Intakes of 4 dietary lignans and cause-specific and all-cause mortality in the Zutphen Elderly Study

BACKGROUND: Plant lignans are converted to enterolignans that have antioxidant and weak estrogen-like activities, and therefore they may lower cardiovascular disease and cancer risks. OBJECTIVE: We investigated whether the intakes of 4 plant lignans (lariciresinol, pinoresinol, secoisolariciresinol, and matairesinol) were inversely associated with coronary heart disease (CHD), cardiovascular diseases (CVD), cancer, and all-cause mortality. DESIGN: The Zutphen Elderly Study is a prospective cohort study in which 570 men aged 64-84 y were followed for 15 y. We recently developed a database and used it to estimate the dietary intakes of 4 plant lignans. Lignan intake was related to mortality with the use of Cox proportional hazards analysis. RESULTS: The median total lignan intake in 1985 was 977 microg/d. Tea, vegetables, bread, coffee, fruit, and wine were the major sources of lignan. The total lignan intake was not related to mortality. However, the intake of matairesinol was inversely associated with CHD, CVD, and all-cause mortality (P </= 0.05 for all) and cancer (P = 0.06). Multivariate-adjusted rate ratios (95% CI) per 1-SD increase in intake were 0.72 (0.53, 0.98) for CHD, 0.83 (0.69, 1.00) for CVD, 0.86 (0.76, 0.97) for all-cause mortality, and 0.81 (0.65, 1.00) for cancer. CONCLUSIONS: Total lignan intake was not associated with mortality. The intake of matairesinol was inversely associated with mortality due to CHD, CVD, cancer, and all causes. We cannot exclude the possibility that the inverse association between matairesinol intake and mortality is due to an associated factor, such as wine consumption

[Prevention of type 2 diabetes mellitus in primary care: the APHRODITE study]

Item does not contain fulltextOBJECTIVE: To determine the effectiveness of a 2.5-year lifestyle intervention aimed at preventing type 2 diabetes mellitus (DM2) in Dutch general practice (the APHRODITE study). DESIGN: Randomized controlled trial (NTR1082). METHODS: Based on a validated questionnaire, individuals from 14 general practices who were found to be at high risk for DM2 were randomized into either an intervention group (n = 479) or a standard-care (reference) group (n = 446). The interventions consisted of lifestyle counselling by the general practitioner and a nurse practitioner as well as group consultations. The standard-care group received verbal and written information at the start of the study. After 2.5 years, the incidence of DM2 and other clinical outcome measures from both groups were compared. RESULTS: The outcomes of both groups showed modest changes in body weight (weight (SD): intervention group: -0.8 (5.1) kg; reference group: -0.4 (4.7) kg; p = 0.69) and in glucose concentrations (fasting glucose levels (SD): intervention group: -0.17 (0.4) mmol/l; reference group: -0.10 (0.5) mmol/l; p = 0.10). No statistically significant differences between groups were found in clinical outcome measures or in the incidence of DM2. In the intervention group, the participants' level of trust in their own competence (self-efficacy) was significantly higher in individuals who had lost more than 2% body weight compared with those who had lost less than 2%. No statistically significant differences in weight loss were found between participants counselled by general practitioners or nurse practitioners with different levels of motivation, confidence in lifestyle interventions in general practice or self-efficacy regarding nutritional and physical activity counselling. CONCLUSIONS: Risk factors for DM2 could significantly be reduced in Dutch general practise. However, the effectiveness of the lifestyle intervention was modest; implementation of the programme in its current form is therefore not advisable. Adaptation or refinement of the delivery and content of the intervention is necessary to increase its effectiveness

Tools to evaluate estrogenic potency of dietary phytoestrogens: A consensus paper from the eu thematic network "Phytohealth" (QLKI-2002-2453)

Phytoestrogens are naturally occurring plantderived polyphenols with estrogenic potency. They are ubiquitous in diet and therefore, generally consumed. Among Europeans, the diet is rich in multiple putative phytoestrogens including flavonoids, tannins, stilbenoids, and lignans. These compounds have been suggested to provide beneficial effects on multiple menopause-related conditions as well as on development of hormone-dependent cancers, which has increased the interest in products and foods with high phytoestrogen content. However, phytoestrogens may as well have adverse estrogenicity related effects similar to any estrogen. Therefore, the assessment of estrogenic potency of dietary compounds is of critical importance. Due to the complex nature of estrogenicity, no single comprehensive test approach is available. Instead, several in vitro and in vivo assays are applied to evaluate estrogenic potency. In vitro estrogen receptor (ER) binding assays provide information on the ability of the compound to I) interact with ERs, II) bind to estrogen responsive element on promoter of the target gene as ligand-ER complex, and III) interact between the co-activator and ERs in ligand-dependent manner. In addition, transactivation assays in cells screen for ligand-induced ERmediated gene activation. Biochemical in vitro analysis can be used to test for possible effects on protein activities and E-screen assays to measure (anti)proliferative response in estrogen responsive cells. However, for assessment of estrogenicity in organs and tissues, in vivo approaches are essential. In females, the uterotrophic assay is applicable for testing ERa agonistic and antagonistic dietary compounds in immature or adult ovariectomized animals. In addition, mammary gland targeted estrogenicity can be detected as stimulated ductal elongation and altered formation of terminal end buds in immature or peripubertal animals. In males, Hershberger assay in peri-pubertal castrated rats can be used to detect (anti)androgenic/ (anti)estrogenic responses in accessory sex glands and other hormone regulated tissues. In addition to these short-term assays, sub-acute and chronic reproductive toxicity assays as well as two-generation studies can be applied for phytoestrogens to confirm their safety in long-term use. For reliable assessment of estrogenicity of dietary phytoestrogens in vivo, special emphasis should be focused on selection of the basal diet, route and doses of administration, and possible metabolic differences between the species used and humans. In conclusion, further development and standardization of the estrogenicity test methods are needed for better interpretation of both the potential benefits and risks of increasing consumption of phytoestrogens from diets and supplements