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The availability of food and the nutritional status of western Europeans have never been so good as in recent decades. However, we have not to go back too long to see that severe malnutrition also occurred in parts of western Europe. An example was the malnutrition and starvation causing high death rates in the western Netherlands in the early months of 1945, just before the end of the Second World War. Today there is an abundance of food in western Europe. Nevertheless we do warn people that the food, nutritious and delicious as it is, may be hazardous to health. Degenerative diseases like cardiovascular diseases, cancer, diabetes, obesity, osteoporosis and hypertension are very prevalent in our society. It is very likely that certain nutrients in foods do contribute both to the causes and prevention of these diseases. In this paper some new findings of the role of diet in health will be reviewed. This will be followed by a brief discussion on the status of nutrition research and training in Europe. Finally attention is asked for the need to start building-up a programme for nutritional leadership in Europe.
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PMID:The future of nutrition in Europe. 826 9

The authors describe a new method for the closure of median sternotomies based on immediate compression with two or three Cotrel-Dubousset (CD) staples. This method was effective in a series of 100 patients. It was the curative treatment of septic sternal pseudarthrosis, and has been extended to high risk patients (age, severe sternal osteoporosis, obesity, diabetes, chronic respiratory insufficiency) or when surgery requires resection of the internal mammary arteries (IMA).
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PMID:[Closure of sternotomy with Cotrel staplers]. 831 80

Examination of thyroxine usage in a study in the United States of America revealed that many patients were prescribed thyroxine for non-thyroid indications, such as obesity and fatigue. Many of those receiving thyroxine had high or low serum thyroid stimulating hormone levels, indicating prescription of incorrect doses or lack of patient compliance with therapy. Long term thyroxine therapy may have effects upon the risk of osteoporosis. The aims of this study were to investigate indications for thyroxine prescription in the United Kingdom and to examine the frequency of abnormal serum thyroid stimulating hormone concentrations in those prescribed thyroxine for hypothyroidism. This was in order to determine the relevance of measurement of thyroid stimulating hormone level in monitoring thyroxine therapy. Subjects receiving thyroxine were identified from the computerized prescribing records of four general practices in the West Midlands. Of 18,944 patients registered, 146 (0.8%) were being prescribed thyroxine; 134 of these had primary hypothyroidism and the remainder had other thyroid or pituitary diseases prior to treatment. Of the 97 patients with primary hypothyroidism who agreed to have their thyroid stimulating hormone level measured, abnormal serum levels were found in 48%, high levels in 27% and low levels in 21%. There was a significant relationship between prescribed thyroxine dose and median serum thyroid stimulating hormone level: high hormone levels were found in 47% of those prescribed less than 100 micrograms thyroxine per day, while low levels were found in 24% of those prescribed 100 micrograms or more. Thus, thyroxine prescription was common in the four practices sampled, although indications for its use were appropriate.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Thyroxine prescription in the community: serum thyroid stimulating hormone level assays as an indicator of undertreatment or overtreatment. 812 26

A population-based case-control study was conducted to examine the effects of past and recent physical activity on the risk of hip fracture in women. Cases included females aged 55-84 years with a first diagnosis of hip fracture in 1989 in metropolitan Toronto, Canada. Controls were a population-based random sample frequency matched by 5-year age groups. Data were collected on 381 cases and 1,138 controls by self-administered mailed questionnaires or telephone interviews. Past activity was calculated as a compilation of activity scores at ages 16, 30, and 50 years. Recent activity was defined as activity in the past year for controls and activity in the year before fracture for cases. Multiple logistic regression was used to control for age, previous fracture, obesity, smoking, osteoporosis, epilepsy, stroke or Parkinson's disease, daily intake of dietary calcium, and duration of use of supplemental calcium, fluoride, and estrogen. After recent activity was adjusted for, statistically significant effects were found for women who in the past had been active (odds ratio estimate (OR) = 0.66, 95% confidence interval (CI) 0.45-0.96) or very active (OR = 0.54, 95% CI 0.33-0.88). After past activity was adjusted for, a similar protective effect was found for women who were moderately active recently (OR = 0.61, 95% CI 0.41-0.90), but women who were very active recently were not protected from hip fracture (OR = 1.15, 95% CI 0.72-1.83). This study showed evidence of independent protective effects of past physical activity and of moderate levels of recent physical activity on the risk of hip fracture in postmenopausal women.
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PMID:Past and recent physical activity and risk of hip fracture. 834 29

Advancing adult age is associated with profound changes in body composition. One of the most prominent of these changes is sarcopenia, defined as the age-related loss in skeletal muscle mass, which results in decreased strength and aerobic capacity and thus functional capacity. Sarcopenia is also closely linked to age-related losses in bone mineral, basal metabolic rate and increased body fat content. Through physical exercise and training, especially resistance training, it may be possible to prevent sarcopenia and the remarkable array of associated abnormalities, such as type II diabetes, coronary artery disease, hypertension, osteoporosis and obesity. Using an exercise program of sufficient frequency, intensity and duration, it is quite possible to increase muscle strength and endurance at any age. There is no pharmacological intervention that holds a greater promise of improving health and promoting independence in the elderly than does exercise.
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PMID:Sarcopenia and age-related changes in body composition and functional capacity. 842 5

The purpose of this study was to prospectively examine the relation of dehydroepiandrosterone sulfate (DHEAS) to bone mineral density in a community-based sample of 260 men and 162 women who were residents of Rancho Bernardo, California. DHEAS levels had been measured in plasma obtained in 1972-1974 when the men were 50-74 years of age and the women were 55-74. In 1988-1991, bone mineral density was measured at the lumbar spine and hip using dual x-ray absorptiometry, and at the mid-radius and ultradistal radius using single photon absorptiometry. Among men, there was a significant decrease in DHEAS levels and bone mineral density at the hip, ultradistal radius, and midshaft radius with increasing age. However, for both men and women, there was no significant association of DHEAS levels with bone mineral density at any site, both before and after adjustment for age, obesity, cigarette smoking, and use of antihypertensive medications. These data do not support the hypothesis of DHEAS having a causal role in senile osteoporosis.
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PMID:A prospective study of dehydroepiandrosterone sulfate (DHEAS) and bone mineral density in older men and women. 845 24

The influence of reproductive factors on bone mass at six skeletal sites was assessed in an age-stratified random sample of white women residing in Rochester, Minnesota. After age-adjustment, whether or not women had ever breastfed, total duration of breastfeeding and duration of breastfeeding per child were not associated with reduced bone mineral, but breastfeeding for more than 8 months was associated with greater bone mineral at some sites. There were no consistent effects on bone mineral, after adjusting for age, of gravidity or parity, age at menarche, age at first delivery, use of oral contraceptives or estrogen replacement therapy, various sex hormones, nor any of the other reproductive factors assessed. There was a strong protective effect of obesity, which was also correlated with a number of the reproductive variables. While animal studies suggest that pregnancy and lactation may be associated with calcium loss from the skeleton, these data indicate that such factors have little long-term impact on bone mass in humans and little potential for identifying women at high risk of osteoporosis later in life.
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PMID:Influence of breastfeeding and other reproductive factors on bone mass later in life. 845 94

Normal human ageing is associated with changes in body composition which include a decrease in muscle mass and strength, bone mass loss and increase in adipose mass. A physiological decrease in growth hormone (GH) and IGF-I secretion accompanies these changes. Many of the physiological changes that accompany normal human ageing are very similar to those found in GH deficient patients. Nevertheless, responsiveness to exogenous administered GH persists with advancing age. GH administration to elderly individuals has produced an decrease in fat mass and an increase in lean body mass, being this finding consistent with the hypothesis that GH deficiency could be a contributing cause to senescent changes in some elderly individuals. GH treatment has also been used with encouraging results in adult subjects with isolated or combined GH deficiency. On the other hand, several clinical studies have recently shown the efficiently of GH treatment on diverse pathological processes such as severe catabolic states (surgery, sepsis, trauma, buns), osteoporosis, diabetic ulcers and obesity. The most frequent side effects are sodium and water retention, impairment in glucose tolerance and carpal tunnel syndrome, although in general the treatment has been well tolerated. The clear definition of the therapeutical applications of GH in the adult warrants further clinical investigation.
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PMID:[New physiological and pharmacological aspects of the growth hormone (II). Therapeutic applications in adults]. 849 41

Our views on paediatric nutrition have considerably changed during the last 20 years. Some hereditary metabolic diseases testify to the remarkable efficacy of a specific preventive dietetics avoiding the development of mental retardation. Although certain deficiencies (in iron, fluorine, folates, vitamin D) are persisting in France, the major problems concern the prevention in childhood of allergy, obesity, atherosclerosis, high blood pressure, osteoporosis and even certain cancers, all diseases which play a crucial role in the morbidity and mortality of adults. Numerous uncertainties still exist, but in the present state of our knowledge we can already develop some recommendations which should replace the much abusive publicity that prevails in the information given to the public.
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PMID:[Towards preventive dietetics in children]. 850 35

There is an approximate 30% decline in muscle strength and a 40% reduction in muscle area between the second and seventh decades of life. Thus, the loss of muscle mass with aging appears to be the major factor in the age-related loss of muscle strength. The loss of muscle mass is partially due to a significant decline in the numbers of both Type I and Type II muscle fibers plus a decrease in the size of the muscle cells, with the Type II fibers showing a preferential atrophy. There appears to be no loss of glycolytic capacity in senescent skeletal muscle whereas muscle oxidative enzyme activity and muscle capillarization decrease by about 25%. Vigorous endurance exercise training in older people, where the stimulus is progressively increased, elicits a proliferation of muscle capillaries, an increase in oxidative enzyme activity, and a significant improvement in VO2max. Likewise, progressive resistive training in older individuals results in muscle hypertrophy and increased strength, if the training stimulus is of a sufficient intensity and duration. Since older individuals adapt to resistive and endurance exercise training in a similar fashion to young people, the decline in the muscle's metabolic and force-producing capacity can no longer be considered as an inevitable consequence of the aging process. Rather, the adaptations in aging skeletal muscle to exercise training may prevent sarcopenia, enhance the ease of carrying out the activities of daily living, and exert a beneficial effect on such age-associated diseases as Type II diabetes, coronary artery disease, hypertension, osteoporosis, and obesity.
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PMID:Changes in skeletal muscle with aging: effects of exercise training. 850 50


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