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Effects of daily consumption of soy protein isolateverses whey protein isolate on thyroid function: A randomized, double blind study
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MOMDAY,OCTOBER22 POSTERSESSION:EDUCATIONAND BEHAVIORALSTRATEGIES/MEDICALNUTRITIONTHERAPY TITLE: COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) USE IN A BROOKLYN COMMUNITY
TITLE: PHARMACISTS' PERCEPTION OF RESPONSIBILITY AND PREPAREDNESS TO OFFER ADVICE ABOUT COMPLEMENTARY OR ALTERNATIVE CARE PRODUCTS
AUTHOR: R. Schnoll, PhD, RD. Brooklyn College of the City University o f New York, Brooklyn, NY. LEARNING OUTCOME: To examine commonly used complementary and alternative therapies and rationale for their use in an urban population. A B S T R A C T TEXT: Dietary supplement use among Brooklyn residents was explored. The types o f supplements used, reasons for use, perceived effectiveness, and support for use in the literature were examined, One hundred Brooklyn residents already using complementary and alternative medicine (CAM) were interviewed for this study. Subjects surveyed had used a variety of supplements including functional foods, nutrient supplements and herbs. The main reason for use was treatment o f health problems including arthritis, colds, anxiety and depression, constipation, hot flashes, insomnia, benign prostatic hyperplasia, and cardiovascular disease. The most commonly used substances were echinacen, glucosamine sulfate, saw palmetto, St. John's wort, kava, black cohosh, chondroitin sulfate, garlic, fish oil, and senna. Ninety percent o f the subjects believed that the substances used were effective in treating their conditions. The literature supported the use o f 62% of the supplements for specified conditions. The results demonstrate that C A M users utilize a variety o f substances to treat an assortment o f conditions. The fact that 38% o f the substances used had no research substantiating their effects underscores the need to incorporate a complementary and alternative medicine component into our dietetics curriculum to educate nutrition students on alternative treatment options and assist them in evaluating their efficacy.
AUTHORS: L. Nagro, BS, C. Plascencia, BS, DW. Hagan, PhD, RD, LD. OHSU/VAMC Dietetic Internship, Oregon Health Sciences University, Portland, OR. LEARNING OUTCOME: To determine Oregon pharmacists' perceptions about responsibility for and preparedness to offer patients/clients advice regarding complementary/alternative care products (CACP). ABSTRACT TEXT: Within the last decade there has been a movement toward increasing use of CACP. With this increase comes the potential for misinformation and the question of who is responsible for providing patient or client education about CACP. A 31-question survey was pilot tested and mailed to 607 Oregon pharmacists. The survey evaluated attitude toward CACP and preparedness to offer advice about CACP. The 607 pharmacists were randomly chosen from a list obtained from the Oregon State Board of Pharmacy of Licensed Pharmacists. Pharmacists not currently practicing were excluded from the study. Survey data were manually input into Mierosoff Excel and analyzed using SPSS software. Answers were analyzed as percentages of total responses. From 607 surveys mailed, 212 (35%) were returned completed and 181 (30%) met the inclusion criteria for evaluation. Fifly-four percent of the pharmacists felt prepared to offer advice about CACP and 89% felt prepared to offer advice about vitamin/mineral supplements. Only 17.1% of respondents reported that CACP was part of their educational curriculum. Of these respondents who received education on CACP, 56% reported that only one class in the curriculum was devoted to CACP. Seventy-seven percent of the pharmacists reported that it is the pharmacists' responsibility to provide customer/client education about CACP. In addition, 67% reported that it is the physicians' and 62% the dietitians' responsibility. The results of fuis study suggest that the healthcare team, not only pharmacists, is responsible in providing patient/client education on the use of CACP. Changes to the curriculum of health care professionals may be necessary to meet customer education demands.
C O N F L I C T OF I N T E R E S T : None TITLE: CONCURRENT DIETARY SUPPLEMENT AND MEDICATION USE IN THE ELDERLY AUTHOR(S): RS Wold, MS, RD, LD, ST Lopez, BS, CL Yan, MA, SL Pareo, MS, DL Waters, PhD, RN Baumgartner, PhD, The University of New Mexico, Albuquerque, NM. LEARNING OUTCOME: To increase the dietetics professional's awareness of dietary supplement and medication interactions in the elderly. ABSTRACT TEXT: With the passage of the Dietary Supplement and Health Education Act in 1994, the use of dietary supplements has dramatically increased. It has been reported that certain dietary supplements may have interactions when combined with medications. In 1999, 340 men and women volunteers ages 60-96 were surveyed for their use ofnonvitamin nonmineral supplements (NVNMS) concurrently with prescription and over-the-counter medications. Nonvitamin nonmineral supplements would include herbs, such as ginkgo biloba and other biologics such as glucosamine and chondroitin. Nineteen NVNMS were surveyed based upon the potential interactions of medications and NVNMS commonly used in this population. Participants were interviewed in their homes by a trained research nutritionist. Information on the current use of all medications and the specified NVNMS was recorded. In this population, 134 participants (39.41%) were concurrently taking one or more of the specified NVNMS with medications. Forty-two participants (12.35% of the population) were taking NVNMS in combination with medications among which there were 50 observations of medication/supplement contraindication. Potentially the most serious of these observations were 20 ginkgo biloba combined with aspirin, and 6 ginkgo biloba combined with other non-steroidal anti-inflammatory agents incidences. The combination of ginkgo biloba with these medications has been reported to alter bleeding time. Dehydroepiandrosterone (DHEA) may alter hormone levels and there were 5 observations of hero,one replacement therapy in combination with DHEA. In conclusion, this elderly population has shown a high percentage of use of NVNMS in conjunction with medications and therefore has a heightened potential for adverse reactions. Supported by NIH AG10149.
A-60 / S e p t e m b e r 2001 S u p p l e m e n t Volume 101 N u m b e r 9
TITLE: EFFECTS OF DAILY CONSUMPTION OF SOY PROTEIN ISOLATE VERSES WHEY PROTEIN ISOLATE ON THYROID FUNCTION: A RANDOMIZED, DOUBLE BLIND STUDY AUTHORS: Carlon M. Colker, M.D), Melissa A. Swain, M.S., C.E.Sf, Leila Lynch, M.S., R.D.2.Department of Medicine, Greenwich Hospitall, Department of Cliulcal Research2, Peak Wellness Foundation, Inc. Greenwich, CT. LEARNING OUTCOME: To determine the effects of supplemental soy protein isolate (SPI) verses WPI on thyroid function in healthy euthyroid adults. ABSTRACT TEXT: Based only on epidemiological and observational population studies, soy protein has been marketed to the consumer as being everything from the penultimate measure in preventive care, to being a panacea for a myriad of illnesses. Yet the isoflavones found in soy inhibit thyroid peroxidase (the enzyme responsible for the formation ofT3 and T4). In fact, although largely ignored, very early studies not only allude to a causative link between soy and goitrogenic and antoimmune thyroiditis, but also a possible carcinogenicity. Given the conflict of today's prosoy propaganda when compared to early scientific findings, to date there exists no clear investigation focused on evaluating the effect of soy protein on thyroid function in normal, healthy adults. In addition, there is no data verifying a comparative advantage of another protein (in this case whey protein isolate) as not interfering with thyroid function. Twenty-seven adults took part in this prospective, randomized, double blind, trial. Each subject ingested either 60 GM soy protein isolate (SPI) or 60 GM whey protein isolate (WPI) daily for three months. Thyroid function (TSH, T3, and T4) was measured at weeks 0, 6, and 12. Data was analyzed for changes over time. Over the course of the study, the time trend values for T4 showed a statistically significant decrease in SPI (p=0.0057), whereas WPI had no change (p=0.8579). These values were also comparatively significant (p=0.0454). Our findings demonstrated that the daily ingestion of 60 GM of SPI had a significant negative effect on "1"4production. Furthermore, ingestion of 60 GM of WPI daily resulted in no such influence on thyroid function. This is the first study to confh'm a comparative disadvantage of SPI and the comparative advantage of WPI as it relates to thyroid function in normal, healthy adults. Study funded in part by Davisco Foods International, Inc., Eden Prairie, MN.
t oct
o . , * * *
g i too*
J * * * * l . a o o o o l o *
t o l l o , o , o * o o * J u
o a o o l * * m * o * * * * o * o , o * l * l o * o t * J l * * * o *
•
MOMDAY,OCTOBER22 POSTERSESSION:EDUCATIONAND BEHAVIORALSTRATEGIES/MEDICALNUTRITIONTHERAPY TITLE: COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM) USE IN A BROOKLYN COMMUNITY
TITLE: PHARMACISTS' PERCEPTION OF RESPONSIBILITY AND PREPAREDNESS TO OFFER ADVICE ABOUT COMPLEMENTARY OR ALTERNATIVE CARE PRODUCTS
AUTHOR: R. Schnoll, PhD, RD. Brooklyn College of the City University o f New York, Brooklyn, NY. LEARNING OUTCOME: To examine commonly used complementary and alternative therapies and rationale for their use in an urban population. A B S T R A C T TEXT: Dietary supplement use among Brooklyn residents was explored. The types o f supplements used, reasons for use, perceived effectiveness, and support for use in the literature were examined, One hundred Brooklyn residents already using complementary and alternative medicine (CAM) were interviewed for this study. Subjects surveyed had used a variety of supplements including functional foods, nutrient supplements and herbs. The main reason for use was treatment o f health problems including arthritis, colds, anxiety and depression, constipation, hot flashes, insomnia, benign prostatic hyperplasia, and cardiovascular disease. The most commonly used substances were echinacen, glucosamine sulfate, saw palmetto, St. John's wort, kava, black cohosh, chondroitin sulfate, garlic, fish oil, and senna. Ninety percent o f the subjects believed that the substances used were effective in treating their conditions. The literature supported the use o f 62% of the supplements for specified conditions. The results demonstrate that C A M users utilize a variety o f substances to treat an assortment o f conditions. The fact that 38% o f the substances used had no research substantiating their effects underscores the need to incorporate a complementary and alternative medicine component into our dietetics curriculum to educate nutrition students on alternative treatment options and assist them in evaluating their efficacy.
AUTHORS: L. Nagro, BS, C. Plascencia, BS, DW. Hagan, PhD, RD, LD. OHSU/VAMC Dietetic Internship, Oregon Health Sciences University, Portland, OR. LEARNING OUTCOME: To determine Oregon pharmacists' perceptions about responsibility for and preparedness to offer patients/clients advice regarding complementary/alternative care products (CACP). ABSTRACT TEXT: Within the last decade there has been a movement toward increasing use of CACP. With this increase comes the potential for misinformation and the question of who is responsible for providing patient or client education about CACP. A 31-question survey was pilot tested and mailed to 607 Oregon pharmacists. The survey evaluated attitude toward CACP and preparedness to offer advice about CACP. The 607 pharmacists were randomly chosen from a list obtained from the Oregon State Board of Pharmacy of Licensed Pharmacists. Pharmacists not currently practicing were excluded from the study. Survey data were manually input into Mierosoff Excel and analyzed using SPSS software. Answers were analyzed as percentages of total responses. From 607 surveys mailed, 212 (35%) were returned completed and 181 (30%) met the inclusion criteria for evaluation. Fifly-four percent of the pharmacists felt prepared to offer advice about CACP and 89% felt prepared to offer advice about vitamin/mineral supplements. Only 17.1% of respondents reported that CACP was part of their educational curriculum. Of these respondents who received education on CACP, 56% reported that only one class in the curriculum was devoted to CACP. Seventy-seven percent of the pharmacists reported that it is the pharmacists' responsibility to provide customer/client education about CACP. In addition, 67% reported that it is the physicians' and 62% the dietitians' responsibility. The results of fuis study suggest that the healthcare team, not only pharmacists, is responsible in providing patient/client education on the use of CACP. Changes to the curriculum of health care professionals may be necessary to meet customer education demands.
C O N F L I C T OF I N T E R E S T : None TITLE: CONCURRENT DIETARY SUPPLEMENT AND MEDICATION USE IN THE ELDERLY AUTHOR(S): RS Wold, MS, RD, LD, ST Lopez, BS, CL Yan, MA, SL Pareo, MS, DL Waters, PhD, RN Baumgartner, PhD, The University of New Mexico, Albuquerque, NM. LEARNING OUTCOME: To increase the dietetics professional's awareness of dietary supplement and medication interactions in the elderly. ABSTRACT TEXT: With the passage of the Dietary Supplement and Health Education Act in 1994, the use of dietary supplements has dramatically increased. It has been reported that certain dietary supplements may have interactions when combined with medications. In 1999, 340 men and women volunteers ages 60-96 were surveyed for their use ofnonvitamin nonmineral supplements (NVNMS) concurrently with prescription and over-the-counter medications. Nonvitamin nonmineral supplements would include herbs, such as ginkgo biloba and other biologics such as glucosamine and chondroitin. Nineteen NVNMS were surveyed based upon the potential interactions of medications and NVNMS commonly used in this population. Participants were interviewed in their homes by a trained research nutritionist. Information on the current use of all medications and the specified NVNMS was recorded. In this population, 134 participants (39.41%) were concurrently taking one or more of the specified NVNMS with medications. Forty-two participants (12.35% of the population) were taking NVNMS in combination with medications among which there were 50 observations of medication/supplement contraindication. Potentially the most serious of these observations were 20 ginkgo biloba combined with aspirin, and 6 ginkgo biloba combined with other non-steroidal anti-inflammatory agents incidences. The combination of ginkgo biloba with these medications has been reported to alter bleeding time. Dehydroepiandrosterone (DHEA) may alter hormone levels and there were 5 observations of hero,one replacement therapy in combination with DHEA. In conclusion, this elderly population has shown a high percentage of use of NVNMS in conjunction with medications and therefore has a heightened potential for adverse reactions. Supported by NIH AG10149.
A-60 / S e p t e m b e r 2001 S u p p l e m e n t Volume 101 N u m b e r 9
TITLE: EFFECTS OF DAILY CONSUMPTION OF SOY PROTEIN ISOLATE VERSES WHEY PROTEIN ISOLATE ON THYROID FUNCTION: A RANDOMIZED, DOUBLE BLIND STUDY AUTHORS: Carlon M. Colker, M.D), Melissa A. Swain, M.S., C.E.Sf, Leila Lynch, M.S., R.D.2.Department of Medicine, Greenwich Hospitall, Department of Cliulcal Research2, Peak Wellness Foundation, Inc. Greenwich, CT. LEARNING OUTCOME: To determine the effects of supplemental soy protein isolate (SPI) verses WPI on thyroid function in healthy euthyroid adults. ABSTRACT TEXT: Based only on epidemiological and observational population studies, soy protein has been marketed to the consumer as being everything from the penultimate measure in preventive care, to being a panacea for a myriad of illnesses. Yet the isoflavones found in soy inhibit thyroid peroxidase (the enzyme responsible for the formation ofT3 and T4). In fact, although largely ignored, very early studies not only allude to a causative link between soy and goitrogenic and antoimmune thyroiditis, but also a possible carcinogenicity. Given the conflict of today's prosoy propaganda when compared to early scientific findings, to date there exists no clear investigation focused on evaluating the effect of soy protein on thyroid function in normal, healthy adults. In addition, there is no data verifying a comparative advantage of another protein (in this case whey protein isolate) as not interfering with thyroid function. Twenty-seven adults took part in this prospective, randomized, double blind, trial. Each subject ingested either 60 GM soy protein isolate (SPI) or 60 GM whey protein isolate (WPI) daily for three months. Thyroid function (TSH, T3, and T4) was measured at weeks 0, 6, and 12. Data was analyzed for changes over time. Over the course of the study, the time trend values for T4 showed a statistically significant decrease in SPI (p=0.0057), whereas WPI had no change (p=0.8579). These values were also comparatively significant (p=0.0454). Our findings demonstrated that the daily ingestion of 60 GM of SPI had a significant negative effect on "1"4production. Furthermore, ingestion of 60 GM of WPI daily resulted in no such influence on thyroid function. This is the first study to confh'm a comparative disadvantage of SPI and the comparative advantage of WPI as it relates to thyroid function in normal, healthy adults. Study funded in part by Davisco Foods International, Inc., Eden Prairie, MN.