Self-Reported Energy Intake and Energy Expenditure in Elderly Women

The elderly are a growing population; however, limited information concerning energy requirements of the elderly is available. Dietary intake data have been collected in research and clinical settings to determine the intakes of energy and nutrients, but the accuracy of dietary intake data has been difficult to verify. Studies using doubly labeled water have suggested that dietary energy intake is underreported by obese subjects (1), adolescents (2), and athletes (3). Diet records were collected for 6 to 14 days in these studies (1), (2), (3). Elderly subjects have also underreported energy intake compared with total energy expenditure (TEE), either measured (4), (5), (6) or predicted (7). However, these studies only collected dietary data for 3 or 4 days, while energy expenditure was measured for 10 to 14 days using doubly labeled water. It is generally accepted that a major source of random variation in dietary energy can be ascribed to a person\u27s day-to-day variation in energy consumption, which averages 20% to 30% (8). This random variation decreases as the square root of the number of study days increases, such that it is approximately 10% for a 7-day record (9). Thus, some of the variability in self-reported energy intake may be attributable to the limited number of observations taken in previous studies of elderly women. To our knowledge, a comparison of TEE using doubly labeled water and concurrent diet records for a full week for elderly women has not been reported previously. The purpose of our study was to determine whether a complete recording of dietary intake would improve the accuracy of and reduce the individual variation in self-reported dietary energy intake compared with energy expenditure measurements using doubly labeled water

Dietary Intake and Energy Expenditure of Female Collegiate Swimmers During Decreased Training Prior to Competition

Swimmers, like all athletes, require a well-balanced diet with adequate energy intake for normal daily activities and the demands of training and competition. Investigators have typically studied nutritional status of athletes during heavy or peak training (1), (2). These studies generally show low levels of energy intake relative to expenditure, and carbohydrate intake also well below recommendations. However, several studies of the effects of exercise on energy intake have shown that as exercise energy expenditure increases or decreases, dietary intake tends to remain the same (3), (4), (5). Because training volume varies with the competitive season, it is important to investigate dietary intake at different levels of training. One period of training during which nutritional intake has not been studied is during taper, a period of decreased training before an athletic event to improve mental and physical readiness for competition (6). An important issue during this period is whether the discrepancy between energy intake and expenditure previously reported during heavy training is maintained during a period of reduced training. Another consideration is the number of reduced-fat food products consumed by female athletes. (In recent years, there has been an overwhelming increase in the availability of low-fat and fat-free food products.) Increased use of these foods may contribute to the increased carbohydrate intake observed in some recent studies of female athletes (7), (8), (9), which contrasts with earlier studies suggesting that carbohydrate intakes of female endurance athletes are 14% to 24% lower than recommended (1)

Physical Activity Effects on Depressive Symptoms in Black Adults

Objectives: Randomized trials found physical activity (PA) effective in decreasing depressive symptoms. Few studies included Black participants. The purpose of this systematic literature review was to determine the effects of PA on depressive symptoms in Black adults. Methods: Articles were abstracted by conducting a computer and hand search of eligible studies. Results: Eight of 13 studies found a significant inverse relationship between PA and depressive symptoms in Black adults. Sources for the heterogeneity were explored. Conclusion: Future studies should include representative samples of Black adults, incorporate a theory which considers multiple levels of influence, account for genetic factors in the etiology of depressive symptoms, include individuals diagnosed with depression and with health conditions which may increase the risk of depressive symptoms, account for intra-group ethnic heterogeneity, measure and differentiate between social support and social network, consider aspects of the physical environment and use standardized measurements of PA

Depressive Symptoms and Walking in African‐Americans

Objective Although increased frequency of physical activity is associated with fewer depressive symptoms in African‐Americans, most studies do not focus on a specific type of activity. Identifying the activity can provide helpful information for designing interventions that focus on depressive symptoms. The objective of this study was to examine the odds of depressive symptoms in relation to walking in African‐Americans. Design and Sample A secondary analysis was performed on the National Survey of American Life. The sample was made up of community‐dwelling African‐American women (n = 1,903) and men (n = 1,075) who did not meet the DSM‐IV‐TR criteria for depression. Measures Walking was measured by self‐reported frequency (i.e., never, rarely, sometimes, often). Depressive symptoms were measured with the Center for Epidemiologic Studies Depression scale. Logistic regression for complex samples was used to examine the odds of depressive symptoms in relation to walking. Results Women who reported often walking had lower odds for depressive symptoms than women who reported never walking (OR = 0.56, 95% CI = 0.38–0.82). Walking frequency was not related to depressive symptoms in men. Conclusions Walking frequency is a modifiable risk factor for elevated depressive symptoms in African‐American women

Leisure-time Physical Activity in Relation to Depressive Symptoms in African-Americans: Results from the National Survey of American Life

Objective To examine the frequency of leisure-time physical activity (LTPA) in relation to depressive symptoms in a nationally representative sample of African American (AA) women and AA men with guidance by Stokols\u27 Social Ecological Framework. Method A secondary analysis of AA women (n = 1811) and AA men (n = 1038) was performed on the National Survey of American Life, where a four stage national area probability sampling was conducted. Interviews were conducted 2001–2003. Clinically depressed AA were excluded from the current study. LTPA was measured by self-report frequency (never, rarely, sometimes, often) of participation in sports/exercise. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression scale. Logistic regression for complex samples was used to examine the relationship between LTPA and depressive symptoms, adjusting for biopsychobehavioral and sociophysical environmental factors. Results Compared with AA women and AA men who reported never participating in LTPA, the multivariate OR for depressive symptoms in AA women and AA men who reported participating in LTPA often was 0.42 (95% CI = 0.24–0.72) and 0.41 (95% CI = 0.25–0.69) respectively. Conclusion Increased frequency of LTPA was associated with fewer depressive symptoms in a nationally representative sample of non-clinically depressed AAs

Gardening/Yard Work and Depressive Symptoms in African Americans

Background The purpose of this study was to examine the frequency of gardening/yard work in relation to depressive symptoms in African-Americans while controlling for biological and social factors. Methods A secondary analysis was performed on the National Survey of American Life (n = 2,903) using logistic regression for complex samples. Gardening/Yard work was measured by self-reported frequency. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression scale. Results Biological and social factors, not gardening/yard work, were associated with depressive symptoms. Conclusions Biological and social factors may need to be addressed before the association between gardening/yard work and depressive symptoms can be determined

Cigarette Smoking Among Low-Income African Americans: A Serious Public Health Problem

Background This study examines the current prevalence of cigarette smoking and the number of cigarettes smoked in a community-based sample of 1021 low-income African-American men and women. Methods Participants were selected using a two-stage, area probability sample design. Data were collected in 2002–2003 in face-to-face interviews and analyzed in 2005. All data and analyses were weighted to account for the complex sampling design. Results Fifty-nine percent of men and 41% of women were current smokers, with younger individuals apparently initiating smoking at an earlier age than older individuals. Conclusions The high prevalence of cigarette use provides further evidence that the excess burden of tobacco-related disease among low-income African-American families may be on the rise. This is of great concern, and if confirmed by further research, indicates an urgent need for preventive intervention

Neighborhood Factors Relevant for Walking in Older, Urban, African American Adults

Focus-group and photo-voice methodology were used to identify the salient factors of the neighborhood environment that encourage or discourage walking in older, urban African Americans. Twenty-one male (n = 2) and female (n = 19) African Americans age 60 years and older (M = 70 ± 8.7, range = 61–85) were recruited from a large urban senior center. Photographs taken by the participants were used to facilitate focus-group discussions. The most salient factors that emerged included the presence of other people, neighborhood surroundings, and safety from crime, followed by sidewalk and traffic conditions, animals, public walking tracks and trails, and weather. Future walking interventions for older African Americans should include factors that encourage walking, such as the presence of other friendly or active people, attractive or peaceful surroundings, and a sense of safety from crime

Submaximal Oxygen Uptake Kinetics, Functional Mobility, and Physical Activity in Older Adults with Heart Failure and Reduced Ejection Fraction

Background: Submaximal oxygen uptake measures are more feasible and may better predict clinical cardiac outcomes than maximal tests in older adults with heart failure (HF). We examined relationships between maximal oxygen uptake, submaximal oxygen kinetics, functional mobility, and physical activity in older adults with HF and reduced ejection fraction. Methods: Older adults with HF and reduced ejection fraction (n = 25, age 75 ± 7 years) were compared to 25 healthy age- and gender-matched controls. Assessments included a maximal treadmill test for peak oxygen uptake (VO2peak), oxygen uptake kinetics at onset of and on recovery from a submaximal treadmill test, functional mobility testing [Get Up and Go (GUG), Comfortable Gait Speed (CGS), Unipedal Stance (US)], and self-reported physical activity (PA). Results: Compared to controls, HF had worse performance on GUG, CGS, and US, greater delays in submaximal oxygen uptake kinetics, and lower PA. In controls, VO2peak was more strongly associated with functional mobility and PA than submaximal oxygen uptake kinetics. In HF patients, submaximal oxygen uptake kinetics were similarly associated with GUG and CGS as VO2peak, but weakly associated with PA. Conclusions: Based on their mobility performance, older HF patients with reduced ejection fraction are at risk for adverse functional outcomes. In this population, submaximal oxygen uptake measures may be equivalent to VO2 peak in predicting functional mobility, and in addition to being more feasible, may provide better insight into how aerobic function relates to mobility in older adults with HF

Aberrant Water Homeostasis Detected by Stable Isotope Analysis

While isotopes are frequently used as tracers in investigations of disease physiology (i.e., 14C labeled glucose), few studies have examined the impact that disease, and disease-related alterations in metabolism, may have on stable isotope ratios at natural abundance levels. The isotopic composition of body water is heavily influenced by water metabolism and dietary patterns and may provide a platform for disease detection. By utilizing a model of streptozotocin (STZ)-induced diabetes as an index case of aberrant water homeostasis, we demonstrate that untreated diabetes mellitus results in distinct combinations, or signatures, of the hydrogen (δ2H) and oxygen (δ18O) isotope ratios in body water. Additionally, we show that the δ2H and δ18O values of body water are correlated with increased water flux, suggesting altered blood osmolality, due to hyperglycemia, as the mechanism behind this correlation. Further, we present a mathematical model describing the impact of water flux on the isotopic composition of body water and compare model predicted values with actual values. These data highlight the importance of factors such as water flux and energy expenditure on predictive models of body water and additionally provide a framework for using naturally occurring stable isotope ratios to monitor diseases that impact water homeostasis