The possibility that the heightened cardiovascular risk associated with the menopause, which is said to be ameliorated by soybeans, can be reduced with soy isoflavones was tested in 21 women. Although several were perimenopausal, all have been included. A placebo-controlled crossover trial tested the effects of 80-mg daily isoflavones (45 mg genistein) over 5- to 10-week periods. Systemic arterial compliance (arterial elasticity), which declined with age in this group, improved 26% (P < .001) compared with placebo. Arterial pressure and plasma lipids were unaffected. The vasodilatory capacity of the microcirculation was measured in nine women; high acetylcholine-mediated dilation in the forearm vasculature was similar with active and placebo treatments. LDL oxidizability measured in vitro was unchanged. Thus, one important measure of arterial health, systemic arterial compliance, was significantly improved in perimenopausal and menopausal women taking soy isoflavones to about the same extent as is achieved with conventional hormone replacement therapy.

OBJECTIVE -The aim of this study was to examine the effect of a moderate-fat diet inclusive of walnuts on blood lipid profiles in patients with type 2 diabetes.RESEARCH DESIGN AND METHODS -This was a parallel randomized controlled trial comparing three dietary advice groups each with 30% energy as fat: low fat, modified low fat, and modified low fat inclusive of 30 g of walnuts per day. Fifty-eight men and women, mean age 59.3 Ϯ 8.1 years, started the trial. Dietary advice was given at baseline with monthly follow-up and fortnightly phone calls for support. Body weight, percent body fat, blood lipids, HbA 1c , total antioxidant capacity, and erythrocyte fatty acid levels were measured at 0, 3, and 6 months. Data were assessed by repeated-measures ANOVA with an intention-to-treat model. RESULTS -The walnut group achieved a significantly greater increase in HDL cholesterolto-total cholesterol ratio (P ϭ 0.049) and HDL (P ϭ 0.046) than the two other treatment groups. A 10% reduction in LDL cholesterol was also achieved in the walnut group, reflecting a significant effect by group (P ϭ 0.032) and time (P ϭ 0.036). There were no significant differences between groups for changes in body weight, percent body fat, total antioxidant capacity, or HbA 1c levels. The higher dietary polyunsaturated fat-to-saturated fat ratio and intakes of -3 fatty acids in the walnut group were confirmed by erythrocyte biomarkers of dietary intake.CONCLUSIONS -Structured "whole of diet" advice that included 30 g of walnuts/day delivering substantial amounts of polyunsaturated fatty acid improved the lipid profile of patients with type 2 diabetes. The literature on recommendations varies to a minor degree, and cultural differences may have an influence (9), but a total fat level of Յ30% energy (10) and Ͻ10% saturated fat is reasonably well accepted (11,12). There is some concern that PUFAs are more susceptible to oxidation and therefore may be more atherogenic (11), so a level of Ͻ10% energy for PUFAs is seen with greater flexibility in the proportions of carbohydrate and MUFA (13). Within the PUFA fraction of the diet, the ratio of -6 to -3 fatty acids is also considered (9) with daily recommendations for a 2,000-kcal diet of 0.65 g for the long-chain -3s (EPA ϩ DHA) and 2.22 g for ALA (14) and the -6 -to--3 ratio reduced to substantially Ͻ10 (14a). Diabetes CareFish are the major source of EPA ϩ DHA, but fish oil supplements produce a decreased oxidative stability of plasma LDL (15,16). In contrast, consumption of fish itself may be protective against type 2 diabetes (17). Nuts provide substantial amounts of dietary PUFA, and nut consumption is inversely associated with the risk of type 2 diabetes in women (18). There is no net effect on glucose homeostasis from nut supplementation, but more interestingly, no net weight gain when nuts were used as a replacement food (19). In subjects with dyslipidemia (total cholesterol Ͼ5.17; LDL Ͼ3.36; triglycerides Ͼ2.26 mmol/l), a low-fat diet supplemented with walnuts was found to reduce total choles...

Dietary patterns may be related to quality of life (QoL) of older adults, although evidence from literature is conflicting. The demographic shifts toward ageing populations in many countries increases the importance of understanding the relationship between diet and QoL in older adults. This review was designed to investigate associations between dietary patterns and QoL in older adults. The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eight electronic databases were searched to identify articles published in English from January 1975 to March 2018 that investigated associations between dietary patterns and QoL in older adults. Relevant studies were identified based on set inclusion and exclusion criteria, data were extracted and analysed to examine the relationships and possible implications for public health recommendations. The systematic review included 15 articles (One randomized control trial, six prospective cohorts and eight cross sectional). The studies looked at correlations between different dietary patterns and/or adherence to particular dietary patterns and self-reported QoL or self-rated health status. Excluding two studies which showed no significant association, healthy dietary patterns were associated with better self-rated health and QoL in one or more domains, and adherence to healthy dietary patterns like the Mediterranean diet were significantly associated with improvement in at least one of the QoL domains.

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