Healthy Eating Enhances Intrinsic Capacity, Thus Promoting Functional Ability of Retirement Home Residents in Northern Taiwan.

Healthy aging is defined as the process of developing and maintaining functional ability in older age with intrinsic capacity, the composite of all the physical and mental capacities of an individual, being the core. This study was conducted to explore the intervention effects of improved dietary quality on intrinsic capacity. A prospective single-group interventional quasi-experimental study with 59 functional independent older adults from retirement homes were recruited. Texture-modified plant-based dietary supplements were provided. In addition, dietary intake, functional ability, and intrinsic capacity in vitality, locomotion, cognition, and psychological capacity were assessed. Vitality was captured by nutritional status, muscle strength, and cardiorespiratory endurance. Locomotor capacity was assessed based on the performance of physical fitness in backscratch test, chair-sit-and-reach test, chair-stand test, one-foot-standing test, and gaits peed. Psychomotor capacity and cognition were measured by using 15-item Geriatric Depression Scale (GDS-15) and Mini-Mental State Examination (MMSE), respectively. In a 4-month of intervention, after controlling for baseline values and covariates, participants with higher dietary intervention adherence showed a significant improvement over time in vitality captured by cardiorespiratory endurance (Pinteraction = 0.009) and significant improvement in locomotion captured by gait speed (Pclusters = 0.034). A significant decrease in the chair-stand test (Ptime = <0.001) and MMSE (Ptime = 0.022) was observed during the four months of intervention. Enhanced intrinsic capacity further contributed to the improvement of ADL over time (Pinteraction = 0.034). In conclusion, healthy eating enhances intrinsic capacity in vitality and locomotion thus promoting functional ability among older adults.

Novel Healthy Eating Index to Examine Daily Food Guides Adherence and Frailty in Older Taiwanese.

This study was conducted to investigate the adherence of Daily Food Guides (DFGs) among older Taiwanese, and the relationship of dietary quality and frailty. 154 functional independent older adults who were retirement home residents or community dwellers involved in congregate meal services were recruited. DFGs adherence was measured using a novel Taiwanese Healthy Index (T-HEI). Dietary quality was further assessed using Dietary Approach to Stop Hypertension (DASH) and Mediterranean Diet Score (MDS). Frailty was defined using modified Fried's criteria. Of the total participants, 12.3% were considered non-frail individuals, while 77.3% were prefrail, and 10.4% were frail. Compared to non-frail participants, prefrail and frail individuals indicated significantly lower adherence to DFGs (ptrend = 0.025). Intake of dark or orange vegetables (ptrend = 0.010), whole grains (ptrend = 0.007), as well as nuts and seeds (ptrend = 0.029) by non-frail individuals were significantly higher than the levels by prefrail and frail individuals. Linear regression model adjusted for age, gender, and functional ability showed that T-HEI was inversely associated with frailty status (ß = -0.16 ± 0, p = 0.047), but additional adjustment for nutritional status attenuated the association (ß = -0.14 ± 0, p = 0.103). A similar relationship was observed for DASH but not MDS (DASH: ß = -0.18 ± 0.01, p = 0.024; MDS: ß = -0.06 ± 0.02, p = 0.465). After adjustment for confounders, the association was not observed. However, the distribution of whole grains component in both DASH and MDS was significantly higher in non-frail than prefrail and frail individuals, indicating the importance of whole grains intake in frailty prevention. In conclusion, higher adherence to DFGs and better dietary quality were associated with a lower prevalence of frailty. Higher nutrient-dense foods intake such as whole grains, dark or orange vegetables, nuts, and seeds mark a watershed in frailty prevention.

Plant-Based, Antioxidant-Rich Snacks Elevate Plasma Antioxidant Ability and Alter Gut Bacterial Composition in Older Adults.

Plant-rich diets alleviate oxidative stress and gut dysbiosis and are negatively linked to age-associated chronic disorders. This study examined the effects of consuming plant-based, antioxidant-rich smoothies and sesame seed snacks (PBASS) on antioxidant ability and gut microbial composition in older adults. Healthy and sub-healthy older adults (n = 42, 79.7 ± 8.6 years old) in two senior living facilities were given PBASS for 4 months. Blood and fecal samples were collected from these individuals at the baseline and after 2 and 4 months of PBASS consumption. After 2 months, serum levels of albumin and high-density lipoprotein-cholesterol and the ratio of reduced to oxidized glutathione (GSH/GSSG) had increased significantly and erythrocytic glutathione, GSH/GSSG and superoxide dismutase activity had decreased significantly compared with baseline levels (p < 0.05). After 4 months, red blood cells, hematocrit, serum blood urea nitrogen and erythrocyte glutathione peroxidase activity had decreased significantly, whereas plasma and erythrocyte protein-bound sulfhydryl groups had increased significantly. Furthermore, plasma glutathione and total antioxidant capacity were significantly greater after 2 months and increased further after 4 months of PBASS consumption. The results of next generation sequencing showed that PBASS consumption prompted significant decreases in observed bacterial species, their richness, and the abundance of Actinobacteria and Patescibacteria and increases in Bacteroidetes in feces. Our results suggest that texture-modified, plant-based snacks are useful nutrition support to benefit healthy ageing via the elevation of antioxidant ability and alteration of gut microbiota.

Intergenerational Comparison of Food Parenting of Home Eating Behaviors of Schoolchildren.

OBJECTIVE: To explore intergenerational differences on key factors of food parenting practices (FPPs) related to home eating behavior of schoolchildren. DESIGN: In-depth interviews with social recognition theory-based semistructured interviews conducted from December 2016 to January 2017. PARTICIPANTS: Primary caregivers of elementary schoolchildren from 23 households (16 parents, 14 grandparents) in 4 remote areas of Hualien, Taiwan. PHENOMENON OF INTEREST: Factors related to FPPs hindering micronutrient-dense food group consumption by schoolchildren in a remote area. SETTING: In-depth interviews were conducted at participants' houses. ANALYSIS: Interviews were audiorecorded and transcribed verbatim. Inductive thematic analysis was performed to elicit studied phenomenon. RESULTS: Routine family meals provided adequate staple, protein, and vegetables but inadequate whole grains, dairy, fruits, and nuts. More parents provided breakfast composed of pan-fried and semiprocessed products made of refined flour and sugary beverages. Both parents and grandparents had ambiguous nutrition concepts and inconsistent FPPs but in different aspects. They both reflected expectations for assistance from local schools for nutrition and FPPs education to shape up healthy eating behavior of children. CONCLUSIONS AND IMPLICATIONS: Study findings pinpoint the strength and barriers of FPPs for primary caregivers. Implementing integrated nutrition education programs tailored for empowering nutrition literacy and FPPs is suggested to enhance the healthy eating behavior of schoolchildren in a remote area.

Interrelationships among genetic C677T polymorphism of 5,10-methylenetetrahydrofolate reductase, biochemical folate status, and lymphocytic p53 oxidative damage in association with tumor malignancy and survivals of patients with hepatocellular carcinoma.

SCOPE: Metabolic genotypes of 5,10-methylenetetrahydrofolate reductase (MTHFR) and folate status on oxidative DNA lesions in hepatocellular carcinoma (HCC) has not been elucidated. The aims of the study were to investigate the folate-polymorphic interactions on genetic oxidative damage in association with advanced HCC malignancy and prognosis. METHODS AND RESULTS: The study included 232 HCC patients with folate nutrition, MTHFR C677T polymorphic, p53 genetic and tumour pathological data collected and analyzed for their survivals after a 7.8-years following up. By adjustment for oxidative risk factors of HCC, the compound CT and TT genotypes in relative to the CC wild-type were associated with 83% reduced lymphocytic p53 oxidative lesions of HCC patients with RBC folate lower than 688 ng/mL (OR: 0.17, 95%CI: 0.07-0.43). Such genetic protective effects by the CT/TT genotypes were 2-fold enhanced among those with high RBC folate (OR: 0.08, 95% CI: 0.03-0.21, P for interaction < 0.001). For those with non-folate-deficient status, the compound CT and TT vs. CC genotypes were associated with 80% reduced risks of advanced HCC stages (III&IV) (OR: 0.2, 95%CI: 0.08-0.56). Such protection was negated either by adjustment of lymphocytic p53 oxidative lesions or by 3-fold increased risks among those with high RBC status (OR: 0.6, 95%CI; 0.31-1.41, P for interaction = 0.009). Multivariate Cox proportional hazards analysis showed that the CT/TT genotypes vs. CC wild-type were the independent predictable factor for better survival outcome of HCC patients (HR: 0.48, CI = 0.30-0.79). For CC homozygote, the second vs. the bottom tertile levels of RBC status were associated with 2-fold increased mortality rate of HCC patients (HR: 2.05, CI = 1.0-4.1). CONCLUSION: Our data demonstrated that reduced MTHFR activities associated with the MTHFR T allele may interact with RBC folate as the risk modifiers of lymphocytic p53 oxidative lesions of HCC patients. The CT/TT genotypes correlated with lower risks of late-stage HCC and a favorable survival of HCC patients, depending on p53 oxidative lesions or RBC folate status.

Co-occurrence of anemia, marginal vitamin B6, and folate status and depressive symptoms in older adults.

Although nutrient deficiencies are thought to play roles in the development of depression, observational studies have yielded inconsistent results. This study aimed to investigate whether multiple marginal nutrient deficiencies are associated with symptoms of depression in community-dwelling older Taiwanese. Data from 1371 elderly adults recruited from the Elderly Nutrition and Health Survey in Taiwan was used in this study. Depressive symptom scores on depressed mood and emotions affecting daily life were derived from the Medical Outcomes Study Short Form-36 (SF-36). Hemoglobin, serum ferritin, plasma vitamins B(6), B(12), and folate concentration, and erythrocyte transketolase and glutathione reductase activation coefficients were measured. After adjusting for age, gender, cognitive function, physical activity, disease history, and medication in the multivariate analysis, anemia, and marginal B(6) deficiency were significantly associated with the presence of depression symptoms, respectively. In addition, co-occurrence of vitamin B(6) with low folate level and co-occurrence of anemia either with low vitamin B(6) or with folate level were all associated with the depressive mood and with depressive emotions defined by SF-36 (odds ratios [OR] in the range of 2.32-7.13, all P values ≤.05). The magnitude of the ORs is larger when the number of deficiencies increased. Elderly people with coexisting marginal deficiencies of nutrients involved in the S-adenosylmethionine and hemoglobin production were more likely to experience depressed mood and emotion that affect daily activity. Examining status of these nutrients is worthy of consideration for older adults with depressed symptoms.

Drinking deep seawater decreases serum total and low-density lipoprotein-cholesterol in hypercholesterolemic subjects.

Drinking deep seawater (DSW) with high levels of magnesium (Mg) decreased serum lipids in animal studies. Therefore the effects of drinking DSW on blood lipids and its antioxidant capacity in hypercholesterolemic subjects were investigated. DSW was first prepared by a process of filtration and reverse osmosis, and then the concentrated DSW with high levels of Mg was diluted as drinking DSW. Forty-two hypercholesterolemic volunteers were randomly divided into three groups: reverse osmotic (RO) water, DSW (Mg: 395 mg/L, hardness 1410 ppm), and magnesium-chloride fortified (MCF) water (Mg: 386 mg/L, hardness 1430 ppm). The subjects drank 1050 mL of water daily for 6 weeks, and blood samples were collected and analyzed on weeks 0, 3, and 6. Drinking DSW caused a decrease in blood total cholesterol levels and this effect was progressively enhanced with time. Serum low-density lipoprotein-cholesterol (LDL-C) was also decreased by DSW. Further, total cholesterol levels of subjects in the DSW group were significantly lower than those in the MCF water or RO water groups. Compared with week 0, the DSW group had higher blood Mg level on weeks 3 and 6, but the Mg levels were within the normal range in all three groups. DSW consumption also lowered thiobarbituric acid-reactive substances (TBARS) values in serum. In conclusion, DSW was apparently effective in reducing blood total cholesterol and LDL-C, and also in decreasing lipid peroxidation in hypercholesterolemic subjects.

Effects of deep-frying oil on blood pressure and oxidative stress in spontaneously hypertensive and normotensive rats.

OBJECTIVE: Ingestion of deep-frying oil has been reported to cause physiologic and histologic changes in experimental animals' tissue, increase the oxidative stress, and possibly lead to death. The purpose of this study was to investigate the effect of deep-frying oil on oxidative stress and blood pressure in spontaneously hypertensive (SHR) and Wistar Kyoto (WKY) rats. METHODS: Deep-frying oil was prepared by frying fresh soybean oil at 180 +/- 5 degrees C for 8 h each day, for 4 consecutive days. Male SHR and WKY rats were fed diets containing 15% fresh soybean oil or deep-frying oil (DO) for 10 wk. RESULTS: Rats ingesting the DO diet had lower feed efficiency and higher relative liver and kidney weights but deep frying had no significant influence on blood pressure in WKY or SHR rats. The DO diet had no effect on plasma renin activity, aldosterone content, or tissue angiotension-I-converting enzyme activity. WKY rats fed the DO diet showed significantly increased urinary thromboxane B(2) and 8-iso-prostaglandin F(2alpha) excretion, but not urinary 6-keto-prostaglandin F(1alpha) excretion. Diets containing deep-frying oil resulted in increased plasma thiobarbituric acid-reactive substances and nitric oxide contents and decreased plasma total antioxidant capacity in SHR and WKY rats. CONCLUSION: The ingestion of deep-frying oil seemed not to influence blood pressure or its related parameters, but altered eicosanoid metabolism and elevated oxidative stress in SHR and WKY rats.

Vitamin D intake and its food sources in Taiwanese.

In the early 20th Century, vitamin D was discovered and its Recommended Daily Allowance developed. However, average daily dietary intakes have not been reported until recently in the US. There are no food composi-tion and no intake data for vitamin D available in Taiwan. We have taken advantage of several population representative Nutrition and Health Surveys in Taiwan (NAHSIT) conducted from 1993 onwards of various age groups to examine this possibility systematically. Firstly, we collected and compiled the vitamin D content of foods from various sources to supplement the Taiwanese Food Composition Tables. Though these vitamin D data may not be fully representative of local food items, they serve as a reference point. Secondly, we have used the three NAHSITs databases, which all used the 24-hr recall method to collect dietary intake date and five food frequency questionnaire type questions to collect supplement data, to estimate most gender- and age-specific (in-clude: school children, adults and elderly) vitamin D intake from food source and supplements. Thirdly, we have defined the sources of vitamin D intake in Taiwanese (gender- and age-specific). Vitamin D intakes of Taiwanese were adequate except girls of high school and indigenous people. Fish and its products, milk, mushroom were the major vitamin D food sources. Supplement source vitamin D also varied greatly between age and gen-der groups. Elderly women consumed almost 20% of vitamin D from supplements; 16-18 years old boys consumed 2.47% vitamin D from supplements only.

Vitamin B2 inhibits glutamate release from rat cerebrocortical nerve terminals.

We examined the effect of riboflavin, vitamin B2, on the release of endogenous glutamate from nerve terminals purified from rat cerebral cortex. The release of glutamate evoked by 4-aminopyridine was inhibited by riboflavin. Further experiments indicated that riboflavin-mediated inhibition of glutamate release (i) results from a reduction of vesicular exocytosis, not from an inhibition of nonvesicular release; (ii) is associated with a decrease in presynaptic N-type and P/Q-type voltage-dependent Ca channel activity. These findings are the first to suggest that, in rat cerebrocortical nerve terminals, riboflavin suppresses voltage-dependent Ca channel activity and in so doing inhibits evoked glutamate release. This finding may explain the neuroprotective effects of vitamin B2 against neurotoxicity.

Thiamin and riboflavin status of Taiwanese elementary schoolchildren.

In The Nutrition and Health Survey of Taiwan Elementary School Children (NAHSIT Children 2001~2002), erythrocyte activity coefficients of transketolase (ETKAC) and glutathione reductase (EGRAC) were chosen as indices for assessing the functional status of thiamin and riboflavin nutriture. Mean values of the ETKAC for boys and girls, both of which were in a normal range, were 1.07+/-0.00 and 1.06+/-0.01, respectively. The respective prevalence rates of marginal and deficient thiamin states were 10.4% and 7.8% for boys and 9.3% and 7.3% for girls. Mean values of the EGRAC were 1.18+/-0.00 for boys and 1.19+/-0.01 for girls, both of which showed an increasing trend with age. The respective rates of marginal and deficient riboflavin states were as high as 32.5% and 3.5% for boys and 35.9% and 4.5% for girls. The marginal and deficient riboflavin statuses of Taiwanese schoolchildren were associated with a low frequency of dairy food consumption and an elevated risk of anemia.

Prevalence of thiamin and riboflavin deficiency among the elderly in Taiwan.

The purpose of this study was to perform biochemical assessments of the nutritional status of thiamin and riboflavin in the 2379 elderly persons (1213 males, 1166 females) participating in the Elderly Nutrition and Health Survey in Taiwan (1999-2000) (Elderly NAHSIT). Through analysis of the data we aimed to investigate possible factors related to the prevalence of vitamin deficiency. Activity coefficients of erythrocyte transketolase and glutathione reductase (ETKAC and EGRAC) were the chosen biochemical indicators for thiamin and riboflavin status. The results showed that 14.7% of men and 11.9% of women were marginally thiamin deficient, and 16.5% of men and 14% of women were thiamin deficient. The prevalence rates of marginal riboflavin deficiency were 25.7% for males and 20.1% for females, and the deficiency rates were 6.6% for elderly males and 4.1% for elderly females. Although the average dietary thiamin and riboflavin intakes reached 146%-164% of Taiwan RDAs, the percentage of senior citizens whose thiamin or riboflavin dietary intakes were less than EARs (equivalent to 83.3% of RDAs) was around 30% for males and 40% for females. Some contributing factors to the significant prevalence of thiamin and riboflavin deficiencies are discussed in this article.

Association of B vitamins status and homocysteine levels in elderly Taiwanese.

To investigate the relationship between homocysteine (Hcy) and B vitamins status in the Taiwanese elderly population, an analysis was made of the plasma Hcy levels in elderly persons. The study sample was taken from the Elderly Nutrition and Health Survey in Taiwan (1999-2000) (Elderly NAHSIT) and included 1094 males and 1135 females aged 65-90 years. The results showed that average plasma Hcy was 13.3+/-0.6 micromol/ L for males and 10.6+/-0.7 micromol/L for females. The average plasma Hcy levels of males from all age groups were significantly higher than those of females, and significantly increased with age (P<0.0001). The overall prevalence of hyperhomocysteinemia (Hcy>15 micromol/L) was 23.4% for elderly males and 11.2% for elderly females, and this also increased with age (P<0.0001). In subjects with normal renal function, folate, vitamin B2, B6, and B12 status were significantly lower in males with hyperhomocysteinemia, while only folate and vitamin B12 were significantly lower in females with hyperhomocysteinemia. Further analysis suggested that folate, vitamin B6 or B12 insufficiency were associated with hyperhomocysteinemia in both sexes, while vitamin B2 insufficiency was significantly associated only in males. In elderly persons with adequate folate, vitamin B6, and B12 status, there was no significant association between vitamin B2 and hyperhomocysteinemia. This association occurred only in those who had concurrent poor folate, vitamin B6, or B12 status. The strength of the association between vitamin B12 insufficiency and hyperhomocysteinemia was not affected by simultaneous vitamin B2 or B6 insufficiency, but increased about 3-fold when combined with folate. This suggests that poor folate and vitamin B12 status has a synergistic effect on the risk of hyperhomocysteinema in the elderly, as did a poor folate and vitamin B6 status. Therefore, maintaining adequate vitamin B12 status and avoiding multiple B vitamin insufficiency, especially that of folate and vitamin B12 or B6, should be emphasized as an important measure for reducing plasma Hcy levels among elderly Taiwanese.