Long-term effect of calcium-vitamin D 3 fortified milk on blood pressure and serum lipid concentrations in healthy older men

Size: px
Start display at page:

Download "Long-term effect of calcium-vitamin D 3 fortified milk on blood pressure and serum lipid concentrations in healthy older men"

Transcription

1 (2009) 63, & 2009 Macmillan Publishers Limited All rights reserved /09 $ ORIGINAL ARTICLE Long-term effect of calcium-vitamin D 3 fortified milk on blood pressure and serum lipid concentrations in healthy older men RM Daly 1 and CA Nowson 2 1 Department of Medicine (RMH/WH), Western Hospital, University of Melbourne, Melbourne, Victoria, Australia and 2 School of Exercise and Nutrition Sciences, Centre for Physical Activity and Nutrition Research, Deakin University, Melbourne, Victoria, Australia Background/Objectives: Some epidemiological and clinical studies have shown that increased dairy consumption or calcium and/or vitamin D supplementation can have a beneficial effect on blood pressure, and lipid and lipoprotein concentrations. The aim of this study was to assess the long-term effects of calcium-vitamin D 3 fortified milk on blood pressure and lipid-lipoprotein concentrations in community-dwelling older men. Subjects/Methods: This is a substudy of a 2-year randomized controlled trial in which 167 men aged 450 years were assigned to receive either 400 ml per day of reduced fat (B1%) milk fortified with approximately 1000 mg of calcium and 800 IU of vitamin D 3 or to a control group receiving no additional fortified milk. Weight, blood pressure, lipid and lipoprotein concentrations were measured every 6 months. Participants on lipid-lowering (n ¼ 32) or antihypertensive medication (n ¼ 39) were included, but those who commenced, increased or decreased their medication throughout the intervention were excluded (n ¼ 27). Results: In the 140 men included in this study (milk, n ¼ 73; control, n ¼ 67), there were no significant effects of the calciumvitamin D 3 fortified milk on weight, systolic or diastolic blood pressure, total cholesterol, high-density lipoprotein or low-density lipoprotein cholesterol or triglyceride concentrations at any time throughout the intervention. Similar results were observed after excluding men taking antihypertensive or lipid-lowering medication or limiting the analysis to those with baseline calcium intakes o1000 mg per day and/or with hypovitaminosis D (25(OH)D o75 nmol/l). Conclusions: Supplementation with reduced-fat calcium-vitamin D 3 fortified milk did not have a beneficial (nor detrimental) effect on blood pressure, lipid or lipoprotein concentrations in healthy community-dwelling older men. (2009) 63, ; doi: /ejcn ; published online 21 January 2009 Keywords: blood pressure; lipids; calcium-vitamin D 3 ; fortified milk; men Introduction High intakes of calcium and/or increased consumption of dairy foods have been reported to have beneficial effects on a number of cardiovascular and metabolic-related parameters. Several clinical trials have shown that calcium supplementation may improve serum lipid concentrations (Bell et al., 1992; Denke et al., 1993; Reid et al., 2002). Higher dietary calcium intakes, primarily from dairy products, have also been shown to be related to lower lipid concentrations, Correspondence: Professor RM Daly, Department of Medicine (RMH/WH), Western Hospital, University of Melbourne, Footscray, Melbourne, Victoria 3011, Australia. rdaly@unimelb.edu.au Received 6 June 2008; revised 11 November 2008; accepted 2 December 2008; published online 21 January 2009 independent of fat mass or waist circumference (Jacqmain et al., 2003). There is also substantial evidence indicating that increased calcium or dairy consumption can lower the risk of hypertension. The findings from a meta-analysis of controlled clinical trials indicate that calcium supplementation (diet and supplements) of mg per day for at least 2 weeks resulted in a small but significant mean 1.4 and 0.8 mm Hg reduction in systolic (SBP) and diastolic (DBP) blood pressure, respectively (Griffith et al., 1999). There was however, considerable heterogeneity in the blood pressure response to increased calcium (McCarron and Reusser, 1999; Zemel, 2001) and there is some evidence that dietary sources of calcium may result in a greater and more consistent response in lowering blood pressure than calcium supplements (Griffith et al., 1999). Epidemiological and clinical studies have also reported an inverse association between vitamin D status and blood

2 994 pressure (Kristal-Boneh et al., 1997; Scragg et al., 2007); serum 25-hydroxyvitamin D (25(OH)D) concentrations have been shown to inversely, albeit weakly, associated with hypertension or blood pressure in some (Kokot et al., 1981; Scragg et al., 2007), but not all studies (Snijder et al., 2007). The link between vitamin D and blood pressure may relate, in part, to the fact that vitamin D is a negative regulator of renin release, which is important in the regulation of blood pressure (Li et al., 2004). There are a number of studies that have also reported a beneficial effect of combined calcium and vitamin D supplementation. In elderly women with serum 25(OH)D o50 nmol/l and increased blood pressure, 8 weeks of calcium-vitamin D supplementation reduced SBP more than calcium supplementation alone (Pfeifer et al., 2001). In overweight/obese women, combined calciumvitamin D supplementation enhanced the beneficial effects of weight loss on plasma lipid concentrations (Major et al., 2007). However, there are no long-term clinical trials that have examined whether dairy products fortified with additional calcium-vitamin D 3 have a beneficial effect on blood pressure or lipid concentrations in older adults. Some evidence suggests that dairy foods, particularly low-fat dairy products, may be important in reducing the risk of various cardiovascular and metabolic-related diseases (Alonso et al., 2005; Ruidavets et al., 2006), but these findings are not consistent (Barr et al., 2000; Al-Delaimy et al., 2003; Barr, 2003). The aim of this study, which was part of a 2-year randomized controlled trial investigating the effects of calcium-vitamin D 3 fortified milk on bone mineral density (BMD) in older men (Daly et al., 2006a, b), was to examine the effect of the fortified milk on blood pressure and serum lipid-lipoprotein concentrations. Subjects and methods Subjects As described previously (Daly et al., 2006b), communityliving Caucasian men aged 450 years were recruited into this study from residential areas of Melbourne, Australia. Participants were initially excluded if they had taken calcium-vitamin D supplements in the preceding 12 months, participated in regular resistance training in the previous 6 months or greater than 150 min per week of weight-bearing exercise, had a body mass index (BMI) 435 kg/m 2, were lactose intolerant, consumed more than four alcoholic beverages per day or had a history of osteoporotic fracture or medical disease or medication use known to affect bone metabolism. All men also had a hip or spine BMD z-score within ±2 s.d. The study was approved by the Deakin University Human Research Ethics Committees, and written consent was obtained from all the participants. Randomization All men (n ¼ 167) were randomly assigned to either a calcium-vitamin D 3 fortified milk (n ¼ 85) or control group receiving no additional fortified milk (n ¼ 82) with stratification according to age (o65 or X65 years) and dietary calcium intake (o800 and X800 mg per day). Of the 167 men, 18 withdrew from the study (9 milk, 9 control), yielding a dropout rate of 10.8% (Daly et al., 2006b). The reasons for withdrawal have been described previously (Daly et al., 2006b). For this study, participants on lipidlowering (n ¼ 32) or antihypertensive medication (n ¼ 39) were included, but those who commenced (n ¼ 16), increased (n ¼ 6) or decreased (n ¼ 5) their number of lipidlowering or antihypertensive drugs throughout the intervention were excluded. Therefore, 140 men were included in this substudy (milk, n ¼ 73; controls, n ¼ 67). Milk supplementation Men randomized to receive the calcium-vitamin D 3 fortified milk were asked to consume ml tetra packs per day of reduced-fat (B1%) ultra-high temperature milk (Murray Goulburn Co-operative Co. Ltd, Australia). Each 200 ml tetra pack contained approximately 500 mg calcium (milk calcium salt, NatraCal) and 400 IU vitamin D 3, 418 kj energy, 6.6 g protein, 2.2 g fat, 11 g lactose, 100 mg sodium and 250 mg phosphorus. The milk was fortified with a calcium salt derived from fresh milk whey. The vitamin D 3 used to fortify the milk was obtained from DSM Nutritional Products Pty Ltd (NSW, Australia). As previously reported (Daly et al., 2006b), eight batches of milk were manufactured throughout the study, with participants receiving a new batch every 3 months. The quality of each batch was analyzed in terms of the calcium and vitamin D 3 level before being distributed. The mean (±s.d.) calcium and vitamin D 3 levels per 200 ml for the eight batches of milk manufactured throughout the study were 497±24 mg and 352±30 IU, respectively. Of the initial 85 men, 7 stopped taking the fortified milk at different time points throughout the intervention. Three of these men stopped taking the milk within the first 6 months, with the remaining men stopping between 11 and 21 months. Five of these men experienced gastrointestinal side effects, one participant was concerned about weight gain and one participant was no longer willing to consume the milk. The mean±s.d. reported milk compliance calculated as the percentage of the tetra packs consumed based on daily diaries was 85±21% (Daly et al., 2006b). Participants assigned to the control group continued with their usual diet. Blood pressure Systolic and diastolic blood pressures were measured while the participants were seated, after a 5-min rest period in a quiet room using an automated blood pressure monitor (Vital Care 506DXN; Criticare System Inc.). Four measurements were taken on the left arm with a 2-min interval

3 between readings; the mean of the final three readings was used in the analysis. Biochemical measurements Fasted, resting morning ( hours) blood samples were obtained at baseline and every 6 months throughout the study and stored at 80 1C until assayed. Serum total cholesterol, triglycerides and high-density lipoprotein (HDL) cholesterol were assessed at all time points using RX daytona automated chemistry analyzer (Furuno Electronic Co. Ltd, Japan). Low-density lipoprotein (LDL) cholesterol was calculated using the Friedewald formula. Each participant s samples were analyzed in the same batch. The interassay coefficients of variance (CVs) ranged from 1.5 to 4.8%. As previously reported (Daly et al., 2006b), serum intact parathyroid hormone (hpth 1 84) was measured by an immunoradiometric assay (IRMA) using the DiaSorin N-tact PTH IRMA kit (DiaSorin Inc., Stillwater, MN, USA). The interassay CV was 5.3%. Serum concentrations of 25(OH)D were measured by a two-step process using the DiaSorin RIA kit (DiaSorin Inc.). The interassay CV was 11.8%. Other measurements Height (cm), weight (kg) and BMI (kg/m 2 ) were assessed using standard techniques. Dietary intakes were estimated from 2 weekdays and 1 weekend day measured food diaries collected every 6 months, and analyzed using the Foodworks nutrient analysis software program (Xyris Software, Brisbane, Australia). The CHAMPS survey was used to assess physical activity (expressed as kj per week) at baseline and every 6 months. Information on medication use, smoking status and alcohol consumption was determined by questionnaire and confirmed by interview at the beginning and every 6 months throughout the study. Statistical analysis Baseline characteristics between the groups were compared by independent t-tests for continuous variables and w 2 -tests for categorical variables. Time, group and interaction effects were examined using pooled time series regression analysis for longitudinal data with random effects models. This analysis is similar to an intention-to-treat analysis in that it includes all participants who entered the study and had at least one follow-up measurement. All analyses were adjusted for use of antihypertensive or lipid-lowering medication, change in weight, and alcohol and saturated fat intake. The data were also analyzed after (1) excluding participants taking antihypertensive (n ¼ 28) and/or lipid-lowering medication (n ¼ 24), or (2) including only those men with low dietary calcium intakes (o1000 mg per day) and/or hypovitaminosis D (serum 25(OH)D concentration o75 nmol/l) at baseline (n ¼ 110). The following parameters were normalized by log transformation: serum 25(OH)D, Table 1 Characteristics of the study participants at baseline-bytreatment group Characteristic Milk (n ¼ 73) Control (n ¼ 67) Age (years) 61.3± ±7.5 Height (cm) 175.5± ±7.6 BMI (kg/m 2 ) 26.2± ±3.2 Physical activity (kj/week) 8800± ±8795 Current smokers (%) Alcohol consumption (%) Antihypertensive therapy (%) Lipid-lowering therapy (%) Abbreviation: BMI, body mass index. Values are mean±s.d. triglycerides and HDL cholesterol. All analyses were performed on the raw data or the natural logarithm transformed scale. All data are presented as means±s.d. or 95% CI unless otherwise stated. Results There were no differences in the baseline characteristics between two groups, with the exception that dietary calcium, saturated fat and dietary cholesterol intakes were marginally greater (11 16%) in the milk group (Tables 1 3). Of the 140 men included in this study, 60% had a dietary calcium intake below the current Australian recommended dietary intake (RDI) of 1000 mg per day for men years of age. One participant was classified as having vitamin D deficiency (25(OH)D o25 nmol/l) at study entry; twelve (8.6%) were insufficient (25(OH)D o50 nmol/l) and sixty (42.9%) were classified as having hypovitaminosis D (25(OH)D o75 nmol/l). In total, 110 men (78.6%) had a dietary calcium intake below 1000 mg per day and/or hypovitaminosis D. Fifteen men (milk, n ¼ 8; control, n ¼ 7) were hypertensive based on a SBP and/or DBP of X140 and X90 mm Hg, respectively. A total of 28 men were on antihypertensive medication (milk, n ¼ 12 (16.4%); control, n ¼ 16 (23.9%)), of which 19 were on a single therapy and 9 were on combination therapy either with a single tablet (n ¼ 3) or with dual tablets (n ¼ 5) and one participant was taking a combination of four drugs. A total of 64 men (47.4%) had elevated serum total cholesterol (45.5 mmol/l) and/or triglyceride (42.0 mmol/l) concentrations at baseline (milk, 50.7%; control, 43.9%), and 24 (17.1%) were taking lipid-lowering medication (milk, n ¼ 12; control, n ¼ 12). Twelve men were taking both antihypertensive and lipidlowering medication. There was a kg nonsignificant increase in weight in the milk group after 12 and 24 months, but there were no between-group differences for the change in weight, physical activity or total energy intake throughout the study (Tables 2 and 3). Dietary calcium and potassium intake increased in 995

4 996 Table 2 Mean daily dietary intakes of participants in the milk supplementation and control group throughout the study (by 3-day food diary) Dietary parameters Baseline 12 months 24 months Milk (n ¼ 73) Control (n ¼ 67) Milk (n ¼ 69) Control (n ¼ 62) Milk (n ¼ 66) Control (n ¼ 58) Energy intake (kj/day) 9171± ± ± ± ± ±1639 % energy carbohydrates 46.5± ± ± ± ± ±8.1 z % energy protein 18.5± ± ±2.8 z a 18.4± ±3.7 w 19.7±4.0* % energy fat 31.0± ± ± ± ±5.6 b 32.2±6.3 w Protein (g/day) 99±24 98±26 110±30 w c 100±25 108±25* 98±21 Total fat (g/day) 79±29 75±28 76±26 77±29 75±21 75±23 % energy saturated fat 12.6±3.7 d 11.2± ±2.7 z a 11.6± ±2.9 b 11.9±3.4 Alcohol intake (g/day) 15.4± ± ±15.3* 21.6± ±14.0* 17.5±16.5 Calcium (mg/day) 1030±417 d 889± ±413 z a 914± ±464 z a 870±309 Cholesterol (mg/day) 295±109 d 257± ± ± ± ±131 Potassium (mg/day) 3555± ± ±1102 z a 3486± ±999 z a 3384±857* Sodium (mg/day) 2701± ± ± ± ± ±1140 Magnesium (mg/day) 356± ±91 402±130 z 366± ± ±94 Values are the mean±s.d. *Pp0.05; w Po0.01; z Po0.001 within-group change from baseline. a Po0.001, b Po0.05, c Po0.01 represent the significance level for the group-by-time interaction at each time point. d Po0.05 vs control group. Alcohol intake represents the mean intake for men who reported consuming alcohol. the milk group and were greater than in the controls throughout the intervention (all Ps o0.001). Dietary protein (and the percentage of energy from protein) also increased in the milk group and was greater than in the control group at 12 months (Po0.01 and o0.001, respectively). The percentage of energy derived from fat increased in the control compared to milk group after 24 months (Po0.01). The change in the percentage of energy from saturated fat also differed between the two groups after 12 and 24 months (Po0.001 and o0.05, respectively). There were no betweengroup differences for any of the remaining dietary parameters. As reported previously (Daly et al., 2006b), there was a significant difference for the change in serum 25(OH)D in favor of the milk group after 12 months (Po0.001), which persisted after 24 months (Po0.001). Serum PTH concentrations decreased in the milk compared to control group after 12 months (Po0.01), and remained different after 24 months (Po0.05). Systolic and diastolic blood pressures decreased in the control relative to milk group after 6 months (both Ps o0.05), but thereafter there were no between-group differences and both blood pressure measures increased similarly in the two groups (Table 3). Similar results were observed in the 104 men who did not take antihypertensive medication throughout the study (data not shown). For all lipid parameters there were no between-group differences for the change relative to baseline in the entire cohort of men (n ¼ 140) (Table 3) or those not taking lipid-lowering medication (n ¼ 108). Similar results were also observed for both blood pressure and all lipid measures when the analyses were limited to those men with dietary calcium intakes below 1000 mg per day and/or hypovitaminosis D (25(OH)D o75 nmol/l) at baseline (data not shown). Discussion Our results indicate that daily consumption of reduced-fat milk fortified with approximately 1000 mg of calcium and 800 IU of vitamin D 3 for 2 years did not have a beneficial (nor detrimental) effect on blood pressure or lipid-lipoprotein concentrations in healthy community-dwelling older men. These findings are consistent with several short-term (Pan et al., 1993; Major et al., 2007) and long-term trials (Orwoll and Oviatt, 1990; Margolis et al., 2008) that reported that combined calcium-vitamin D supplementation did not lower blood pressure. To the best of our knowledge, our study is the longest trial to have assessed the blood pressure responses to additional calcium-vitamin D 3, using food (milk) as a carrier. Although the baseline dietary calcium intakes of the men in our study averaged 962 mg per day, which is similar to the current Australian RDI of 1000 mg per day for men aged years, 60% of the men had intakes below this level. It has been proposed that the bloodpressure-lowering effects of calcium supplementation alone tend to be greatest in those with the lowest dietary calcium intakes (o600 mg per day) before supplementation (Reid et al., 2005) and/or those who are hypertensive (Allender et al., 1996). Similarly, several meta-analyses have failed to detect a blood-pressure-lowering effect of calcium supplementation with intakes around mg per day in groups with a wide range of usual calcium intakes (Dickinson et al., 2006; van Mierlo et al., 2006). Furthermore, because only approximately 30% of the men in our study were classified as hypertensive at baseline, it is possible that the lack of an effect of calcium plus vitamin D 3 supplementation in our study, and in several previous trials (Orwoll and Oviatt, 1990; Pan et al., 1993; Major et al., 2007), was due to

5 Table 3 Mean baseline weight, 25(OH)D, PTH, blood pressure, lipid and lipoprotein concentrations in the milk supplementation and control group, and the mean absolute changes within each group relative to baseline after 6, 12, 18 and 24 months 997 Baseline D 6 months (baseline) D 12 months (baseline) D 18 months (baseline) D 24 months (baseline) Weight (kg) Milk 80.9± ( 0.5, 0.5) 0.5 (0.0, 1.1) 0.0 ( 0.6, 0.6) 0.6 ( 0.1, 1.4) Control 81.3± ( 0.7, 0.2) 0.1 ( 0.4, 0.7) 0.7 ( 1.3, 0.1)* 0.1 ( 0.6, 0.8) 25-Hydroxyvitamin D (nmol/l) Milk 78± ( 0.3, 9.5)* a 4.8 ( 0.2, 9.7)* a Control 76± ( 19.3, 8.7) z 14.4 ( 19.6, 9.1) z PTH (pg/ml) Milk 28± ( 6.1, 2.6) z b 1.8 ( 4.2, 0.6) c Control 30±9 0.1 ( 2.0, 1.7) 2.2 ( 0.2, 4.6) Systolic blood pressure (mm Hg) Milk 123.7± ( 1.4, 3.4) c 5.8 (3.6, 8.1) z 5.4 (2.8, 7.9) z 6.8 (4.2, 9.3) z Control 120.4± ( 6.2, 0.7)* 3.4 (0.6, 6.2)* 3.9 (1.2, 6.6) w 5.3 (2.4, 8.2) z Diastolic blood pressure (mm Hg) Milk 69.5± ( 2.8, 1.7) c 1.5 ( 0.6, 3.6) 4.0 (1.8, 6.2) z 4.2 (2.1, 6.2) z Control 71.0± ( 5.5, 1.6) z 0.2 ( 2.1, 2.5) 2.6 (0.8, 4.4) w 3.9 (2.0, 5.8) z Total cholesterol (mmol/l) Milk 5.21± ( 0.09, 0.20) 0.02 ( 0.19, 0.15) 0.02 ( 0.16, 0.21) 0.04 ( 0.23, 0.16) Control 5.28± ( 0.36, 0.01) 0.07 ( 0.25, 0.11) 0.11 ( 0.28, 0.07) 0.19 ( 0.39, 0.00) HDL cholesterol (mmol/l) Milk 1.42± ( 0.02, 0.07) 0.06 ( 0.11, 0.01)* 0.02 ( 0.08, 0.03) 0.06 ( 0.12, 0.01)* Control 1.42± ( 0.07, 0.05) 0.04 ( 0.09, 0.02) 0.02 ( 0.07, 0.04) 0.06 ( 0.11, 0.00) LDL cholesterol (mmol/l) Milk 3.19± ( 0.14, 0.11) 0.00 ( 0.13, 0.14) 0.03 ( 0.11, 0.18) 0.05 ( 0.20, 0.10) Control 3.23± ( 0.33, 0.06) w 0.06 ( 0.19, 0.08) 0.09 ( 0.22, 0.04) 0.13 ( 0.27, 0.01) Total/HDL cholesterol ratio Milk 3.81± ( 0.11, 0.05) 0.19 (0.09, 0.29) z 0.07 ( 0.01, 0.16) 0.15 (0.06, 0.23) w Control 3.87± ( 0.15, 0.02) 0.06 ( 0.03, 0.15) 0.03 ( 0.11, 0.06) 0.04 ( 0.07, 0.15) Triglycerides (mmol/l) Milk 1.34± ( 0.06, 0.24) 0.09 ( 0.03, 0.21) 0.03 ( 0.10, 0.15) 0.13 ( 0.06, 0.32) Control 1.39± ( 0.12, 0.27) 0.04 ( 0.05, 0.14) 0.00 ( 0.12, 0.12) 0.14 ( 0.12, 0.10) Values are mean±s.d. or mean changes from baseline (95% CI). *Po0.05; w Po0.01; z Po0.001 within-group change from baseline; a Po0.001, b Po0.01, c Po0.05 represent the significance level for the group-by-time interaction at each time point. the fact that the participants in our study had adequate calcium intakes (B1000 mg per day) and serum 25(OH)D concentrations (B75 nmol/l) and/or were normotensive before supplementation. There is some evidence to support the beneficial effects of combined calcium-vitamin D supplementation on blood pressure in subgroups of older adults. In elderly women with serum 25(OH)D concentrations o50 nmol/l and high SBP and DBP (B142 and 83 mm Hg, respectively), supplementation with 1200 mg per day calcium plus 800 IU per day vitamin D 3 resulted in a 9.3% reduction in SBP compared to supplementation with 1200 mg per day calcium alone (Pfeifer et al., 2001). The mechanisms by which calcium and/or vitamin D supplementation may lower blood pressure are uncertain, but may include suppression of renin formation by vitamin D, thereby acting as a negative endocrine regulator of the renin angiotensin system (Li et al., 2004), and/or their effects on reducing serum PTH and 1,25(OH) 2 D, which may reduce vascular smooth muscle tone and therefore peripheral vascular resistance (Zemel, 2001). In our study, we observed a significant but small reduction in serum PTH, which may be explained by the lower initial PTH concentrations in our cohort of men. Thus, it would appear that if calcium-vitamin D supplementation does have blood-pressure-lowering effects, the benefits are likely to limited to specific subsets of the population, which may include those with hypertension, low circulating 25(OH)D (or elevated 1,25(OH) 2 D) and/or elevated PTH concentrations. A unique feature of our study was that we used fortified milk to increase dietary intakes of calcium and vitamin D 3. Several studies have reported that increased consumption of

6 998 milk and other low-fat dairy products can reduce the risk of hypertension and lower blood pressure (Buonopane et al., 1992; Appel et al., 1997; Zemel et al., 2004; Alonso et al., 2005; Ruidavets et al., 2006), and may even lead to greater reductions than can be achieved by supplements alone (Griffith et al., 1999). However, there are no long-term controlled intervention studies that have confirmed this effect. It has been proposed that the range of components in dairy products (for example, potassium and magnesium) (Massey, 2001), or the interaction between different nutrients (Alonso et al., 2005; Jauhiainen and Korpela, 2007) or the small amounts of angiotensin-i-converting enzyme inhibitory peptides in milk (Jauhiainen and Korpela, 2007) may contribute to a blood-pressure-lowering effect. However, several controlled studies have failed to confirmed this finding (Lee et al., 2007; Engberink et al., 2008), which could be explained in part by differences in the amount of calcium and/or vitamin D present in milk. In our study, consumption of reduced-fat fortified milk led to a significant increase in dietary protein, potassium and magnesium, without a corresponding increase in total fat or the percentage of energy derived from saturated fat. Although saturated fat intakes remained marginally higher than the recommended maximum of 10% energy from saturated fat, there was no evidence of a blood-pressure-lowering effect of milk supplementation even after adjusting for dietary factors. Therefore, although our results contrast with several short-term intervention studies in both normotensive (Van Beresteijn et al., 1990; Buonopane et al., 1992; Hilary Green et al., 2000) and hypertensive individuals (Hilary Green et al., 2000), they are consistent with the results from a meta-analysis indicating that increasing dietary calcium has a negligible effect on lowering blood pressure (Dickinson et al., 2006). An unexpected finding in our study was the significant ( mm Hg) increase in SBP and DBP in both groups after 2 years. Although a rise in blood pressure appears to be an inevitable consequence of aging, the average age-related increase in SBP is reported to around mm Hg per year (Pearson et al., 1997; Izzo et al., 2000). Given that there were no marked changes in any of the well-known determinants of blood pressure in our study, we are unable to explain the relatively large increases in blood pressure in both groups, but importantly there was no difference between the supplemented and control groups. Previous intervention studies examining the effects of milk supplementation or increased dairy consumption on lipid concentrations have produced varying results, which are likely due to differences in the amount and fat composition of the milk (or dairy product) used, participant characteristics, study duration and/or whether the intervention was combined with weight loss or a low-fat diet (Buonopane et al., 1992; Steinmetz et al., 1994; Barr et al., 2000; Zemel et al., 2004). Our findings are consistent with a 12-week trial that found that advice to drink three glasses of skim or fat-reduced milk per day did not change any lipid parameter in older men and women (Barr et al., 2000). Whole milk contains a significant amount of saturated fat, which raises serum cholesterol and LDL cholesterol (Stone, 1990), but other components in milk, including possibly vitamin D, may moderate any adverse effects on serum lipids; and low-fat milk products contain less saturated fat than whole milk. There are also mixed results regarding the effects of calcium supplementation on lipid concentrations (Bostick et al., 2000; Reid et al., 2002). Although supplementary calcium phosphate has been found to increase bile acid excretion (Ditscheid et al., 2005) and an increase in fecal fat excretion was observed when calcium intake was increased by around 1200 mg per day (Jacobsen et al., 2005), this effect is unlikely to be replicated when dietary calcium is increased through the consumption of food products. There are several key limitations with our study. First, neither blood pressure nor the lipid parameters were our prespecified primary end points. Second, our cohort included predominantly well-nourished healthy men, with some taking medication for the treatment of hypertension or hyperlipidemia. Although similar results were observed when we excluded these men from the analysis, the findings from this study cannot be extrapolated to other groups. Furthermore, post hoc estimates of the sample size required to detect any potential effects of the fortified milk on blood pressure indicate that our study lacked statistical power to detect differences in blood pressure. The expected between-group differences in blood pressure and total cholesterol were estimated to be 3.5 mm Hg (s.d. 9.0 mm Hg) and 0.5 mmol/l (s.d. 1.0 mmol/l), respectively. Thus, to provide 80% power to detect this difference at the 5% significance level, a sample size of 105 and 64 per group would be required. In conclusion, consumption of 400 ml per day of reducedfat fortified milk containing approximately 1000 mg per day of calcium and 800 IU per day of vitamin D 3 for 2 years does not have a beneficial nor detrimental effect on blood pressure or lipid-lipoprotein concentrations in healthy community-living older men. Therefore, these findings do not support the role for increasing dietary calcium and vitamin D to these levels as a strategy to control blood pressure or an adverse lipid profile in healthy older men. Acknowledgements We thank Murray Goulburn Co-operative Co. Ltd for providing the calcium-vitamin D 3 fortified milk used in the study. We also thank Jeni Black, Joanne Daly and Sam Korn for their assistance with the clinical testing, and Sandra Godfrey and Nicole Fitzpatrick for performing the hormonal and biochemical analyses. Most importantly, we are indebted to the volunteers whose cooperation and dedication made this study possible. This study was financially supported by a grant from the Geoffrey Gardiner Dairy Foundation. Associate professor Robin Daly was supported by a National Health and Medical Research Council (NHMRC) Career Development Award (ID ).

7 Disclosure/Conflict of interest The authors have no conflicts of interest. References Al-Delaimy WK, Rimm E, Willett WC, Stampfer MJ, Hu FB (2003). A prospective study of calcium intake from diet and supplements and risk of ischemic heart disease among men. Am J Clin Nutr 77, Allender PS, Cutler JA, Follmann D, Cappuccio FP, Pryer J, Elliott P (1996). Dietary calcium and blood pressure: a meta-analysis of randomized clinical trials. Ann Intern Med 124, Alonso A, Beunza JJ, Delgado-Rodriguez M, Martinez JA, Martinez- Gonzalez MA (2005). Low-fat dairy consumption and reduced risk of hypertension: the Seguimiento Universidad de Navarra (SUN) cohort. Am J Clin Nutr 82, Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP, Sacks FM et al. (1997). A clinical trial of the effects of dietary patterns on blood pressure. DASH Collaborative Research Group. N Engl J Med 336, Barr SI, McCarron DA, Heaney RP, Dawson-Hughes B, Berga SL, Stern JS et al. (2000). Effects of increased consumption of fluid milk on energy and nutrient intake, body weight, and cardiovascular risk factors in healthy older adults. J Am Diet Assoc 100, Barr SI (2003). Increased dairy product or calcium intake: is body weight or composition affected in humans? J Nutr 133, 245S 248S. Bell L, Halstenson CE, Halstenson CJ, Macres M, Keane WF (1992). Cholesterol-lowering effects of calcium carbonate in patients with mild to moderate hypercholesterolemia. Arch Intern Med 152, Bostick RM, Fosdick L, Grandits GA, Grambsch P, Gross M, Louis TA (2000). Effect of calcium supplementation on serum cholesterol and blood pressure. A randomized, double-blind, placebo-controlled, clinical trial. Arch Fam Med 9, Buonopane GJ, Kilara A, Smith JS, McCarthy RD (1992). Effect of skim milk supplementation on blood cholesterol concentration, blood pressure, and triglycerides in a free-living human population. J Am Coll Nutr 11, Daly RM, Bass S, Nowson C (2006a). Long-term effects of calciumvitamin-d3-fortified milk on bone geometry and strength in older men. Bone 39, Daly RM, Brown M, Bass S, Kukuljan S, Nowson CA (2006b). Calcium and vitamin D3 fortified milk reduces bone loss at clinically relevant skeletal sites in older men: a 2-year randomised controlled trial. J Bone Miner Res 31, Denke MA, Fox MM, Schulte MC (1993). Short-term dietary calcium fortification increases fecal saturated fat content and reduces serum lipids in men. J Nutr 123, Dickinson HO, Nicolson DJ, Cook JV, Campbell F, Beyer FR, Ford GA et al. (2006). Calcium supplementation for the management of primary hypertension in adults. Cochrane Database Syst Rev CD Ditscheid B, Keller S, Jahreis G (2005). Cholesterol metabolism is affected by calcium phosphate supplementation in humans. J Nutr 135, Engberink MF, Schouten EG, Kok FJ, van Mierlo LA, Brouwer IA, Geleijnse JM (2008). Lactotripeptides show no effect on human blood pressure: results from a double-blind randomized controlled trial. Hypertension 51, Griffith LE, Guyatt GH, Cook RJ, Bucher HC, Cook DJ (1999). The influence of dietary and nondietary calcium supplementation on blood pressure: an updated metaanalysis of randomized controlled trials. Am J Hypertens 12, Hilary Green J, Richards JK, Bunning RL (2000). Blood pressure responses to high-calcium skim milk and potassium-enriched high-calcium skim milk. J Hypertens 18, Izzo Jr JL, Levy D, Black HR (2000). Clinical Advisory Statement. Importance of systolic blood pressure in older Americans. Hypertension 35, Jacobsen R, Lorenzen JK, Toubro S, Krog-Mikkelsen I, Astrup A (2005). Effect of short-term high dietary calcium intake on 24-h energy expenditure, fat oxidation, and fecal fat excretion. Int J Obes (London) 29, Jacqmain M, Doucet E, Despres JP, Bouchard C, Tremblay A (2003). Calcium intake, body composition, and lipoprotein-lipid concentrations in adults. Am J Clin Nutr 77, Jauhiainen T, Korpela R (2007). Milk peptides and blood pressure. J Nutr 137, 825S 829S. Kokot F, Pietrek J, Srokowska S, Wartenberg W, Kuska J, Jedrychowska M et al. (1981). 25-Hydroxyvitamin D in patients with essential hypertension. Clin Nephrol 16, Kristal-Boneh E, Froom P, Harari G, Ribak J (1997). Association of calcitriol and blood pressure in normotensive men. Hypertension 30, Lee YM, Skurk T, Hennig M, Hauner H (2007). Effect of a milk drink supplemented with whey peptides on blood pressure in patients with mild hypertension. Eur J Nutr 46, Li YC, Qiao G, Uskokovic M, Xiang W, Zheng W, Kong J (2004). Vitamin D: a negative endocrine regulator of the renin angiotensin system and blood pressure. J Steroid Biochem Mol Biol 89 90, Major GC, Alarie F, Dore J, Phouttama S, Tremblay A (2007). Supplementation with calcium þ vitamin D enhances the beneficial effect of weight loss on plasma lipid and lipoprotein concentrations. Am J Clin Nutr 85, Margolis KL, Ray RM, Van Horn L, Manson JE, Allison MA, Black HR et al. (2008). Effect of calcium and vitamin D supplementation on blood pressure: the Women s Health Initiative Randomized Trial. Hypertension 52, Massey LK (2001). Dairy food consumption, blood pressure and stroke. J Nutr 131, McCarron DA, Reusser ME (1999). Finding consensus in the dietary calcium blood pressure debate. J Am Coll Nutr 18, 398S 405S. Orwoll ES, Oviatt S (1990). Relationship of mineral metabolism and long-term calcium and cholecalciferol supplementation to blood pressure in normotensive men. Am J Clin Nutr 52, Pan WH, Wang CY, Li LA, Kao LS, Yeh SH (1993). No significant effect of calcium and vitamin D supplementation on blood pressure and calcium metabolism in elderly Chinese. Chin J Physiol 36, Pearson JD, Morrell CH, Brant LJ, Landis PK, Fleg JL (1997). Age-associated changes in blood pressure in a longitudinal study of healthy men and women. J Gerontol A Biol Sci Med Sci 52, M177 M183. Pfeifer M, Begerow B, Minne HW, Nachtigall D, Hansen C (2001). Effects of a short-term vitamin D(3) and calcium supplementation on blood pressure and parathyroid hormone levels in elderly women. J Clin Endocrinol Metab 86, Reid IR, Mason B, Horne A, Ames R, Clearwater J, Bava U et al. (2002). Effects of calcium supplementation on serum lipid concentrations in normal older women: a randomized controlled trial. Am J Med 112, Reid IR, Horne A, Mason B, Ames R, Bava U, Gamble GD (2005). Effects of calcium supplementation on body weight and blood pressure in normal older women: a randomized controlled trial. J Clin Endocrinol Metab 90, Ruidavets JB, Bongard V, Simon C, Dallongeville J, Ducimetiere P, Arveiler D et al. (2006). Independent contribution of dairy products and calcium intake to blood pressure variations at a population level. J Hypertens 24,

8 1000 Scragg R, Sowers M, Bell C (2007). Serum 25-hydroxyvitamin D, ethnicity, and blood pressure in the Third National Health and Nutrition Examination Survey. Am J Hypertens 20, Snijder MB, Lips P, Seidell JC, Visser M, Deeg DJ, Dekker JM et al. (2007). Vitamin D status and parathyroid hormone levels in relation to blood pressure: a population-based study in older men and women. J Intern Med 261, Steinmetz KA, Childs MT, Stimson C, Kushi LH, McGovern PG, Potter JD et al. (1994). Effect of consumption of whole milk and skim milk on blood lipid profiles in healthy men. Am J Clin Nutr 59, Stone NJ (1990). Diet, lipids, and coronary heart disease. Endocrinol Metab Clin North Am 19, Van Beresteijn EC, van Schaik M, Schaafsma G (1990). Milk: does it affect blood pressure? A controlled intervention study. J Intern Med 228, van Mierlo LA, Arends LR, Streppel MT, Zeegers MP, Kok FJ, Grobbee DE et al. (2006). Blood pressure response to calcium supplementation: a meta-analysis of randomized controlled trials. J Hum Hypertens 20, Zemel MB (2001). Calcium modulation of hypertension and obesity: mechanisms and implications. J Am Coll Nutr 20, 428S 435S; discussion 440S 442S. Zemel MB, Thompson W, Milstead A, Morris K, Campbell P (2004). Calcium and dairy acceleration of weight and fat loss during energy restriction in obese adults. Obes Res 12,

Robin M Daly, Nicole Petrass, Shona Bass, and Caryl A Nowson

Robin M Daly, Nicole Petrass, Shona Bass, and Caryl A Nowson The skeletal benefits of calcium- and vitamin D 3 fortified milk are sustained in older men after withdrawal of supplementation: an 18-mo follow-up study 1 3 Robin M Daly, Nicole Petrass, Shona Bass, and

More information

Milk and weight management

Milk and weight management Milk and weight management Angelo Tremblay Division of Kinesiology Human obesity: is insufficient calcium/dairy intake part of the problem? Risk factors for overweight and obesity in adulthood: Results

More information

POTASSIUM. The Facts. compiled by the Nestlé Research Center

POTASSIUM. The Facts. compiled by the Nestlé Research Center POTASSIUM The Facts compiled by the Nestlé Research Center A public health concern? Studies have shown that a diet high in sodium or low in potassium is linked with a higher risk for elevated blood pressure

More information

Supplementary appendix

Supplementary appendix Supplementary appendix This appendix formed part of the original submission and has been peer reviewed. We post it as supplied by the authors. Supplement to: Bolland MJ, Grey A, Gamble GD, Reid IR. The

More information

Dairy Intake and Risk Factors for Chronic Disease

Dairy Intake and Risk Factors for Chronic Disease Dairy Intake and Risk Factors for Chronic Disease Seminar, Nutrition 566-1 Amber Brouillette Hannah Griswold LETS TAKE A POLL Claims for Dairy Consumption Unnatural Claims Against Cancer development High

More information

ORIGINAL INVESTIGATION. C-Reactive Protein Concentration and Incident Hypertension in Young Adults

ORIGINAL INVESTIGATION. C-Reactive Protein Concentration and Incident Hypertension in Young Adults ORIGINAL INVESTIGATION C-Reactive Protein Concentration and Incident Hypertension in Young Adults The CARDIA Study Susan G. Lakoski, MD, MS; David M. Herrington, MD, MHS; David M. Siscovick, MD, MPH; Stephen

More information

Bone Metabolism in Postmenopausal Women Influenced by the Metabolic Syndrome

Bone Metabolism in Postmenopausal Women Influenced by the Metabolic Syndrome Bone Metabolism in Postmenopausal Women Influenced by the Metabolic Syndrome Thomas et al. Nutrition Journal (2015) 14:99 DOI 10.1186/s12937-015-0092-2 RESEARCH Open Access Acute effect of a supplemented

More information

MILK. Nutritious by nature. The science behind the health and nutritional impact of milk and dairy foods

MILK. Nutritious by nature. The science behind the health and nutritional impact of milk and dairy foods MILK Nutritious by nature The science behind the health and nutritional impact of milk and dairy foods Weight control Contrary to the popular perception that dairy foods are fattening, a growing body of

More information

Role of Minerals in Hypertension

Role of Minerals in Hypertension Role of Minerals in Hypertension Lecture objectives By the end of the lecture students will be able to Define primary and secondary hypertention and their risk factors. Relate role of minerals with hypertention.

More information

Calcium, Dairy Products and Weight Management

Calcium, Dairy Products and Weight Management Calcium, Dairy Products and Weight Management Arne Astrup Head, professor, MD, DMSc Slide 1 Is there How evidence does eating of benefit dairy from products dairy foods? impact health in the long run?

More information

Dairy Intake, Blood Pressure, and Incident Hypertension in a General Dutch Population 1 3

Dairy Intake, Blood Pressure, and Incident Hypertension in a General Dutch Population 1 3 The Journal of Nutrition Nutritional Epidemiology Dairy Intake, Blood Pressure, and Incident Hypertension in a General Dutch Population 1 3 Mariëlle F. Engberink, 4 Johanna M. Geleijnse, 4 * Nynke de Jong,

More information

UCLA Nutrition Bytes. Title. Permalink. Journal ISSN. Author. Publication Date. Calcium and Hypertension. https://escholarship.org/uc/item/68b658ss

UCLA Nutrition Bytes. Title. Permalink. Journal ISSN. Author. Publication Date. Calcium and Hypertension. https://escholarship.org/uc/item/68b658ss UCLA Nutrition Bytes Title Calcium and Hypertension Permalink https://escholarship.org/uc/item/68b658ss Journal Nutrition Bytes, 4(2) ISSN 1548-601X Author Martinez, Christina Publication Date 1998-01-01

More information

ISPUB.COM. Comparing Weight Reduction and Medications in Treating Mild Hypertension: A Systematic Literature Review. S Hamlin, T Brown BACKGROUND

ISPUB.COM. Comparing Weight Reduction and Medications in Treating Mild Hypertension: A Systematic Literature Review. S Hamlin, T Brown BACKGROUND ISPUB.COM The Internet Journal of Advanced Nursing Practice Volume 3 Number 2 Comparing Weight Reduction and Medications in Treating Mild Hypertension: A Systematic Literature S Hamlin, T Brown Citation

More information

A cross-sectional study on association of calcium intake with blood pressure in Japanese population

A cross-sectional study on association of calcium intake with blood pressure in Japanese population (2002) 16, 105 110 2002 Nature Publishing Group All rights reserved 0950-9240/02 $25.00 www.nature.com/jhh ORIGINAL ARTICLE A cross-sectional study on association of calcium intake with blood pressure

More information

Emerging Areas Relating Vitamin D to Health

Emerging Areas Relating Vitamin D to Health ILSI SEA Region Vit D Conference, Australia, June 2012 (www.ilsi.org/sea Region) Emerging Areas Relating Vitamin D to Health Peter R Ebeling MD FRACP NorthWest Academic Centre and Dept Endocrinology The

More information

Hypertension with Comorbidities Treatment of Metabolic Risk Factors in Children and Adolescents

Hypertension with Comorbidities Treatment of Metabolic Risk Factors in Children and Adolescents Hypertension with Comorbidities Treatment of Metabolic Risk Factors in Children and Adolescents Stella Stabouli Ass. Professor Pediatrics 1 st Department of Pediatrics Hippocratio Hospital Evaluation of

More information

Relationship between dietary sodium, potassium, and calcium, anthropometric indexes, and blood pressure in young and middle aged Korean adults

Relationship between dietary sodium, potassium, and calcium, anthropometric indexes, and blood pressure in young and middle aged Korean adults Nutrition Research and Practice (Nutr Res Pract) 2010;4(2):155-162 DOI: 10.4162/nrp.2010.4.2.155 Relationship between dietary sodium, potassium, and calcium, anthropometric indexes, and blood pressure

More information

Vitamin D status and parathyroid hormone levels in relation to blood pressure: a population-based study in older men and women

Vitamin D status and parathyroid hormone levels in relation to blood pressure: a population-based study in older men and women Original Article doi: 10.1111/j.1365-2796.2007.01778.x Vitamin D status and parathyroid hormone levels in relation to blood pressure: a population-based study in older men and women M. B. Snijder 1,2,

More information

w High Blood Pressure Guidelines Create New At-Risk Classification

w High Blood Pressure Guidelines Create New At-Risk Classification Journal of Cardiovascular Nursing Vol. 19, No. 6, pp 357-371 2004 LippincoltWilliams SWilkins, Inc. w High Blood Pressure Guidelines Create New At-Risk Classification Changes in Blood Pressure Classification

More information

NIH Public Access Author Manuscript J Steroid Biochem Mol Biol. Author manuscript; available in PMC 2011 February 10.

NIH Public Access Author Manuscript J Steroid Biochem Mol Biol. Author manuscript; available in PMC 2011 February 10. NIH Public Access Author Manuscript Published in final edited form as: J Steroid Biochem Mol Biol. 2010 July ; 121(1-2): 445 447. doi:10.1016/j.jsbmb.2010.04.013. 1,25-Dihydroxyvitamin D 3 reduces systolic

More information

The CARI Guidelines Caring for Australians with Renal Impairment. Cardiovascular Risk Factors

The CARI Guidelines Caring for Australians with Renal Impairment. Cardiovascular Risk Factors Cardiovascular Risk Factors ROB WALKER (Dunedin, New Zealand) Lipid-lowering therapy in patients with chronic kidney disease Date written: January 2005 Final submission: August 2005 Author: Rob Walker

More information

ARTICLE. Dietary Nutrients and Blood Pressure in Urban Minority Adolescents at Risk for Hypertension

ARTICLE. Dietary Nutrients and Blood Pressure in Urban Minority Adolescents at Risk for Hypertension ARTICLE Dietary Nutrients and Blood Pressure in Urban Minority Adolescents at Risk for Hypertension Bonita Falkner, MD; Katherine Sherif, MD; Suzanne Michel, MPH, RD; Harvey Kushner, PhD Objective: To

More information

Dietary Fatty Acids and the Risk of Hypertension in Middle-Aged and Older Women

Dietary Fatty Acids and the Risk of Hypertension in Middle-Aged and Older Women 07/14/2010 Dietary Fatty Acids and the Risk of Hypertension in Middle-Aged and Older Women First Author: Wang Short Title: Dietary Fatty Acids and Hypertension Risk in Women Lu Wang, MD, PhD, 1 JoAnn E.

More information

Dietary intake in male and female smokers, ex-smokers, and never smokers: The INTERMAP Study

Dietary intake in male and female smokers, ex-smokers, and never smokers: The INTERMAP Study (2003) 17, 641 654 & 2003 Nature Publishing Group All rights reserved 0950-9240/03 $25.00 www.nature.com/jhh ORIGINAL ARTICLE Dietary intake in male and female smokers, ex-smokers, and never smokers: The

More information

ASSOCIATION BETWEEN DIETARY CALCIUM INTAKES AND WEIGHT LOSS

ASSOCIATION BETWEEN DIETARY CALCIUM INTAKES AND WEIGHT LOSS ASSOCIATION BETWEEN DIETARY CALCIUM INTAKES AND WEIGHT LOSS Presented By: Prof. Mohamed S. Ismail Institution Current: Dept. Clin. Nutr. Univ. Of Dammam, KSA Permanent: Nutr. Food Sci. Menoufia Univ. Egypt

More information

The Auckland calcium study: 5-year post-trial follow-up

The Auckland calcium study: 5-year post-trial follow-up Osteoporos Int (2014) 25:297 304 DOI 10.1007/s00198-013-2526-z ORIGINAL ARTICLE The Auckland calcium study: 5-year post-trial follow-up L. T. Radford & M. J. Bolland & B. Mason & A. Horne & G. D. Gamble

More information

Vitamin D. Vitamin functioning as hormone. Todd A Fearer, MD FACP

Vitamin D. Vitamin functioning as hormone. Todd A Fearer, MD FACP Vitamin D Vitamin functioning as hormone Todd A Fearer, MD FACP Vitamin overview Vitamins are organic compounds that are essential in small amounts for normal metabolism They are different from minerals

More information

Hypertension, which affects approximately 50 million

Hypertension, which affects approximately 50 million AJH 2001; 14:206S 212S Are Low Intakes of Calcium and Potassium Important Causes of Cardiovascular Disease? David A. McCarron and Molly E. Reusser Inadequate levels of calcium and potassium intake have

More information

Managing High Blood Pressure Naturally. Michael A. Smith, MD Life Extension s Healthy Talk Series

Managing High Blood Pressure Naturally. Michael A. Smith, MD Life Extension s Healthy Talk Series Managing High Blood Pressure Naturally Michael A. Smith, MD Life Extension s Healthy Talk Series Part 1 What is Blood Pressure? Blood Pressure Systole Systolic Forward Pressure 110 mmhg 70 mmhg Diastole

More information

Obesity Prevention and Control: Provider Education with Patient Intervention

Obesity Prevention and Control: Provider Education with Patient Intervention Obesity Prevention and : Provider Education with Patient Summary Evidence Table and Population Cohen et al. (1991) 1987-1988 : RCT Location: Pittsburgh, PA Physician training session by a behavioral psychologist

More information

Feasibility and Effect on Blood Pressure of 6-Week Trial of Low Sodium Soy Sauce and Miso (Fermented Soybean Paste)

Feasibility and Effect on Blood Pressure of 6-Week Trial of Low Sodium Soy Sauce and Miso (Fermented Soybean Paste) Circ J 2003; 67: 530 534 Feasibility and Effect on Blood Pressure of 6-Week Trial of Low Sodium Soy Sauce and Miso (Fermented Soybean Paste) Mieko Nakamura, MD; Nobuo Aoki, MD; Takuji Yamada, MD*; Nobuaki

More information

A systematic review of the effects of calcium supplementation on body weight

A systematic review of the effects of calcium supplementation on body weight British Journal of Nutrition (2006), 95, 1033 1038 q The Authors 2006 DOI: 10.1079/BJN20051727 Review Article A systematic review of the effects of calcium supplementation on body weight Rebecca Trowman

More information

Metabolic Syndrome Case Presentation. Presented by: Keonie Moore (B. Naturopathy SCU NHAA) IMER The Alfred Hospital 5 June 2013

Metabolic Syndrome Case Presentation. Presented by: Keonie Moore (B. Naturopathy SCU NHAA) IMER The Alfred Hospital 5 June 2013 Metabolic Syndrome Case Presentation Presented by: Keonie Moore (B. Naturopathy SCU NHAA) IMER The Alfred Hospital 5 June 2013 Presenting Complaint: August 2011 51 year female presented with osteopenia

More information

THE NEW ZEALAND MEDICAL JOURNAL

THE NEW ZEALAND MEDICAL JOURNAL THE NEW ZEALAND MEDICAL JOURNAL Vol 116 No 1179 ISSN 1175 8716 Efficacy of an oral, 10-day course of high-dose calciferol in correcting vitamin D deficiency Fiona Wu, Toni Staykova, Anne Horne, Judy Clearwater,

More information

Association between Raised Blood Pressure and Dysglycemia in Hong Kong Chinese

Association between Raised Blood Pressure and Dysglycemia in Hong Kong Chinese Diabetes Care Publish Ahead of Print, published online June 12, 2008 Raised Blood Pressure and Dysglycemia Association between Raised Blood Pressure and Dysglycemia in Hong Kong Chinese Bernard My Cheung,

More information

Supplementary Appendix

Supplementary Appendix Supplementary Appendix This appendix has been provided by the authors to give readers additional information about their work. Supplement to: Wanner C, Inzucchi SE, Lachin JM, et al. Empagliflozin and

More information

Calcium and Vitamin D Supplementation is an Ineffective Strategy for the Prevention of Fractures in Older People

Calcium and Vitamin D Supplementation is an Ineffective Strategy for the Prevention of Fractures in Older People Calcium and Vitamin D Supplementation is an Ineffective Strategy for the Prevention of Fractures in Older People For the Motion: Professor Roger Francis, Institute for Ageing and Health, Newcastle University,

More information

original Se Hwa Kim 1), Tae Ho Kim 1) and Soo-Kyung Kim 2)

original Se Hwa Kim 1), Tae Ho Kim 1) and Soo-Kyung Kim 2) Endocrine Journal 2014, 61 (12), 1197-1204 original Effect of high parathyroid hormone level on bone mineral density in a vitamin D-sufficient population: Korea National Health and Nutrition Examination

More information

Diet, Lifestyle and Obesity Management. Healthy behaviours and interventions remain the cornerstone of chronic disease management and

Diet, Lifestyle and Obesity Management. Healthy behaviours and interventions remain the cornerstone of chronic disease management and Diet, Lifestyle and Obesity Management Healthy behaviours and interventions remain the cornerstone of chronic disease management and prevention. They should be universally applied to all of those with

More information

New Hypertension Guideline Recommendations for Adults July 7, :45-9:30am

New Hypertension Guideline Recommendations for Adults July 7, :45-9:30am Advances in Cardiovascular Disease 30 th Annual Convention and Reunion UERM-CMAA, Inc. Annual Convention and Scientific Meeting July 5-8, 2018 New Hypertension Guideline Recommendations for Adults July

More information

Clinical Recommendations: Patients with Periodontitis

Clinical Recommendations: Patients with Periodontitis The American Journal of Cardiology and Journal of Periodontology Editors' Consensus: Periodontitis and Atherosclerotic Cardiovascular Disease. Friedewald VE, Kornman KS, Beck JD, et al. J Periodontol 2009;

More information

Metabolic Health: The impact of Dairy Matrix. Arne Astrup, MD, DMSc Head of department & professor. Department of Nutrition, Exercise and Sports

Metabolic Health: The impact of Dairy Matrix. Arne Astrup, MD, DMSc Head of department & professor. Department of Nutrition, Exercise and Sports Department of Nutrition, Exercise and Sports Metabolic Health: The impact of Dairy Matrix 3 October 2017 Dias 1 Arne Astrup, MD, DMSc Head of department & professor Department of Nutrition, Exercise and

More information

Metabolic Health: The impact of Dairy Matrix. Arne Astrup, MD, DMSc Head of department & professor. Department of Nutrition, Exercise and Sports

Metabolic Health: The impact of Dairy Matrix. Arne Astrup, MD, DMSc Head of department & professor. Department of Nutrition, Exercise and Sports Metabolic Health: The impact of Dairy Matrix 1 November 2017 Dias 1 Arne Astrup, MD, DMSc Head of department & professor EFSA: As low as possible 1 November 2017 Dias 2 People don t want to hear the truth

More information

A Study on Prevalence of Hypertension among Chronic Kidney Disease Patients admitted in the Nephrology Department of CAIMS, Karimnagar

A Study on Prevalence of Hypertension among Chronic Kidney Disease Patients admitted in the Nephrology Department of CAIMS, Karimnagar Original Article A Study on Prevalence of Hypertension among Chronic Kidney Disease Patients admitted in the Nephrology Department of CAIMS, Karimnagar Murari Rajendra Prasad 1, Gopal Rao Jogdand 2, Mahesh

More information

Metformin should be considered in all patients with type 2 diabetes unless contra-indicated

Metformin should be considered in all patients with type 2 diabetes unless contra-indicated November 2001 N P S National Prescribing Service Limited PPR fifteen Prescribing Practice Review PPR Managing type 2 diabetes For General Practice Key messages Metformin should be considered in all patients

More information

Nutrition and gastrointestinal cancer: An update of the epidemiological evidence

Nutrition and gastrointestinal cancer: An update of the epidemiological evidence Nutrition and gastrointestinal cancer: An update of the epidemiological evidence Krasimira Aleksandrova, PhD MPH Nutrition, Immunity and Metabolsim Start-up Lab Department of Epidemiology German Institute

More information

Professor Clare Collins

Professor Clare Collins Dietary Patterns and Cardiovascular Disease (CVD) Outcomes: An evidence summary Professor Clare Collins PhD, BSc, Dip Nutr&Diet, Dip Clin Epi, advapd, FDAA Director of Research, School of Health Sciences,

More information

Forebyggelse af metabolisk syndrom vha. mejeriprodukter

Forebyggelse af metabolisk syndrom vha. mejeriprodukter Forebyggelse af metabolisk syndrom vha. mejeriprodukter Kjeld Hermansen Medicinsk Endokrinologisk afd. MEA, Aarhus Universitetshospital Mejeriforskningens Dag 2. marts 2017, Hotel Legoland Metabolic Syndrome

More information

V t i amin i n D a nd n d Calc l iu i m u : Rol o e l in i n Pr P eve v nt n io i n and n d Tr T eatment n of o Fr F actur u es and n d Fa F ll l s

V t i amin i n D a nd n d Calc l iu i m u : Rol o e l in i n Pr P eve v nt n io i n and n d Tr T eatment n of o Fr F actur u es and n d Fa F ll l s Vitamin D and Calcium: Role in Prevention and Treatment of Fractures and Falls Osteoporosis 21: New Insights In Research, Diagnosis, and Clinical Care Deborah Sellmeyer, MD Director, Johns Hopkins Metabolic

More information

A Dietary Approach to Prevent Hypertension: A Review of the Dietary Approaches to Stop Hypertension (DASH) Study

A Dietary Approach to Prevent Hypertension: A Review of the Dietary Approaches to Stop Hypertension (DASH) Study Clin. Cardiol. 22, (Suppl. 111), 111611110 (1999) A Dietary Approach to Prevent Hypertension: A Review of the Dietary Approaches to Stop Hypertension (DASH) Study FRANKM. SACKS, M.D., LAWRENCE J. &pa,

More information

Milk and Dairy for Cardiometabolic Health

Milk and Dairy for Cardiometabolic Health Milk and Dairy for Cardiometabolic Health Anne Mullen, BSc, PhD, FHEA, RD Director of Nutrition at The Dairy Council November 2016 Email: a.mullen@dairycouncil.org.uk Tel: 020 7025 0560 Web: www.milk.co.uk

More information

Dairy consumption and cardiometabolic health do the trials support the epidemiology?

Dairy consumption and cardiometabolic health do the trials support the epidemiology? Dairy consumption and cardiometabolic health do the trials support the epidemiology? Karen Murphy, PhD RNutr & Georgina Crichton Food Industry Forum, 31 st August 2010 Dairy Australians are eating 1-1.5

More information

Shon E. Meek, M.D., Ph.D. Assistant Professor of Medicine

Shon E. Meek, M.D., Ph.D. Assistant Professor of Medicine Shon E. Meek, M.D., Ph.D. Assistant Professor of Medicine meek.shon@mayo.edu 2016 MFMER 3561772-1 Update on Vitamin D Shon Meek MD, PhD 20 th Annual Endocrine Update January 30-Feb 3, 2017 Disclosure Relevant

More information

Is dairy good for you?

Is dairy good for you? Is dairy good for you? A focus on bone health Dr Johanita Kruger PhD Nutrition Department of Food Science and Institute of Food, Nutrition and Well-being, University of Pretoria Radical consumer believes

More information

Dairy consumption and risk of type 2 diabetes mellitus: a meta-analysis of cohort studies

Dairy consumption and risk of type 2 diabetes mellitus: a meta-analysis of cohort studies (2011) 65, 1027 1031 & 2011 Macmillan Publishers Limited All rights reserved 0954-3007/11 www.nature.com/ejcn ORIGINAL ARTICLE Dairy consumption and risk of type 2 diabetes mellitus: a meta-analysis of

More information

How to Design, Conduct, and Analyze Vitamin D Clinical Trials

How to Design, Conduct, and Analyze Vitamin D Clinical Trials How to Design, Conduct, and Analyze Vitamin D Clinical Trials William B. Grant, PhD Sunlight, Nutrition and Health Research Center wbgrant@infionline.net Disclosure I receive funding from Bio-Tech Pharmacal,

More information

Diabetes Care Publish Ahead of Print, published online October 21, 2009

Diabetes Care Publish Ahead of Print, published online October 21, 2009 Diabetes Care Publish Ahead of Print, published online October 21, 2009 Vitamin D, Parathyroid Hormone and Insulin Resistance Associations of Serum Concentrations of 25-Hydroxyvitamin D and Parathyroid

More information

N Follow -up years. (cases/controls or participants, gender) Cases: 105 men and 125 women; Controls: 206 men and 246 women

N Follow -up years. (cases/controls or participants, gender) Cases: 105 men and 125 women; Controls: 206 men and 246 women Supplementary Table 1. characteristics of 21 independent studies (extracted from 1 eligible articles) of blood 2(OH)D Levels and incident type 2 Author, Publicatio n year Source populatio n Design N Follow

More information

Sodium and Potassium Intake and Cardiovascular and Bone Health:

Sodium and Potassium Intake and Cardiovascular and Bone Health: Sodium and Potassium Intake and Cardiovascular and Bone Health: How Important is the Ratio? Connie M. Weaver Nutrition Science Purdue University Disclosures Boards/Scientific Advisory Committees ILSI Showalter

More information

Journal of the American College of Cardiology Vol. 48, No. 2, by the American College of Cardiology Foundation ISSN /06/$32.

Journal of the American College of Cardiology Vol. 48, No. 2, by the American College of Cardiology Foundation ISSN /06/$32. Journal of the American College of Cardiology Vol. 48, No. 2, 2006 2006 by the American College of Cardiology Foundation ISSN 0735-1097/06/$32.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2006.03.043

More information

Fructose, Uric Acid and Hypertension in Children and Adolescents

Fructose, Uric Acid and Hypertension in Children and Adolescents Fructose, Uric Acid and Hypertension in Children and Adolescents Daniel I. Feig, MD, PhD, MS Director, Division of Nephrology Department of Pediatrics University of Alabama, Birmingham Topics for Discussion

More information

Weight Loss for Young Women - What Works?

Weight Loss for Young Women - What Works? Weight Loss for Young Women - What Works? Helen O Connor PhD APD 1 Research Team Hayley Griffin PhD APD 1, Hoi Lun Cheng APD 1, Kieron Rooney PhD 1, Prof Kate Steinbeck MBBS FRACP 2 1. Exercise & Sport

More information

Update on vitamin D. J Chris Gallagher Professor of Medicine and Endocrinology Creighton University Omaha,Nebraska USA

Update on vitamin D. J Chris Gallagher Professor of Medicine and Endocrinology Creighton University Omaha,Nebraska USA Update on vitamin D J Chris Gallagher Professor of Medicine and Endocrinology Creighton University Omaha,Nebraska 68131 USA Cali, Colombia 2016 definitions DRIs are the recommended dietary reference intakes

More information

Salt reduction - benefits beyond blood pressure

Salt reduction - benefits beyond blood pressure Salt reduction - benefits beyond blood pressure Jennifer Keogh Associate Professor Sansom Institute for Health Research University of South Australia Intersalt study 1 Epidemiological study of electrolyte

More information

The effect of a change in ambient temperature on blood pressure in normotensives

The effect of a change in ambient temperature on blood pressure in normotensives (2001) 15, 113 117 2001 Nature Publishing Group All rights reserved 0950-9240/01 $15.00 www.nature.com/jhh ORIGINAL ARTICLE The effect of a change in ambient temperature on blood pressure in normotensives

More information

Women Men Children g/d 1.6. Upper intake level UL - -

Women Men Children g/d 1.6. Upper intake level UL - - Potassium NNR 2012 1 (5) 1 2 3 4 5 6 7 8 9 10 11 12 Potassium... 1 Introduction... 1 Dietary sources and intake... 1 Physiology and metabolism... 1 Requirement and recommended intake... 1 Reasoning behind

More information

Coordinator of Post Professional Programs Texas Woman's University 1

Coordinator of Post Professional Programs Texas Woman's University 1 OSTEOPOROSIS Update 2007-2008 April 26, 2008 How much of our BMD is under our control (vs. genetics)? 1 2 Genetic effects on bone loss: longitudinal twin study (Makovey, 2007) Peak BMD is under genetic

More information

Health Benefits of Lowering Sodium Intake in the US

Health Benefits of Lowering Sodium Intake in the US Health Benefits of Lowering Sodium Intake in the US Lawrence J Appel, MD, MPH Professor of Medicine, Epidemiology and International Health (Human Nutrition) Director, Welch Center for Prevention, Epidemiology

More information

Why you should take the latest sodium study with a huge grain of salt

Why you should take the latest sodium study with a huge grain of salt Harvard School of Public Health The Nutrition Source Flawed Science on Sodium from JAMA Why you should take the latest sodium study with a huge grain of salt A new study would have you believe that low-salt

More information

Misperceptions still exist that cardiovascular disease is not a real problem for women.

Misperceptions still exist that cardiovascular disease is not a real problem for women. Management of Cardiovascular Risk Factors in the Cynthia A., MD University of California, San Diego ARHP 9/19/08 Disclosures Research support Wyeth, Lilly, Organon, Novo Nordisk, Pfizer Consultant fees

More information

Changes in Skeletal Systems over the Lifespan. Connie M. Weaver, Ph.D. Purdue University

Changes in Skeletal Systems over the Lifespan. Connie M. Weaver, Ph.D. Purdue University Changes in Skeletal Systems over the Lifespan Connie M. Weaver, Ph.D. Purdue University Disclosures Boards/Scientific Advisory Committees ILSI Showalter Pharmavite Grants NIH Dairy Research Institute Nestle

More information

Dietary Calcium and Magnesium Intake and Mortality: A Prospective Study of Men

Dietary Calcium and Magnesium Intake and Mortality: A Prospective Study of Men American Journal of Epidemiology ª The Author 2010. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail:

More information

Dietary intake patterns in older adults. Katherine L Tucker Northeastern University

Dietary intake patterns in older adults. Katherine L Tucker Northeastern University Dietary intake patterns in older adults Katherine L Tucker Northeastern University Changes in dietary needs with aging Lower energy requirement Less efficient absorption and utilization of many nutrients

More information

Hypertension awareness, treatment, and control

Hypertension awareness, treatment, and control O r i g i n a l P a p e r Prevalence of Self-Reported High Blood Pressure Awareness, Advice Received From Health Professionals, and Actions Taken to Reduce High Blood Pressure Among US Adults Healthstyles

More information

Vitamin D deficiency as a risk factor for Metabolic Syndrome in Hypertensive Subjects

Vitamin D deficiency as a risk factor for Metabolic Syndrome in Hypertensive Subjects Original Research Article Vitamin D deficiency as a risk factor for Metabolic Syndrome in Hypertensive Subjects Abhishek Singhai*, Priyanka Pandey, Ashwin Porwal, Rajesh Kumar Jha Associate Professor,

More information

Abbreviated Class Review: Vitamins and Electrolytes (Potassium, Magnesium, and Phosphate Supplementation)

Abbreviated Class Review: Vitamins and Electrolytes (Potassium, Magnesium, and Phosphate Supplementation) Copyright 2012 Oregon State University. All Rights Reserved Drug Use Research & Management Program Oregon State University, 500 Summer Street NE, E35, Salem, Oregon 97301-1079 Phone 503-947-5220 Fax 503-947-1119

More information

Antihypertensive Trial Design ALLHAT

Antihypertensive Trial Design ALLHAT 1 U.S. Department of Health and Human Services Major Outcomes in High Risk Hypertensive Patients Randomized to Angiotensin-Converting Enzyme Inhibitor or Calcium Channel Blocker vs Diuretic National Institutes

More information

Project Summary: Draft Proposal Continued RESULTS. on the DASH Diet and 30 of the 40 original subjects on the Pro-DASH Diet.

Project Summary: Draft Proposal Continued RESULTS. on the DASH Diet and 30 of the 40 original subjects on the Pro-DASH Diet. Project Summary: Draft Proposal Continued RESULTS Subjects The HNFE 3034 Spring 2013 semester s research study included 34 of the 38 original subjects on the DASH Diet and 30 of the 40 original subjects

More information

The Evidence for Populationwide Reduction in Sodium Intake: Why All the Fuss?

The Evidence for Populationwide Reduction in Sodium Intake: Why All the Fuss? The Evidence for Populationwide Reduction in Sodium Intake: Why All the Fuss? CIA-Harvard Menus of Change National Leadership Summit June 10, 2014 Cambridge, MA General Session IV Lawrence J Appel, MD,

More information

Traditional Asian Soyfoods. Proven and Proposed Cardiovascular Benefits of Soyfoods. Reduction (%) in CHD Mortality in Eastern Finland ( )

Traditional Asian Soyfoods. Proven and Proposed Cardiovascular Benefits of Soyfoods. Reduction (%) in CHD Mortality in Eastern Finland ( ) Proven and Proposed Cardiovascular Benefits of Soyfoods Mark Messina, PhD, MS Soy Nutrition Institute Loma Linda University Nutrition Matters, Inc. markjohnmessina@gmail.com 1000 80 20 60 40 40 60 20 80

More information

Implementing Type 2 Diabetes Prevention Programmes

Implementing Type 2 Diabetes Prevention Programmes Implementing Type 2 Diabetes Prevention Programmes Jaakko Tuomilehto Department of Public Health University of Helsinki Helsinki, Finland FIN-D2D Survey 2004 Prevalence of previously diagnosed and screen-detected

More information

1,2. Diabetes Care 28: , 2005

1,2. Diabetes Care 28: , 2005 Metabolic Syndrome/Insulin Resistance Syndrome/Pre-Diabetes O R I G I N A L A R T I C L E Dietary Calcium, Vitamin D, and the Prevalence of Metabolic Syndrome in Middle-Aged and Older U.S. Women SIMIN

More information

Robin M. Daly PhD, FASMF

Robin M. Daly PhD, FASMF Robin M. Daly PhD, FASMF Professor Chair of Exercise and Ageing Centre for Physical Activity and Nutrition Research (C-PAN) Deakin University, Burwood, Melbourne Email: rmdaly@deakin.edu.au The average

More information

HEART HEALTH AND HEALTHY EATING HABITS

HEART HEALTH AND HEALTHY EATING HABITS HEART HEALTH AND HEALTHY EATING HABITS ELIZABETH PASH PENNIMAN RD,LD CLINICAL DIETITIAN Professional Member American Heart Association; Council on Nutrition, Physical Activity and Metabolism PURPOSE: Recognize

More information

9/26/2016. The Impact of Dietary Protein on the Musculoskeletal System. Research in dietary protein, musculoskeletal health and calcium economy

9/26/2016. The Impact of Dietary Protein on the Musculoskeletal System. Research in dietary protein, musculoskeletal health and calcium economy The Impact of Dietary Protein on the Musculoskeletal System Outline A. The musculoskeletal system and associated disorders Jessica D Bihuniak, PhD, RD Assistant Professor of Clinical Nutrition Department

More information

Branko N Huisa M.D. Assistant Professor of Neurology UNM Stroke Center

Branko N Huisa M.D. Assistant Professor of Neurology UNM Stroke Center Branko N Huisa M.D. Assistant Professor of Neurology UNM Stroke Center THE END! CHANGABLE Blood pressure Diabetes Mellitus Hyperlipidemia Atrial fibrillation Nicotine Drug abuse Life style NOT CHANGABLE

More information

Calcium intake, body composition, and lipoprotein-lipid concentrations in adults 1 3

Calcium intake, body composition, and lipoprotein-lipid concentrations in adults 1 3 Calcium intake, body composition, and lipoprotein-lipid concentrations in adults 1 3 Mélanie Jacqmain, Eric Doucet, Jean-Pierre Després, Claude Bouchard, and Angelo Tremblay ABSTRACT Background: Recent

More information

Dairy matrix effects on T2 diabetes and cardiometabolic health?

Dairy matrix effects on T2 diabetes and cardiometabolic health? Department of Nutrition, Exercise and Sports Dairy matrix effects on T2 diabetes and cardiometabolic health? Arne Astrup Head of department, professor, MD, DMSc. Department of Nutrition, Exercise and Sports

More information

Dr Seeta Durvasula.

Dr Seeta Durvasula. Dr Seeta Durvasula seeta.durvasula@sydney.edu.au 1 Avoid sun skin cancer risk Australia has highest rates of skin cancer in the world Epidemic of Vitamin D deficiency Lack of Vitamin D increases risk of

More information

Vitamin D supplementation of professionally active adults

Vitamin D supplementation of professionally active adults Vitamin D supplementation of professionally active adults VITAMIN D MINIMUM, MAXIMUM, OPTIMUM FRIDAY, SEPTEMBER 22 ND 2017 Samantha Kimball, PhD, MLT Research Director Pure North S Energy Foundation The

More information

Association of Vitamin D Levels with Blood Pressure in Dialysis Patients in a Dialysis Centre in Tehran

Association of Vitamin D Levels with Blood Pressure in Dialysis Patients in a Dialysis Centre in Tehran Original Article Association of Vitamin D Levels with Blood Pressure in Dialysis Patients in a Dialysis Centre in Tehran Shahnaz Tofangchiha 1, Omid Gharooi Ahangar 2 *, Miralireza Takyar 3 and Narges

More information

Lactotripeptides Show No Effect on Human Blood Pressure Results From a Double-Blind Randomized Controlled Trial

Lactotripeptides Show No Effect on Human Blood Pressure Results From a Double-Blind Randomized Controlled Trial Lactotripeptides Show No Effect on Human Blood Pressure Results From a Double-Blind Randomized Controlled Trial Mariëlle F. Engberink, Evert G. Schouten, Frans J. Kok, Linda A.J. van Mierlo, Ingeborg A.

More information

Salt, soft drinks & obesity Dr. Feng He

Salt, soft drinks & obesity Dr. Feng He Salt, soft drinks & obesity Dr. Feng He Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, UK f.he@qmul.ac.uk BP Salt CVD Obesity

More information

290 Biomed Environ Sci, 2016; 29(4):

290 Biomed Environ Sci, 2016; 29(4): 290 Biomed Environ Sci, 2016; 29(4): 290-294 Letter to the Editor Prevalence and Predictors of Hypertension in the Labor Force Population in China: Results from a Cross-sectional Survey in Xinjiang Uygur

More information

ASSeSSing the risk of fatal cardiovascular disease

ASSeSSing the risk of fatal cardiovascular disease ASSeSSing the risk of fatal cardiovascular disease «Systematic Cerebrovascular and coronary Risk Evaluation» think total vascular risk Assess the risk Set the targets Act to get to goal revised; aupril

More information

Nutritional concepts for the prevention and treatment of osteoporosis: what, for whom, when? Objectives

Nutritional concepts for the prevention and treatment of osteoporosis: what, for whom, when? Objectives Nutritional concepts for the prevention and treatment of osteoporosis: what, for whom, when? Bess Dawson-Hughes, MD Disclosures: Amgen, DSM, Nestle, Opko, Pfizer, Roche, Tricida Interrelationships of muscle

More information

Vitamin D, Calcium and Blood Pressure in the U.S.

Vitamin D, Calcium and Blood Pressure in the U.S. The University of San Francisco USF Scholarship: a digital repository @ Gleeson Library Geschke Center Master's Projects and Capstones Theses, Dissertations, Capstones and Projects Winter 12-16-2016 Vitamin

More information

Vitamin D Status among Patients Attending Hussein Medical Center for Diabetes in Jordan

Vitamin D Status among Patients Attending Hussein Medical Center for Diabetes in Jordan Vitamin D Status among Patients Attending Hussein Medical Center for Diabetes in Jordan Muwafag Hyari MD*, Hala Abu-Romman MD ** ABSTRACT Objective: Vitamin D is a steroid fat soluble vitamin, in which

More information

Building Our Evidence Base

Building Our Evidence Base Plant-Based Diets Neal D. Barnard, MD, FACC Adjunct Associate Professor of Medicine George Washington University School of Medicine Physicians Committee for Responsible Medicine Washington, DC Building

More information

A: Epidemiology update. Evidence that LDL-C and CRP identify different high-risk groups

A: Epidemiology update. Evidence that LDL-C and CRP identify different high-risk groups A: Epidemiology update Evidence that LDL-C and CRP identify different high-risk groups Women (n = 27,939; mean age 54.7 years) who were free of symptomatic cardiovascular (CV) disease at baseline were

More information