Nutrition protocols for the prevention of cardiovascular disease

Effects of therapeutic lifestyle change diets on blood lipids, lipoproteins, glycemic parameters, and blood pressure: a systematic review and meta-analysis of clinical trials

CONTEXT

Cardiovascular disease is the leading cause of death worldwide. Low-calorie, low-fat therapeutic diets (TDs) developed by the US National Cholesterol Education Program, ie, the Step I and II diets and the therapeutic lifestyle changes diet, are approximately similar and are the initial therapeutic interventional approaches for lifestyle modification.

OBJECTIVE

This systematic review with meta-analysis was undertaken to evaluate the effects of TDs diet on blood lipids, apolipoprotein A-1, apolipoprotein B, blood pressure, fasting blood glucose, and insulin.

DATA SOURCES

A comprehensive search of the PubMed/MEDLINE, Web of Science, Scopus, and Google Scholar databases until October 2022 was performed to identify clinical trials investigating the effects of TDs on the aforementioned parameters.

DATA EXTRACTION

One investigator screened the records and extracted data, and another reviewed the extracted data.

DATA ANALYSIS

A total of 910 records were retrieved. After records were screened for eligibility, 34 clinical trials met the inclusion criteria. The pooled analysis from the random-effects model revealed a significant reduction in total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, apolipoprotein A-1, and apolipoprotein B in the TD intervention group vs the control group. The overall effects of TDs on fasting blood glucose, insulin, and blood pressure were not significant, but the results of subgroup analysis revealed a significant reduction in fasting blood glucose with the Step II diet and an intervention duration of more than 24 weeks. For blood pressure, the Step I diet and an intervention duration of more than 24 weeks resulted in significant reduction. There was no evidence of publication bias, but strong heterogeneity was observed.

CONCLUSION

Therapeutic diets have promising effects on lipid profile parameters, glycemic indexes, and blood pressure, which can promote cardiovascular health.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO registration no. CRD42021259355.

Chimaphila umbellata; a biotechnological perspective on the coming-of-age prince's pine

Chimaphila umbellata has been studied for almost two centuries now, with the first paper exploring the phytochemistry of the plant published in 1860. Almost all contemporary studies focus on the biotechnological advances of C. umbellata including its utilization as a natural alternative in the cosmetic, food, biofuel, and healthcare industry, with a special focus on its therapeutic uses. This literature review critically investigates the significance and applications of secondary metabolites extracted from the plant and presses on the biotechnological approaches to improve its utilization. C. umbellata is home to many industrially and medicinally important phytochemicals, the majority of which belong to phenolics, sterols, and triterpenoids. Other important compounds include 5-hydroxymethylfurfural, isohomoarbutin, and methyl salicylate (the only essential oil of the plant). Chimaphilin is the characteristic phytochemical of the plant. This review focuses on the phytochemistry of C. umbellata and digs into their chemical structures and attributes. It further discusses the challenges of working with C. umbellata including its alarming conservation status, problems with in-vitro cultivation, and research and development issues. This review concludes with recommendations based on biotechnology, bioinformatics, and their crucial interface.

Rice bran nutraceutics: A comprehensive review

Agro-industry yields ample quantity of several byproducts with considerable importance. These byproducts are mostly under-utilized, often used as animal feed or rejected as waste; hence their true potential is not harnessed. The use of such superfluous resources is of not only economic significance but also a form of commercial recycling. Rice bran is an important byproduct of rice milling industry with a global potential of 29.3 million tons annually. It is gaining great attention of the researchers due to its nutrient-rich composition, easy availability, low cost, high antioxidant potential, and promising effects against several metabolic ailments. Bioactive components of rice bran, mainly γ-oryzanol, have been reported to possess antioxidant, anti-inflammatory, hypocholesterolemic, anti-diabetic, and anti-cancer activities. Rice bran oil contains appreciable quantities of bioactive components and has attained the status of "Heart oil" due to its cardiac-friendly chemical profile. Nutraceutics have successfully been extracted from rice bran using several extraction techniques such as solvent extraction, supercritical fluid extraction, microwave-, and ultrasonic-assisted extraction. Current paper is an attempt to highlight bioactive moieties of rice bran along with their extraction technologies and health benefits.

Cytotoxic, Antimitotic, and Antiproliferation Studies on Rasam: A South Indian Traditional Functional Food

Background

Rasam is a traditional South Indian food, prepared using tamarind juice as a base, with a variety of spices. Rasam, with all its ingredients medicinally claimed for various ailments, is a functional food. Systematic consumption of traditional functional food provides an excellent preventive measure to ward off many diseases.

Objective

To study rasam for cytotoxic, antimitotic, and antiproliferation potential beyond its culinary and nutritional effect.

Materials and Methods

Brine shrimp lethality assay, onion root tip inhibition assay, and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay in Calu-6, HeLa, MCF-7 cell lines for four stage-wise samples in the preparation of rasam (RS1, RS2, RS3, and RS4) were studied.

Results

RS4, the end product of rasam showed high lethality with an LC₅₀ value of 38.7 μL/mL. It showed maximum antimitotic activity in a dose-dependent manner compared to other samples with an IC₅₀ value of 189.86 μL/mL. RS4 also showed an IC₅₀ value of 350.22 and 410.15 μL/mL in MCF-7 and Calu-6 cell lines, respectively.

Conclusion

From this study, we suggest that rasam is a classic example of traditional functional food and it can treat breast and lung cancer on chronic use.

SUMMARY

Rasam, a South Indian traditional functional food, showed high lethality (LC₅₀ = 38.7 mL/mL) against brine shrimpsRasam also showed potential antimitotic activity (IC₅₀ = 189.86 mL/mL) by inhibiting the onion root tipsRasam showed an IC₅₀ value of 350.22 and 410.15 mL/mL against MCF-7 and Calu-6 cell lines respectivelyRasam, when consumed on daily dietary basis, can treat breast and lung cancer. Abbreviations used: SS 316: Stainless Steel 316 grade; MTT: 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide; DMEM: Dulbecco's modified Eagle medium; FBS: Fetal bovine serum media; TPVG: Trypsin phosphate versene glucose; EDTA: Ethylene diamine tetra acetic acid; PBS: Phosphate buffered saline; DMSO: Dimethyl sulfoxide.

Food intake patterns and cardiovascular risk factors in Japanese adults: analyses from the 2012 National Health and nutrition survey, Japan

BACKGROUND

There is an increasing global interest in the role of Japanese diet as a possible explanation for the nation's healthy diet, which contributes to the world's highest life-expectancy enjoyed in Japan. However, nationwide studies on current food intake status among general Japanese population have not been established yet. This study examined the association between food intake patterns and cardiovascular risk factors (CVRF) such as waist circumference (WC), body mass index (BMI), blood pressure (SBP, DBP), HbA1c and blood lipid profiles among general Japanese adults.

METHODS

De-identified data on the Japan National Health and Nutrition Survey (NHNS) 2012 with a total of 11,365 subjects aged 20-84 years were applied. Food intake patterns were derived by principal component analysis (PCA) based on 98 food groups. Generalized linear regression analysis was used to assess the relation between the food intake patterns and CVRF.

RESULTS

We identified three food intake patterns: traditional Japanese, Westernized, and meat and fat patterns. Traditional Japanese pattern was significantly related to high WC and BMI in men, and high DBP in women. Westernized pattern was associated with lower SBP, but high total cholesterol and LDL cholesterol in both men and women. Meat and fat pattern was associated with high WC, high BMI, high blood pressure and blood lipid profiles in both men and women (trend P < 0.001).

CONCLUSION

The significant association between cardiovascular disease risks and three food intake patterns derived from the NHNS, showed a similar tendency to other dietary survey methods.

Rosemary supplementation (Rosmarinus oficinallis L.) attenuates cardiac remodeling after myocardial infarction in rats

BACKGROUND

Myocardial infarction (MI) is one of the leading causes of morbidity and mortality worldwide. Dietary intervention on adverse cardiac remodeling after MI has significant clinical relevance. Rosemary leaves are a natural product with antioxidant/anti-inflammatory properties, but its effect on morphology and ventricular function after MI is unknown.

METHODS AND RESULTS

To determine the effect of the dietary supplementation of rosemary leaves on cardiac remodeling after MI, male Wistar rats were divided into 6 groups after sham procedure or experimental induced MI: 1) Sham group fed standard chow (SR0, n = 23); 2) Sham group fed standard chow supplemented with 0.02% rosemary (R002) (SR002, n = 23); 3) Sham group fed standard chow supplemented with 0.2% rosemary (R02) (SR02, n = 22); 4) group submitted to MI and fed standard chow (IR0, n = 13); 5) group submitted to MI and fed standard chow supplemented with R002 (IR002, n = 8); and 6) group submitted to MI and fed standard chow supplemented with R02 (IR02, n = 9). After 3 months of the treatment, systolic pressure evaluation, echocardiography and euthanasia were performed. Left ventricular samples were evaluated for: fibrosis, cytokine levels, apoptosis, energy metabolism enzymes, and oxidative stress. Rosemary dietary supplementation attenuated cardiac remodeling by improving energy metabolism and decreasing oxidative stress. Rosemary supplementation of 0.02% improved diastolic function and reduced hypertrophy after MI. Regarding rosemary dose, 0.02% and 0.2% for rats are equivalent to 11 mg and 110 mg for humans, respectively.

CONCLUSION

Our findings support further investigations of the rosemary use as adjuvant therapy in adverse cardiac remodeling.

A Comprehensive Review on Rasam: A South Indian Traditional Functional Food

The view that food can have an expanded role that goes well beyond providing a source of nutrients truly applies to traditional functional foods. The systematic consumption of such traditional functional food provides an excellent preventive measure to ward off many diseases. Rasam, a soup of spices, is a traditional South Indian food. It is traditionally prepared using tamarind juice as a base, with the addition of Indian sesame oil, turmeric, tomato, chili pepper, pepper, garlic, cumin, curry leaves, mustard, coriander, asafoetida, sea salt, and water. Rasam is a classic example of traditional functional food with all its ingredients medicinally claimed for various ailments. The preclinical and clinical studies on rasam and its ingredients support their traditional claim. This review is an attempt to compile the literatures on rasam, its ingredients, and to highlight its medicinal potential that has been underestimated.

Critical Analysis on Characterization, Systemic Effect, and Therapeutic Potential of Beta-Sitosterol: A Plant-Derived Orphan Phytosterol

Beta-sitosterol (BS) is a phytosterol, widely distributed throughout the plant kingdom and known to be involved in the stabilization of cell membranes. To compile the sources, physical and chemical properties, spectral and chromatographic analytical methods, synthesis, systemic effects, pharmacokinetics, therapeutic potentials, toxicity, drug delivery and finally, to suggest future research with BS, classical as well as on-line literature were studied. Classical literature includes classical books on ethnomedicine and phytochemistry, and the electronic search included Pubmed, SciFinder, Scopus, the Web of Science, Google Scholar, and others. BS could be obtained from different plants, but the total biosynthetic pathway, as well as its exact physiological and structural function in plants, have not been fully understood. Different pharmacological effects have been studied, but most of the mechanisms of action have not been studied in detail. Clinical trials with BS have shown beneficial effects in different diseases, but long-term study results are not available. These have contributed to its current status as an "orphan phytosterol". Therefore, extensive research regarding its effect at cellular and molecular level in humans as well as addressing the claims made by commercial manufacturers such as the cholesterol lowering ability, immunological activity etc. are highly recommended.

Oral administration of veratric acid, a constituent of vegetables and fruits, prevents cardiovascular remodelling in hypertensive rats: a functional evaluation

In our previous studies, veratric acid (VA) shows beneficial effect on hypertension and its associated dyslipidaemia. In continuation, this study was designed to investigate the effect of VA, one of the major benzoic acid derivatives from vegetables and fruits, on cardiovascular remodelling in hypertensive rats, primarily assessed by functional studies using Langendorff isolated heart system and organ bath system. Hypertension was induced in male albino Wistar rats by oral administration of N ω -nitro-l-arginine methyl ester hydrochloride (l-NAME) (40 mg/kg body weight (b.w.)) in drinking water for 4 weeks. VA was orally administered at a dose of 40 mg/kg b.w. l-NAME-treated rats showed impaired cardiac ventricular and vascular function, evaluated by Langendorff isolated heart system and organ bath studies, respectively; a significant increase in the lipid peroxidation products such as thiobarbituric acid-reactive substances and lipid hydroperoxides in aorta; and a significant decrease in the activities of superoxide dismutase, catalase, glutathione peroxidase and levels of GSH, vitamin C and vitamin E in aorta. Fibrotic remodelling of the aorta and heart were assessed by Masson's Trichrome staining and Van Gieson's staining, respectively. In addition, l-NAME rats showed increased heart fibronectin expression assessed by immunohistochemical analysis. VA supplementation throughout the experimental period significantly normalised cardiovascular function, oxidative stress, antioxidant status and fibrotic remodelling of tissues. These results of the present study conclude that VA acts as a protective agent against hypertension-associated cardiovascular remodelling.

Improving heart healthy lifestyles among participants in a Salud para su Corazón promotores model: the Mexican pilot study, 2009-2012

INTRODUCTION

In Mexico, cardiovascular disease and its risk factors are growing problems and major public health concerns. The objective of this study was to implement cardiovascular health promotion and disease prevention activities of the Salud para su Corazón model in a high-risk, impoverished, urban community in Mexico City.

METHODS

We used a pretest-posttest (baseline to 12-week follow-up) design without a control group. Material from Salud para su Corazón was validated and delivered by promotores (community health workers) to community members from 6 geographic areas. Two validated, self-administered questionnaires that assessed participants' knowledge and behaviors relating to heart health were administered. We used t tests and χ(2) tests to evaluate pretest and posttest differences, by age group (≤60 and >60 years), for participants' 3 heart-healthy habits, 3 types of physical activity, performance skills, and anthropometric and clinical measurements.

RESULTS

A total of 452 (82%) adult participants completed the program. Heart-healthy habits from pretest to posttest varied by age group. "Taking action" to modify lifestyle behaviors increased among adults aged 60 or younger from 31.5% to 63.0% (P < .001) and among adults older than 60 from 30.0% to 45.0% (P < .001). Positive responses for cholesterol and fat consumption reduction were seen among participants 60 or younger (P = .03). Among those older than 60, salt reduction and weight control increased (P = .008). Mean blood glucose concentration among adults older than 60 decreased postintervention (P = .03).

CONCLUSION

Significant improvements in some heart-healthy habits were seen among adult participants. The model has potential to improve heart-healthy habits and facilitate behavioral change among high-risk adults.

Effect of morin, a flavonoid against DOCA-salt hypertensive rats: a dose dependent study

OBJECTIVE

To determine the protective effect of morin, a flavonoid against deoxycorticosterone acetate (DOCA)-salt induced hypertension in male Wistar rats.

METHODS

Hypertension was induced in uninephrectomized rats by weekly twice subcutaneous injection of DOCA (25 mg/kg bw) and 1% NaCl in the drinking water for six consecutive weeks. Effect of morin against DOCA-salt induced hypertension was evaluated by measuring blood pressure and performing biochemical estimations and histopathological examination of renal tissues.

RESULTS

DOCA-salt hypertensive rats showed considerably increased systolic and diastolic blood pressure, serum hepatic marker enzyme activities such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and gamma-glutamyl transpeptidase (GGT) and renal function markers (urea, uric acid and creatinine) in plasma. Oral administration of morin (25, 50 and 75 mg/kg bw) brought back all the above parameters to near normal level. Histopathology of kidney also confirmed the biochemical findings of this study. The effect at a dose of 50 mg/kg bw of morin was more pronounced than that of the other two doses (25 and 75 mg/kg bw).

CONCLUSIONS

These findings indicate that morin exhibits strong antihypertensive effect against DOCA-salt induced hypertension.

Association between dietary fiber intake and risk of coronary heart disease: A meta-analysis

BACKGROUND & AIMS

The association between coronary heart disease (CHD) and dietary fiber intake is not consistent, especially for the subtypes of dietary fiber. The aim of our study was to conduct a meta-analysis of existing cohort published studies assessing the association between dietary fiber intake and risk of CHD, and quantitatively estimating their dose-response relationships.

METHODS

We searched PubMed and EMBASE before May 2013. Random-effect model was used to calculate the pool relative risk (RRs) for the incidence and mortality of CHD. Dose-response, subgroup analyses based on fiber subtypes, heterogeneity and publication bias were also carried out.

RESULTS

Eighteen studies involving 672,408 individuals were finally included in the present study. The pooled-adjusted RRs of coronary heart disease for the highest versus lowest category of fiber intake were 0.93 (95% confidence interval (CI), 0.91-0.96, P < 0.001) for incidence of all coronary events and 0.83 (95% CI, 0.76-0.91, P < 0.001) for mortality. Further subgroup analyses based on fiber subtypes (cereal, fruit, and vegetable fiber), indicated that RRs were 0.92 (95% CI, 0.85-0.99, P = 0.032), 0.92 (95% CI, 0.86-0.98, P = 0.01), 0.95 (95% CI, 0.89-1.01, P = 0.098) respectively for all coronary event and 0.81 (95% CI, 0.72-0.92, P = 0.001), 0.68 (95% CI, 0.43-1.07, P = 0.094), 0.91 (95% CI, 0.74-1.12, P = 0.383) for mortality. In addition, a significant dose-response relationship was observed between fiber intake and the incidence and mortality of CHD (P < 0.001).

CONCLUSIONS

Our results indicate that consumption of dietary fiber is inversely associated with risk of coronary heart disease, especially for fiber from cereals and fruits. Besides, soluble and insoluble fibers have the similar effect. A significant dose-response relationship is also observed between fiber intake and CHD risk.

Blood lipids profile in hyperlipidemic children undergoing different dietary long chain polyunsaturated supplementations: a preliminary clinical trial

The aim of this preliminary study was to explore the effect size of different dietary long chain polyunsaturated supplementations on blood lipid profile in children with primary hyperlipidemia. Thirty-six children (8-13 years) were recruited. After an 8-week stabilization period on the Step I diet, they were randomized to additionally receive for a 16-week period one capsule (500 mg) daily of docosahexaenoic acid (DHA) alone or a DHA plus eicosapentaenoic acid (EPA) mixture (45.6% DHA; 41.6% EPA) or wheat germ oil (control). An effect size (as percentage change from baseline) of +8%, -12% and -16% for high-density lipoprotein cholesterol (HDL-C), total cholesterol/HDL-C ratio and triglycerides was observed in children supplemented with DHA, compared to +2%, -8% and -12%, respectively, in children supplemented with DHA plus EPA. This preliminary study suggests powered trials appear feasible and are warranted to evaluate efficacy of n-3 long-chain polyunsaturated fatty acid dietary supplementations on the blood lipid profile of children with primary hyperlipidemia.

Increased vegetable and fruit consumption during weight loss effort correlates with increased weight and fat loss

BACKGROUND

Individuals who focused on calorie counting lost more weight than those who focused on increasing vegetable and fruit (V&F) intake in a weight loss program. We now present serum carotenoid data (biomarkers of V&F intake) from both groups and test whether these biomarkers correlate with changes in weight and body fat.

DESIGN

Sixty obese volunteers were randomized to one of the following weight loss programs: 500 kcal per day reduction (Reduction) or a focus on consuming eight vegetables per day and 2-3 fruits per day (HiVeg). Volunteers in the Reduction group were 36.8±10.3 years with a body mass index of 33.5; 83% were white, 17% chose not to report race; 70% were not Hispanic or Latino, 13% were Hispanic or Latino and 17% chose not to report ethnicity. Volunteers in the HiVeg group were 30.4±6.6 years with a body mass index of 33.2: 74% white, 11% Asian, 5% black or African American, 5% multiracial and 5% chose not to report race; 89% were not Hispanic or Latino, 5% were Hispanic or Latino and 5% chose not to report ethnicity. Subjects were taught basic nutrition principles, received breakfast and lunch 5 days per week for 3 months, meals 2 days per week during month 4, then regular phone calls to month 12.

RESULTS

Total serum carotenoid concentrations increased from baseline to 3 months and remained elevated at 12 months, but there was no difference between groups. Changes in weight, fat and % fat correlated negatively with serum carotenoid concentrations.

CONCLUSION

Increased serum carotenoids (a biomarker for V&F intake) correlated with improved weight and fat loss indicating that increased V&F consumption is an appropriate strategy for weight loss. However, in light of the fact that the Reduction group lost more weight, the consumption of increased V&F for the purpose of weight loss should happen within the context of reducing total caloric intake.

The flavonoid morin restores blood pressure and lipid metabolism in DOCA-salt hypertensive rats

OBJECTIVE

This study was undertaken to investigate the antihypertensive and antihyperlipedimic potential of morin against deoxycorticosterone acetate (DOCA)-salt hypertensive rats.

METHODS

Hypertension was induced in uninephrectomized rats (UNX) by weekly twice subcutaneous injection of DOCA (25 mg/kg) and 1% NaCl in the drinking water for six consecutive weeks. Morin (50 mg/kg) was administered to DOCA-salt rats orally using an intragastric tube daily for a period of 6 weeks.

RESULTS

The DOCA-salt hypertensive rats showed significant elevation in mean arterial pressure (MAP), heart rate (HR) and reduction in body weight. A significant increase in the concentrations of plasma and tissue (liver, kidney, heart, and aorta) lipids such as total cholesterol, triglycerides, free fatty acids, phospholipids, plasma low-density and very low-density lipoproteins cholesterol, and a decrease in the concentration of high-density lipoprotein cholesterol were noticed in DOCA-salt hypertensive rats. Also, the levels of urinary protein and the activity of 3-hydroxy 3-methylglutaryl coenzyme A reductase in the plasma and tissues were increased, and lecithin cholesterol acyl transferase activity in the plasma was decreased in DOCA-salt rats. Morin supplementation (50 mg/kg) throughout the experimental period restored all the above parameters significantly.

CONCLUSION

Morin has a potential role in attenuating severe hypertension and hyperlipedimia.

Antihypertensive and antioxidant potential of vanillic acid, a phenolic compound in L-NAME-induced hypertensive rats: a dose-dependence study

We investigated the antihypertensive and antioxidant potential of vanillic acid (VA) in N(ω)-Nitro-L-arginine methyl ester hydrochloride (L-NAME) - treated adult male albino Wistar rats. Treatment of rats with L-NAME (40 mg/kg Bw for 30 days) caused a sustained increase in systolic- (SBP) and diastolic blood pressure (DBP) and significantly decreased the concentration of nitrite/nitrate (NO(x)) in plasma as compared with that in the control. Rats treated with VA restored SBP and DBP to normal level and preserve the plasma NO metabolites concentration. Moreover, VA reduced lipid peroxidation products (thiobarbituric acid reactive substances, lipid hydroperoxides, conjugated dienes) and significantly restored enzymatic antioxidants (superoxide dismutase, catalase, and glutathione peroxidase), non-enzymatic antioxidants (vitamin C, vitamin E, and reduced glutathione) in the plasma. To assess the toxicity if any of VA treatment, hepatic and renal function markers were measured. Our results showed that the effect at a dose of 50 mg/kg Bw of VA was more pronounced than that of the other two doses, 25 and 100 mg/kg Bw. These results were supported by histopathology studies. We conclude that VA possesses an antihypertensive and antioxidant activity in L-NAME-induced hypertensive rats.

Fermented wheat germ extract (avemar) in the treatment of cardiac remodeling and metabolic symptoms in rats

Avemar, a product of industrial fermentation of wheat germ with a standardized content of benzoquinone and plant flavonoids, has been tested as an anti-cancer and immunomodulatory dietary supplement. Proposed mechanisms include anti-oxidant and anti-inflammatory actions. This study has determined whether these actions of Avemar may also be useful in the treatment of cardiovascular diseases. Two experimental rat models of cardiovascular remodeling were used in this project: the deoxycorticosterone acetate (DOCA)-salt-induced model of chronic hypertension (study I) and a high-carbohydrate/high-fat diet-induced model producing chronic symptoms of the metabolic syndrome and its associated cardiovascular complications (study II). Our results in these rat models of hypertension and diet-induced obesity show that treatment with Avemar improved cardiac function, decreased macrophage infiltration resulting in decreased collagen deposition in the ventricular myocardium, reversed an increased stiffness of the left ventricle in the diseased hearts and attenuated increased plasma malondialdehyde concentrations. In addition to the changes in the heart, Avemar reversed glucose intolerance, normalized systolic blood pressure and decreased visceral fat deposition in rats fed a high-fat/high-carbohydrate diet. In conclusion, the fermented wheat germ extract Avemar has a potential role in attenuating chronic hypertension, diabetes or metabolic syndrome-induced cardiovascular symptoms along with metabolic abnormalities such as glucose tolerance and obesity.

Nutritional related cardiovascular risk factors in patients with coronary artery disease in Iran: a case-control study

Background and aims

There are limited findings available on coronary artery disease (CAD) risk factors and nutritional pattern of CAD patients in Iran. The purpose of this study was to compare nutritional-related risk factors of CAD patients with that of matched controls.

Methods

In a case-control design, dietary patterns and CAD risk factors of 108 documented patients (determined by cardiac catheterization showing greater than 70% stenosis or established myocardial infarction) whom were admitted to coronary care units (CCU) of Ahvaz teaching hospitals were compared with that of 108 gender- and age-matched subjects of normal cardiac catheterization (lesser than 40% stenosis). Measured variables consisted of blood lipid profile, smoking habits, dietary patterns, anthropometric indices and blood pressure levels.

Results

Almost all patients had hypertriglyceridemia and high LDL-C levels. Odds ratios (CI 95%) for consuming fish, tea, vegetable oils were 0.55(0.31-0.91), 0.3(0.15-0.65), 0.23(0.13-0.42), respectively. However, consumption of hydrogenated fats, and full-fat yoghurt was associated with higher CAD risk (OR = 2.12(1.23-3.64) and 2.35(1.32-4.18), respectively. Patients' serum lipid profiles, sugar concentrations, and blood pressure levels were significantly higher than defined cut-off points of the known risk factors. Considerable numbers of the control group also showed high levels of the known risk factors.

Conclusions

Consumption of fish, tea and vegetable oils shown to have protective effect on CAD while full fat yoghurt and hydrogenated fats increase the risk of CAD. Moreover, CAD patients obviously have higher blood lipids and sugar concentrations, blood pressure, body fat percent and BMI levels compared with their matched counterparts. We need to define specific local cut-off points with more practical criteria to detect CAD patients.

Vegetable and fruit intake and non-Hodgkin lymphoma survival in Connecticut women

We investigated whether an increased intake of vegetables and fruits favors NHL survival. A cohort of 568 female cases of incident NHL diagnosed during 1996-2000 in Connecticut was followed up for a median of 7.7 years. Adjusted hazard ratios (HRs) were estimated by Cox proportional hazard models. Our results show that a pre-diagnostic high intake of vegetables appeared to favor overall survival (HR = 0.74, 95% CI 0.57-0.98) among patients with NHL who survived longer than 6 months. In particular, pre-diagnostic high intakes of green leafy vegetables and citrus fruits were associated with 29% (95% CI 0.51-0.98) and 27% (95% CI 0.54-0.99) reduced risk of death, respectively. When different types of vegetables and fruits were investigated separately, their impacts were found to vary in NHL subtypes. Our study suggests that increasing vegetable and citrus fruit consumption could be a useful strategy to improve survival in NHL patients.

Nutritional recommendations for preventing coronary heart disease in women: evidence concerning whole foods and supplements

AIMS

Some food groups and supplements have been recommended for preventing coronary heart disease (CHD) in women. In this article, evidence on recommendations for some of these food groups (whole grains, fruits, vegetables, fish, nuts, and soy) and supplements (phytosterols, antioxidants, folic acid, and B-complex vitamins) is reviewed. Additionally, gender differences in nutritional requirements and recommendations are described.

DATA SYNTHESIS

Studies of nutrition in women and those emphasizing gender differences in nutritional requirements were selected for this review.

CONCLUSION

Observational data support the benefit of vegetables, fruits, and whole grains in CHD prevention. Trial data provide support for consuming fish at least twice a week, although women of childbearing age should limit their intake of fish that may contain high levels of mercury. Nuts are nutritious snacks but their caloric impact must be considered. Soy products do not affect low-density lipoprotein cholesterol (LDL-C) or CHD but may be beneficial in replacing high-fat meat. Foods supplemented with plant stanol/sterol-esters are recommended for reducing LDL-C. Antioxidant supplementation is not recommended for prevention of heart disease. A direct causal relationship between vitamin D deficiency and CHD has not been established. Homocysteine lowering through folic acid and B-complex vitamin supplementation has not been proven to improve CHD risk. More gender-specific analyses are needed to determine whether nutritional requirements differ between men and women.

Thermostable Kunitz trypsin inhibitor with cytokine inducing, antitumor and HIV-1 reverse transcriptase inhibitory activities from Korean large black soybeans

A large number of trypsin inhibitors belonging to various types have been purified from different kinds of legumes. In this study, by using liquid chromatography, a Kunitz type trypsin inhibitor (KBTI) with a molecular weight of 20107.645 Da was purified from Korean large black soybeans. KBTI reduced the proteolytic activities of trypsin and alpha-chymotrypsin with the activity of approximately 8520 BAEE units/mg and approximately 24 BTEE units/mg, respectively. It showed high thermal stability (0-100 degrees C) as well as stability over a large range of pH values (pH 3-11). Furthermore, KBTI inhibited HIV-1 reverse transcriptase activity with an IC(50) value of 0.71 microM and induced the release of pro-inflammatory cytokines such as TNF-alpha, IL-1beta, IL-2 and interferon-gamma at the mRNA level. KBTI exerted weak antiproliferative activity toward CNE-2 and HNE-2 nasopharyngeal cancer cells, MCF-7 breast cancer cells, and Hep G2 hepatoma cells. KBTI was destitute of mitogenic, ribonuclease and antifungal activities.

Today's Food System: How Healthy Is It?

With its focus on the quantity of production, often to the exclusion of other goals, today's food system is on an unsustainable course. The problem begins with and is driven by industrialized production of both crops and animals. Industrialization is a product of technological change, public policy, and, most recently, globalized trade. The lack of sustainability derives from reliance on the intensive use of nonrenewable and hard-to-renew resources-soil, antibiotics, fresh water, and fossil fuels, for example-but also from the waste and pollution created by the industrial model. For at least 50 years, American agriculture policies have promoted production of, and ultimately lower market prices for, commodity crops like corn, wheat, and soybeans. Over the last 3 decades in particular, these "cheap food" policies have exacerbated the negative impacts of an industrialized agriculture on the health of the agro-ecosystem, as well as on the health of the humans who must share and be sustained by it. Sustainability and health are two sides of the same food system coin. Policies that put US food production on more sustainable footing can help aid in public efforts to address the myriad crises confronting both the food and health systems.

Nutrition as a vehicle for cardiovascular translational research

It is becoming increasingly evident that poor nutrition plays an important role in inducing cardiovascular disease. Just as importantly, data now support the contention that appropriate nutritional interventions may have just as important an effect in preventing or delaying the appearance of cardiovascular disease. If this is indeed true, then it is critical that these advances in our knowledge of the effects of nutritional interventions be translated into effective strategies to combat cardiovascular disease. It is argued in this paper, with a few specific examples, that the translation of nutritional interventions can provide powerful approaches to alleviating the clinical challenges currently facing us today in the cardiovascular field. Furthermore, the value-added economic advantages of translating nutritional strategies on a wide scale into the public become another intriguing argument to further support investigations in this growing field.

Culturally tailored foods and CVD prevention

Culture plays an integral role in people's food choices and lifestyle decisions. Health care messages may conflict with cultural beliefs for many immigrant, minority, and low income populations. The multiple ways that culture can positively and negatively affect disease risk must be utilized in the development of 'culturally tailored' messages or interventions. Only through the creation of interventions that are meaningful and culturally-relevant can successful behavior stability or change occur. The recognition of current health-promoting factors is important to develop rapport and credibility with individuals and population groups in order to reduce the risk of CVD and other lifestyle-based chronic diseases for optimal health.