Holistic Health Articles and Research Related to Herbal Medicines, Foods and Phytochemicals

Wednesday, 4 October 2017

Food Therapy: Coffee Caffeine Withdrawal Symptoms, Is It True?

By Kyle J. Norton

In compared to herbal medicine, food therapy even takes longer to ease symptoms, depending to stage of the treatment which directly address to the cause of disease.

Abruptively abstained caffeine intake may cause some withdrawal symptoms in regular and daily coffee caffeine intakers, the American University study suggested.
Coffee, second to tea, is a popular and social beverage all over the world, particular in the West, made from roasted bean from the Coffea plant, native to tropical Africa and Madagascar.

Coffee withdrawal symptoms is a set of the unpleasant physical condition caused by ceasing intake of additive caffeine for long term coffee lovers.

In a study of caffeine consumers (N=213) completed the CWSQ after 16h of caffeine abstinence, researchers at the above institute found that general withdrawal symptoms in participants included (1) Fatigue/drowsiness; (2) Low alertness/difficulty concentrating; (3) Mood disturbances; (4) Low sociability/motivation to work; (5) Nausea/upset stomach; (6) Flu-like feelings; and (7) Headache.

Regular and daily coffee intake group showed a significant and greater effect in symptoms of fatigue/drowsiness, low alertness/difficulty concentrating, mood disturbances, and headache in compared to group of non coffee caffeine drinkers.

Other, in the study of genetic effect, related to caffeine content of a beverage on caffeine withdrawal, suggested that withdrawal symptoms may be exaggerated in people who believe that certain genes may have a great influence in increased caffeine withdrawal and people with psychological belief that consumed caffeine leads to a reduction in withdrawal symptoms when no caffeine is consumed.

According to the returned questionnaire from participants 24 hours after caffeine abstinence, then given a cup of decaffeinated coffee, half the participants were told that their coffee was caffeinated participants displayed a strong belief of a greater reduction in withdrawal symptoms than those told it was decaffeinated. And genetic testing demonstrated a result information produced no difference in reported withdrawal symptoms.

In support to the above analysis, the study conducted by the University of Sydney, School of Psychology, using caffeine as a model to test the effect of expectancy on withdrawal symptoms, specifically whether the belief that one has ingested caffeine is sufficient to reduce caffeine withdrawal symptoms and cravings in abstinent coffee drinkers by using the same method as in above study, found that a similar result of greater reduction in the factors of cravings, fatigue, lack of alertness and flu-like feelings of the CWSQ, than those in the Told Decaf condition.

The finding evidences indicated that genetic and psychological and personal belief have a great affect in caffeine withdrawal symptoms, especially cravings, when no caffeine was consumed.

Arthritis Is Curable
You Can Eliminate Osteoarthritis
By addressing the Underlying Causes through Clinical Trials and Studies

Ovarian Cysts And PCOS Elimination
Holistic System In Existence That Will Show You How To
Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

FOOD HACK for Weight Loss
A Simple Cooking Technique That Cuts The Calories & Glycemic
Impact In Rice, Pasta, And Potatoes In Half

Author Biography
Kyle J. Norton, Master of Nutrients
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Sources
(1) Development of the caffeine withdrawal symptom questionnaire: caffeine withdrawal symptomscluster into 7 factors by Juliano LM1, Huntley ED, Harrell PT, Westerman AT.(PubMed)
(2) Effect of Genetic Information and Information About Caffeine Content on Caffeine Withdrawal Symptoms by Mills L1, Dar-Nimrod I2, Colagiuri B2.(PubMed)
(3) Placebo caffeine reduces withdrawal in abstinent coffee drinkers by Mills L1, Boakes RA2, Colagiuri B2.(PubMed)

Tuesday, 3 October 2017

Food Therapy: Intake of Coffee In Ameliorated Risk of Primary Sclerosing Cholangitis

Kyle J. Norton, Master of Nutrients
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

In compared to herbal medicine, food therapy may even take longer to ease symptoms, depending to stages of the treatment which directly address to the cause of disease.

Recent study suggested that coffee and caffeine consumption may be associated to reduced risk of primary sclerosing cholangitis

Primary sclerosing cholangitis (PSC) is a medical condition of inflammation and obliterative fibrosis of the bile ducts.

Coffee, a popular and social beverage all over the world, particular in the West, is a drink made from roast bean from the Coffea plant, native to tropical Africa and Madagascar.

In the study of 606 patients with primary biliary cirrhosis (PBC), 480 with primary sclerosing cholangitis (PSC), and 564 healthy volunteers acted as controls, researchers filed the following results

1. 24% of patients with PSC had never drunk coffee in compared to 16% of controls.
2. Patients with PSC also consumed fewer lifetime cups per month and spent a smaller percentage of their lifetime drinking coffee in compared to healthy adults.

Base on these information, Dr.Lammert C, the lead author opinionated, coffee consumption is lower among patients with PSC, in compared with controls.

Additionally, In patients with PSC, recruited from Oslo University Hospital Rikshospitalet in Norway through 2011, randomly chosen from the Norwegian Bone Marrow Donor Registry (control subjects) of 240 patients with PSC and 245 control subjects also indicated a similar conclusion as follow
1. In compared to control, PSC patients showed a lower daily drinking coffee habit as the time of study and at the age of 18 years observed in men.
2. Ever daily coffee drinker at the age of 18 years were independently and negatively associated with PSC.

These result showed that coffee intake may have a profound effect in protection against development of PSC.

The finding evidences demonstrated that coffee and caffeine consumption may have a significant effect in attenuated risk of primary sclerosing cholangitis developing, but further large and multi centers studies are necessary to validate this claim.

Alternative Therapy: Yoga in Reduced Symptoms of Postural Stability and Improved Quality of Life in Patients with Schizophrenia

Kyle J. Norton (Scholar, Master of Nutrients, All right reserved)
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Yoga ameliorated symptoms and complications of patient with Schizophrenia, particular in improved postural stability, a renowned institute reported.

Schizophrenia is a mental disorder induced inconsistent or contradictory elements such as breakdown of certain relation in thought, emotion, and behavior, leading to faulty perception, inappropriate actions and feelings,....

Yoga, the ancient technique practice is used in parts of India to promote the body to heal itself through enhancing the physical and mental well being.

According to the Keio University School of Medicine, patients with schizophrenia-spectrum disorders showed a significant improvement in risk of falling that may lead to fractures, after attending the yoga lessons.

In an 8 week single-blind randomized controlled study with an eight-week follow-up of outpatients with schizophrenia or related psychotic disorder (ICD-10) randomly assigned to either yoga therapy or a control group, yoga treatment group expressed a significant improvement in a total length of trunk motion, the Romberg ratio(a set feature in the sensory organization test (SOT) as an indicator of proprioceptive contribution to postural stability), and ante flexion in standing after 8 weeks in compared control.

Dr. Ikai S, the lead author said, "the beneficial effects of the yoga therapy on postural stability in patients with schizophrenia. However, the therapeutic effects seemed transient, which warrants further investigations on strategies to sustain the improvements.".

Furthermore, in the review of the data base of the Cochrane Schizophrenia Group Trials Register (December 2008), based on regular searches of CINAHL, EMBASE, MEDLINE and PsycINFO,
yoga had a better outcome for mental state as well as physical health improved significantly in the exercise group compared to those in standard care.

The study also indicated that beside enhanced mental and physical well being, yoga therapy also improved the quality of life in patients with schizophrenia.

Taking together, there is no doubt that yoga has a potential effect in reduced postural physical disability and promoted quality of life in patients with schizophrenia with no adverse effects.

For More information of yoga lessons tailor to a complete well being for women, please visit: YOGA BURN

Arthritis Is Curable
You Can Eliminate Osteoarthritis
By addressing the Underlying Causes through Clinical Trials and Studies

Ovarian Cysts And PCOS Elimination
Holistic System In Existence That Will Show You How To
Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

FOOD HACK for Weight Loss
A Simple Cooking Technique That Cuts The Calories & Glycemic
Impact In Rice, Pasta, And Potatoes In Half

Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca

Sources
(1) Effects of yoga therapy on postural stability in patients with schizophrenia-spectrum disorders: a single-blind randomized controlled trial by Ikai S1, Uchida H, Suzuki T, Tsunoda K, Mimura M, Fujii Y.(PubMed)
(2) Exercise therapy for schizophreni by Paul Gorczynski1 and Guy Faulkner1(PubMed)

Food Therapy: Green Tea in Reduced Symptoms Severity and Treatment of Osteoarthritis

Kyle J. Norton, Master of Nutrients
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Regular drinking of green tea may have a positive effect in reduced symptoms of pain and treatment of osteoarthritis, a study by respectable institute postulated.

Green tea, a precious drink processes numbers of health benefit known to almost everyone in Asia and Western world. However, as yin in nature herbal medicine ,or food, long term injection of large amounts may obstruct the balance of yin-yang, induced "yin excessive syndrome" or "yang vacuity syndrome" including weaken immunity and painful case of GERD,... according to traditional Chinese medicine's Yin-Yang theory. But a slice of ginger will neutralize that adverse effects.

Osteoarthritis (OA), a form of arthritis, is a condition characterized by aging progression of wear and tear on a joint, affecting over 25 million people in the United States in alone

In a randomized open-label active-controlled clinical trial of 50 adults with osteoarthritis of knee allocated to receive the green tea extract (in dosage form of tablet) plus diclofenac tablet as "intervention group"; or: diclofenac tablet alone as "control group" for a period of four weeks, combination treated group exerted a significant improvement of physical function in compared to control.

Treatment group also expressed a similar progress in pain reduction during knee joint physical function in adults with osteoarthritis as in control group.

Additionally, in the compared the effect of curcuminoids extract, hydrolyzed collagen and green tea extract, in chondrocytes culture cell, researchers found that combination of all components score a enormous expression of reduced production of pro inflammatory cytokins through various mechanisms, including ameliorated free radical elucidation.

Furthermore, in the support of the above differentiation, the study in the investigation of a posttraumatic osteoarthritis (OA) mouse model tested with EGCG against progression of OA and relieve OA-associated pain, suggested that EGCG-treated mice promoted cartilage production against Safranin O, staining of the knee joint cartilage loss and cartilage erosion in compared to control group with no treatment.
Importantly, cartilage of treated mice also displays a significant reduction of gene in regulated degeneration of connective tissue as well as pathways involved promotional of tissues inflammation.

Additionally, pain score of treated mice also exhibited a significant enhancement in compared control group.

Taking together, there is no doubt that green tea process a therapeutic and integrated form for prevention and treatment of symptoms of pain as well as improved physical activity of OA patients through protection against cartilage degeneration.

Arthritis Is Curable
You Can Eliminate Osteoarthritis
By addressing the Underlying Causes through Clinical Trials and Studies

Ovarian Cysts And PCOS Elimination
Holistic System In Existence That Will Show You How To
Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

FOOD HACK for Weight Loss
A Simple Cooking Technique That Cuts The Calories & Glycemic
Impact In Rice, Pasta, And Potatoes In Half

Sources
(1)Green tea (Camellia sinensis) for patients with knee osteoarthritis: A randomized open-label active-controlled clinical trial by Hashempur MH1, Sadrneshin S2, Mosavat SH3, Ashraf A4.(PubMed)
(2) Curcuminoids extract, hydrolyzed collagen and green tea extract synergically inhibit inflammatory and catabolic mediator's synthesis by normal bovine and osteoarthritic human chondrocytes in monolayer by Comblain F1, Sanchez C1, Lesponne I2, Balligand M3, Serisier S2, Henrotin Y4.(PubMed)
(3) Green tea polyphenol treatment is chondroprotective, anti-inflammatory and palliative in a mouse post-traumatic osteoarthritis model by Leong DJ, Choudhury M, Hanstein R, Hirsh DM, Kim SJ, Majeska RJ, Schaffler MB, Hardin JA, Spray DC, Goldring MB, Cobelli NJ, Sun HB.(PubMed)

Coffee and Coffee Caffeine Influences Sleep Pattern and Quality in Doses Dependent Manner

Kyle J. Norton, Master of Nutrients
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

In compared to herbal medicine, food therapy even takes longer than six months to ease symptoms, depending to stage of the treatment which directly address to the cause of disease.

Coffee and coffee caffeine may have a strong effect in prolonged sleep latency, reduced total sleep time and sleep efficiency and and worsened perceived sleep quality, a joint study lead by the University of Zürich postulated.
Coffee, becoming a popular and social beverage all over the world, particular in the West, is a drink made from roast bean from the Coffea plant, native to tropical Africa and Madagascar.

In a review systematically explores evidence from epidemiological studies and randomized controlled trials. researchers filed the below interesting results
1. Caffeine affected the sleep quality more in of older adults in compared to younger adults.
2. Pronounced individual differences are also present in young people,
3. Genetic complex may also play an important role in individual sensitivity to sleep disruption by caffeine.

Furthermore, researchers also expressed the concerns of studies in the review with mostly conducted in male adults of Western countries, which may limit the generalizability of the findings

Other, in the study of active duty military personnel (N = 366) returned from deployments to Afghanistan or Iraq in seeking treatment for PTSD, researchers found that
1. Higher caffeine use in these group veterans showed a lower insomnia symptom severity in compared to elevated insomnia symptom severity in no caffeine use group.
2. Caffeine use was not associated with any other measures of sleep disturbance or with PTSD symptoms.

The study also explained that caffeine do not induced greater effect in insomnia and sleep disturbances in this sample probably due to the result of insomnia symptoms was already elevated in this sample, instead of insomnia symptoms severity abstained from any caffeine intake.

Interestingly, in a 13-night sleep laboratory study of 18 normal young adult males twice received 1 cup of warm water, 1-, 2-, and 4-cup equivalents of regular coffee, a 4-cup equivalent of decaffeinated coffee, and a 4-cup equivalent of caffeine administered 30 min before bedtime according to a balanced Latin-square design,

1. Coffee intake showed a dose-related changes in most standard electroencephalogram-electrooculogram (EEG-EOG) in sleep parameters.
2. Regular coffee and caffeine intake caused rapid eye movement (REM) sleep to shift to the early part of the night and stages 3 and 4 sleep to shift to the later part.
3. Decaffeinated coffee had no effect

Taking altogether, there is no doubt that coffee may have a found effect in affecting sleep pattern and sleep quality in dose dependent manor. People with history of insomnia and sleep disturbance should reduce intake of coffee and only drink them in the morning.

Monday, 2 October 2017

Alternative Therapy: Yoga, A Safe and Effective Therapy in Alleviated Menopause Symptoms

Menopause is the transition stage of permanent cessation of the ovaries functions in egg production inducing less production of estrogen and progesterone, signalling the end of the reproductive phrase a woman's life. In perimenopause, menstruation has become irregular and slowly stop overtime, but in some women, menstrual flow may come to a sudden halt.

Yoga, the ancient technique practice for harmonized external and internal body well being, through breath control, meditation, bodily movement and gesture..... has been well known for people in Western world and some parts in Asia due to health benefits reported by various respectable institutes' research and supported by health advocates.

In a secondary analysis of a randomized controlled trial in comparing the effects of yoga with those of usual cares in 40 breast cancer survivors suffered from menopausal symptoms, with all participants completed all 3 assessments (week 0, week 12, and week 24), yoga attendees scored a significant improvement of total menopausal symptoms, including psychological menopausal symptoms, and urogenital menopausal symptoms, as well as enhanced, quality of life, social well-being, emotional well-being, functional well-being and fatigue in comparison to control group.

Dr.Koch AK, the lead author said, "self-esteem plays a vital role in the beneficial effect of yoga and that yoga can have long-term benefits for women diagnosed with breast cancer and undergoing menopausal transition".

Furthermore, in the compared study to test the effects of a 12-week traditional Hatha yoga and meditation intervention on menopausal symptoms in breast cancer survivors, yoga and meditation intervention expresses a significant improvement in lower total menopausal symptoms compared with the usual care group at week 12 (mean difference, -5.6; 95% confidence interval, -9.2 to -1.9; P = .004) and at week 24.

Additionally, Yoga group also showed a remarkable benefit in less some ato vegetative, psychological, and urogenital menopausal symptoms; less fatigue at weeks 12, particular in short terms.

With the promising results, some researchers suggested that yoga can be considered as a safe and effective alternative intervention in ameliorated menopausal symptoms with persistence of at least 3 months.

In fact, yoga intervention also has positive and specific implications on menopausal symptoms frequency. According to the 37 disease-free women experiencing hot flashes randomized to the 8-week Yoga of Awareness program (gentle yoga poses, meditation, and breathing exercises) or to wait-list control. yoga group expressed a significantly greater improvement relative to the control condition in hot-flash frequency, severity, and total scores and in levels of joint pain, fatigue, sleep disturbance, symptom-related bother, and vigor in post treatment in compared control group.

More importantly, at 3 months follow-up, patients in yoga group onlymaintained the improvement in hot flashes, joint pain, fatigue, symptom-related bother, and vigor but also showed additional significant gains in negative mood, relaxation, and acceptance as same in post treatment.

Taking together, Participation in yoga class may be one of the safe and effective intervention in attenuated menopause symptoms in many aspects.

For More information of yoga lessons tailor to a complete well being for women, please visit: YOGA BURN

Back to Kyle J. Norton Home page http://kylejnorton.blogspot.ca

Sources
(1) The effects of yoga and self-esteem on menopausal symptoms and quality of life in breast cancersurvivors-A secondary analysis of a randomized controlled trial by Koch AK1, Rabsilber S2, Lauche R3, Kümmel S4, Dobos G5, Langhorst J6, Cramer H3.(PubMed)
(2) Yoga and meditation for menopausal symptoms in breast cancer survivors-A randomized controlled trial by Cramer H1,2, Rabsilber S3,4, Lauche R1,2, Kümmel S4, Dobos G1(PubMed).

Food Therapy: Coffee Intake in reduced Risk of Stroke, Particularly in Women

By Kyle J. Norton

Coffee, second to green tea is a popular and social beverage all over the world, particular in the West, made from roast bean from the Coffea plant, native to tropical Africa and Madagascar.

A stroke is medical condition characterized by interrupted blood supply, thus reducing oxygen and nutrients delivery to the brain, resulting in death of brain cells.

Intake of coffee and coffee caffeine may have a profound effect in reduced risk of stroke incidence, a renowned institute study suggested.

In a third National Health and Nutrition Examination Survey (1988-1994; NHANES III) data to examine coffee consumption and stroke with participants aged ≥17 years old, researchers found that

coffee intake of this population showed a significantly inverse association to stroke risk incidence, regardless to smoke status.

Interestingly, the study also discovered that frequent coffee drinkers displayed a less occurrence of heart failure, diabetes, and hypertension but risk of high cholesterol for those consuming ≥3 cups per day.

Dr. Liebeskind DS, the lead author said, "Heavier daily coffee consumption is associated with decreased stroke prevalence" and ". Multivariate analyses revealed an independent effect of heavier coffee consumption (≥3 cups/day) on reduced stroke".

Further more, in an analyzed data from a prospective cohort of 83,076 women in the Nurses' Health Study without history of stroke, coronary heart disease, diabetes, or cancer at baseline, with coffee consumption assessed first in 1980, then repeatedly every 2 to 4 years, and follow-up through 2004, researchers at the Harvard School of Public Health filed the following results

1. The relative risk ratio of stroke in participants coffee consumption (<1 cup per month, 1 per month to 4 per week, 5 to 7 per week, 2 to 3 per day, and >or=4 per day) were 1, 0.98, 0.88, 0.81, and 0.80 repetitively.
2. Intake of coffee and coffee caffeine daily and regularly showed a significantly positive effect in reduced stroke risk after taking in to count of other favors, including high blood pressure, hypercholesterolemia, and type 2 diabetes.
3. Risk of stroke also associated stronger correlation among never and past smokers (RR for >or=4 cups a day versus <1 cup a month, 0.57) than among current smokers (RR for >or=4 cups a day versus <1 cup a month, 0.97).
4. Decaffeinated coffee intake also was associated to a trend in lower risk of stroke after adjustment for caffeinated coffee consumption.

5. Caffeine consumption of other beverage do not associate to risk or reduced risk of stroke.

The findings suggested that long-term coffee consumption was not associated to risk of stroke but modestly reduce risk of stroke.

Promisingly, a Asian study of data obtained from the Health Examinees (HEXA) Study, involved 146,830 individuals aged 40-69 years demonstrated that high coffee consumption was associated with a 38% lower odds ratio for stroke in women in compared to (none drinkers vs. ≥ 3 cups/day drinkers in women but not in men.

The expression of coffee intake in reduced risk of stroke also found greater in women who are healthy, younger, non-obese, non-hypertensive, non-diabetic, non-smokers, and non-alcohol drinkers.

Taking together, there is no doubt that intake of coffee daily and regularly have a remarkable effect in reduced risk of stroke, particular in women.

Arthritis Is Curable
You Can Eliminate Osteoarthritis
By addressing the Underlying Causes through Clinical Trials and Studies

Ovarian Cysts And PCOS Elimination
Holistic System In Existence That Will Show You How To
Permanently Eliminate All Types of Ovarian Cysts Within 2 Months

FOOD HACK for Weight Loss
A Simple Cooking Technique That Cuts The Calories & Glycemic
Impact In Rice, Pasta, And Potatoes In Half

Author Biography
Kyle J. Norton, Master of Nutrients
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Sources
(1) The coffee paradox in stroke: Increased consumption linked with fewer strokes by Liebeskind DS1, Sanossian N2, Fu KA2, Wang HJ3, Arab L4(PubMed)
(2) Coffee consumption and risk of stroke in women by Lopez-Garcia E1, Rodriguez-Artalejo F, Rexrode KM, Logroscino G, Hu FB, van Dam RM.(PubMed)