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OBJECTIVE: Diets rich in whole and unrefined foods, like whole grains, dark green and yellow/orange-fleshed vegetables and fruits, legumes, nuts and seeds, contain high concentrations of antioxidant phenolics, fibers and numerous other phytochemicals that may be protective against chronic diseases. This study compared the effects of a phytochemical-rich diet versus a refined-food diet on lipoproteins, antioxidant defenses and colon function. METHODS: Twelve hyperlipidemic women followed two diets for four weeks starting with a refined-food diet. Subjects then directly crossed over to the phytochemical-rich diet. Duplicate, fasting serum lipids and single, fasting antioxidant enzymes were measured at the end of the four-week refined-food diet period (baseline) and again at the end of the phytochemical-rich diet period. RESULTS: Total energy and total fat intake were similar during both diet periods, but there was a decrease in saturated fat (SFA) of 61% in the phytochemical-rich diet group. Dietary fiber, vitamin E, vitamin C and carotene intakes were 160%, 145%, 160% and 500% more, respectively, than during the refined-food diet period. The phytochemical-rich diet induced a drop of 13% in total cholesterol (TC) (p < 0.05) and 16% (p < 0.001) in low density lipoprotein-cholesterol (LDL-C). Erythrocyte superoxide dismutase decreased 69% (p < 0.01) and glutathione peroxidase dropped 35% (p < 0.01). Colon function was improved on the phytochemical-rich diet. CONCLUSIONS: A diet abundant in phytochemically-rich foods beneficially affected lipoproteins, decreased need for oxidative defense mechanisms and improved colon function.

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This article compares the social disability and service utilization across the life course of men and women with schizophrenia. Based on an analysis of data from the 1989 Mental Health Supplement to the National Health Interview Survey (n = 376), we compare functional limitations, service utilization and social integration among younger, middle aged, and older age groups. Compared to those with manic depression, individuals with schizophrenia are more disabled, and are more socially disadvantaged. These data confirm the generally held view of schizophrenia as the most disabling mental illness, point to the very high levels of need associated with it, and emphasize the need for general health care. Findings from the multivariate analysis provide mixed support for our hypotheses. Contrary to expectations based on new findings in the literature on course and outcome in schizophrenia, disability (both service utilization and functional limitations) was greater among older and middle aged adults than among their younger counterparts. In contrast, older individuals with schizophrenia appear to be more connected to potential sources of support. From a policy perspective, those improvements in social integration which do appear with age--whether marriage for men or the ability to make and keep friends among women--have their primary impact on the quality of life of the individual, without any direct opportunity for cost saving in terms of services to the seriously mentally ill.

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The hypothesis that blood biochemical measurements of iron (Fe), copper (Cu), magnesium (Mg) and zinc (Zn) nutritional status and dietary intakes of these minerals are useful predictors of 100-yd free-style swimming performance during actual competition was examined in five female and five male collegiate swimmers. Dietary intakes of Fe, Cu, Mg, and Zn exceeded 70% of daily recommended or estimated safe and adequate intakes. Anemia was not present but body iron stores, assessed with serum ferritin concentration, were reduced in female swimmers who had significantly increased erythrocyte Mg and superoxide dismutase activity which suggest a biochemical adaptation to physical training. Actual 100-yd freestyle times (53.1 +/- 1.4 sec; mean +/- SE) measured during competition were similar to values (52.6 +/- 1.4 sec) predicted with models previously derived from other groups of swimmers. These findings indicate the important role of mineral nutritional status in facilitating the development of peak physical performance and support the hypothesis that mineral element nutritional status is one factor contributing to attainment of optimal human physiological function.

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Based on data from the National Health Interview Survey Mental Health Supplement, 1989 (NCHS, 1991), this article compares health outcomes for respondents living with someone who is mentally ill (N = 776) with a randomly selected subsample of respondents not living with someone identified as mentally ill (N = 716). When other predictors of health are controlled, sharing a household with a mentally ill person is associated with poorer self-reported physical health, increased risk of reporting some activity limitation, and increased service utilization-both greater risk of hospitalization or visiting a physician, and a greater number of days hospitalized and number of physician visits among those utilizing these services. The severity and duration of mental illness have little effect across health outcome measures. Impaired health and increased utilization of medical care among persons living with someone who is mentally ill suggest hidden costs to individuals, to families of the mentally ill, and to the service system.

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The effects of three diets--high meat (HM), low meat (LM), or low meat with mineral supplements (LS)--on zinc absorption, elemental balance, and related clinical indexes were investigated in a metabolic study of 14 women aged 51-70 y. The women ate each of the three diets for 7 wk in random order. Lean beef, chicken, ham, and tuna in the HM diet replaced foods with a low mineral content in the LM diet. The LS diet was similar to the HM diet in K, P, Fe, Mg, and Zn contents. Compared with the other diets, the HM diet increased zinc absorption and retention, and slightly increased urinary zinc. Nitrogen and calcium balances and urinary calcium were not different for the HM and LM diets. Iron balance was not different for the HM and LS diets with similar iron content, but the HM diet was unexpectedly associated with lower iron status (higher iron-binding capacity and lower ferritin than LM and LS diets). These results indicate that 0.8 g protein/kg body wt meets protein requirements in older women, and that high meat consumption increases zinc retention without compromising calcium status and may reduce indexes of iron status, in contrast with iron absorption results from studies with radiolabeled test meals.

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The effect of ascorbic acid supplementation on apparent iron absorption was tested in women with low iron stores. For 10 wk, 25 healthy nonpregnant women, aged 20-45 y with low serum ferritin (3.5-17.7 micrograms/L), consumed either a diet with predicted poorly bioavailable iron or a typical Western diet, classified according to dietary meat and ascorbic acid contents. Meals were supplemented with ascorbic acid (500 mg, three times a day) for 5 of the 10 wk, in a double-blind, crossover design. Ascorbic acid did not affect most biochemical indexes of iron status, the biological half-life of 59Fe, or apparent iron absorption (diet-feces) from either diet, but slightly increased serum ferritin (11.9 vs 10.7 micrograms/L, P < 0.06) when data from both diets were combined. These results support other evidence that ascorbic acid has less effect on iron bioavailability than has been predicted from tests with single meals.

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Based on interviews with widows and wives, this article analyzes the effects of marriage and widowhood on older women's help to kin and friends. Although married women provide more help to kin than do widows, most of these differences can be explained in terms of the greater material resources marriage provides. In contrast, even controlling for other social characteristics, widows spend more time and give more practical help, in particular, to more friends than do wives. In two senses, then, marriage privatizes women's help to others--it provides them with both the resources and opportunity to help those related, while it reduces help--both its breadth and intensity--to those not related.

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Five free-living women (ages 23-38 years) who consumed a self-selected diet and five women (ages 23-44 years) residing in a metabolic unit who were fed constant diet were assessed for variation in vitamin and general chemistry indices. Blood was drawn from these women once a month for five months, once a week for five weeks, and once a day for five days to assess analytical and biological variability of the indices. Analytical variability was determined by concurrently analyzing control samples prepared from plasma and serum pools. All samples were analyzed in duplicate. Of the measured indices, vitamins and lipids seemed to be the most variable. Diet had a significant effect only on ascorbic acid. We were unable to show any seasonal change for these analytes. Estimations of analytical variability, along with estimates of biological variability, and knowledge of dietary practices are essential when interpreting differences in analytes.

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The influence of physical training on copper, iron, and zinc nutriture was studied before and at the end of a competitive season in 16 female and 13 male swimmers and in 13 female and 15 nontraining control subjects. Mean daily energy, protein, and carbohydrate intakes increased (p less than 0.05) in the swimmers. Estimated copper, iron, and zinc intakes increased (p less than 0.05) in the male swimmers. Hematocrit and hemoglobin did not change but ferritin increased (p less than 0.05) in male swimmers. Plasma copper, iron and zinc were within the ranges of normal values and did not change. Erythrocyte superoxide dismutase (SOD) activity increased (p less than 0.01) after training. The findings indicate that copper, iron, and zinc nutriture is not adversely affected by physical training when dietary intakes are adequate, and that increases in red blood cell SOD activity without an increase in dietary copper are a functional adaptation of copper metabolism to aerobic training.

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The effect of ascorbic acid on iron retention from a diet with predicted low iron bioavailability (containing minimal meat and ascorbic acid) was investigated in iron-depleted premenopausal women. Eleven women were depleted of storage iron (indicated by serum ferritin) through a combination of diet (5.0 mg Fe/2000 kcal for 67-88 d) and phlebotomy. They then consumed a diet containing 13.7 mg Fe/2000 kcal, supplemented with placebo or ascorbic acid three times daily (1500 mg total) with meals for 5.5 wk. Ascorbic acid improved apparent iron absorption (balance method) [38 +/- 2% (means +/- SEM) vs 27 +/- 2%]. Ascorbic acid also improved hemoglobin, erythrocyte protoporphyrins, and serum iron but not hematocrit, serum ferritin, iron-binding capacity, or transferrin saturation. In iron-depleted women consuming a diet with predicted poor iron availability, ascorbic acid supplementation enhanced body iron retention for 5.5 wk.

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We investigated response sensitivities of indices of iron status to controlled iron depletion and repletion in 11 premenopausal women. The women were depleted of storage iron (as reflected by serum ferritin) through a combination of a low-iron diet and phlebotomy. They then consumed a diet containing 13.7 mg of iron per 2000 kcal, supplemented with either ascorbic acid or placebo (for 5 1/2 weeks) and a daily 50-mg iron supplement (for the subsequent 17 days). The relative sensitivities of different indices for detecting iron depletion were as follows: ferritin greater than % transferrin saturation greater than plasma iron greater than hemoglobin greater than hematocrit greater than zinc protoporphyrin (ZnPP) and erythrocyte protoporphyrin (EP). Ascorbic acid treatment during repletion, before iron supplementation, significantly (P less than 0.05) affected changes in hemoglobin, ZnPP, ZnPP/heme, and EP/heme. Changes in heme synthesis evidently do not occur until iron stores are depleted and, conversely, during iron repletion hematopoiesis must be satisfied before iron stores, as reflected by ferritin, increase. Thus, the use of only one index of iron status is of limited value for detecting iron depletion.

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Five free-living women (ages 28-38 y) and five women (ages 23-44 y) residing in a metabolic unit and eating a constant diet were assessed for variation in indices related to mineral nutrition. Blood was sampled once a month for five months, once a week for five weeks, and once a day for five days to assess analytical and biological variability. Analytical variability was determined by using concurrently run duplicate control samples prepared from plasma or serum pools. Of the measured indices, serum ferritin varied most, with intra-individual variance of 4.72% to 18.0%. Much of this variance may have been because of changes in iron status or in the analytical technique used. Intra-individual month-to-month variance for other indices ranged from 17% for superoxide dismutase (EC 1.15.1.1) to 1.5% for calcium. Correction for long-term analytical variation indicated that most of the variance was associated with the biological component. The higher biological variabilities of some indices, including ferritin or superoxide dismutase, need to be considered when nutritional status is being evaluated or when serial observations are made over a protracted period in clinical studies or trials.

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Five postmenopausal women aged 50-63 y were fed a diet of mixed Western foods that supplied an average of 2.6 mg zinc/d for 6 mo. Plasma zinc did not change significantly during Zn depletion but increased slightly when Zn was fed. Zn content of blood cellular components and activities of Zn-containing enzymes were not affected by Zn intake. Ethanol tolerance tests performed at the end of control, middle of depletion, end of depletion, and end of repletion showed a change in ethanol metabolism at the end of the low-Zn intake period that was corrected within 1 mo with Zn supplementation. These data suggest that there are homeostatic mechanisms that maintain circulating levels of Zn. Zn and activity of Zn enzymes in tissues may be decreased before changes in circulating Zn levels are seen. Functional indices of Zn biochemistry, such as ethanol metabolism, may be more sensitive indicators of Zn stores and nutriture than circulating Zn.

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Dietary histories and seven-day food records were obtained for 54 apparently healthy older adults. The two dietary methods correlated for most nutrients, but mean differences were significant for several nutrients. Intakes below recommended levels occurred most frequently for energy, calcium, and zinc. Biochemical evidence of thiamin and riboflavin deficiency was unexpectedly frequent. Using food records, dietary iron correlated with serum ferritin. Using dietary histories, dietary protein correlated with serum albumin, and dietary zinc correlated with plasma zinc. Using either dietary method, plasma ascorbate was associated positively with both dietary ascorbate and ascorbate supplements, and negatively with cigarette smoking. Use of thiamin- or folate-containing supplements was associated with improved biochemical status for the respective vitamin. Though neither dietary histories nor food records give precise intake data for individuals, either method may be useful for epidemiologic studies with appropriate sample sizes.

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