B-Vitamin Biomarkers in Relation to Immune Function in Older Adults: Preliminary Analysis from the TUDA Study

Background and objectives: Immune function typically declines with age, increasing susceptibility to disease. Many factors contribute to this decline, including nutritional status. Emerging evidence shows associations of folate and related B-vitamins (B12, B6, and riboflavin) with immune health, but these interactions are complex. The aim of this study was to investigate B-vitamin biomarkers in relation to immune function in ageing. We hypothesised that the higher status of certain B-vitamins will be associated with improved inflammatory markers. Methods: The data were analysed from the Trinity-Ulster-Department of Agriculture (TUDA) study, aimed at investigating health and lifestyle factors in relation to disease, in community-dwelling older adults recruited from the island of Ireland (2008–2012). Of the 5186 TUDA participants, 2724 fulfilled the inclusion criteria for the current investigation. We measured B-vitamin biomarkers, namely, red blood cell folate, serum B12, plasma pyridoxal-5-phosphate (PLP; B6), the erythrocyte glutathione reductase activation coefficient (EGRac; riboflavin), pro-inflammatory markers (interleukin IL-6, tumor necrosis factor-alpha [TNF-α], and c-reactive protein [CRP]), and the anti-inflammatory marker (IL-10). Results: Plasma PLP was negatively associated with CRP (β: −0.066; 95% CI: −0.005–0.000; p = 0.020), and plasma homocysteine was positively associated with CRP (β: 0.062; 95% CI: 0.003–0.066; p = 0.030) and TNF-α (β: 0.086; 95% CI: 0.023–0.124; p = 0.004). No other significant associations between B-vitamins and inflammatory markers were found. As regards general characteristics, the concentrations of IL-6 (p = 0.040) and CRP (p = 0.010) increased with age; CRP (p < 0.001); TNF-α (p = 0.024) increased with BMI; higher IL-6 (p = 0.041) was associated with living alone; and higher CRP (p < 0.001) was associated with smoking. Discussion: These preliminary findings suggest that improving vitamin B6 status and maintaining a healthy weight in older age may support a healthier immune system. Further investigation, particularly in the form of randomised controlled trials, is required to confirm the current findings and investigate the impact of B-vitamins on immune function

A randomized controlled trial of folic acid intervention in pregnancy highlights a putative methylation-regulated control element at ZFP57

Table S1. Pyrosequencing and transcriptional primer sets used in this study. Pyroassay primers are given as bisulfite converted sequence. The same primers were used for both RT-PCR and RT-qPCR. (DOCX 15 kb

Exercise and manual physiotherapy arthritis research trial (EMPART) for osteoarthritis of the hip: a multicenter randomized controlled trial.

OBJECTIVES: To determine the effectiveness of exercise therapy (ET) compared with ET with adjunctive manual therapy (MT) for people with hip osteoarthritis (OA); and to identify if immediate commencement of treatment (ET or ET+MT) was more beneficial than a 9-week waiting period for either intervention. DESIGN: Assessor-blind randomized controlled trial with a 9-week and 18-week follow-up. SETTING: Four academic teaching hospitals in Dublin, Ireland. PARTICIPANTS: Patients (N=131) with hip OA recruited from general practitioners, rheumatologists, orthopedic surgeons, and other hospital consultants were randomized to 1 of 3 groups: ET (n=45), ET+MT (n=43), and waitlist controls (n=43). INTERVENTIONS: Participants in both the ET and ET+MT groups received up to 8 treatments over 8 weeks. Control group participants were rerandomized into either ET or ET+MT groups after 9 week follow-up. Their data were pooled with original treatment group data: ET (n=66) and ET+MT (n=65). MAIN OUTCOME MEASURES: The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function (PF) subscale. Secondary outcomes included physical performance, pain severity, hip range of motion (ROM), anxiety/depression, quality of life, medication usage, patient-perceived change, and patient satisfaction. RESULTS: There was no significant difference in WOMAC PF between the ET (n=66) and ET+MT (n=65) groups at 9 weeks (mean difference, .09; 95% confidence interval [CI] -2.93 to 3.11) or 18 weeks (mean difference, .42; 95% CI, -4.41 to 5.25), or between other outcomes, except patient satisfaction with outcomes, which was higher in the ET+MT group (P=.02). Improvements in WOMAC, hip ROM, and patient-perceived change occurred in both treatment groups compared with the control group. CONCLUSIONS: Self-reported function, hip ROM, and patient-perceived improvement occurred after an 8-week program of ET for patients with OA of the hip. MT as an adjunct to exercise provided no further benefit, except for higher patient satisfaction with outcome

Identification of nutrition factors in the metabolic syndrome and its progression over time in older adults: analysis of the TUDA cohort

BACKGROUND: Nutrition is recognized as playing an important role in the metabolic syndrome (MetS), but the dietary components involved are unclear. We aimed to investigate nutrition factors in relation to MetS and its progression in older adults over a follow-up period of 5.4 years.METHODS: Community-dwelling adults (≥ 60y) from the Trinity-Ulster-Department-of-Agriculture study, sampled at baseline (2008-12) and follow-up (2014-18; n 953), were classified as 'with MetS' by having three or more of: waist circumference (≥ 102 cm, males; ≥ 88 cm, females); HDL-cholesterol (&lt; 1.0 mmol/L, males; &lt; 1.3 mmol/L, females); triglycerides (≥ 1.7 mmol/L); blood pressure (systolic ≥ 130 and/or diastolic ≥ 85 mmHg); and hemoglobin A1c (≥ 39 mmol/mol).RESULTS: MetS was identified in 67% of participants, increasing to 74% at follow-up. Predictors at baseline for the development of metabolic syndrome (MetS) at follow-up were higher waist circumference (odds ratio [95%CI]; 1.06 [1.01-1.11]), but not BMI, and increased triglyceride concentrations (2.01 [1.29-3.16]). In dietary analysis (at follow-up), higher protein (g/kg bodyweight/day) and monounsaturated fatty acid (g/day) intakes were each associated with lower risk of MetS (0.06 [0.02-0.20] and 0.88 [0.78-1.00], respectively), whilst higher protein was also associated with lower abdominal obesity (0.10 [0.02-0.51]) and hypertension (0.22 [0.00-0.80]). Furthermore, participants with, compared to without, MetS consumed less high-quality protein foods (P = 0.006) and more low-quality protein foods (P &lt; 0.001), as defined by the protein digestibility-corrected amino acid score.CONCLUSIONS: Dietary interventions targeting protein quantity and quality may have specific benefits in preventing or delaying the progression of MetS in at-risk older people, but this requires investigation in the form of randomized trials.</p

Association of dietary flavan-3-ol intakes with plasma phenyl-γ-valerolactones: analysis from the TUDA cohort of healthy older adults

Background: Dietary polyphenols, including flavan-3-ols (F3O), are associated with better health outcomes. The relationship of plasma phenyl-γ-valerolactones (PVLs), the products of colonic bacterial metabolism of F3O, with dietary intakes is unclear. Objectives: To investigate whether plasma PVLs are associated with self-reported intakes of total F3O and procyanidins+(epi)catechins. Design: We measured 9 PVLs by uHPLC-MS-MS in plasma from adults (&gt;60y) in the Trinity-Ulster-Department of Agriculture (TUD study (2008 to 2012; n=5,186) and a follow-up subset (2014 to 2018) with corresponding dietary data (n=557). Dietary (poly)phenols collected by FFQ were analyzed using Phenol-Explorer. Results: Mean (95% confidence interval [CI]) intakes were estimated as 2283 (2213, 2352) mg/d for total (poly)phenols, 674 (648, 701) for total F3O, and 152 (146, 158) for procyanidins+(epi)catechins. Two PVL metabolites were detected in plasma from the majority of participants, 5-(hydroxyphenyl)-γ-VL-sulfate (PVL1) and 5-(4'-hydroxyphenyl)-γ-VL-3'-glucuronide (PVL2). The 7 other PVLs were detectable only in 1-32% of samples. Self-reported intakes (mg/d) of F3O (r = 0.113, P = 0.017) and procyanidin+(epi)catechin (r = 0.122, P = 0.010) showed statistically significant correlations with the sum of PVL1 and PVL 2 (PVL1+2). With increasing intake quartiles (Q1-Q4), mean (95% CI) PVL1+2 increased; from 28.3 (20.8, 35.9) nmol/L in Q1 to 45.2 (37.2, 53.2) nmol/L in Q4; P = 0.025, for dietary F3O, and from 27.4 (19.1, 35.8) nmol/L in Q1 to 46.5 (38.2, 54.9) nmol/L in Q4; P = 0.020, for procyanidins+(epi)catechins. Conclusions: Of 9 PVL metabolites investigated, 2 were detected in most samples and were weakly associated with intakes of total F3O and procyanidins+(epi)catechins. Future controlled feeding studies are required to validate plasma PVLs as biomarkers of these dietary polyphenols