A systematic review and meta-analysis of the effects of isoflavone formulations against estrogen-deficient bone resorption in peri- and postmenopausal women
Age-related estrogen deficiency leads to accelerated bone resorption. There is evidence that, through selective estrogen receptor modulation, isoflavones may exert beneficial effects against estrogen-deficient bone loss. Isoflavone aglycones show higher bioavailability than their glycosidic counterp...
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| Veröffentlicht in: | The American journal of clinical nutrition 2017-09, Vol.106 (3), p.801-811 |
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| creator | Lambert, Max Norman Tandrup Hu, Lin Meng Jeppesen, Per Bendix |
| description | Age-related estrogen deficiency leads to accelerated bone resorption. There is evidence that, through selective estrogen receptor modulation, isoflavones may exert beneficial effects against estrogen-deficient bone loss. Isoflavone aglycones show higher bioavailability than their glycosidic counterparts and thus may have greater potency.
To summarize evidence, we executed a systematic review and meta-analysis examining isoflavone therapies and bone mineral density (BMD) loss in peri- and postmenopausal women.
We systematically searched EMBASE and PubMed for randomized controlled trials (RCTs) evaluating isoflavone therapies for treating BMD loss at the lumbar spine and femoral neck in estrogen-deficient women. Separate meta-analyses were carried out with the use of random-effects models for the lumbar spine and femoral neck for all studies providing isoflavones as aglycones.
Twenty-six RCTs (n = 2652) were included in the meta-analysis. At the lumbar spine, isoflavone treatment was associated with a significantly (P < 0.00001) higher weighted mean difference (WMD) of BMD change of 0.01 (95% CI: 0.01, 0.02) than the control. For the femoral neck (18 RCTs, n = 1604), isoflavone treatment showed a significantly (P < 0.01) higher WMD of BMD change of 0.01 (95% CI: 0.00, 0.02) compared with the control. When isolating studies that provide isoflavone aglycones in their treatment arm, the average effect was further significantly increased at the spine (5 RCTs, n = 682) to 0.04 (P < 0.00001; 95% CI: 0.02, 0.05) and femoral neck (4 RCTs, n = 524) to 0.03 (P < 0.05; 95% CI: 0.00, 0.06) compared with the control. This protective effect against bone loss disappeared when only studies with formulations comprising predominantly isoflavone glycosides were included.
Isoflavone treatments exert a moderately beneficial effect against estrogen-deficient bone loss in women. The effect appears dependent on whether isoflavone treatments are in aglycone form; we conclude that beneficial effects against bone loss may be enhanced for isoflavone aglycones. |
| doi_str_mv | 10.3945/ajcn.116.151464 |
| format | Article |
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To summarize evidence, we executed a systematic review and meta-analysis examining isoflavone therapies and bone mineral density (BMD) loss in peri- and postmenopausal women.
We systematically searched EMBASE and PubMed for randomized controlled trials (RCTs) evaluating isoflavone therapies for treating BMD loss at the lumbar spine and femoral neck in estrogen-deficient women. Separate meta-analyses were carried out with the use of random-effects models for the lumbar spine and femoral neck for all studies providing isoflavones as aglycones.
Twenty-six RCTs (n = 2652) were included in the meta-analysis. At the lumbar spine, isoflavone treatment was associated with a significantly (P < 0.00001) higher weighted mean difference (WMD) of BMD change of 0.01 (95% CI: 0.01, 0.02) than the control. For the femoral neck (18 RCTs, n = 1604), isoflavone treatment showed a significantly (P < 0.01) higher WMD of BMD change of 0.01 (95% CI: 0.00, 0.02) compared with the control. When isolating studies that provide isoflavone aglycones in their treatment arm, the average effect was further significantly increased at the spine (5 RCTs, n = 682) to 0.04 (P < 0.00001; 95% CI: 0.02, 0.05) and femoral neck (4 RCTs, n = 524) to 0.03 (P < 0.05; 95% CI: 0.00, 0.06) compared with the control. This protective effect against bone loss disappeared when only studies with formulations comprising predominantly isoflavone glycosides were included.
Isoflavone treatments exert a moderately beneficial effect against estrogen-deficient bone loss in women. The effect appears dependent on whether isoflavone treatments are in aglycone form; we conclude that beneficial effects against bone loss may be enhanced for isoflavone aglycones.</description><identifier>ISSN: 0002-9165</identifier><identifier>EISSN: 1938-3207</identifier><identifier>DOI: 10.3945/ajcn.116.151464</identifier><identifier>PMID: 28768649</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Age ; Aglycones ; Bioavailability ; Biological Availability ; bone ; Bone and Bones - drug effects ; Bone and Bones - metabolism ; Bone density ; Bone Density - drug effects ; Bone Density Conservation Agents - pharmacology ; Bone Density Conservation Agents - therapeutic use ; Bone loss ; Bone mineral density ; Bone resorption ; Bone Resorption - etiology ; Bone Resorption - metabolism ; Bone Resorption - prevention & control ; estrogen deficiency ; Estrogens ; Estrogens - deficiency ; Female ; Femur ; Formulations ; Glycosides ; Glycosides - pharmacology ; Glycosides - therapeutic use ; Humans ; isoflavone ; Isoflavones ; Isoflavones - pharmacology ; Isoflavones - therapeutic use ; Menopause ; Meta-analysis ; Middle Aged ; osteopenia ; osteoporosis ; Osteoporosis - etiology ; Osteoporosis - metabolism ; Osteoporosis - pathology ; Osteoporosis - prevention & control ; Phytotherapy ; Plant Extracts - pharmacology ; Plant Extracts - therapeutic use ; Post-menopause ; Spine ; Spine (lumbar) ; Systematic review ; Womens health</subject><ispartof>The American journal of clinical nutrition, 2017-09, Vol.106 (3), p.801-811</ispartof><rights>2017 American Society for Nutrition.</rights><rights>Copyright American Society for Clinical Nutrition, Inc. Sep 1, 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c482t-afc4b1ee4b25c338c62513108009a5a467f1e3f7ccc4cd0697a55b94713a5f9d3</citedby><cites>FETCH-LOGICAL-c482t-afc4b1ee4b25c338c62513108009a5a467f1e3f7ccc4cd0697a55b94713a5f9d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28768649$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lambert, Max Norman Tandrup</creatorcontrib><creatorcontrib>Hu, Lin Meng</creatorcontrib><creatorcontrib>Jeppesen, Per Bendix</creatorcontrib><title>A systematic review and meta-analysis of the effects of isoflavone formulations against estrogen-deficient bone resorption in peri- and postmenopausal women</title><title>The American journal of clinical nutrition</title><addtitle>Am J Clin Nutr</addtitle><description>Age-related estrogen deficiency leads to accelerated bone resorption. There is evidence that, through selective estrogen receptor modulation, isoflavones may exert beneficial effects against estrogen-deficient bone loss. Isoflavone aglycones show higher bioavailability than their glycosidic counterparts and thus may have greater potency.
To summarize evidence, we executed a systematic review and meta-analysis examining isoflavone therapies and bone mineral density (BMD) loss in peri- and postmenopausal women.
We systematically searched EMBASE and PubMed for randomized controlled trials (RCTs) evaluating isoflavone therapies for treating BMD loss at the lumbar spine and femoral neck in estrogen-deficient women. Separate meta-analyses were carried out with the use of random-effects models for the lumbar spine and femoral neck for all studies providing isoflavones as aglycones.
Twenty-six RCTs (n = 2652) were included in the meta-analysis. At the lumbar spine, isoflavone treatment was associated with a significantly (P < 0.00001) higher weighted mean difference (WMD) of BMD change of 0.01 (95% CI: 0.01, 0.02) than the control. For the femoral neck (18 RCTs, n = 1604), isoflavone treatment showed a significantly (P < 0.01) higher WMD of BMD change of 0.01 (95% CI: 0.00, 0.02) compared with the control. When isolating studies that provide isoflavone aglycones in their treatment arm, the average effect was further significantly increased at the spine (5 RCTs, n = 682) to 0.04 (P < 0.00001; 95% CI: 0.02, 0.05) and femoral neck (4 RCTs, n = 524) to 0.03 (P < 0.05; 95% CI: 0.00, 0.06) compared with the control. This protective effect against bone loss disappeared when only studies with formulations comprising predominantly isoflavone glycosides were included.
Isoflavone treatments exert a moderately beneficial effect against estrogen-deficient bone loss in women. The effect appears dependent on whether isoflavone treatments are in aglycone form; we conclude that beneficial effects against bone loss may be enhanced for isoflavone aglycones.</description><subject>Age</subject><subject>Aglycones</subject><subject>Bioavailability</subject><subject>Biological Availability</subject><subject>bone</subject><subject>Bone and Bones - drug effects</subject><subject>Bone and Bones - metabolism</subject><subject>Bone density</subject><subject>Bone Density - drug effects</subject><subject>Bone Density Conservation Agents - pharmacology</subject><subject>Bone Density Conservation Agents - therapeutic use</subject><subject>Bone loss</subject><subject>Bone mineral density</subject><subject>Bone resorption</subject><subject>Bone Resorption - etiology</subject><subject>Bone Resorption - metabolism</subject><subject>Bone Resorption - prevention & control</subject><subject>estrogen deficiency</subject><subject>Estrogens</subject><subject>Estrogens - deficiency</subject><subject>Female</subject><subject>Femur</subject><subject>Formulations</subject><subject>Glycosides</subject><subject>Glycosides - pharmacology</subject><subject>Glycosides - therapeutic use</subject><subject>Humans</subject><subject>isoflavone</subject><subject>Isoflavones</subject><subject>Isoflavones - pharmacology</subject><subject>Isoflavones - therapeutic use</subject><subject>Menopause</subject><subject>Meta-analysis</subject><subject>Middle Aged</subject><subject>osteopenia</subject><subject>osteoporosis</subject><subject>Osteoporosis - etiology</subject><subject>Osteoporosis - metabolism</subject><subject>Osteoporosis - pathology</subject><subject>Osteoporosis - prevention & control</subject><subject>Phytotherapy</subject><subject>Plant Extracts - pharmacology</subject><subject>Plant Extracts - therapeutic use</subject><subject>Post-menopause</subject><subject>Spine</subject><subject>Spine (lumbar)</subject><subject>Systematic review</subject><subject>Womens health</subject><issn>0002-9165</issn><issn>1938-3207</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU9v1DAQxS1ERZe2Z27IEuds7fhP4mNVUUCqxIWeLccZF68SO9hOq_0ufFicbuHGaTTSb97MvIfQB0r2THFxbQ427CmVeyool_wN2lHF-oa1pHuLdoSQtlFUinP0PucDIbTlvXyHztu-k73kaod-3-B8zAVmU7zFCZ48PGMTRjxDMY0JZjpmn3F0uPwEDM6BLS-tz9FN5ikGwC6meZ2qQAwZm0fjQy4YcknxEUIzgvPWQyh42OAEOaZlY7EPeIHkm5d9S8xlhhAXs2Yz4edYm0t05syU4eq1XqCHu88_br8299-_fLu9uW8s79vSGGf5QAH40ArLWG9lKyijpCdEGWG47BwF5jprLbcjkaozQgyKd5QZ4dTILtCnk-6S4q-1Xq4PcU3196ypkowzQlhbqesTZVPMOYHTS_KzSUdNid7S0FsauqahT2nUiY-vuusww_iP_2t_BdQJgPpdtT7pvFllYfSpGq3H6P8r_gevEp0m</recordid><startdate>20170901</startdate><enddate>20170901</enddate><creator>Lambert, Max Norman Tandrup</creator><creator>Hu, Lin Meng</creator><creator>Jeppesen, Per Bendix</creator><general>Elsevier Inc</general><general>American Society for Clinical Nutrition, Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T7</scope><scope>7TS</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>P64</scope></search><sort><creationdate>20170901</creationdate><title>A systematic review and meta-analysis of the effects of isoflavone formulations against estrogen-deficient bone resorption in peri- and postmenopausal women</title><author>Lambert, Max Norman Tandrup ; Hu, Lin Meng ; Jeppesen, Per Bendix</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c482t-afc4b1ee4b25c338c62513108009a5a467f1e3f7ccc4cd0697a55b94713a5f9d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Age</topic><topic>Aglycones</topic><topic>Bioavailability</topic><topic>Biological Availability</topic><topic>bone</topic><topic>Bone and Bones - drug effects</topic><topic>Bone and Bones - metabolism</topic><topic>Bone density</topic><topic>Bone Density - drug effects</topic><topic>Bone Density Conservation Agents - pharmacology</topic><topic>Bone Density Conservation Agents - therapeutic use</topic><topic>Bone loss</topic><topic>Bone mineral density</topic><topic>Bone resorption</topic><topic>Bone Resorption - etiology</topic><topic>Bone Resorption - metabolism</topic><topic>Bone Resorption - prevention & control</topic><topic>estrogen deficiency</topic><topic>Estrogens</topic><topic>Estrogens - deficiency</topic><topic>Female</topic><topic>Femur</topic><topic>Formulations</topic><topic>Glycosides</topic><topic>Glycosides - pharmacology</topic><topic>Glycosides - therapeutic use</topic><topic>Humans</topic><topic>isoflavone</topic><topic>Isoflavones</topic><topic>Isoflavones - pharmacology</topic><topic>Isoflavones - therapeutic use</topic><topic>Menopause</topic><topic>Meta-analysis</topic><topic>Middle Aged</topic><topic>osteopenia</topic><topic>osteoporosis</topic><topic>Osteoporosis - etiology</topic><topic>Osteoporosis - metabolism</topic><topic>Osteoporosis - pathology</topic><topic>Osteoporosis - prevention & control</topic><topic>Phytotherapy</topic><topic>Plant Extracts - pharmacology</topic><topic>Plant Extracts - therapeutic use</topic><topic>Post-menopause</topic><topic>Spine</topic><topic>Spine (lumbar)</topic><topic>Systematic review</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lambert, Max Norman Tandrup</creatorcontrib><creatorcontrib>Hu, Lin Meng</creatorcontrib><creatorcontrib>Jeppesen, Per Bendix</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><jtitle>The American journal of clinical nutrition</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lambert, Max Norman Tandrup</au><au>Hu, Lin Meng</au><au>Jeppesen, Per Bendix</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A systematic review and meta-analysis of the effects of isoflavone formulations against estrogen-deficient bone resorption in peri- and postmenopausal women</atitle><jtitle>The American journal of clinical nutrition</jtitle><addtitle>Am J Clin Nutr</addtitle><date>2017-09-01</date><risdate>2017</risdate><volume>106</volume><issue>3</issue><spage>801</spage><epage>811</epage><pages>801-811</pages><issn>0002-9165</issn><eissn>1938-3207</eissn><abstract>Age-related estrogen deficiency leads to accelerated bone resorption. There is evidence that, through selective estrogen receptor modulation, isoflavones may exert beneficial effects against estrogen-deficient bone loss. Isoflavone aglycones show higher bioavailability than their glycosidic counterparts and thus may have greater potency.
To summarize evidence, we executed a systematic review and meta-analysis examining isoflavone therapies and bone mineral density (BMD) loss in peri- and postmenopausal women.
We systematically searched EMBASE and PubMed for randomized controlled trials (RCTs) evaluating isoflavone therapies for treating BMD loss at the lumbar spine and femoral neck in estrogen-deficient women. Separate meta-analyses were carried out with the use of random-effects models for the lumbar spine and femoral neck for all studies providing isoflavones as aglycones.
Twenty-six RCTs (n = 2652) were included in the meta-analysis. At the lumbar spine, isoflavone treatment was associated with a significantly (P < 0.00001) higher weighted mean difference (WMD) of BMD change of 0.01 (95% CI: 0.01, 0.02) than the control. For the femoral neck (18 RCTs, n = 1604), isoflavone treatment showed a significantly (P < 0.01) higher WMD of BMD change of 0.01 (95% CI: 0.00, 0.02) compared with the control. When isolating studies that provide isoflavone aglycones in their treatment arm, the average effect was further significantly increased at the spine (5 RCTs, n = 682) to 0.04 (P < 0.00001; 95% CI: 0.02, 0.05) and femoral neck (4 RCTs, n = 524) to 0.03 (P < 0.05; 95% CI: 0.00, 0.06) compared with the control. This protective effect against bone loss disappeared when only studies with formulations comprising predominantly isoflavone glycosides were included.
Isoflavone treatments exert a moderately beneficial effect against estrogen-deficient bone loss in women. The effect appears dependent on whether isoflavone treatments are in aglycone form; we conclude that beneficial effects against bone loss may be enhanced for isoflavone aglycones.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28768649</pmid><doi>10.3945/ajcn.116.151464</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Age Aglycones Bioavailability Biological Availability bone Bone and Bones - drug effects Bone and Bones - metabolism Bone density Bone Density - drug effects Bone Density Conservation Agents - pharmacology Bone Density Conservation Agents - therapeutic use Bone loss Bone mineral density Bone resorption Bone Resorption - etiology Bone Resorption - metabolism Bone Resorption - prevention & control estrogen deficiency Estrogens Estrogens - deficiency Female Femur Formulations Glycosides Glycosides - pharmacology Glycosides - therapeutic use Humans isoflavone Isoflavones Isoflavones - pharmacology Isoflavones - therapeutic use Menopause Meta-analysis Middle Aged osteopenia osteoporosis Osteoporosis - etiology Osteoporosis - metabolism Osteoporosis - pathology Osteoporosis - prevention & control Phytotherapy Plant Extracts - pharmacology Plant Extracts - therapeutic use Post-menopause Spine Spine (lumbar) Systematic review Womens health |
| title | A systematic review and meta-analysis of the effects of isoflavone formulations against estrogen-deficient bone resorption in peri- and postmenopausal women |
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