This review assessed the efficacy of isoflavone supplements to reduce vasomotor symptoms in menopausal women by reviewing all published randomized controlled trials. Systematic literature searches were carried out in 70 databases. Randomized and placebo controlled studies were included if they investigated the treatment of isoflavone supplements derived from soy or red clover on vasomotor symptoms in peri- or postmenopausal women for at least 12 wks. Data were analyzed concerning outcome and methodological quality of the study. Twenty-three trials met the inclusion criteria, thereof 17 investigated soy isoflavones and 6 red clover isoflavones. Without exception, selected trials examining the effect of red clover isoflavones were already assessed in several meta-analyses and were therefore excluded from this evaluation. As the soy isoflavone studies were very heterogeneous concerning interventions and outcome measures, meta-analysis could not be performed and trials were systematically assessed in a structured approach. Included soy isoflavone studies had numerous quality deficiencies and did not consistently show a reduction of flushes after treatment with soy isoflavones. Therefore, there is no conclusive evidence, but only some indication of a benefit of soy isoflavones on hot flush frequency or severity.
Background/Methods: In Germany, iodine deficiency is common. In a representative group of 2,500 Germans (age 1 13 years), using a specially designed food questionnaire, the iodine intake was calculated. In addition, iodine and creatinine concentrations in spot urine samples were determined in three groups with a possibly increased risk of iodine deficiency (769 conscripts, 886 pairs of mothers and newborns) or future hyperthyroidism (574 adults, age range 50-70 years) from 26 representative regions. In four groups of controls (young and older male and female adults; n = 91), 24-hour urine iodine and creatinine were measured in six diurnal fractions to calculate group-and period-specific factors for the estimation of the 24-hour iodine excretion from data of iodine/creatinine ratio and time of micturition in spot urine samples. Results: The mean calculated iodine intake (excretion) was 119 Ìg/day for the group of Germans above 13 years; it was 119 Ìg/day (125 Ìg/day) for adults aged 50-70 years, 137 Ìg/day (125 Ìg/day) for conscripts, and 162 Ìg/day for breast-feeding mothers. The median iodine concentration (iodine/creatinine ratio) was 9.4 Ìg/dl (83 Ìg/g) in 566 adults aged 50-70 years, 8.3 Ìg/dl (57 Ìg/g) in 772 conscripts. and 5.6 Ìg/dl (156 Ìg/g) in 739 breast-fed newborns. Conclusions: Compared to older data, the iodine intake in Germany has increased. In 1996, the meticulously quantified average deficit was about 30% of the recommended iodine intake.
Several approaches to the use of health claims on foods have been made around the world, and the common theme is that any health claim will require scientific validation and substantiation. There is also broad consensus that any regulatory framework should protect the consumer, promote fair trade and encourage innovation in the food industry.This paper is based on a critical evaluation of existing international approaches to the scientific substantiation of health claims, with a view to identifying common new ideas, definitions, best practice and a methodology to underpin current and future developments. There is a clear need to have uniform understanding, terminology and description of types of nutrition and health claims. Two broad categories were defined: Nutrition Claims, i. e. what the product contains, and Health Claims, i. e. relating to health, well-being and/or performance, including well-established nutrient function claims, enhanced function claims and disease risk reduction claims. Such health claims relate to what the food or food components does or do. The categories of health claims are closely and progressively related and are, in practice, part of a continuum. Provision is also made for "generic" or well-established, generally accepted claims and for "innovative" or "product-specific" claims. Special attention was paid to reflect the health-promoting properties of a food or food component in such a way as to facilitate the making of risk reduction claims outside the medical scope of the term prevention. The paper sets out basic principles and guidelines for communication of health claims and principles of nutritional safety. The main body of the work examines the process for the assessment of scientific support for health claims on food and emphasises an evidence-based approach consisting of: Identification of all relevant studies exploring the collection of evidence, data searches, the nature of the scientific evidence, sources of scientific data (including human intervention studies, human observational studies, animal studies and in vitro studies, and the use of biomarkers in human studies. Evaluation of the quality of individual studies to ensure good experimental design and interpretation. Interpretation of the totality of evidence to apply scientific judgement to interpret the weight of evidence as a whole. Assessment of significant scientific agreement on a case-by-case basis to agree within the relevant scientific community that an association between a food or a food component and a health benefit is valid. Annexes include an international comparison of regulatory approaches to health claims, suggestions for the documentation and presentation of evidence, and a procedure for reviewing the evidence.
To evaluate the iodine supply of the German population, 2500 representative subjects older than 13 years were elected for answering a specific food questionnaire. In addition spot urine samples in 3 selected risk groups for iodine deficiency (574 adults aged 50-70 years, 769 conscripts, 886 pairs of mothers and newborns) from 26 representative regions were collected. Furthermore the circadian iodine excretion was measured in 24 h urine samples collected in 6 fractions per day in 4 subgroups (young and older males and females) of 91 controls and this 24 h iodine excretion related to iodine/creatinine ratio in these subgroups. Mean estimated iodine intake was 119 microg/d in adults aged 50-70 years, 137 microg/d in conscripts, and 162 microg/d in mothers at still birth. The mean iodine concentration (iodine/creatinine ratio) was 9.4 microg/dl in 566 adults aged 50-70 years, 8.3 microg/dl in 772 conscripts and 5.6 microg/dl in 739 breast fed newborns. The mean daily iodine excretion was 134 microg/d in 278 men aged 50-70 years, 117 microg/d in 288 women aged 50-70 years, 125 microg/d in 772 conscripts and 74 microg/d in 53 breast-feeding mothers not using iodine tablets. These results show, that iodine intake in Germany has increased over the last years. The deficit in iodine intake with significant regional differences and defined risk groups for iodine deficiency (e.g. breast feeding mothers without iodine deficiency prophylaxis) is estimated to be about 30% of the recommended iodine intake.
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