Lakša strana kalcija: utjecaj kalcija i mliječnih proizvoda na tjelesnu težinu

This review explains the physiological involvement of calcium in overweight/obesity (as it is understood now) and presents some of the studies where this role has been documented, as well as those reporting no effect of Ca on body weight/composition. Based on much of the presently reported data, Ca and even more so dairy foods, might help in weight reduction/maintenance when combined with energy-restricted diet. The scientific community is in agreement that there is a pressing need for large clinical trials to assess the effect of Ca on weight reduction and to investigate whether weight loss could be achieved easier with Ca supplements or dairy products. It has yet to be learned what amount of Ca would be optimal for those purposes and what influence, if any, an individual’s current Ca intake and existing weight might play. Additionally, it is still hard to pinpoint which component(s) in dairy foods have a role in weight reduction and whether they act alone or in synergism with Ca. Considering the overwhelming prevalence of overweight/obesity and consequences to population health and economic burden it entails, it is of crucial importance to develop strategies to curtail the problem of obesity from all fronts and the one involving Ca seems quite promising. However, more research in this area is necessary.U preglednom radu prikazane su dosadašnje spoznaje o ulozi kalcija u nastanku prekomjerne tjelesne težine te navedeni rezultati istraživanja gdje je taj utjecaj dokazan, kao i nalazi gdje ta uloga kalcija nije potvrđena. Na temelju većine dosad objavljenih radova može se zaključiti da kalcij, a pogotovo mliječni proizvodi, zajedno sa smanjenim energetskim unosom, mogu pridonijeti smanjenju tjelesne težine i/ili održavanju niže tjelesne težine. Međutim treba istaknuti da su postojeći podaci u literaturi nedostatni za konačnu prosudbu utjecaja kalcija na smanjenje tjelesne težine. Nužna su velika klinička istraživanja kojima bi se utvrdilo da li se smanjenje tjelesne težine može lakše i učinkovitije postići suplementiranjem preparatima kalcija ili mliječnim prerađevinama. Nije poznato ni kolika bi količina kalcija bila optimalna u tu svrhu, ni kakav utjecaj može imati uobičajeni unos kalcija i postojeća težina osobe. Također se još ne zna koji bi sastojak ili sastojci u mliječnim prerađevinama mogli imati aktivnu ulogu u smanjenju težine te je li ta uloga izolirana ili je u kombinaciji s kalcijem. S obzirom na golem porast pojave prekomjerne tjelesne težine u ljudi, što ima štetne i zdravstvene i ekonomske posljedice, nužno je razviti mjere za suzbijanje pretilosti i debljine na svim razinama. Strategija koja bi uključivala unos kalcija u hrani čini se razumnim i realnim rješenjem, ali su potrebna daljnja istraživanja kojima bi se konačno potvrdila ta pretpostavka

Osteosarcopenic Obesity Syndrome: What Is It and How Can It Be Identified and Diagnosed?

Conditions related to body composition and aging, such as osteopenic obesity, sarcopenia/sarcopenic obesity, and the newly termed osteosarcopenic obesity (triad of bone muscle and adipose tissue impairment), are beginning to gain recognition. However there is still a lack of definitive diagnostic criteria for these conditions. Little is known about the long-term impact of these combined conditions of osteoporosis, sarcopenia, and obesity in older adults. Many may go undiagnosed and progress untreated. Therefore, the objective of this research is to create diagnostic criteria for osteosarcopenic obesity in older women. The proposed diagnostic criteria are based on two types of assessments: physical, via body composition measurements, and functional, via physical performance measures. Body composition measurements such as T-scores for bone mineral density, appendicular lean mass for sarcopenia, and percent body fat could all be obtained via dual energy X-ray absorptiometry. Physical performance tests: handgrip strength, one-leg stance, walking speed, and sit-to-stand could be assessed with minimal equipment. A score could then be obtained to measure functional decline in the older adult. For diagnosing osteosarcopenic obesity and other conditions related to bone loss and muscle loss combined with obesity, a combination of measures may more adequately improve the assessment process

Interventions for Improving Nutrition and Physical Activity Behaviors in Adult African American Populations: A Systematic Review, January 2000 Through December 2011

Introduction The incidence of preventable chronic diseases is disproportionally high among African Americans and could be reduced through diet and physical activity interventions. Our objective was to systematically review the literature on clinical outcomes of diet and physical activity interventions conducted among adult African American populations in the United States. Methods We used the Preferred Reporting Items for Systematic Review and Meta Analysis construct in our review. We searched Medline (PubMed and Ovid), Cochrane, and DARE databases and restricted our search to articles published in English from January 2000 through December 2011. We included studies of educational interventions with clinically relevant outcomes and excluded studies that dealt with nonadult populations or populations with pre-existing catabolic or other complicated disorders, that did not focus on African Americans, that provided no quantitative baseline or follow-up data, or that included no diet or physical activity education or intervention. We report retention and attendance rates, study setting, program sustainability, behavior theory, and education components. Results Nineteen studies were eligible for closer analysis. These studies described interventions for improving diet or physical activity as indicators of health promotion and disease prevention and that reported significant improvement in clinical outcomes. Conclusion Our review suggests that nutrition and physical activity educational interventions can be successful in improving clinically relevant outcomes among African Americans in the United States. Further research is needed to study the cost and sustainability of lifestyle interventions. Further studies should also include serum biochemical parameters to substantiate more specifically the effect of interventions on preventing chronic disease and reducing its incidence and prevalence

Relationship of Physical Performance with Body Composition and Bone Mineral Density in Individuals over 60 Years of Age: A Systematic Review

The purpose of this review was to examine the relationship between physical performance and body composition measurements, including fat/muscle mass and bone mineral density (BMD) in individuals ≥60 years of age. Various measurements used to assess body composition, BMD, and physical performance (PP) were discussed as well. Medline/PubMed, CINAHL, and SCIE were used to identify articles. After limiting the search for age and kind of physical performance measures, 33 articles were evaluated. Higher fat mass was associated with poorer physical performance while higher muscle mass was a predictor of better physical performance, especially in the lower extremities. Additionally, evidence showed that higher muscle fat infiltration was a determinant of poorer physical performance. BMD was shown to be a good predictor of physical performance although the relationship was stronger in women than in men. Developing standardized methods for PP measurements could help in further investigation and conclusions of its relationship with body composition

Stalna kronična upala niskoga stupnja zbog suvremenog načina prehrane potiče pretilost i osteoporozu

Some of the universal characteristics of pre-agricultural hominin diets are strikingly different from the modern human diet. Hominin dietary choices were limited to wild plant and wild animal foods, while the modern diet includes more than 70 % of energy consumed from refined sugars, refined vegetable oils, and highly processed cereals and dairy products. The modern diet, with higher intake of fat has also resulted in a higher ratio of omega-6 (n-6) to omega-3 (n-3) polyunsaturated fatty acids (PUFA), contributing to low-grade chronic inflammation (LGCI) and thus promoting the development of many chronic diseases, including obesity and osteoporosis. In this review, we describe the changes in modern diet, focusing on the kind and amount of consumed fat; explain the shortcomings of the modern diet with regard to inflammatory processes; and delineate the reciprocity between adiposity and inflammatory processes, with inflammation being a common link between obesity and osteoporosis. We present the evidence that overconsumption of n-6 PUFA coupled with under-consumption of n-3 PUFA results in LGCI and, along with the increased presence of reactive oxygen species, leads to a shift in mesenchymal stem cells (precursors for both osteoblasts and adipocytes) lineage commitment toward increased adipogenesis and suppressed osteoblastogenesis. In turn, high n-6 to n-3 PUFA ratios in the modern diet, coupled with increased synthesis of pro-inflammatory cytokines due to adiposity, propagate obesity and osteoporosis by increasing or maintaining LGCI.Pojedina univerzalna svojstva prehrane hominina prije pojave poljodjelstva izrazito se razlikuju od suvremene prehrane. Prehrambene navike hominina vjerojatno su bile ograničene na plodove divljeg bilja i lovinu; više od 70 % moderne prehrane odnosi se na konzumaciju rafiniranih šećera, biljnih ulja, žitarica i mliječnih prerađevina. Moderna je prehrana s višim unosom masti također dovela do nepovoljnijeg omjera omega-6 i omega-3 višestruko nezasićenih masnih kiselina (engl. krat. PUFA), koji pridonosi održavanju kronične upale niskoga stupnja, a time i nastanku mnogih kroničnih bolesti, uključujući pretilost i osteoporozu. U ovom se preglednom članku opisuju promjene uslijed modernog načina prehrane, s posebnim osvrtom na vrste i količine konzumirane masti. Također se objašnjavaju nedostatci moderne prehrane s obzirom na upalne procese te međusobna povezanost između pretilosti i upalnih procesa, koji su usto i poveznica između pretilosti i osteoporoze. U članku se iznose saznanja o tome da pretjerana konzumacija omega-6 masnih kiselina uz nedostatnu konzumaciju omega-3 masnih kiselina dovodi do kronične upale niskoga stupnja i povišenih vrijednosti reaktivnih kisikovih čestica (ROS), a time i do pomaka u mezenhimskih matičnih stanica (prekursora osteoblasta i adipocita) prema povećanoj adipogenezi i smanjenoj osteoblastogenezi. Uz povećanu sintezu upalnih citokina zbog pretilosti, moderna prehrana s nepovoljnim omjerom omega-6 i omega-3 kiselina u korist prvih nastavlja poticati pretilost i osteoporozu jer održava i pogoršava kroničnu upalu

Lifestyle characteristics influencing hypertension in middle-age to old people: comparison of two populations

Background: Hypertension is a significant global public health problem and the data suggest a wide health disparity in hypertension prevalence worldwide. Our objective was to assess some epidemiological determinants in individuals ≥ 50 years influencing blood pressure/hypertension in United States and Croatia and derive some meaningful conclusions and recommendations. Material and methods: We used the American National Health and Nutrition Examination Survey (NHANES) (n = 1,556; 48.9% women) and the Croatian Adult Health Cohort Study (CroHort) (n = 2,182; 66% women), both taken in 2008. The health indicators compared were anthropometries, blood pressure, socioeconomic and marital status, education and lifestyle, including physical activity, alcohol and coffee consumption, smoking and presence of dyslipidemia and diabetes. Results: Prevalence of hypertension based either on medication use or blood pressure values was significantly higher in Croatian men and women compared to American (all p < 0.001). Waist circumference was the main positive predictor and education a negative predictor for blood pressure in CroHort; significance was not reached in NHANES, although the trends were similar. Taking medications for diabetes decreased the odds for hypertension in NHANES, while taking medications for both diabetes and dyslipidemia decreased the odds in CroHort. Conclusions: Croatian people older than 50 years have higher prevalence of hypertension compared to their counterparts in the U.S. The difference in the prevalence of hypertension in two populations cannot be explained by different prevalence of risk factors examined, except education level. Higher prevalence of hypertension diagnosed by medication use indicates a relatively good control of the disease in both populations

Dissemination Trial For Health For Hearts United: Model Development, Preliminary Outcomes and Lessons Learned

BACKGROUND: Cardiovascular disease CVD), the leading cause of death in the U.S., is a particular problem for African Americans (AAs). Church-based health interventions are effective in reducing CVD risk, yet few have been successfully disseminated. This paper describes the model development, preliminary health outcomes, and lessons learned from the Health for Hearts United (HHU) dissemination trial which evolved from the longitudinal Reducing CVD Risk Study in a two-county area in North Florida. Community-based participatory research approaches and the socio-ecological model guided the study. METHODS: Data for this paper were from health leaders (n = 25) in the first six churches investigated, and the outreach participants (n = 86) they engaged. Health leaders completed survey items (daily servings of fruits/vegetables [F/V], fat consumption [FAT], and daily minutes of physical activity [PA]) and clinical measures (body mass index [BMI]; waist, hip and abdomen circumferences; and systolic and diastolic blood pressure [BP]). For outreach participants, a brief CVD Awareness Quiz was administered. Data were analyzed using description statistics, Pearson correlations, and repeated measures analysis of variance. RESULTS: Findings showed that the dissemination model was implemented by 100% of the churches, and resulted in health outcomes changes for health leaders (significant increases between pre- and post-test in F/V; significant decreases in FAT, BMI, abdomen circumference, with educational level and marital status as selected significant covariates) and in a significant increase in CVD awareness for outreach participants. Lessons learned are discussed. Although preliminary, the results suggest that the HHU dissemination model has promise for reducing CVD risk in AA's

Are New Generations of Female College-Student Populations Meeting Calcium Requirements: Comparison of American and Croatian Female Students

We compared calcium (Ca) sources and intake, as well as multivitamin/mineral supplement use between female students with nutrition/health background and those from general-student-populations. 314 participants 18–37 y, including 57 African-Americans and 54 Caucasian-Americans recruited from Nutrition and/or other Health Sciences departments (NHS), and 100 African-American and 103 Croatian women representing general-student-population (GSP), completed food frequency questionnaire assessing their usual Ca intake and supplement use. NHS populations met recommendations and consumed significantly more Ca, particularly from dairy sources, and were more likely to take supplements than GSP groups, suggesting that health education may influence Ca intake

Reducing Cardiovascular Disease Risk In Mid-Life and Older African Americans: A Church-Based Longitudinal Intervention Project At Baseline

Introduction: African Americans (AAs) experience higher age-adjusted morbidity and mortality than Whites for cardiovascular disease (CVD). Church-based health programs can reduce risk factors for CVD, including elevated blood pressure [BP], excess body weight, sedentary lifestyle and diet. Yet few studies have incorporated older adults and longitudinal designs. Purposes: The aims of this study are to: a) describe a theory-driven longitudinal intervention study to reduce CVD risk in mid-life and older AAs; b) compare selected dietary (fruit and vegetable servings/day, fat consumption), physical activity (PA) and clinical variables (BMI, girth circumferences, systolic and diastolic BP, LDL, HDL, total cholesterol [CHOL] and HDL/CHOL) between treatment and comparison churches at baseline; c) identify selected background characteristics (life satisfaction, social support, age, gender, educational level, marital status, living arrangement and medication use) at baseline that may confound results; and d) share the lessons learned. Methods: This study incorporated a longitudinal pre/post with comparison group quasi-experimental design. Community-based participatory research (CBPR) was used to discover ideas for the study, identify community advisors, recruit churches (three treatment, three comparison) in two-counties in North Florida, and randomly select 221 mid-life and older AAs (45 +) (n = 104 in clinical subsample), stratifying for age and gender. Data were collected through self-report questionnaires and clinical assessments. Results and Conclusions: Dietary, PA and clinical results were similar to the literature. Treatment and comparison groups were similar in background characteristics and health behaviors but differed in selected clinical factors. For the total sample, relationships were noted for most of the background characteristics. Lessons learned focused on community relationships and participant recruitment

Measuring body composition in overweight individuals by dual energy x-ray absorptiometry

BACKGROUND: Dual energy x-ray absorptiometry (DXA) is widely used for body composition measurements in normal-weight and overweight/obese individuals. The limitations of bone densitometers have been frequently addressed. However, the possible errors in assessing body composition in overweight individuals due to incorrect positioning or limitations of DXA to accurately assess both bone mineral density and body composition in obese individuals have not received much attention and are the focus of this report. DISCUSSION: We discuss proper ways of measuring overweight individuals and point to some studies where that might not have been the case. It appears that currently, the most prudent approach to assess body composition of large individuals who cannot fit under the scanning area would be to estimate regional fat, namely the regions of thigh and/or abdomen. Additionally, using two-half body scans, although time consuming, may provide a relatively accurate measurement of total body fat, however, more studies using this technique are needed to validate it. SUMMARY: Researchers using bone densitometers for body composition measurements need to have an understanding of its limitations in overweight individuals and address them appropriately when interpreting their results. Studies on accuracy and precision in measurements of both bone and soft tissue composition in overweight individuals using available densitometers are needed