Dietary Micronutrients Intake Status among Chinese Elderly People Living at Home: Data from CNNHS 2010-2012

Effects of a food supplement containing phosphatidylserine on cognitive function in Chinese older adults with mild cognitive impairment: A randomized double-blind, placebo-controlled trial

BACKGROUND

Phosphatidylserine (PS) and α-Linolenic acid (ALA), are positively associated with cognitive function, but their combination effects and possible mechanisms remain unclear. We aimed to explore the effects on cognition and potential mechanism of the supplements.

METHODS

This randomized, double-blind, placebo-controlled trial recruited 190 MCI patients in Tianjin, China, and randomly assigned in intervention group and placebo group. Each group consumed two capsules every day for 12 months. Each capsule for intervention group contains 144 mg ALA, 31.5 mg PS and 3.6 mg Ginkgo total flavonoids as main functional components, with 0.48 mg Vitamin B1 (as thiamine hydrochloride), 0.48 mg Vitamin B6 (as pyridoxine hydrochloride) and 90 μg folic acid as supplement. Capsules for placebo group were identical but contain no active ingredients. Cognitive function, serum n-3 polyunsaturated fatty acids (PUFAs) and neurotransmitters were assessed at baseline and 12 months. Linear mixed effects model and causal mediation analysis were conducted to explore the effects and potential mechanism of the intervention.

RESULTS

A total of 190 participants (mean [SD] age, 67.95 [5.62] years; 70 (36.8 %) male and 120 (63.2 %) female) were randomized to the placebo group (n = 95) and intervention group (n = 95). Compared with placebo group, the intervention group had statistically significant improvements in arithmetic testing (β, 0.688; 95 % CI, 0.103-1.274), the similarity test (β, 1.070; 95 % CI, 0.472-1.667) and short-term memory (β, 0.600; 95 % CI, 0.399-0.800). Besides, the intervention group had statistically significant increases in serum ALA (β, 1.620; 95 % CI, 0.967-2.265), DHA (β, 2.797; 95 % CI, 1.075-4.532), EPA (β, 1.472; 95 % CI, 0.296-2.643), acetylcholine (β, 0.441; 95 % CI, 0.415-0.468), GABA (β, 0.009; 95 % CI, 0.001-0.016) and 5-HT (β, 0.160; 95 % CI, 0.081-0.238) compared to the placebo group. And the intervention may improve short-term memory by increasing serum ALA levels (average causal mediation effect = 0.132, 95 % CI, 0.053-0.225) with 19.7 % mediation proportion.

CONCLUSIONS

This food supplement containing phosphatidylserine could improve different cognitive functions of MCI patients, especially short-term memory, and increase serum n-3 PUFAs and neurotransmitters levels. Serum ALA level might play a mediation role.

Does Vitamin B6 Act as an Exercise Mimetic in Skeletal Muscle?

Marginal vitamin B6 (B6) deficiency is common in various segments worldwide. In a super-aged society, sarcopenia is a major concern and has gained significant research attention focused on healthy aging. To date, the primary interventions for sarcopenia have been physical exercise therapy. Recent evidence suggests that inadequate B6 status is associated with an increased risk of sarcopenia and mortality among older adults. Our previous study showed that B6 supplementation to a marginal B6-deficient diet up-regulated the expression of various exercise-induced genes in the skeletal muscle of rodents. Notably, a supplemental B6-to-B6-deficient diet stimulates satellite cell-mediated myogenesis in rodents, mirroring the effects of physical exercise. These findings suggest the potential role of B6 as an exercise-mimetic nutrient in skeletal muscle. To test this hypothesis, we reviewed relevant literature and compared the roles of B6 and exercise in muscles. Here, we provide several pieces of evidence supporting this hypothesis and discuss the potential mechanisms behind the similarities between the effects of B6 and exercise on muscle. This research, for the first time, provides insight into the exercise-mimetic roles of B6 in skeletal muscle.

Low energy intake and nutritional maladaptation in terminal stage IV periodontitis

AIM

Impairment of masticatory function in elderly patients with terminal dentition due to stage IV periodontitis (TDS4P) may lead to lower nutritional intake. The study aimed to report the dietary intake and nutrition status of elderly patients with TDS4P and compare them with those of the elderly Chinese population and the Chinese Dietary Reference Intakes (DRIs).

MATERIALS AND METHODS

Fifty-one consecutive subjects (≥55 years old) with TDS4P were enrolled. Average dietary intake was evaluated based on a 3-day 24-h dietary recall (24HR) and food frequency questionnaire (FFQ). The daily intake of fresh vegetables and fruits, dietary energy as well as macro and micronutrients were calculated and compared with matched national data and the Chinese DRIs. Nutritional status was assessed by Short-Form Mini-Nutritional assessment.

RESULTS

Of the subjects, 19.6% (95% CI: 7.2%-28.1%) were at risk of malnutrition. The mean daily energy intake was 1517.4 kcal (95% CI: 1400.5-1634.3) for males and 1110.7 kcal (95% CI: 1001.5-1219.9) for females, which were very low compared with both the national data and the DRIs. Females derived a higher percentage of energy from fat. The mean daily intake of vegetables was 151.4 g (95% CI: 128.1-174.8) by FFQ and 130.9 g (95% CI: 104.6-157.3) by 24HR. Both results were significantly lower than the national reports (95% CI: 310.3-340.1) and the DRIs (300-450 g). Insufficient micronutrient intake, especially vitamins A, C and E, was also found.

CONCLUSIONS

Elderly subjects with TDS4P had a lower daily energy intake, vegetable and fruit consumption and essential macro and micronutrient intake. More studies are needed to clarify the impact of periodontitis and tooth loss/replacement on nutrition and healthy ageing.

Dietary nutrient intake study among older adults: baseline Malaysian pure study

INTRODUCTION

The older adults (OA) is vulnerable to malnutrition, which may affect their health and quality of life. This study assesses the prevalence of deficiencies in dietary nutrients among the Malaysian OA stratified by residency, genders, socioeconomic status (SES) and body mass index (BMI).

METHODOLOGY

A cross-sectional study was conducted, utilizing purposive sampling, recruiting 2,299 Malaysian people aged 60 years old and above who agreed to be interviewed via a comprehensive semi-quantitative food frequency questionnaire. The nutrients intake was calculated based on the Malaysian food composition and US Department of Agriculture food composition databases. Then, the nutrients intake was compared with the Malaysian Recommended Nutrients Intake guidelines, and the prevalence of deficiencies in dietary nutrients were calculated. The median (interquartile ranges) intakes of nutrients were compared between residency (urban and rural), genders (male and female), and SES (low and middle-high) using the Mann-Whitney U test. The differences in nutrient intake between BMI categories (underweight, normal, and overweight) were identified using the Kruskal-Wallis test followed by Dunn's post hoc test.

RESULTS

The response rate was 70.3% (n = 2,299), predominantly were females (50.8%), received primary education (76.6%), were currently married (84.3%), were middle-high SES (57.7%), and had a normal BMI (59.8%). There was a notable inadequate intake prevalence of magnesium (100.0%), manganese (97.9%), zinc (95.6%), vitamin B6 (98.4%), potassium (91.0%), calcium (89.3%), vitamin B12 (80.2%), vitamin E (91.2%), and vitamin K (81.5%) among Malaysian OA. Additionally, significant differences were observed in nutrients intake levels across gender, residency, SES, and BMI within this population.

CONCLUSIONS

This study shows a high prevalence of dietary nutrients deficiency (> 80%) among the Malaysian OA, particularly for magnesium, manganese, potassium, zinc, vitamin B6, vitamin E, calcium, vitamin B12, and vitamin K. To improve the nutritional status of OA and safeguard against adverse health effects, it is necessary to formulate and execute strategies to enhance their dietary nutrient intakes. The strategies may involve intervention such as nutrient supplementation and promotion of consuming nutrient-rich foods.

The potential of biofortification technologies for wheat and rice to fill the nutritional Zn intake gap in China

BACKGROUND

Zinc (Zn) deficiency in humans is of worldwide concern. The objective of this study was to investigate the Zn intake gap in Chinese adults and identify the potential role of biofortification technologies for wheat and rice, including crop nutrient management and breeding, in filling the gap.

RESULTS

We use data from the China Health and Nutrition Survey in 2011 to identify food consumption patterns and dietary Zn intake of 4512 adults to define and quantify the Zn intake gap in the population. The dietary Zn intake gap of surveyed adults ranged from -0.8 to 6.53 mg day-1 across nine provinces and differences were associated with differences in food consumption patterns. Both dietary Zn intake and Zn gap for males were higher than for females. The potential of changes in five management strategies (improved nitrogen fertilization, improved phosphorus fertilization, foliar Zn fertilization, improved water management and growing varieties reaching the grain Zn breeding target) was analyzed. Breeding and foliar Zn fertilization were shown to be the two most effective management strategies that could increase dietary intake by 1.29 to 5 mg Zn day-1 dependent on sex and province.

CONCLUSION

This study shows that the Zn gap varied across regions in China, with some large enough to warrant interventions. Wheat and rice as two major Zn sources could be targeted without a direct need for dietary diversification. By promoting both biofortification breeding of wheat and rice and Zn fertilization, dietary Zn intake could be enhanced to contribute to human health improvement in China. © 2023 Society of Chemical Industry.

Adequacy and Distribution Equity of Nutrition Supplies across China

Procuring food enriched with diverse nutrients is pivotal for maintaining a robust immune system. However, the food system is now unprecedentedly globalized and faces challenges arising from climate change, pandemics, and political unrest. This study aims to illuminate the gap in exploring the adequacy and distribution equity of nutrition supplies in response to potential trade fluctuations and restrictions on agrifood within China's local agriculture endowments. Also, it seeks to identify the role of trade in contributing to these indices. Accordingly, we analyzed the distribution of nutrients in agrifood categories from production to consumption and assessed the adequacy and distribution equity of corresponding available nutrition supply from the local food provision system in terms of meeting residents' nutritional requirements, across China, and compared with those in the practical market. The local self-supply system showed that 12 out of 31 provinces have difficulty achieving an iron supply with 11% to 108% deficiencies. Except for iron, 52% (folate)-90% (vitamin B12) of agricultural output was available for diet provisioning nationwide. While food trade emerges as a crucial factor in enhancing secure and equitable nutrition supply, risks associated with micronutrient deficiencies necessitate careful consideration in current global circumstances. Our analysis explored a regional pool of nutrient information in supplements to the conventional food profile in China and could implicate better knowledge toward healthier food supplies and tailored improvements for achieving a resilient nutrition supply.

Antioxidant Minerals Modified the Association between Iron and Type 2 Diabetes in a Chinese Population

Inconsistent findings exist regarding the relationship between heme iron intake and type 2 diabetes (T2D) among Western and Eastern populations. Easterners tend to consume a plant-based diet which is abundant in antioxidant minerals. To examine the hypothesis that antioxidant mineral may modify the relationship between iron and T2D, we performed a case-control study by measuring the serum mineral levels in 2198 Chinese subjects. A total of 2113 T2D patients and 2458 controls were invited; 502 T2D patients and 1696 controls were finally analyzed. In the total population, high serum iron showed a positive association with T2D odds (odds ratio [OR] = 1.27 [1.04, 1.55]); high magnesium (OR = 0.18 [0.14, 0.22]), copper (OR = 0.27 [0.21, 0.33]), zinc (OR = 0.37 [0.30, 0.46]), chromium (OR = 0.61 [0.50, 0.74]), or selenium concentrations (OR = 0.39 [0.31, 0.48]) were inversely associated with T2D odds. In contrast, in individuals with higher magnesium (>2673.2 µg/dL), zinc (>136.7 µg/dL), copper (>132.1 µg/dL), chromium (>14.0 µg/dL), or selenium concentrations (>16.8 µg/dL), serum iron displayed no association with T2D (p > 0.05). Serum copper and magnesium were significant modifiers of the association between iron and T2D in individuals with different physiological status (p < 0.05). Our findings support the idea that consuming a diet rich in antioxidant minerals is an effective approach for preventing T2D.

How to promote telemedicine in underdeveloped cities in central China? Qualitative interviews with medical personnel in tertiary A-level hospital of Xinyang City

Background

Telemedicine has emerged as a novel healthcare service model that plays a vital role in addressing the unequal distribution of medical resources. Telemedicine has recently gained significant traction in economically prosperous cities such as Beijing, Shanghai, and Guangzhou in China. However, Xinyang City in Henan Province is an economically less developed city, and telemedicine is still in its early stages. By exploring the views of medical staff and administrators at Xinyang City's tertiary A-level hospital on telemedicine, this study aims to determine the development status of telemedicine services in Xinyang City. The objective was to identify the challenges in the construction process and formulate corresponding strategies for advancing telemedicine in Xinyang City.

Methods

Face-to-face personal interviews were conducted with 16 medical staff and administrators from a tertiary A-level hospital in Xinyang City, Henan Province, and the data were collected and analyzed using grounded theory. In the process of data analysis, NVivo12 software was used to encode and organize the data line by line.

Results

The development of telemedicine in Xinyang City has the potential to benefit residents, hospitals, and healthcare personnel despite several challenges, including the absence of laws and regulations, inadequate policy support, limited hospital cooperation, and low resident awareness, which must be addressed to unlock the full potential of telemedicine.

Conclusion

The telemedicine system in Xinyang City is currently in a coordinated developmental phase, and several areas require further improvement. The development of standardized telemedicine in Xinyang City requires government support, better training for general practitioners, public awareness campaigns, and improved technology while ensuring reasonable work schedules and motivating medical personnel.

Usual Nutrient Intake Distribution and Prevalence of Nutrient Intake Inadequacy among Japanese Children and Adults: A Nationwide Study Based on 8-Day Dietary Records

In this cross-sectional study, we evaluated nutrient intake adequacy in 4450 Japanese people aged 1-79 years. Dietary data was collected through non-consecutive 8-day weighed dietary records. Usual nutrient intakes from foods and beverages were estimated using the Multiple Source Method. Participant proportions with intakes below and above the Japanese Dietary Reference Intakes (2020) were calculated. Usual intakes of most nutrients were below the Estimated Average Requirement; calcium showed a high percentage of inadequacy across all sex and age groups (29-88%), and iron showed a high inadequacy among females aged 12-64 years (79-95%). The percentages of energy from protein and carbohydrates, dietary fibre, and potassium were typically below the lower limit of the Tentative Dietary Goal for Preventing Lifestyle-related Diseases (DG). Furthermore, over 20% of the participants exceeded the upper limit of the DG for the percentages of energy from total and saturated fats, and over 88% exceeded the upper limit of the DG for sodium. Japanese children and adults could improve their nutrient intake by increasing calcium, iron, dietary fibre, and potassium and reducing total and saturated fats and sodium. These findings can inform policies and interventions to improve nutrient intake in Japan.

High Prevalence of Energy and Nutrients Inadequacy among Brazilian Older Adults

Poor nutrition increases the risk of diseases and adverse health outcomes in older adults. We evaluated the potential inadequacy of nutrient intake among older adults in Brazil and its association with body anthropometry and composition outcomes. Dietary intake was obtained from 295 community-living older adults (>60 years old), of both genders, using a seven-day food record. Nutrient inadequacy was further identified based on the Dietary Reference Intakes and European Guidelines. Skeletal muscle mass (SM), strength and performance, and the diagnosis of sarcopenia were assessed using reference methods. Nutritional inadequacy was high, with energy, dietary fiber, and six micronutrients exhibiting the greatest inadequacy levels (>80%). Energy intake was correlated with SM strength (p = 0.000) and performance (p = 0.001). Inadequate energy, fiber, and protein intakes influenced BMI, while inadequate intake of vitamin B6 directly affected the diagnosis of sarcopenia (p ≤ 0.005). Further research is required to investigate whether these inadequacies can be associated with other clinical health outcomes.

The STROMICS genome study: deep whole-genome sequencing and analysis of 10K Chinese patients with ischemic stroke reveal complex genetic and phenotypic interplay

Ischemic stroke is a leading cause of global mortality and long-term disability. However, there is a paucity of whole-genome sequencing studies on ischemic stroke, resulting in limited knowledge of the interplay between genomic and phenotypic variations among affected patients. Here, we outline the STROMICS design and present the first whole-genome analysis on ischemic stroke by deeply sequencing and analyzing 10,241 stroke patients from China. We identified 135.59 million variants, > 42% of which were novel. Notable disparities in allele frequency were observed between Chinese and other populations for 89 variants associated with stroke risk and 10 variants linked to response to stroke medications. We investigated the population structure of the participants, generating a map of genetic selection consisting of 31 adaptive signals. The adaption of the MTHFR rs1801133-G allele, which links to genetically evaluated VB9 (folate acid) in southern Chinese patients, suggests a gene-specific folate supplement strategy. Through genome-wide association analysis of 18 stroke-related traits, we discovered 10 novel genetic-phenotypic associations and extensive cross-trait pleiotropy at 6 lipid-trait loci of therapeutic relevance. Additionally, we found that the set of loss-of-function and cysteine-altering variants present in the causal gene NOTCH3 for the autosomal dominant stroke disorder CADASIL displayed a broad neuro-imaging spectrum. These findings deepen our understanding of the relationship between the population and individual genetic layout and clinical phenotype among stroke patients, and provide a foundation for future efforts to utilize human genetic knowledge to investigate mechanisms underlying ischemic stroke outcomes, discover novel therapeutic targets, and advance precision medicine.

Association between dietary approaches to stop hypertension (DASH) diet and hyperuricemia among Chinese adults: findings from a nationwide representative study

Background

Certain foods and food groups could positively or negatively impact serum uric acid (SUA) levels. However, evidence on the holistic dietary strategy to prevent and control hyperuricemia (HUA) development remains limited.

Objective

The aim of this research work was to explore the association of dietary approaches to stop hypertension (DASH) diet with SUA levels and odds of HUA among Chinese adults.

Methods

This research premise included 66,427 Chinese adults aged 18 and above who were part of the China Adult Chronic Disease and Nutrition Surveillance in 2015. Dietary consumptions were assessed via the household condiment weighing approach and a three-day, 24-hour dietary recall. Total fat, saturated fat, calcium, protein, potassium, cholesterol, magnesium, fiber, and sodium were all adopted to calculate the DASH score (score range, 0–9). The associations of DASH score with SUA levels and odds of HUA were evaluated using multiple linear and logistic regression models, respectively.

Results

We established that a higher DASH score was linked with a lower SUA levels (β = − 0.11; 95% CI: − 0.12, − 0.1; p < 0.001) and odds of HUA (OR = 0.85; 95% CI: 0.83, 0.87; p < 0.001) after adjustment for age, sex, ethnicity, education status, marital status, health behaviours and health factors. The association of the DASH diet with odds of HUA was stronger among men (p-interaction = 0.009), non-Han Chinese (p-interaction< 0.001) as well as rural residents (p-interaction< 0.001).

Conclusions

Our results illustrate that the DASH diet was remarkably negatively with SUA levels and odds of HUA in the Chinese adult population.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12937-023-00845-w.

Effect of a Single Multi-Vitamin and Mineral Supplement on Nutritional Intake in Korean Elderly: Korean National Health and Nutrition Examination Survey 2018-2020

Inadequate nutritional intake is common, especially among elderly individuals. Although micronutrient intake may help fill nutritional gaps, the effects of multi-vitamin and mineral supplements (MVMS) among the Korean elderly are not well known. Therefore, we investigated the nutrition-improving effects of a single MVMS. A total of 2478 people aged ≥65 years who participated in the Korea National Health and Nutrition Survey 2018-2020 were analyzed. Nutrient intake from food and supplements was measured using the 24 h recall method. We compared the nutritional intake and insufficiency between the food-only group (n = 2170) and the food and MVMS group (n = 308). We also evaluated the differences in inadequate nutritional intake after taking MVMS with food. The analysis included vitamins A and C, thiamine, riboflavin, niacin, calcium, iron, and phosphorus. The proportion of insufficient intake ranged from 6.2% to 80.5% for men and from 21.2% to 82.4% for women, depending on the nutrients. Intake of MVMS with food was associated with lower rates of inadequacy (3.8-68.5% for men and 3.3-75.5% for women) compared to the food-only group. The results suggest that micronutrient deficiency frequently occurs in the Korean elderly population and can be improved by MVMS intake.

Association of Serum Antioxidant Minerals and Type 2 Diabetes Mellitus in Chinese Urban Residents

Antioxidant minerals including zinc, copper and selenium play critical roles in the maintenance of the redox balance in the body. However, their influences on type 2 diabetes mellitus (T2DM) are still inconclusive in Chinese populations. To elucidate the relationship between antioxidant minerals and T2DM, serum zinc, copper and selenium concentrations were measured in 1443 Chinese urban residents using a 1:2 matched case-control study. Conditional logistic regression models (CLR) were used to obtain the odds ratios (ORs) and 95% confidence intervals (CIs), and restricted cubic splines (RCS) were used to examine their dose−response associations. Serum zinc (OR = 0.52 [0.35, 0.77]) and copper concentrations (OR = 0.25 [0.17, 0.37]) were negatively associated with T2DM in a fully adjusted model. An L-shaped zinc-T2DM association (Poverall association = 0.003, and Pnonlinearity = 0.005) and a negative linear copper-T2DM association (Poverall association < 0.0001, and Pnonlinearity = 0.395) were observed. No association was found between serum selenium and T2DM in fully adjusted CLR or RCS models. In addition, joint associations with T2DM were identified between serum zinc and copper and between serum selenium and copper. In conclusion, our study emphasizes the importance of an adequate intake of antioxidant minerals for T2DM prevention in the Chinese population.

Usual Intake of Micronutrients and Prevalence of Inadequate Intake among Chinese Adults: Data from CNHS 2015-2017

Previous studies have used the traditional average-value method to calculate the usual dietary intake of a population, but the results may be biased due to the measurement errors. The aim of this study was to provide an assessment of the usual micronutrient intake and estimate the prevalence of inadequate intake among Chinese adults. Data from the Chinese Nutrition and Health Surveillance 2015−2017 as well as a total of 72,231 subjects aged 18 years and older were included in the analysis. The 24 h recall method combined with the condiment weighing method were used for three consecutive days to collect daily food and condiments intake. The daily intake of 16 micronutrients was calculated based on the Chinese Food Component Tables. The National Cancer Institute (NCI) method was used to estimate the usual intake of micronutrients, and the prevalence of inadequate intake was estimated using the estimated average requirement (EAR) cut-point method. The results showed that, except for sodium, copper, iron (only for males), vitamin E, and phosphorus, the usual intake of micronutrients in Chinese adults was low, and the prevalence of inadequate intake ranged from 38.67 to 97.63%. The prevalence of inadequate calcium and riboflavin intake was more than 90%, and the proportion of individuals with a usual intake of thiamine, vitamin A, potassium, and selenium below EAR also reached 80%. Manganese, magnesium, vitamin C, and zinc were potentially deficient micronutrients, with the prevalence of inadequate intake ranging from 38.67% to 77.09%. However, usual sodium intake was extremely high with an average of 5139.61 mg/day, and only a quarter of Chinese adults were below the World Health Organization (WHO) recommended value. For most micronutrients, the usual dietary intake declined with age and the prevalence of inadequate intake increased with age. Except for zinc, vitamin A, and B-vitamins, the prevalence of micronutrient deficiencies was higher in females than in males in the same age group (p < 0.05). Therefore, Chinese adults do not receive enough micronutrients. Effective nutrition supplementary strategies and measures are needed to address these problems.

Reaching and maintaining higher dietary diversity is associated with decreased risk of all-cause mortality: A longitudinal study from the China Health and Nutrition Survey

It is generally believed that higher dietary diversity is associated with better health status. The dietary diversity of individuals may change with age; however, evidence on the trajectory of change in the long-term and whether it is related to all-cause mortality is still scant. In this study, we used data from the China Health and Nutrition Survey (CHNS) collected in five follow-ups between 2004 and 2015 to explore the association between changes in dietary diversity scores (DDS) and all-cause mortality, as well as the dynamic change in DDS with age. In total, 6,737 subjects (aged between 30 and 60 at enrollment) were included in the analysis. Latent Class Trajectory Modeling (LCTM) was used to explore the different trajectories of DDS changes among participants. Four classes were identified: class 1 with the lowest average DDS (3.0) that showed a gradual decline during the follow-ups; class 2 with relatively low DDS (4.0) that experienced slight growth; class 3 with medium DDS (5.2) that also demonstrated similar growth rate to class 2; and class 4 with the highest DDS (6.7) maintained at a high level. Cox proportional hazards regression models were applied to investigate the association between the DDS trajectories and the risk of death. Only class 4, which was characterized by the highest and stable DDS, had significant reduced risk of all-cause mortality of 71.0% (hazard ratio [HR]: 0.29; 95% confidence interval [CI]: 0.10–0.83), 68% (HR: 0.32; 95% CI: 0.11–0.89), and 66.0% (HR: 0.34; 95% CI: 0.12–0.94), compared to classes 1, 2, and 3, respectively, while the first three classes showed no significant inter-class differences. When considering the average DDS during the study period, each point of increase in DDS corresponded to a 22% reduced risk of mortality (HR: 0.78; 95% CI: 0.69–0.89). In summary, reaching and maintaining a higher DDS was associated with a decreased risk of all-cause mortality. Therefore, promoting diversified eating and increasing the accessibility of varieties of foods should be paid more attention from policymakers and be more emphasized in dietary guidelines.

Mineral-Enriched Postbiotics: A New Perspective for Microbial Therapy to Prevent and Treat Gut Dysbiosis

Postbiotics are non-viable probiotic preparations that confer a health benefit on the host. In the last years, scientific literature has proved that postbiotics have health-promoting features and technological advantages compared to probiotics, augmenting their full potential application in the food and pharmaceutical industries. The current work comprehensively summarizes the benefits and potential applications of postbiotics and essential mineral-enriched biomass and proposes a new strategy for microbial therapy—mineral-enriched postbiotics. We hypothesize and critically review the relationship between micronutrients (calcium, magnesium, iron, zinc, selenium) and postbiotics with gut microbiota, which has been barely explored yet, and how the new approach could be involved in the gut microbiome modulation to prevent and treat gut dysbiosis. Additionally, the bioactive molecules and minerals from postbiotics could influence the host mineral status, directly or through gut microbiota, which increases the mineral bioavailability. The review increases our understanding of the health improvements of mineral-enriched postbiotics, including antioxidant functions, highlighting their perspective on microbial therapy to prevent and threaten gut-related diseases.

A Cross-Sectional Study of the Distribution Patterns and Potential Determinants in Plasma Selenium Status Among Chinese Adults With Hypertension

Selenium (Se) is an essential trace element in selenoproteins biosynthesis for the human body and plays an important role in the prevention and control of subsequent cardiovascular disease in adults with hypertension. However, reports on Se status and its potential determinants in populations from different regions of China are limited, especially data on adults with hypertension, a high-risk group more vulnerable to oxidative stress. Thus, we conducted a cross-sectional study from February 2017 to May 2018 of 2,599 participants (1,389 men and 1,210 women) on middle-aged to elderly adults with hypertension with a mean age of 63.1 years (SD 13.3) from 14 provinces of China and aimed to examine the relationship of plasma Se status with demographic characteristics and lifestyles. Overall, the male participants (mean value 75.0 μg/L) tended to have higher plasma Se concentrations than the female participants (73.7 μg/L) when controlling for relevant factors. There were significant differences among regions, and in age and body mass index (BMI) in plasma Se distribution, and plasma Se concentrations were significantly lower among those in the regions with relatively lower Se, aged 60 years or older, and with BMI lower than 28 kg/m². Moreover, a higher frequency of meat consumption (1-2 or ≥3 times/week vs. <1 time/week) was significantly associated with higher plasma Se concentrations in men and women, and male alcohol drinkers had significantly higher plasma Se concentrations than non-alcohol drinkers. Adequate consumption of fruits and vegetables (0.5-1.5 kg/week) was associated with higher plasma Se concentrations among women, but was associated with relatively lower plasma Se concentrations in men. Our results indicated relatively low plasma Se status in Chinese adults with hypertension from 14 provinces, while specific factors including geographic, demographic, and lifestyle characteristics and blood pressure were significantly associated with plasma Se status in this hypertensive population. In addition, more studies are required to further evaluate dietary structure and other lifestyle factors that influence circulating Se status.

Natural Variation in Vitamin B1 and Vitamin B6 Contents in Rice Germplasm

Insufficient dietary intake of micronutrients contributes to the onset of deficiencies termed hidden hunger-a global health problem affecting approximately 2 billion people. Vitamin B1 (thiamine) and vitamin B6 (pyridoxine) are essential micronutrients because of their roles as enzymatic cofactors in all organisms. Metabolic engineering attempts to biofortify rice endosperm-a poor source of several micronutrients leading to deficiencies when consumed monotonously-have led to only minimal improvements in vitamin B1 and B6 contents. To determine if rice germplasm could be exploited for biofortification of rice endosperm, we screened 59 genetically diverse accessions under greenhouse conditions for variation in vitamin B1 and vitamin B6 contents across three tissue types (leaves, unpolished and polished grain). Accessions from low, intermediate and high vitamin categories that had similar vitamin levels in two greenhouse experiments were chosen for in-depth vitamer profiling and selected biosynthesis gene expression analyses. Vitamin B1 and B6 contents in polished seeds varied almost 4-fold. Genes encoding select vitamin B1 and B6 biosynthesis de novo enzymes (THIC for vitamin B1, PDX1.3a-c and PDX2 for vitamin B6) were differentially expressed in leaves across accessions contrasting in their respective vitamin contents. These expression levels did not correlate with leaf and unpolished seed vitamin contents, except for THIC expression in leaves that was positively correlated with total vitamin B1 contents in polished seeds. This study expands our knowledge of diversity in micronutrient traits in rice germplasm and provides insights into the expression of genes for vitamin B1 and B6 biosynthesis in rice.

Hair Se Is a Sensitive Biomarker to Monitor the Effects of Se Supplementation in Elderly

It is rapidly increasing to have selenium (Se) supplementation for urban elderly population in China since they are facing a widespread deficiency daily Se intake. However, until now, there is no low-cost, non-invasive, rapid, and reliable method to monitor the health improvement or risk for elderly Se-supplemented population in China. The present cross-sectional study (229 participants with older than 55 years old) performed in Beijing, China, revealed that the Se concentrations of non-supplementer users (n = 27) were 55 ± 23 μg/L in urine, 139.9 ± 102.3 μg/L in serum, and 487.6 ± 158.7 μg/kg in hair. But a significant increase on hair Se concentrations (615.4 ± 238.8 μg/kg) was observed for Se supplementer users (n = 202) (p < 0.05); there were no significant statistical differences in serum and urine between the Se-supplemented (n = 202) and Se non-supplemented groups (n = 27). This indicated the hair Se levels could be a more sensitive biomarker for Se-supplemented elderly population. Participants who consumed Se supplements for 7-12 months had the highest Se status based on hair and serum Se concentrations (p < 0.05). The present study also revealed that most elderly adults in Beijing just need to supplement 50 μg Se per day to achieve Se plateau status. Furthermore, hair Se levels were positively related with triglycerides/TG levels (p < 0.05) but not body mass index/BMI, total cholesterol/TC, and low-density lipoprotein cholesterol/LDL, implicating Se supplementation for Se sufficiency baseline in elderly population in Beijing likely posed health risk, especially on TG because of excessive Se oxidation stress. An ongoing monitoring of Se status via hair is still warranted to prevent future Se deficiency or excess in China.

Nutritional Status and Serum Levels of Micronutrients in an Elderly Group Who Participate in the Program for Complementary Food in Older People (PACAM) from the Metropolitan Region, Santiago de Chile

The increase in the Chilean elderly population has promoted public policies to favor an adequate nutrition in later life. This study evaluated the nutritional status, micronutrients intake and serum micronutrients levels of an elderly group beneficiary of the PACAM from the Metropolitan Region, Santiago de Chile. Anthropometric and dietary survey (24 h food recalls) were assessed in 182 elderly individuals (60 and 80 years old). Blood serum collection was used to measure the micronutrient status. The sample was comprised by 12.6%, 46.1%, 28.0% and 13.2% of underweight, normal weight, overweight and obese subjects, respectively. Women presented 11% of underweight, 45% of normal weight and 44% of overweight and obese, while men—18%, 50% and 32%, respectively. Only the 63% of the elderlies consumed PACAM foods, reaching average daily intakes below (50%) the recommended daily serving. Serum deficiencies of 25-hydroxyvitamin D (88%), vitamin B₁₂ (33%) and calcium (36%) were observed, being the highest ones in the PACAM foods women (60–75 years old). Chilean elderlies presented mainly a normal weight; however, an important proportion of overweight/obese subjects was observed. Although PACAM foods consumption significantly increased the micronutrient intake, it was not enough to ensure an adequate serum micronutrient levels in the elderly.

Dietary Diversity and Nutrient Intake of Han and Dongxiang Smallholder Farmers in Poverty Areas of Northwest China

This study aimed to evaluate the status of dietary diversity and nutrient intake among Han and Dongxiang smallholder farmers in poor rural areas of northwest China. In this cross-sectional study, dietary intake was assessed in 499 smallholder farmers aged 18–75 years from two nationally designated impoverished counties in Gansu Province, China, using three consecutive 24 h dietary recalls. The dietary diversity score (DDS) and nutrient adequacy ratio (NAR) were adopted to assess dietary diversity and micronutrient adequacy, respectively. The mean DDS (range from 1 to 9) in participants was relatively low (3.81 ± 1.01). Consumption of grains was excessive, while consumption of vegetables, fruits, meat, beans, eggs, fish, and dairy was inadequate. The NAR values were higher in Han Chinese, with the exceptions of vitamin C, potassium, pyridoxine, and selenium (p < 0.05). For each nutrient, the high DDS group had a higher mean NAR (p < 0.05), except for pyridoxine. High household monthly income, being Han Chinese, high DDS, and being aged over 45 years were positively associated with mean adequacy ratio (MAR) of 14 micronutrients evaluated. Lack of dietary diversity and insufficient intake of essential micronutrients are public health concerns in northwest China. Nutrition education and other proper methods to address these issues are needed.

Overview of age-related changes in psychomotor and cognitive functions in a prosimian primate, the gray mouse lemur (Microcebus murinus): Recent advances in risk factors and antiaging interventions

Aging is not homogeneous in humans and the determinants leading to differences between subjects are not fully understood. Impaired glucose homeostasis is a major risk factor for cognitive decline in middle-aged humans, pointing at the existence of early markers of unhealthy aging. The gray mouse lemur (Microcebus murinus), a small lemuriform Malagasy primate, shows relatively slow aging with decreased psychomotor capacities at middle-age (around 5-year old). In some cases (∼10%), it spontaneously leads to pathological aging. In this case, some age-related deficits, such as severe cognitive decline, brain atrophy, amyloidosis, and glucoregulatory imbalance are congruent with what is observed in humans. In the present review, we inventory the changes occurring in psychomotor and cognitive functions during healthy and pathological aging in mouse lemur. It includes a summary of the cerebral, metabolic, and cellular alterations that occur during aging and their relation to cognitive decline. As nutrition is one of the major nonpharmacological antiaging strategies with major potential effects on cognitive performances, we also discuss its role in brain functions and cognitive decline in this species. We show that the overall approach of aging studies in the gray mouse lemur offers promising ways of investigation for understanding, prevention, and treatments of pathological aging in humans.

The Role of Micronutrients in Ageing Asia: What Can Be Implemented with the Existing Insights

Life expectancy as a measure of population health does not reflect years of healthy life. The average life expectancy in the Asia-Pacific region has more than doubled since 1900 and is now above 70 years. In the Asia-Pacific region, the proportion of aged people in the population is expected to double between 2017 and 2050. Increased life expectancy leads to an increase in non-communicable diseases, which consequently affects quality of life. Suboptimal nutritional status is a contributing factor to the prevalence and severity of non-communicable diseases, including cardiovascular, cognitive, musculoskeletal, immune, metabolic and ophthalmological functions. We have reviewed the published literature on nutrition and healthy ageing as it applies to the Asia-Pacific region, focusing on vitamins, minerals/trace elements and omega-3 fatty acids. Optimal nutritional status needs to start before a senior age is reached and before the consequences of the disease process are irreversible. Based on the nutritional status and health issues in the senior age in the region, micronutrients of particular importance are vitamins A, D, E, C, B-12, zinc and omega-3 fatty acids. The present paper substantiates the creation of micronutrient guidelines and proposes actions to support the achievement of optimal nutritional status as contribution to healthy ageing for Asia-Pacific populations.

The Status of Dietary Energy and Nutrients Intakes among Chinese Elderly Aged 80 and Above: Data from the CACDNS 2015

This study analyzed the status of dietary energy and nutrients intakes among the oldest-old in China. Data was obtained from the China Adult Chronic Disease and Nutrition Surveillance in 2015 (CACDNS 2015). We enrolled 1929 Chinese elderly people aged 80 and above who participated in both 3-day 24-h dietary recalls and household condiments weighing. The dietary intakes were calculated based on Chinese Food Composition Tables and assessed using Chinese Dietary Reference Intakes (DRIs). The dietary intakes of energy and most nutrients were all below the EAR or AI, except for fat, vitamin E, niacin, iron and sodium. As a result, daily dietary intakes of energy and most nutrients were inadequate in the oldest-old in China, especially vitamin A, vitamin B1, vitamin B2, folate and calcium, with the prevalence of deficiency more than 90%. Furthermore, the prevalence of inadequacy of vitamin C, zinc, selenium and magnesium was also high with the proportion below the EAR more than 60%. Approximately 30% of the subjects with dietary vitamin E intake did not reach AI, and more than 90% of subjects have reached AI in the intake of sodium, while more than 90% did not reach AI in potassium. The mean intakes of niacin and iron have reached EAR, but around 15% were still faced with the risk of deficiency. In addition, although the dietary energy intake was below EER, the energy contribution from fat in total population and all subgroups (region, age, gender, education level, material status, household income level groups) all exceeded the recommended proportion of 30% from the DRIs and close to or over 35%, is a significant concern. For the majority of nutrients, higher daily dietary intakes and lower prevalence of deficiencies were found in the oldest-old living in urban areas, aged 80-84 years, with high school and above education level, living with spouse and from high household income family. These findings indicates that the dietary intakes of energy and nutrients were inadequate, while the energy contribution from fat and dietary sodium intake were too high among the oldest-old in China. Most oldest-old were at high risk of nutritional deficiency, particularly for those who living in rural areas, with lower education level and from low household income.

Difference and Variance in Nutrient Intake by Age for Older Adults Living Alone in Japan: Comparison of Dietary Reference Intakes for the Japanese Population

This study aimed to estimate the distribution of usual intakes in protein, sodium, potassium, and calcium by age group and assessed whether proportions of deficiencies/excesses of each nutrient would occur more in older age via a comparison with the dietary reference intakes for the Japanese population (DRIs_J). A cross-sectional analysis was conducted using a database of the 2-day nutrient intake of 361 Japanese people aged 65-90 years. The AGEVAR MODE was used to estimate usual intake. Percentile curves using estimated distribution by sex and age and usual nutrient intake were compared to those of the DRIs_J. The usual intake of protein (male and female) and potassium and calcium (female) were lower with older age. Within-individual variance of protein in female (p = 0.037) and calcium in male (p = 0.008) subjects were considerably lower with older age. The proportion of deficiencies in protein (male and female), potassium (female), and calcium (female) were higher with older age. However, the proportion of people with excess salt (converted from sodium; male and female) did not differ by age. The variances found herein could be important for enhancing the understanding of differences in dietary intake by age.

Establishing reference intervals for vitamins A and E in Chinese elderly people using liquid chromatography-tandem mass spectrometry

BACKGROUND

Vitamins A and E play important roles in sustaining life activities and maintaining a good physical condition. However, most people, particularly the elderly, experience micronutrient deficiencies. This study aimed to establish reference intervals (RIs) for vitamins A and E in Chinese elderly people using a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method.

METHODS

A total of 356 apparently healthy individuals aged ≥64 years who underwent health checkups were randomly selected for the study. Vitamin A and E levels were measured using LC-MS/MS. The effect of sex on vitamin A and E levels was evaluated, and RIs were established using a parametric method.

RESULTS

Females showed significantly higher levels of vitamin E than males (p < 0.05). However, no significant sex-specific difference was observed with vitamin A levels. The RI for vitamin A in the elderly was 0.283-0.730 mg/L. For vitamin E, the RIs were 4.39-15.63, 4.51-16.14, and 4.41-14.67 mg/L for the total, female, and male participants, respectively. In multiple linear regression, alanine aminotransferase, glutamyl transpeptidase, urea, glucose, and uric acid levels increased with increasing vitamin A levels (p < 0.05), and total cholesterol and low-density lipoprotein cholesterol levels increased with increasing vitamin E levels (p < 0.05). Direct bilirubin levels decreased with increasing vitamin E levels (p < 0.05).

CONCLUSIONS

This study established RIs for vitamins A and E in Chinese elderly individuals using an LC-MS/MS method. We also found that females had significantly higher vitamin E levels than males. The findings could provide a scientific basis for interpreting vitamin status in the elderly.

Vitamin Status and Diet in Elderly with Low and High Socioeconomic Status: The Lifelines-MINUTHE Study

Socioeconomic health inequalities are an important global public health problem. However, it is not well known to what extent socioeconomic inequalities culminate in impaired vitamin status and whether this is mediated by diet. We, therefore, aimed to assess vitamin status in a population already at increased risk of micronutrient deficiency, i.e., elderly with high and low socioeconomic status (SES), and to investigate whether potential differences therein were mediated by diet quality. Vitamin status in 1605 individuals (60–75 years) from the Lifelines- Micronutrients and Health inequalities in Elderly (MINUTHE) Study was assessed by measuring folic acid and the vitamins B6, B12, D, A, E, and K. Multinomial logistic and linear regression analyses were applied to test the associations between SES and vitamin status. Mediation analysis was used to explore the interrelationship between SES, diet quality, and vitamin status. Low SES was associated with poorer status of vitamin B6, vitamin B12, and, notably, folic acid. Moreover, multivitamin deficiencies were more prevalent in the low SES group. Diet quality was found to mediate the associations of SES with folic acid (for 39.1%), vitamin B6 (for 37.1%), and vitamin B12 (for 37.2%). We conclude that low SES is a risk factor for a spectrum of vitamin deficiencies. Diet quality can partially explain the socioeconomic differences in vitamin status, suggesting that policymakers can mitigate socioeconomic inequality in nutritional status through improving diet quality.

Evaluation of acute and sub-chronic toxicity of lithothamnion sp. in mice and rats

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Lithothamnion sp. is widely available as a marine algae-derived calcium and multi-mineral dietary supplement.

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In an acute toxicity test, Lithothamnion sp. was deemed non-toxic with a LD₅₀ >10 g/kg BW.

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In a standard sub-chronic toxicity study, the no-observed-adverse-effect-level (NOAEL) of Lithothamnion sp. in rats was >2 g/kg BW.

Lithothamnion sp., a red algae of the Corallinaceae family, when harvested in its calcareous form, is rich in calcium, magnesium and a variety of trace minerals. It is used as a beneficial dietary mineral supplement across the world (Aquamin F). This study was designed to evaluate the acute and sub-chronic toxicity of Lithothamnion sp. according to the Procedure and Methods of Food Safety Toxicological Assessment GB-15193 (China). In an acute toxicity test, mice (n = 20, 10 male, 10 female) were administered a single dose of 10 g/kg BW of Lithothamnion sp. No mortality, or signs of toxicity were observed. In the sub-chronic toxicity arm of the study, SD rats (n = 80, 40 male, 40 female) were randomly divided into four groups with 10 rats in each group and provided pelleted food containing the algae at either 0.00 %, 0.625 %, 1.25 %, 2.50 % inclusion rates for 90 days. Lithothamnion sp. at all inclusion rates did not cause any mortality, and no treatment-related changes were observed in body weight, organ weight, feed consumption, feed utilization rate, urinalysis, hematological and biochemical blood analysis, gross necropsy or histopathologic examinations. In summary, the median lethal dose (LD₅₀) of Lithothamnion sp. was >10 g/kg BW. The no-observed-adverse-effect-level (NOAEL) for female and male rats of Lithothamnion sp. under these experimental conditions was 2.69 g/kg BW and 2.10 g/kg BW respectively.