A Follow-up of vitamin B12 and lipids status is essential in older people, being closely related to non-communicable diseases. Their relationships with cognitive and physical status are not clear. The aim was to analyze the evolution of vitamin B12 and related parameters, lipid and hematological profiles, and their relationships with cognitive and physical status among institutionalized elderly. Sixty residents, ranged from 62 to 99, were evaluated. Biomarkers (vitamin B12 and related parameters, lipid and hematological profiles), functional capacity (handgrip, arm and leg strength), and cognitive status (Mini-Mental State Examination) were evaluated four times at 4-month intervals. At the beginning of the study, 63% and 70% of the sample showed abnormal homocysteine and folate values, respectively. At the end of the year, abnormal homocysteine increased to 68%, abnormal folate values decreased to 50%. Throughout the year, serum folate showed a significant increase (14.9 vs. 16.3 nmol/L), (p < 0.05). Serum cobalamin (299 vs. 273 pmol/L). HDL-cholesterol (49.9 vs. 47.0 mg/dL) and triglyceride levels (102.4 vs. 123.2 mg/dL) showed a significant decrease and increase respectively in mean values (all p < 0.05). Serum cobalamin and HDL-cholesterol were the most important biomarkers associated with cognitive function (both p < 0.05). The most relevant biomarkers associated with poor physical strength depending on the body part analyzed were low concentrations of HDL-cholesterol, LDL-cholesterol, apolipoprotein A1, and albumin (all p < 0.05). The evolution of lipid biomarkers, their significance with cognitive values, and association with handgrip, point to the importance of the handgrip measurement, a very simple test, as an important health marker. Both serum albumin and physical strength are important health markers in older people.

Purpose The aim of this study was to assess the association between physical fitness (PF) and energy and nutrient intake in Spanish older adults. Methods Three hundred and twenty-four participants (59.9% females, aged over 55 years) performed a battery of four validated PF tests and participants were divided into three: low, medium, and high PF. Dietary intake was assessed by two non-consecutive 24 h dietary recalls. Energy and nutrient intake was calculated using the ALIMENTA software. Energy expenditure (EE) was calculated using a validated questionnaire. Results Median energy intake (EI) was 2135, 1999, and 2111 kcal/day in the low, medium, and high PF in males, respectively. In females, the median EI was 1576, 1564, and 1625 kcal/day in the low, medium, and high PF groups. There were significant and positive associations between participants in the high PF group and intake of phosphorous, selenium, vitamin B 6 , C, D, E, niacin, and folates (all p < 0.05). However, subjects in the high PF group presented negative associations with thiamine and riboflavin intake (all p < 0.05). A total of 8.3% of participants presented inadequate intake of 11 micronutrients. PF seems to affect total nutrient intake. Conclusions Higher protein and fat intake was observed in the high PF group compared to the other PF groups in males, although participants in the high PF group had also higher EE. However, females presented different patterns. In both sexes participants in the high PF group showed a better micronutrient intake profile than the other PF groups. There is a need to develop combined nutritional and fitness programs.

This study aimed to assess the effect of rehydration during and after acute aerobic submaximal exercise on total homocysteine (tHcy) concentrations and related parameters in physically active adult males. Twenty trained males (29.4 ± 7.9 years old) completed four exercise tests: two without rehydration during exercise (NH1 and NH2), one with rehydration during exercise using water (H1) and one with rehydration during exercise using an isotonic sports drink (H2). After finishing the exercise tests, subjects followed a rehydration protocol for 2 h. Serum tHcy, vitamin B12, folate, creatine and creatinine were analysed before, after and at 2, 6 and 24 h after exercise. Data were analysed with and without correcting for haemoconcentration to assess the changes in tHcy related. The methylenetetrahydrofolate reductase (MTHFR) 677TT genotype was also analysed. THcy (uncorrected by haemoconcentration) increased significantly after exercise (P < 0.05) in the NH1 and NH2 tests [mean increase ± SD: 1.55 ± 0.33 (15.18%) and 1.76 ± 0.25 (17.69%) µmol/L, respectively], while no significant differences were found in the H1 and H2 tests [mean increase: 0.65 (6.29%) and 0.90 (8.69%) μmol/L, respectively]. The increase was partly due to haemoconcentration and partly due to the metabolism underlying acute exercise. THcy concentrations recovered to baseline after 24 h in all tests. In conclusion, adequate rehydration during acute aerobic exercise using either water or a sports drink maintains tHcy concentrations at baseline and for up to 2 h after exercise in physically active male adults and prevents further increases when compared to no rehydration.

Biomarkers have been postulated as essential variables to measure the effects of exercise on the human body. To investigate the relationship between physical fitness (PF) and blood biomarkers that are associated with disease risk in Spanish older adults, four hundred and twenty-nine adults (57% females) aged older than 55 years from a cross-sectional study were included. A battery of PF test was performed, and participants were divided into 3 groups: low, medium and high fitness. Blood samples were collected, and subjects were also grouped based on a particular biomarker being within its reference range. Furthermore, drug intake and dietary intake were considered for each participant. Higher concentrations out of the reference range were observed for vitamin 25(OH)D (67.9%) and total cholesterol (TC) (58.6%). Participants from the low PF group presented lower significant concentrations out of the reference range for vitamin B12 and triglycerides; however, participants in the low PF group showed higher significant concentrations out of the reference range for total homocysteine, creatinine, TC, HDL-cholesterol and LDL-cholesterol (LDL-c) than those in the high PF group (all p<0.05). Considering drugs related to blood lipid modifications, subjects who regularly consumed lipid reducers presented higher significant concentrations out of the reference range for TC and LDL-c than participants who did not take these drugs (p<0.01). Participants from the high PF group presented better blood marker profiles, namely, lower blood markers related to disease risk out of the reference range. These blood markers could be used as a routine method for considering PF groups in older adults.

There is evidence supporting the importance of a healthy diet; however, there are few studies analyzing the seasonal variation of food intake. The present study was aimed to evaluate seasonal variation of food and energy intake in Spanish elderly also to investigate diet quality based on the Healthy Eating Index (HEI) score. From a cross-sectional study, 28 individuals (39% males) aged over 55 years volunteered for a longitudinal follow-up. Dietary assessment was evaluated through 24-h dietary recalls. Energy and nutrient intake were calculated using DIAL software. Furthermore, diet quality was measured using HEI. Data was analyzed considering the interaction of sex, age, fitness status, and body composition. Cereals intake was significantly lower in summer than in winter and autumn (both p < 0.05); whereas, drinks intake was significantly higher in summer than in winter, spring, and autumn (all p < 0.01). Daily energy intake was significant higher in spring than in summer, and in autumn than in summer (p < 0.05), and energy intake from lunch was also statistically higher in spring than in summer (p < 0.01). The HEI was classified as good; however, a negative and significant association was observed between HEI and cholesterol, alcohol, and monounsaturated fatty acids intake (p < 0.01). Cereals and drinks intake and total daily energy intake changed according to seasons. This should be considered in nutritional studies. Diet quality seems not to be affected by these seasonal changes, and HEI did not show a good association with the majority of foods and macro- and micronutrients.

Background: As there is no gold-standard methodology to classify older people in relation to physical activity (PA) and sedentary behavior (SB), this paper aimed to propose a classification combining PA and SB. Methods: Within a broader study, 433 subjects, aged 55 years and older (57% females) from Madrid and Majorca, were evaluated for PA and SB by means of validated questionnaires. Physical fitness was analyzed objectively using the EXERNET test battery. Cluster analyses were used to establish behavioral patterns, combining PA and SB. Results: Males spent more time doing regular PA but less time walking and working at home than females ( P < .001). Comparing the groups (inactive and high sedentary, inactive and low sedentary, active and high sedentary, and active and low sedentary), the worst aerobic endurance ( P < .001) and lower body strength ( P < .05) were obtained in males from both inactive groups. Agility was highest in the active and low sedentary group ( P < .05). No significant differences were observed in females. Conclusions: The proposed classification is valid, as it classifies subjects according to their PA and SB, and outcomes are related to objectively measured fitness. It could facilitate the work of public health authorities, researchers, and physicians.

Objectives: To assess prevailing food patterns, and its association with physical activity and fitness among Spanish older adults. Methods: Cross-sectional study in Spain, collecting data from a sample (n = 380; 54% female) aged 55–80 years (men) and 60–80 years (women) with no previously documented cardiovascular disease. Body weight, body fat and waist circumference were assessed. Physical activity performed was measured using the Minnesota Leisure-time Physical Activity Questionnaire (LTPA). Physical fitness was assessed using a validated physical fitness test battery. Food consumption was assessed by a validated semi-quantitative food-frequency questionnaire. Factor analysis identified two major dietary food patterns: “Western” (WDP) and “Mediterranean” (MDP) dietary patterns. Results: Participants in MDP’s fourth quartile were classified in the second (men) and third (men and women) tertile of LTPA. After adjusting for age, body fat, waist-to-height ratio, and METs, in both sexes, a negative significant association was found between 30-s Chair stand and 6-min walking test, a positive significant association was found between 30-m Gait speed and 8-foot Time Up-and-Go (except in men) tests with WDP. The 30-m Gait speed test was negatively associated with MDP in men. Conclusions: MDP is associated with more time spent on LTPA, and this association was independent of body composition and a fast gait speed in men. WDP is associated with slower gait speed and lower body strength, agility and aerobic endurance. MDP has protective effect on healthy physical fitness, and WDP may be a contributor to frailty.

Studies have shown that vitamin D deficiency increases the risk for lipid metabolism disorders, but this relationship has provided inconsistent results in elderly. Thus the aim was to assess the association between body composition and blood lipid profile levels on serum 25-hydrovitamin D [25(OH)D] concentration in Spanish elderly. A cross-sectional multicentre study was carried out in 383 participants (58.2% females) aged of 55-88 years. Fasting blood samples analyzed serum concentrations of 25(OH)D, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TG) and total cholesterol (TC). Body composition parameters (fat mass, fat free mass) were obtained by bioimpedance, waist circumference (WC), physical activity and vitamin D intake were also evaluated. BMI, fat mass and total fat mass were lower in vitamin D sufficient subjects than vitamin D insufficient and deficient subjects, but this difference was not significant (p>0,05). Those with vitamin D adequate levels also showed lower TC/HDL ratio than those who had inadequate (insufficient or deficient) vitamin D levels (p=0.04). Significant association between 25(OH)D and BMI, waist circumference, total muscle mass, TC/HDL-c ratio, HDL and TG (for all p≤ 0.05) was found after controlling for some confounders. Subjects with inadequate HDL levels (<40mg/dL) showed 1.7 times higher odds than vitamin D deficiency than those with adequate HDL levels (>60mg/dL) (95% CI= 1.10 to 2.85 p= 0.017) and WC was negatively associated with vitamin D status odds ratio of 0.98 (0.96 to 1.00; p= 0.04). Vitamin D concentration was positively correlated with HDL-c and total muscle mass, as well as negatively correlated with WC, LDL-c/HDL-c and TC/HDL-c independently of age, gender and some confounders.

High total homocysteine (tHcy) concentrations contribute to an increased risk of cardiovascular diseases and neurodegenerative disorders. Several investigations have focused on the effect of exercise on tHcy concentrations, but results remain controversial. The differences among the methodologies in the investigations make difficult the interpretation of results. This review differentiates the effects of exercise on tHcy and establishes the relation with the implicated biomarkers on tHcy metabolism related to exercise. The electronic database MEDLINE (http://www.ncbi.nlm.nih.gov) was used for searching studies published between years 2002 and 2015. 'Homocysteine', 'Training', 'Exercise', 'Physical Activity' as well as combinations out of these terms were entered in the database. Articles were grouped in: 1) Acute effect of exercise on tHcy, 2) chronic exercise and tHcy, 3) relationship of physical activity (PA) level and cardiorespiratory fitness with tHcy, and 4) biomarkers related to tHcy and exercise. From a total of 30 articles, most of the studies analyzing the acute effect of exercise showed an increase on tHcy concentrations. Studies analyzing the chronic effect on tHcy concentrations showed contradictory results and no consensus exists probably due to the differences in the methodology, exercise interventions and participants characteristics. Low cardiorespiratory fitness seems to be associated with high tHcy; in contrast, the relation of PA levels and tHcy needs further research. Regarding biomarkers related to tHcy and exercise, some studies showed an increase of folate, vitamin B-12, and creatine after acute exercise that could to be due to requirement of protein turnover and an increased metabolic demand of vitamin-B.

Older people are vulnerable to hypohydration due to physiological and cognitive changes that occur with age. Inadequate fluid intake is the main contributor to hypohydration in this age group, but very little is known about their drinking habits and specific fluid intake recommendations are lacking. Therefore, the aim of this short review was to summarise published data on fluid consumption in adults aged 65 years and older. The PubMed database was searched for all relevant studies published between 1995 and 2014 globally. The search identified 12 suitable papers for review. Results indicated that reported fluid intake in older adults varied considerably between studies. Lack of standardisation for reporting 'fluid intake' is a problem in this literature. In conclusion, data about fluid intake in older adults are scarce and inconclusive. Consensus on a definition for ` fluid intake' is necessary if an international age-specific reference range for the elderly is to be set.

Continuous physical exercise leads the athlete to maintain an unstable balance between dietary intake, energy expenditure and the additional demands of a high amount of physical activity. Thus, an accurate assessment of nutritional status is essential to optimize the performance, since it affects health, body composition, and the recovery of the athlete. Specific aspects like the type of sport, specialty or playing position, training schedule and competition calendar, category, specific objectives, which differ from the general population, must be considered. A biochemical assessment can give us a general idea of the nutritional status, lipid profile, liver or kidney function, if diet is too high in proteins or fats, as well as possible nutritional deficiencies and the need for supplementation. Sport kinanthropometry has great utility that enables the assessment of body mass, height, length, diameter, perimeter and skinfolds, where information is processed by applying different equations, obtaining information on somatotype, body composition, and the proportionality of different parts of the body. To give proper nutritional counselling, energy needs of the athlete must be known. If objective measurement is not possible, there are tables including theoretically established energy requirements of different sports. Dietary assessment should include information about food consumption and nutrient intake to establish the relationship between diet, health status and athlete's performance. On the other hand, an adequate hydration status in athletes is essential to maintain adequate performance. Hence, the knowledge of fluid intake by the athlete is a matter of the utmost importance. Dehydration can cause harmful effects on athletes' health. As there is no gold standard, urine gravidity and urine colour are the most extended methods for analyzing hydration status. There is consensus that due to complexity, the combination of different methods assures an effective data collection which will be useful to proceed in dietary and nutritional intervention..

INTRODUCTION:Data on hydration status in older adults are scarce and there are very few studies focusing on the impact of physical activity (PA) on drinking behavior.OBJECTIVE:To assess the impact of physical activity and sedentarism on fluid intake in Spanish elderly.METHODS:433 non-institutionalized Spanish older adults (58% females), aged 55-88 years, volunteered for the PHYSMED study. PA data were obtained by means of the Minnesota and EXERNET questionnaires. Population was divided into four groups: ILS (inactive and low sedentary), IHS (inactive and high sedentary), ALS (active and low sedentary) and AHS (active and high sedentary). Serum from fasting blood samples was analysed for osmolarity.RESULTS:The mean of total liquid intake was 1,751 ± 628 mL/d. Significant differences were observed for total liquid intake between ILS/ALS and IHS/ALS (p < 0.001). ALS subjects consumed a higher amount of beverages such as water, juice, milk, coffee, sport drink, beer, wine and distilled drinks than the other PA groups. There was a significant difference for water intake between PA groups (p < 0.01). Serum osmolarity values were within references ranges in all subjects, and there was a signifi cant difference between PA groups (p < 0.01).CONCLUSIONS:Spanish older adults meet the DACH recommendations set by the German, Austrian and Swiss nutrition societies' liquid intake recommendations in the mean independently of PA and sedentary level. All participants are within reference ranges of serum osmolarity. Subjects in the active and low sedentary group consumed higher amounts of water and other beverages than in the other PA groups.

Traditionally, biomarkers have been of interest in sports in order to measure performance, progress in training and for identifying overtraining. During the last years, growing interest is set on biomarkers aiming at evaluating health-related aspects which can be modulated by regular physical activity and sport. The value or concentration of a biomarker depends on many factors, as the training status of the subject, the degree of fatigue and the type, intensity and duration of exercise, apart from age and sex. Most of the biomarkers are measured in blood, urine and saliva. One of the main limitations for biochemical biomarkers is that reference values for blood concentration of biomarkers specifically adapted to physically active people and athletes are lacking. Concentrations can differ widely from normal reference ranges. Therefore, it is important to adapt reference values as much as possible and to control each subject regularly, in order to establish his/her own reference scale.Other useful biomarkers are body composition (specifically muscle mass, fat mass, weight), physical fitness (cardiovascular capacity, strength, agility, flexibility), heart rate and blood pressure. Depending on the aim, one or several biomarkers should be measured. It may differ if it is for research purpose, for the follow up of training or to prevent risks. For this review, we will get deeper into the biomarkers used to identify the degree of physical fitness, chronic stress, overtraining, cardiovascular risk, oxidative stress and inflammation.

Comunicacion oral en el congreso "Nutrition at Key life stages: new findings, new approaches conferences".

Vitamin B-12 deficit is one of the most common vitamin deficiencies. However, there is no consensus on the cut-off points for vitamin B-12 and its co-markers, such as folate, holotranscobalamin, methylmalonic acid and homocysteine. In order to establish the state of the art about cut-off points used to determine vitamin B-12 deficiency in the last decades, the database MEDLINE was used for searching studies published in adults between December 1992 and May 2014 (69 articles), using search terms like 'vitamin B-12 ', 'cobalamin', 'cut-off', 'deficiency' alone or in combinations. Broad ranges of cut-off points for vitamin B-12 and its biomarkers were identified: vitamin B 12 ranged between 100 pmol/L and 350 pmol/L, holotranscobalamin 20-50 pmol/L, methylmalonic acid 0.210-0.470 mu mol/L, homocysteine 10-21.6 mu mol/L, serum folate 3.7-15.9 nmol/L and red blood cell 124-397 nmol/L. For the majority of studies, the potential influence of age, analytical methods, gender and fortified food consumption was not taken in account when choosing cut-off values. This could explain the discrepancies between studies on vitamin B-12 and folate deficiency prevalences. We conclude that there is inconsistency in the literature regarding vitamin B-12 cut-offs. It would be necessary to establish different reference cut-offs according to age, considering the analytical methods used.

Percentiles 10th, 25th, 50th, 75th and 90th are presented for circulating white blood cells (WBC), neutrophils, lymphocytes, monocytes, eosinophils and basophils in healthy European adolescents (12.5–17.5 years, n = 405, 48.9 % boys), considering age, sex, puberty and body mass index (BMI). CD3+ (mature T cells), CD4+ (T helper), CD8+ (T cytotoxic), CD16+56+ (natural killer), CD19+ (B cells), CD3+CD45RA+, CD4+CD45RA+, CD8+CD45RA+ (naïve), CD3+CD45RO+, CD4+CD45RO+ and CD8+CD45RO+ (memory) lymphocytes were also analysed by immunophenotyping. Girls presented higher WBC, neutrophil, CD3+CD45RO+ and CD4+CD45RO+ cell counts and CD3+/CD19+ ratio, and lower CD3+CD45RA+ and CD4+CD45RA+ counts than boys. Age was associated with higher neutrophil counts and CD3+/CD19+, and lower CD19+ counts; in boys, with lower CD3+CD45RA+, CD4+CD45RA+ and CD8+CD45RA+ counts as well; in girls, with higher WBC, CD3+CD45RO+ and CD4+CD45RO+ counts. Pubertal maturation in boys was associated with lower WBC and lymphocyte counts; in girls, with higher basophil, CD3+CD45RO+ and CD4+CD45RO+ values. BMI was associated with higher WBC counts; in boys, also with higher lymphocyte counts; in girls, with higher neutrophil, CD4+, CD3+CD45RO+ and CD4+CD45RO+ counts.

We examined the association of physical activity (PA), cardiovascular fitness (CVF) and fatness with total homocysteine (tHcy) concentrations in European adolescents. The present study comprised 713 European adolescents aged 14.8 ± 1.2 y (females 55.3%) from the multicenter HELENA cross-sectional study. PA was assessed through accelerometry, CVF by the 20-m shuttle run test, and body fat by skinfold thicknesses with the Slaughter equation. Plasma folate, cobalamin, and tHcy concentrations were measured. To examine the association of tHcy with PA, CVF, and fatness after controlling for a set of confounders including age, maturity, folate, cobalamin, creatinine, smoking, supplement use, and methylenetetrahydrofolate reductase 677 genotype (CC 47%, CT 43%, TT 10%), bivariate correlations followed by multiple regression models were performed. In the bivariate correlation analysis, tHcy concentrations were slightly negatively correlated (p<0.05) with CVF in females (measured both by stages: r=-0.118 and by VO2max: r=-0.102) and positively with body mass index (r=0.100). However, daily time spent with moderate and vigorous PA showed a weak positive association with tHcy in females (p<0.05). tHcy concentrations showed a tendency to decrease with increasing CVF and increase with increasing BMI in female European adolescents. However, tHcy concentrations were positively associated with moderate and vigorous PA in female European adolescents.