Differential relations between cognition and 15N isotopic content of hair in elderly people with dementia and controls

The association between carbon and nitrogen stable isotope ratios of human hair and hypertension

BACKGROUND

The relationship between stable isotope ratios and dietary protein sources has been reported. However, few studies have examined the effect of stable isotope ratios on metabolic risk in humans. We investigated whether the stable isotope ratios of carbon and nitrogen in human hair are associated with blood pressure and hypertension.

METHODS

We conducted a cross-sectional study of 392 subjects (228 men and 164 women). Hair samples of the subjects were used for the measurement of stable isotope ratios of carbon (δ¹³C) and nitrogen (δ¹⁵N).

RESULTS

The δ¹³C and δ¹⁵N values showed positive correlations with diastolic blood pressure in the subjects without antihypertensive medication. In the subjects without antihypertensive medication, the multivariable-adjusted odds ratio (95% confidence interval) for hypertension was 1.55 (1.04-2.30) per 1‰ increase in δ¹⁵N and 1.22 (0.86-1.73) per 1‰ increase in δ¹³C, respectively. However, in the subjects with antihypertensive medication, neither δ¹³C nor δ¹⁵N values showed a significant association with hypertension.

CONCLUSIONS

The stable isotopic ratio of nitrogen in scalp hair is independently associated with hypertension in subjects without antihypertensive medication. The hair δ¹⁵N value might be used as a surrogate marker to screen a high-risk population for hypertension.

Cognitive performance of women at various stages of reproductive aging and associated risk factors

OBJECTIVE

Menopausal transition among midlife women is accompanied by the issues of hot flushes, mood swings as well as sleep disturbances, night sweats, urogenital diminution and cognitive changes. The present cross-sectional study is an attempt to recognize the cognitive differences associated with various stages of reproductive aging.

METHODS

The study included women (N = 404) aged between 40 and 65 years from rural areas of Punjab (North India). The Mini-Mental State Examination (Hindi version) was used to evaluate orientation, registration, attention, recall, language and visual spatial skills domains of the global cognitive functioning of all participants.

RESULTS

The results of the present study exhibited a decline in cognitive scores across successive menopausal transitional stages in most of the cognitive domains except registration. The results of multivariate regression analysis demonstrated that illiteracy, vegetarian diet, perimenopause and late postmenopause phase were significantly associated with lower global cognitive scores.

CONCLUSION

With increased longevity, early identification of potential risk factors associated with cognitive decline among women during their midlife can be beneficial in improving the mental health of postmenopausal women.

Association between Nitrogen Stable Isotope Ratios in Human Hair and Serum Levels of Leptin

Stable isotope ratios have been reported to be potential biomarkers of dietary intake and nutritional status. High serum levels of leptin, a hormone which regulates energy metabolism and food intake, are associated with insulin resistance and metabolic syndrome. However, little is known about the association between stable isotope ratios and the metabolic risk in humans. We investigated whether the carbon and nitrogen stable isotope ratios in hair are associated with serum leptin levels. Hair samples were collected from 399 healthy adults (233 men and 166 women) aged 40 to 70 years of a community-based cohort in Korea and the bulk stable isotope ratios of carbon (δ¹³C) and nitrogen (δ¹⁵N) were measured for all hair samples. Serum leptin levels were analyzed by radioimmunoassay. δ¹⁵N showed positive correlations with serum leptin levels. In multivariate models, increasing δ¹⁵N were associated with elevated serum leptin levels (defined as ≥ the median values), whereas δ¹³C were not significantly associated with serum leptin levels. The odds ratio (95% confidence interval) per 1‰ increase in δ¹⁵N for an elevated serum leptin level was 1.58 (1.11-2.26). In participants with high body mass index, δ¹⁵N showed positive associations with serum leptin levels, whereas these associations were not seen in participants with low body mass index. The nitrogen stable isotopic ratio in hair is positively associated with serum leptin levels. The hair δ¹⁵N could be used as a clinical marker to estimate metabolic risk.

Prediction of human dietary δ15N intake from standardised food records: validity and precision of single meal and 24-h diet data

Natural stable isotope ratios (δ¹⁵N) of humans can be used for nutritional analyses and dietary reconstruction of modern and historic individuals and populations. Information about an individual's metabolic state can be obtained by comparison of tissue and dietary δ¹⁵N. Different methods have been used to estimate dietary δ¹⁵N in the past; however, the validity of such predictions has not been compared to experimental values. For a total of 56 meals and 21 samples of 24-h diets, predicted and experimental δ¹⁵N values were compared. The δ¹⁵N values were predicted from self-recorded food intake and compared with experimental δ¹⁵N values. Predicted and experimental δ¹⁵N values were in good agreement for meals and preparations (r = 0.89, p < .001) as well as for the 24-h diets (r = 0.76, p < .001). Dietary δ¹⁵N was mainly determined by the amount of fish, whereas the contribution of meat to dietary δ¹⁵N values was less pronounced. Prediction of human dietary δ¹⁵N values using standardised food records and representative δ¹⁵N data sets yields reliable data for dietary δ¹⁵N intake. A differentiated analysis of the primary protein sources is necessary when relating the proportion of animal-derived protein in the diet by δ¹⁵N analysis.

Improved radiocarbon analyses of modern human hair to determine the year-of-death by cross-flow nanofiltered amino acids: common contaminants, implications for isotopic analysis, and recommendations

RATIONALE

In forensic investigation, radiocarbon ((14)C) measurements of human tissues (i.e., nails and hair) can help determine the year-of-death. However, the frequent use of cosmetics can bias hair (14)C results as well as stable isotope values. Evidence shows that hair exogenous impurities percolate beyond the cuticle layer, and therefore conventional pretreatments are ineffective in removing them.

METHODS

We conducted isotopic analysis ((14)C, δ(13)C, δ(15)N and C/N) of conventionally treated and cross-flow nanofiltered amino acid (CFNAA)-treated samples (scalp- and body-hair) from a single female subject using fingernails as a reference. The subject studied frequently applies a permanent dark-brown dye kit to her scalp-hair and uses other care products for daily cleansing. We also performed pyrolysis-gas chromatography/mass spectrometry (Py-GC/MS) analyses of CFNAA-treated scalp-hair to identify contaminant remnants that could possibly interfere with isotopic analyses.

RESULTS

The conventionally treated scalp- and body-hair showed (14)C offsets of ~21‰ and ~9‰, respectively. These offsets confirm the contamination by petrochemicals in modern human hair. A single CFNAA extraction reduced those offsets by ~34%. No significant improvement was observed when sequential extractions were performed, as it appears that the procedure introduced some foreign contaminants. A chromatogram of the CFNAA scalp-hair pyrolysis products showed the presence of petroleum and plant/animal compound residues, which can bias isotopic analyses.

CONCLUSIONS

We have demonstrated that CFNAA extractions can partially remove cosmetic contaminants embedded in human hair. We conclude that fingernails are still the best source of keratin protein for year-of-death determinations and isotopic analysis, with body-hair and/or scalp-hair coupled with CFNAA extraction a close second.

Advances in natural stable isotope ratio analysis of human hair to determine nutritional and metabolic status

PURPOSE OF REVIEW

We review the literature on the use of stable isotope ratios at natural abundance to reveal information about dietary habits and specific nutrient intakes in human hair protein (keratin) and amino acids. In particular, we examine whether hair isotopic compositions can be used as unbiased biomarkers to provide information about nutritional status, metabolism, and diseases.

RECENT FINDINGS

Although the majority of research on the stable isotope ratio analysis of hair has focused on bulk protein, methods have been recently employed to examine amino acid-specific isotope ratios using gas chromatography or liquid chromatography coupled to an isotope ratio mass spectrometer. The isotopic measurement of amino acids has the potential to answer research questions on amino acid nutrition, metabolism, and disease processes and can contribute to a better understanding of the variations in bulk protein isotope ratio values. First results suggest that stable isotope ratios are promising as unbiased nutritional biomarkers in epidemiological research. However, variations in stable isotope ratios of human hair are also influenced by nutrition-dependent nitrogen balance, and more controlled clinical research is needed to examine these effects in human hair.

SUMMARY

Stable isotope ratio analysis at natural abundance in human hair protein offers a noninvasive method to reveal information about long-term nutritional exposure to specific nutrients, nutritional habits, and in the diagnostics of diseases leading to nutritional stress and impaired nitrogen balance.

Effect of a controlled dietary change on carbon and nitrogen stable isotope ratios of human hair

The carbon ((13)C/(12)C) and nitrogen ((15)N/(14)N) stable isotope ratios of human hair can be used for the interpretation of dietary habits and nutritional status in contemporary or past populations. Although the results of bulk or segmental isotope ratio analysis of human hair have been used for the reconstruction of an individual's diet for years, only limited data of controlled dietary changes on the carbon and nitrogen isotopic composition of human hair are available. Hair of four individuals, two males and two females, who participated in a dietary change experiment for 28 days was segmentally analysed for delta(13)C and delta(15)N. The dietary change included a change from C3 to C4 plant enriched diets and a simultaneous replacement of terrestrial animal products by marine products. This resulted in an increase in delta(13)C(diet) of +8.5 to +9.9 per thousand and in delta(15)N(diet) of +1.5 to +2.2 per thousand. All subjects showed significant increases in delta(13)C(hair) and delta(15)N(hair) during the dietary change period, although no subject reached a new steady state for either carbon or nitrogen. The change in delta(15)N(hair) was faster than the change in delta(13)C(hair) for all individuals. The magnitude of change of the isotopic composition during the dietary change period could be attributed to the degree of physical activity of the individuals, with a higher physical activity resulting in a faster change.

Correspondence between human diet, body composition and stable isotopic composition of hair and breath in Fijian villagers

The main aim of this work was to describe the relationship between diet, and hair and breath isotopic composition. From one Fijian rural village, hair and breath samples were procured from 20 women. Physical anthropometrics were made, and hair (13)C/(12)C and (15)N/(14)N and breath (13)C/(12)C were measured. Individual diet diaries were kept for two of the four preceding weeks, and isotopic compositions of items which accounted for most of the diet were measured. Individual average diets were analysed for macronutrient and energy content and conform to reasonable nutritional expectation. Characteristics of the diet are described in terms of protein and energy, their patterning with respect to different clusters of food items and their relationship to individuals' anthropometry. Breath CO(2) is depleted in (13)C by 1-2 per thousand on average with respect to the total diet. Hair was enriched on average by 4.1 per thousand in nitrogen and 4.5 per thousand in carbon with respect to the total diet. There was insufficient population variation in hair isotopic composition to establish individual hair-diet isotopic differences. The definite relationship that we establish in this work, between dietary and tissue isotopic values for a human community, provides a basis for determining and validating dietary regimes more generally within non-industrial, non-global-'supermarket' economies.

Red blood cell delta15N: a novel biomarker of dietary eicosapentaenoic acid and docosahexaenoic acid intake

BACKGROUND

The long-chain omega-3 (n-3) fatty acids derived from fish, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are associated with a reduced risk of cardiovascular disease and other chronic diseases. Study of the associations between EPA and DHA intake and disease requires a valid biomarker of dietary intake; however, the direct measurement of tissue fatty acid concentrations is expensive and time consuming.

OBJECTIVE

Because the nitrogen stable isotope ratio ((15)N/(14)N, expressed as delta(15)N) is elevated in fish, we investigated whether delta(15)N is a valid alternative biomarker of EPA and DHA intake.

DESIGN

We examined the relation between red blood cell (RBC) delta(15)N and RBC EPA and DHA in a community-based sample of 496 Yup'ik Eskimos with widely varying intake of n-3 fatty acids. We also assessed the correlation between delta(15)N and dietary EPA and DHA intake based on 24-h dietary recalls and 3-d food records completed by a subset of 221 participants.

RESULTS

RBC delta(15)N was strongly correlated with RBC EPA and DHA (r = 0.83 and 0.75, respectively). These correlations differed only modestly by sex and age class. RBC delta(15)N also correlated with dietary EPA and DHA intake (r = 0.47 and 0.46, respectively) and did not differ by sex and age.

CONCLUSIONS

The results strongly support the validity of RBC delta(15)N as a biomarker of EPA and DHA intake. Because the analysis of RBC delta(15)N is rapid and inexpensive, this method could facilitate wide-scale assessment of EPA and DHA intake in clinical and epidemiologic studies.

Cognitive performance among the elderly and dietary fish intake: the Hordaland Health Study

BACKGROUND

Increasing evidence suggests that cognitive impairment and dementia in older subjects might be influenced by a diet including seafood.

OBJECTIVE

The objective was to examine the cross-sectional relation between intake of different amounts of various seafood (fish and fish products) and cognitive performance.

DESIGN

The subjects (n = 2031 subjects; 55% women), aged 70-74 y, were recruited from the general population in Western Norway and underwent cognitive testing. A cognitive test battery included the Kendrick Object Learning Test, Trail Making Test (part A), modified versions of the Digit Symbol Test, Block Design, Mini-Mental State Examination, and Controlled Oral Word Association Test. Poor cognitive performance was defined as a score in the highest decile for the Trail Making Test and in the lowest decile for all other tests.

RESULTS

Subjects whose mean daily intake of fish and fish products was >/=10 g/d (n = 1951) had significantly better mean test scores and a lower prevalence of poor cognitive performance than did those whose intake was <10 g/d (n = 80). The associations between total intake of seafood and cognition were strongly dose-dependent; the maximum effect was observed at an intake of approximately 75 g/d. Most cognitive functions were influenced by fish intake. The effect was more pronounced for nonprocessed lean fish and fatty fish.

CONCLUSIONS

In the elderly, a diet high in fish and fish products is associated with better cognitive performance in a dose-dependent manner.

Age-related variation in red blood cell stable isotope ratios (delta13C and delta15N) from two Yupik villages in southwest Alaska: a pilot study

OBJECTIVES

A significant fraction of the Alaska Native population appears to be shifting from a primarily subsistence-based diet to a market-based diet; therefore, the ability to link diet pattern to disease risk has become increasingly important to predicting public health needs. Our research aims to develop the use of stable isotope ratios as diet pattern biomarkers, based on naturally-occurring isotopic differences in the elemental composition of subsistence and non-subsistence foods. These differences are reflected in human blood, hair and fingernail isotope signatures.

STUDY DESIGN

In this preliminary study, we investigate the potential for 13C and 15N to serve as dietary biomarkers for age-related dietary differences in a subset of participants involved with a long-term study initiated by the Center for Alaska Native Health Research (CANHR) at the University of Alaska Fairbanks (UAF).

METHODS

We measured delta13C and delta15N in red blood cells collected from 12 "elder" participants (age 60+ yrs) and 14 younger participants (age 14-19 yrs). Samples were evenly divided between males and females, and between two villages sampled in 2004. We also sampled market and subsistence foods in Fairbanks, AK, as an indicator of the isotopic differences likely to be observed in village foods.

RESULTS

Elders were significantly enriched in 15N, but depleted in 13C, relative to younger participants. These differences are consistent with increased intake of marine subsistence in elders, and of certain market foods in younger participants. However, elders were considerably more variable in delta15N, suggesting greater differences among individuals in their usual intake.

CONCLUSIONS

Overall we find that RBC stable isotope signatures exhibit variation consistent with previously documented dietary patterns in Alaska Natives, and we describe future directions for developing these biomarkers for diet pattern monitoring.

Multiple stable isotope (18O, 13C, 15N and 34S) analysis of human hair to identify the recent migrants in a rural community in SW England

Relationships between recent migration and hair delta(18)O values were examined for 40 people living in a rural community in SW England. The isotopic contents of 35 'local' hair samples were compared with those of 5 recently arrived individuals (from Australia, Canada, Chile, Germany and the USA). The hair delta(18)O values of these 'visitors' were +7.9 (Omaha, USA), +11.2 (Jena, Germany), +12.1 (Osorno, Chile), +12.6 (Montreal, Canada) and +14.3 per thousand (Adelaide, Australia). The hair value for the USA visitor (+7.9 per thousand) fell outside the range for the 33 local adult residents, +10.5 to +14.3 per thousand (+12.7 +/- 0.8 per thousand). Hair delta(18)O values did not identify the individuals from Adelaide, Montreal and Osorno as 'visitors', but hair delta(13)C or delta(34)S data did. Combining the hair delta(18)O, delta(13)C and delta(34)S values using principal components analysis (two components explained 89% of the overall variation among the 40 subjects) helped to more clearly distinguish European from non-European individuals, indicating the existence of global overall isotope (geo-origin) relationships.

Tracking human travel using stable oxygen and hydrogen isotope analyses of hair and urine

The stable oxygen and hydrogen isotope compositions of organic samples are increasingly being used to investigate patterns of animal migration. Relatively few studies have applied these techniques to modern humans, despite a variety of potential forensic applications. We analyzed drinking water and food at two geographic locations, East Greenbush, New York (USA) and Fairbanks, Alaska (USA), with different delta(18)O and deltaD values for precipitation and tap water. Foods varied widely in measured delta(18)O and deltaD values, but not systematically by purchase location. We measured delta(18)O and deltaD values of scalp hair from five residents at each location. We used a mixing model to establish the proportion of oxygen and hydrogen in head hair derived from drinking water ( approximately 27% and approximately 36%, respectively). Finally, we analyzed the delta(18)O and deltaD values of facial hair and urine from a subject who traveled from Fairbanks to East Greenbush, on to the UK and back to Fairbanks. Urine delta(18)O and deltaD values responded immediately and strongly to travel-related change in drinking water, and were well described by a single-pool turnover model. Beard hair delta(18)O values tracked changes in urine delta(18)O closely, and oscillated between the values for the resident populations in both locations. In contrast, beard hair deltaD values did not track changes in urine deltaD as well, and retained a signature of the traveler's permanent residence. Our findings show that the delta(18)O and deltaD values of urine and facial hair (specifically delta(18)O) can provide a record of the geographical movements of humans.

Lead and copper in drinking water fountains--information for physicians

BACKGROUND

Lead and copper are potentially toxic metals. The objective of our work was to test the water from the drinking fountains of a large public access office complex in southwest Houston, Texas, for the presence of lead, copper, and microbiologic contamination. The data for the water fountains were compared with what we found in the local municipal drinking water supplies.

METHODS

Samples were collected as the first draw at the beginning of the work week. These samples were acidified to prevent the precipitation of heavy metals and analyzed using United States Environmental Protection Agency (USEPA) approved procedures and quality control.

RESULTS

Traces of lead were detected in 37.5% and copper in 100% of the tested water fountains. In two buildings, concentrations in some fountains exceeded the USEPA action level for lead (by up to 12-fold) and for copper (by up to 3.9 fold). One sample was positive for total coliform and Escherichia coli bacteria. Comparison with samples from the local municipal drinking water supplies indicated that both metals and bacteria were the result of secondary contamination at the water fountain sites.

CONCLUSIONS

This study showed that drinking water fountains can be an unexpected and unappreciated source of intake of metal and bacterial contaminants.

An objective means of diagnosing anorexia nervosa and bulimia nervosa using 15N/14N and 13C/12C ratios in hair

An objective means based on the carbon and nitrogen stable isotope analysis of five hairs per individual is presented for distinguishing between individuals with anorexia nervosa and/or bulimia nervosa from non-clinical individuals (i.e. clinically normal controls). Using discriminant analysis, an algorithm has been developed that provides both sensitivity and specificity of 80% in making diagnoses of individuals with these eating disorders. With further refinements, the results suggest that it may be also possible to distinguish between individuals with anorexia or bulimia. Finally, the study shows the value of conducting blind tests and using larger sample sizes of both control and treatment groups. Both groups are needed to validate the diagnostic value of a method and to provide measures of sensitivity and specificity of any diagnostic test.

Alzheimer disease is substantially preventable in the United States -- review of risk factors, therapy, and the prospects for an expert software system

Epidemiology studies, including both regional incidence and the analysis of specific risk factors for Alzheimer's disease indicate that substantial prevention of the disease, in the 50-70 percent range, is a practical possibility for the United States. Epidemiology has identified a rich diversity of specific prevention strategies relating to nutrition, dietary supplements, lifestyle, food and environmental toxins, and in some cases medication, many of which have a capacity to reduce Alzheimer's risk by 50 percent or more. The interaction of these risk factors with brain biology is increasingly understood. In contrast, therapeutic strategies for un-prevented Alzheimer's generally prove incapable of delaying disease progression by more than 3-11 months, because extensive brain cell death occurs even in preclinical or mild cases. A public health program aimed at prevention can be fashioned with expert software packages, based on already identified risk factors. Such statistical analysis should allow the prediction of individual and group Alzheimer's risks of sufficient power to instruct the formulation of lifestyle, nutritional and environmental programs to substantially reduce disease incidence. A less satisfactory but complementary alternative is very early disease detection with therapeutic strategies focused on retardation of brain cell death, so that the person dies of another cause before the disease is clinically manifested.

Nitrogen balance and delta15N: why you're not what you eat during nutritional stress

While past experiments on animals, birds, fish, and insects have shown changes in stable isotope ratios due to nutritional stress, there has been little research on this topic in humans. To address this issue, a small pilot study was conducted. Hair samples from eight pregnant women who experienced nutritional stress associated with the nausea and vomiting of morning sickness (hyperemesis gravidarum) were measured for carbon (delta13C) and nitrogen (delta15N) stable isotope ratios. The delta13C results showed no change during morning sickness or pregnancy when compared with pre-pregnancy values. In contrast, the delta15N values generally increased during periods of weight loss and/or restricted weight gain associated with morning sickness. With weight gain and recovery from nutritional stress, the hair delta15N values displayed a decreasing trend over the course of gestation towards birth. This study illustrates how delta15N values are not only affected by diet, but also by the nitrogen balance of an individual. Potential applications of this research include the development of diagnostic techniques for tracking eating disorders, disease states, and nitrogen balance in archaeological, medical, and forensic cases.

Nitrogen balance and delta15N: why you're not what you eat during pregnancy

Carbon (13C/12C) and nitrogen (15N/14N) stable isotope ratios were longitudinally measured in human hair that reflected the period from pre-conception to delivery in 10 pregnant women. There was no significant change in the delta13C results, but all subjects showed a decrease in delta15N values (-0.3 to -1.1 per thousand) during gestation. The mechanisms causing this decrease in hair delta15N have not been fully elucidated. However, since the delta15N values of dietary nitrogen and urea nitrogen are significantly lower compared to maternal tissues, it is hypothesized that the increased utilization of dietary and urea nitrogen for tissue synthesis during pregnancy resulted in a reduction of the steady state diet to a body trophic level effect by approximately 0.5-1 per thousand. An inverse correlation (R2 = 0.67) between hair delta15N and weight gain was also found, suggesting that positive nitrogen balance results in a reduction of delta15N values independent of diet. These results indicate that delta15N measurements have the ability to monitor not only dietary inputs, but also the nitrogen balance of an organism. A potential application of this technique is the detection of fertility patterns in modern and ancient species that have tissues that linearly record stable isotope ratios through time.