Evaluation of a Web-based decision aid for people considering the APOE genetic test for Alzheimer risk.

PURPOSE: With the increasing interest in apolipoprotein E (APOE) genetic testing to estimate the risk of developing late-onset Alzheimer disease, new educational tools are needed to help people make the best decision for themselves about whether to undergo this test. This study evaluated an online tool to assist in this decision process. METHODS: A prototype decision aid was studied in a two-part survey that collected data from participants before and after they examined the decision aid. Both surveys had multiple-choice options and opportunities for open-ended responses, yielding quantitative and qualitative information. The responses before and after use of the aid were compared for each participant. RESULTS: A total of 1,262 individuals completed both surveys. The overall effectiveness of the decision aid was shown by three measures: 94% found the decision aid very helpful or somewhat helpful; general knowledge was increased; and some people changed their minds about APOE genetic testing, with 35% shifting to a higher likelihood of undergoing the test and 20% to a lower likelihood. Suggestions for improvements were noted and incorporated into the online tool. CONCLUSION: This decision aid can provide useful educational assistance to many individuals as they consider APOE genetic testing as well as facilitate further discussions with their health-care providers.Genet Med advance online publication 03 November 2016.

African americans may have to consume more than 12 grams a day of resistant starch to lower their risk for type 2 diabetes.

African Americans have a high prevalence rate of type 2 diabetes mellitus (DM). High-maize 260 (National Starch and Chemical Co., Bridgewater, NJ, USA) resistant starch (RS) is a promising food ingredient to reduce risk factors for type 2 DM. A 14-week, double-blind, crossover design study was conducted with African American male (n = 8) and female (n = 7) subjects at risk for type 2 DM. All subjects consumed bread containing 12 g of added RS or control bread (no added RS) for 6 weeks, separated by a 2-week washout period. There were no significant differences in the subjects' fasting plasma glucose levels due to the consumption of the RS bread versus the control bread. Fructosamine levels were significantly lower after consumption of both RS and control bread than at baseline. However, we found no significant difference in fructosamine levels due to treatment effects, i.e., RS bread intake versus the control bread. There were no significant differences in insulin or C-reactive protein levels due to treatment, gender, or sequence effects. Mean homeostasis model assessment of insulin resistance decreased to normal values (>2.5) at the end of the 14-week study, although there were no significant treatment effects. The results of this study suggest that African Americans may need to consume more than 12 g/day of RS to lower their risk for type 2 DM.

Isoflavones improve plasma homocysteine status and antioxidant defense system in healthy young men at rest but do not ameliorate oxidative stress induced by 80% VO2pk exercise.

AIMS: (1) Determination of whether isoflavones, as antioxidants and estrogen-like substances, reduce the atherosclerotic process. (2) Assessment of isoflavone anti-atherosclerotic effectiveness by means of measuring plasma markers of atherosclerosis: homocysteine (Hcy), antioxidant status, and lipid peroxidation. (3) Testing of isoflavone antioxidant effectiveness in the presence and absence of oxidative stress induced by exercise. METHODS: Thirty subjects paired by aerobic fitness level were randomly assigned to either a placebo or high-genistein isoflavone extract (HGI, 150 mg/day) treatment. Blood samples were collected before and within 5 min, after 30 min at 80% peak oxygen consumption (VO(2)pk) exercise, and before and after 4-week supplementation. RESULTS: Plasma genistein and daidzein were significantly increased by 4-week HGI supplementation before and after exercise (p < 0.05). HGI decreased pre-exercise (pre-ex) plasma malondialdehyde (MDA) (p < 0.05) and Hcy (p = 0.01), and increased pre-ex blood total glutathione (TGSH) (p = 0.01), but did not diminish the increase of MDA and the decrease of TGSH due to the exercise. Furthermore, HGI supplementation enhanced pre-ex total antioxidant capacity (p < 0.05), but did not influence plasma vitamin C and E and uric acid concentrations. CONCLUSION: Isoflavones reduce plasma Hcy and have antioxidant activity in healthy young men. However, the effect of isoflavones on antioxidant systems may not be potent enough to diminish an abrupt surge of oxidative stress due to acute exercise.