Monika Neuhäuser-Berthold

Coffee Consumption and Total Body Water Homeostasis as Measured by Fluid Balance and Bioelectrical Impedance Analysis

To investigate the impact of coffee consumption on fluid balance, 12 healthy volunteers were supplied with a standardized diet for 2 days after having abstained from consumption of methylxanthines for 5 days. During the first day, fluid requirement was met by mineral water. On the following day the same amount of fluid was supplied and the mineral water was in part replaced by 6 cups of coffee containing 642 mg of caffeine. This led to an increase in 24-hour urine excretion of 753 +/- 532 ml (p < 0.001), a corresponding negative fluid balance and a concomitant decrease in body weight of 0.7 +/- 0.4 kg (p < 0.001). Total body water as measured with bioelectrical impedance analysis decreased by 1.1 +/- 1.2 kg or 2.7% (p < 0.01). Urinary excretion of sodium and potassium was elevated by 80 +/- 62 mmol or 66% (p < 0.01) and 14 +/- 12 mmol or 28% (p < 0.01), respectively.

Underreporting of Energy Intake in an Elderly German Population

OBJECTIVES Within the longitudinal study on nutrition and health status in an aging population in Giessen, Germany (GISELA), the underreporters of energy intake (EI) were identified and characterized. METHODS EI was assessed in 238 female and 105 male participants of the GISELA study (age range = 60-89 y) by means of a 3-day estimated dietary record developed especially for this study. Resting metabolic rate (RMR) was measured by indirect calorimetry after an overnight fast. EI was expressed as a multiple of RMR and subjects with an EI:RMR ratio below 1.073 were classified as underreporters. RESULTS Mean EI:RMR was 1.62 +/- 0.46 in females and 1.53 +/- 0.46 in males; 7.6% of the females and 16.2% of the males were identified as underreporters. They showed lower levels of education and significantly greater body weight, body mass index, and fat mass than the adequate reporters. Further, underreporters stated more often than adequate reporters that they want to lose weight. Except for beta-carotene in males, reported nutrient intakes were significantly lower in underreporters than in adequate reporters. Carbohydrate and fat intake in both sexes, protein intake in females calculated as a percentage of EI, and vitamin and mineral densities were not affected by underreporting. CONCLUSIONS The results indicate that underreporting of EI is related to a low educational level and greater body weight, body mass index, and fat mass and affects all nutrients. These findings should be considered when the association between nutrition and health status is investigated in the elderly.

Eight-year trends in food, energy and macronutrient intake in a sample of elderly German subjects.

Time trends in the food and the corresponding energy and macronutrient intake between 1994 and 2002 are investigated as part of the longitudinal study on nutrition and health status in an ageing population in Giessen, Germany (GISELA study). The dietary intake is assessed via a 3 d estimated dietary record especially developed and validated for this study. A total of 2135 records from 532 subjects, aged 60 years and over, are analysed separately according to sex and age groups (born 1904-1928 and born 1929-1942). Results show that the food, energy and macronutrient intake of the GISELA subjects stayed fairly stable over the study period. However, some significant changes in the consumption pattern are observed, predominantly in the women and the younger age groups, which correspond to the national trends in Germany. Most obvious changes observed among the GISELA subjects are the increased intake of water (between +21.05 and +41.61 ml/d per year) and vegetables (between +2.94 and +3.38 g/d per year) and a reduced consumption of coffee and tea (between -10.65 and -15.99 ml/d per year) as well as of meat (between -1.79 and -2.56 g/d per year). The healthier food choices and the ability to change food habits could be related to the relatively high health-awareness of the GISELA subjects compared to the federal average of equivalent age groups.

Longitudinal changes in energy expenditure in an elderly German population: a 12-year follow-up

Background/Objectives:This study investigates age-dependent changes in different components of energy expenditure (EE) within the longitudinal study on nutrition and health status in an aging population in Giessen, Germany (GISELA).Subjects/Methods:Between 1994 and 2006, data obtained at a total of 3033 visits from 363 women and 153 men with a mean initial age of 67.4±5.9 and 66.9±5.2 years, respectively, were evaluated. The mean duration of follow-up was 8 years. Resting metabolic rate (RMR) was assessed by indirect calorimetry and physical activity patterns were assessed by questionnaire. EE of physical activity and total EE (TEE) were calculated using multipliers for RMR. Energy intake was determined through a validated 3-day estimated dietary record. Linear mixed models were used to analyze the influence of age on EE adjusted for covariates.Results:Resting metabolic rate decreased in women and men by 158 and 326 kJ/d per decade, respectively; after considering changes in body composition and fat distribution, respective decreases were 81 and 286 kJ/d per decade. EE of physical activity decreased similarly in both sexes (472 kJ/d per decade). TEE dropped in women and men by 540 and 823 kJ/d per decade, respectively. No statistically significant changes in energy intake and body weight were observed in the course of follow-up.Conclusions:The age-dependent decrease in TEE is mainly due to a decrease in physical activity. The stable energy intake and body weight of the GISELA subjects may be indicators for a relatively good health status.

Intake of Vitamin and Mineral Supplements in an Elderly German Population

Aim: To assess the prevalence of vitamin and mineral supplement use in a free-living elderly population and the contribution of these supplements to usual dietary intake. Methods: Analyses are based on data obtained from 388 subjects (≧60 years) participating in the longitudinal study on nutrition and health status in an ageing population in Giessen (GISELA), Germany, in 2002. Nutrient intake from food was assessed by means of a 3-day estimated dietary record. Supplement use was recorded over a period of 3 days using a self-administered questionnaire. Results: Nearly half of the study population consumed at least 1 supplement within these 3 days. The use of supplements was more prevalent among women than among men (51.5 vs. 33.9%). On average women consumed 2.03 ± 1.30 products and men 1.65 ± 1.07 products. Magnesium, vitamin C and vitamin E were supplemented most often by men, while women supplemented magnesium, vitamin E and calcium most often. Most of the supplemented nutrients did not distinctly increase the average intake of the respective nutrients from the diet in this population. However, supplement use markedly decreased the proportions of elderly subjects with an intake below the current reference values for certain nutrients, particularly for vitamin E. Conclusion: Results indicate that the intake of supplements is a common behavior in the population under investigation and therefore has to be considered when nutrient intake is evaluated.

Serum 25-hydroxyvitamin D3 and body composition in an elderly cohort from Germany: a cross-sectional study.

BackgroundEmerging evidence indicates that there is an association between vitamin D and obesity. The aim of this study was to investigate whether the level of serum 25-hydroxyvitamin D3 [25(OH)D3] in the elderly is influenced by parameters of anthropometry and body composition independent of potential confounding lifestyle factors and the level of serum intact parathyroid hormone (iPTH).MethodsCross-sectional data of 131 independently living participants (90 women, 41 men; aged 66–96 years) of the longitudinal study on nutrition and health status in senior citizens of Giessen, Germany were analysed. Concentrations of 25(OH)D3 and iPTH were ascertained by an electrochemiluminescence immunoassay. Body composition was measured by a bioelectrical impedance analysis. We performed univariate and multiple regression analyses to examine the influence of body composition on 25(OH)D3 with adjustments for age, iPTH and lifestyle factors.ResultsIn univariate regression analyses, 25(OH)D3 was associated with body mass index (BMI), hip circumference and total body fat (TBF) in women, but not in men. Using multiple regression analyses, TBF was shown to be a negative predictor of 25(OH)D3 levels in women even after controlling for age, lifestyle and iPTH (ß = −0.247; P = 0.016), whereas the associations between BMI, hip circumference and 25(OH)D3 lost statistical significance after adjusting for iPTH. In men, 25(OH)D3 was not affected by anthropometric or body composition variables.ConclusionsThe results indicate that 25(OH)D3 levels are affected by TBF, especially in elderly women, independent of lifestyle factors and iPTH.

Grade of adiposity affects the impact of fat mass on resting energy expenditure in women.

Body fat mass (FM) adds to the variance in resting energy expenditure (REE). However, the nature and extent of this relationship remains unclear. Using a database of 1306 women and a linear regression model, we systematically analysed the contribution of FM to the total variance in REE at different grades of adiposity (ranges of body %FM). After adjusting for age, the relative contribution of FM on REE variance increased from low (<or= 10 %FM) to normal (>10- <or= 30 %FM) and moderately elevated (>30- <or= 40 %FM) grades of adiposity but decreased sharply at high (>40- # 50 %FM) and very high (>50 %FM) grades of adiposity according to the ratio between regression coefficients. These data suggest that the specific metabolic rate of fat tissue is reduced at high adiposity. This should be considered when REE is normalized for FM in obesity.

Changes in resting metabolic rate in an elderly German population: Cross-sectional and longitudinal data

Background/ObjectivesThis study investigates age-dependent changes in resting metabolic rate (RMR) considering changes in body composition and fat distribution within the longitudinal study on nutrition and health status in an aging population in Giessen (GISELA), Germany, using three different approaches.Subjects/MethodsIn approach 1 cross-sectional data from 358 female and 155 male participants of the GISELA study were evaluated (mean age of 67.4 ± 5.9 and 66.9 ± 5.2 y, respectively). In approach 2 longitudinal data of 107 female and 55 male subjects who participated over a follow up period of 10 years were analysed. In approach 3 all data obtained at a total of 3033 visits from 363 women and 153 men between 1994 and 2006 were evaluated. The mean duration of follow-up was eight years. RMR was assessed by indirect calorimetry.ResultsApproach 1: RMR correlates significantly negatively with age in women and men. Considering fat free mass, fat mass, and WHR, age proved to be a significant predictor of RMR in both sexes in multiple regression analysis; RMR falls by 11.2 kJ/d and 34.1 kJ/d per year in females and males, respectively. Approach 2: In males but not in females RMR decreases significantly in the course of the follow up. After ten years measured RMR is significantly lower than expected RMR predicted on the basis of body composition and fat distribution in females and males. Deviations correspond to a decline in RMR by 11.4 and 27.5 kJ/d per year independently of changes in body composition and fat distribution. Approach 3: Results of the mixed linear model show that RMR decreases in the course of aging in both women and men; after considering changes in body composition and fat distribution respective decreases were 8.7 and 30.7 kJ/d per year.ConclusionsThese results indicate that the decline in RMR with advancing age cannot be totally due to changes in body composition.

Effect of Age on Plasma Homocysteine Concentrations in Young and Elderly Subjects Considering Serum Vitamin Concentrations and Different Lifestyle Factors

OBJECTIVES The aim of this study was to investigate whether an increase in total homocysteine (tHcy) concentration with increasing age is due to diminishing serum concentrations of pyridoxal-5-phosphate (PLP), vitamin B-12, and folate. The possible influence of different lifestyle factors on tHcy concentration was considered. METHODS Plasma tHcy, serum concentrations of pyridoxal-5-phosphate, vitamin B-12, and folate, intake of coffee and tea, alcohol, and methionine, as well as cigarette smoking, were determined in 252 elderly subjects (60-87 years old) of the longitudinal study on nutrition and health status in an aging population in Giessen (GISELA) and 99 young adults (20-34 years old) of the study on health and nutrition of young adults (GEJE). RESULTS Mean plasma tHcy concentrations were significantly higher in elderly than in young female subjects (9.7 +/- 1.9 micromol/L vs. 9.0 +/- 1.6 micromol/L, p < 0.05), but there was no difference between elderly and young men (10.6 +/- 2.1 micromol/L vs. 10.7 +/- 2.6 micromol/L). No differences in tHcy were observed between young and elderly subjects after adjustment for serum concentrations of PLP, vitamin B-12, and folate. Multiple linear regression analysis revealed a significant influence of age only in elderly, but not in younger subjects. CONCLUSION Higher tHcy concentrations in the elderly, in comparison to younger women, are due to lower serum concentrations of PLP, vitamin B-12, and folate, whereas within the age group of elderly subjects alone tHcy concentrations increase with age irrespective of serum vitamin concentrations.

Identifying Elderly Women with Osteoporosis by Spinal Dual X-ray Absorptiometry, Calcaneal Quantitative Ultrasound and Spinal Quantitative Computed Tomography: A Comparative Study

The ability of spinal dual x-ray absorptiometry (DXA), calcaneal quantitative ultrasound (QUS) and spinal quantitative computed tomography (QCT) to identify women with osteoporosis within the GISELA study was evaluated in 43 women, aged 62-87 years. Osteoporosis was defined as a T-score below or equal to -2.5 using DXA (femoral neck). To determine the performance of each method, the sensitivity, specificity and area under the curve (by means of a receiver operating characteristic [ROC] analysis) were calculated. The median T-scores from the measurements differed significantly (p < 0.0001). DXA (spine) identified 75% of women with osteoporosis; QUS and QCT identified 100%. The specificity was 89% for DXA (spine), 66% for QUS and 29% for QCT. ROC analysis showed that all three methods are qualified to identify women with osteoporosis; however, the different sensitivities and specificities of the methods, as well as the thresholds used for diagnosing osteoporosis have to be considered.