Suzanne C. Ho

Walking speed and stride length predicts 36 months dependency, mortality, and institutionalization in Chinese aged 70 and older

BACKGROUND: Increasing emphasis is being placed on physical performance measures as an outcome predictor. It is uncertain whether one or two simple measurements will have predictive value compared with a battery of tests.

Coffee consumption and risk of coronary heart diseases: a meta-analysis of 21 prospective cohort studies.

BACKGROUND A large amount of cohort studies addressed coffee consumption and risk of coronary heart disease (CHD) and yielded inconsistent results. We conducted a meta-analysis to estimate the pooling effects. METHODS We searched for all published English articles indexed in MEDLINE or PubMed from January 1966 to January 2008. Twenty-one independent prospective cohort studies, which tested CHD risk by coffee consumption, were identified. A general variance-based method was used to pool the relative risks (RR). 15,599 cases from 407,806 participants were included in pooling the overall effects. RESULTS As compared to the light coffee consumption (<1 cup/d in US or <or=2 cups/d in Europe), under the random-effects model, the pooled CHD RRs (95% CI) for all studies combined were 0.96 (0.87-1.06), 1.04 (0.92-1.17) and 1.07 (0.87-1.32) for the moderate (1-3 or 3-4 cups/d), heavy (4-5 or 5-6 cups/d) and very heavy (>or=6 or >or=7 cups/d) categories of coffee consumption (all p>0.05); Moderate coffee consumption showed significantly lower CHD RR (95% CI) of 0.82 (0.73-0.92) (p<0.001) in women, and of 0.87 (0.80-0.86) (p=0.001) in men and women followed <or=10 years. CONCLUSION Our findings do not support the hypothesis that coffee consumption increases the long-term risk of coronary heart disease. Habitual moderate coffee drinking was associated with a lower risk of CHD in women.

Greater vegetable and fruit intake is associated with a lower risk of breast cancer among Chinese women

The effect of vegetable and fruit consumption on breast cancer risk is controversial. We examined the association between vegetable and fruit intake and breast cancer risk in a hospital‐based case–control study conducted in Guangdong, China. Four hundred and thirty‐eight cases were frequency matched to 438 controls by age (5‐year interval) and residence (rural/urban). Dietary intake was assessed by face‐to‐face interviews using a validated food frequency questionnaire. Multivariate logistic regression was used to estimate the odds ratios (ORs) and 95% confidence interval (CI) after adjusting for various potential confounders. Total vegetable and fruit intake was found to be inversely associated with breast cancer risk. The ORs of the highest quartile relative to the lowest quartile of total vegetable and fruit intake were 0.28 (95% CI 0.18–0.43) and 0.53 (95% CI 0.34–0.82), respectively. Consumption of individual vegetable and fruit groups such as dark green leafy vegetables, cruciferous vegetables, carrots and tomatoes, banana, watermelon/papaya/cantaloupe were all inversely and significantly related with breast cancer risk. An inverse association was also observed for vitamin A, carotene, vitamin C, vitamin E, and fiber intake. These data indicate that greater intake of vegetables and fruits is associated with a decreased risk of breast cancer among Chinese women residing in Guangdong.

Impact of caregiving on health and quality of life : a comparative population-based study of caregivers for elderly persons and noncaregivers

This study aims to investigate the impact of caregiving on the health status and quality of life (QOL) of primary informal caregivers (PCGs) of elderly care recipients in Hong Kong. A total of 246 PCGs and 492 matched noncaregiver (NCG) controls were identified in a population-based cross-sectional study through random telephone dialing. Their health status and QOL were assessed based on structured questionnaires and Short Form 36 (SF-36) Health Survey. Multiple conditional logistic regression analysis showed that compared with NCGs, PCGs had significantly increased risks for reporting worse health, more doctor visits, anxiety and depression, and weight loss. Female PCGs were more likely to report chronic diseases, symptoms, and insomnia. PCGs, particularly women, had significantly lower scores in all eight domains of SF-36 Health Survey. High caregiver burden score (Zarit Burden Scale) was positively associated with adverse physical and psychological health and poorer QOL. The results indicate that PCGs, particularly women, had an adverse physical and psychological health profile and poorer QOL compared with NCGs.

Longitudinal Changes in Body Mass Index and Body Composition over 3 Years and Relationship to Health Outcomes in Hong Kong Chinese Age 70 and Older

OBJECTIVES: To determine longitudinal changes in body mass index (BMI) and body composition with age and the relationship between these changes with mortality, morbidity, functional capacity, and other health outcome measures.

Soy Intake and the Maintenance of Peak Bone Mass in Hong Kong Chinese Women

Our previous study on bone health among premenopausal women showed that bone mass consolidation is attained by the early 30s, and small loss of spinal bone mineral density (SBMD) occurs soon after peak bone mass attainment. Recent interest has been shown in the potential beneficial effects of phytoestrogens on bone health. However, data are lacking, particularly in Asian women. This study aims to investigate the effect of soy isoflavones intake on the maintenance of peak bone mass in a cohort of 132 women aged 30‐40 years who were followed up for 3 years. Baseline measurements of SBMD (L2‐L4) were obtained using dual‐energy X‐ray densitometry, and dietary intake of soy foods and other key nutrients, including dietary calcium, were obtained through a quantitative food frequency method. Information on body measurements; physical activity (PA), weight‐bearing activity in particular; age of menarche; and number of pregnancies were obtained at baseline. Repeated measurements of SBMD were obtained yearly for a further 3 years with an average follow‐up time of 38 months. Analyses were performed on 116 subjects with at least three SBMD measurements (at baseline, 3‐year follow‐up, and at least one measurement during follow‐up). The individual SBMD regression slope was computed for each of the subjects. Soy isoflavones consumption was categorized as quartiles of intake. We observed a significant difference in the SBMD individual regression slopes between women belonging to the fourth and first soy isoflavones intake quartiles. The positive effect of soy isoflavones on SBMD remained after adjusting for age and body size (height, weight, and bone area). Multiple linear regression analysis including the other known covariates (lean body mass, PA, energy adjusted calcium, and follow‐up time) showed that soy isoflavones, together with these variables, accounted for 24% of the variances of the SBMD individual regression slope. This longitudinal study shows that soy intake had a significant effect on the maintenance of SBMD in women aged 30‐40 years. The effects of phytoestrogens on bone health should be explored further in a population with habitual dietary soy but low calcium intake.

Soy protein consumption and bone mass in early postmenopausal Chinese women

Recent interest has been shown in the potential beneficial effects of phytoestrogens on bone health. As the early years of menopause are a period of rapid bone loss, and the risk for osteoporosis increases substantially, the habitual intake of soy protein and isoflavones may play a role in the retardation of bone loss. This paper reports the results of the baseline cross-sectional analysis of the association between dietary soy protein intake and bone mineral density/content in a population-based study of Chinese women. The sample comprised 454 healthy Chinese women (mean age 55.1±3.57) within the first 12 years of postmenopause. We estimated the dietary intake of soy protein and isoflavones, and other key nutrients, including dietary protein and calcium, using the quantitative food frequency method. Bone mineral density (BMD) and content (BMC) at the spine, hip and total body were measured with a dual energy X-ray densitometer (Hologic 4500A). Soy protein consumption was categorized as quartiles of intake, and related to BMD values at the spine and hip, and BMC of total body. Stratified analyses were carried out among women within or at least 4 years postmenopausal. We observed few differences in BMD/BMC values among the intake quartiles in women within the first 4 years of menopause. However, among the later postmenopausal women, we noted a dose-response relationship with increasing higher BMD values at the trochanter, intertrochanter as well as the total hip and total body with increasing soy protein intake quartiles (P<0.05 from tests for trend). The BMD values differed by about 4–8% between the first and fourth soy protein intake quartiles. Though women from the fourth intake quartile had a 2.9% higher BMD value compared with those from the first intake quartile, the difference was not statistically significant. Stepwise multiple linear regression analyses showed the association between soy intake quartiles and hip BMD as well as total body BMC values remained after adjusting for body weight, which was retained in the final model. Analyses based on soy isoflavones content yielded similar results. This study demonstrated that, among women after the initial few years postmenopausal, soy protein/isoflavones intake had a modest but significant association with hip BMD as well as total body BMC. The effects of soy protein and soy isoflavones on bone health should be further explored in populations with habitual dietary soy intake.

Effect of long-term intervention of soy isoflavones on bone mineral density in women: a meta-analysis of randomized controlled trials.

INTRODUCTION A number of RCTs have examined the role of soy isoflavones on bone mineral density (BMD) and yielded inconsistent results. This meta-analyses aims to assess the overall effect of soy isoflavones on BMD. METHODS We searched for all articles published in English from January 1990 to March, 2008. We included RCTs of soy isoflavone supplementation in women of at least one year duration. The main outcomes were BMD changes from baseline at the lumbar spine, total hip and femoral neck. RESULTS We identified 10 eligible RCTs containing 896 women. A mean dose of 87 mg soy isoflavones for at least one year did not significantly affect BMD changes. The mean (95%CI) differences in BMD changes (in mg/cm(2)/year) were 4.1 (-1.6, 9.8) (0.4%) at the lumbar spine, -1.5 (-7.2, 4.3) (-0.3%) at the femoral neck under random-effects model, and 2.5 (-0.5, 5.4) (0.2%) at the total hip by fix-effects model, respectively. Similar results were obtained in subgroup analyses by isoflavone sources (soy protein vs. isoflavone extract), ethnic differences (Asian vs. Western). Larger dose (>or=80 mg/d), but not lower dose (<80 mg/d), of isoflavone intervention tended to have a weak beneficial effect on spine BMD (p=0.08 vs. p=0.94). CONCLUSIONS Soy isoflavone supplementation is unlikely to have significant favorable on BMD at the lumbar spine and hip in women.

Greater fruit and vegetable intake is associated with increased bone mass among postmenopausal Chinese women

Although studies in Caucasian populations have reported the beneficial effects of intakes of fruit and vegetables on bone mass, limited data are available in the Asian populations. We examined the association of the intake of fruits and vegetables with bone mineral density (BMD) in a population-based cross-sectional study of 670 postmenopausal Chinese women aged 48-63 years. Habitual dietary intakes were assessed using a food frequency questionnaire. BMD at the whole body, lumbar spine and left hip were measured with dual-energy X-ray absorptiometry. Univariate regression analyses showed that the total intake of fruits and vegetables was significantly associated with greater BMD at the whole body, lumbar spine (L1-L4), total hip, trochanter and intertrochanter. An independently positive association between fruit and vegetable intake and BMD at the whole body (P = 0.005), lumbar spine (P < 0.001) and total hip (P = 0.024) remained even after adjusting for age, years since menopause, body weight and height, dietary energy, protein and Ca, and physical activities. A daily increase of 100 g fruit and vegetable intake was associated with 0.0062 (95 % CI 0.0019, 0.0105) g/cm2, 0.0098 (95 % CI 0.0041, 0.0155) g/cm2 and 0.0060 (95 % CI 0.0011, 0.0109) g/cm2 increases in BMD at the whole body, lumbar spine and total hip, respectively. In conclusion, greater fruit and vegetable intake is independently associated with better BMD among postmenopausal Chinese women.

Effects of soy isoflavone supplementation on cognitive function in Chinese postmenopausal women : a double-blind, randomized, controlled trial

Objective:To investigate whether soy-derived isoflavone extract improves performance in cognitive function and quality of life in Chinese postmenopausal women. Design:The study was a 6-month double-blind, randomized, placebo-controlled, parallel group trial. Participants were community-dwelling women aged 55 to 76 years; 191 eligible women were randomly assigned to receive a daily oral intake of 80 mg soy-derived isoflavones or an identical-appearing placebo for 6 months. Standardized neuropsychological tests of memory, executive function, attention, motor control, language, and visual perception and a global cognitive function assessment were administered face-to-face individually at baseline and at 6-months posttreatment. The validated Chinese version of the Short Form-36 was used for quality of life measurements. Results:Of the participants, 88% (168 women: 80 among the supplementation group and 88 among the placebo group) completed the trial. Intention-to-treat analysis, conducted for 176 participants with 6-month assessment results, revealed no significant differences in outcome measures between treatment groups. Subgroup analysis among the good compliers only (consumed at least 80% of the supplements or placebo; n = 168) and among the age groups younger or older than 65 years also indicated no significant differences for any outcome measures. Types of complaints of adverse events were similar in both treatment groups and included mainly gastrointestinal and musculoskeletal problems. Conclusions:This 6-month trial indicates that 80-mg soy-derived isoflavone supplementation did not improve performance on standard neuropsychological tests and overall quality of life in generally healthy Chinese postmenopausal women.