The Effect of Soy Isoflavones on Blood Pressure in Postmenopausal Women

Title: The Effect of Soy Isoflavones on Blood Pressure in Postmenopausal Women Author: Cecilia Assarsson & Camilla Hansson Supervisor: Andrea Mikkelsen Examiner: Anna Winkvist Programme: Programme in dietetics, 180/240 ECTS Type of paper: Bachelor’s thesis in clinical nutrition, 15 higher education credits Date: May 23, 2017 Background: During menopause the production of estrogen in women gradually decreases. This increases the risk of hypertension which in turn can cause cardiovascular disease. Hormone replacement therapy has been shown to cause breast cancer which has sparked an interest in soy isoflavones and their estrogen like properties. Objective: The objective of this systematic review was to examine the scientific evidence regarding the effect of supplementation with soy isoflavones on blood pressure in postmenopausal women. Search strategy: Searches were conducted in two data bases, PubMed and Scopus, to cover as much as possible of the existing scientific evidence that was relevant for the objective. Following words and MeSH terms were used: blood pressure, hypertension, soy isoflavones, isoflavone supplement, menopause, postmenopause, postmenopausal women and climacteric. Selection criteria: Inclusion criteria were randomized controlled trials in English or Swedish, postmenopausal women whose last menstruation occurred at least twelve months prior and studies examining the effect of soy isoflavones on blood pressure. Exclusion criteria were diseases other than untreated hypertension and combination therapy. The outcome measures were systolic and diastolic blood pressure. Data collection and analysis: Five studies were included and critically reviewed with SBU’s guide for randomized studies. Grading of the evidence were made according to GRADE. Main results: Four of the studies did not show a decrease in SBP in the intervention groups compared to the control groups. Only one study showed a significant decrease in SBP. For the outcome measure DBP there was no significant difference between the intervention and control group in either of the studies. Conclusions: There is moderate (+++) evidence that supplementation with soy isoflavones does not lower SBP in postmenopausal women. Regarding supplementation with soy isoflavones on DBP, there is strong (++++) evidence that it does not have any lowering effect on blood pressure. Keywords: blood pressure, hypertension, soy isoflavones, phytoestrogens, menopause, postmenopausal womenTitel: Effekt av sojaisoflavoner på blodtryck hos postmenopausala kvinnor Författare: Cecilia Assarsson & Camilla Hansson Handledare: Andrea Mikkelsen Examinator: Anna Winkvist Linje: Dietistprogrammet, 180/240 hp Typ av arbete: Självständigt arbete i klinisk nutrition, 15 hp Datum: 2017-05-23 Bakgrund: Under klimakteriet minskar successivt produktionen av östrogen hos kvinnor. Det ökar risken att drabbas av hypertoni vilket är en riskfaktor för hjärt-kärlsjukdom. Eftersom hormonbehandling kan öka risken för bröstcancer finns ett intresse för sojaisoflavoner då de har östrogenliknande egenskaper. Syfte: Syftet med denna systematiska översiktsartikel var att undersöka det vetenskapliga underlaget för effekten av supplementering med sojaisoflavoner på blodtryck hos postmenopausala kvinnor. Sökväg: Litteratursökningar av originalartiklar gjordes i två databaser, PubMed och Scopus, för att täcka så mycket som möjligt av det befintliga vetenskapliga underlaget för frågeställningen. Följande sökord och MeSH-termer användes: blood pressure, hypertension, soy isoflavones, isoflavone supplement, phytoestrogens, menopause, postmenopause, postmenopausal women och climacteric. Urvalskriterier: Inklusionskriterierna var randomiserade kontrollerade studier (RCT) på engelska eller svenska, postmenopausala kvinnor med utebliven menstruation i minst tolv månader och studier som undersökte sojaisoflavoners effekt på blodtryck. Exklusions-kriterierna var sjukdomstillstånd utöver obehandlad hypertoni och kombinationsbehandling. Effektmått var systoliskt och diastoliskt blodtryck. Datainsamling och analys: Fem studier inkluderades och granskades sedan utifrån SBU:s mall för randomiserade studier. Evidensgradering av effektmåtten gjordes enligt GRADE. Resultat: Fyra av studierna visade inte på någon sänkning av SBP i interventionsgrupperna jämfört med kontrollgrupperna. Endast en studie visade på en signifikant sänkning av SBP. För effektmått DBP fanns ingen signifikant skillnad mellan intervention och kontroll i samtliga studier. Slutsats: Det finns måttlig (+++) evidens för att supplementering med sojaisoflavoner inte sänker SBP hos postmenopausala kvinnor. Gällande supplementering med sojaisoflavoner på DBP är evidensstyrkan hög (++++) för att det inte finns någon sänkande effekt på blodtryck. Nyckelord: Blodtryck, hypertoni, sojaisoflavoner, fytoöstrogener, menopaus, postmenopausala kvinno

Le métier de modélisateur multinational

Cet article présente les principaux problèmes que posent la construction et l'utilisation des modèles macro-économétriques multinationaux. Il montre les disparités qui existent entre les différents modèles multinationaux. Il met l'accent sur la difficulté de mettre en évidence et d'expliquer les différences de comportement entre les différents pays. L'analyse de l'évolution du taux de change est également un point délicat. Les modèles multinationaux permettent de comparer les équilibres non coopératifs où chaque pays choisit isolément sa politique économique aux équilibres coopératifs où les politiques sont coordonnées.This article presents the main problems that economists face when they build or when they use multinational macroeconometric models. It shows the disparities between the existing multinational models. It insists on the difficulties to estimate and to explain behaviour disparities between countries. Analysis of the exchange rate evolution is also a delicate art. Multinational models allow to compare non-cooperative equilibria where each country fixes individually its policy instruments to cooperative equilibria where economie policies are coordinate

Investment in Swedish Manufacturing: Analysis and Forecasts

This paper uses a neoclassical investment model extended with installation costs for capital, agency costs for investment financing, and the possibility of the firm being output constrained as a framework for an empirical analysis of investment behaviour in the Swedish manufacturing industry. The theory is implemented within a multivariate error-correction approach on data covering the time period 1951 to 1995, and we gain the following main results: (1) Tobins average Q is not the sole determinant of investment, neither in the short nor in the long run, and other variables like real output and capital gearing also affect investment activity; (2) the out-of-sample forecasts of the model track the evolution of actual investment growth quite impressively, especially at short- and medium-term horizons (1-2 years); (3) a relative equity-price variable is shown to constitute a good approximation of average Q, both for empirical modelling in general and forecasting in particular

Aspekter kring empatiska robotar i klassrummet – ur ett lärar- och lärarstudentperspektiv

Sammanfattning: Syftet med studien har varit att undersöka lärares och blivande lärares inställning till ett tekniskt hjälpmedel med mänskliga karaktärsdrag. Vi är intresserade av att ta reda på hur lärare ser på och förhåller sig till att arbeta med en empatisk robot i klassrummet. Vi är också intresserade av vad lärare ser för för- och nackdelar med att arbeta med en empatisk robot. Vi har valt ett kvalitativt tillvägagångssätt och använt oss av fokusgrupper för att på så sätt samla in material till studien. Fokusgrupperna har ljudinspelats för att senare transkriberas. Efter att noggrant ha studerat de insamlade data, kom vi fram till att de lärare som deltagit i vår studie, ställer sig positiva till empatiska robotar i klassrummet. Respondenterna anser att en bra programmerad robot kan bli ett stort hjälpmedel i skolan. För att kunna använda roboten optimalt, önskar de att en pedagog skall vara med vid programmeringen. Eftersom roboten kommer lagra data om eleverna den arbetar tillsammans med, önskar lärarna att en tydlig policy för datalagring tas fram. Det för att reglera mängden data som får lagras och under vilken tidsperiod samt för att förhindra att elevers trygghet och integritet kränks. Det finns en viss oro för att robotarna tar över lärarens roll men framför allt tar den lärarassistenternas arbete

Photon Splatting Using a View-Sample Cluster Hierarchy

Splatting photons onto primary view samples, rather than gathering from a photon acceleration structure, can be a more efficient approach to evaluating the photon-density estimate in interactive applications, where the number of photons is often low compared to the number of view samples. Most photon splatting approaches struggle with large photon radii or high resolutions due to overdraw and insufficient culling. In this paper, we show how dynamic real-time diffuse interreflection can be achieved by using a full 3D acceleration structure built over the view samples and then splatting photons onto the view samples by traversing this data structure. Full dynamic lighting and scenes are possible by tracing and splatting photons, and rebuilding the acceleration structure every frame. We show that the number of view-sample/photon tests can be significantly reduced and suggest further culling techniques based on the normal cone of each node in the hierarchy. Finally, we present an approximate variant of our algorithm where photon traversal is stopped at a fixed level of our hierarchy, and the incoming radiance is accumulated per node and direction, rather than per view sample. This improves performance significantly with little visible degradation of quality

Exploiting coherence in time-varying voxel data

We encode time-varying voxel data for efficient storage and streaming. We store the equivalent of a separate sparse voxel octree for each frame, but utilize both spatial and temporal coherence to reduce the amount of memory needed. We represent the time-varying voxel data in a single directed acyclic graph with one root per time step. In this graph, we avoid storing identical regions by keeping one unique instance and pointing to that from several parents. We further reduce the memory consumption of the graph by minimizing the number of bits per pointer and encoding the result into a dense bitstream

Does the Supreme Court Follow the Economic Returns? A Response to A Macrotheory of the Court

Today, there is a widespread idea that parents need to learn how to carry out their roles as parents. Practices of parental learning operate throughout society. This article deals with one particular practice of parental learning, namely nanny TV, and the way in which ideal parents are constructed through such programmes. The point of departure is SOS family, a series broadcast on Swedish television in 2008. Proceeding from the theorising of governmentality developed in the wake of the work of Michel Foucault, we analyse the parental ideals conveyed in the series, as an example of the way parents are constituted as subjects in the ‘advanced liberal society’ of today. The ideal parent is a subject who, guided by the coach, is constantly endeavouring to achieve a makeover. The objective of this endeavour, however, is self-control, whereby the parents will in the end become their own coaches.

Waist-to-hip ratio and mortality in heart failure

Aims: A higher body mass index (BMI) is associated with better survival in heart failure (HF) patients, also known as the obesity paradox. However, BMI does not account for body composition. We therefore analysed the association between abdominal fat, measured via waist‐to‐hip ratio (WHR), BMI and all‐cause mortality in patients with HF. Methods and results: For this analysis, 1738 patients from the Scottish BIOlogy Study to TAilored Treatment in Chronic Heart Failure (BIOSTAT‐CHF) validation study were included. Patients without waist and hip measurements were excluded. WHR was defined as waist circumference/hip circumference, divided into tertiles and split for sex. A linear regression of principal components from an extensive panel of biomarkers was performed to provide insight in the pathophysiology behind a higher WHR. In total, 1479 patients were included, of which 33% were female and mean age was 75 ±11 years. A higher WHR was independently associated with a higher BMI, a higher prevalence of diabetes and higher New York Heart Association functional class. There was a significant interaction between sex and WHR on its association with mortality (P <0.001). In women, a higher WHR was associated with a higher mortality risk [hazard ratio (HR) 2.23, 95% confidence interval (CI) 1.37–3.63; P =0.001], whereas no significant association was found in men (HR 0.87, 95% CI 0.63–1.20; P = 0.409). We found a strong association between a higher WHR and elevated markers of inflammation and MAPK cascade in women, while these associations were less profound in men. Conclusions: A higher WHR was associated with a higher risk of death in female but not in male HF patients. These findings challenge the obesity paradox, and suggest that fat deposition is pathophysiologically harmful and may be a target for therapy in female patients with HF