Estimation of salt intake assessed by urinary excretion of sodium over 24 h in Spanish subjects aged 7-11 years.

PURPOSE: High intake of salt is associated with early development of cardiovascular risk factors (e.g., hypertension, obesity). In "developed" countries, individuals frequently exceed dietary recommendations for salt intake. Taking into account the limited data on sodium intake by 24-h excretion in urine in schoolchildren, we wished to determine baseline salt intake in Spanish subjects aged 7-11 years. METHODS: The present study was an observational study involving 205 schoolchildren (109 boys and 96 girls) selected from various Spanish provinces. Sodium intake was ascertained by measuring sodium excretion in urine over 24 h. Creatinine was used to validate completeness of urine collections. The correlation between fat-free mass determined by anthropometry and that determined via urinary excretion of creatinine was calculated (r = 0.651; p < 0.001). RESULTS: Mean 24-h urinary excretion of sodium was 132.7 ± 51.4 mmol/24 h (salt equivalent: 7.8 ± 3.1 g/day). Hence, 84.5 % of subjects aged ≤10 years had intakes of >4 g salt/day, and 66.7 % of those aged >10 years had intakes of >5 g salt/day. Urinary excretion of sodium was correlated with systolic blood pressure and diastolic blood pressure (r = 0.1574 and r = 0.1400, respectively). Logistic regression analyses, adjusted by sex, showed that a high body mass index (odds ratio = 1.159; 95 % CI 1.041-1.290; p < 0.05) was associated with an increased likelihood of high urinary excretion of sodium. CONCLUSIONS: Sodium intake, as estimated by 24-h urinary excretion, was (on average) higher than recommended. Reducing the sodium content children's diet is a sound policy to reduce cardiovascular risk.

Selenium status in a group of schoolchildren from the region of Madrid, Spain.

BACKGROUND: To assess the selenium status of a group of schoolchildren from the Region of Madrid, Spain. METHODS: Study subjects comprised 483 children (216 boys and 267 girls) aged between 8 and 13 years. Selenium intake was determined using a 3-day food record. The foods consumed were transformed into energy and nutrients, and the selenium intake was compared with that recommended. Serum selenium levels were also recorded. RESULTS: Mean (SD) selenium intake [91.0 (25.2) µg day(-1) ] was above the recommended level in 99.4% of subjects; the main dietary sources were cereals, meats, fish and milk products. The serum selenium concentration [mean (SD) 71.1 (14.4) µg L(-1) ], however, was <60 µg L(-1) in 13.9% of subjects, and <45 µg L(-1) in 5.6%. The serum selenium concentration correlated with the selenium intake (r = 0.169; P < 0.05). Children with a serum selenium concentration of <75 µg L(-1) had significantly smaller selenium intakes than those with a serum concentration of ≥75 µg L(-1) . CONCLUSIONS: Although selenium intake was generally above that recommended, the serum selenium concentration of the children could be improved. This could be achieved by increasing the relative consumption of cereals and other selenium rich foods such as fish.

Dietary glycaemic load and odds of depression in a group of institutionalized elderly people without antidepressant treatment.

BACKGROUND: Depression is a very common disorder in elderly, especially in those institutionalized. Nutrition could play an important role in the onset and/or progression of depression, since the intake of carbohydrates with a high glycaemic index (GI) or diets with a high glycaemic load (GL) may increase the insulin-induced brain serotonin secretion. OBJECTIVE: The aim of our study was to analyse the association between dietary GI and GL and the odds of suffering depression in institutionalized elderly people without antidepressant treatment. METHODS: This cross-sectional study included 140 institutionalized elderly people from the Madrid region (Spain) (65-90 years of age) whose diets were recorded using a precise weighing method over seven consecutive days. Energy and nutrient intakes were recorded and the GI and GL calculated. The participants' affective capacity was assessed using the Geriatric Depression Scale (GDS). Subjects were grouped into non-depressed (GDS ≤ 5) and depressed (GDS > 5). Since GDS scores and gender were statistically associated (p < 0.01), the data were grouped considering this association. RESULTS: Dietary GI (51.09 ± 3.80) and GL (97.54 ± 13.46) were considered as medium. The dietary GL was significantly higher in the non-depressed (100.00 ± 12.13) compared with the depressed group (93.97 ± 14.04, p < 0.01). However, a similar GI was observed between non-depressed (51.50 ± 3.29) and depressed groups (50.52 ± 4.46). Additionally, participants with a dietary GL placed in the second and third tertiles had a 67.4 % and 65.3 %, respectively, less odds of suffering depression than those in the first tertile. GDS scores and dietary GL were inversely related; therefore, an increase in one unit in the dietary GL scale decreased the GDS score by 0.058 units. CONCLUSIONS: Glyaemic load is associated with a lower odd of depression.

[Food sources and average intake of calcium in a representative sample of Spanish schoolchildren]. / Ingesta y fuentes de calcio en una muestra representativa de escolares españoles.

INTRODUCTION: There is controversy about the adequacy of calcium intake to that recommended in Spanish schoolchildren. Some studies indicate that the intake is inadequate in a variable percentage of children, while others insist on the danger of an excessive intake in a huge percentage of this population. AIM: To assess calcium intake and food sources of this nutrient in a representative sample of Spanish children and to judge the adequacy of its contribution to the coverage of recommended intakes. METHODS: 903 schoolchildren (7 to 11 years) from 10 Spanish provinces (Tarragona, Caceres, Burgos, Guadalajara, Valencia, Salamanca, Cordoba, Vizcaya, Lugo and Madrid) were studied. They constituted a representative sample of the Spanish schoolchildren population. The energy and nutrient intake was determined using a "Food record questionnaire" for 3 days, including a Sunday. Calcium intake was compared with the recommended intakes (RI) for the mineral. Weight and height were recorded and body mass index (BMI) calculated. RESULTS: In the studied group (55.3% girls and 44.7% of children), 30.7% had an excess body weight (23.3% overweight and 7.4% obesity). Calcium intake was 859.9 ± 249.2 mg / day (79.5% of the recommendations). 76.7% of children had intakes below 100% of those recommended and 40.1% below of 67% of RI. The ratios calcium/phosphorus (0.74 ± 0.21) and calcium/protein (10.1 ± 2.8) and the index of nutritional quality for calcium (0.78 ± 0.29) were lower than recommended in 91.6%, 99.8% and 81.1% of children, respectively. Dietary calcium came from dairy products (64.7%), dietetic products and infant formulae (7.6%), cereals (7.3%), vegetables (3.5%), fruits (3.4%), pre-cooked meals (3.3%), meats (2.8%), fishes (2.8%) and pulses (2.2%), with no differences by gender. CONCLUSION: Calcium intake was lower than recommended in 76.7% of the children and 40.1% had insufficient intake (< 67% of RI). Having in mind that the main calcium source was dairy products (64.7%), increase consumption of this food group is recommended, especially in the 37.1% of children who did not reach the 2 recommended servings per day.

Effects of omega 3 fatty acids supplementation in behavior and non-neurodegenerative neuropsychiatric disorders.

This work provides a systematic review of all published randomised, controlled clinical trials (RCT) investigating the effects of n-3 PUFA intake on the prevention and treatment of non-neurodegenerative neuropsychiatric disorders. Five databases (PubMed, EMBASE, LILACS, CINAHL and The Cochrane Database) were searched for RCT in this area published up to April 2011. The selected studies all involved human participants and included a comparison group. Thirty eight studies were identified, which examined the influence of n-3 PUFA supplementation on the prevention/treatment of depression (non-perinatal) (n 23), perinatal depression (n 6) and attention deficit hyperactivity disorder (ADHD) (n 9). Great heterogeneity was noticed in terms of study design, the doses of n-3 PUFA administered, and study duration. Some benefit was noted with respect to the treatment of hyperactivity and depression in over half the examined studies, although the evidence was not conclusive. For any firm conclusions to be drawn, further studies will be needed that take into account the initial n-3 PUFA status of the subjects. Excessive n-3 PUFA intakes might be associated with a greater risk of peroxidation events and therefore neuropsychiatric deterioration. Indeed, some studies only recorded benefits when lower doses were administered. It is therefore important that the dose required to achieve any potential benefit be determined.

Poor zinc status is associated with increased risk of insulin resistance in Spanish children.

Zn plays a key role in the synthesis and action of insulin. The aim of the present work was to determine whether a poorer Zn status was associated with insulin resistance in a group of 357 Spanish schoolchildren. Zn intake was determined by using a 3 d food record (i.e. Sunday to Tuesday). The body weight, height and waist and hip circumferences of all subjects were recorded and fasting plasma glucose, insulin and Zn concentrations were determined. Insulin resistance was determined using the homoeostasis model assessment (HOMA) marker. Children (11·5 %) with Zn deficiency (serum Zn concentration < 10·7 µmol/l) had higher HOMA values than those with a more satisfactory Zn status (1·73 (sd 0·93)) compared with 1·38 (sd 0·90; P < 0·05). An inverse correlation was found between the HOMA value and the serum Zn concentration (r - 0·149, P < 0·05). The risk of having a greater insulin resistance value (HOMA greater than the 75th percentile) increased with age (OR 1·438; 95 % CI 1·021, 2·027) and BMI (OR 1·448; 95 % CI 1·294, 1·619) and decreased as Zn serum levels increased (OR 0·908; 95 % CI 0·835, 0·987; P < 0·001). Moreover, an inverse relationship was observed between HOMA values and Zn dietary density (r - 0·122), and the Zn intakes of male children with a HOMA value of >3·16 made a significantly smaller contribution to the coverage of those recommended (59·7 (sd 14·7) %) than observed in children with lower HOMA values (73·6 (sd 18·2) %; P < 0·05). Taking into account that Zn intake was below than that recommended in 89·4 % of the children, it would appear that increasing the intake of Zn could improve the health and nutritional status of these children, and thus contribute to diminish problems of insulin resistance.

[An inadequate intake of manganese may favour insulin resistance in girls]. / Una ingesta inadecuada de manganeso podría contribuir a la aparición de resistencia a la insulina en niñas.

AIM: to study the relationship between an adequate manganese (Mn) intake and glucose, insulin levels and insulin resistance among healthy children from Madrid (Spain). MATERIALS AND METHODS: 573 schoolchildren between 8 and 13 years old were studied. Energy and nutrients intake (especially Mn) was calculated with a "3-day diet record". Mn intake was compared to Adequate Intakes (AI) for this mineral. Weight and height were measured and body mass index (BMI) calculated. Fasting glucose and insulin were determined and the HOMA index was calculated to establish the presence of insulin resistance in children. RESULTS: Girls with and inadequate intake (below the 100% of the AI value) had higher insulin and HOMA values than girls with adequate AI values (equal or higher to 100% of AI). Having in mind confounding factors (energy, carbohydrates and lipids intake, BMI and age), a significant positive correlation was found between the contribution of Mn intake to AI and HOMA levels in girls. CONCLUSION: It seems important to ensure an adequate Mn intake in girls in order to prevent insulin resistance and diabetes type 2 in the future.

[Overweight and obesity among Spanish adults]. / Prevalencia de sobrepeso y obesidad en adultos españoles.

AIM: to assess the prevalence of overweight and obesity in Spanish adults and to know the current situation and its evolution in the last years. MATERIAL AND METHODS: The study involved 418 subjects (196 men and 222 women) from 18 to 60 years, who were selected to constitute a representative sample of the Spanish population as a whole. Sanitary, socioeconomic and anthropometric (weight, height, waist circumference and percentage body fat by bioimpedance) data was collected. Body Mass Index and waist-height were ratio calculated. RESULTS: The prevalence of overweight was 34.2%, 43.9% in men and 25.7% in women, and the prevalence of obesity was 13.6% (it was similar in men and women). 47.8% of the population had excess of body weight and 70.2% excess of body fat, these parameters were higher in men than in women and they increased with age. 22.2% of the population had central obesity (taking waist circumference as reference) and 54.7% central obesity and high cardiovascular risk (because waist/height was > 0.5), both parameters were higher in men than in women. CONCLUSION: Overweight and obesity prevalence among the Spanish population is very high and more than the half of the population is in risk of suffering from cardiovascular disease. Furthermore, the situation is worse than a few years ago, so it is necessary to continue working to decrease the prevalence of overweight and obesity among the Spanish population.

Vitamin D status in a group of Spanish schoolchildren.

AIM: The aim was to determine the vitamin D status of a group of Spanish schoolchildren in order to help in the design of campaigns to prevent vitamin D deficiency in this subpopulation. METHODS: This was a cross-sectional observational study, carried out in schools in Madrid (Spain), during 2007-2008. The study enrolled 102 schoolchildren (aged 9-13 years). Vitamin D intake was monitored using a three-day food record. All foods consumed were converted into energy and nutrients and the vitamin D intake compared to that recommended. The children's serum 25-OH-cholecalciferol (25[OH]D) concentrations were also recorded. RESULTS: Vitamin D intake (2.83±3.27 mg/day) was below that recommended in 86.9% of the children, and the serum 25(OH)D concentration (49.6±15.9 nmol/L) below 50 nmol/L (moderate deficit) in 51% of the children; in 8% it was below 30 nmol/L (severe deficit). The children who showed a coverage of at least 67% of the recommended intake of vitamin D (Group HD) consumed more dairy products, fish, fruit and vegetables than those whose intakes covered <67% of the recommended intake (Group LD). The HD children had higher serum 25(OH)D concentrations than the LD children; in addition, fewer cases of deficit were seen among them. CONCLUSION: The vitamin D status of the studied children was likely to improve, and could be ameliorated via a relatively increased consumption of dairy products, fish, cereals, fruits and vegetables, by including foods fortified in vitamin D if necessary, and by increased ­ but safe ­ exposure to the sun.

Influence of the consumption of fruits and vegetables on the nutritional status of a group of institutionalized elderly persons in the Madrid region.

AIM: To determine the nutritional status in a group of institutionalized elderly people in the Madrid region of Spain, with respect to their consumption of fruits and vegetables. SETTING: The Madrid region, Spain. PARTICIPANTS: Men and women 65 years of age (n=180). MEASUREMENTS: A dietetic study undertaken using the precise weighing method (7 consecutive days). Anthropometric and blood analysis data were also recorded. The study subjects were grouped according to whether or not they consumed the WHO/FAO-recommended amount of 400 g/day of fruits and vegetables. RESULTS: Mean fruit and vegetable consumption was 446.77 ± 168.80 g/day. The subjects who consumed at least 400 g/day of these foods also took in the largest total weight of food, and had the largest macronutrient, fiber, vitamin and mineral intakes. They also had higher serum and erythrocyte folate concentrations and lower plasma homocysteine concentrations than those who consumed less than the recommended 400 g/day of fruits and vegetables. CONCLUSIONS: The subjects who consumed at least 400 g/day of fruits and vegetables generally showed a better nutritional status. It would be advisable that the consumption of such foods be relatively increased, especially by those who currently consume less than 400 g/day.

Fat intake and asthma in Spanish schoolchildren.

OBJECTIVES: To study the relationship between lipid, fatty acid and lipid-rich food intake and current asthma in a group of Spanish schoolchildren. SUBJECTS/METHODS: The subjects of this cross-sectional study were 638 Spanish schoolchildren (8-13 years of age). The weight and height of all the subjects were recorded. A questionnaire, completed by the subjects' parents, was used to obtain personal and health information. Current asthma was established when the children had ever had asthma, if they had been diagnosed with asthma by a doctor and if they had been treated with medications at some time in the previous 12 months. Food intake was monitored using a 3-day food record. All foods consumed were converted into energy and nutrients. RESULTS: The energy derived from lipids, saturated fatty acids (SFAs) and myristic and palmitic acids was independently associated with current asthma (Odds Ratio (OR) third tertile 2.85 (1.01-8.07) P=0.049, 10.00 (0.89-111.97) P=0.002, 11.21 (1.36-92.24) P=0.002, 7.58 (1.40-41.03) P=0.022, respectively), as was the intake of butter (OR third tertile 2.97 (1.01-8.68) P=0.001). No relationship was seen between this condition and the intake of any other fatty acid, the n-6/n-3 ratio, nor the consumption of margarine, milk products, fish, meat, eggs or vegetable oils. CONCLUSIONS: Increased intakes of SFAs, myristic and palmitic acids and butter seem to be related to the risk of current asthma in children.

Review and future perspectives on recommended calcium intake.

The suitability of recommended calcium intakes has been the subject of debate in recent years. The present work reviews the recommendations currently made for different population groups in Spain and other countries. To date, these recommended intakes have mainly been based on the role of calcium in the formation and maintenance of bone; less attention has been paid to its other roles in health (e. g., its effect on blood pressure, the prevention of cancer or the regulation of body weight), or the interaction of calcium with other nutrients. However, an increasing number of reports highlight the importance of calcium in these other areas - information that should be taken into account when assessing the suitability of recommended calcium intakes. It should also be remembered that the calcium intakes of a large proportion of the population are lower than those recommended. This paper reviews the suitability of current calcium recommendations for different groups of the population and highlights the areas where research is needed to help determine the intakes that would provide the greatest short and long term health benefits.

Associations between abdominal fat and body mass index on vitamin D status in a group of Spanish schoolchildren.

BACKGROUND/OBJECTIVES: To analyze the association between different anthropometric variables and vitamin D status in a group of Spanish schoolchildren. SUBJECTS/METHODS: Study subjects were 102 children aged 9-13 years. Records were made of their height, body weight, body mass index (BMI), waist and hip measurements (to determine the quantity of visceral or abdominal fat), and the thickness of the tricipital and bicipital skinfold (to determine the quantity of subcutaneous fat). Diets were analyzed using a 3-day weighed food record and vitamin D intakes compared with those recommended. Serum 25-hydroxyvitamin D (25(OH)D) concentrations were measured using chemiluminescent assay. RESULTS: The mean serum 25(OH)D concentration was 49.6+/-15.9 nmol/l. The mean serum 25(OH)D in the ID subjects (that is, those with insufficient vitamin D levels, 25(OH)D of <70 nmol/l) was 46.6+/-13.4 nmol/l and in the AD subjects (that is, those with adequate vitamin D levels, 25(OH)D of > or =70 nmol/l) was 77.5+/-8.4 nmol/l (P<0.001). No significant difference was observed between both groups in vitamin D intake. However, the ID subjects had higher body weight, BMI, waist measurement and waist/height ratio than the AD subjects. Using a multiple linear regression analysis, only weight and BMI were found to independently influence 25(OH)D values. Children with a body weight, BMI, bicipital skinfold thickness, waist measurement and waist/height ratio above the 50th percentile for each variable were at a greater risk of having a low serum 25(OH)D concentration (<70 nmol/l). CONCLUSIONS: BMI and abdominal obesity influence the appearance of vitamin D insufficiency in children.

[Body weight perception and dieting behaviour in Spanish population]. / Percepción del peso corporal y medidas adoptadas para su control en población española.

INTRODUCTION: A high percentage of the population initiate or keep diets to lose weight independently of suffering or not overweight/obesity. Nevertheless, exists a great unknowledge on the more convenient guidelines to achieve this aim. OBJECTIVE: To analyze weight perception and types of behavior to control the corporal weight in Spanish adults in order to be able to start the campaigns most adapted to provide a correct nutritional information to the population. METHODS: 2,168 subjects (18 +/- 50 years) of 5 Spanish provinces were studied. Anthropometric and information about the worry about corporal weight data was obtained. RESULTS: 65.6% of subjects declare a desire to lose weight and 44.9% have followed diets with this purpose in some moment (especially in female population). 63.9% of subjects increase physical activity to control weight, 23.9% consumes dietetic products or medicinal herbs and 48.0% compensate the excesses when they try to lose weight. Sweets (24.5%), fats (15.4%), pastries (11.4%) and bread (11.4%) are avoided and fruits and vegetables consumption is increased (specially by women) when try to lose weight. CONCLUSIONS: Weight loss practices use to be inadequate due to the desire to lose weight quickly and to the unknowledge about the most adecuate diet to achieve this aim. It is necessary to avoid this type of practices and to improve the knowledge on nutrition in the population.

[Obesity, insulin resistance and increase in adipokines levels: importance of the diet and physical activity]. / Obesidad, resistencia a la insulina y aumento de los niveles de adipoquinas: importancia de la dieta y el ejercicio físico.

With obesity the amount of pro- and anti-inflammatory adipokines released is increased within the fat tissue. These molecules are implicated in many clinical manifestations of this pathology such as diabetes, arterial hypertension, or cardiovascular disease. At the first stage, the fat tissue of the obese patient becomes resistant to the action of insulin due to the effect of some of these adipokines such as tumour necrosis alpha (TNF-alpha) or interleukine-6 (IL-6). At a second stage, this resistance occurs at other tissues and glucose and insulin levels are increased. This increase, together with high adipokines levels that occur in diabetes, lead to the occurrence of different adverse events, such as the following: increase in oxidative stress, endothelial dysfunction, increase in blood pressure, and impairments in lipoprotein metabolism, all of which are harmful for health. Practising physical activity and following a balanced diet, similar to the Mediterranean pattern with low fat and salt consumption, would be helpful for improving insulin resistance and adipokines levels in obese people, thus helping improving their health status in the long run.

Vitamin B6 status improves in overweight/obese women following a hypocaloric diet rich in breakfast cereals, and may help in maintaining fat-free mass.

OBJECTIVE: To analyze the changes in vitamin B6 status in women following slightly hypocaloric diets based on the relative increase consumption of foods whose intakes are below those recommended, and to study how these changes influence the proportion of fat-free mass. DESIGN: Intervention study of two slightly hypocaloric diets: diet V (increased consumption of vegetables), or diet C (increased consumption of cereals, especially breakfast cereals). SUBJECTS: A total of 49 women with a body mass index (BMI) of 25-35 kg/m2. MEASUREMENTS: Dietetic, anthropometric and biochemical data were collected at the start of the study and at 2 and 6 weeks. RESULTS: Both the C and V subjects showed a reduction in their energy intake, body weight, BMI and fat mass. Pyridoxine intake increased in both groups and plasma pyridoxal phosphate (PLP) levels increased only with diet C. An association was found between the increase in plasma PLP at 6 weeks and the increase in pyridoxine intake (r=0.451; P<0.01). Multiple regression analysis showed a positive association between the increase in PLP at the end of the study and the increases in the pyridoxine intake, B6 density or B6/protein ratio. At the end of the study, and only in those women whose PLP levels were increased, the higher the increase in PLP level, the higher the increase in fat-free mass percentage (r=0.4426, P<0.05). CONCLUSIONS: Interventions aimed at weight control should also try to maintain or improve nutritional status. A diet rich in cereals (especially fortified breakfast cereals) appears to be useful in improving vitamin B6 status. Such an improvement could help maintain fat-free mass during periods of weight loss.

[Dietary habits and their relationship with the knowledge on the concept of a balanced diet in a group of young women with overweight/obesity]. / Hábitos alimentarios y su relación con los conocimientos, respecto al concepto de dieta equilibrada, de un colectivo de mujeres jóvenes con sobrepeso/obesidad.

OBJECTIVE: To know the dietary habits of a population of women with overweight/obesity and their knowledge on the concept of proper feeding in order to design nutrition educational campaigns focused on this population. MATERIALS AND METHODS: A group of 67 women, aged 20 to 35 years with body mass index 24-35 kg/m2 were asked about their frequency of food intake and what they thought to be correct to achieve a balanced diet. RESULTS: Studied women more frequently consumed oils (4.3 +/- 4.5 times/week) and sweets (2.5 +/- 3.6 times/week) and less frequently water (-19.1 +/- 22.7 times/week), vegetables (-4.3 +/- 5.7 times/week), fruits (-3.7 +/- 6.2 times/week), legumes (-1.3 +/- 2.0 times/week) and fish (-2.2 +/- 3.7 times/week) than what they thought they should consume. When comparing what they declare to consume to what has been established as minimal recommended intake for the different groups of foods it is observed that the intake of grains and legumes, fruits and vegetables, and slightly less that of fish and eggs, should de increased. CONCLUSIONS: given the incorrect dietary habits observed in a population of women with overweight/obesity, it should be convenient to carry out nutrition educational campaigns. This education could help improve the diet of all the population and the occurrence of overweight and obesity could be prevented in many cases. Besides, in those cases in which the pathology is already present, this could prevent following regimens that are harmful for the health and for weight management.

Modification of iron status in young overweight/mildly obese women by two dietary interventions designed to achieve weight loss.

AIMS: To determine the modification of iron status in a group of overweight/mildly obese women following two different weight control programs. METHODS: The study subjects were 57 women who were assigned to one of two slightly hypocaloric diets: V (increased consumption of vegetables), or C (increased consumption of cereals, especially breakfast cereals). All data were determined at the start of the study and at 2 and 6 weeks into the dietary intervention period. RESULTS: Both diets led to a reduction in body weight and heme iron intake, and an increase in the intake of total and non-heme iron, at 2 and 6 weeks. At 6 weeks, a reduction in transferrin levels was seen in C subjects. Subjects with the worst initial iron status (hemoglobin

The influence of fruit and vegetable intake on the nutritional status and plasma homocysteine levels of institutionalised elderly people.

OBJECTIVE: To determine the difference in the nutritional status of elderly people depending on their consumption of fruits and vegetables, and to study the possible association between the consumption of these foods and different cardiovascular risk factors, especially total plasma homocysteine (t-Hcys) levels. DESIGN, SETTING AND SUBJECTS: A cross-sectional study in 152 institutionalised older people from Madrid aged > or = 65 years. Food and nutrient intakes were recorded over 7 days using the 'precise individual weighing' method. The weight, height, and waist and hip circumferences of all subjects were recorded, as were their alpha-erythrocyte glutathione reductase, serum B6, B12 and folate levels, erythrocyte folate levels, t-Hcys levels, serum lipids and blood pressure. The experimental population was then divided into tertiles depending on the serving intake of fruit and vegetables (T1, < 2.29 servings day(-1); T2, 2.29-2.79 servings day(-1); and T3, >2.79 servings day(-1)). RESULTS: Compared with T1 subjects, T3 subjects showed consumptions of cereals, pulses, meat, fish and eggs closer to those recommended (P < 0.05). In addition, the contribution of their diet towards covering the recommended daily intake of vitamin B1, niacin, vitamin B6, folic acid, vitamin C, B12, vitamin A, and P, Mg, Zn and Fe was higher. The intake of fibre increased with consumption of fruit and vegetables (r = 0.6839, P < 0.001). T3 subjects also had better serum and erythrocyte folate levels than T1 and T2 subjects (P < 0.05). A positive correlation was found between the consumption of fruit and vegetables and serum folate (r = 0.2665, P < 0.01) and with erythrocyte folate levels (r = 0.2034, P < 0.05), and a negative correlation with t-Hcys (r = -0.2493, P < 0.01). CONCLUSIONS: Greater consumption of fruit and vegetables is associated with better food habits, increased vitamin and mineral intakes and lower t-Hcys levels. Considering that the fruit and vegetable intake in Spanish elderly people is very low, it is recommended that the consumption of fruits and vegetables by elderly people be increased.