1. The Scarborough Fair Study Effects of increased intake of fruit, vegetables and herbs on adiponectin Caroline Gunn, Janet Weber & Marlena C Kruger. Institute of Food, Nutrition and Human Health, Massey University, Palmerston North, NZ. Anne-Thea McGill. University of Auckland

2. Group A (50 PM women) Intervention Group B (50 PM women) Intervention Group C Group C (43 PM women) Control Usual diet. Overview of 3 month study Randomised active comparator design

3. Groups A (50) B (50) C (43) P Age60 (4)61 (4)61 (5) NS Years since Menopause 11 (5)11 (4)11 (5) NS Weight72 (13)70 (13)66 (11) NS BMI27 (5)25 (5)24 (5) 0.01 Characteristics of study groups at baseline Mean (SD)

4. Groups A (49) B (50) C (43) P BMD (g/cm 2 ) Spine1.0 (0.2)0.9 (0.1)1.0 (0.2) N/S Total Hip BMD0.9 (0.1) N/S Neck of Hip0.8 (0.1)0.7 (0.1)0.8 (0.1) N/S Bone Mineral Density Mean (SD)

5. DEXA classification

6. BMI classification

7. Relationship between body weight and hip bone mineral density in post-menopausal study women (n=142) r=0.6, p<0.001. r=0.58 p<0.001

8. Servings /dayA (47) B (47) C (40) P Fruit Baseline 2.0 (0.9)1.8 (0.9)2.2 (1.2) 0.15 End 2.9 (1.4)3.0 (1.0)2.2 (1.4) 0.003 Vegetable Baseline 3.4 (1.2)3.3 (1.3)3.7 (1.3) 0.21 End 5. 5 (1.9)6.1 (1.9)4.0 (1.2) 0.001 PRAL mEq/day Baseline - 0.1 (16) - 1.2 (15) - 1.8 (13) 0.76 PRAL mEq/day End - 17 (17) - 23 (16) - 3 (16) 0.001 Changes in food group servings and PRAL Means (SD)

9. Change in PRAL Milli equivalents

10. Nutrient intake and changes at 3 months A (47) B (47) C (40) EAR/AI RDI/SDTP Fibre(g)27(8) 28 (8) /25 /28 change5.7 (7)6.4 (10)-0.5 (0) 0.001 Folate (μg)368 (153)380(225)381 (134) 400/ 600 change109 (213)121 (250) _ 9 (164) 0.009 Sodium (mg)2345 (618)2766 (900)2551 (979) /1600 change _ 63 (887) _ 376 (943)24.5 (1256 Potassium (mg)3695 (766)3643 (1000)3781±790 /2800 /4700 change935 (953)1393(1375)64(933) 0.001 Calcium (mg)850(257)872(347)905(270) 1100 /1300 change181(353)164 (141)5 (293) 0.03

11. Urinary mineral excretion mmol/24hours GroupBaselineEndChange% change P change Calcium A (29)3.9 (2.0)2.7 (1.5) - 1.2( - 1.8- - 0.5) - 26.002 Calcium B (36)4.8 (2.1)3.5 (1.8) - 1.3( - 2.0- - 0.6) - 24.001 Calcium C (22)4.2 (1.6)3.6 (1.6) - 0.61( - 1.6- - 0.2)2 0.14 p change between groups N/S<0.05 Potassium A (29)135 (91)221 (199) 86( - 5-167)93 0.04 Potassium B (36)174 (189)260 (217) 85( - 9-178)141 0.07 Potassium C (22)187 (150)291 (265)104( - 27-235)93 0.10 p change between groups NS Changes in urinary mineral excretion Means (SD) or 95% CI

12. Adiponectin secreted by osteoblasts and adipocytes in both marrow fat and visceral depots anti-inflammatory, anti-diabetic and anti-atherogenic effects and increased bone loss three major forms: low molecular weight (LMW) trimer medium molecular weight (MMW) hexamer high molecular weight (HMW) oligomer.

13. Changes in adiponectin within each group Adiponectin (µg/ml) A (48,47) B (50,47) C (43,39) P Baseline9.0 (7.9-10.1)8.5 (7.5-9.3)8.0 (7.1-9.2) 0.5 End6.7(5.8-7.5)7.1(6.0-8.06.3(5.4-7.7) 0.8 Change-2.3(3.4- - 1.2)-1.4( - 2.4- - 0.4)-1.2( - 2.3- - 0.1) 0.3 P change 4 p<0.000p<0.003p<0.007 Values are means (95% CI). P values for group comparisons are derived from ANOVA. P change by student t tests. P<0.05 is statistically significant. Cytokines log transformed for ANOVA.

14. Change in adiponectin in PM women (n=141) stratified by bone mineral density Bone Mineral Density Adiponectin Normal (51) Osteopenia (73) Osteoporosis (17) P (ug/ml)/kg fat mass 1 Baseline0.32(0.26-0.38)0.34 (0.30-0.39)0.52 (0.39-0.65) 0.007 Final 0.28 (0.21-0.35) 0.28(0.24-0.33) 0.30 (0.18-0.41) 0.72 Change-0.04(0.01-0.08)-0.06(0.03-0.09)-0.22(0.12-0.33) 0.001 1 Values are means (95% CI). 2 P values derived from ANOVA using log transformed values. P<0.05 statistically significant

15. Dietary intake for potassium, calcium, folate, sodium, fibre and magnesium more favourably aligned with MOH (NZ) recommendations in groups A and B Significantly less calcium lost from urine in intervention groups A and B with lowered PRAL Lowered inflammatory levels resulted in significant reduction in adiponectin in all groups Adiponectin significantly decreased in women with osteoporosis Main Findings

16. Funding for this study was kindly provided from the following organisations Hawke’s Bay Medical Research Foundation Massey University Research Fund (MURF) National Heart Foundation (NZ) AMGEN (Osteoporosis Australia, Glaxo Smith Kline, Australian and NZ Bone Mineral Society).