Background: Convincing evidence shows that soy protein intake has beneficial effects on lipid changes, but it is unclear which components of soy protein are responsible. Objective: We conducted a ...meta-analysis to identify and quantify the effects of soy protein containing isoflavones on the lipid profile. Design: Twenty-three eligible randomized controlled trials published from 1995 to 2002 were identified from the PUBMED data-base (National Library of Medicine, Bethesda, MD). Weighted mean effect sizes were calculated for net changes in serum lipid concentrations by using fixed-effect or random-effect models. Prespecified subgroup analyses were performed to explore the influence of covariates on net lipid change. Results: Soy protein with isoflavones intact was associated with significant decreases in serum total cholesterol (by 0.22 mmol/L, or 3.77%), LDL cholesterol (by 0.21 mmol/L, or 5.25%), and triacylglycerols (by 0.10 mmol/L, or 7.27%) and significant increases in serum HDL cholesterol (by 0.04 mmol/L, or 3.03%). The reductions in total and LDL cholesterol were larger in men than in women. Initial total cholesterol concentrations had a powerful effect on changes in total and HDL cholesterol, especially in subjects with hypercholesterolemia. Studies with intakes >80 mg showed better effects on the lipid profile. The strongest lowering effects of soy protein containing isoflavones on total cholesterol, LDL cholesterol, and triacylglycerol occurred within the short initial period of intervention, whereas improvements in HDL cholesterol were only observed in studies of >12 wk duration. Tablets containing extracted soy isoflavones did not have a significant effect on total cholesterol reduction. Conclusions: Soy protein containing isoflavones significantly reduced serum total cholesterol, LDL cholesterol, and triacylglycerol and significantly increased HDL cholesterol, but the changes were related to the level and duration of intake and the sex and initial serum lipid concentrations of the subjects.
To synthesize the available data on the association between metabolic syndrome and all-cause mortality, we conducted a meta-analysis of prospective cohort studies. We performed a literature search ...using Medline, EMBASE and Cochrane Library from 2001 to December 2009, with no restrictions. We included studies if they were prospective, had an assessment of metabolic syndrome at baseline and risk of all-cause mortality. We recorded several characteristics for each study. We extracted relative risks (RR) and 95% confidence intervals (CI) and pooled them using fixed or random effects models. We performed sensitivity analysis, and assessed heterogeneity and publication bias. A total of 21 studies including 372,411 participants were included in our meta-analysis. 18,556 deaths from any cause occurred during a mean follow-up of 11.5 years. Individuals with the metabolic syndrome, compared to those without, had an increased mortality from all causes (pooled RR 1.46; 95% CI 1.35-1.57). The RR of all-cause mortality associated with metabolic syndrome was higher in studies using the National Cholesterol Education Program Adult Treatment Panel (NCEP) than the revised NCEP criteria (RR: 1.45 vs. 1.25; P = 0.0002). Metabolic syndrome is an important risk factor for all-cause mortality. The diagnosis and treatment of the underlying risk factors for the metabolic syndrome should be an important strategy for the reduction of all-cause mortality associated with metabolic syndrome in the general population.
Objective: To evaluate the validity and reproducibility of a food frequency questionnaire (FFQ) developed for assessing the association between dietary factors and breast cancer risk among Chinese ...women in Guangdong. Methods: 61 women (24-64 years) were recruited from the community in Guangzhou city. An 81-item FFQ was administered twice, one year apart (FFQ1, FFQ2). In the mean time, six 3-day dietary records (DRs) were collected at two month intervals within the year. Daily consumption of nutrients and foods from the FFQs and DRs, correlation coefficients between the two FFQs and the FFQ with DRs were calculated. Results: Median intakes of nutrients and food group items are higher in FFQ1 than FFQ2. The energy-adjusted Pearson correlation coefficients between the FFQ1 and FFQ2 ranged from 0.46 to 0.71 for nutrients and 0.36 to 0.66 for food group items, respectively. In the validation study, energy-adjusted correlation coefficients were 0.25 to 0.65 for nutrients and 0.30 to 0.68 for food groups. Mean proportion of subjects being classified into the same quartile of nutrients and foods intake from the FFQ and DRs was 36% and 43%, respectively. Mean misclassification of subjects into opposite quartiles was 5% for nutrients and 3% for foods. Bland-Altman analysis showed that no linear trend existed between the differences and means for nutrients. Conclusions: The 81-item FFQ has satisfactory reproducibility and reasonable validity, and is useful in assessing the usual consumption of major nutrients and food groups among Chinese women in Guangdong.
Studies suggested that the inter-individual differences in metabolizing isoflavone daidzein to equol or O-desmethylangolensin (ODMA) might explain the inconsistency of the soy/isoflavones efficacy on ...cardiovascular health.
The study aims to evaluate the relationship between equol and ODMA phenotypes and cardiovascular risks with habitual isoflavone consumption in Chinese postmenopausal women.
This is a cross-sectional study among 726 prehypertensive postmenopal women who were screened for a randomized controlled trial. 648 women returned a daidzein-challenged urine samples for determination of equol and O-DMA production. 595 attended clinic visits for assessment of cardiovascular risks including body composition, blood pressure (BP), serum lipids, uric acid, high sensitivity C-reactive protein (hs-CRP), fasting glucose and free fatty acid (FFA).
The prevalences of equol and O-DMA producers were 53.2% and 60.9% respectively. Equol producers had higher fat free mass (p = 0.001), lower systolic (p = 0.01) and diastolic (p = 0.01) BP, serum triglyceride (p = 0.023), hs-CRP (p = 0.015) and FFA (p = 0.001) than non-producers. O-DMA producers had lower body fat% (p = 0.032), SBP (p = 0.02), total cholesterol (p = 0.002) than non-producers. The significant differences remained after further adjustment for potential confounders. The habitual soy isoflavones intake had little relation to cardiovascular risk factors in either equol/O-DMA producer phenotypes.
Equol/O-DMA producers had more favorable cardiovascular risk profiles than non-producers in prehypertensive postmenopausal women.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Longitudinal data with regard to the association between intrinsic capacity (IC) and mortality is required for prevention efforts. We examined the association between IC and 10-year mortality among ...older people.
We recruited a cohort of 2032 Chinese people aged 70 years and older, 1371 of them could be traced over follow-up, of which 1096 died within 10 years. Of those who were traceable, 846 were complete cases regarding the data for the exposure, outcome and covariates. Multiple imputation was used to handle missing data. Nine indicators were included to represent the construct of IC. All-cause mortality was collected from the Death Registry. Multivariable Cox proportional hazard regression model and Kaplan-Meier estimator were used to assess the association between IC and mortality.
The mean age of the 2032 participants was 79.7 years and 51 % were female. Compared with those in the lowest (best) quartile of IC, those in the highest (worst) quartile were associated with 1.48-fold (95 % CI 1.21–1.82) higher risk of mortality, after adjustment for sociodemographic variables. When past medical illnesses were further adjusted, the hazard ratio was attenuated (1.41; 95 % CI 1.15–1.73). Kaplan-Meier estimator for survival probability similarly showed a graded mortality pattern. The association between IC and mortality remained similar when the analysis was confined to community-dwelling older people.
IC is associated with mortality in a dose-response fashion. Assessment of IC should be instituted in community and institutional settings to enable formulation of early interventions.
This cross-sectional study aimed to explore the relationship between menopause status and attitude toward menopause, and also its relationship with quality of life (QoL) of Chinese midlife women in ...Hong Kong.
Hong Kong Chinese women aged 40 to 59 years were recruited through computer-generated random telephone dialing. Information was obtained through telephone interviews based on a structured questionnaire. Women were classified into 3 groups: premenopausal, perimenopausal, and postmenopausal. Menopause Belief Scale and Utian Quality of Life Scale (QoL) were used to measure respondents' attitude toward menopause and their QoL. Information on social, health, and lifestyle factors was also collected.
The mean age of the participants was 49.4 ± 5.2 years. Respondents generally had a positive attitude toward menopause. Compared with premenopausal women, postmenopausal women were noted to have significantly higher attitude score toward menopause. No significant differences in QoL score were noted among women of the 3 menopause statuses. Stepwise regression analysis showed that women with more positive attitude toward menopause tended to have higher QoL score. Furthermore, better self-reported health status, doing physical activities, higher education level, being married, and non-smoking status were associated with better QoL.
Postmenopausal women tended to have more positive attitude toward menopause. Although menopause status did not seem to be associated with QoL, attitude toward menopause, self-reported health status, as well as social and lifestyle factors were associated with QoL in Chinese midlife women.
The role of passive smoking on breast cancer risk was unclear. This study aimed to evaluate the association between passive smoking and breast cancer risk among Chinese women.
A hospital-based ...case-control study, including 877 breast cancer cases and 890 controls, frequency-matched by age and residence, was conducted. A structured questionnaire was used to collect information on passive smoking history through face-to-face interview by trained interviewers. Unconditional logistic regression models were used to estimate the association between passive smoking and breast cancer risk. A positive association between any passive smoking exposure and breast cancer risk was observed. Compared with women who were never exposed to passive smoking, women who were ever exposed had a higher breast cancer risk, with the adjusted odds ratio (OR) and 95% confidence interval (CI) of 1.35 (1.11-1.65). Similar result was found on home passive smoking exposure and breast cancer risk, but not on workplace passive smoking exposure. Women who were ever exposed to tobacco smoke at home had a higher risk of breast cancer compared with never exposed women, with the adjusted OR (95% CI) of 1.30 (1.05-1.61). Home passive smoking exposure showed significant dose-response relationships with breast cancer risk in smoker-years, cigarettes/day and total pack-years (Ptrend=0.003, 0.006 and 0.009, respectively). An increased total smoker-years of any passive exposure significantly elevated the risk of breast cancer (Ptrend<0.001). Positive associations and dose-response relationships were found among postmenopausal women and all subtypes of estrogen receptor (ER) and progesterone receptor (PR) status of breast cancer.
Passive smoking was associated with an increased risk of breast cancer among non-smoking Chinese women. A stronger positive association with breast cancer risk was seen mainly among postmenopausal women.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background: Evidence from animal and observational studies has supported the beneficial effects of soy intake on glycemic control, but intervention studies in humans have generated mixed results and ...have not been systematically examined.
Objective: We aimed to quantitatively evaluate the effects of soy intake on measures of glycemic control.
Design: We conducted a structured electronic search of PubMed, EMBASE, the Cochrane Library, and the China National Knowledge Infrastructure (updated to March 2010) databases for randomized controlled trials that described the effectiveness of different soy regimes on measures of glycemic control homeostatic model assessment of insulin resistance (HOMA-IR) and fasting glucose and insulin, glycated hemoglobin (Hb A1c), and 2-h glucose and insulin concentrations. Data on participants, interventions, outcomes, and potential effect modifiers were extracted independently. Weighted mean effect sizes were calculated for net changes by using fixed-effects or random-effects models. We performed prespecified subgroup analyses to explore the influence of covariates on net changes of fasting glucose and insulin concentrations.
Results: Twenty-four trials with a total of 1518 subjects were included in the meta-analysis. Soy consumption did not significantly affect measures of glycemic control. The mean (95% CI) difference was −0.69 mg/dL (−1.65, 0.27 mg/dL) for fasting glucose concentrations in the fixed-effects model (P = 0.16) and −0.18 mg/dL (−0.70, 0.34 mg/dL) for fasting insulin concentrations in the random-effects model (P = 0.50). Significant heterogeneity was noted in the results of fasting insulin concentrations and HOMA-IR.
Conclusions: There was not a significant overall effect of soy intake on improvements of fasting glucose and insulin concentrations; however, a favorable change in fasting glucose concentrations was observed in studies that used whole soy foods or a soy diet in the subgroup analysis. Evidence for other glycemic variables such as Hb A1c and 2-h postchallenge glucose and insulin concentrations was limited because of the small number of trials.
Background
Social isolation in older people has been increasingly regarded as a public health issue in the face of rapid population ageing. It is not clear whether social isolation mediates the ...relationship between socioeconomic status and functional impairment.
Methods
We used data from a cohort of Chinese older people aged 70 or older living in community (
n
= 1590). Socioeconomic status (SES) was operationalised as highest education attainment, monthly income at baseline and longest held occupation in lifetime. Functional abilities were measured using Barthel’s Index for activities of daily living (ADL) measured at 18 and 36 months of follow-up, from which impairment was defined as score ≤ 19. Social isolation was measured by six attributes, such as marital status, living alone, and social contact with others. A score of ≥ 3 was defined as being in social isolation. Causal mediation analysis using natural effect models was used to assess mediation by social isolation.
Results
We found that lower monthly income at baseline was related to higher risk of social isolation relative risk comparing lowest to highest income (RR) = 1.52, 95% confidence interval (95% CI) 1.01–2.28. Social gradient of ADL impairment was not clearly present. The evidence for the mediating role of social isolation was not clear.
Conclusions
Older people with low SES, particularly those with lower income, were at greater risk of social isolation. Policymakers should strive to improve the current community services and pension scheme to mitigate the situation of social isolation in older people in Hong Kong.
To assess the validity of self-reported weight, height, body mass index (BMI), waist circumference and blood pressure compared with standardized clinical measurements and to determine the ...classification accuracy in overweight/obesity and central adiposity.
This pilot study was integrated into a life-course study entitled "Hong Kong Women's Health Study" among 1,253 female nurses in Hong Kong who were aged 35 years to 65 years. Data were collected from self-administered questionnaires that were mailed to the respondents. Of these participants, we obtained the standard body measurements of 144 (11.5%) at our research center. We then compared the self-reported anthropometric variables and blood pressure with the measured data to assess validity based on the level of misreporting, percentage of agreement, consistency, sensitivity and specificity.
The self-reported and measured values were highly correlated in terms of anthropometry and blood pressure (correlation coefficients ranged from 0.72 to 0.96). Height was overestimated at an average of 0.42 cm, and waist circumference was underestimated at 2.33 cm (both P<0.05), while no significant differences were observed from weight, blood pressure and BMI (all P>0.05). The proportions of overweight, obesity, and central adiposity by self-reported data did not vary greatly from the measured data (all P>0.05). The self-reporting resulted in correct classifications of BMI, waist circumference, and systolic blood pressure in 85%, 78%, and 87% of women, with corresponding Kappa index values of 0.79, 0.55, and 0.82, respectively. Sensitivity and specificity were 84.6% and 95.7%, respectively, with respect to overweight/obesity detection, whereas those for central adiposity detection were 70.6% and 83.8%, respectively.
In a sample of female Hong Kong nurses, the self-reported measures of height, weight, BMI, waist circumference and blood pressure were generally valid. Furthermore, the classification accuracies of overweight/obesity and central adiposity were acceptable.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
PDF
