Association between oxidative stress and nutritional status in the elderly

Mediating effects of physical activities and cognitive function on the relationship between dietary diversity and all-cause mortality in community-dwelling older adults

Background

Although dietary diversity (DD) has been confirmed to be associated with multiple health outcomes and longevity in older people, the related mechanisms have not been elucidated. In this study, we explored the mediating roles of physical activities and cognitive function in the relationship between DD and all-cause mortality.

Methods

We recruited 34 068 community-dwelling older adults aged ≥60 years from the Chinese Longitudinal Healthy Longevity Study and followed them up until 2018. Dietary diversity score (DDS) was assessed by the intake frequency of nine food sources. We evaluated physical activities and cognitive function using the Katz index and Mini-Mental State Examination. We explored the mediating roles of physical activities and cognitive function between DDS and all-cause mortality using mediated analyses in Cox proportional risk regression models.

Results

A total of 25 362 deaths were recorded during 148 188.03 person-years of follow-up. Participants with physical disability and cognitive impairment had lower DDS than the normal group (P < 0.001). After controlling for all covariates, DDS, physical activities, and cognitive functioning were negatively associated with all-cause mortality. Physical activities and cognitive function mediated 18.29% (95% confidence interval (CI) = 12.90-23.10) and 27.84% (95% CI = 17.52-37.56) of the total effect of DDS on mortality, respectively.

Conclusions

Physical activities and cognitive function mediated the association between DDS and all-cause mortality. Maintaining DD may benefit early death prevention by reducing physical disability and cognitive impairment in community-dwelling older people.

Evaluation of Selected Parameters of Oxidative Stress and Adipokine Levels in Hospitalized Older Patients with Diverse Nutritional Status

Malnutrition is classified as one of the Giant Geriatric Syndromes. It carries serious consequences, such as sarcopenia or depression, which lead to functional disability. The main objective of this study was to identify parameters of oxidative stress and adipokines, which may be potential biomarkers of malnutrition in hospitalized older patients. During the study, selected parameters were determined in 137 senile patients, taking into account their nutritional status determined according to the Mini Nutritional Assessment (MNA), as well as an additional tool, namely the Geriatric Nutritional Risk Index (GNRI). Leptin and resistin were determined as the parameters with statistically significant differences between the patients classified according to the MNA. This phenomenon was confirmed using the GNRI classification. However, additional parameters for which differences were observed include the oxidized low-density lipoprotein level and activity of glutathione peroxidase. In conclusion, the determination of the mentioned markers in hospitalized senile patients as an adjunct to the routine assessment of nutritional status might be suggested to identify the early risk of malnutrition so that a personalized nutritional therapy can be implemented as early as possible.

Adherence to High Dietary Diversity and Incident Cognitive Impairment for the Oldest-Old: A Community-Based, Nationwide Cohort Study

BACKGROUND AND AIMS

Dietary diversity change is associated with cognitive function, however, whether the effect still exists among the oldest-old (80+) is unclear. Our aim was to examine the effect of dietary diversity changes on cognitive impairment for the oldest-old in a large prospective cohort.

METHODS

Within the Chinese Longitudinal Healthy Longevity Study, 6237 adults older than 80 years were included. The dietary diversity score (DDS) was assessed by a simplified food frequency questionnaire (FFQ). Cognitive impairment was defined as a Mini-Mental State Examination (MMSE) score lower than 18 points. Cognitive decline was defined as a reduction of total MMSE score ≥3 points, and cognitive decline of different subdomains was defined as a reduction of ≥15% in the corresponding cognitive domain. The multivariate-adjusted Cox proportional hazard model evaluated the effects of DDS change on cognitive decline. The linear mixed-effect model was used to test subsequent changes in MMSE over the years.

RESULTS

During 32,813 person-years of follow-up, 1829 participants developed cognitive impairment. Relative to the high-high DDS change pattern, participants in the low-low and high-low patterns were associated with an increased risk of cognitive impairment with a hazard ratio (95% confidential interval, CI) of 1.43 (1.25, 1.63) and 1.44 (1.24, 1.67), and a faster decline in the MMSE score over the follow-up year. Participants with the low-high pattern had a similar incidence of cognitive impairment with HRs (95% CI) of 1.03 (0.88, 1.20). Compared with the stable DDS status group (-1-1), the risk of cognitive impairment was higher for those with large declines in DDS (≤-5) and the HR was 1.70 (95% CI: 1.44, 2.01).

CONCLUSIONS

Even for people older than 80, dietary diversity change is a simple method to identify those who had a high risk of cognitive decline. Keeping high dietary diversity is beneficial for cognitive function and its subdomain even in the final phase of life, especially for females and the illiterate oldest-old.

Association between dietary diversity and cognitive impairment among the oldest-old: Findings from a nationwide cohort study

BACKGROUND & AIMS

Dietary diversity is widely recommended in national and international guidelines; however, whether the beneficial effects on cognitive function still apply in the oldest-old (80+) has rarely been studied. This study aimed to evaluate the associations of dietary diversity with cognitive function among the oldest-old in a large prospective cohort in China.

METHODS

We conducted a long-term prospective analysis on 11,970 participants aged 80+ (6581 octogenarians, 3730 nonagenarians, and 1659 centenarians). We constructed the baseline dietary diversity score (DDS) based on eight food items of a food frequency questionnaire. Mini-mental state examination (MMSE) was used to classify the participants as having cognitive impairment or not and was also used as a continuous metric. Non-linear associations of DDS with cognitive impairment was evaluated by cox models with penalized splines. We used mixed-effect models for longitudinal data with repeated measurements of MMSE (for up to seven time during the follow-up between 1998 and 2014).

RESULTS

We documented 4778 cognitive impairment during 46,738 person-years of follow-up. Each one unit increase in DDS was associated with a 4% lower risk of cognitive impairment (adjusted hazard ratio (HR): 0.96; 95% confidential interval (CI): 0.94-0.98). Compared to participants with DDS of 0 score, those with a DDS of 1-2, 3-4, and higher than 5 scores had a lower cognitive impairment risk, the HRs were 0.86 (0.79-0.95), 0.82 (0.74-0.91), and 0.72 (0.64-0.82) respectively, and a significant trend emerged (p < 0.001). Compared with DDS of zero score, a DDS of 1-2,3-4, ≥5 was related to slower MMSE decline (β = 0.128, 0.162, 0.301, respectively, p < 0.01).

CONCLUSIONS

Even after the age of 80, dietary diversity may offer a simple and straightforward mean of identifying and screening individuals at high risk for cognitive impairment. Recommendation of dietary diversity may be advocated to attenuate cognitive decline and decrease the risk of cognitive impairment in the oldest-old, especially in a low income or middle-income countries.

Effects of pre- or post-exercise whey protein supplementation on oxidative stress and antioxidant enzymes in older women

BACKGROUND

Oxidative stress is an imbalance between antioxidant system and production of free radicals and has been associated with the age-related deleterious changes. The defense system can be modulated by exercise and nutrition.

OBJECTIVE

The purpose of this investigation was to evaluate the effect of whey protein supplementation pre- or post-resistance training on oxidative stress and antioxidant enzyme activity in pre-conditioned older women.

METHODS

In a randomized, double-blind, and placebo-controlled design, 70 older women (≥60 years) were randomly assigned to one of the following three groups: whey protein-placebo (WP-PLA, n = 24), placebo-whey protein (PLA-WP, n = 23), and placebo-placebo (PLA-PLA, n = 23). Each group received 35 g of whey product or placebo pre- and post-training. The RT program was carried out over 12 weeks (3x/week; 3x 8-12 repetitions maximal). Oxidative stress and blood markers were assessed before and after intervention period. ANOVA for repeated measures was used for data analysis.

RESULTS

There was a significant time effect (P < 0.05), with all groups showing improvements in all oxidative stress markers and antioxidant enzyme activity. A significant (P < 0.001) interaction time vs group was observed for uric acid, with both WP-PLA and PLA-WP presenting greater reductions compared with the PLA-PLA, without differences between the timing of protein intake (WP-PLA: -8.3%; PLA-WP: -11.0%; PLA-PLA:-2.0%).

CONCLUSION

In already pre-conditioned older women, whey protein supplementation reduces plasma uric acid concentration with no further effect on antioxidant enzyme activity and oxidative stress markers. ClinicalTrials.gov: NCT03247192.

Didymin improves UV irradiation resistance in C. elegans

Didymin, a type of flavono-o-glycoside compound naturally present in citrus fruits, has been reported to be an effective anticancer agent. However, its effects on stress resistance are unclear. In this study, we treated Caenorhabditis elegans with didymin at several concentrations. We found that didymin reduced the effects of UV stressor on nematodes by decreasing reactive oxygen species levels and increasing superoxide dismutase (SOD) activity. Furthermore, we found that specific didymin-treated mutant nematodes daf-16(mu86) & daf-2(e1370), daf-16(mu86), akt-1(ok525), akt-2(ok393), and age-1(hx546) were susceptible to UV irradiation, whereas daf-2(e1371) was resistant to UV irradiation. In addition, we found that didymin not only promoted DAF-16 to transfer from cytoplasm to nucleus, but also increased both protein and mRNA expression levels of SOD-3 and HSP-16.2 after UV irradiation. Our results show that didymin affects UV irradiation resistance and it may act on daf-2 to regulate downstream genes through the insulin/IGF-1-like signaling pathway.

Oxidative stress, eryptosis and anemia: a pivotal mechanistic nexus in systemic diseases

The average lifespan of circulating erythrocytes usually exceeds hundred days. Prior to that, however, erythrocytes may be exposed to oxidative stress in the circulation which could cause injury and trigger their suicidal death or eryptosis. Oxidative stress activates Ca²⁺ -permeable nonselective cation channels in the cell membrane, thus, stimulating Ca²⁺ entry and subsequent cell membrane scrambling resulting in phosphatidylserine exposure and activation of Ca²⁺ -sensitive K⁺ channels leading to K⁺ exit, hyperpolarization, Cl^- exit, and ultimately cell shrinkage due to loss of KCl and osmotically driven water. While the mechanistic link between oxidative stress and anemia remains ill-defined, several diseases such as diabetes, hepatic failure, malignancy, chronic kidney disease and inflammation have been identified to display both increased oxidative stress as well as eryptosis. Recent compelling evidence suggests that oxidative stress is an important perpetrator in accelerating erythrocyte loss in different systemic conditions and an underlying mechanism for anemia associated with these pathological states. In the present review, we discuss the role of oxidative stress in reducing erythrocyte survival and provide novel insights into the possible use of antioxidants as putative antieryptotic and antianemic agents in a variety of systemic diseases.

Effect of seasonal changes on nutritional status and biochemical parameters in Turkish older adults

BACKGROUND/OBJECTIVES

Available data suggest that seasonal changes may influence the nutritional status and overall health of elderly individuals. Therefore, this study was conducted to investigate the effects of seasonal changes and related factors on energy and nutrient intake of older adults.

SUBJECTS/METHODS

Individuals aged 65 years or over were prospectively enrolled in this single-center study (male: 11, female: 20). Data were collected between May 2013 and February 2014 during winter, spring, summer and autumn. Food consumption and biochemical parameters were taken during each season to assess the seasonal nutrition status of the elderly. Upon analysis of biochemical parameters (retinol, vitamin D and vitamin C), an high-performance liquid chromatography device was utilized whereas an Immulite 2000 device was utilized during analysis of serum folic acid and parathyroid hormone.

RESULTS

Fruit, fat, egg and bread consumption varied seasonally in males and females (P < 0.05). During winter, daily energy intake was found to be greater than in other seasons in males (557 kcal) and females (330 kcal) (P < 0.05). Additionally, carbohydrates, vegetable protein, n-3 fatty acid and sodium intake increased in winter, while the n-6/n-3 ratio increased in summer among males (P < 0.05). Dietary fiber and sodium intake in winter, vitamin C, iron and zinc intake in spring, and cholesterol, retinol, vitamin D and niacin intake in autumn were found to be higher in females when compared to other seasons (P < 0.05). Serum parathyroid hormone level was higher in winter, and vitamin D level was higher in autumn in both genders (P < 0.05). In males, blood folic acid level was higher in winter, while vitamin C level was higher in females, and there was no seasonal variation in retinol concentration (P < 0.05).

CONCLUSION

Food consumption and biochemical parameters showed significant seasonal variations in older adults. It is not clear if nutrition plans in older adults will benefit from consideration of seasonal changes in eating habits.

Antioxidant Activity and Upregulation of Antioxidant Enzymes of Phenolic Glycosides from Aquilaria crassna Leaves

The leaves of Aquilaria crassna Pierre ex Lecomte (Thymelaeaceae) have been used in the traditional medicine and consumed as a health-promoting tea in several Asian countries. This study investigated the antioxidant activity of three major bioactive constituents of A. crassna leaves, genkwanin 5- O-β-primeveroside (1), iriflophenone 3,5- C-β-D-diglucoside (2) and iriflophenone 3- C-β-D-glucoside (3) using DPPH and superoxide scavenging assays, as well as their effects on induction of mRNA and protein expressions of antioxidant enzymes in HEK-293 cells. The benzophenone glycoside 3 exhibited significant scavenging activity against both types of free radicals and increased the mRNA expression of antioxidant enzymes such as glutathione peroxidase-1, glutathione reductase and heme oxygenase-1 in HEK-293 cells. In addition, all three compounds also increased the protein expression of glutathione peroxidase-1. These findings revealed the effects of these compounds at cellular level, and might be useful for the development of A. crassna leaves as supplements for prevention of oxidative stress.

Avaliação da ingestão de nutrientes antioxidantes pela população brasileira e sua relação com o estado nutricional

RESUMO: Introdução: O estudo dos antioxidantes dietéticos tem ganhado destaque em função da elucidação dos efeitos deletérios do estresse oxidativo ao organismo. Objetivo: Avaliar a ingestão de nutrientes antioxidantes pela população brasileira e sua relação com o estado nutricional. Métodos: Realizou-se um estudo transversal com coleta de dados secundários do consumo alimentar de 33.459 indivíduos de ambos os sexos, de 10 ou mais anos, de todas as regiões do Brasil, a partir dos microdados da Pesquisa de Orçamentos Familiares (2008 - 2009), Inquérito Nacional de Alimentação. Foram analisados os teores das vitaminas E, A e C, zinco, manganês, cobre e selênio de 188 itens alimentares, divididos em 12 grupos, conforme a forma habitual de consumo. As médias de ingestão dos nutrientes antioxidantes de acordo com o estado nutricional foram comparadas por meio do teste t de Bonferroni. Resultados: Foram observados maiores percentuais de ingestão insuficiente para as vitaminas do que para os minerais antioxidantes. Notou-se diferença significativa na ingestão da vitamina E em relação ao estado nutricional, sendo que a ingestão por indivíduos com excesso de peso foi inferior em relação aos com peso adequado. Verificou-se que os indivíduos com baixo peso apresentaram menor ingestão de quase todos os minerais antioxidantes, exceto o cobre, em que a ingestão por indivíduos com baixo peso foi igual à ingestão por aqueles com peso adequado. Conclusão: Elevados percentuais de ingestão insuficiente de nutrientes antioxidantes foram observados na população estudada, especialmente para as vitaminas. Além disso, a ingestão de nutrientes antioxidantes variou conforme o estado nutricional, o sexo e o estágio de vida.

Dietary Diversity and Cognitive Function among Elderly People: A Population-Based Study

OBJECTIVES

To explore associations of dietary diversity with cognitive function among Chinese elderly.

DESIGN

This cross-sectional study was conducted in 2011-2012, data were analyzed using multiple linear regression and logistic regression models.

SETTING

community-based setting in the 23 provinces in China.

SUBJECTS

8,571 elderly participants, including 2984 younger elderly aged 65-79 and 5587 oldest old aged 80+ participated in this study.

MEASUREMENT

Intake frequencies of food groups was collected and dietary diversity (DD) was assessed based on the mean of DD score. Cognitive function was assessed using the Chinese version of Mini-Mental State Examination (MMSE), and cognitive impairment was defined using education-based cutoffs. Information about socio-demographics, lifestyles, resilience and health status was also collected.

RESULTS

Poor dietary diversity was significantly associated with cognitive function, with β (95% CI) of -0.11(-0.14, -0.08) for -log (31-MMSE score) and odds ratio (95% CI) of 1.29 (1.14, 1.47) for cognitive impairment. Interaction effect of age with DD was observed on cognitive impairment (P interaction=0.018), but not on -log (31-MMSE score) (P interaction=0.08). Further separate analysis showed that poor DD was significantly associated with increased risk of cognitive impairment in the oldest old (p<0.01), with odds ratio (95% CI) of 1.34 (1.17, 1.54), while not in the younger elderly (p>0.05), with OR (95% CI) being 1.09 (0.80, 1.47) in the fully adjusted model. Similar results were obtained when DD was categorized into four groups.

CONCLUSIONS

Poor dietary diversity was associated with worse global cognitive function among Chinese elderly, and particularly for the oldest old. This finding would be very meaningful for prevention of cognitive impairment.

Biological functions of selenium and its potential influence on Parkinson's disease

Parkinson's disease is characterized by the death of dopaminergic neurons, mainly in the substantia nigra, and causes serious locomotor dysfunctions. It is likely that the oxidative damage to cellular biomolecules is among the leading causes of neurodegeneration that occurs in the disease. Selenium is an essential mineral for proper functioning of the brain, and mainly due to its antioxidant activity, it is possible to exert a special role in the prevention and in the nutritional management of Parkinson's disease. Currently, few researchers have investigated the effects of selenium on Parkinson´s disease. However, it is known that very high or very low body levels of selenium can (possibly) contribute to the pathogenesis of Parkinson's disease, because this imbalance results in increased levels of oxidative stress. Therefore, the aim of this work is to review and discuss studies that have addressed these topics and to finally associate the information obtained from them so that these data and associations serve as input to new research.

Nutritional supplementation for Alzheimer's disease?

PURPOSE OF REVIEW

Evidence for the benefit of nutrition in Alzheimer's disease continues to accumulate. Many studies with individual vitamins or supplements show marginal, if any, benefit. However, new findings with combinatorial formulations demonstrate improvement in cognitive performance and behavioral difficulties that accompany Alzheimer's disease. Herein, we review some of the most recent clinical advances and summarize supportive preclinical studies.

RECENT FINDINGS

We present novel positive effects on Alzheimer's disease derived from diet, trace elements, vitamins and supplements. We discuss the inherent difficulty in conducting nutritional studies because of the variance in participants' nutritional history, versus pharmacological interventions in which participants are naive to the intervention. We examine the evidence that epigenetics play a role in Alzheimer's disease and how nutritional intervention can modify the key epigenetic events to maintain or improve cognitive performance.

SUMMARY

Overall consideration of the most recent collective evidence suggests that the optimal approach for Alzheimer's disease would seem to combine early, multicomponent nutritional approaches (a Mediterranean-style diet, multivitamins and key combinatorial supplements), along with lifestyle modifications such as social activity and mental and physical exercise, with ultimate addition of pharmacological agents when warranted.