Dietary risk of malnutrition, high for vitamin A, and moderate to low for vitamins B1 and B2, did not increase with alcohol consumption. Biochemical evidence of malnutrition indicated a significant deterioration of folate status in HD of both sexes, and for B1 in HD males only; there was no change in riboflavin status. Plasma levels of retinol were higher, and prevalence of vitamin A deficiency lower, in HD, a finding that warrants further investigation.(ABSTRACT TRUNCATED AT 250 WORDS)     

Sociodemographic Factors and Life-Styles Affecting Micronutrient Status in an Apparently Healthy Elderly Japanese Population

To define the effects of sociodemographic factors and life-styles on intakes and biochemical measures of iron, thiamine, riboflavin and ascorbic acid in healthy elderly Japanese, a survey was conducted on 190 subjects aged 65 to 80 years. Results of multivariate analyses of the data indicated that, independent of the other factors, smoking was significantly and negatively associated with ascorbic acid status and its intake (expressed as its concentration per unit of energy in diets). After controlling for the other factors, participation in a nutrition education program in the past was significantly and positively associated with intakes of thiamine, riboflavin and ascorbic acid. Biochemical measures of these three vitamins were also significantly better in the participants.     

Vitamin plasma levels in long-term enteral feeding patients

Plasma levels of vitamins were determined in eight patients who were nourished with long-term enteral feeding using commercial formulas. The type and quantity of the formula were individually tailored to the patients' needs. Caloric intake (mean +/- SEM) amounted to 1564 +/- 97 kcal/day. Vitamins intake from the formulas, expressed as percent of Recommended Daily Allowances (RDA), was as follows: pantothenic acid, 222 +/- 44%; vitamin B12, 206 +/- 34%; vitamin C, 376 +/- 51%; thiamine, 207 +/- 34%; niacin, 207 +/- 34%; riboflavin, 207 +/- 34%; pyridoxine, 222 +/- 17%; biotin, 113 +/- 13%; vitamin A, 93 +/- 4%; and folic acid, 104 +/- 14%. Plasma levels of thiamine, riboflavin, pyridoxine, pantothenic acid, folic acid, and vitamin B12 were within normal limits in all patients. Two patients had lower than normal plasma levels of nicotinic acid despite the high intake. Plasma biotin levels were above normal in all patients, with a mean of 931 +/- 140 pg/ml (N: 200-500 pg/ml). Ascorbic acid levels were within or above normal, but no correlation with intake was found. Carotene levels were measured in five patients and found to be below the lower limit of normal, a reflection of lack of intake from the enteral formulas. The plasma vitamin A levels were normal in all patients. It is concluded that feeding with commercial enteral formulas results in normal plasma levels of vitamins in patients maintained on these formulas for over 6 months. The excessive amounts of vitamins in the formulas do not result in elevated plasma levels, except for Biotin.     

Nutritional status of vitamin A, E, C, B1, B2, B6, nicotinic acid, B12, folate, and beta-carotene in young women

To investigate the vitamin status of young Japanese women, dietary intakes of vitamin A, E, C, B1, B2, B6, B12, niacin, folate, and beta-carotene were assessed by a 3-d weighed food record in 150 female students aged 21-22. Whole blood levels of vitamin B1, B2, and nicotinic acid, and serum levels of retinol, alpha-tocopherol, vitamin B6, and beta-carotene were determined by HPLC. Vitamin B12 and folate in serum were measured by chemiluminescence immunoassay, and serum vitamin C was done by dinitrophenylhydrazine method. When the 6th revision RDAs for the Japanese (physical activity level 1) were applied, 46.7% of the females showed sufficient intake for vitamin A, 28.7% for E, 80.7%, for B1, 92.7% for B2, 54.7% for B6, 99.3% for niacin, 76.0% for B12, 34.0% for folate, and 54.0% for C. Fifty-nine percent of total vitamin A (microgRE) intakes were derived from beta-carotene. The mean+/- SD of energy intakes was low, 1.572+/-315 kcal. Significant correlations among intakes of energy and all these vitamins were found. Serum folate and ascorbic acid levels in the females with corresponding vitamin intakes above the RDA were significantly higher than in those with intakes below the RDA. There were significant correlations between blood vitamin levels and vitamin intakes in vitamin B12 (r=0.185), folate (r=0.255), vitamin C (r=0.272), and beta-carotene (r=0.319). Mean blood levels of folate, ascorbic acid, vitamin B2, B12, and beta-carotene were higher in the highest quartile of intake than in the lowest. The 95% confidence intervals of blood vitamin levels obtained from the females with sufficient vitamin intakes were nearly equal to those obtained from all subjects. Only a few females (0.7-4.7%) had their blood vitamin levels below the lower limits. Serum alpha-tocopherol levels were significantly correlated with serum levels of retinol, beta-carotene, and vitamin C. This data suggested that young women should increase suitable dietary food intakes in order to maintain good status of vitamin. Moreover, sufficient amount of physical activity would be expected for prevention of excessive energy intake.     

The diets of pregnant and post-pregnant women in different social groups in London and Edinburgh: calcium, iron, retinol, ascorbic acid and folic acid

Dietary records were obtained twice in pregnancy and once post-partum, from 265 women in all social classes in London and Edinburgh. Some Edinburgh women, and lactating women, showed the higher levels of calcium intake. For iron, retinol, ascorbic acid and folic acid, there was a consistent and significant regional and social class gradient in intakes. This favoured English women in 'non-manual' social groups, leaving the Scottish 'manual' class, after pregnancy, with the lowest intakes. Mean intakes of Ca and Fe were consistently below the current UK recommended daily amount (RDA). Intakes of retinol were all above it, and ascorbic acid intakes ranged above and below the RDA.     

Food intakes and pattern of consumption among elderly Nigerians with a low income†

Nutrition Planning to meet the nutritional needs of the elderly often presents many problems. A dietary survey was conducted on 173 old men and 134 old women, in five local government areas of the Cross River State, Nigeria. The intake of 26 women and 31 men was determined by weighing. Information about the food eaten for one week, the sources of food, income and methods of food preparation were also obtained. The old persons investigated had relatively normal body weights. The mean protein intake was adequate at all ages but 11 percent of the men and 13 percent of the women had intakes below FAO requirements. With age there was a gradual reduction of energy intake due to diminishing ability to swallow. Thirty percent of the men and 25 percent of the women did not meet their energy requirements. The mean intakes of ascorbic acid and vitamin A for men aged 60–69 years were adequate. The consumption of thiamine, riboflavin and niacin were very low. Ninety‐six percent of the men had intakes of niacin and riboflavin below FAO requirements. A majority of the subjects did not eat eggs, meat, poultry and milk due to beliefs and superstitions. Poor methods of food preparation and preservation may further have reduced the values of calculated intakes at various ages.

Recognition of the problem posed by inadequate intake of the elderly is a first necessity and solutions must be sought early enough to keep pace with increasing urbanization in developing countries.     

Nutrition status of the elderly in Anogia,Crete, Greece.

General health and nutritional status of 167 free-living elderly Greek (aged 65-91 years) were assessed. The most prevalent diseases/symptoms encountered were related to respiratory, gastrointestinal, musculoskeletal and vascular systems (hypertension). Most subjects were socially active. Body mass index was < 20 and > 25 Kg/m2 in 7 and 57% of the subjects, respectively. Systolic blood pressure was significantly higher in women than in men, and as a group, 18 and 42%, respectively, had diastolic blood pressures > 90 and systolic blood pressures > 160 mmHg. Anemia and hypoalbuminemia were detected in < 5% of the population. Total fat intake was 40-45% of total energy intake and most of it came from monounsaturated fat. Hypercholesterolemia (> 6 mmol/L) was present in 32% of subjects. The percentages of men who smoked (66%) or drank (68%) were significantly higher than those of women (2 and 1%, respectively). Dietary intake data were compared with US recommended dietary allowances (RDA) for elderly. Daily energy and protein intakes were lower than the US RDA levels; calcium intake was > 50% of the US RDA, while magnesium and vitamin B6 levels were < 50% of the US RDA. Vitamin C intake was much higher than that of the US RDA. Mean thiamin, vitamin A, riboflavin and iron intakes were below the US RDA, while fiber intake was < 50% of the corresponding US estimate. Phosphorus was higher than the US RDA in men, while lower for women. Sodium intakes exceeded those recommended, while potassium levels were higher than those recommended in males, and lower in females.(ABSTRACT TRUNCATED AT 250 WORDS)     

Supplement use: vitamin intakes and biochemical indexes in 40- to 108-month-old children

Intakes and related biochemical indexes of ascorbic acid, thiamin, riboflavin, pyridoxine, vitamin B-12, and folic acid were examined for adequacy in 30 normal children aged 40 to 108 months. Comparisons were made between intake and biochemical index values of children who reported regular use of vitamin supplements and those who reported none. Three-day food records provided nutrient intake data; blood samples, drawn following an overnight fast, were analyzed for biochemical indexes. Student's t-test and the Pearson r were used for comparisons. Mean intakes of most nutrients differed significantly between the supplemented and nonsupplemented groups only when supplements were considered. Mean biochemical indexes differed significantly for riboflavin (p less than .005). Correlations between intakes and respective biochemical indexes were significant for riboflavin (p less than .01) and vitamin B-12 (p less than .01) in the supplemented group and for folate with RBC folate (p less than .005) in the nonsupplemented group. No deficiencies in either group were evident from biochemical indexes; improvement in indexes with supplement use was interpreted as being only relative and not suggestive that such use is beneficial.     

Evaluation of pyridoxine intake and pyridoxine status among aged institutionalised people

The vitamin B6 status of 60 institutionalised elderly subjects (group A: 31 men, mean age = 77 yr and 29 women, mean age = 84 yr) and 41 healthy young adults (group B or control group: 18 men, mean age = 30 yr and 23 women, mean age = 27 yr) was evaluated using erythrocyte aspartate aminotransferase activity coefficient (alpha EGOT) and plasma pyridoxal phosphate (PLP) level (vitamin B6-deficient subjects = alpha greater than 2.0 and PLP less than 80 nmol/l). The kilocalorie, protein and pyridoxine intakes were also estimated. Regarding calories and protein, the diets may be generally considered satisfactory in respect to the French 1981 RDA. The mean dietary intake of vitamin B6 was less than 2 mg/day in all groups. Ninety per cent of the aged, 80 per cent of females in group B in contrast to 56 per cent of males in group B consumed less than their individual vitamin B6 requirements as determined by a probability method. As the incidence of vitamin B6 biochemical deficiency was much higher in the group A (71% for males and 86% for females) than in the control group (11% for males and 30% for females), it is concluded that the high incidence of biochemical vitamin B6 deficiency noted in the aged appeared more relevant from an altered metabolism of the vitamin than from a too low energy intake. Supplements with high doses of vitamin B6 to aged subjects caused a significant decrease in alpha EGOT and a significant increase in PLP levels.     

Dietary studies of children from a biracial population: intakes of vitamins in 10- and 13-year-olds

Impact of vitamin supplements upon dietary intakes of eight vitamins was examined in 10- and 13-year-old children randomly selected from a biracial community, Bogalusa, LA. More younger children reported taking supplements daily (17%) than did adolescents (12%). Over 90% of the children surveyed had dietary intakes of vitamin E and niacin that met or exceeded the RDA. One-half to two-thirds of children using supplements had adequate intakes of ascorbic acid from diet alone. Children who most needed ascorbic acid supplements were the least likely to take them. One-quarter to one-half of the children did not consume the RDA levels of vitamin A, thiamine, and riboflavin. Adolescents had less adequate vitamin A intakes than younger children. In all surveys, a higher proportion of girls than boys had intakes that did not meet the RDA for vitamins B6 and B12. Vitamin intakes of Bogalusa children and adolescents were comparable to other U.S. surveys. Inclusion of vitamin E and niacin in supplements may be unnecessary.     

Dietary studies of children from a biracial population: intakes of vitamins in 10- and 13-year-olds.

Impact of vitamin supplements upon dietary intakes of eight vitamins was examined in 10- and 13-year-old children randomly selected from a biracial community, Bogalusa, LA. More younger children reported taking supplements daily (17%) than did adolescents (12%). Over 90% of the children surveyed had dietary intakes of vitamin E and niacin that met or exceeded the RDA. One-half to two-thirds of children using supplements had adequate intakes of ascorbic acid from diet alone. Children who most needed ascorbic acid supplements were the least likely to take them. One-quarter to one-half of the children did not consume the RDA levels of vitamin A, thiamine, and riboflavin. Adolescents had less adequate vitamin A intakes than younger children. In all surveys, a higher proportion of girls than boys had intakes that did not meet the RDA for vitamins B6 and B12. Vitamin intakes of Bogalusa children and adolescents were comparable to other U.S. surveys. Inclusion of vitamin E and niacin in supplements may be unnecessary.     

成都市城乡居民膳食组成及营养素的总膳食研究

应用总膳食研究方法对成都市城乡代表人群的膳食组成和16种营养素（碳水化合物、蛋白质、脂肪、视黄醇、硫胺素、核黄素、抗坏血酸、钙、铁、锌、镁、钾、钠、铜、锰、钻）进行了研究。结果表明：城市居民动物性食物消费普遍高于农村，其中，以猪肉为代表的肉类消费仍分别占城乡居民动物性食物消费总量的61．9％和87．6％；城乡代表性膳食组成仍以粮谷类和蔬菜等植物性为主；全市平均及城市多数食物消费水平已超过或接近推荐的2000年膳食目标，但农村与目标差距较大。全市平均及分城乡摄入的热量分别达到RDA的106．9％、102．1％和111．8％；蛋白质分别达到RDA的96．7％、104．7％和91，2％；铁、铜、锰、钴、钠的摄入量较充足，已分别达到我国RDA和WHO提出的ESADDI；但也存在全市平均及分城乡视黄醇当量、硫胺素、核黄素、抗坏血酸、钙、锌、钾均摄入不足以及城市脂肪摄入过高，农村蛋白质质量较差等值得重视的问题。与以往的研究结果比，居民的营养改善不明显。     

Apparent absorption of eight micronutrients and phytic acid from vegetarian meals in ileostomized human volunteers

OBJECTIVES: Apparent absorption of eight micronutrients and degradation of phytic acid were studied in human subjects who underwent ileostomy. The prominent factors affecting micronutrient absorption from vegetarian Indian meals (n = 11) were identified. METHODS: Levels of beta-carotene, ascorbic acid, riboflavin, and thiamine in food and ileostomy contents were estimated by spectrophotometry and spectrofluorometry. Contents of zinc, iron, copper, and manganese were estimated by atomic absorption spectrometry and that of phytic acid by gradient elution ion exchange chromatography. Statistical analyses were done with SPSS 10.0. RESULTS: Absorption of beta-carotene, ascorbic acid, riboflavin, and thiamine was 63% to 75.6%. There was a negative non-significant trend in values of beta-carotene absorption with increased intake of beta-carotene (r = - 0.51, P > 0.1) and iron (r = -0.67, P = 0.1) but a positive significant trend with riboflavin intakes (r = 0.84, P = 0.018). Percentage of absorption of ascorbic acid showed weak positive associations with intakes of riboflavin (r = 0.71) and ascorbic acid (r = 0.5). Percentage of absorption of ascorbic acid was positively correlated with percentage of absorption of beta-carotene (r = 0.80, P < 0.05), iron, and riboflavin (r = 0.64, P = 0.086), indicating some common influencing factors. Percentages of absorption for zinc (20.2), iron (9.9), and copper (17.6) was comparable with those reported for soy protein-based, high phytate diets. Pattern of phytic acid in the meals and output indicated partial degradation and absorption (34%). CONCLUSIONS: For vegetarian Indian meals, apparent absorptions of beta-carotene and ascorbic acid were 76% and 73.5% and of riboflavin and thiamine was 63%. Zinc, copper, and iron showed a lower absorption (10% to 20%).     

Nutrition of old people in sheltered housing

Two hundred and thirty-five sheltered housing tenants (59 men and 176 women) were investigated by using the 24-h dietary recall and checklist devised by the Nutrition Advisory Group on the Elderly (NAGE) to estimate their energy and nutrient intakes, and by measuring their body weight and demi-span to calculate ratios of weight to demi-span. Sixty seven per cent had energy intakes below the mean previously recorded in a national survey of old people living at home, but most had an adequate intake of protein, while, in 44%, the proportion of energy consumed as fat exceeded 35%. For most nutrients, few tenants had intakes below the lower recommended nutrient intake (LRNI). Exceptions were that there were 64% with pyridoxine intakes and 63% with vitamin D intakes below this level. Only 18% of men but 74% of women had weight to demi-span ratios below the means recorded in elderly people living at home in another recent survey. There was no correlation between these anthropometric ratios and energy intakes.     

Thiamine deficiency is prevalent in a selected group of urban Indonesian elderly people

This cross-sectional study involved 204 elderly individuals (93 males and 111 females). Subjects were randomly recruited using a list on which all 60-75 y-old-people living in seven sub-villages in Jakarta were included. The usual food intake was estimated using semiquantitative food frequency questionnaires. Hemoglobin, plasma retinol, vitamin B-12, red blood cell folate and the percentage stimulation of erythrocyte transketolase (ETK), as an indicator of thiamine status, were analyzed. Median energy intake was below the assessed requirement. More than 75% of the subjects had iron and thiamine intakes of approximately 2/3 of the recommended daily intake, and 20.2% of the study population had folate intake of approximately 2/3 of the recommended daily intake. Intakes of vitamins A and B-12 were adequate. Biochemical assessments demonstrated that 36.6% of the subjects had low thiamine levels (ETK stimulation > 25%). The elderly men tended to have lower thiamine levels than the elderly women. The overall prevalence of anemia was 28.9%, and the elderly women were affected more than the elderly men. Low biochemical status of vitamins A, B-12 and RBC folate was found in 5.4%, 8.8 % and 2.9% of the subjects, respectively. Dietary intakes of thiamine and folate were associated with ETK stimulation and plasma vitamin B-12 concentration (r = 0.176, P = 0.012 and r = 0.77, P = 0.001), respectively. Results of this study suggest that anemia, thiamine and possibly vitamin B-12 deficiency are prevalent in the elderly living in Indonesia. Clearly, micronutrient supplementation may be beneficial for the Indonesian elderly population living in underprivileged areas.     

Ascorbic acid status of children with developmental disabilities.

Ascorbic acid status of thirty-nine white children with developmental disabilities, ages three to nineteen years, is reported. Mean daily ascorbic acid intakes were calculated from three-day food records. Biochemical assessment consisted of fasting serum levels and a 6-hr. load test. Nine children served as a control group for the load test only. Mean dietary intakes for the vitamin were 204 per cent of the allowance. The mean serum ascorbic acid value was 1.3 mg. per deciliter. Only two children had levels at the unacceptable deficient level. Following load tests, ten children were identified as low excretors (less than 17 per cent), nine were moderate excretors (17 to 23 per cent), and the rest were high excretors (above 23 per cent). All of the normal children were high excretors. Two of three children with low ascorbic acid intakes (below 66 per cent of the recommended allowance) were verified as deficient by their fasting serum levels and urinary recovery after a load.     

重庆市中小学生膳食营养状况的概率分析

采用概率分析法对重庆市620名7～15岁散居中小学生的膳食调查资料进行评价。结果表明,用概率分析法评价膳食调查资料预示各种营养素摄入不足的发生率均高于用人群营养素摄入量均值与RDA作直接对照的结果。所有学生营养素摄入不足的概率均以钙及硫胺素为最高,钙、硫胺素、核黄素、抗坏血酸、锌、蛋白质和铁摄入不足的概率分别为:57.1～79.7％,34.3～60.5％,14.3～43.9％,15.9～31.9％,4.4～24.7％,5.7～14.1％和0.1～5.1％。其中11和13～15岁组多种营养素摄入不足的概率略高于其它年龄组.中小学生膳食结构单调和偏食可能是营养素摄入不足的重要原因.     

Alterations of Homocysteine Serum Levels during Alcohol Withdrawal Are Influenced by Folate and Riboflavin: Results from the German Investigation on Neurobiology in Alcoholism (GINA)

Aims: Various studies have shown that plasma homocysteine (HCY) serum levels are elevated in actively drinking alcohol-dependent patients a during alcohol withdrawal, while rapidly declining during abstinence. Hyperhomocysteinemia has been associated not only with blood alcohol concentration (BAC), but also with deficiency of different B-vitamins, particularly folate, pyridoxine and cobalamin. Methods: Our study included 168 inpatients (110 men, 58 women) after admission for detoxification treatment. BAC, folate, cobalamin, pyridoxine, thiamine and riboflavin were obtained on admission (Day 1). HCY was assessed on Days 1, 7 and 11. Results: HCY levels significantly declined during withdrawal. General linear models and linear regression analysis showed an influence of BAC, folate and riboflavin on the HCY levels on admission as well as on HCY changes occurring during alcohol withdrawal. No significant influence was found for thiamine, cobalamin and pyridoxine. Conclusions: These findings show that not only BAC and plasma folate levels, but also plasma levels of riboflavin influence HCY plasma levels in alcohol-dependent patients.