Effects of cow's milk beta-casein variants on symptoms of milk intolerance in Chinese adults: a multicentre, randomised controlled study.

BACKGROUND: A major protein component of cow's milk is ß-casein. The most frequent variants in dairy herds are A1 and A2. Recent studies showed that milk containing A1 ß-casein promoted intestinal inflammation and exacerbated gastrointestinal symptoms. However, the acute gastrointestinal effects of A1 ß-casein have not been investigated. This study compared the gastrointestinal effects of milk containing A1 and A2 ß-casein versus A2 ß-casein alone in Chinese adults with self-reported lactose intolerance. METHODS: In this randomised, crossover, double-blind trial, with a 3-day dairy washout period at baseline, subjects were randomised to consume 300 mL of milk containing A1 and A2 ß-casein (ratio 58:42; conventional milk) or A2 ß-casein alone; subjects consumed the alternative product after a 7-day washout period. Urine galactose was measured at baseline after a 15 g lactose load. Subjects completed 9-point visual analogue scales for gastrointestinal symptoms (borborygmus, flatulence, bloating, abdominal pain, stool frequency, and stool consistency) at baseline and at 1, 3, and 12 h after milk consumption. RESULTS: A total of 600 subjects were included. All six symptom scores at 1 and 3 h were significantly lower after consuming A2 ß-casein versus conventional milk (all P<0.0001). At 12 h, significant differences remained for bloating, abdominal pain, stool frequency, and stool consistency (all P<0.0001). Symptom scores were consistently lower with A2 ß-casein in both lactose absorbers (urinary galactose ≥0.27 mmol/L) and lactose malabsorbers (urinary galactose <0.27 mmol/L). CONCLUSION: Milk containing A2 ß-casein attenuated acute gastrointestinal symptoms of milk intolerance, while conventional milk containing A1 ß-casein reduced lactase activity and increased gastrointestinal symptoms compared with milk containing A2 ß-casein. Thus, milk-related gastrointestinal symptoms may result from the ingestion of A1 ß-casein rather than lactose in some individuals. TRIAL REGISTRATION: NCT02878876 , registered August 16, 2016. Retrospectively registered.

Beneficial Effect of Educational and Nutritional Intervention on the Nutritional Status and Compliance of Gastric Cancer Patients Undergoing Chemotherapy: A Randomized Trial.

Surgery combined with chemotherapy is the standard treatment for gastric cancer (GC); however, chemotherapy-relative adverse effects are common and result in malnutrition and a poor prognosis. In addition, compliance to postoperative chemotherapy remains a problem. This study aimed to prospectively investigate the effect of educational and nutritional interventions on the nutritional status and compliance of GC patients undergoing postoperative chemotherapy. A total of 144 GC patients were randomized into an intervention group that received intensive individualized nutritional and educational interventions during the entire course of chemotherapy and control group that received basic nutrition care and health education during hospitalization. The nutritional status and compliance between the two groups were compared. The interventions significantly improved calorie and iron intake within 24 h after the first chemotherapy session, and improved patients' weight, hemoglobin, total serum protein, and albumin levels during the entire course of chemotherapy. The compliance rate with chemotherapy was significantly higher in the intervention group than in the control group (73.61% vs. 55.56%, P = 0.024). A combination of nutritional and educational interventions provided beneficial effect on the nutrition status and compliance of gastric patients undergoing postoperative chemotherapy, which is worthy of clinical application.

[Effect of early vitamin D supplementation on lung inflammatory factors in baby rat with asthma].

OBJECTIVE: To explore the effect of different doses of 1,25-(OH)(2)VitD(3) early supplementation on airway inflammation and lung inflammatory factors in baby rats with asthma. METHODS: Forty male weaned Wistar rats were divided into normal group, model group, low 1,25-(OH)(2)VitD(3) group, middle 1,25-(OH)(2)VitD(3) group, high 1,25-(OH)(2)VitD(3) group using random number table (8 rats each group). The rats in low, middle and high 1,25-(OH)(2)VitD(3) groups were given 1, 4, 10 µg/kg of 1,25-(OH)(2)VitD(3) every other day by intraperitoneal injection respectively for 25 days. Except normal group, the rats in other groups were challenged with ovalbumin to establish the asthma model. The pathologic changes of lung tissue, the total white blood cell and classified cell counts in bronchoalveolar lavage fluid (BALF) were measured. The concentrations of IL-4, IL-5 and IFN-γ in serum and BALF were measured by ELISA method. RESULTS: The level of total white blood cell counts in BALF were (5.98 ± 1.67)×10(5)/ml, (25.34 ± 4.28)×10(5)/ml, (17.24 ± 3.3)×10(5)/ml, (9.31 ± 3.37)×10(5)/ml, (45.1 ± 15.75)×10(5)/ml, respectively (F = 33.453, P < 0.01). The percent ratio of EOS in BALF were (1.44 ± 0.78)%, (17.81 ± 6.88)%, (15.00 ± 5.70)%, (8.89 ± 3.66)%, (25.88 ± 5.57)%, respectively (F = 27.299, P < 0.01). The level of IL-4 in serum of normal, model, low, middle and high-1,25-(OH)(2)VitD(3) groups were (0.62 ± 0.54), (7.57 ± 1.04), (3.58 ± 0.56), (2.70 ± 0.78) and (5.27 ± 0.30) pg/ml, respectively (F = 116.287, P < 0.01); IL-5 in resume were (32.20 ± 4.23), (67.14 ± 18.14), (37.51 ± 0.47), (40.69 ± 2.47) and (124.60 ± 36.19) pg/ml, respectively (F = 23.902, P < 0.01); IFN-γ in serum were (79.71 ± 10.08), (49.06 ± 4.46), (59.15 ± 2.51), (59.27 ± 2.33) and (53.85 ± 1.97) pg/ml, respectively (F = 39.954, P < 0.01). Also in BLAF, the IL-4 of all groups were (0.51 ± 0.30), (102.92 ± 54.61), (8.64 ± 4.07), (3.10 ± 1.28) and (33.67 ± 8.1) pg/ml, respectively (F = 24.062, P < 0.01); the IFN-γ were (247.37 ± 189.18), (43.82 ± 13.76), (81.32 ± 17.07), (86.50 ± 14.26) and (59.89 ± 34.17) pg/ml, respectively (F = 7.157, P < 0.01); the IL-5 in BALF were (38.81 ± 0.60), (80.48 ± 17.90), (45.11 ± 1.33), (43.39 ± 1.11) and (149.60 ± 45.87) pg/ml, respectively (F = 35.978, P < 0.01). Pathologic changes in lung of asthma rat groups were obvious. The lung pathologic changes in low and middle dose groups showed a significant improvement compared to the asthma group and high dosage group showed more serious pathologic changes compared to the low and middle dose groups. CONCLUSION: Intervention with appropriate dose of 1,25-(OH)(2)VitD(3) in the early life could improve lung pathologic changes and reduce the effect of inflammatory factors in air way of baby rat asthma model. However, overdose might play detrimental effect.

Environmental tobacco smoke exposure and Chinese schoolchildren's respiratory health: a prospective cohort study.

BACKGROUND: Although China is the most coveted cigarette market worldwide, few studies have examined the longitudinal effects of environmental tobacco smoke (ETS) on health. PURPOSE: To examine the relationship between exposure to ETS and respiratory health in Chinese schoolchildren. METHODS: The study subjects included 1718 children, who were never-smokers, aged 10.05±0.86 years and asthma-free at baseline. The children performed spirometric tests in 2006 and 18 months later. Parents reported the children's respiratory symptoms and illnesses, ETS exposure, and other related information by self-administered survey at both assessment points. The data were analyzed in 2010. RESULTS: Significant exposure-response relationships were found between ETS exposure and coughing at night (p for trend<0.001); sneezing (p for trend=0.031); and sneezing with itchy, watery eyes (p for trend=0.006) in the first survey, and coughing at night (p for trend=0.019); phlegm without a cold (p for trend<0.001); and sneezing (p for trend=0.036) in the second survey. Compared with those who reported no ETS exposure in either survey, children who had a high ETS exposure level (>5 cigarettes/day) in either survey had lower growth rates in forced expiratory flow between 25% and 75% of forced vital capacity (FEF(25-75); ß= -0.104, p=0.020) and forced expiratory flow at 25% of forced vital capacity (FEF(25); ß= -0.077, p=0.027). A monotonic exposure-response effect was observed between ETS exposure and the deficits in the growth rate of FEF(25) and FEF(25-75.) CONCLUSIONS: Exposure to ETS increased the risks of respiratory symptoms in Chinese school-aged children and was associated with impaired lung function growth. A dose-response relationship was observed for the latter effect.

[Effects of soybean isoflavone on liver lipid metabolism in nonalcoholic fatty liver rats].

OBJECTIVE: To study the effects of soybean isoflavone on liver lipid, serum lipid, antioxidant index and hepatic lipid metabolism associated factors in nonalcoholic fatty liver rats. METHODS: Thirty-six male rats (SD) were randomly divided into four groups by weight: normal control group, nonalcoholic fatty liver disease (NAFLD) model control group, low-dose isoflavone treatment group (10 mg/kg) and high-dose isoflavone group (20 mg/kg), 9 rats in each group. Normal control rats were fed with D12450B (10% fat energy), model control and isoflavone intervention rats were fed with D12492 (60% fat energy). Twelve weeks later, liver lipid, serum lipid and antioxidant index were observed. Liver sterol regulatory element binding protein-1c (SREBP-1c), fatty acid synthase (FAS) and peroxisome proliferators activated receptor alpha (PPAR alpha) were detected by western blotting. RESULTS: Liver triglyceride (TG) in normal control group, NAFLD model control group, low-dose isoflavone group and high-dose isoflavone group were (8.11 ± 4.13), (57.06 ± 16.95), (31.26 ± 10.48), (31.38 ± 13.25) mmol/mg protein, respectively (F = 22.569, P < 0.01); liver free fatty acid (FFA) were (0.030 ± 0.007), (0.042 ± 0.009), (0.038 ± 0.009), (0.032 ± 0.005) µmol/mg protein, respectively (F = 4.857, P < 0.01); liver superoxide dismutase (SOD) activity were (502.29 ± 23.71), (201.83 ± 16.99), (228.93 ± 21.71), (238.08 ± 15.96) U/mg protein, respectively (F = 9.555, P < 0.01); liver malondialdehyde (MDA) were (1.29 ± 0.29), (2.85 ± 0.73), (2.07 ± 0.49), (2.03 ± 0.37) nmol/mg protein, respectively (F = 13.449, P < 0.01); SREBP-1c protein expression were 0.45 ± 0.16, 1.42 ± 0.30, 1.02 ± 0.31, 0.47 ± 0.27, respectively (F = 24.515, P < 0.01); FAS protein expression were 0.27 ± 0.08, 1.97 ± 0.47, 1.35 ± 0.30, 0.49 ± 0.12, respectively (F = 60.361, P < 0.01); PPARα protein expression were 2.03 ± 0.56, 0.41 ± 0.17, 0.81 ± 0.27, 0.66 ± 0.16, respectively (F = 37.97, P < 0.01). CONCLUSION: Soy isoflavone can reduce the hepatic lipid deposition and increase antioxidant capacity, the mechanism may be related to inhibition of SREBP-1c and activation of PPARα expression in liver.

Physical activity, cardiorespiratory fitness, and obesity among Chinese children.

OBJECTIVE: To investigate the relationships of cardiorespiratory fitness (CRF) and physical activity (PA) with the risk of overweight/obesity in Chinese schoolchildren. METHODS: A total of 1795 children aged 8-13 years at baseline were followed-up for 18 months from 2006 to 2008 in Guangzhou, China. Children were categorized as "normal weight", "overweight", and "obese" using Chinese obesity cut-off points. Data on self-reported PA were obtained. CRF was determined by the 20-meter multistage fitness test, and the sex-specific median values were set as the cut-off points for the classification of high and low CRF. RESULTS: Significantly higher CRF was found in children with normal weight (from 6.55 to 8.65 ml/kg/min) or physically active children (from 0.42 to 1.22 ml/kg/min) compared with the reference group. CRF was inversely associated with the kg/m(2) change in BMI during the follow-up period (ß=-0.63 kg/m(2) and -0.64 kg/m(2) for boys and girls, respectively, both p<0.001). Significant association of baseline CRF with overweight/obesity was found in boys (odds ratio (OR) 8.71; 95% confidence interval (CI) 2.59-29.26, p<0.001), whereas the association was marginally insignificant in girls (OR 6.87; 95% CI 0.96-49.09, p=0.055). CONCLUSIONS: The results showed a strong negative association between CRF levels and children's BMI and weight gain.

Effects of ambient air pollution on lung function growth in Chinese schoolchildren.

OBJECTIVE: To evaluate the adverse effect of exposure to air pollution on lung function growth in school-aged children. METHODS: A cohort of 1983 children from three districts in Guangzhou, China was followed-up for 6 months. The children performed pulmonary function tests twice, and their parents reported the child's respiratory symptoms by self-administered questionnaires in both surveys. RESULTS: The annual mean concentrations of air pollutants for the past 5 years for particulate matter less than 10 microns in diameter (PM(10)), nitrogen (NO(2)), and sulfur dioxide (SO(2)) were respectively: 96.1 microg/m(3), 76.0 microg/m(3), and 65.7 microg/m(3) in the highly-polluted district (HPD), 80.3 microg/m(3), 67.6 mug/m(3), and 54.5 microg/m(3) in the moderately-polluted district (MPD), and 80.0 microg/m(3), 48.1 microg/m(3), and 52.2 microg/m(3) in the least-polluted district (LPD). After adjustment for potential confounders, significant deficits were found in the annual growth rates of forced expiratory flows at 25% (FEF(25)), and between 25% and 75% (FEF(25-75)) in boys and FEF(25) in girls (In boys, for FEF(25), -0.136 l/s, p = 0.008 in MPD and -0.153 l/s, p = 0.004 in HPD, respectively; for FEF(25-75), -0.176 l/s, p = 0.013 in MPD and -0.167 l/s, p = 0.021 in HPD, respectively. In girls, for FEF(25), -0.123 l/s, p = 0.043 in HPD), using LPD as the reference. Deficits in the annual growth rate of forced expiratory volume in 1 s (FEV(1)) were also negatively associated with air pollution in boys (-0.063 L, p = 0.032 in HPD). CONCLUSIONS: The study adds more evidence that exposure to air pollution has adverse effects on lung function growth in schoolchildren.

Respiratory health in overweight and obese Chinese children.

OBJECTIVES: Childhood obesity has been suggested to be associated with asthma and impairment of pulmonary functions, but the findings are conflicting. The aim of this study was to examine the relationship of body mass index (BMI) with asthma, asthma-like symptoms, and lung functions in Chinese schoolchildren. METHODS: Data from a survey of 2,179 children aged 10.04 +/- 0.85 years in Guangzhou, China were analyzed. Children's history of respiratory symptoms/diseases and other potential confounders were obtained by standardized questionnaires. Anthropometric and spirometry tests were performed in all subjects. Children were categorized as "normal weight," "overweight," and "obesity" using Chinese Obesity cut-off points based on age- and gender-specific BMI values. RESULTS: Being overweight was significantly associated with an increased risk of cough with cold (odds ratio, OR 1.60; 95% CI 1.01-2.55) in boys, and phlegm with cold (OR 2.46; 95% CI 1.25-4.85) and cough without cold (OR 2.91; 95% CI 1.05-8.08) in girls. Being obese was positively associated with an increased risk of phlegm with cold (OR 1.69; 95% CI 1.04-2.87) in boys, and wheezing (OR 3.82; 95% CI 1.28-11.42) and wheezing with cold in girls (OR 8.75; 95% CI 2.11-36.34). The forced vital capacity (FVC) increased with BMI in all children, overweight boys and obese girls also had significantly higher forced expiratory volume in 1 sec (FEV(1)) than those with normal weight. CONCLUSIONS: Our findings demonstrate that overweight and obesity are high risks for children's respiratory symptoms and diseases. Pulmonary function was not adversely affected by obesity in schoolchildren.

Energy expenditure and energy intake in 10-12 years obese and non-obese Chinese children in a Guangzhou boarding school.

OBJECTIVE: The objective of this study was to observe the variation of energy intake and energy expenditure in the obese Chinese children. METHODS: Basic metabolic rate was measured by using open-circuit indirect calorimetry in 54 obese children and 60 non-obese children aged 10-12 years in a full- time boarding school in Guangzhou suburb, China. Total energy expenditure was estimated by using a factorial method. Dietary intake was surveyed by the weighed inventory method. Physical activity was determined using a 2-day activity diary. RESULTS: Univariate analysis showed that basic metabolic rate was significantly higher (p<0.05) in obese children than in non-obese ones, but the significant difference disappeared after controlling for fat free mass and fat mass. Energy intake and total energy expenditure were significantly higher (p<0.05) in obese than in non-obese children. Obese children spent more time in sleeping and light physical activity, but less time in moderate physical activity and vigorous physical activity than non-obese children (p<0.05). CONCLUSIONS: Compared to non-obese children, both energy intake and expenditure were higher in obese Chinese children. It appears that an area for preventive strategies may be to encourage increased physical activity expenditure in this age group.

Cardiovascular risk factors in overweight and obese Chinese children: a comparison of weight-for-height index and BMI as the screening criterion.

BACKGROUND: Childhood obesity is a widespread and growing problem in the world. Body mass index (BMI) and weight-for-height criterion have been used to determine childhood obesity. No data was available to evaluate cardiovascular risk factors in overweight and obese Chinese children screened by weight-for-height index and Chinese newly developed BMI criterion. AIM OF THE STUDY: To evaluate cardiovascular risk factors in overweight and obese Chinese children by using Chinese BMI and weight-for-height index as screening criterion. METHODS: A total of 215 children aged 7.5-13 years were recruited from 3 primary schools in Guangzhou, PR China. Measurements included body weight, height, waist and hip circumference, fasting serum glucose, insulin, total triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), apolipoprotein A (apo A), apolipoprotein B (apo B). Chinese BMI and weight-for- height criterion were used to classify overweight and obesity. RESULTS: According to Chinese BMI criterion, 65 from 108 obese children originally identified by weight-for-height were reclassified as obese and other 41 children were classified as overweight. Compared with non-obese children, obese children screened by Chinese BMI and weight-for-height index had increased levels of TG, LDL-C, apo B, insulin; decreased levels of HDL-C, apo A; and significantly higher prevalence of hypertriglyceridemia and high LDL-C. Children identified as overweight by Chinese BMI criterion had also shown high TG, LDL-C, apo B, insulin levels, low HDL-C, apo A levels, and significantly higher prevalence of hypertriglyceridemia than the normal weight children. CONCLUSIONS: Our study reveals that overweight and/or obesity screened by both Chinese new BMI and weight-for-height criterion are associated with increased levels of cardiovascular risk factors (e.g., elevated serum TG, LDL, apo B, and reduced HDL-C, apo A levels). Using Chinese BMI criterion may underestimate the prevalence of childhood obesity but it could be adopted as a unique tool for screening children's overweight in population-based screening programs.