Effect of whole soy and purified daidzein on ambulatory blood pressure and endothelial function--a 6-month double-blind, randomized controlled trial among Chinese postmenopausal women with prehypertension.

BACKGROUND/OBJECTIVES: Although observational studies suggest that soy foods or isoflavones are cardio-protective, clinical trials on whole soy or isoflavone daidzein (one major isoflavone and the precursor of equol) on blood pressure (BP) and endothelial function (EF) are few and have not been specifically conducted among equol producers, a population most likely to benefit from soy treatment. SUBJECTS/METHODS: We performed a 6-month double-blind, randomized, placebo-controlled trial to examine the effect of whole soy (soy flour) or purified daidzein on BP and EF in prehypertensive or untreated hypertensive postmenopausal women verified to be equol producers. A total of 270 eligible women were recruited and randomized to either one of the three treatment groups, 40 g soy flour (whole soy group), 40 g low-fat milk powder+63 mg daidzein (daidzein group) or 40 g low-fat milk powder (active control group) daily, each given as a solid beverage powder for 6 months. The primary outcome measures were 24 h ambulatory BP (ABP) and EF assessed by flow-mediated dilation using brachial artery ultrasound. RESULTS: A total of 253 subjects completed the study according to protocol. Urinary isoflavones indicated good compliance with the interventions. Intention to treat and per-protocol analysis indicated that there was no significant difference in the 6-month changes or % changes in parameters of ABP and brachial flow-mediated dilation among the three treatment groups. A further subgroup analysis among hypertensive women (n=138) did not alter the conclusions. CONCLUSIONS: Whole soy and purified daidzein had no significant effect on BP and vascular function among equol-producing postmenopausal women with prehypertension or untreated hypertension.

A mild favorable effect of soy protein with isoflavones on body composition--a 6-month double-blind randomized placebo-controlled trial among Chinese postmenopausal women.

BACKGROUND: In vitro and animal studies suggested that soy protein and isoflavones promote weight and body fat loss. However, clinical trials in humans were few and the effects remained uncertain. OBJECTIVES: To examine whether soy protein with isoflavones and isoflavone extracts exert beneficial effects on body composition among postmenopausal women. DESIGN: A double-blind randomized placebo-controlled trial was conducted among 180 postmenopausal Chinese women with mild hyperglycemia. After a 2-week adaptation, participants were randomly assigned to one of the three arms to receive 15 g soy protein and 100 mg isoflavones (Soy group), or 15 g milk protein and 100 mg isoflavones (Iso group), or 15 g milk protein (placebo group) on a daily basis for 6 months. RESULTS: We observed a mild but significant favorable effect of soy protein with isoflavones on the changes of body weight (BW), body mass index, and body fat percentage relative to isoflavone extracts and milk protein after 6-month supplementation. The mean differences of BW between the Soy and the Iso groups were -0.75 kg (95% CI: -1.363 to -0.136, P=0.017), and between the Soy and the placebo groups were -0.60 kg (95% CI: -1.209 to -0.019, P=0.047). The mean difference of change percentage in body fat percentage between the Soy and the Iso groups was -3.74% (95% CI: -6.88 to -0.60%, P=0.02), and between the Soy and the placebo groups was -2.54% (95% CI: -5.69 to 0.12%. P=0.08). CONCLUSIONS: Six-month supplementation of soy protein with isoflavones had a mild favorable effect on body composition in postmenopausal women.

Protective effects of Chinese herbs on D-galactose-induced oxidative damage.

A mixture of traditional Chinese herbs ('FTDA') was found to improve several oxidation-related biomarkers in D-galactose-induced mimetic aging mice. FTDA consists of seven herbal components: Cuscutae Semen, Schisandrae Fructus, Dioscoreae Rhizoma, Lonicerae Flos, Nelumbinis Semen, Angelica Radix and Poria, and is routinely used for treating mice with D-galactose-induced oxidative damage. Measurements of antioxidant status, including superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), total antioxidant status (TAS) and malondialdehyde (MDA) were made on blood, brain and liver tissue collected from animals after 60 days of treatment with D-galactose subcutaneous injections. High-dose, medium-dose and control groups exhibited higher levels of SOD, GSH-Px and TAS in their blood, as well as lower levels of serum MDA activity, compared with the D-galactose group. In the liver, all three experimental and PBS groups demonstrated significant increases in SOD activity and a decrease in MDA activity. The MDA activity decreased in medium-dose, high-dose and PBS groups, while medium-dose and PBS groups demonstrated increased SOD activity compared with that seen in the brain. These results support the efficacy of FTDA in improving the antioxidant status of D-galactose-induced mimetic aging mice.

Soy intake and the maintenance of peak bone mass in Hong Kong Chinese women.

Our previous study on bone health among premenopausal women showed that bone mass consolidation is attained by the early 30s, and small loss of spinal bone mineral density (SBMD) occurs soon after peak bone mass attainment. Recent interest has been shown in the potential beneficial effects of phytoestrogens on bone health. However, data are lacking, particularly in Asian women. This study aims to investigate the effect of soy isoflavones intake on the maintenance of peak bone mass in a cohort of 132 women aged 30-40 years who were followed up for 3 years. Baseline measurements of SBMD (L2-L4) were obtained using dual-energy X-ray densitometry, and dietary intake of soy foods and other key nutrients, including dietary calcium, were obtained through a quantitative food frequency method. Information on body measurements; physical activity (PA), weight-bearing activity in particular; age of menarche; and number of pregnancies were obtained at baseline. Repeated measurements of SBMD were obtained yearly for a further 3 years with an average follow-up time of 38 months. Analyses were performed on 116 subjects with at least three SBMD measurements (at baseline, 3-year follow-up, and at least one measurement during follow-up). The individual SBMD regression slope was computed for each of the subjects. Soy isoflavones consumption was categorized as quartiles of intake. We observed a significant difference in the SBMD individual regression slopes between women belonging to the fourth and first soy isoflavones intake quartiles. The positive effect of soy isoflavones on SBMD remained after adjusting for age and body size (height, weight, and bone area). Multiple linear regression analysis including the other known covariates (lean body mass, PA, energy adjusted calcium, and follow-up time) showed that soy isoflavones, together with these variables, accounted for 24% of the variances of the SBMD individual regression slope. This longitudinal study shows that soy intake had a significant effect on the maintenance of SBMD in women aged 30-40 years. The effects of phytoestrogens on bone health should be explored further in a population with habitual dietary soy but low calcium intake.

A man with osteoblastic metastasis and hypocalcaemia.

We report a case of an 80-year-old man with osteoblastic metastases from advanced carcinoma of the prostate presenting with a grand mal seizure resulting from severe hypocalcaemia. He had low serum phosphate and ionised calcium levels, elevated serum skeletal alkaline phosphatase and intact parathormone levels. 99mTc radioisotope bone scan revealed a "super bone scan" suggestive of osteomalacia. The serum 1, 25-dihydroxycholecalciferol level was unexpectedly elevated. The biochemical abnormalities persisted despite high dose calcium replacement, but improved with supraphysiological doses of 1,25 (OH)2 vitamin D3 (Rocaltrol) therapy. We hypothesise that the hypocalcaemia in this patient was due to vitamin D resistance secondary to a humoral factor secreted by the tumour.

Nutritional status of elderly patients during recovery from chest infection and the role of nutritional supplementation assessed by a prospective randomized single-blind trial.

We examined changes in the nutritional status of elderly patients with chest infection for a period of 3 months after discharge from hospital, including the effects of nutritional supplementation on well-being and functional status as well as on nutritional indices. Eighty-one subjects admitted to an acute medical ward aged 65 years and over with chest infection were recruited consecutively, and randomized to receive supplement (500 ml of Ensure liquid daily) for 1 month, or no supplement, on discharge. Assessment at baseline, 1, 2 and 3 months included a questionnaire to determine health, mental and functional status, and anthropometric measurements. Biochemical nutritional status was assessed at baseline, 1 and 3 months, and dietary intake (24 h recall method) at 1 and 3 months. During recovery, both supplement and non-supplement groups showed improvement in various measures of well-being and biochemical status. In addition, the former group showed improvement in more anthropometric measurements, in thiamine and pyridoxine status, while the non-supplement group showed a lower level of functional ability after 3 months. Various measures of well-being and biochemical status of the water-soluble vitamins were better in the supplement groups. We conclude that nutritional supplementation may have a role in helping elderly patients to recover from chest infections.

Potassium intake and urinary calcium excretion in healthy subjects.

Potassium depletion increases and potassium supplementation decreases urinary calcium excretion. To determine whether these experimental observations have any significance in healthy free living subjects, we measured 24 h urinary calcium, sodium, potassium and serum parathyroid hormone (PTH) in 142 healthy young (aged 18-40 years) female Chinese subjects. Sodium excretion and potassium excretion were positively correlated with calcium excretion (r = 0.494, p < 0.0001 and r = 0.181, p = 0.031, respectively). However stepwise multiple regression analysis showed that only urinary sodium excretion contributed to the excretion of calcium. We conclude that in free living subjects potassium intake has little effect on calcium excretion.

The role of Chinese traditional medical practice as a form of health care in Singapore--III. Conditions, illness behaviour and medical preferences of patients of institutional clinics.

Both the modern scientific and the Chinese traditional forms of health care are within easy geographical, economical and quantitative accessibility to the people in Singapore. The fourth component of accessibility, socio-cultural component encompasses the social milieu surrounding the individual, and the values and beliefs attached to diseases and health care services. This paper reveals the findings of a survey of a quota sample of patients in institutional clinics providing Chinese traditional medical consultations. The survey aimed to look at the types of illness conditions presented in these clinics, the multi-usage of both modern and traditional health care by these patients, and the inter-relationship between illness behaviour and differential preferences of treatment methods for various disease conditions.

The role of Chinese traditional medical practice as a form of health care in Singapore--II. Some characteristics of providers.

A survey of 19 voluntary institutions providing Chinese traditional medical services in Singapore investigated their organisation, the types of medical services provided, patient volume, and the characteristics of the physicians working there. This paper reports on the findings of the survey.

The role of Chinese traditional medical practice as a form of health care in Singapore. I. Preliminary study.

A retrospective study of 672 sampled records of patients of a major institution providing Chinese traditional medicine in Singapore reveals that 97.3% of the patients were Chinese, with a dialect group distribution following closely that of the Singapore Chinese. The male-to-female patient ratio was 1.0:1.13. There were fewer patients of the pediatric age group and more of those from age 30 upwards. Some 43% of the patients sought treatment for "infective" and "internal, emotional and weakness" diseases. The prevalent disease conditions seen among patients from the different age groups are also analyzed and discussed in this paper.