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<document><webSite>c.zhiwenweb.cn</webSite><webMaster>lzwy0820@foxmail.com</webMaster><updatePeri>15</updatePeri>    <item>
        <title>Western Xia Mausoleum 西夏王陵</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/Culture/ChineseCulture/2012/01/663997694033.html]]></link>
        <text><![CDATA[The Western Xia Mausoleum is located on the eastern slope of the Helan Mountain, 30 kilometers west of Yinchuan City. Covering an area of 53 square kilometers, the mausoleum is one of the largest and best preserved imperial mausoleums in China. 

Dubbed the "Eastern Pyramids," the Western Xia Mausoleum includes nine imperial mausoleums and 250 tombs of imperial relatives and officials. 

Each main tomb has four corner towers and an array of watchtowers, pavilions housing stone tablets, a sacrificial hall and a coffin platform &ndash; most of which are now unrecognizable. Archaeologists believe that octagonal glazed-tile pagodas once stood by each tomb. 

The tombs were originally created by the founder of the Western Xia Kingdom (1038-1237), Li Yuanhao, who built over 70 tombs &ndash; one for himself, some for his relatives and more to be left empty, presumably a decoy against theft. 

In contrast to the wooden and stone structures of the Ming (1368-1644) and Qing (1644-1911) dynasty imperial tombs, the Western Xia Tombs are made of earth and brick, reflecting the culture of the ancient western kingdom. 

In recent years, scientific research and exploration have been conducted at the site in hopes of decoding the sudden disappearance of the Western Xia civilization. 

Tips: 

Admission: 60 yuan 

Working Hours: 8 a.m. &ndash; 4:30 p.m. (April &ndash; October) 

8 a.m. &ndash; 4 p.m. (January &ndash; March, November &ndash; December) 

How to get there: Take buses from South Gate Bus Station or North Gate Bus Station to get there for 8 Yuan; or take bus No. 1, 2, 4, 18 at downtown Yinchuan and get off at Yinchuan Railway Station, then hire a car to get there for 35 yuan.]]></text>
        <category><![CDATA[20108661550776]]></category>
        <author><![CDATA[]]></author>
        <source><![CDATA[cultural-china.com]]></source>
        <pubDate>2012-01-03 09:12:53</pubDate>
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        <title>China Hui Culture Park 中华回乡文化园</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/Culture/ChineseCulture/2012/01/51452940890.html]]></link>
        <text><![CDATA[The China Hui Culture Park, situated in Yongning County of Yinchuan, is the only theme park in China that showcases the ethnic Hui religion, traditions and culture, an integration of Islamic and traditional Chinese culture from the Han and Tang dynasties. 

Opened in 2005, the park covers an area of 20 hectares and accommodates a Hui museum, a ritual palace, a Hui ethnic customs village and a Hui catering and performance center. 

The main attraction of the park is a white Islamic-style building that is encircled by a long corridor. The building is designed based on the Indian Taj Mahal. 

Tips: 

Working Hours: 8 a.m. &ndash; 8 p.m. (summer) 

8 a.m. &ndash; 6:30 p.m. (winter) 

Admission: 120 Yuan (free on Tuesdays); 

How to get there: take the No. 302 bus to get there for 2 yuan or take the Beijing-Tibet Expressway and get off at Yongning. 

Website: http://www.zhhxwhy.com/en/index.asp]]></text>
        <category><![CDATA[20108661550776]]></category>
        <author><![CDATA[]]></author>
        <source><![CDATA[cultural-china.com]]></source>
        <pubDate>2012-01-03 09:12:52</pubDate>
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        <title>Beijings botanical garden in autumn</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/Culture/ChineseCulture/2012/01/688697747940.html]]></link>
        <text><![CDATA[

Beijing's botanical garden, known as zhiwuyuan, is located at the foot of the western hills, just fifteen kilometers west of the city centre. It is an important organization to undertake botanical research, public education, plant germplasm conservation and utilization. It also serves as a tourism, relax and recreational place for the public.
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        <category><![CDATA[20108661550776]]></category>
        <author><![CDATA[]]></author>
        <source><![CDATA[cultural-china.com]]></source>
        <pubDate>2012-01-03 09:12:49</pubDate>
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        <title>Calligraphic Art in Stamps</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/Culture/ChineseCulture/2012/01/93162.html]]></link>
        <text><![CDATA[The State Post Bureau of China issued a set of special stamps named Calligraphic Arts in Ancient China-Seal Character in February 2003. As the first series of thematic artistic stamps, they featured the masterpieces from large seal script and small seal script respectively with inscriptions on Mao-kung Ding of the late Western Chou period (1046-771BC) and Inscribed Stones on Mount Tai by Li Si of the Qin Dynasty (221BC-206BC).


The calligraphic art of Chinese characters is a treasure of Chinese cultural heritage. After the unification of Qin, the small seal style became the standard character across China and experienced a developing process in China-seal Character, Li Shu (script in square style), Cao Shu (script in cursive style), Kai Shu (script in regular style) and Xing Shu (running script, semi-cursive script). The five writing styles are commonly seen on stamps.
1. China-seal Character
China-seal Character, serving as a catch-all of large seal script and small seal script, consists of carapace-bone-script, inscriptions on bronze and Zhou Wen (a style of calligraphy from the Chou Dynasty (c. 11th century-256 BC)).
1）Carapace-bone-script of the Shang Dynasty (1600-1046BC) is the earliest pictographic and phonetic character style in Chinese history. It possesses three elements of calligraphy, including stroke, structure and composition. It has a history of over 3,000 years.


2）Inscription on bronze has been termed as Jin Wen since it usually appeared on bronze. Evolving from Carapace-bone-script, it has a history of about 3,000 years. The stamps below feature Jin Wen on &ldquo;Jimo zhi fahua&rdquo; Knife Coin and Chime-bells from the Tomb of Marquis Yi of the Zeng State.


3）Zhou Wen, also known as &ldquo;inscriptions on drum-shaped stone blocks&rdquo;, is the earliest known inscription style on stones. It appeared over 2,600 years ago. Stamp T98(8-1) features Zhou Wen, written by Wu Changshi


4）Small seal character, including Qin seal script and script of bold and thin lines, appeared after the unification of Qin. Together with large seal script, including carapace-bone-script, Jin Wen and Zhou Wen, they form the calligraphic art of the China-seal-character. Special stamps featuring the Chinese character &ldquo;hou&rdquo; in 1992, &ldquo;ji&rdquo; in 1993 and &ldquo;gou&rdquo; in 1994, by Huang Binhong, as well as stamp T33(2-1), provide vivid examples of small seal character.

2. Square Script
Derived from the Warring State period (403-221 BC) and developed by Cheng Miao in the Qin Dynasty, Li Shu took the place of small seal character in the late Qin Dynasty. In the Han Dynasty (202BC-220AD), it was perfected into Han Li which is still used today. The main features of Li Shu include a square style in stroke and weakening pictographic style in structure. The stamp issued in 1994 about the 4th congress of All-China Philatelic Federation has over 200 characters of Li Shu. The Chinese characters of &ldquo;zhu&rdquo;, &ldquo;shu&rdquo; and &[NextPage]ldquo;niu&rdquo; on the stamps below are all written in Li Shu style.


3. Cursive Script
Dating back to the beginning of the Han Dynsasty, Cao Shu has a long history of over 2,000 years. It consists of Zhang Cao, which developed from the cursive writing style of Li Shu and Jin Cao, created by Zhang Zhi in the end of the Han. In stamps, the Cao Shu works by Mao Zedong were mostly common used. Thirteen out of 14 stamps issued on Oct 1, 1968 about Mao&rsquo;s poetry are written in Cao Shu. The following stamps feature Chinese the characters of &ldquo;hu&rdquo;, &ldquo;tu&rdquo; and &ldquo;long&rdquo; in Cao Shu style.


4. Regular Script
Kai Shu, also evolving from Han Li, is distinguished by its foursquare form and straight strokes. Invented by Wang Ci in the Eastern Han Dynasty (25-220), it has a history of 1,800 years with added development in the Wei (220-265) and Jing (265-420) Dynasties, prevailing in the Northern and Southern Dynasties (420-581) and culminating in the Tang Dynasty (618-907). The commemorative stamps from the 90th anniversary of the birth of Sun Yat-sen and the 70th anniversary of the Revolution of 1911 have Sun&rsquo;s inscription in Kai Shu. Guo Muruo&rsquo;s writing of &ldquo;Long friendship of the Chinese and Japanese peoples&rdquo; on a stamp issued in 1987 was also in Kai Shu style. Stamps issued in 2001, 2002 and 2003 carry the Chinese characters of &ldquo;she&rdquo;, &ldquo;ma&rdquo; and &ldquo;yang&rdquo; in Kai Shu.


5. Running Script
Xing Shu, a semi-cursive writing style, was created by Liu Chuansheng in the end of the Eastern Han Dynasty (25-220), bloomed in the Three Kingdoms Dynasty (25-280) and flourished in the Jin Dynasty. It has a history of over 1,700 years. Zhong You and Wang Xizhi were two exponents of the writing style. The following stamps features inscriptions by Zhou Enlai and the Traditional Chinese character &ldquo;yi&rdquo; written by Mi Fu in Xing Shu style.


Translated by Wangzhen
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        <category><![CDATA[20108661550776]]></category>
        <author><![CDATA[]]></author>
        <source><![CDATA[cultural-china.com]]></source>
        <pubDate>2012-01-03 09:12:45</pubDate>
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        <title>Armenian Weddings</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/Digest/2012/01/055181.html]]></link>
        <text><![CDATA[An Armenian bride traditionally wears a red silk wedding gown. She also wears a headpiece made of cardboard that is shaped into wings and covered with feathers. The bride and groom enter the reception under an arch formed by bridesmaids and grooms men. To symbolize their love and happiness, the couple releases a dove. It is also customary for guests to throw coins at the bride.]]></text>
        <category><![CDATA[20103493262903]]></category>
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        <pubDate>2012-01-03 09:12:45</pubDate>
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        <title>Charms in Ancient China</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/Culture/ChineseCulture/2012/01/7584421163260.html]]></link>
        <text><![CDATA[Even with the repeated natural disasters in the formative periods of its ancient civilization, the Chinese maintained a zest for life.
By the time the First Emperor united China at the end of the third century B.C., a decadent or popular form of Taoism had emerged. Popular Taoism was a religion of spirits and magic that provided the spiritual comfort not found in either philosophical Taoism or Confucianism.
Its goals were long life and personal immortality. These goals were to be achieved not so much as a reward for ethical conduct but through magical charms, among other things.

As early as the Han Dynasty (206 BC - 230 AD), the Chinese started to wear charms as pendants around their necks, to hang from their waists, or to attach to rafters of houses, temples, pagodas or other important structures.

Some scholars even believe that Chinese open work charms were among the first to be used for dress ornamentation and decoration purposes.
Over the centuries, Chinese charms for various purposes and of different shapes gradually developed. Some were meant to be part of daily wear. Others were worn only on special holidays or for important rituals.


The charms may use depictions of animals, plants and other objects to substitute for other words because of their similarity in pronunciation, even though they may not have any other relationship to what is being expressed.


source
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        <category><![CDATA[20108661550776]]></category>
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        <source><![CDATA[cultural-china.com]]></source>
        <pubDate>2012-01-03 09:12:43</pubDate>
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        <title>Wedding Speech Tips If You’re the Best Man</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/Digest/2012/01/061006.html]]></link>
        <text><![CDATA[Traditionally, the best man&#8217;s speech is delivered last, after the parents of the bride speech and groom&#8217;s speech. Because most weddings nowadays also include speeches by the groom&#8217;s parents, the maid of honor and the bride, the best man&#8217;s speech doesn&#8217;t necessarily have to be delivered the last. It can be delivered anytime, as long as it doesn&#8217;t precede the parents of the bride&#8217;s speech and the groom&#8217;s speech. Here&#8217;s a quick and easy outline for the best man&#8217;s speech:

 Begin your speech by acknowledging the groom&#8217;s speech. Follow it up by thanking the newlyweds for including you and the rest of the wedding party in their special day. Don&#8217;t hold back on the compliments, flatter the couple, especially the bride, and be sincere about it!
 You don&#8217;t really have to deliver a serious speech. In fact, as the best man, it&#8217;s your job to tell funny stories and embarrass the groom a bit. Keep your stories and revelations about the groom acceptable and appropriate, though. Keep in mind that while you can tell the guests embarrassing stories about the groom and some of his misadventures, try not to say anything that will humiliate him, distress his bride and offend their parents.
 If there are letters or messages from people who are unable to attend the wedding, it&#8217;s your job as best man to read them.
 End your speech by complimenting the new bride and offering a toast to the new couple.
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        <category><![CDATA[20103493262903]]></category>
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        <pubDate>2012-01-03 09:12:42</pubDate>
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        <title>Cross-dressing in Beijing Opera</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/Culture/ChineseCulture/2012/01/070559.html]]></link>
        <text><![CDATA[Cross-dressing has a long history in Beijing opera, dating back to Feudal times when women were not allowed to perform on stage. As a result, male opera singers had to perform female roles. It was during what many term &ldquo;Chinese opera&rsquo;s golden age&rdquo; in the 1920s and 30s that women were first allowed to openly make an appearance on stage. Owing to the move toward gender equality among the intelligentsia during that era, some female singers decided to take on male roles &ndash; just as male singers had traditionally taken on female roles.


Face-painting gives audiences a key hint as to the role a character plays.

What is important to keep in mind is that cross-reading was never thought of as humorous or ironic as in the West. &ldquo;People didn&rsquo;t go to the theatre to see men play women&rsquo;s roles,&rdquo; accomplished female impersonator Liu Zheng, of the Tianjin Peking Opera Company, said. &ldquo;Although some audience members might have known that you were really a man, they would not have paid much attention to your gender, forgetting about that during the performance. It was very important that the male be made up to be really beautiful and that his gestures and mannerisms be really feminine.&rdquo;
But it was not simply an issue of putting on the opposite sex's garb. &ldquo;Not many people are really good at it,&rdquo; Wang Peiyu, of the same company, said. But when asked how difficult it was for her to assume a male persona, she said she had never really given it much thought. &ldquo;I had 10 years of training, and it was both thorough and systematic,&rdquo; she said. &ldquo;I never really thought about my gender when I was performing. I was just playing a part.&rdquo;
During the Cultural Revolution (1966 &ndash; 1976), traditional Chinese opera was banned, replaced by Madam Mao&rsquo;s Eight Model Plays, which drew on class struggle and communist exploits during the anti-Japanese war and Chinese civil war as themes. Although traditional Beijing opera was allowed to be performed again in 1978, it has never regained its former popularity. Modern audiences understand neither the historical contexts nor the literary allusions of the scripts. They are also unfamiliar with the highly stylized conventions that can make the genre all but unintelligible to the uninitiated.
Beijing opera is opera on a grand scale. It combines singing with drama, music, dancing, and martial arts. Elaborate costumes and exquisite face-painting are an integral part of the spectacle as the colours and designs give audiences hints as to a character&rsquo;s personality and the role he plays. Sets are simple and props are kept to an absolute minimum, with simple gestures, gaits and movements conveying much of the action. Thus, if a performer makes a certain movement or gesture, the audience will know intuitively if he is changing clothes, walking through a door, or riding a horse. For the uninitiated, Beijing opera can seem overwhelmingly complex an[NextPage]d difficult to enjoy.
Both Wang and Liu suggested that those new to the genre forget about trying to understand the technical aspects of Beijing opera and concentrate on enjoying the performance. &ldquo;It can help if audiences read the synopsis beforehand,&rdquo; Liu suggested. &ldquo;In the end, the music, the singing and the costumes are so beautiful, how could anyone not enjoy it? People should just sit back and enjoy the show.&rdquo;
Perhaps. But learning a few basics &ndash; such as how to distinguish between someone who is loyal (red face) or treacherous (white face) or brave (blue face) &ndash; can be fun and certainly won&rsquo;t detract from anyone&rsquo;s enjoyment of Beijing Opera.

Male parts female roles

Yang Lei goes through the stages of transformation to play a female role. Zou Hong / China Daily

Yang Lei's thick eyebrows belie his smooth jaw till the Peking Opera performer reveals he shaves before applying makeup, to make sure there is no stubble. After all, stubble just won't do when the 33-year-old goes on stage dressed in dazzling costumes and sings a soprano aria. Yang is one of the nation's young nan dan (man who plays a female role), a practice forged at a time when women were forbidden to take the stage. The heyday of nan dan was the first half of the 20th century, when Mei Lanfang, Shang Xiaoyun, Cheng Yanqiu and Xun Huisheng - dubbed the "Four Great Dan" - established the four dan styles of mei, shang, cheng and xun. Bi Guyun, 80, a senior nan dan performer, witnessed the boom of this art form in the 1940s and 1950s.
"The four masters were all active at that time. Shows were on every night at more than 10 theaters in Beijing," Bi recalls, saying that Peking Opera was the leading form of entertainment then.
But the "cultural revolution" (1966-1976) dealt a death blow to the opera, and along with it the nan dan. Although the 1980s saw a gradual revival, the nan dan remained in the shadows with the rise of women performers on the Peking Opera stage, leaving only about 10 male dan.
But Yang, who belongs to the cheng school, believes the nan dan is irreplaceable, even if there are more female performers.
"Every single detail of the dan role presumed it would be a man playing this role," Yang says, pointing to the characteristic hand gesture that was designed to make the hand look smaller and softer.
Also, the foot-shaped stilts that male performers walked on in some plays, were meant to imitate women's bound feet.
"More importantly, men have better sounding falsettos given their wider vocal range and also have more stamina," Yang adds.
Mu Yuandi, 28, who started his nan dan journey when he was 9 and belongs to the shang school, agrees that women cannot cope with the martial arts that distinguishes this style.
"My waist and legs still carry the scars of my injuries," he says.
Hu Wenge, 44, is the only nan dan apprentice of 77-year-old Peking Opera master Mei Baojiu - son of the legendary Mei Lanfang.
Hu took to Peking Opera at the rath[NextPage]er late age of 34 and therefore had to try even harder to master the repertoire.
"I may have given up but for my teacher's encouragement," Hu says.
The dan is the only female role of the five main roles in a Peking Opera show, so the issue of men playing these roles often gives rise to curiosity and questions about their sexual orientation.
Hu, who earned fame as a pop singer dressing and singing as a woman, is candid about switching to Peking Opera in his quest for more respect from audiences. At the peak of his career as a singer, Chinese society was more conservative than it is now, he explains.
"Peking Opera is a stylized art," says nan dan performer Bi. "We don't imitate real women but only present an abstract image, based on classic novels and paintings."
Yang, meanwhile, is offended when asked about his sexual orientation, and insists it is a private matter.
"Onstage and offstage are two separate lives for me," he says.
He also stresses a real man is one who is tolerant and takes responsibility for himself, his family, and society.
Yin Jun, 23, from the xun school, is the youngest of the new-generation nan dan. An undergraduate student at the National Academy of Chinese Theater Arts, he is preparing to enroll for the post-graduate exam.
Hu, meanwhile, held six solo concerts in the United States in March, reprising the time when Mei Lanfang toured there in 1930.
Hu Wenge, Yang Lei, Mu Yuandi and Yin Jun are often called today's "Four Young Dan".
A concert of their joint performances that started at the beginning of October at Chang'an Grand Theater marks the eighth round of their joint-performances in Beijing and Shanghai since March 2010.
As the curtains open, backstage, 77-year-old Mei Baojiu adjusts Hu's headgear one more time and gives him some last minute pointers.
Five minutes later, Mei lifts Hu's right arm and escorts him onto the stage.
Standing behind the curtain he observes his protg's every move with an air of anticipation.
"These young (Peking Opera artists) have won the first battle," he says. "But it's a long road ahead."
Source: China Daily]]></text>
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        <source><![CDATA[cultural-china.com]]></source>
        <pubDate>2012-01-03 09:12:41</pubDate>
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        <title>Top 10 Chinese tourist cities in foreigners eyes</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/Culture/ChineseCulture/2012/01/57559329052.html]]></link>
        <text><![CDATA[Ranking as the world's fourth largest destination for inbound tourism, China is a hot destination for people all over the world who want to experience its vast and varied territories, long history, multi-ethnic culture and world renowned food. The ten destinations listed below reflect all of these excellent characteristics and why so many foreigners' eyes are drawn towards China. 



Luoyang- 洛阳 


Ranking as the world's fourth largest destination for inbound tourism, China is a hot destination for people all over the world who want to experience its vast and varied territories, long history, multi-ethnic culture and world renowned food. The ten destinations listed below reflect all of these excellent characteristics and why so many foreigners' eyes are drawn towards China. 


Luoyang, located along the southern banks of the middle reaches of the Yellow River, is one of the seven ancient capitals of China over a stretch of about 1,600 years. 


Luoyang, located along the southern banks of the middle reaches of the Yellow River, is one of the seven ancient capitals of China over a stretch of about 1,600 years. Considered a microcosm of ancient Chinese history, Luoyang is one of the cradles of the Chinese civilization. 

Luoyang is home to many historically interesting points due to its long history. For example, the Longmen Caves, about eight miles south of Luoyang on the Yi River, were a work in progress over the span of seven dynasties. During that period, more than 1,300 caves were created to host 40 small pagodas and 100,000 Buddha statues that range in size from just a mere inch to a towering 57 feet. 

If you're interested in Kungfu, you can visit the Shaolin Temple. Located about twenty kilometers west of Luoyang with a history of 1,900 years, this temple was the first Buddhist monastery ever built in China and it is still inhabited by monks. 

In addition to many places of interest, Luoyang takes pride in its peonies. Every April, the city's Peony Show attracts numerous visitors from home and abroad. Luoyang is also famous for its three-colored glazed pottery, bronze ware, and palace lanterns.]]></text>
        <category><![CDATA[20108661550776]]></category>
        <author><![CDATA[]]></author>
        <source><![CDATA[cultural-china.com]]></source>
        <pubDate>2012-01-03 09:12:39</pubDate>
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        <title>Weihai-威海</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/Culture/ChineseCulture/2012/01/090786.html]]></link>
        <text><![CDATA[Weihai is a coastal city with beautiful scenery and mild climate, holding extraordinary allure for millions of visitors. 

Located in eastern Shandong Province, Weihai is a coastal city with beautiful scenery and mild climate, holding extraordinary allure for millions of visitors. Because it lies in the transition zone between a humid subtropical and humid continental climate, Weihai has mild weather with an average temperature between 16-26 degrees Centigrade. Weihai is a commercial port and major fishing center with some light industries. Weihai won the honor of "Top 50 Cities in Aggregate Economic Strength" as well as UN Habitat Prize in 2003. 

Weihai has abundant tourism resources, featuring gentle slopes, broad valleys, appealing seashores, historical cultural relics, gardens and distinct local customs. 

Besides being a popular tourist destination, Weihai has various festivals that showcase traditional local culture such as the Rongcheng International Fisherman Festival that displays fishing culture. ]]></text>
        <category><![CDATA[20108661550776]]></category>
        <author><![CDATA[]]></author>
        <source><![CDATA[cultural-china.com]]></source>
        <pubDate>2012-01-03 09:12:38</pubDate>
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        <title>Budget Tips For Your Wedding Reception</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/Digest/2012/01/166491.html]]></link>
        <text><![CDATA[Wedding receptions are expensive affairs and can set you back a pretty penny. However, most brides have their heart set on an all out wedding reception. Here are some ways to cut back the costs, without compromising on the quality of the wedding reception.

Alcohol is probably the largest expense at any wedding reception. There are several ways you can cut short the liquor budget at your wedding reception.

Offer punch &#8211; virgin and spiked &#8211; instead of having a bar. This works really well if you are having a summer luncheon wedding reception.
Offer only wine and beer along with soft drinks, coffee and tea at the bar. Ask the staff to pass around glasses of champagne especially for the wedding toast.
Close the bar an hour before the wedding reception ends. Serve only cold drinks, tea and coffee afterwards.
If possible, choose a venue that allows you to bring your own liquor. Once you are bringing your own liquor the rates go down considerably and you can consider having an open bar at the wedding reception.


The venue is another large expense for the wedding reception. Think about having your wedding during off-season. Most wedding venues will be available for discounted prices during the off-season.
Also, booking a wedding venue for your wedding reception well in advance gives you the leverage to try and bargain for a good discount. If you cannot get a monetary discount try and wrangle some perks like valet parking at the venue for your guests.
Wedding cakes can get really expensive. Instead of having one single large wedding cake, order a smaller wedding cake to be cut at the wedding reception. Use this cake for display and for the cake cutting ceremony. Let the guests be served from sheet cakes inside the kitchen, which are a whole lot cheaper. You also don?t need any other dessert other than the wedding cake.
If you are on a really tight budget, plan a cocktail wedding reception instead of one that includes a full meal. Also, discuss with your caterer, which foods are in season. Using foods that are freely available also means they are cheaper. Strawberry shortcake in the middle of summer costs a whole lot more than it does in winter!
Wedding photographs and wedding photographers can be expensive too. Hire a wedding photographer to take only special moments of the wedding reception. Restrict the wedding photographer right from the beginning and put him on a budget. Instead, get someone in the family or a good friend to click photographs all through the wedding. Even if you have to click 5 rolls of film to get a few good photos of the wedding reception, it will save you big bucks. Disposable wedding cameras placed at each reception table can also help you capture those special moments. Have your guests use the wedding cameras through out the reception for some wonderful candid wedding photos for pennies a photo.

At the end of the day, money won?t make your wedding reception a success. How much fun you and your spouse have at the we[NextPage]dding reception will determine how much fun the guests have and how many memories you create!
Copyright Andrea Britt, 2005.
Do not copy or reprint without express permission.]]></text>
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        <pubDate>2012-01-03 09:12:37</pubDate>
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        <title>Zhuhai-珠海</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/Culture/ChineseCulture/2012/01/4456503987.html]]></link>
        <text><![CDATA[Zhuhai has been awarded various titles, such as 'Top Tourist City of China,' 'State Environmental Protection Model City,' and 'State-level Ecology Demonstration Zone,' all of which testify to its unique beauty. 

Zhuhai is located in the southwestern part of the Pearl River Delta in Guangdong Province, with Hong Kong to the east, Macau to the south, Xinhui and Taishan to the west and Zhongshan to the north. 

Zhuhai has been awarded various titles, such as 'Top Tourist City of China,' 'State Environmental Protection Model City,' and 'State-level Ecology Demonstration Zone,' all of which testify to its unique beauty. 

With a subtropical monsoon climate, the city enjoys adequate sunshine and rainfall. The annual average temperature is a comfortable 72. 

If you want to see some spectacular architecture in Zhuhai, New Yuanmingyuan Garden is a must-see scenic spot. Built based on the original Yuanmingyuan Garden in Beijing, the New Yuanmingyuan Garden in Zhuhai is an imitation and contains eighteen of the original forty sights found in Beijing. Chinese-style palaces, buildings and pavilions demonstrate the imperial architectural style of the Qing Dynasty (1644-1911) and the layout of classical gardens in southern China, while the Western style architecture in the west section of the garden draws from classic European styles. It is a good place for any architectural enthusiasts. 

There are a lot of fun places in Zhuhai. Avid motor-racing fans already know Zhuhai as the host of the only international circuit in China. High speeds on the streets are met with aerospace advances as Zhuhai plays host to the biannual International Aerospace Expo, the grandest expo of its kind in China.]]></text>
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        <source><![CDATA[cultural-china.com]]></source>
        <pubDate>2012-01-03 09:12:35</pubDate>
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        <title>Lhasa-拉萨</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/Culture/ChineseCulture/2012/01/7480983426226.html]]></link>
        <text><![CDATA[Lhasa is a city that rightly captures the imagination of the world, not just for its remoteness and exceedingly high altitude, but also for its impressive heritage that spans over a thousand years of cultural and spiritual history that has helped to create the romantic and mysterious Tibetan religion. 

Lhasa is a city that rightly captures the imagination of the world, not just for its remoteness and exceedingly high altitude (3,650 meters), but also for its impressive heritage that spans over a thousand years of cultural and spiritual history that has helped to create the romantic and mysterious Tibetan religion. 

Differing from elsewhere in Tibet, Lhasa is unique and has an allure of its own. In Tibetan language, Lhasa means the Holy Land or the "Land of the Gods." It is the heart of Tibet's politics, economy and culture. The splendor and grandeur of the Potala Palace in Lhasa remains a world-famous symbol of Tibet. Non-Chinese nationals are required to obtain a special permit before visiting Tibet. 

Generally the best time to visit the city is between March and October. Since Lhasa is situated at such a high altitude, visitors need careful preparations before hitting the road. Taking the train, the highest railway system in the world, is a fabulous option which allows you to view amazing mountain views and adjust for altitude sickness. 

Lhasa has plenty of attractions but here are some of the must-go highlights; the Potala Palace, Jokhong Monastery, Sera Monastery, Drepung Temple and Norbulinka Palace. Lhasa's original look and old lifestyle are largely kept intact at Barhkor Street in Old Lhasa, where pilgrims walk around Jokhang Temple while turning prayer wheels in their hands. Here you can also enjoy bargaining with local Tibetan vendors for the handicrafts which are rarely seen elsewhere in the world.]]></text>
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        <source><![CDATA[cultural-china.com]]></source>
        <pubDate>2012-01-03 09:12:31</pubDate>
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        <title>Staying Within Your Wedding Budget</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/Digest/2012/01/644823068204.html]]></link>
        <text><![CDATA[Planning and organizing a wedding budget can greatly reduce the stress of putting together a wedding. The very thought of a wedding conjures up images of finery and elegance, music and dance, fun, frolic and lavish spreads. However, all the extravagance can cost quite a pretty penny. Thus, whatever the size and style of the wedding, one cannot underestimate the importance of a wedding budget.
Getting started on the wedding budget
You need to determine who is paying for the wedding. Traditionally, the bride&#8217;s parents sponsored the entire wedding. This no longer holds true. So put your heads together and decide who is paying for what.
What is the total wedding budget?
Once you know who is paying for what, you also need to calculate the total wedding budget. Calculate all the income that you intend to spend on the wedding. You need to include the groom&#8217;s contribution, the bride&#8217;s contribution and contributions from both sets of parents if any.
Also, sometimes family and friends may choose to sponsor a part of the wedding like the honeymoon or the decoration or the cake. Ensure that you ask the persons sponsoring, how much they want to spend and stay within their budget. If you want to go a little over the budget they have allocated, you must bear the cost.
Set priorities
Before you start allocating the resources to different items, you need to set priorities. Is it important for you to invite everyone you know or is it more important for you to have a grand wedding? If you absolutely have to invite the 200 odd people you know, then you may need to choose a cheaper venue and think of having a cocktail reception instead of a dinner or luncheon reception. If you have your heart set on a lavish wedding, then cut back on the number of guests to stay within budget.
Maintain a notebook
Don?t even think of having a wedding budget and sticking to it without putting it all on paper. Weddings have a tendency to get out of hand real quick. Write down your wedding budget, the breakup of the wedding budget and how you intend to spend it and the actual expenditure in a single notebook. Maintaining a wedding budget book will help you track all the expenditure easily. In case you start to overshoot, you can immediately takes steps to amend it.
You can even maintain a wedding budget online. There are many wedding websites that enable you to maintain a wedding budget online. It is a simple, efficient and effective solution to your problems.
Ask family and friends for help
If you have a small wedding budget ask family and friends for cash gifts instead of the regular chinaware. It will make things easier for them as well as you.
Planning a wedding is an effort in itself. Staying within the wedding budget is positively an art but you can do it!

Copyright Andrea Britt, 2005
Do not copy or reproduce without express permission.]]></text>
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        <pubDate>2012-01-03 09:12:31</pubDate>
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    <item>
        <title>Write a Romantic Soundtrack to Your Special Day</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/Digest/2012/01/63093035746.html]]></link>
        <text><![CDATA[Music plays a very important part in the human psyche and the sounds you surround your wedding celebration with can evoke warm memories for years to come.
When choosing the style of music to be played at your wedding, you have a multitude of choices. If the budget allows it, there is always the added enhancement of live music at your wedding ceremony and reception. A good band can allow for variations in the routine of your wedding affair and even work their musical magic to enhance the experience. Even if a full string quartet is out of the question, an experienced disk jockey, or DJ for short, can help you find just the right musical expressions to make your wedding a memorable occasion. There are parts of the ceremony that require some members of the wedding party to offer a song to the newlyweds and a live band can handle this best. Check with your DJ if that is the route you take. Make sure he has the appropriate accompanying music for their songs.
It is hard to go wrong with the classics. As time honored tradition, the &#8220;Bridal Chorus&#8221; by Richard Wagner will evoke strong associations with the wedding event. Popularly known by its slang moniker of &#8220;Here Comes the Bride&#8221;, it takes only a few notes to put everyone in the right frame of mind for a wedding. The &#8220;Wedding March&#8221; by Felix Mendelssohn will take the newly married couple back down the aisle after the ceremony as beautifully now as it did hundreds of years ago.
Whether you are having a traditional Catholic wedding or bring in the bagpipes for a Scottish wedding reel, you can find many places online that will offer suggestions, sheet music and even downloadable mp3&#8242;s of the music that associate themselves most closely to the wedding experience. Throughout the ceremony and the following reception there are ample opportunities to evoke the emotions with musical accompaniment and background themes. The gentle strains of Ludwig van Beethoven&#8217;s &#8220;Fur Elise&#8221;, written to celebrate his own love for a special woman, will add an aural beauty to your wedding that will keep it a fond memory for years to come.
The thematic music available for your wedding can extend them out to encompass religious motifs as well. There are many fine songs and musical selections that will add reverence to the Christian wedding. Even going so far as to use popular Walt Disney music can add charm to your wedding. A happy rendition of &#8220;Go On and Kiss the Girl&#8221; from &#8220;The Little Mermaid&#8221; will put an extra stretch on the smiles at your happy union.]]></text>
        <category><![CDATA[20103493262903]]></category>
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        <pubDate>2012-01-03 09:12:26</pubDate>
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    <item>
        <title>12 More Ways to Give Your Wedding a Stellar Touch</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/Digest/2012/01/89563138131287.html]]></link>
        <text><![CDATA[Our first installment of &#8220;12 Ways to Give Your Wedding a Stellar Touch&#8221; was so popular we thought we would give you 12 more fabulous ideas to make your wedding day stand out.  Here are a few more of our favorite ideas for your big day.

 Have a fairy tale wedding theme! Wear a Cinderella-inspired gown. Place the rings in miniature carriages. You choose your fairy tale and incorporate its elements in your wedding.
Stars who did this: Leighanne Wallace and Brian Littrell (one-fifth of The Backstreet Boys)
  Have an evening ceremony. Outdoors or indoors, it will be perfect.
Stars who did this: Jennifer Lopez and Cris Judd; Andie MacDowell (&#8220;Four Weddings and A Funeral&#8221;) and Rhett DeCamp Hartzog
 Get married in a castle if you&#8217;ve got the budget and want to have a lavish and memorable wedding.
Stars who did this: Madonna and filmmaker Guy Ritchie; Posh Spice Victoria Adams David Beckham; Jada Pinkett and Will Smith
  Go barefoot,because it can be elegant!
Stars who did this: Faith Hill and Tim McGraw; Diane Lane and Josh Brolin
  Get married on the first day of spring! It&#8217;s symbolic of your new life together.
Stars who did this: Annette O&#8217; Toole (&#8220;Smallville&#8221;) and actor Michael McKean (&#8220;Laverne and Shirley&#8221;, &#8220;This Is Spinal Tap&#8221;)
  Get married at the Little White Wedding Chapel in Vegas!
Stars who did this: Demi Moore and Bruce Willis; Britney Spears and Jason Alexander
 Got a sentimental streak? Remember the place you and your future spouse first met by giving wedding favors reminiscent of that place. If you met at Starbucks, give guests Starbucks gift certificates!
Stars who did this: Gena Lee Nolin (&#8220;Baywatch&#8221;) and Canadian hockey player Cale Hulse
 White isn&#8217;t the only color for weddings. Don&#8217;t be afraid to plan your weddingaround your favorite color.
Stars who did this: Shaquille O&#8217;Neal and Shaunie Nelson
 Have a rose petal shower as you and your new spouse emerge from the church or leave for the reception.
Stars who did this: Alicia Rickter (&#8220;Baywatch&#8221;) and New York Mets catcher Mike Piazza
 Get a multi-tiered wedding cake in different flavors, it&#8217;s like having several wedding cakes in one!
Stars who did this: Denise Richards and Charlie Sheen
  Remember family members and relatives dear to you who have passed away by having their photos present during your wedding. If photos are not available, wear anything they used to own; a ring, a necklace, earrings?
Stars who did this: LeAnn Rimes and dancer Dean Sheremet
 Involve your guests in the wedding decorations;request that they bring their favorite flowers on your wedding day. The result will be a riot of blooms and a festive wedding.
Stars who did this: Supermodel Rebecca Romijn and former teen heartthrob John Stamos
]]></text>
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        <pubDate>2012-01-03 09:12:24</pubDate>
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        <title>Effects of the interaction of sex and food intake on the relation between energy expenditure and body composition 1, 2,</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/Digest/2012/01/328432507.html]]></link>
        <text><![CDATA[【摘要】
      Background: The relation between physical activity energy expenditure (PAEE) and percentage body fat (%BF) is not very strong in the general population. It is possible that variables such as sex, food intake, or both may in part explain this poor coupling.

Objective: This study was designed to show the relation between PAEE and %BF and to determine whether sex, food intake, or both influence the strength of the relation.

Design: We used doubly labeled water or energy intake balance, indirect calorimetry, dietary interview, and dual-energy X-ray absorptiometry to measure total energy expenditure (TEE), resting energy expenditure (REE), food intake, and %BF, respectively, in 91 healthy persons (women: aged 48 y, 38.6%BF, n = 47; men: aged 47 y, 24.1%BF, n = 44).

Results: TEE, PAEE, and REE were significantly lower in women than in men. TEE was related to %BF in women ( r = 0.53, P < 0.0001) but not in men ( r = -0.22, P 0.05). The relation between PAEE and %BF was significant in men ( r = -0.34, P < 0.03) but not in women. PAL was also significantly related to %BF in men ( r = -0.36, P < 0.02) but not in women. Macronutrient intake (% of total energy) did not differ significantly between the sexes, but carbohydrate ( r = -0.44, P < 0.003) and fat ( r = 0.31, P < 0.04) intakes were significantly related to %BF in women.

Conclusions: These results suggest that the relation between PAEE and %BF is stronger in men than in women. Macronutrient composition seems have a stronger influence on %BF in women than in men. 
          【关键词】 Doubly labeled water physical activity energy expenditure body fat body composition food intake
		  INTRODUCTION
Despite the widely held notion that maintaining or reducing body weight or fat is facilitated by an increase in physical activity, the relation between physical activity energy expenditure (PAEE) and body composition [percentage body fat (%BF), body mass index (in kg/m 2 ), or both] is not very strong ( 1 - 6 ). These results suggest that maintenance of a healthy body weight or body composition, or both, may not be related to PAEE alone and that other variables related to energy balance (such as the regulation of food intake) may be equally important.
An additional variable that may alter the strength of this relation is sex. Two studies have indicated that the %BF of active men is likely to be lower than that of less active men ( 2, 7 ), but the same relation was not observed in women ( 2 ). Westerterp and Goran ( 2 ) hypothesized that the difference in the relation of PAEE and %BF between the sexes may be due to an increase in energy intake (EI) on the part of active women to compensate for their high degree of physical activity. Unfortunately, Westerterp and Goran did not report EI data. The lack of food intake data is significant because changes in energy balance, body weight, and fat are smaller in women than in men undergoing a similar exercise challenge ( 8, 9 ).
Overall, few studies show the appar[NextPage]ent sex difference in the relation between energy expenditure (EE) and body composition, and none report food intake data. Therefore, the purposes of the present study were to investigate the relation between EE and body composition in women and in men and to examine the importance of food intake to this relation.
SUBJECTS AND METHODS
Subjects
Ninety-one healthy adult volunteers (47 women and 44 men; Table 1 ) participated in this study after completing a brief questionnaire on health status, weight-reduction attempts, body weight history, smoking status and history, physical injuries, and time spent in exercise ( 10 ). Subjects reporting changes in physical activity, smoking status, body weight, or EI during the previous 6 mo were excluded from the study. Women who were currently pregnant or had been pregnant during the past 12 mo were also excluded from the study. The study protocol was approved by the Johns Hopkins University Bloomberg School of Public Health Committee on Human Research, and written informed consent was obtained from each subject before participation.
TABLE 1. Characteristics of the subjects 1
Energy expenditure
Resting EE (REE) was measured with the use of respiratory gas analysis using a ventilated hood for 40 min in the early morning after a 12-h overnight fast, as described previously ( 11 ). REE was calculated from the central 20 min of respiratory gas data by using the Weir equation ( 12 ). The %BF was measured by using dual-energy X-ray absorptiometry (Lunar DPX; Lunar Radiation Corporation, Madison, WI).
TEE was measured by using the doubly labeled water method (27 women and 12 men) or the EI balance method (20 women and 32 men). These 2 methods have been shown in our laboratory to result in TEE values that agree within 0.3% ( 13 ). TEE via EI balance was measured during a controlled feeding study that included a weight-maintenance diet 12 wk in length. During the controlled feeding period, subjects ate only foods prepared by the Beltsville Human Nutrition Research Center (BHNRC). Each week, the subjects' daily weights were reviewed, and EIs were altered in increments of 0.84 MJ/d to achieve weight maintenance. The first 4 wk of the controlled feeding period were not included in the calculation of weight-maintenance EI so that the initial adjustment period would not adversely affect the results. TEE was considered the average daily EI value during the 8-wk weight-maintenance period that followed the first 4 wk of controlled feeding. Diet compositions and EIs were calculated by a registered dietitian using NUTRITIONIST 4 software (First DataBank, San Bruno, CA).
TEE in the remaining subjects was measured by using the doubly labeled water method. Subjects reported to the BHNRC between 0630 and 0900, at which time they received an oral dose of H 2 18 O (0.12 g/kg body wt) and 2 H 2 O (0.55 g/kg body wt). Urine samples were collected immediately before the dose and on days 1, 2, 3, 12, 13, and 14 after the dose. The first [NextPage]sample was collected 24 h after the dose. Subjects recorded the specific time of sample collection on each of the collection days. Enrichment of deuterium and 18 O in urine samples was measured by infrared spectroscopy and isotope ratio mass spectrometry, respectively. TEE was calculated from the 2 H and 18 O decay kinetics as described by Schoeller ( 14 ). PAEE was calculated as the difference between TEE and REE. Physical activity level (PAL) was defined as the ratio of TEE to REE ( 15 ).
Energy intake
EI and macronutrient composition were determined by 24-h recall with the use of the dietary data collection system ( 16 ) used in the third National Health and Nutrition Examination Survey ( 10 ). The dietary interviews (2 per subject) were conducted at the BHNRC by a registered dietitian trained at the University of Minnesota Nutrition Coordinating Center. The recall, which is a triple-pass method, begins with the subjects' quick compilation of a list of food items consumed, which is followed first by an in-depth description of each food listed and then by a final review of foods and descriptions. The interviews were conducted 3-10 d apart and completed <IMG SRC="/math/le.gif" ALT=" 2 wk before measurement of TEE. The nutrient composition data for the foods reported during the interviews were generated by using the University of Minnesota 1996 NUTRIENT DATABASE (versions 15-25; University of Minnesota Nutrition Coordinating Center, Minneapolis; 17 ). The EIs (% of total EI) of carbohydrate, protein, and fat were calculated without including the contribution of alcohol. Approximately 45% of the subjects abstained from alcohol consumption, and the overall alcohol intake was only 2% of total intake.
Statistical analysis
Pearson's product-moment correlations were used to determine the relation between variables. The significance of differences between the sexes was determined by using ANOVA software (version 8.02; SAS Institute, Cary, NC). Results are presented as mean &plusmn; SD.
RESULTS
Energy expenditure
TEE, REE, and PAEE were significantly greater for men than for women, but PAL did not differ significantly between the sexes ( Table 2 ). Reported exercise was 1354.3 &plusmn; 1284.0 min/wk for women and 1585.8 &plusmn; 2586.2 min/wk for men. These differences were not significant.
TABLE 2. Energy expenditure-related variables in 47 women and 44 men 1
TEE was significantly related to %BF in all subjects ( r = -0.26, P < 0.03), but PAEE ( r = 0.27, P 0.05) and PAL ( r = -0.11, P 0.05) were not. When the men and the women were analyzed separately, the relation of TEE to %BF was significant in the women, and the relation of PAEE and PAL to %BF was significant in the men ( Figure 1 ).
FIGURE 1. Relation between percentage body fat and energy expenditure [total energy expenditure (TEE), physical activity energy expenditure (PAEE), and physical activity level (PAL)] in 47 women ( ) and 44 men ( ). TEE in women: r = 0.53, P < 0.0001; PAEE in women: r = 0.27, P 0.05; PAEE in men: r = -0.34, P < 0.03; PAL in women: r = -0.04, P 0.05; PAL in men: r = -0.36, P < 0.02 (Pearson's product-moment correlation).
Food intake
Dietary recalls indicated that energy and macronutrient intakes were greater in men than in women ( Table 3 ). These differences were no longer significant when macronutrient intake was expressed as a percentage of total daily EI ( Table 4 ). There was no significant relation between %BF and macronutrient intake (% of total EI) in men ( Table 5 ). However, there was a significant relation between %BF and macronutrient intake (% carbohydrate and fat intake) in women.
TABLE 3. Macronutrient and total energy intake from dietary recall in 47 women and 44 men 1
TABLE 4. Macronutrient intake (% of total energy intake) from dietary recalls in 47 women and 44 men 1
TABLE 5. Relation between macronutrient intake (% of total energy intake) by dietary recall and percentage body fat in 47 women and 44 men 1
DISCUSSION
The results of th[NextPage]e present investigation confirm those of previous studies indicating that the relation between PAEE and %BF is not very strong ( 1, 2, 5, 6 ) and is significant in men but not in women ( 2 ). According to the results of the dietary recalls, fat and carbohydrate intakes may explain part of this sex difference.
The relation between PAEE (and PAL) and %BF indicates that active subjects were not more likely to have a lower %BF than were sedentary subjects. It is difficult to explain the lack of strength in this relation. One possibility may be the confounding effects of body weight, fat-free mass, age, and height on measures of EE ( 16, 18, 19 ). For example, persons with a greater body weight may expend more energy in daily activities than may persons with a lower body weight, regardless of fitness status, activity level, or %BF. Another possibility could be that the relations between EE and %BF in this study (and others) are not very strong because weight gain is generally a long-term process and may not be representative of the EI and EE patterns sampled. Men and women generally gain 4.5 and 7.3 kg, respectively, over the course of 30 y ( 20 ). Thus, the physical activity, body-weight and -composition, and EI patterns sampled may not reflect the status of energy balance that existed over several years. Future studies should follow subjects for a longer period.
It is readily apparent that another reason for the overall poor relation between EE (TEE, PAEE, and PAL) and %BF derives from sex differences in the relation of EE and %BF. The results of the present study indicate that more active men tend to have a lower %BF than do less active men, but the same is not true in women. Similarly, a 16-mo exercise intervention study found a statistically significant fat loss (-4.9 kg) in men but essentially no change (-0.2 kg) in women ( 9 ). An alternative explanation for the sex-specific changes in body fat in response to EI could be the difference between the sexes in body weight, and thus EE should be expressed as a function of body weight ( 21 ). However, Carpenter et al ( 18 ) indicated that it is not appropriate to express TEE as a function of body weight, because the relation between those factors does not have a zero intercept. The relation between PAEE and %BF also does not have a zero intercept ( 22 ). Therefore, correcting EE for body weight is not appropriate because it introduces significant bias into the results ( 23 ). Another means of comparing the sexes is the use of PAL, because the effect of body weight is negated when EE is expressed as PAL ( 15 ). When EE was expressed as PAL, %BF was still more likely to be lower in more active men than in less active men, whereas the same was not true in women.
The results of dietary recalls indicate that women with higher fat and lower carbohydrate intakes have a concomitantly higher %BF. There are many possible explanations for the relation between food intake and body fat observed in this study. One[NextPage] of these explanations may be the tendency for foods high in fat also to be energy dense ( 24 ). Foods that have a high energy density are associated with higher overall EI ( 25, 26 ), which increases the likelihood of a positive energy balance and the accumulation of body fat. Women with higher %BF may tend to select foods that are high in fat and low in carbohydrate (or energy dense), without compensating for the higher EI by increasing their EE.
There is another possible role for food intake in explaining the poor relation between PAEE and %BF in women. A number of investigations indicated that women may compensate for EE by increasing EI to a greater extent than do men ( 2, 27, 28 ). Therefore, the sex differences observed in this investigation may be related to the notion that women with more active lifestyles tend to compensate with an increase in food intake to a greater extent than do men. Stubbs et al ( 27, 28 ) performed 2 separate experiments in which sedentary men and women increased TEE over 7 d by implementing 2 different amounts of daily exercise ( 1.9 MJ/d and 3.4 MJ/d). These authors reported that EI did not increase in response to increased TEE in men, but there was 33% compensation in EI by women. The compensation in EI by the women was due to an increased consumption of foods that contained carbohydrate and fat, but not protein. The results of these experiments support the concept that active women compensate for their higher TEE by increasing EI more than do active men. However, the significance of the sex differences observed in these studies is debatable, because the authors reported that there were no treatment x sex effects for EI when the data were pooled ( 28 ).
The results of the dietary recalls should be interpreted with caution, because of potential limitations of the 24-h recall technique. These and other techniques are susceptible to problems such as underreporting (generally about 20%) and reactivity (unintentional or intentional decrease in food intake during the recording period), which may result in a misreporting of the absolute intake of nutrients ( 29 ). According to the technique proposed by Black ( 30 ), the recalls from 21% of the women and 14% of the men were likely misreported. The differences between EI and TEE in the women and men were -1.8 MJ/d and -0.6 MJ/d, respectively, which indicates an improbable negative energy balance in both sexes. It is worth noting that when the data were reanalyzed with these subjects removed, the results were not significantly altered. Despite these limitations, the relations between EE and food intake may not be altered by poor reporting, and thus the conclusions of the study would not be changed ( 29 ).
Finally, it is possible that sex-specific differences in metabolism may explain the lack of a significant relation between PAEE and %BF and the role that food intake plays in that relation. There are known sex differences in basal and exercise substrate oxidation ( 31 )[NextPage], postabsorption lipolysis ( 32 ), storage of dietary fatty acids ( 33 ), and postmeal glucose flux and whole-body insulin sensitivity ( 34 ). Perhaps the combination of these factors and differences in carbohydrate and fat intake could result in greater fat deposition, sparing of endogenous body fat stores, or both. Unfortunately, none of these variables were measured in this study.
In conclusion, the relation between PAEE and %BF is negative and statistically significant only in men. A possible explanation for the lack of a relation in women may be the carbohydrate and fat intakes in their diet. Future research must focus on more accurate methods of tracking food intake and must investigate means to reduce the potential for body fat accumulation in women.
ACKNOWLEDGMENTS
DRP was responsible for statistical analysis and manuscript preparation. JAN and WVR were responsible for all phases of the experiment. No author had any financial interest in the organization that sponsored the research (USDA).
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Black AE, Coward WA, Cole TJ, Prentice AM. Human energy expenditure in affluent societies: an analysis of 574 doubly-labelled water measurements. Eur J Clin Nutr 1996;50:72-92.

McDowell MA, Briefel RR, Warren RA, Buzzard IM, Feskanich D, Gardner SN. The Dietary Data C system. An automated interview and coding system for NHANES III. Proceedings of the 14 th National Nutrient Databank Conference. Ithaca, NY: CBORD Group, Inc, 1990.

Nutrient Database Versions 15-25. Minneapolis: University of Minnesota, Nutrition Coordinating Center, 1996.

Carpenter WH, Poehlman ET, O'Connell M, Goran MI. Influence of body composition and resting metabolic rate on variation in total energy expenditure: a meta-analysis. Am J Clin Nutr 1995;61:4-10.

Schulz LO, Schoeller DA. A compilation of total daily energy expenditures and body weights in healthy adults. Am J Clin Nutr 1994;60:676-81.

Kuczmarski RJ. Prevalence of overweight and weight gain in the United States. Am J Clin Nutr 1992;55(suppl):495S-502S.

Schoeller DA, Jefford G. Determinants of the energy costs of light activities: inferences for interpreting doubly labeled water data. Int J Obes Relat Metab Disord 2002;26:97-101.

Prentice AM, Goldberg GR, Murgatroyd PR, Cole TJ. Physical activity and obesity: problems in correcting expenditure for body size. Int J Obes Relat Metab Disord 1996;20:688-91.

Allison DB, Paultre F, Goran MI, Poehlman ET, Heymsfield SB. Statistical considerations regarding the use of ratios to adjust data. Int J Obes Relat Metab Disord 1995;19:644-52.

Blundell JE, Stubbs RJ. High and low carbohydrate and fat intakes: limits imposed by appetite and palatability and their implications for energy balance. Eur J Clin Nutr 1999;53(suppl 1):S148-65.

Stubbs J, Ferres S, Horgan G. Energy density of foods: effects on energy intake. Crit Rev Food Sci Nutr 2000;40:481-515.

J&eacute;quier E. Pathways to obesity. Int J Obes Relat Metab Disord 2002;26(suppl 2):S12-7.

Stubbs RJ, Sepp A, Hughes DA, et al. The effect of graded levels of exercise on energy intake and balance in free-living women. Int J Obes Relat Metab Disord 2002;26:866-9.

Stubbs RJ, Sepp A, Hughes DA, et al. The effect of graded levels of exercise on energy intake and balance in free-living men, consuming their normal diet. Eur J Clin Nutr 2002;56:129-40.

de Castro JM. Eating behavior: lessons from the real world of humans. Nutrition 2000;16:800-13.

Black AE. The sensitivity and specificity of the Goldberg cut-off for EI:BMR for identifying diet reports of poor validity. Eur J Clin Nutr 2000;54:395-404.

Blaak E. Gender differences in fat metabolism. Curr Opin Clin Nutr Metab Care 2001;4:499-502.

Jensen MD. Gender differences in regional fatty ac[NextPage]id metabolism before and after meal ingestion. J Clin Invest 1995;96:2297-303.

Romanski SA, Nelson RM, Jensen MD. Meal fatty acid uptake in adipose tissue: gender effects in nonobese humans. Am J Physiol Endocrinol Metab 2000;279:E455-62.

Robertson MD, Livesey G, Mathers JC. Quantitative kinetics of glucose appearance and disposal following a 13 C-labelled starch-rich meal: comparison of male and female subjects. Br J Nutr 2002;87:569-77.]]></text>
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        <title>12 Ways to Give Your Wedding Reception a Stellar Touch</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/Digest/2012/01/337730068.html]]></link>
        <text><![CDATA[The rich and famous aren&#8217;t the only ones who can create a breath taking wedding reception. Here are some simple and not-so-simple things some famous couples did to make their wedding reception stellar!

 Announce your entrance to the reception hall with a blast of trumpets. Entertain guests with live music; violinists, string quartet, flutists.
Stars who did this: Traci Bingham (&#8220;Baywatch&#8221;) and Robb Vallier
 Rent space in your favorite museum after business/tour hours and hold your reception there. It&#8217;s a great way to combine art and food.
Stars who did this: Model Christy Turlington and Edward Burns
 If you and your spouse love comedy or love to laugh, hire impersonators of your favorite comic actor.
Stars who did this: Courteney Cox and David Arquette
 If you&#8217;re planning on a winter or December wedding, have artificial snowflakes fall gently over the reception hall.
Stars who did this: Celine Dion and Rene Angelil
 Have an amusement park-themed reception and let your guests ride on rollercoasters and bumper cars.
Stars who did this: Kelly Baldwin and Joey Fatone (&#8220;NSync&#8221;)
 Put up a big white tent in your property (or in your or your spouse-to-be&#8217;s parents property) and treat your guests to an open-air reception.
Stars who did this: Katie Lee and Billy Joel; Heather McComb and James Van Der Beek (&#8220;Dawson&#8217;s Creek&#8221;)
 Decorate the reception hall with ice sculptures and lots of flowers.
Stars who did this: Shadonna Jones and rap singer Juvenile
 Love to dive, swim, boat? If you and your spouse love the ocean, let your wedding reception be a reflection of that love! Have a nautical theme reception.
Stars who did this: Lucy Lawless (&#8220;Xena&#8221;) and Rob Tapert
 Vegetarians? Have an Indian/vegetarian-themed wedding
Stars who did this: Heather Mills and Paul McCartney; Stella McCartney and Alasdhair Willis
 Treat your guests to your version of Las Vegas. Have a casino-themed reception.
Stars who did this: Sharon and Ozzy Osbourne
 Rent a yacht and give your guests a classy wedding reception.
Stars who did this: Alicia Rickter (&#8220;Baywatch&#8221;) and New York Mets catcher Mike Piazza
 Have a poetry reading. Request your friends to read poems.
Stars who did this: Maria Shriver and Arnold Schwarzenegger
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        <pubDate>2012-01-03 09:12:19</pubDate>
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        <title>Effect of -linolenic acid supplementation during pregnancy on maternal and neonatal polyunsaturated fatty acid status and pregnancy outcome 1, 2,</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/Digest/2012/01/2041277.html]]></link>
        <text><![CDATA[【摘要】
      Background: Maternal essential fatty acid status declines during pregnancy, and as a result, neonatal concentrations of docosahexaenoic acid (DHA, 22:6n-3) and arachidonic acid (AA, 20:4n-6) may not be optimal.

Objective: Our objective was to improve maternal and neonatal fatty acid status by supplementing pregnant women with a combination of -linolenic acid (ALA, 18:3n-3) and linoleic acid (LA, 18:2n-6), the ultimate dietary precursors of DHA and AA, respectively.

Design: From week 14 of gestation until delivery, pregnant women consumed daily 25 g margarine supplying either 2.8 g ALA + 9.0 g LA ( n = 29) or 10.9 g LA ( n = 29). Venous blood was collected for plasma phospholipid fatty acid analyses at weeks 14, 26, and 36 of pregnancy, at delivery, and at 32 wk postpartum. Umbilical cord blood and vascular tissue samples were collected to study neonatal fatty acid status also. Pregnancy outcome variables were assessed.

Results: ALA+LA supplementation did not prevent decreases in maternal DHA and AA concentrations during pregnancy and, compared with LA supplementation, did not increase maternal and neonatal DHA concentrations but significantly increased eicosapentaenoic acid (20:5n-3) and docosapentaenoic acid (22:5n-3) concentrations. In addition, ALA+LA supplementation lowered neonatal AA status. No significant differences in pregnancy outcome variables were found.

Conclusions: Maternal ALA+LA supplementation did not promote neonatal DHA+AA status. The lower concentrations of Osbond acid (22:5n-6) in maternal plasma phospholipids and umbilical arterial wall phospholipids with ALA+LA supplementation than with LA supplementation suggest only that functional DHA status improves with ALA+LA supplementation. 
          【关键词】 Docosahexaenoic acid arachidonic acid linolenic acid linoleic acid Osbond acid pregnancy neonatal outcome essential fatty acids pregnant women fatty acid intakes birth weight gestational age
		  INTRODUCTION
It is well known that the essential fatty acid (EFA) status and long-chain polyene (LCP) status of pregnant women decrease during pregnancy ( 1 ). This particularly applies to arachidonic acid (AA, 20:4n-6) and docosahexaenoic acid (DHA, 22:6n-3), the major LCPs derived from linoleic acid (LA, 18:2n-6) and -linolenic acid (ALA, 18:3n-3), respectively. Because the developing fetus depends on its mother for LCP accretion ( 2, 3 ), neonatal LCP status may not be optimal under present dietary conditions ( 1, 4 ).
AA and DHA are important building blocks in all cell membranes and are present in high concentrations in neural and retinal tissues ( 5 - 7 ). Infants born preterm often experience neurodevelopmental problems ( 8, 9 ), and although a causal relation with their low LCP status at birth has not been ascertained, such an association is suggested by the results of postnatal intervention studies, which generally show that early LCP supplementation improves neuro-mental development, at least temporarily ( 10 - 12[NextPage] ). In term neonates, who have a higher LCP status than do preterm infants ( 13 ), LCP supplementation has also been shown to improve neuro-mental development, although the results are less convincing than for preterm infants ( 14 - 18 ).
The central nervous system of a fetus undergoes a growth spurt in the last trimester of pregnancy. Therefore, adequate prenatal LCP availability can be considered of key importance for optimal brain development and function. This view is supported by the recent findings of Bakker ( 19 ), who showed that certain measures of brain maturation at 7 y of age are positively related to neonatal DHA status at birth.
Maternal supplementation with fish oil has been used successfully to increase fetal DHA availability and neonatal DHA status. However, increasing the DHA status of pregnant women with fish oil lowers AA concentrations in their infants ( 20, 21 ). Because AA is the second most abundant LCP in neural tissue ( 22 ), this may not be desirable. Although endogenous DHA synthesis from dietary ALA is limited in humans ( 23 - 26 ), evidence suggests that this synthesis may increase during pregnancy ( 27 ). Moreover, ALA supplementation has been shown to result in the accretion of ALA-derived DHA in the brains of baboon fetuses ( 28 ). Therefore, dietary ALA may be an effective alternative to fish oil for use in increasing maternal and neonatal DHA status. Because Al et al ( 29 ) showed that neonatal n-6 LCP status can be increased by supplementation with LA during pregnancy, the aim of the present study was to increase the availability of maternal DHA and AA for fetal accretion by supplementation of pregnant women with a margarine containing relatively high amounts of ALA and LA, the ultimate dietary precursors of DHA and AA, respectively.
SUBJECTS AND METHODS
Experimental design
The study was a double-blind, randomized, controlled dietary intervention trial in pregnant women who were randomly assigned to receive daily 25 g of either an ALA-enriched, high-LA margarine (experimental group) or a high-LA margarine without ALA (control group) from week 14 of pregnancy until delivery. During pregnancy, the subjects were visited at their homes every 3 wk so that they could be provided with the margarines, fill out questionnaires, or have blood collected (at weeks 14, 26, and 36 of pregnancy). Immediately on delivery, another maternal blood sample was collected, together with a blood sample from the umbilical vein and a piece of the umbilical cord. Finally, a maternal blood sample was drawn 32 wk after delivery. From the blood and tissue samples collected, phospholipid fatty acid profiles were determined by gas chromatography for investigation of the effect of the intervention on the EFA and LCP status of the mothers during pregnancy and at 32 wk after delivery and of the neonates at birth.
Subjects
The pregnant subjects were recruited by midwives in the region around Maastricht, Heerlen, and Sittard in the southeastern par[NextPage]t of the Netherlands and by the Departments of Obstetrics and Gynecology of hospitals in the same area (University Hospital Maastricht, Atrium Medical Center in Heerlen, and Maasland Hospital in Sittard). The selection criteria for study entry were as follows: white origin; a gestational age <14 wk; normal health, ie, not suffering from any hypertensive, metabolic, cardiovascular, renal, psychiatric, or neurologic disorder; and fish consumption <2 times/wk.
Earlier studies by our group showed average plasma phospholipid DHA concentrations of 4.07% and 3.80% by wt at weeks 14 and 36 of pregnancy, respectively ( 30 ). Because the decrease in DHA concentration between weeks 14 and 36 of pregnancy was 0.27% by wt, and because we aimed at preventing this decrease by ALA supplementation, the target for the difference in DHA concentration between the experimental group and the control group at 36 wk of pregnancy was set at 0.27% by wt. At the SD of our DHA measurement (0.34% by wt) and a power of 90% (at = 0.05), the number of subjects needed in each group was calculated to be 27. However, the women were oversampled because of expected withdrawals and dropouts during the study. A total of 79 women enrolled in the study, which was approved by the Medical Ethics Committees of the University Hospital Maastricht and Maasland Hospital in Sittard. Written informed consent was obtained from all participants.
Supplements
The margarines, which were provided by Unilever Research and Development (Vlaardingen, Netherlands), contained 79.5% fat, and the remainder consisted of water (20%), vitamins (0.04%), flavor (0.04%), lecithin (0.3%), and butylated hydroxytoluene (0.12%). The fatty acid compositions of the margarines, which were determined after lipid extraction by gas chromatographic analysis, are shown in Table 1. In the margarine given to the experimental group, LA and ALA constituted 45.4% and 14.2% of total fatty acids, respectively; thus, with the requested intake of 25 g margarine/d, the subjects in the experimental group consumed 9.02 g LA/d and 2.82 g ALA/d. This amount of margarine was about equal to the subjects' habitual margarine or butter intake (24.9 g) as measured by using food-frequency questionnaires (FFQs). In the margarine given to the control group, LA and ALA constituted 55.02% and 0.17% of total fatty acids, respectively; thus, with the requested intake of 25 g margarine/d, the subjects in the control group consumed 10.94 g LA/d and 0.03 g ALA/d.
TABLE 1. Fatty acid composition of the margarines given to the 2 groups 1
The composition of the ALA-containing margarine was based on calculations that daily consumption of 25 g of this margarine would result in a ratio of n-3 to n-6 fatty acids of 1:5 in the total diet of the experimental group. The choice of this ratio was based on guidelines for polyunsaturated fatty acid intake issued by various international authorities; these guidelines state that for optimum benefit, the ratio of n-3 to n-6 fatty acids should be between 1:4 and 1:10, preferably 1:5 ( 31 - 33 ).
Every 3 wk the volunteers received 3 tubs each containing 250 g margarine. The leftovers were [NextPage]collected and weighed to estimate total consumption. The subjects were instructed to consume the margarines primarily on bread. If their consumption was lower than the required 25 g/d, the subjects were advised to put the margarine on top of potatoes or pasta (in place of the habitual sauce). The subjects were not allowed to use the margarine for baking because of possible adverse effects on the polyunsaturated fatty acid content of the margarines. The subjects were allowed to maintain their usual diets during the entire course of the study, with the exception of the use of butter or their usual brand of margarine, which were to be replaced by the experimental or control margarines.
Questionnaires
Assessment of dietary fat intake
Because dietary intake can influence the plasma fatty acid profile, the subjects' fat intake was measured by using a well-validated, prestructured FFQ ( 3 ). This FFQ was especially designed to collect data on fat consumption. Frequency of consumption had to be recorded, and amounts eaten had to be indicated in household units or grams.
Whether fat intake changed during pregnancy was monitored by having the women complete this FFQ at weeks 14 and 36 of pregnancy. After the FFQs were returned, they were checked by an experienced dietitian and, if required, were corrected after a telephone interview. The food consumption data were converted into dietary intake data, including fatty acid intake data, by using the computer program KOMEET ( 34 ). This program is based on the database of the Dutch Nutrient Databank ( 35 ).
Other questionnaires
At the start of the study (week 14), the subjects filled out an additional questionnaire, which included items about age, prepregnancy weight, height of the mother, height and weight of the father, smoking habits, education, the use of supplements, and medical history, including former pregnancies and medical treatments. Education was scored on an 8-point scale, ranging from primary education to higher vocational training and university education ( 36 ). After delivery, the subjects completed a medical questionnaire about the course of the current pregnancy, blood transfusion, gestational age at delivery, course of parturition, sex of the newborn, birth weight, and Apgar score.
Fatty acid analysis
Plasma was separated from blood cells by centrifugation (0.2688 x g, 10 min, 4 &deg;C) and collected in tubes, which were closed under nitrogen and stored at -80 &deg;C until fatty acid analysis. From the pieces of umbilical cords, umbilical arteries and veins were isolated. The vein and both arteries from each umbilical cord were frozen in liquid nitrogen, pulverized, and freeze-dried before lipid extraction ( see below).
Fatty acid profiles of phospholipids isolated from maternal venous plasma, umbilical venous plasma, and umbilical venous and arterial vessel walls were determined as previously described by Al et al ( 1 ) and Otto et al ( 37 ). Briefly, after addition of an internal standard [NextPage](1,2-dinonadecanoyl- sn -glycero-3-phosphocholine), plasma or tissue total lipid extracts were prepared by a modified Folch extraction method ( 38 ), and phospholipid fractions were isolated from the lipid extracts by using aminopropyl (500 mg/4.0 mL) Extract-Clean columns (Alltech, Breda, Netherlands) ( 39 ). Heptadecanoic acid (17:1) was added to the samples so that any carryover of free fatty acids during the isolation of phospholipids could be detected. The phospholipid fractions were hydrolyzed, and the fatty acids were methylated with boron trifluoride in methanol ( 40 ). The fatty acid composition of the phospholipids was then determined by using capillary gas chromatography with a WCOT fused silica CP-SIL 88 fame column (50 m x 0.25 mm inside diameter, film thickness of 0.2 &micro;m; Varian, Bergen op Zoom, Netherlands) and helium as the carrier gas. The injection and detection temperatures were 300 &deg;C. The starting temperature of the column was 160 &deg;C. After 10 min, the temperature was increased 3.2 &deg;C/min up to 190 &deg;C and then kept constant for 15 min. Finally, the temperature was increased up to 230 &deg;C at a rate of 5 &deg;C/min.
Total amounts of phospholipid-associated fatty acids are expressed as mg/L plasma or mg/kg tissue, and relative fatty acid concentrations are expressed as percentages of the total amount of phospholipid-associated fatty acids (% by wt). Forty-two fatty acids were identified, but only the following selection will be reported (full results available on request): LA, dihomo- -linolenic acid (20:3n-6), AA, adrenic acid (22:4n-6), Osbond acid (ObA, 22:5n-6), ALA, eicosapentaenoic acid (EPA, 20:5n-3), docosapentaenoic acid (DPA, 22:5n-3), and DHA. In addition, the following fatty acid combinations and ratios are presented: sum of saturated fatty acids, sum of monounsaturated fatty acids, sum of n-7 fatty acids, sum of n-9 fatty acids, total amount of LCPs of the n-3 and n-6 families (n-3 LCPs and n-6 LCPs; LCPs were defined as fatty acids with 20 carbon atoms and 3 double bonds), EFA status index [(sum n-3 fatty acids + sum n-6 fatty acids)/(sum n-7 fatty acids + sum n-9 fatty acids)], DHA deficiency index (DHADI, 22:5n-6/22:4n-6), and DHA sufficiency index (DHASI, 22:6n-3/22:5n-6).
Statistics
The various statistical techniques used to evaluate the data are detailed in the Results. The statistical package SPSS 10.0 (SPSS Inc, Chicago) was used to perform the statistical analyses, and data are presented as means &plusmn; SDs. In this study, 3 fatty acids were of primary interest: DHA, AA, and ObA. The latter fatty acid is generally accepted as the deficiency indicator of DHA, because ObA synthesis increases if there is a functional DHA shortage ( 41 ). These fatty acids of primary interest were studied separately from the other fatty acids and fatty acid combinations. For these principal fatty acids, the P value required for significance was set at <0.05. Analyses of the data for the other fatty acids required adaptation of this P value to P < 0.01 because of multiple testing.
RESULTS
Subjects
A total of 79 pregnant women enr[NextPage]olled in the study. However, 21 women were not followed up completely: 3 subjects (2 in the experimental group and 1 in the control group) had a premature delivery (before week 36 of gestation), 4 subjects (1 in the control group and 3 in the experimental group) were not motivated to complete the study because they considered it too time consuming, and 3 subjects (1 in the control group and 2 in the experimental group) were excluded for noncompliance. Two women (both in the control group) dropped out because they did not like the margarine, and 2 subjects (1 in each group) withdrew because they experienced too much morning sickness. One subject in the control group had to be removed from the study because of a stillbirth, and 1 woman in the control group was removed because she developed diabetes mellitus gravidae. Two women (1 in each group) were lost to follow-up because of long-term hospitalization during the study, 1 woman in the experimental group was lost because of a lengthy stay abroad, and 2 subjects (1 in each group) were lost because of insufficient blood samples for analysis. A total of 58 women (29 in each group) completed the study until delivery.
During the period after delivery, 2 subjects in the experimental group dropped out: 1 subject could not be reached in time because she moved away from the research area, and 1 subject withdrew because of postpartum depression. All the remaining mothers had uncomplicated pregnancies and delivered full-term, singleton newborns.
Maternal characteristics
Maternal characteristics are shown in Table 2. Comparisons between the groups were performed by using either the unpaired t test or the Mann-Whitney U test for continuous variables and the chi-square test for discrete variables. Except for the number of breastfeeding mothers, no significant differences between the groups were observed.
TABLE 2. Subject characteristics
Significantly more mothers in the experimental group than in the control group breastfed their infants ( P = 0.020, chi-square test). The mean duration of breastfeeding by the lactating mothers did not differ significantly between the 2 groups, although a tendency was observed for a longer duration of breastfeeding in the experimental group ( P = 0.095, unpaired t test).
Maternal dietary fatty acid intake
Daily margarine consumption was 27.4 &plusmn; 3.2 g in the control group and 27.8 &plusmn; 3.3 g in the experimental group. The difference between the 2 groups was not significant (unpaired t test). Dietary fatty acid intakes measured by using an FFQ in weeks 14 and 36 of pregnancy are shown in Table 3. At week 14, the differences between the 2 groups were not significant (Mann-Whitney U test). The same holds true for week 36, with the exception of the ALA intake, which was significantly higher in the experimental group than in the control group ( P < 0.001, Mann-Whitney U test)
TABLE 3. Dietary fat intake during pregnancy in the control group (C, n = 26) and the experimental group (E, n = 29) as measured b[NextPage]y using a food-frequency questionnaire 1
During the intervention period, the total intake of polyunsaturated fatty acids and the intake of LA increased significantly in both groups, whereas total fat intake increased significantly only in the experimental group (Wilcoxon's signed-ranks test). The increase in LA intake was significantly higher in the control group than in the experimental group (Mann-Whitney U test). ALA intake increased significantly in the experimental group and decreased significantly in the control group (Wilcoxon's signed-ranks test), which made the difference in response between the groups significant also (Mann-Whitney U test).
The subjects in the experimental group had higher DHA consumption at week 14 of pregnancy than did those in the control group, and this difference showed a trend for significance ( P = 0.074, Mann-Whitney U test). The changes in DHA and EPA intakes during pregnancy did not differ significantly between the 2 groups (Mann-Whitney U test). However, the decreases in DHA and EPA intakes in the experimental group showed a trend for significance ( P = 0.051 and 0.076, respectively).
Maternal plasma phospholipid fatty acids
To analyze the potential differences between the control group and the experimental group in maternal fatty acid concentrations in plasma phospholipids during pregnancy (weeks 14-40), the general linear model for repeated measures was used with correction for fatty acid concentrations at the start of the study (week 14), smoking ( 42 ), and parity ( 43 ). The between-subjects factor had 2 levels (control group and experimental group), whereas the within-subjects factor, time, had 3 levels (week 26, week 36, and partus, which was set at week 40). Missing values during pregnancy were imputed by using missing value analyses. Only one missing value per subject was allowed.
Mean total amounts of phospholipid-associated fatty acids did not differ significantly between the 2 groups. Therefore, only the relative fatty acid concentrations (% by wt) are reported in Table 4.
TABLE 4. Plasma phospholipid-associated fatty acid concentrations over time in mothers in the control group (C) and the experimental group (E) 1
Compared with consumption of the control margarine, consumption of the experimental margarine resulted in significantly higher ALA concentrations ( P < 0.001). In both groups, DHA concentrations decreased significantly during the intervention period ( P = 0.028). Because these decreases were not significantly different between the groups, the overall DHA concentrations were not significantly different between the groups. Changes in the same direction were observed for AA, although these were not significant. ObA concentrations increased significantly during pregnancy ( P = 0.026). However, overall ObA concentrations were significantly lower in the experimental group than in the control group ( P = 0.002).
Adrenic acid concentrations were significantly lower in the experimental group than in the control group ( P < 0.001), whereas EPA and DPA concentrations were significantly higher ( P = 0.003 and 0.001, respectively). Differences between the groups during pregnancy in the other fatty acids and fatty acid combinations listed in Table 4 were not significant, although the lower dihomo- -linolenic acid concentrations, lower total n-6 LCP concentrations, and higher DHASI values in the experimental 95% ( P required for significance < 0.01).
Univariate analysis of variance with group as the between-subjects factor (control group and experimental group) and with maternal fatty acid concentration at the start of the study (week 14), smoking, parity, and duration of breastfeeding ( 27 ) as covariables was used to investigate potential differences in maternal plasma fatty acid concentrations between the 2 groups at 32 wk after delivery (week 72). At this point in time, only ALA concentrations were still significantly different between the 2 groups, with higher concentrati[NextPage]ons in the experimental group than in the control group ( P = 0.004).
Neonatal fatty acids
Mean total amounts of phospholipid-associated fatty acids in umbilical plasma phospholipids and in phospholipids from umbilical vessel walls (both venous and arterial) did not differ significantly between the 2 groups (unpaired t tests). Therefore, only the relative amounts of fatty acids (% by wt) are reported in Table 5. The differences in neonatal fatty acid concentrations between the 2 groups were analyzed by univariate analysis of variance with correction for gestational age, parity, maternal smoking, and maternal fatty acid concentrations at the start of the study (week 14) if necessary after log transformation to ascertain normality.
TABLE 5. Neonatal phospholipid-associated fatty acid concentrations in the control group (C) and the experimental group (E) 1
Umbilical venous plasma
Umbilical venous plasma samples were available for 26 newborns in the control group and 28 newborns in the experimental group (Table 5 ). No significant difference in umbilical plasma DHA concentrations in phospholipids was found between the 2 groups. In contrast, the AA concentrations were significantly lower in the experimental group than in the control group ( P = 0.004). After log transformation and correction for potential confounders, ObA concentrations did not differ significantly between the 2 groups ( P = 0.095).
The average EPA concentration in the experimental group was 2 times that in the control group ( P < 0.001), whereas total n-6 LCP concentrations were significantly lower in the experimental group than in the control group ( P = 0.004). Values for other fatty acids and fatty acid combinations were not significantly different between the 2 groups.
Umbilical vein walls
From each group, 28 samples of umbilical veins and 28 samples of umbilical arteries were available for analysis. Results are shown in Table 5. After correction for potential confounders, neither DHA ( P = 0.183) nor ObA ( P = 0.085) concentrations differed significantly between the 2 groups. AA concentrations also did not differ significantly between the 2 groups.
DPA concentrations were significantly higher in the experimental group than in the control group ( P < 0.001). There were trends for higher DHASI and n-3 LCP values ( P = 0.023 and 0.038, respectively) and lower DHADI values ( P = 0.034) in the experimental group than in the control group. Other fatty acids and fatty acid combinations were not significantly different between the 2 groups.
Umbilical arterial walls
After correction for potential confounders, phospholipid ObA concentrations in the experimental group were significantly lower than those in the control group ( P = 0.037). The differences in DHA and AA concentrations between the 2 groups were not significant.
DPA concentrations were significantly higher in the experimental group than in the control group ( P < 0.001). Differences between the 2 groups in the other fatty acids and fatty acid combinations were not significant (Table 5 ).
Arteriovenous differences
As shown by the general linear model, significant within-subjects effects for arteriovenous differences in many of the fatty acids listed in Table 5 (total fatty acids, LA, ObA, sum of n-9 fatty acids, monounsaturated fatty acids, and DHADI) were found (data not shown), whereas the group x arteriovenous interactions were not significant. Consequently, the arteriovenous differences in the experimental group were not significantly different from those in the control group. However, significant between-subjects (control group and experimental group) effects were found for ObA[NextPage], DPA, DHADI, and DHASI, which indicated that the average amount of phospholipid fatty acids in arterial and venous vessel walls was lower for DPA and DHASI and higher for ObA and DHADI in the control group than in the experimental group.
Neonatal outcome variables
With the use of one-way analysis of variance, the newborns in the experimental group had a significantly higher mean birth weight than did those in the control group ( P = 0.043; Table 2 ). Mean pregnancy duration was 4.5 d longer in the experimental group than in the control group (Table 2 ). This difference tended to be significant as well ( P = 0.091, Kruskal-Wallis test). No significant differences between the groups in Apgar score ( P 0.05, Mann-Whitney U test) or sex ( P 0.05, chi-square test) were observed.
DISCUSSION
It is known from longitudinal studies that under present dietary conditions, relative AA and DHA concentrations in maternal plasma phospholipids decrease during the second and third trimester of pregnancy ( 1, 37, 44, 45 ). Supplementation with a combination of n-6 and n-3 fatty acids was suggested as being required for optimal fatty acid status ( 46 ). Although endogenous DHA production from dietary ALA is known to be low ( 23 - 26 ), Otto et al ( 27 ) obtained some indications that LCP synthesis from EFA precursors may be enhanced during pregnancy. Therefore, in the present study, margarine high in ALA and LA was tested for its efficacy in increasing maternal and neonatal DHA concentrations without reducing AA concentrations. Some neonatal outcome variables were also measured in this study. Some of the results obtained require special attention and are discussed here.
Maternal dietary fat intake
Analysis of the FFQs used in the present study showed that the participants' total fat intake increased during pregnancy, although this increment was significant for the experimental group only, and the difference in intake between the 2 groups was not significant. Using the same FFQ, Al et al ( 3 ) did not observe a change in habitual fat consumption during the second and third trimesters of pregnancy. Therefore, the difference that we observed probably resulted from the study regimen. This was confirmed by an analysis of the items in the FFQs, which showed a rather frequent habitual use of light margarines at week 14, which were replaced in the study by the full-fat experimental and control intervention products. The higher fat intake provided about 108 kcal (0.026 MJ)/d. This partly satisfied the recommendation for higher energy intake during pregnancy ( 47 ).
Maternal plasma fatty acid concentrations during pregnancy
In the present study, supplementation with margarines rich in ALA+LA or in LA only did not prevent the well-known reductions in DHA and AA concentrations during the second and third trimesters of pregnancy (Table 4 ). In addition, plasma DHA concentrations after supplementation with the ALA+LA-rich margarine were not significantly higher than those after [NextPage]supplementation with a comparable margarine without ALA. Although the possibility that a higher ALA dose may increase plasma DHA concentrations cannot be excluded, this seems rather unlikely because Francois et al ( 48 ) showed that even an ALA dosage of 10.7 g/d does not increase plasma DHA concentrations in lactating women. Interestingly, the lower ObA concentrations in the experimental group of our study than in the control group indicate that functional DHA status may have been slightly higher with ALA supplementation, because ObA is generally accepted as a functional shortage marker for DHA ( 41 ). This suggests that any additional DHA that may have been produced from the supplemented ALA was transferred directly to certain (fetal) target tissues and, therefore, did not increase the DHA concentration of maternal plasma phospholipids.
Maternal fatty acids 32 wk postpartum
In the present study, the effect of ALA supplementation during pregnancy on maternal plasma fatty acid concentrations was also studied in blood collected 32 wk postpartum. The choice of this time was made on the basis of an earlier study by Otto et al ( 27 ), which showed that maternal EFA and LCP concentrations return to prepregnancy values 32 wk postpartum, irrespective of whether or not the mother breastfeeds. We confirmed that the concentrations of most fatty acids at 32 wk postpartum were either equal to or higher than the corresponding concentrations during early pregnancy. Moreover, the concentrations were not significantly different between the 2 groups. The only exception was ALA, which was still higher in the experimental group. Although this may indicate a long-term effect of the dietary intervention, a difference due to selection bias cannot be ruled out.
Neonatal phospholipid fatty acids
The significantly lower ObA concentrations in umbilical arterial vessel walls in the experimental group than in the control group suggests a higher functional DHA status in infants of ALA-supplemented mothers, although DHA concentrations themselves were not significantly higher in the experimental group. This suggestion is supported by the significantly higher DHASI values and significantly lower DHADI values in umbilical venous wall phospholipids in the neonates in the experimental group. Moreover, maternal ALA supplementation during pregnancy resulted in significantly higher neonatal concentrations of EPA (plasma only) and DPA (umbilical vessel walls) than did supplementation with LA without ALA. Maternal ALA supplementation during pregnancy was also associated with lower neonatal AA concentrations and lower neonatal total concentrations of n-6 LCPs (significant in plasma only). These results show that maternal ALA consumption during pregnancy hardly increases neonatal DHA status and does not prevent a reduction in n-6 LCPs. This reduction in n-6 LCPs during pregnancy was also not prevented by fish-oil supplementation during pregnancy ( 20, 21 ).
Neonatal outcome variables
Hig[NextPage]h birth weight has been associated with a low risk of development of adult heart disease, type 2 diabetes mellitus, and related risk factors such as hypertension and dyslipidemia ( 49 - 52 ). Consequently, in the present study, the significantly higher birth weight of the neonates born to ALA-supplemented mothers than of those born to mothers supplemented with LA only may be relevant indeed. Therefore, we performed a post hoc stepwise multiple regression analysis to detect possible confounding variables. On the basis of the literature, gestational age, alcohol consumption, neonatal sex, maternal prepregnancy weight, maternal height, height and weight of the father, smoking, and drug usage during pregnancy were included in the model. Gestational age, maternal prepregnancy weight, smoking, and height of the father contributed significantly to the model ( P < 0.05), and after correction for these possible confounders, no significant difference in birth weight remained between the experimental group and the control group.
Conclusion
Supplementation with ALA+LA during pregnancy does not prevent a decrease in maternal LCPs during pregnancy, whereas the small improvement in neonatal DHA status is accompanied by a reduction in neonatal n-6 LCP status. Because supplementation with DHA is more efficient than is supplementation with ALA in promoting DHA status ( 53 ), we suggest that a mixture of DHA and AA may be a more efficient option to optimize maternal and neonatal LCP status.
ACKNOWLEDGMENTS
We thank all the mothers and their infants for participating in this study. The participation of the midwives from the region of Southern Limburg and of the medical staff of the Departments of Obstetrics and Gynecology of the hospitals in the same region is greatly appreciated. We thank H Aydeniz for technical assistance; A Kester for statistical advice; A Badart-Smook, J Breedveld (NutriScience, Maastricht, Netherlands), and I Verkooijen (NutriScience) for their help in the analyses of the FFQs; and E de Deckere (Unilever Research and Development, Vlaardingen, Netherlands) for critically reading the manuscript.
RHMdG was the principal investigator. GH was the supervisor of the study. RHMdG and GH wrote the manuscript. ACvH was involved in development of the study design and in management of the study and critically reviewed the manuscript. FR assisted in subject recruitment and reviewed the manuscript. None of the authors had any conflicts of interest.
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        <pubDate>2012-01-03 09:12:19</pubDate>
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        <title>Waist circumference and not body mass index explains obesity-related health risk 1, 2,</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/Digest/2012/01/4680602532.html]]></link>
        <text><![CDATA[【摘要】
      Background: The addition of waist circumference (WC) to body mass index (BMI; in kg/m 2 ) predicts a greater variance in health risk than does BMI alone; however, whether the reverse is true is not known.

Objective: We evaluated whether BMI adds to the predictive power of WC in assessing obesity-related comorbidity.

Design: Subjects were 14 924 adult participants in the third National Health and Nutrition Examination Survey, grouped into categories of BMI and WC in accordance with the National Institutes of Health cutoffs. Odds ratios for hypertension, dyslipidemia, and the metabolic syndrome were compared for overweight and class I obese BMI categories and the normal-weight category before and after adjustment for WC. BMI and WC were also included in the same regression model as continuous variables for prediction of the metabolic disorders.

Results: With few exceptions, overweight and obese subjects were more likely to have hypertension, dyslipidemia, and the metabolic syndrome than were normal-weight subjects. After adjustment for WC category (normal or high), the odds of comorbidity, although attenuated, remained higher in overweight and obese subjects than in normal-weight subjects. However, after adjustment for WC as a continuous variable, the likelihood of hypertension, dyslipidemia, and the metabolic syndrome was similar in all groups. When WC and BMI were used as continuous variables in the same regression model, WC alone was a significant predictor of comorbidity.

Conclusions: WC, and not BMI, explains obesity-related health risk. Thus, for a given WC value, overweight and obese persons and normal-weight persons have comparable health risks. However, when WC is dichotomized as normal or high, BMI remains a significant predictor of health risk. 
          【关键词】 Abdominal obesity metabolic syndrome hypertension dyslipidemia
		  INTRODUCTION
It has long been recognized that body mass index (BMI; in kg/m 2 ) is a predictor of the morbidity and mortality that are due to numerous chronic diseases, including type 2 diabetes, cardiovascular disease (CVD), and stroke ( 1, 2 ). In addition, it has been established that abdominal obesity, assessed by waist circumference (WC), predicts obesity-related health risk ( 1 - 4 ), and the weighted evidence indicates that WC coupled with BMI predicts health risk better than does BMI alone ( 3, 5 - 7 ). In fact, recent findings indicate that WC is a stronger marker of health risk than is BMI ( 4 ). The utility of BMI and WC in predicting obesity-related health risk has been recognized by the National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH; 2 ). The NIH guidelines indicate that the health risk increases in a graded fashion when moving from the normal-weight through obese BMI categories, and that within each BMI category men and women with high WC values are at a greater health risk than are those with normal WC values ( 2 ). Thus, it is assumed that BMI and [NextPage]WC have independent effects on obesity-related comorbidity.
Although it is evident that the addition of WC to BMI predicts a greater variance in health risk than does BMI alone, whether the reverse is true is unclear. That is, for a given WC value or WC category (eg, normal or high), it is not known whether higher BMI values indicate a greater health risk than do lower BMI values. However, it has been shown that WC and hip or thigh circumference have independent and opposite effects on metabolic health risk. Whereas WC is positively associated with health risk, hip and thigh circumferences are negatively associated with health risk ( 8 - 13 ). This implies a protective effect of a large hip or thigh circumference (or both), which could be due to a greater lean mass in the nonabdominal regions. Indeed, lean body mass is negatively associated with all-cause mortality ( 14 ). When this fact is coupled with the knowledge that WC is a strong predictor of both abdominal and nonabdominal fat ( 15, 16 ), it seems reasonable to suggest that, for a given WC value, higher BMI values may not indicate an increased health risk. Addressing this issue could have important implications for the determination of the manner in which WC and BMI are used to predict obesity-related comorbidity in both the research and the clinical settings.
The purpose of this investigation was to determine whether BMI adds to the predictive power of WC in assessing obesity-related health risk. This question was addressed by using metabolic and anthropometric data from the third National Health and Nutrition Examination Survey (NHANES III), which is a large cohort representative of the US population.
SUBJECTS AND METHODS
Study population
NHANES III was conducted by the National Center for Health Statistics and the Centers for Disease Control and Prevention to estimate the prevalence of major diseases, nutritional disorders, and potential risk factors for these diseases ( 17 ). NHANES III was a nationally representative, 2-phase, 6-y (mid-1988 through mid-1994), cross-sectional survey. The complex sampling plan used a stratified, multistage, probability cluster design. The total sample comprised 33 199 persons. Full details of the study design, recruitment, and procedures are available from the Department of Health and Human Services ( 17 ). Of the total sample, 14 924 were persons aged 17 y in whom measures of WC, height, weight, and metabolic variables were obtained and who fit within the BMI categories examined (see below). Written informed consent was obtained from all participants, and the protocol was approved by the National Center for Health Statistics.
Survey methods
Body mass index and waist circumference
Body weight and height were measured to the nearest 0.1 kg and 0.1 cm, respectively, by using standardized equipment and procedures ( 17, 18 ). WC was measured to the nearest 0.1 cm at the level of the iliac crest while the subject was at minimal respiration ( 17 ).
Metabolic[NextPage] variables
Three blood pressure measurements were obtained at 60-s intervals with the subject in a seated position by using a standard manual mercury sphygmomanometer ( 17 ). The average of the 3 readings was used for this analysis. Blood samples were obtained after a minimum 6-h fast for the measurement of serum cholesterol, triacylglycerol, lipoproteins, and glucose as described in detail elsewhere ( 17, 19 ). Briefly, cholesterol and triacylglycerol concentrations were measured enzymatically in a series of coupled reactions that hydrolyzed cholesterol ester and triacylglycerol to cholesterol and glycerol, respectively. Plasma glucose was assayed by using a hexokinase enzymatic method ( 17, 20 ).
Confounding variables
The confounding variables, including age, race, health behaviors (ie, alcohol, smoking, physical activity), and the ratio of poverty to income, were assessed by questionnaire. Age and poverty:income were included in the analysis as continuous variables. Poverty:income, which was calculated on the basis of family income and family size ( 17 ), was used as an index of socioeconomic status. Race was coded as 0 for non-Hispanic whites, 1 for non-Hispanic blacks, 2 for Hispanics, and 3 for other races. Alcohol consumption was graded as none (0 drinks/mo), moderate (1-15 drinks/mo), 15 drinks/mo). Subjects were considered current smokers if they smoked at the time of the interview; previous smokers if they were not current smokers but had smoked 100 cigarettes, 20 cigars, or 20 pipefuls of tobacco in their entire life; and nonsmokers if they had smoked less than those amounts. Leisure time physical activity was graded as none (<4 times/mo), 19 times/mo).
Definition of groups and terms
Subjects were pided into 2 WC groups and 3 BMI groups according to the NIH cutoffs ( 2 ). Men and women with WC values <IMG SRC="/math/le.gif" ALT=" 102 and <IMG SRC="/math/le.gif" ALT=" 88 cm, respectively, were considered to have a normal WC, whereas 88 cm, respectively, were considered to have a high WC. On the basis of BMI, subjects were classified as normal-weight (BMI of 18.5-24.9), overweight (BMI of 25.0-29.9), or class I obese (BMI of 30.0-34.9). Because all of those who were underweight (BMI <18.5) had normal 99%) of those with class II and III obesity (BMI of 35.0) had high WC values, they were excluded from the data analysis.
Hypertension was defined according to the guidelines of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure-ie, systolic blood pressure 140 mm Hg, diastolic blood pressure 90 mm Hg, or the use of antihypertensive medication ( 21 ). Dyslipidemia and the metabolic syndrome were defined according to the latest National Cholesterol Education Program guidelines; that is, dyslipidemia was defined as hypercholesterolemia (total cholesterol 240 mg/dL), high LDL cholesterol ( 160 mg/dL), low HDL cholesterol (<40 mg/dL), and high triacylglycerol (serum triacylglycerol 200 mg/dL), and metabolic syndrome was defined as 3 or 4 of the following: triacylglycerol concentration 150 mg/dL, HDL cholesterol concentration <40 mg/dL in men or <50 mg/dL in women, blood pressure 130/85 mm Hg, and fasting glucose concentration 110 mg/dL ( 22 ). The metabolic syndrome, which is also known as syndrome X and the insulin resistance syndrome, represents a clustering of plasma lipid, glucose, and blood pressure risk factors and abdominal obesity. Although the National Cholesterol Education Program guidelines include high WC as a component of the metabolic syndrome ( 22 ), for our analysis the diagnosis of the metabolic syndrome did not include a high WC.
Statistical analysis
The INTERCOOLED STATA 7 software program (Stata Corporation, College Station, TX) was used to properly weight the sample to be representative of the population and to take into account the complex sampling strategy of the NHANES III design. Differences in age and WC were compared between normal-weight, overweight, and class I obese subjects within each WC category by using an analysis of variance. Logistic regression analysis was used to examine the associations between BMI classification and metabolic disease. Dummy variables (eg, class I obese, 0; overweight, 1; normal weight, 2) were created to compute odd[NextPage]s ratios (ORs) for these factors. The normal-weight BMI category was used as the reference category (OR = 1.00). The logistic regression was performed in 3 steps. In the first step (eg, partially adjusted), the ORs were adjusted for the potential confounding variables including age, health behaviors, and poverty:income. In the second step (eg, fully adjusted; model 1), the ORs were adjusted for the potential confounding variables and WC, which in this case was included in the regression model as a dichotomous variable, so that the subjects were classified as having a normal (<IMG SRC="/math/le.gif" ALT=" 102 cm in men, <IMG SRC="/math/le.gif" ALT=" 88 cm in women) WC. In the third step (eg, fully adjusted; model 2), the ORs were adjusted for the potential cofounders and WC, which was included in the regression model as a continuous variable. Logistic regression analysis was also used to examine the independent and combined effects of BMI and WC on comorbidity; BMI and WC were entered into the regression model as continuous variables. For this analysis, the ORs were computed for each unit of increase in BMI and WC. All analyses were performed separately for men and women.
RESULTS
The descriptive and metabolic characteristics for the entire sample of men and women are shown in Table 1, and a breakdown of the subjects according to WC and BMI category is shown in Table 2. Within both the normal and high WC categories, normal-weight subjects were older (men only) and had smaller BMIs and WCs than did overweight subjects (Table 2 ). The overweight subjects in turn were younger and had smaller BMI and WC values than did the obese subjects within the same WC category (Table 2 ). Therefore, even within the same WC category (eg, normal or high), BMI and WC values were higher in the overweight and obese persons than in those with a normal BMI.
TABLE 1 Descriptive characteristics and metabolic risk factors in the total sample of normal-weight, overweight, and class I obese participants from the third National Health and Nutrition Examination Survey 1
TABLE 2 Comparison of age, body mass index (BMI), and waist circumference (WC) in normal-weight, overweight, and class I obese men and women within the normal and high WC categories
Results of the logistic regression, which show the ORs for the various obesity-related comorbidities according to BMI category, are presented in Table 3. After adjustment for the confounding variables alone (eg, partially adjusted ORs), the odds for all of the comorbidities were higher for the overweight and obese men and women than for the normal-weight subjects (except for high LDL cholesterol in men). After WC was included in the regression model as a dichotomous variable (eg, normal or high WC; fully adjusted OR; model 1), the odds for many of the comorbidities remained significantly higher in the overweight and obese groups (Table 3 ). However, after WC was included in the regression model as a continuous variable (eg, WC value in cm; fully adjusted OR; model 2), the odds of comorbidity were no longer significantly higher in either the overweight or obese men or women (except for high triacylglycerol and hypercholesterolemia in overweight men and women, respectively) than in the normal-weight men or women. An example of this effect is shown in Figure 1, which illustrates the odds of the metabolic syndrome with increasing BMI category before adjustment for WC, after adjustment for WC category (normal or high), and after adjustment for WC (cm) as a continuous variable.
TABLE 3 Odds ratios (and 95% CIs) for metabolic disorders[NextPage] comparing normal-weight, overweight, and class I obese subjects before and after adjustment for waist circumference 1
FIGURE 1. Odds ratios (ORs) and 95% CIs for the metabolic syndrome by BMI category before and after adjustment for waist circumference (WC) in normal-weight ( n = 3163; reference category: OR = 1.00), overweight ( n = 3081), and class I obese ( n = 1161) men and normal-weight ( n = 3428; reference category: OR = 1.00), overweight ( n = 2606), and class I obese ( n = 1505) women before adjustment for WC, after adjustment for WC category (normal or high), and after adjustment for WC as a continuous variable. Subjects were 14 924 adult participants from the third National Health and Nutrition Examination Survey. *Significantly greater than in the normal-weight subjects, P < 0.01.
The results of the logistic regression in which BMI alone, WC alone, or both BMI and WC were used as continuous variables to predict the obesity-related comorbidities are shown in Table 4. Without exception and independent of sex, both BMI alone and WC alone were strong positive predictors of comorbidity. Because the units for BMI and WC are different, the magnitude of the ORs for BMI and WC presented in Table 4 are not directly comparable. For example, in women the odds of the metabolic syndrome were 1.15 for BMI and 1.06 for WC. Thus, for every 1.0 kg/m 2 increase in BMI, the odds of the metabolic syndrome increased by 15%, and for every 1.0-cm increase in WC, those odds increased by 6%. When both BMI and WC were included in the regression model, WC remained a predictor of all of the comorbidities in both men and women (except for LDL cholesterol in men). However, when both BMI and WC were included in the regression model, BMI was no longer a predictor of comorbidity in either sex (except for hypertension in men).
TABLE 4 Odds ratios (and 95% CIs) for metabolic disorders using prediction models with body mass index (BMI) alone, waist circumference (WC) alone, or both BMI and WC 1
DISCUSSION
The results of this study provide compelling evidence that BMI coupled with WC does not predict an increase in obesity-related health risk better than does WC alone when the 2 values are examined on a continuous scale. Thus, overweight and obese persons have a health risk that is comparable to that of normal-weight persons with the same WC value. However, when WC is dichotomized as a normal or high-risk value according to the NIH obesity guidelines, BMI remains a significant predictor of metabolic health risk. This suggests that the obesity classification system advocated by the NIH is misleading and can be improved.
The primary finding of this study, that BMI coupled with WC did not predict obesity-related health risk better than did WC alone when these 2 anthropometric measures were examined on a continuous scale, indicates that WC, and not BMI, explains obesity-related health risk. However, when WC was dichotomized into the normal and high-risk categories advocated by the [NextPage]NIH, BMI remained a significant predictor of health risk. This was probably explained by the fact that, even when the subjects were in the same WC category (ie, normal values), the absolute WC values were considerably greater in the obese (98 cm in men, 85 cm in women) and overweight (94 cm in men, 83 cm in women) subjects than in the normal-weight (84 cm in men, 76 cm in women) subjects.
Although our findings provide evidence that the NIH obesity classification system is useful, they also indicate that those guidelines are misleading. Specifically, the results suggest that WC is a better marker of health risk than is BMI, and consequently a greater emphasis should be placed on WC in the obesity classification system. Furthermore, our results suggest that WC is related to health risk in a graded fashion, and consequently it would 2 risk strata for WC. Lean et al ( 23 ) proposed that WC values should be classified into 3 risk strata ( 102 cm in men; <80, 88 cm in women). However, BMI still predicted more variance in health risk than did WC alone, even after we subpided the subjects into these 3 WC categories (results not shown). Nonetheless, if WC values were stratified into 5 or 6 risk strata, much as BMIs are stratified in the current NIH guidelines ( 2 ), it is possible that WC alone could be used as an indicator of health risk and that measures of BMI would not be required. This possibility has important implications, given that most members of the population cannot readily calculate their BMI ( 23 ), and this difficulty is compounded by the inaccuracy of self-reported height and weight measurements ( 24, 25 ). Approximately 20% of adults are classified in the incorrect BMI category on the basis of self-reported height and weight ( 25 ). By comparison, only 2% of men and women are classified in the incorrect 3-tiered WC category (eg, low, moderate, or high) on the basis of self-measured WC ( 26 ).
Our finding that WC is an independent predictor of health risk contrasts with the finding of Kiernan and Winkleby ( 27 ). They examined the utility of the NIH weight loss guidelines, which are based on an algorithm that employs BMI, WC, and 8 other CVD risk factors, such as LDL cholesterol and blood pressure values ( 2 ). The results of their study indicate that 98% of adults receive the same recommendations for weight loss when the NIH algorithm (based on BMI, WC, and CVD risk factors) is used and when an algorithm based on BMI and CVD risk factors alone is used. One interpretation of this finding is that WC is not a useful clinical measure, at least within the context of the NIH weight-loss guidelines. The results of that study do not, however, indicate that WC does not add to the predictive capacity of BMI in determining the actual CVD risk factors and the risk of CVD. In fact, the results of the present study and numerous others ( 3, 5 - 7 ) clearly show that WC coupled with BMI predicts CVD and its risk factors better than does BMI alone. The purpose of using simple anthropometry in the identification of those at increased health risk is to identify those with CVD risk factors. Thus, it is not surprising that WC was not a significant predictor of those in need of weight management after the actual CVD risk factors were taken into account ( 27 ). In other words, the NIH weight-loss algorithm as currently presented does not permit determination of the independent contribution of WC to health risk.
Given that the subject pool of NHANES III was large and representative of the US population, that study provided perhaps the best data set with which to test our hypothesis. Even so, our study has 2 limitations that warrant recognition. First, the cross-sectional nature of this study precludes causal inferences about the associations between WC, BMI, and comorbidity. However, many studies have shown that high WC and BMI values precede the onset of morbidity and mortality ( 3, 7, 28, 29 ). The results of t[NextPage]his study set the stage for prospective studies of these relations. Second, there was a potential bias due to survey nonresponse and the absence of values for some of the metabolic and confounding variables. However, previous NHANES studies showed little bias due to nonresponse ( 30 ).
In summary, obesity-related health risk is explained by WC and not by BMI. Thus, for a given WC value, overweight and obese persons have a health risk that is comparable with that of normal-weight persons. Future studies are required to determine whether WC alone can be used as an indicator of health risk in clinical and research settings if a greater number of WC risk strata are developed, much as are currently used for BMI. Such an expansion of WC risk strata could have important implications, given the difficulty that most members of the public have in calculating their BMI and the inaccuracy of their findings.
ACKNOWLEDGMENTS
IJ performed the data analysis and wrote the manuscript draft and the final article. PTK aided in the presentation and interpretation of the results and statistical analysis. RR was responsible for the study design and aided in the presentation and interpretation of the results. None of the authors declared any conflicts of interest.
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Janssen I, Heymsfield SB, Allison DB, Kotler DP, Ross R. Body mass index and waist circumference independently contribute to the prediction of nonabdominal, abdominal subcutaneous, and visceral fat. Am J Clin Nutr 2002;75:683-8.

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Lohman TG, Roche AF, Martello R. Anthropometric standardization reference manual. Champaign, IL: Human Kinetics, 1988.

Johnson CL, Rifkind BM, Sempos CT, et al. Declining serum total cholesterol levels among US adults. The National Health and Nutrition Examination Surveys. JAMA 1993;269:3002-8.

Harris MI, Flegal KM, Cowie CC, et al. Prevalence of diabetes, impaired fasting glucose, and impaired glucose tolerance in U. S. adults. The Third National Health and Nutrition Examination Survey, 1988-1994. Diabetes Care 1998;21:518-24.

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Lean ME, Han TS, Morrison CE. Waist circumference as a measure for indicating need for weight management. BMJ 1995;311:158-61.

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Han TS, Lean ME. Self-reported waist circumference compared with the 'Waist Watcher' tape-measure to identify inpiduals at increased health risk through intra-abdominal fat accumulation. Br J Nutr 1998;80:81-8.

Kiernan M, Winkleby MA. Identifying patients for weight-loss treatment: an empirical evaluation of the NHLBI Obesity Education Initiative Expert Panel treatment recommendations. Arch Intern Med 2000;160:2169-76.

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        <text><![CDATA[【摘要】
      The purpose of this review is to put into perspective the many health benefits of vitamin D and the role of vitamin D deficiency in increasing the risk of many common and serious diseases, including some common cancers, type 1 diabetes, cardiovascular disease, and osteoporosis. Numerous epidemiologic studies suggest that exposure to sunlight, which enhances the production of vitamin D 3 in the skin, is important in preventing many chronic diseases. Because very few foods naturally contain vitamin D, sunlight supplies most of our vitamin D requirement. 25-Hydroxyvitamin D [25(OH)D] is the metabolite that should be measured in the blood to determine vitamin D status. Vitamin D deficiency is prevalent in infants who are solely breastfed and who do not receive vitamin D supplementation and in adults of all ages who have increased skin pigmentation or who always wear sun protection or limit their outdoor activities. Vitamin D deficiency is often misdiagnosed as fibromyalgia. A new dietary source of vitamin D is orange juice fortified with vitamin D. Studies in both human and animal models add strength to the hypothesis that the unrecognized epidemic of vitamin D deficiency worldwide is a contributing factor of many chronic debilitating diseases. Greater awareness of the insidious consequences of vitamin D deficiency is needed. Annual measurement of serum 25(OH)D is a reasonable approach to monitoring for vitamin D deficiency. The recommended adequate intakes for vitamin D are inadequate, and, in the absence of exposure to sunlight, a minimum of 1000 IU vitamin D/d is required to maintain a healthy concentration of 25(OH)D in the blood. 
          【关键词】 Vitamin D sunlight hydroxyvitamin D cancer bone health diabetes
		  INTRODUCTION
Once our sun ignited, it began to emit enormous amounts of energy. This energy bombarded all of its satellite planets. The third planet from the Sun (ie, Earth) had a huge ocean and a small land mass. In the bubbling, organically rich tide pools, life began to evolve and became dependent on solar energy for its very existence. Early in evolution, organisms captured the suns energy in the form of carbohydrates through the process of photosynthesis. As organisms evolved, they continued to make a wide variety of complex macromolecules, not only for the purpose of replication but also to sustain lifes functions. The life forms took advantage of their ocean environment and became dependent on calcium for signal transduction and metabolic functions. In addition, calcium became an important component for organisms that developed exoskeletons. The use of calcium for structural scaffolding became critically important in the evolution of ocean-dwelling vertebrates. The plentiful calcium in the oceans provided the ideal element to incorporate into a collagen-based matrix that gave rise to the structurally rigid vertebrate skeleton. The development of the vertebrate endoskeleton not only provided an opportunity for organisms[NextPage] to grow in size but also gave organisms the opportunity to venture onto land. As vertebrate organisms left their ocean environment for a land-based existence, they needed to develop an efficient method of utilizing the calcium that was absorbed into plants from the calcium-rich soil environment. Remarkably, it was the suns energy that was called on to promote the photosynthesis of vitamin D 3 in the skin of vertebrates that was responsible for enhancing the efficiency of intestinal calcium absorption ( 1 ).
Little is known about when vitamin D made its appearance on Earth and what its function was. However, it is known that some of the earliest phytoplankton and diatom life forms, including Emiliania huxlei 750 million years and which has used calcium for its structural support (it is a coccolithophore), produced ergosterol (provitamin D 2 ). When exposed to simulated sunlight, the ergosterol in E huxlei was converted to previtamin D 2 (which rapidly isomerized to vitamin D 2; 2 ). Skeletonema menzelii, a diatom that also contained ergosterol, converted it to previtamin D 2. Little is known about the biologic function of ergosterol, previtamin D 2, and vitamin D 2 in nonvertebrate species. It has been suggested that ergosterol and its photoproducts are an ideal sunscreening system because of their high absorption of ultraviolet radiation ( 1 ). Ergosterol, previtamin D 2, vitamin D 2, and their photoproducts efficiently absorb the ultraviolet radiation that is damaging to DNA, RNA, and protein-ie, 230-330 nm. Thus, before the ozone layer (which now efficiently absorbs all ultraviolet radiation < 290 nm) evolved, the ergosterol-vitamin D 2 system may have played a critical role in protecting organisms from the high-energy ultraviolet radiation that could have damaged their ultraviolet-sensitive proteins, RNA, and DNA. It is also possible that, if ergosterol existed in the plasma membrane of early life forms, it altered the membranes permeability for calcium when it was converted to the structurally less rigid vitamin D 2 ( 1, 2 ).
PHOTOSYNTHESIS OF PREVITAMIN D
Ergosterol is a plant and fungal sterol. Animals synthesize cholesterol. The immediate precursor in the cholesterol biosynthetic pathway is 7-dehydrocholesterol (provitamin D 3 ). 7-Dehydrocholesterol is produced in relatively large quantities in the skin of many vertebrate animals, including humans. The few exceptions are some bat species, mole rats, cats, and dogs ( 3 - 5 ). During exposure to sunlight, the 7-dehydrocholesterol in the epidermal and dermal cells absorbs ultraviolet B (UVB) radiation with wavelengths of 290-315 nm. The absorption of this radiation results in a rearrangement of the 5,7-diene in the B-ring that causes a break in the B-ring to form the 9,10-secosterol, previtamin D 3. Previtamin D 3 is thermodynamically unstable, and it rearranges its double bonds to form the more thermodynamically stable vitamin D 3 structure ( Figure 1 ).
FIGURE 1. Schematic representation of cutaneous production of vita-min D and its metabolism and regulation of calcium homeostasis and cellular growth. During exposure to sunlight, 7-dehydrocholesterol (7-DHC) in the skin absorbs solar ultraviolet B (UVB) radiation and is converted to previtamin D 3 (preD 3 ). Once formed, preD 3 undergoes thermally induced transformation to vitamin D 3. Further exposure to sunlight converts preD 3 and vitamin D 3 to biologically inert photop[NextPage]roducts. Vitamin D coming from the diet or from the skin enters the circulation and is metabolized in the liver by vitamin D-25-hydroxylase (25-OHase) to 25-hydroxyvitamin D 3 [25(OH)D 3 ]. 25(OH)D 3 reenters the circulation and is converted in the kidney by 25-hydroxyvitamin D 3 -1 -hydroxylase (1-OHase) to 1,25-dihydroxyvitamin D 3 [1,25(OH) 2 D 3 ]. A variety of factors, including serum phosphorus (P i ) and parathyroid hormone (PTH), regulate the renal production of 1,25(OH) 2 D. 1,25(OH) 2 D regulates calcium metabolism through its interaction with its major target tissues, the bone, and the intestine. 1,25(OH) 2 D 3 also induces its own destruction by enhancing the expression of 25-hydroxyvitamin D-24-hydroxylase (24-OHase). 25(OH)D is metabolized in other tissues for the purpose of regulation of cellular growth. VDR, vitamin D receptor.
Velluz et al ( 6 ) were the first to identify previtamin D 3 and to show the transformation of previtamin D 3 to vitamin D 3. At room temperature, this process took 12 d to complete ( 7 ). Although this transformation was remarkable, it would have been impractical for cold-blooded vertebrates to produce an amount of vitamin D 3 in their skin that was adequate to sustain their calcium-needy skeletons.
Previtamin D 3 exists in 2 conformeric forms. Once 7-dehydrocholesterol undergoes its exocyclic ring opening, it converts to the 5, 6- cis, cis (cZc) conformer. However, this conformer is extremely unstable because of the steric interference of the C-19 methyl group, and it immediately rotates into the more stable 5, 6- trans, cis (tZc) previtamin D 3. However, only the cZc conformer can convert to vitamin D 3. To overcome this impediment, the 7-dehydrocholesterol was incorporated into the lipid bilayer of the plasma membrane. This resulted in the sandwiching of 7-dehydrocholesterol between the polar head group and the long-chain fatty acids. Thus, during exposure to sunlight, the 7-dehydrocholesterol immediately converted to cZc previtamin D 3, which could not rotate into the favored tZc conformer, and that resulted in the rapid conversion of previtamin D 3 to vitamin D 3. This probably explains why the conversion of previtamin D 3 to vitamin D 3 in the skin is 10 times faster than that in an organic solvent ( 7 ).
FACTORS THAT ALTER PHOTOSYNTHESIS OF PREVITAMIN D 3
During exposure to sunlight, 7-dehydrocholesterol is converted to previtamin D 3, which in turn is isomerized by a thermally induced process to vitamin D 3. Once formed, vitamin D 3, which is structurally incompatible with being sandwiched between the hydrophobic fatty acid chains of the plasma membrane, is ejected into the extracellular space. It is then drawn into the dermal capillary bed by the vitamin D-binding protein, which has a small but effective affinity for it ( 8 ).
It is remarkable that lifeguards and sun worshippers have never suffered from vitamin D intoxication due to excessive exposure to the sun ( 9 ). The reason for this is that [NextPage]previtamin D 3 and vitamin D 3 efficiently absorb sunlight and are converted to a multitude of other photoproducts, including lumisterol, tachysterol, suprasterols, and toxisterols ( 1, 2, 9; Figure 1 ). Thus, because of this unique solar regulation, the skin can never generate quantities of vitamin D 3 excessive enough to cause vitamin D 3 intoxication ( 9 ).
Because the production of previtamin D 3 in the skin is directly related to the number of UVB photons that are absorbed by 7-dehydrocholesterol, any process that either decreases the number of UVB photons entering the epidermis or decreases the amount of 7-dehydrocholesterol in the skin will result in a significant reduction in or the complete elimination of vitamin D 3 production in the skin.
A heightened awareness of the role that excessive exposure to sunlight plays in increasing the risk of nonmelanoma skin cancer and wrinkles led to the widespread use of topical sunscreens. Sunscreens efficiently absorb UVB radiation and thus markedly diminish the total number of UVB photons that reach the 7-dehydrocholesterol in the skins cells. When used properly (ie, 2 mg/cm 2 or 35 mL-ie, 1 oz-on the whole body one time), a sunscreen with an sun protection factor of 8 reduces cutaneous production of previtamin D 3 95% ( 10, 11 ). The proper use of a sunscreen with a sun protection factor of 15 reduces 99%. The facts that most sunscreen users apply as little as 18% and no more than 35-50% of the recommended amount of sunscreen, and they do tan indicate that they are making sufficient amounts of vitamin D 3 in their skin. The fact that they tan is a reflection of the fact that UVB penetrates the epidermis to stimulate the melanocytes and make vitamin D 3. Melanin is a natural sunscreen that evolved to protect humans from blistering solar radiation as they evolved in equatorial regions of the world. This skin pigment is an extremely effective sunscreen with absorption properties from the ultraviolet C 700 nm), and it competes quite well with 7-dehydrocholesterol for UVB photons. Thus, people of color who have greater amounts of melanin in their epidermis than do whites are less efficient in producing vitamin D 3 than are whites ( 11, 12 ). A person with skin type 5/6 (dark skin, never develops a sunburn) requires 10-50 times the exposure to sunlight to produce the same amount of vitamin D 3 in their skin as does a white person with skin type 2 or 3 ( 12 ).
The stratospheric ozone layer is efficient in absorbing all solar radiation below 290 nm. However, the ozone layer also can absorb UVB radiation above 290 nm that is responsible for producing previtamin D 3 in the skin. The ultraviolet radiation that can be absorbed by 7-dehydrocholesterol has energies down to 315 nm. Thus, when the angle of the sunlight (zenith angle) reaching the Earths surface is very oblique (ie, early morning, late afternoon, and winter), sunlight must pass through more ozone, which efficiently absorbs the previtamin D 3 -produ[NextPage]cing UVB photons, and thus very few, if any, reach the earths surface. Because the zenith angle is dependent on time of day, season of the year, and latitude, those factors have a dramatic effect on the cutaneous production of vitamin D 3 ( 13, 14 ). Below 35&deg;, the zenith angle is more direct, and therefore previtamin D 3 synthesis can occur in the skin year-round. However, above 35&deg; latitude, the angle of the sun is so oblique during the winter months that most, if not all, of the UVB photons below 315 nm are absorbed by the ozone layer, thereby either reducing or completely preventing the production of previtamin D 3 in the skin. For example, residents of Boston (42 &deg;N), Edmonton, Canada (52 &deg;N), and Bergen, Norway (61 &deg;N) cannot produce sufficient quantities of vitamin D 3 in their skin for 4, 5, and 6 mo, respectively. We have conducted studies around the globe that provide guidelines for when, where, and at what time of day vitamin D 3 can be produced in the skin ( 14; Figure 2 ).
FIGURE 2. Influence of season, time of day, and latitude on the synthesis of previtamin D 3 in the northern (A and C: Boston,; Edmonton,; Bergen, ) and southern (B: Buenos Aires,; Johannesburg,; Cape Town,; Ushuala,; D: Buenos Aires,; Johannesburg,; Cape Town,; Ushuala, ) hemispheres. The hour indicated in C and D is the end of the 1-h exposure time in July and January, respectively. Adapted with permission ( 14 ).
SOURCES OF VITAMIN D
Very few foods naturally contain vitamin D. Cod liver oil and oily fish such as salmon, mackerel, and sardines are good sources. Eating oily fish at least 3-4 times/wk will help satisfy the requirement for adequate intake. Some foods such as milk (100 IU/8 oz), orange juice (100 IU/8 oz), and some cereals and breads are fortified with vitamin D ( 11, 12, 15 ). The vitamin D content in milk is often less than the label proclaims it to be, and thus the contribution of vitamin D from the diet is highly variable. To satisfy the bodys requirement for vitamin D, most humans obtain it from casual exposure to sunlight. During the spring, summer, and fall, enough vitamin D 3 is produced in the skin to be stored in the body fat, and it can be mobilized during winter months when little, if any, vitamin D 3 is produced in the skin.
The skin has a large capacity to produce vitamin D 3. Blood concentrations of vitamin D 3 were compared in healthy young and middle-aged adults who were exposed to simulated sunlight that was equivalent to being on a sunny beach and obtaining enough sun to cause a slight pinkness to the skin (1 minimal erythemal dose) and who took an oral dose of vitamin D 2. The exposure was equivalent to an oral dose of 20 000 IU vitamin D 2 ( 9; Figure 3 ). Although aging decreases the amount of 7-dehydrocholesterol produced in the skin by as much as 75% by the age of 70 y ( 16, 17 ), the skin has such a large capacity to make vitamin D 3 that even elderly exposed to sunlight can achieve increased blood concentr[NextPage]ations of vitamin D 3 and 25(OH)D ( 17 - 19 ).
FIGURE 3. Serum vitamin D concentrations after a whole-body exposure to 1 minimal erythemal dose (MED) of simulated sunlight in a tanning bed and after a single oral dose of either 10 000 or 25 000 IU vitamin D 2. UV, ultraviolet. Reproduced with permission ( 9 ).
CAUSES AND CONSEQUENCES OF VITAMIN D DEFICIENCY
It is estimated that 10 million households in the United States have a reptile as a pet. In their natural environment, reptiles are often exposed to sunlight. They are vertebrates, and, like humans, they require a source of calcium and vitamin D. Iguanas are at particular risk of severe vitamin D deficiency because they are herbivores that, as pets, often are fed a steady diet of lettuce and because they are housed in glass enclosures with a light source that is devoid of UVB transmission. Lettuce contains very little calcium and no vitamin D, and thus iguanas and other vertebrates who do not receive an adequate amount of calcium and vitamin D develop the metabolic bone diseases osteoporosis and osteomalacia that result in fractures and ultimately death. Most reptile owners are aware of the need not only to provide their precious pets with a commercial source of calcium supplementation, but also to provide them with a light that emits UVB radiation similar to sunlight so that the animals can produce vitamin D 3 in their skin.
Humans are no different. They need an adequate source of calcium and vitamin D. Without vitamin D, the small intestine absorbs no more than 10-15% of dietary calcium. In a person with vitamin D sufficiency, the small intestine absorbs, on average, 30% of dietary calcium; during growth, lactation, and pregnancy, the efficiency increases to 80%. Vitamin D deficiency during bone development and growth causes the bone-deforming disease rickets. In adults bone growth stops and bone remodeling continues. Vitamin D deficiency in adults causes secondary hyperparathyroidism that can precipitate and exacerbate osteoporosis ( 2, 9, 11 ). The secondary hyperparathyroidism associated with vitamin D deficiency often maintains the serum calcium concentration within the normal range, but it causes a loss of phosphorus in the urine. This loss results in inadequate serum calcium x phosphorus to promote mineralization of the osteoid in the bone, which in turn results in osteomalacia, ie, nonmineralization of the collagen matrix. Because the nonmineralized matrix cannot provide structural support, the risk of fracture is greater.
How common is vitamin D deficiency? Surprisingly, it has made a resurgence in neonates and young children, in part because of the campaign to encourage all women to provide all of their infants nutrition through breastfeeding. Because there is very little, if any, vitamin D in human milk, infants, especially infants of women of color, are at high risk of developing vitaminD deficiency and rickets if they are not given a vitamin D supplement ( 20, 21 ).
The elderly a[NextPage]re at risk for vitamin D deficiency because of poor dietary vitamin D intake and decreased exposure to sunlight. We observed that 30%, 42%, and 84% of free-living white, Hispanic, and black elderly were vitamin D deficient [25(OH)D < 50 nmol/L] at the end of August in Boston ( 9 ). It has always been assumed that young and middle-aged adults are not at risk of vitamin D deficiency because of their outdoor activities and dietary intake. However, it was recently recognized that 42% of African American women aged 15-49 y throughout the United States were vitamin D deficient [25(OH)D < 40 nmol/L] at the end of the winter ( 22 ). Hard-working young and middle-aged adults who very seldom spend any time outdoors or always wear sun protection outdoors are also at high risk of vitamin D deficiency. We observed that 32% of healthy adults 18-29 y of age were vitamin D deficient [25(OH)D < 50 nmol/L] at the end of the winter in Boston ( 23 ).
Obesity is often associated with vitamin D deficiency ( 24 ). It is now recognized that, whether vitamin D is ingested in the diet or obtained from exposure to sunlight, it is efficiently deposited in the large body fat stores and is not bioavailable ( 25; Figure 4 ). This is probably the reason that obese persons are chronically vitamin D deficient.
FIGURE 4. A: Mean (&plusmn; SEM) serum vitamin D 3 concentrations before ( ) and 24 h after ( ) whole-body irradiation (27 mJ/cm 2 ) with ultraviolet B radiation. The response of the obese subjects was attenuated when compared with that of the control group. There was a significant time-by-group interaction, P = 0.003. *Significantly different from preradiation values ( P < 0.05). B: Mean (&plusmn; SEM) serum vitamin D 2 concentrations in the control () and obese ( ) groups before and 25 h after oral intake of vitamin D 2 (50 000 IU, or 1.25 mg). *Significant time and group effects by ANOVA ( P < 0.05) but no significant time-by-group interaction. The difference in peak concentrations between obese and nonobese control subjects was not significant. Reproduced with permission ( 25 ).
Vitamin D deficiency often goes undiagnosed or, worse, is misdiagnosed ( 9, 26 - 29 ). There are 3 reasons for this. First, it is believed that either exposure to sunlight or dietary intake of vitamin D is adequate, and, therefore, that Americans and Europeans are not at risk of vitamin D deficiency. Second, physicians who perform routine blood work-ups often obtain a blood calcium value. If they find it to be normal, they assume that the patient is vitamin D sufficient, which is not correct. Third, many physicians erroneously order an analysis for the active form of vitamin D, 1,25-dihydroxyvitamin D [1,25(OH) 2 D], to determine the vitamin D status of a patient. Unfortunately, 1,25(OH) 2 D not only is not a measure of vitamin D status, but its measurement also can mislead the physician into thinking that the patient is vitamin D sufficient. The reason for this is that, as a person becomes vitamin D-deficient, there is an increase in the concentration of parathyroid hormone (PTH), which increases the renal production of 1,25(OH) 2 D, the circulating concentrations of which often become normal or even elevated ( 9 ).
The vitamin D metabolite that should be measured to determine vitamin D status is 25(OH)D, which is the major circulating form of vitamin D, circulating at 1000 times the concentration of 1,25(OH) 2 D and having a half-life of 2 wk ( 2, 9, 11 ). As a person becomes vitamin D-deficient, there is a decrease in the efficiency of intestinal calcium absorption. The ionized calcium concentrations begin to drop; this decrease is immediately recognized by the calcium sensor in the parathyroid glands, which increases the production of PTH ( 30 ). PTH compensates for the decrease in intestinal calcium absorption by increasing the mobilization of calcium stores from the skeleton and by increasing tubular reabsorption of calcium in the kidney ( 31, 32 ).
NONSKELETAL CONSEQUENCES OF VITAMIN D DEFICIENCY
It has long been recognized that people who live at higher latitudes face an increased risk of many c[NextPage]hronic diseases, including common cancers ( 33 - 39 ), multiple sclerosis ( 39, 40 ), and hypertension ( 41 ). As early as 1941, Apperly ( 37 ) observed that people living at higher latitudes, eg, Massachusetts and New Hampshire, had a higher risk of dying of the most common cancers than did people living in the South, eg, Georgia and South Carolina. In 1979, Rostand ( 41 ) reported that people living at higher latitudes in both the United States and Europe were at higher risk of hypertension. In the late 1980s and early 1990s, several investigators reported increased risks of dying of colon, prostate, and breast cancer in people living at higher latitudes in both the United States and Europe ( 33 - 35 ). Grant ( 42 ) reported that 25% of the deaths due to breast cancer in women in Europe could be attributed to the womens lack of UVB from exposure to sunlight. Both men and women are at higher risk of dying of cancer if they have minimum exposure to sunlight ( 38; Figure 5 A and B). In a retrospective study, Ahonen et al ( 44 ) reported that men on average begin to develop prostate cancer by the age of 52 y, whereas men exposed to more sunlight throughout their lives did not begin developing prostate cancer until 3-5 y later.
FIGURE 5. A: Premature mortality due to cancer in white females, as determined on the basis of the July 1992 DNA-weighted ultraviolet B (UV-B) radiation by use of a total ozone mapping spectrometer. B: Premature mortality due to cancer in white males in the United States from 1970 through 1994, as determined on the basis of the July 1992 DNA-weighted UV-B radiation. Reproduced by permission of Wiley-Liss, Inc, a subsidiary of John Wiley & Sons, Inc ( 43 ). Copyright (2002) American Cancer Society.
VITAMIN D METABOLISM AND NONCALCEMIC FUNCTIONS
Most tissues and cells in the body, including heart, stomach, pancreas, brain, skin, gonads, and activated T and B lymphocytes, have nuclear receptors for 1,25(OH) 2 D, called vitamin D receptors ( 46 - 48 ). Thus, it is not at all surprising that 1,25(OH) 2 D has a multitude of biologic effects that are noncalcemic in nature ( 9, 31, 45 ).
One of the most intriguing important and unappreciated biologic functions of 1,25(OH) 2 D is its ability to down-regulate hyperproliferative cell growth ( 9, 31, 49 ). Normal and cancer cells that have a vitamin D receptor often respond to 1,25(OH) 2 D by decreasing their proliferation and enhancing their maturation. This was the rationale for using 1,25(OH) 2 D 3 and its analogs to treat the common hyperproliferative skin disorder psoriasis ( 50, 51 ).
Vitamin D receptors are present in activated T and B lymphocytes and in activated macrophages. The most common autoimmune diseases, including type 1 diabetes, rheumatoid arthritis, and multiple sclerosis, have all been successfully prevented in models using mice that were prone to these diseases if they received 1,25(OH) 2 D 3 early in life ( 45, 52 - 55 ).
When nonobese diabetic mice, who typically d[NextPage]evelop type 1 diabetes, received 1,25(OH) 2 D 3 throughout their life, their risk of developing type 1 diabetes was reduced by 80% ( 52, 55 ). This is in good agreement with the recent observation by Hypponen et al ( 56 ) that children receiving 2000 IU vitamin D from age 1 y on decreased their risk of getting type 1 diabetes by 80%.
Krause et al ( 57 ) reported that hypertensive patients exposed 180% increase in circulating concentrations of 25(OH)D and a 6 mm Hg decrease in their diastolic and systolic blood pressures, results similar to those expected if the patients had received a blood pressure medication ( Figure 6 ). A similar group of patients who were exposed to ultraviolet A radiation and whose circulating concentrations of 25(OH)D did not increase continued to be hypertensive throughout the 3-mo study. The exact mechanism by which UVB radiation returned the blood pressure to normal [presumably due to increased blood concentrations of 25(OH)D] in these hypertensive adults is not well understood, but the observation by Li et al ( 58 ) sheds some light on the question. They observed in a mouse model that 1,25(OH) 2 D is effective in down-regulating renin and angiotensin and thereby decreasing blood pressure.
FIGURE 6. Effect of ultraviolet B (UVB) and ultraviolet A (UVA) radiation from a tanning bed on ambulatory daytime and nighttime blood pressure in hypertensive adults before and after exposure to tanning bed radiation 3 times/wk for 3 mo. The daytime and nighttime blood pressures after UVB tanning bed radiation were significantly ( P < 0.01) different from those before irradiation. The mean is indicated by the thick line. Reproduced with permission from Elsevier ( 57 ).
THE CANCER-VITAMIN D CONNECTION
Because an increased risk of vitamin D deficiency is one of the well-documented effects of living at higher latitudes on human health, it was reasonable to suggest that both living at higher latitudes and an increased risk of common diseases were associated with a decrease in the synthesis of vitamin D 3 in the skin. It was intuitively obvious to many, on the basis of new information about vitamin D metabolism and action, that increased exposure to sunlight at lower latitudes would increase blood concentrations of 25(OH)D 3, which could be activated in the kidney to 1,25(OH) 2 D 3. Because 1,25(OH) 2 D 3 is extremely potent in inhibiting cancer cell growth, this all seemed to make sense. Unfortunately, it was also well known that the renal production of 1,25(OH) 2 D was tightly regulated by PTH, calcium, and phosphorus ( 31 ). Indeed, neither increased exposure to sunlight nor increased oral intake of vitamin D raised blood concentrations of 1,25(OH) 2 D ( 59 - 61 ). Thus, the question remained: how was it that increased exposure to sunlight was related, presumably by increasing the production of vitamin D 3 in the skin, to a decreased risk of many common cancers and other chronic diseases?
It had always been assumed that the kidney was the sole source for the bodys production of 1,25(OH) 2 D. This was based on many observations in animals and in humans whereby, in the abs[NextPage]ence of any renal function, there were little if any circulating concentrations of 1,25(OH) 2 D. It had been reported that the placenta, epidermal cells, and bone cells could produce 1,25(OH) 2 D, but the physiologic relevance of these observations was not well understood ( 62, 63 ). In 1985, Schwartz et al ( 64 ) reported that cultured prostate cancer cells expressed the enzymatic machinery to convert 25(OH)D to 1,25(OH) 2 D ( Figure 7 ). Since that observation, it has been shown that a wide variety of normal tissues as well as various cancer cells, including colon cancer, breast cancer, and lung cancer, all have the ability to make 1,25(OH) 2 D ( 65 - 67 ).
FIGURE 7. Measurement of 25-hydroxyvitamin D-1 -hydroxylase (1 -OHase) activity in prostate cells that were either normal ( ), benign but hypertrophied ( ), or cancerous ( ). The activity was measured by incubating the cells with [ 3 H]25-hydroxyvitamin D 3 and measuring the percentage of conversion to [ 3 H]1,25-dihydroxyvitamin D 3 after 24 h.
Thus, it is reasonable to conclude that increased exposure to sunlight or increased intake of vitamin D leads to higher circulating 80 nmol/L) of 25(OH)D. 25(OH)D acts as a substrate for the 25-hydroxyvitamin D-1-hydroxylase in various tissues, including colon, breast, and lung. These tissues can produce 1,25(OH) 2 D, which acts in an autocrine fashion to regulate cell growth and decrease proliferative activity ( Figure 8 ). It can also induce apoptosis when called on. Thus, 1,25(OH) 2 D 3 can effectively manipulate cell growth and maintain it in a normal proliferative state under most circumstances. Once it accomplishes this, it induces the 25-hydroxyvitamin D-24-hydroyxlase, which hydroxylates the 1,25(OH) 2 D in the side chain on carbons 23 and 24, and this results in cleavage between carbons 23 and 24 that forms the water-soluble, biologically inert calcitroic acid ( 31, 68; Figure 1 ). This is the likely explanation for why patients with renal failure develop a 1,25(OH) 2 D deficiency that results in secondary hyperparathyroidism and renal osteodystrophy.
FIGURE 8. Schematic representation of the multitude of other potential physiologic actions of vitamin D with respect to cardiovascular health, cancer prevention, regulation of immune function, and decreased risk of autoimmune diseases. 25(OH)D, 25-hydroxyvitamin D; 1,25(OH) 2 D, 1,25-dihydroxyvitamin D.
CONCLUSIONS
The Institute of Medicine reported in 1997 that the recommended vitamin D intake was inadequate for adults over the age of 50 y ( 69 ). They recommended that the adequate intake for children and adults up to the age of 50 be 200 IU vitamin D/d. However, adults aged 50-70 y and 70 y required 400 and 600 IU vitamin D/d, respectively. As noted in Heaneys McCollum Award presentation ( 70 ) and as indicated in a considerable number of published reports, including that of Heaney et al ( 71 ), the new recommendations are totally inadequate, especially if a person has no exposure to sunlight[NextPage]. Without exposure to sunlight, a minimum of 1000 IU vitamin D/d is required. We gave healthy young and middle-aged adults 1000 IU vitamin D/d in orange juice from March through May. Their 25(OH)D concentrations increased by 150%, and what is considered to be a healthy 25(OH)D concentration, ie, 78-100 nmol/L (30-40 ng/mL), was maintained. Those adults receiving orange juice not fortified with vitamin D increased their blood concentration of 25(OH)D by 45%. This was due to their casual exposure to sunlight in the spring ( 15; Figure 9 ).
FIGURE 9. Mean (&plusmn; SEM) weekly 25-hydroxyvitamin D [25(OH)D] concentrations in healthy adults ingesting orange juice fortified with vitamin D (1000 IU &middot; 8 oz -1 &middot; d -1, ) or unfortified orange juice ( ). * P <IMG SRC="/math/le.gif" ALT=" 0.01. Reproduced with permission ( 15 ).
The easiest method of correcting vitamin D deficiency is to give the patient one pill that contains 50 000 IU vitamin D once a week for 8 wk ( 71 ). This will usually increase the 25(OH)D 50 nmol/L (20 ng/mL; Figure 10 ). If not, the vitamin D "tank" may still not be full, and another 8-wk course of therapy usually corrects the vitamin D deficiency ( 67; Figure 10 ). One should suspect a fat-malabsorption problem or poor compliance if the 25(OH)D concentration does not increase 25% after these treatments. Exposure to sunlight or a tanning bed will correct vitamin D deficiency in patients with severe intestinal fat- malabsorption syndrome ( 72 ).
FIGURE 10. A: Serum concentrations of 25-hydroxyvitamin D [25(OH)D; ] and parathyroid hormone (PTH; ) before and after therapy with 50 000 IU vitamin D 2 and calcium supplementation once a week for 8 wk. * P < 0.05. B: Serum concentrations of PTH in patients who had 25(OH)D concentrations between 10 and 25 ng/mL and who were stratified in increments of 5 ng/mL before () and after ( ) receiving 50 000 IU vitamin D 2 and calcium supplementation for 8 wk. * P < 0.05, ** P < 0.01. Reproduced with permission ( 71 ).
Why should we care about vitamin D deficiency? It is insidious and has both short- and long-term consequences. Infants and young children who are vitamin D deficient may be imprinted for the rest of their lives with increased risks of type 1 diabetes, multiple sclerosis, rheumatoid arthritis, and many common cancers (Figure 8 ). Adults are at increased risk of common cancers and cardiovascular disease. Recently, it has been reported that young adults with vitamin D deficiency were at greater risk of congestive heart failure than were their vitamin D-sufficient counterparts ( 73, 74 ).
Therefore, to maximize health and reduce the risk of common diseases, it is reasonable to pay attention to the 25(OH)D concentration. Just as the blood concentration of cholesterol is often measured on an annual basis, so too should the blood concentration of 25(OH)D be measured. Indeed, vigilance in maintaining a healthy 25(OH)D concentration may have more important health ramifications than a simple lowering of a blood cholesterol concentration to prevent coronary artery disease. A minimum concentration of 25(OH)D should be 50 nmol/L, and, for maximum bone health and prevention of many chronic diseases, the 25(OH)D concentration should be 78-100 nmol/L.
The simplest way to obtain vitamin D is from moderate exposure to sunlight. I recommend that exposure of han[NextPage]ds, face and arms, or arms and legs to sunlight for a period equal to 25% of the time that it would take to cause a light pinkness to the skin (1 minimum erythemal dose) is sufficient not only to satisfy the bodys requirement, but also to make sufficient amounts of vitamin D to store in the body for use on rainy days and during times when sun exposure is inadequate to produce enough vitamin D in the skin. I have provided guidelines for the amount of sun exposure needed by people of all skin types to achieve their vitamin D requirement without significantly increasing the risk of skin damage and skin cancer ( 9, 39 ). Increasing the intakes of foods fortified with vitamin D, including milk, orange juice, cereals, and oily fish, is a reasonable approach 1 multivitamin is counterproductive, because too much vitamin A would be ingested, and that increases the risk of birth defects and osteoporosis. Alternatively, one multivitamin containing 400 IU vitamin D and a vitamin D supplement containing either 400 or 1000 IU vitamin D is appropriate.
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        <pubDate>2012-01-03 09:11:38</pubDate>
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        <title>Effect of conjugated linoleic acid on body composition and plasma lipids in humans: an overview of the literature 1,</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/Digest/2012/01/89205689908688.html]]></link>
        <text><![CDATA[【摘要】
      Studies in mice have indicated that feeding diets containing 0.5-1% conjugated linoleic acid (CLA) considerably reduces body fat. These findings have attracted much interest because of the potential use of CLA as a tool to promote weight loss in humans. Several CLA studies in humans have now been published, and the objective of the present review was to give an overview of these experiments. Most of the studies were done in free-living subjects and were not strictly controlled for nutrient and energy intakes. None of the studies found a significant reduction in body weight, and only 2 studies showed a significant but relatively small body fat-lowering effect. Some studies suggested that CLA may have a tendency to increase lean body mass. Furthermore, there are indications from animal studies that CLA may have effects on plasma lipids. However, only one study in humans showed a significant HDL-cholesterol-lowering effect of CLA; in all the other studies, there were no significant effects on plasma total, LDL-, and HDL-cholesterol concentrations or on plasma triacylglycerol concentrations. Thus, the results of the studies in humans indicate that the effect of CLA on body fat is considerably less than that anticipated from mice studies and that CLA has no major effect on plasma lipids. 
          【关键词】 Conjugated linoleic acid body composition plasma lipids body fat
		  INTRODUCTION
Conjugated linoleic acids (CLAs) are a group of isomers of conjugated octadecadienoic acid that occur naturally in food, mostly in dairy products. Ritzenthaler et al ( 1 ) reported that the intake of total CLA as measured with the food duplicate method was 212 mg/d for men and 151 mg/d for women. Furthermore, 60% of the CLA intake was derived from dairy products and 37% from meat products, and the cis -9, trans -11 CLA isomer, also called 90% of the total CLA intake. Commercial CLA preparations are produced by isomerization of linoleic acid and contain predominantly cis -9, trans -11 and trans -10, cis -12 octadecaenoic acids in a 1:1 ratio ( 2 ).
CLA has attracted much interest since the discovery that it has anticarcinogenic ( 3 ) and body fat-lowering ( 4 ) effects. Furthermore, studies in hamsters ( 5 - 8 ), rats ( 9, 10 ), and rabbits ( 11 ) suggest that CLA may also have lipid- and atherosclerosis-reducing properties. Park et al ( 4 ) were the first to report that the incorporation of 0.5% (wt:wt) CLA in the diets of mice reduces body fat 60%. These findings were confirmed in several other studies with mice ( 12 - 14 ), and additional experiments indicated that this body fat-lowering effect is attributable to the trans -10, cis -12 isomer ( 6, 15 - 18 ). The body fat-lowering property of CLA was also reported in other experimental animals, such as pigs ( 19 ), rats ( 20 ), hamsters ( 21 ), and chickens ( 22 ), but the effect in those animals is less striking than that in mice.
The body fat-lowering effect of CLA in experimental animals has led to the ide[NextPage]a that CLA could be used as a tool in body weight management in humans. Several studies in humans have been published, but the results appear to be less promising than was expected ( 23, 24 ). In the present article, an overview of the results of these studies in humans is given. Furthermore, the effects of CLA on plasma lipids were measured in several of these studies, and an overview of these results is also presented.
However, CLA, and in particular the trans -10, cis -12 isomer, also appears to have some less desirable side effects. Mice that were fed the trans -10, cis -12 CLA isomer had severe hyperinsulinemia and insulin resistance ( 16, 25, 26 ), and a similar trend was observed in CLA-fed hamsters ( 27 ) and pigs ( 28 ). Furthermore, the body fat-lowering effect of the trans -10, cis -12 isomer in mice was associated with a significant reduction in plasma leptin concentrations ( 16, 26 ), and a similar tendency was seen in rats ( 29, 30 ). Some studies in mice ( 25, 31 ), rats ( 10 ), and hamsters ( 27 ) also showed a significant increase in plasma glucose concentrations after the animals were fed CLA, and the trans -10, cis -12 isomer appeared to be responsible for this effect ( 25, 27 ). Several studies in humans who consumed CLA have examined these effects, and the results of those studies are also reviewed.
MATERIALS AND METHODS
Only studies that were published as full articles are included in the review. Most of the articles were retrieved from the University of Wisconsin website ( 32 ) that keeps track of all the literature published on CLA. One study describing the effects of CLA on body composition in humans was not included in this review because of the lack of a control group ( 33 ).
The data presented in the tables and the figure were reproduced from the articles or, if possible, calculated from the data given in the original publications. The net effect of CLA on body weight and body fat was also calculated by correcting the changes in the CLA group with those in the control group. The net effect of CLA was calculated as ( V f CLA - V i CLA ) - ( V f control - V i control ), where V i and V f are the initial and final values, respectively, of the control and CLA groups.
RESULTS
Conjugated linoleic acid preparations and study design
The first studies in humans were done with CLA preparations that contained various CLA isomers ( 2, 34 - 36 ) and were produced by Pharmanutrients Inc (Lake Bluff, IL). Later studies used more-defined CLA preparations that were comprised predominantly of the trans -10, cis -12 and cis -9, trans -11 isomers in a 1:1 ratio ( Tables 1 -3 ) and were manufactured by Natural Ltd (Hovdebygda, Norway) and Loders Croklaan bv (Wormerveer, Netherlands). Only Riserus et al ( 45 ) used a CLA preparation that contained almost exclusively the trans -10, cis -12 isomer, and Noone et al ( 43 ) administered a CLA preparation that contained the trans -10, cis -12 and cis -9, trans -11 isomers in a ratio of 2:8. There[NextPage] is substantial evidence that the trans -10, cis -12 isomer is responsible for the effects of CLA on body fat and lipid metabolism ( 15, 18 ), and therefore the dosages of the trans -10, cis -12 isomer are also given in the tables.
TABLE 1 Effect of conjugated linoleic acid (CLA) on body weight and body composition in humans 1
TABLE 3 Effect of conjugated linoleic acid (CLA) on plasma glucose, insulin, and leptin concentrations in humans 1
The dosage of total CLA used in the various studies ranged from 1.4 g/d in the study by Mougios et al ( 40 ) to 6.8 g/d in the study by Blankson et al ( 38 ) (Tables 1 - 3 ). These dosages used in humans appear to be comparable with the dosages used in mice studies. The metabolizable energy intake of a reference human weighing 70 kg is 10 MJ/d, and dosages of 1.4 and 6.8 g total CLA/d translate into intakes of 0.14 and 0.68 g total CLA/MJ of metabolizable energy, respectively. In most of the mice studies, 0.5-1% total CLA by weight was added to the diets ( 4, 13, 14 ). High-fat mice diets have an energy density of 20 kJ of metabolizable energy/g ( 14 ), and the CLA intake was thus 0.25-0.5 g total CLA/MJ of metabolizable energy intake.
The CLA preparations in all the studies were administered in the form of capsules, and the number of capsules that had to be taken per day varied from 2 ( 40 ) to 12 ( 38 ). Compliance with the intake of the capsules ranged from 77% to 100% (Tables 1 - 3 ). In all the studies, one or more groups were administered capsules containing a CLA preparation, and a control group was administered capsules containing a placebo, such as olive oil, sunflower oil, soybean oil, or linoleic or oleic acid (Tables 1 - 3 ). In one study ( 34 ), CLA was administered in the form of triacylglycerols (TAGs); the other studies did not report whether CLA was administered in the form of TAGs or free fatty acids, but CLA was most likely given as free fatty acids. Most of the experiments were done in free-living subjects and were not strictly controlled for nutrient and energy intake. Only in the studies by Benito et al ( 34 ), Medina et al ( 46 ), and Zambell et al ( 36 ), did the researchers confine the subjects to a metabolic suite and control for food intake.
Most of the studies were designed to examine whether CLA would promote the loss of body weight and fat. The objective of one study, however, was to learn how CLA would influence the regaining of body weight and fat after a weight-loss program ( 39 ). In that study, the subjects were fed a very-low-energy diet (2.1 MJ/d) for 3 wk and lost 6 kg body wt. Subsequently, the subjects were switched back to their habitual diet, and the effects of CLA on body weight regain and body composition were studied.
Body weight and composition
All the studies indicated that the administration of CLA had no significant effect on body weight or body weight regain (Table 1 ). After correction for changes in body weight in the control groups, there was a net increase i[NextPage]n body weight due to CLA in the body weight regain study by Kamphuis et al ( 39 ), and this increase ranged from 0.6 to 2.0 kg. In the other studies, the corrected net change in body weight ranged from an increase of 0.4 kg to a decrease of 2.2 kg. None of these changes, however, were significant ( Figure 1 ).
FIGURE 1. Net effect of conjugated linoleic acid (CLA) on body weight, body fat, and lean body mass as observed in various human studies. The net effect was calculated as described in the Materials and Methods section. The BMI values listed are those at the beginning of the study. The dosage values are for the trans -10, cis -12 CLA isomer, which is the isomer active in lipid metabolism. In the study by Mougios et al ( 40 ), 0.35 g of the trans -10, cis -12 CLA isomer was administered during the first 4 wk of the study, and 0.70 g of the isomer was administered during the last 4 wk of the study. *,** Significantly different from the control group: * P < 0.05, ** P < 0.01.
There was a significant effect of CLA on body fat mass in only 2 studies ( 38, 42 ). This effect could not be ascribed to a higher intake of CLA in these studies than in the other studies, and there appeared to be no relation between the dose of trans -10, cis -12 isomer, the isomer involved in the body fat-lowering effect, and the body fat-lowering effect (Figure 1 ). Furthermore, in these 2 studies that reported a significant body fat-lowering effect of CLA, the subjects also participated in a light or intensive training program ( 38 ) or did 90 min of strenuous exercise 3 times/wk ( 42 ). Thus, it is possible that exercise may have enhanced the body fat-lowering effect of CLA.
In the studies by Berven et al ( 37 ), Blankson et al ( 38 ), and Thom et al ( 42 ), the net decrease in body fat tended to be greater than the net decrease in body weight, and in the study by Smedman and Vessby ( 41 ), there was a slight net increase in body weight but a net decrease in body fat. This finding indicates that in these studies, a change took place not only in body fat but also in lean body mass (LBM). A net decrease in body fat that was greater than the net decrease in body weight indicates that there was an increase in LBM or that the decrease in LBM was less than that in the control group, as seen in the study by Berven et al ( 37 ). Furthermore, in the weight regain study by Kamphuis et al ( 39 ), CLA tended to promote body weight regain after a weight-loss regimen, and this net increase in body weight was predominantly due to an increase in LBM (Figure 1 ).
Plasma lipids
The studies in Table 2 did not show any significant effect of CLA on plasma cholesterol concentrations or on LDL-cholesterol concentrations. In the study by Smedman and Vessby ( 41 ), CLA significantly increased total and LDL-cholesterol concentrations, but this increase was not significant in comparison with that seen in the control group. Furthermore, Riserus et al ( 45 ) found that, relative to the change in HDL-cholesterol conc[NextPage]entrations in the control group, HDL-cholesterol concentrations decreased significantly when the trans -10, cis -12 isomer was administered but not when a mixture of the trans -10, cis -12 and cis -9, trans -11 isomers was administered ( 44, 45 ). Mougios et al ( 40 ) also reported a significant HDL-cholesterol-lowering effect of CLA, but this change in HDL cholesterol concentration was not significant when compared with that in the control group. Smedman and Vessby ( 41 ), on the other hand, found that CLA significantly increased HDL-cholesterol concentrations, but this increase was smaller than that in the control group; as a consequence, the net effect of CLA on HDL was negative. Plasma TAG concentrations decreased significantly after CLA administration in 2 studies ( 34, 43 ), but this decrease was not significant when compared with the change in the control group. Furthermore, this effect on plasma TAG concentrations was seen only when a mixture of the 2 isomers was fed, but not when the cis -9, trans -11 isomer was given ( 43 ).
TABLE 2 Effect of conjugated linoleic acid (CLA) on plasma lipid concentrations in humans 1
Plasma insulin, leptin, and glucose
Studies in humans who consumed daily a mixture of the 2 CLA isomers containing 0.7-2.0 g of the trans -10, cis -12 isomer did not show significant changes in plasma insulin concentrations, although a dose of 2 g of the trans -10, cis -12 isomer ( 41 ) tended to increase insulin concentrations, whereas insulin concentrations in the control group decreased (Table 3 ). Riserus et al ( 45 ), however, reported that humans who consumed as much as 3.4 g of the purified trans -10, cis -12 isomer/d had significantly decreased insulin sensitivity compared with the change in the control group; plasma insulin and glucose concentrations also increased significantly in the CLA group, but these effects were not significant when compared with the changes in the control group.
Leptin is secreted by adipocytes in proportion to the amount of lipid stored and may act as a signal of body energy stores to the brain ( 47 ). In humans the consumption of CLA for 9 ( 46 ) and 12 wk ( 45 ) did not significantly affect leptin concentrations (Table 3 ). In the study by Medina et al ( 46 ), relative to the change in leptin concentrations in the control group, leptin concentrations in the CLA group decreased significantly after 7 wk, but this effect disappeared after 9 wk.
In the study by Riserus et al ( 44 ), plasma glucose concentrations increased significantly in both the control group and the CLA group, but this effect was more pronounced in the control group than in the CLA group (Table 3 ). In another study, Riserus et al ( 45 ) reported that plasma glucose concentrations increased significantly only in the CLA group; however, this increase was not significant when compared with the change in the control group. Furthermore, Smedman and Vessby ( 41 ) also found higher plasma glucose concentrations in the CLA group t[NextPage]han in the control group ( P = 0.054).
DISCUSSION
Body composition
The effects of CLA on body weight and body fat in humans were considerably less than those seen in mice although the doses of CLA used in the mouse and human studies were comparable. Dosages of 1.4-6.8 g/d in humans ( 0.14-0.68 g/MJ of metabolizable energy intake) lowered body fat by only 2-22% (Table 1 ), whereas mice fed 1% CLA in their diet ( 0.5 g CLA/MJ) had a 60% decrease in body fat ( 14 ). Mice, however, have a considerably higher metabolic rate than do humans, and, as discussed previously ( 48 ), this difference in metabolic rate may at least partly explain the different results in humans and mice.
The results in humans did not point to any relation between the dose of CLA and the effect on body weight and fat (Table 1 and Figure 1 ). Most of the studies, however, were done in free-living subjects, and variations in nutrient intake and energy intake and expenditure may have occurred. The effects of CLA on body composition appear to be rather small, and thus possible variations in energy intake and expenditure may easily interfere with the effects of CLA. Furthermore, compliance with the intake of the CLA capsules ranged from 77% to 100%, and differences in compliance may also have affected the results.
Some of the studies in humans suggested that the body fat-lowering effect of CLA tended to be associated with an increase in LBM (Table 1 ), as seen also in mice ( 14 ). Studies in mice indicated that CLA may enhance energy expenditure ( 12, 14 ) and the oxidaton of fatty acids ( 4 ), and these processes take place predominantly in muscle tissues, ie, the LBM. An increase in LBM may be an adaptive response to increased energy expenditure. Kamphuis et al ( 39 ) reported that resting metabolic rates in humans are related to the amount of LBM and that increases in resting metabolic rates due to consumption of CLA are associated with an increase in the amount of LBM.
Plasma lipids
All the studies in humans indicated that, compared with placebo, CLA had no significant effect on plasma cholesterol concentrations. Similarly, most of the numerous studies in experimental animals such as mice, rats, and pigs did not show any effect on plasma cholesterol concentrations. There are, however, some studies in hamsters ( 5 - 8 ) and rats ( 9, 10 ) that reported a significant cholesterol-lowering effect. Furthermore, this cholesterol-lowering effect of CLA in hamsters was seen only when the hamsters were fed the trans -10, cis -12 isomer, but not when they were fed the cis -9, trans -11 isomer ( 5, 6 ). A study in chickens fed CLA also showed a decrease in plasma cholesterol concentrations ( 49 ), but 2 other chicken studies found an increase ( 22, 50 ). Thus, only some studies in experimental animals found an effect of CLA on plasma cholesterol concentrations, and the results in humans suggest that CLA does not have a major effect on plasma cholesterol concentrations.
Compared with placebo[NextPage], CLA had no significant effect on plasma TAG concentrations (Table 2 ). CLA significantly lowered TAG concentrations in the studies by Noone et al ( 43 ) and Benito et al ( 34 ), but these decreases were not significant when compared with the changes in the control groups. Several studies indicated that feeding mice the trans -10, cis -12 isomer but not the cis -9, trans -11 isomer decreases the activity of hepatic stearoyl Co-A desaturase ( 51, 52 ), an enzyme involved in the desaturation of stearic acid and palmitic acid into oleic acid and palmitoleic acid, respectively. Plasma TAGs are predominantly transported in the VLDL and are synthesized in the liver. Oleic acid is the preferred substrate for the synthesis of TAG ( 53 ), and mice with a disruption of the gene for the stearoyl-CoA desaturase enzyme have very low plasma TAG concentrations ( 54 ). Moreover, studies in hypertriglyceridemic mice and humans suggest that there is a relation between hepatic stearoyl-CoA desaturase activity and plasma TAG concentrations ( 55 ). Thus, one may anticipate that a decrease in stearoyl-CoA desaturase activity due to consumption of the trans -10, cis -12 isomer will also result in a lowering of plasma TAG concentrations. In vitro studies indicated that the trans -10, cis -12 isomer inhibits the secretion of TAG ( 56 ) and apolipoprotein B in HepG2 cells ( 57 ). When compared with placebo, CLA did not have a significant effect on plasma TAG concentrations in the human studies (Table 2 ). Most of the subjects in these studies, however, had relatively low plasma TAG concentrations, but an effect could become apparent in severely hypertriglyceridemic patients. The results of animal studies are also not conclusive. Some studies in hamsters found a significant reduction in plasma TAG concentrations ( 6, 58 ), whereas other hamster studies showed a significant increase ( 5 ). Furthermore, these increases and decreases in TAG concentrations were attributable to the trans -10, cis -12 isomer, whereas the cis -9, trans -11 isomer did not have any effect ( 5, 6 ). In pigs, there was also a trend for increased TAG concentrations ( 59 - 61 ), and one study even found a significant increase in plasma TAG concentrations ( 62 ). Similarly, a study in chickens showed a significant increase in plasma TAG concentrations ( 50 ), but another study in chickens did not ( 49 ). Most of the studies in mice did not show any significant effect of CLA on plasma TAG concentrations, but in one study, plasma TAG concentrations decreased significantly in mice that were fed the cis -9, trans -11 isomer but not in mice that were fed the trans -10, cis -12 isomer ( 25 ).
Plasma insulin concentrations and insulin resistance
Studies in experimental animals ( 63 ) and humans ( 64 - 66 ) have shown a relation between the fatty acid composition of structural lipids (ie, phospholipids) in the cell membranes of skeletal muscle and measures of insulin action. For example, in human studies insul[NextPage]in action was positively correlated with the degree of unsaturation and the proportion of long-chain polyunsaturated fatty acids, particularly arachidonic acid, in muscle phospholipids ( 64, 65 ). Furthermore, insulin action was also positively correlated with 5 -desaturase activity as reflected in the proportion of arachidonic acid. The trans -10, cis -12 CLA isomer is known to inhibit the activity of stearoyl-CoA desaturase or 9 -desaturase ( 51, 52 ), and there are indications that this CLA isomer may also decrease the activity of 5 - and 6 -desaturases ( 67 ). 9 -Desaturase plays a role in the desaturation process of fatty acids derived from palmitic and stearic acids (n-9 series), and the 5 - and 6 -desaturases play a role in the desaturation process of fatty acids derived from linoleic (n-6 series) and linolenic (n-3 series) acids. Studies in pigs ( 61, 68 - 71 ), rats ( 72, 73 ), perch ( 74 ), and chickens ( 22, 49 ) have indeed shown that the ratio of palmitic acid + stearic acid:palmitoleic acid + oleic acid, an index of 9 -desaturase activity, increases in muscle lipids after animals are fed CLA. Moreover, these studies showed that the degree of unsaturation of the fatty acids in muscle lipids decreases after CLA consumption and that the proportion of arachidonic acid also decreases consistently after CLA consumption, which points to a lowering of 5 -desaturase activity. No studies have examined the effect of CLA on muscle fatty acid composition in mice and humans after consumption of the trans -10, cis -12 CLA isomer, but similar changes may occur. Thus, the reduced insulin action and increased plasma insulin concentrations due to consumption of the trans -10, cis -12 CLA isomer may at least partly be related to changes in fatty acid composition, ie, a decreased degree of unsaturation of the fatty acids in the lipids, particularly in the phospholipids in muscles.
Insulin resistance has also been reported to be associated with elevated concentrations of TAGs in muscle tissues ( 75 ). As discussed by Nadler and Attie ( 76 ), obesity and lipodystrophy in mice are associated with a fatty liver and insulin resistance. In both situations, there is no functional adipose tissue, the lipogenic burden shifts from the adipose tissue to the liver, and lipid deposition in non-adipose tissue takes place. Feeding CLA to mice also results in lipodystropy together with accumulation of TAGs in the liver ( 16, 26 ). There are no studies in mice and humans given CLA that have examined the lipid content of muscle tissues, but studies in CLA-fed pigs ( 69, 77 ), perch ( 74 ), and rats ( 73 ) showed a trend toward an increase in intramuscular fat, and pigs that were fed CLA also tended to have increased insulin concentrations ( 28 ). Thus, it is possible that impaired insulin action due to consumption of the trans -10, cis -12 CLA isomer is also related to an accumulation of TAGs in muscle tissues, a major site of insulin action. In obese Zucker rats ( 78 ),[NextPage] however, CLA reduces the amount of intramuscular fat, which may explain why CLA improves insulin action in obese and insulin-resistant rats ( 78 - 80 ).
Conclusions
The CLA isomer that is involved in the body fat-lowering effect and that is active in lipid metabolism is the trans -10, cis -12 90% of the total CLA intake from food in humans is accounted for by the cis -9, trans -11 isomer. The results of studies in humans indicate that the effect of the trans -10, cis -12 CLA isomer on body fat is considerably less than that anticipated from mice studies and that CLA has no major effect on plasma lipids. Furthermore, mice studies showed that the trans -10, cis -12 CLA isomer may have some undesirable side effects, such as insulin resistance, increased plasma insulin concentrations, and decreased plasma leptin concentrations, and there are indications that some of these effects may become apparent in humans. Additional studies that are well controlled for nutrient and energy intakes may be needed, and pure CLA isomers should be used to clearly define the short- and long-term effects and side effects of each inpidual CLA isomer.
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        <pubDate>2012-01-03 09:11:32</pubDate>
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        <title>The effects of phytoestrogen isoflavones on bone density in women: a double-blind, randomized, placebo-controlled trial 1, 2, 3 1-</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/Digest/2012/01/370575018.html]]></link>
        <text><![CDATA[【摘要】
      Background: Isoflavone phytoestrogen therapy has been proposed as a natural alternative to hormone replacement therapy (HRT). HRT has a beneficial effect on bone, but few trials in humans have investigated the effects of isoflavones on bone.

Objective: The objective of the study was to determine the effect on bone density of a red clover-derived isoflavone supplement that provided a daily dose of 26 mg biochanin A, 16 mg formononetin, 1 mg genistein, and 0.5 mg daidzein for 1 y. Effects on biochemical markers of bone turnover and body composition were also studied.

Design: Women aged 49-65 y ( n = 205) were enrolled in a double-blind, randomized, placebo-controlled trial; 177 completed the trial. Bone density, body composition, bone turnover markers, and diet were measured at baseline and after 12 mo.

Results: Loss of lumbar spine bone mineral content and bone mineral density was significantly ( P = 0.04 and P = 0.03, respectively) lower in the women taking the isoflavone supplement than in those taking the placebo. There were no significant treatment effects on hip bone mineral content or bone mineral density, markers of bone resorption, or body composition, but bone formation markers were significantly increased ( P = 0.04 and P = 0.01 for bone-specific alkaline phosphatase and N -propeptide of collagen type I, respectively) in the intervention group compared with placebo in postmenopausal women. Interactions between treatment group and menopausal status with respect to changes in other outcomes were not significant.

Conclusion: These data suggest that, through attenuation of bone loss, isoflavones have a potentially protective effect on the lumbar spine in women. 
          【关键词】 Isoflavones phytoestrogens bone density randomized controlled trial body composition estrogen and vitamin D receptor polymorphisms
		  INTRODUCTION
Estrogens play an important role in skeletal homeostasis, and ovarian hormone deficiency is one of the most important risk factors for osteoporosis. There are clear bone-related benefits of hormone replacement therapy (HRT; 1 ), but compliance with such regimens is generally very poor ( 2, 3 ), partly as a result of fears about the risks of cancer ( 3 ).
Isoflavones are compounds in plant foods, particularly soybeans ( 4, 5 ), that are structurally similar to the mammalian estrogens ( 6, 7 ) and that have received considerable attention for their potential bone-sparing properties. Rates of hip fracture in Asian populations, whose traditional diets are rich in soy, are substantially lower than those in whites residing in the United States ( 8 ). However, bone mineral density (BMD) in Asian populations is comparable to that in white populations after adjustment for height and weight ( 9 ). Nevertheless, data from animal experiments provided evidence that soy protein can attenuate menopausal bone loss ( 10, 11 ), and it was suggested that isoflavones in soy might be responsible for protective effects on bone ( [NextPage]12 ). In humans, some ( 13 - 17 ) but not all ( 18 ) cross-sectional studies in Asian populations reported significant positive associations between soy protein or isoflavone intakes and BMD. Furthermore, intervention trials in humans using either soy protein or isoflavone extracts generally reported protective effects on bone, although sample sizes were small and trials often were relatively short. In postmenopausal women, consumption of soy protein providing 90 mg isoflavones/d for 24 wk resulted in a significant increase in lumbar spine bone mineral content (BMC) and BMD ( 19 ), and a red clover isoflavone supplement providing 57 or 85.5 mg isoflavones/d for 6 mo resulted in an increase in BMD of the proximal radius and ulna ( 20 ). In perimenopausal women, soy protein that provided 80.4 mg isoflavones/d for 24 wk did not increase lumbar spine BMC or BMD, but it did lower the extent of bone loss compared with that in the control group ( 21 ). Several intervention studies reported the effects of soy protein or isoflavone extracts on markers of bone turnover. In postmenopausal women, diets rich in soyfoods resulted in significant increases in serum osteocalcin concentrations ( 22, 23 ) and decreases in urinary N -telopeptide excretion ( 22 ). In perimenopausal women, a 4-wk intervention with an isoflavone extract resulted in a significant reduction in the bone resorption marker pyridinoline ( 24 ), but other studies reported little or no effect of soy protein or isoflavone supplements on markers of bone turnover in humans ( 25 - 27 ).
We aimed to determine the effects of consuming a red clover-derived isoflavone supplement (in a daily dose providing 26 mg biochanin A, 16 mg formononetin, 1 mg genistein, and 0.5 mg daidzein) for 1 y on the BMC and BMD of the lumbar spine and hip, on biochemical markers of bone turnover, and on body composition.
SUBJECTS AND METHODS
Subjects
Between November 1997 and May 1999, women aged 49-65 y were recruited from the Breast Screening Unit of Addenbrooke's Hospital (Cambridge, United Kingdom). The primary outcome measure was breast density, and women were selected for the study according to the extent of dense tissue seen on their most recent mammogram; mammograms from 1908 women were classified according to their Wolfe pattern ( 28 ), and women with P2 or DY Wolfe breast patterns (ie, dense breast patterns; n = 1149, 60% of all mammograms classified) were sent a recruitment letter, which contained a short description of the study and a reply slip. The rate of response to the letter was 68% ( n = 781); of the responders, 205 (18% of the women who received letters) were eligible and were randomly assigned to receive an isoflavone or placebo tablet ( Figure 1 ). Women were not eligible to participate if they had a personal history of breast cancer or major breast surgery or if they were currently taking HRT. Women who expressed an interest in taking part were visited at home. During this initial home visit, the stu[NextPage]dy was explained in detail, and all women who wished to participate were asked for written informed consent. A total of 205 women were randomly assigned to receive isoflavone or placebo tablets (Figure 1 ). Additional home visits were made after 5.5 and 11 mo on the study. All study procedures were approved by the Dunn Human Nutrition Unit Ethics Committee and the Cambridge Local Research Ethics Committee.
FIGURE 1. Flow chart describing the progress of the volunteers during the trial. HRT, hormone replacement therapy. *Includes 2 women who completed the trial but were excluded from all analyses because they had taken oral contraceptives or had been treated for alcoholism. **Includes 1 woman who completed the trial but was excluded from all analyses because she had taken oral contraceptives.
Participants were randomly assigned to receive daily either a red clover-derived isoflavone tablet that provided 26 mg biochanin A, 16 mg formononetin, 1 mg genistein, and 0.5 mg daidzein (Promensil; Novogen Ltd, Sydney, Australia) or a placebo of identical appearance. We did not measure the isoflavone content of the Promensil tablets in our laboratory, but an independent study showed that the manufacturer's statements as to the quantity and type of isoflavones in the tablets were correct ( 29 ). Randomization was performed by using random number generation in MICROSOFT EXCEL (version 2.2; Microsoft Corp, Redmond, WA), and researchers and study participants remained blinded to the tablet allocation throughout the study. Participants were asked to take 1 tablet/d. The code identifying those who had been taking the isoflavone tablets and those who had been taking the placebo was broken when all participants had completed all stages of the study.
Urine samples
Women were asked to make 24-h urine collections at baseline and 12 mo. To check compliance, women also were asked to make a 24-h urine collection at 6 mo. The completeness of all urine collections was assessed by using the p -aminobenzoic acid (PABA)-check test ( 30 ). Samples containing 85-110% of the ingested PABA were designated satisfactory. For samples with PABA recoveries of between 70% and 85%, which indicated that all tablets had been taken but that the urine collection was incomplete, the urinary excretion of isoflavones was adjusted to 93% PABA recovery ( 31 ). Samples with <70% recovery were designated incomplete. Samples 110% PABA recovery were considered unsatisfactory, because additional sources of PABA (eg, a multivitamin) may have been consumed, and an accurate determination of sample completeness could not be made.
Urinary excretion of genistein, daidzein, formononetin, and biochanin A was measured by using HPLC and a modification of the method of Setchell et al ( 32 ) and Franke et al ( 33 ). Briefly, samples were incubated with &szlig;-glucuronidase for 20-72 h at 37 &deg;C. Phenolic components were extracted into an ethyl:acetate (6:4 by vol) solvent mixture. After vortex mixing for 30 s and subsequent 10-min centrifugation at 2320 x g and 20 &deg;C, the organic phase was transferred to a 2-mL vial and evaporated to dryness under vacuum at 43 &deg;C. Extraction residues were reconstituted in 100 &micro;L 50% isopropanol solution and [NextPage]centrifuged for 10 min at 2320 x g and 20 &deg;C. A 5-&micro;L aliquot was then injected directly onto the HPLC column, which consisted of an Alltima 250 x 2.1-mm, 5 &micro;mol/L, C-18 stationary phase (Alltech Associates, New South Wales, Australia), and a mobile phase (acetonitrile and water) containing 0.05% trifluoroacetic acid with a gradient of acetonitrile from 25-100%. Detection and quantification were performed via photo diode array detector. Flavone was used as the internal standard; the limit of detection (LOD) was 0.05 &micro;g/mL, and the limit of quantitation (LOQ) was 0.1 &micro;g/mL.
Total and free pyridinoline and deoxypyridinoline, markers of bone resorption, were measured in urine samples collected at baseline and when nearing completion at 12 mo with the use of a rapid automated assay technique according to the method of Pratt et al ( 34 ). Briefly, for total pyridinoline and deoxypyridinoline, 0.5 mL urine was hydrolyzed with an equal volume of 12 mmol/L HCl for 18 h at 107 &deg;C. Hydrolysates were centrifuged for 2 min at 13 500 x g and room temperature, and hydroxypyridinium cross-links were extracted from 0.5 mL of the supernatant by solid-phase extraction (employing cellulose). Pyridinoline and deoxypyridinoline were separated and quantified by using HPLC. Free pyridinoline and deoxypyridinoline were measured without the hydrolysis step. The within-batch CV was <3% for pyridinoline and <5% for deoxypyridinoline measurements; baseline and 12-mo urine samples from inpidual participants were analyzed together in the same batch. All urine samples were analyzed for their creatinine content (Kone autoanalyser; Jaffe method), and excretion of pyridinoline and deoxypyridinoline was corrected for creatinine excretion.
Blood samples
Fasting blood samples were taken at baseline and 12 mo. Participants were asked to refrain from eating or drinking (except water) from midnight until after the sample had been taken the following morning. A total of 35.5 mL blood was drawn at each visit, including 9.0 mL blood that was drawn into a lithium heparin tube and 9.0 mL that was drawn into a serum tube. The serum tube was left at room temperature for 1 h before centrifugation to allow clotting. After centrifugation for 10 min at 2000 rpm and 5 &deg;C, aliquots of plasma and serum were stored at -20 &deg;C. Before centrifugation, 1 mL whole blood was removed from the lithium heparin tube, and DNA was extracted by using a Qiagen kit (Qiagen Ltd, Crawley, United Kingdom) and was used for genotyping of estrogen receptor and vitamin D receptor gene polymorphisms ( Pvu II and Bsm I, respectively).
Plasma bone-specific alkaline phosphatase (bone ALP), a marker of bone formation, was measured by using the Metra kit (Quidel Ltd, Oxford, United Kingdom; 35 ). The intraassay and interassay CVs were 3.9% and 10.9%, respectively. Plasma concentrations of the N -propeptide of collagen type I (PINP), also a marker of bone formation, were measured by using the Orion Diagnostica radioimmunoassay kit (Espoo, Finland; 36 ), for which the intraassay and interassay CVs were 9.3% and 12.5%, respectively. For both assays, baseline and 12-mo samples from each participant were run together on the same plate to minimize variability.
Serum estradiol was measured by using a previously described method ( 37 ), and ser[NextPage]um follicle-stimulating hormone (FSH) was measured by using an enzyme immunoassay on an Abbott AxSYM automated analyzer (Abbott Diagnostics, Maidenhead, United Kingdom). Menopausal status was determined by using baseline concentrations of estradiol and FSH as follows; women were classified as premenopausal if they had 100 pmol estradiol/L, as postmenopausal 30 IU FSH/L and <100 pmol estradiol/L, and 100 pmol estradiol/L or <30 IU FSH/L and <100 pmol estradiol/L. However, if a woman had noted on the questionnaire completed at the initial home visit that she was currently menstruating, but her baseline hormone profile was that of a postmenopausal 30 IU FSH/L and <100 pmol estradiol/L), she was classified as perimenopausal.
Bone density, body composition, and calcium and vitamin D intakes
Bone density and body composition were assessed by dual-energy X-ray absorptiometry (DXA) at baseline and after 12 mo with the use of an Hologic QDR-4500A scanner (Hologic Inc, Waltham, MA). The precision of the in vivo measurement of BMC by DXA in the Metabolic Bone Unit at Addenbrooke's Hospital is 1% in the spine and 2-3% in the proximal femur.
Inpidual scans of the lumbar spine (L1-L4), hip (femoral neck, trochanter, and intertrochanteric region), and whole body were taken. If a scan revealed signs of osteoporosis (ie, a BMD T-score <-2.5), the participant was notified in writing and advised to visit her general practitioner. Follow-up spine data were not available for one woman in the isoflavone group, and follow-up bone density and body-composition data were not available for one woman in the placebo group. Six women from the isoflavone group and 8 women from the placebo group were excluded from all analyses regarding bone, because they had taken medications during the study that can affect bone density (eg, bisphosphonates, statins, or calcium and vitamin D supplements). Participants' height and weight were measured at the time of the DXA scans, and body mass index (BMI) was calculated as [weight (kg)/height (m 2 )]; baseline height was unavailable for one woman in the isoflavone group.
Participants were asked to complete a food-frequency questionnaire (FFQ) at baseline and after 12 mo on the study. Participants were given verbal and written instructions on how to complete the FFQ, and calculation of calcium and vitamin D intakes was based on published food-composition tables ( 38 ).
Sample size and data analysis
A sample of 100 in each treatment group gave 80% power to detect a 1.3% difference between groups with respect to the change in BMC over 1 y, assuming an SD of 3.2% and setting at 0.05. Interactions between treatment group and polymorphisms in the estrogen receptor and vitamin D receptor genes are not reported because of a lack of power to detect significant associations. Results are available from the authors on request.
Statistical analyses were performed by using SAS statistical software (version 6.12; SAS Institute, Cary, NC) under the Windows operating system. A P value of <0.05 was considered significant. Changes in BMC, BMD, markers of bone turnover, body composition, and intakes of calcium and vitamin D were calculated as 12-mo data minus baseline data. We used Student's t tests to test for differences between treatment groups for changes in BMC, BMD, markers of bone turnover, and body composition. Data on changes in calcium and vitamin D intakes were skewed, and therefore the nonparametric Wilcoxon's rank-sum test was used to test for differences between treatment groups.
RESULTS
Baseline characteristics are shown in Table 1. Differences between treatment groups were nonsignificant ( P 0.05). Sixteen women withdrew from the isoflavone group and 12 withdrew from the placebo group (Figure 1 ). The principal reasons for withdrawal were commencement of HRT and work commitments or family problems that prevented completion of study activities. Other reasons included feeling no beneficial effects of the intervention or having no interest in continuing on the trial, heavy menstrual bleeding, or illnesses preventing completion of study activities (eg, severe hip pain, skin irritation and sores, vomiting, and diarrhea). One woman in the isoflavone group was diagnosed with an interval cancer of the breast (ie, a cancer detected in the interval after a negative mammographic result) 2 mo after the start of the intervention and was withdrawn from the study. The difference between treatment groups in the number of withdrawals was not significant ( 2 = 1.123, P = 0.29).
TABLE 1. Baseline characteristics and time between measurements in subjects receiving isofla[NextPage]vone or placebo tablets 1
According to the PABA-check method, 58%, 72%, and 77% of the women had complete urine collections at baseline, 6 mo, and 12 mo, respectively. A further 22%, 11%, and 13% had PABA recoveries between 70% and 85% at baseline, 6 mo, and 12 mo, respectively. Differences between treatment groups in sum isoflavone excretion (sum of daidzein, genistein, formononetin, and biochanin A) were nonsignificant at baseline, but differences were highly significant at 6 and 12 mo ( Figure 2 ). The data shown do not include women with 110% PABA recovery. Inclusion of these women did not alter the results. Among women in the placebo group, isoflavone excretion did not change significantly from baseline to 6 mo ( P = 0.80) or from baseline to 12 mo ( P = 0.15; Figure 2 ).
FIGURE 2. Mean (&plusmn;SEM) urinary isoflavone excretion (sum of daidzein, genistein, formononetin, and biochanin A) by treatment group at baseline, 6 mo, and 12 mo, excluding samples with 110% p -aminobenzoic acid recovery. At baseline: isoflavone group, n = 66; placebo group, n = 72. At 6 mo: isoflavone group, n = 70; placebo group, n = 73. At 12 mo: isoflavone group, n = 76; placebo group, n = 79. The difference in isoflavone excretion between treatment groups was nonsignificant at baseline ( P = 0.23), but differences between treatment groups at 6 and 12 mo were highly significant (both: P < 0.001).
There were no significant differences between treatment groups with respect to changes in dietary intakes of calcium and vitamin D from baseline to 12 mo; mean (&plusmn;SD) changes in calcium intakes for women in the isoflavone and placebo groups, respectively, were - 43 &plusmn; 224 and - 54 &plusmn;165 mg/d ( P = 0.32), and changes in vitamin D intakes for women in the isoflavone and placebo groups, respectively, were - 0.24 &plusmn; 1.6 and - 0.19 &plusmn; 2.3 &micro;g/d ( P = 0.52).
Changes in spine and hip BMC and BMD at 1 y by treatment group are shown in Figure 3. Interactions between treatment group and menopausal status for the changes in spine or hip BMC and BMD were not significant ( P 0.05). Differences between treatment groups for losses of spine BMC and BMD were significant. Percentage change in spine BMC and BMD among women in the isoflavone and placebo groups, respectively, showed similar trends: mean (&plusmn;SEM) BMC: -1.42 &plusmn; 0.36% and -2.35 &plusmn; 0.37% ( P = 0.07); BMD: -1.08 &plusmn; 0.27% and -1.86 &plusmn; 0.29% ( P = 0.05). Decreases in BMC and BMD of the hip were generally greater among women in the placebo group than among women in the isoflavone group, but differences between treatment groups were not significant (Figure 3 ). Similar results were found when considering percentage changes (data not shown). In an analysis of covariance on changes from baseline to 12 mo, with baseline data (BMC or BMD) as a covariate, the effect of treatment group on the changes in spine BMC and BMD remained significant ( P = 0.05, and P = 0.03, respectively). Simila[NextPage]rly, for changes in hip BMC and BMD, the effect of treatment group remained nonsignificant ( P = 0.38 and P = 0.85, respectively).
FIGURE 3. Mean (&plusmn;SEM) changes in spine and hip bone mineral content (BMC) and bone mineral density (BMD) at 1 y by treatment group. Isoflavone group, n = 77 ( n = 78 for hip); placebo group, n = 81. Interactions between menopausal status and treatment group for changes in BMC or BMD were nonsignificant. Differences between treatment groups with respect to changes in spine BMC and BMD were significant ( P = 0.04 and P = 0.03, respectively); differences between treatment groups with respect to changes in hip BMC and BMD were nonsignificant ( P = 0.48 and P = 0.30, respectively).
Markers of bone turnover at baseline and 12 mo by treatment group are shown in Table 2. The difference between treatment groups with respect to the change in PINP was of borderline significance. The interaction between treatment group and menopausal status was significant for the changes in bone ALP and PINP ( P = 0.05 and P = 0.03, respectively). When grouped by menopausal status, differences between treatment groups were significant among postmenopausal women; mean (&plusmn;SD) changes in bone ALP among postmenopausal women in the isoflavone and placebo groups, respectively, were 5.65 &plusmn; 5.92 and 3.71 &plusmn; 2.92 U/L ( P = 0.04), and changes in PINP among postmenopausal women in the isoflavone and placebo groups, respectively, were 9.72 &plusmn; 25.19 and -1.40 &plusmn; 19.12 mg/L ( P = 0.01). No other changes differed significantly between treatment groups. Results similar to those for total pyridinoline and deoxypyridinoline were obtained for free pyridinoline and deoxypyridinoline (data not shown). There were no significant differences between treatment groups with respect to the changes in whole-body BMC or BMD or body-composition measures ( Table 3 ), and interactions between treatment group and menopausal status were not significant ( P 0.05).
TABLE 2. Markers of bone turnover at baseline and at 12 mo according to treatment group 1
TABLE 3. BMI, body composition, and total-body bone mineral content (BMC) and bone mineral density (BMD) at baseline and at 12 mo by treatment group 1
DISCUSSION
This is one of the longest and largest studies to date to examine the effects of an isoflavone supplement derived from red clover on spine and hip BMC and BMD, biochemical markers of bone turnover, and body composition. We observed an attenuation of lumbar spine bone loss among women taking the isoflavone supplement compared with that among women taking the placebo. Trends for losses of hip BMC and BMD were similar to those seen in the lumbar spine, but differences between treatments were not significant. However, this was not entirely surprising, given that the hip contains a relatively large proportion of cortical bone, which is metabolically less active than the trabecular bone of which the spine is primarily composed ( 39, 40 ). Fur[NextPage]thermore, precision of the measurement of hip BMC is lower than that of the measurement of spine BMC ( 2-3% for the proximal femur compared with 1% for the spine; JE Compston, personal communications, 1997 and 2002), and therefore the power to detect significant differences between treatment groups was lower as a result of slow bone turnover and lower measurement precision.
Potter et al ( 19 ) previously reported an increase in lumbar spine BMC and BMD among postmenopausal women whose diets were supplemented daily for 24 wk with soy protein isolate providing 90 mg, but not 56 mg, isoflavones/d. In our study, we did not see an increase in BMC or BMD with the isoflavone supplement, but the daily dose of isoflavones was lower than that used by Potter et al ( 19 ). However, in a study of perimenopausal women, Alekel et al ( 20 ) did not see an increase in lumbar spine BMC or BMD with a daily dose of 80.4 mg isoflavones (as soy protein) for 24 wk, but, similar to our study, they saw a reduction in the extent of bone loss. In a recent study of 28 premenopausal women (mean age: 24 y) there were no significant effects of a soy protein supplement that provided either 0 or 90 mg isoflavones/d for 12 mo ( 41 ). This suggests that isoflavones may be beneficial in attenuating age-associated bone loss rather than in enhancing peak bone mass in younger premenopausal women.
Promensil tablets contain isoflavones derived from red clover and, unlike soy protein, relatively large proportions of biochanin A and formononetin, in addition to daidzein and genistein ( 29 ). It has been observed that the use of isoflavone extracts does not always result in lipid-lowering effects ( 42, 43 ) that are the same as those seen with intact soy protein ( 44 ), and it has been suggested that the isoflavone extraction process may remove some component of the food that has synergistic effects in combination with isoflavones or that isoflavones may become inactivated during the isolation and purification process ( 45, 46 ). However, the combination of isoflavones in a food or dietary supplement also may be important in terms of their potential beneficial health effects. It was suggested that daidzein may be more important than other isoflavones in terms of relieving menopausal symptoms ( 47 ), and the tablets used in the present study were previously shown to produce beneficial effects on bone ( 20 ), but conflicting data have been presented with respect to blood lipid concentrations ( 42, 43 ).
Because of both the structural similarity of isoflavones to mammalian estrogens and their ability to bind to estrogen receptors ( 7 ), it is widely hypothesized that the actions of isoflavones are mediated via the estrogen receptors. However, the exact mechanism of action of isoflavones on bone remains to be fully elucidated. In our study, the 2 bone formation markers increased in postmenopausal women taking the isoflavone supplement. This is somewhat in agreement with studies in ovariectomiz[NextPage]ed rats suggesting that soy or isoflavones stimulate bone formation ( 10, 48 ). However, we did not see overall increases in BMC or BMD, but such discord between markers of bone turnover and BMD adds to the ongoing controversy surrounding the use of biochemical markers as predictors of BMD ( 49 ).
Prospective and case-control studies showed positive associations between weight and the risk of breast cancer among postmenopausal women and negative associations among premenopausal women (reviewed in 50 ). Furthermore, increased abdominal fat has consistently been associated with increased mortality and with the incidence of cardiovascular disease, hypertension, and diabetes ( 51, 52 ). The menopause is associated with a potentially detrimental shift in the distribution of fat toward a more central location ( 53 - 55 ), but in users of HRT, this shift is minimized, and HRT users are more likely to have less abdominal fat than do nonusers ( 56 - 58 ). In the present study, we did not see a significant effect of the isoflavone supplement on the distributions of fat and lean tissue within the body after 1 y.
Despite being one of the longest intervention studies with an isoflavone supplement to date, a potential limitation of this study is that it was relatively short-term with respect to the outcome measures; longer-term studies are needed to determine the effects of isoflavones (both as intact soy protein and as dietary supplements) on hip BMC and BMD and also on longer-term outcome measures such as fracture rates. Nevertheless, our findings suggest that, through attenuation of bone loss, the isoflavone supplement has a potentially protective effect on the lumbar spine.
ACKNOWLEDGMENTS
We thank Sue Gardner, Nicola Duffy, Nasima Siddiqui, Jane Bettany, and Jayne Girvan for their assistance with the day-to-day running of the trial; Shirley Love for the measurement of bone density and body composition; Simon P Robins, Phyllis Nicol, and Alexander Duncan for the bone marker assays; Alison Dunning, Catherine Healey, and Alex Loktionov for the genotyping; and Addenbrooke's Hospital Pharmacy for administering the tablets. Novogen Ltd performed the urinary isoflavone analyses.
All authors participated fully in the preparation of the manuscript. CA was responsible for subject recruitment and day-to-day running of the trial, sample analyses, and statistical analyses; JEC was responsible for bone densitometry; NED was responsible for the data analysis; MD was responsible for the hormone assays; and SAB was responsible for the design of the experiment, sample analysis, and significant advice and consultation regarding all aspects of the trial. None of the authors had conflicts of interest.
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        <pubDate>2012-01-03 09:11:28</pubDate>
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        <title>Twelfth China Hainan Joy Festival Opening</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/gn/2012/01/54952122279.html]]></link>
        <text><![CDATA[  Hainan, Xinhua channel on December 30 (Reporter Zhang Yongfeng) 30 am, Wanning City, Hainan Province, a beautiful style town is booming returned immersed in a sea of ​​joy, full of laughter, festive atmosphere filled with school.  2011 Twelfth China Hainan Island Happy Festival in Wanning City, Hainan Province officially kicked off.   It is understood that in order to "make the world warm up" as the theme of this fun festival will last three days.  One of the most exciting, "Happy New Year's Eve Festival" will be the evening of December 31, Xinglong Town, Wanning City in the grand plaza at the moon, when the festival will be Star bright, star cluster, joy will be fully detonated.   Happy Day After the ceremony, five first-class team of happy parade in "Happy-channel."  Lion Team of the Ku sing, drunk Lion Dance, Russian Dance dance dance beauty fashion hit with the perfect combination of skills, strong national characteristics Brazil gorgeous dance costumes, hair and fashion sense with the Poets Dance, are attracted to the audience.   Side of the channel in the joy of flight rally arena, the athletes live for a special performance and thrilling dynamics suspension formation, formation parachute, helicopter stand-alone show, model airplane stunts, parachute and other aerobatics flying rapidly off-site hot atmosphere.   China Hainan Joy Festival began in 2000, is to identify and enhance a culture of Hainan tourism festival, organized by the cities and counties for domestic and foreign tourists travel to Hainan to provide a relaxed and cheerful resort environment, shaping the Hainan "Happy island, paradise, "the tourism image.  Joy Festival held at the end of each year, 12 set of carefully orchestrated so that Hainan Joy Festival has become an international tourism and cultural influence of business cards. ]]></text>
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        <pubDate>2012-01-03 09:11:24</pubDate>
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        <title>Supplementation with flaxseed alters estrogen metabolism in postmenopausal women to a greater extent than does supplementation with an equal amount of soy 1, 2,</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/Digest/2012/01/1026408.html]]></link>
        <text><![CDATA[【摘要】
      Background: Phytoestrogens, which are abundant in flaxseed and soy, have chemical structures resembling those of endogenous estrogens and have been shown to exert hormonal effects, thereby affecting chronic diseases.

Objective: We compared the effects of consuming equal amounts of flaxseed or soy on estrogen metabolism and biochemical markers of bone metabolism in postmenopausal women.

Design: In a parallel design, the diet of postmenopausal women ( n = 46) was supplemented with either a placebo, soy (25 g soy flour), or flaxseed (25 g ground flaxseed) muffin for 16 wk. Blood and 24-h urine samples were collected at baseline and at the endpoint. Urine samples were analyzed for phytoestrogens, estrogen metabolites (2-hydroxyestrone, 16 -hydroxyestrone), and serum hormones (estradiol, estrone, estrone sulfate). Serum and urine samples were also analyzed for biochemical markers of bone metabolism.

Results: Urinary concentrations of 2-hydroxyestrone, but not of 16 -hydroxyestrone, increased significantly in the flaxseed group ( P = 0.05). In the flaxseed group, the ratio of 2-hydroxyestrone to 16 -hydroxyestrone was positively correlated with urinary lignan excretion ( r = 0.579, P = 0.02). In the soy and placebo groups, no significant correlation was observed. No significant change in serum hormones or biochemical markers of bone metabolism was observed within or between the treatment groups.

Conclusions: Supplementation with flaxseed modifies urinary estrogen metabolite excretion to a greater extent than does supplementation with an equal amount of soy. This modification by flaxseed is associated with an increase in urinary lignan excretion. Despite the shift in estrogen metabolism to favor the less biologically active estrogens, a negative effect on bone cell metabolism was not observed. 
          【关键词】 Flaxseed lignans soy isoflavones estrogen metabolism hydroxyestrone hydroxyestrone biochemical markers of bone metabolism postmenopausal women
		  INTRODUCTION
Flaxseed and soy are rich sources of lignans and isoflavones, respectively ( 1 ). Lignans and isoflavones are phytoestrogens with diphenolic ring structures resembling those of endogenous estrogens ( 2, 3 ) and have been shown to exert hormonal effects ( 4 - 6 ).
Estradiol is the biologically active estrogen that is most often associated with mammary tumorigenesis and maintenance of skeletal homeostasis ( 7 - 10 ). The metabolism of estrogen is primarily oxidative and occurs predominantly in the liver ( 11 ). Estradiol is first oxidized to estrone and then hydroxylated at either the A ring (C2 position) or the D ring (C16 position) by the cytochrome P450 enzymes 2-hydroxylase or 16 -hydroxylase ( 11, 12 ). This leads to the formation of the 2 major metabolites of estradiol, 2-hydroxyestrone (2OHE1) and 16 -hydroxyestrone (16 OHE1) ( 13 ), which are excreted in either the urine or the feces ( 14 ) and have distinct biological properties. Although hydroxylation of estradiol and[NextPage] estrone can also occur at multiple sites (carbons 1, 2, 4, 6, 7, 11, and 14-18), the 2- and 16 -hydroxylated metabolites are the most abundant ( 15 ).
2OHE1 has shown little biological activity, with some antiestrogenic action in vitro ( 16 - 18 ). Conversely, 16 OHE1 has shown estrogen agonistic activity, including increased cell proliferation of human breast cancer cell lines in vitro ( 17 - 19 ), and an uterotropic effect comparable with that of estrogen in vivo ( 20, 21 ). Therefore, persons who have an increased proportion of 16 -hydroxylation (a low ratio of 2OHE1 to 16 OHE1) are suggested to have an increased risk of breast cancer ( 17, 22, 23 ). With respect to bone, 16 OHE1 is suggested to be an estrogen agonist in ovariectomized rats ( 24 ) and is associated with increased bone mineral density (BMD) in postmenopausal women ( 25 ).
Consumption of flaxseed and soy influences estrogen metabolism, as indicated by both urinary metabolite excretion ( 26 - 28 ) and serum hormone concentrations ( 3, 29 ). Furthermore, in vitro studies showed that flaxseed lignans moderately inhibit the cytochrome P450 enzyme aromatase, which catalyzes the conversion of androgens to estrogens ( 30, 31 ). In addition, flaxseed lignans and soy isoflavones modulate the activity of 17&szlig;-hydroxysteroid dehydrogenases ( 32 ), enzymes involved in the balance between estradiol and estrone ( 33, 34 ).
In previous human studies on estrogen and bone metabolism, the diet of postmenopausal women was supplemented with ground flaxseed in the amounts of 5, 10 ( 3, 28 ), and 40 ( 35 ) g. Soy has been given as isolated soy protein (ISP) ( 36 - 39 ) or soy milk ( 26, 29 ), with various amounts of isoflavones. Isoflavones have also been administered in tablet form ( 40 ). Studies comparing the effects of equal amounts by weight of flaxseed and soy in amounts and forms that may be encountered in a habitual diet have not been conducted. Therefore, the specific objective of the present study was to compare the effects of consuming a moderate amount (25 g) of ground flaxseed or ground soy flour incorporated into a muffin on the metabolism of estrogen [ie, urinary estrogen metabolites (2OHE1 and 16 OHE1) and serum hormones] and biochemical markers of bone metabolism in postmenopausal women. The results will suggest whether these phytoestrogen-rich foods favorably modulate estrogen and bone metabolism.
SUBJECTS AND METHODS
Subjects
A randomized, double-blind, parallel, placebo-controlled study of postmenopausal women was designed. The healthy postmenopausal women included in the present study ( n = 46) were a subsample (selected for compliance) of those ( n = 99) who participated in a study examining the effects of flaxseed and soy supplementation on symptoms of menopause. Natural menopause had been achieved 1 y before the start of the study. The exclusion criteria were as follows: active bowel disease; malabsorption syndrome; use of exogenous estrogens within the past 3 mo; use of[NextPage] phytoestrogen supplements within the past 1 mo; any thyroid disorder (treated or untreated); use of oral or parenteral corticosteroids; antibiotic use 4 wk before the study; any serious, active medical condition; a known allergy or intolerance to study ingredients; 4 wk during the study period. The demographic characteristics of the subjects in each treatment group are shown in Table 1. There were no significant differences in the selected variables (age, height, weight, body mass index, or age at menopause) between the treatment groups at baseline or at the endpoint or within the treatment groups over time. All subjects gave written informed consent, and the study protocol was reviewed and approved by the Sunnybrook Research Ethics Board and the University of Toronto Human Ethics Committee.
TABLE 1. Demographic characteristics of the subjects by treatment group 1
Study design
The women were randomly assigned to 3 treatment groups in which the daily diet was supplemented with either a placebo muffin ( n = 15), a flaxseed muffin ( n = 16), or a soy muffin ( n = 15) for 16 wk. Fasting blood samples and 24-h urine samples were collected, and 3-d food records were recorded at baseline (week 0) and at the endpoint (week 16). The subjects were asked to record their muffin ingestion on daily diary cards and to return uneaten muffin portions. Compliance measured by this means was similar for all the treatment groups. The muffins were well tolerated, with compliance calculated to be 96%. Compliance was also monitored through measurement of urinary phytoestrogen excretion.
The subjects were asked to maintain their habitual diet and to avoid foods containing flaxseed and soy during the study. The subjects were counseled by the research assistant to maintain their prestudy weight throughout the trial because changes in body weight may influence endogenous hormone concentrations ( 41, 42 ). The study muffins for all 3 treatment groups contained similar ingredients and were prepared from either white flour (20.7 g; flaxseed and soy groups) or whole-wheat flour (20.7 g; placebo group) by using traditional methods. The flaxseed muffin contained 25 g ground flaxseed, which supplied 50 mg of the mammalian lignan precursor secoisolariciresinol diglycoside/d (26.4 mg secoisolariciresinol/d). Soy muffins contained 25 g soy flour, which supplied 41.9 mg isoflavones/d (15.5 mg daidzein/d, 25.7 mg genistein/d, 0.7 mg glycitein/d). The placebo muffin was prepared with whole-wheat flour, instead of white flour, to raise the fiber content of the placebo muffin closer to that of the other muffins. Wheat fiber has been shown to have no significant effect on urinary estrogen metabolites ( 43 ). All muffins were formulated in an attempt to make them isocaloric and equivalent in macronutrients (fat, protein, and fiber). Hence, additional canola oil was added to the placebo (10 g) and soy muffins (4 g) but not to the flaxseed muffin. Muffins were also flavored with nutmeg, cinn[NextPage]amon, and vanilla extract to help maintain subject blindness. To maintain the double-blind status of the study, muffins were packaged in opaque wrappings with 7 muffins to a tray so that the different muffins could not be visually distinguished, and the muffins were labeled with a unique 4-digit number before delivery to the research assistant. For each subject visit, the research assistant received a list indicating which 4 trays of prewrapped muffins were to be dispensed to the subject for that 4-wk period.
The macronutrient content of the muffins is shown in Table 2 (Association of Official Analytical Chemists, Official Methods of Analysis, 16th ed, Washington, DC: AOAC, 1997). Three-day food records were analyzed and averaged by using the NUTRIWATCH nutrient analysis program (version 6.1.22E Delphi 1, based on the 1997 Canadian Nutrient File; Elizabeth Warwick, PEI, Cornwall, Canada).
TABLE 2. Macronutrient content of the muffins
Urinary phytoestrogen analysis
Urinary phytoestrogens were analyzed by gas chromatography-mass spectrometry, which is routinely used in our laboratory ( 44 ). Briefly, mammalian lignans and isoflavones were extracted from the urine samples on a reversed-phase octadecylsilane bonded silica cartridge (C 18; Applied Separations, Allentown, PA). Phytoestrogens absorbed to the silica particles were eluted with 4 mL methanol and evaporated to dryness. The residue was treated overnight with &szlig;-glucuronidase at 37 &deg;C. The unconjugated phytoestrogens were extracted from the hydrolysate by being passed through another C 18 column and were further purified and isolated on a DEAE Sephadex ion-exchange column that had been prepared in the alcohol form (methanol). Phytoestrogens were then derivatized (Tri-Sil Reagent; Pierce, Rockford, IL), dissolved in 100 &micro;L hexane, and analyzed by gas chromatography-mass spectrometry (GC 5890 Series II, MS 5971; Hewlett-Packard, Avondale, PA). The oven temperature began at 100 &deg;C and was programmed to increase to 250 &deg;C at a rate of 30 &deg;C/min. An HP-1 capillary column (25 m x 0.2 mm x 0.11 &micro;m; Agilent Technologies Inc, Wilmington, DE), which consisted of a cross-linked methyl silicone gum phase, was used with helium as the carrier gas. Total analysis time was 15 min.
Enzyme-linked immunoassay for 2OHE1 and 16 OHE1
ESTRAMET (ImmunaCare, Bethlehem, PA) is a competitive, solid-phase enzyme immunoasssay for the quantification of the urinary estrogen metabolites 2OHE1 and 16 OHE1. Values obtained from this method correlate highly with those obtained by using gas chromatography-mass spectrometry ( 45 ). Analysis of samples was carried out with kits from the same lot and performed within 2 wk of delivery. Baseline and follow-up samples for each subject were analyzed within the same plate. A laboratory control (24-h postmenopausal urine sample) was also included within each assay. Standards, controls, and samples, all of which were run in triplicate, were first deconjug[NextPage]ated of glucuronic acid and sulfate through the addition of a mixture containing &szlig;-glucuronidase and arylsulfatase enzymes isolated from the snail Helix Pomatia, and concentrations are expressed in &micro;g/24 h. The interassay coefficients for 2OHE1 and 16 OHE1 were 9.02% and 6.85%, respectively, and the intraassay coefficients were 2.99% and 4.53%, respectively.
Serum hormones
Serum estradiol, estrone, and estrone sulfate concentrations were determined by using a double-antibody 125 I radioimmunoassay (DSL-4800, 8700, and 5400, respectively; Diagnostic Systems Laboratories Inc, Webster, TX). Analysis was conducted as described by the manufacturer. All samples were run in duplicate with the same kit lot, and samples from each treatment group were included in each assay. Baseline and follow-up samples from each subject were analyzed within the same assay. The interassay coefficients for estradiol, estrone, and estrone sulfate were 8.97%, 11.83%, and 23.58%, respectively, and the intraassay coefficients were 10.76%, 4.47%, and 8.11%, respectively.
Biochemical markers of bone turnover
Bone-specific alkaline phosphatase (AP) was measured in fasting serum samples by using an enzyme-linked immunoassay (Metra BAP; Quidel Corporation, San Diego). Free deoxypyridinoline (DPD) was measured in 24-h urine samples by using an enzyme-linked immunoassay (Metra DPD; Quidel Corporation), and concentrations are expressed as a function of creatinine. Creatinine was measured by using a colorimetric assay (Kit 555-A; Sigma Chemical Co, Mississauga, Canada). All samples were run in duplicate with the same kit lot, and baseline and follow-up samples for each subject were analyzed within the same batch. The interassay coefficients for AP and DPD were 7.40% and 3.19%, respectively, and the intraassay coefficients were 9.27% and 6.92%, respectively.
Statistical analyses
Urinary estrogen metabolites and phytoestrogens, serum hormones, biochemical markers of bone metabolism, dietary intakes, and weight and body mass index data were analyzed by using two-factor analysis of variance followed by Tukey's multiple comparison test. The ratio of 2OHE1 to 16 OHE1 within each group was also examined by using a paired t test. Demographic data were compared between treatment groups by using one-factor analysis of variance followed by Tukey's multiple comparison test. Regression analysis was used to examine the association between urinary concentrations of estrogen metabolites and phytoestrogens (lignans and isoflavones). Where necessary, data were log transformed to satisfy the normality assumptions of the statistical tests. Results were converted back to the original scale for reporting purposes. Two subjects were excluded from the soy group because of a missing urine volume; thus, the total number of subjects used for statistical analysis was 44. Urinary metabolite concentrations that were <0.625 ng/mL (the lower detection limit of the kit) were assigned values of 0.625 ng/mL, as done by others ( 28 ). All of the treatment groups had a similar number of samples with concentrations <0.625 ng/mL (3, 2, and 2 for the placebo, soy, and flaxseed groups, respectively). In all cases, P <IMG SRC="/math/le.gif" ALT=" 0.05 was considered statistically significant. All statistical analyses were conducted by using SIGMASTAT 2.0 (Jandel Corporation, San Rafael, CA).
RESULTS
Subjects and diet
The mean macronutrient intake of each treatment group is sho[NextPage]wn in Table 3. No significant changes in macronutrient intake were observed with any of the 3 treatments, nor were significant differences observed between the groups either at baseline or at the endpoint.
TABLE 3. Macronutrient intakes at baseline (week 0) and at the endpoint (week 16) by treatment group 1
Urinary phytoestrogens
There were no significant differences in total urinary phytoestrogen (lignans + isoflavones) excretion at baseline ( Figure 1 ). After the 16-wk study period, total urinary phytoestrogen excretion values (arithmetic &plusmn; SEM) in the placebo, soy, and flaxseed groups were 3.24 &plusmn; 0.71, 21.84 &plusmn; 4.37, and 41.05 &plusmn; 8.49 &micro;mol/d, respectively. Both the soy and the flaxseed groups had significantly higher urinary phytoestrogen excretion than did the placebo group. Although the flaxseed group tended to have higher total urinary phytoestrogen excretion than did the soy group, the difference was not significant. However, the flaxseed group excreted primarily enterodiol and enterolactone, whereas the soy group excreted primarily genistein, daidzein, and equol.
FIGURE 1. Mean (&plusmn;SEM) total urinary phytoestrogen excretion at baseline (week 0) and at the endpoint (week 16) by treatment group (placebo, n = 15; soy, n = 13; flaxseed, n = 16). A significant group x time interaction was observed ( P < 0.05). *Significantly different from the placebo group at week 16, P < 0.05 (two-factor ANOVA followed by Tukey's test). **Significantly different from week 0 within the same group, P < 0.001 (two-factor ANOVA followed by Tukey's test).
Urinary estrogen metabolites and sex hormone analyses
Baseline values for both estrogen metabolites and their ratio (2OHE1:16 OHE1) were not significantly different between the treatment groups (7.93 &plusmn; 1.96, 4.19 &plusmn; 0.46, and 5.60 &plusmn; 0.93 &micro;g 2OHE1/24 h and 5.97 &plusmn; 1.03, 4.64 &plusmn; 0.89, and 4.78 &plusmn; 0.81 &micro;g 16 OHE1/24 h in the placebo, soy, and flaxseed groups, respectively) ( Figure 2 ). Two-factor analysis of variance showed a group x time interaction for both 2OHE1 and 2OHE1:16 OHE1. Supplementation with flaxseed but not soy or placebo significantly increased urinary 2OHE1 concentrations (7.25 &plusmn; 1.48, 6.15 &plusmn; 0.97, and 11.36 &plusmn; 1.93 &micro;g/24 h in the placebo, soy, and flaxseed groups, respectively). No significant differences in 16 OHE1 concentrations after 16 wk were observed in any of the treatment groups (6.87 &plusmn; 1.32, 6.24 &plusmn; 1.05, and 5.07 &plusmn; 0.79 &micro;g/24 h in the placebo, soy, and flaxseed groups, respectively). Tukey's multiple comparison test did not show significant differences between the groups in 2OHE1:16 OHE1. However, when the ratios within each group were examined by using a paired t test, a significant increase in the ratio was observed in the flaxseed group but not in the soy or placebo groups.
FIGURE 2. Mean (&plusmn;SEM) urinary excretion of 2-hydroxyestrone (2OHE1) and 16 -hydroxyestrone (16 OHE1) and mean (&plusmn;SEM) ratio of 2OHE1 to 16 OHE1 at baseline (, week 0) and at the endpoint (, week 16) by treatment group (placebo, n = 15; soy, n = 13; flaxseed, n = 16). Two-factor ANOVA followed by Tu[NextPage]key's test showed a significant group x time interaction for both 2OHE1 and 2OHE1:16 OHE1. *Significantly different from week 0, P = 0.05 (post hoc Tukey's test). **Significantly different from week 0, P = 0.005 (paired t test).
Linear regression showed a significant positive correlation between changes in urinary lignans and changes in 2OHE1:16 OHE1 within the flaxseed group ( Figure 3A ). When a similar regression was conducted for the soy group, no significant correlation was observed (Figure 3B ). There were no significant differences in serum estradiol, estrone, and estrone sulfate concentrations between the treatment groups and no significant differences within any of the treatment groups between the concentrations at baseline and those at the endpoint ( Table 4 )
FIGURE 3. Correlation between the change in total urinary phytoestrogen (primarily enterolactone and enterodiol) excretion and the change in the ratio of 2-hydroxyestrone (2OHE1) to 16 -hydroxyestrone (16 OHE1) in the flaxseed treatment group (A) and correlation between the change in total urinary phytoestrogen (primarily genistein, daidzein, and equol) excretion and the change in 2OHE1:16 OHE1 in the soy treatment group (B).
TABLE 4. Concentrations of serum hormones and biochemical markers of bone metabolism at baseline (week 0) and at the endpoint (week 16) by treatment group 1
Biochemical markers of bone metabolism
The results of serum AP and urinary DPD analyses are shown in Table 4. There were no significant differences in AP or DPD concentrations between the groups or within the groups over time. A significant inverse correlation between the change in serum AP and the change in total urinary lignan excretion was observed in the flaxseed group only ( Figure 4 ).
FIGURE 4. Correlation between the change in total urinary lignan excretion and the change in serum bone-specific alkaline phosphatase (AP) in the flaxseed treatment group.
DISCUSSION
This study showed that dietary supplementation with 25 g ground flaxseed but not with 25 g soy flour significantly alters the metabolism of estradiol in favor of the less biologically active estrogen metabolite (2OHE1) in postmenopausal women. Our study showed for the first time that changes in urinary lignan excretion with flaxseed supplementation are positively related to significant changes in 2OHE1:16 OHE1.
In support of our results, Haggans et al ( 28 ) reported that supplementation with 10 g ground flaxseed/d for 7 wk significantly increased the urinary excretion of 2OHE1 (34%) as well as 2OHE1:16 OHE1 (21%) in postmenopausal women, although no correlation between these markers and urinary lignans was reported. Our study showed a further increase in 2OHE1 concentration (103%) and in 2OHE1:16 OHE1 (98%) with an increase in dose from 10 ( 28 ) to 25 g. However, in our study, only the change in 2OHE1 concentration was significant.
Some studies showed that supplementation with soy as ISP providing 56-132 mg isoflavones/d influences urin[NextPage]ary estrogen metabolite excretion in postmenopausal women ( 46 ), whereas other studies did not ( 36 ). In comparison, our study used soy flour containing 42 mg isoflavones. Results in premenopausal women appear to be more consistent. Supplementation with soy as ISP in similar amounts was found to influence premenopausal urinary estrogen metabolite excretion ( 26, 27 ), which suggests that the effect of dietary soy may be dependent on estrogen status ( 47 ).
Results concerning the effects of phytoestrogen supplementation on serum hormones are conflicting. Although the present study reports no change in serum hormone concentrations, another study reported that consumption of 5 or 10 g ground flaxseed/d for 7 wk significantly reduced serum estradiol concentrations in postmenopausal women ( 3 ). The 10-g dose also reduced serum estrone sulfate concentrations ( 3 ). In support of our results, Lucas et al ( 35 ) found that supplementation with 40 g flaxseed/d for 3 mo had no effect on serum estradiol or estrone concentrations in postmenopausal women.
The effect of soy supplementation on serum hormones also varies and, like the effect on urinary metabolites, appears to be dependent on estrogen status. In agreement with our results, both Persky et al ( 36 ), in whose study postmenopausal women consumed ISP supplying 56 or 90 mg isoflavones/d for 3 or 6 mo, and Petrakis et al ( 48 ), in whose study postmenopausal women consumed ISP with 38 mg genistein for 6 mo, observed no effects on serum hormones in postmenopausal women. Studies in premenopausal women report conflicting results, with some showing no effect ( 40, 49 ), and others showing a moderate reduction ( 29, 39 ).
Despite increased metabolism to the less estrogenic metabolite (2OHE1) (with no change in 16 OHE1 concentration) in the flaxseed group, a corresponding change in biochemical markers of bone metabolism was not observed. Lim et al ( 25 ) found that postmenopausal women with osteopenia had significantly lower urinary 16 OHE1 excretion than did healthy control subjects. 2OHE1:16 OHE1 was also found to be negatively correlated with spinal BMD in these women ( 25 ). Supporting this apparent estrogenicty of 16 OHE1 with respect to bone, 16 OHE1 treatment in ovariectomized, growing rats resulted in bone measurements that did not differ from those after estradiol treatment ( 24 ).
Few studies relating flaxseed consumption to markers of bone metabolism have been conducted. Our results are supported by those of Lucas et al ( 35 ), who found that flaxseed supplementation had no effect on postmenopausal markers of bone metabolism. It is important to note the inverse correlation between urinary lignan excretion and serum bone-specific alkaline phosphatase that was observed in the flaxseed group in the present study. This correlation suggests a potentially antiestrogenic effect of flaxseed supplementation on bone, although the correlation did not translate to changes in the concentrations of the bioch[NextPage]emical markers measured.
Studies in postmenopausal women have shown conflicting results concerning the influence of soy isoflavones on BMD. Significant relations between habitual dietary isoflavone intake and BMD in postmenopausal Asian women have been observed ( 50, 51 ). However, intervention studies in postmenopausal women that examined both biochemical markers of bone metabolism and BMD yielded inconsistent results. Some studies showed a beneficial effect ( 37, 52 ), but another study showed none ( 38 ). These studies have generally involved ISP supplementation (56-90 mg isoflavones/d) over the short term (3-6 mo). With respect to bone, there is some question of whether the beneficial agent is the soy protein component rather than the isoflavones in soy ( 53, 54 ). Further studies investigating the effect of long-term supplementation with dietary phytoestrogens on BMD and, ultimately, the incidence of fracture are needed to fully understand this relation.
Estrogen is involved in the development and progression of several chronic diseases, including osteoporosis and hormone-sensitive cancers such as breast cancer. The structural similarity of the phytoestrogens enterolactone and enterodiol from flaxseed and genistein and daidzein from soy suggests that they may interfere with estrogen metabolism. Studies, including our own, suggest that flaxseed lignans and soy isoflavones interfere with the normal physiologic activity and metabolism of estrogens ( 4, 30 - 32, 55, 56 ). The ability to modulate estrogen metabolism and thereby affect tissue exposure to biologically active estrogens (ie, estradiol and 16 OHE1) may influence disease.
From the present study, we conclude that flaxseed supplementation in the amount of 25 g/d modifies estrogen metabolism, as indicated by changes in urinary metabolite excretion. Consumption of 25 g flaxseed/d significantly increased urinary 2OHE1 excretion, whereas consumption of 25 g soy/d did not. The increase in 2OHE1:16 OHE1 in the flaxseed group was not significant after a post hoc Tukey's test but was significant after a paired t test. A similar significant effect was not seen in the soy or placebo groups. Thus, these results should be interpreted cautiously and suggest that perhaps with a larger sample size, a significant effect may be achieved by using Tukey's test. The positive correlation between 2OHE1:16 OHE1 and urinary phytoestrogens in the flaxseed group (primarily lignans) but not in the soy group (primarily isoflavones) suggests that changes in metabolite excretion may be related to the higher activity and availability of lignans than of isoflavones. This suggestion is supported by the higher total phytoestrogen excretion in the flaxseed group than in the soy group (although not significant) despite the lower phytoestrogen intake of the flaxseed group.
The ability of phytoestrogens (in the present study, those from flaxseed most notably) to modify estrogen metabolism suggests a mechanism through which t[NextPage]hese compounds may be involved in both disease prevention and treatment strategies. However, flaxseed is also a very rich source of -linolenic acid (ALA) ( 57 ). Flaxseed oil has been shown to reduce mammary tumor growth ( 58 ), and ALA has been shown to alter the growth of breast cancer cell lines in vitro ( 59 ). Although the mechanism involving the effect of ALA, which may include an effect on estrogen metabolism, remains controversial, ALA should not be ruled out as a contributor to the effects seen with dietary flaxseed.
Modulation of estrogen metabolism has the capacity to influence tissue estrogen exposure and therefore breast cancer and osteoporosis ( 38, 60, 61 ). The present study suggests no negative effect of changing estrogen metabolism on biochemical markers of bone metabolism; however, the study was limited by the short treatment time and the small number of subjects. This suggests the need for long-term studies in larger treatment groups to examine the effect of whole soy and flaxseed, as well as their isolated components (eg, secoisolariciresinol diglycoside), on estrogen and bone metabolism to further understand their role as alternatives to traditional hormone replacement therapy. With the findings of the Women's Health Initiative study raising serious concerns about the safety of pharmacologic estrogen therapy ( 62 ), the potential of natural alternatives becomes more attractive.
ACKNOWLEDGMENTS
We thank Felicia Cheung and Minghua Chen for urinary lignan analysis.
JDB drafted the manuscript and did the analysis for sex hormones, estrogen metabolites, and nutrient intakes. WEW did the bone marker analysis and helped write the manuscript. JH, JEL, LN, and EW coordinated the subject recruitment and the sample and data collection for the original menopausal symptom study. LUT was the principal investigator for the estrogen metabolite and bone marker component of the study and helped write the manuscript. None of the authors had any conflicts of interest.
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        <pubDate>2012-01-03 09:11:24</pubDate>
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        <title>Fruit and vegetable intakes are an independent predictor of bone size in early pubertal children 1, 2,</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/Digest/2012/01/88260192538241.html]]></link>
        <text><![CDATA[【摘要】
      Background: Adequate intakes of fruit and vegetables are recommended for optimum health in children.

Objective: The objective of this study was to determine whether 3 times per day is beneficial to bone mass in children.

Design: Fifty-six white females (Tanner stage 2) recorded dietary intake on 3 independent days. The numbers of servings of fruit and vegetables were recorded for each day and tallied, and the subjects were pided into 2 consumption groups for analysis (low consumption: <3 servings/d, n = 22; high consumption: 3 servings/d, n = 34). Bone area and the bone mineral content of the whole body and radius were assessed by using dual-energy X-ray absorptiometry. Radioimmunoassays measured serum parathyroid hormone and 25-hydroxyvitamin D. Twenty-four-hour urine samples were assessed for calcium, sodium, and creatinine.

Results: After adjustment for age, body mass index, and physical activity, those children who reported consuming 3 servings fruit and vegetables/d had more bone area of the whole body (6.0%; P = 0.03) and radius (8.3%; P = 0.03), lower urinary calcium excretion (2.6 &plusmn; 0.2 compared with 1.8 &plusmn; 0.3 mg/kg; P = 0.04), and lower parathyroid hormone (19.6 &plusmn; 1.9 compared with 25.0 &plusmn; 1.6 pg/mL; P = 0.01) than did those children who reported consuming <3 servings fruit and vegetables/d.

Conclusions: High fruit and vegetable intakes have beneficial effects on the bone area of the radius and whole body in early pubertal girls. The lower urinary calcium output associated with higher fruit and vegetable intakes may be a modulating factor. 
          【关键词】 Dualenergy Xray absorptiometry children bone mass urinary calcium excretion
		  INTRODUCTION
The assessment of dietary factors on bone accretion in children has focused on the quantity of calcium required for optimal bone accrual. In childhood, bone accrual reflects the genetic and environmental influences on calcium and bone metabolism. Urinary calcium excretion is one component of calcium balance that may provide insight into the effects of dietary intake on calcium and bone metabolism. Welch et al ( 1 ) showed that 92% of urinary calcium excretion reflects bone metabolism rather than dietary calcium intake. Understanding the factors that contribute to urinary calcium excretion may be crucial to the design of dietary interventions that maximize bone accrual.
The studies relating dietary factors to calcium excretion in children focused on the effect of dietary calcium, protein, phosphorus, and sodium consumption ( 2, 3 ). Of these factors, only sodium intake was shown to have modest effects on calcium excretion ( 2 ). In theory, each of these nutrients can be related to the excretion of calcium in the urine, but it is the net metabolic effect of the total diet that dictates how much calcium is excreted in the urine.
Wachman and Bernstein ( 4 ) proposed that dietary intake is related to the development of osteoporosis through the regulation of th[NextPage]e acid-base balance. Bone tissue is a rich source of bases (calcium, carbonate, citrate, magnesium, and potassium) that can buffer acute acid loads ( 5 ) and chronic metabolic acidosis ( 5, 6 ). Dietary intake is made up of foods that contribute to the metabolic acid load (protein-rich foods, grains, and cereals) and foods that provide base products to neutralize the acid load (fruit and vegetables). In the absence of sufficient base products in the diet, the bone-fluid barrier contributes to the buffering of the acid to maintain pH within narrow limits ( 5 ). Thus it follows that high consumption of fruit and vegetables should counterbalance a similar consumption of foods that produce more acid and thus should spare the skeleton.
In adults, evidence has mounted suggesting that a diet with higher consumption of fruit and vegetables is beneficial to bone mineral density (BMD; 7 - 12 ). Feeding studies showed that increased consumption of dietary fruit and vegetables in combination with controlled calcium intake reduces urinary calcium excretion ( 13, 14 ) and the pH of urine ( 14 ). Intestinal absorption of calcium was unchanged, which suggests increased calcium retention ( 14 ). Jones et al ( 15 ) showed that urinary potassium excretion, a potential marker for fruit and vegetable intakes, correlates with BMD of the total body, femoral neck, and lumbar spine in calcium-replete children. But there are, to our knowledge, no data that tie fruit and vegetable intakes to urinary calcium and bone mass in children. The main objective of this research project was to evaluate the influence of fruit and vegetable intakes on urinary calcium excretion and bone mass in a group of early pubertal girls. A secondary aim was to evaluate whether parathyroid hormone (PTH), 25-hydroxyvitamin D [25(OH)D], and markers of bone formation and resorption were related to fruit and vegetable intakes.
SUBJECTS AND METHODS
Subjects
Fifty-six white females were recruited to participate in a randomized calcium supplementation trial through direct mailing and advertisements in the local media. The girls were between the ages of 8 and 13 y, and they presented at Tanner stage 2 of sexual development. Girls were excluded from entering the study if they reported chronic use of medicines known to affect calcium metabolism. Each subject and her legal guardian provided written informed consent in accordance with the human investigation and review boards at the University of Tennessee.
Study measurements
Subjects completed height, weight, and bone measurements and provided a 24-h urine sample, a blood sample, and a 1-d food record before being randomly assigned to receive placebo or 1000 mg calcium carbonate/d. Two additional 1-d food records were collected after randomization. Tanner stage was self-reported.
Anthropometry
Body weight was measured on a balance-beam scale to the nearest 0.1 kg. Height was measured twice to the nearest 0.1 cm by using a Harpenden stadiometer (Holtain, Crym[NextPage]ych, United Kingdom). 0.5 cm, a third measurement was performed. The average of the 2 measurements within 0.5 cm was used for these analyses. Body mass index (BMI) was calculated as weight in kg pided by height in meters squared.
Dual-energy X-ray absorptiometry of the whole body and wrist
Dual-energy X-ray absorptiometry (DXA) was performed by using a Hologic Quantitative Digital Radiography bone densitometer (model 2000; Hologic Inc, Bedford, MA) to measure bone area, bone mineral content (BMC), and BMD of the whole body and nondominant wrist. Whole-body measurements were assessed by using the array mode and analyzed by using enhanced whole-body software (version 5.73a; Hologic Inc). The nondominant wrist was scanned in the pencil-beam mode and analyzed by using the same software. The DXA quality assurance manual for the study was used to standardize subject positioning and scan analysis. Two scans at the baseline visit were obtained with repositioning. The average of the 2 scans are reported as the bone indexes. In addition, we applied the method developed by Brismar et al ( 16 ) for calculating the whole-body bone mineral apparent density [in g/cm 3 = areal BMD of whole body/(whole body area - head area/(body height - 18 cm)].
Laboratory assessments
All subjects collected a 24-h urine sample for measurement of calcium, creatinine, and sodium. Subjects were given detailed verbal as well as written instructions on how to collect a complete 24-h urine sample and given a 2.5-L plastic bottle to take with them. Time and volume of collections were recorded. Samples were considered to be complete if the volume exceeded 24 mL urine/kg body wt and if creatinine was within the 2 SDs of creatinine values for the subject's height ( 17 ). Urinary calcium was measured with the use of o -cresolphthalein. Urinary sodium was measured by using an ion-selective electrode. Urinary creatinine was measured by using the Jaffe reaction (picric acid). The intraassay CVs for these 24-h urine specimens were 0.3-2.3% for calcium, 0.3-1.6% for sodium, and 0.6-1.5% for creatinine. Urinary deoxypyridoline was measured by using a competitive enzyme immunoassay (Pyrilinks D; Metra Biosystems Inc, Mountain Home, CA). The interassay CVs for these assays were 0.9-1.2% for calcium, 1.1-2.7% for sodium, 2.5-3.2% for creatinine, and 5% for deoxypyridoline.
Serum was drawn between 1600 and 1900. Serum PTH was measured by using a 2-site immunoradiometric assay and 2 affinity-purified antibodies. One antibody raised against the mid- and C -terminal (PTH 39-84) is immobilized on plastic beads, and the other antibody raised against the N -terminal (PTH 1-34) is labeled with 125 I (DiaSorin, Stillwater, MN). The CV for this assay is <7%, and the range for normal children is 13-50 pg/mL. We evaluated the effect of consuming foods and beverages within 4 h of the blood draw on PTH concentrations between the 2 fruit and vegetable consumption groups. There were no differences between the 2 groups with regard to food consumption. Serum 25(OH)D was measured by using a radioimmunoassay (DiaSorin). The intraassay and interassay CVs are <10%. The reference range for 25(OH)D was 15-60 ng/L. We used a competitive enzyme immunoassay and a monoclonal antibody to measure both intact osteocalcin and its large N -terminal midfragment (Nichols Inc, San Juan Capistrano, CA). The interassay CV for osteocalcin was <4.9%.
Dietary intake
Food records
Each subject and her parent or guardian were provided detailed instructions on keeping a 1-d food record by using a standardized collection form. Food models and photographs of serving sizes of foods were used to estimate the qua[NextPage]ntity of all foods and beverages consumed. A technician was trained and certified by a registered dietitian to provide instructions to the subjects for recording all food and beverages and to review the completed records with each girl and her parent or guardian. Ninety-six percent of the subjects provided food records for 3 independent days within 12 mo of beginning the study; 2% did so by 15 mo, and 2% did so by 24 mo.
Food group consumption
A trained technician assigned each food consumed to 1 of 6 food categories: meat and meat alternatives, fats and sweets, milk and milk products, grain products, fruit, and vegetables. Each time a food in one of the major food categories was consumed, its food category was credited with one point. The method used to assign food items to food groups is described in detail by Krebs-Smith et al ( 18 ). Ten percent of the records were coded by another research technician and checked for accuracy. A third researcher rectified differences between the 2 coders in assigning a food to a food group. For statistical analyses, data from 3 d were summarized for each subject. Subjects were grouped into consumption groups; a low intake was <3 servings/d, and a high intake was 3 servings/d.
Nutrient intake
The food records used to estimate food group consumption were analyzed for nutrient content by using NUTRIBASE 2001 CLINICAL software (version 3.03; CyberSoft Inc, Phoenix, AZ). Nutrient intake reflects the average of the independent food records for 3 d. For each nutrient, the actual intake was compared with the estimated average requirement or adequate intake set by the Institute of Medicine ( 19 - 22 ).
Physical activity
Subjects completed a 1-d physical activity checklist on the same days that diet records were collected. The physical activity log used for this study was developed and validated by Sallis et al ( 23 ). All physical activities for a 24-h period, including activities of daily living, were recorded. Energy expenditure was calculated on the basis of the subject's weight and the frequency and duration of each activity recorded ( 24, 25 ).
Statistical analysis
Data were analyzed by using SAS software ( 26 ). Means and SEs were used to describe all continuous measures according to the consumption groups: urinary measures, serum measures, and physical characteristics of the participants. Student's t tests were used to compare differences between the fruit and vegetable consumption groups in age, height, weight, BMI, percentage body fat, household size, and parent's education. A chi-square test was used to determine whether there were differences between the fruit and vegetable consumption groups with respect to family income and the percentage of subjects who consumed the estimated average requirement or the adequate intake of the respective nutrient. The energy intake differed significantly between the 2 consumption groups (low consumption: 2059 &plusmn; 98 kcal; high consumption: 2394 &plusmn; 94 kcal; P = 0.02). Nutrient intakes of the 2 food consumption g[NextPage]roups were compared after adjustment for differences in energy intake. Comparisons of bone indexes, urinary sodium and calcium, serum PTH and 25(OH)D, and markers of bone turnover between the 2 consumption groups were evaluated after adjustment for age, BMI, and physical activity. A P value of <0.05 was considered significant when the 2 consumption groups were compared. The adjusted means are presented for nutrient intake and bone assessments.
RESULTS
The characteristics of the study population according to fruit and vegetable intake groups are shown in Table 1. Sixty-one percent of the girls reported consuming 3 servings fruit or vegetables/d. The consumption groups did not differ significantly with respect to age, height, weight, BMI, percentage body fat, household size, parent education, physical activity expenditure, or family income. The sample represents a fairly affluent group: 75% of the participants' families reported an $50 000/y.
TABLE 1 Characteristics of girls with low and high fruit and vegetable consumption 1
The consumption of milk and milk products, meat and meat alternatives, cereals and grains, and fats and sweets did not differ significantly between the low and high fruit and vegetable consumption groups, with respect to the reported intake ( Table 2 ). The energy-adjusted nutrient intakes for the high and low fruit and vegetable consumption groups are shown in Table 3. The report of higher fruit and vegetable intakes reflects higher nutrient intakes of vitamin A, vitamin C, potassium, and magnesium. There were no significant differences between the 2 groups in calcium, phosphorus, vitamin D, or protein intakes, nor were there significant differences in sodium contained in the 24-h urine sample. When the percentage of subjects in the low and high fruit and vegetable consumption groups who met the estimated average requirement or the adequate intake for the respective nutrients were compared, the low-consumption group had significantly fewer persons reporting adequate intake of vitamin C and calcium, but no differences for the other nutrients. Overall, both fruit and vegetable consumption groups met the estimated average requirement for the macronutrients but fell short for calcium, phosphorus, magnesium, and vitamin A.
TABLE 2 Reported intake of food groups according to fruit and vegetable consumption group 1
TABLE 3 Energy-adjusted nutrient intakes according to fruit and vegetable consumption 1
Bone assessments
Compared with the low-consumption group, the high fruit and vegetable consumption group had a 6% and 8.3% larger bone area of the whole body ( P = 0.03) and of the wrist ( P = 0.03), respectively. The BMC of the whole body was 7.4% larger ( P = 0.07) and that of the wrist was 7.0% larger ( P = 0.09) in the high-consumption group than in the low-consumption group ( Figure 1 ). BMD of the whole body did not differ significantly between the low- and high-consumption groups (0.712 &plusmn; 0.005 and 0.719 &plusmn; 0.006 mg/cm 2, respectively; P 0.05). Similar results were obtained for BMD of the wrist (low-consumption group: 0.389 &plusmn; 0.005 mg/cm 2; high-consumption [NextPage]group: 0.389 &plusmn; 0.004 mg/cm 2; P 0.05). With the use of a correction for bone size, whole-body bone mineral apparent density did not differ significantly between the 2 groups (low-consumption group: 0.084 &plusmn; 0.002 mg/cm 3; high-consumption group: 0.083 &plusmn; 0.001 mg/cm 3; P 0.05).
FIGURE 1. Mean (&plusmn; SE) bone area and bone mineral content (BMC) of the whole body and the nondominant radius according to fruit and vegetable consumption group (, low-consumption group: <3 servings/d, n = 22;, high-consumption group: 3 servings/d, n = 34) after adjustments for age, physical activity, and BMI. *Significantly different from high-consumption group, P = 0.03.
Urinary calcium
The difference in 24-h urinary calcium concentrations between the 2 consumption groups after adjustment for age, physical activity, and BMI is graphically depicted in Figure 2. Those reporting high fruit and vegetable intakes had lower concentrations of urinary calcium/kg body wt ( P < 0.05). Differences between the 2 groups were also found when urinary calcium was corrected for creatinine (low-consumption group: 0.37 &plusmn; 0.04 mmol/L; high-consumption group: 0.27 &plusmn; 0.03 mmol/L; P < 0.02).
FIGURE 2. Mean (&plusmn; SE) urinary calcium and serum parathyroid hormone (PTH) concentrations according to fruit and vegetable consumption (, low-consumption group: <3 servings/d, n = 22;, high-consumption group: 3 servings/d, n = 34). *,**Significantly different from high-consumption group (Student's t test): * P = 0.04, ** P = 0.01.
Parathyroid hormone and 25-hydroxyvitamin D
PTH concentrations were higher in the low fruit and vegetable consumption group than in the high-consumption group (Figure 2 ). There were no significant differences in 25(OH)D stores between the 2 groups (low-consumption group: 26.1 &plusmn; 1.5 ng/mL; high-consumption group: 29.4 &plusmn; 1.5 ng/mL). Adjustment for age, BMI, and physical activity did not change the results.
Biomarkers of bone turnover
Deoxypyridoline did not differ significantly between the low (20.2 &plusmn; 1.3 nmol/L) and high (21.7 &plusmn; 0.9 nmol/L) fruit and vegetable consumption groups ( P 0.05). Nor did osteocalcin differ significantly between the low (34 &plusmn; 2.4 ng/mL) and high (24.8 &plusmn; 1.9 ng/mL) fruit and vegetable consumption groups ( P 0.05).
DISCUSSION
Early pubertal girls who reported consuming fruit and vegetables 3 times a day had, when compared with similar girls who reported consuming fruit and vegetables <3 times a day, lower urinary calcium excretion, lower PTH concentrations, and larger bone size as indicated by bone area of the whole body and of the nondominant wrist after control for age, BMI, and physical activity. The girls with high fruit and vegetable intakes reported higher concentrations of potassium, magnesium, vitamin A, and vitamin C than did those who had low fruit and vegetable intakes, and there was no difference between the 2 groups in protein, phosphorus, and calcium intakes after adjustment for differences in caloric intake. These results suggest that a diet high in fruit and vegetable intakes may be important to the developing skeleton, especially as related to bone size.
Diet, metabolic acidosis, and buffering
Diets in Westernized countries are characterized as rich in meat products and lower in fruit and vegetables than is recommended for optimal health. The net metabolic acid load of these diets is considered to produce larger quantities of acid, as indicated by the bicarbonate and pH of the blood ( 27 ). In humans with normal kidney function, the acid-base balance is dependent on the ability of the kidney to excrete excess acid and the availability of a base for buffering ( 28 ). Fruit and vegetables provide a natural source of base to buffer the acid produced by other dietary components. In the acute phase, potassium and sodium contained in the bone-fluid barrier are the first line of defense for buffering metabolic acidosis, and thus they spare the bone tissue ( 28 ). In a chronic state of metabolic acidosis, bone crystals are dissolved to provide calcium, carbonate, and citrate for buffering ( 28 ). Much of the work to support these observations has been done in adults or animal models ( 29, 30 ). In contrast, different[NextPage] assumptions may be required about the role of bone and nutrient intake in modulating the acid-base balance in children.
Skeletal effects
In the growing skeleton, increases in BMC should parallel increases in bone area, with modest changes in BMD ( 31 ). Within 3-6 y after cessation of longitudinal growth, the secondary consolidation of bone mineral should be complete ( 32 ). It is only at this point or when peak bone mass is reached that differences in bone area, BMC, and BMD due to dietary influences such as high fruit and vegetable consumption can be realized. Factors that can affect the skeletal size at any point in time during puberty include Tanner stage of sexual maturation, genetics, and environmental influences ( 33 ). To control for nondifferential error attributed to these influences, we included chronologic age, physical activity, and BMI in all of the analyses.
Our cross-sectional analyses imply that high fruit and vegetable consumption may also affect BMC. Because the hydration of bone tissue is proportional to the age of the bone and is a primary determinant of the chemical reactivity of bone ( 29, 30 ), there may be an increased capacity in children to buffer acid loads without affecting the density of bone tissue, but that capacity may limit the accrual of BMC and ultimately BMD at peak bone mass. This would be in accord with adult studies linking diets with higher fruit and vegetable intakes to greater bone density ( 7 - 12 ). In contrast with our study, Jones et al ( 15 ) linked urinary potassium as a surrogate for fruit and vegetable intakes to greater bone density of the hip, lumbar spine, and whole body in prepubertal children, but they did not report on bone size or BMC. Differences that may have contributed to the disparate findings include a larger sample size of boys and girls residing in Tasmania, pubertal status, calcium-replete status, and the use of urinary potassium excretion as a surrogate for fruit and vegetable intakes.
Urinary excretion
One consequence of greater endogenous acid production is an increase in calcium excreted in the urine ( 6, 13, 14, 27 ). However, sodium excretion has been reported to be a significant determinant of calcium excretion in children ( 2, 3, 34 ). In both our study and that of Jones et al ( 15 ), there were no differences in 24-h urinary sodium concentrations between the groups according to fruit and vegetable consumption groups (ie, high or low consumption) or urinary potassium excretion.
Dietary protein was shown to increase the excretion of calcium in adults ( 35 - 38 ). The primary mechanism is through the deamination of nitrogen during protein metabolism, which yields a higher metabolic acid load. Hydrogen ions are also derived from oxidation of sulfur-containing methionine and cysteine. Because our nutrient analysis program did not specify the amino acid content of the diets, we cannot exclude the possibility that there were differences in sulfur-containing amino acids between [NextPage]the 2 consumption groups that contributed to differences in urinary calcium excretion or bone size.
Dietary potassium has been implicated as a calcium-sparing nutrient because of its ability to buffer metabolic acid load through either supplements ( 39, 40 ) or diet ( 14, 36 ). Whether this effect is due to the potassium content of the diet or is secondary to higher fruit and vegetable intakes cannot be ascertained from our study.
Indicators of bone metabolism
Feeding studies have shown that consuming an alkaline diet inhibits bone resorption ( 14, 41 ) in adults, whereas in vitro studies show that osteoclastic activity mobilizes bone calcium to buffer metabolic acid loads ( 42 ). The lack of association between bone turnover in our 2 fruit and vegetable consumption groups may be due to a cross-sectional study design, insufficient sample size, or measurement error associated with diet-assessment techniques.
Diet assessment
Adequate representation of the diet is critical to the underlying assumptions of this research. We averaged 3 independent days of intake over a 24-mo period to incorporate seasonal and weekday variations to obtain a better estimate of usual intake. We controlled for this potential bias of underreporting of fruit and vegetable intakes in the low-consumption group by adjustment for energy in our statistical analyses of nutrient intakes. Because fruit and vegetable intakes were quantified as a unit when reported on the food records, we could not exclude the possibility that serving size may make a difference in the ability to buffer acid load, and our results may have been attenuated. The report of similar intakes of each food group except fruit and vegetables by the 2 consumption groups suggests that differences in the quality of the diet are factors mitigating the lower urinary calcium excretion and larger bone size.
Study limitations
Whereas our study does provide support that consistent intakes of fruit and vegetables may be beneficial to bone mass in early pubertal girls, it does have limitations. This study was cross-sectional, and thus we cannot confer causality between diet and bone mass. The sample was small-limited to 56 white girls from affluent families-and thus our results cannot be generalized to all ethnic or socioeconomic groups. The study included only one 24-h urine sample, which raises the possibility that excretion of urinary calcium and sodium could be underestimated or overestimated ( 43 ).
Summary
In summary, high fruit and vegetable intakes have beneficial effects on bone size of the radius and whole body in early-pubertal white girls after control for age, BMI, and physical activity. The lower urinary calcium output and serum PTH associated with higher fruit and vegetable intakes may be a modulating factor. However, cumulative effects on bone mass accrual and peak bone mass remain to be determined.
ACKNOWLEDGMENTS
We acknowledge Bruce Hollis, who performed the vitamin D and parathyroid hormone analyses, an[NextPage]d Martha A Mayhugh and Sherry M Lewis from the National Center for Toxicological Research, FDA (Jefferson, AR), for analysis of the dietary data.
FAT was responsible for the conception, management, design, and funding of the study, as well as for recruitment, data collection, analysis, and writing the manuscript. KH was responsible for the collection and analysis of food group data from food records and was involved in writing the manuscript. LC was involved in the conception, management, and design of the study and in writing the manuscript. RD, CW, and JN were responsible for the medical consultation and were involved in writing the manuscript. None of the authors had financial or personal affiliations with the sponsors of this research.
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        <pubDate>2012-01-03 09:11:19</pubDate>
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        <title>Energy requirements in the eighth decade of life 1, 2,</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/Digest/2012/01/377969690.html]]></link>
        <text><![CDATA[【摘要】
      Background: Knowledge of energy requirements among relatively healthy elderly is limited.

Objectives: The objectives of the study were to measure total energy expenditure (TEE)-derived energy requirements in a biracial population of older adults without limitations to daily life and to test these empirical measures against national and international recommendations.

Design: TEE (measured by the doubly labeled water method), resting metabolic rate (RMR), activity-related energy expenditure (AEE), and body composition were measured in 288 persons aged 70-79 y selected from the Health, Aging, and Body Composition Study.

Results: TEE was lower in women ( 530 kcal/d; P < 0.0001) than in men because of the women's lower RMR and AEE. Fat-free mass explained the sex difference in RMR, but body weight failed to account for the women's lower AEE ( 1 kcal &middot; kg -1 &middot; d -1; P = 0.007). Blacks had lower TEE than did whites ( 100 kcal/d, P = 0.03), and that was explained by blacks' lower RMR. Physical activity level (TEE/RMR) did not differ significantly between sexes and races (1.70 &plusmn; 0.23). The World Health Organization (WHO) recommendations overestimated TEE by 10 &plusmn; 15% ( P < 0.0001) in women but not in men, and the dietary reference intakes (DRIs) were accurate to 0 &plusmn; 14% ( P = 0.1). Both WHO and DRI recommendations are based on an underestimated physical activity level, and WHO recommendations are based on overestimated RMR.

Conclusions: This study of well-functioning older adults confirms the racial difference in energy metabolism and supports the use of the 2002 DRIs. Because the DRIs and WHO recommendations underestimated PAL, new predictive equations of energy requirements are proposed. 
          【关键词】 Aging obesity malnutrition African Americans sex energy expenditure
		  INTRODUCTION
It is projected that, by 2040, 20% of the US population will be 65 y old; by comparison, in 1997, 12% of the US population was aged 65 y, and at the beginning of the last century, that proportion was only 4% ( 1, 2 ). Recent 65 y old have a chronic disease or some other form of disability, and, consequently, the total societal burden of physical impairment will increase with the rise in the elderly population ( 3, 4 ). To mitigate any age-related decline in autonomy, particularly that engendered by nutrition-related chronic diseases, it is essential to develop strategies to promote adequate nutrition.
Among these strategies, the maintenance of energy balance is critical but complex in the elderly ( 5 - 7 ). Total energy expenditure (TEE) decreases with age because of an equivalent reduction in resting metabolic rate (RMR) and activity-related energy expenditure (AEE; 7, 8 ). However, the ability to control food intake after overeating or undereating becomes impaired with age ( 9, 10 ). These problems, in conjunction with chronic diseases, chewing problems, polypharmacy, living alone, and low income, likely explain the high [NextPage]vulnerability of the elderly to energy imbalances. Ultimately, an inappropriate energy intake leads to weight gain or undernutrition, which, together with physical inactivity, further contributes to the decline of bodily functions and the development of age-associated chronic degenerative diseases ( 5, 6 ).
Dietary interventions are particularly challenging in the elderly because of the paucity of data on which accurate recommendations for age-related changes in energy requirements can be based ( 7, 11 ). This scantiness of data reflects 3 main factors. First, the elderly are a highly heterogeneous population ranging from the highly active newly retired to the institutionalized. Second, accurate energy requirements must be derived from free-living TEE measured by using the state-of-art, costly, expertise-requiring doubly labeled water (DLW) method ( 12 ). Third, low minority inclusion has impaired the ability to determine the general applicability of TEE estimates ( 13 ).
The Health, Aging, and Body Composition Study (Health ABC Study) provided a unique opportunity to evaluate energy requirements in the eighth decade of life in a cohort of people free of functional limitations and disabilities of daily living. This cohort constitutes a particularly interesting population compared with those of previous reports of studies using DLW because of its large size and generally well functioning status. In a group of 288 elderly persons, we specifically investigated whether TEE-derived energy requirements differ by sex and race and the extent to which the current World Health Organization (WHO; 14 ) and the new 2002 Dietary References Intake (DRI; 15 ) recommendations are accurate in such a population; then we generated new predictive equations of energy requirements applicable to the growing elderly population.
SUBJECTS AND METHODS
Subjects
Initiated in 1997, the Health ABC Study consisted of a cohort of 3075 participants recruited at 2 field centers: the University of Pittsburgh and the University of Tennessee (Memphis). Participants were aged 70-79 y ( age: 73.6 y), and the population was roughly stratified for sex and race (51.5% women and 41.5% black). Participants were eligible if they reported an ability to walk 0.4 km and climb 10 steps without rest and, in addition, were free of selected physical limitations in the activities of daily living. Additional exclusion criteria included life-threatening cancers, participation in any research study involving medications or modification of eating or exercise habits, and plans to move out of the area in the next 3 y.
The energy expenditure (EE) substudy was conducted between July 1998 and June 2000, and it included a race- and sex-stratified random selection of participants from the larger Health ABC Study. Substudy exclusion criteria included recent blood transfusion or intravenous fluid administration, use of supplemental oxygen or insulin, and overnight travel immediately before or during the EE measur[NextPage]ement period. Participants were recruited from a list of 500 persons randomly selected from the original 3075 subjects and were balanced by race and sex. A replacement list of 200 subjects, also stratified for race and sex, was generated. Whenever a participant from the primary list was ineligible or refused to participate, a participant from the same race and sex subgroup was contacted from the replacement list to determine his or her eligibility and willingness to participate. The field centers had lower yields in several cells, and, at the end of 1999, the EE substudy was unbalanced with respect to race. The study was extended to the year 2000 and a new primary list was generated, which oversampled participants in the race and sex categories most lacking at each field center. A total of 323 subjects were enrolled in the EE substudy. No differences were noted between the EE substudy and the entire Health ABC cohort with respect to body mass index (BMI; in kg/m 2 ), age, sex, race, knee extension strength, self-reported physical abilities, or self-reported energy intake. The substudy cohort, however, had a 5% faster time on a standardized walk. We assessed the influence of this difference by adding 400-m walking speed to the multiple regression for physical activity level (PAL). The 5% difference in speed translated to a 1.5% difference in PAL, and the substudy can therefore be considered as representative of the overall Health ABC Study cohort.
Protocol
The testing protocols were completed in the field centers during 2 visits over a 2-wk period. The participants arrived for both visits in the fasted state. During visit 1, participants received a dose of DLW for the measurement of TEE according to a protocol previously described in detail ( 16 ), and body composition was determined by using dual-energy X-ray absorptiometry (DXA). Approximately 14 d (14 &plusmn; 1 d) after the DLW dosing, the participants returned to the field centers for visit 2. Body weight was recorded, and the participants were asked to relax in a prone position for 30 min in a quiet room with a light cover for thermal comfort. After this, RMR was measured for 40 min by using respiratory gas exchange. During this visit, 2 urine samples were collected for the endpoint DLW analysis. Between visit 1 and visit 2, the subjects were asked to maintain their normal activity pattern.
The protocol was approved by the Internal Review Boards at the University of Tennessee-Memphis and the University of Pittsburgh. The participants were fully informed of the purpose and potential risks of the experimental protocol, and inpidual informed written consent was obtained before the study.
Total energy expenditure measurements
The TEE was determined by using the 2-point DLW method according to Schoeller et al ( 17, 18 ). The specific DLW protocol applied during the Health ABC EE substudy (ie, dose, sample preparations, mass spectrometry analyses of deuterium and 18-oxygen isotopic enrichments in [NextPage]biological specimens, and EE calculations) was detailed elsewhere ( 16 ). Briefly, DLW was orally dosed at 0.2 g 18 O and 0.14 g deuterium/kg estimated total body water. Results were calculated according to Racette et al ( 19 ) with a food quotient estimated at 0.86 from the third National Health and Nutritition Examination Survey ( 20 ) and Black's formula ( 21 ). Ten percent of the population displayed delayed urinary isotopic equilibration, and thus plasma enrichment was used for calculation ( 16 ).
Blinded repeat isotopic analyses were completed in 16 participants by using duplicate urine aliquots. For the total body water, the within-subject repeatability, calculated as the average percentage difference between the 2 analyses, was -0.1 &plusmn; 1.2%. The within-subject analytic repeatability for TEE was 1.2 &plusmn; 5.4%. Results were within the limits of expectation predicted for the typical analytic variation in our laboratory.
Resting metabolic rate and activity-related energy expenditure
The RMR was measured on one of 2 Deltatrac II respiratory gas analyzers (Datex Ohmeda Inc, Helsinki). After the subjects rested for 30 min, gas exchanges were measured for 40 min. Data from the first 10 min were excluded, as were the data for 2 min after any movement or loss of wakefulness. The remaining minute-by-minute data were averaged. Methanol burn tests were performed in duplicate once or twice a month. Carbon dioxide recovery averaged 100.1 &plusmn; 1.4% at the Pittsburgh site and 100.5 &plusmn; 1.5% at the Memphis site. Gas exchange ratios for methanol differed by 2.5% ( P < 0.001) between sites; those at Memphis (0.666 &plusmn; 0.014; n = 71) were accurate, and those at Pittsburgh (0.683 &plusmn; 0.015; n = 48) were a little greater than theoretical. The respiratory ratios for participants enrolled at Pittsburgh were corrected accordingly.
The diet-induced thermogenesis was assumed to be 8% of TEE ( 22 ), and the AEE was calculated as 0.92 x TEE - RMR. PAL was calculated as the ratio of TEE to RMR.
Body composition
Total body fat (fat mass, FM) and fat-free mass (FFM) were measured by DXA by using a Hologic 4500A Scanner (Hologic Inc, Watham, MA) with HOLOGIC software (version 8.21; Hologic Inc) for analysis. Health ABC validation studies, however, had shown that DXA FFM systematically overestimated FFM, and DXA FFM and FM were corrected accordingly ( 23 ).
Statistical analyses
Of the 323 subjects included in the EE substudy, 35 were excluded from the statistical analysis. Nine of the 323 subjects did not return to the field centers to complete the protocol, 2 failed to collect appropriate urine specimens, 8 had inconsistencies in their stable isotope data, 2 had highly variable RMR measurements, and 14 did not undergo DXA measurements within 15 d of the EE measurements.
Before the statistical analysis, the normality of the data was ascertained by using the Kolmogorov-Smirnov test. Differences between groups were tested by a factorial analysis of variance (ANOVA) with race, sex, and site as main effects. RMR was analyzed by an analysis of covariance (ANCOVA) with FFM as the covariate because regression analysis identified FFM as the main predictor of RMR ( R 2 = 0.66). The model, however, rejected the hypothesi[NextPage]s of slope homogeneity for race (FFM-by-race interaction: P = 0.02), but not for sex (FFM-by-sex interaction: P = 0.08). Thus, the interaction term for race was kept in the ANCOVA model for use in calculating the adjusted RMR values. To characterize the effects of the different slopes, RMR values adjusted for FFM were calculated at different percentiles of the population FFM. RMR was also adjusted for both FFM and FM; FFM was measured from DXA and FM was measured from isotope dilution to avoid circularities in analysis. Predictive equations of RMR were derived by using multiple regression analysis. Statistical analyses were performed by using STATVIEW software (version 5.01; SAS Institute Inc, Cary, NC) considering a P value of <0.05 to be significant. Values are expressed as means &plusmn; SDs, unless otherwise stated.
RESULTS
Anthropometric data and body composition
The physical characteristics and body composition of the participants are presented in Table 1. To be consistent with the statistical analysis, the results are presented according to the main effects of the ANOVA. None of the 3-factor interactions were significant.
TABLE 1. Anthropometric and body-composition data 1
Sex effects
No sex differences by age or BMI were noted. As expected, the mean body weight of the men was 16% higher than that of the women. A significant sex-by-race interaction was observed for FM, which indicated that the general sex effect was dependent on race: FM weight was 25% higher in the black women than in the black men, whereas this sex difference was only 6% in the white subjects. FM expressed as percentage of body weight was one-third higher in the women than in the men.
Race effects
Age, weight, and BMI did not differ between races. The observation of a sex-by-race interaction for weight and BMI showed that the difference in weight and BMI between the blacks and the whites was dependent on sex. The weight of the black women was 10% greater than that of the white women, whereas no race difference was noted between the men; the same trend was noted for BMI. FM did not differ significantly between the black and white participants but was 5% higher in the white subjects than in the black subjects when expressed as a percentage of body weight. The sex-by-race interaction in FM showed, however, that most of the race difference was among the men rather than among the women.
Site effects
The age of the participants did not differ significantly between the 2 sites. Significant sex-by-site interactions were noted for weight ( P = 0.05), BMI ( P = 0.04), and FM ( P = 0.02), and, as with the race effects, they were mainly attributed to differences among the women. Weight was 9% higher in the women in Pittsburgh than in the women in Memphis (73.7 &plusmn; 16.9 and 67.3 &plusmn; 13.9 kg, respectively), but it did not differ significantly between the men (Memphis: 82.8 &plusmn; 13.9 kg; Pittsburgh: 82.16 &plusmn; 13.2 kg). As expected, the same observation was made for BMI: the BMIs of the men from Memphis and Pittsburgh did not differ significantly (27.2 &plusm[NextPage]n; 4.5 and 27.5 &plusmn; 4.3, respectively), but the women from Pittsburgh had a 10% greater BMI than did the women from Memphis (29.0 &plusmn; 6.0 and 26.1 &plusmn; 5.1, respectively). Because FFM did not differ significantly between cities, these disparities were mainly attributed to differences in FM. Effectively, FM was shown to be 16% greater in the Pittsburgh women than in the Memphis women (30.5 &plusmn; 10.4 versus 26.0 &plusmn; 9.3 kg), whereas FM did not differ significantly between the men at the 2 sites (Memphis: 23.7 &plusmn; 8.0 kg; Pittsburgh: 23.3 &plusmn; 7.6 kg).
Energy metabolism
The energy components of the participants are presented in Table 2 stratified by the main effects of the ANOVA. None of the 3-factor interactions were significant.
TABLE 2. Energy expenditure components 1
Sex effects
As expected, the TEE was 25% lower in the women than in the men. This difference was due to a 21% lower RMR and a 31% lower AEE in the women. After statistical adjustment for FFM, RMR did not differ significantly between the men and the women. When AEE was normalized per unit of body weight, the difference observed in nonadjusted values was maintained. PAL did not differ significantly between the sexes, although a trend toward significance was observed.
Race effects
The TEE was 3% lower in the blacks than in the whites. Because AEE did not differ significantly between the races, the difference in TEE was mainly due to a 4% lower RMR in the blacks. The race-by-sex interaction observed for TEE shows the sex specificity of the race difference; ie, TEE did not differ significantly between the black women and the white women, but an 8% TEE difference was noted between the black men and the white men. The relation between FFM and the RMR differed significantly between the races ( Figure 1 ). To account for this difference, race-specific RMR/FFM slopes were maintained in the ANCOVA model, and adjusted RMRs were estimated at different percentiles (25th, 50th, 75th) of the covariate. At all FFM percentiles, RMR adjusted for FFM was significantly lower in the blacks than in the whites ( P < 0.001 for all), and it was 100 kcal/d at the 50th percentile. The race difference in RMR was maintained even after adjustment for both FFM and FM. The absence of a difference between races in AEE was maintained after normalization per kilogram of body weight. PAL did not differ significantly according to race. It is interesting that age was a significant determinant of RMR. However, by plotting RMR/FFM residuals against age, we observed that the age effect did not differ significantly between the blacks and the whites (Figure 1 ). Thus, the race difference in slopes of the relation RMR/FFM was not due to an artifact related to age.
FIGURE 1. Top: Regression plot of resting metabolic rate (RMR) against fat-free mass (FFM) in the black ( n = 139; ) and the white (n = 149; ) participants. For the blacks, the relation displayed an intercept of 410 kcal/d (95% CI: 307, 513 kcal/d) and a slope of 16.3 kcal &middot; kg -1 &middot; d -1 (95% CI: 14.3, 18.2 kcal &middot; kg -1 &middot; d -1 ) with an R 2 of 0.66. For the whites, the relation had an intercept of 374 kcal/d (95% CI: 283, 473 kcal/d) and a slope of 18.9 kcal &middot; kg -1 &middot; d -1 (95% CI: 17.0, 20.8 kcal &middot; kg -1 &middot; d -1 ) with an R 2 of 0.74. The slopes differed significantly between the blacks and the whites ( P = 0.02). Bottom: Relation between the residuals of the top figure and age. The overall relation was significant ( R 2 = 0.07, P < 0.0001) with y = 819 -11 x age in the blacks ( n = 139; ) and 733 -10 x age in the whites ( n = 149; ). The slopes did not differ significantly between races (race-by-age interaction: P = 0.8).
Site effects
The TEE was 6% higher in the Pittsburgh subjects than in the Memp[NextPage]his subjects (2229 &plusmn; 428 and 2102 &plusmn; 459 kcal/d, respectively; P = 0.01). This was attributable to a difference in AEE but not in RMR. Effectively, AEE expressed in kcal/d was 12% lower in the Memphis subjects (672 &plusmn; 459 kcal/d) than in the Pittsburgh subjedts (760 &plusmn; 672 kcal/d; P = 0.01), and the difference (10%) was still significant after normalization for body mass (Memphis subjects: 9.0 &plusmn; 3.5; Pittsburgh subjects: 10.0 &plusmn; 9.0 kcal &middot; d -1 &middot; kg -1; P = 0.04). As expected, these differences were also observed in PAL, which was 4% higher in the Pittsburgh subjects (1.73 &plusmn; 0.22) than in the Memphis subjects (1.67 &plusmn; 0.24; P = 0.02).
Accuracy of the WHO and 2002 DRI energy requirement predictions
In Figure 2, we compared the estimated and measured energy requirements for each sex and race subgroup. Each step of calculation-ie, RMR, PAL, and then TEE-is compared with the WHO-derived estimates. Inpidual age, height, and weight and an estimated PAL were used to calculate energy requirements by using the new nonlinear equation of the 2002 DRIs. Because obesity has been shown to increase EE, the cohort was pided according BMI < 29.9) and obese persons (BMI 30). Ten participants, with a PAL of 1.60 &plusmn; 0.20, had a BMI <20, and they were excluded from this analysis because the DRI predictive equations were calculated for a person at an ideal BMI of 25. By splitting our data according to BMIs <30 and 30, we allowed a meaningful comparison of the Health ABC Study data with the DRIs at an average BMI of 25. Several points emerged from a repeated-measures ANOVA. The WHO calculations overestimated RMR by 15% ( P < 0.0001). This overestimation was greater for the blacks than for the whites (19% and 12%, respectively; P < 0.0001) and greater for the obese persons than for the lean or overweight persons (18% and 14%, respectively; P < 0.0001). We also found that the WHO-proposed PAL was low by 10% ( P < 0.0001), and the difference was greater in the men than in the women (7% and 15%, respectively; P = 0.0003). The WHO-derived energy requirements overestimated TEE by 5 &plusmn; 15% ( P < 0.0001). More detailed analysis showed that this overestimation was observed in the women, but not in the men (10% and 0.2%, respectively; P < 0.0001), and it was more important in the obese persons than in the normal-weight persons (8% and 2%, respectively; P < 0.0001) and more important in the blacks than in the whites (7% and 2%, respectively; P = 0.002). Conversely, the 2002 DRI energy requirement estimates were accurate with an overall difference of 0 &plusmn; 14% for TEE ( P = 1.0). No effects of sex ( P = 0.2) or BMI range ( P = 0.4) appeared in the statistical analysis. A race effect ( P = 0.002) was, however, observed, but the presence of a sex-by-race-by-BMI range interaction ( P < 0.02) showed that the race effect was due only to a significant overestimation of energy requirements in obese black men (12%). Nonetheless, as was seen with the WHO recommendations, the range of PAL used in the DRI predictive PAL <1.6) was underestimated.
FIGURE 2. Mean (&plusmn;SEM) measured and predicted resting metabolic rate (RMR), physical activity level (PAL), and total energy expenditure (TEE). Results are grouped by BMI (kg/m 2 ) by using a cutoff of 30 to separate the high-energy cost of obesity. Comparisons were made with the recommendations of the World Health Organization (WHO) and with the 2002 dietary reference intakes (DRIs). Note that WHO energy requirements are calculated by using the product of a fixed PAL and sex-based estimation of RMR from body weight, whereas DRIs are calculated from a nonlinear equation by using age, height, weight, and an estimated PAL range of 1.4-1.6. The mean value of 1.5 is indicated on the figure. The WHO calculations overestimated RMR by 15% ( P < 0.0001). The overestimation was greater for the blacks than for the whites (19% and 12%, respectively; P < 0.0001) and greater for the obese persons than for the lean or overweight persons (18% and 14%, respectively; P < 0.0001). WHO-proposed PAL was low by 10% ( P < 0.0001), and the difference was greater in the men than in the women (7% and 15%, respectively; P = 0.0003). The WHO-derived energy requirements overestimated TEE by 5 &plusmn; 15% ( P < 0.0001), but this overestimation was observed in the women, but not in the men (10% and 0.2%, respectively; P < 0.0001), and it was more important in the obese persons than in the normal-weight persons (8% and 2%, respectively; P < 0.0001) and more important in the blacks than in the whites (7% and 2%, respectively; P = 0.002). The 2002 DRI energy requirement estimates were accurate with an overall difference of 0 &plusmn; 14% with TEE ( P = 1.0). No significant effects of sex ( P = 0.2) or BMI range ( P = 0.4) were noted. A race effect ( P = 0.002), explained by an overestimation of energy requirements in black men, was observed (12%). The WHO recommendations underestimated the DRI range for PAL. The group with a BMI 30 included 23 black women, 14 white women, 18 black men, and 18 white men. The group with a BMI of 20-29.9 included 42 black women, 59 white women, 51 black men, and 53 white men.
Health ABC Study-derived predictive equations of energy requirements
Predictive equations of RMR based on the Health ABC Study cohort are proposed in Table 3. Because the RMR:FFM relation differed by race, the RMR predictive equations were independently generated for the blacks and the whites. The frequency distribution of PAL among subjects with BMIs above and below 30 are shown in Figure 3. Because PAL did not differ by BMI, sex, or race, TEE can be predicted by multiplying the derived RMR by 1.52, 1.67, and 1.85 for persons of below-average (taken at the 25th PAL population percentile), average (50th percentile) and above-average (75th percentile) physical activity, respectively.
TABLE 3. Predictive equations of resting metabolic rate based on weight or fat-free mass in whites ( n = 149) and blacks ( n = 139) 1
FIGURE 3. Frequency distribution of the physical activity levels (PALs) grouped by BMI (kg/m 2 ). n = 206 persons with a BMI of 20-29.9; n = 72 persons with a BMI 30.
DISCUSSION
In the Health ABC Study, the women had[NextPage] lower TEEs than did the men ( 539 kcal/d), as expected from previous studies ( 24 - 26 ). Among the previous studies, the largest one reported an overall sex difference ( 741 kcal/d) but no effect due to race on unadjusted values of EE ( 24 ). Because FFM is a main determinant of TEE, those authors adjusted TEE to account for the difference in FFM. In doing so, they unmasked a lower TEE in blacks than in whites ( 43 kcal/d), and the sex difference was maintained ( 383 kcal/d). In the Health ABC Study cohort, unadjusted TEE was lower in the blacks than in the whites ( 72 kcal/d), and the presence of a sex-by-race interaction showed that the race effect was attributable to a difference in the men, but not in the women. We propose that it is an oversimplification to linearly adjust TEE for FFM only, because TEE differences are explained by variations in RMR, AEE, or diet-induced thermogenesis, each of which should be adjusted for their determinant or determinants. Nevertheless, to compare the Health ABC Study data with data from previous reports ( 24 ), we also adjusted TEE by FFM and confirmed the race effect ( 146 kcal/d; P < 0.001), but not the sex effect ( P = 0.23); however, these studies differ in sample size and the age range of the subjects (the largest study has 65 participants with a mean age of 65 y; 24 ). Six other studies, as reviewed elsewhere ( 13 ), investigated the race differences in TEE in prepubertal or early pubertal and middle-aged subjects. One of these studies showed a tendency for lower TEE in black subjects. In this current study, FFM differences explained the sex effect in TEE, but failed to account totally for the race difference.
On the other hand, because the relation between FFM and RMR has an intercept different from zero, Ravussin and Bogardus ( 27 ) concluded that RMR values should be adjusted for FFM by a multivariate-based approach. Theoretically, however, such an analysis can be performed only if the slopes for RMR versus FFM for blacks and whites or men and women are similar ( 28 ). In previous, smaller studies, slopes were not found to be different, but the Health ABC Study cohort is the largest group thus studied; we observed nonhomogeneity of the slopes for race but not for sex (ie, RMR differences between blacks and whites increased with FFM). Gannon et al ( 13 ) also reported that 10 of the 15 studies they reviewed had found a lower RMR in blacks than whites. The differences ranged from 81 to 275 kcal/d and were not explained by age, FFM, or method. Given the difference in the slopes, we applied the unequal-slope model of ANCOVA and calculated adjusted RMR at different percentiles of FFM in the population. Indeed, at all percentiles, the RMR adjusted for FFM was lower in blacks than in whites and was 99 kcal/d at the 50th FFM percentile (50.2 kg). Regarding the sex effect, our results do not support the observations of others ( 29 - 31 ) that RMR adjusted for FFM is lower in women than men. Given the age of our cohort, we speculate that the sex difference decreases with advanced age, perhaps because of concomitant decreases in sex hormones ( 32 ).
ANCOVA implies that FFM is a homogeneous compartment, but Heymsfield et al ( 33 ) showed that FFM is not an energetically homogeneous compartment, but, rather, that tissues vary with respect to heat production per gram of FFM. Viewed from this perspective, the nonhomogeneity of the slope suggests that, with increasing body mass, blacks respond with greater fractional increases in low-metabolic-[NextPage]rate tissues (ie, skeletal muscle, connective tissue, bone) than do whites. However, the similar intercepts suggest that blacks and whites are comparable in terms of the high-metabolic-rate residual mass (ie, heart, kidney, brain). Aloia et al ( 34 ) showed that body cell mass is similar in white women and black women in early adulthood, but declines with age to a greater extent in white women than in black women. Therefore, the unequal slopes observed in the present study may be specific to our age group and not simply due to the greater power resulting from the sample size.
It is widely accepted that physical activity and EE during physical activity decline with age, but activity in the elderly varies greatly, depending on health and independence. The mean values therefore depend on the subjects included in the sample. The Health ABC Study cohort was selected to reflect a relatively healthy, well-functioning group of older persons who were free of severe disabilities. Even so, the CV for AEE was 40.9%. The sex difference observed in unadjusted AEE in the Health ABC Study cohort was expected ( 24 ). AEE adjusted for FFM, however, did not show an effect of sex ( P = 0.55) or race ( P = 0.52) in the Health ABC Study cohort. Nevertheless, on the basis of theoretical considerations ( 35 ), we consider the use of the ratio of AEE to kilogram of body weight a better approach to adjusting AEE. When we did so, the women had an AEE 1.2 kcal &middot; kg -1 &middot; d -1 lower than did the men, without any effect of race. Other studies conducted in younger subjects had mixed findings with regard to low AEEs in black women ( 36, 37 ). Because low physical activity is a risk factor for obesity with increasing age ( 38 ), special attention should be given to interventions that increase physical activity in the elderly, especially black women, given that their peak prevalence of obesity (60%) occurs at a later age (60-69 y; 39 ).
PAL is an indirect index of physical activity and is useful in recommending energy intakes based on measured or estimated RMR and a level of physical activity. No effect of race or sex was noted in PAL, despite a tendency toward significance for sex. Several investigators have reviewed PAL values in the elderly ( 7, 11, 40, 41 ). Black et al ( 41 ) suggested that PAL is 1.62 75 y. For men in those same age ranges, PAL is 1.61 and 1.54, respectively. Similar values for women (1.61) were found by Starling et al ( 11 ) in a recent review, but they reported a higher value for men (1.75). Our values are close to the estimate of Starling et al ( 11 ).
The WHO-derived energy requirements are calculated in 2 steps ( 14 ). First, the RMR is estimated from body weight according to a modified Schofield equation ( 42 ). Second, the resulting RMR is multiplied by PALs of 1.51 and 1.56 for men and women 65 y, respectively. Sawaya et al ( 43 ) and Roberts et al ( 40 ) suggested, on the basis of studies of relatively few subjects, that the WHO-derive[NextPage]d PAL is underestimated in elderly men but not in elderly women. More recently and in a larger group of subjects, Starling et al ( 11 ) also reported that the WHO equations underestimated PAL among elderly men, but not among elderly black women. In contrast, we observed that the WHO equations do not underestimate energy requirements as previously suggested but, rather, overestimate them. This overestimation was only 5 &plusmn; 15% for the overall Health ABC Study cohort, but it was greater in women, blacks, and obese persons. More important, the WHO equations are derived from overestimated RMR and underestimated PAL. This WHO-derived RMR overestimation, but not the underestimation of PAL, was previously reported ( 40 ). It is relevant that the WHO database for derived RMR equations ( 42 60 y old.
In 1985 WHO recommended ( 14 ) that energy requirements be derived from measurements of TEE, and the 2002 DRI ( 15 ) sex-based energy-requirement equations were so derived. The DRI nonlinear sex-based equations 19 y old, but the contribution of elderly and African American persons with normal BMIs was small. The accuracy of these equations is, nevertheless, very good-a difference of 0 &plusmn; 14% from the actual TEE was noted-but the elderly in our study had PALs above PAL < 1.6). No relevant race effects were noted, either because the error in the energy requirement estimates overlapped the race difference in TEE or because the DRI database was somehow weighted for the race effect by inclusion of data from some black persons. To overcome the limitations of the current WHO recommendations and to account for the DRIs' underestimation of PAL, we propose RMR prediction equations that take into account both race and sex and that can be easily used by clinicians.
ACKNOWLEDGMENTS
We thank the staff at the Memphis and Pittsburgh Health, Aging, and Body Composition Study field centers for subject recruitment and specimen collection.
SB performed data analysis and drafted the manuscript. DAS supervised the data analysis and edited the manuscript. DB consulted on study design and edited the manuscript. MED supervised the data collection and edited the manuscript. FT supervised the data collection and edited the manuscript. EMS designed the study and edited the manuscript. TBH was the principal investigator, designed the study, and edited the manuscript. SBK consulted on study design, recruited subjects, and edited the manuscript. JEE designed the study and edited the manuscript. None of the authors had personal or financial conflicts of interest.
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Rothenberg E, Bosaeus I, Lernfelt B, Landahl S, Steen B. Energy intake and expenditure: validation of a diet history by heart rate monitoring, activity diary and doubly labeled water. Eur J Clin Nutr 1998;52:832-8.

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Ferraro R, Lillioja S, Fontvieille AM, Rising R, Bogardus C, Ravussin E. Lower sedentary metabolic rate in women compared with men. J Clin Invest 1992;90:780-4.

Arciero PJ, Goran MI, Poehlman ET. Resting metabolic rate is lower in women than in men. J Appl Physiol 1993;75:2514-20.

Poehlman ET, Toth MJ, Ades PA, Calles-Escandon J. Gender differences in resting metabolic rate and noradrenaline kinetics in older inpiduals. Eur J Clin Invest 1997;27:23-8.

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Wong WW, Butte NF, Ellis KJ, et al. Pubertal African-American girls expend less energy at rest and during physical activity than Caucasian girls. J Clin Endocrinol Metab 1999;84:906-11.

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Sawaya AL, Saltzman E, Fuss P, Young VR, Roberts SB. Dietary energy requirements of young and older women determined by using the doubly labeled water method. Am J Clin Nutr 1995;62:338-44.]]></text>
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        <title>Chinese bid farewell to golf island living close to public</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/gn/2012/01/120942.html]]></link>
        <text><![CDATA[  Hainan, Xinhua channel on December 30 (by deal Xiao Wei Yun) recently, who lives in Haikou City, Hainan Province, Lu-wing likes to play golf more than a happy thing.  Because it has ten golf course at Mission Hills Golf Resort Haikou, first introduced for golf enthusiasts of the "week golf card."  According to reports, this card greatly reduces the threshold of golf, if the play twice a week to calculate the price of golf each less than 300 yuan, much lower than the same environment near the golf course.   Golf enthusiasts Lu-Rong said: "We usually play in accordance with the frequency of view, it is quite favorable. After the court more and more, they want cheaper fares, so that everyone can play in this game. Do not put it into a noble crown campaign hat, and made the people do not dare to try to play. "   Despite the introduction into China, less than 30 years of golf history, but has the world's largest golf club, golf supplies the world's largest manufacturing base.  Today, China is becoming more European, American International Golf Pro Tour outside contractors League matches than any other country.   November 23, 2011, Omega Mission Hills World Cup at Mission Hills Haikou, Hainan Province kicks off International Golf Resort, which has been held in China in a row the 4th World Cup of Golf tournament.   Led his unit to play golf in 2011 Omega Mission Hills World Cup, Deputy Secretary General of China Golf Association, the State Sports General Administration of Sports Management Center sports ball four administrative vice minister, told reporters, said Pang, the China Golf Association's international status in recent years greatly improved.   Pang government said: "Because China is the world's economic growth in recent years for all to see, then the world economic center of gravity to Asia, to China. Golf also is the case, from the previous years are not optimistic about China, and now very seriously, as China's economy and raise the level, we include the Association of Golf in the international status, has also been greatly improved and now includes the U.S. Tour, European Tour, so some organizations, the Chinese have a good working relationship. "   In 2005, the development of golf in China is an important node, the European Tour beginning to expand into China, there are six races of the year hosted in China.   In 2007, the "Olympics of golf," said China ushered in the era of the World Cup of Golf, Golf Pro Tour International League contract with the Mission Hills Golf Club, the World Cup since 2007 will be held in China in 12 consecutive sessions, up to 2018 ; famous watch brands Omega also announced the 12th consecutive title sponsor of the Golf World Cup held in China, totaling 12 billion yuan.   International Golf Association Executive Committee Chairman Zhuangnian Long is optimistic that China Golf has a huge market potential, no doubt.  The next 10 years golf will take off in China.   Zhuangnian Long said: "(I) 1995 held in China for the first time when you see the potential in China, has not wavered whether to return to China. Basically, we not only value the economic factors, have also seen a lot of China's population, people like golf are growing, in fact, that time has come to believe that golf can take off in China. " [NextPage]  Share the same view was also to attend the competition of foreign players.  Mission Hills Golf World Cup in 2011 is to win by Matt Kuchar and Gary Woodland composed of the United States.  This is their first trip to China in the World Cup of Golf.  Although time is short, but golf's top events held in China gave them a deep impression.  ]]></text>
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        <title>Edentulism and nutritional status in a biracial sample of well-functioning, community-dwelling elderly: the Health, Aging, and Body Composition Study 1, 2,</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/Digest/2012/01/80160513003397.html]]></link>
        <text><![CDATA[【摘要】
      Background: Edentulism may affect dietary intake in older adults, but the relation between edentulism and nutritional status is not completely understood.

Objective: The present study examined whether edentulism is associated with nutritional status and whether there is an interaction between race and edentulism on nutritional status among well-functioning, community-dwelling elderly.

Design: The study cohort included 3075 elderly aged 70-79 y (52% women, 42% black) in the Health, Aging, and Body Composition Study. Dietary intake, anthropometric variables, weight change, and serum albumin and lipid concentrations were compared between edentate and dentate participants by the use of multiple linear and logistic regressions.

Results: Edentulism was not associated with total energy or food intake but was associated with the food groups consumed, particularly fat, micronutrients, and hard-to-chew foods. Edentulism was more strongly linked to dietary intake in whites than in blacks. Unlike black edentate elderly, white edentate elderly consumed significantly lower energy-adjusted amounts of vitamin A and &szlig;-carotene, higher amounts of energy-adjusted total and saturated fat and cholesterol, and higher percentages of energy from fat than did white dentate elderly. Anthropometry and biochemical indexes were not significantly different by edentulism status in both races. Edentulism was associated with 5% in 1 y in both races.

Conclusions: Edentulism was associated with differences in the nutritional status of well-functioning, community-dwelling elderly, more so in whites than blacks. Edentate elders may benefit from dental, medical, and nutrition interventions targeted to addressing these findings. 
          【关键词】 Edentulism nutritional status wellfunctioning communitydwelling elderly socioeconomic status racialethnic differences Health ABC Study
		  INTRODUCTION
Despite a steady decline in the rate of complete tooth loss over the past several decades, more than one-third (33.1%) of those aged 65 y are edentulous ( 1 - 3 ). Because such a large segment of the elderly is edentulous, the effect of edentulism on nutritional and health status is an important but overlooked public health issue for the elderly ( 4 ).
Edentulism can substantially affect oral and general health as well as overall quality of life, including enjoyment of food and overall nutrition ( 5 ). Some evidence suggests that impaired oral health status, particularly edentulism, may affect dietary intake. The loss of all teeth, even with dentures, reduces masticating efficiency and affects food taste, food preferences, and food consumption patterns ( 6 - 12 ). Edentulism may also be associated with suboptimal intakes of various nutrients ( 13, 14 ), which prevents edentate inpiduals from meeting current dietary recommendations ( 15, 16 ). Several studies have shown that edentate elderly consume fewer fruit and vegetables; less dietary fiber, carotene, calcium, and prote[NextPage]in; and more cholesterol and saturated fat than do their dentate counterparts ( 8, 13, 14, 17 - 23 ). Furthermore, these alterations in dietary intake have been suspected to increase the risk of significant weight loss ( 24, 25 ) and possibly of selected systemic diseases such as cancer and cardiovascular disease ( 26 - 28 ).
Most previous research was conducted among frail elderly who were institutionalized or hospitalized or white, community-dwelling elderly with higher economic and educational attainments ( 8, 17, 25, 26, 29 - 31 ). Little is known about the relation between edentulism and nutritional status in other elderly populations, including minority elderly. The inclusion of minority participants is important because these persons have both a higher burden of oral health problems than do white elderly populations ( 1, 32 ) and cultural differences in food patterns ( 33 ).
The purpose of the present study was to examine whether edentulism is associated with nutritional status as measured by nutrient intake, food consumption patterns, anthropometric indexes, weight change, and biochemical indexes in a biracial, well-functioning sample from the Health, Aging, and Body Composition (Health ABC) Study. We hypothesized that edentate elderly persons would have nutrient and food group intakes that were lower than dietary recommendations and higher weights and body mass indexes, greater weight changes, and poorer serum albumin and lipid concentrations than would dentate elderly persons. We also hypothesized that these proposed differences between edentate and dentate elderly would be similar between blacks and whites.
SUBJECTS AND METHODS
Study population
The Health ABC Study is a longitudinal study designed to help us understand how changes in body composition relate to the incidence of disability. To be eligible for the study, elderly persons had to be free of difficulties with activities of daily living and lower-extremity functional limitations, defined as difficulty walking 0.4 km (0.25 mi) or climbing 10 steps without resting. Participants were recruited from a random sample of Medicare beneficiaries in designated zip codes in and around Pittsburgh and Memphis, which represent northeast and south regions of the United States, respectively. Different sociodemographic characteristics (for example, participants in Memphis were less educated and had lower family incomes than did those in Pittsburgh; 34 ) and dietary intakes by region were carefully considered in study design and implementation. The study cohort consisted of 3075 white and black (42%) men and women (52%) aged 70-79 y. All measurements used for this study were collected at baseline, except nutrient intake and food consumption pattern, which were collected at the first follow-up examination. All procedures were in accordance with the ethical standards of the institutional review boards of the participating institutions, who approved the protocol and informed consent forms.
Oral he[NextPage]alth
Basic oral health questions were included in the baseline health assessment in 1997. Edentulism was determined by self-reported information regarding whether a participant had any remaining natural teeth. Participants were also asked whether they wore dentures and whether they had chewing pain.
Nutrient intake
A modified Block 98 food-frequency questionnaire (FFQ) was administered by a trained dietary interviewer at the first annual follow-up examination to estimate inpidual participants usual nutrient and food group intakes. The FFQ, developed and modified by Block Dietary Data Systems (Berkeley, CA) for the Health ABC Study, was based on age-appropriate intake data from the third National Health and Nutrition Examination Survey. The food lists were based on the survey 24-h dietary recall data 65 y, either non-Hispanic white or black, and residing in either the Northeast or the South. A total of 108 food items were included. All interviews were periodically monitored throughout the study to ensure the quality and consistency of data collection procedures. Wood blocks, real food models, and flash cards were used to help participants estimate portion size. Nutrient and food group intakes and numbers of servings of the food guide pyramid food groups were estimated by Block Dietary Data Systems by using the food guide pyramid-recommended serving sizes.
We focused the analysis on energy and 15 nutrients selected on the basis of previous research to reflect concerns related to edentulism ( 8, 17 - 23, 26, 29, 30 ) and deficient intakes in the elderly ( 35, 36 ). Intakes of protein, vitamin A, vitamin C, vitamin E, thiamine, riboflavin, vitamin B-6, folate, niacin, iron, magnesium, and zinc were compared with recommended dietary allowances ( 37 - 39 ). The calcium and fiber intakes of the participants were compared with the adequate intake recommendation ( 40, 41 ).
Food consumption pattern
Percentages of energy from major nutrients (carbohydrate, fat, and protein) and from sweets and desserts were compared with recommendations ( 42 ) for edentate and dentate elderly. Daily servings of 5 food groups (vegetables, meat and protein, grains, and dairy products) and the daily intake frequency of fruit and fats, oils, and sweets were compared with the food guide pyramid serving recommendations to assess compliance with dietary guidelines appropriate for sex, age, and energy requirement ( 43 ).
The daily intake frequency of hard- or easy-to-chew foods was also compared between edentate and dentate elderly. Hard- or easy-to-chew food items were selected on the basis of previous research determining masticating ability and perceived chewing ability ( 6, 7, 18, 20, 23 ) and availability in the FFQ. Hard-to-chew foods included raw apples or pears, carrots, mixed vegetables, coleslaw, cold cereal without milk, green salad, nuts and seeds, fried chicken, and beef. The texture of some hard-to-chew food can be modified by using different cooking methods. We were[NextPage] not, however, able to separate out some of the soft dishes (such as pot roast) made with beef given the nature of the food group category in the FFQ. For the purpose of creating a conservative hard-to-chew food score, we included the beef group in the score. Easy-to-chew foods included applesauce, canned fruit cocktail, canned pears, canned peaches, bananas, cooked cereals, cottage cheese, yogurts, puddings, and liquid nutrient supplements.
Anthropometry and weight change
Baseline weight and standing height measurements were used in this analysis. Weight was measured in kilograms with the use of a standard balance beam scale. Standing height was measured in centimeters with the use of a stadiometer (Harpenden; Holtain Ltd, Crosswell, United Kingdom). Weight change between baseline and 1 y was classified into 3 groups: 1 5% of baseline body weight), 2 ) stable (&plusmn;5% weight change), and 3 5% of baseline body weight).
Biochemical indexes
Fasting blood was collected from participants at the baseline clinic visit through venipuncture with the use of standard protocols. Serum albumin and serum lipids (total cholesterol, LDL cholesterol, HDL cholesterol, and triacylglycerols) were selected for this analysis. Serum lipid concentrations were compared with the National Cholesterol Education Program Adult Treatment Panel II guidelines ( 42 ).
Controlling variables
Edentulism, nutrient and food intakes, anthropometry, and biochemical indexes vary by sociodemographic, economic, health behavioral, and medical conditions ( 5, 17, 36, 44 - 46 ). To examine whether edentulism was independently associated with nutritional status, we controlled for these potential confounding variables.
Sociodemographic and economic characteristics included age, sex, education, living alone, study site, and family income. Education status was categorized into 2 groups according to the highest educational level attained: less than high school (<12 y) or more. Questions on marital status and household size were used to create a two-category "living alone" variable as follows: living alone and living with others, including spouse. Study site included 2 categories: Pittsburgh or Memphis. Family income during the past year was classified into 2 groups: <$10 000 or more.
Health behavioral characteristics included smoking and drinking status. Smoking status was categorized as never smoker, former smoker, and current smoker. Similarly, drinking status was categorized as never drinker, former drinker, and current drinker. Self-reported health status was controlled as a dichotomous variable to reflect how ill a person felt (fair or poor compared with others).
Self-reported chewing pain was controlled as a dichotomous variable for examining the relation between edentulism and dietary intake. However, denture use was not controlled for because edentulism was strongly interwined with denture use. Most edentate elderly wore dentures (90%), whereas only 40% of dentate elderly wore dentures. The effect of edentulism on nutritional status cannot be adequately assessed while statistically controlling for denture use. Because the Health ABC cohort was well-functioning at baseline, cognitive function and physical performance known to be related with nutritional health in other cohorts were not included in the analys[NextPage]es.
Analytic sample
The present study included 3068 participants with edentulism information at baseline. However, because the FFQ data were collected 1 y later, only 88% of the original Health ABC participants had this data. Of 362 participants who did not complete the FFQ, 77 did not attend the exam (36 were deceased, 4 were withdrawn, and 37 were missed), and these participants were more likely to be edentulous, black, poor, and less educated. Similarly, weight change was calculated for 89% of the participants whose weight was measured both at baseline and 1 y later. Family income during the past year was completed by 88% (2701) of the participants. Sociodemographic characteristics between those with income data and those without it were similar except for sex, living alone, and drinking history, which were already included as potential confounders in our analysis. Nutrient intakes between those with income data and those without it were not significantly different.
For each analysis, persons missing values for specific variables were omitted from that analysis; thus, the analytic sample for various measures varied slightly in total number, ie, n = 2360 for nutrient intake and food consumption pattern, n = 2670 for anthropometry, n = 2376 for weight changes, and n = 2656 for biochemical indexes.
Statistical analyses
Differences in means and proportions of covariates by edentulism were analyzed by using t tests and chi-square tests, respectively. Multiple linear regression procedures were used to compare adjusted means of energy and energy-adjusted nutrient and food group intakes, anthropometry, and biochemical indexes between edentate and dentate elderly with control for confounding variables. Logistic regression procedures were used to assess whether edentate elderly were less likely to meet two-thirds of dietary recommendations and dietary fat and fiber recommendations than were dentate elderly. It was also used to examine whether edentate elderly were more likely to have weight changes than were dentate elderly. There were significant interactions between race and edentulism on intakes of dietary fats (total fat, saturated fat, and cholesterol), several micronutrients (vitamin A, &szlig;-carotene, and phosphorus), and the meat group; thus, analyses for these variables were stratified by race. There were no significant interactions between sex and edentulism or among sex, race, and edentulism. All statistical analyses were conducted by using SAS 8.01 (SAS Institute Inc, Cary, NC; 47 ). Statistical significance was set at P < 0.05.
RESULTS
Baseline sociodemographic, economic, and health characteristics of edentate and dentate Health ABC participants are presented in Table 1. Twenty-one percent of the Health ABC participants were edentulous. Most of the edentate participants wore dentures and were more likely to report chewing pain, poor appetite (poor or very poor desire to eat during the past month), and poorer health status than were dentate elder[NextPage]ly. This was the case for both white and black participants. In both whites and blacks, edentate elderly reported lower educational status and were more likely to have a smoking history than were dentate elderly.
TABLE 1. Characteristics of edentate and dentate white and black elderly participants of the Health, Aging, and Body Composition Study
The prevalence of edentulism and oral health characteristics, however, differed by race. Blacks were twice as likely as whites to be edentulous (30.0% compared with 15.9%) and were more likely to report chewing pain and poor appetite. Overall educational and economic attainments were lower in blacks than in whites. Even after control for other significant factors, including sex, education, family income, smoking history, living alone, and self-reported health status, blacks were 1.41 times as likely to be edentulous (95% CI: 1.13, 1.75). Compared with white dentate elderly, black dentate elderly were more likely to wear dentures ( P = 0.0001) and to report chewing pain ( P = 0.0019).
Nutrient intake patterns between edentate and dentate persons were compared by using multivariate analyses. Regardless of edentate status, adjusted mean intakes of specific nutrients by the Health ABC cohort were higher than dietary recommendations except for vitamin E, calcium, magnesium, and dietary fiber. Blacks consumed more energy and cholesterol but had lower energy-adjusted mean intakes of dietary fiber and most micronutrients (vitamin A, vitamin E, vitamin B-6, calcium, magnesium, iron, zinc, and phosphorus) than did whites. Regardless of race, total energy intake and solid food intake did not differ significantly between edentate and dentate elderly ( Table 2 ). Edentate elderly had significantly lower intakes of energy-adjusted dietary fiber, vitamin C, calcium, and magnesium and lower percentages of energy from protein and sweets and desserts than did dentate elderly independent of race.
TABLE 2. Average energy and energy-adjusted nutrient intakes of edentate and dentate elderly participants of the Health, Aging, and Body Composition Study 1
The energy-adjusted intake pattern of dietary fats and several micronutrients in edentate and dentate elderly persons, however, differed by race ( Table 3 ). Among whites, edentate elderly had marginally but significantly higher intakes of energy-adjusted total fat, saturated fat, and cholesterol and a higher percentage of energy from fat than did dentate elderly. White edentate elderly also had marginally but significantly lower energy-adjusted mean intakes of vitamin A and &szlig;-carotene than did their dentate counterparts. Among blacks, however, intakes of most dietary fats and several micronutrients were not significantly different between edentate and dentate elderly, except for intakes of phosphorus. Blacks consumed a greater percentage of energy from total fat and had a higher intake of cholesterol and lower intakes of vitamin A and phosphorus than did whites, and dent[NextPage]ate status did not further influence this pattern in blacks as much as in whites.
TABLE 3. Average energy-adjusted nutrient and food group intakes of edentate and dentate white and black elderly participants of the Health, Aging, and Body Composition Study 1
Overall, more edentate than dentate elderly tended to consume less than two-thirds of the recommendations for most nutrients (NS; Table 4 ). Intakes of total and saturated fats between edentate and dentate elderly differed by race. Relative to dietary guidelines, white edentate elderly tended to consume more fat than their dentate counterparts [total fat odds ratio (OR): 1.35 (95% CI: 0.97, 1.87); saturated fat OR: 1.64 (95% CI: 1.22, 2.22)]. Dietary fat intake did not differ significantly between black edentate and dentate elderly [total fat OR: 0.86 (95% CI: 0.63, 1.20); saturated fat OR: 1.02 (95% CI: 0.75, 1.38)].
TABLE 4. Percentages of edentate and dentate elderly who consumed < 67% of dietary recommendations for selected nutrients and the corresponding relative odds ratios (ORs) in the Health, Aging, and Body Composition Study 1
Intakes of several food groups and of foods that are hard or easy to chew by dentate status are shown in Table 5. Blacks consumed fewer vegetables, fewer dairy group foods, and fewer hard-to-chew foods than did whites. Regardless of race, edentate elderly consumed significantly fewer foods from the fruit and fruit juice group; fat, oils, and sweets group; and hard-to-chew food group than did dentate elderly. Intake of foods in the meat group by edentate and dentate elderly, however, differed by race. Relative to dietary recommendations, white edentate elderly had significantly higher intakes of meats than did their dentate counterpart, unlike black edentate elderly, who did not have significantly different intake of meats from dentate black elderly (Table 3 )
TABLE 5. Average food group intakes as a percentage of daily recommended servings and as daily intake frequencies for edentate and dentate elderly participants of the Health, Aging, and Body Composition Study 1
Overall, there were no significant differences in anthropometry or biochemical indexes between edentate and dentate elderly, regardless of race. However, edentate elderly persons were more 5% of baseline weight in 1 y than were dentate elderly ( Figure 1 ). Multiple logistic regression results showed that edentulism significantly increased 5% of baseline weight, even after control for confounders (OR: 1.73; 95% CI: 1.17, 2.57; P = 0.0060).
FIGURE 1. 5% of baseline weight in 1 y., weight gain;, weight loss. *Significantly different from edentate, P < 0.05.
DISCUSSION
More than 1 in every 5 of this well-functioning, community-dwelling elderly cohort was edentulous. The overall prevalence of edentulism in our sample was close to the national objective set in Healthy People 2010 (20%) ( 2 ), but the prevalence was not equally distributed across different socioeconomic subgroups. Consistent with previous research ( 1, 17, 45 ), edentulism was more common among the less educated, the poor, and those reporting poorer health status. In particular, blacks had a highe[NextPage]r prevalence of edentulism than did whites, and this pattern remained even after control for socioeconomic status. Racial-ethnic differences in edentulism may be due to differences in not only socioeconomic status but also health behaviors, access to professional dental services, and exposure to community-based oral disease prevention services between the 2 groups, as suggested by previous research ( 5, 32, 45, 48, 49 ).
The present results show that both black and white edentate elderly, even though a large majority wore dentures, had compromised masticating ability and reported more chewing pain than did dentate elderly. Their compromised masticating ability was not associated with total energy or food intake, but it did affect the food groups consumed, particularly fat and micronutrients. Similar to previous research ( 8, 15, 17 - 20, 22 ), edentate elderly were more likely to consume more fats, oils, and sugars than were their dentate counterparts, which may reflect the ease of chewing these foods. These alterations in nutrient intake may explain the higher weight changes (particularly gain) among the edentate participants. Overall, the absolute differences in nutrient intake by dentition status were marginal compared with findings in frail elderly who were institutionalized and hospitalized ( 25, 31 ). This may in part be due to generally good dietary intake in the present cohort of well-functioning older adults compared with recommended intakes.
Black participants had poorer dental status and a higher proportion of edentulism than did whites, so it was expected that the implication of edentulism on nutrition would be greater in blacks than in whites. However, edentulism was more strongly linked to nutrient and food intake patterns in whites than in blacks. White edentate elderly were more likely to have poorer intakes of dietary fats and micronutrients than were their dentate counterparts, unlike black edentate elderly, in whom intakes of dietary fats and micronutrients were not significantly different from those in their dentate counterparts.
Blacks consumed more fat, fewer vegetables, and less calcium, magnesium, and dietary fiber than did whites irrespective of dentition status, similar to the findings of previous reports ( 33, 50 - 52 ). Among blacks, edentate elderly did not have significantly different fat intakes from those in dentate elderly, unlike white edentate elderly, who consumed more foods high in fat than did their dentate counterparts. At least 2 interpretations are possible to explain the racial-ethnic differences in nutrient and food intake patterns related to edentulism. One interpretation is that fundamental differences in sociodemographic and economic characteristics exist between racial groups, and that because of this, blacks diets are less sensitive to changes in dentition status. Blacks had lower socioeconomic status. Thus, blacks might have limited ability to get adequate quality and sufficient quantity of foods t[NextPage]o maintain healthy eating regardless of dentition status.
The other interpretation is that edentulism alone may not be a good indicator of diminished masticating ability, which results in significant changes in nutrient intake, particularly among blacks. Consistent with another report ( 53 ), the results of higher denture use and chewing pain in black than in white dentate elderly suggest that the former group has poorer dental status. This poor dental status may compromise masticating ability as much as in edentate elderly. Thus, similar nutrient and food group intakes were shown between edentate and dentate black elderly. More information on dental status, masticating ability, and food choice and eating behavior along with socioeconomic status needs to be considered to determine which or what other possible interpretations can explain racial-ethnic differences in nutrient intake.
This study has limitations. Most of the data used were cross-sectional, such that it was not possible to determine whether any observed relation between edentulism and nutritional status was causal in either racial group. In particular, higher intakes of sweets and lower intakes of calcium among edentate elderly of both races suggest the potential of reverse causality. Sweets are known to be cariogenic, leading to dental caries and mediated tooth loss ( 44, 54 ). Furthermore, lower calcium intake is known to lead to bone loss and potentially tooth loss ( 55, 56 ). Demonstration of an association between edentulism and nutrient intake irrespective of reverse causality, however, indicates that edentate elderly are at risk of poorer nutrient intake. Nutrient and food group intakes were estimated with the use of an FFQ designed specially for this study, which made use of the best approaches available. However, inherent limitations of the FFQ may not be avoidable in assessing the dietary intake pattern of a biracial older population, in whom little validity research has been done ( 57 - 61 ).
Our analysis did not include detailed information on dental status (ie, number of natural teeth remaining, functional units, denture use, or periodontal diseases) or oral health behavior variables. In particular, lack of extensive information on denture use (type, age, quality, fit, and frequency of use) limits a complete understanding of the heterogeneous dental status of the participants (especially the dentate participants), which may results in underestimates of the association between edentulism and nutritional status. Some previous research showed that wearing dentures may not be associated with poorer dietary intake and may depend on the type of food selected within or across food groups ( 13, 62, 63 ). More data on full dental and periodontal examinations conducted in the Health ABC Study will provide a better understanding of the relation between edentulism and nutritional status.
The results of the present study suggest several strategies for maintaining or improving the nutr[NextPage]itional status of edentate elderly. First, appropriate dental, medical, and public health services should be provided to prevent or delay edentulism as long as dental status permits and to help edentate elderly compensate for their compromised masticating ability. Particular attention needs to be given to the underserved and disadvantaged elderly. Second, nutrition education or other interventions should be provided to help edentate elderly consume appropriate servings of the food guide pyramid with easy-to-chew choices. Racial-ethnic differences in the effect of edentulism on nutritional status warrant investigation so that nutrition education messages can be tailored to different racial groups. Finally, more emphasis needs to be placed on providing easy-to-chew, tasty food products that have a high proportion of nutrients to calories. Such products would be of practical help for edentate elderly to achieve healthy eating. Nutritionists, food scientists, and food manufacturers need to work together to develop these types of foods.
The present results underscore the message from the first-ever Surgeon Generals report on oral heath (1), which stated that general health cannot be achieved without oral health. With increasing proportions of elderly in the population, particularly persons aged 85 y, the actual number of edentate elderly is expected to grow. More attention needs to be given to maintaining and improving the nutritional status of edentate elderly and to preparing relevant health professionals to provide needed services and education to edentate elderly and their caregivers ( 64, 65 ). These efforts will contribute to improving the overall quality of life and well-being among older adults.
ACKNOWLEDGMENTS
JSL and ABN were responsible for the study concept and research design. JSL performed the data analysis and drafted the article. ABN, TBH, RJW, SBK, and RR critically revised the article for important intellectual content. SMR and PC provided administrative, technical, or logistic support. None of authors had any possible conflicts of interest.
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Mayer-Davis EJ, Vitolins MZ, Carmichael SL, et al. Validity and reproducibility of a food frequency interview in a multi-cultural epidemiology study. Ann Epidemiol 1999;9:314-24.

Resnicow K, Odom E, Wang T, et al. Validation of three food frequency questionnaires and 24-hour recalls with serum carotenoid levels in a sample of African-American adults. Am J Epidemiol 2000;152:1072-80.

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        <title>Ma Delun appointed Vice-Governor of the Central Bank of China</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/ty/2012/01/4720452802.html]]></link>
        <text><![CDATA[China has appointed Ma Delun vice governor of the People&#8217;s Bank of China (PBOC), reported Wednesday the Shanghai Securities.
aged 58, Ma Delun replaces Xiang Junbo who had been appointed Head of the Agricultural Bank of China in June 2007, the newspaper said.
An anonymous official confirmed the report in Xinhua, adding that the appointment has not been officially announced by the Ministry of Personnel.
My had served as spokesman for the central bank and deputy director of the State Administration of Foreign Exchange.

马德伦获委任为副主席的中国中央银行行长 
中国已任命马德伦人民的中国银行（央行）副行长，今天报导，上海证券。
 58岁，马德伦谁接替项俊波已被任命为2007年6月对中国农业银行负责人，该报说。
一位不愿透露姓名的官员证实，在新华社报道补充说，任命尚未正式由人事部公布。
马曾担任发言人，央行和国家外汇管理局副局长。03.01.08]]></text>
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        <title>Hot spot - the main battlefield of China Anti-Poverty, published</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/gn/2012/01/691711082798.html]]></link>
        <text><![CDATA[  Guizhou, Xinhua channel power recently on December 30, "hot spot - the main battlefield of China Anti-Poverty," published by Xinhua Publishing House.   Author, Xinhua News Agency senior correspondent Liu Zaifu, Guizhou poverty alleviation through the development of long-term research interview, recorded nearly 30 years, Guizhou challenge "Earth Cancer" rocky, to eliminate absolute poverty, creation of a "mental block poverty poverty extended mode "and" political bank and joint financing of poverty reduction mode "," Qinglong mode "," Indian River experience "and a series of feature-rich Guizhou poverty alleviation and development mode and full of vigor and vitality of the poverty alleviation mechanism.  Book for future anti-poverty work has a strong practical significance and reference.   "Hot spot - the main battlefield of China Anti-Poverty," a book to Guizhou comprehensive, in-depth and sustained poverty relief to carry out decisive battle for the starting point, panoramic view of the China Poverty Alleviation launched the era of magnificent picture of Armageddon.  Poverty alleviation and development work for the understanding of China's history, status and trends for the next ten years to grasp the new round of strategic objectives of poverty alleviation and development, poverty alleviation a really good job of great benefit. ]]></text>
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        <title>Trade between Brazil and China increased by over 42% in 2007</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/ty/2012/01/1607780.html]]></link>
        <text><![CDATA[Trade between Brazil and China reached 23.367 billion dollars in 2007, an increase of 42.55% compared to 2006, said Wednesday the Brazilian Ministry of Development of Industry and Trade.
China has replaced Argentina to become the second largest exporter in Brazil after the United States, exporting 12.618 billion worth of goods to Brazil, an increase of 57.9% over 2006.
China was Brazil&#8217;s third largest importer after the United States and Argentina importing 10.749 billion dollars in 2007, an increase of 27.9% over 2006.
In 2007, Brazil&#8217;s foreign trade totaled 281.26 billion dollars, with 160.65 billion dollars (+16.6%) for exports and 120.61 billion dollars (32%) for imports, achieving a surplus of 40 billion dollars, an increase of 13.8%.
Economic experts have noted that the Brazilian real has appreciated 17% against the dollar, explaining the sharp increase in imports.

巴西之间的贸易与中国增加了42％，2007年 
贸易巴西和中国在2007年达到233.67亿美元，增长了42.55％，与2006年相比，12日表示，在工业和贸易发展巴西外交部。
中国已取代阿根廷，成为巴西仅次于美国出口，出口12618000000的货物到巴西，1比2006年的57.9％的增幅。
中国是巴西的第三大，仅次于美国和进口在2007年107.490亿美元，阿根廷为27.9％，比2006年增加进口。
 2007年，巴西外贸总额达281260000000美元，其中1606.50亿美元，出口1206.1亿美元（32％）为（16.6％），进口，实现了40亿美元，增长13.8％的盈余。
经济专家们指出，巴西雷亚尔已经对美元升值17％，说明进口急剧上升。03.01.08]]></text>
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        <title>China encourages foreign investment in new energy environment-friendly vehicles</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/gn/2012/01/778582844072.html]]></link>
        <text><![CDATA[  Bloomberg December 29, 2011 report, the growth rate due to car sales dropped to one-tenth of last year, China will no longer encourage foreign investment in China's automobile industry, so the industry can be "healthy development."  Shanghai K-car (LMC Automotive) analyst Jenny Gu said the decision to change the seven consecutive years, China's concessions to foreign investors, including the reduction of import tariffs on plant equipment.  China's National Development and Reform Commission and Ministry of Commerce said in a statement, fuel-efficient cars on the field of foreign investment will continue to be encouraged by the state.  Jenny Gu said, "The car manufacturers in the future be allowed to start building the new plant will be more difficult, unless they invest in new energy vehicles." China's National Development and Reform Commission said in a statement that China needs to focus on fostering strategic type new industries to manufacturing more sophisticated, more globally competitive.   (Source: Bloomberg Excerpt: Asia-Pacific Finance and Development Center)   Download attachments: 
	 							  
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        <title>China has closed more than 10 000 coal mines in three years</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/ty/2012/01/95937921529830.html]]></link>
        <text><![CDATA[China has closed 10 412 coal mines over the past three years to improve safety and preserve natural resources, according to the highest safety inspector of labor in the country.
Li Yizhong, director of the State Administration of Work Safety of China, said that 1 100 more coal mines should be closed because the government ordered the closure of 11 618 coal mines at the end the month of November.
He made the remarks at a recent meeting on the development of coal mines, organized in Beijing.
China, the world&#8217;s largest producer of coal, has made significant efforts to improve safety in its coal mines. But accidents are frequent because law enforcement is often inadequate, the mine owners seeking to make better profits by increasing production above the safety threshold.
In 2006, China produced 2.4 billion tons of coal. The accident occurred in small mines with an annual capacity of less than 300 000 tonnes were killed 3 431 people.
The government has set a target of close to 10 000 small coal mines between August 2005 and mid-2008. These mines are 1 / 3 of the total coal production in China, but account for 2 / 3 of deaths from mining accidents.
&#8220;Small existing coal mines were closed and no new mines should be open,&#8221; Li said last year. He stressed that the situation of safety was still worrisome.

中国已关闭了3年，超过10万名煤矿 
中国已经关闭，在过去3年，10 412煤矿，以提高安全性和保护自然资源，根据劳动最高安全检查员在该国。
李毅中的工作的中国国家安全生产监督管理局局长，他说，1 100多个煤矿，一律关闭，因为政府下令在最后11 618煤矿关闭11月份。
他是在对在北京举办的煤矿，发展最近一次会议上说这番话的。
中国是世界上最大的煤炭生产商，已作出了重大努力，以改善其煤矿安全。但是，事故频繁发生，因为执法往往不足，矿主试图通过增加安全阈值以上的生产更好的利润。
 2006年，中国生产的24.0亿吨标准煤。这起事故发生在小煤矿的一个不到300万吨的年生产能力死亡3 431人。
政府已分别于2005年8月中旬的近10万个小煤矿的目标，2008年。这些地雷是1 /在中国的煤炭产量占3，但占2 /从煤矿事故死亡3。
“现有小煤矿被关闭，没有新的地雷，必须公开，”他说，去年。他强调，安全局势仍然令人担忧。03.01.08]]></text>
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        <title>Let children learn happily - Shanghai on behalf of members of two hot hot Reform</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/gn/2012/01/4567067017.html]]></link>
        <text><![CDATA[  Xinhua Shanghai Jan. 22 (Xinhua Chou Yi, Yu Wan) is now the kids too hard, too hard a test.  "In this year's Shanghai two-site, independent college admissions exam, children of migrant workers, education, compulsory school choice wind," the park is difficult, "" admission you "... ... the majority of these affect the nerves of the topic of students and parents to become a hot topic on behalf of members.   On behalf of members that need to get to the root of University Enrollment independent, non-students into the error to snatch; to protect children of migrant workers each have the right to education, and from "a study on the" to "eager to learn"; balanced education resources to curb the compulsory education "school choice wind"; break "hard park", "park your" pre-school education to be universal but also to ensure quality.   Brilliant idea of reform: Baotuan exam students do not rush into Baotuan   Tsinghua University, Peking University and Tongji University in conjunction with other institutions such as the formation of three "exam" camp, now in its admissions pro forma stage.  More than a short period of 1 year, the university self-enrollment "exam" the faster the pace the more step in the implementation of the national self-enrollment more than 80 colleges and universities in the rapid spread of reform.  It is expected that brilliant idea of reform to change the "one test for life," the status quo, while many of the actual effect on behalf of members also expressed some concerns.   Shanghai Municipal People's Congress, Fudan University, Professor Ding Guanghong Admissions Office, said: "Independent Colleges and Universities Enrollment goal is to make children out of the shackles of examination-oriented education to achieve the comprehensive development of the quality of students, and college students have full right to choose. Implement joint exam, students greatly reduce the cost of examinations, choice also increased significantly. from the side, the exam is obvious progress. However, if self-enrollment exam become 'small entrance', the selection of talents into selection ' super talent ', it goes against the original intention of Independent Enrollment. "   Shanghai Municipal People's Congress, Party Secretary of Shanghai University of Traditional Chinese Medicine Jianqun said Xie, "exam" is a "trial and error", the actual results need long-term observation.  "Beware of entrance to eliminate defects in the formation of new educational inequity. If the brilliant idea of reform finally evolved into the 'Baotuan grab students', it is likely to become the object of accusation." Xie Jianqun said, "The current system of higher education reform, the key thing is to establish 'strict exit' the training mode, send a qualified one, this is the state, society and the students responsible. "   Children of migrant workers: from "learning on the" to "eager to learn"   By giving priority to enter the Shanghai Public schools, private schools the Government to buy places, etc., to achieve more than 47 living children of migrant workers to enjoy free compulsory education. [NextPage] How children of migrant workers from "a study on the" to "eager to learn" by leaps and bounds, becoming a new round of tests on the Government.   Shanghai Installation Engineering Co., Ltd. from Shanghai People's Congress Zhang Xiongwei, said: "I am very pleased to see that the children of migrant workers are entitled to education and livelihood areas of the city more and more treatment." Zhang Xiongwei in 2008 on the proposed further liberalization of foreign employees to enroll their children in vocational technical schools in Shanghai proposal by departments to adopt it.  "This year, Mayor Han Zheng said the government work report 'employees in Shanghai to increase the proportion of children sit in the vocational school', I am pleased to see their recommendations, many migrant workers are fulfilling the desire."   It is reported that Shanghai will further expand the public schools to receive the proportion of children of migrant workers living and organizations meet the children of migrant workers living in the actual teaching methods.  As a representative of migrant workers, Zhang Xiongwei also made The greatest gift of advice: "In addition to full coverage of compulsory education outside, hoping for more migrant workers children in Shanghai for a pre-school, high school education and so."   Compulsory Education: A balanced development of containment "School Choice in the wind"   Compulsory school choice for the current hot, hot research, training, heat intensified social phenomenon, Lin Liping, Shanghai People's Congress proposed that teachers can learn from Japan's experience in mobile systems, the pilot implementation of primary and secondary school principals, teachers, "regular flow system", a balanced education resources to effectively promote the full implementation of quality education.   Lin Liping, said the State Council recently issued "on the development of national education system reform," which on a number of cities including Shanghai, the existence of "education epidemic" out of the prescription.  Treatment "choice air" popular, need the personnel organizations of teachers and management system, development of relevant laws and regulations, so that teachers flow into a normal, balanced allocation of resources to promote education for the children to create a relaxed environment conducive to the growth of physical and mental health education atmosphere.   This reporter learned that, in order to promote balanced development of education, compulsory education in Shanghai has been the pilot school teachers to explore inter-exchange system, a number of districts and counties are implementing "going to teach" mode, that is, class teachers, subject leaders and other groups to outstanding teachers He guided the school to achieve outstanding teachers district, the city's share.   "School Choice in the wind," the popular shows from one side of the family and society in developing the positioning of children and blind materialistic bias.  Shanghai Municipal People's Congress, Datong Yang Jie secondary school teachers admitted: "there is an objective of human intelligence differences, and some parents have to find ways to focus on school children into the elite class that teaches children do not have the expertise, the children of course learn very tired. "Shanghai People's Congress, Jia Wei, the Secretary for Education, Changning District, said:" Mayor Han Zheng, Shanghai municipal government work report at the explicit proposal to explore the establishment of a scientific education quality evaluation system, this is very profound and necessary. obligations education, children need to establish the scientific health index, index of student learning and a happy life, the development index of academic achievement, scores from the children freed from, really enjoy the fruits of quality education. " [NextPage]  Pre-school education: "Admission is difficult", "park your" need to respond effectively   Pre-school education is the "new parents" are one of the topics of most concern.  Two sessions in Shanghai, on behalf of the members have pre-school education to improve and promote the development of advice and suggestions.   Pei Zhen, Shanghai People's Congress said that the current "hard park", "park your" and "join in trouble" and still exists.  "In some places the lack of private-run kindergartens to fill the seats by the charges greatly increased, and the people a kind of 'being noble' feeling; some kindergartens hardware good, but high-quality stream, but to the teachers, we can not guarantee the quality of pre-school education . "   "Government needs to introduce strong measures to effectively solve the lack of resources or pre-school problem of imbalance." Pei Zhen said, "such as the creation of more-run kindergartens, to ensure that new residential construction of public facilities, to increase the preparation and improve the wages of teachers and so. "   Shanghai CPPCC members from the Shanghai Women's Federation Zhao is that the current term in education, especially infants and children 0 to 3-year-old early education there is still the management system, professional guidance is weak, the lack of attention to other issues relevant departments.  "These issues challenge on pre-school education, but also created rare development opportunities. Suggested government departments guidance, coordination and assistance as soon as early education services to industry associations to establish, promote public welfare, universal, quality assurance early education at reasonable prices. "(End) ]]></text>
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        <pubDate>2012-01-03 09:10:40</pubDate>
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        <title>Hainan court protection from the High Court additional environmental water, blue sky</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/gn/2012/01/041966.html]]></link>
        <text><![CDATA[  Xinhua Hainan Channel January 22 (Xinhua Fu Yongtao) reporter from the Hainan Provincial Higher People's Court heard that a few days ago, Hainan Province, Hainan Provincial High Court and the editorial board formally approved the additional protection of the court in the trial court.  Will begin to accept cases in the second half of this year.   To meet the ecological province of Hainan and the need for international tourism island, Hainan Provincial High Court and the Intermediate Court and the Wuzhishan, Qiongzhong, Danzhou and other environmental conditions are heavier tasks and basic courts, the establishment of environmental courts to properly hear coastal forest rehabilitation and construction projects, energy conservation, environmental pollution control and other ecological construction and environment caused by pollution of all kinds of infringement cases, norms of ecological protection and reasonable development of regional resources.   Dean Dong Zhiliang Hainan Provincial High Court said in the first half, the High Court in Hainan environmental public interest litigation to do fund management, grant eligibility and the subject of proceedings in three aspects of the preparation work of institutions, so that environmental courts is not a mere formality.  Hainan government will allocate at least 70 million for environmental public interest litigation fund to protect the environmental action in the case of funds in place in time.  High Court will also meet the requirements of environmental responsibility departments awarded the qualification proceedings.  In addition, Hainan Province, the tribunal's institutional establishment has been approved to complete the preparation committee.   Environmental Court High Court hearing will be mainly involved in Hainan area of water resources, air, noise, radioactive pollution and environmental damage and other types of second-instance civil and commercial cases, and relates to environmental protection against administrative organs of the specific administrative act which occurred in the second instance administrative proceedings case, the executive protection because they do not perform administrative duties and thus do not occur as a second-instance administrative litigation cases involving environmental protection and state compensation cases of second instance.   In addition, the trial court will be responsible for the province's environmental protection work in research and guidance to ensure that environmental laws and regulations to implement and actively participate in comprehensive management of environmental and resource protection.   Currently, the First Intermediate People's Court in Hainan Province, the Provincial Second Intermediate People's Court, Haikou City Intermediate People's Court, Sanya City Intermediate People's Court has also set up environmental protection among the divisions. ]]></text>
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        <pubDate>2012-01-03 09:10:31</pubDate>
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        <title>The number of Hainan last year, 83.2 million passengers travel</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/gn/2012/01/671556893546.html]]></link>
        <text><![CDATA[  Xinhua Hainan Channel January 22 (Xinhua Jiang Tieying) with the economic trends continue to change for the better, the international tourism market gradually recovered in 2010 exceeded the number of entry and exit of Hainan Province 800000, 83.2 million, up 22 over 2009 .1%.  The open ports by the Hainan private immigration the number of mainland residents exceed 10 million mark for the first time, the rapid increase over 2009 rose 54.8%.   Haikou Meilan Frontier Inspection Station, according to the person in charge, Meilan Airport last year, presents the work of four new entry-exit port characteristics, namely, mainland residents will choose outbound significantly enhanced.  Second, Haikou, Hong Kong, Macao and from the number of personnel to maintain stable growth.  Last year alone, more than 5.6 million visitor arrivals in Taiwan people, a substantial increase of 21.3% year on year.  Third, the number of foreigners entering the sea quickly restored to pre-crisis levels, Laiqiong main purpose of entry for the foreign tourism and leisure, and the proportion is growing rapidly.  Fourth, the gradual recovery of the total entry and exit of the aircraft to the highest level in previous years.   Meanwhile, the data show that residents choose to travel abroad in Hainan last year, will significantly enhance, Singapore, Hong Kong, Taiwan, Malaysia, Vietnam, people in Hainan to the top five countries and regions.  Among them, Singapore's first super-destination for Hong Kong as the preferred exit.  Meanwhile, Hainan, Hong Kong, Macao and from the number of personnel to maintain stable growth.  Visitor arrivals in Taiwan in 2010 more than 5.6 million passengers, an 21.3% increase substantially.  The number of foreigners entering Hainan also showed rapid growth trend. ]]></text>
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        <pubDate>2012-01-03 09:10:23</pubDate>
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        <title>Hainan: transfer function of travel service hotline opened</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/gn/2012/01/21999823.html]]></link>
        <text><![CDATA[  Xinhua Hainan Channel January 22 (Xinhua Vivian Chow) to further enhance the holiday tourism in Hainan Province of service quality and management level, to maintain the legitimate rights and interests of tourists, Hainan Provincial Tourism Quality Supervision, management-owned travel service hotline 12301 (Tourist Complaint Center) successfully launched to answer the transfer function.   It is understood that travel service hotline 12301 to answer the transfer function before the opening, due to the individual needs of tourists increases, receiving visitors in the consultation process, staff can not fully grasp the broad array of travel related information, the immediate return of the tourists, tourism There are also complaints after receiving complaints complicated transfer process and reduce process time and the issue of complaints.   Receive realization of the transfer function, the staff can tourists demand, the division of functions and jurisdiction in accordance with Government management principles, directly transferred to the corresponding telephone complaints from tourists receiving platform, and tourist information phone can also be forwarded to the relevant travel agencies, tourist attractions, hotels, etc. relevant units in order to provide visitors with a more detailed and personalized service, tourist information and complaints to improve the working efficiency, but also improve the quality of tourism services. ]]></text>
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        <pubDate>2012-01-03 09:10:13</pubDate>
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        <title>China: telecommunications costs down 13.6%</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/ty/2012/01/90305.html]]></link>
        <text><![CDATA[The Chinese telephone subscribers now benefit from a slight reduction of their costs through a reform of industrial monopoly in this sector. In 2007, the costs of télécommunictions fell an average of 13.6%.
Costs have been halved during the past five years, said Wang Xudong, Minister of Information Industry at a work conference held Wednesday in Beijing. He added that &#8216;a preliminary pricing oriented market had been established &#8220;.
He did not detail the amounts or how costs are calculated. A spokesman for the department declined comment.
As more and more Chinese have accused the telecommunications industry, dominated by large state enterprises to make significant profits through their monopoly prices, the government asked companies to provide In February a service that can receive calls for free.
China Mobile has begun to provide tariff offers to receive calls for free in February, a major change promoted by the Ministry of Information Industry in 2007. Similar packages were also adopted by rival China Unicom. The Chinese operators of mobile telephony were used to charge the caller and the callee.
The lower prices did not reduce the profits of mobile operators in that the 639 million subscribers are encouraged to call more. China Mobile has registered 37, 9 million yuan in net profits (5.19 million dollars), up 25.7% in the first half of last year.
But the fixed telephone operators have experienced reduced profits because the mobile operators telepone have won customers by offering attractive prices. 39.9% of the population owns a mobile phone and only 28.3% a landline.
revenues of telecommunications companies amounted to 1 680.86 billion yuan, an increase of 27% over the first 11 months of last year.

中国：电信费用下降13.6％ 
的中国电话用户受益于它们的成本通过行业垄断改革稍有减少，这一部门。 2007年，télécommunictions的成本下降了13.6％的平均水平。
费用已在过去5年前的一半，说王旭东，信息产业部部长于周三在北京举行工作会议。他补充说，&#8217;一个初步定价为导向的市场设立了“。
他没有详细说明的金额或费用是如何计算出来的。该署发言人拒绝对此发表评论。
随着越来越多指责中国电信行业中，大型国有企业为主导，通过自己的垄断价格可观的利润，政府要求公司提供今年2月，这种服务可以得到免费通话。
中国移动已开始提供关税优惠，在2月收到的免费电话，一个重大变革由信息产业部2007年晋升。相似软件包还通过了竞争对手中国联通。移动电话运营商的中国被用来负责调用方和被调用。
较低的价格并没有减少对移动运营商利润639万用户呼吁更多的鼓励。中国移动已经注册的37个，900万净利润（5.19亿美元），同比增长25.7％，而去年上半年元。
但是，固定电话运营商经历了利润减少，因为手机掉移动运营商赢得了客户提供有吸引力的价格。 39.9％的人口拥有手机，只有28.3％的固定电话。
电讯公司的收入总额为1 6808.60亿元，为27％，比去年首11个月增加。03.01.08]]></text>
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        <pubDate>2012-01-03 09:10:12</pubDate>
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        <title>Guaranteeing payment in 2010 made 77 million yuan 6.5 billion in price subsidies</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/gn/2012/01/602706678440.html]]></link>
        <text><![CDATA[  Xinhua Hainan Channel January 22 (Xinhua deal) at the press 22 learned from the Hainan Provincial Civil Affairs Department, Hainan Province in 2010 urban and rural low payments were distributed 6.5 billion for urban and rural low, hit hard objects, and the beneficiaries public subsidies to more than 7700 million price paid to ensure the basic livelihood of people in financial difficulties.   Hainan Province in 2010 guaranteeing the work to accelerate standardization, the establishment and improvement of the subsistence allowances review mechanism, democratic evaluation mechanism, a public notice system, file management, improved management of urban and rural low level of standardization.  As of last year, Hainan Province, and the beneficiaries objects urban and rural low 43.94 million urban and rural low security standards are on average 248 yuan per person and 168 yuan per person, on average, subsidy levels were 190 yuan and 110 yuan per person per person are higher than the national average, the annual payment of subsistence allowances of approximately 6.5 billion.   The Home Office in Hainan Province, the provincial Department of Finance's efforts to promote, the living standard of rural five objects was significantly improved, to December 2010, the province's rural five months has reached 224 yuan per person to support the standard.  Hainan Province has also introduced a special grant of orphans living allowance, they receive basic living expenses for the orphans, the province will focus on supporting orphans and raise the standard uniform scattered orphans increased to not less than 600 yuan per person per month.   To mitigate the price increases impact on the lives of low-income groups, Hainan Province has launched a low-income groups with timely price increases linkage mechanism, to the urban and rural low, objects, and the beneficiaries paid the price subsidies for poor people affected more than 7700 million, to ensure difficult life of the masses do not decrease because of price increases. ]]></text>
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        <pubDate>2012-01-03 09:10:05</pubDate>
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        <title>A victim of Japanese atrocities and rotten leg by germ warfare</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/ty/2012/01/91510.html]]></link>
        <text><![CDATA[Wang Lihan, 83 years, living in the city of Yushan, Jiangxi province in eastern China, showing his rotten leg with his wife in his house, October 18, 2007, a day before the feast of traditional Chinese double nine (the 9th day of 9th month of Chinese lunar calendar). Wang suffered for 65 years after his leg had rotted due to biological warfare provoked by the troops of Japanese aggression.

阿的细菌战受害者对日本的暴行和烂腿 
汪哩鼾，83岁，在玉山，中国江西东部省份则和他的妻子在他的家，10月18日，2007年，前节日的腐朽腿，城市生活的传统中双9（即第九次农历本月9日）。王遭受了65年后他的腿已经腐烂，由于生物战由日本侵略军挑起的。19.10.07]]></text>
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        <pubDate>2012-01-03 09:10:04</pubDate>
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        <title>Aim at high-distance Jiangong Twelve Five</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/gn/2012/01/028876.html]]></link>
        <text><![CDATA[  According to the "Labor Daily" reported that the city of Shanghai People's attention, "two sessions" a close victory.  "Two sessions", including the convening of the unity of workers, including the mobilization of the masses for the realization of the city's "second Five-Year" plan and work is of great significance.   Shanghai 2011 is the implementation of "second five" first year.  "Twelve five" innovation and development work for the union provided a favorable opportunity to play a dominant role for the working class provided a vast stage.  Achieve "second Five Year Plan" objectives and tasks of the workers and the city is the common pursuit of people and goals, the city staff to be more enterprising and ambitious, the pace with the times, and the fate of reform and opening up, aim at high-distance, meritorious deeds " second five. "   Aim at high-distance, meritorious deeds "Twelve Five", we should adhere to the "innovation-driven."  We want to stand in the global and strategic perspective, employees fully understand the technological innovation in building an innovative city, accelerate the transformation of economic development to the important role and direct the staff to become "innovation experts."   Aim at high-distance, meritorious deeds "Twelve Five", we should adhere to the "transformation and development."  The first change in mode of development, Shanghai workers glorious mission and tasks are arduous.  Shanghai based on their own employees to work in the "speed up" work hard, in the "change" on the real thing, in the "development" on the see results.   To improve the quality of the workforce as a "big school", the union can not be ignored.  Shanghai trade unions at all levels should focus on "innovation-driven, transformation and development" theme, and create a strong learning culture and encourage employees innovation, cultivate and foster high-quality workforce ambitious; to vigorously carry forward the great spirit of model workers and the working class character, and guide staff study hard and strive for progress, and striving to promote scientific development, promote social harmony and excellent workers; to carry out widespread socialist labor emulation, enhanced competition, targeted, effective and inspiring, uniting and leading the workers to adhere to scientific development and to accelerate make contributions to the transformation of economic development mode.   Today, Shanghai is undergoing profound changes.  The city workers must take the wisdom and strength to the completion of Shanghai "second five" task of planning objectives, based on their own, work, and make new achievements! ]]></text>
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        <pubDate>2012-01-03 09:09:58</pubDate>
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        <title>Full text of Constitution of the CPC (12)</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/ty/2012/01/5317718999.html]]></link>
        <text><![CDATA[CHAPTER XI
EMBLEM AND FLAG OF THE PARTY
Article 51 The emblem of the Chinese Communist Party is made up of the pattern of the sickle and hammer.
Article 52 The flag of the Chinese Communist Party is a red flag with the golden emblem of the Party.
Article 53 The Party emblem and flag of the Party are the symbol and the identifiers of the Chinese Communist Party. Party organizations at all levels and all Party members shall safeguard the sanctity of the emblem and flag of the Party. These must be produced and used according to regulation.

全文共产党（12宪法） 
第十一章
国徽，国旗党的
第五十一条中共党徽是由对镰刀和锤子图案。
第五十二条中共党旗，是与党的金色会徽红旗。
第53条的党徽和党旗的象征和中共的标识符。党的各级组织和全体党员应维护国徽，党旗的尊严。这些必须是生产和使用，按照规则。26.10.07]]></text>
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        <pubDate>2012-01-03 09:09:55</pubDate>
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        <title>China Network in 2011 • moved named Person of the Year Documentary Network</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/gn/2012/01/039585.html]]></link>
        <text><![CDATA[  Spotlights, hero lights for the grass-roots   - "China's Wang Shi moved to 2011," named Person of the Year Documentary Network   Xinhua Beijing, December 28 (reporter Xu Xueyi) "beautiful mother", "Girls torch" "the grave keeper veterans", "stick a teacher," "cabbage Dad" ... In 2011, users have to give these amiable and respectable "grassroots "personalized labels, and use them in their own way from the top eleven.   Annual, pay tribute to in the extension, this is a dream of glory and embrace the responsibility, when the "2011 Chinese net thing moving," named Person of the Year of the network for these grass-roots hero again spotlights lit, we know that the network will shrink the world, will resonate enlarge.   Grassroots hero carries the whole community generally agrees that good, tough, self-play, Lutheran, the stars shine shine a history deeply rooted in people's "inner moral force", the stage has witnessed hundreds of thousands of bright grass-roots drive the historical process of moving trajectory.   Strong roots and build the most solid foundation of the whole society   "The most beautiful girl", "building bridges and Grandpa", "premorbid Daughters," "send porridge Grandma," "sturdy repair man" ... ... batch after batch of grassroots heroes in front of us, they are ordinary people around us , doing their ordinary work in 三百六十行, live ordinary and peaceful life, have fun, but also trouble.  Their deeds may not be spectacular, as they may be negligible, but they pay little by little has demonstrated a real dimension, tell us: there is always something worth hold on, there are always some good worth pursuing, and the ordinary world You and I can do.   This is our roots, rapid social transition in China, suffered in the impact of moral values, they are doing to build the most solid foundation of the whole society.   When the "old man fell not to help him up" and other issues in people's hearts entangled, the petite, illiterate Chen Xian Mei did not hesitate to pick up the car crushed by a small Yue Yue, lady's idea is simple - "not so more "" always someone to help. "In this regard, users Shishu Si Xinhua that" such a person like Mrs. Chen appeared much more, we will wake up the conscience of the people inside to help others bravely, without fear of is blackmail, not worried about their personal interests are not hurt. "   When the "money first" "faith is gradually became scarce commodity" and other arguments lead us to think, the Chongqing "Bang Bang" Zheng Dingxiang in the cold snow in the hard to find an employer for five days, wearing unlined, shivering, but never move padded bag too; and his comrades to 60 years ago on a promise to give up 86-year-old European Hing grandchildren, dragging sick footer, comes with dry food, two years four to Beijing, visited six provinces, as reconstruction of the west gate of Huaibei Japanese Martyrs everywhere, and adhere to the 2400 number at the expense of his comrades, the grave keeper for 30 years.   When some people and indifference to the city, alert linked, 64-year-old Chen Xingdi 5 o'clock in the spring season to go out every day, the steaming white rice and ginger to queue up for tickets in the hands of migrant workers. [NextPage] Under the influence of her, a dozen community workers, a group of pupils winter vacation, and even Taiwanese volunteers are added to the "free porridge grandmother" of the team.  Friends "small xuan" that a sixtieth old to her personally, to give help to others and warmth, but also evoke such warm the hearts of good people, called to more and more people to join her team.  In the "mind our own business" environment, Chen grandmother of these seemingly "trivial" little things, but it reveals the glory of human nature, love to pass the earth.  User "囧 囧 hair", said: We can not change the world of suffering, but you can pay a small within the limits of love.  Even a small love, but also valuable.   This time, "China's Wang Shi moved to 2011" the Year contest last year, the network people, has been selected four times quarterly, 60 (group) have a greater impact on users of the annual grass-roots people to become candidates, their Behind is a huge grass-roots groups.   As users' music Shuishan Weng, "said: read the" 2011 China moved to Wang Shi "Annual Network characters candidate brief story, I want to cast one vote each.  They are ordinary little people, some elderly, disabled or old, a teenager, but they are doing, all reflect the good of humanity, love of beauty, moral light.  The face of them, our hearts will be purified and sublimated.  Thank the network, so that so many "Cao Min" has become a hero.   1 2 3 Next ]]></text>
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        <title>Opening of the 11th International Acrobatics Festival of Wuqiao</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/ty/2012/01/7242396311359.html]]></link>
        <text><![CDATA[The 11th International Festival of acrobatics Wuqiao opened in Shijiazhuang in Hebei province October 27. The festival organized by the Ministry of Culture and the local government of Hebei last 9 days. About 200 acrobats from 25 troops from more than 16 countries and regions such as Russia, France, the United States, Germany, the Republic of Korea, Spain etc.., Have participated in the contest Award Golden Lion.

开幕的第十一届国际吴桥杂技艺术节 
第十一届国际吴桥杂技艺术节在石家庄开幕河北省10月27日。由文化部和河北省当地政府举办的最后9天的电影节。大约200名杂技演员来自超过16个国家和地区，如俄罗斯，法国，美国，德国，韩国，西班牙等。，在参加比赛奖共和国部队25金狮。29.10.07]]></text>
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        <title>Shanghai 22, 5 days without rain and snow temperature -1 ℃ ~ 7 ℃</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/gn/2012/01/29404282.html]]></link>
        <text><![CDATA[  According to "the Oriental Morning Post" reported that the recent weather is more conducive to the public the whole city travel, but most of the south temperatures are low, home of the road is still very cold.   27, with the rain area south of the North carrying, Shanghai is in turn converted to overcast with rain in the weather.   Yesterday, as rain and snow into East Sea, Shanghai is controlled by the high ground to the main cloudy in the morning also ushered in the warm sunshine, the temperature was higher than the day before pick-up, reaching 4.3 ℃.  Shanghai Central Meteorological Observatory predicted five-day Shanghai is still managing to mainly cloudy weather, the overall weather more conducive to public travel, but the temperature is still -1 ℃ ~ 7 ℃ low levels between the public and visitors to purchase home , need to pay attention when traveling to warm cold.   Fast Road again yesterday de-icing   Temperature in the city yesterday morning, "freezing" hanging around Xujiahui is only 0.8 ℃, the temperature of other counties -0.2 ℃ to 1.1 ℃ in between.  Yesterday, 1:15, Expressway Monitoring Center issued a snow report, the conservation units one after another on a snow-prone sections and frozen sections of steel bridges salt; in the loop in a timely manner for all Interchange salt to prevent the road is icy ; Nanpu Bridge, Lupu Bridge in the snow section of the conservation officers were on the salt and snow operations.  The measures in place, yesterday morning peak hours, the city's rapid road, bridge and no more snow ice river tunnel phenomenon, vehicle speed to reach normal levels.   Yesterday 8:40, with the sun briefly show his face, the temperature rise, which lasted nearly 40 hours of road icing yellow warning was finally lifted, lawn, trees, snow on the roof is gradually melting.  Although some gloomy afternoon sky, but no rain or snow production, people travel smoothly.  Since yesterday the weather is better, Shanghai is also the highest temperature reached during the day and 4.3 ℃, higher than the day before yesterday picked up nearly 2 ℃.   At still -1 ℃   Meteorological Observatory, said high voltage control by the cold, cloudy weather for the city today, but by the radiation cooling effect of the temperature this morning at -1 ℃, travel back some of the people to wear more than the daytime temperatures rise, up to 6 ℃.   Managing the city for five days will be mainly cloudy weather, which during the day on Saturday midnight to Sunday, shallow trough of Shougao Kong, the city will become cloudy weather, the southern suburbs of precipitation in some areas may be weak, not The sleet had expected the weather, so the impact of city traffic and a smaller spring.  But Meteorological also warns that despite the recent weather in the city than the whole beneficial to the public travel, but the temperatures are still low levels, in between -1 ℃ ~ 7 ℃ and the temperature is low most of the south, foreign workers still very way home cold, warm cold work is still not careless. [NextPage] And 27, with the rain area south of the North carrying, Shanghai is in turn converted to overcast with rain in the weather.   Than the day before the snow, rain and snow yesterday, the South has also been weakened, but because of deep snow in some areas there are still significant road icing, still have an adverse effect on the spring.   Meteorological Department expects managing two days south of the Huaihe River in the eastern and southwestern regions are still more rain and snow in most areas, in which central and northern Guizhou, Hunan, central-northern and small to moderate snow.  The recent freezing rain and snow weather will continue production of the south, living, transportation and other adverse effects, the relevant departments and the public still needs to be concerned about the weather and travel safety. ]]></text>
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        <pubDate>2012-01-03 09:09:47</pubDate>
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        <title>The Secretary General of the UN is concerned about the situation in Somalia</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/ty/2012/01/57006067582.html]]></link>
        <text><![CDATA[In its latest report on the situation in Somalia released Tuesday in New York, Secretary General of UN, Ban Ki-moon expressed his concern at the continued tension and violence in the country, arguing that some measures locally and internationally should be able to contribute to stabilizing the situation.
Recalling that the objective of the UN in that country was twofold - a policy intended to encourage dialogue within the transitional federal government and with opposition movements in the country and abroad, the other security to strengthen the military capabilities of the Mission of the African Union to allow the withdrawal of foreign forces from Somalia, Mr Ban said the UN was created for this purpose an ad hoc interdepartmental and inter - agencies to reflect on these issues.
He urged the Transitional Federal Institutions to implement promptly the recommendations of the congress, including the development of a roadmap for the constitutional process, preparation of the census and elections, in 2009.
Secretary-General also strongly denounced the attacks against the forces of AMIS and the United Nations premises in Mogadishu, and urged the international community to reflect on the possibility of establishing, in addition to the Mission AU and a possible peacekeeping force of UN peacekeeping, a coalition of the brave - a multinational force that would also be deployed in Somalia.
Reaffirming the commitment of the Organization to continue to meet the substantial humanitarian needs of Somalia, the Secretary-General also urged Somalia&#8217;s neighbors to respect the territorial integrity and sovereignty of this country.
In addition, a statement of the Office for the Coordination of Humanitarian Affairs of the United Nations released today shows that just last week, 24,000 people have fled Mogadishu because of clashes there were between insurgents and troops government, bringing to over 110. 000 the number of people who left this city for the last weekend of October. The statement also said dozens of civilians have been killed or wounded during this period.

在联合国秘书长表示关注索马里局势 
表示，在其最近关于索马里局势周二公布的在纽约，联合国秘书长，秘书长潘基文报告，他在持续的紧张局势和该国的暴力行为表示关注，认为一些本地和国际的措施，应能有助于稳定局势。
回顾了联合国在该国的目标是双重的-目的是鼓励在过渡联邦政府的对话和与国内和国外的反对派运动的政策，其他安全，加强对非洲联盟特派团的军事能力，以便从索马里撤出外国部队，潘基文说，联合国是为这一目的而设立的一个特设部门间和-机构，以反映这些问题。
他敦促过渡联邦机构迅速执行大会的建议，包括为制宪进程路线图，在人口普查和选举筹备工作的发展，在2009年。
秘书长也强烈谴责对非盟特派团和联合国在摩加迪沙的处所部队的袭击，并敦促国际社会，以反映对设立的可能性，除了观察团非盟和联合国维和，一个勇敢的联盟-一个多国部队也将可能在索马里部署维和部队。
重申该组织承诺继续满足大量人道主义需要索马里，秘书长还敦促索马里的邻国尊重领土完整和这个国家的主权。
此外，该办事处人道主义事务协调联合国今天发表声明就在上周，24,000人逃离摩加迪沙，因为那里的冲突与叛乱分子和军队节目政府，使110多个。 000人的数目谁离开10月的最后周末这个城市。声明还说，数十名平民被杀害或在此期间受伤。14.11.07]]></text>
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        <pubDate>2012-01-03 09:09:42</pubDate>
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        <title>Exhibition of Chinese artists and writers Dan-ink display in Xiamen</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/gn/2012/01/91700.html]]></link>
        <text><![CDATA[ Xiamen Xinhua, December 29 (Reporter Liao Yi) Chinese literature, Chinese Writers Association Foundation, the "literary newspaper" Press, ARATS office in Macau, Xiamen City Press and Publication Bureau co-sponsored "the same root Civilization - Exhibition of Chinese artists and writers Dan ink ", following a successful exhibition of Macao after the 28th stage of Xiamen Cultural Arts Center Museum.   Vice Chairman Chen Jiangong Chinese Writers Association, said the opening ceremony of the exhibition, this show came with the theme of water across the island of Taiwan, Xiamen history so closely on display, has a special meaning.   "Yan Huang Yizu, calligraphy with the home"; "the same root culture, even the rationale for rivers and mountains" ... Strait and Hong Kong and Macao from a hundred writers, artists and celebrities to edges of color sway with the weight of the root of civilization with respect and pride.   Throughout the exhibition, paintings and many more "hometown" "homeland," "Brideshead Revisited" "the enemy" as the theme, vivid outline, pervaded the deep feelings of homesickness.  "Who's that wide river? A reed hang of. Who said that Songyuan? Foot with six toes to look to." "Say south is the former residence, the dream scenery, or as fair. And vertical threads in the sea, not only to catch a black dragon fish." "The green water span of faint and fall do not withered grass south. 24 bridge moon night, where partner in teaching flute." ... well-known writer liang, Chen Shixu and other hand-written ancient Chinese poetry, delay, deepening of the mind sees .   Facing Taiwan across the water, more artists and writers willing to speak one's mind to pen and ink, "Yuan Wang Xiamen Yanai, the water line Ziyun heavy day. Beichen vertical development shop Tianyi, one with the Strait of things." Tuan pro poet poetry book "Qilu Xiamen lights" touching hearts; "it was a cricket in the Strait over there singing, singing here in the Strait, an alley in Taipei's singing, a village in Sichuan to sing ..." well-known writer, poet Chang Liu Shahe with my hand-written poem, the audience feeling Xixu.   China Literature Foundation Secretary-General Li Xiaohui said, "with the root of civilization - Chinese ink artists and writers Dan Show" since the preparation has been many well-known Hong Kong and Macao Strait writers and artists of the overwhelming response, the exhibition a success, we looking forward to next year's show a success in Taiwan.  (End) <]]></text>
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        <pubDate>2012-01-03 09:09:41</pubDate>
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        <title>Holiday supply of daily necessities to ensure that the market practice in Gansu, Daily News system</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/gn/2012/01/08279.html]]></link>
        <text><![CDATA[  Gansu Xinhua News Channel on January 22 during the holiday season for the good supply of the commodity market and maintain market stability and ensuring food safety on sale a few days ago, Gansu Provincial Department of Commerce issued a notice to the City make arrangements for the state Department of Commerce Spring Festival market supply in 2011 work.  For the current snow and weather emergencies impact on the market necessities, from January 24, 2011 until February 11, Gansu Province, the market necessities of life to practice the "Daily" system to ensure market supply.   In addition, the state Bureau of Commerce also require municipalities to guide enterprises around the New Year, food, food, household appliances, clothing and other hot consumer to carry out shopping festival, food festival, New Year and promote development, and other consumer activities.  In food safety, the Department of Commerce calls for a variety of business anniversary during the festival, promotional activities to strengthen supervision of counterfeit and shoddy goods, disrupted the market order and other illegal activities, and strengthen agricultural (set) and trade markets, wholesale markets, shopping malls, supermarkets, pig slaughtering and processing enterprises and other business premises fire safety inspection to ensure safety in production business area.   Editor: Wang Heng ]]></text>
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        <pubDate>2012-01-03 09:09:40</pubDate>
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        <title>APEC: Chinese President delivers a speech on the establishment of a sustainable future</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/ty/2012/01/649123404917.html]]></link>
        <text><![CDATA[Chinese President Hu Jintao has expressed views on China on the establishment of a sustainable future, in a speech during a meeting of businessmen Forum Asia Pacific Economic Cooperation (APEC) held Thursday in Sydney.
In his speech entitled &#8220;promote the comprehensive cooperation in the pursuit of sustainable development,&#8221; Hu made a five-point proposal, calling for the promotion of a balanced global economic growth, the introduction a just multilateral trade regime, the maintenance of energy supply in a stable, the protection of a healthy natural environment and advances in science, technology and education.
Le président Hu se trouve actuellement à Sydney pour participer à une conférence des dirigeants de l&#8217;APEC, prévue pour les 8 et 9 septembre.
The two-day meeting of businessmen, which opened Thursday, is an important forum within the APEC meetings.
The conference this year, with the theme: &#8220;Strengthening our community, establish a Sustainable Future&#8221;, focused on a range of subjects including trade, structural problems, the market, energy, clean development Climate change and education.

亚太经合组织：江泽民主席提供了关于建立一个可持续的未来讲话 
中国国家主席胡锦涛表示，在一商人论坛会议的亚太经济合作会议（APEC在中国的意见对建立一个可持续的未来在一次讲话中，）周四在悉尼举行。
在发表题为“推动在追求可持续发展的全面合作，”胡锦涛提出了5点建议，为平衡全球经济增长的促进致电的话，引进一个公正的多边贸易体制，在保持稳定的能源供应，一个健康的自然环境和保护科学进步，技术和教育。
胡锦涛目前在悉尼参加于9月8日和9日举行亚太经合组织领导人会议。
在为期两天的会议商人，周四开幕，是在APEC会议的重要论坛。
今年的会议，主题是：“加强我们的社会，建立一个可持续的未来”，就多项议题，包括贸易的重点，结构问题，市场，能源，清洁发展气候变化和教育。07.09.07]]></text>
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        <pubDate>2012-01-03 09:09:35</pubDate>
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        <title>Qinghai, China • Happy first rainbow ice and snow culture in the mutual opening of the Festival</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/gn/2012/01/4234265351.html]]></link>
        <text><![CDATA[ Silver Mountain Dragon King dressed in white, passionate Weiyuan town.  December 29, the first rainbow of China's Qinghai Snow Festival in mutual cultural joy rainbow tribe Tu Tu Autonomous County Park kicked off.  Provincial CPPCC Vice Chairman Bao Yizhi attended the opening ceremony.   Snow slide, snow, extreme yo-yo, snow parks, snow and ice maze, snow motorcycles, snow fun world of ice bumper car ... ... a large variety of recreational activities for the winter snow and ice soil Township became a sea of ​​joy, has become race to play outside of the winter tourist paradise.   Up to hot and cold in winter, the snow's still alive, the Tu culture aroused to put up with winter tourism.  Through this series of events held in ice and snow play, and experience to further tap the plateau winter tourism resources, culture of Tu-round, multi-level, wide-angle interpretation, publicity and promotion, then ice and snow culture and folk culture, local culture, barley Organic wine culture integration, better make up for the winter ice and snow tourism projects in our province blank, creating a precedent for winter tourism in Qinghai.   This session of the festival is to demonstrate the joy of ice and snow culture "great beauty Qinghai, winter mutual aid" is a major undertaking, the development of winter tourism in Qinghai will have an important impact.  This event a success, will provoke a wave of winter tourism in Qinghai, to further promote the province's tourism and snow tourism industry development and growth, and thus to enhance the "hometown of Chinese rainbow Tu" tourism brand.   The Provincial Tourism Bureau snow Joy Festival, organized mutual aid and Tu Autonomous County, Qinghai Investment and Technology Development Co., Ltd. barley city contractors.  Festival activities will be the scientific development concept, the spirit of cultural development, and prosperity of the requirements of the "government-led, community participation and market operation" principle, strive to create a boutique brand of cultural tourism, culture and tourism industry to promote mutual good and rapid development.   Section will be a period of nearly three months, to February 23, 2012 closing.  In addition to snow entertainment, there are the traditional Tu real wedding, Shadow Happy New year, the wheels fall performances of intangible cultural performances, visitors can enjoy traditional village into the art of soil, soil Township will have to become the most dynamic winter the place.  (Author: Lin Min Yu Zhong should be) <]]></text>
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        <pubDate>2012-01-03 09:09:33</pubDate>
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        <title>Shandong, a classic reading of the new regulations, recommended reading text ban</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/gn/2012/01/38087127.html]]></link>
        <text><![CDATA[  Shandong Xinhua Channel Dec. 30 (Xinhua Zhao Renwei) Shandong Provincial Department of Education recently issued a circular calling for schools to carry out traditional cultural education should be carefully screened and selected, in principle, should be based on local curriculum "traditional culture" as the provisions of chapter learning read the main content of non-selective full text is not recommended, such as "Students", "Three Character Classic," "child prodigy Poetry" and so on.   Shandong Province Education Department said in recent years, the province Zhong Xiaoxue accordance with relevant provisions, extensive carry forward the Chinese traditional culture, fostering the national spirit of educational activities, achieved significant results, but there have been some notable problems.  Some of the implementation of the curriculum in primary and secondary schools not seriously setting up local programs "traditional culture", in some places and schools in carrying out activities in primary and secondary students read classic on the content of reading activities, not deep analysis is not transparent, the screening is not enough, resulting in Some sexual content with the dross into the schools, distort the values of students, the corrosion of the primary and secondary heart, resulting in a very bad negative impact caused by the strong social and parental concerns.   Shandong requirements, primary and secondary levels of education administration and school organization to celebrate traditional culture and education activities for the content of the topic, learn to read the content carefully chosen, follow the "essence, to its dregs" principle, careful screening and selection for that reflect the fine Chinese culture, reflecting patriotism as the core of the great national spirit, reflecting the ideals and beliefs and the right spirit of national self-esteem, reflecting the good moral character and civilized behavior of literature recommended to students.  (End) ]]></text>
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        <pubDate>2012-01-03 09:09:27</pubDate>
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        <title>Backgrounder: 42 candidate sites for UNESCO World Heritage List</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/gn/2011/12/56976435864.html]]></link>
        <text><![CDATA[The 35th session of the World Heritage Committee will be held in Paris from June 19 to 29. The annual meeting will consider 42 natural and cultural properties in 40 countries for the inscription on the World Heritage List of the UN Educational, Scientific and Cultural Organization （UNESCO）.Last year’s meeting added 21 out of 32 proposed candidate sites onto the list. The following is a full list of the sites to be considered this year:Ten natural properties scheduled for consideration:Ningaloo Coast （Australia）; Pendjari National Park （Benin, an extension of W National Park of Niger）; Wudalianchi National Park （China）; Ancient Beech Forests of Germany （Germany, an extension of the Primeval Beech Forests of the Carpathians, Slovakia and Ukraine）; Western Ghats （India）; Harra Protected Area （Iran）; Ogasawara Islands （Japan）; Kenya Lake System in the Great Rift Valley （Kenya）; Trinational Sangha （Congo, Cameroon, Central African Republic）; and the nomination under new criteria of the World Heritage property of Phong Nha - Ke Bang National Park （ Vietnam）.Twenty-nine cultural properties scheduled for consideration:Pearling, Testimony of an Island Economy （Bahrain）; Bridgetown and its Garrison （Barbados）; West Lake Cultural Landscape of Hangzhou （China）; Coffee Cultural Landscape （Colombia）; Konso Cultural Landscape （Ethiopia）; The Causses and the Cevennes （ France）; The architectural work of Le Corbusier, an outstanding contribution to the Modern Movement （France, Argentina, Belgium, Germany, Japan, Switzerland）; Fagus Factory in Alfeld （Germany）; The Persian Garden （Iran）; The Land of Caves and Hiding （Israel）; The Triple-arch Gate at Dan （Israel）; The Longobards in Italy, Places of Power, 568-774 A.D. （Italy）; Hiraizumi -- Temples, Gardens and Archaeological Sites Representing the Buddhist Pure Land （Japan）; Fort Jesus, Mombasa （Kenya）; Fundidora Monterre （ Mexico）; Transboundary Nomination for Yapese Stone Money Sites in Palau and Yap （Micronesia/Palau）; Petroglyphic Complexes of the Mongolian Altai （Mongolia）; Leon Cathedral （Nicaragua）; Oke-Idanre Cultural Landscape （Nigeria）; Historical City of Jeddah （Saudi Arabia）; Cultural Landscape of the Serra de Tramuntana （Spain）; Archaeological Sites of the Island of Meroe （Sudan）; Prehistoric Pile dwellings around the Alps （Switzerland, Austria, France, Germany, Italy, Slovenia）; Ancient villages of Northern Syria （ Syrian Arab Republic）; Old City and Ramparts of Alanya with Seljuk Shipyard （Turkey）; Selimiye Mosque and its social Complex （Turkey）; Residence of Bukovinian and Dalmatia Metropolitans （Ukraine）; Cultural Sites of Al Ain: Hafit, Hili, Bidaa Bint Saud and Oases Areas （United Arab Emirates）; Citadel of the Ho Dynasty （Vietnam）.Three properties proposed for both natural and cultural criteria as "mixed natural and cultural" sites:Blue and John Crow Mountains National Park （Jamaica）; Wadi Rum （Jordan）; Saloum Delta]]></text>
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        <pubDate>2011-12-30 11:32:52</pubDate>
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        <title>Chinese Bridge links China with Russian students’ dreams</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/gn/2011/12/001348.html]]></link>
        <text><![CDATA[Julia Shupta is standing on the stage, reciting a love poem in Chinese with soft music, "See me, Or see me not, I am here, Without joy or tear ..." The Russian girl said she wants to be a Chinese language teacher after receiving graduate degree.A contestant plays the Chinese zither during the final of the 10th "Chinese Bridge" ChineseProficiency Competition for Foreign College Students in Moscow, capital of Russia, on May6, 2011. The 10th "Chinese Bridge" Chinese Proficiency Competition for Foreign CollegeStudents in Moscow concluded here Friday. （Xinhua/Zhao Danwen）Julia was selected as the "top three" in the 10th Chinese Bridge competition, a Chinese language speaking contest, in Moscow on Friday, and got a chance to "battle" in China with other selected Chinese-learners from various universities in dozens of countries in August."I’m so glad I could go back to China," Julia, who has studied in China for one and half year, told Xinhua with smiles. "I missed so much my teachers and friends in China." The girl said she could not forget her impressive experiences in the Asian country."I want to go to China for my graduate studies," the girl said.Julia, who came from Russia’s Kazan Federal University, has been studying Chinese language for nearly four years, while Nikita Kuzmin, a boy from Moscow Normal University, has studied in China for one year and learned how to play a zither.In the competition, Nikita played a piece of well-known Chinese music "Fisherman’s Song" and recited a poem written by Tang Dynasty Chinese poet Wang Wei."After rain the empty mountain, Stands autumnal in the evening, Moonlight in its groves of pine, Stones of crystal in its brooks .. ." Nikita drew attentions from the whole room when he played zither and recited the poem "An Evening in the Mountains."A contestant presents her talent for Chinese calligraphyduring the final of the 10th "Chinese Bridge" ChineseProficiency Competition for Foreign College Students inMoscow, capital of Russia, on May 6, 2011. The 10th"Chinese Bridge" Chinese Proficiency Competition forForeign College Students in Moscow concluded here Friday.（Xinhua/Zhao Danwen）After his performance, Nikita told Xinhua he didn’t care about the result of the competition. "I just want to learn from other competitors."The boy, who wooed the audiences and judges, also earned his chance to go to China."I have seen his every step in growing up," his Chinese teacher said. "He is fond of Chinese language and culture."A contestant sings a Chinese song during the final of the10th "Chinese Bridge" Chinese Proficiency Competition for ForeignCollege Students in Moscow, capital of Russia, on May 6, 2011.The 10th "Chinese Bridge" Chinese Proficiency Competition forForeign College Students in Moscow concluded here Friday.（Xinhua/Zhao Danwen）Another boy Paul Burlov, from Moscow State Linguistic University, was also selected as the "top three".Other competitors also won applause in their performance and surprised audiences by the[NextPage]ir understanding of Chinese culture.Their amazing performance also impressed Zhao Guocheng, minister-counsellor of the Chinese Embassy in Russia."All competitors have reached high levels of Chinese language proficiency," Zhao said.Zhao noted the competition reflected the situation of Chinese language teaching in Russia and was also a proof of the development of Sino-Russian ties.Irina Khaleeva, president of Moscow State Linguistic University, the host of the competition, valued the Chinese Bridge competition as "a platform to promote Chinese culture over the world."A contestant answers questions during the final of the 10th "Chinese Bridge" ChineseProficiency Competition for Foreign College Students in Moscow, capital of Russia, on May6, 2011. The 10th "Chinese Bridge" Chinese Proficiency Competition for Foreign CollegeStudents in Moscow concluded here Friday. （Xinhua/Zhao Danwen）So far, more than 40 universities and some 20 middle and primary schools list Chinese as their first foreign language and nearly 20 Confucius Institutes and three Confucius classrooms opened in Russia from the extreme southeast Far Eastern city of Vladivostok to Kazan along the Volga River.According to Chinese Ambassador to Russia Li Hui, some 2,000 Russian students went to China for advanced study in 2010.The Chinese Bridge is an annual competition where foreign students could showcase their language proficiency.]]></text>
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        <pubDate>2011-12-30 11:32:45</pubDate>
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        <title>Hakka Earth Buildings: How to keep the leaving resident？</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/gn/2011/12/049352.html]]></link>
        <text><![CDATA[
Let’s visit the Yongding Hakka Earth Buildings in Fujian Province. 
The town welcomed more than 30-thousand visitors during the first two days of the May Day holidays. That’s about 70 percent more than the same period last year. 
But many visitors said they did not feel the usual charm. As with many tourist destinations, they complained about excessive commercialization of the community. But another common observation is that there are fewer and fewer residents living in the Earth buildings.
At the Shize building in Yongding, most of the local residents who have small business inside the earth building, do not live there. In most cases, the earth building was their original home, but now it serves as a work place for them. The only residents that stay are children and the elderly.
Jiang Weihuang, resident of Shize Building, said, "The younger generation do not wish to stay there. Most of them have bought a house in the city."
Jiang Jinrong was a resident in Chengqi Building, which is hailed as "the King of Earth Buildings". He said his whole family moved out more than ten years ago. The reason was that there was not enough space for them to live as a family. There was only one bed, but he had six children. Meanwhile, there is no running water or toilet.
Wuyun Lou, which is just beside Chengqi building, has only three families left.
So, will the lack of residents affect the earth buildings？ Some people in the travel industry think the situation is still acceptable.
Xu Shengjin, director of Fujian Hakka Earth Bldg Travel & Dev. Co., said, "Now the residents inside are still more than when the earth building was constructed. Earth buildings have the advantage that they are cool in the Summer and warm in the Winter. I don’t think the living situation will be affected."
But an expert in the Yongding Hakka Earth Building Research Institute, Hu Daxin, expressed an opposing view. He predicts that in 20 years or so, the number of residents will be so few as to endanger the fragile earth buildings, which require constant maintenance. If his theory is correct, much more should be done to protect this world heritage site.]]></text>
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        <pubDate>2011-12-30 11:32:40</pubDate>
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        <title>Xidi: Ancient town modernized with tourism</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/gn/2011/12/99662029652763.html]]></link>
        <text><![CDATA[
And the ancient town of Xidi in East China’s Anhui Province, also saw tens of thousands of tourists during the just ended May Day holiday. 
In fact, the number of visitors hit a new record in the town’s short history of local tourism. Situated in southern Anhui Province, Xidi was built during the Northern Song Dynasty nearly 1000 years ago. 
More than 300 houses constructed during the Ming and Qing Dynasties are well preserved. And half of them have been inscribed in UNESCO’s World Culture Heritage List. Tourism in the town has been on the rise since the 1990s, and for the most part, the original look of the town remains unchanged. But happily for the residents, some things have changed.
Xidi residents have dwelled in their ancestral houses for centuries. Many of them had no tap water and lavatory when the idea of tourism was first introduced to the historic town. 
The local government became committed to renovating the local living conditions by installing tap water facilities and building bathrooms where there were once only henhouses and hogpens. 
Hu Yihong, Xidi Town resident, said, "Now we are living like urbanites. We have satellite TV, shower and gas... everything. We also accommodate tourists sometimes and can make 20-thousand yuan per year as an extra income."
Xidi gradually became known to tourists from home and abroad. And residents can get a share from the yearly ticket sale, as long as they are able to preserve the original look of their own buildings. Last year, over 650-thousand people visited the town and the total ticket sales were 26-million yuan. Each household gets 8000 yuan after maintenance costs.
In the past five years, visitor numbers have risen 10 to 15 percent every year. And the zooming tourism fever has inspired the local government to find new ways to better safeguard the ancient flavor of the town.]]></text>
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        <pubDate>2011-12-30 11:32:35</pubDate>
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        <title>Jackie Chan’s 100th film gets Sept. 26 release</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/yl/2011/12/1169437.html]]></link>
        <text><![CDATA[Actor Jackie Chan in the film "1911" [Photo: yule.sohu.com]
Jackie Chan’s 100th movie, "1911", an all-star tribute film to the 100th anniversary of the 1911 Revolution, will hit Chinese theaters September 26, Sohu.com reports.
The film, which Chan directed, produced and acts in, is an artistic chronicle of the monumental revolution, known in China as the Xinhai Revolution, that began in 1911 and eventually brought an end to China’s last feudal dynasty.
Chan, who describes the film as a combination of history, action, war and romance, has brought together 70-plus celebrities for the cast. Among them are Li Bingbing, Winston Chao, Joan Chen, Ning Jing, Yu Shaoqun, as well as Chan’s actor-singer son, Jaycee.
Distributor Well Go USA has purchased the film’s North American rights, and aims to give it a day-and-date release in the United States, according to "The Hollywood Reporter".]]></text>
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        <pubDate>2011-12-30 11:32:31</pubDate>
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        <title>Education ministers discuss balanced student flows between Asia, Europe</title>        <link><![CDATA[http://c.zhiwenweb.cn/CulturesA/xwzx/gn/2011/12/057321.html]]></link>
        <text><![CDATA[European and Asian education ministers met here Tuesday to discuss how to balance flows of students between higher education institutes in Asia and Europe.The ministers, as well as stakeholders in the higher education sector, met at the Third Asia Europe Meeting （ASEM） for Ministers of Education to discuss balanced student mobility, quality assurance, and ways to engage business and industry in education."We have had many recommendations but have especially discussed the need to make connections between business and educational institutions," said Danish Education Minister Troels Lund Poulsen."We also discussed mobility, that is the exchange of students from Asia to Europe and from Europe to Asia," he told Xinhua.Hao Ping, vice minister of China’s Ministry of Education, presenting a paper on the mobility of students and staff between higher education institutes in Asia and Europe.Siegbert Wuttig, director of the ASEM education secretariat, said there is currently "imbalanced mobility between Asia and Europe.""We are trying, for instance, to increase the number of European students who may like to spend some time in Asian countries," Wuttig told Xinhua.Wuttig believed there is a need to improve transparency in quality assurance, saying some of the national delegations at the meeting were interested in developing a common qualification framework. This would help correctly recognize qualifications and enable smoother exchange of students and academics, he said.Rujhan Mustafa, director-general of Malaysia’s Ministry of Higher Education, said that "Through quality assurance and recognition, we can have a proper balanced mobility of staff and students within Asia and Europe."Malaysia is scheduled to host the next ASEM summit in 2013, and is expecting to host up to 150,000 foreign students by 2015.According to Mustafa, the country wants to "develop a framework of how credit transfers can be put in place." This means students spending a semester abroad can count those credits towards courses back home.Delegates pointed out that implementing joint curricula, summer courses and collaboratively-financed programs can also help balance student mobility."We would welcome more national investment in structured collaboration programs," said Elizabeth Colucci f
