Effects of orange juice and proline betaine on glycine betaine and homocysteine in healthy male subjects

Background Proline betaine (PB), a glycine betaine (GB) analogue found in citrus foods, increases urinary GB loss and plasma total homocysteine (tHcy) concentrations in rats. Its presence in human plasma is associated with increased GB excretion. Aim To compare the effects of dietary levels of PB on GB excretion, and on plasma tHcy and GB concentrations in healthy volunteers. Methods In a randomized crossover study, eight healthy males (18–50 years) ingested either 750 mL orange juice (containing 0.545 g PB), a PB supplement (0.545 g PB dissolved in 750 mL apple juice), or 750 mL apple juice (control). Plasma PB, GB and tHcy, and urine PB, GB and creatinine concentrations were measured hourly for 6 h and at 24 h post-treatment. Results Plasma tHcy concentrations were not increased (relative to control) following ingestion of either orange juice or PB supplement. Both treatments produced a significant increase in plasma PB concentrations (P < 0.001), this effect being greater following orange juice compared with PB supplement (P < 0.05, 1–2 h). Urinary excretion of PB was greater than the control following both orange juice (P < 0.001) and PB supplement (P < 0.001), from 2 to 24 h post-treatment. This increase in PB excretion was significantly greater following orange juice compared with PB supplement with higher peak excretion (C _max difference, P = 0.008). GB excretion was significantly greater following ingestion of orange juice compared with PB in apple juice (P = 0.007) and apple juice control (P < 0.001) in the first 2 h post-ingestion. Conclusions PB administered in dietary doses had little effect on plasma tHcy concentrations in healthy humans. Ingestion of PB in orange juice compared with PB alone resulted in greater increases in the urinary excretion of PB and GB.     

Effects of a 3‐month supplementation with a novel soluble highly viscous polysaccharide on anthropometry and blood lipids in nondieting overweight or obese adults

Background: High viscosity fibre is known to exert many beneficial effects on appetite and metabolism. It could potentially help in weight management, in dieting or nondieting individuals. The present study investigated the effects of the daily intake of a novel high viscosity polysaccharide (HVP) over 3 months in nondieting obese or overweight men and women. Methods: The study comprised a double‐blind, randomised controlled clinical trial. Participants ingested 5–15 g per day of either HVP (n = 29, experimental group) or inulin (n = 30, control group) for 15 weeks. Changes in anthropometry (weight, waist and hip circumferences), blood lipids and glucose tolerance were studied from the beginning to the end of administration. Compliance and tolerance were examined. Results: Differences appeared between HVP and inulin supplementation in female participants only. Mean (SD) decreases in body weight [1.6 (3.2) kg; approximately 2% of initial weight] and hip circumference [2.8 (3.6 ) cm] occurred in women of the HVP group but not in controls (Time × Group interactions, P ≤ 0.002). Total, high‐density lipoprotein and low‐density lipoprotein‐cholesterol were lower at the end of supplementation in the women of the HVP group compared to controls (P ≤ 0.021). No effect appeared in waist circumference and triacylglycerol. No difference was noted in the number or severity of the adverse effects reported in both groups. Adverse effects were mild and agreed with commonly reported reactions to intake of dietary fibre. Conclusions: Beneficial although modest effects appeared after several weeks of daily HVP intake in nondieting obese or overweight women. The effects of HVP should be investigated in the context of a weight loss programme.     

Orange Juice Ingestion and Supplemental Vitamin C Are Equally Effective at Reducing Plasma Lipid Peroxidation in Healthy Adult Women

Objective: To directly examine the contribution of vitamin C to the antioxidant potential of fruits and vegetables, the antioxidant effect of orange juice consumption (8 and 16 fl. oz.) was compared to the antioxidant effect of supplemental vitamin C (dosage equivalent to that supplied by 8 fl. oz. of orange juice).

Methods: Subjects (n = 11; 28.6 ± 2.1 years) received each treatment in a 3 × 3 randomized crossover design, and each two-week treatment was preceded by a two-week washout. During the entire trial, subjects restricted fruit and vegetable consumption to ≤3 servings per day except the vitamin C-rich foods (items containing >20 mg/serving), which were restricted to ≤3 servings per week. A fasting blood sample was collected at the end of each washout and each treatment period.

Results: Following washouts, plasma vitamin C and lipid peroxidation (plasma TBARS) were similar by treatment group and averaged 25.4 ± 3.6 μmol/L and 3.82 ± 0.10 nmol/mL respectively. Plasma vitamin C concentrations were similar following each treatment period, 37.9 ± 8.1, 45.8 ± 9.4, and 38.3 ± 12.4 μmol/L for the 8 and 16 fl. oz. orange juice treatments and the supplement treatment, respectively. All intervention treatments reduced plasma TBARS as compared to pretreatment values: ?47% (p = 0.013), ?40% (p = 0.083), and ?46% (p = 0.015) for the 8 and 16 fl. oz. orange juice treatments and supplement treatment respectively.

Conclusions:These data indicate that the regular consumption of 8 fl. oz. orange juice or supplemental vitamin C (～70 mg/day) effectively reduced a marker of lipid peroxidation in plasma.     

Riboflavin Status in Acutely Ill Patients and Response to Dietary Supplements

Background: Although a number of studies have reported riboflavin deficiency in free‐living older people, no data are available on riboflavin intake and status in older people during acute illness. Methods: To determine the riboflavin response to dietary supplements during acute illness, 297 hospitalized, acutely ill older patients are randomly assigned to receive a daily oral nutritional supplement containing 1.3 mg of riboflavin or a placebo for 6 weeks. Outcome measures are riboflavin intake and riboflavin biochemical status at baseline, 6 weeks, and 6 months using the erythrocyte glutathione reductase activation coefficient (EGRAC), a measure of riboflavin tissue saturation. EGRAC values are inversely proportional to riboflavin status. Results: Fifty‐six percent of patients (167/297) have suboptimal riboflavin status (EGRAC > 1.30). No significant correlation is found between EGRAC and either total energy or riboflavin intakes. Significant correlations are found between total energy intake and riboflavin intakes both in hospital and at home (r = 0.67, P < .0001 and r = 0.57, P < .0001, respectively). Smokers and patients with chronic obstructive pulmonary disease (COPD) have lower riboflavin status (high EGRAC values) compared with nonsmokers and those without COPD. Riboflavin status improves significantly in the supplement group at 6 weeks compared with the placebo group, but status declines between 6 weeks and 6 months, after patients stop taking the supplements. Conclusions: A high proportion of acutely ill patients have suboptimal riboflavin status. Supplementation with a physiological amount of riboflavin in a mixed‐nutrient supplement significantly improves riboflavin status, but the effect is transient and status deteriorates again after patients stop taking the supplements.     

Rapid Incorporation of ω‐3 Fatty Acids Into Colonic Tissue After Oral Supplementation in Patients With Colorectal Cancer

Background: The purpose of the study was to examine whether a preoperative supplement with ω‐3 fatty acids (FAs) leads to their incorporation into colonic tissue in patients scheduled for colorectal cancer surgery. This would be of interest because ω‐3 FAs have potential beneficial (local) immunological effects that might benefit these patients. Methods: In a randomized, double‐blind, prospective, placebo‐controlled, single‐center intervention trial, patients referred for elective colorectal cancer surgery received either an ω‐3 FA–enriched oral nutrition supplement (ONS) (200 mL twice daily) providing 2.0 g of eicosapentaenoic acid (EPA) and 1.0 g of docosahexaenoic acid (DHA) per day or a standard ONS for 7 days before surgery. Tissue samples from healthy colonic tissue (mucosa and muscular layer) were obtained during surgery, and tissue fatty acid composition was analyzed by gas chromatography. Results: EPA was significantly higher in colonic mucosa (P = .001) and in the colonic muscular layer (P = .004) in the ω‐3 FA group compared with controls. Patients in the ω‐3 FA group also tended to have higher docosapentaenoic acid and DHA levels in colonic tissue. Conclusions: EPA is incorporated rapidly into colonic mucosa and colonic muscular layer in patients given 3 g of ω‐3 FA daily for 7 days before surgery for colorectal cancer. This may lead to potential beneficially effects on (local) immune function, which might benefit these patients.     

Influence of dietary carbohydrates and glycaemic response on subjective appetite and food intake in healthy elderly persons

Increased satiety and decreased food intake are reported following the consumption of low glycaemic index (GI) foods, which gradually increase blood glucose. This observation, however, is not uniformly supported and few studies have examined the impact of different GI foods on satiety and intake in the elderly. After an overnight fast, 10 men and 10 women (aged 60-82 years) consumed similar amounts of available carbohydrate as high (glucose drink or potatoes) or low (barley) GI foods or a non-energy placebo drink on four mornings. Blood glucose and subjective appetite were measured throughout a 120 min post-ingestion period, followed by consumption of an ad libitum lunch. Differences in plasma glucose after test food ingestion (glucose > potatoes > barley > placebo; P < 0.03) did not predict subjective appetite or lunch intake. Potatoes increased subjective satiety the most, followed by barley, then glucose, which trended towards greater satiety than placebo. Potatoes led to less hunger than placebo (P = 0.0023) and less prospective consumption than the other three foods (P < 0.0083), and potatoes and barley led to greater fullness than glucose and placebo (P < 0.0001). Lunch intake was decreased, compared with placebo (502 ± 47 kcal, P < 0.031), by potatoes (405 ± 40 kcal) and barley (441 ± 41 kcal); however, only potatoes (41.9 ± 12.3%) led to greater compensation at lunch for test food ingestion compared with glucose (11.9 ± 9.5%, P = 0.016). These results suggest that elderly subjects are sensitive to the effects of different foods on subjective appetite and food intake, and that the GI of the foods tested did not predict their effects on satiety and food intake.     

Plasma and Erythrocyte Zinc Concentrations and their Relationship to Dietary Zinc Intake and Zinc Supplementation During Pregnancy in Low-Income African-American Women

Objective To evaluate the effects of usual dietary intake of zinc and of zinc supplementation during pregnancy on plasma and erythrocyte zinc concentrations.Design A randomized, double-blind, placebo-controlled trial.Subjects Low-income African-American women (n=580) assigned randomly to groups at 19 weeks of gestation.Intervention A daily dose of zinc (25 mg) or a placebo until delivery.Main outcome measures Plasma, erythrocyte, and dietary zinc levels.Statistical analyses Multiple regression and repeated measures analysis of variance.Results In both the placebo and the supplemented groups, when all subjects were grouped by usual dietary zinc intake above or below the median (12 mg/day), results were the same: Women with high dietary zinc intake had higher erythrocyte zinc levels at the time of randomization and at all subsequent measurements during pregnancy than those who had low dietary zinc intake (P≤.06; difference not significant for zinc-supplemented group); no difference was observed for plasma zinc levels. On the other hand, when the subjects were stratified at the median by total daily zinc intake (usual dietary zinc + 25 mg zinc supplement) during pregnancy, a significant difference in plasma zinc levels (P<.005) was found between women with high total zinc intake (mean=38 mg/day) and low total intake (mean=13 mg/day) at 26, 32, and 38 weeks of gestation; however, no such differences were found in erythrocyte zinc levels.Applications These results should help dietitians and other health professionals better understand the expected changes in plasma and erythrocyte zinc levels during pregnancy, and the relationship between dietary and supplemental zinc and zinc nutriture. J Am Diet Assoc. 1997;97:1296-1274.     

Effects of NUTRIOSE® dietary fiber supplementation on body weight,body composition,energy intake,and hunger in overweight men

The objective of the present study was to determine the effectiveness of a soluble dietary fiber, NUTRIOSE^®, on body weight, body composition, energy intake and hunger in overweight Chinese men. The volunteers were randomized in double-blind fashion to 250 ml fruit juice supplemented with NUTRIOSE^® (Test, n = 60) or a maltodextrin (Control, n = 60) at a dosage of 17 g twice daily for 12 weeks. Body weight, body composition were performed at 0, 4, 8 and 12 weeks while daily energy intake and hunger were assessed every 3 days. Test subjects had reductions in body weight (1.5 kg, P < 0.001), body mass index (0.5 kg/m², P < 0.001) and body fat percentage (0.3%, P < 0.001) versus Controls. NUTRIOSE^® supplementation resulted in a lower daily energy intake (3,079 kJ/day, P < 0.001) with group differences noted as early as 3 days. Test subjects reported less hunger across the study period versus Controls (P < 0.01). NUTRIOSE^® supplementation for 12 weeks results in body composition improvements and reduces body weight, energy intake and hunger in overweight men.     

Effects of synbiotic supplementation on lactating mothers’ energy intake and BMI,and infants’ growth

Abstract

In this randomized, double-blind, placebo-controlled trial, 80 lactating mothers were randomly divided into two groups to receive daily supplement of synbiotic (n?=?40) or a placebo (n?=?40) for 30 days. Information on dietary intake was collected and anthropometric measurements were taken using standard calibrated instruments. Data analysis was carried out using nutritionist IV, SPSS and Epi Info software. Synbiotic supplementation resulted in a slight increase in mean energy intake while, in the placebo group, maternal energy intake decreased significantly (p?<?0.023). Although maternal weight and BMI increased slightly in the supplemented group, these two parameters decreased significantly in the placebo group (p?<?0.01). Also, infants’ weight gain in the synbiotic group was significantly higher than the placebo group after the intervention (p?<?0.044). Synbiotics may prevent weight loss in lactating mothers and result in weight gain in infants. Further experiments are required to study these effects in undernourished lactating mothers and their infants.     

Effect of consumption of tomato juice enriched with n-3 polyunsaturated fatty acids on the lipid profile, antioxidant biomarker status, and cardiovascular disease risk in healthy women

Purpose

We compared the effects of consumption of n-3 polyunsaturated fatty acids (PUFA)-enriched tomato juice versus plain tomato juice on the serum lipid profile and levels of biomarkers related to antioxidant status and cardiovascular disease (CVD) risk in women.

Methods

Eighteen healthy women participated in a 2-week intervention trial involving the daily intake of 500?mL of n-3 PUFA-enriched juice (n?=?11) or plain tomato juice (n?=?7). Each serving of enriched juice provided 250?mg of eicosapentaenoic acid (EPA) plus docosahexanoic acid (DHA). Both juices provided natural antioxidant compounds such as phenolics (181?mg) and lycopene (26.5?mg).

Results

Intervention with the enriched juice had no effect on the lipid profile, and serum levels of triglycerides and cholesterol (total, LDL, and HDL) remained unchanged. The serum antioxidant status improved following juice intake, as revealed by an increase in total antioxidant capacity and a slight decrease in lipid peroxidation. The serum levels of homocysteine, a cardiovascular risk factor, decreased following n-3 PUFA-enriched juice consumption. A decrease in vascular adhesion molecule 1 (VCAM-1) levels was also noted after intake of either plain or enriched tomato juice, whereas intercellular adhesion molecule 1 (ICAM-1) levels only decreased following intake of the enriched juice.

Conclusions

Overall, stronger positive amelioration of CVD risk factors was observed following the intake of n-3 PUFA-enriched juice than after plain tomato juice consumption, which suggested a possible synergistic action between n-3 PUFAs and tomato antioxidants.     

Effect of a blueberry nutritional supplement on macronutrients,food group intake,and plasma vitamin E and vitamin C in US athletes

Antioxidants from a blueberry beverage may impact plasma vitamins. We examined vitamins/food selection in 12 college athletes during 30 days compared with placebo. Blood was collected before and after exercise at the beginning of the study (day 1) and then after a 30-day period of taking a daily supplemental beverage (day 30). The six trials involved blood that was drawn pre-beverage ingestion/pre-exercise (trials 1 and 4), post-beverage ingestion/pre-exercise (trials 2 and 5), and post-beverage ingestion/1 h post-exercise (trials 3 and 6), on day 1 (trials 1, 2, and 3) and day 30 (trials 4, 5, and 6). Analysis of variance revealed non-significant differences for macronutrient or γ-tocopherol and vitamin C intakes by food frequency questionnaire or plasma vitamins by liquid chromatography. There was a trend (P=0.083) in the group×time interaction for α-tocopherol intake by repeated-measures analysis of variance. Blueberry α-tocopherol (23.91±9.31 mg) was significantly (P<0.05) higher than placebo α-tocopherol intake (7.59±0.95 mg) on day 1, but not on day 30 (blueberry, α-tocopherol=9.04±2.35 mg, placebo, α-tocopherol=11.46±3.65 mg) by pairwise comparisons. Blueberry supplementation did not affect plasma vitamin concentrations or γ-tocopherol and vitamin C intakes, and may reduce α-tocopherol intake in those starting with a higher α-tocopherol intake, yet not altering athletes' eating habits.     

Quercetin is bioavailable from a single ingestion of grape juice

The in vivo bioactivity of polyphenols will depend on their bioavailability. Grape juice is an important source of dietary phenolics. This paper reports results that prove that quercetin (3,3′,4′,5,7-pentahydroxyflavone) is bioavailable after a single ingestion of red grape juice by healthy volunteers. Blood plasma samples were collected before and after 2 h of ingestion of 100 ml of concentrated grape juice (n = 14), and of a placebo solution (n =6). Significant differences in the variation of the total plasma quercetin content (before and after ingestion) between the grape juice ingestion group (3.1 µg/l increase, as a mean) and the placebo group (6.0 µg/l decrease, as a mean) were found. This relatively low increase in comparison with that obtained after 2 h of ingestion of onions (201 µg/l, as a mean) and with those reported in the literature for other foods/beverages was attributed to differences in the amount of quercetin ingested, in the form in which quercetin is present, and in the food matrix.     

No effect of increased water intake on blood viscosity and cardiovascular risk factors

Observational data have suggested that increased water intake decreases the risk of CHD. A postulated mechanism is that increased water ingestion reduces blood viscosity. The aim of the present study was to assess the effect of increased fluid intake on blood viscosity. Men (n 67) and postmenopausal women (n 27) with one or more risk factors for CVD who reported intake of < or =0.5 litres water daily were randomised to a control group (n 31), an intervention group (n 32) that increased their daily water intake by 1 litre/d and an intervention group (n 31) that ingested 1 litre blueberry juice/d. All were encouraged to continue their usual diet and lifestyle. Whole-blood viscosity and blood and urine chemistries were measured by standard techniques after 2 and 4 weeks. Urine volume increased (by a median of 872 and 725 ml in the water and blueberry juice groups, respectively, v. 10 ml in the control group; P< or =0.002), confirming the subjects' adherence to the protocol. Urine osmolality and urinary levels of Na, K and creatinine decreased in the water and blueberry juice groups v. the controls (P<0.05). No change was seen in whole-blood viscosity or in levels of fibrinogen, total protein, lipids, glucose, insulin, C-peptide or other chemistry and haematology variables. In conclusion, a postulated protective effect of increased water or fluid intake is not explained by a change in blood viscosity and increased fluid intake does not influence CVD risk factors in the short term.     

Evaluation of the effects of a preoperative 2-hour fast with maltodextrine and glutamine on insulin resistance, acute-phase response, nitrogen balance, and serum glutathione after laparoscopic cholecystectomy: a controlled randomized trial

Background: Prolonged preoperative fasting increases insulin resistance (IR). The authors investigated whether an abbreviated preoperative fast with glutamine (GLN) plus a carbohydrate (CHO)–based beverage would improve the organic response after surgery. Methods: Forty‐eight female patients (19‐62 years) were randomized to either standard fasting (control group) or to fasting with 1 of 3 different beverages before video‐cholecystectomy. Beverages were consumed 8 hours (400 mL; placebo group: water; GLN group: water with 50 g maltodextrine plus 40 g GLN; and CHO group: water with 50 g maltodextrine) and 2 hours (200 mL; placebo: water; GLN: water with 25 g maltodextrine plus 10 g GLN; and CHO: water with 25 g maltodextrine) before anesthesia. Blood samples were collected pre‐ and postoperatively. Results: The mean (SEM) postoperative homeostasis model assessment–insulin resistance was greater (P < .05) in control patients (4.3 [1.3]) than in the other groups (placebo, 1.6 [0.3]; CHO, 2.3 [0.4]; and GLN, 1.5 [0.1]). Glutathione was significantly higher (P < .01) in the GLN group than in both CHO and control groups. Interleukin‐6 increased in all groups except the GLN group. The C‐reactive protein/albumin ratio was higher (P < .05) in controls than in CHO and GLN groups. The nitrogen balance was less negative in GLN (–2.5 [0.8] gN) than in both placebo (–9.0 [2] gN; P = .001) and control (–6.6 [0.4] gN; P = .04) groups. Conclusions: Preoperative intake of a GLN‐enriched CHO beverage appears to improve IR and antioxidant defenses and decreases the inflammatory response after video‐cholecystectomy.     

Molecular Mechanisms of Green Tea Polyphenols

In the Women's Health Initiative (WHI) trial of calcium plus vitamin D (CaD), we examined the treatment effect on incidence and mortality for all invasive cancers. Postmenopausal women (N = 36,282) were randomized to 1,000 mg of elemental calcium with 400 IU vitamin D3 or placebo. Cox models estimated risk of cancer incidence and mortality. After 7.0 yr, 1,306 invasive cancers were diagnosed in the supplement and 1,333 in the placebo group [hazard ratio (HR) = 0.98; CI = 0.90, 1.05, unweighted P = 0.54]. Mortality did not differ between supplement (315, annualized% = .26) and placebo [(347, 0.28%; P = 0.17; HR = 0.90 (0.77, 1.05)]. Significant treatment interactions on incident cancer were found for family history of cancer, personal total intake of vitamin D, smoking, and WHI dietary trial randomized group. Calcium/vitamin D supplementation did not reduce invasive cancer incidence or mortality. Supplementation lowered cancer risk in the WHI healthy diet trial arm and in women without a first-degree relative with cancer. The interactions are only suggestive given multiple testing considerations. The low vitamin D dose provided, limited adherence, and lack of serum 25(OH)D values should be considered when interpreting these findings.     

Calcium intake in the United States from dietary and supplemental sources across adult age groups: new estimates from the National Health and Nutrition Examination Survey 2003-2006

Background

Adequate lifelong calcium intake is essential in optimizing bone health. Recent National Health and Nutrition Examination Survey data were used to quantify variation in calcium intake across adult age groups and to relate age-associated changes in calcium intake with energy intake. Additional goals were to assess differences in dietary calcium intake between supplemental calcium users and nonusers and to evaluate associations between age and calcium density in the diet.

Design

This cross-sectional analysis determined calcium and energy intake for National Health and Nutrition Examination Survey respondents during 2003-2006. Diet was assessed with 24-hour recall and supplement use via questionnaire. Trends in median intakes for dietary calcium, total calcium, and energy across age categories were assessed using survey analysis methods. Nutrient density was represented using calcium to energy intake ratios.

Results

The analyses included data from 9,475 adults. When compared to the 19- to 30-year age group, median dietary calcium intake was lower in the ≥81-year age group by 23% in men (P<0.001) and by 14% in women (P=0.003). These reductions coincided with 35% and 28% decreases, respectively, in median energy intake (P<0.001 for each sex). In contrast, the frequency of calcium supplement use increased (P<0.001) with age in both men and women. Yet, among female supplement users, the decline in median dietary calcium intake was greater than in nonusers (P=0.02). Calcium density in the diet significantly increased relative to age in men and women (P<0.001 for each sex); however, dietary and total calcium to energy ratios were insufficient to meet target ratios inferred by adequate intake standards after age 50 years.

Conclusions

Although supplemental calcium use and calcium density were highest in older age groups, they were not sufficient in meeting recommended levels. New approaches to increasing the frequency and level of calcium supplement use to enhance calcium density in diets may be necessary to reduce osteoporosis risk among older Americans.     

Clinical Effects of Probiotic Bifidobacterium longum BB536 on Immune Function and Intestinal Microbiota in Elderly Patients Receiving Enteral Tube Feeding

Background: Immune system function declines with age. We evaluated the effects of supplementation with the probiotic Bifidobacterium longum BB536 on immune function and intestinal microbiota in the elderly. Materials and Methods: In a double‐blind study, 45 elderly patients fed by enteral tube feeding (mean [SD] age 81.7 [8.7] years) were given BB536 (n = 23) or a placebo powder (n = 22) for 12 weeks and were observed for an additional 4 weeks posttreatment. At week 4, all patients received an influenza vaccination (A/H1N1, A/H3N2, and B). Clinical data were assessed, including body temperature, bowel movements, fecal microbiota, and immunological biomarkers in blood. Results: BB536 intake significantly increased cell numbers of bifidobacteria in fecal microbiota. There was a tendency toward an increase (P = .085 at week 4 and P = .070 at week 16) of serum IgA in the BB536 group compared with the placebo group. BB536 intake did not significantly affect hemagglutination inhibition (HI) titers in response to the influenza vaccine. Natural killer (NK) cell activity decreased significantly in the placebo group during the intervention but not in the BB536 group. Among those subjects with low NK cell activity (<55%, n = 10 for each group), a significant intergroup difference (P < .05) was observed in the changed values from baseline of NK cell activity at weeks 8 and 12. Conclusions: These results shed new light on the potential of long‐term ingestion of BB536 in increasing the cell number of bifidobacteria in intestinal microbiota and modulating immune function in the elderly.     

Fluid Intake and Colorectal Cancer Risk in the Netherlands Cohort Study

Total fluid intake, specifically water intake, has been suggested to protect against colorectal cancer. We examined the association of total fluid intake with colorectal cancer endpoints and possible effect modification by fiber intake within the Netherlands Cohort Study (N = 120,852). We also investigated intake of specific beverages. After 13.3 yr, 1,443 male and 1,040 female colorectal cancer cases with complete baseline questionnaires were available for case-cohort analyses. Multivariate analyses showed no dose-response relationship of total fluid intake and intake of specific beverages with the risk of overall colorectal, proximal, and distal colon cancer. For rectal cancer risk in men, there was a nonsignificant positive trend for total fluid intake [> 1,500 vs. ≤ 1,000 ml/day: HR = 1.50, 95% CI = 0.95–2.37, P trend = 0.08) and a significant positive trend for coffee intake (> 6 vs. ≤ 2 cups/day: HR = 1.60, 95% CI = 0.96–2.66, P trend = 0.05). However, a nonsignificant positive trend for total fluid intake was no longer observed when additionally adjusting for coffee intake. Tests for interaction were not significant. In conclusion, total fluid intake was not associated with colorectal cancer risk in either men or women. There was no evidence that fiber intake modified associations. Of the specific beverages, coffee intake was positively associated with rectal cancer risk in men.     

Functionality of endogenous folates from rye and orange juice using human <Emphasis Type="Italic">in vivo</Emphasis> model

Summary. Background: Cereals contribute about a quarter of the daily folate intake from a typical diet in several European countries. However, studies on bioavailability of endogenous folates, in particular of cereal sources, are scarce. Aim of the study: We aimed to study how well natural folates from rye (different rye breads and muesli made of malted rye) and orange juice function in improving folate status of human volunteers compared to a diet containing folic acid fortified wheat bread. Methods: Healthy human volunteers aged 20–66 y took part in a four-week intervention trial in which bread, breakfast cereal and juice were provided. The study had a parallel design with two groups, 1) rye and orange juice group (33 volunteers) and 2) fortified wheat bread and apple juice group (31 volunteers). The test foods provided on average 184 μg and 188 μg folate per day in rye and wheat groups, respectively. Test foods were consumed as part of the subjects' normal diet. Results: In both groups statistically significant increases in serum and red cell folates were observed after the intervention period. The serum folate increased 26 % and 31 %, and red cell folate levels increased 17 % and 15 % in rye and orange juice and wheat and apple juice groups, respectively. The effects did not differ between the rye and wheat groups. Increases in serum and red cell folate were more profound among subjects with low starting folate levels. Decrease in the plasma homocysteine concentrations was observed only in the highest tertile of both groups but not in the group means. Conclusions: Endogenous folates incorporated into a healthy diet, even in moderate amounts, is an efficient way to improve folate status among healthy adults. Folates from different rye products and orange juice showed good bioavailability that was similar to folic acid from fortified white bread. Received: 19 July 2002, Accepted: 6 October 2002 Correspondence to: Dr. Liisa Vahteristo     

Calcium Plus Vitamin D Supplementation and Joint Symptoms in Postmenopausal Women in the Women's Health Initiative Randomized Trial

BackgroundLow vitamin D intake and levels have been associated with increased joint symptoms in some observational studies but the findings are mixed and evidence from randomized trials sparse.ObjectiveTo evaluate the influence of supplemental calcium and vitamin D on joint symptoms in the Women’s Health Initiative randomized, placebo-controlled, clinical trial.DesignIn post hoc analyses, the results of the Women’s Health Initiative randomized clinical trial in which 36,282 postmenopausal women were randomized to receive calcium carbonate (1,000 mg as elemental calcium) with vitamin D-3 (400 IU) daily or placebo were examined in the 6% subgroup of 1,911 participants, oversampled for minorities, who had serial joint symptom assessment. Qualitative information on joint pain and joint swelling was collected by questionnaire before entry and 2 years after randomization. Logistic regression models were used to compare the occurrence and severity of joint symptoms across randomization groups.ResultsAt baseline, total calcium and vitamin D intakes from diet and supplements were similar in the two randomization groups. In addition, both joint pain (reported by 73%) and joint swelling (reported by 34%) were commonly reported and comparable in the supplement and placebo groups. Two years after randomization, no statistically significant differences between supplement and placebo groups were seen for joint pain frequency (74.6% compared with 75.1% [P=0.79] for supplement and placebo groups, respectively) or joint swelling frequency (34.6% compared with 32.4% [P=0.29], respectively) or in severity scores for either outcome. Subgroup analyses suggested study participants also using nonprotocol calcium supplements at study entry may have less joint pain with supplement group randomization (interaction P=0.02).ConclusionsJoint symptoms are relatively common in postmenopausal women. However, daily supplementation with 1,000 mg calcium carbonate and 400 IU vitamin D-3 in a randomized, placebo-controlled clinical trial setting did not reduce the self-reported frequency or severity of joint symptoms.