Dietary factors may influence the process of atherosclerosis and coronary artery calcification (CAC). This study assessed CAC and its association with dietary intake in asymptomatic men. We evaluated ...150 asymptomatic men with mean age of 58.2 + or -5.3 years. The dietary intake was assessed by the Food Consumption Register method. CAC was measured through multidetector computed tomography (MDCT) and assessed in accordance with the Agatston score. Modified Poisson regression model was used to estimate the effects of intake of different nutrients that are prevalent in moderate/severe CAC, adjusted for calorie intake and CAC risk factors by means of prevalence ratios and 95% confidence intervals 95%CI. An association was found between the intake of some nutrients and moderate/severe CAC. Lower carbohydrate intake (P=0.021) and higher lipid intake (P=0.006) were associated with moderate/severe CAC. After adjustment, the nutrients associated with the prevalence of moderate/severe CAC were carbohydrates (P=0.040), lipids (P=0.005), and saturated fatty acids (SFA) (P=0.013). A 1% increase in lipids and SFA intake caused an increase of 4% 95%CI: 1-7% and 8% 95%CI: 2-14% in the prevalence of moderate/severe CAC, respectively. A 1% increase of carbohydrate intake led to a 2% decrease in the likelihood of moderate/severe CAC 95%CI: 1-4%. These conclusions showed that the higher intake of total lipids and SFA was associated with higher CAC scores, whereas higher carbohydrate intake was associated with lower CAC scores in asymptomatic men. Key words: Vascular calcification; Diet; Lipids; Fatty acids; Carbohydrates; Men
Summary
1. Japanese immigrants from Okinawa living in Brazil have a higher mortality from cardiovascular diseases and have their mean life expectancy shortened compared with their counterparts living ...in Japan.
2. A cross‐sectional study comparing Okinawans living in Okinawa (OO) and Okinawan immigrants living in Brazil (OB) was designed to characterize the dietary factors that could interfere with the profile of cardiovascular risk factors and with this reduction on the life expectancy when Okinawans emigrate to Brazil.
3. In total, 234 OO and 160 OB (aged 45–59 years) were recruited to the present study to undergo medical and dietary history, blood pressure measurement, electrocardiograph (ECG), blood tests and 24 h food/urine collection.
4. In the present study, OO subjects presented with 37% less obesity and 50% less systemic hypertension than OB. The OB subjects used threefold more antihypertensive medication than OO. Meat intake was 34% higher in OB than OO, whereas fish intake was sevenfold higher in OO than OB. Serum potassium levels were 10% higher in OO than OB. Urinary taurine (an index of seafood intake) was 43% higher in OO than OB. Urinary isoflavones (an index of the intake of soy products) were significantly lower in OB than in OO. Of acid (20 : 5) and docosahexaenoic acid (22 : 6) were two‐ and threefold higher in OO than OB, respectively.
5. The rate of ischaemic ECG changes in OO subjects was only 50% of that of OB subjects.
6. There were no differences in the smoking rate between OO and OB sugjects.
7. The results of the present study suggest that coronary risk factors and cardiovascular health are not only regulated by genetic factors, but that the impact of lifestyle (mainly diet) can be large enough to modulate the expression of genes.
Background. Several studies have been published on the association between ACE (angiotensin I-converting enzyme) polymorphism and longevity. However, the results are controversial. Methods. We ...analyzed the association between ACE polymorphism and age in two different ethnic populations: a population originating from different European countries (Gaucha Population, GP) and a population originating from Japan (JP). Both populations live in Brazil's southern region. Results. We determined the ACE genotype in 834 persons aged 10–104 years. The ACE genotype and allele frequencies differed between the two populations, with the D allele being more frequent in GP than JP. We found an association between the DD genotype and D allele and age in the GP group only. The ACE polymorphism–age association occurred at age >60 years in the GP population with decreasing II frequency. Conclusion. We cannot dismiss the possibility of the association between ACE polymorphism and age involving linkage disequilibrium, since the nature of this phenomenon is still controversial. From our studies, it appears that there is a correlation between age, ethnicity, and ACE polymorphism. More of such studies are warranted, as further investigation in this area will have a high clinical relevance to cardiovascular disease and aging research.
The prevalence of dementing disorders in Campo Grande of a community of Japanese‐Brazilians who immigrated from Okinawa was studied. Previous reports showed that the dietary pattern in Japanese ...immigrants in Brazil, which characterized by a low fish and large meat intake, is possibly responsible for increased risk of cardiovascular diseases compared with Japanese in Okinawa. A total of 157 persons over 70‐year‐old were examined, and 19 cases were diagnosed as having dementia. The prevalence (cases/100 aged 70‐year‐older) was 12.1 for all types of dementia, 5.7 for Alzheimer's disease (AD), 0.6 for vascular dementia (VD), 4.5 for mixed dementia (AD/VD) and 1.3 for other types of dementia. There was no case of dementia with Lewy bodies or frontotemporal lobar degeneration. These results are similar to many previous studies in Western countries and some recent surveys in Japan, and clearly show that more AD than VD appears even in the Japanese‐Brazilian population. The higher prevalence rate of dementia in Japanese‐Brazilians compared with several studies in Japan may indicate the importance of dietary factors rather than genetic factors.
As it is already known that depression can cause a demonstrable impact on cognition in elderly subjects, the objective of this study was to determine whether also the mourning process is associated ...with any cognitive impairment in this age range. A random and representative sample (a sample with 77 subjects/total county population of oldest-old with 219 subjects = 35%) aged 80 years or more was selected from the county of Veranópolis in the Brazilian rural southern region. Of this group, the cognitive function of subjects without grief and of subjects with the presence of grief were compared. Five neuropsychological tests (the Buschke-Fuld Selective Reminding Test, the word-list from the CERAD battery, the Verbal Fluency Test, and two subtests of the Wechsler memory scale), the Mini-Mental State Examination (MMSE) and two self-perceived memory impairment questionnaires were used. Presence of depressive symptomatology was identified by the Yesavage Geriatric Depression Scale (GDS). The prevalence rates of some psychiatric diagnoses (syndromic general anxiety disorder, major and minor depression) were compared between the bereaved group and the control group. There was not a statistically significant difference between the scores of controls and subjects with grief in the GDS. The frequency of affective disorders in both groups did not differ. However, the recently bereaved elderly subjects presented a mild cognitive impairment when evaluated with the MMSE, with the digit span test and with Word-list neuropsychological memory test. Likewise these bereaved octogenarian subjects presented more frequently a diagnosis of 'aging-associated cognitive decline' when compared with non-bereaved oldest-old. These results suggest that the normal sadness and/or the chronic stress of the grieving process, even without the presence of an identifiable syndromal-level depression, are associated with memory and cognitive differences among the bereaved oldest-old. Cause-effect relationships, however, cannot be established from this cross-sectional correlational study: Grief may influence cognitive functioning in the elderly, but mildly cognitively compromised elderly persons may be more likely to experience strong grief reactions after loss.
Aggressive behaviour is commonly observed in patients with dementia, and current pharmacological treatments are still deficient in terms of efficacy and tolerability. Allopurinol is an inhibitor of ...the enzyme xanthine oxidase, with previously suggested anti-aggressive effects. After successful treatment of aggression in two patients, we performed a case-series study with allopurinol 300 mg a day orally for 6 weeks (increasing 300 mg every 2 weeks if the response was less than 50%) in six patients with dementia associated with prominent aggressive behaviour who failed to respond to two previous treatment strategies. Five patients were considerably responsive to allopurinol (four with 300 mg within 2 weeks and one with 600 mg), apparently without side-effects, which is in accordance with its well-established safety and tolerability profile. The observed therapeutic effect of allopurinol might be due to the inhibition of the enzyme xanthine oxidase, possibly decreasing production of oxygen-free radicals or promoting the accumulation of purines. Controlled studies are warranted to confirm these preliminary observations.
Although a variety of techniques have been devised to assess salt sensitivity, most have proven cumbersome from a methodological perspective. We therefore attempted to develop a 2-week method by ...which participants could be tested in an outpatient setting without requirement of a strict dietary regimen. In this method, subjects take 140 mEq of an NaCl supplement per day for 1 week and 25 mg of hydrochlorothiazide daily for another week while maintaining their customary diet. In our first trial, 8 healthy volunteers submitted to this method, as well as to a widely-used rapid volume expansion and contraction protocol. Blood pressure measurements, blood sampling and 24-h urine collection were performed before, in the middle of, and after each intervention. There was a fair correlation (r =0.69) between the two protocols with respect to the changes in mean blood pressure (ΔMBP), a measure of salt sensitivity. In our second trial, we tested the method on 82 Japanese subjects who had never been treated with antihypertensive drugs. ΔMBP was significantly correlated with plasma renin activity (PRA) during salt loading (r =0.52, p <0.0001) and with the changes in atrial natriuretic peptide (ΔANP) (r =-0.34, p =0.0018). When total subjects were divided into two subgroups by age, a similar tendency of correlation was observed. Age, PRA during salt loading, ΔANP, and Δnorepinephrine were proven to be significant predictors of salt sensitivity and accounted for 46% of the ΔMBP variances. Based on these results, the dietary method presented here seems to be applicable for a population-based survey. Our preliminary data also suggest that PRA and ANP would be of predictive value in the salt sensitivity test. (Hypertens Res 2002; 25: 801-809)
To describe the prevalence of generalized anxiety disorder (GAD) in a community-dwelling population aged 80 years and older. Also to compare sleep patterns, cognitive function and prevalence of other ...psychiatric conditions between healthy controls and GAD subjects.
DSM-IV criteria were used to diagnose GAD. A representative random sample of 77 community-dwelling subjects (35%), aged 80 years or more from the rural southern county of Veranopolis, Brazil, was selected. Sleep patterns were assessed using the Pittsburgh Sleep Quality Index and a 2-week sleep/wake diary. Five neuropsychological tests (Buschke-Fuld Selective Reminding Test, CERAD word list, verbal fluency test and two sub-tests of the Wechsler memory scale) were used for cognitive evaluation.
The estimated GAD prevalence was 10.6 percent. GAD was associated with major depression, with a significant greater number of depressive symptoms as measured by the Geriatric Depression Scale and with a significant more frequent occurrence of minor depression. Sleeping patterns and cognition function among GAD subjects were not compromised. The severity of physical diseases was similar in both GAD subjects and healthy controls. GAD was associated with a significantly lower health-related quality of life.
In comparison with previous studies, the prevalence of GAD is higher in the studied population. This disorder is frequently associated with both depressive symptoms and a lower health-related quality of life.
Objective: Some human studies and animal models of experimental osteoporosis have shown that soy isoflavones may be effective on bone health. In this study, we carried out an intervention study to ...explore the effects of dietary isoflavone on bone metabolism. Methods: Forty healthy female postmenopausal Japanese immigrants living in Brazil were divided into two groups: isoflavone-administered (n = 20) or placebo (n = 20). Subjects in the isoflavone-administered group ingested 37.3 mg per day for 10 weeks. The collection of 24-hour urine and the measurement of bone stiffness were performed at 0 and 10 weeks. Urinary excretion of isoflavones and bone resorption markers were analyzed. Results: Urinary isoflavone excretion in the isoflavone-administered group was significantly increased at weeks 3 and 10. Urinary excretion of bone resorption markers was reduced in the isoflavone-administered group, while the placebo group did not show any significant reduction. Differences in levels of urinary isoflavones and bone resorption markers between the two groups were significant. Conclusion: This study demonstrated that the bone resorption was associated with the intake of soy isoflavones in postmenopausal women, and continuous dietary intake of isoflavone may inhibit postmenopausal osteoporosis.
PDF
