Elsa Correa-Muñoz

Menopause as risk factor for oxidative stress.

ObjectiveThe aim of this study was to determine the influence of menopause (hypoestrogenism) as a risk factor for oxidative stress. MethodsWe carried out a cross-sectional study with 187 perimenopausal women from Mexico City, including 94 premenopausal (mean ± SD age, 44.9 ± 4.0 y; estrogen, 95.8 ± 65.7 pg/mL; follicle-stimulating hormone, 13.6 ± 16.9 mIU/mL) and 93 postmenopausal (mean ± SD age, 52.5 ± 3.3 y; estrogen, 12.8 ± 6.8 pg/mL; follicle-stimulating hormone, 51.4 ± 26.9 mIU/mL) women. We measured lipoperoxides using a thiobarbituric acid–reacting substance assay, erythrocyte superoxide dismutase and glutathione peroxidase activities, and the total antioxidant status with the Randox kit. An alternative cutoff value for lipoperoxide level of 0.320 &mgr;mol/L or higher was defined on the basis of the 90th percentile of young healthy participants. All women answered the Menopause Rating Scale, the Athens Insomnia Scale, and a structured questionnaire about pro-oxidant factors, that is, smoking, consumption of caffeinated and alcoholic beverages, and physical activity. Finally, we measured weight and height and calculated body mass index. ResultsThe lipoperoxide levels were significantly higher in the postmenopausal group than in the premenopausal group (0.357 ± 0.05 vs 0.331 ± 0.05 &mgr;mol/L, P = 0.001). Using logistic regression to control pro-oxidant variables, we found that menopause was the main risk factor for oxidative stress (odds ratio, 2.62; 95% CI, 1.35-5.11; P < 0.01). We also found a positive correlation between menopause rating score, insomnia score, and lipoperoxides, and this relationship was most evident in the postmenopausal group (menopause scale, r = 0.327 [P = 0.001]; insomnia scale, r = 0.209 [P < 0.05]). ConclusionsOur findings suggest that the depletion of estrogen in postmenopause could cause oxidative stress in addition to the known symptoms.

Implementation of an active aging model in Mexico for prevention and control of chronic diseases in the elderly

BackgroundWorld Health Organization cites among the main challenges of populational aging the dual disease burden: the greater risk of disability, and the need for care. In this sense, the most frequent chronic diseases during old age worldwide are high blood pressure, type 2 diabetes mellitus, cancer, arthritis, osteoporosis, depression, and dementia. Chronic disease-associated dependency represents an onerous sanitary and financial burden for the older adult, the family, and the health care system. Thus, it is necessary to propose community-level models for chronic disease prevention and control in old age. The aim of the present work is to show our experience in the development and implementation of a model for chronic disease prevention and control in old age at the community level under the active aging paradigm.Methods/DesignA longitudinal study will be carried out in a sample of 400 elderly urban and rural-dwelling individuals residing in Hidalgo State, Mexico during five years. All participants will be enrolled in the model active aging. This establishes the formation of 40 gerontological promoters (GPs) from among the older adults themselves. The GPs function as mutual-help group coordinators (gerontological nuclei) and establish self-care and self-promotion actions for elderly well-being and social development. It will be conformed a big-net of social network of 40 mutual-help groups of ten elderly adults each one, in which self-care is a daily practice for chronic disease prevention and control, as well as for achieving maximal well-being and life quality in old age. Indicators of the models impact will be (i) therapeutic adherence; (ii) the incidence of the main chronic diseases in old age; (iii) life expectancy without chronic diseases at 60 years of age; (iv) disability adjusted life years lost; (v) years of life lost due to premature mortality, and (vi) years lived with disability.DiscussionWe propose that the implementation of the model active aging framework will permits the empowerment of older adults, which constitutes basic social capital for chronic disease prevention and control in old age.

Program of active aging in a rural Mexican community: a qualitative approach

BackgroundEducation is one of the key elements in the promotion of a thorough paradigm for active aging. The aim of this study is to analyze factors that contribute the empowerment of older adults in a rural Mexican community and, thus, promote active aging.MethodsThe study was conducted in a rural Mexican community (Valle del Mezquital), based on an action-research paradigm. One hundred and fifty-five elderly subjects with elementary school education participated in a formal training program promoting gerontological development and health education. Participants in turn became coordinators of mutual-help groups (gerontological nucleus) in Mexico. In-depth interviews were carried out to assess the empowerment after training for active aging.ResultsIt was found that there was an increasing feeling of empowerment, creativity and self-fulfillment among participants. Among the main factors that positively influenced training of the elderly toward active aging were the teaching of gerontology topics themselves; besides, their motivation, the self-esteem, the increased undertaking of responsibility, the feeling of belonging to the group, and the sharing of information based on personal experience and on gerontological knowledge.ConclusionThe main factors that contribute to empowerment of older adults in a rural Mexican community for participate in active aging programs are the training and teaching of gerontology topics themselves; besides, their interest, experience and involvement.

Relationship between Metabolic Syndrome Components and Oxidative Stress in Elderly Community-Dwelling Mexicans

Aim: To determine the relationship between metabolic syndrome (MetS) components and oxidative stress (OxS) in elderly community-dwelling Mexicans. Methods: We carried out a comparative cross-sectional study on 113 elderly subjects (≧60 years old); 50 of them did not have MetS and 63 did have MetS (based on Adult Treatment Panel III criteria). We measured total antioxidant status (TAS), plasma lipid peroxidation (LPO), antioxidant activity of superoxide dismutase (SOD) and glutathione peroxidase (GPx), and calculated the SOD/GPx ratio. High blood pressure (HBP) was defined as systolic blood pressure (SBP) ≧140 mm Hg and/or diastolic blood pressure (DBP) ≧90 mm Hg. Results: We found a statistically significant increase in the percentage of cases of severe OxS in elderly subjects with MetS in comparison to healthy elderly (17 vs. 8%, OR: 7.33, 95% CI: 1.38–42.39; p < 0.01). It was observed that subjects with 5 MetS components had a 10-fold higher risk of developing OxS than subjects with 1 component (OR: 11.00, 95% CI: 1.72–115.17; p < 0.01). A positive correlation between SBP and LPO (r = 0.202, p < 0.05), and a negative correlation of SBP and DBP with TAS activity (r = –0.232, p < 0.05; r = –0.211, p < 0.05) were also observed. Conclusion: Our findings suggest that MetS is linked to severe OxS, that the number of metabolic syndrome components is a significant risk factor in the development of OxS, and that HBP is the most important metabolic syndrome component linked to OxS in the elderly.

Hyperleptinemia as a Risk Factor for High Blood Pressure in the Elderly

CONTEXT Studies have demonstrated that high serum leptin levels are associated with aging. However, we do not know whether hyperleptinemia is a relevant risk factor for high blood pressure (HBP) in the elderly. OBJECTIVE To determine the relationship between hyperleptinemia and HBP in the elderly. DESIGN A comparative cross-sectional study was carried out in a convenience sample of 70 healthy elderly persons comprising 46 women (mean age, 67 +/- 5.8 years) and 24 men (mean age, 73 +/- 7.5 years), and a group of 91 elderly persons with HBP, comprising 62 women (mean age, 67 +/- 8.2 years) and 29 men (mean age, 70 +/- 0.3 years). We measured serum leptin levels through the radioimmunoassay method. RESULTS The elderly subjects with HBP had significantly higher leptin levels than the healthy elderly subjects (P = .02). Furthermore, in female elderly subjects we observed a statistically significant correlation between systolic blood pressure and leptin (r = 0.37, P = .003), as well as systolic blood pressure and age (r = 0.29, P = .02), but not with diastolic blood pressure. In male elderly subjects, there was no correlation between leptin and systolic blood pressure or leptin and diastolic blood pressure. However, hyperleptinemia as risk factor for HBP was nearly 5 times higher in men than in women (men, odds ratio = 18.0, 95% confidence interval 3.2-100.9, P < .001 vs women, odds ratio = 3.33, 95% confidence interval 1.4-7.4, P = .003). CONCLUSIONS Our data suggest that hyperleptinemia was a significant risk factor for HBP elderly individuals, mainly in men.

Undernutrition and oxidative stress as risk factors for high blood pressure in older Mexican adults.

Objective: To determine the relationship between undernutrition and oxidative stress as risk factors for high blood pressure (HBP) in older Mexican adults. We carried out a case-control study in a convenience sample of 62 older adults, 60–80 years of age; 32 without HBP (mean age 75.8 ± 5.1 years) and 30 with HBP (mean age 65.2 ± 6.8 years). Methods: We measured serum lipoperoxide (LPO) levels, antioxidant enzymes, total antioxidant activity and lipid profile; in addition, we evaluated the nutritional status with anthropometric measurements, the Mini Nutritional Assessment and food intake frequency. Data were analyzed with Student t and odds ratio (OR) statistical tests. Results: We observed significantly higher LPO levels in subjects with HBP than in normotensive subjects (0.303 ± 0.10 vs. 0.256 ± 0.06 μmol/l; p < 0.05). With respect to risk factors for HBP, we found an OR of 12.2 (95% CI 1.9–76.4, p < 0.01) in subjects with high LPO levels (≥0.320 μmol/l) and an OR of 5.0 (95% CI 1.1–23.0, p < 0.05) in those with undernutrition. Conclusion: Our findings suggest that high LPO levels and undernutrition are significant risk factors for HBP.

Relationship between social support networks and diabetes control and its impact on the quality of life in older community-dwelling Mexicans

OBJECTIVE To determine the relationship between social support networks and diabetes control and its impact on quality of life in older community-dwelling Mexicans. METHODS A cross-sectional study was carried out on a convenience sample of 182 older diabetic people who were active participants in community self-care and mutual help groups in Mexico City for more than one year. All were independents and had medical diagnostics determining that they had diabetes without complications for one year or more. We measured biochemical and anthropometric parameters, social support networks for older people (SSN-Older) and perceived quality of life. Patients with uncontrolled diabetes mellitus had HbA1c (%) ≥ 8. RESULTS It was found that 65% (118/182) of the elderly diabetics in the study were controlled. We observed a significantly higher average score in the SSN-Older scale on the extra-familial support subscale in the controlled diabetic group compared with the uncontrolled group (57 ± 25 vs. 49 ± 30, p < 0.05). Additionally, the average satisfaction score, as observed from SSN-Older scale data, was significantly higher in the controlled diabetics group compared with the uncontrolled group (51 ± 21 vs.42 ± 22, p = 0.01). Likewise, in the quality of life analysis, we observed that 81% of the controlled diabetics perceived a high quality of life compared with 19% of the uncontrolled group (p < 0.001). CONCLUSIONS Our findings suggest that social support networks, especially community self-help groups, represent a determining social capital for control of diabetes mellitus in older people in the community.

Relationship between Social Support Networks and Physical Functioning in Older Community-Dwelling Mexicans

Some studies have demonstrated the relationship between social support networks (SSNs) and health status. In this sense, it has been considered that physical and mental functioning is a key indicator of the health in the age people. The aim of this study was to determine the association between social support networks and physical functioning. A cross-sectional study was carried out including a convenience sample of 150 older community-dwelling Mexicans. We assessed the familial, extra-familial and institutional SSNs; social contacts; the activities of daily living (ADL); the instrumental activities of daily living (IADLs); and physical functioning task (PFT) performance among study participants. Of the 150 older subjects, 53 reported living alone (35%), 113 (75%) reported having few SSNs, and 37 (25%) reported having enough SSNs. Persons with few familial SSNs were at increased odds of demonstrating dependence in at least one of the ADL (OR = 3.25, 95% CI 1.06–9.92, p < 0.05). Likewise, persons with few institutional SSNs and few social contacts were at increased odds of demonstrating dependence in at least one of the IADL (OR = 6.96, 95% CI 1.57–30.7, p < 0.01; OR = 5.02, 95% CI 1.44–17.5, p < 0.01, respectively). We also observed that having few extra-familial SSNs and few social contacts were the main risk factors for PFT dependence, with ORs of 3.70 (95% CI 1.21–11.2, p < 0.05) and 3.85 (95% CI 1.10–13.5, p < 0.05), respectively. Our findings suggest that having few SSNs could be a significant risk factor for reduced physical functioning in older adults.

Relación entre el estrés oxidativo y la pérdida de masa muscular en la posmenopausia temprana: estudio exploratorio

BACKGROUND Endocrine changes due to menopause have been associated to oxidative stress and muscle mass loss. The study objective was to determine the relationship between both variables in early postmenopause. MATERIAL AND METHODS An exploratory, cross-sectional study was conducted in 107 pre- and postmenopausal women (aged 40-57 years). Levels of serum lipid peroxides and uric acid and enzymes superoxide dismutase and glutathione peroxidase, as well as total plasma antioxidant capacity were measured as oxidative stress markers. Muscle mass using bioelectrical impedance and muscle strength using dynamometry were also measured. Muscle mass, skeletal muscle index, fat-free mass, and body mass index were calculated. RESULTS More than 90% of participants were diagnosed with overweight or obesity. Postmenopausal women had lower values of muscle mass and strength markers, with a negative correlation between lipid peroxide level and skeletal muscle index (r= -0.326, p<.05), and a positive correlation between uric acid and skeletal muscle index (r=0.295, p<.05). A multivariate model including oxidative stress markers, age, and waist circumference showed lipid peroxide level to be the main contributor to explain the decrease in skeletal muscle mass in postmenopause, since for every 0.1μmol/l increase in lipid peroxide level, skeletal muscle index decreases by 3.03 units. CONCLUSION Our findings suggest an association between increased oxidative stress and muscle mass loss in early postmenopause.

Contents Vol. 56, 2010

F. Azizi, Tehran A. Berg, Freiburg F. Branca, Rome R. Brigelius-Flohé, Nuthetal P.C. Calder, Southampton N. Chang, Seoul T. Decsi, Pécs K. Eder, Halle/Saale A. El-Sohemy, Toronto, Ont. H. Goldenberg, Vienna R. Hakkak, Little Rock, Ark. H. Hauner, Munich S. Hercberg, Paris H. Heseker, Paderborn N. Houalla, Beirut A. Kafatos, Heraklion M.-H. Kang, Daejeon E.T. Kennedy, Boston, Mass. M. Krawinkel, Giessen G. Krejs, Graz A.V. Kurpad, Bangalore W. Langhans, Zurich M. Lawrence, Burwood, Vic. D. Li, Hangzhou X. Lin, Shanghai J. Linseisen, Heidelberg J.A. Martinez, Pamplona Y. Naito, Kyoto H.Y. Paik, Seoul M. Panagiotidis, Reno, Nev. J.M. Pettifor, Johannesburg L.A. Réthy, Budapest G. Rimbach, Kiel J. Sabaté, Loma Linda, Calif. W.H.M. Saris, Maastricht L. Serra-Majem, Las Palmas de Gran Canaria A.P. Simopoulos, Washington, D.C. P. Stehle, Bonn J.J. Strain, Coleraine I. Th orsdottir, Reykjavik K. Tontisirin, Nakhon Pathom R. Uauy, Santiago H. Vannucchi, Ribeirão Preto A. von Rücker, Bonn M. Wahlqvist, Clayton W. Waldhäusl, Vienna E. Wasantwisut, Salaya B. Watzl, Karlsruhe W.M. Windisch, Vienna T. Yoshikawa, Kyoto J. Zempleni, Lincoln, Nebr. A. Zittermann, Bad Oeynhausen Journal of Nutrition, Metabolic Diseases and Dietetics