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Biomedical subjects

J L Slavin

Publications and source records attributed to J L Slavin.

At least 19 recordsLinked to original sources

Pigmented villonodular synovitis of the hip mimicking soft-tissue sarcoma: a case report.

Pigmented villonodular synovitis is a rare and benign but potentially locally aggressive disease that should be considered in younger patients who present with monoarticular joint symptoms and pathology. We present a 30-year-old Sudanese woman with a huge mass arising from the right hip joint. A multimodality radiological approach to investigation and diagnosis is demonstrated and discussed. Histopathological examination of the resected specimen confirmed the diagnosis of pigmented villonodular synovitis with the mass consisting of a proliferation of fibrohistiocytic cells, abundant haemosiderin, foamy histiocytes, and occasional giant cells. The patient made a good recovery, with mobility aided by arm crutches and a hip abduction brace.

Adult↗

The role of whole grains in disease prevention.

Despite universal acceptance of the importance of whole grains in the diet, consumer knowledge of the benefits of whole grains and intake of these foods are low. This review summarizes the research supporting whole-grain consumption and gives practical suggestions about how to increase whole-grain intake. Whole-grain foods are valuable sources of nutrients that are lacking in the American diet, including dietary fiber, B vitamins, vitamin E, selenium, zinc, copper, and magnesium. Whole-grain foods also contain phytochemicals, such as phenolic compounds, that together with vitamins and minerals play important roles in disease prevention. The exact mechanisms linking whole grains to disease prevention are not known but may include gastrointestinal effects, antioxidant; protection, and intake of phytoestrogens. Dietary intake studies indicate that consumption of whole grains is far less than the recommended intake of 3 servings a day, with an average daily intake of 1 or fewer servings a day. A new whole-grains health claim, allowed in July 1999 by the Food and Drug Administration, and inclusion of a whole-grain recommendation in the 2000 revision of the US Dietary Guidelines for Americans, should help increase whole-grain consumption.

Blood Glucose↗

Effects of dietary arabinogalactan on gastrointestinal and blood parameters in healthy human subjects.

OBJECTIVES: Arabinogalactan (AG) is a non-digestible soluble dietary fiber that resists hydrolytic enzyme action and enters the large bowel intact where it is fermented by resident microflora. To determine whether AG has similar physiological properties to other soluble dietary fibers, we examined the effect of 15 and 30 g per day of a commercially available AG from Western Larch on several gastrointestinal and blood parameters. METHODS: Gastrointestinal parameters included fecal microflora, fecal enzyme activity, fecal short-chain fatty acids, fecal pH, fecal weight, transit time and bowel frequency. Blood parameters included total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, Apo-A1, Apo-B, glucose and insulin. The study consisted of two three-week diet treatments with no washout period. Participants (n=20, 11 males, 9 females) consumed their usual diet in addition to 15 or 30 g AG in a beverage sweetened with aspartame as compared to their usual diet with the control beverage. RESULTS: Significant increases in total fecal anaerobes were observed with 15 g (p=0.01) and 30 g AG (p=0.001). A significant increase (p=0.02) in Lactobacillus spp. was observed when subjects consumed AG for a total of six weeks regardless of dose. There were no significant changes in other microflora, fecal enzyme activity, transit time, frequency, fecal weight, fecal pH and short-chain fatty acids. Fecal ammonia levels decreased with 15 g (p=0.001) and 30 g (p=0.002) AG. No significant changes in blood lipids or blood insulin were observed. CONCLUSIONS: These data suggest that dietary AG is easily incorporated into the diet, well tolerated in subjects and has some positive effects on fecal chemistry.

Ammonia↗

Grain processing and nutrition.

Whole grains provide a wide range of nutrients and phytochemicals that optimize health. Epidemiologic studies support the protectiveness of whole grain consumption for cardiovascular disease and cancer. Dietary guidance endorses increased whole grains in our diet. A crucial question remaining is the effect of processing of whole grains on their content of nutrients and phytochemicals. Although processing is often considered to be a negative attribute in nutrition, and some forms of processing reduce nutritional value, many factors support the importance of processing of grains to enhance grain consumption. First, whole grains as harvested are generally not consumed directly by humans but require some processing prior to consumption. While refining, that is, removal of the bran and the germ, reduces the nutrient content of grain, milling of grains otherwise concentrates desirable grain components and removes poorly digested compounds and contaminants. Cooking of grains generally increases digestibility of nutrients and phytochemicals. Studies in both animal models and humans support the notion that processed grains are often nutritionally superior to unprocessed grains, probably because of enhanced nutrient bioavailability in processed grains. Processing of grains also provides shelf-stable products that are convenient and good tasting for consumers.

Animals↗

Flaxseed consumption influences endogenous hormone concentrations in postmenopausal women.

Lignans, similar in structure to endogenous sex steroid hormones, may act in vivo to alter hormone metabolism and subsequent cancer risk. The objective of this study was to examine effects of dietary intake of a lignan-rich plant food (flaxseed) on serum concentrations of endogenous hormones and binding proteins (estrone, estrone sulfate, 17 beta-estradiol, sex hormone-binding globulin, progesterone, prolactin, dehydroepiandrosterone sulfate, dehydroepiandrosterone, androstenedione, testosterone, and free testosterone) in postmenopausal women. This randomized, crossover trial consisted of three seven-week feeding periods, during which 28 postmenopausal women, aged 52-82 yr, consumed their habitual diets plus 0, 5, or 10 g of ground flaxseed. Serum samples collected during the last week of each feeding period were analyzed for serum hormones using standard diagnostic kits. The flaxseed diets significantly reduced serum concentrations of 17 beta-estradiol by 3.26 pg/ml (12.06 pmol/l) and estrone sulfate by 0.09 ng/ml (0.42 nmol/l) and increased prolactin by 1.92 micrograms/l (0.05 IU/ml). Serum concentrations of androstenedione, estrone, sex hormone-binding globulin, progesterone, testosterone, free testosterone, dehydroepiandrosterone, and dehydroepiandrosterone sulfate were not altered with flaxseed feeding. In this group of postmenopausal women, consuming flaxseed in addition to their habitual diets influenced their endogenous hormone metabolism by decreasing serum 17 beta-estradiol and estrone sulfate and increasing serum prolactin concentrations.

Aged↗

Mechanisms for the impact of whole grain foods on cancer risk.

Dietary guidance recommends consumption of whole grains for the prevention of cancer. Epidemiologic studies find that whole grains are protective against cancer, especially gastrointestinal cancers such as gastric and colonic, and hormonally-dependent cancers including breast and prostate. Four potential mechanisms for the protectiveness of whole grains against cancer are described. First, whole grains are concentrated sources of dietary fiber, resistant starch, and oligosaccharides, fermentable carbohydrates thought to protect against cancer. Fermentation of carbohydrates in the colon results in production of short chain fatty acids that lower colonic pH and serve as an energy source for the colonocytes. Secondly, whole grains are rich in antioxidants, including trace minerals and phenolic compounds, and antioxidants have been proposed to be important in cancer prevention. Thirdly, whole grains are significant sources of phytoestrogens that have hormonal effects related to cancer protection. Phytoestrogens are thought to be particularly important in the prevention of hormonally-dependent cancers such as breast and prostate. Finally, whole grains mediate glucose response, which has been proposed to protect against colon and breast cancer.

Antioxidants↗

Grain processing and nutrition.

Whole grains provide a wide range of nutrients and phytochemicals that optimize health. Epidemiologic studies support the protectiveness of whole grain consumption for cardiovascular disease and cancer. Dietary guidance endorses increased whole grains in our diet. A crucial question remaining is the effect of processing of whole grains on their content of nutrients and phytochemicals. Although processing is often considered to be a negative attribute in nutrition, and some forms of processing reduce nutritional value, many factors support the importance of processing of grains to enhance grain consumption. First, whole grains as harvested are generally not consumed directly by humans but require some processing prior to consumption. While refining, that is, removal of the bran and the germ, reduces the nutrient content of grain, milling of grains otherwise concentrates desirable grain components and removes poorly digested compounds and contaminants. Cooking of grains generally increases digestibility of nutrients and phytochemicals. Studies in both animal models and humans support the notion that processed grains are often nutritionally superior to unprocessed grains, probably because of enhanced nutrient bioavailability in processed grains. Processing of grains also provides shelf-stable products that are convenient and good tasting for consumers.

Animals↗

The effect of flaxseed and wheat bran consumption on urinary estrogen metabolites in premenopausal women.

Estrogen is metabolized along two competing pathways to form the 2-hydroxylated and the 16alpha-hydroxylated metabolites. Based on proposed differences in biological activities, the ratio of these metabolites, 2-hydroxyestrogen:16alpha-hydroxyestrone (2:16alpha-OHE1), has been used as a biomarker for breast cancer risk. Women with an elevated 2:16alpha-OHE1 ratio are hypothesized to be at a decreased risk of breast cancer. Flaxseed, the most significant source of plant lignans, and wheat bran, an excellent source of dietary fiber, have both been shown to have chemoprotective benefits. Some of these benefits may be attributable to their influence on endogenous sex hormone production and metabolism. We examined the effect of flaxseed consumption alone and in combination with wheat bran on urinary estrogen metabolites in premenopausal women. Sixteen premenopausal women were studied for four feeding treatments lasting two menstrual cycles each in a randomized cross-over design. During the four feeding treatments, subjects consumed their usual diets supplemented with baked goods containing no flaxseed or wheat bran, 10 g of flaxseed, 28 g of wheat bran, or 10 g of flaxseed plus 28 g of wheat bran/day. Urinary excretion of 2-hydroxyestrogen and 16alpha-hydroxyestrone, as well as their ratio, 2:16alpha-OHE1, were measured by enzyme immunoassay. Flaxseed supplementation significantly increased the urinary 2:16alpha-OHE1 ratio (P = 0.034), but wheat bran had no effect. These results suggest that flaxseed may be chemoprotective in premenopausal women.

Adolescent↗

Flaxseed influences urinary lignan excretion in a dose-dependent manner in postmenopausal women.

Dietary estrogens, such as lignans, are similar in structure to endogenous sex steroid hormones and may act in vivo to alter hormone metabolism and subsequent cancer risk. The objective of this study was to examine the effect of dietary intake of a lignan-rich plant food (flaxseed) on urinary lignan excretion in postmenopausal women. This randomized, cross-over trial consisted of three 7-week feeding periods during which 31 healthy postmenopausal women, ages 52-82 years, consumed their habitual diets plus 0, 5, or 10 grams of ground flaxseed per day. Urine samples collected for 2 consecutive days during the last week of each feeding period were analyzed for lignan content (enterodiol, enterolactone, and matairesinol) by isotope dilution gas chromatography/mass spectrometry. Compared with the 0-gram flaxseed diet, consumption of 5 or 10 grams of flaxseed significantly increased excretion of enterodiol by 1,009 and 2,867 nmol/day, respectively; significantly increased excretion of enterolactone by 21,242 and 52,826 nmol/day, respectively; and significantly increased excretion of total lignans (enterodiol + enterolactone + matairesinol) by 24,333 and 60,640 nmol/day, respectively. Excretion of matairesinol was not significantly altered by flaxseed consumption. Consumption of flax, a significant source of dietary estrogens, in addition to their habitual diets increased excretion of enterodiol and enterolactone, but not matairesinol, in a dose-dependent manner in this group of postmenopausal women. Urinary excretion of lignan metabolites is a dose-dependent biomarker of flaxseed intake within the context of a habitual diet.

Aged↗

Implementation of dietary modifications.

Recommendations for dietary fiber intake for adults fall within the range of 20-35 g/day, or 10-13 g/1,000 kcal. However, popular U.S. foods are not high in dietary fiber, and common serving sizes of grains, fruits, and vegetables contain only 1-3 g of dietary fiber. In spite of the widespread dissemination of the recommendations for fiber consumption, however, the usual intake of dietary fiber in the United States remains lower than these recommended levels, averaging only 14-15 g/day. It is generally recommended that constipation be treated with a concentrated source of insoluble fiber, and cholesterol can be lowered with soluble fiber, as suggested by claims made for oat bran and psyllium. Scientific evidence supports the role of wheat bran fiber in reducing the risk of colorectal cancer, yet this message needs to be delivered to the average consumer. Most surveys suggest that coarse, brown fiber is not well accepted, as consumers say such foods "taste bad." Implementation of guidelines for increased intake of wheat bran fiber will require public education on the importance of this recommendation. Further, consumers need to be convinced that wheat bran fiber can taste good by the development of a wide range of products high in wheat bran fiber that can be consumed throughout the day.

Colonic Neoplasms↗

Osteosarcoma of the scapula arising in osteogenesis imperfecta.

A case of osteosarcoma arising in the scapula of a 37 year old woman with severe congenital sporadic white sclera type osteogenesis imperfecta (OI) is presented. Osteosarcoma occurs as a sporadic rather than a related occurrence in patients with OI. A delay in the diagnosis of osteosarcoma may occur due to the similarity in symptomatology between the two conditions and because of the difficulty in differentiating between hyperplastic callus and tumor using conventional radiographic imaging techniques.

Adult↗

Plausible mechanisms for the protectiveness of whole grains.

Dietary guidelines recommend the consumption of whole grains to prevent chronic diseases. Epidemiologic studies support the theory that whole grains are protective against cancer, especially gastrointestinal cancers such as gastric and colon can-cer, and cardiovascular disease. Components in whole grains that may be protective include compounds that affect the gut environment, such as dietary fiber, resistant starch, and oligosaccharides. Whole grains are also rich in compounds that function as antioxidants, such as trace minerals and phenolic compounds, and phytoestrogens, with potential hormonal effects. Other potential mechanisms whereby whole grains may protect against disease include binding of carcinogens and modulation of the glycemic response. Clearly, the range of protective substances in whole grains is impressive and advice to consume additional whole grains is justified. Further study is needed regarding the mechanisms behind this protection so that the most potent protective components of whole grains will be maintained when developing whole grains into acceptable food products for the public.

Cardiovascular Diseases↗

Effect of flaxseed consumption on urinary estrogen metabolites in postmenopausal women.

Flaxseed, the richest known source of plant lignans, has been shown to have chemoprotective effects in animal and cell studies. Some of its effects may be mediated through its influence on endogenous hormone production and metabolism. Two competing pathways in estrogen metabolism involve production of the 2-hydroxylated and 16 alpha-hydroxylated metabolites. Because of the proposed differences in biological activities of these metabolites, the balance of the two pathways has been used as a biomarker for breast cancer risk. We examined the effects of flaxseed consumption on urinary estrogen metabolite excretion in postmenopausal women. Twenty-eight postmenopausal women were studied for three seven-week feeding periods in a randomized crossover design. During the feeding periods, subjects consumed their usual diets plus ground flaxseed (0, 5, or 10 g/day). Urinary excretion of the estrogen metabolites 2-hydroxyestrogen (2-OHEstrogen) and 16 alpha-hydroxyestrone (16 alpha-OHE1) as well as their ratio, 2/16 alpha-OHE1, was measured by enzyme immunoassay. Flaxseed supplementation significantly increased urinary 2-OHEstrogen excretion (p < 0.0005) and the urinary 2/16 alpha-OHE1 ratio (p < 0.05) in a linear, dose-response fashion. There were no significant differences in urinary 16 alpha-OHE1 excretion. These results suggest that flaxseed may have chemoprotective effects in postmenopausal women.

Aged↗

Effects of soy intake on sex hormone metabolism in premenopausal women.

Studies suggest that phytoestrogens in soy products may impart hormonal effects that protect women against breast cancer. Limited research suggests that intake of soy products high in isoflavonoid phytoestrogens affects sex hormone metabolism, but it is unknown whether phytoestrogens in soy have any effect on menstrual function or serum sex hormones in women on common hormone therapies, such as oral contraceptives (OC). We studied the effects of soy in 36 premenopausal women, 20 of whom used OC. Subjects consumed their normal diet for two menstrual cycles and added a soy beverage containing 20 g of protein and 38 mg of total isoflavones to their usual diet for another two menstrual cycles. No significant differences were observed in serum estrone, estradiol, sex hormone-binding globulin, dehydroepiandrosterone sulfate, prolactin, or progesterone concentrations with soy feeding in the non-OC or the OC group. No changes in menstrual cycle length or the urinary estrogen metabolite ratio of 2-hydroxyestrone to 16 alpha-hydroxyestrone were seen with soy feeding in the non-OC or the OC group. Levels of urinary estrogen metabolites were significantly different between the non-OC and the OC group. Thus soy consumption had no significant effect on the menstrual cycle, serum sex hormones, or urinary estrogen metabolite ratio in premenopausal OC or non-OC users.

Adolescent↗

Urinary isoflavonoid and lignan excretion on a Western diet: relation to soy, vegetable, and fruit intake.

Dietary isoflavone and lignan phytoestrogens are potential chemopreventive agents. This has led to a need to monitor exposure to these compounds in human populations and to determine which components of a mixed diet contribute to the exposure. Typically, urinary isoflavonoid excretion is associated with soy consumption and that of lignans is associated with whole grains. However, other plant foods are known to contain phytoestrogen precursors. The purpose of this study was to examine the association between urinary isoflavonoid and lignan excretion and intakes of vegetables and fruits (V&F). Isoflavonoids (genistein, daidzein, O-desmethylangolensin, and equol) and lignans (enterolactone, enterodiol, and matairesinol) were measured in urine collected for 3 days from 49 male and 49 female volunteers (age, 18-37 years) reporting a wide range of habitual V&F intakes. Dietary intakes were assessed using 5-day diet records and a food frequency questionnaire. V&F groupings (total V&F, total V, total F, soyfoods, and V&F grouped by botanical families) were used to assess the relationship between V&F intake and urinary isoflavonoid and lignan excretion. Pearson correlations were performed. Intake of soyfoods was correlated significantly with urinary genistein (r = 0.40; P = 0.0001), O-desmethylangolensin (r = 0.37; P = 0.0002), daidzein (r = 034; P = 0.0007), and the sum of isoflavonoids (r = 0.39; P = 0.0001). There was no association between equol excretion and soy intake or between the isoflavonoids and any other V&F groupings. In addition, isoflavonoid excretion was correlated positively with intake of high-fat and processed meats, particularly among men who did not consume soy. This suggests that, even in the United States, on a Western diet, soyfoods are the primary contributors to isoflavone intake; however, additional "hidden sources" of soy may also contribute to exposure. In contrast, a variety of fiber-containing foods contributed to lignan excretion; the sum of the urinary lignans, enterodiol, enterolactone, and matairesinol, was associated with intake of total F (r = 0.27; P = 0.008), total V&F (r = 0.25; P = 0.01), soyfoods (r = 0.28; P = 0.006), and dietary fiber (r = 0.36; P = 0.0003). Overall, urinary phytoestrogens (isoflavonoids + lignans) were significantly higher in "high" compared with "low" V&F consumers. Compared with the "low" V&F group, the "high" group consumed diets that were, on average, higher in fiber and carbohydrate and soyfoods and lower in fat; thus, the urinary phytoestrogens may also be a useful marker of healthier dietary patterns.

Adolescent↗

Influence of soybean processing, habitual diet, and soy dose on urinary isoflavonoid excretion.

In an attempt to explain the wide individual variation seen in urinary isoflavonoid phytoestrogen excretion, we conducted a series of 3 human feeding studies: a large cross-sectional study of equol production in humans with a soy challenge, a comparison of phytoestrogen metabolism when subjects consumed fermented and unfermented soy products, and a dose-response study of urinary isoflavonoid excretion at the low end of soy consumption. All studies were conducted in young, healthy humans. Urinary isoflavonoids were measured by isotope-dilution gas chromatography-mass spectrometry. Similar to results from other studies, 35% of screened subjects (30 men and 30 women) excreted equol (>2000 nmol/d). In women, equol excretion was associated with higher intake of dietary fiber and carbohydrate. Fermentation of soy decreased the isoflavone content of the product fed but increased the urinary isoflavonoid recovery, suggesting that fermentation increases availability of isoflavones in soy. When soy-protein powder was fed at 0, 5, 10, and 20 g/d (0-36 mg isoflavones), there was a linear dose response of urinary isoflavonoid excretion to soy consumption that did not differ between subjects with high and low equol excretion. These results suggest that equol excretion may be related to the fermentable carbohydrate content of the diet; additional study is needed. Processing of soy affects isoflavone metabolism and must be considered in recommending exposure to isoflavones from soyfoods. Although optimal isoflavone exposure for disease protection has not been determined, urinary isoflavonoid excretion appears linear at low-to-moderate soy consumption.

Biological Availability↗