Chronically increased activity of the sympathetic nervous system: our diet-related "evolutionary" inheritance

Hot and Cold Theory: Evidence in Nutrition

Ancient scholars across cultures have postulated that by being less potent versions of herbs, food plays a substantive role in the maintenance of health and treatment of disease. A commonality among these traditional medical systems is in relation to the 'heating' and 'cooling' properties of foods. In this chapter, 'hot' and 'cold' classifications of foods are explored, along with ways to optimize health and combat disease. Scientific evaluations of 'hot' and 'cold' properties are also reviewed in relation to chemical compositions and physiological impacts. A broad scoping Google Scholar search was conducted to identify relevant articles. Scientific evaluations were heterogeneous and of mixed quality. Nonetheless some evidence supported the traditional 'hot' and 'cold' classifications. Overall, 'heating' foods were associated with metabolism and sympathetic nervous system enhancement via increased proportions of caffeine, carbohydrate, protein, fat, and calories; as well as greater oxidation potential; vasodilatory and pro-inflammatory effects; and higher acidity and aromatic compound content. 'Cooling' foods were contrastly found to be higher in water, fiber, alkalinity, and aliphatic compounds; as well as associated with anti-inflammatory, and detoxification (elimination) processes. With the potential to specifically tailor diets to suit individual needs, further high-quality research to substantiate traditional food classifications is warranted.

Headache outcomes of a sleep behavioral intervention in breast cancer survivors: Secondary analysis of a randomized clinical trial

BACKGROUND

Breast cancer survivors often have persisting headache. In a secondary analysis of the Brief Behavioral Therapy for Cancer-Related Insomnia (BBT-CI) clinical trial (ClinicalTrials.gov identifier NCT02165839), the authors examined the effects of BBT-CI on headache outcomes in patients with breast cancer.

METHODS

Patients with breast cancer who were receiving chemotherapy were randomly assigned to receive either the BBT-CI intervention or the Healthy EAting Education Learning for healthy sleep (HEAL) control intervention, and both were delivered over 6 weeks by trained staff. Headache outcomes and heart rate variability (HRV) were measured at baseline, 6 weeks, 6 months, and 12 months. Mixed-effects models were used to examine longitudinal headache outcomes in the groups according to the intention to treat. Principal component analysis and agglomerative hierarchical clustering were conducted to reduce 16 variables for data-driven phenotyping.

RESULTS

Patients in the BBT-CI arm (n = 73) exhibited a significant reduction in headache burden over time (P = .02; effect size [Cohen d] = 0.43), whereas the reduction was not significant among those in the HEAL arm (n = 66). The first principal component was positively loaded by headache, sleep, fatigue, and nausea/vomiting and was negatively loaded by cognitive, physical, and emotional functioning. Agglomerative hierarchical clustering revealed 3 natural clusters. Cluster I (n = 58) featured the highest burden of headache, insomnia, and nausea/vomiting; cluster II (n = 50) featured the lowest HRV despite a low burden of headache and insomnia; and cluster III (n = 31) showed an inverse relation between HRV and headache-insomnia, signifying autonomic dysfunction.

CONCLUSIONS

BBT-CI is efficacious in reducing headache burden in breast cancer survivors. Patient phenotyping demonstrates a headache type featuring sleep disturbance, nausea/vomiting, and low physical functioning-revealing similarities to migraine.

LAY SUMMARY

Breast cancer survivors often have persisting headache symptoms. In patients with cancer, treatment of chronic headache disorders using daily medications may be challenging because of drug interactions with chemotherapy and other cancer therapies as well as patients' reluctance to add more drugs to their medicine list. Headache and sleep disorders are closely related to each other. This study demonstrates that a sleep behavioral therapy reduced headache burden in breast cancer survivors. In addition, the majority of headache sufferers had a headache type with similarities to migraine-featuring sleep disturbance, nausea/vomiting, and low physical functioning.

SARS-CoV-2 and the sympathetic immune response: Dampening inflammation with antihypertensive drugs (Clonidine and Propranolol)

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is now a pandemic with the United States now carrying the highest number of cases and fatalities. Although vaccines and antiviral agents are the main focus of therapy, here we present a plausible hypothesis to leverage our understanding of neuroimmunomodulation to intervene in the pathophysiology of the disease to prevent death.

Diet-Induced Hyperinsulinemia as a Key Factor in the Etiology of Both Benign Prostatic Hyperplasia and Essential Hypertension?

Benign prostatic hyperplasia and hypertension are common age-related comorbidities. Although the etiology of benign prostatic hyperplasia (BPH) is still largely unresolved and poorly understood, a significant age-independent association was found between BPH and hypertension, indicating a common pathophysiological factor for both diseases. It has previously been suggested that the development of essential hypertension may be related to diet-induced hyperinsulinemia. This study follows the question, whether BPH may develop due to the same mechanism, thereby explaining the well-known comorbidity of these 2 disorders. The scientific evidence presented shows that BPH and hypertension share the same pathophysiological changes, with hyperinsulinemia as the driving force. It further shows that significant dietary changes during human history cause disruption of a finely tuned metabolic balance that has evolved over millions of years of evolution: high-insulinemic food, typical of current “Western” diets, has the potential to cause hyperinsulinemia and insulin resistance, as well as an abnormally increased activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system, alterations that play a pivotal role in the pathogenesis of BPH and hypertension.

Concussion and the autonomic nervous system: An introduction to the field and the results of a systematic review

BACKGROUND

Recent evidence suggests that autonomic nervous dysfunction may be one of many potential factors contributing to persisting post-concussion symptoms.

OBJECTIVE

This is the first systematic review to explore the impact of concussion on multiple aspects of autonomic nervous system functioning.

METHODS

The methods employed are in compliance with the American Academy of Neurology (AAN) and PRISMA standards. Embase, MEDLINE, PsychINFO, and Science Citation Index literature searches were performed using relevant indexing terms for articles published prior to the end of December 2016. Data extraction was performed by two independent groups, including study quality indicators to determine potential risk for bias according to the 4-tiered classification scheme of the AAN.

RESULTS

Thirty-six articles qualified for inclusion in the analysis. Only three studies (one Class II and two Class IV) did not identify anomalies in measures of ANS functioning in concussed populations.

CONCLUSIONS

The evidence supports the conclusion that it is likely that concussion causes autonomic nervous system anomalies. An awareness of this relationship increases our understanding of the physical impact of concussion, partially explains the overlap of concussion symptoms with other medical conditions, presents opportunities for further research, and has the potential to powerfully inform treatment decisions.

Oxidative stress as a mechanism of added sugar-induced cardiovascular disease

Added sugars comprising of table sugar, brown sugar, corn syrup, maple syrup, honey, molasses, and other sweeteners in the prepared processed foods and beverages have been implicated in the pathophysiology of cardiovascular diseases. This article deals with the reactive oxygen species (ROS) as a mechanism of sugar-induced cardiovascular diseases. There is an association between the consumption of high levels of serum glucose with cardiovascular diseases. Various sources of sugar-induced generation of ROS, including mitochondria, nicotinamide adenine dinucleotide phosphate-oxidase, advanced glycation end products, insulin, and uric acid have been discussed. The mechanism by which ROS induce the development of atherosclerosis, hypertension, peripheral vascular disease, coronary artery disease, cardiomyopathy, heart failure, and cardiac arrhythmias have been discussed in detail. In conclusion, the data suggest that added sugars induce atherosclerosis, hypertension, peripheral vascular disease, coronary artery disease, cardiomyopathy, heart failure, and cardiac arrhythmias and that these effects of added sugars are mediated through ROS.

Acute effects of different glycemic index diets on serum motilin, orexin and neuropeptide Y concentrations in healthy individuals

AIM

To determine whether different glycemic index (GI) diets have different effects on the acute secretion of motilin, orexin and neuropeptide Y (NPY), regulators of food intake, energy homeostasis and glucose metabolism.

METHODS

Fifty healthy volunteers were randomly assigned to two groups and were fed an isocaloric breakfast (464 kcal) containing high GI (HGI; GI=90) or low GI (LGI; GI=47) components. Serum motilin, orexin, and NPY concentrations were measured before (0 h) and 2h after the meal.

RESULTS

The concentrations of motilin, orexin-A, NPY, C-peptide, and blood glucose at 0 h were similar in both groups of subjects. However, 2 h after breakfast, the serum motilin, NPY, C-peptide, and blood glucose concentrations were increased and orexin-A concentrations were decreased in both groups. The percentage changes from 0 to 2 h [(2-h value-0-h value)/baseline×100)] in motilin (27.72±2.46% vs. 20.95±2.06%, p=0.04) and orexin-A (9.15±2.06% vs. 3.49±1.67%, p=0.038) concentrations were significantly higher in the LGI group than in the HGI group. By contrast, the percentage changes in NPY (53.7±9.73% vs. 28.1±5.2%, p=0.026) and blood glucose (12.3±3.78% vs. 1.77±2.52%, p=0.025) concentrations were significantly greater in the HGI group than in the LGI group. Although C-peptide concentrations increased significantly after breakfast in both groups, the magnitude of the increase was similar (132.69±25.15% vs. 139.98±27.29%, p=0.845). Motilin and NPY concentrations were moderately positive correlated (r=0.410, p=0.042), while orexin-A and NPY concentrations were negatively correlated (r=-0.429, p=0.033) at 2h in the LGI group.

CONCLUSIONS

A breakfast with a LGI reduced the secretion of orexin-A but significantly stimulated motilin secretion, without marked effects on the secretion of NPY. Therefore, consumption of a LGI diet may help to regulate food intake and energy expenditure in healthy individuals based on the changes in these hormones.