A path model of sarcopenia on bone mass loss in elderly subjects.

OBJECTIVE: Aging is associated with decreases in muscle mass, strength, power (sarcopenia) and bone mineral density (BMD). The aims of this study were to investigate in elderly the role of sarcopenia on BMD loss by a path model, including adiposity, inflammation, and malnutrition associations. METHODS: Body composition and BMD were measured by dual X-ray absorptiometry in 159 elderly subjects (52 male/107 female; mean age 80.3 yrs). Muscle strength was determined with dynamometer. Serum albumin and PCR were also assessed. Structural equations examined the effect of sarcopenia (measured by Relative Skeletal Muscle Mass, Total Muscle Mass, Handgrip, Muscle Quality Score) on osteoporosis (measured by Vertebral and Femoral T-scores) in a latent variable model including adiposity (measured by Total Fat Mass, BMI, Ginoid/Android Fat), inflammation (PCR), and malnutrition (serum albumin). RESULTS: The sarcopenia assumed a role of moderator in the adiposity-osteoporosis relationship. Specifically, increasing the sarcopenia, the relationship adiposity-osteoporosis (ß: -0.58) decrease in intensity. Adiposity also influences sarcopenia (ß: -0.18). Malnutrition affects the inflammatory and the adiposity states (ß: +0.61, and ß: -0.30, respectively), while not influencing the sarcopenia. Thus, adiposity has a role as a mediator of the effect of malnutrition on both sarcopenia and osteoporosis. Malnutrition decreases adiposity; decreasing adiposity, in turn, increase the sarcopenia and osteoporosis. CONCLUSIONS: This study suggests such as in a group of elderly sarcopenia affects the link between adiposity and BMD, but not have a pure independent effect on osteoporosis.

[Significant two-weeks clinical efficacy of an association between Massaciuccoli peat and sodium chloride water of Undulna Thermae measured on gynoid lipodystrophy in a group of overweight female]. / Efficacia significativa del trattamento di due settimane con associazione di torba del Massaciuccoli ed acqua clorurato-sodica delle terme di Undulna sulla lipodi- strofia a localizzazione ginoide in un gruppo di donne sovrappeso.

BACKGROUND: Peloid has been popularly used as an effective base in cosmetic preparations, although its biologically-active materials and mechanisms on skin have not yet been fully determined. An association between Massaciuccoli peat and sodium chloride water of Undulna Thermae was evaluated as a 2-weeks therapy for gynoid lipodystrophy in a group of 30 overweight females (age: 20-50y, BMI: 25-35 kg/m2) by means of evidence based-medicine criteria. METHODS: The modification of the body diameters was the primary end-point, and the variation of skinfold thicknesses, bioimpendance parameters, evaluation of skin elasticity, rated thermal contact to liquid crystals and measurement of subcutaneous fat tissue were the secondary end-points. It was asked, by visual-analog scale, for an opinion to the patients about effectiveness of treatment. RESULTS: At the end of treatment, after 2 weeks, all body diameters significantly decreased in the intervention group (waist circumference: 91.95 +/- 8.94 versus 90.60 +/- 8.90 cm, p < 0.001). Moreover, total body water were significantly reduced in the intervention group (35.05 +/- 3.74 versus 34.38 +/- 3.41 l, p < 0.03). As regards skin elasticity (+5.52%, p < 0.001), significant improvements have been determined; subcutaneous perfusion was also improved and thickness of subcutaneous fat was significantly reduced (thighs delta = -1.3 mm, p < 0.01; abdomen delta = -4.6 mm, p < 0.001). Furthermore, response to the visual-analog scale was positive (7.55 +/- 0.87). CONCLUSIONS: This treatment appears potentially useful in the clinical management of gynoid lipodystrophy in overweight females.

Relationship between the absorption of 5-hydroxytryptophan from an integrated diet, by means of Griffonia simplicifolia extract, and the effect on satiety in overweight females after oral spray administration.

The management of overweight may include the use of dietary supplements targeted to counter the feeling of hunger. A randomized, double-blind, placebo-controlled trial has been performed in 20 overweight females. These subjects were randomly assigned to supplement their diet with either an extract from Griffonia Simplicifolia (10 subjects) or a placebo (10 matched subjects) for 4-weeks, in conjunction with a personalised reduced calorie diet. The main aim of this study was to evaluate the efficacy, by the assessment of 24-h urinary 5-hydroxyindoleacetic acid levels (5-HIAA), of 1-month administration of a dietary supplement containing 5-hydroxytryptophan (5-HTP) from botanical extracts in healthy, overweight females. Secondary endpoints were the assessment of sensation of appetite (by Haber score), body composition, and severity of binge eating. The supplemented group had a significant increase of 24-h urinary 5-HIAA levels (p<0.001), and a decrease in Haber score (p<0.001) while the placebo group did not show significant changes. With regard to changes in body composition, statistically significant differences between the treatment groups were found for the mean change in BMI, suprailiac skinfold thicknesses, arm circumference and hip circumference. Other parameters were found to be similar in the treated and in the placebo groups. In conclusion, this study shows that the 5-hydroxytryptophan present in the Griffonia extract, administered via spray to the oral cavity, is adequately absorbed, as confirmed by the increase in 24-h urinary 5-HIAA, and that the supplementation of the diet of overweight women with 5-hydroxytryptophan increases the feeling of satiety associated with a decrease in BMI.

Beta-glucan- or rice bran-enriched foods: a comparative crossover clinical trial on lipidic pattern in mildly hypercholesterolemic men.

BACKGROUND/OBJECTIVES: There has been growing interest in using dietary intervention to improve the lipid profile. This work aims at analyzing the effects and the comparison of the enrichment of a diet with beta-glucans or rice bran in mildly hypercholesterolemic men. SUBJECTS/METHODS: The subjects initially consumed a 3-week Step 1 American Heart Association diet with rice bran-enriched foods. After this adaptation period, volunteers were randomly assigned to follow a crossover, controlled trial that consisted of two treatment with beta-glucan- or rice bran-enriched foods, each of 4 weeks, with a 3-week wash-out, like the adaptation period, between periods. Fasted blood samples were collected on days 0, 21, 49, 70 and 98 in both study arms for measuring low-density lipoprotein (LDL)-cholesterol (primary outcome), total cholesterol, high-density lipoprotein (HDL)-cholesterol, triglycerides, apolipoprotein (apo) A-I, apo B and glucose levels. RESULTS: Twenty-four men (mean age: 50.3±5.3, mean body mass index: 24.9±1.9) completed the 14-week trial. Subjects in the 3-week adaptation period experienced significant reductions in the mean level of LDL cholesterol, total cholesterol, total cholesterol/HDL cholesterol, LDL cholesterol/HDL cholesterol, apo A-I, apo A-I/apo B and glucose. During the intervention diet periods, a difference was found between treatment groups for the mean change in LDL (0.21 (95% confidence interval (CI): 0.02-0.40), P=0.033) and total cholesterol (0.34 (95% CI: 0.20-0.47), P<0.001). Other parameters evaluated were not significantly affected by the diet consumed. CONCLUSIONS: The results of the present crossover clinical trial showed that beta-glucan-enriched foods are more effective in lowering serum LDL levels, compared with rice bran-enriched foods.

Long chain omega 3 polyunsaturated fatty acids supplementation in the treatment of elderly depression: effects on depressive symptoms, on phospholipids fatty acids profile and on health-related quality of life.

OBJECTIVE: Recent observations showed that long chain omega 3 polyunsaturated fatty acids (n-3 LCPUFA) could represent a potential treatment for elderly depression. To determine if a n-3 LCPUFA containing supplement improves depressive symptoms, changes phospholipids acids profile and ameliorates Health related quality of life (HRQoL) in depressed elderly patients. DESIGN: Two-months, randomized, double-blind, placebo-controlled trial. SETTING: Nursing home in Pavia, Italy. SUBJECTS: Forty-six depressed females, aged 66-95 years. INTERVENTION: 22 depressed females were included in the intervention group (n-3 group, that received 2.5 g/day of n-3 LCPUFA, with 1.67 grams of EPA and 0.83 grams of DHA), and 24 patients in the placebo group. The primary endpoint was the improvement of depressive symptoms as evaluated by Geriatric Depression Scale (GDS). Secondary endpoints were the evaluation of modifications of erythrocyte membrane phospholipids fatty acid profile and of of HRQoL, by using the Short-Form 36-Item Health Survey (SF-36). All parameters were assessed before and after the treatment period of 8 weeks. RESULTS: The mean GDS at 2 months was significantly lowered only for the n-3 group. SF-36 physical and mental components were significantly increased in the intervention group. Compliance was good, as confirmed by erythrocyte membrane phospholipid FA concentrations, with significant increase of EPA and DHA in the intervention group. CONCLUSION: The supplementation of n-3 LCPUFA in elderly female patients reduces the occurrence of depressive symptoms, improves phospholipids fatty acids profile and health-related quality of life.

[Pilot study to assess and compare the eating habits and nutrition knowledge in school-age Italians and Finns, using specific questionnaires]. / Studio pilota per la valutazione ed il confronto delle abitu- dini alimentari e dello stile di vita di un gruppo di ragazzi italiani ed un gruppo di ragazzi finlandesi grazie all'ausilio di specifici questionari.

In recent decades, the American diet has emerged in our country as a reference model food, particularly among young people, to the detriment of the Mediterranean diet, an healthy eating pattern rich in fruits and vegetables, olive oil, whole grains and fish. Even in Europe, North American habits are widespread at the expense of traditional northern nutritional powers, characterized by a lot of fish, wild game meat that are much thinner than from farm animals, rye, oats, cabbage, root vegetables. Given this background, in Pavia (Italy) and Tampere (Finland) we conducted a pilot study with the objective to assess and compare the eating habits and nutrition knowledge in school-age children using 2 questionnaires entitled "what do you eat?" and "what do you know about diet and health?". The results of the first questionnaire clearly shows that, among young people of both countries, there is the loss of traditional food: the Mediterranean and the Finnish diet. All the boys wear it with a low frequency fish, fruit and vegetables, and instead a high frequency of adverse health foods, such as potato chips and sweet drinks. The answers to questions which relate to nutrients and their properties, show that children of all groups have little knowledge about these topics. The use of questionnaires, such as those administered by us, can be easily performed to investigate the dietary habits and the nutritional level of culture, due to make nutrition education interventions aimed at correcting poor eating habits.

Satiety and amino-acid profile in overweight women after a new treatment using a natural plant extract sublingual spray formulation.

OBJECTIVE: To test the effect on satiety of a formulation comprising plant extracts naturally containing 5-hydroxytryptophan, delivered as sublingual spray (5HTP-Nat Exts), administered five times a day for 2 months. DESIGN: Two-month, randomized, double-blind, placebo-controlled trial. SUBJECTS: A total of 27 healthy, adult overweight women were randomly assigned to the treatment (14) or the placebo group (13). MEASUREMENTS: Visual analog scales were used to assess appetite sensations every day. Moreover, the study evaluated the bioavailability of 5-hydroxytryptophan following sublingual delivery over 8 weeks, by comparing 24-h urinary excretion of 5-hydroxy-3-indoleacetic acid (5-HIAA), determined at baseline and after 2 months. Other secondary end points of the study were to compare body composition, depressive symptoms, severity of binge eating and quality of life. Finally, the study tested whether a single administration of 5HTP-Nat Exts in fasting state has an effect on amino-acid profile and on appetite ratings and whether 5HTP-Nat Exts administered before a fixed test meal has any effect on satiety. RESULTS: The group using the 5HTP-Nat Exts experienced a significantly greater increase in their sensation of satiety over an 8-week timeframe and in fasting state following administration of 5HTP-Nat Exts than the placebo group did (AUC=305.2 (52.8) vs 236.6 (59.4), mean difference -68.7 (95% confidence interval (CI) -116.2 to -21.2), P=0.007; mean difference in Haber score change 2.5 (95% CI 0.62-3.12, P=0.007)). A difference was observed between the groups for the mean change in 5-HIAA. All the amino acids evaluated after a single administration of 5HTP-Nat Exts were found to be similar. Differences were found for the mean change in body mass index, skinfold thicknesses and hip circumference. The other parameters were found to be similar. CONCLUSION: All these findings suggest that 5HTP-Nat Exts may be safely used to treat the problem of appetite control in overweight women during a weight loss program.

[The biological activity of beta-glucans]. / Le attività biologiche dei beta-glucani.

This review summarizes the recent knowledge about the positive effect of betaglucans on human health. Beta-glucans are polysaccharides occurring in the bran of cereal grains (barley and oats and to a much lesser degree in rye and wheat, in amounts of about 7%, 5%, 2% and less than 1%, respectively), the cell wall of baker's yeast, certain types of fungi, and many kinds of mushrooms. The differences between soluble and insoluble beta-glucans are significant in regards to application, mode of action, and overall biological activity. A growing body of science indicates that beta-glucans promote health in a number of important ways. Beta-glucans have been studied for their hypocholesterolemic effects; these mechanisms include: reducing the intestinal absorption of cholesterol and bile acids by binding to glucans; shifting the liver from cholesterol syntheses to bile acid production; and fermentation by intestinal bacteria to short-chain fatty acids, which are absorbed and inhibit hepatic cholesterol syntheses. Several studies have also shown that oat beta-glucans blunt the glycemic and insulin response. Moreover, beta-1,3-glucans improve the body's immune system defense against foreign invaders by enhancing the ability of macrophages, neutrophils and natural killer cells to respond to and fight a wide range of challenges such as bacteria, viruses, fungi, and parasites. Finally, there is renewed interest in the potential usefulness of beta-glucan as a radioprotective drug for chemotherapy, radiation therapy and nuclear emergencies, particularly because glucan can be used not only as a treatment, but also as a prophylactic.

[Focus on folic acid benefits]. / Focus sull'acido folico.

Folic acid, or vitamin B9, derives its name from the Latin word folium, which was used to indicate large-leafed plants rich in folic acid. Naturally occurring in spinach leaves, this complex acid was first synthesized in 1945. Since then, mounting scientific evidence has demonstrated its beneficial effects on the human body. An essential nutrient for well-being and health, folic acid intake during pregnancy is especially important for preventing neural tube defects. This focus highlights the importance of correct intake levels of folic acid, particularly in subjects at risk of vitamin B(9) deficiency.

Relationship among nutritional status, pro/antioxidant balance and cognitive performance in a group of free-living healthy elderly.

AIM: Nutrition plays a role in health promotion and well-being, but there is still a lack of knowledge about nutrition-related risk factors in aging cognitive impairment. The purpose of this project was to evaluate the link between nutritional status, cognitive performance and pro/antioxidant balance in healthy elderly subjects residing in a small metropolitan community. METHODS: The subjects were 69 free-living urban healthy elderly people (41 females and 28 males aged 84+/-7 years, mean +/- standard deviation SD, range 70-89). In this group of elderly subjects an analysis of the diet over the 3 days before the study entry was performed. The nutrients intake for individuals were compared with the Italian Recommended Dietary Allowances (RDA). We also collected residents' background information, nutritional status (Mini Nutritional Assessment, MNA), and data on daily nursing routines in institutions, including nutritional care. Plasma malondialdehyde and erythrocyte glutathione peroxidase activity were evaluated in elderly people as compared to a group of healthy young people (control group) as indices of the oxidative balance. RESULTS: The mean vitamin and mineral intake for participants met the RDAs except for calcium and vitamin D. No difference was observed as regards plasma malondialdehyde between young and elderly subjects: 4.5 (3-6.2) mmol/L vs 4.45 (2.4-5.8) mmol/L respectively, median with range, whereas the latter exhibited higher erythrocyte glutathione peroxidase activity: 16.0 (9.3-48) U/g hemoglobin (Hb) vs 15 (10-35) U/g Hb, respectively, median with range (P<0.05). A significant negative correlation (P<0.05, r=0.24) between dietary intake of vitamin D and malondialdeyde and between dietary intake of vitamin D and poor performance on cognitive tests (P<0.01, r=0.35) was observed. CONCLUSION: In line with previous findings, our results highlighted the potential impact of nutritional factors on cognitive performance in older adults.

[Effect of treatment with a food supplement (containing: selected sea fish cartilage, vitamin C, vitamin E, folic acid, zinc, copper) in women with iron deficiency: double blind, randomized, placebo-controlled trial]. / Ruolo cardine dell'assunzione di un integratore alimentare (contenente idrolizzato di cartilagine di pesce marino, vitamina C,vitamina E, acido folico, zinco, rame) nel trattamento della sideropenia in un gruppo di pazienti in etá fertile.

AIM: The term iron deficiency is used to indicate a condition in which the content of iron (Fe) in the organism is low, even before the consequent reduction in erythropoiesis comes about. This clinical situation is very frequent in patients in fertile age. The therapy commonly used (Fe salts) is often poorly tolerated. The use of a food supplement containing nutrients useful for improving the bioavailability of Fe and that is well tolerated can represent a valid alternative to iron therapy. METHODS: The present study examines 49 fertile women with iron deficiency, of normal weight and not undergoing estroprogestin treatment. The patients underwent 3 assessments: basal, after 30 and after 60 days to determine their complete haemochrome, blood iron, blood ferritin, blood transferrin, iron binding capacity, folates, TSH, FT3, and FT4. Following the basal assessment, patients were randomly assigned to 1 of 2 treatment groups: treatment A (25 patients): food supplement containing hydrolyzed sea fish cartilage, vitamin C, vitamin E, folic acid, zinc, copper (Captafer); treatment B (24 patients): placebo. RESULTS: The patients were then subdivided into 2 groups according to the basal blood iron (<60 microg/dL) or blood ferritin (<20 ng/mL) values. In the group presenting blood iron of <60 microg/dL only treatment A supplement produced a significant improvement in blood iron after 30 (P<0.001) and after 60 (P<0.005) days of treatment. The group with basal blood ferritin of <20 ng/mL presented blood iron levels of >60 microg/dL; in these patients after 60 days of treatment with the supplement, there was a significant increase in blood ferritin (P<0.05); the patients treated with placebo, on the other hand, did not show any significant difference compared to basal values. CONCLUSIONS: This study has shown that, in patients with iron deficiency, the use of a food supplement, consisting of nutrients that improve the bioavailability of Fe, leads to a significant improvement in blood iron and blood ferritin levels.

[Nutritional management of patients suffering of chronic renal failure]. / La terapia nutrizionale nel nefropatico non dializzato.

Nutritional support constitutes a fundamental approach to favour the management of chronic renal failure and to postpone the need of kidney dialysis. The specific goals of the nutrition intervention are: control of protein intake, control of phosphate and of calcium intake, control of potassium intake, control of energy intake, control of lipid intake with clear identification of the polyunsaturated vs monounsaturated vs saturated fatty acid rate, control of vitamin intake, prevention of malnutrition and intervention with oral supplements or artificial nutrition (even if for short time) if malnutrition occurs. The proper management of the nutritional problems of patients with chronic renal failure slows the disease progression, prevents or controls symptoms associated with uremia and postpones the beginning of substitutive treatment that is of hemodialysis or of peritoneal dialysis, thus allowing a better quality of life either in the short or long term for patients suffering of chronic renal failure.

[Dietary restriction and oral administration of antioxidant and omega-3: what are the effects on the clinical variables in a group of obese women?]. / La dietoterapia ipocalorica bilanciata personalizzata ed il trattamento con integratori a base di antiossidanti e omega-3 (quali gli effetti sulle variabili cliniche di outcome in un gruppo di donne in sovrappeso?)

BACKGROUND: Obesity is now recognized as a major risk factor for many pathologies. The state of obesity is associated with an increase in reactive oxygen species; persistent overconsumption of calories in the obese may be exposing them to excessive damage besides maintaining the state of obesity. It is possible that dietary modification and association with assumption of antioxidant and omega-3 oral integration contributes to a reduction in reactive oxygen species generation and a corresponding reduction in indexes of oxidative damage, including lipid peroxidation. METHODS: Given this back-ground, the pro/anti-oxidant balance, biochemical parameters and the body composition were studied in two groups of obese women: a first group of 10 obese women were studied before and after eight weeks of dietary restriction and a second group of 12 obese women were studied before and after eight weeks of dietary restriction and oral administration of antioxidant and omega-3. RESULTS: In summary, as regards the preliminary results of clinical outcome parameters, interestingly enough the glycemic levels fall markedly in association with both dietary restriction and oral integration with antioxidant and omega-3. Another important finding of this study is that of calcium levels and phase angle (measured by impedenzometry) increase in the group treated with dietary restriction and oral administration of antioxidant and omega-3. CONCLUSIONS: Studies that aimed to explore whether oxidative status predicts clinical outcome would provide important details on the putative link between oxidative status and state of obesity.