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Biomedical subjects

M L Wahlqvist

Publications and source records attributed to M L Wahlqvist.

At least 19 recordsLinked to original sources

Wellness management through Web-based programmes.

We established a Web-based programme called the 'Wellness Online Program' or WOLP. The programme runs for six weeks. It aims to help individuals manage their own wellness regardless of geographical location. WOLP is based on a holistic approach to health and consists of six wellness dimensions: physical (exercise and diet), emotional, social, intellectual, spiritual and occupational. A total of 150 volunteers from the general public were recruited online for this study and data were collected at three intervals: at the beginning of the programme (week 1), mid-programme (week 3) and at the end of the programme (week 6). Ninety of the participants (60%) completed the six-week programme. Acceptance of WOLP, measured by the frequency of individual usage, increased from the start to the end of the programme. Overall personal wellness management improved after six weeks on the wellness programme (5-10%). The study shows that personal wellness management, which had been demonstrated in the narrower confines of the corporate sector, is also possible in the public domain.

Adolescent↗

Nutrition and prevention of chronic diseases: a unifying eco-nutritional strategy.

Increasing efforts are being made to address, in public health policy (PHP), both the persistence of nutritional deprivation in economically disadvantaged communities, and the increase in so-called "chronic disease" (abdominal obesity, diabetes, cardiovascular disease, certain cancers, osteoporosis, arthritides, and inflammatory disease) in communities at all stages of economic development. The problems in the "chronic disease" descriptor are that its origins may be as early as conception, rather than during the postnatal lifespan, or even in previous generations; it may appear abruptly or slowly; and it may be amenable to environmental and behavioural intervention well into its course and in older age groups. It is also not necessarily "non-communicable", a qualifier often used for "chronic disease" (chronic non-communicable disease or CNCD) and often has inflammatory features, for example the inflammatory marker C-reactive protein is a predictor of macrovascular disease and ischaemic events can, in part, be prevented in the affected by influenzal vaccination. The nexus between immunodeficiency, inflammatory processes and nutritional status which is characteristic of "infective" and food-borne illness, is also more and more evident in "chronic disease". It may be more helpful to consider "chronic disease" as "eco-disease" with its environmental and behavioural contributors, and to regard that which is clearly nutritionally dependent as "eco-nutritional disease".

Chronic Disease↗

Factors contributing to variation in lipoprotein (a) in Melbourne Anglo-Celtic population.

AIM: The purpose of this report is to survey the factors contributing to variation in lipoprotein(a) (Lp(a)) in a population-based sample of Anglo-Celtic Melburnians. RESULTS: The plasma Lp(a) levels were highly skewed towards low levels in this population, with a median of 156 mg/l and a mean of 262 mg/l. Approximately 33% had plasma Lp(a) above the threshold value of 300 mg/l, while 35% had Lp(a) levels below 100 mg/l. The most commonly occurring phenotype was apo(a) S3. In this phenotype, Lp(a) concentrations ranged from 10 to 596 mg/l. Lp(a) was consistently associated with diastolic blood pressure, systolic blood pressure, total protein, albumin and nitrogen excretion in the 40-60 y age group. Multiple stepwise regression analyses, in non-dietary factors, were used to explain about 13% of the variance in Lp(a) (19% in men and 23% in women). Remarkably, in the <40 y age group, non-dietary factors may account for 86% of the variance in Lp(a) and dietary factors, analysed separately, 46%. Thus, although Lp(a) is mainly genetically determined, there are clearly other factors which contribute to variations in Lp(a) concentrations.

Adult↗

Age-fitness. How achievable with food?

To be fit as we age could be described as "Age fitness". Increasing evidence points to opportunities for greater wellness, health maintenance and reduction of the burden of disease in later life for a growing proportion of the community than previously envisaged. The scope of "age fitness" is social, mental, physiological and physical. We know a great deal about food cultures associated with successful aging--Greek, Okinawan, and Scandinavian, for example. Within these cultures, we are beginning to account for variances in health and survival by integrative scores of food intake and their validation.

Activities of Daily Living↗

The influence of fish, meat and polyunsaturated fat intakes on platelet phospholipid polyunsaturated fatty acids in male Melbourne Chinese and Caucasian.

OBJECTIVE: The aims of this study were to investigate (1) platelet phospholipid (PL) polyunsaturated fatty acid (PUFA) composition in subjects who were the Melbourne Chinese migrants, compared with those who were the Melbourne Caucasians and (2) the relationship between platelet PL PUFA and intake of fish, meat and PUFA. DESIGN: Cross-sectional comparison of the Melbourne Chinese and Caucasians. SETTING: Free-living male subjects. SUBJECTS: Ninety-seven Melbourne Chinese migrants and 78 Melbourne Caucasians who were recruited in Melbourne. OUTCOME MEASURES: Dietary intake was assessed using a semi-quantitative food frequency questionnaire. The platelet PUFA was measured by gas-liquid chromatography. RESULTS: The Melbourne Chinese had significantly higher proportions of platelet PL 20:5n-3 (P=0.006), 22:6n-3 (P<0.0001), total n-3 (P=0.027) and 22:5n-6 (P=0.0002), and a significantly higher intake of fish (P=0.012) and white meat (P=0.0045) compared with the Melbourne Caucasians. In addition, the Melbourne Chinese had significantly lower proportions of 20:3n-6 (P=0.023), 20:4n-6 (P<0.002), 22:4n-6 (P<0.0001), total n-6 (P=0.037), 22:5n-3 (P<0.0001) and ratio of n-6/n-3 (P=0.011), and a significantly lower intake of red and total meat (P<0.0001) than the Melbourne Caucasians. Fish consumption was significantly positively correlated with platelet PL 20:5n-3 and 22:6n-3, and significantly negatively correlated with 22:5n-3 (P<0.05). Meat consumption was significantly positively correlated with 22:5n-3 and significantly negatively correlated with 22:5n-6, 20:5n-3 and 22:6n-3 (P<0.05). Dietary PUFA intake was significantly positively correlated with 20:3n-6, 22:4n-6 and 22:5n-3, and significantly negatively correlated with 22:5n-6, 20:5n-3 and 22:6n-3 (P<0.05). CONCLUSIONS: Compared with Caucasians, the Melbourne Chinese had a significantly higher level of platelet PL n-3 PUFA, which might contribute to the low CVD mortality in this population. Platelet PL 20:5n-3 and 22:6n-3 were significantly positively correlated with fish intake, and negatively significantly correlated with dietary intake of meat and PUFA, while 22:5n-3 was significantly positively correlated with dietary meat and PUFA intake, and significantly negatively correlated with fish intake. Dietary intake of PUFA and fish are potential confounding factors for assessing the effects of meat consumption on platelet PL individual PUFA. Dietary intake of PUFA and meat did not influence the incorporation of fish long chain n-3 PUFA to platelet PL in this study population. SPONSORSHIP: Palm Oil Research Institute of Malaysia, Meat Research Corporation Australia.

Adult↗

Impaired fasting glycaemia in middle-aged women: a prospective study.

OBJECTIVES: To investigate: (i) the incidence of impaired fasting glycaemia (IFG) developed over 5 y in a population-based sample of Australian-born women; (ii) prospectively the factors which are associated with the development of IFG; (iii) the association of the menopausal transition with the onset of IFG and an increase in serum insulin concentrations. DESIGN AND METHODS: A total of 265 women (110 pre-, 138 peri-, 17 postmenopausal) participants in the longitudinal phase of the Melbourne Women's Midlife Health Project, aged 46-57 and with normal fasting plasma glucose concentrations at the time of the initial measure, were interviewed, had physical measurements and blood taken annually over a 5 y follow-up period. RESULTS: During the study period 43 women (16%) recorded a fasting glucose concentration of > or =6.1 mmol/l (IFG). Women who recorded IFG prospectively had, at the time of the initial measure when fasting glucose concentrations were normal: higher body mass index (BMI), trunk skinfold thicknesses, waist and hip circumferences (P<0.005), lower SHBG, higher free androgen index and serum insulin concentrations (P<0.05), higher systolic blood pressure, serum triglyceride and lower HDL-cholesterol concentrations (P<0.05) than women whose fasting glucose concentrations remained normal. The onset of IFG was not triggered by the menopausal transition or hormone use. Changes in insulin concentration were associated with changes in BMI (P<0.05). CONCLUSION: Women who developed IFG during the menopausal transition exhibited significantly higher levels of body fatness and dyslipidemia, premenopausally, compared with the women who did not develop IFG. The menopausal transition did not have an effect on the development of IFG, but weight gain during this period was associated with an increase in insulin concentration.

Australia↗

Skin wrinkling: can food make a difference?

OBJECTIVES: This study addressed whether food and nutrient intakes were correlated with skin wrinkling in a sun-exposed site. METHODS: 177 Greek-born subjects living in Melbourne (GRM), 69 Greek subjects living in rural Greece (GRG), 48 Anglo-Celtic Australian (ACA) elderly living in Melbourne and 159 Swedish subjects living in Sweden (SWE) participating in the International Union of Nutritional Sciences IUNS "Food Habits in Later Life" study had their dietary intakes measured and their skin assessed. Food and nutrient intakes were assessed using a validated semi-quantitative food frequency questionnaire (FFQ). Skin wrinkling was measured using a cutaneous microtopographic method. RESULTS: SWE elderly had the least skin wrinkling in a sun-exposed site, followed by GRM, GRG and ACA. Correlation analyses on the pooled data and using the major food groups suggested that there may be less actinic skin damage with a higher intake of vegetables (r(s)=-0.31, p<0.0001), olive oil (r(s)=-0.29, p<0.0001), fish (r(s)=-0.24, p<0.0001) and legumes (r(s)=-0.16, p<0.0001), and lower intakes of butter (r(s)=0.46, p<0.0001) and margarine (r(s)=0.24, p<0.001), milk products (r(s)=0.16, p<0.01) and sugar products (r(s)=0.12, p<0.01). Similar findings were obtained using regression analyses, except fish was no longer significant; 32% of the variance for actinic skin damage was predicted by six out of the ten major food groups. In particular, a high intake of vegetables, legumes and olive oil appeared to be protective against cutaneous actinic damage (collectively explaining 20% of the variance); a high intake of meat, dairy and butter appeared to be adverse (explaining <5% of the variance). Prunes, apples and tea explained 34% of variance amongst ACA. CONCLUSION: This study illustrates that skin wrinkling in a sun-exposed site in older people of various ethnic backgrounds may be influenced by the types of foods consumed.

Aged↗

Hypocholesterolemic effect of an enteric-coated garlic supplement.

OBJECTIVE: To evaluate the hypocholesterolemic effect of an enteric-coated garlic supplement standardized for allicin-releasing potential in mild to moderate hypercholesterolemic patients. METHODS: A double-blind randomized, placebo-controlled intervention study was conducted in 46 hypercholesterolemic subjects who had failed or were not compliant with drug therapy. Each subject was given dietary counseling to lower fat intake and enteric-coated Australian garlic powder tablets with 9.6 mg allicin-releasing potential or matching placebo tablets. RESULTS: After 12 weeks, the garlic supplement group (n=22) had a significant reduction in total cholesterol (TC, -0.36 mmol/L. -4.2%) and LDL-cholesterol (LDL-C, -0.44 mmol/L, -6.6%) while the placebo group (n=24) had a non-significant increase in TC (0.13 mmol/L, 2.0%) and LDL-C (0.18 mmol/L, 3.7%). HDL-cholesterol was significantly increased in the placebo group (0.09 mmol/L, 9.1%), compared to the garlic group (-0.02 mmol/L, -0.9%). and no significant difference in triglycerides or in LDL/HDL ratio was observed between groups. CONCLUSIONS: The study demonstrates that enteric-coated garlic powder supplements with 9.6 mg allicin-releasing potential may have value in mild to moderate hypercholesterolemic patients when combined with a low fat diet. Taken with other evidence, the efficacy of garlic for lipoprotein metabolism might require allicin bioavailability to be enhanced through the use of, for example, an enteric-coated dose form. If this is the case, the possibility remains that greater hypocholesterolemic efficacy may be evident at a higher allicin dose. Also noteworthy in this study was a small reduction in energy intake with garlic compared with placebo, attributable to reduction in fat, carbohydrate and alcohol intakes. This may also have contributed to the effects on blood lipids. This study suggests that garlic supplementation has a cholesterol-lowering effect, which may be mediated by direct action of a biologically active compound or compounds and in part through the effect on food and nutrient intake.

Administration, Oral↗

Can skin wrinkling in a site that has received limited sun exposure be used as a marker of health status and biological age?

OBJECTIVES: to determine if skin wrinkling in a site that had received limited sun exposure may be a marker of health status and biological age. DESIGN: population-based, cross-sectional study. PARTICIPANTS: we evaluated the health status of representative samples of elderly Greek-born people living in Melbourne, Greeks living in rural Greece, Anglo-Celtic Australians living in Melbourne and Swedes living in Sweden. We carried out microtopographic assessment of their skin and measured plasma dehydroepiandrosterone concentrations. METHODS: we derived activities of daily living, well-being, memory and general health status scores from a cross-cultural questionnaire. We measured skin wrinkling using cutaneous microtopographic methods and plasma dehydroepiandrosterone by enzyme immuno-assay. RESULTS: skin wrinkling was positively correlated with age (r(s)=0.27, P<0.0001) and negatively with body mass index (r(s)=-0.19, P<0.0001). Therefore, all analyses were controlled for these variables. Plasma dehydroepiandrosterone was higher in smokers than non-smokers (2.86 vs 2.08; P<0.001) and men had significantly higher plasma dehydroepiandrosterone than women (2.74 vs 1.69; P<0.0001). In the pooled data, skin wrinkling was negatively associated with general health score (r(s)=-0.13, P<0.01) and activities of daily living score (r(s)=-0.14, P<0.05) after controlling for age, body mass index and smoking. These associations were more pronounced in women. Finally, those with the least skin wrinkling had the highest dehydroepiandrosterone level (r(s)=-0.12, P=0.06) after adjusting for age, smoking and sex. CONCLUSION: skin wrinkling in a site with limited sun exposure might be used as a marker of health status and, to some extent, biological age--particularly for women.

Aged↗

Nutrition and diabetes in the Asia-Pacific region with reference to cardiovascular disease.

In many parts of the Asia-Pacific region, diabetes prevalence is increasing and seems destined to become a major risk factor for cardiovascular disease. The phenomenon seems predicated on insulin resistance (IR), partly attributable to an early impact of abdominal (visceral) adiposity than in Caucasian populations. Food intake along with physical activity and emotional stress are all determinants of glycaemic status. The glycaemic index (GI) of foods indicates that a number of food factors other than glucose content are important for good glycaemic response to foods and meals. These include (i) low GI foods could also be ones low in fat, (ii) foods that have the lowest GI which include lentils, pasta, noodles, multigrain breads and some fruits (e.g. grapefruit, plums) and (iii) fruits are to be preferred to their juices. The nutritional management of diabetes is best served by counselling changes in a sociocultural context and step-wise fashion by negotiation rather than prescription. It needs to be accompanied by advice to engage in regular physical activity, both aerobic and strength training. The same concept applies to the prevention of abdominal adiposity and diabetes mellitus type II in the Asia-Pacific region, but with particular reference to protective regional food.

Abdomen↗

Evidence-based nutrition and cardiovascular disease in the Asia-Pacific region.

The Asia-Pacific region is undergoing a major change in both food and health patterns, with a connection between the two more than likely. Evidence for certain traditional Asia-Pacific foods as protective agents against chronic non-communicable disease and cardiovascular disease (CVD), in particular, is growing at a time when their usage diminishes. The nature of the evidence to establish relevant Asia-Pacific food-health linkages will include randomised placebo-controlled clinical trials, but is much more extensive and meaningful. Okinawans have probably achieved one of the most successful food cultures from a health point of view and serve as a reference point for the Asia-Pacific region. The expert working party has produced, in November 2000, the 'Okinawan Recommendations on Nutrition and CVD in the Asia-Pacific region'.

Asia↗

Interventions aimed at dietary and lifestyle changes to promote healthy aging.

Desirable dietary habits and other lifestyle practices reduce premature mortality and compress the period of morbidity experienced towards the end of life. Aging adults are at risk of nutritionally inadequate diets especially in relation to protein, vitamins D, B1, B6, B12, fluid and other food components. Interventions aimed at ensuring dietary adequacy also need to consider the social and cultural aspects of eating as food is fundamental to a person's well-being and quality of life. The nutrition-related health problems associated with aging such as frailty, depression, incontinence and chronic non-communicable diseases should be identified in both the individual and in the community before dietary and other health interventions are implemented. In older adults, these dietary and health promoting interventions should then focus on maximizing function and quality of life, be acceptable and finally, measurable in terms of effectiveness.

Aged↗

Psychological factors in nutritional disorders of the elderly: part of the spectrum of eating disorders.

OBJECTIVE: To illustrate common psychogenic factors involved in undereating and undernutrition in the elderly. METHOD: Two cases are described. RESULTS: In the context of age-related physical and social factors, obsessional, phobic, and hypochondriacal anxieties can lead to significant food restrictions and undernutrition. DISCUSSION: Psychogenic factors need to be considered in undernutrition of the elderly and the phenomena considered in the spectrum of eating disorders.

Aged↗

The significance of eating patterns: an elderly Greek case study.

Eating patterns are a relatively neglected area of nutrition assessment with considerable potential health importance. Cross-cultural and socio-anthropological studies provide insight into the great range of food patterns which are related to health, biochemical measurements and anthropometry. The International Union of Nutritional Sciences (IUNS) study of aged folk in food-culturally disparate communities has provided opportunities to explore these issues. This paper uses cross-sectional data from the Greek arms of the IUNS study to explore associations between eating pattern variables (number of meals, time of meals, main meal for lunch and/or dinner, meal plus alcohol) and with the prevalence of self-reported heart disease and diabetes, body fatness, blood lipids, blood glucose and the overall variety of foods consumed. The eating pattern variables were not associated with blood lipids, self-reported heart disease or diabetes. Body fatness was negatively associated with the consumption of a greater number of meals/snacks daily (p<0.01), with the consumption of two cooked meals daily (p<0. 05) or when the main meal was consumed at lunch time (p<0.05) and when breakfast was consumed earlier rather than later in the morning (p<0.01). Later dinner times were positively correlated with a higher fasting blood glucose in non-diabetic elderly Greeks (p<0. 0005). A more varied diet was positively associated with the consumption of alcohol with dinner (p<0.0001) and with a greater number of meals/snacks daily (p<0.0001). These findings suggest that adherence to the traditional Greek eating pattern may be protective against obesity and appears to promote greater food variety.

Aged↗

Are the advantages of the Mediterranean diet transferable to other populations? A cohort study in Melbourne, Australia.

A prospective cohort study, involving 141 Anglo-Celts and 189 Greek-Australians of both sexes aged 70 years or more, was undertaken in Melbourne, Australia. The objective was to evaluate whether adherence to the principles of the Mediterranean diet affects survival of elderly people in developed non-Mediterranean countries. Diet was assessed using an extensive validated questionnaire on food intake. A one unit increase in a diet score, devised a priori on the basis of eight key features of the traditional common diet in the Mediterranean region, was associated with a 17% reduction in overall mortality (two-tailed P value 0.07). Mortality reduction with increasing diet score was at least as evident among Anglo-Celts as among Greek-Australians. We conclude that a diet that adheres to the principles of the traditional Mediterranean diet is associated with longer survival among Australians of either Greek or Anglo-Celtic origin.

Aged↗