M.S.

While the relationship between elevated total serum cholesterol levels and the risk for coronary heart disease (CHD) has been evident for a number of years, relatively few studies attempting to attain reductions in total serum cholesterol have utilized specific behavioral protocols. This study was conducted with 16 middle aged men (mean age = 46.4 years) with elevated total serum cholesterol (TSC) levels (x = 233 mg/dl). Multiple measures of TSC were taken. After an extended baseline phase, participants were randomly assigned to treatment conditions. One group ("Simple") received a cholesterol reduction class only (designed to stress the National Cholesterol Education Program's (NCEP) Step One Diet) and the other group ("Intensive’) received the cholesterol reduction class in addition to weekly cholesterol feedback, specific dietary feedback (shown graphically) and individually tailored goals. Dietary information was collected by individual food diaries. The results indicated that both groups reduced their TSC level (9.60% Intensive and 5.52% Simple) with no statistically significant difference between the groups. Both groups made changes in their diet yet, neither group completely met the guidelines set by the NCEP. However, there was some evidence for greater dietary adherence to the Step One diet and reaching risk (categorization) reduction goals for men in the intensive condition. Additional research has shown more intensive interventions led to substantially greater reductions (14%-16%) in TSC and dietary change. These results and prior research suggest that modest reductions in TSC can be achieved by less intensive programs that follow and/or slightly enhance the NCEP program, but that greater reductions in TSC (and reductions in CHD risk) may require programs with more intensive procedures. / Master of Science

The effectiveness of biweekly feedback regarding blood total cholesterol (TCH) to assist dietary adherence and lower blood TCH levels was assessed in a mixed population of healthy and cardiac diseased subjects (S) engaging in an unsupervised mall walking program. Based upon screening with a portable lipid analyzer (and with their physician's permission) 36 S’s (x age=63, 83% females) with TCH levels between 200-300 mg/dl were randomized to control (CG) or experimental groups (EG). The CG received instruction regarding the National Cholesterol Education Program's Step 1 low-fat, low-cholesterol diet at 0, 2, 4, 6 weeks and completed 3-day food records at 0, 4, 8 weeks. In addition to this instruction, the EG received graphic feedback regarding their TCH at 0, 2, 4, and 6 weeks. Both groups had a goal of a 10% reduction in TCH. By 8 weeks, the CG increased TCH by 2.2 mg/dl (1%) from 240.2 ± 24.8 to 242.4 ± 40.0 mg/dl while the EG decreased TCH by 11.8 mg/dl (5%) from 239.9 ± 22.6 to 228.1 ± 26.8 mg/dl. Repeated measures ANOVA showed a trend toward a lowering of TCH in the EG (time*group) [FC1,34)=3.39, p=.07]. A one-way repeated measures ANOVA for TCH within the EG between 0 and 8 weeks was significant [F(4,64)=3.14, p=.02]. Goal attainment was statistically greater in the experimental group [z=2.12: p=.0017]). Food record two-way ANOVAS revealed no significant differences between groups over time on dietary intake of fats or dietary cholesterol. Using one-way ANOVAs the experimental group demonstrated a significant pattern of initial decreases from food record 1 to food record 2 which Was maintained at food record 3. A recently reported study conducted in a structured cardiovascular exercise program (Burkett, Southard, Herbert, & Walberg, 1990) showed statistical significance over a 16 week trial period using this feedback technique. The results of the present study suggest that the findings of Burkett, et al. may be generalizable to populations participating in an unsupervised mall walking program. / Master of Science

The purpose of this study was to determine if a training program consisting of 30 minutes of running on a treadmill, 3 days per week for 6 weeks, would lower serum cholesterol and/or triglyceride concentration in women using oral contraceptives. The intensity of the training was maintained at approximately 75% of the subject's pre-training maximal oxygen uptake. Comparisons were made in the variables triglyceride, cholesterol, maximum ventilation and maximum oxygen uptake, prior to and following training, between subjects who used birth control pills and those who did not. Eighteen women volunteers between the ages of 25-39 years, participated in the training program. Nine women were using oral contraceptives of the combined type. The subjects were free of metabolic diseases and were judged to be sedentary. Fasting blood samples were taken prior to and following the training program for lipid analyses. Maximum oxygen uptake and ventilation were determined by pre-training and post-training stress tests. To isolate training as the factor responsible for any changes in serum lipid concentration, the factors of body weight, skinfold thickness, fasting times and dietary patterns were held constant across the training period. Using multivariate analysis of covariance, one-way classification, to compare the group using oral contraceptives with the group not using them, no significant differences (p < 0.05) were found between the groups for either the blood lipids or the measures of functional capacity. Hotelling’s T² for comparison of pre-test to post~test differences within groups was employed using the linear combinations of the means of maximum ventilation and maximum oxygen uptake. The same analysis was used for the linear combination of the means of triglyceride and cholesterol. Only the group not using oral contraceptives showed significant difference (p < 0.05) in any of the variables. This difference was an increase after training, in maximum ventilation and maximum oxygen uptake. Other changes as a result of training were noted, although differences were not statistically significant at the 0.05 level of probability. These changes were 1) an improvement in the physical working capacity of the group using oral contraceptives, 2) a decrease in serum triglyceride and/or cholesterol levels in subjects whose initial values were in the upper ranges of clinical normality for these lipids. Exercise did not appear to affect the lipid levels of subjects who initially had low or average values. / Doctor of Education

Chiu Chi Pang. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (leaves 121-134). / Abstracts in English and Chinese. / DECLARATION --- p.i / ACKNOWLEDGEMENTS --- p.ii / ABBREVIATIONS --- p.iii / ABSTRACT --- p.vi / 摘要 --- p.viii / Chapter CHAPTER 1: --- GENERAL INTRODUCTION --- p.1 / Chapter 1.1 --- Cholesterol --- p.1 / Chapter 1.1.1 --- History of cholesterol --- p.1 / Chapter 1.1.2 --- Structure of cholesterol --- p.1 / Chapter 1.1.3 --- Biological function of cholesterol --- p.3 / Chapter 1.1.4 --- Sources of cholesterol in our body --- p.3 / Chapter 1.2 --- Lipid hypothesis --- p.4 / Chapter 1.2.1 --- Relationship between dietary cholesterol and plasma cholesterol --- p.4 / Chapter 1.2.2 --- "Hypercholesterolemia , atherosclerosis and coronary heart disease (CHD)" --- p.4 / Chapter 1.2.3 --- Individual variation --- p.5 / Chapter 1.3 --- Cholesterol homeostasis --- p.7 / Chapter 1.3.1 --- SREBPs up-regulates the expression of LDL-receptor and HMG-CoA reductase --- p.7 / Chapter 1.3.2 --- HMG-CoA reductase as the rate-limiting enzyme in cholesterol synthesis --- p.11 / Chapter 1.3.3 --- LDL-receptor as the major protein removing plasma cholesterol …… --- p.12 / Chapter 1.3.4 --- LXR-α as an activator of CYP7A1 --- p.14 / Chapter 1.3.5 --- CYP7A1 controls the classical pathway for the elimination of hepatic cholesterol --- p.16 / Chapter 1.3.6 --- Bile acids as the metabolites of CYP7A1 --- p.17 / Chapter 1.4 --- Previous works in our laboratory --- p.20 / Chapter 1.5 --- Objective of this project --- p.22 / Chapter CHAPTER 2: --- INCREASED EXPRESSION OF LDL-RECEPTOR IS RESPONSIBLE FOR THE HYPO-RESPONSIVENESS OF RATS TO DIETARY CHOLESTEROL --- p.23 / Chapter 2.1 --- Introduction --- p.23 / Chapter 2.2 --- Objective --- p.24 / Chapter 2.3 --- Methods and materials --- p.25 / Chapter 2.3.1 --- Animals --- p.25 / Chapter 2.3.2 --- Diets --- p.25 / Chapter 2.3.3 --- Determination of serum cholesterol --- p.26 / Chapter 2.3.4 --- Western blot --- p.26 / Chapter 2.3.5 --- Probe production for LDL-receptor --- p.27 / Chapter 2.3.5.1 --- Extraction of total RNA --- p.27 / Chapter 2.3.5.2 --- Reverse-transcription reaction of total RNA --- p.28 / Chapter 2.3.5.3 --- Polymerase chain reaction (PCR) of LDL- receptor fragment from cDNA template --- p.28 / Chapter 2.3.5.4 --- Separation and purification of PCR products --- p.29 / Chapter 2.3.5.5 --- Polishing of purified PCR products --- p.29 / Chapter 2.3.5.6 --- Ligation of PCR products and pPCR-script Amp SK(+) cloning vector --- p.30 / Chapter 2.3.5.7 --- Transformation --- p.30 / Chapter 2.3.5.8 --- Preparing glycerol stocks containing the bacterial clones --- p.31 / Chapter 2.3.5.9 --- Plasmid DNA preparation --- p.31 / Chapter 2.3.5.10 --- Clones confirmation by restriction enzyme digestion --- p.32 / Chapter 2.3.5.11 --- Clones confirmation by automatic sequencing --- p.32 / Chapter 2.3.5.12 --- Linearization of the plasmid DNA --- p.33 / Chapter 2.3.5.13 --- DIG-labeling of RNA probe --- p.35 / Chapter 2.3.5.14 --- Testing of DIG-labeled probe --- p.35 / Chapter 2.3.6 --- Probe production for HMG-CoA reductase --- p.36 / Chapter 2.3.7 --- Probe production for GAPDH --- p.37 / Chapter 2.3.8 --- Northern blot --- p.38 / Chapter 2.3.9 --- Determination of hepatic cholesterol --- p.39 / Chapter 2.3.10 --- Statistics --- p.40 / Chapter 2.4 --- Results --- p.42 / Chapter 2.4.1 --- Growth and food intake --- p.42 / Chapter 2.4.2 --- Effect of cholesterol supplements on serum cholesterol --- p.42 / Chapter 2.4.3 --- Effect of cholesterol supplements on liver cholesterol content --- p.45 / Chapter 2.4.4 --- "Stimulatory effect of high cholesterol diet on nSREBP-2, LDL-receptor and HMG-CoA reductase in rats" --- p.45 / Chapter 2.4.5 --- "Effect of high cholesterol diet on nSREBP-2, LDL-receptor and HMG-CoA reductase in hamsters" --- p.49 / Chapter 2.4.6 --- The regulation of LDL-receptor and HMG-CoA reductase existed at transcriptional level --- p.54 / Chapter 2.5 --- Discussion --- p.59 / Chapter CHAPTER 3: --- RATS ARE HYPO-RESPONSIVE TO DIETARY CHOLESTEROL DUE TO EFFICIENT ELIMINATION OF CHOLESTEROL --- p.67 / Chapter 3.1 --- Introduction --- p.67 / Chapter 3.2 --- Objective --- p.69 / Chapter 3.3 --- Methods and materials --- p.70 / Chapter 3.3.1 --- Animals and diets --- p.70 / Chapter 3.3.2 --- Western blot --- p.70 / Chapter 3.3.3 --- Probe production for CYP7A1 and LXR-α --- p.71 / Chapter 3.3.4 --- Northern blot --- p.71 / Chapter 3.3.5 --- Determination of fecal neutral and acidic sterols --- p.71 / Chapter 3.3.5.1 --- Separation of neutral and acidic sterols --- p.71 / Chapter 3.3.5.2 --- Neutral sterols analysis --- p.72 / Chapter 3.3.5.3 --- Acidic sterols analysis --- p.72 / Chapter 3.3.5.4 --- GLC analysis of neutral and acidic sterols --- p.73 / Chapter 3.3.6 --- Statistics --- p.73 / Chapter 3.4 --- Results --- p.76 / Chapter 3.4.1 --- Effect of cholesterol supplements on fecal total neutral sterols --- p.76 / Chapter 3.4.2 --- Effect of cholesterol supplements on fecal total bile acids --- p.76 / Chapter 3.4.3 --- CYP7A1 protein on rats showed a concentration-dependent increase with response to dietary cholesterol while hamsters did not --- p.79 / Chapter 3.4.4 --- The regulation of CYP7A1 was at transcriptional level --- p.79 / Chapter 3.4.5 --- LXR-α demonstrated a parallel changes in its expression at both translational and transcriptional level --- p.84 / Chapter 3.5 --- Discussion --- p.88 / Chapter CHAPTER 4: --- MECHANISM FOR INDIVIDUAL VARIATION OF SERUM CHOLESTEROL LEVEL IN RATS AND HAMSTERS FED A HIGH CHOLESTEROL DIET --- p.94 / Chapter 4.1 --- Introduction --- p.94 / Chapter 4.2 --- Objective --- p.96 / Chapter 4.3 --- Methods and materials --- p.97 / Chapter 4.3.1 --- Diet and animals --- p.97 / Chapter 4.3.2 --- Western blot --- p.97 / Chapter 4.3.3 --- Statistics --- p.97 / Chapter 4.4 --- Results --- p.99 / Chapter 4.4.1 --- Growth and food intake --- p.99 / Chapter 4.4.2 --- Change of serum cholesterol --- p.99 / Chapter 4.4.3 --- Correlation between various protein expression and serum cholesterol --- p.99 / Chapter 4.4.3.1 --- Correlation between LDL-receptor and serum total cholesterol in rats --- p.99 / Chapter 4.4.3.2 --- Correlation between CYP7A1 and serum total cholesterolin rats --- p.99 / Chapter 4.4.3.3 --- Correlation between nSREBP-2 and serum total cholesterolin rats --- p.105 / Chapter 4.4.3.4 --- Correlation between LXR-a and serum total cholesterol in rats --- p.105 / Chapter 4.4.3.5 --- Correlation between HMG-CoA reductase and serum total cholesterol in rats --- p.105 / Chapter 4.4.3.6 --- Correlation between LDL-receptor and serum total cholesterol in hamsters --- p.105 / Chapter 4.4.3.7 --- Correlation between CYP7A1 and serum total cholesterolin hamsters --- p.109 / Chapter 4.4.3.8 --- Correlation between nSREBP-2 and serum total cholesterolin hamsters --- p.109 / Chapter 4.4.3.9 --- Correlation between HMG-CoA reductase and serum total cholesterol in hamsters --- p.109 / Chapter 4.5 --- Discussion --- p.114 / Chapter CHAPTER 5: --- CONCLUSION --- p.117 / REFERENCES --- p.121

Ma, Ka Ying. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2008. / Includes bibliographical references (leaves 113-129). / Abstracts in English and Chinese. / ACKNOWLEDGMENTS --- p.I / ABSTRACT --- p.II / LIST OF ABBREVIATIONS --- p.VII / TABLE OF CONTENTS --- p.IX / Chapter Chapter 1 --- General Introduction --- p.1 / Chapter 1.1 --- Calcium --- p.1 / Chapter 1.1.1 --- Recommendation of calcium intake --- p.1 / Chapter 1.1.2 --- Calcium toxicity --- p.2 / Chapter 1.1.3 --- Calcium homeostasis --- p.2 / Chapter 1.1.3.1 --- Role of parathyroid hormone in calcium homeostasis --- p.4 / Chapter 1.1.3.2 --- "Role of 1,25-dihydroxyvitamin D3 in calcium homeostasis" --- p.4 / Chapter 1.1.3.3 --- Role of calcitonin in calcium homeostasis --- p.6 / Chapter 1.2 --- Magnesium --- p.7 / Chapter 1.2.1 --- Recommendation of magnesium intake --- p.7 / Chapter 1.2.2 --- Absorption and secretion of magnesium --- p.8 / Chapter 1.3 --- Cholesterol --- p.9 / Chapter 1.3.1 --- Cholesterol homeostasis --- p.11 / Chapter 1.3.1.1 --- Role of LDLR --- p.14 / Chapter 1.3.1.2 --- Role of SREBP-2 --- p.17 / Chapter 1.3.1.3 --- HMGR as rate limiting step for cholesterol synthesis --- p.19 / Chapter 1.3.1.4 --- CYP7A1 as a key factor in production of bile acids --- p.21 / Chapter 1.3.1.5 --- Role of LXR in production of bile acids --- p.22 / Chapter 1.3.1.6 --- AC AT regulates cholesterol uptake in intestine --- p.22 / Chapter Chapter 2 --- Effect of Calcium Deficiency and Inadequacy on Blood Cholesterol Level in Intact Male and Castrated Hamsters --- p.25 / Chapter 2.1 --- Introduction --- p.25 / Chapter 2.2 --- Objective --- p.28 / Chapter 2.3 --- Materials and methods --- p.29 / Chapter 2.3.1 --- Hamsters --- p.29 / Chapter 2.3.1.1 --- Intact male hamster --- p.29 / Chapter 2.3.1.2 --- Castrated hamster --- p.30 / Chapter 2.3.2 --- Diets --- p.31 / Chapter 2.3.3 --- Determination of calcium content in animal diet --- p.33 / Chapter 2.3.4 --- "Determination of serum lipid, lipoproteins and calcium concentration" --- p.33 / Chapter 2.3.5 --- Determination of cholesterol concentration in organs --- p.34 / Chapter 2.3.6 --- Determination of fecal neutral and acidic sterols --- p.37 / Chapter 2.3.7 --- Determination of fecal neutral sterols --- p.37 / Chapter 2.3.8 --- Determination of fecal acidic sterols --- p.40 / Chapter 2.3.9 --- Statistics --- p.42 / Chapter 2.4 --- Results on intact male hamsters --- p.43 / Chapter 2.4.1 --- Diet composition --- p.43 / Chapter 2.4.2 --- Growth and food intake --- p.43 / Chapter 2.4.3 --- Organ weights --- p.43 / Chapter 2.4.4 --- Effect of calcium deficiency diet on the plasma lipid profile and calcium concentration of hamsters --- p.43 / Chapter 2.4.5 --- Effect of calcium deficiency diet on hepatic cholesterol of hamsters --- p.44 / Chapter 2.4.6 --- Effect of calcium on fecal neutral sterol output --- p.48 / Chapter 2.4.7 --- Effect of calcium on fecal acidic sterol output --- p.48 / Chapter 2.5 --- Results on castrated hamsters --- p.50 / Chapter 2.5.1 --- Growth and food intake --- p.50 / Chapter 2.5.2 --- Organ weights --- p.50 / Chapter 2.5.3 --- Effect of calcium deficiency diet on the plasma lipid profile and calcium concentration of hamsters --- p.50 / Chapter 2.5.4 --- Hepatic cholesterol --- p.50 / Chapter 2.5.5 --- Effect of calcium on fecal neutral sterol output --- p.53 / Chapter 2.5.6 --- Effect of calcium on fecal acidic sterol output --- p.53 / Chapter 2.6 --- Discussion --- p.55 / Chapter Chapter 3 --- Effect of Calcium Deficiency and Inadequacy on Blood Cholesterol Level in Intact Female and Ovariectomized Hamsters --- p.57 / Chapter 3.1 --- Introduction --- p.57 / Chapter 3.2 --- Objective --- p.58 / Chapter 3.3 --- Materials and methods --- p.59 / Chapter 3.3.1 --- Hamsters --- p.59 / Chapter 3.3.1.1 --- Intact female hamster --- p.59 / Chapter 3.3.1.2 --- Ovariectomized hamster --- p.60 / Chapter 3.3.2 --- Diets --- p.60 / Chapter 3.3.3 --- "Determination of serum lipid, lipoproteins and calcium concentration" --- p.60 / Chapter 3.3.4 --- "Determination of cholesterol concentration in organs, fecal neutral and acidic sterols" --- p.60 / Chapter 3.3.5 --- "Western blottting of liver SREBP-2, LDLR, HMGR, LXR and CYP7A1 proteins" --- p.61 / Chapter 3.3.6 --- Preparation of intestinal microsome --- p.62 / Chapter 3.3.7 --- Intestinal acyl coenzyme A: cholesterol acyltransferase (ACAT) activity measurement --- p.63 / Chapter 3.3.8 --- Statistics --- p.64 / Chapter 3.4 --- Results on intact female hamsters --- p.65 / Chapter 3.4.1 --- Growth and food intake --- p.65 / Chapter 3.4.2 --- Organ weights --- p.65 / Chapter 3.4.3 --- Effect of calcium deficiency diet on the plasma lipid profile and calcium concentration of hamsters --- p.65 / Chapter 3.4.4 --- Effect of calcium deficiency diet on hepatic cholesterol of hamsters --- p.65 / Chapter 3.4.5 --- Effect of dietary calcium on fecal neutral sterol output --- p.66 / Chapter 3.4.6 --- Effect of dietary calcium on fecal acidic sterol output --- p.66 / Chapter 3.4.7 --- Effect of dietary calcium on liver LDLR immunoreactive mass --- p.71 / Chapter 3.4.8 --- Effect of dietary calcium on liver CYP7A1 immunoreactive mass --- p.71 / Chapter 3.4.9 --- Effect of dietary calcium on liver LXR immunoreactive mass --- p.71 / Chapter 3.4.10 --- Effect of dietary calcium on liver SREBP-2 immunoreactive mass --- p.71 / Chapter 3.4.11 --- Effect of dietary calcium on liver HMGR immunoreactive mass --- p.71 / Chapter 3.4.12 --- Effect of dietary calcium deficiency on intestinal ACAT activity --- p.77 / Chapter 3.5 --- Results on ovariectomized hamsters --- p.79 / Chapter 3.5.1 --- Growth and food intake --- p.79 / Chapter 3.5.2 --- Organ weights --- p.79 / Chapter 3.5.3 --- Effect of calcium deficiency diet on plasma lipid profile and calcium concentration of hamsters --- p.79 / Chapter 3.5.4 --- Hepatic cholesterol --- p.79 / Chapter 3.5.5 --- Effect of dietary calcium on fecal neutral sterol output --- p.80 / Chapter 3.5.6 --- Effect of dietary calcium on fecal acidic sterol output --- p.80 / Chapter 3.5.7 --- Effect of dietary calcium on liver LDLR immunoreactive mass --- p.85 / Chapter 3.5.8 --- Effect of dietary calcium on liver CYP7A1 immunoreactive mass --- p.85 / Chapter 3.5.9 --- Effect of dietary calcium on liver LXR immunoreactive mass --- p.85 / Chapter 3.5.10 --- Effect of dietary calcium on liver SREBP-2 immunoreactive mass --- p.85 / Chapter 3.5.11 --- Effect of dietary calcium on liver HMGR immunoreactive mass … --- p.85 / Chapter 3.6 --- Discussion --- p.91 / Chapter Chapter 4 --- Effect of Dietary Magnesium Supplementation on Blood Cholesterol Level in Intact Male Hamsters --- p.94 / Chapter 4.1 --- Introduction --- p.94 / Chapter 4.2 --- Objective --- p.96 / Chapter 4.3 --- Materials and methods --- p.97 / Chapter 4.3.1 --- Hamsters --- p.97 / Chapter 4.3.2 --- Diets --- p.98 / Chapter 4.3.3 --- "Determination of serum lipid, lipoproteins and magnesium concentration" --- p.100 / Chapter 4.3.4 --- "Determination of cholesterol concentration in organ, fecal neutral and acidic sterols" --- p.100 / Chapter 4.3.5 --- Statistics --- p.100 / Chapter 4.4 --- Results on male hamster --- p.101 / Chapter 4.4.1 --- Growth and food intake --- p.101 / Chapter 4.4.2 --- Organ weights --- p.101 / Chapter 4.4.3 --- Effect of dietary magnesium on plasma lipid profile and magnesium concentration in hamsters --- p.101 / Chapter 4.4.4 --- Effect of dietary magnesium on hepatic cholesterol of hamsters..… --- p.102 / Chapter 4.4.5 --- Effect of dietary magnesium on fecal neutral sterol output --- p.105 / Chapter 4.4.6 --- Effect of dietary magnesium on fecal acidic sterol output --- p.105 / Chapter 4.6 --- Discussion --- p.107 / Chapter Chapter 5 --- Conclusion --- p.110 / References --- p.113

Background: International research has shown that socioeconomically disadvantaged groups experience significantly higher mortality and morbidity rates than other groups. Both cardiovascular disease (CVD) and diabetes are major contributors to Australia's burden of disease, and individuals from lower socioeconomic groups are more likely to be affected by both, and to have worse prognoses and outcomes. There is substantial research evidence that a range of preventive activities can reduce the morbidity and mortality associated with these conditions. Research in countries with good access to primary health care services has demonstrated that socioeconomically disadvantaged groups tend to have higher levels of medical consultations, but make less use of preventive care and screening services. This fact contributes to their poorer health outcomes, as diagnosis will typically occur later than for more advantaged individuals, thus leading to a poorer prognosis. However, to date, there has been little research on the differential utilisation of preventive health services for CVD and diabetes by different socioeconomic groups in Australia. To understand socioeconomic influences on the use of preventive health services, a comprehensive review of the literature of determinants of health service utilisation was conducted and a number of explanations for this relationship considered. It was proposed that the following factors are likely to be important in this relationship: differences in the perception of the availability of, and accessibility to health care, attitudes and beliefs toward preventive health care, having a regular source of care, perception of interpersonal care from general practitioners, and social support. A number of theoretical models were also reviewed; in particular, the Andersen Behavioural Model of Health Service Research Utilisation. Aims: This doctoral research program has described the relationship between socioeconomic position (SEP) and utilisation of preventive health services in relation to CVD and diabetes. It aims to improve the understanding of the determinants of uptake and utilisation of preventive health services in general practice by different socioeconomic groups in Australia. Methods: The study was conducted in Brisbane Australia, in 2004, using a cross-sectional design and a self-administered mailed survey for data collection. A sample of adults aged 25-64 years was selected randomly from the Brisbane Electoral Roll. A conceptual model incorporating a range of relevant socio-demographic, risk-factor and behavioural variables in the relationship between SEP and GP-based use of preventive health services was used to develop a self-administered questionnaire. The questionnaire was pilot-tested and then reviewed by a panel of international experts. A new self-administered questionnaire, the Health Service Utilisation Questionnaire (HSUQ), was developed. It included 79 items: 12 socio-demographic items; 10 items assessing health status, disease conditions and smoking status; 20 items assessing use of health services; and 37 items assessing the factors that might affect use of health services utilisation. The HSUQ was then mailed to 800 randomly selected survey participants. The survey response rate was 65.6 per cent. After exclusion of those patients with cardiovascular diseases and diabetes, the final sample size was 381, consisting of 155 males and 226 females. Socioeconomic indicators were individual education level and family income. Blood pressure, blood cholesterol and blood glucose check-ups by general practitioners (GPs) were used as the major outcome variables. Nine scales and two dichotomous variables that measure those potential factors were derived following Principal Component Analysis and reliability testing. The data were analysed separately by gender, and adjusted for age and each of the socioeconomic indicators. Statistical description, bivariate analysis and multivariable modelling in SPSS were applied for the data analysis. Results: The survey results were suggestive of socioeconomically disadvantaged people being less likely than more advantaged people to utilise preventive health services for CVD and diabetes. For males, the low socioeconomic groups recorded the least use of preventive health services among the three education and income groups, including blood cholesterol and blood glucose check-ups, while the high socioeconomic group recorded the greatest use of preventive health services. There was no apparent relationship between education level and blood pressure check-up, while individuals from low-income families were less likely to go for a blood pressure check-up. For females, most of the results suggested that the low socioeconomic groups were less likely than the high socioeconomic groups to have blood cholesterol and blood glucose check-ups. However, this was not the case for blood pressure check-ups. The results showed that the low and middle socioeconomic groups were more likely than the high socioeconomic groups to have BP check-ups. However, the low socioeconomic groups were still less likely than the middle socioeconomic groups to have a blood pressure check-up. Overall, there was a similar pattern between education and income and the use of GP-based preventive health services among both males and females. The findings from the examination of the mediating factors between SEP and the GP-based use of preventive health services suggested that socioeconomically disadvantaged adults (both low level of education and low income) are more concerned about transport and travel time to health care, and accessibility to health care in terms of finding a GP who bulk bills, the cost of seeing a GP and having a choice of GP. They are also less likely to have a regular place of care and social support. These potential factors are likely to result in a lesser use of preventive health services than their high-SEP counterparts. In addition, the findings also suggested that respondents with a low level of education have less-positive attitudes towards health care, and that those from low-income families do not have a regular care provider and are less likely to visit their GP for a preventive check-up in relation to CVD and diabetes in Australia. Conclusions: Strategies for reducing socioeconomic health inequalities are partly associated with changing social and economic policies, empowering individuals, strengthening social and family networks, and improving the equity of the health care system. Strategies have been recommended for implementation in general practice that are directed at targeting the needs of disadvantaged groups; for example, providing longer consultation time and actively offering information on preventive care. Implementation of health promotion programs is needed in disadvantaged areas to keep the community informed about the availability of health services and to make health services more accessible. The health care system needs to be geographically accessible through improvements to the transport system. In addition, improving access to a regular source of primary health care is likely to be an important step in encouraging low-SEP individuals to use preventive health services.

Enzymatic and lipid transfer reactions involved in reverse cholesterol transport were studied in HDL deficient plasma systems. Fasting plasma samples were obtained from control and cholesterol fed guinea pigs as well as from a fish eye disease patient and were used to localize the enzyme LCAT among plasma lipoproteins (VLDL, LDL, and HDL). In both guinea pig and fish eye disease patient plasma, the LCAT activity was found in association with the HDL type particles. Cholesterol feeding in guinea pigs altered the properties of lipoprotein substrates for LCAT resulting in some changes, specifically: 1) decreased fractional rate of plasma cholesterol esterification and, 2) lower transfer of free cholesterol (FC) and esterified cholesterol (CE) within the lipoprotein fractions.

Cardiovascular disease (CVD) is a major health problem in developed countries and, with increasing prevalence in developing countries and Eastern Europe. Due to the increased incidence with advancing age, there is a need to develop primary preventive interventions to prolong the period of healthy life. Diet has a substantial influence on health and aging. The composition of the human diet plays an important role in the management of lipid and lipoprotein. In this respect, we have focused on the effects of two kinds of functional foods, tea seed oil and dietary onion on their hypocholesterolemic activities and underlying mechanisms in the present study. / Clearly, there are many claims on health benefits of Alliums , however, most, with the exception of garlic, have not received any rigorous or even gentle scientific investigation. Thus, the present study was carried out to explore hypocholesterolemic effects of onion supplementation. After fed for 2 weeks of the high fat high cholesterol diet, thirty-six 8-week male hamsters were divided into four groups. Control group was continued fed with high fat high cholesterol diet, while the other two experimental groups were fed control diet plus 1% (1OP) and 5% (5OP) onion powder for 8 weeks. It was found that feeding high dose of onion powder diet significantly prevented the increase in serum TC, Non-HDL-C and the ratio of non-HDL-C/HDL respectively in hamsters fed a 0.1% cholesterol diet. In contrast, the ratio of HDL/TC in high dose group was significantly increased than that in the control. Low onion dose group tended to have the similar effects as high dose group but, statistically, no difference was observed between the control and low dose groups. Besides, both doses of onion powder diets could significantly countered the increase in serum TG levels. High dose of onion supplementation tended to increase output of fecal neutral and acidic sterols, resulting in reduction of cholesterol retained and absorption. High dose of onion powder diet could significantly up- regulate SREBP-2, LXRbeta, and CYP7A1 protein expressions. The hypocholesterolemic activities of onion might due to the richness in alkyl and alkenyl sulfoxide compounds, anthocyanin, quercetin and cycloalliin, all of which have therapeutic effects. / In conclusion, diet plays an important role in reducing the risk of CVD. This has led to the search for specific foods and food components that may help to improve the serum lipoprotein profile. In present study, tea seed oil and onion was proved to help favorably modify the plasma lipoprotein profile, serving as health supplementation. However, their potential mechanisms were not fully studied and need to be further explored. / Interest in tea seed oil (named tea oil) as a cooking oil is increasing. However, its effect on blood cholesterol is not known. This study was therefore conducted to compare the hypocholesterolemic activity of tea oil with grape seed, canola and corn oils. Fifty 8-week-old male hamsters were first fed a high fat diet (5% lard), and supplemented with 0.1% cholesterol for 2 weeks and then divided into five groups. Control group was continuously fed high fat high cholesterol diet, while the experimental groups were fed high fat, high cholesterol diet plus 10% tea oil, grape seed oil, canola oil and corn oil for 12 weeks. Results showed that plasma total cholesterol (TC), non-HDL-cholesterol (non-HDL-C) and triacylglycerols (TG) in hamsters fed a 0.1% cholesterol diet containing tea, grape, canola or corn oil was significantly reduced compared with those in lard-fed group. Tea oil decreased only non-HDL-C and had no or little effect on HDL-C concentration, while grape oil reduced both. Besides, tea oil-fed hamsters excreted less neutral but greater acidic sterols compared with other three oils. Unlike grape oil, tea oil up-regulated sterol regulatory element binding protein (SREBP-2) and LDL receptor. Differences between tea oil and the tested vegetable oils could be attributable partially to >80% oleic acid in tea oil. / Guan, Lei. / Adviser: Chung Hau Yin. / Source: Dissertation Abstracts International, Volume: 72-04, Section: B, page: . / Thesis (Ph.D.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 98-125). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese.

This study was designed to answer the following research questions: "Are those at risk for coronary heart disease being screened for high blood cholesterol?" and "Are those with high blood cholesterol being treated according to the national guidelines?" The importance of early detection and treatment of high blood cholesterol is vital for preventive health care. A chart review of patient records was conducted to determine the behavior of the family practice residents. From the analysis of data it was determined that the residents screened their patients 83.0% of the time and when compared with national guidelines, treated those patients identified with high blood cholesterol 52.8% of the time. Third year residents screened their patients more (88.7%) for blood cholesterol than first (82.1%) or second (74.7%) year residents. Male residents screened a higher percent of their patients (84.8%) than female residents (75.0%). / Department of Physiology and Health Science