Phyto-oestrogens and risk of prostate cancer in Scottish men.

A population-based case-control study of diet, inherited susceptibility and prostate cancer was undertaken in the lowlands and central belt of Scotland to investigate the effect of phyto-oestrogen intake and serum concentrations on prostate cancer risk. A total of 433 cases and 483 controls aged 50-74 years were asked to complete a validated FFQ and provide a non-fasting blood sample. Multivariate logistic regression analysis found significant inverse associations with increased serum concentrations of enterolactone (adjusted OR 0.40, 95 % CI 0.22, 0.71] and with the consumption of soy foods (adjusted OR 0.52, 95 % CI 0.30, 0.91). However, no significant associations were observed for isoflavone intake or serum genistein, daidzein and equol. This study supports the hypotheses that soy foods and enterolactone metabolised from dietary lignans protect against prostate cancer in older Scottish men.

Phyto-oestrogen intake in Scottish men: use of serum to validate a self-administered food-frequency questionnaire in older men.

OBJECTIVE: To study dietary intake and serum concentrations of isoflavones in order to provide relative validation of isoflavone intake estimates from the Scottish Collaborative Group - Food-Frequency Questionnaire (SCG-FFQ). DESIGN: Validation study. SETTING: Southern Scotland. METHOD: Dietary intake of isoflavones was estimated using the semiquantitative SCG-FFQ and rank correlation and Kappa statistics were used for the relative validation of intakes against serum isoflavone concentrations in 203 male participants who were population controls in a case-control study of diet and prostate cancer. RESULTS: The median intake of isoflavones (daidzein and genistein) was 1.0mg/day (l-QR 0.6-1.8). The median serum concentration of genistein was 33.79 nmol/l (I-QR 14.12-64.93), nearly twice that of daidzein (18.00 nmol/l, I-QR 8.26-29.45). Equol was detected in 49% of subjects; in these subjects the median was 0.67 nmol/l (I-QR 0.34-1.51). Isoflavone intake was significantly correlated with serum concentrations of daidzein (p = 0.24, P = 0.001), genistein (p = 0.26, P < 0.001) and total isoflavonoids (sum of daidzein, genistein and equol) ( p = 0.27, P < 0.001). Whereas values for weighted Kappa ranged from 0.16 (P = 0.002) for daidzein and equol combined to 0.22 (P < 0.001) for genistein. CONCLUSIONS: These results demonstrate the suitability of the SCG-FFQ to rank usual isoflavone intakes in older Scottish men, a population observed to have low consumption of soy foods.

Nutritional supplementation in older adults: pleasantness, preference and selection of sip-feeds.

OBJECTIVES: Malnourishment is common in older adults, and nutritional supplementation is used to improve body weight and well-being. Clinical reports suggest, however, that patients routinely reject sip-feeds. The present study examined the following questions: whether sip-feeds are less preferred and less likely to be selected than other energy-dense foods in healthy elders; and whether eating alone further reduces intake relative to eating in a social setting. METHODS: Twenty-one healthy older adults (aged 60-79 years) attended the laboratory on three occasions. Subjects rated six different flavours of sip-feed and then rated the pleasantness of the taste of the favoured flavour against five other energy-dense familiar foods/drinks. Intake of these foods was measured when subjects ate alone or in a group of familiar others. RESULTS: Favourite flavour of sip-feed compared well with other more familiar foods and was selected as part of a snack. Snack intake increased by 60% when consumed in a group setting compared with eating alone. CONCLUSIONS: The study suggests that sip-feeds are rated as pleasant and selected by free-living elders. Rejection of sip-feeds in hospitalized elders may relate more to loss of appetite than to the taste preference for sip-feeds, and that eating alone rather than in groups of familiar others is likely to compound eating problems.

Intake and sources of phylloquinone (vitamin K1): variation with socio-demographic and lifestyle factors in a national sample of British elderly people.

Intake and sources of phylloquinone (vitamin K1) were examined according to socio-demographic and lifestyle factors in free-living British people aged 65 years and over, from the 1994-5 National Diet and Nutrition Survey. Complete 4-d weighed dietary records were obtained from 1152 participants living in private households. Using newly-available, mainly UK-specific food content data, the weighted geometric mean intake of phylloquinone was estimated at 65 (95 % CI 62, 67) microg/d for all participants, with higher intakes in men than in women (70 v. 61 microg/d respectively, P<0.01). The mean nutrient densities of phylloquinone intake were 9.3 and 10.5 microg/MJ for men and women respectively (P<0.01), after adjusting for age group, region and smoking status. Of all the participants, 59 % had phylloquinone intakes below the current guideline for adequacy of 1 microg/kg body weight per d. Participants aged 85 years and over, formerly in manual occupations, or living in Scotland or in northern England reported lower phylloquinone intakes than their comparative groups. Overall, vegetables contributed 60 % of total phylloquinone intake, with cooked green vegetables providing around 28 % of the total. Dietary supplements contributed less than 0.5 % of phylloquinone intake. Participants living in northern England or in Scotland, in particular, derived less phylloquinone from vegetables than those living in southern England.

Preferences for different high-energy foods in elderly medical in-patients.

Malnourishment is a common finding in hospitalised elderly patients. It is often addressed by the provision of nutritional supplements, in the form of sip-feeds. Patients' intake of these is frequently inadequate. We assessed the palatability of sip-feed nutritional supplements and other high-energy foods to elderly medical in-patients. Using the Lickhert Scale, 49 subjects rated the taste of a previously selected sip-feed supplement and five other high-energy foods, cheese biscuit, plain potato crisps, chocolate, cherry-flavoured cereal bar and stout beer. Subjects rated the taste of sip-feeds as favourably as all other offered foods, with the exception of the lower rated stout beer (p = 0.0001). Taste alone is unlikely to account for the poor intake of sip-feed nutritional supplements by elderly hospital patients.

Compilation of a provisional UK database for the phylloquinone (vitamin K1) content of foods.

This paper reports the compilation of a food composition database for phylloquinone (vitamin K1) derived from the direct analysis of foods, recipe calculation and the assignment of values based on food similarities. All the basic and other food items used in these calculations had been analysed by HPLC and about 170 of the items had been obtained and assayed in the UK. Recipe calculations took account of the cooking method and changes in water and fat content. Currently, approximately 1501 food items with Royal Society of Chemistry/Ministry of Agriculture, Fisheries and Food food codes have been allocated a vitamin K1 value, and a further 282 new recipe codes are included in the database. Representative values from each food group are reported together with an indication of the potential variation. Detailed examples of some recipe calculations are included, and also the impact of changing the type of fat in recipes. Vitamin K1 is associated with, and most abundant in, photosynthetic tissues of plants. Accordingly, the highest concentrations (3000-6000 micrograms/kg) are found in dark-green leafy vegetables and herbs, such as kale, parsley, spinach and green cabbage. Intermediate concentrations (1000-2000 micrograms/kg) are found in plants with paler leaves such as white cabbage and lettuce or in green, non-leafy vegetables such as broccoli and brussel sprouts. Fats and oils contain variable amounts of vitamin K1 with the highest concentrations (300-1300 micrograms/kg) in soyabean, rapeseed and olive oils and the margarines based on them. Other foods such as dairy products, meat dishes and cereal-based foods (bread, biscuits, cakes, desserts etc.), although not in themselves particularly rich in vitamin K1 (< 200 micrograms/kg), may contribute significantly to intakes when consumption of green vegetables is poor. Within the scope of this present study, it has not been possible to address issues such as inter-sample variability, losses during storage or the bioavailability from different foods and further work on these aspects is needed.

Plasma vitamin C and food choice in the third Glasgow MONICA population survey.

STUDY OBJECTIVE: To determine the contribution of different foods to the estimated intakes of vitamin C among those differing in plasma vitamin C levels, and thereby inform dietary strategies for correcting possible deficiency. DESIGN: Cross sectional random population survey. SETTING: North Glasgow, Scotland, 1992. PARTICIPANTS: 632 men and 635 women, aged 25 to 74 years, not taking vitamin supplements, who participated in the third MONICA study (population survey monitoring trends and determinants of cardiovascular disease). MEASUREMENTS AND MAIN RESULTS: Dietary and sociodemographic information was collected using a food frequency and lifestyle questionnaire. Plasma vitamin C was measured in non-fasted venous blood samples and subjects categorised by cut points of 11.4 and 22.7 micromol/l as being of low, marginal or optimal vitamin C status. Food sources of dietary vitamin C were identified for subjects in these categories. Plasma vitamin C concentrations were compared among groups classified according to intake of key foods. More men (26%) than women (14%) were in the low category for vitamin C status; as were a higher percentage of smokers and of those in the older age groups. Intake of vitamin C from potatoes and chips (fried potatoes) was uniform across categories; while the determinants of optimal versus low status were the intakes of citrus fruit, non-citrus fruit and fruit juice. Optimal status was achieved by a combined frequency of fruit, vegetables and/or fruit juice of three times a day or more except in older male smokers where a frequency greater than this was required even to reach a marginal plasma vitamin C level. CONCLUSION: Fruit, vegetables and/or fruit juice three or more times a day increases plasma vitamin C concentrations above the threshold for risk of deficiency.

Evidence for age-related differences in the fatty acid composition of human adipose tissue, independent of diet.

OBJECTIVE: To test the null-hypothesis that no age difference in adipose tissue fatty acid composition exists independent of dietary fat intake. DESIGN: A cross-sectional survey of coronary heart disease risk factors, the Scottish Heart Health Study, provided needle biopsy adipose tissue fatty acid data and food frequency-derived dietary data. SETTING: Twenty-two Scottish Districts between 1984 and 1986. SUBJECTS: A total of 10,359 men and women aged 40-59 y were randomly recruited in sex and five-year age bands from GP lists. A sub-set of 2308 men and 2049 women (42%) provided satisfactory adipose tissue and dietary data. MAIN OUTCOME AND MEASURES: Multiple regression analysis (adjusting for dietary fats, body mass index and smoking, with and without menopause status for women) of the relationship between individual fatty acids in adipose tissue and age, and between age and the ratio of linoleic acid (C18:2, n-6) to gamma-linolenic acid (C18:3, n-6) as an indicator of delta-6 desaturase activity. RESULTS: Sex-consistent changes with age occurred for linoleate (adjusted regression slope +/- s.e. for men -0.299 +/- 0.1339 and for women -0.504 +/- 0.1731) and gamma-linolenate (adjusted regression slope +/- s.e. for men -0.141 +/- 0.0341 and for women -0.154 +/- 0.0469) both P < 0.0001. These changes gave rise to a significant increase (P < or = 0.005) in the C18:2, n-6 to C18:3, n-6 ratio with age). Dihomo-gamma-linolenic acid (C20:3, n-6) and docosahexa- plus docosapentaenoic acids (C22:5 + C22:6, n-3) also increased significantly with age (P < or = 0.01). For the latter, the adjusted regression slopes were far greater for women (0.596 +/- 0.0575) than men (0.131 +/- 0.0417). CONCLUSIONS: The results show that ageing does influence adipose tissue fatty acid composition independent of diet. The sex differences may partially be due to inadequate adjustment for changes in sex hormone status in males with ageing. Using the current indicator, a decline in the rate limiting step of beta-6 desaturation appeared to occur with age, and was greater in women than in men. These results may indicate that an increase in dietary gamma-linolenic acid (C18:3, n-6) is necessary with age to offset the relative imbalance between PUFA levels which appears to occur. However, any direct health benefit regarding the common diseases of ageing from such a strategy still remain to be clarified.

Coffee and tea consumption and the prevalence of coronary heart disease in men and women: results from the Scottish Heart Health Study.

STUDY OBJECTIVES: The aim was to determine if there was a relationship between coffee or tea consumption and the prevalence of coronary heart disease in Scotland. DESIGN: The relationship between self reported coffee and tea consumption and the prevalence of coronary heart disease (history, symptoms, or electrocardiographic evidence) was investigated using multiple logistic regression analysis in the Scottish Heart Health Study (SHHS), a cross sectional study. SETTING: Twenty two Scottish districts were surveyed for the SHHS between 1984 and 1986. SUBJECTS: A total of 10,359 men and women aged 40-59 years were studied. MEASUREMENTS AND MAIN RESULTS: Of the 9740 subjects who were assigned a category, 21.8% (2122) were classified as having indications of coronary heart disease. Men and women were combined in the odds ratio analysis because they showed almost identical patterns in the prevalence of coronary heart disease across the coffee and tea quarters (grouped according to consumption). Those who did not drink coffee had a significantly higher (p < 0.05) prevalence of coronary heart disease than the three groups for coffee drinkers. Adjustments for risk factors including cigarette smoking, total blood cholesterol, and diastolic blood pressure did not remove the significance of the odds ratios. There was a positive dose-response effect between tea consumption and coronary heart disease which was removed after adjustment for various risk factors. CONCLUSIONS: These findings do not support a positive relationship between coffee or tea consumption and coronary heart disease in this British study where most coffee consumed is instant coffee.

Effect of polyunsaturated fatty acids of the n-3 and n-6 series on lipid composition and eicosanoid synthesis of platelets and aorta and on immunological induction of atherosclerosis in rabbits.

The effect of dietary fish oil (rich in n-3 polyunsaturated fatty acids (PUFA], corn oil (rich in n-6 PUFA) and coconut oil (low in n-3 and n-6 PUFA) on the induction of atherosclerosis by serum sickness in rabbits was investigated over a 12-month period. Dietary fish oil led to a significant increase in the level of eicosapentaenoic acid (EPA) in all platelet phospholipid fractions and to a significant reduction in the level of platelet phosphatidylethanolamine arachidonic acid (AA). In aortic total phospholipids, rabbits given fish oil showed a significant reduction in AA and a significant increase in EPA. Rabbits given fish oil showed significantly lower collagen-induced platelet thromboxane A2 release and aortic production of 6-keto-PGF1 alpha. Serum total immune complex levels and anti-horse serum IgG levels were not influenced by diet. There was a significant reduction in total aortic atherosclerosis in fish oil-fed animals compared with coconut oil fed animals.

The effect of a dietary supplement of n-3 polyunsaturated fat on platelet lipid composition, platelet function and platelet plasma membrane fluidity in healthy volunteers.

1. Eight healthy male volunteers (aged 22-39 years) supplemented their normal daily diet with 15 g encapsulated fish oil (MaxEPA) for a 6 week period. Fasting blood samples were taken before, at the completion of and 3 months after the period of supplementation. 2. Evaluation of nutrient intakes showed that the intake of n-3 polyunsaturated fatty acids rose significantly (P less than 0.01) during supplementation. This was reflected in changes in the fatty acid composition of platelet phosphatidyl choline (PC) and phosphatidyl ethanolamine (PE) without any changes in phosphatidyl serine, phosphatidyl inositol or sphingomyelin. 3. In both PC and PE there were significant (P less than 0.05) increases in the levels of 18:1n-9 and 20:5n-3 fatty acids and a significant (P less than 0.05) decrease in 20:4n-6 during supplementation. 16:0 rose significantly in PC (P less than 0.05) while in PE, 18:0 fell and both 22:5n-3 and 22:6n-3 rose significantly (P less than 0.05). 4. There were no significant effects of fish-oil supplementation on serum lipids, platelet cholesterol: phospholipid, collagen-induced platelet aggregation or collagen-induced platelet thromboxane B2 production. However, there was a significant correlation (P less than 0.001; r + 0.63) between total phospholipid arachidonic acid and platelet thromboxane production. 5. The fluorescent probe 1,6-diphenyl-1,3,5-hexatriene was used to determine whether fish-oil supplementation altered fluorescence polarization of isolated platelet plasma membrane and, by inference, platelet plasma membrane fluidity. No significant effect of fish-oil supplementation on fluorescence polarization was seen.