Vitamin D dan fungsi kognitif manula

Penelitian ini mendapatkan bahwa kadar vitamin D yang rendah berhubungan dengan penurunan fungsi kognitif pada manula

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Vitamin D and Risk of Cognitive Decline in Elderly Persons

David J. Llewellyn, PhD; Iain A. Lang, PhD; Kenneth M. Langa, MD, PhD; Graciela Muniz-Terrera, PhD;Caroline L. Phillips, MS; Antonio Cherubini, MD; Luigi Ferrucci, MD, PhD; David Melzer, PhD

Arch Intern Med. 2010;170(13):1135-1141. doi:10.1001/archinternmed.2010.173

Background  To our knowledge, no prospective study has examined the association between vitamin D and cognitive decline or dementia.
Methods  We determined whether low levels of serum 25-hydroxyvitamin D (25[OH]D) were associated with an increased risk of substantial cognitive decline in the InCHIANTI population–based study conducted in Italy between 1998 and 2006 with follow-up assessments every 3 years. A total of 858 adults 65 years or older completed interviews, cognitive assessments, and medical examinations and provided blood samples. Cognitive decline was assessed using the Mini-Mental State Examination (MMSE), and substantial decline was defined as 3 or more points. The Trail-Making Tests A and B were also used, and substantial decline was defined as the worst 10% of the distribution of decline or as discontinued testing.
Results  The multivariate adjusted relative risk (95% confidence interval [CI]) of substantial cognitive decline on the MMSE in participants who were severely serum 25(OH)D deficient (levels <25 nmol/L) in comparison with those with sufficient levels of 25(OH)D (75 nmol/L) was 1.60 (95% CI, 1.19-2.00). Multivariate adjusted random-effects models demonstrated that the scores of participants who were severely 25(OH)D deficient declined by an additional 0.3 MMSE points per year more than those with sufficient levels of 25(OH)D. The relative risk for substantial decline on Trail-Making Test B was 1.31 (95% CI, 1.03-1.51) among those who were severely 25(OH)D deficient compared with those with sufficient levels of 25(OH)D. No significant association was observed for Trail-Making Test A.
Conclusion  Low levels of vitamin D were associated with substantial cognitive decline in the elderly population studied over a 6-year period, which raises important new possibilities for treatment and prevention.

Penurunan berat badan mengurangi hot flush

Penelitian ini membuktikan bahwa menurunkan berat badan pada wanita menopause yang overweight dan obes, akan mengurangi hot flushes.

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An Intensive Behavioral Weight Loss Intervention and Hot Flushes in Women

Alison J. Huang, MD; Leslee L. Subak, MD; Rena Wing, PhD; Delia Smith West, PhD; Alexandra L. Hernandez, MPH;Judy Macer, BSc; Deborah Grady, MD; for the Program to Reduce Incontinence by Diet and Exercise Investigators

Arch Intern Med. 2010;170(13):1161-1167. doi:10.1001/archinternmed.2010.162

Background  Higher body mass index is associated with worse hot flushes during menopause but the effect of weight loss on flushing is unclear.
Methods  Self-administered questionnaires were used to assess bothersome hot flushes in a 6-month randomized controlled trial of an intensive behavioral weight loss program (intervention) vs a structured health education program (control) in 338 women who were overweight or obese and had urinary incontinence. Weight, body mass index, abdominal circumference, physical activity, calorie intake, blood pressure, and physical and mental functioning were assessed at baseline and at 6 months. Repeated-measures proportional odds models examined intervention effects on bothersome hot flushes and potential mediating factors.
Results  Approximately half of participants (n = 154) were at least slightly bothered by hot flushes at baseline. Among these women, the intervention was associated with greater improvement in bothersome flushes vs control (odds ratio [OR] for improvement by 1 Likert category, 2.25; 95% confidence interval [CI], 1.20-4.21). Reductions in weight (OR, 1.32; 95% CI, 1.08-1.61; per 5-kg decrease), body mass index (1.17; 1.05-1.30; per 1-point decrease), and abdominal circumference (1.32; 1.07-1.64; per 5-cm decrease) were each associated with improvement in flushing, but changes in physical activity, calorie intake, blood pressure, and physical and mental functioning were not related. The effect of the intervention on flushing was modestly diminished after adjustment for multiple potential mediators (OR, 1.92; 95% CI, 0.95-3.89).
Conclusion  Among women who were overweight or obese and had bothersome hot flushes, an intensive behavioral weight loss intervention resulted in improvement in flushing relative to control.

Intervensi gizi untuk pasien diabetes tipe 2

Penelitian ini membuktikan bahwa diet dapat memperbaiki parameter glikemik dan antropometrik untuk penderita diabetes tipe 2 yang belum terkontrol dengan pengobatan.

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BMJ 2010;341:c3337

Nutritional intervention in patients with type 2 diabetes who are hyperglycaemic despite optimised drug treatment—Lifestyle Over and Above Drugs in Diabetes (LOADD) study: randomised controlled trial

Kirsten J Coppell, senior research fellow1, Minako Kataoka, research dietitian2, Sheila M Williams, research associate professor3, Alex W Chisholm, senior lecturer nutrition2, Sue M Vorgers, research nurse2, Jim I Mann, professor of human nutrition and medicine1
1 Edgar National Centre for Diabetes and Obesity Research, Department of Medical and Surgical Sciences, University of Otago, PO Box 913, Dunedin 9054, New Zealand, 2 Department of Human Nutrition, University of Otago, 3Department of Preventive and Social Medicine, University of Otago

Objective To determine the extent to which intensive dietary intervention can influence glycaemic control and risk factors for cardiovascular disease in patients with type 2 diabetes who are hyperglycaemic despite optimised drug treatment.
Design Randomised controlled trial.
Setting Dunedin, New Zealand.
Participants 93 participants aged less than 70 years with type 2 diabetes and a glycated haemoglobin (HbA1c) of more than 7% despite optimised drug treatments plus at least two of overweight or obesity, hypertension, and dyslipidaemia.
Intervention Intensive individualised dietary advice (according to the nutritional recommendations of the European Association for the Study of Diabetes) for six months; both the intervention and control participants continued with their usual medical surveillance.
Main outcome measures HbA1c was the primary outcome. Secondaryoutcomes included measures of adiposity, blood pressure, and lipid profile.
Results After adjustment for age, sex, and baseline measurements, the difference in HbA1c between the intervention and control groups at six months (–0.4%, 95% confidence interval –0.7% to –0.1%) was highly statistically significant (P=0.007), as were the decreases in weight (–1.3 kg, –2.4 to –0.1 kg; P=0.032), body mass index (–0.5, –0.9 to –0.1; P=0.026), and waist circumference (–1.6 cm, –2.7 to –0.5 cm; P=0.005). A decrease in saturated fat (–1.9% total energy, –3.3% to –0.6%; P=0.006) and an increase in protein (1.6% total energy, 0.04% to 3.1%; P=0.045) in the intervention group were the most striking differences in nutritional intake between the two groups.
Conclusions Intensive dietary advice has the potential to appreciably improve glycaemic control and anthropometric measures in patients with type 2 diabetes and unsatisfactory HbA1c despite optimised hypoglycaemic drug treatment.

Effects of Homocysteine-Lowering With Folic Acid Plus Vitamin B12 vs Placebo on Mortality and Major Morbidity in Myocardial Infarction Survivors

Suplementasi asam folat dan vitamin B12 untuk menurunkan kadar homosistein dalam jangka panjang tidak berhasil menekan kejadian vaskuler.

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Abstract

 

Effects of Homocysteine-Lowering With Folic Acid Plus Vitamin B12 vs Placebo on Mortality and Major Morbidity in Myocardial Infarction Survivors
A Randomized Trial
Study of the Effectiveness of Additional Reductions in Cholesterol and Homocysteine (SEARCH) Collaborative Group*

JAMA. 2010;303(24):2486-2494.
Context  Blood homocysteine levels are positively associated with cardiovascular disease, but it is uncertain whether the association is causal.
Objective  To assess the effects of reducing homocysteine levels with folic acid and vitamin B12 on vascular and nonvascular outcomes.
Design, Setting, and Patients  Double-blind randomized controlled trial of 12 064 survivors of myocardial infarction in secondary care hospitals in the United Kingdom between 1998 and 2008.
Interventions  2 mg folic acid plus 1 mg vitamin B12 daily vs matching placebo.
Main Outcome Measures  First major vascular event, defined as major coronary event (coronary death, myocardial infarction, or coronary revascularization), fatal or nonfatal stroke, or noncoronary revascularization.
Results  Allocation to the study vitamins reduced homocysteine by a mean of 3.8 µmol/L (28%). During 6.7 years of follow-up, major vascular events occurred in 1537 of 6033 participants (25.5%) allocated folic acid plus vitamin B12 vs 1493 of 6031 participants (24.8%) allocated placebo (risk ratio [RR], 1.04; 95% confidence interval [CI], 0.97-1.12;P = .28). There were no apparent effects on major coronary events (vitamins, 1229 [20.4%], vs placebo, 1185 [19.6%]; RR, 1.05; 95% CI, 0.97-1.13), stroke (vitamins, 269 [4.5%], vs placebo, 265 [4.4%]; RR, 1.02; 95% CI, 0.86-1.21), or noncoronary revascularizations (vitamins, 178 [3.0%], vs placebo, 152 [2.5%]; RR, 1.18; 95% CI, 0.95-1.46). Nor were there significant differences in the numbers of deaths attributed to vascular causes (vitamins, 578 [9.6%], vs placebo, 559 [9.3%]) or nonvascular causes (vitamins, 405 [6.7%], vs placebo, 392 [6.5%]) or in the incidence of any cancer (vitamins, 678 [11.2%], vs placebo, 639 [10.6%]).
Conclusion  Substantial long-term reductions in blood homocysteine levels with folic acid and vitamin B12 supplementation did not have beneficial effects on vascular outcomes but were also not associated with adverse effects on cancer incidence.

Food Combination and Alzheimer Disease Risk

Pola diet dapat menurunkan risiko penyakit alzheimer pada usia lanjut (>65 tahun)

Yaitu diet yang tinggi sayur, kacang2an, ikan, tomat, unggas, buah sementara rendah high-fat dairy products, daging merah, organ meat, dan butter

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Food Combination and Alzheimer Disease Risk
A Protective Diet

Yian Gu, PhD; Jeri W. Nieves, PhD; Yaakov Stern, PhD; Jose A. Luchsinger, MD, MPH; Nikolaos Scarmeas, MD, MS

Arch Neurol. 2010;67(6):699-706. Published online April 12, 2010 (doi:10.1001/archneurol.2010.84).

Objective  To assess the association between food combination and Alzheimer disease (AD) risk. Because foods are not consumed in isolation, dietary pattern (DP) analysis of food combination, taking into account the interactions among food components, may offer methodological advantages.

Design  Prospective cohort study.

Setting  Northern Manhattan, New York, New York.

Patients or Other Participants  Two thousand one hundred forty-eight community-based elderly subjects (aged >65 years) without dementia in New York provided dietary information and were prospectively evaluated with the same standardized neurological and neuropsychological measures approximately every 1.5 years. Using reduced rank regression, we calculated DPs based on their ability to explain variation in 7 potentially AD-related nutrients: saturated fatty acids, monounsaturated fatty acids, n-3 polyunsaturated fatty acids, n-6 polyunsaturated fatty acids, vitamin E, vitamin B12, and folate. The associations of reduced rank regression–derived DPs with AD risk were then examined using a Cox proportional hazards model.

Main Outcome Measure  Incident AD risk.

Results  Two hundred fifty-three subjects developed AD during a follow-up of 3.9 years. We identified a DP stronglyassociated with lower AD risk: compared with subjects in the lowest tertile of adherence to this pattern, the AD hazard ratio (95% confidence interval) for subjects in the highest DP tertile was 0.62 (0.43-0.89) after multivariable adjustment (P for trend = .01). This DP was characterized by higher intakes of salad dressing, nuts, fish, tomatoes, poultry, cruciferous vegetables, fruits, and dark and green leafy vegetables and a lower intake of high-fat dairy products, red meat, organ meat, and butter.

Conclusion  Simultaneous consideration of previous knowledge regarding potentially AD-related nutrients and multiple food groups can aid in identifying food combinations that are associated with AD risk.