No Significant Effects of Lutein, Lycopene or β-Carotene Supplementation on Biological Markers of Oxidative Stress and LDL Oxidizability in Healthy Adult Subjects Lutein supplementation reduces plasma lipid peroxidation and C-reactive protein in healthy nonsmokers. Dietetic guidelines: diet in secondary prevention of cardiovascular disease. The pediatric cancer quality of life inventory‐32 (PCQL‐32) Carotenoids in Age-Related Maculopathy Italian Study (CARMIS): Two-Year Results of a Randomized Study Effects of an Antioxidant‐enriched Multivitamin in Cystic Fibrosis. A Randomized, Controlled, Multicenter Clinical Trial Pistachios increase serum antioxidants and lower serum oxidized-LDL in hypercholesterolemic adults. Using Guasha to treat musculoskeletal pain: A systematic review of controlled clinical trials Smoking and exposure to environmental tobacco smoke decrease some plasma antioxidants and increase gamma-tocopherol in vivo after adjustment for dietary antioxidant intakes. Protocol for systematic reviews of determinants/correlates of obesity-related dietary and physical activity behaviors in young children (preschool 0 to 6 years): evidence mapping and syntheses Prevention of cervical cancer in HIV-seropositive women from developing countries: a systematic review protocol Effects of Curcumin on the Oxidative Stress Response to a Dual Stress Challenge in Trained Men Pelvic floor muscle training and adjunctive therapies for the treatment of stress urinary incontinence in women: a systematic review Cost-effectiveness of interventions to control cardiovascular diseases and type 2 diabetes mellitus in South Asia: protocol for a systematic review Oxidative stress responses in older men during endurance training and detraining. Pulsatile release patterns of luteinizing hormone and progesterone in relation to symptom onset in women with premenstrual syndrome. No Differences in DNA Damage and Antioxidant Capacity Between Intervention Groups of Healthy, Nonsmoking Men Receiving 2, 5, or 8 Servings/Day of Vegetables and Fruit Psychosocial determinants of fruit and vegetable intake in adult population: a systematic review Sequence variants in antioxidant defense and DNA repair genes, dietary antioxidants, and pancreatic cancer risk. Effect of Tomato Product Consumption on the Plasma Status of Antioxidant Microconstituents and on the Plasma Total Antioxidant Capacity in Healthy Subjects SF-36 scores vary by method of administration: implications for study design. Effects of lutein and lycopene on carotid intima-media thickness in Chinese subjects with subclinical atherosclerosis: a randomised, double-blind, placebo-controlled trial. Systematic evaluation of implementation fidelity of complex interventions in health and social care The effect of lutein- and zeaxanthin-rich foods v. supplements on macular pigment level and serological markers of endothelial activation, inflammation and oxidation: pilot studies in healthy volunteers. Systematic Reviews of Animal Studies; Missing Link in Translational Research? A single portion of blueberry (Vaccinium corymbosum L) improves protection against DNA damage but not vascular function in healthy male volunteers. Macular xanthophylls and ω-3 long-chain polyunsaturated fatty acids in age-related macular degeneration: a randomized trial. Effects of intentional weight loss in patients with obesity and heart failure: a systematic review. Evidence that cranberry juice may improve augmentation index in overweight men.
Objective : The objective of this study was to determine the effect of individual carotenoid supplementation on biochemical indices of oxidative status in apparently healthy adult males . Methods : The study was a placebo controlled single blind study . Healthy male volunteers ( n=175 ) were assigned to four groups . They received daily supplements of β-carotene ( 15 mg ) , lutein ( 15 mg ) , lycopene ( 15 mg ) and placebo for three months . The effects of the supplementation on antioxidant status were monitored by plasma carotenoid , vitamin C and A levels , glutathione ( GSH and GSSG ) concentrations , protein SH groups , erythrocyte antioxidant enzyme activities ( Cu-Zn SOD , Se-GSH-Px ) and susceptibility of LDL to copper-induced oxidation . Results : β-carotene , lycopene and lutein supplementation led to significant plasma and LDL increases in each of these carotenoids , without modifications of other carotenoid levels in plasma or in LDL . The supplementation failed to enhance the resistance of LDL to oxidation or to modify the LDL polyunsaturated/saturated fatty acid ratio . Vitamin C , GSH , protein SH groups and antioxidant metalloenzyme activities were also unchanged . Conclusion : We did not observe beneficial or adverse effects of lutein , lycopene or β-carotene supplementation on biomarkers of oxidative stress . In apparently healthy subjects , carotenoid supplementation does not lead to significantly measurable improvement in antioxidant defenses OBJECTIVE The aim of this study was to determine whether lutein affected biomarkers related to cardiovascular diseases ( CVD ) in healthy nonsmokers . METHODS A r and omized , double-blind , placebo-controlled trial of lutein supplementation was conducted in healthy nonsmokers . 117 eligible subjects were r and omly assigned to receive 10 or 20 mg/d of lutein or placebo for 12 weeks . Levels of plasma carotenoid concentrations , total antioxidant capacity ( TAOC ) , the lipoprotein profile , and antioxidant enzymes activities were determined at baseline and at 6 , and 12 weeks after the initiation of treatment . Biomarkers of oxidative damage to protein and lipids , and C-reactive protein ( CRP ) concentrations were measured at baseline and after supplementation . RESULTS Plasma lutein and TAOC significantly increased in both active treatment groups during 12 weeks . A significant reduction was found in malondialdehyde in the 20 mg lutein group . CRP concentration decreased in a dose-dependent manner for lutein supplementation , and there was a significant between-group difference in CRP between the 20 mg lutein and the placebo group . Serum CRP was directly related to the change in plasma lutein and TAOC for both active treatment groups . CONCLUSION The results support the possibility that lutein supplementation reduce biomarkers of CVD risk via decreased lipid peroxidation and inflammatory response by increasing plasma lutein concentrations and antioxidant capacity AIM To produce dietetic guidelines summarizing the systematic review evidence on dietary advice for secondary prevention of cardiovascular disease . METHODS The Cochrane Library , MEDLINE and EMBASE were comprehensively search ed for systematic review s on aspects of diet and heart health . Review s were included if they search ed systematic ally for r and omised controlled trials relating to diet and secondary prevention of cardiovascular disease . Two members of the UK Heart Health and Thoracic Dietitians Group critically appraised each review . The quality and results of each review were discussed and summarized in a whole group meeting . The guidelines were trialled in seven dietetic departments and modified where necessary . RESULTS Providing evidence -based dietary information ( including increasing omega-3 fat plus fruit and vegetable intake ) to all people after myocardial infa rct ion will save more lives than concentrating dietary advice on those in need of weight loss or lipid lowering . The practice of prioritizing dietetic time to those with raised lipids is out of date since the advent of statin therapy . CONCLUSION There is good systematic review evidence that dietary advice to those with cardiovascular disease can reduce mortality and morbidity as well as modify risk factors .  Dietary advice that does this most effectively should be prioritized Multidimensional measurement of pediatric cancer patients ' health‐related quality of life ( HRQOL ) in Phase III r and omized controlled clinical trials is being recognized increasingly as an essential component in evaluating the comprehensive health outcomes of modern antineoplastic treatment protocol s. The Pediatric Cancer Quality of Life Inventory‐32 ( PCQL‐32 ) is a st and ardized patient self‐report and parent proxy‐report assessment instrument design ed to assess systematic ally pediatric cancer patients ' HRQOL outcomes Purpose The high concentration of carotenoids in the macula , plus evidence linking oxidative stress to age-related macular degeneration ( AMD ) and carotenoids to antioxidation , generated the hypothesis that higher antioxidant intakes can prevent AMD . The aim of this study was to determine whether nutritional supplementation with a targeted nutritional supplement improves visual acuity and visual function in AMD . Methods In this multicenter , prospect i ve open-label r and omized study , 145 patients were r and omly assigned to 2 different treatment groups . Interventions were lutein ( 10 mg ) , zeaxanthin ( 1 mg ) , astaxanthin ( 4 mg ; AZYR SIFI , Catania , Italy ) , and antioxidants/vitamins supplementation formula or no dietary supplementation for 2 years . Primary outcome was mean changes in visual acuity ( VA ) at 12 and 24 months . Other measures included contrast sensitivity ( CS ) and National Eye Institute visual function question naire ( NEI VFQ-25 ) scores at 12 and 24 months . Results Patients in the treated group showed stabilization of VA with significantly ( p=0.003 ) better VA scores ( 81.4±7.2 ) compared to the nontreated group ( 76.8±8.9 ) at 24-month follow-up . An improvement in CS ( p=0.001 ) and final mean NEI VFQ-25 composite scores at 12 and 24 months higher in treated group compared to nontreated group were also shown ( p<0.001 ) . Conclusions Patients treated with lutein/zeaxanthin and astaxanthin together with other nutrients were more likely to report clinical ly meaningful stabilization/improvements in VA , CS , and visual function through 24 months compared with nontreated subjects . Further studies are needed with more patients and for longer periods of time Rationale : Cystic fibrosis ( CF ) is characterized by dietary antioxidant deficiencies , which may contribute to an oxidant‐antioxidant imbalance and oxidative stress . Objectives : Evaluate the effects of an oral antioxidant‐enriched multivitamin supplement on antioxidant concentrations , markers of inflammation and oxidative stress , and clinical outcomes . Methods : In this investigator‐initiated , multicenter , r and omized , double‐blind , controlled trial , 73 pancreatic‐insufficient subjects with CF 10 years of age and older with an FEV1 between 40 % and 100 % predicted were r and omized to 16 weeks of an antioxidant‐enriched multivitamin or control multivitamin without antioxidant enrichment . Endpoints included systemic antioxidant concentrations , markers of inflammation and oxidative stress , clinical outcomes ( pulmonary exacerbations , anthropometric measures , pulmonary function ) , safety , and tolerability . Measurements and Main Results : Change in sputum myeloperoxidase concentration over 16 weeks , the primary efficacy endpoint , was not significantly different between the treated and control groups . Systemic antioxidant ( & bgr;‐carotene , coenzyme Q10 , & ggr;‐tocopherol , and lutein ) concentrations significantly increased in the antioxidant‐treated group ( P < 0.001 for each ) , whereas circulating calprotectin and myeloperoxidase decreased in the treated group compared with the control group at Week 4 . The treated group had a lower risk of first pulmonary exacerbation requiring antibiotics than the control group ( adjusted hazard ratio , 0.50 ; P = 0.04 ) . Lung function and growth endpoints did not differ between groups . Adverse events and tolerability were similar between groups . Conclusions : Antioxidant supplementation was safe and well tolerated , result ing in increased systemic antioxidant concentrations and modest reductions in systemic inflammation after 4 weeks . Antioxidant treatment was also associated with a lower risk of first pulmonary exacerbation . Clinical trial registered with www . clinical trials.gov ( NCT01859390 ) Pistachios are high in lutein , beta-carotene , and gamma-tocopherol relative to other nuts ; however , studies of the effects of pistachios on oxidative status are lacking . We conducted a r and omized , crossover controlled-feeding study to evaluate 2 doses of pistachios on serum antioxidants and biomarkers of oxidative status in 28 hypercholesterolemic adults ( LDL-cholesterol > or=2.86 mmol/L ) . Participants consumed 3 isoenergetic diets for 4 wk each after a 2-wk baseline Western diet . Experimental diets included a lower-fat control diet without pistachios ( 25 % total fat ) with 1 serving/d ( i.e. 32 - 63 g/d ; energy adjusted ) of pistachios ( 1 PD ; 10 % energy from pistachios ; 30 % total fat ) or with 2 servings/d ( 63 - 126 g/d ; energy adjusted ) of pistachios ( 2 PD ; 20 % energy from pistachios ; 34 % total fat ) . When participants consumed the pistachio-enriched diets , they had higher plasma lutein ( P < 0.0001 ) , alpha-carotene , and beta-carotene ( P < 0.01 ) concentrations than after the baseline diet . After consuming the pistachio diets , participants had greater plasma lutein ( P < 0.001 ) and gamma-tocopherol ( P < 0.05 ; 2 PD only ) relative to the lower-fat control diet . After the 2 PD diet period , participants also had lower serum oxidized-LDL concentrations than following the baseline diet period ( P < 0.05 ) . After both the 1 PD and 2 PD diet periods , they had lower serum oxidized-LDL concentrations than after the control diet period ( P < 0.05 ) . The change in oxidized-LDL from baseline correlated positively with the change in LDL-cholesterol across all treatments ( r = 0.42 ; P < 0.005 ) . After controlling for the change in serum LDL-cholesterol as a covariate , increases in serum lutein and gamma-tocopherol following the 2 PD period were still modestly associated with decreases in oxidized-LDL ( r = -0.36 , P = 0.06 and r = -0.35 , P = 0.08 , respectively ) . This suggests that a heart-healthy diet including pistachios contributes to the decrease in the serum oxidized-LDL concentration through cholesterol-lowering and may provide an added benefit as a result of the antioxidants the pistachios contain Background Guasha is a therapeutic method for pain management using tools to scrape or rub the surface of the body to relieve blood stagnation . This study aims to systematic ally review the controlled clinical trials on the effectiveness of using Guasha to treat musculoskeletal pain . Methods We search ed 11 data bases ( without language restrictions ) : MEDLINE , Allied and Complementary Medicine ( AMED ) , EMBASE , Cumulative Index to Nursing and Allied Health Literature ( CINAHL ) , Korean Studies Information ( KSI ) , DBPIA , Korea Institute of Science and Technology Information ( KISTI ) , KoreaMed , Research Information Service System ( RISS ) , China National Knowledge Infrastructure ( CNKI ) and the Cochrane Library . The search strategy was Guasha ( OR scraping ) AND pain . Risk of bias was assessed with the Cochrane criteria ( i.e. sequence generation , blinding , incomplete outcome measures and allocation concealment ) . Results Five r and omized controlled trials ( RCTs ) and two controlled clinical trials ( CCTs ) were included in the present study . Two RCTs compared Guasha with acupuncture in terms of effectiveness , while the other trials compared Guasha with no treatment ( 1 trial ) , acupuncture ( 4 trials ) , herbal injection ( 1 trial ) and massage or electric current therapy ( 1 trial ) . While two RCTs suggested favorable effects of Guasha on pain reduction and response rate , the quality of these RCTs was poor . One CCT reported beneficial effects of Guasha on musculoskeletal pain but had low method ological quality . Conclusion Current evidence is insufficient to show that Guasha is effective in pain management . Further RCTs are warranted and method ological quality should be improved BACKGROUND Free radicals in cigarette smoke may cause oxidative damage to macromolecules , contributing to cardiovascular diseases and cancer . Decreased plasma antioxidant concentrations may indicate cigarette smoke-related oxidative stress . OBJECTIVE We compared the effects on plasma antioxidant concentrations in cotinine-confirmed active and passive smokers with those in nonsmokers , independent of differences in dietary intakes and other covariates . DESIGN Plasma sample s from 83 smokers , 40 passive smokers , and 36 nonsmokers were analyzed for total ascorbic acid , alpha- and gamma-tocopherols , 5 carotenoids , retinol , and cotinine . Groups were compared by using analysis of variance with adjustment for sex , age , race , body mass index , alcohol intake , triacylglycerol concentration , fruit and vegetable intakes , and dietary antioxidants . RESULTS After adjustment for dietary antioxidant intakes and other covariates , smokers and passive smokers had significantly lower plasma beta-carotene concentrations than did nonsmokers ( 0.15 , 0.17 , and 0.24 micro mol/L , respectively ) and significantly higher gamma-tocopherol concentrations ( 7.8 , 7.8 , and 6.5 micro mol/L , respectively ) . Smokers had significantly lower plasma ascorbic acid and beta-cryptoxanthin concentrations than did nonsmokers and passive smokers ( ascorbic acid : 43.6 , 54.5 , and 54.6 micro mol/L , respectively ; beta-cryptoxanthin : 0.12 , 0.16 , and 0.16 micro mol/L , respectively ) and significantly lower concentrations of lutein and zeaxanthin than did nonsmokers ( 0.33 compared with 0.41 micro mol/L ) . The P values for all the differences described above were < 0.05 . No significant differences in plasma concentrations of alpha-tocopherol , alpha-carotene , total carotenoids , lycopene , or retinol were observed . CONCLUSIONS These results indicate that cigarette smokers and nonsmokers exposed to cigarette smoke have a significantly lower plasma antioxidant status than do unexposed nonsmokers , independent of differences in dietary antioxidant intakes . Further research is required to explain why plasma gamma-tocopherol concentrations were significantly higher in smokers and passive smokers than in nonsmokers Background The aim of these review s is to inform the design and content of interventions to reduce obesity in young children . The behaviors that are associated with obesity/overweight have been studied extensively ; however , the factors associated with these behaviors in young children ( 0 to 6 years ) have not been systematic ally review ed . Over the past few years the focus of obesity prevention has shifted to preschool children because of the high prevalence of obesity at school entry and recognition that habits formed in early life could track into adulthood . In order to develop effective interventions and change behavior , it is important to underst and the factors that are associated with those behaviors . For example , we need to underst and whether it would be more important to target the family , childcare setting s or the wider environment and identify the most effective way of changing these energy balance related behaviors . Methods / Design Quantitative ( intervention and observational ) and qualitative literature on determinants/correlates of fruit and vegetable intake , sugar sweetened beverage and other unhealthy diet intake , and physical activity and sedentary behaviors in young children will be systematic ally identified , mapped and review ed . A common search strategy ( no language or period restrictions ) will be used to identify papers from eight electronic data bases and this will be supplemented by h and - search ing . Next , studies in developed countries that examine the factors associated with these behaviors in children aged 0 to 6 years ( at baseline ) will be screened and mapped descriptively followed by in-depth data extraction , quality assessment and synthesis . Data from quantitative studies will be summarized using either forest plots or harvest plots and narrative synthesis , and qualitative studies using thematic analysis . Qualitative evidence will be integrated with the quantitative evidence , using a parallel synthesis approach , to provide a deeper underst and ing of effective strategies to influence these energy balance related behaviors . Discussion In addition to updating and mapping current research , these review s will be the first to comprehensively synthesize and integrate both the quantitative and qualitative evidence pertaining to determinants/correlates/barriers/facilitators of obesity related behaviors in this young age group ( 0 to 6 years ) with the aim of informing future interventions . Systematic review registration International Prospect i ve Register for Systematic Review s ( PROSPERO ) Registration number : Background Over 85 % of cervical cancer cases and deaths occur in developing countries . HIV-seropositive women are more likely to develop precancerous lesions that lead to cervical cancer than HIV-negative women . However , the literature on cervical cancer prevention in seropositive women in developing countries has not been review ed . The aim of this study is to systematic ally review cervical cancer prevention modalities available for HIV-seropositive women in developing countries . Methods / design This protocol was developed by following the Preferred Reporting Items for Systematic Review s and Meta-Analyses Protocol s ( PRISMA -P ) statement , and the systematic review will be reported in accordance with the PRISMA guidelines . Embase , MEDLINE , PubMed , CINAHL and Cochrane Library will be search ed from inception up to date of final search , and additional studies will be located through citation and reference list tracking . Eligible studies will be r and omised controlled trials , prospect i ve and retrospective cohort studies , case-control and cross-sectional studies carried out in developing countries . Studies will be included if they are published in English and examine cervical cancer prevention modalities in HIV-seropositive women . Results will be summarised in tables and , where appropriate , combined using meta- analysis . Discussion This review will address the gap in evidence by systematic ally review ing the published literature on the different prevention modalities being used to prevent  cervical cancer in HIV-seropositive women in developing countries . The findings may be used to inform evidence -based guidelines for prevention of cervical cancer in seropositive women as well as future research . Systematic review registration PROSPERO CRD42017054678 Abstract Firefighters and military personnel are exposed to a variety of stressors . The combination of mental and physical stress ( i.e. , dual stress challenges [ DSCs ] ) results in significant oxidative stress ( OS ) , which may contribute to cardiometabolic dysfunction . Curcumin ( CUR ) is an exogenous antioxidant that may attenuate such OS . Fourteen trained men participated in a r and omized , cross-over design to investigate the impact of CUR on markers of OS result ing from DSC . CUR or placebo was ingested three days prior to , and the morning of , testing . The DSC involved 20 min of mental stress challenges during 35 min of cycling at 60 % V̇O2 peak . Blood was sample d before , as well as immediately , 30 min , and 60 min after , exercise and analyzed for glutathione ( GSH ) , superoxide dismutase ( SOD ) , hydrogen peroxide ( H2O2 ) , and advanced oxidation protein products ( AOPP ) . There was no treatment effect for any variable . However , the DSC result ed in significant reductions in SOD , H2O2 , and AOPP at 30 and 60 min after exercise . Previous studies have shown that DSC results in significant OS compared to exercise alone . However , these data suggest the DSC was associated with reductions in postexercise markers of OS . Antioxidant therapy is likely not needed in trained men exposed to DSC Background Stress urinary incontinence ( SUI ) is a prevalent and costly condition which may be treated surgically or by physical therapy . The aim of this review was to systematic ally assess the literature and present the best available evidence for the efficacy and effectiveness of pelvic floor muscle training ( PFMT ) performed alone and together with adjunctive therapies ( eg biofeedback , electrical stimulation , vaginal cones ) for the treatment of female SUI . Methods All major electronic sources of relevant information were systematic ally search ed to identify peer- review ed English language abstract s or papers published between 1995 and 2005 . R and omised controlled trials ( RCTs ) and other study design s eg non-r and omised trials , cohort studies , case series , were considered for this review in order to source all the available evidence relevant to clinical practice . Studies of adult women with a urodynamic or clinical diagnosis of SUI were eligible for inclusion . Excluded were studies of women who were pregnant , immediately post-partum or with a diagnosis of mixed or urge incontinence . Studies with a PFMT protocol alone and in combination with adjunctive physical therapies were considered . Two independent review ers assessed the eligibility of each study , its level of evidence and the method ological quality . Due to the heterogeneity of study design s , the results are presented in narrative format . Results Twenty four studies , including 17 RCTs and seven non- RCTs , met the inclusion criteria . The method ological quality of the studies varied but lower quality scores did not necessarily indicate studies from lower levels of evidence . This review found consistent evidence from a number of high quality RCTs that PFMT alone and in combination with adjunctive therapies is effective treatment for  women  with  SUI  with rates of ' cure ' and ' cure/improvement ' up to 73 % and 97 % respectively . The contribution of adjunctive therapies is unclear and there is limited evidence about treatment outcomes in primary care setting s. Conclusion There is strong evidence for the efficacy of physical therapy for the treatment for SUI in women but further high quality studies are needed to evaluate the optimal treatment programs and training protocol s in subgroups of women and their effectiveness in clinical practice Introduction While a number of strategies are being implemented to control cardiovascular diseases ( CVDs ) and type 2 diabetes mellitus ( T2DM ) , the cost-effectiveness of these in the South Asian context has not been systematic ally evaluated . We aim to systematic ally review the economic ( cost-effectiveness ) evidence available on the individual- , group- and population -level interventions for control of CVD and T2DM in South Asia . Methods and analysis This review will consider all relevant economic evaluations , either conducted alongside r and omised controlled trials or based on decision modelling estimates . These studies must include participants at risk of developing CVD/T2DM or with established disease in one or more of the South Asian countries ( India , Bangladesh , Pakistan , Sri Lanka , Nepal , Maldives , Bhutan and Afghanistan ) . We will identify relevant papers by systematic ally search ing all major data bases and registries . Selected articles will be screened by two independent research ers . Method ological quality of the studies will be assessed using a modified Drummond and a Phillips checklist . Cochrane guidelines will be followed for bias assessment in the effectiveness studies . Results Results will be presented in line with the PRISMA ( Preferred Reporting Items for Systematic review and Meta- analysis ) checklist , and overall quality of evidence will be presented as per the GRADE ( Grade s of Recommendation , Assessment , Development and Evaluation ) approach . Ethics and dissemination The study has received ethics approval from the All India Institute of Medical Sciences , New Delhi , India . The results of this review will provide policy-relevant recommendations for the uptake of cost-effectiveness evidence in prioritising decisions on essential chronic disease care packages for South Asia . Study registration number PROSPERO CRD42013006479 PURPOSE Aging is associated with increased oxidative stress , whereas systematic exercise training has been shown to improve quality of life and functional performance of the aged . This study aim ed to evaluate responses of selected markers of oxidative stress and antioxidant status in inactive older men during endurance training and detraining . METHODS Nineteen older men ( 65 - 78 yr ) were r and omly assigned into either a control ( C , N = 8) or an endurance-training ( ET , N = 11 , three training sessions per week , 16 wk , walking/jogging at 50 - 80 % of HR(max ) ) group . Before , immediately posttraining , and after 4 months of detraining , subjects performed a progressive diagnostic treadmill test to exhaustion ( GXT ) . Plasma sample s , collected before and immediately post-GXT , were analyzed for malondialdehyde ( MDA ) and 3-nitrotyrosine ( 3-NT ) levels , total antioxidant capacity ( TAC ) , and glutathione peroxidase activity ( GPX ) . RESULTS ET caused a 40 % increase in running time and a 20 % increase in maximal oxygen consumption ( VO(2max ) ) ( P < 0.05 ) . ET  lowered MDA ( 9 % at rest , P < 0.01 ; and 16 % postexercise , P < 0.05 ) and 3-NT levels ( 20 % postexercise , P < 0.05 ) , whereas it increased TAC ( 6 % at rest , P < 0.01 ; and 14 % postexercise , P < 0.05 ) and GPX ( 12 % postexercise , P < 0.05 ) . However , detraining abolished these adaptations . CONCLUSIONS ET may attenuate basal and exercise-induced lipid peroxidation and increase protection against oxidative stress by increasing TAC and GPX activity . However , training cessation may reverse these training-induced adaptations OBJECTIVE To explore the pulsatile-release characteristics of LH and P  in women with premenstrual syndrome ( PMS ) compared with age-matched phase-matched controls . DESIGN Prospect i ve , repeated measures , two-group study . SETTING Human volunteers in an academic research environment . PARTICIPANTS Six women with rigorously defined prospect ively determined PMS ; six age-matched phase-matched controls . MAIN OUTCOME MEASURES Frequency , amplitude , concentration , and coincident pulsatile release characteristics of LH and P  at three symptom-related points of the luteal phase . RESULTS No significant between-group differences in frequency , amplitude , or concentration were found . In pooled data , significant coincident pulsing between LH and P was demonstrated . The length of time between LH and P pulses systematic ally increased across the luteal phase , a finding not previously reported . In the PMS group only , significant coincident pulsing occurred at an unexpected zero time lag on the symptom-onset sampling day . CONCLUSION A progressively increasing coupling interval may reflect the gradual decline of the corpus luteum . Presence of a zero time lag between LH and P at symptom onset in women with PMS may indicate an aberrance in corpus luteum response to LH stimulation The effects of different intake levels of vegetables and fruit ( VF ) on some cancer-relevant biomarkers such as DNA damage and oxidative stress were investigated . In a r and omized controlled trial , 64 nonsmoking male subjects were asked to consume a diet with 2 servings of VF/day for 4 wk . Then subjects were r and omly assigned to 1 of 3 groups with either a low ( 2 servings/day ) , medium ( 5 servings/day ) , or high ( 8 servings/day ) intake level of VF for another 4 wk . At the end of study , the plasma lutein , zeaxanthin , α -carotene , and β-carotene but not cryptoxanthin and lycopene concentrations were significantly higher in subjects consuming 8 servings/day than in those receiving 2 servings/day . Different levels of  VF  consumption and plasma carotenoid concentrations did not result in differences in the levels of endogenous DNA str and breaks , oxidative DNA damage , antigenotoxic capacity of lymphocytes , plasma markers for lipid peroxidation ( malondialdehyde , 8-iso-prostagl and in-F2α ) and antioxidant capacity [ trolox-equivalent antioxidant capacity assay ] . Thus , although consumption of 8 servings vs 2 servings/day of VF for 4 wk significantly increased the carotenoid level in plasma , there were no differences in DNA damage , lipid peroxidation , and antioxidant capacity markers among healthy , well-nourished , nonsmoking men Background Accumulating evidence suggests that fruit and vegetable intake ( FVI ) plays a protective role against major diseases . Despite this protective role and the obesity p and emic context , population s in Western countries usually eat far less than five servings of fruits and vegetables per day . In order to increase the efficiency of interventions , they should be tailored to the most important determinants or mediators of FVI . The objective was to systematic ally review social cognitive theory-based studies of FVI and to identify its main psychosocial determinants . Methods Published papers were systematic ally sought using Current Contents ( 2007 - 2009 ) and Medline , Embase , PsycINFO , Proquest and Thesis , as well as Cinhal ( 1980 - 2009 ) . Additional studies were identified by a manual search in the bibliographies . Search terms included fruit , vegetable , behaviour , intention , as well as names of specific theories . Only studies predicting FVI or intention to eat fruits and vegetables in the general population and using a social cognitive theory were included . Independent extraction of information was carried out by two persons using predefined data fields , including study quality criteria . Results A total of 23 studies were identified and included , 15 study ing only the determinants of FVI , seven study ing the determinants of FVI and intention and one study ing only the determinants of intention . All pooled analyses were based on r and om-effects models . The r and om-effect R2 observed for the prediction of FVI was 0.23 and it was 0.34 for the prediction of intention . Multicomponent theoretical frameworks and the theory of planned behaviour ( TPB ) were most often used . A number of method ological moderators influenced the efficacy of prediction of FVI . The most consistent variables predicting behaviour were habit , motivation and goals , beliefs about capabilities , knowledge and taste ; those explaining intention were beliefs about capabilities , beliefs about consequences and perceived social influences . Conclusions Our results suggest that the TPB and social cognitive theory ( SCT ) are the preferable social cognitive theories to predict behaviour and TPB to explain intention . Efficacy of prediction was nonetheless negatively affected by method ological factors such as the study design and the quality of psychosocial and behavioural measures To investigate whether polymorphisms in genes related to oxidative stress act alone or in combination with antioxidants to modulate pancreatic cancer risk . Cases ( n=189 ) , ages ≥ 20 years , were ascertained in 1994 - 1998 from all hospitals in the Twin Cities and the Mayo Clinic . Controls ( n=486 ) were r and omly selected from the general population and frequency matched to cases by age and sex . After adjustment for confounders , individuals who were homozygous or heterozygous for the variant allele of SOD2 polymorphism ( Ala16Val , rs4880 ) experienced a 43 % lower risk than those who were homozygous for the wild-type allele [ OR ( 95 % CI ) : 0.57 ( 0.37 , 0.89 ) ] . Conversely , an increased risk was observed for the variant allele of hOGG1 polymorphism ( Ser326Cys , rs1052133 ) compared with the wild-type allele [ OR ( 95 % CI ) for Ser/Cys or Cys/Cys vs. Ser/Ser : 1.57 ( 1.04 , 2.39 ) ] . The protective effect of the variant allele of SOD2 was more pronounced among subjects with a low dietary intake ( < median ) of lutein/ zeaxanthin , lycopene , α-carotene , and α-tocopherol [ OR ( 95 % CI ) : 0.46 ( 0.27 , 0.81 ) , 0.42 ( 0.23 , 0.75 ) , 0.47 ( 0.26 , 0.85 ) , and 0.48 ( 0.27 , 0.87 ) , respectively ] . Individual variations in the capacity to defend against oxidative stress and to repair oxidative DNA damage influence pancreatic cancer risk , and some of these genetic effects are modified by dietary antioxidants Objectives : to identify the plasma antioxidant microconstituents mainly affected by tomato product consumption , to check whether tomato product consumption can affect antioxidant status , and to identify tomato-product antioxidant-microconstituents mainly involved in the effect of these products on oxidative stress . Design : Medium-term dietary supplementation study . Setting : Human Nutrition Laboratory , Clermont-Ferr and , France . Subjects : Twenty healthy young ( 20 < years < 40 ) , non obese ( 18 < BMI ( kg/m2 ) < 25 ) , females were recruited by advertisement . All of them completed the study . Intervention : The usual diet of the subjects was supplemented for three weeks with 96 g/day tomato puree . The volunteers then avoided tomato-product-rich foods for a subsequent three-week period . Measures of Outcome : Fasting blood sample s were collected the day before supplementation , the day after the supplementation period , and the day after the depletion period . The status of several antioxidant microconstituents ( plasma microconstituent concentrations ) , and the antioxidant status ( plasma total antioxidant capacity ) were assessed . Results : Supplementation with tomato puree significantly increased plasma lycopene , β-carotene and lutein . Conversely it did not significantly affect plasma vitamin C and E , plasma antioxidant trace metals ( Cu , Zn and Se ) , and plasma total antioxidant capacity . Avoidance of tomato-product-rich foods for three weeks significantly ( p < 0.05 ) decreased plasma lycopene , β-carotene , lutein and vitamin C , as well as plasma total antioxidant capacity . Plasma total antioxidant capacity , as measured by chemiluminescence , was positively related ( p < 0.05 ) to the status of lycopene , vitamin C and β-carotene . Conclusions : Tomato product consumption can affect not only the lycopene status , but also that of other antioxidant microconstituents ( β-carotene and lutein ) . Lycopene , but also β-carotene , are apparently the main tomato microconstituents responsible for the effect of tomato products on antioxidant status BACKGROUND Previous research suggests that people respond differently to health status measures when data are collected by interview or self completion of a question naire . The objective of this study was to determine whether SF-36 health status scores differ systematic ally by method of administration . METHOD A r and omized cross-over study was carried out on 210 new attenders at general medicine , endocrinology , gastroenterology and urological out-patient departments . The outcome was the difference in SF-36 profiles comparing clinic based interviews with self completion at home by the same subjects . RESULTS For seven of the eight variables of the SF-36 scores were lower in the  self assessment  , the differences being statistically significant in four of the eight comparisons . The largest differences were in role limitations due to emotional problems ( difference 14.74 , 95 per cent confidence interval ( CI ) 7.76 - 21.7 ) and social function ( difference 7.21 , 95 per cent CI 3.19 - 11.23 ) . CONCLUSIONS Clinic based interviews systematic ally exaggerate health status compared with self assessment .  The difference is sufficiently large to underestimate the effectiveness of health service interventions when a clinic based pre-intervention and postal self completed follow-up design is used , unless adjustment is made for this systematic bias The aim of the present study was to evaluate the effects of lutein and lycopene supplementation on carotid artery intima-media thickness ( C AIM T ) in subjects with sub clinical atherosclerosis . A total of 144 subjects aged 45 - 68 years were recruited from local communities . All the subjects were r and omly assigned to receive 20 mg lutein/d ( n 48 ) , 20 mg lutein/d+20 mg lycopene/d ( n 48 ) or placebo ( n 48 ) for 12 months . C AIM T was measured using  Doppler ultrasonography at baseline and after 12 months , and serum lutein and lycopene concentrations were determined using HPLC . Serum lutein concentrations increased significantly from 0·34 to 1·96 μmol/l in the lutein group ( P < 0·001 ) and from 0·35 to 1·66 μmol/l in the combination group ( P < 0·001 ) . Similarly , serum lycopene concentrations increased significantly from 0·18 to 0·71 μmol/l in the combination group at month 12 ( P < 0·001 ) , whereas no significant change was observed in the placebo group . The mean values of C AIM T decreased significantly by 0·035 mm ( P= 0·042 ) and 0·073 mm ( P < 0·001 ) in the lutein and combination groups at month 12 , respectively . The change in C AIM T was inversely associated with the increase in serum lutein concentrations ( P < 0·05 ) in both the active treatment groups and with that in serum lycopene concentrations ( β = - 0·342 , P= 0·031 ) in the combination group  . Lutein and lycopene supplementation significantly increased the serum concentrations of lutein and lycopene with a decrease in C AIM T being associated with both concentrations . In addition , the combination of lutein and lycopene supplementation was more effective than lutein alone for protection against the development of C AIM T in Chinese subjects with sub clinical atherosclerosis , and further studies are needed to confirm whether synergistic effects of lutein and lycopene exist Background Evaluation of an  implementation process  and its  fidelity can give insight into the ' black box ' of interventions . However , a lack of st and ardized methods for study ing fidelity and implementation process have been reported , which might be one reason for the fact that few prior studies in the field of health service research have systematic ally evaluated interventions ' implementation processes . The aim of this project is to systematic ally evaluate  implementation fidelity  and possible factors influencing fidelity of complex interventions in health and social care . Methods A modified version of The Conceptual Framework for Implementation Fidelity  will be used as a conceptual model for the evaluation . The modification implies two additional moderating factors : context and recruitment . A systematic evaluation process was developed . Multiple case study method is used to investigate implementation of three complex health service interventions . Each case will be investigated in depth and longitudinally , using both quantitative and qualitative methods . Discussion This study is the first attempt to empirically test The Conceptual Framework for  Implementation Fidelity . The study can highlight mechanism and factors of importance when implementing complex interventions . Especially the role of the moderating factors on implementation fidelity can be clarified . Trial Registration Supported Employment , SE , among people with severe mental illness -- a r and omized controlled trial : NCT00960024 The aim of the present study was to compare the effect of lutein- and zeaxanthin-rich foods and supplements on macular pigment level ( MPL ) and serological markers of endothelial activation , inflammation and oxidation in healthy volunteers . We conducted two 8-week intervention studies . Study 1 ( n 52 ) subjects were r and omised to receive either carrot juice ( a carotene-rich food ) or spinach powder ( a lutein- and zeaxanthin-rich food ) for 8 weeks . Study 2 subjects ( n 75 ) received supplements containing lutein and zeaxanthin , β-carotene , or placebo for 8 weeks in a r and omised , double-blind , placebo-controlled  trial . MPL , serum concentrations of lipid-soluble antioxidants , inter-cellular adhesion molecule 1 , vascular cell adhesion molecule 1 , C-reactive protein and F2-isoprostane levels were assessed at baseline and post-intervention in both studies . In these intervention studies , no effects on MPL or markers of endothelial activation , inflammation or oxidation were observed . However , the change in serum lutein and zeaxanthin was associated or tended to be associated with the change in MPL in those receiving lutein- and zeaxanthin-rich foods ( lutein r 0.40 , P = 0.05 ; zeaxanthin r 0.30 , P = 0.14 ) or the lutein and zeaxanthin supplement ( lutein r 0.43 , P = 0.03 ; zeaxanthin r 0.22 , P = 0.28 ) . In both studies , the change in MPL was associated with baseline MPL ( food study r - 0.54 , P < 0.001 ; supplement study r - 0.40 , P < 0.001 ) . We conclude that this 8-week supplementation with lutein and zeaxanthin , whether as foods or as supplements , had no significant effect on MPL or serological markers of endothelial activation , inflammation and oxidation in healthy volunteers , but may improve MPL in the highest serum responders and in those with initially low MPL Background The method ological quality of animal studies is an important factor hampering the translation of results from animal studies to a clinical setting . Systematic review s of animal studies may provide a suitable method to assess and thereby improve their method ological quality . Objectives The aims of this study were : 1 ) to evaluate the risk of bias assessment in animal-based systematic review s , and 2 ) to study the internal validity of the primary animal studies included in these systematic review s. Data Sources We systematic ally search ed Pubmed and Embase for SRs of pre clinical animal studies published between 2005 and 2012 . Results A total of 91 systematic review s met our inclusion criteria . The risk of bias was assessed in 48 ( 52.7 % ) of these 91 systematic review s. Thirty-three ( 36.3 % ) SRs provided sufficient information to evaluate the internal validity of the included studies . Of the evaluated primary studies , 24.6 % was r and omized , 14.6 % reported blinding of the investigator/caretaker , 23.9 % blinded the outcome assessment , and 23.1 % reported drop-outs . Conclusions To improve the translation of animal data to clinical practice , systematic review s of animal studies are worthwhile , but the internal validity of primary animal studies needs to be improved . Furthermore , risk of bias should be assessed by systematic review s of animal studies to provide insight into the reliability of the available evidence It has been suggested that anthocyanin-rich foods may exert antioxidant effects and improve vascular function as demonstrated mainly in vitro and in the animal model . Blueberries are rich sources of anthocyanins and we hypothesized that their intake could improve cell protection against oxidative stress and affect endothelial function in humans . The aim of the study was to investigate the effect of one portion ( 300 g ) of blueberries on selected markers of oxidative stress and antioxidant protection ( endogenous and oxidatively induced DNA damage ) and of vascular function ( changes in peripheral arterial tone and plasma nitric oxide levels ) in male subjects . In a r and omized cross-over design , separated by a wash out period ten young volunteers received one portion of blueberries ground by blender or one portion of a control jelly . Before and after consumption ( at 1 , 2 , and 24 hours ) , blood sample s were collected and used to evaluate  anthocyanin absorption ( through mass spectrometry ) , endogenous and H(2)O(2)-induced DNA damage in blood mononuclear cells ( through the comet assay ) , and plasma nitric oxide concentrations ( through a fluorometric assay ) . Peripheral arterial function was assessed by means of Endo-PAT 2000 . Blueberries significantly reduced ( P < .01 ) H(2)O(2)-induced DNA damage ( -18 % ) 1 hour after blueberry consumption compared to control . No significant differences were observed for endogenous DNA damage , peripheral arterial function and nitric oxide levels after blueberry intake . In conclusion , one portion of blueberries seems sufficient to improve cell antioxidant defense against DNA damage , but further studies are necessary to underst and their role on vascular function IMPORTANCE It has been shown that the functionality of the macula lutea depends on the nutritional uptake of lutein and zeaxanthin and that it is inversely associated with the risk of age-related macular degeneration ( AMD ) . Additionally , ω-3 long-chain polyunsaturated fatty acids ( LC-PUFAs ) may also be protective . OBJECTIVE To investigate the effect of a 12-month intervention with macular xanthophylls and ω-3 LC-PUFAs on xanthophylls and fatty acids in plasma , antioxidant capacity , and optical density of the macular pigment of patients with nonexudative AMD . DESIGN The LUTEGA study was a r and omized , double-blind , placebo-controlled , parallel clinical trial that was conducted for 12 months . SETTING University Eye Hospital and Institute of Nutrition , Friedrich Schiller University Jena , Germany . PARTICIPANTS A total of 172 individuals with nonexudative AMD . INTERVENTION Individuals were enrolled and r and omly divided as follows : placebo group , group 1 ( a capsule containing 10 mg of lutein , 1 mg of zeaxanthin , 100 mg of docosahexaenoic acid , and 30 mg of eicosapentaenoic acid administered each day ) , and group 2 ( same substances but twice the dose used in group 1 ) . One hundred forty-five participants completed the study successfully . MAIN OUTCOME MEASURES Plasma xanthophyll concentrations and fatty acid profiles , optical density of the macular pigment , and antioxidant capacity in plasma ( 6-hydroxy-2,5,7,8-tetramethylchroman-2-carboxylic acid [ Trolox ] equivalent antioxidant capacity and photochemiluminescence ) . RESULTS The concentrations of the administered carotenoids in plasma as well as the optical density of the macular pigment increased significantly in the groups r and omized to receive supplementary macular xanthophylls and ω-3 LC-PUFAs after 1 month of intervention and remained at this level through the end of the study . Use of the double dose result ed in a beneficial alteration of the fatty acid profile in the plasma of patients with AMD in comparison with the dose in group 1 . The lipophilic antioxidant capacity in plasma was significantly elevated with the intervention . CONCLUSIONS AND RELEVANCE A supplement containing a fixed combination of lutein , zeaxanthin , and ω-3 LC-PUFAs during 12 months significantly improved plasma antioxidant capacity , circulating macular xanthophyll levels , and the optical density of the macular pigment . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00763659 OBJECTIVE Obesity is an independent risk factor for the development of heart failure , and the two commonly co-exist . The European Society of Cardiology does not provide guidance regarding weight loss strategies in heart failure . The aim of this study was to systematic ally review the evidence for outcomes following intentional weight loss in patients with heart failure and obesity . METHOD A systematic review of English articles was undertaken using data bases PubMed , Embase and CENTRAL . R and omized controlled trials and observational studies reporting outcomes following intentional weight loss by lifestyle , surgical or pharmacotherapy intervention in patients with obesity and heart failure were included . RESULTS Four r and omized controlled trials and seven observational studies were identified . Two r and omized controlled trials used  diet and exercise  as an intervention , one used diet alone and one used a pharmacological intervention ( orlistat ) . All but one reported significant weight loss . Two reported improvement in exercise capacity and quality of life . One reported improvement in New York Heart Association functional class in heart failure with preserved ejection fraction . The observational studies , five of which reported on outcomes following bariatric surgery , despite being small , heterogeneous and high risk of bias , suggested a trend in improvement of left ventricular function , quality of life and exercise capacity following weight loss . CONCLUSION Weight loss is achievable with lifestyle intervention in those with heart failure and obesity and may result in improvements in New York Heart Association classification , quality of life and exercise capacity The stiffening of arteries is a key step in atherogenesis leading to cardiovascular disease . It has been suggested that dietary polyphenols may be cardioprotective through possible favorable effects on oxidative stress and vascular function . The present study was undertaken in order to examine the effect of consuming low-calorie cranberry juice cocktail ( CJC ) , a source of polyphenols , on arterial stiffness in abdominally obese men . We hypothesize that regular CJC consumption will reduce circulating oxidized low-density lipoproteins concentrations and have a beneficial impact on endothelial function . Thirty-five men ( mean age ± SD : 45 ± 10 years ) were r and omly assigned to drink 500 mL CJC/day ( 27 % juice ) or 500 mL placebo juice (PJ)/day for 4 weeks in a double-blind crossover design . Augmentation index ( AIx ) , an index of arterial stiffness , was measured by applanation tonometry of the radial artery and the cardiometabolic profile was assessed in each participant before and after each phase of the study . We found no significant difference in AIx changes between men who consumed CJC or PJ for 4 weeks ( P = .5820 ) . Furthermore , there was no between-treatment difference in changes in AIx responses to salbutamol ( P = .6303 ) and glyceryl trinitrate ( P = .4224 ) . No significant difference was noted in other cardiometabolic variables between men consuming PJ or CJC . However , a significant within group decrease in AIx ( mean decrease ± SE ; -14.0 ± 5.8 % , P = .019 ) was noted following the consumption of 500 mL CJC/day for 4 weeks . Our results indicate that the effect of chronic consumption of  CJC on AIx was not significantly different from changes associated with the consumption of PJ . However , the significant within-group decrease in AIx following CJC consumption in abdominally obese men may deserve further investigation
The literature on risk factors for cardiometabolic diseases showed that lutein might be beneficial for atherosclerosis and inflammatory markers , but there were inconsistent associations with blood pressure , adiposity , insulin resistance , and blood lipids .
CONCLUSIONS Our findings suggest that higher dietary intake and higher blood concentrations of lutein are generally associated with better cardiometabolic health .
BACKGROUND The antioxidant lutein is suggested as being beneficial to cardiometabolic health because of its protective effect against oxidative stress , but evidence has not systematic ally been evaluated .
OBJECTIVE We aim ed to evaluate systematic ally the effects of lutein ( intake or concentrations ) on cardiometabolic outcomes in different life stages .