3-day Record Research Articles

Plasma linoleic acid partially mediates the association of bipolar disorder on self-reported mental health scales

We have shown that bipolar individuals have reduced quality diets, including lower intake of polyunsaturated fatty acids (PUFA). We have also reported reduced plasma levels of the n-6 PUFA, linoleic acid (LA), and the n-3 PUFA, eicosapentaenoic acid (EPA) in bipolar subjects. In the current analysis we hypothesized that LA and EPA plasma levels would mediate lower self-reported mental health and life functioning scores in bipolar subjects. In a cross-sectional study, we collected a 7-day diet record in bipolar (n = 56) and control subjects (n = 46) followed by a fasted blood draw. We used structured equation modeling path analysis to test for mediating effects of dietary intake and plasma levels of LA and EPA on self-reported mental health questionnaire scores, including the Life Functioning Questionnaire (LFQ), the Patient Health Questionnaire (PHQ9), and the Short Form Health Survey (SF12), extracting the mental health component summary score (SF12-MH). We adjusted for age, gender, psychiatric medication use, body mass index (BMI), and total caloric intake as covariates with bipolar disorder as the primary predictor. We found a significant path association from bipolar disorder to lower plasma LA levels (p = 0.03) and significant paths from plasma LA to PHQ9 (p = 0.05), LFQ (p = 0.01) and SF12-MH (p = 0.05) scores, such that lower plasma LA predicted worse outcomes. We found no significant paths from plasma EPA levels to any of the outcome measures. These findings suggest that plasma LA levels partially mediate the effect of bipolar disorder on self-reported measures of mental health and life functioning.

Intradiurnal patterns of allergenic airborne pollen near a city motorway in Berlin, Germany

In this study, the seasonally averaged intradiurnal patterns of four different pollen types (Fraxinus, Betula, Poaceae and Artemisia) and the role of traffic volume, air pollution and selected weather parameters were investigated. Measurements were carried out with a 7-day recording volumetric spore trap (Hirst type) near a congested city motorway (the A 100) in Berlin, Germany, in 2012, 2013 and partly 2011. Both Poaceae and Artemisia pollen showed distinct patterns which were similar across the years. The main period of grass pollen concentrations in the air was from 8 a.m. to 10 p.m. with peaks about midday or in the afternoon. Mugwort pollen mainly occurred between 6 a.m. and 2 p.m. with a clear maximum from 8 to 10 a.m. With regard to Fraxinus and Betula pollen, the patterns were not as clear and showed differences throughout the years. The intradiurnal patterns of traffic volume and pollen load, mainly of Poaceae in the afternoon and Artemisia in the morning, were partly coincident. The combination of both a high pollen count and air pollution, due to exhaust emissions, represents a special health threat which could result in a double burden for allergy sufferers. In the case of the daily means of Betula and Poaceae, relative humidity had a significantly negative effect on pollen concentrations on the same and/or next day/s, sunshine duration (Poaceae) and air temperature (Artemisia) a positive one.

Total fluid intake assessed with a 7-day fluid record versus a 24-h dietary recall: a crossover study in Indonesian adolescents and adults

Purpose To compare total fluid intake (TFI), defined as the sum of water and all other fluid types, assessed with a 24-h dietary (food and fluid) recall with mean TFI assessed with a 7-day fluid-specific record among adolescents and adults.Methods This repeated cross-sectional study compared TFI as assessed by two fluid assessment instruments using a crossover approach. 290 adolescents (17.3 ± 0.8 years, 50 % boys) and 289 adults (43 ± 9.3 years, 50 % men) from Indonesia completed the study.ResultsSignificant correlations were observed between fluid intake assessed with the 24-h recall and the 7-day fluid record (r = 0.333; p < 0.001). The Bland–Altman method, however, showed an underestimation (bias) of mean TFI by a 24-h recall when compared with the 7-day fluid record [mean difference (95 % CI) −382 mL (−299, −465); p < 0.001]. The mean difference also increased with increasing TFI: Mean difference for the lowest and highest quartiles of TFI was 139 versus −1265 mL/day. The 7-day fluid record recorded two (95 % CI −1.9, −2.4; p < 0.0001) extra drinking acts compared with the 24-h recall, whereas the mean volume per drinking act was significantly higher with the 24-h recall [mean difference (95 % CI) 39 mL (31, 47); p < 0.001].ConclusionCompared with a 7-day fluid record, a 24-h dietary recall significantly underestimated TFI. Subjects recalled two less drinking acts, while estimating the volume consumed per drinking act to be larger. Since the adequate intakes for total water intake are based on median intakes observed in national surveys that most frequently used the 24-h recall method, they may potentially be underestimated.

PTU-183 Advice from a dietitian regarding the low fodmap diet broadly maintains nutrient intake and does not alter fibre intake

<h3>Introduction</h3> Dietary restriction of certain fermentable carbohydrates (low FODMAP diet, LFD) is increasingly utilised for managing symptoms of irritable bowel syndrome (IBS). Exclusion diets carry a risk of nutritional inadequacy, and lower calcium intake has been reported during a LFD. Furthermore, it is important to understand whether the positive impact of the LFD is due to FODMAP restriction or an unintended dietary change (e.g. fibre intake). This single-blind randomised controlled trial aimed to compare nutrient intake in patients with IBS following LFD advice with baseline and a sham diet. <h3>Method</h3> Adult patients with IBS referred to a secondary care dietetic service were screened for inclusion (n = 162). Suitable patients who were following their habitual diet (baseline) were randomised to blinded LFD advice or sham (placebo) dietary advice provided by a registered dietitian. The sham diet was designed to be equivalent in nutrients and FODMAP content compared with baseline intake. A 7-day diet record was completed and weight recorded at baseline and 4 weeks. Mean daily nutrient intakes were calculated from diet records (excluding supplements) entered into dietary composition software (Dietplan 6, Forestfield Software Ltd). Comparisons were made with dietary reference values (DRVs). Data was analysed using t-tests and McNemar tests. <h3>Results</h3> A total of 95 patients completed the study (63 females, 66%) with 8 withdrawals and 1 lost to follow up (LFD n = 4, sham n = 5). Mean weight change was not different between groups (LFD -0.3 kg vs sham -0.4 kg, p = 0.738). There were no differences in mean energy and nutrient intakes, including calcium, between LFD and sham at baseline or follow up except vitamin B₁₂at follow up (LFD 6.3 µg/d vs sham 4.7 µg/d, p = 0.004). There was a significant reduction in mean iron intake in LFD from baseline (11.3 mg/d) to follow up (10.2 mg/d, p = 0.008), although proportion of LFD meeting the iron DRV did not differ (baseline 52% vs follow up 48%, p = 0.375). Proportion of LFD meeting the fibre DRV did not change (baseline 53% vs follow up 53%, p = 1.00). Proportion of LFD meeting the calcium DRV at baseline was higher (64%) than after LFD (47%, p = 0.039). Overall, mean LFD nutrient intakes were similar to data for the healthy population. <h3>Conclusion</h3> More than half of patients following LFD advice did not meet DRVs for iron and calcium, although mean nutrient intakes were comparable to the healthy population. Energy and nutrient intake after LFD advice is not different to sham dietary advice, confirming that altered fibre intake is not responsible for its impact on IBS symptoms. <h3>Disclosure of interest</h3> None Declared.

Relationships of Circadian Rhythms and Physical Activity With Objective Sleep Parameters in Lung Cancer Patients.

Lung cancer patients undergo various treatments leading to sleep problems, rest-activity circadian rhythms disruption, and reduced levels of physical activity. It is important to understand the relationships among these variables. Appropriate interventions can possibly be implemented to improve sleep quality in lung cancer patients. The objective of this study was to examine the relationships of circadian rhythms and physical activity with objective sleep parameters in 106 of Taiwanese lung cancer patients. This study used a cross-sectional design. The instruments included an actigraph to measure the objective sleep parameters (total sleep time [TST], sleep efficiency, and sleep-onset latency [SOL]), rest-activity circadian rhythms (r24 [24-hour autocorrelation coefficient] and I < O [in-bed less than out-of-bed dichotomy index]), and physical activity frequency (UP activity mean). The daily physical activity amount in minutes was measured by the Bouchard 3-day physical activity record. Patients performing light-intensity physical activity of 295 min/d or greater had better values for the TST, sleep efficiency, SOL, r24, and I < O than those performing less than 295 min/d (all P < .05). Significant predictors of the TST included age (β = -.31), I < O (β = .32), and UP activity mean (β = -.42). Predictors of the SOL included current treatment (β = .20), I < O (β = -.28), UP activity mean (β = .51), and 24-hour light-activity minutes (β = -.23). Marked circadian rhythms and adequate light-intensity physical activity may improve sleep quality in lung cancer patients. Adequate light-intensity physical activity can be an effective intervention to improve sleep quality in lung cancer patients.

Atrial ectopy predicts late recurrence of atrial fibrillation after pulmonary vein isolation.

Late recurrence of atrial fibrillation (AF) after radiofrequency ablation remains significant. Asymptomatic recurrence poses a difficult clinical problem as it is associated with an equally increased risk of stroke and death compared with symptomatic AF events. Meta-analyses reveal that no single preablation patient characteristic efficiently predicts these AF recurrences. This study aimed to evaluate the prognostic value of premature atrial complex (PAC) occurrence with regard to the risk of late AF recurrence after radiofrequency ablation. The study cohort consisted of 124 patients with 7-day Holter recordings at 6 months post radiofrequency ablation for AF. No patients had AF recurrence before this time. Patients were followed-up every 6 months. Holter-detected PACs were defined as any supraventricular complexes occurring >30% earlier than expected. During a median follow-up of 4.2 years (first quartile to third quartile [Q1-Q3]=1.6-4.5), 32 patients (26%) had late recurrences of AF at a median of 462 days (Q1-Q3=319-1026) post radiofrequency ablation. The number of PACs per 24 hours was 248 (Q1-Q3=62-1026) in patients with and 77 (Q1-Q3=24-448) in patients without recurrence of AF (P=0.02). Multivariate analysis of the risk of late AF recurrence found ≥142 PACs per 24 hours to have a hazard ratio 2.84 (confidence interval, 1.26-6.43), P=0.01. This study showed that occurrence of ≥142 PACs per day at 6 months after PVI was independently associated with a significantly increased risk of late AF recurrence. These results could have important clinical implications for the design of post-PVI follow-up. URL: http://www.anzctr.org.au. Unique identifier: ACRTN12606000467538.

Comparison of Virtual Nutri Plus® and Dietpro 5i® software systems for the assessment of nutrient intake before and after Roux-en-Y gastric bypass

OBJECTIVES:The assessment of nutritional intake before and after bariatric surgery assists in identifying eating disorders, nutritional deficiencies and weight loss/maintenance. The 7-day record is the gold standard for such an assessment and is interpreted using specialized software. This study sought to compare the Virtual Nutri Plus® and Dietpro 5i® software systems in assessing nutrient intake in obese patients with type 2 diabetes mellitus who underwent a Roux-en-Y gastric bypass.METHODS:Nutritional intake was assessed in 10 obese women with type 2 diabetes mellitus before and 3 months after Roux-en-Y gastric bypass. The 7-day record was used to assess food intake and then, the Virtual Nutri Plus® and Dietpro 5i® software systems were used to calculate calorie, macronutrient and micronutrient intake based on validated food chemical composition databases. Clinicaltrials.gov: NCT01251016.RESULTS:During the preoperative period, deficits in the ingestion of total fiber and 15 out of 22 estimated micronutrients were observed when using the Virtual Nutri Plus®, compared to deficiencies in total fiber and 4 micronutrients when using the Dietpro 5i®. During the postoperative period, both the Virtual Nutri Plus® and Dietpro 5i® systems detected deficits in the ingestion of total fiber, carbohydrates and 19 micronutrients, but only the Virtual Nutri Plus® detected deficits in complex B vitamins (except B12) and minerals.CONCLUSION:Virtual Nutri Plus® was more sensitive than Dietpro 5i® for the identification of deficits in nutrient intake in obese, type 2 diabetes mellitus patients undergoing Roux-en-Y gastric bypass.

Long-term characterization of persistent atrial fibrillation: wave morphology, frequency, and irregularity analysis.

Short-term properties of atrial fibrillation (AF) frequency, f-wave morphology, and irregularity parameters have been thoroughly studied, but not long-term properties. In the present work, f-wave morphology is characterized by principal component analysis, introducing a novel temporal parameter defined by the cumulative normalized variance of the three largest principal components (r3). Based on 7-day recordings from nine patients with stable chronic heart failure and persistent AF, long-term properties were studied in terms of r3 AF frequency, and sample entropy (SampEn). The main result of the present study is that detection of circadian rhythms depends on the parameter considered: rhythms were found in six (r3, SampEn) and five (AF frequency) patients, but not always in the same patient. Another important result is that circadian rhythms detected in 7-day recordings could not always be detected in 24-h periods, thus shedding new light on the results in previous studies which all were based on 24-h recordings. Infradian rhythms were found in four (r3, SampEn) and one (AF frequency) patients.

Dietary Intake, Eating Behaviors, and Diurnal Patterns of Salivary Cortisol and Alpha-Amylase Secretion Among Professional Young Adult Female Tennis Players.

The aims of study were to examine the eating behaviors among 26 professional female tennis players and to assess the diurnal patterns of stress hormones through the measurement of awakening and diurnal profiles of salivary alpha-amylase (sAA) and cortisol concentrations. Eating behaviors were assessed through three questionnaires (Eating Attitudes Test-26; Eating Disorders Inventory 2; and Body Shape Questionnaire), food intake by a 7-day diet record, and menstrual status by questionnaire. Perceived stress scale and anxiety state were also evaluated. Saliva samples were collected at awakening, 30 min, 60 min, and 12 hr post awakening after 6-days' rest. Forty-six percent of tennis players presented Disordered Eating attitudes (DE) (n = 12) with a lower body mass index, and higher state anxiety as compared with the group without DE. No differences in the Perceived Stress Scale scores were noted. Mean energy intake, protein and carbohydrates intakes were lower (p < .05) in the DE group as compared with the group without DE. Although in both groups, sAA concentrations presented a decrease in the first 30 min after awakening, and then progressively rose toward the afternoon, DE players exhibited reduced concentrations of the sAA with a decrease in its overall day secretion. Moreover, they showed a higher overall day secretion of salivary cortisol and a higher Cortisol Awakening Response. These results suggest that the activity of the sympathetic nervous system is impaired whereas the cortisol awakening response is enhanced. The long-term consequences of these modifications on health remain to be elucidated.

J14 Mediterranean Diet And Nutritional Composition Of Patients With Huntington's Disease. Spanish Multicenter Study Of The European Group For Huntington's Disease

<h3>Background</h3> The impact of a diet is well known in human health. Intake of food groups (fruits and ‘uts, vegetables, legumes, olive oil, whole grains, fish and wine) in the traditional Mediterranean Diet (MeDi) and high MeDi adherence have been associated with lower incidence of chronic diseases and slower cognitive decline, but the relationship between MeDi adherence and nutritional composition has not been reported. <h3>Objectives</h3> To describe MeDi and nutritional composition in patients with HD. <h3>Methods</h3> Spanish multicenter, cross-sectional study (EHDN). To assess MeDi we used a 3-days dietary record. Food groups, macro and micronutrients and energy intake information were obtained using the software AyS, version 2.0. MeDi scores ranged from 0–9, and higher scores indicated higher adherence. <h3>Results</h3> 98 patients were included, 62% women, age 49 ± 14 years, medians TFC 9.0 (7–12), motor UHDRS 32 (7–45) and cognitive UHDRS 161 (132–203), and mean CAG 44 ± 6, BMI 24.6 ± 4.6, waist circumference (WC) 87.7 ± 14.6, waist-height ratio (WHR) 0.54 ± 0.45. Low MeDi adherence was found in 56% of the sample most of them in the age group of 18–50 years. Percentage calories from: protein 18 ± 4, lipid 36 ± 7, and carbohydrates 46 ± 8. MeDi adherence was similar items of age, sex, BMI, WC, WHR, educational level, type of caregiver, TFC and physical activity. Compared to lower MeDi adherence, HD patient with moderate/high adherence had higher: SF36 score (p = 0.009), AGP+AGM)/AGS ratio (p &lt; 0.0001), fibre (p = 0.029), vitamin C, (p = 0.024), vitamin E (p = 0.008), selenium (p = 0.001), biotin (p = 0.002), folic acid (p = 0.030) and copper (p = 0.016). <h3>Conclusions</h3> Patients with HD show low MeDi adherence. In this study we found that higher MeDi adherence was associated with higher quality of life and better nutritional composition. Longitudinal studies and warranted to assess if higher MeDi adherence may delay HD progression and comorbidities. We gratefully acknowledge to European Huntington’s Disease Network for financial support to this work.

Nutritional intake of elite football referees

There is a paucity of dietary data in football referees. In this study, 23 elite main and assistant referees (34.4 ± 5.6 years) completed a 7-day dietary record during the competitive season. No nutritional intake differences were observed between main and assistant referees. Referees’ mean daily energy intake (DEI) was 2819 ± 279 kcal. The intake of proteins (1.7 ± 0.2 g · kg−1), carbohydrates (4.1 ± 0.8 g · kg−1) and fats (1.4 ± 0.2 g · kg−1) represented, respectively, 18.4 ± 1.5%, 44.4 ± 4.4% and 34.6 ± 4.1% of the DEI. Carbohydrate intakes before, during and after exercise were 66 ± 42, 7 ± 15 and 120 ± 62 g. Daily carbohydrate, fibre, polyunsaturated fat and water intakes were below recommendations, while fat, saturated fat, cholesterol and sodium intakes were above recommended values. The prevalence of inadequate intake was high for vitamin E (96%), folate (74%), vitamin A (61%), vitamin C (39%), magnesium (26%) and calcium (22%). Carbohydrate intake before, during and after exercise were far from achieving the minimum recommended values. Most referees demonstrated a negligent behaviour of hydration during exercise. Referees would benefit from dietary education in order to optimise performance and health.

Beat-to-beat, reading-to-reading, and day-to-day blood pressure variability in relation to organ damage in untreated Chinese

Whether target organ damage is associated with blood pressure (BP) variability independent of level remains debated. We assessed these associations from 10-minute beat-to-beat, 24-hour ambulatory, and 7-day home BP recordings in 256 untreated subjects referred to a hypertension clinic. BP variability indices were variability independent of the mean, maximum-minimum difference, and average real variability. Effect sizes (standardized β) were computed using multivariable regression models. In beat-to-beat recordings, left ventricular mass index (n=128) was not (P≥0.18) associated with systolic BP but increased with all 3 systolic variability indices (+2.97-3.53 g/m(2); P<0.04); the urinary albumin-to-creatinine ratio increased (P≤0.03) with systolic BP (+1.14-1.17 mg/mmol) and maximum-minimum difference (+1.18 mg/mmol); and pulse wave velocity increased with systolic BP (+0.69 m/s; P<0.001). In 24-hour recordings, all 3 indices of organ damage increased (P<0.03) with systolic BP, whereas the associations with BP variability were nonsignificant (P≥0.15) except for increases in pulse wave velocity (P<0.05) with variability independent of the mean (+0.16 m/s) and maximum-minimum difference (+0.17 m/s). In home recordings, the urinary albumin-to-creatinine ratio (+1.27-1.30 mg/mmol) and pulse wave velocity (+0.36-0.40 m/s) increased (P<0.05) with systolic BP, whereas all associations of target organ damage with the variability indices were nonsignificant (P≥0.07). In conclusion, while accounting for BP level, associations of target organ damage with BP variability were readily detectable in beat-to-beat recordings, least noticeable in home recordings, with 24-hour ambulatory monitoring being informative only for pulse wave velocity.

Association Between Internalizing Disorders and Day-to-Day Activities of Low Energetic Expenditure

The objective of this study is to compare energetic expenditure in day-to-day activities among subjects with internalizing disorders (depression and anxiety), externalizing disorders (attention deficit/hyperactivity disorder and oppositional defiant disorder) and healthy children and adolescents without any psychiatric diagnosis. One hundred and five (n = 105) students from a community sample were evaluated throughout a structured psychiatric interview and categorized into three groups: internalizing (n = 54), externalizing (n = 12) and typically developing controls (TDC, n = 39). Energetic expenditure was evaluated using 3-day physical activity record. Subjects with internalizing disorders performed activities with lower energetic expenditure as compared to those with externalizing disorders and TDC. Participants with externalizing disorders had more energetic expenditure variability. Our study suggests that internalizing disorders are associated with activities of low energetic expenditure in day-to-day activities, extending previous findings with physical exercise. These findings may further contribute to the understanding of the associated morbidity previously described in patients with internalizing disorders.

Beat-to-Beat, Reading-to-Reading, and Day-to-Day Blood Pressure Variability in Relation to Organ Damage in Untreated Chinese

Whether target organ damage is associated with blood pressure (BP) variability independent of level remains debated. We assessed these associations from 10-minute beat-to-beat, 24-hour ambulatory, and 7-day home BP recordings in 256 untreated subjects referred to a hypertension clinic. BP variability indices were variability independent of the mean, maximum-minimum difference, and average real variability. Effect sizes (standardized β) were computed using multivariable regression models. In beat-to-beat recordings, left ventricular mass index (n=128) was not (P≥0.18) associated with systolic BP but increased with all 3 systolic variability indices (+2.97-3.53 g/m(2); P<0.04); the urinary albumin-to-creatinine ratio increased (P≤0.03) with systolic BP (+1.14-1.17 mg/mmol) and maximum-minimum difference (+1.18 mg/mmol); and pulse wave velocity increased with systolic BP (+0.69 m/s; P<0.001). In 24-hour recordings, all 3 indices of organ damage increased (P<0.03) with systolic BP, whereas the associations with BP variability were nonsignificant (P≥0.15) except for increases in pulse wave velocity (P<0.05) with variability independent of the mean (+0.16 m/s) and maximum-minimum difference (+0.17 m/s). In home recordings, the urinary albumin-to-creatinine ratio (+1.27-1.30 mg/mmol) and pulse wave velocity (+0.36-0.40 m/s) increased (P<0.05) with systolic BP, whereas all associations of target organ damage with the variability indices were nonsignificant (P≥0.07). In conclusion, while accounting for BP level, associations of target organ damage with BP variability were readily detectable in beat-to-beat recordings, least noticeable in home recordings, with 24-hour ambulatory monitoring being informative only for pulse wave velocity.

Effect of Donepezil on Sleep and Activity in Alzheimer’s Disease: Actigraphic and Polysomnographic Assessment

Aim: To examine the effect of donepezil on sleep and daily activity in patients with Alzheimer-type dementia (ATD) using polysomnography and actigraphy. Methods: Ten patients with mild to moderate ATD (mean age: 76 ± 6.2 years) were studied. The Alzheimer’s disease Assessment Scale-cognitive component-Japanese version (ADAS-Jcog),polysomnography, and 7-day recording of actigraphy data were performed. Following this baseline assessment, donepezil (5 mg daily) was administered every morning for 6 weeks, after which the ADAS-Jcog, polysomnography, and actigraphy were repeated. Results: After 6 weeks of treatment with donepezil, daily activity was significantly increased (276.2 ± 89.2 vs. 326.1 ± 98.6; p < 0.05). Similarly, rapid eye movement (REM) sleep (11.3 ± 4.1 vs. 17.1 ± 4.4; p<0.01) and sleep efficiency (76.2 ± 16.3 vs. 82.8 ± 10.6; p<0.05) were significantly increased compared with baseline. Although the ADAS-Jcog score did not decrease significantly (18.5 ± 6.8 vs. 15.9 ± 7.3; P= 0.054), there was a significant positive correlation between the decrease of this score and the increase of daily activity (r= 0.2137, p= 0.4809). Conclusions: An increase of daily activity and cognition were induced by donepezil treatment in patients with ATD, possibly based on improvement of the sleep structure. Trial Registration: Controlled-trials. Com Identifier: UMIN000005018

Factors Associated with Adherence to the Mediterranean Diet in the Adult Population

Our aim was to analyze the variables associated with adherence to the Mediterranean diet in the adult population. We conducted a cross-sectional study in an established cohort of 1,553 healthy study participants (mean age=55±14 years; 60.3% women). Mediterranean diet adherence was evaluated based on a 14-item questionnaire and the Mediterranean diet adherence screener, which defines adequate adherence as a score of ≥9. Physical activity was evaluated using the 7-day physical activity record. Sociodemographic, biological, and anthropometric variables were also evaluated. The differences between Mediterranean diet compliers and noncompliers are defined by the consumption of fruit, red meats, carbonated beverages, wine, fish/shellfish, legumes, pasta, and rice (P<0.01). Adherence was lower among individuals younger than 49 years of age. In the first age tertile, adherence was greater in women and in nonobese individuals, and the triglyceride levels were lower among compliers. In the second age tertile, the compliers exercised more and had a lower body fat percentage. In the third age tertile, the compliers also possessed less body fat. The logistic regression analysis revealed the following factors associated with improved Mediterranean diet adherence: more physical exercise (odds ratio=1.588), older age (odds ratio=2.162), and moderate alcohol consumption (odds ratio=1.342). The factors associated with improved Mediterranean diet adherence included female sex, age older than 62 years, moderate alcohol consumption, and more than 17 metabolic equivalents (METs)/h/wk of physical exercise. Poorer adherence was associated with males and obesity.

Community Resource Utilization, Psychosocial Health, and Sociodemographic Factors Associated with Diet and Physical Activity among Low-Income Obese Latino Immigrants

Low-socioeconomic-status (SES) Latinos are disproportionately represented among the 78 million obese Americans. Tailored behavioral weight-loss interventions show promise, but there is limited adaptation to lower-SES Latino immigrants. This study provides guidance for tailoring obesity-reduction strategies for this population by evaluating food security, educational community resource utilization, education level, depression, sex, and length of US residence as predictors of diet and physical activity. The cross-sectional study used baseline data collected in July 2009 through September 2010 for a weight-loss trial among lower-SES obese (body mass index 30 to 55) Latino immigrants who were enrolled at a community health clinic (n=207). Physical activity was measured using 7-day pedometer recording. Dietary intake was measured using an interviewer-administered food frequency questionnaire. Factors assessed by questionnaire included education community resource use (nutrition and physical activity classes), education level, US residence (years), food security, and depressive symptoms. Data were analyzed using multivariate-adjusted linear regression models. More than one third of participants were sedentary (<5,000 steps/day), and 41% had low fruit and vegetable intake (<5 servings/day). In multivariate-adjusted models, educational community resource use, male sex, less education, fewer depressive symptoms, and shorter US residence time were associated with more physical activity (all, P≤0.05). Educational community resource use was positively associated with fruit and vegetable intake (P=0.05). Male sex was associated with more sweet-beverage intake (P=0.02) and fast-food intake (P=0.04). Fewer depressive symptoms were associated with lower sweet-beverage intake (P=0.05). In conclusion, obesity-reduction strategies among low-SES Latino immigrants might effectively emphasize educational community resource use and interventions tailored for psychosocial and sociodemographic characteristics.

Association between dietary folate intake and serum insulin-like growth factor-1 levels in healthy old women

ObjectiveHigh serum levels of insulin-like growth factor-1 (IGF-1) seem to coincide with higher rates of some types of cancer and the risk of all-cause mortality in old people. Eating vegetables seems to reduce IGF-1 levels because they are rich in micronutrients such as vitamins. This study investigates the possible association between vitamin intake and IGF-1 levels in a representative group of healthy elderly women with Mediterranean dietary habits. DesignThis cross-sectional study included 124 healthy women with a mean age of 71.3±4.2years and a mean body mass index (BMI) of 27.37±3.48kg/m2 attending a mild fitness program twice a week at public gyms in Padova. The main parameters considered were IGF-1 (measured by chemiluminescence) and diet, assessed on the basis of a 3-day record and a questionnaire on the frequency with which they usually ate certain foods. ResultsThe mean IGF-1 level for the sample as a whole was 136.2±38.9μg/l, and was significantly lower in women with a higher folate intake (p=0.04). On simple linear analysis, the vitamins found associated with serum IGF-1 levels were: folates (r: −0.25; p=0.003); vitamin E (r: −0.21; p=0.01); vitamin D (r: −0.17; p=0.03); and riboflavin (r: −0.16; p=0.03). After removing the effect of calorie, protein, carbohydrate and fat intake, and other known potential confounders (age, BMI, alcohol intake), only folate intake correlated with IGF-1 levels (r=−0.17; p=0.04). ConclusionA folate-rich diet could have the effect of lowering circulating IGF-1 levels in elderly women.

Zawartość wapnia w diecie kobiet karmiących stosujących dietę bezmleczną

The primary method of treatment for children with hypersensitivity to cow's milk protein and yet exclusively breastfed is the temporary elimination of cow milk and its products from the mother's diet. Aim of the studyAn evaluation of the calcium content in the diet of lactating women including the supply of this macroelement during using milk-free elimination diet. Materials and methodsThe examined group consisted of 43 women who were on milk-free elimination diet, breastfeeding children with hypersensitivity to cow's milk. The control group consisted of 40 mothers taking no dietary restrictions. The 3-day record method was used to estimate the level of calcium intake. ResultsThe percentage of women on a milk-free diet, who were not provided with an adequate supply of calcium was as high as 95.3%. The average daily intake of calcium from the diet in the study group was 269.95±91.11mg (27% of the recommended dietary allowance), and in the control group 717.76±359.55mg (71.78% of the recommended dietary allowance). After taking supplementation into account, the average calcium intake in the study group was 414.32±213.84mg per day (41.43% of the recommended dietary allowance), and in the control group – 781.96±362.49mg per day (78.20% of the recommended dietary allowance). In the control group, the mothers who took calcium supplements fulfilled the recommended dietary allowance in 90.01%. ConclusionThe calcium consumption by lactating women is insufficient. The women using the elimination milk-free diet require adequate supplementation of calcium.

Performance of an external transtelephonic loop recorder for automated detection of paroxysmal atrial fibrillation.

Although atrial fibrillation (AF) is the most commonly encountered arrhythmia, some of the properties make its detection challenging. In daily practice, underdiagnosis can lead to less effective treatment in prevention of stroke. Based on data from studies on treatment of AF, more intensive follow-up strategies, including 7-day Holter recording, 30-day event recording, and even implantable cardiac monitoring devices, are suggested. The study purpose is to evaluate the performance of a continuous single-channel loop recorder with automatic AF detection and transtelephonic electrocardiogram (ECG) transmission capabilities. A consecutive cohort of 153 patients admitted to the stroke unit with a presumptive diagnosis of ischemic cerebrovascular accident was screened for AF. Twenty-four-hour rhythm observation was performed using a single-channel external loop recorder (ELR) configured for automated AF detection. A total of 45 patients with a known history of AF, AF on the admission ECG, or incomplete registrations were excluded. Extensive additional frequency-based settings were used to establish a reference registration. In total, 2923 recordings were transmitted. We evaluated all events, of which 1190 were designated by the device as AF. The sensitivity, specificity, PPV, and NPV for identifying AF using the ELR were, respectively, 93%, 51%, 5%, and 99%. In this ELR validation study, the dedicated AF detection algorithm showed to be highly sensitive but not specific for AF. Applicability of an ELR might be limited for efficacious detection of AF, as manual verification is mandatory for a vast amount of recordings.