1.
Associations between maternal antioxidant intakes in pregnancy and infant allergic outcomes.
West, CE, Dunstan, J, McCarthy, S, Metcalfe, J, D'Vaz, N, Meldrum, S, Oddy, WH, Tulic, MK, Prescott, SL
Nutrients. 2012;4(11):1747-58
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Plain language summary
This research studied the maternal intake of antioxidants (carotene, vitamin C, vitamin E, copper and zinc) during pregnancy and the effect on allergic outcomes during early infancy (eczema, food allergies, allergic sensitisation and wheeze) at 1 year of age. The study included 300 mother and child pairs from a pregnancy cohort in Western Australia from 2005 to 2008. The pregnant women had a family history of allergic rhinitis, asthma, eczema, food or other allergy. A post-natal randomised trial allocated either 650mg fish oil (280mg docosahexaenoic acid (DHA) and 110mg eicosapentaenoic acid (EPA)) or a placebo of olive oil for the first 6 months of life. The study also examined the effect of maternal diet during pregnancy. Demographic information was collected, and a semi quantitative food frequency questionnaire covering 212 foods was completed during the final trimester of pregnancy. Clinical outcome measures of the infants were taken at 12 months of age via a detailed history and examination. Eczema, IgE mediated food allergies and allergic sensitisation were the most common clinical outcomes of the study. The majority of pregnant women met the recommended daily intakes of antioxidants apart from vitamin E and zinc. At 12 months of age there was no difference in the occurrence of clinical outcomes between the fish oil and placebo groups. Higher dietary vitamin C in the mothers was associated with reduced risk of any diagnosed allergic disease when children were a year old, and also a reduced risk of wheeze. Higher copper intake was related to reduced risk of wheeze and development of early allergic disease. However, this was only seen in relation to nutrients from food rather than supplements. It was noted that there were no significant associations between early allergic responses/disease and dietary intake of carotene, vitamin E and zinc. In the group studied, the majority of mothers used some vitamin/mineral supplementation during pregnancy. There was no statistically significant association between carotene, vitamin E and zinc intake in pregnancy and risk of developing any allergic disease. Women reported intakes of dietary vitamin C were above the daily recommended intake of 60mg, and authors noted that allergic outcomes were not affected by vitamin supplementation.
Abstract
Antioxidant intakes in pregnancy may influence fetal immune programming and the risk of allergic disease. We investigated associations between maternal intakes of β-carotene, vitamin C, vitamin E, copper and zinc, and infant allergic outcomes. Antioxidant intakes of pregnant women (n = 420) assessed prospectively by a food frequency questionnaire, were examined in relation to allergic outcomes at 1 year of age (n = 300). The main relationships with allergic outcomes were seen with dietary vitamin C and copper. Specifically, higher maternal dietary vitamin C intake was associated with a reduced risk of any diagnosed infant allergic disease and wheeze. After adjustment for potential confounders the relationship with wheeze remained statistically significant. There was also an inverse linear relationship between vitamin C and food allergy. Higher dietary copper intake was associated with reduced risk of eczema, wheeze and any allergic disease. The relationship with wheeze and any allergic disease remained statistically significant in multivariate analysis, and there was also an inverse linear relationship between copper and food allergy. However, these relationships were only seen for nutrients present in food. There were no relationships between β-carotene, vitamin E or zinc and any allergic outcomes. In summary, this study suggests that maternal diet of fresh foods rich in vitamin C is associated with reduced risk of infant wheeze, and that copper intake is associated with reduced risk of several allergic outcomes.
2.
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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Plain language summary
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.