Short-term folate,vitamin B-12 or vitamin B-6 supplementation slightly affects memory performance but not mood in women of various ages

Based on research demonstrating associations between folate, B-12 and B-6 vitamins and cognition and mood, we investigated the effects of short-term supplementation in 211 healthy younger, middle-aged and older women who took either 750 microg of folate, 15 microg of vitamin B-12, 75 mg of vitamin B-6 or a placebo daily for 35 d. In addition, we examined associations between dietary intake of these vitamins and cognition and mood. Usual dietary intake status was estimated using a retrospective, self-report, quantified food frequency questionnaire. Participants completed alternate forms of standardized tests of cognitive processing resources, memory, executive function, verbal ability and self-report mood measures before and after supplementation. Supplementation had a significant positive effect on some measures of memory performance only, and no effect on mood. Dietary intake status was associated with speed of processing, recall and recognition and verbal ability.     

Increasing Iron and Zinc in Pre-Menopausal Women and Its Effects on Mood and Cognition: A Systematic Review

Iron and zinc are essential minerals often present in similar food sources. In addition to the adverse effects of frank iron and zinc-deficient states, iron insufficiency has been associated with impairments in mood and cognition. This paper reviews current literature on iron or zinc supplementation and its impact on mood or cognition in pre-menopausal women. Searches included MEDLINE complete, Excerpta Medica Database (EMBASE), psychINFO, psychARTICLES, pubMED, ProQuest Health and Medical Complete Academic Search complete, Scopus and ScienceDirect. Ten randomized controlled trials and one non-randomized controlled trial were found to meet the inclusion criteria. Seven studies found improvements in aspects of mood and cognition after iron supplementation. Iron supplementation appeared to improve memory and intellectual ability in participants aged between 12 and 55 years in seven studies, regardless of whether the participant was initially iron insufficient or iron-deficient with anaemia. The review also found three controlled studies providing evidence to suggest a role for zinc supplementation as a treatment for depressive symptoms, as both an adjunct to traditional antidepressant therapy for individuals with a diagnosis of major depressive disorder and as a therapy in its own right in pre-menopausal women with zinc deficiency. Overall, the current literature indicates a positive effect of improving zinc status on enhanced cognitive and emotional functioning. However, further study involving well-designed randomized controlled trials is needed to identify the impact of improving iron and zinc status on mood and cognition.     

Higher Body Iron Is Associated with Greater Depression Symptoms among Young Adult Men but not Women: Observational Data from the Daily Life Study

Studies investigating possible associations between iron status and mood or depressive symptoms have reported inconsistent results. However, they have neither used body iron to measure iron status nor measured mood using daily measures. We investigated whether body iron was associated with depressive symptoms, daily mood, daily tiredness, difficulty concentrating, and stress in young adult women and men. Young adult (17–25 years) women (n = 562) and men (n = 323) completed the Center for Epidemiologic Studies Depression Scale, then reported negative and positive mood, and other states daily for 13 days. Non-fasting venous blood was collected to determine hemoglobin, serum ferritin and soluble transferrin receptor (to calculate body iron), C-reactive protein, and alpha-1-acid glycoprotein concentration. Regression models tested linear associations between body iron and the outcome variables, controlling for possible confounders. No associations were found between body iron and the outcome variables in women. However, higher body iron was associated with more depressive symptoms in men (3.4% more per body iron mg/kg; 95% confidence intervals (CI): 0.8%, 5.9%). In young adult women, body iron is unlikely to be associated with significant deficits in mood or depressive symptoms. However, higher body iron may be associated with more depressive symptoms in young adult men.     

Dietary iron intake is positively associated with hemoglobin concentration during infancy but not during the second year of life

Iron status during infancy and early childhood reflects highly dynamic processes, which are affected by both internal and external factors. The regulation of iron metabolism seems to be subjected to developmental changes during infancy, although the exact nature of these changes and their implications are not fully understood. We wanted to explore the association between dietary iron intake and indicators of iron status, and to assess temporal changes in these variables. This was done by secondary analysis of data from a recently conducted dietary intervention trial in which healthy, term, well-nourished infants were randomly assigned to consume iron-fortified infant cereals with regular or low phytate content, or iron-fortified infant formula. Dietary iron intake from 6 to 8 mo and from 9 to 11 mo was associated with hemoglobin (Hb) concentration at 9 mo (r = 0.27, P < 0.001) and 12 mo (r = 0.21, P = 0.001), respectively, but iron intake from 12 to 18 mo was not associated with Hb at 18 mo. In contrast, iron intake from 6 to 11 mo was not associated with serum ferritin (S-Ft) at 9 or 12 mo, whereas iron intake from 12 to 17 mo was positively associated with S-Ft at 18 mo (r = 0.14, P = 0.032). These shifts in associations between dietary iron intake, and Hb and S-Ft, respectively, may be due to developmental changes in the channeling of dietary iron to erythropoiesis relative to storage, in the absence of iron deficiency anemia. These observations should be taken into consideration when evaluating iron nutritional status during infancy and early childhood.     

Placental expression of the heme transporter, feline leukemia virus subgroup C receptor, is related to maternal iron status in pregnant adolescents

Little is known about the expression of heme transporters in human placenta and possible associations between these transporters and maternal or neonatal iron status. To address this area of research, relative protein expression of 2 heme transporters, Feline Leukemia Virus, Subgroup C, Receptor 1 (FLVCR1) and Breast Cancer Resistance Protein (BCRP), was assessed using Western-blot analysis in human placental tissue in relation to maternal/neonatal iron status and placental iron concentration. Placental FLVCR1 (n = 71) and BCRP (n = 83) expression were assessed at term (36.6-41.7 wk gestation) in a cohort of pregnant adolescents (13-18 y of age) at high-risk of iron deficiency. Both FLVCR1 and BCRP were detected in all placental samples assayed. Placental FLVCR1 expression was positively related to placental BCRP expression (n = 69; R(2) = 0.104; P < 0.05). Adolescents that were anemic at delivery had lower placental FLVCR1 expression (n = 49; P < 0.05). Placental FLVCR1 expression was positively associated with placental iron concentration at delivery (n = 61; R(2) = 0.064; P < 0.05). In contrast, placental BCRP expression was not significantly associated with maternal iron status or placental iron content. Both FLVCR1 and BCRP are highly expressed in human placental tissue, but only FLVCR1 was significantly inversely associated with maternal iron status and placental iron concentration. Further analysis is needed to explore potential functional roles of FLVCR1 in human placental iron transport.     

Combined Effects of Cognitive Impairment and Nutritional Trajectories on Functional Recovery for Older Patients after Hip-Fracture Surgery

ObjectivesMalnutrition and cognitive impairment are associated with poor functional recovery in older adults following hip-fracture surgery. This study examined the combined effects of cognitive impairment and nutritional trajectories on postoperative functional recovery for older adults following hip-fracture surgery.DesignProspective longitudinal correlational study.Setting and ParticipantsThis study recruited 350 older adults (≥60 years of age) who received hip-fracture surgery at a 3000-bed medical center in northern Taiwan from September 2012 to March 2020.MethodsParticipant data were collected over a 2-year period after surgery for nutritional and cognitive status and activities of daily living (ADLs). Participants were grouped by type of nutritional trajectory using group-based trajectory modeling. Generalized estimating equations analyzed associations between trajectory groups/cognitive status at discharge and performance of ADLs.ResultsNutritional trajectories best fit a 3-group trajectory model: malnourished (19%), at-risk of malnutrition (40%), and well-nourished (41%). Nutritional status for the malnourished group declined from 12 months to 24 months following surgery; nutritional status remained stable for at-risk of malnutrition and well-nourished groups. Interactions for cognitive impairment-by-nutritional status were significant: the malnourished + intact cognition subgroup had significantly better ADLs than the malnourished + cognitive impairment subgroup (b = 27.1, 95% confidence interval = 14.0–40.2; P < .001). For at-risk of malnutrition and well-nourished groups, there were no significant differences between cognitive impairment and intact cognition in ADLs. These findings suggest that nutritional status may buffer the negative effect of cognitive impairment on ADLs.Conclusions and ImplicationsBetter nutritional status over time for older adults following hip fracture can protect against adverse influences of cognitive impairment on ADLs during postoperative recovery. Participants with malnutrition and cognitive impairment had the poorest ADLs. These findings suggest interventions tailored to improving nutritional status may improve recovery for older adults following hip-fracture surgery.     

Blood lead, anemia, and short stature are independently associated with cognitive performance in Mexican school children

Lead exposure and nutritional factors are both associated with cognitive performance. Lead toxicity and nutritional status are also associated with each other. We examined whether nutritional status variables account for part or all of the association between cognitive performance and lead exposure. First-grade children (n = 724) ages 6-8 y, attending Mexican public schools located in the vicinity of a metal foundry were asked to participate and 602 enrolled in the study. Blood lead, iron status, anemia, anthropometry, and cognitive function were assessed. Results from 7 standardized tests are presented here. The mean blood lead concentration was 11.5 +/- 6.1 micro g/dL (0.56 +/- 0.30 micro mol/L) and 50% of the children had concentrations >10 micro g/dL (0.48 micro mol/L). The prevalence of mild anemia (<124 g/L) was low (10%) and stunting (<2 SD) was nonexistent (2.3%). In bivariate analyses, lead was negatively associated with 4 cognitive tests and was also inversely correlated with iron status, height-for-age Z scores, and head circumference. In multivariate models, the association between lead and cognitive performance was not strongly affected by nutritional variables, suggesting that the relation of lead to cognition is not explained by lead's relation to iron deficiency anemia or growth retardation. In multivariate models, hemoglobin concentration was also positively associated with Peabody Picture Vocabulary Test and Number Sequencing performance, whereas serum ferritin was negatively related to the Coding subscale of the Wechsler Intelligence Scales for Children-Revised Mexican Version (WISC-RM).     

Iron status of the Taiwanese elderly: the prevalence of iron deficiency and elevated iron stores

Iron status, prevalence of iron deficiency and elevated iron stores, and the effect of gastrointestinal ulceration on iron status in free-living Taiwanese elderly persons were all assessed in a nationally representative, cross-sectional nutrition survey--the Elderly NAHSIT. The survey included blood measurements of iron indices. Data were collected from 1202 elderly men and 1152 elderly women aged 65 years and older. Multiple iron measures, including serum ferritin (SF), transferrin saturation (Tsat), and hemoglobin were used to evaluate the prevalence of iron deficient erythropoiesis (ID) and iron deficiency anemia (IDA). Despite no routine practice of iron fortification in Taiwan, elderly subjects had a low prevalence of ID and IDA. The prevalence of ID was 2.3% in men and 1.4% in women. The prevalence of IDA was 2.5% in men and 2.0% in women. In contrast, 15.7% of men and 9.8% of women had elevated iron stores as diagnosed by SF>300 microg/L. Subjects with a history of gastrointestinal ulceration had significantly lower serum ferritin than those without ulcers, but the prevalence of anemia, ID and IDA was unaffected. In conclusion, elderly people in Taiwan are an iron-replete population with a high prevalence of elevated iron stores and a low prevalence of iron deficiency.     

The association between nutritional status and handgrip strength in older Rwandan refugees

OBJECTIVES: To investigate the association between nutritional status and handgrip strength in older Rwandan refugees. DESIGN: Cross-sectional study. SETTING: Rwandan refugee camp located in Karagwe district in the north-west of Tanzania. The study was carried out in the post-emergency phase. The response rate was 85%. SUBJECTS: A total of 413 men and 415 women aged 50-92 y participated in the study. METHODS: Weight, height, mid-upper-arm circumference (MUAC) and triceps skinfold were obtained using standard techniques. For people with visible kyphosis, height was estimated from armspan using regression equations developed from non-kyphotic subjects within the sample. Handgrip was measured using a mechanical handgrip dynamometer. Information regarding physical activity and health status was obtained by interview and clinical screening. RESULTS: Handgrip strength (kg) was significantly higher in men than in women (30.3+/-6.7 vs 22.3+/-5.1), and significantly lower in each older age group in both sexes. Handgrip strength was positively correlated to BMI (body mass index) and AMA (arm muscle area). The relative risk of impaired handgrip strength in individuals with poor nutritional status (BMI<18.5 kg/m(2)) compared with those of adequate nutritional status was 1.75. After controlling for potential confounders (sex, age and height), BMI remained a significant contributor to the variation in handgrip strength. CONCLUSION: Poor nutritional status is associated with poor handgrip strength independent of sex, age and height, in this refugee population. This may indicate that underweight older people are likely to have more difficulties in functioning independently in the community. Research is needed to investigate if improving nutritional status can lead to better functional ability. SPONSORSHIP: Department for International Development (UK) and HelpAge International.     

High Rates of Malnutrition in Older Adults Receiving Different Levels of Health Care in Lleida,Catalonia: An Assessment of Contributory Factors

The aim of this study was to define the factors associated with the presence or risk of malnutrition in older adults (>65 years of age) attending health care centers in Lleida, Catalonia, using a cross-sectional study approach. Nutritional parameters assessed included the Mini Nutritional Assessment Scale, sociodemographic and psychosocial factors, functional and cognitive status, swallowing and oral problems, texture and route of administration of the diet, changes in dietary intake, and presence of digestive disorders. A total of 398 individuals (184 men) with an average age of 77 years were included in the assessment. Poor nutritional status was recorded in 58% of the individuals. Factors independently associated with unsatisfactory nutritional status included weight loss, functional dependence, cognitive impairment, loneliness, living without a partner, history of heart disease, lung disease, and the presence of acute vomiting.     

Effects of an oral mixture containing glycine, glutamine and niacin on memory, GH and IGF-I secretion in middle-aged and elderly subjects

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.     

High rates of malnutrition in older adults receiving different levels of health care in Lleida, Catalonia: an assessment of contributory factors

The aim of this study was to define the factors associated with the presence or risk of malnutrition in older adults (>65 years of age) attending health care centers in Lleida, Catalonia, using a cross-sectional study approach. Nutritional parameters assessed included the Mini Nutritional Assessment Scale, sociodemographic and psychosocial factors, functional and cognitive status, swallowing and oral problems, texture and route of administration of the diet, changes in dietary intake, and presence of digestive disorders. A total of 398 individuals (184 men) with an average age of 77 years were included in the assessment. Poor nutritional status was recorded in 58% of the individuals. Factors independently associated with unsatisfactory nutritional status included weight loss, functional dependence, cognitive impairment, loneliness, living without a partner, history of heart disease, lung disease, and the presence of acute vomiting.     

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.     

Maternal social capital and child nutritional status in four developing countries

Social capital has been shown to be positively associated with a range of health outcomes, yet no studies have explored the association between maternal social capital and child nutritional status. Using data from the Young Lives study comprising 7242 1-year-old children from Peru, Ethiopia, Vietnam and the state of Andhra Pradesh in India, we find significant differences in the levels of, in particular, structural social capital (group membership and citizenship) between countries. While few associations were found between structural measures of social capital, support from individuals and cognitive social capital (e.g. trust, social harmony) displayed fairly consistent positive associations with child nutritional status across countries.     

Is Higher Consumption of Animal Flesh Foods Associated with Better Iron Status among Adults in Developed Countries? A Systematic Review

Iron deficiency (ID) is the most prevalent nutrient deficiency within the developed world. This is of concern as ID has been shown to affect immunity, thermoregulation, work performance and cognition. Animal flesh foods provide the richest and most bioavailable source of dietary (haem) iron, however, it is unclear whether low animal flesh diets contribute to ID. This systematic review aimed to investigate whether a higher consumption of animal flesh foods is associated with better iron status in adults. CINAHL, Cochrane, EMBASE and MEDLINE were searched for published studies that included adults (≥18 years) from developed countries and measured flesh intakes in relation to iron status indices. Eight experimental and 41 observational studies met the inclusion criteria. Generally, studies varied in population and study designs and results were conflicting. Of the seven high quality studies, five showed a positive association between animal flesh intake (85–300 g/day) and iron status. However, the optimum quantity or frequency of flesh intake required to maintain or achieve a healthy iron status remains unclear. Results show a promising relationship between animal flesh intake and iron status, however, additional longitudinal and experimental studies are required to confirm this relationship and determine optimal intakes to reduce ID development.     

Perceived and objective neighborhood environment attributes and health related quality of life among the elderly in Bogotá, Colombia

This study examines associations between neighborhood environment attributes and health related quality of life (HRQOL) and self-rated health (SRH) among older adults (60 years and over) in Bogotá, Colombia. Perceived and objective neighborhood environmental characteristics were assessed in a cross sectional multilevel design with 1966 older adults within 50 neighborhoods. Outcome variables included HRQOL (physical and mental dimensions) and SRH measured with the Spanish version of the Short Form 8 (SF-8). Independent variables included perceived and objective neighborhood characteristics as well as self-reported levels of walking. Hierarchical linear and logistic regression models were used for the analysis. Among perceived neighborhood characteristics, safety from traffic was positively associated with both HRQOL dimensions and SRH. Having safe parks was positively associated with the mental dimension of HRQOL and with SRH. Street noise was negatively associated with both HRQOL dimensions. Regarding objective neighborhood characteristics, residing in areas with more than eight percent of land covered by public parks was positively associated with SRH. Objective and perceived neighborhood characteristics could provide insight into potential interventions among older adults from rapidly urbanizing settings in Latin America.     

The association of betaine, homocysteine and related metabolites with cognitive function in Dutch elderly people

The importance of the one-carbon metabolites, choline and homocysteine, to brain function is well known. However, the associations between the one-carbon metabolites choline, betaine, methionine and dimethylglycine with cognition in elderly are unclear. We therefore examined the associations of these metabolites with cognition in a double-blind, placebo-controlled trial. Individuals (n 195) were randomized to receive daily oral capsules with either 1000 microg cobalamin (vitamin B12), or 1000 microg cobalamin plus 400 microg folic acid, or placebo for 24 weeks. Concentrations of homocysteine, methionine, choline, betaine and dimethylglycine were assessed before and after 12 and 24 weeks of treatment. Cognitive function, including domains of attention, construction, sensomotor speed, memory and executive function, was assessed before and after 24 weeks of treatment. At baseline, elevated plasma homocysteine was associated with lower performance of attention, construction, sensomotor speed and executive function. In addition, betaine was positively associated with better performance of construction, sensomotor speed and executive function, whereas elevated concentrations of methionine were positively associated with sensomotor speed. Daily combined supplementation with cobalamin plus folic acid decreased total homocysteine concentrations by 36%, and increased betaine concentrations by 38%. Participants with the largest increases in betaine concentrations showed a borderline significant (P = 0.07) higher memory performance compared to those without it. Although this trial observed associations of homocysteine and betaine with cognitive domains prior to supplementation, decreased concentrations of homocysteine were not related to improved cognitive performance. There was a tendency of participants with the largest increases in betaine concentrations to show the greatest improvement in memory function.     

The relationship between dental status,food selection,nutrient intake,nutritional status,and body mass index in older people

This paper reviewed the findings from a national survey in Great Britain which assessed whether dental status affected older people's food selection, nutrient intake, and nutritional status. The survey analyzed national random samples of free-living and institution subjects for dental examination, interview, and four-day food diary as well as blood and urine tests In the free-living sample, intakes of non-starch polysaccharides, protein, calcium, non-heme iron, niacin, and vitamin C were significantly lower in edentulous as compared to dentate subjects. People with 21 or more teeth consumed more of most nutrients, particularly non-starch polysaccharides. This relationship in intake was not apparent in the hematological analysis. Plasma ascorbate and retinol were the only analytes significantly associated with dental status. Having 21 or more teeth increased the likelihood of having an acceptable body mass index (BMI). Thus, maintaining a natural and functional dentition defined as having more than twenty teeth into old age plays an important role in having a healthy diet rich in fruits and vegetables, a satisfactory nutritional status, and an acceptable BMI.     

Iron deficiency and iron-deficiency anemia in the first two years of life: strategies to prevent loss of developmental potential

This article examines the association of iron deficiency (ID) and iron deficiency anemia (IDA) with children's development and behavior, with the goal of providing recommendations to prevent the developmental loss associated with these conditions. Children's risk for ID and IDA is particularly high during the second 6 months of life when prenatal stores are depleted. Longitudinal studies from infancy through adolescence and early adulthood suggest that socioemotional development is uniquely vulnerable to ID and IDA, perhaps being associated with shared neural pathways, and the effects of early iron deficiencies may be irreversible. In addition to direct effects on brain function, ID and IDA may also affect child development indirectly through non-responsive mother-child interactions. Maternal ID is a global problem that may contribute to high rates of maternal depression and non-responsive caregiving. Intervention trials illustrate that children benefit from both nutritional intervention and early learning interventions that promote responsive mother-child interactions. Recommendations to reduce the developmental loss associated with ID and IDA are to reduce the incidence of these conditions by efforts to prevent premature birth, delay cord clamping, ensure adequate maternal iron status, provide iron-rich complementary foods, and ensure access to postnatal interventions that promote responsive mother-infant interaction patterns and early learning opportunities for infants.     

Low Hemoglobin Levels Are Associated with Reduced Psychomotor and Language Abilities in Young Ugandan Children

Children living in Sub-Saharan Africa are vulnerable to developmental delay, particularly in the critical first five years due to various adverse exposures including disease and nutritional deficiencies. Anemia and iron deficiency (ID) are highly prevalent in pregnant mothers and young children and are implicated in abnormal brain development. However, available evidence on the association between anemia, ID and neurodevelopment in sub-Saharan Africa is limited. Using data from the Entebbe Mother and Baby Study prospective birth cohort, we examined the effect of maternal and child hemoglobin (Hb) levels and child iron status on developmental scores in 933 and 530 pre-school Ugandan children respectively. Associations between Hb levels, iron status and developmental scores were assessed using regression analyses adjusting for potential confounders. Lower maternal and child Hb levels were associated with reduced psychomotor scores at 15 months, while only lower Hb levels in infancy were associated with reduced language scores. We found no evidence that anemia or ID was associated with cognitive or motor scores at five years. This study emphasizes the importance of managing anemia in pregnancy and infancy and highlights the need for further studies on the effects of anemia and ID in children living in Sub-Saharan Africa.