The Association of Nutrition Quality with Frailty Syndrome among the Elderly

Low diet quality among the elderly may be correlated with some diseases, including Frailty Syndrome (FS). This decline in function restricts the activity of older people, resulting in higher assistance costs. The aim of this study was to increase knowledge of diet quality predictors. Dietary intake was assessed among 196 individuals aged 60+ years using the three-day record method and FS by Fried’s criteria. Based on the compliance with the intake recommendation (% of EAR/AI), we distinguished three clusters that were homogeneous in terms of the nutritional quality of the diet, using Kohonen’s neural networks. The prevalence of frailty in the entire group was 3.1%, pre-frailty 38.8%, and non-frailty 58.1%. Cluster 1 (91 people with the lowest diet quality) was composed of a statistically significant higher number of the elderly attending day care centers (20.7%), frail (6.9%), pre-frail (51.7%), very low vitamin D intake (23.8% of AI), using sun cream during the summer months (always 19.8% or often 39.6%), having diabetes (20.7%), having leg pain when walking (43.1%), and deteriorating health during the last year (53.5%). The study suggests the need to take initiatives leading to the improvement of the diet of the elderly, especially in day care senior centers, where there are more frail individuals, including nutritional education for the elderly and their caregivers.

The Influence of Iron and Zinc Supplementation on Iron Apparent Absorption in Rats Fed Vitamins and Minerals Reduced Diets

Deficient human diet is usually reduced in many nutrients, but animal studies on iron absorption have been only carried out for rats fed well-balanced (control) and iron-deficient diets. The aim of this study was to evaluate the effect of iron or iron/zinc supplementation on iron apparent absorption (IAA) in rats fed a diet reduced in all vitamins and minerals (R). The study was conducted on 77, 6-week-old male Wistar rats in 3 stages as follows: stage I, 4-week period of adaptation to R diet (50% less vitamins and minerals compared to AIN-93M recommendations); stage II, 4-week supplementation period with iron (RSFe) or iron/zinc (RSFeZn); stage III, 2-week post-supplementation period (rats fed R diet). Feces samples to IAA determination were collected at the 20-22nd days of stage I and II and the 10-12th days of stage III. To determine the changes in IAA after introducing and discontinuation of supplementation, feces were collected for 3 days after introducing (stage II) and 5 days after the supplementation discontinuation (stage III). At the end of stage II, compared to R rats, the IAA was statistically significantly higher in RSFe and RSFeZn rats (30.3 ± 2.0% vs. 47.4 ± 1.2% and 51.0 ± 1.7%, respectively). After introducing iron or iron/zinc supplementation, the IAA stabilized fast already in the first day, while after discontinuation of the supplementation, at least 4 days was required to the stabilization. At the end of stage III, the IAA was significantly lower in RSFe (15.8 ± 6.6%) than in RSFeZn rats (43.4 ± 5.9%). In conclusion, to confirm that iron and zinc supplementation is more beneficial than iron supplementation only, especially after discontinuation of supplementation, further research among humans is necessary.

Vitamin B-6 intake is related to physical performance in European older adults: results of the New Dietary Strategies Addressing the Specific Needs of the Elderly Population for Healthy Aging in Europe (NU-AGE) study

BACKGROUND

Maintenance of high physical performance during aging might be supported by an adequate dietary intake of niacin, vitamins B-6 and B-12, and folate because these B vitamins are involved in multiple processes related to muscle functioning. However, not much is known about the association between dietary intake of these B vitamins and physical performance.

OBJECTIVES

The objectives of this study were to investigate the association between dietary intake of niacin, vitamins B-6 and B-12, and folate and physical performance in older adults and to explore mediation by niacin status and homocysteine concentrations.

METHODS

We used baseline data from the New Dietary Strategies Addressing the Specific Needs of the Elderly Population for Healthy Aging in Europe (NU-AGE) trial, which included n = 1249 healthy older adults (aged 65-79 y) with complete data on dietary intake measured with 7-d food records and questionnaires on vitamin supplement use and physical performance measured with the short physical performance battery and handgrip dynamometry. Associations were assessed by adjusted linear mixed models.

RESULTS

Intake of vitamin B-6 was related to lower chair rise test time [β: -0.033 ± 0.016 s (log); P = 0.043]. Vitamin B-6 intake was also significantly associated with handgrip strength, but for this association, a significant interaction effect between vitamin B-6 intake and physical activity level was found. In participants with the lowest level of physical activity, higher intake of vitamin B-6 tended to be associated with greater handgrip strength (β: 1.5 ± 0.8 kg; P = 0.051), whereas in participants in the highest quartile of physical activity, higher intake was associated with lower handgrip strength (β: -1.4 ± 0.7 kg; P = 0.041). No evidence was found for an association between intake of niacin, vitamin B-12, or folate and physical performance or for mediation by niacin status or homocysteine concentrations.

CONCLUSIONS

Vitamin B-6 intake was associated with better chair rise test time in a population of European healthy older adults and also with greater handgrip strength in participants with low physical activity only. Homocysteine concentrations did not mediate these associations. The NU-AGE trial was registered at clinicaltrials.gov as NCT01754012.

Intake of Vitamins and Minerals From Voluntarily Fortified Foods and/or Dietary Supplements in School Adolescents in Central-Eastern Poland

Background: The key issue is whether voluntarily fortified foods and vitamin/mineral supplements available on the market serve public health needs. The study aim was to estimate nutrient intakes from voluntarily fortified foods and vitamin/mineral supplements in relation to the Dietary Reference Intake (DRI) in adolescents (n = 759) aged 13–19 who attended public secondary schools in Central-Eastern Poland.

Methods: Data on the consumption of voluntarily fortified foods were collected using a semi-quantitative food frequency questionnaire containing 58 food items. Data on the use of dietary supplements were assessed via an open-ended question. The content of nutrients was estimated using the producer's labeling declaration. The distribution of nutrient intakes according to the percentage of DRI categories (<20%, 20–39.9%, 40–59.9%, 60–79.9%, 80–99.9%, 100–119%, or >120%) was estimated.

Results: Consumption of voluntarily fortified foods was a common behavior in adolescents (86.7% of participants), while vitamin/mineral supplements were used by less than one-fifth of them (17.7%). The amounts of nutrient intakes from fortified foods and/or supplements were at different levels: (I) vitamins A, D, calcium, magnesium (>50% of adolescents did not exceed 20% of DRI); (II) vitamins E, B₁₂, iron (>50% of respondents consumed at least 20% of DRI); (III) niacin and pantothenic acid (>50% of respondents consumed at least 40% of DRI); IV) vitamins C, B₁, B₂, B₆, folate, biotin (>50% of participants consumed at least 60% of DRI). In a subgroup of respondents who used fortified foods and supplements simultaneously (n = 126), some nutrients (i.e., vitamins C, B₁, B₂, B₆, niacin, and biotin) were consumed in amounts ≥150% of DRI. Intake above the Tolerable Upper Intake Levels was observed for niacin, vitamin A, B₆ and folic acid in individual cases (up to 1.1% of respondents); a higher risk of overconsumption was associated with using vitamin/mineral supplements than voluntarily fortified foods.

Conclusion: Adolescents should be educated on how to reasonably use fortified foods and dietary supplements to help to overcome the potential deficiency of nutrients without causing excessive consumption.

Intake of Vitamins and Minerals from Voluntarily Fortified Foods in School Children in Central-Eastern Poland

Objective: To estimate vitamin and mineral intakes from voluntarily fortified foods (VFFs) in relation to the Dietary Reference Intake (DRI) in children aged 6 - 12. Methods: The study was conducted among 677 school children from Central-Eastern Poland. Data on VFFs consumption were collected using a semi-quantitative food frequency questionnaire containing 58 food items available on the Polish market; the content of nutrients in VFFs was estimated using the producers labelling declaration. The amounts of nutrients consumed from VFFs were compared to DRI and Tolerable Upper Intake Levels (ULs). The distribution of nutrient intakes according to the percentage of DRI categories (<20%, 20 - 39.9%, 40 - 59.9%, 60 - 79.9%, 80 - 99.9%, 100 - 119%, and >120%) was investigated. Results: In our study, 78.3% (n = 530) of children were classified as VFF-consumers. The most often consumed groups of VFFs were cereal products and juices/non-alcoholic beverages (92.5% and 76.6% of children, respectively). The amounts of vitamin D intake were negligible (92.5% of children did not exceed 20% of DRI from VFFs); vitamins A, E, B12 and calcium were small (>60% did not exceed 40% of DRI); vitamins B1, B2, niacin, folic acid, pantothenic acid and iron were moderate (>25% consumed 80% of DRI or above); while vitamins C, B6 and biotin were high (>40% consumed 100% of DRI or above). Intake above ULs was observed for niacin and folic acid (2.6% and 1.1% of children, respectively). Conclusions: Substantial differences between the VFFs contribution of various micronutrients to the DRIs were observed. Consumption of VFFs may prevent inadequate intakes for the majority of nutrients. Keywords: children, DRI, inadequate intake, minerals, fortified foods, vitamins.

[Influence of selected factors on fortified food intake by children]

BACKGROUND

The range of food products fortified with vitamins and minerals in Poland is growing rapidly in the last years. Also the consumption of such food and dietary supplements is increasing. Therefore there is a risk of excessive intake of vitamins and minerals.

OBJECTIVE

The aim of the study was to analyze the determinants of intake of food products fortified with vitamins and minerals among children aged 6-12.

MATERIAL AND METHODS

Data was collected by a questionnaire specially developed and a FFQ method including vitamins and/or minerals in fortified food products. There were collected data from parents of 743 children (374 boys, 369 girls) attending primary schools, placed in four different districts of Poland.

RESULTS

More than 70% of children consumed food products fortified with vitamins and/or minerals, among them 76% - every day. As a main reason of intake of fortified food by children, parents mentioned the beneficial effects on health (86.2% parents) and taste preferences (61.2%). However, the main reason of no consuming this kind of products, were proper nutrition of the children (57.4%), no influence on health (30.3%) and prohibitive price (24,1%). There were statistically significant relationships between intake of food fortified with vitamins and/or minerals and children's age (75.8% of age 6-9 years vs. 58.1% of age 10-12 years), health condition (71.6% of children with good and very good health status -assessed by parents - vs. 55.6% with average and poor health status), the number of meals eaten during the day (75.6% eating 4 meals/day vs. 67.8% - 5 and more meals vs. 52.3% - 3 meals), regular breakfast eating (71.8% eating vs. 50.0% non consumption), brunch eating (73.3% vs. 54.0% respectively), afternoon snack eating (75.7% vs. 59.4%) and using of dietary supplements (84.6% among children who use supplements vs. 61.4% among non users).

CONCLUSIONS

It was established that about 22% of parents were unaware that their children consumed food fortified with vitamins and/or minerals. Food fortified with vitamins and/or minerals was consumed more frequently among younger children, specially among those who eat more meals per day and with good and very good health status. Due to the fact that many children consumed both fortified foods and dietary supplements, there is a risk of exceeding levels consider as safe (UL) of some vitamins and/or minerals.

[Factors influenced vitamin or mineral supplements use in a chosen group of children aged 6-12]

BACKGROUND

Due to growing popularity of food supplements the producers of such products introduce food supplements developed especially for children. This, as a consequence, may lead to a risk of exceeded intake of some nutrients.

OBJECTIVE

The aim of this study was to identify determinants of vitamin/mineral supplements intake in 6-12-year-old children.

METHOD

The study was conducted by questionnaire method among parents of 743 children attending primary schools. Dietary supplements during the year preceding the survey received 40% of children, while 16.7% on the tested day.

RESULTS

It was found that women with secondary and higher education level more frequently reported use of such preparations by their children (43% and 40% respectively). Supplements received more children with moderate or slight deficient body weight (54.2%) compared to children with severe deficiency (29.7%) or obese (25.8%); children with chronic diseases (56%) compared to healthy (37%), participating in extracurricular sport activities (49%) compared to non-participating (35%) and children with more correct dietary habits. Simultaneously supplements and fortified products were used by 34% of children.

CONCLUSIONS

. The decision of supplements use parents often undertook alone (67% of preparation), while only 31% of them after medical consultation. There is a need to educate children and their parents about the use of supplements and the risks associated with it.

Daily rat tibial growth in vivo following hypothalamic sex reversal with neonatal and pubertal treatments with gonadal steroids

A striking sex-related difference in postpubertal growth and growth hormone (GH) secretory pattern in the rat has been described. Although this sexual dimorphism seems to be determined by the neonatal effects of gonadal steroids on the hypothalamus, peripubertal exposure to steroids also plays an important role. In order to study the real influence of the hypothalamic sex and/or peripubertal gonadal steroids, the growth pattern of female and male rats in response to neonatal and peripubertal sexual steroid treatments was studied using microknemometry, a technique that allows non-invasive daily measurements of rat tibial growth rate. Neonatal steroid environment in males was modified by castration on day 1, whereas in females it was changed by a single neonatal testosterone administration on day 5 followed by castration at 13 days of age. From the onset of puberty to adulthood, both female and male animals received testosterone or estrogens, respectively. Neonatal treatment alone, i.e. androgenization of female and castration of male rats, were only able to induce a partial reversal of the original sex-dependent growth pattern. Additional peripubertal treatments achieved a complete change in the sex-linked growth pattern. Consistent with the effects observed on growth, the pituitary GH concentration was significantly increased in females, and diminished in males, when they were treated both at the neonatal and peripubertal stages. However, only this latter group, whose growth was more seriously compromised, showed decreased plasma insulin-like growth factor-I (IGF-I) levels. In conclusion, a complete feminization of male tibial growth pattern or masculinization of female pattern can only be achieved by maintaining the new steroid environment from puberty to adulthood.