Effects of plant oils with different fatty acid composition on cardiovascular risk factors in moderately hypercholesteremic Chinese adults: a randomized, double-blinded, parallel-designed trial.

OBJECTIVES: Plant oil for cooking typically provides 40% to 50% of dietary fat, 65% of linoleic acid, 44% of α-linolenic acid and 41% of oleic acid in the Chinese diet. However, the comparative effects of fatty acids derived from plant oil on cardiovascular risk factors in Chinese are still inconclusive. Hence, the aim of this study is to investigate whether cardiovascular risk factors are altered depending on various types of plant oils such as peanut oil rich in oleic acid, corn oil rich in linoleic acid, and blend oil fortified by α-linolenic acid. DESIGN: A randomized, double-blinded, parallel-designed trial. SETTING: The First and the Second Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. PARTICIPANTS: A total of 251 volunteers with fasting blood total cholesterol between 5.13 and 8.00 mmol L-1 were enrolled. INTERVENTION: Volunteers received peanut oil, corn oil or blend oil to use for cooking for one year. MAIN OUTCOME MEASURES: The erythrocyte membrane fatty acid composition, fasting plasma lipids, glucose and insulin concentrations and high sensitivity C-reactive protein (hsCRP) levels were measured before, during and after the intervention. The level of α-linolenic acid in erythrocyte membranes was significantly increased in the blend oil group after the intervention (P < 0.001). The level of other fatty acids did not show any statistically significant differences between the three groups. No significant differences were observed in the concentrations of fasting plasma lipids, hsCRP, glucose, and insulin among the three groups using different types of plant oils. CONCLUSIONS: The results suggest that although ingesting cooking oil with different fatty acid composition for one year could change erythrocyte membrane fatty acid compositions, it did not significantly modify cardiovascular risk factors in moderately hypercholesteremic people.

The effects of different levels of calcium supplementation on the bone mineral status of postpartum lactating Chinese women: a 12-month randomised, double-blinded, controlled trial.

Increasing dietary Ca intake may prevent the excessive mobilisation of bone mineral in nursing mothers. We aimed to investigate whether higher Ca intake could positively modulate the bone mineral changes in Chinese postpartum lactating women. The study was a 12-month randomised, double-blinded, parallel group trial conducted over 12 months. A total of 150 postpartum women were randomly selected to receive either 40 g of milk powder containing 300 mg of Ca and 5 µg of vitamin D (Low-Ca group) or same milk powder additionally fortified with 300 mg of Ca (Mid-Ca group) or 600 mg of Ca (High-Ca group). Bone mineral density (BMD) for the whole body, the lumbar spine, the total left hip and its sub-regions was measured using dual-energy X-ray absorptiometry. A total of 102 subjects completed the whole trial. The duration of total lactating time was 7·9 (SD 2·8) months on average. The intention-to-treat analysis yielded the following mean percentage changes in BMD for the whole body, the lumbar spine and the total left hip, respectively: -0·93 (SD 1·97), 2·11 (SD 4·90) and -1·60 (SD 2·65)% for the Low-Ca group; -0·56 (SD 1·89), 2·21 (SD 3·77) and -1·43 (SD 2·30)% for the Mid-Ca group; and -0·44 (SD 1·67), 2·32 (SD 4·66) and -0·95 (SD 4·08)% for the High-Ca group. The differences between the groups were not statistically significant (P: 0·5-0·9). The results of the complete case analysis were similar. In sum, we found no significant differences in the bone mineral changes from baseline to 12 months in postpartum lactating women consuming milk powder fortified with different levels of Ca.

Association between n-3 polyunsaturated fatty acids in erythrocytes and metabolic syndrome in Chinese men and women.

PURPOSE: Evidence of an association between n-3 polyunsaturated fatty acids (PUFAs) and metabolic syndrome (MS) is limited and inconsistent. We investigated the association between n-3 PUFAs in erythrocytes and the presence of MS in Chinese adults. METHODS: The levels of α-linolenic acid (ALA), eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA) in erythrocytes were measured using gas chromatography in 3072 participants (900 men and 2172 women) aged 30-75 years from Guangzhou, China. Cardiometabolic factors were determined, and MS was defined using the updated Adult Treatment Panel III criteria. Other covariates were collected via interviewer-administered questionnaires. RESULTS: After adjusting for age and other confounders, higher levels of marine-derived n-3 PUFAs, including EPA, DPA, and DHA, were associated with a lower presence of metabolic syndrome in both men and women. The odds ratios (95 % confidence interval) for MS obtained by comparing extreme quartiles were 0.55 (0.35-0.88) (EPA), 0.54 (0.34-0.87) (DPA), 0.45 (0.27-0.73) (DHA), and 0.52 (0.32-0.84) (total n-3 PUFAs) in men (p trend <0.05 for all results); and 0.74 (0.56-0.99) (EPA), 0.73 (0.55-0.98) (DPA), 0.75 (0.56-1.02) (DHA), and 0.71 (0.53-0.96) (total n-3 PUFAs) in women, respectively. No significant association of ALA with MS was observed (p trend > 0.05). CONCLUSION: Higher levels of total n-3 PUFAs, EPA, DPA, and DHA, but not of ALA, in erythrocyte membranes are associated with a lower presence of metabolic syndrome in Chinese adults.

Calcium supplementation and bone mineral accretion in Chinese adolescents aged 12-14 years: a 12-month, dose-response, randomised intervention trial.

A 12-month, dose-response, randomised, intervention trial was conducted to determine adequate Ca intake levels for Chinese adolescents by investigating the effect of Ca supplementation on bone mineral accretion. A total of 220 Han adolescents (111 girls and 109 boys) aged 12-14 years were recruited. All subjects were randomly divided into three groups. The bone mineral content (BMC) and bone mineral density (BMD) of the whole body, lumbar spine (L1-L4), left hip and femoral neck were measured by dual-energy X-ray absorptiometry. Girls in the high-Ca group (actual Ca intake: 1243 (sd 193) mg/d) exhibited greater increases in the femoral neck BMC compared with those in the low-Ca group (9·7 v. 6·4 %, P =0·04) over the 1-year intervention period. The increases in femoral neck BMC were greater in boys in the high-Ca and medium-Ca groups (actual Ca intake: 985 (sd 168) mg/d) than in those in the low-Ca group (15·7 v. 11·7 %, P =0·03; 15·8 v. 11·7 %, P =0·03). Ca supplementation had significant effects on the whole-body BMC and BMD in subjects with physical activity levels>34·86 metabolic equivalents and on the spine BMD and BMC and BMD of most sites in subjects with Tanner stage < 3. Increasing Ca intake levels with Ca supplementation enhanced femoral neck mineral acquisition in Chinese adolescents. Furthermore, high physical activity levels and low Tanner stage appeared to significantly contribute to the effect of Ca supplementation on bone mass. Whether this is a lasting beneficial effect leading to the optimisation of peak bone mass needs to be determined in other long-term prospective studies.

Effects of milk salt supplementation on bone mineral gain in pubertal Chinese adolescents: a 2-year randomized, double-blind, controlled, dose-response trial.

BACKGROUND/OBJECTIVE: Adequate calcium intakes may enhance bone mineral accumulation during childhood. Little is known about the optimal calcium intake in Chinese adolescents. We examined the effects of three levels of calcium intake on bone mineral accretion in adolescents. METHODS: This was a 2-year randomized, double-blind, controlled trial. The subjects were randomly assigned to receive 40 g of milk powder containing 300 mg of calcium and 200 IU of vitamin D (Low-Ca group), or same milk powder additionally fortified with 300 mg of calcium (Mid-Ca group) or 600 mg of calcium (High-Ca group) for 2 years. The subjects' bone mineral density (BMD) and bone mineral content (BMC) at the total body, lumbar spine and left hip were determined by dual-energy X-ray absorptiometry at baseline and after the second year of treatment. Of the 111 girls and 109 boys (aged 12-14 years) enrolled, 91 girls and 91 boys completed the trial. RESULTS: The girls in the High-Ca group (1,110 mg/d) had 2.3%, 2.7% and 2.6% greater BMD accretion at the total hip, femoral neck and shaft (P<0.05) but not at total body less head and spine than those in the Low-Ca group (655 mg/d). A significant effect of higher calcium intake was also observed for percentage change of size-adjusted BMC at femur neck (P=0.047). Bonferroni tests indicated no significant differences in the percentage changes in BMD, BMC or size-adjusted BMC between the Mid- and Low-Ca groups and between the High- and Mid-Ca groups. Extra calcium had no observable additional effect in the boys (P>0.05). CONCLUSION: An intake of 1000 mg/d or more might be helpful in maximizing bone mineral accretion in the hip for girls. But further large studies are required to identify its long-term effects and the optimal calcium intake for boys.

Erythrocyte membrane n-3 fatty acid levels and carotid atherosclerosis in Chinese men and women.

OBJECTIVE: Prospective studies have supported the beneficial effects of n-3 fatty acid consumption on cardiac deaths, but limited data focused on atherosclerosis. We investigated the associations between n-3 fatty acids in erythrocytes and atherosclerosis in middle-aged and older Chinese. METHODS: 847 subjects (285 men and 562 women), aged 40-65 years, from Guangzhou, China were included in this community-based cross-sectional study between December 2005 and January 2008. The levels of α-linolenic acid (ALA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in erythrocytes were measured by gas chromatography. Carotid ultrasound examination was conducted to obtain intima-media thickness of the common carotid artery and the carotid bifurcation. Dietary data and other covariates were collected using interviewer-administered questionnaires. RESULTS: After adjustment for age, sex, and other confounders, negative dose-response associations between the contents of individual n-3 polyunsaturated fatty acids in the erythrocyte membrane and the prevalence of carotid artery wall thickening and plaque were observed. A comparison in the highest and lowest tertiles gave odds ratios (95% confidence interval) for thickening in the walls of the common carotid artery of 0.58 (0. 34-0.97; P-trend = 0. 037) for DHA, and 0.39 (0.23-0.67; P-trend < 0.001) for ALA. However, EPA was not significantly associated with carotid atherosclerosis. Similar results were found for thickening at the carotid bifurcation and the occurrence of carotid artery plaque. CONCLUSIONS: Higher levels of DHA and ALA in the erythrocyte membrane were significantly associated with a lower burden of subclinical atherosclerosis.

Fruit and vegetable intake and bone mass in Chinese adolescents, young and postmenopausal women.

OBJECTIVE: Previous studies showed an inconsistent association of fruit and vegetable consumption with bone health. We assessed the associations in Chinese adolescents, young and postmenopausal women. DESIGN: A cross-sectional study conducted in China during July 2009 to May 2010. SETTING: Bone mineral density (BMD) and content (BMC) at the whole body, lumbar spine and left hip were measured with dual-energy X-ray absorptiometry. Dietary intakes were assessed using an FFQ. All these values were separately standardized into Z-scores in each population subgroup. SUBJECTS: One hundred and ten boys and 112 girls (11-14 years), 371 young women (20-34 years, postpartum within 2 weeks) and 333 postmenopausal women (50-70 years). RESULTS: After adjustment for potential covariates, analysis of covariance showed a significantly positive association between fruit intake and BMD and BMC in all participants combined (P-trend: < 0.001 to 0.002). BMD Z-score increased by 0.25 (or 2.1 % of the mean), 0.22 (3.5 %), 0.23 (3.0 %) and 0.25 (3.5 %), and BMC Z-score increased by 0.33 (5.7 %), 0.25 (5.8 %), 0.34 (5.9 %) and 0.29 (4.7 %), at the total body, lumbar spine, total hip and femoral neck in participants belonging to the top tertile compared with the bottom tertile of fruit intake (all P < 0.05), respectively. There was no significant association between vegetable intake and bone mass at all bone sites studied except for total body BMD (P = 0.030). Relatively more pronounced effects were observed in boys and postmenopausal women. CONCLUSION: Our findings add to the existing evidence that fruits and vegetables may have a bone sparing effect.

Soy germ isoflavones improve menopausal symptoms but have no effect on blood lipids in early postmenopausal Chinese women: a randomized placebo-controlled trial.

OBJECTIVE: Estrogen therapy is, to date, the most effective treatment of menopausal syndrome and also has a favorable effect on lipid profiles. Because of its potential adverse effects, however, a more acceptable alternative therapy needs to be identified. This study examines the effect of soy germ isoflavones on menopausal symptoms and serum lipids. METHODS: Ninety early postmenopausal Chinese women, aged 45 to 60 years, were randomly assigned to three treatment groups (30 each) receiving daily doses of 0 (placebo), 84, and 126 mg of soy germ isoflavones. Hot flush frequency, Kupperman scores, serum 17ß-estradiol, follicle-stimulating hormone, luteinizing hormone, and serum lipids, including triglyceride, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, apolipoprotein A-I, and apolipoprotein B100, were assessed at baseline and at 12 and 24 weeks after treatment. RESULTS: Both the frequency of hot flushes and the Kupperman index score decreased in all three treatment groups during the intervention period, but the percentage decreases in both were significantly greater in the two isoflavone groups (44.3 ± 19.1 and 57.8 ± 37.4 [84 mg isoflavones]; 48.5 ± 27.2 and 56.7 ± 26.7 [126 mg isoflavones]) than in the placebo group (27.8 ± 15.5 and 34.6 ± 46.2; p < 0.01). There was no significant difference in the changes in estradiol, follicle-stimulating hormone, and luteinizing hormone among the three treatment groups during the study, and no significant differences were observed in the lipid components. CONCLUSIONS: A daily supplement of 84 or 126 mg soy germ isoflavones may improve menopausal symptoms, although neither dose was found to affect lipid profiles in early postmenopausal Chinese women after 24 weeks of treatment. The favorable effects are unlikely to be associated with female hormones.

Effect of milk and calcium supplementation on bone density and bone turnover in pregnant Chinese women: a randomized controlled trail.

OBJECTIVE: Calcium demand is increased during pregnancy. However, few randomized controlled trials examined the effects of calcium supplementation on bone mass during pregnancy. This study determined effects of calcium and milk supplementation on maternal bone mineral density (BMD) and bone turnover in pregnant Chinese women with habitual low calcium intake. METHODS: In this randomized controlled trial, 36 Chinese pregnant women (24-31 years, 18 gestational weeks) were randomly assigned to the following three arms (12 each): I, usual diet; II, "I" + 45 g milk powder (containing 350 mg calcium); or III, "II" + 600 mg calcium/day from gestational age of 20 weeks to 6 weeks post-partum (PP). BMD was measured post-treatment using dual-energy X-ray absorptiometry. Dietary intakes, 24-h urinary calcium, bone resorption (urinary hydroxyproline) and formation (serum osteocalcin) biomarkers were examined at the gestational age of 20 and 34 weeks, and 6 weeks PP. RESULTS: A dose-dependent relationship was observed between calcium intake and BMDs. The BMD values were significantly higher in subjects with calcium and milk supplementation than those in the controls at the whole body and spine (p < 0.05) but not at the hip sites. We found significant decreases in changes of urinary hydroxyproline, and significant increases in serum osteocalcin during the intervention period in the calcium/milk intervention groups than those in the control group (all p < 0.05). CONCLUSION: Calcium/milk supplementation during pregnancy is associated with greater BMD at the spine and whole body and suppresses bone resorption in Chinese women with habitual low calcium intake.

Effect of long-term intervention of soy isoflavones on bone mineral density in women: a meta-analysis of randomized controlled trials.

INTRODUCTION: A number of RCTs have examined the role of soy isoflavones on bone mineral density (BMD) and yielded inconsistent results. This meta-analyses aims to assess the overall effect of soy isoflavones on BMD. METHODS: We searched for all articles published in English from January 1990 to March, 2008. We included RCTs of soy isoflavone supplementation in women of at least one year duration. The main outcomes were BMD changes from baseline at the lumbar spine, total hip and femoral neck. RESULTS: We identified 10 eligible RCTs containing 896 women. A mean dose of 87 mg soy isoflavones for at least one year did not significantly affect BMD changes. The mean (95%CI) differences in BMD changes (in mg/cm(2)/year) were 4.1 (-1.6, 9.8) (0.4%) at the lumbar spine, -1.5 (-7.2, 4.3) (-0.3%) at the femoral neck under random-effects model, and 2.5 (-0.5, 5.4) (0.2%) at the total hip by fix-effects model, respectively. Similar results were obtained in subgroup analyses by isoflavone sources (soy protein vs. isoflavone extract), ethnic differences (Asian vs. Western). Larger dose (>or=80 mg/d), but not lower dose (<80 mg/d), of isoflavone intervention tended to have a weak beneficial effect on spine BMD (p=0.08 vs. p=0.94). CONCLUSIONS: Soy isoflavone supplementation is unlikely to have significant favorable on BMD at the lumbar spine and hip in women.

[Study of effects of dietary fatty acids on the serum lipids in hypercholesterolemic subjects].

OBJECTIVE: To study the effects of dietary fatty acids on the serum lipids in hypercholesterolemic subjects. METHODS: All 297 residents with hypercholesterolemia were enrolled in Guangzhou. The dietary composition and the changes in serum lipid levels during the 6-month follow-up were analyzed. RESULTS: (1) 297 subjects were enrolled and 281 subjects (88 male, 193 female) completed the 6-month follow-up. The serum TC concentration of the subjects was (6.09+/-0.68) mmol/L at baseline. (2) According to the percentage of energy from total fat, all of the subjects were divided into three groups, including total fat % en<25% (group I, 90 subjects), 25%-30% (group II, 97 subjects), >30% (group III, 94 subjects). The reduction of TC and LDL-C in group I and group II was greater than that in group III. (3) According to the percentage of energy from SFA, all of the subjects were divided into three groups, including SFA % en<7% (group I, 81 subjects), 7%-10% (group II, 129 subjects), >10% (group III, 71 subjects). The reduction of TC and LDL-C in group I and group II was greater than that in group III. (4) All of the subjects were divided into three groups, according to the percentage of energy from MUFA, including MUFA % en<10% (group I, 93 subjects), 10%-13% (group II, 106 subjects), >13% (group III, 82 subjects). The reduction of TC and LDL-C in group II was greater than that in group I and group III. (5) All of the subjects were divided into three groups according to the percentage of energy from PUFA, including PUFA % en<7% (88 subjects), 7%-9% (94 subjects), >9% (99 subjects). No significant difference was found among the reduction of serum lipids in the three groups. CONCLUSION: Dietary total fat % en

[Effects of soybean isoflavone on born metabolism and morphology in animal model of osteoporosis rats].

OBJECTIVE: To study the effects of soybean isoflavone (SI) on born metabolism and morphology in animal model of osteoporosis rats. METHODS: All 70 female Sprague-Dawley (SD) rats were randomly divided into 7 groups according to the levels of total cholesterol (TC) in serum: hyper-lipoid group, estrogen group, low-dose SI group, middle-dose SI group, high-dose SI group, sham group and normal control groups. Bilateral ovaries were extirpated except sham and normal control groups. Except the rats in normal control group, the other rats were fed with high fat diet. Body weight was weighted ad unam vice per week. The estrogen, different dose of SI or deionized water were fed with intragastric administration for 12 weeks. Vena caudalis serum were collected after being ovariectomized, administered for 4 w, 8 w and killed. Serum alkaline phosphatase (AKP) activity and bone density were measured etc. RESULTS: To interfere of estrogen and SI might recover AKP enzyme activity after its being ovariectomized. There almost sowed no differences between high dose SI intervention and estrogen on bone density and microstructure. Bone loss due to being ovariectomized was relieved after SI intervention. SI might protect cardiocyte myofilament and mitochondrial ultramicrostructure. There was mirror image in estrogen, high dose SI group resembling the normal control group, and there was obvious damage in hyper-lipoids group. CONCLUSION: There should be effects of high dose SI on bone metabolism and morphology in animal model of osteoporosis rats. Serum AKP enzyme activity and bone density should have significantly recovered, the serum level of calcium and phosphorus were maintained after high dose intervened but no significant effects for low dose of SI.

Soy isoflavones attenuate bone loss in early postmenopausal Chinese women : a single-blind randomized, placebo-controlled trial.

BACKGROUND: Previous studies show that daily doses of 40-99 mg soy isoflavones produce inconsistent effects on preventing estrogen-related bone loss in postmenopausal women. AIM OF THE STUDY: To examined the bone-sparing effect of isoflavones at a higher dose in early Chinese postmenopausal women. METHODS: A total of 90 eligible women aged 45-60 years were randomly assigned to three treatment groups (30 subjects/group) with daily dosages of 0 (placebo), 84 and 126 mg isoflavones for 6 months. Further inclusion criteria included body mass index <30 kg/m(2) and Kuppermann Climacteric Scale >15. Bone mineral density (BMD) of the spine and hip were measured using dual- energy X-ray absorptiometry at 0 and 6 months. Serum osteocalcin, bone-specific alkaline phosphatase (BAP) and urinary deoxypyridinoline were examined at 0, 3 and 6 months. RESULTS: Mean percent changes in BMD at the lumbar spine (p = 0.114) and femoral neck (p = 0.053) increased with the supplementations of soy isoflavones after adjusting for age, years since menopause, body weight and height, dietary intakes of isoflavones, calcium and protein, physical activities and baseline BMD at the relevant sites. We observed significantly dose-dependent linear relationship between the supplemental isoflavones and percent changes of BMD at the spine (p = 0.042) and femoral neck (p = 0.016) post-treatment, and urinary total deoxypyridinoline (p = 0.014) at 12 weeks but not at 24 weeks after adjusting for the above factors. No significant difference in percent changes in serum osteocalcin (p > 0.05) and BAP (p > 0.05) was found among the three treatment groups at 12-week and 24-week post-treatment. CONCLUSION: There is a significantly dose-dependent effect of soy isoflavones on attenuating bone loss at the spine and femoral neck possibly via the inhibition of bone resorption in non-obese postmenopausal Chinese women with high Kuppermann Scale.

[Effect of dietary n-6/n-3 polyunsaturated fatty acid ratio on spleen lymphocyte's function and fatty acid composition in mice].

OBJECTIVE: To study the effect of dietary n-6/n-3 PUFA ratio on spleen lymphocyte's function and fatty acid composition in mice. METHODS: Male BALb/c mice were divided into 5 groups: the dietary S : m : p was 1 : 1.5 : 1 n-6/ n-3 PUFA ratio was 1, 7.5, 15, 30 respectively, and in the control group, dietary S : M : P was 1 : 1.5 : 3.7, which was followed the AIN-93G formulation. All groups consumed purified diet based on the AIN-93G formulation. The different n-6/ n-3 PUFA ratios in diets were varied by mixing of oils. After 12 wks breeding, all mice were sacrificed, and the function and fatty acid composition of Lymphocyte, IL-2 and PGE2 concentration were measured. RESULTS: When dietary n-6/n-3 PUFA ratio approximated 1, the lymphocyte proliferation, proportions of CD4+ and CD8+ T cell, IL-2 and PGE2 concentration decreased significantly. The concentration of C18 : 2, C20 : 4, n-6 PUFA in lymphocyte decreased significantly; Meanwhile, the concentration of C22 : 6, C16 : 1, C18 : 1 and total MUFA in lymphocyte significantly higher than other groups. The concentration of C2 : 6 in lymphocytes were significantly negative correlated with the proliferation of spleen lymphocytes. The concentration of C20 : 5 in lymphocyte was significantly negative correlated with the proportions of CD4+ T cell and IL-2 level. The concentration of C16 : 1 in lymphocyte was significantly negative correlated with the proportions of CD4+ and CD8+ T cell. CONCLUSION: The fatty acid composition of diet affected that of lymphocyte in mice. Compared with the T lymphocyte function in diet with n-6/n-3 ratio approximated 30, the T lymphocyte function in mice was suppressed when dietary n-6/n-3 ratio approximated 1.