AJCN Dec, 2006

[Control weight even when much older] http://www.ajcn.org/cgi/content/full/84/6/1257 - Public health success in recent decades may be in danger if lifestyles of the elderly are neglected - The prevalence and severity of cardiovascular disease risk factors increase with age, and these risk factors remain powerful predictors of cardiac events even in old age. Because obesity is associated with an unfavorable cardiovascular disease risk profile, an increased prevalence of obesity in old age endangers the healthy life expectancy that has increased over recent decades. Obesity is clearly associated with a decrease in life expectancy (2) and with an increase in unhealthy life-years (3). High fatness, rather than low fat-free mass, predicts disability in subjects aged 65–100 y (4). Villareal et al (1) report the effects of a lifestyle intervention consisting of an energy-restricted diet, supervised exercise training, and behavioral therapy on metabolic risk factors in frail, obese, elderly persons.... Insights regarding these issues have changed dramatically. Although relative risk indeed decreases with aging, the absolute risk of mortality associated with obesity increases (6). Thus, the difference in absolute risk between an obese and a normal-weight person is high in the elderly.

[Get vitamin B12 to save brain function when you are getting older] http://www.ajcn.org/cgi/content/full/84/6/1259 - Assessing the association between vitamin B-12 status and cognitive function in older adults - the clinical manifestations of overt, severe vitamin B-12 deficiency include both hematologic (macrocytic or megaloblastic anemia) and neurologic (subacute combined degeneration of the spinal cord, peripheral neuropathy, cognitive impairment) sequelae. The neurologic consequences ... can become permanent if vitamin B-12 replacement therapy is not initiated within a year of the onset of symptoms...However, measurement of total vitamin B-12 does have limitations in that individuals may present with vitamin B-12–responsive metabolic or neurologic abnormalities despite having a total vitamin B-12 concentration within the normal range..."

[risks of iron supplements for kids] http://www.ajcn.org/cgi/content/abstract/84/6/1261- Iron supplementation in early childhood: health benefits and risks - The prevalence of iron deficiency among infants and young children living in developing countries is high. Because of its chemical properties—namely, its oxidative potential—iron functions in several biological systems that are crucial to human health. Iron, which is not easily eliminated from the body, can also cause harm through oxidative stress, interference with the absorption or metabolism of other nutrients, and suppression of critical enzymatic activities. We reviewed 26 randomized controlled trials of preventive, oral iron supplementation in young children (aged 0–59 mo) living in developing countries to ascertain the associated health benefits and risks. The outcomes investigated were anemia, development, growth, morbidity, and mortality. ..With iron supplementation, weight gains were adversely affected in iron-replete children; the effects on height were inconclusive...In a malaria-endemic population of Zanzibar, significant increases in serious adverse events were associated with iron supplementation..."

[fish oil intake reduces LDL level] http://www.ajcn.org/cgi/content/abstract/84/6/1290- Effects of altering the ratio of dietary n–6 to n–3 fatty acids on insulin sensitivity, lipoprotein size, and postprandial lipemia in men and postmenopausal women aged 45–70 y: the OPTILIP Study - "Background: Insulin resistance is associated with elevated plasma triacylglycerol, low HDL concentrations, elevated postprandial lipemia, and a predominance of small, dense LDLs (sdLDLs). It has been hypothesized that the dietary ratio of n–6 to n–3 (n–6:n–3) polyunsaturated fatty acids (PUFAs) may have favorable effects on these risk factors by increasing insulin sensitivity...Conclusions: Decreasing the n–6:n–3 does not influence insulin sensitivity or lipase activities in older subjects. The reduction in plasma triacylglycerol after an increased intake of n–3 long-chain PUFAs results in favorable changes in LDL size."

[Many fish lack much fishoil-take capsules to be safe] http://www.ajcn.org/cgi/content/abstract/84/6/1299- Fish intake and serum fatty acid profiles from freshwater fish - "Only fatty fish intake, particularly salmonid, and estimated EPA + DHA intake from fatty fish were significantly associated with serum EPA + DHA. No relation was observed between the quantity of locally caught fish (g/d) consumed or the estimated FA intake from locally caught fish and serum n–3 FAs. "

[Get exercise and watch diet when older]http://www.ajcn.org/cgi/content/abstract/84/6/1317 -Effect of lifestyle intervention on metabolic coronary heart disease risk factors in obese older adults - "Background: Coronary heart disease (CHD) risk factors increase with age and body mass index (BMI; in kg/m2). However, whether lifestyle intervention ameliorates metabolic CHD risk factors in obese older adults is unknown...A 6-mo outpatient randomized controlled trial was conducted in obese (BMI 30) older (65 y) adults randomly assigned to diet and exercise therapy...Conclusions: Lifestyle intervention decreases multiple metabolic CHD risk factors simultaneously in obese older adults. "

[Low glycemic-index diet reduces food intake] http://www.ajcn.org/cgi/content/abstract/84/6/1365-Glycemic and insulinemic responses as determinants of appetite in humans - "a low–glycemic index meal may reduce subsequent energy intake. In contrast, postprandial insulin seems to affect short-term appetite sensations. "

[Get at least 3 g soluble fiber per day] http://www.ajcn.org/cgi/content/abstract/84/6/1385- Interaction between cholesterol and glucose metabolism during dietary carbohydrate modification in subjects with the metabolic syndrome - "...The subjects were randomly assigned to diets with rye bread and pasta (RPa) or oat, wheat bread, and potato (OWPo) as the main carbohydrate source ...Conclusions: Carbohydrate modifications had dissimilar effects on cholesterol metabolism. Consumption of RPa, as compared with OWPo, may be clinically more favorable because it seems to inhibit the absorption of cholesterol, a factor crucial in the development of arterial atherosclerosis. [Soluble fiber increases bile acid excretion and inhibits cholesterol absorption, decreases LDL by 10-15% when you consume about 3g soluble fiber/day.]

[Benefit to people over 65 of high dose B12] http://www.ajcn.org/cgi/content/abstract/84/6/1422-Elevated serum S-adenosylhomocysteine in cobalamin-deficient elderly and response to treatment -"...Results: The 149 elderly subjects had a mean age of 76.3 y; 81% were female, and 30% were African American...Conclusions: Elevated serum SAH concentrations are common in elderly and are strongly influenced by both renal status and cobalamin deficiency. These elevated concentrations can be lowered with high-dose oral cobalamin therapy."

[Natural and synthetic vitamin E are different] http://www.ajcn.org/cgi/content/abstract/84/6/1430-A feasibility study quantifying in vivo human -tocopherol metabolism - "Conclusions: Both isomers were well absorbed; all-rac--tocopherol was preferentially degraded and eliminated in urine, the major route. RRR--tocopherol had a longer residence time and larger distribution than did all-rac--tocopherol. Liver had 2 distinct -tocopherol pools. The model is a hypothesis, its estimates are model-dependent, and it encourages further testing. "

[Pregnant women need high vitamin E intake]http://www.ajcn.org/cgi/content/abstract/84/6/1442 - Vitamin E: maternal concentrations are associated with fetal growth - "Conclusion: Early and late circulating concentrations of -tocopherol are positively associated with fetal growth." [Notes of interest - Use of standard multivitamin increased vit E level about 1 mcg/ml. Quintiles ranged from below 9 to above 13 mcg/ml, so 400 IU vitamin E supplements would be useful. Among non-antioxidant benefits of vitamin E are up-regulation of prostacyclin, a reduction in inflammation, and a decrease is cellular adhesion molecules.]

[keep babies active]http://www.ajcn.org/cgi/content/abstract/84/6/1449- Rapid growth among term children whose birth weight was appropriate for gestational age has a longer lasting effect on body fat percentage than on body mass index - "Objective: The aim was to examine the effect of rapid growth in infancy on body mass index SD score (BMI SDS) and body fat percentage (%BF) trajectories until age 7 y... Results: Fifty-nine of the 206 children (28.6%) displayed rapid growth (an increase in SDS for weight of >0.67 between birth and age 2 y). From 6 mo of age, their growth trajectories diverged from normal growers, and by age 7 y they had a higher BMI, more fat mass, and a higher risk of overweight ...Conclusions: Rapid growth in infancy and early childhood results in an increased BMI and %BF throughout childhood and an increased risk of overweight at age 7 y among AGA children. Rapid growth in AGA children has a more pronounced effect on %BF than on BMI."

[low protein, low carb intake reduce cancer risk] -http://www.ajcn.org/cgi/content/abstract/84/6/1456- Long-term low-protein, low-calorie diet and endurance exercise modulate metabolic factors associated with cancer risk - "Background: Western diets, obesity, and sedentary lifestyles are associated with increased cancer risk. ..Conclusions: Exercise training, decreased adiposity, and long-term consumption of a low-protein, low-calorie diet are associated with low plasma growth factors and hormones that are linked to an increased risk of cancer. Low protein intake may have additional protective effects because it is associated with a decrease in circulating IGF-I independent of body fat mass."

[at least one serving dairy per day controls weight]http://www.ajcn.org/cgi/content/abstract/84/6/1481 - Association between dairy food consumption and weight change over 9 y in 19 352 perimenopausal women - "Background: Dairy foods may play a role in the regulation of body weight. Objective: We examined the association between changes in dairy product consumption and weight change over 9 y...The intake frequencies of whole milk and sour milk (3% fat), medium-fat milk (1.5% fat), low-fat milk and sour milk (0.5% fat), cheese, and butter were calculated at baseline and follow-up. The women were categorized into 4 groups according to their intake: 1) constant, <1 serving/d; 2) increased from <1 serving/d to 1 serving/d; 3) constant, 1 serving/d; and 4) decreased from 1 serving/d to <1 serving/d. .. The constant (at least one1 serving/d) intakes of whole milk and sour milk and of cheese were inversely associated with weight gain;.. No significant associations were seen for the other 3 intake groups. When stratified by BMI, the findings remained significant for cheese and, for normal-weight women only, for whole milk and sour milk...Conclusion: The association between the intake of dairy products and weight change differed according to type of dairy product and body mass status. The mechanism behind these findings warrants further investigation."

[why fruits and veggies make you healthy]http://www.ajcn.org/cgi/content/abstract/84/6/1489 -Fruit and vegetable intakes, C-reactive protein, and the metabolic syndrome - "Conclusions: Higher intakes of fruit and vegetables are associated with a lower risk of the metabolic syndrome; the lower risk may be the result of lower CRP concentrations. These findings support current dietary recommendations to increase daily intakes of fruit and vegetables as a primary preventive measure against cardiovascular disease."

[fish oil may reduce depression]http://www.ajcn.org/cgi/content/abstract/84/6/1513 -Depression and cardiovascular mortality: a role for n–3 fatty acids? "...Results: Compared with a low intake (: 21 mg/d), a high intake (: 407 mg/d) of n–3 FAs was associated with fewer depressive symptoms [odds ratio: 0.46...]...Conclusion: An average intake of 400 mg n–3 FA/d may reduce the risk of depression. Our results, however, do not support the hypothesis that the intake of n–3 FAs explains the relation between depression and CVD."

[Policosanol does not help]http://www.ajcn.org/cgi/content/abstract/84/6/1543 -Policosanol is ineffective in the treatment of hypercholesterolemia: a randomized controlled trial -"ackground: Policosanol is one of the fastest growing over-the-counter supplements sold in the United States. The use of policosanol to treat elevated cholesterol is based on clinical trials conducted in Cuba...Conclusion: Policosanol does not alter the serum lipid profile over an 8-wk period in adults with mild hypercholesterolemia."