Recently, it was shown that substituting soy nuts for nonsoy protein in a therapeutic lifestyle change (TLC) diet lowered systolic and diastolic blood pressure by 9.9% and 6.8%, respectively, in postmenopausal women with hypertension and by 5.2% and 2.9%, respectively, in normotensive postmenopausal women. In this study, to examine mechanisms for these reductions, markers of inflammation were measured, including soluble vascular cell adhesion molecule-1, soluble intercellular adhesion molecule-1, C-reactive protein, interleukin-6, and matrix metalloproteinase-9. Sixty healthy postmenopausal women (48 normotensive and 12 with hypertension) were randomized in a crossover design to a TLC diet alone or a TLC diet in which 0.5 cups of soy nuts (25 g soy protein and 101 mg aglycone isoflavones) replaced 25 g of nonsoy protein daily. Each diet was followed for 8 weeks. Compared with the TLC diet alone, levels of soluble vascular cell adhesion molecule-1 were significantly lower on the soy diet in women with hypertension (623.6 +/- 153.8 vs 553.8 +/- 114.4 ng/ml, respectively, p = 0.003), whereas no significant differences were observed in normotensive women. Soy nuts were associated with a trend toward reduction in C-reactive protein in normotensive women. No effect on levels of soluble intercellular adhesion molecule-1, interleukin-6, or matrix metalloproteinase-9 was observed. In conclusion, the reduction in soluble vascular cell adhesion molecule-1 with soy nuts in women with hypertension suggests an improvement in endothelial function that may reflect an overall improvement in the underlying inflammatory process underlying atherosclerosis.

Assessment of the rate of muscle oxygen consumption, UO 2m , in vivo during exercise involving a large muscle mass is critical for investigating mechanisms regulating energy metabolism at exercise onset. While UO 2m is technically difficult to obtain under these circumstances, pulmonary oxygen uptake, VO 2p , can be readily measured and used as a proxy to UO 2m . However, the quantitative relationship between VO 2p and UO 2m during the nonsteady phase of exercise in humans, needs to be established. A computational model of oxygen transport and utilizationbased on dynamic mass balances in blood and tissue cells-was applied to quantify the dynamic relationship between model-simulated UO 2m and measured VO 2p during moderate (M), heavy (H), and very heavy (V) intensity exercise. In seven human subjects, VO 2p and muscle oxygen © Springer-Verlag 2006 Correspondence to: M. E. Cabrera, mec6@cwru.edu. NIH Public Access

The dynamics of the pulmonary oxygen uptake (VO2) responses to square-wave changes in work rate can provide insight into bioenergetic processes sustaining and limiting exercise performance. The dynamic responses at the onset of exercise and during recovery have been investigated systematically and are well characterized at all intensities in adults; however, they have not been investigated completely in adolescents. We investigated whether adolescents display a slow component in their VO2 on- and off-kinetic responses to heavy- and very heavy-intensity exercise, as demonstrated in adults. Healthy African American male adolescents (n=9, 14-17 years old) performed square-wave transitions on a cycle ergometer (from and to a baseline work rate of 20 W) to work rates of moderate (M), heavy (H), and very heavy (VH) intensity. In all subjects, the VO2 on-kinetics were best described with a single exponential at moderate intensity (tau1, on=36+/-11 s) and a double exponential at heavy (tau1, on=29+/-9 s; tau2, on=197+/-92 s) and very heavy (tau1, on=36+/-9 s; tau2, on=302+/-14 s) intensities. In contrast, the VO2 off-kinetics were best described with a single exponential at moderate (tau1, off=48+/-9 s) and heavy (tau1, off=53+/-7 s) intensities and a double exponential at very heavy (tau1, off=51+/-3 s; tau2, off=471+/-54 s) intensity. In summary, adolescents consistently displayed a slow component during heavy exercise (on- but not off-transition) and very heavy exercise (on- and off-transitions). Although the overall response dynamics in adolescents were similar to those previously observed in adults, their specific characterizations were different, particularly the lack of symmetry between the on- and off-responses.

Background-Epidemiological studies suggest a low incidence of hot flashes in populations that consume dietary soy. The present study examined the effect of soy nuts on hot flashes and menopausal symptoms.

We examined the effect of an outpatient office-based diet and exercise counseling program on weight loss and lipid levels with an onsite dietitian who sees patients at the same visit with the physician and is fully reimbursable. Eighty overweight or obese patients (average age 55 ± 12 years, baseline body mass index 30.1 ± 6.4 kg/m 2 ) with ≥1 cardiovascular risk factor (86%) or coronary heart disease (14%) were counseled to exercise 30 minutes/day and eat a modified Dietary Approaches to Stop Hypertension (DASH) diet (saturated fat <7%, polyunsaturated fat to 10%, monounsaturated fat to 18%, low in glycemic index and sodium and high in fiber, low-fat dairy products, fruits, and vegetables). Weight, body mass index, lipid levels, and blood pressure were measured at 1 concurrent follow-up visit with the dietitian and physician and ≥1 additional follow-up with the physician. Maximum weight lost was an average of 5.6% (10.8 lb) at a mean follow-up of 1.75 years. Sixtyfour (81%) of these patients maintained significant weight loss (average weight loss 5.3%) at a mean follow-up of 2.6 years. Average decrease in low-density lipoprotein cholesterol was 9.3%, average decrease in triglycerides was 34%, and average increase in high-density lipoprotein cholesterol was 9.6%. Systolic blood pressure was lowered from 129 to 126 mm Hg (p = 0.21) and diastolic blood pressure from 79 to 75 mm Hg (p = 0.003). In conclusion, having a dietitian counsel patients concurrently with a physician in the out-patient setting is effective in achieving and maintaining weight loss and is fully reimbursable.It has been reported that the average American makes 3 visits per year to office-based physicians. 1 More than 62% of these visits are made to patients' primary care physicians. 2 In the Behavioral Risk Factor Surveillance System, a random-digit telephone survey conducted by state health departments, <50% of obese subjects reported receiving advice to lose weight. 3 Nevertheless, receiving advice to lose weight was strongly associated with attempts to implement that advice. Rates of counseling about physical activity may be even lower. Nationally, the reported rate of physician counseling about exercise is ~34%. 4 However, many clinicians do not routinely measure patients' weight, assess their lifestyle, or offer advice on such topics. The main reasons for such low levels of clinician involvement are most often attributed to their lack of training in these areas, insufficient time for counseling in practice settings, an absence of clear guidelines and practice tools, scarcity of patient education materials, and minimal to no reimbursement. 1 In the present report, we describe our results with an onsite dietitian, who sees patients at the same visit with the physician and is fully reimbursable, on weight loss and lipid levels.