The effect of a fermented soy beverage among patients with localized prostate cancer prior to radical prostatectomy.

BACKGROUND: Fermented soy products have shown to possess inhibitory effects on prostate cancer (PCa). We evaluated the effect of a fermented soy beverage (Q-Can®), containing medium-chain triglycerides, ketones and soy isoflavones, among men with localized PCa prior to radical prostatectomy. METHODS: We conducted a placebo-controlled, double-blind randomized trial of Q-Can®. Stratified randomization (Cancer of the Prostate Risk Assessment (CAPRA) score at diagnosis) was used to assign patients to receive Q-Can® or placebo for 2-5 weeks before RP. Primary endpoint was change in serum PSA from baseline to end-of-study. We assessed changes in other clinical and pathologic endpoints. The primary ITT analysis compared PSA at end-of-study between randomization arms using repeated measures linear mixed model incorporating baseline CAPRA risk strata. RESULTS: We randomized 19 patients, 16 were eligible for analysis of the primary outcome. Mean age at enrollment was 61, 9(56.2%) were classified as low and intermediate risk, and 7(43.8%) high CAPRA risk. Among patients who received Q-Can®, mean PSA at baseline and end-of-study was 8.98(standard deviation, SD 4.07) and 8.02ng/mL(SD 3.99) compared with 8.66(SD 2.71) to 9.53ng/mL(SD 3.03), respectively, (Difference baseline - end-of-study, p = 0.36). There were no significant differences in Gleason score, clinical stage, surgical margin status, or CAPRA score between treatment arms (p > 0.05), and no significant differences between treatment arms in end-of-study or change in lipids, testosterone and FACT-P scores (p > 0.05). CONCLUSIONS: Short exposure to Q-Can® among patients with localized PCa was not associated with changes in PSA levels, PCa characteristics including grade and stage or serum testosterone. Due to early termination from inability to recruit, study power, was not achieved.

Does an environmental stringent policy really matter to achieve environmental sustainability in BRICS-T region? Evidence from novel method of moments quantile regression approach.

Amidst pressing global environmental challenges, exacerbated by climate change and the imminent threat of global warming, there is a critical need to assess the efficacy of environmental policies. This study centers its attention on the pivotal role of these policies in addressing environmental concerns. Specifically, our research aims to scrutinize the impact of stringent environmental policies on environmental quality under the theoretical underpinnings of environmental Kuznets curve. To achieve this objective, the study collected data from BRICS-T economies over the period of 1990-2020. This study employed the method of moments quantile regression technique for empirical analysis. Our study validates the presence of the Environmental Kuznets curve (EKC hypothesis). Empirical findings reveal the sustained significance of environmental stringency across all quantiles, demonstrating a positive correlation in lower quantiles and a negative correlation in higher quantiles. At lower quantiles, the impact is insignificant initially, but pronounced due to efficiency improvements induced by stringent policies. The effects became negative at middle quantiles, indicating stringent policies might encounter diminishing returns where policy measures start stabilizing ecological impacts. At higher quantiles, the influence of ESI remains significant, reflecting ongoing adaptations in larger economies with higher ecological footprints. This suggests the potential effectiveness of stringent regulatory measures in mitigating environmental impacts and reducing ecological footprints. The identified inverted U-shaped curve signifies that while stringent policies may not inherently enhance environmental health, beyond a certain threshold, they can indeed contribute to its improvement. Our policy recommendation advocates for the widespread adoption and promotion of such stringent measures to safeguard environmental health.

Fermented Soy Drink (Q-CAN® PLUS) Induces Apoptosis and Reduces Viability of Cancer Cells.

This study tested the ability of a fermented soy product to induce tumor cell toxicity and to assess if this was due to fermentation of soy, and to the genistein content. Four cancer cell lines were cultured without additive, with fermented soy (Q-CAN® PLUS), nonfermented soy, or genistein, and cell viability was examined at 24 h, 48 h, and 72 h. The sensitivity of the cell lines to apoptosis by Q-CAN PLUS was tested with the Annexin V assay. All cell lines demonstrated a dose and time response reduction in tumor cell viability with exposure to Q-CAN PLUS (IC50 at 24 h 3.8 mg/mL to 9 mg/mL). Unfermented soy did not show reduction in viability of any cell line within the same concentration range. The IC50 of genistein for each of the cell lines was significantly greater than for Q-CAN PLUS. All four tumor cell lines demonstrated apoptosis in response to Q-CAN PLUS. Q-CAN PLUS reduces viability and increases apoptosis of cancer cells in a concentration- and fermentation-dependent manner. Taking into consideration the IC50 of genistein and the concentration of genistein in Q-CAN PLUS, the genistein content of Q-CAN PLUS is not responsible for the majority reduction in tumor cell viability. This suggests that fermentation of soy results in the production of metabolites that reduce cancer cell viability and induce cellular apoptosis, and play a major role in addition to any effects produced by their genistein content.

Flood risk perception and communication: The role of hazard proximity.

Climate change-induced extreme events have increased worldwide, including riverine flooding in rural areas. Risk communication is an effective mechanism that affects risk perception and can significantly reduce flood risk. This study quantifies risk perception and communication in flood-prone rural areas of District Dera Ghazi Khan, Pakistan. The rural communities were divided into two zones based on the distance from rivers, i.e., Zone 1 (households within 0-3 km) and Zone 2 (households within 3-6 km). After a thorough literature review, indicators measured on the Likert scale were selected for risk perception and communication. Using Yamane's sampling, 420 samples were collected using a household survey. Chi-square and t-tests were used to identify differences between the two zones. Linear regression was performed to identify the socioeconomic determinants of risk communication and perception. Results showed that the people living away from the river had higher risk perception and received better risk communication than their peers. The main reason was attributed to their past flood experiences. The study also found a strong correlation between flood risk perception and risk communication. Hazard proximity was also found to affect risk perception and communication. People with higher risk perception are likely to seek risk communication information and engage in flood preparedness and mitigation measures. This study provides an insight into the need for risk communication for improving the effectiveness of flood risk reduction.

Efficacy and Safety of Massage for Osteoarthritis of the Knee: a Randomized Clinical Trial.

BACKGROUND: Current treatment options for knee osteoarthritis have limited effectiveness and potentially adverse side effects. Massage may offer a safe and effective complement to the management of knee osteoarthritis. OBJECTIVE: Examine effects of whole-body massage on knee osteoarthritis, compared to active control (light-touch) and usual care. DESIGN: Multisite RCT assessing the efficacy of massage compared to light-touch and usual care in adults with knee osteoarthritis, with assessments at baseline and weeks 8, 16, 24, 36, and 52. Subjects in massage or light-touch groups received eight weekly treatments, then were randomized to biweekly intervention or usual care to week 52. The original usual care group continued to week 24. Analysis was performed on an intention-to-treat basis. PARTICIPANTS: Five hundred fifty-one screened for eligibility, 222 adults with knee osteoarthritis enrolled, 200 completed 8-week assessments, and 175 completed 52-week assessments. INTERVENTION: Sixty minutes of protocolized full-body massage or light-touch. MAIN MEASURES: Primary: Western Ontario and McMaster Universities Arthritis Index. Secondary: visual analog pain scale, PROMIS Pain Interference, knee range of motion, and timed 50-ft walk. KEY RESULTS: At 8 weeks, massage significantly improved WOMAC Global scores compared to light-touch (- 8.16, 95% CI = - 13.50 to - 2.81) and usual care (- 9.55, 95% CI = - 14.66 to - 4.45). Additionally, massage improved pain, stiffness, and physical function WOMAC subscale scores compared to light-touch (p < 0.001; p = 0.04; p = 0.02, respectively) and usual care (p < 0.001; p = 0.002; p = 0.002; respectively). At 52 weeks, the omnibus test of any group difference in the change in WOMAC Global from baseline to 52 weeks was not significant (p = 0.707, df = 3), indicating no significant difference in change across groups. Adverse events were minimal. CONCLUSIONS: Efficacy of symptom relief and safety of weekly massage make it an attractive short-term treatment option for knee osteoarthritis. Longer-term biweekly dose maintained improvement, but did not provide additional benefit beyond usual care post 8-week treatment. TRIAL REGISTRATION: clinicaltrials.gov NCT01537484.

Mindfulness-Based Stress Reduction for Adolescents with Functional Somatic Syndromes: A Pilot Cohort Study.

OBJECTIVE: To assess the feasibility of a mindfulness-based stress reduction (MBSR) program for adolescents with widespread chronic pain and other functional somatic symptoms and to make preliminary assessments of its clinical utility. STUDY DESIGN: Three cohorts of subjects completed an 8-week MBSR program. Child- and parent-completed measures were collected at baseline and 8 and 12 weeks later. Measures included the Functional Disability Inventory (FDI), the Fibromyalgia/Symptom Impact Questionnaire-Revised (FIQR/SIQR), the Pediatric Quality of Life Inventory, the Multidimensional Anxiety Scale (MASC2), and the Perceived Stress Scale. Subjects and parents were interviewed following the program to assess feasibility. RESULTS: Fifteen of 18 subjects (83%) completed the 8-week program. No adverse events occurred. Compared with baseline scores, significant changes were found in mean scores on the FDI (33% improvement, P = .026), FIQR/SIQR (26% improvement, P = .03), and MASC2 (child: 12% improvement, P = .02; parent report: 17% improvement, P = .03) at 8 weeks. MASC2 scores (child and parent) and Perceived Stress Scale scores were significantly improved at 12 weeks. More time spent doing home practice was associated with better outcomes in the FDI and FIQR/SIQR (44% and 26% improvement, respectively). Qualitative interviews indicated that subjects and parents reported social support as a benefit of the MBSR class, as well as a positive impact of MBSR on activities of daily living, and on pain and anxiety. CONCLUSIONS: MBSR is a feasible and acceptable intervention in adolescents with functional somatic syndromes and has preliminary evidence for improving functional disability, symptom impact, and anxiety, with consistency between parent and child measures. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02190474.

Massage Therapy and Quality of Life in Osteoarthritis of the Knee: A Qualitative Study.

Objective: We hypothesized that participants receiving Swedish massage would experience benefits such as stress reduction and enhanced quality of life, in addition to the osteoarthritis-specific effects assessed in a randomized controlled clinical trial. Design: Qualitative methods were used to explore a deeper contextual understanding of participants' experiences with massage and osteoarthritis, in addition to the quantitative data collected from primary and secondary outcome measures of the dose-finding study. Setting: Two community hospitals affiliated with academic health centers in Connecticut and New Jersey. Subjects: Eighteen adults who previously participated in a dose-finding clinical trial of massage therapy for osteoarthritis of the knee. Methods: Face-to-face and telephone interviews using a standardized interview guide. Triangulation of qualitative and quantitative data allowed for a more thorough understanding of the effects of massage therapy. Results: Three salient themes emerged from our analysis. Participants discussed 1) relaxation effects, 2) improved quality of life associated with receiving massage therapy, and 3) the accessibility of massage therapy in treating osteoarthritis. Conclusions: Participant responses noted empowerment with an improved ability to perform activities of daily living after experiencing massage therapy. The majority of statements were consistent with their quantitative changes on standard osteoarthritis measures. Future research in pain conditions should include health-related quality of life assessments as well as outcomes related to perceived well-being, along with greater exploration of the concept of salutogenic side effects of an intervention in the context of complementary and integrative therapies.

Experiences of patients identifying with chronic Lyme disease in the healthcare system: a qualitative study.

BACKGROUND: Chronic Lyme disease is a term that describes a constellation of persistent symptoms in patients with or without evidence of previous Borrelia burgdorferi infection. Patients labeled as having chronic Lyme disease have a substantial clinical burden. Little is known about chronic Lyme disease patient experiences in the healthcare system and their relationships with healthcare providers. The purpose of this study was to gather insights about the experiences of patients who carry a diagnosis of chronic Lyme disease in the United States healthcare system. METHODS: Qualitative, phenomenological study in 12 adult participants who identified themselves as having chronic Lyme disease. Semi-structured face-to-face in-depth interviews were conducted, 60-90 minutes in length, focusing on perceptions of disease burden and of their healthcare providers, using the dimensions of the Health Belief Model. Transcribed interviews were analyzed for emergent topics and themes in the categories of beliefs/understanding, personal history/narrative, consequences/limitations, management, and influences on care. RESULTS: Enrollment continued until theoretical saturation was obtained. Four major themes emerged from participants' descriptions of their experiences and perceptions: 1) changes in health status and the social impact of chronic Lyme disease, 2) doubts about recovery and the future, 3) contrasting doctor-patient relationships, 4) and the use of unconventional therapies to treat chronic Lyme disease. CONCLUSIONS: Participants reported a significant decline in health status associated with chronic Lyme disease and were often unsatisfied with care in conventional settings. Negative experiences were associated with reports of dismissive, patronizing, and condescending attitudes. Positive experiences were associated with providers who were reported to be attentive, optimistic, and supportive. Consultations with CAM practitioners and use of CAM therapies were common. Actively engaged and sympathetic clinical encounters may foster greater satisfaction in healthcare settings.

A point-of-sale communications campaign to provide consumers safety information on drug-dietary supplement interactions: a pilot study.

Concurrent use of dietary supplements with over-the-counter and prescription pharmaceuticals has become increasingly common, and with this trend, so has the incidence of adverse drug-supplement interactions. In the current market, consumers have no way to distinguish between safe and potentially harmful supplements. Thus, the primary objective of this study was to test the hypothesis that messages designed to increase consumers' awareness of potential health risks of concurrent use of dietary supplements with over-the-counter and prescription pharmaceuticals would promote further consideration and action, as evidenced by (a) seeking additional information from an authoritative source or qualified health care professional and (b) changing dietary supplement usage patterns. To test this hypothesis, an innovative consumer information delivery system, referred to as the Buyer Information Network (BuyIN), was utilized. BuyIN uses currently available, Web-enabled point-of-sale (POS) technology to provide up-to-date, evidence-based, health- and safety-related messages to consumers at the retail checkout counter. Results showed that more than one-fourth (27.1%) of consumers (n = 199) who purchased targeted items reported they were aware of the messages. Of this subgroup of aware consumers, 11.2% reported that they sought additional information from a physician or pharmacist, 11.5% reported that they visited the website listed on the coupon, and 10.5% indicated that they changed their dietary supplement usage patterns as a result of the messages. Future research should include a large-scale study of a fully implemented and capable system at multiple test sites around the country, including investigating the utility of BuyIN in different retail settings.

Exploring the impact of energy consumption on poverty in Pakistan: evidence from the asymmetric ARDL approach.

This research work contributes to the literature by examining the role of energy consumption in mitigating poverty via decomposing energy consumption into its positive and negative components, covering the period spanning from 1985 to 2017. To accomplish this objective, this study employs the nonlinear autoregressive distributed lag (NARDL) approach recently popularized by Shin et al., (2014). The NARDL approach is well-suited to our study becuase of its capability to delineate hidden asymmetries. The empirical findings reveal the prevalence of long-run associations among the studied variables. The outcomes show that an increase (decrease) in energy consumption combats (augments) poverty in Pakistan. The empirical findings underscore that the decreasing effect of energy consumption on poverty is found to be more promising than its increasing effect, both in the long and short run. Based on the empirical outcomes, we suggest that the policymakers, and other stakeholders should consider the asymmetric or nonlinear behavior of the studied variables for better poverty policy-making in Pakistan.

Role of renewable and non-renewable energy consumption in environmental quality and their subsequent effects on average temperature: an assessment of sustainable development goals in South Korea.

Environmental quality is a global concern, and an accurate assessment of environmental progress has emerged as a key element in achieving sustainable development goals. The study offers a two-pronged contribution by analyzing the interplay between renewable energy consumption, traditional energy consumption, and urbanization on environmental quality while simultaneously testing the impact of environmental quality on average temperature. Distinguishing itself from prior research, the study employs both carbon emissions and ecological footprint to ensure an intricate and reliable analysis. Current study analyzes data from 1970 to 2022 from South Korea to indicate that energy-environment association is influenced by energy consumption, urbanization, and economic growth, while renewable energy consumption is key in long-term environmental sustainability. Our extensive econometric analysis allows us to suggest that South Korea need to prioritize renewable energy, and green growth is prioritized so that economic growth and green agenda are synchronized to overcome environmental challenges. Addictingly, there is need to devise long-term environmental policies to strengthen the role of environmental innovation in energy productivity and boost renewable energy consumption.

Asymmetric relationship of environmental degradation and economic growth with tourism demand in Pakistan: evidence from non-linear ARDL and causality estimation.

The purpose of this study is to assess the asymmetric associations of environmental degradation and economic growth with Pakistan's tourism demand. To fulfil this purpose, "non-linear autoregressive distributed lag" (NARDL) modelling was performed on the time series data collected from Pakistan for 26 years. The unit root test, co-integration test, long-run estimation and NARDL estimations were applied to the data to generate findings. The present study revealed that there exist the significant asymmetric associations between environmental degradation and tourism demand. It has also indicated that there exist the significant asymmetric associations between economic growth and tourism demand. It is found through the non-linear ARDL estimation results that the increase or decrease in economic growth leads towards the increase of the tourism demand of Pakistan. It means that any change (either positive or negative) in economic growth is followed by the increase of the tourism demand. Results further indicate that the increase in environmental degradation in Pakistan causes its tourism demand to reduce while the negative change in the environmental degradation does not cause any significant effect on tourism demand. However, this relationship becomes significant in the long run as the negative change in environmental degradation caused significant inverse effect on tourism demand in long run. The current study tends to be theoretically significant and practically beneficial for Pakistan's policymakers. It will help them realize the role of economic growth of the country and environmental degradation in shaping Pakistan's tourism demand and thus help them develop and implement better policies for the growth of the tourism sector.

Effect of fruit and vegetable concentrates on endothelial function in metabolic syndrome: a randomized controlled trial.

BACKGROUND AND OBJECTIVE: Dehydrated fruit and vegetable concentrates provide an accessible form of phytonutrient supplementation that may offer cardioprotective effects. This study assessed the effects of two blends of encapsulated juice powder concentrates (with and without added berry powders) on endothelial function in persons with metabolic syndrome, a risk factor for type 2 diabetes and cardiovascular disease. METHODS: Randomized, double blind, placebo controlled crossover clinical trial with three treatment arms. 64 adults with metabolic syndrome were enrolled and received 8-week sequences of each blend of the concentrates and placebo. The primary outcome measure was change in endothelial function (assessed as flow-mediated dilatation of the brachial artery) 2 hr after consuming a 75 g glucose load, after 8-weeks of daily consumption (sustained) or 2 hr after consumption of a single dose (acute). Secondary outcome measures included plasma glucose, serum insulin, serum lipids, and body weight. RESULTS: No significant between-group differences in endothelial function with daily treatment for 8 weeks were seen. No other significant treatment effects were discerned in glucose, insulin, lipids, and weight. CONCLUSION: Encapsulated fruit and vegetable juice powder concentrates did not alter insulin or glucose measures in this sample of adults with metabolic syndrome. TRIAL REGISTRATION: clinicaltrials.gov NCT01224743.

The fermented soy beverage Q-CAN® plus induces beneficial changes in the oral and intestinal microbiome.

BACKGROUND: Soy products are associated with many beneficial health consequences, but their effects on the human intestinal microbiome are poorly characterized. OBJECTIVES: To identify the changes in the oral and fecal microbiome in lean and obese participants due to consumption of Q-CAN®, and to assess the expected consequences of these changes based on the published literature. METHODS: Prospective study of lean (10) and obese (9) participants consuming Q-CAN® twice daily for 4 weeks with 8 weeks follow-up. Microbial DNA was extracted from saliva and stool samples, amplified against the V4 region of the 16S ribosomal RNA gene and data analyzed using QIIME 1.9.1 bioinformatics. Four hundred forty-four samples were collected in total, 424 of which were productive and yielded good quality data. RESULTS: STOOL. In the lean population Bifidobacteria and Blautia show a significant increase while taking Q-CAN®, and there was a trend for this in the obese population. ORAL. There were relatively fewer major changes in the oral microbiome with an increase in the family Veillonellaceae in the lean population while on Q-CAN®. CONCLUSION: Q-CAN® consumption induced a number of significant changes in the fecal and oral microbiome. Most notably an increase in the stool microbiome of Bifidobacteria and Blautia, both of which are associated with positive health benefits, and in the saliva an increase in Veillonellaceae. TRIAL REGISTRATION: This trial was registered with Clinicaltrials.gov on January 14th 2016. ClinicalTrials.gov Identifier: NCT02656056.

A brief report: Yale Research Symposium on Complementary and Integrative Medicine.

The 2010 Yale Research Symposium on Complementary and Integrative Medicine highlighted original research in related areas by Yale faculty and provided a forum to discuss and debate issues of evidence and plausibility. In this brief report, we describe selected presentations on such diverse foci as nutritional influences on cancer, acupuncture for low back pain, protein intake's effects on bone consumption, Chinese herb-derived adjuvant chemotherapy, and the relationship between anger and cardiac arrhythmia. This symposium demonstrated that rigorous research methods are being used to study unconventional therapies and that an integrative medicine approach requires a solid scientific foundation.

Mindfulnes-Based Stress Reduction for Older Couples with Metabolic Syndrome: a Pilot Randomized Controlled Trial.

OBJECTIVE: We examined the feasibility and explored the physical, psychological, relational, and biological effects of Mindfulness-Based Stress Reduction (MBSR), an 8-week standardized mindfulness program, involving older married couples (60 years or older) with metabolic syndrome (one or both partners had metabolic syndrome). We also explored gender differences. METHODS: A pilot randomized controlled trial (RCT) compared MBSR to a Wait List Control (WLC) arm at baseline, post-intervention, and 3-month follow-up clinic visits. Twenty-two spouses (11 couples) self-reported stress, physical and mental functioning, mindfulness, and relationship satisfaction at each time point. Fasting glucose, cholesterol, triglycerides, blood pressure, weight, and waist circumference were measured. MBSR couples answered questions about partner influences on participation, adherence, and practice at the post-intervention visit. RESULTS: In terms of adherence to MBSR sessions, four of the six couples attended all 10 sessions; one couple attended 7; and one wife attended 6 and her husband attended 5 sessions. In terms of efficacy, there were no significant intervention effects; however, there were significant gender by intervention effects. Pre- to post-intervention, MBSR wives displayed greater increases in physical functioning (ß = 1.18, t(36) = 3.17, p = .003) and relationship satisfaction (ß = .72, t(36) = 2.81, p = .007) than WLC wives. Effects for husbands were not significant. Qualitatively, participants reported encouragement and increased relationship closeness. CONCLUSIONS: Engaging in MBSR as a couple to address symptoms of metabolic syndrome was well-received and feasible. Preliminary effects suggest more benefits for wives than husbands in terms of physical functioning and relational well-being.

Fermented Soy Beverage Q-CAN Plus Consumption Improves Serum Cholesterol and Cytokines.

Soy-based beverages are well recognized for their rich nutritional contents and positive health benefits. However, there is little information regarding the composition of various commercially available soy-based beverages and uncertainty among patients regarding the utility of fermented soy products. Current study evaluates the health benefits of QCAN® Plus-an easily available fermented soy drink. This study was performed in lean (n = 10) and obese (n = 10) subjects. The subjects were observed during pre-soy (weeks -2, -1, and 0), on-soy (weeks 1, 2, 3, and 4), and post-soy (weeks 6, 8, 10, and 12) periods. The serum samples during these visits were subjected to lipid profile analysis and multiplex assay for cytokines. The results revealed that total cholesterol and low-density lipoprotein (LDL) cholesterol levels were significantly reduced in both lean and obese individuals during on-soy (P ≤ .05). Furthermore, cytokines such as platelet-derived growth factor (PDGF) AA and AB/BB were significantly lowered on-soy compared with pre-soy (P ≤ .05) in lean subjects and PDGF AA, IL-1RA, and GMCSF were significantly reduced on-soy (P ≤ .05) in obese subjects. In addition, a qualitative and quantitative analysis of the Q-CAN Plus by a third-party laboratory confirmed its chemical and microbial safety. Our preliminary study on Q-CAN Plus ensures its safety for consumption and highlights its hypolipidemic and suppressive effect on certain cytokines. These observations and relevant studies in future might guide clinicians in future to consider Q-CAN Plus as a therapeutic nutritional supplement.

The role of culture, environment, and religion in the promotion of physical activity among Arab Israelis.

INTRODUCTION: Despite low levels of physical activity among Arabs in Israel, interventions designed to increase physical activity in this population have been scarce. To improve our understanding of the cultural, religious, and environmental barriers and enablers to physical activity, we conducted a qualitative study among Arab Israeli college students in Israel. METHODS: A total of 45 students participated in 8 focus groups. Purposeful sampling was used to capture the diverse characteristics of participants. Two researchers analyzed the data independently guided by grounded theory. Peer-debriefing sessions were held to group preliminary categories into larger themes. Generally, consensus between researchers was high, and minor differences were resolved. RESULTS: Participants recognized the importance of physical activity in chronic disease prevention, yet most were not regularly physically active. This contradiction could be explained by the fact that many participants lived in an extended-family setting that deemphasized the importance of physical activity. Women often found themselves exercising at odd hours so that they would not be noticed by neighbors. Religion, in comparison, was considered a facilitating factor because the scriptures supported physical activity. Furthermore, an urban environment was an enabling factor because it provided exercise facilities, sidewalks, and a socially acceptable venue for activity. Participants felt resources were not allocated by the government to accommodate physical activity. CONCLUSION: Increasing Arab Israelis' access to safe and culturally appropriate exercise facilities should become a priority. Thus, policy changes in allocating appropriate funds to promote physical activity must be considered, along with using multiple health promotion strategies.

A leukocyte activation test identifies food items which induce release of DNA by innate immune peripheral blood leucocytes.

BACKGROUND: Leukocyte activation (LA) testing identifies food items that induce a patient specific cellular response in the immune system, and has recently been shown in a randomized double blinded prospective study to reduce symptoms in patients with irritable bowel syndrome (IBS). We hypothesized that test reactivity to particular food items, and the systemic immune response initiated by these food items, is due to the release of cellular DNA from blood immune cells. METHODS: We tested this by quantifying total DNA concentration in the cellular supernatant of immune cells exposed to positive and negative foods from 20 healthy volunteers. To establish if the DNA release by positive samples is a specific phenomenon, we quantified myeloperoxidase (MPO) in cellular supernatants. We further assessed if a particular immune cell population (neutrophils, eosinophils, and basophils) was activated by the positive food items by flow cytometry analysis. To identify the signaling pathways that are required for DNA release we tested if specific inhibitors of key signaling pathways could block DNA release. RESULTS: Foods with a positive LA test result gave a higher supernatant DNA content when compared to foods with a negative result. This was specific as MPO levels were not increased by foods with a positive LA test. Protein kinase C (PKC) inhibitors resulted in inhibition of positive food stimulated DNA release. Positive foods resulted in CD63 levels greater than negative foods in eosinophils in 76.5% of tests. CONCLUSION: LA test identifies food items that result in release of DNA and activation of peripheral blood innate immune cells in a PKC dependent manner, suggesting that this LA test identifies food items that result in release of inflammatory markers and activation of innate immune cells. This may be the basis for the improvement in symptoms in IBS patients who followed an LA test guided diet.