1.
Menopause-Associated Lipid Metabolic Disorders and Foods Beneficial for Postmenopausal Women.
Ko, SH, Kim, HS
Nutrients. 2020;12(1)
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Menopause is the absence of menstruation due to the loss of ovarian activity with ageing. During this transition period, changes in hormones, primarily the decline in the oestrogen estradiol, give rise to altered lipid metabolism. An unfavourable lipid profile presents a risk for metabolic disorders, such as cardiovascular diseases and type 2 diabetes. Post-menopausal changes also lead to shifts in body fat and fat distribution, resulting in an increased tendency for central fat accumulation and obesity. Obesity is associated with insulin resistance. This susceptibility for weight accumulation is possibly also driven by the age-associated decline in skeletal muscle, which reduces metabolic energy expenditure. This review summarizes the physiology of menopause and postmenopause and the consequential impact on lipid metabolism. In addition, there is a discussion of dietary recommendations, nutritional and plant-derived compounds that could support the management of menopause associated changes in lipid levels, metabolic risk factors and obesity. The recommendations discussed include traditional healthy diets and low-calorie diets, with attention drawn to adequate protein intake. Furthermore, the role of probiotics, nutritional and plant-sourced constituents are considered, including Vitamin D, Omega-3 fatty acids, antioxidants like Vitamin A, β-carotene, Vitamin C and E, genistein, resveratrol, flavonoids, indoles and capsaicin. The authors advocate sourcing these compounds from a varied whole-foods diet, which would minimize nutrient interactions and absorption issues that can occur with supplementation. This review may be of interest to those supporting the nutritional needs of menopausal and post-menopausal women, that are experiencing or are at risk of experiencing metabolic disorders.
Abstract
Menopause is clinically diagnosed as a condition when a woman has not menstruated for one year. During the menopausal transition period, there is an emergence of various lipid metabolic disorders due to hormonal changes, such as decreased levels of estrogens and increased levels of circulating androgens; these may lead to the development of metabolic syndromes including cardiovascular diseases and type 2 diabetes. Dysregulation of lipid metabolism affects the body fat mass, fat-free mass, fatty acid metabolism, and various aspects of energy metabolism, such as basal metabolic ratio, adiposity, and obesity. Moreover, menopause is also associated with alterations in the levels of various lipids circulating in the blood, such as lipoproteins, apolipoproteins, low-density lipoproteins (LDLs), high-density lipoproteins (HDL) and triacylglycerol (TG). Alterations in lipid metabolism and excessive adipose tissue play a key role in the synthesis of excess fatty acids, adipocytokines, proinflammatory cytokines, and reactive oxygen species, which cause lipid peroxidation and result in the development of insulin resistance, abdominal adiposity, and dyslipidemia. This review discusses dietary recommendations and beneficial compounds, such as vitamin D, omega-3 fatty acids, antioxidants, phytochemicals-and their food sources-to aid the management of abnormal lipid metabolism in postmenopausal women.
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Effects of ascorbic acid supplementation on oxidative stress markers in healthy women following a single bout of exercise.
Yimcharoen, M, Kittikunnathum, S, Suknikorn, C, Nak-On, W, Yeethong, P, Anthony, TG, Bunpo, P
Journal of the International Society of Sports Nutrition. 2019;16(1):2
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Moderately intense exercise often causes muscle damage, which initiates an acute inflammatory response. Vitamin C or ascorbic acid is suggested to provide antioxidant protection against oxidative stress. The efficacy of ascorbic acid supplementation on exercise-induced oxidative stress remains unclear. The aim of this crossover study was to determine the effects of ascorbic acid supplementation on circulating biomarkers of oxidative stress and muscle damage in 19 healthy women after a single bout of moderately-intense exercise. Participants performed 30 minutes of cycling after ingesting 1000 mg of ascorbic acid or placebo with a one-week washout period. Blood samples were taken before exercise, immediately after and 30 minutes post-exercise to determine various markers of oxidative stress and muscle damage. This study found ascorbic acid supplementation prior to moderately-intense exercise improves antioxidant capacity but does not prevent muscle damage. The exercise performed in this study did not induce systemic inflammation, only low-grade muscle damage. Based on these results, the authors suggest further investigation of the effects of ascorbic acid supplementation during exercise be done to better understand the molecular interactions of ascorbic acid during exercise.
Abstract
BACKGROUND Ascorbic acid is a water-soluble chain breaking antioxidant. It scavenges free radicals and reactive oxygen species (ROS), which are produced during metabolic pathways. Exercise can produce an imbalance between ROS and antioxidants, leading to oxidative stress-related tissue damages. This study was designed to determine the effects of ascorbic acid supplementation on circulating biomarkers of oxidative stress and muscle damage following a single bout of exercise. METHODS In a crossover design with a 1 wk. wash-out period, 19 healthy women performed 30 min moderate-intensity cycling after ingesting 1000 mg of ascorbic acid (AA) or placebo. Blood samples were taken immediately before, immediately after and 30 min post-exercise to determine plasma albumin, total protein, glucose, oxidative stress and muscle damage markers. RESULTS Plasma albumin and total protein levels increased immediately after exercise in placebo alongside slight reductions in glucose (p = 0.001). These effects were absent in AA cohort. Ferric reducing ability of plasma and vitamin C levels in AA cohort significantly increased after exercise (p < 0.05). Superoxide dismutase activity was significantly elevated after exercise (p = 0.002) in placebo but not AA. Plasma malondialdehyde did not change after exercise in placebo but was significantly decreased in AA (p < 0.05). The exercise protocol promoted slight muscle damage, reflected in significant increases in total creatine kinase in all subjects after exercise. On the other hand, plasma C-reactive protein and lactate dehydrogenase remained unchanged. CONCLUSION Supplementation with ascorbic acid prior exercise improves antioxidant power but does not prevent muscle damage.
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Evaluation of Nutritional Status of Patients with Depression.
Kaner, G, Soylu, M, Yüksel, N, Inanç, N, Ongan, D, Başmısırlı, E
BioMed research international. 2015;2015:521481
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The aim of this study was to identify the nutritional status, body composition and biochemical parameters of individuals who had been diagnosed with major depression. Fifty-nine people in Turkey, aged between 18 and 60 years old were randomly assigned to 2 groups – a depression group (29 people on antidepressant medication) and a control group (30 normal, healthy people). A number of measurements were taken: anthropometric measurements, biochemical markers (eg fasting blood glucose, insulin, folate, B12), demographic data, a 24-hour diet recall and activity/exercise levels. Those with serious mental illness such as psychotic disorders, bipolar and schizophrenia were excluded, as were those recently prescribed with thyroid medication, weight loss treatment or diabetes. The anti-depressant medication used by the individuals in the depression group was not identified. The depression group was 65% female and the control group was 60% female. The results showed that the depression group had a lower intake of the nutrients vitamin A, thiamine, riboflavin, B6, folate, vitamin C, sodium, potassium, magnesium, calcium, phosphorus, iron and zinc, as well as fibre. In addition, median values of body weight, waist and hip circumferences, and waist to hip ratios were significantly higher in this group. The depression group also had lower fasting blood glucose levels, vitamin B12 and folic acid than the control group. Serum insulin and insulin resistance levels were similar in both groups. The rate of night eating was higher, and the consumption of fresh fruit, vegetables and fish was lower in those with depression, although the authors noted that the PUFA intake in both groups was very similar. Levels of light physical exercise were higher in the depression group. The authors concluded that individuals with depression tended to eat a poorer quality diet. Vitamin B consumption, serum B12 and folic acid levels were low in those patients with depression, and they also showed more signs of abdominal obesity. It was also noted that vitamins A and C, and magnesium levels were lower in depression. It was acknowledged that the self-reported diets are likely to contain inaccuracies.
Abstract
AIMS AND OBJECTIVES Our goal was to determine nutritional status, body composition, and biochemical parameters of patients diagnosed with depression based on DSM-IV-TR criteria. METHODS A total of 59 individuals, aged 18-60 years admitted to Mental Health Centre of Kayseri Education and Research Hospital, were included in the study. The participants were randomly assigned to two groups; depression group (n = 29) and control group (n = 30). Anthropometric measurements, some biochemical parameters, demographic data, and 24-hour dietary recall were evaluated. RESULTS 65.5% of depression and 60.0% of control group were female. Intake of vitamins A, thiamine, riboflavin, B6, folate, C, Na, K, Mg, Ca, P, Fe, Zn, and fibre (p < 0.05) were lower in depression group. Median levels of body weight, waist circumference, hip circumference, waist-to-hip ratio (p < 0.05) were significantly higher in depression group. Fasting blood glucose levels, serum vitamins B12, and folic acid (p < 0.05) in depression group were lower than controls. Serum insulin and HOMA levels of two groups were similar. CONCLUSION Some vitamin B consumption and serum vitamin B12 and folic acid levels were low while signs of abdominal obesity were high among patients with depression. Future research exploring nutritional status of individuals with depression is warranted.
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Functional biochemical and nutrient indices in frail elderly people are partly affected by dietary supplements but not by exercise.
de Jong, N, Chin A Paw, MJ, de Groot, LC, de Graaf, C, Kok, FJ, van Staveren, WA
The Journal of nutrition. 1999;129(11):2028-36
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Elderly people are at risk of nutritional deficiencies for a variety of reasons including reduced appetite, increased medication, and alterations in the absorption and metabolism of vitamins and minerals with age. The aim of this study was to measure the influence of exercise, and supplementing the diet with vitamins and minerals, on indicators of nutritional and health status in frail elderly people. A 17-week randomised controlled trial was carried out on 145 frail elderly people living in the community. Participants were given either; 1) food products enriched with vitamins D, E, thiamine, riboflavin, B6, folic acid, B12, calcium, magnesium, zinc, iron and iodine; 2) an exercise programme; 3) both enriched food products and exercise programme; or 4) food products that had not been enriched and a social programme (the control group). At the end of the study, significant improvements in the blood levels of vitamins B6, B12, C and D were detected in the groups receiving the enriched food products compared to the controls. There was no additional benefit to be gained from exercise. The improvement in nutritional status did not appear to influence several other biological indicators of health, perhaps because these indicators were already within normal levels at the start of the study. Despite this, the authors concluded that long-term supplementation may help to maintain optimal vitamin and mineral levels in elderly people, and therefore reduce the chance of this population developing health problems related to malnutrition.
Abstract
A decline in dietary intake due to inactivity and, consequently, development of a suboptimal nutritional status is a major problem in frail elderly people. However, benefits of micronutrient supplementation, all-round physical exercise or a combination of both on functional biochemical and hematologic indicators of nutritional and health status in frail elderly subjects have not been tested thoroughly. A 17-wk randomized controlled trial was performed in 145 free-living frail elderly people (43 men, 102 women, mean age, 78 +/- 5.7 y). Based on a 2 x 2 factorial design, subjects were assigned to one of the following: 1) nutrient-dense foods, 2) exercise, 3) both (1) and (2) or 4) a control group. Foods were enriched with micronutrients, frequently characterized as deficient [25-100% of the recommended daily allowance (RDA)] in elderly people. Exercises focused on skill training, including strength, endurance, coordination and flexibility. Dietary intake, blood vitamin levels and nutritional and health indicators, including (pre)albumin, ferritin, transferrin, C-reactive protein, hemoglobin and lymphocytes were measured. At baseline, 28% of the total population had an energy intake below 6.3 MJ, up to a maximum of 93% having vitamin intakes below two thirds of the Dutch RDA. Individual deficiencies in blood at baseline ranged from 3% for erythrocyte glutathione reductase-alpha to 39% for 25-hydroxy vitamin D and 42% for vitamin B-12. These were corrected after 17 wk in the two groups receiving the nutrient-dense foods, whereas no significant changes were observed in the control or exercise group. Biochemical and hematologic indicators at baseline were within the reference ranges (mean albumin, 46 g/L; prealbumin, 0.25 g/L; hemoglobin, 8.6 mmol/L) and were not affected by any of the interventions. The long-term protective effects of nutrient supplementation and exercise, by maintaining optimal nutrient levels and thereby reducing the initial chance of developing critical biochemical values, require further investigation. Other indicative functional variables for suboptimal nutritional status, in addition to those currently selected, should also be explored.