OBJECTIVES The aims of this study were to determine if ultraviolet light (UV) is immunosuppressive in healthy older males, if beta-carotene (betaC) supplementation could prevent any observed UV-induced immunosuppression, and to compare these effects with those observed previously in younger men. METHODS The study was a placebo-controlled, randomized trial that employed a 2 x 2 factorial design. Healthy older men (mean age 65.5 years) received 30 mg betaC or placebo daily throughout the 47-day trial, while on a low carotenoid diet. After 28 days, half of each group received 12 suberythemic exposures to UV over a 16-day period. Delayed-type hypersensitivity (DTH) tests and plasma carotenoid assays were performed at baseline, pre-UV and post-UV time points, with DTH testing performed on an area of skin protected from UV exposure. RESULTS UV exposure resulted in significantly suppressed DTH response in the placebo group but not in the betaC-UV group. While there was no significant interaction between betaC supplementation and UV on DTH response, there was a significant inverse relationship between final plasma betaC concentration and extent of UV-induced suppression of DTH response. A similar correlation existed among subjects not exposed to UV. CONCLUSIONS Suberythemic UV exposure was immunosuppressive, as measured by DTH response, in healthy older men as in younger men. Higher plasma betaC was significantly associated with maintenance of DTH response, although the extent of protective effect of betaC appeared less than previously observed in younger subjects. The attenuated effect of betaC in the older UV-exposed subjects may have resulted in part from muted plasma betaC responses to betaC supplementation and/or higher plasma vitamin E levels than those of younger men. The finding that stronger DTH responses were associated with higher plasma betaC concentrations in both UV and non-UV subjects further supports a role for this nutrient in immunomodulation.

We examined the relationship between body composition and changes in plasma carotenoid concentration in response to dietary carotenoid restriction or beta-carotene (beta C) supplementation in healthy older men. Subjects (mean age 65 y) were assigned randomly to supplement (30 mg beta C/d) or placebo groups, and all subjects consumed a standard low carotenoid basal diet plus 1.5 mg beta C/d as carrots. Body composition was measured at baseline by hydrodensitometry, and plasma carotenoids were measured at baseline and after 28 d of treatment by HPLC. Baseline plasma total carotenoid concentration was significantly and negatively correlated with body mass index (BMI) and fat-free mass (FFM) but not with fat mass, whereas baseline beta C concentration was negatively associated with all three variables. The increase in plasma beta C concentration in response to beta C supplementation was significantly and inversely correlated with BMI and FFM but not with fat mass. Likewise, the decline in plasma total carotenoid concentration in the placebo group was also significantly and inversely related to BMI and FFM but not to fat mass. Thus, FFM seems to be an important determinant of plasma carotenoid concentrations and to explain a substantial portion of the often-observed relationship between BMI and blood carotenoid levels. Fat-free mass seems to represent a dynamic reservoir that dampens short-term changes in plasma carotenoid concentrations during fluctuation in carotenoid intake.

A study on the determinants of nutritional marasmus (NM) and kwashiorkor (K) was conducted using Sudanese children aged 6-36 months. The hypotheses tested were related to the specific circumstances leading to the development of NM and K. Subjects consisted of 55 children with NM and 55 with K, admitted to the Children's Emergency Hospital in Khartoum. This paper presents the results of the association between NM and prolonged breastfeeding without introduction of supplementary feeding between the ages of 6 and 24 months. Mothers were interviewed in hospital, and information on duration of breastfeeding, age at introduction of supplementary foods, and weaning foods was obtained. Observations were made in 20 per cent of homes of study children. The results suggest a positive association between prolonged breastfeeding without introduction of supplementary feeding between the ages of 6 and 24 months, and NM. Using multivariate analysis the data show that late introduction of supplementary foods produces an increase of 1.4-fold the odds of developing nutritional marasmus, rather than kwashiorkor. In contrast the odds ratio is 1.9 for the two conditions in terms of age of cessation of breastfeeding, the kwashiorkor children breastfeeding for fewer months. Results suggest strategies to reduce the prevalence of NM and K, plus mild and moderate PEM.

Single drug and drug combinations taken by elderly individuals may impose nutritional risk. Nutritional risk induced by drug intake include anorexia, excessive increase in appetite, drug-induced nutritional deficiencies, and toxic reactions. Drug side effects, such as postural hypotension, may interfere with food shopping or cooking ability. Prescribed diets may also impose a risk of drug-induced side effects or diminished drug efficacy. Unwanted outcomes of drug-food and drug-nutrient interactions can be minimized by instructing elderly men and women and their caregivers to avoid timing errors in drug-taking behavior and toxic reactions due to food incompatibility. In addition, drug-induced nutritional deficiencies can be avoided by advising drug-taking elderly on the appropriate levels of nutrient intake.

Two groups of Sudanese children, 55 with nutritional marasmus (NM) and 55 with kwashiorkor (K) were studied to differentiate between the etiology of NM and K. Subjects were between 6 and 36 months of age, admitted to the Children's Emergency Hospital in Khartoum. This paper presents the results of the association between K and infections during the weaning period. Data on morbidity were obtained by a physician consulting health records and asking the mothers in the hospital to recall the occurrence of measles, and the frequency of gastroenteritis, malaria, pneumonia, whooping cough, tuberculosis and other respiratory illnesses, three months prior to hospitalization. A clinical examination and appetite estimation were also performed. Biochemical tests, included hematology, serum proteins and urea, were performed on all subjects. The findings provide strong evidence that K is more associated with infections during the weaning period than is NM. The odds ratios for measles (2.3), frequency of pneumonia (2.1), and other respiratory illnesses (2.9) during the weaning period provide support for the suggestion that these illnesses are significant in predicting the occurrence of K. In contrast diarrhea seems to be a frequent antecedent and concurrent feature of both types of PEM. The results suggest important elements for prevention and control of PEM.

The importance of a regular meal pattern is commonly stressed to elderly diabetic persons and to their caretakers. This recommendation takes for granted that there are no physical or financial barriers to buying or preparing food. The diabetic elderly who fail to comply with their diets are assumed to lack motivation, intelligence, or both ( 1. Lockwood D Frey ML Gladish NA Hiss RG The biggest problem in diabetes. Diabetes Educator. 1986; 12: 30-34 Google Scholar , 2. Cerkoney KAB Hart LK The relationship between the health belief model and complicance of persons with diabetes mellitus. Diabetes Care. 1980; 3: 594-598 Google Scholar , 3. Eckerling L Kohrs MB Research on compliance with diabetic regimens: applications to practice. J Am Diet Assoc. 1984; 84: 805-807 Google Scholar ).

The effects of exercise training on riboflavin requirements and of riboflavin intake on endurance were examined in 14 women, 50–67 y of age, who participated in a 10-wk, two-period crossover exercise study at two riboflavin intakes, 0.15 µg/kJ (0.6 µg/kcal) and 0.22 µg/kJ (0.9 µg/kcal). Subjects exercised 20–25 min/d, 6 d/wk, for 4-wk periods on a cycle ergometer at 75–85% of their maximal heart rate. Riboflavin status was assessed by measuring the erythrocyte glutathione reductase activity coefficient (EGRAC) and urinary riboflavin excretion. Physical performance was evaluated by using a walking treadmill test to determine maximal oxygen capacity (V̇O2max) and anaerobic threshold by gas exchange (ATGe). Exercise significantly affected riboflavin status as EGRAC increased (P < 0.001) and riboflavin excretion decreased (P < 0.01) in both groups. V̇O2max increased significantly with exercise (P < 0.01). However, changes in V̇O2max (L/min) and ATGE with exercise training were not different in the two groups. Riboflavin requirements of older women increased with exercise training, but increased riboflavin intake did not enhance improvements in endurance.

Water, green pepper, pineapple, tomato, strawberry, carrot, and celery juices were made 46 mg/100 ml in ascorbic acid by the addition of distilled water or ascorbate. The ability of each juice to inhibit endogenous formation of N-nitrosoamino acids (NAA) in humans was determined in controlled experiments. Sixteen men consumed a standard diet low in nitrate and ascorbic acid for 18 consecutive days. Nitrate (5.24 mmol) and L-proline (4.35 mmol) were given orally on days 3, 5, 7, 9, 11, 13, 15, 17 and 18. On days 3 and 18, L-proline was immediately followed by 100 ml distilled water (positive control). On days 5, 7, 9, 11, 13, 15 and 17, L-proline was immediately followed by 100 ml juice or 46 mg ascorbate in 100 ml distilled water (treatment). Only diet was given in between dosing days to ensure baseline levels of NAA excretion. Urine was collected for 24 h following treatments and analyzed for NAA. Green pepper, pineapple, tomato, strawberry and carrot treatments significantly inhibited N-nitrosoproline (NPRO) formation relative to the positive control. Also, green pepper, pineapple and tomato juices significantly inhibited NPRO formation relative to ascorbic acid alone. Green pepper significantly inhibited N-nitrosothiazolidine-carboxylic acid formation relative to ascorbic acid alone. These data demonstrate that green pepper, tomato, pineapple, strawberry and carrot juice have greater ability to inhibit endogenous nitrosation than would be expected based solely on their ascorbate content.

The aim of this study was to examine whether beta-carotene protects against the immunosuppression seen with long-wave ultraviolet-light (UV-A) exposure. Free-living, healthy men, aged 19-39 y received 30 mg beta-carotene/d or a placebo while on a single-menu, low-carotenoid diet. After 28 d all subjects received 12 exposures to a UV-A/B light source over a 16-d period. The total UV-A dose received ranged from 15.9 to 19.3 J/cm2. The total shorter-wave ultraviolet-light (UV-B) dose varied from 1.59 to 1.96 J/cm2. Follow-up continued for 21 d. Carotenoid assays and delayed-type hypersensitivity (DTH) tests were performed at baseline, pre-UV, post-UV, and after follow-up. The DTH-test responses were significantly suppressed in the placebo group after UV treatments. The suppression was inversely related to plasma beta-carotene concentrations in this group. There was no significant suppression of DTH test responses in the beta-carotene group. It is concluded that beta-carotene protects against photosuppression of immune function.

Annals of the New York Academy of SciencesVolume 669, Issue 1 p. 156-163 Effects of Drugs on Vitamin Needs DAPHNE A. ROE, DAPHNE A. ROE Division of Nutritional Sciences 108 Savage Hall Cornell University Ithaca, New York 14853Search for more papers by this author DAPHNE A. ROE, DAPHNE A. ROE Division of Nutritional Sciences 108 Savage Hall Cornell University Ithaca, New York 14853Search for more papers by this author First published: September 1992 https://doi.org/10.1111/j.1749-6632.1992.tb17096.xCitations: 5AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume669, Issue1Beyond Deficiency: New Views on the Function and Health Effects of VitaminsSeptember 1992Pages 156-163 RelatedInformation

We examined how social, economic, location, health, and food need characteristics are related to elderly persons' not eating for 1 or more days. The following variables were positively related to not eating: ethnicity, location, receipt of Medicaid, living alone, health problems, mobility, age less than 80 years, cancer, nausea, difficulty swallowing, diarrhea, loss of appetite, and receipt of food from a food pantry. These results have implications for allocating meal program funds, screening clients, and monitoring whether clients eat regularly.

The temporal effect of ascorbic acid intake on the endogenous formation of N-nitrosoproline and N-nitrosothiazolidine-4-carboxylic acid was determined over 15 days in 10 ascorbate depleted men consuming a low nitrate and ascorbic acid (<23 μmol) diet. N-nitrosoproline precursors were given as follows: days 3–15, nitrate (5.24 mmol); days 2–15, l-proline (4.35 mmol) 30 min following the nitrate; days 5–11, ascorbic acid (2.62 mmol) 6, 5, 4, 3, 2, 1, and 0.5 hr before the proline, concurrent with the proline on day 12, and 0.5, 1 and 2 hr following the proline on days 13–15. Urine was analyzed for N-nitrosoamino and ascorbic acids. Gastric pH and residence time were measured on days 3–4 concurrently with the proline challenge. Excretion of N-nitrosoproline on nitrate and proline only days was 42.2 ± 16.0 nmol. Significant (P < 0.05) inhibition was observed when ascorbic acid was given 5 hr before proline (29.1 ± 10.5 nmol). These data suggest that the ascorbic acid content of the stomach due to secretion is sufficient to partially inhibit gastric nitrosation. Diets high in ascorbic acid could reduce gastric formation of N-nitroso compounds even if ascorbic acid is not consumed at the same time as the precursors. No correlation between gastric pH and gastric residence time with N-nitrosoproline and N-nitrosothiazolidine-4-carboxylic acid excretion was observed over the pH range observed. Several subjects consistently excreted high or low levels of N-nitrosoproline or N-nitrosothiazolidine-4-carboxylic acid compared to the mean, regardless of the ascorbic acid intake. This suggests that physiological differences between subjects may account for their endogenous nitrosation capacity.

A microcomputer inservice program on drug-nutrient interactions was developed and evaluated at a 242-bed geriatric facility. Interviews with dietary, medical, and nursing staff were conducted to identify their nutrition information needs. The program included an introductory session, a discussion session, and interactive self-instruction on IBM-PCs. Reference manuals were developed and placed in each unit of the facility. Modest program participation and knowledge gains were associated with clinically and statistically significant decreases in the rate of definite drug-nutrient interactions in the short term. Pre-post decreases in the rates of interactions among 81 patients were more likely to take place among older patients, among males, and among patients in skilled nursing units. Drug-nutrient interactions due to appetite-altering drugs, along with interactions due to drugs that alter therapeutic effects, showed the most significant decreases in the frequency of interactions. This evaluation research suggests that a variety of educational approaches-an introductory session, computer-assisted instruction, a discussion session, and reference manuals-may be effective for lowering the rates of drug-nutrient interactions by making relatively innocuous procedural changes in long-term care. The limitations of the study design indicate an urgent need to independently test for the effect of each educational approach on improved patient outcomes.

Salivary nitrate and nitrite concentrations, in vitro kinetics of nitrate reduction in saliva, and numbers of salivary nitrate-reducing micro-organisms were each compared with N-nitrosoamino acid excretion in 16 humans eating controlled diets. N-Nitrosoproline (NPRO) and N-nitrosothiazolidine-4-carboxylic acid (NTCA) excretion were measured after intake of nitrate (5.24 mmol) and l-proline (4.35 mmol) before and after treatment with an oral antiseptic (Peridex, 0.12% chlorhexidine gluconate). Peridex treatment resulted in a 94% reduction in the numbers of salivary nitrate-reducing bacteria, a decline from 17 to 4% in the amount of salivary nitrate that was reduced to nitrite in vivo, and an 85% reduction in the rate of in vitro nitrate reduction by saliva. Concurrently, there were 62 and 74% inhibitions of endogenous NPRO and NTCA formation, respectively. Correlations of the numbers of nitrate reductase micro-organisms, in vivo oral nitrate reduction and salivary nitrite concentrations, with individual NPRO excretion, indicated that individuals with higher oral nitrate-reducing capacities formed more N-nitrosoamino acid endogenously. These data suggest that individual differences in oral nitrate reduction are a significant factor in gastric nitrosation and account for a large proportion of the interindividual variability in nitrosoamino acid excretion.