Choline Intake Was Mildly Associated With Hypertension Among Older Adults in Cross-Sectional NHANES 2011–2014

Abstract Objectives The study objective is to investigate the relationships of choline intake with blood pressure (BP) and hypertension among U.S. adults aged ≥65 y using the sample from the 2011–2014 National Health and Examination Survey (NHANES). The association between choline-containing supplement usage and BP in adults aged ≥20 y was also assessed to confirm previous findings. Methods The cross-sectional associations of choline intake with prevalent hypertension (n = 2113) and BP (n = 843) were assessed among the NHANES older adults using logistic and multiple linear regression models for complex surveys, respectively. Logistic regression was used to test the association between supplemental choline use and prevalent hypertension in adults aged ≥20 y (n = 9561). Effect modification by sex, race/ethnicity, body mass index (BMI) and comorbidity were also investigated. Results Among older adults, choline intake interacted with BMI (P-interaction = 0.04) such that choline intake tended to be associated with lower odds of hypertension among people with BMI lower than 18.5 kg/m2 (odds ratio [95% Confidence Interval], OR [95% CI]: 0.64 [0.4,1.00]; P = 0.052). Choline intake was not associated with systolic BP. In contrast, its relation to diastolic BP differed by comorbidity (P-interaction = 0.03) with a negative direction of association observed among those who were free of comorbidities and a positive direction observed among those with comorbidities. No association was found between choline supplement use and the odds of hypertension. Conclusions Collectively, these results suggested that the associations of choline intake with BP levels and hypertension risk among older adults are mild and dependent on other risk factors. A higher choline intake may be beneficialy associated with BP among people who have healthier profiles. Funding Sources This study was supported by the Young Faculty Research Grant, Faculty of Agro-Industry, Chiang Mai, Thailand.

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Associations of choline intake with hypertension and blood pressure among older adults in cross-sectional 2011 – 2014 NHANES differ by body mass index and comorbidity status

British Journal Of Nutrition ◽

10.1017/s0007114521003068 ◽

2021 ◽

pp. 1-22

Author(s):

Siraphat Taesuwan ◽

Paradee Thammapichai ◽

Ariel B. Ganz ◽

Wachira Jirarattanarangsri ◽

Julaluk Khemacheewakul ◽

...

Keyword(s):

Blood Pressure ◽

Older Adults ◽

Body Mass Index ◽

Body Mass ◽

Primary Study ◽

Linear Regression Models ◽

Cross Sectional ◽

Positive Direction ◽

Choline Intake ◽

Comorbidity Status

Abstract Blood pressure (BP) is a known cardiovascular risk factor that is hypothesized to be inversely related to choline intake. A previous study suggested that this association may be more apparent in older adults and may differ according to demographic and health characteristics. The primary study objectives are to investigate the cross-sectional associations of total choline intake with BP (n=843) and prevalent hypertension (n=2,113) among U.S. adults aged ≥65 y using the sample from the 2011–2014 National Health and Nutrition Examination Survey. Logistic and multiple linear regression models for complex surveys were employed for hypertension status and BP respectively. Effect modification by sex, race, body mass index (BMI) and comorbidity status were separately investigated using an interaction term. Choline intake interacted with BMI (P-interaction=0.04) such that choline intake tended to be associated with lower odds of hypertension among people with BMI <18.5 kg/m2 (OR [95% CI]: 0.64 [0.4,1.00]; P=0.052). Choline intake was not associated with systolic BP (mean±SEM change per 100 mg of choline: −1.03±0.74 mmHg; P=0.16). In contrast, its relation to diastolic BP differed by cardiovascular comorbidity (P-interaction=0.03) with a non-significant (P=0.13) negative direction of association observed among those who were free of comorbidities and a non-significant (P=0.26) positive direction observed among those with comorbidities. Collectively, these results suggested that the associations of choline intake with BP levels and hypertension risk among older adults are dependent on other risk factors.

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Social Engagement and Episodic Memory in Non-Hispanic Black and White Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.1101 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 343-343

Author(s):

Abbey Hamlin ◽

A Zarina Kraal ◽

Laura Zahodne

Keyword(s):

Social Support ◽

Older Adults ◽

Episodic Memory ◽

Cognitive Aging ◽

Social Engagement ◽

Future Research ◽

Social Activities ◽

Linear Regression Models ◽

Significant Positive Association ◽

Cross Sectional

Abstract Social engagement may confer cognitive benefits in older adulthood, but studies have typically been restricted to largely non-Hispanic White (NHW) samples. Levels of social engagement vary across race such that NHW report larger social networks, more frequent participation in social activities, and greater social support than non-Hispanic Blacks (NHB). Associations between social engagement and cognition may also vary by race, but research is sparse. The current cross-sectional study examined associations between different aspects of social engagement and episodic memory performance, as well as interactions between social engagement and race among NHB and NHW participants in the Michigan Cognitive Aging Project (N = 247; 48.4% NHB; age = 64.19 ± 2.92). Social engagement (network size, activities, support) was self-reported. Episodic memory was a z-score composite of immediate, delayed, and recognition trials of a list-learning task. Separate hierarchical linear regression models quantified interactions between race and each of the three social engagement variables on episodic memory, controlling for sociodemographics, depressive symptoms, and health conditions. Results showed a main effect of more frequent social activity on better episodic memory, as well as an interaction between race and social support indicating a significant positive association in NHB but not NHW. These preliminary findings suggest that participating in social activities may be equally beneficial for episodic memory across NHB and NHW older adults and that social support may be particularly beneficial for NHB. Future research is needed to determine the potential applications of these results in reducing cognitive inequalities through the development of culturally-relevant interventions.

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Use of vitamin and mineral supplements in long-term care home residents

Applied Physiology Nutrition and Metabolism ◽

10.1139/h11-141 ◽

2012 ◽

Vol 37 (1) ◽

pp. 100-105 ◽

Cited By ~ 12

Author(s):

Navita Viveky ◽

Lynda Toffelmire ◽

Lilian Thorpe ◽

Jennifer Billinsky ◽

Jane Alcorn ◽

...

Keyword(s):

Older Adults ◽

Vitamin D ◽

Long Term Care ◽

Care Home ◽

Care Facility ◽

Dementia Diagnosis ◽

Term Care ◽

Supplement Use ◽

Supplement Usage

Vitamin–mineral supplementation may offer older adults health and cognition-related benefits but overuse may contribute to polypharmacy. We examined the prevalence of supplement usage in long-term care facility (LTC) residents (≥65 years of age). As cognition may be affected by nutrition, we also examined use in those with diagnosis of dementia and those with no dementia diagnosis. The prevalence of supplement usage and overall “pill count” from pharmaceutical use was assessed in 189 LTC residents and a subsample of 56 older adults with dementia diagnosis, respectively. Participants were residing in an LTC facility of a mid-size metropolitan area during 2009. The average use of supplements was 1.0 per day for all residents, with 35% taking vitamin D supplements, 20% multivitamins, and 26% calcium. Supplement use was similar (p ≥ 0.05) for those with dementia diagnosis (53%, average 2.0 per day) and for those without such diagnosis (45%, average 2.2 per day). Usage ranged between 1–6 supplements per day. In both of these groups, ∼73% of users were taking vitamin D. The number of prescribed medications ranged from 4 to 24 (average 10.2) in a subsample of residents whose supplement intake was 0 to 6 (average 2). These findings suggest an overall low rate of supplement use, with no significant differences (p ≥ 0.05) in use between residents with and without dementia diagnosis. However, some residents were at risk for supplement overuse.

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Associations of Vigorous Gardening With Cardiometabolic Risk Markers for Middle-Aged and Older Adults

Journal of Aging and Physical Activity ◽

10.1123/japa.2021-0207 ◽

2021 ◽

pp. 1-7

Author(s):

Jonathan Kingsley ◽

Nyssa Hadgraft ◽

Neville Owen ◽

Takemi Sugiyama ◽

David W. Dunstan ◽

...

Keyword(s):

Older Adults ◽

Cardiometabolic Risk ◽

Cross Sectional Study ◽

Cardiometabolic Health ◽

Risk Markers ◽

Linear Regression Models ◽

Cross Sectional ◽

Vigorous Intensity ◽

And Gender ◽

Cardiometabolic Risk Markers

This study investigates the associations of vigorous-intensity gardening time with cardiometabolic health risk markers. This cross-sectional study (AusDiab) analyzed 2011–2012 data of 3,664 adults (55% women, mean [range], age = 59.3 [34–94] years) in Australia. Multiple linear regression models examined associations of time spent participating in vigorous gardening (0, <150 min/week, ≥150 min/week) with a clustered cardiometabolic risk (CMR) score and its components, for the whole sample and stratified by age and gender. Of participants, 61% did no vigorous gardening, 23% reported <150 min/week, and 16% reported ≥150 min/week. In the whole sample, spending ≥150 min/week in vigorous gardening was associated with lower CMR (lower CMR score, waist circumference, diastolic blood pressure, and triglycerides) compared with no vigorous gardening. Stratified analyses suggested that these associations were almost exclusively observed for older adults and women. These findings suggest the public health potential of vigorous-intensity gardening in reducing CMR.

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The Influence of Sitting, Standing, and Stepping Bouts on Cardiometabolic Health Markers in Older Adults

Journal of Aging and Physical Activity ◽

10.1123/japa.2020-0443 ◽

2021 ◽

pp. 1-9

Author(s):

Simone J.J.M. Verswijveren ◽

Cormac Powell ◽

Stephanie E. Chappel ◽

Nicola D. Ridgers ◽

Brian P. Carson ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Body Composition ◽

Linear Regression ◽

Regression Models ◽

Fasting Glucose ◽

Cardiometabolic Health ◽

Linear Regression Models ◽

Cross Sectional

Aside from total time spent in physical activity behaviors, how time is accumulated is important for health. This study examined associations between sitting, standing, and stepping bouts, with cardiometabolic health markers in older adults. Participants from the Mitchelstown Cohort Rescreen Study (N = 221) provided cross-sectional data on activity behaviors (assessed via an activPAL3 Micro) and cardiometabolic health. Bouts of ≥10-, ≥30-, and ≥60-min sitting, standing, and stepping were calculated. Linear regression models were fitted to examine the associations between bouts and cardiometabolic health markers. Sitting (≥10, ≥30, and ≥60 min) and standing (≥10 and ≥30 min) bouts were detrimentally associated with body composition measures, lipid markers, and fasting glucose. The effect for time spent in ≥60-min sitting and ≥30-min standing bouts was larger than shorter bouts. Fragmenting sitting with bouts of stepping may be targeted to benefit cardiometabolic health. Further insights for the role of standing need to be elicited.

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Associations Between the DASH Diet and Nocturnal Blood Pressure in a Sample of Chinese Elderly Subjects

Current Developments in Nutrition ◽

10.1093/cdn/nzaa046_050 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 550-550

Author(s):

Muzi Na ◽

Yanxiu Wang ◽

Ming Gao ◽

Aijun Xing ◽

Shouling Wu ◽

...

Keyword(s):

Blood Pressure ◽

Elderly Subjects ◽

Linear Regression Models ◽

Hypertension Status ◽

Cross Sectional ◽

Dash Diet ◽

Funding Sources ◽

Sleep Parameters ◽

The Mean ◽

Diet Score

Abstract Objectives The Dietary Approaches to Stop Hypertension (DASH) diet is known to reduce daytime blood pressure (BP). This study aims to examine the relationship between DASH diet and BP monitored during sleep in a sample of Chinese old adults. Methods A cross-sectional sample of 324 participants aged ≥ 60 years who did not take BP-lowering drugs were included (68.8% men; 70.1% with hypertension). Usual dietary intake was assessed using a validated food frequency questionnaire. The DSAH diet score was calculated based on the intake ranking of 9 dietary components. 24-hour ambulatory BP was measured and the mean and variability independent of the mean (VIM) for nocturnal systolic (SBP) and diastolic BP (DBP) were calculated. Multivariable linear regression models were constructed of each BP outcome as a function of the DASH diet score adjusting for socio-demographic characteristics (age, sex, and education), body mass index, hypertension, lifestyle factors (smoking, alcohol intake, and physical activity). The interaction between DASH diet and hypertension status was also tested in the above models. We further adjusted for three self-reported sleep parameters (duration, insomnia, snoring) to explore the potential impact of sleep on the diet-nocturnal BP relationship. Results Mean (SD) age of subjects was 66.3 (6.0) years. There was no significant relationship between the DASH diet score and mean nocturnal SBP or DBP. However, per one unit increase of DASH diet score, nocturnal VIM-SBP and VIM-DBP were significantly reduced by −0.16 SD (95%CI: −0.30, −0.01) and −0.16 SD (95%CI: −0.28, −0.05) in the adjusted model. No significant interaction was detected between DASH diet and hypertension status. The significant associations persisted after further adjustment for the sleep parameters. Conclusions Adherence to the DASH diet may contribute to lower nocturnal systolic and diastolic blood pressure variability in elderly people. Future studies are warrant to explore the effect of modifiable diet on blood pressure during sleep, which has significant predictive value of heart health and mortality in high-risk populations. Funding Sources Broadhurst Career Development Professorship for the Study of Health Promotion and Disease Prevention, College of Health and Human Development, Pennsylvania State University.

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Elevated brain lesion volumes in older adults who use calcium supplements: a cross-sectional clinical observational study

British Journal Of Nutrition ◽

10.1017/s0007114514000828 ◽

2014 ◽

Vol 112 (2) ◽

pp. 220-227 ◽

Cited By ~ 4

Author(s):

Martha E. Payne ◽

Douglas R. McQuoid ◽

David C. Steffens ◽

John J. B. Anderson

Keyword(s):

Older Adults ◽

Observational Study ◽

Brain Lesion ◽

Lesion Volume ◽

Cross Sectional ◽

Supplement Use ◽

Established Risk Factor ◽

Automated Technique ◽

Dietary Supplement Use ◽

Randomised Controlled

Recent studies have implicated Ca supplements in vascular risk elevation, and therefore these supplements may also be associated with the occurrence of brain lesions (or hyperintensities) in older adults. These lesions represent damage to brain tissue that is caused by ischaemia. In the present cross-sectional clinical observational study, the association between Ca-containing dietary supplement use and lesion volumes was investigated in a sample of 227 older adults (60 years and above). Food and supplemental Ca intakes were assessed with the Block 1998 FFQ; participants with supplemental Ca intake above zero were categorised as supplement users. Lesion volumes were determined from cranial MRI (1·5 tesla) scans using a semi-automated technique; volumes were log-transformed because they were non-normal. ANCOVA models revealed that supplement users had greater lesion volumes than non-users, even after controlling for food Ca intake, age, sex, race, years of education, energy intake, depression and hypertension (Ca supplement use: β = 0·34, se 0·10, F1,217= 10·98, P= 0·0011). The influence of supplemental Ca use on lesion volume was of a magnitude similar to that of the influence of hypertension, a well-established risk factor for lesions. Among the supplement users, the amount of supplemental Ca was not associated with lesion volume (β = − 0·000035, se 0·00 015, F1,139= 0·06, P= 0·81). The present study demonstrates that the use of Ca-containing dietary supplements, even low-dose supplements, by older adults may be associated with greater lesion volumes. Evaluation of randomised controlled trials is warranted to determine whether this relationship is a causal one.

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Trends in Physical and Cognitive Performance Among Community-Dwelling Older Adults in Switzerland

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa008 ◽

2020 ◽

Vol 75 (12) ◽

pp. 2347-2353 ◽

Cited By ~ 1

Author(s):

Yves Henchoz ◽

Christophe Büla ◽

Armin von Gunten ◽

Juan Manuel Blanco ◽

Laurence Seematter-Bagnoud ◽

...

Keyword(s):

Older Adults ◽

Cognitive Performance ◽

Population Aging ◽

Community Dwelling ◽

Sample Population ◽

Linear Regression Models ◽

Timed Up And Go ◽

Cross Sectional ◽

Physical Tests ◽

Community Dwelling Older Adults

Abstract Background With population aging, a key question is whether new cohorts of older people are in better health than previous ones. This study aimed to compare the physical and cognitive performance of community-dwelling older adults assessed at similar age in 2005, 2010, and 2015. Methods This repeated cross-sectional analysis used data from the Lausanne cohort 65+, a three random sample population-based study. Performance of participants aged 66–71 years in 2005 (N = 1,309), 2010 (N = 1,253), and 2015 (N = 1,328) was compared using a battery of six physical and four cognitive tests. Analyses included tests for trend across samples and multivariable linear regression models. Results Adjusted performance in all four timed physical tests (gait speed, Timed Up-and-Go, five times chair stand, and Moberg Picking-Up) improved across samples from 2005 to 2015, by +12.7% (95% confidence interval {CI} +10.5%; +14.9%) to +20.4% (95% CI +17.7%; +23.0%) in females, and by +10.6% (95% CI +8.7%; +12.4%) to +16.7% (95% CI +13.4%; +20.0%) in males. In contrast, grip strength and balance did not improve across samples. Adjusted cognitive performance showed no change in the Trail Making Test, but worsened significantly across samples for the Mini-Mental State Examination, verbal fluency, and the clock drawing test in both females (−1.9% [95% CI −2.7%; −1.1%] to −6.7% [95% CI −8.9%; −4.6%]) and males (−2.5% [95% CI −3.4%; −1.6%] to −8.0% [95% CI −11.1%; −4.9%]). Conclusions Over the last decade, performance of adults aged 66–71 years improved significantly in timed physical tests but worsened in most cognitive measures among later-born samples.

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Associations Between Vitamin B6 Status and Plasma Polyunsaturated Fatty Acids Among US Older Adults: NHANES 2003−2004

Current Developments in Nutrition ◽

10.1093/cdn/nzab053_042 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 1049-1049

Author(s):

Hyojung Kim ◽

Evelyn Enrione ◽

Vijaya Narayanan ◽

Tan Li ◽

Adriana Campa

Keyword(s):

Older Adults ◽

Fatty Acids ◽

Polyunsaturated Fatty Acids ◽

Vitamin B6 ◽

Active Form ◽

Population Based ◽

Cross Sectional ◽

Funding Sources ◽

The Relationship ◽

Pufa Metabolism

Abstract Objectives Previous evidence suggests that vitamin B6 deficiency may have a deleterious impact on aging and the metabolism of polyunsaturated fatty acids (PUFA). However, the relationship of aging with vitamin B6 status and PUFA metabolism is poorly understood; population-based studies to assess the relationship between plasma pyridoxal 5′-phosphate (PLP; an active form of vitamin B6) and PUFA status for older adults are lacking. Thus, we examined the associations between plasma PLP concentration and plasma PUFA concentrations and ratios [eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), arachidonic acid (AA), EPA + DHA, EPA/AA, and (EPA + DHA)/AA] among US older adults. We further investigated the association of adequate (PLP ≥ 20 nmol/L) versus deficient (PLP < 20 nmol/L) vitamin B6 status in those participants with plasma PUFA concentration above the median. Methods A cross-sectional study analyzed 467 participants aged ≥60 years from the National Health and Nutrition Examination Survey (NHANES) 2003−2004. Nutrient intake data were estimated from two 24-h recalls and from questionnaires on the use of supplements. Plasma PLP and PUFA concentrations were measured. We used multivariable linear regression for obtaining unstandardized (b) and standardized (β) coefficients; multivariable logistic regression for adjusted odds ratios. Covariates included demographic, socioeconomic, dietary variables, physical activity, smoking, alcohol consumption, prescription medication use, and BMI. Results Plasma PLP was directly associated with plasma EPA (β = 0.176, b = 0.101, P = 0.002), DHA (β = 0.109, b = 0.046, P = 0.004), EPA + DHA (β = 0.137, b = 0.060, P = 0.002), EPA/AA (β = 0.169, b = 0.089, P = 0.009). The odds of having plasma EPA/AA and (EPA + DHA)/AA concentration above the median were greater in those with adequate vitamin B6 compared with those who were deficient [adjusted OR (aOR): 1.32, 95% CI: 0.8−2.17, P = 0.0001; aOR: 2.08, 95% CI: 1.0−4.33, P = 0.049, respectively]. Conclusions In US older adults, plasma PLP was directly associated with plasma EPA, DHA, EPA + DHA, EPA/AA. Adequate vitamin B6 status was associated with having above the median EPA/AA and (EPA + DHA)/AA. These findings suggest that adequate B6 status may positively influence PUFA metabolism in the older US population. Funding Sources No funding sources.

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Prevalence of drug–herb and drug–supplement interactions in older adults: a cross-sectional survey

British Journal of General Practice ◽

10.3399/bjgp18x699101 ◽

2018 ◽

Vol 68 (675) ◽

pp. e711-e717 ◽

Cited By ~ 14

Author(s):

Taofikat B Agbabiaka ◽

Neil H Spencer ◽

Sabina Khanom ◽

Claire Goodman

Keyword(s):

Older Adults ◽

Drug Interactions ◽

Dietary Supplements ◽

Prescription Drugs ◽

Community Dwelling ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Evening Primrose ◽

Supplement Use ◽

Concurrent Use

BackgroundPolypharmacy is common among older adults, with increasing numbers also using prescription drugs with herbal medicinal products (HMPs) and dietary supplements. There is no reliable evidence from the UK on concurrent use of HMPs and dietary supplements with prescription drugs in older adults.AimTo establish prevalence of concurrent prescription drugs, HMPs, and dietary supplements among UK community-dwelling older adults and identify potential interactions.Design and settingCross-sectional survey of older adults registered at two general practices in South East England.MethodA questionnaire asking about prescription medications, HMPs, and sociodemographic information was posted to 400 older adults aged ≥65 years, identified as taking ≥1 prescription drug.ResultsIn total 155 questionnaires were returned (response rate = 38.8%) and the prevalence of concurrent HMPs and dietary supplements with prescriptions was 33.6%. Females were more likely than males to be concurrent users (43.4% versus 22.5%; P = 0.009). The number of HMPs and dietary supplements ranged from 1 to 8, (mean = 3, median = 1; standard deviation = 1.65). The majority of concurrent users (78.0%) used dietary supplements with prescription drugs. The most commonly used dietary supplements were cod liver oil, glucosamine, multivitamins, and vitamin D. Others (20.0%) used only HMPs with prescription drugs. Common HMPs were evening primrose oil, valerian, and Nytol Herbal® (a combination of hops, gentian, and passion flower). Sixteen participants (32.6%) were at risk of potential adverse drug interactions.ConclusionGPs should routinely ask questions regarding herbal and supplement use, to identify and manage older adults at potential risk of adverse drug interactions.

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