Lifetime dietary change and its relation to increase in weight in Spanish women

Potential for, and readiness to, dietary-style changes during the retirement status passage: a systematic mixed-studies review

Context

Unfavorable diets contribute to the global burden of disease and particularly affect individuals’ health in old age. To promote healthy aging, it is vital to understand the biographical circumstances under which diets manifest and change.

Objective

This systematic mixed-studies review explored changes in dietary styles of people facing retirement.

Data Sources

Seven electronic databases were searched systematically, along with reference lists.

Data Extraction

Five qualitative and five quantitative studies were identified out of n = 974 records screened. Relevant study characteristics were extracted with a piloted form.

Data Synthesis

A qualitative convergent synthesis design was conducted.

Results

Study results were inconsistent. The majority of studies identified various dietary-style changes after retirement – some in favorable ways (eg, increased vegetable consumption [n = 4]) and some in rather unfavorable ways (eg, increased snacking [n = 2]). Influencing factors were changes in mealtime structures, available time, and financial situations accompanying retirement.

Conclusion

More high-quality, longitudinal research is needed to build a sound basis for interventions by utilizing the retirement transition as a window of opportunity for dietary changes.

Systematic Review Registration

PROSPERO registration no. CRD42018074049.

Diet as a Risk Factor for Cognitive Decline in African Americans and Caucasians with a Parental History of Alzheimer's Disease: A Cross-Sectional Pilot Study Dietary Patterns

BACKGROUND

African Americans (AA) are more likely to develop Alzheimer's disease (AD) than Caucasians (CC). Dietary modification may have the potential to reduce the risk of developing AD.

OBJECTIVE

The objective of this study is to investigate the relationship between Southern and Prudent diet patterns and cognitive performance in individuals at risk for developing AD.

DESIGN

Cross-sectional observational study.

PARTICIPANTS

Sixty-six cognitively normal AA and CC individuals aged 46-77 years with a parental history of AD were enrolled.

MEASUREMENTS

Participants completed a Food Frequency questionnaire, cognitive function testing, which consisted of 8 neuropsychological tests, and cardiovascular risk factor assessments, including evaluation of microvascular and macrovascular function and ambulatory blood pressure monitoring.

RESULTS

Results revealed a relationship between the Southern diet and worse cognitive performance among AAs. AAs who consumed pies, mashed potatoes, tea, and sugar drinks showed worse cognitive performance (p<0.05) compared with CCs. In addition, gravy (p=0.06) and cooking oil/fat (p=0.06) showed negative trends with cognitive performance in AAs. In both CC and AA adults, greater adherence to a Prudent dietary pattern was associated with better cognitive outcomes. Cardiovascular results show that participants are overall healthy. AAs and CCs did not differ on any vascular measure including BP, arterial stiffness and endothelial function.

CONCLUSION

Research shows that dietary factors can associate with cognitive outcomes. This preliminary cross-sectional study suggests that foods characteristic of the Southern and Prudent diets may have differential effects on cognitive function in middle-aged individuals at high risk for AD. Results suggest that diet could be a non-pharmaceutical tool to reduce cognitive decline in racially diverse populations. It is possible that the increased prevalence of AD in AA could be partially reduced via diet modification.

A New Approach to Assess Lifetime Dietary Patterns Finds Lower Consumption of Animal Foods with Aging in a Longitudinal Analysis of a Health-Oriented Adventist Population

Life-course diet patterns may impact risk of disease, but little is known about dietary trends with aging. In a retrospective longitudinal analysis we estimated lifetime intake of animal products and adherence to vegetarian dietary patterns among 51,082 Adventist Health Study-2 (AHS-2) subjects using data from a reliable life-course dietary (meats, dairy, eggs) questionnaire. Results showed a marked tendency to consume fewer animal products (in total) in older years and to reduce consumption of meat, poultry and fish, but not eggs or dairy. Among the 29% of elderly subjects who during their lifetime kept the same dietary pattern (LTS) were: LTS-vegans (1.1%), LTS-lacto-ovo vegetarians (31.2%), LTS-pesco vegetarians (0.49%), LTS-semi vegetarians (3.7%), and LTS-non-vegetarians (63.5%). Among the 71% of switchers were “Converters” (59.7%) who moved towards and “Reverters” (9.1%) who moved away from vegetarian diets, and Multiverters (31.2%), who had moved in both directions. LTS-non-vegetarians, and also reverters, were more overweight and showed a less healthy lifestyle than others. We conclude that the dietary patterns are dynamic with strong trends to reduce animal foods and to adopt more vegetarian patterns with aging. The disease experience of subjects with different lifetime dietary patterns can be compared.

Food habits, socioeconomic status and body mass index among premenopausal and post-menopausal women in Mauritius

BACKGROUND

Although many health disparities arise as a result of socioeconomic inequalities, less is known about the diet quality of women after menopause. The present study aimed to determine the factors affecting food habits and body mass index (BMI) among premenopausal and post-menopausal Mauritian working women.

METHODS

The study was conducted as a cross-sectional survey in different workplaces located in the nine districts of Mauritius. Mauritian women (n = 400; 215 premenopausal, 185 post-menopausal) were recruited using stratified random sampling. Participants completed a self-reported questionnaire comprising a food frequency questionnaire previously constructed and used to address dietary guidelines that assess the intake of vegetables, fruits, dairy products, cereals, high- and low-fat protein sources, fats and sweetened beverages, as well as questions aiming to elicit socioeconomic profile, menopausal status, physical activity level and demographic data. Height, weight, waist and hip circumferences were measured. An independent sample t-test, chi-squared test and one-way analysis of variance were used for the statistical analyses.

RESULTS

The mean dietary guideline score was significantly higher for post-menopausal than premenopausal women, (P = 0.017). Each socioeconomic status (SES) category of post-menopausal women also demonstrated a higher dietary guideline score than that of premenopausal women (P > 0.05). A high BMI was significantly associated with a low SES of participants (P = 0.042) and post-menopausal stage (P = 0.001).

CONCLUSIONS

Low SES and post-menopausal stage are risk factors for obesity among female workers in Mauritius. Although post-menopausal women ate a better diet, their mean BMI was higher than that of premenopausal women.

Nutritional assessment and diet quality of visually impaired Spanish children

BACKGROUND

The visually impaired represents a fairly numerous group in Spain although no data on their nutritional status has previously been published.

AIM

This work aims to assess the nutritional state of a sample of visually impaired children and the quality of their diet.

SUBJECTS AND METHODS

The sample comprised 229 boys and girls aged between 8 and 18 years (mean = 14, SD = 2.6), all of whom had a visual discapacity and were students of the Centros de Recursos Educativos (CREs; Educational Resources Centres) of the Organización Nacional de Ciegos de España (ONCE; Spanish National Organization for the Blind).

RESULTS

This sample featured a high prevalence of overweight (25.8%) and obesity (11.8%) according to the international standard. The mean daily energy consumption and the quantity of carbohydrates, fats, proteins and fibre were greater in boys (2604 kcal day(-1); 290 g of carbohydrates, 126 g of fats and 90 g of proteins) than in girls (2159 kcal day(-1), 232 g of carbohydrates, 107 g of fats and 80 g of proteins). No differences in diet intake according to degree of visual impairment were found. Their diet was unbalanced in comparison with the nutritional objectives for the Spanish population, since consumption of carbohydrates was low and that of fats was very high. The results relating to the quality of the diet reveal quite large deviations from the Mediterranean model. Only 11.9% of the whole sample had a value corresponding to a good quality diet.

CONCLUSION

The pattern of dietary consumption was the same as that observed in non visually impaired children in Spain in quantity and quality, nevertheless the prevalence of overweight and obesity is higher than in children without visual handicaps.

Environmental contexts of menopause in Spain

OBJECTIVE

This study had two main objectives: (1) to detect the differences in basic aspects of the reproductive aging process (age at menopause, menopausal symptoms, the medicalization of aging) among women from the region of Madrid, who at the time of the study were living in three different environmental contexts (rural, semiurban, and urban), and (2) to identify the main factors responsible for these differences.

DESIGN

Data from two different research projects have been pooled for the DAMES project (Decisions At MEnopause Study), and the Ecology of Reproductive Aging Project. The sample size was 1,142, women 45 to 55 years of age (103 rural, 744 semiurban, 295 urban).

RESULTS

Probit analysis was used to estimate median age at natural menopause in the three contexts. Rural women have a later onset of menopause (rural, 52.07 y; semiurban, 51.9 y; urban, 51.23 y) and significantly higher levels of the symptoms related to declines in estrogen, eg, hot flashes (rural, 56%; semiurban, 43%; urban, 46%; chi2=6.717, P=0.035) or loss of sexual desire (rural, 51%; semiurban, 44%; urban, 41%; chi2=24.934, P=0.001). Conversely, urban women suffer more from symptoms related to stress, eg, impatience (rural, 34%; semiurban, 25%; urban, 45%; chi2=41.328, P<0.001). The medicalization of menopause, measured in terms of both surgical menopause and the use of hormone therapy, is significantly higher in the urban population (surgical menopause: rural, 5.8%; semiurban, 8.7; urban, 10%; chi2=16.009, P<0.001). Despite these differences, levels of postmenopausal hormone therapy use are still somewhat lower than in other West European and North American populations. Two different logistic regression analyses were carried out to identify (1) factors associated with differences in ovarian aging, measured through menopausal status, and (2) factors associated with prevalence of hot flashes with respect to ovarian aging. Parity, body mass index, age, environmental context, and, slightly less so, smoking, alcohol consumption, age, education, age at menarche, and marital status all contribute significantly or nearly significantly and independently to the explanation of differences found. For the likelihood of having hot flashes, environmental context, age, education, age at menarche, menopausal status, and postmenopausal hormone therapy use all hae a significant or borderline significant effect.

CONCLUSIONS

Significant differences have been shown to exist in rural, semiurban and urban settings in the median age at menopause, in basic symptom frequency and type, and in the levels of medicalization of the process of reproductive aging. Within multivariate regression models, it has been shown that body mass index, age, and environmental context all contribute to differences in reproductive aging. The factors associated with ovarian aging and hot flashes are comparable to those in other industrialized populations, although standard interpretations should be expanded to include context-based realities, including (1) the higher levels of modernization of urban women that influence differential behavior with respekt to risk factors at menopausal age; (2) the different ecological realities surrounding nutrition, physical activity, and social support that characterize women's period of development; and (3) the differential construction of their identity as women in terms of assertiveness, aesthetic perceptions, and the use of health services. Context does, indeed, matter.

How feasible are healthy eating and physical activity for young women?

Objective:

This study investigated young women's perceptions of the feasibility of physical activity and healthy eating behaviours, and how these vary by socio-economic status, domestic characteristics and weight status.

Design:

This population-based study used a mailed questionnaire to investigate perceptions of the feasibility of commonly recommended healthy eating and physical activity behaviours among a sample of young women. The feasibility of 29 physical activity behaviours (e.g. relating to frequency, intensity, duration, domain/setting) and 15 healthy eating behaviours (e.g. relating to location/setting, fruit and vegetable intake, fat/sugar intake) was assessed. Height, weight and sociodemographic details were also obtained.

Setting:

Nation-wide community-based survey.

Subjects:

A total of 445 women aged 18–32 years selected randomly from the Australian electoral roll.

Results:

Most women reported that they either were already engaged in many of the healthy eating behaviours or saw these as highly feasible. Many physical activity behaviours, on the other hand, were perceived as less feasible, particularly among women with children and women who were overweight.

Conclusions:

Health promotion messages and strategies aimed at increasing physical activity and healthy eating are unlikely to succeed unless they take into account perceptions that these behaviours are not feasible. For young women, this may involve promoting more time-effective, flexible ways of achieving recommended physical activity. Messages specifically targeted to women with children, and women who are overweight, are required.

You are what you ate: the Biosetpoint hypothesis

The current epidemic of obesity has developed at a rate that cannot be attributed to genetic drift. Attempts to treat obesity using diet and activity have been largely disappointing. Genes are fixed at conception, but genetic expression is known to be influenced by nutriture during the stages of growth and development, these occurring in humans from conception through arrival at adulthood. Based on an extrapolation from existing data and cultural models, it is hypothesized that there is a mechanism by which diet and lifestyle habits present during the individual stages of growth and development help to define and program genetic expression in a way that resists change. It is through this mechanism that current nutritional and lifestyle practices have impacted genetic expression and contributed to the rapid development of resistant obesity. The details of the interaction between nutrition, lifestyle and genetic expression during growth must be examined, and intervention strategies devised for early stages of growth to prevent the seeds of obesity from taking root.

Long-Term Nutritional and Digestive Consequences of Pelvic Radiation

OBJECTIVE

To study long-term changes in nutritional status and gastrointestinal (GI) functions of 15 women previously treated with radiotherapy for gynecological cancer. Two years prior to this research, these patients had been assessed twice: before external radiotherapy and 5 weeks later, at the completion of the external dose (45-50 Gy).

METHODS

Each patient was given complete clinical evaluation, consisting of dietary, physical activity and digestive symptoms questionnaires. Blood was drawn for routine clinical laboratory tests (hemoglobin, white blood cell count, creatinine, lipoproteins, glucose, total proteins, albumin, and C reactive protein). Body composition was assessed by classical anthropometric indicators and double beam X-ray absorptiometry (DEXA), while muscle strength was measured through a hand dynamometer. Resting energy expenditure (REE), obtained by indirect calorimetry, was subtracted from energy ingestion, derived from dietary records, to calculate energy balance.

RESULTS

This third evaluation included fifteen patients. A significant increase in body mass index (BMI), % body fat and waist circumference were observed in comparison to earlier evaluations. The lean compartment decreased significantly, and REE descended in parallel. Meanwhile, total energy, fat and protein intake increased, compared to previous measurements. The changes in bowel habits observed during radiotherapy persisted at this third evaluation, with the exception of diarrhea, which was less reported. Abdominal bloating and rectal symptoms were the most prevalent complaints.

CONCLUSIONS

After radiation treatment for gynecological cancer, patients gained more body fat than expected in Chilean women around menopause. In spite of high protein ingestion, the loss of fat-free mass observed during radiation treatment was not recovered along with weight increase. This is probably associated with infrequent physical activity, both during and after treatment, and hyperphagia.

Gender specific associations of the Trp64Arg mutation in the beta3-adrenergic receptor gene with obesity-related phenotypes in a Mediterranean population: interaction with a common lipoprotein lipase gene variation

OBJECTIVE

To investigate the association between the Trp64Arg beta3-adrenergic receptor (ADRB3) mutation and obesity-related phenotypes in a Mediterranean Spanish population considering the effect of other genetic and environmental factors. DESIGN AND SUBJECT: Cross-sectional study in 1063 (476 men and 587 women) randomly selected from this population (aged: 18-68 years).

MEASUREMENTS

Anthropometric (weight, height and waist-to-hip ratio), blood pressure, biochemical (lipids, fasting glucose, and uric acid), life-style variables, and the Trp64Arg, HindIII-Lipoprotein lipase (LPL) and apolipoprotein E polymorphism.

RESULTS

Frequency of the Arg64 allele was low (0.051; 95% CI: 0.042-0.060). We found gender-specific associations between the Trp64Arg mutation and obesity related phenotypes. In men, carriers of the Arg64 variant had higher body mass index (BMI) (27.63 +/- 3.81 vs. 26.34 +/- 3.57 kg m-2, P=0.049) and total cholesterol (5.85 +/- 1.45 vs. 5.28 +/- 1.06 mmol L-1; P=0.011) compared with wild-type individuals. Logistic regression analysis, revealed that the risk of overweight was two times higher in male carriers of the Arg64 allele. In women, the Arg64 variant was only associated with higher fasting glucose (P=0.031). These genotype effects persisted after adjustment for age, genetic and life-style variables. For the LPL polymorphism, the H-/H- genotype was associated with lower BMI and with lower risk of overweight (OR: 0.49; 95% CI: 0.30-0.81) in both men and women. However, after adjustment for covariates, these associations only remained statistically significant (P < 0.02) in women. Moreover, in women, a statistically significant interaction (P=0.026) between the LPL and the ADRB3 gene loci in determining BMI was found. Thus, the Arg64 allele was associated with a higher BMI only in H+/H+ women.

CONCLUSIONS

The Trp64Arg mutation was associated with BMI and lipids in men. In women, an additional gene-gene interaction with the LPL-HindIII polymorphism may explain the results.