A brisk walk daily is the easiest way to trim waistline

Research from Duke University Medical Center shows that even a modest amount of brisk walking weekly is enough to trim waistlines and cut the risk of metabolic syndrome (MetS), an increasingly frequent condition linked to obesity and a sedentary lifestyle.

It’s estimated that about a quarter of all U.S. adults have MetS, a cluster of risk factors associated with greater likelihood of developing heart disease, diabetes and stroke: large waist circumference, high blood pressure, high levels of triglycerides, low amounts of HDL, or “good” cholesterol, and high blood sugar. To be diagnosed with MetS, patients must have at least three of these five risk factors, and according to many studies, a growing number of people do.

But Johanna Johnson, a clinical researcher at Duke Medical Center and the lead author of a new study examining the impact of exercise on MetS, said a person can lower risk of MetS by walking just 30 minutes a day, six days per week. “That’s about 11 miles per week. And our study shows that you’ll benefit even if you don’t make any dietary changes.”

“The results of our study underscore what we have known for a long time,” said Duke cardiologist William Kraus. “Some exercise is better than none; more exercise is generally better than less, and no exercise can be disastrous.”

The study appears in the December 15 issue of the American Journal of Cardiology.

The results come from a multi-year, federally funded study called STRRIDE (Studies of a Targeted Risk Reduction Intervention through Defined Exercise) that examined the effects of varying amounts and intensity of exercise on 171 middle-aged, overweight men and women.

Before exercising regularly, 41 percent of the participants met the criteria for MetS. At the end of the 8-month exercise program, only 27 percent did.

“That’s a significant decline in prevalence,” said Johnson. “It’s also encouraging news for sedentary, middle-aged adults who want to improve their health. It means they don’t have to go out running four or five days a week; they can get significant health benefits by simply walking around the neighborhood after dinner every night.”

Still, some exercise regimens were better than others. Those who exercised the least, walking about 11 miles per week, gained significant benefit, while those who exercised the most, jogging about 17 miles per week, gained slightly more benefit in terms of lowered MetS scores.

One group puzzled the researchers, however. Those who did a short period of very vigorous exercise didn’t improve their MetS scores as much as those who performed less intense exercise a longer period.

Kraus said there may be more value in doing moderate intensity exercise every day rather than more intense activity just a few days a week.

In all three of the study’s exercise groups, waistlines got smaller over the 8-month period. In general, men who exercised saw greater improvement in their MetS risk factors than women. But Johnson points out that at baseline, the men generally had worse scores than women, “so they had more room to improve,” she said.

Over the course of the STRRIDE study, the inactive control group – those who didn’t change their diet or activity level at all – gained an average of about one pound and a half-inch around the waist. “That may not sound like much, but that’s just six months,” Kraus said. “Over a decade, that’s an additional 20 pounds and 10 inches at the beltline.”

—————————-
Article adapted by MD Only Weblog from original press release.
—————————-

Contact: Michelle Gailiun
Duke University Medical Center

The study was funded by the National Institutes of Health.

Colleagues at Duke who contributed to the study include Cris Slentz, Gregory Samsa, Lori Bateman and Brian Duscha. Collaborating authors from East Carolina University include Joseph Houmard, Jennifer McCartney and Charles Tanner.

Plant pigment in cherries helps lower sugar levels

Perhaps George Washington wouldn’t have chopped down his father’s cherry tree if he knew what chemists now know. They have identified a group of naturally occurring chemicals abundant in cherries that could help lower blood sugar levels in people with diabetes. In early laboratory studies using animal pancreatic cells, the chemicals, called anthocyanins, increased insulin production by 50 percent, according to a peer-reviewed study scheduled to appear in the Jan. 5 issue of the American Chemical Society’s Journal of Agricultural and Food Chemistry. ACS is the world’s largest scientific society.Anthocyanins are a class of plant pigments responsible for the color of many fruits, including cherries. They also are potent antioxidants, highly active chemicals that have been increasingly associated with a variety of health benefits, including protection against heart disease and cancer.

“It is possible that consumption of cherries and other fruits containing these compounds [anthocyanins] could have a significant impact on insulin levels in humans,” says study leader Muralee Nair, Ph.D., a natural products chemist at Michigan State University in East Lansing. “We’re excited with the laboratory results so far, but more studies are needed.” Michigan is the top cherry producing state in the nation.

Until human studies are done on cherry anthocyanins, those with diabetes should continue following their doctor’s treatment recommendations, including any medicine prescribed, and monitor their insulin carefully, the researcher says. The compounds show promise for both the prevention of type 2 (non-insulin-dependent) diabetes, the most common type, and for helping control glucose levels in those who already have diabetes, he adds.

While fresh cherries and fruits containing these anthocyanins are readily available, medicinal products may be the most efficient way to provide the beneficial compounds, according to Nair. It’s possible that anthocyanins eventually could be incorporated into new products, such as pills or specialty juices that people could take to help treat diabetes. Such disease-specific products may take several more years to develop, he notes.

Scientists in Nair’s laboratory have even developed a unique process, patented by the university, for removing sugar from fruit extracts that contain anthocyanins. This could lead to “sugar-free” medicinal products for people with diabetes.

The current study, partially funded by the U.S. Department of Agriculture, involved tart cherries (also known as sour cherries or pie cherries), a popular variety in the United States, and the Cornelian cherry, which is widely consumed in Europe. Nair and his associates, B. Jayaprakasam, Ph.D., L.K. Olson, Ph.D., and graduate student S. K. Vareed, tested several types of anthocyanins extracted from these cherries against mouse pancreatic-beta cells, which normally produce insulin, in the presence of high concentrations of glucose.

Insulin is the protein produced by the pancreas that helps regulate blood sugar (glucose) levels. Compared to cells that were not exposed to anthocyanins, exposed cells were associated with a 50 percent increase in insulin levels, the researchers say. The mechanism of action by which these anthocyanins boost insulin production is not known, Nair says.

Nair and his colleagues are currently feeding anthocyanins to a group of obese, diabetic mice to determine how the chemicals influence insulin levels in live subjects. Results of these tests are not yet available.

Although other fruits, including red grapes, strawberries and blueberries, also contain anthocyanins, cherries appear to be the most promising source of these compounds on the basis of serving size, according to the researcher. The compounds are found in both sweet and sour (tart) cherry varieties.

The potential benefits of cherries extend beyond diabetes. Previous studies by the researcher found that certain anthocyanins isolated from cherries have anti-inflammatory properties and may be useful in fighting arthritis. Nair’s colleagues have found that cherries also may help fight colon cancer.

But people with diabetes are encouraged to use caution when it comes to consuming maraschino cherries, the bright red candied version that adorns ice cream and cocktails, Nair points out. Many of the beneficial cherry pigments that were present in the fresh fruit have been removed during processing, replaced with food coloring, and extra sugar has been added.

The American Chemical Society is a nonprofit organization, chartered by the U.S. Congress, with a multidisciplinary membership of more than 159,000 chemists and chemical engineers. It publishes numerous scientific journals and databases, convenes major research conferences and provides educational, science policy and career programs in chemistry. Its main offices are in Washington, D.C., and Columbus, Ohio.

—————————-
Article adapted by MD Only Weblog from original press release.
—————————-

Contact: Michael Bernstein
American Chemical Society

Adding Vitamins C and E to diet improves effectiveness of insulin

Adding antioxidants to therapy improves drug’s ability to reduce blood sugar

Boosting insulin with vitamins C and E may improve the drug’s effectiveness for treating diabetes.

A UC Irvine College of Medicine study has found that the popular antioxidant supplements not only enhance insulin’s ability to reduce blood sugar, but also lower the risks of organ damage that can occur despite insulin treatments. The study appears in the January issue of Kidney International.

Dr. Nick Vaziri, professor of medicine, and his team found that untreated diabetes raised blood pressure and increased the production of damaging oxidizing agents called free radicals. The free radicals converted sugars and proteins into harmful chemicals, increasing the risks of tissue damage often seen in untreated diabetes.

Treating the rats with insulin alone improved high blood pressure somewhat and partially spared the sugars and proteins from the free radicals’ assault. But it also added a new problem, as the free radicals turned their attack on nitric oxide, a ubiquitous molecule that usually protects the body from free radicals. This new attack results in yet more toxic chemicals, with the potential to inflict damage to tissues.

Adding vitamins C and E to insulin, however, spared the sugars, proteins and nitric oxide from attack.

“Blood pressure was lowered to normal, and free radicals were not in sufficient numbers to degrade the sugars, proteins and nitric oxide,” Vaziri said. “We think this shows that a diet rich in antioxidants may help diabetics prevent the devastating cardiovascular, kidney, neurological and other damage that are common complications of diabetes.”

Diabetes affects nearly 17 million Americans. Insulin is the predominant treatment, but patients eventually develop complications, like various forms of heart disease and nerve, liver and kidney damage. Studies would still have to be tested in humans, but Vaziri believes that adding vitamins C and E to an insulin-dependent diabetic’s diet should help treat the disease and perhaps prevent future organ damage.

—————————-
Article adapted by MD Only Weblog from original press release.
—————————-

Contact: Andrew Porterfield
University of California – Irvine

Ginseng extract fights diabetes, lowers cholesterol and decreases weight

An extract from the ginseng berry shows real promise in treating diabetes and obesity, reports a research team from the University of Chicago’s Tang Center for Herbal Medicine Research. In the June issue of the journal Diabetes, they show that the extract completely normalized blood glucose levels, improved sensitivity to insulin, lowered cholesterol levels, and decreased weight by reducing appetite and increasing activity levels in mice bred to develop diabetes.For more than 2000 years, traditional Chinese medicine has used ginseng root to treat a variety of ailments. This study focused instead on substances found in the ginseng berry, which has very different concentrations of ginsenosides, the substances thought to be medically useful.

“Ginseng berry has a distinctive chemical profile and has not previously been used for therapy,” said Chun-Su Yuan, M.D., Ph.D., assistant professor of anesthesia and critical care at the University of Chicago and director of the study. “We were stunned by how different the berry is from the root and by how effective it is in correcting the multiple metabolic abnormalities associated with diabetes.”

Yuan’s team, which included researchers from the Tang Center, anesthesia, clinical pharmacology and medicine, studied the effects of the extract, made from the pulp of the berry. They also studied one particular substance known as ginsenoside Re, which is concentrated in ginseng berries but quite scarce in the root.

They tested the extract by injecting it once a day into mice with a gene defect that causes weight gain and type 2 diabetes. They found that —

• Daily injections of 150 mg/kg of the ginseng berry extract restored normal blood-sugar levels in diabetic mice. Blood-glusoce levels fell from 222 mg/dl (quite high for a mouse) to 137 mg/dl (normal) within 12 days. Treated mice also had better scores on a glucose tolerance test, which measures how quickly the mice could remove excess glucose from the blood.
• The extract caused diabetic mice, which were also obese, to lose more than 10 percent of their body weight in 12 days. Untreated mice gained five percent of their weight in 12 days. The treated mice ate 15 percent less and were 35 percent more active than untreated mice. Once the injections stopped, weight gain gradually resumed.
• The extract improved insulin secretion and insulin sensitivity, both of which were abnormal in mice with diabetes.
• Treated diabetic mice had 30 percent lower cholesterol levels than untreated diabetic mice (117mg/dl versus 169mg/dl).

The extract had no detectable effect on normal mice.

Tests using a ginsenoside Re alone found that it had all of the anti-diabetic but none of the obesity-fighting activities of the extract.

“This novel compound could serve as the basis for a whole new class of anti-diabetic medications,” said Yuan, who is also working to isolate other substances from the extract that contributed to the weight loss.

There is a pressing need for new and more effective drugs for both diabetes and obesity. Diabetes is the seventh leading killer in the U.S. Type 2 diabetes affects almost six percent of the U.S. population and 18.4 percent of those over 65. The cost of the disease is estimated at $105 billion each year.

The U.S. Surgeon General estimates that 61 percent of adults are overweight or obese. Obesity — wieghing more than 20 percent over your maximum recommended body weight — contributes to an estimated 300,000 deaths each year. The economic cost of obesity in the U.S. was about $117 billion in 2000. The rising rate of obesity also contributes to the growing prevalence of type 2 diabetes.

“Since this berry contains agents that are effective against both obesity and diabetes, the ginseng fruit has enormous promise as a source of new drugs,” said Yuan, who has worked with the University to apply for a patent on the development of ginsenoside Re as a diabetes medication.

“The next step is to isolate the other substances in the extract, find out whether they also effect glucose regulation or weight gain, learn how they work and determine the safe and effective dose.”

—————————-
Article adapted by MD Only Weblog from original press release.
—————————-

Contact: John Easton
University of Chicago Medical Center

Additional authors of the study were Anoja Attele, Yun-Ping Zhou, Jing-Tian Xie, Ji An Wu, Liu Zhang, Lucy Dey, William Pugh and Paul Rue of the University of Chicago and Kenneth Polonsky, now at Washington University in St. Louis. The research was funded by the Tang Family Foundation and the National Institutes of Health.

Achieve Maximum Heart Health Eating Omega-3 Fatty Acids

While a heart-healthy diet has become synonymous with plenty of fruits and vegetables and little fat and cholesterol, there’s more to the story. Omega-3 fatty acids should be part of a heart-healthy diet, too, according to the August issue of Mayo Clinic Health Letter.

Omega-3 fatty acids are a form of polyunsaturated fat important to overall health. As it pertains to heart disease, their main benefit is their ability to reduce the risk of heart rhythm problems in certain groups of people, thus reducing the risk of sudden cardiac death. In addition, omega-3s may help reduce triglycerides, lower blood pressure slightly and reduce blood clotting.

The best source of omega-3s is fatty, cold water fish such as herring, mackerel, salmon and tuna. Plant oils, such as canola and flaxseed oils, also are sources of omega-3s.

For heart disease prevention, near-maximum benefit comes from eating two 3-ounce servings of cold water fish a week. More than that doesn’t appear to offer any additional preventive benefit.

Higher amounts of two kinds of omega-3, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), may benefit some people with established heart disease or high triglyceride levels and can have an anti-inflammatory effect for people with rheumatoid arthritis. In addition, DHA is being studied to see if it can slow the progression of Alzheimer’s disease.

For those who don’t eat fish, a fish oil supplement or an algae supplement can provide omega-3 fatty acids. However, supplements aren’t cheap, and the amount of DHA and EPA in supplements varies widely. Except for people who have established heart disease, the evidence of heart disease prevention is stronger when one eats fish instead of taking supplements. Supplements can pose risks, too. Taking more than 3 grams of fish oil a day may increase the risk of bleeding, worsen heart rhythm problems in those who have arrhythmias or cause other side effects.

—————————-
Article adapted by MD Only Weblog from original press release.
—————————-

Mayo Clinic
200 First St. SW
Rochester, MN 55902
United States
http://www.mayoclinic.com

Cinnamon and Cloves Double Team Diabetes and Cardiovascular Disease

Cinnamon and cloves shown in studies to improve insulin function, lower risk factors for diabetes, and cardiovascular disease.

Two studies provide new evidence for the beneficial effects (and biochemical actions) of cinnamon as an anti-inflammatory agent and support earlier findings of its power as an anti-oxidant agent and an agent able to lower cholesterol, triglycerides, and glucose, and improve how well insulin functions.In a related study, extracts of cloves also were found to improve the function of insulin and to lower glucose, total cholesterol, LDL and triglycerides in people with type 2 diabetes. Earlier studies had shown these positive effects in laboratory studies; one study presented at Experimental Biology provides the first evidence of these beneficial effects in humans taking the equivalent of one to two cloves per day.

Earlier studies in the laboratory of one of the co-authors of all these papers, Dr. Richard A. Anderson, Beltsville Human Nutrition Research Center, United States Department of Agriculture, had shown that the equivalent of a quarter to half a teaspoon of cinnamon given to humans twice a day decreased risk factors for diabetes and cardiovascular disease, including glucose, cholesterol and triglycerides, by 10 to 30 percent. These new studies showing cinnamon’s ability to block inflammation extend our understanding of the potential for the spice, says Dr. Anderson. As an anti-inflammatory agent, cinnamon may be useful in preventing or mitigating arthritis as well as cardiovascular disease. And as scientists increasingly understand the relationship between inflammation and insulin function in Alzheimer’s (causing some to refer to the neurodegenerative disease as “type 3 diabetes”), cinnamon’s ability to block inflammation and enhance insulin function may make it useful in combating that disease as well.

The cinnamon and clove studies were presented at Experimental Biology in San Francisco as part of the scientific program of the American Society for Nutrition, Inc. The three studies are:

• Dr. Heping Cao of the Beltsville Human Nutrition Research Center and colleagues, including Dr. Anderson, investigated the biochemical basis for the insulin-like effects of cinnamon. Results showed that cinnamon, like insulin, increases the amount of three critically important proteins involved in the body’s insulin signaling, glucose transport, and inflammatory response. Dr. Cao says the study provides new biochemical evidence for the beneficial effects of cinnamon in potentiating insulin action and suggests anti-inflammatory properties for the antioxidants in cinnamon. Other researchers involved in the study are Dr. Marilyn M. Polansky of the USDA-ARS Beltsville (Maryland) Human Nutrition Research Center, and Dr. Perry J. Blackshear of the National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina.
• Dr. Stephanie Mae Lampke, University of California, Santa Barbara (UCSB), and colleagues, used fractionation and electrospray mass spectrometry to identify the chemical structure of active ingredients in cinnamon. She worked with UCSB’s James Pavolich and Donald Graves. This study provides information on how cinnamon works. Working with Dr. Lampe, Dr. Anderson, and Dr. Polansky (also involved in the paper above) were members of the USDA BHNRC. Research was supported in part by a grant from Cottage Hospital, Santa Barbara, to Dr. Graves.
• Dr. Alam Khan, Agricultural University, Peshawar, Pakistan, a former postdoctoral student and Fulbright Fellow in the Anderson laboratory, reports the first study of the effect of cloves on insulin function in humans. Thirty-six people with type 2 diabetes were divided into four groups, which then took capsules with either 0, 1, 2, or 3 grams of cloves for 30 days. There were no significance differences in responses among the three levels of cloves used – but there were markedly significant differences between those who took cloves and those who did not. At the end of the 30 days, individuals with diabetes who had been taking some level of clove supplementation showed a decrease in serum glucose from an average 225 to 150 mg/dL, triglycerides from an average 235 to 203 mg/dL, a decrease in serum total cholesterol from 273 to 239 mg/dL, and a decrease in LDL from 175 to 145 mg/dL. The individuals with diabetes who had not been taking clove capsules showed no differences. Serum HDL was not affected by consumption of cloves.

The people with diabetes who had been in the experimental group then were taken off clove supplementation and, after 10 days, their glucose, triglycerides, total cholesterol and LDL measured. Although these had begun to rise somewhat, all remained significantly lower than at the beginning of the study. Dr. Khan says the finding that intake of 1 to 3 grams of cloves per day lowered risk factors of diabetes without changing HDL concentration suggest strongly that cloves are beneficial for people with type 2 diabetes. Co-authors of the study in addition to Dr. Khan and Dr. Anderson are Dr. Syed Saceed Qadir, Agricultural University, Peshawar, Pakistan, and Dr. Khan Nawaz Khattak, HMC, Hayatabad, Peshawar, Pakistan. The research was supported by the Higher Education Commission of Pakistan.

The effect of cinnamon is a major research interest in Dr. Anderson’s laboratory, where human studies are now taking place looking at how this ingredient can improve insulin functioning in women with polycystic ovary syndrome (a disease of insulin sensitivity in which perturbed hormone levels cause difficulty in getting pregnant, among other problems), people with type 2 diabetes and the prediabetic metabolic syndrome; and people who are very obese (because Dr. Anderson believes that improving insulin function will lead to improvements in weight and lean body mass).

A post doctoral fellow in the Anderson laboratory also is beginning to investigate whether improving insulin functioning will decrease the chance of developing Alzheimer’s disease.

Two final bits of advice from Dr. Anderson: First, eating great quantities of cinnamon straight from the can is not a good idea. Table cinnamon is not water soluble, meaning it can build up in the body with unknown consequences. Second, the powered cinnamon has another limitation. Dr. Anderson’s personal 60-point decline in total cholesterol occurred only after he switched from sprinkling cinnamon on his breakfast cereal to taking it in a capsule. Saliva contains a chemical harmful to cinnamon.

—————————-
Article adapted by MD Only Weblog from original press release.
—————————-

Contact: Sarah Goodwin
ebpress@bellsouth.net
Federation of American Societies for Experimental Biology

Cinnamon May Help to Alleviate Diabetes Says UCSB Researcher

Cinnamon may be more than a spice — it may have a medical application in preventing and combating diabetes. Cinnamon may help by playing the role of an insulin substitute in type II diabetes, according to cellular and molecular studies at the University of California, Santa Barbara, Iowa State University and the U.S. Department of Agriculture.”Cinnamon itself has insulin-like activity and also can potentiate the activity of insulin,” said Don Graves of UCSB. “The latter could be quite important in treating those with type II diabetes. Cinnamon has a bio-active component that we believe has the potential to prevent or overcome diabetes.”

The healthful effects of cinnamon on mice with diabetes are being studied in a joint project at the UCSB and the Sansum Diabetes Research Institute in Santa Barbara.

The researchers have been studying the effects of cinnamon on obese mice, which have been fed water laced with cinnamon at Sansum’s lab, according to Graves, who is running the project with Lois Jovanovic, Sansum’s research director.

When the trials are completed, 60 diabetic mice will have been studied, sponsored by a grant to UCSB from Cottage Hospital, Santa Barbara. The study began six months ago and final results are expected in about six months.

“More than 170 million people worldwide suffer from diabetes, and for many, drugs or other forms of treatment are unavailable,” said Graves. “It may be possible that many of these people could benefit from readily available natural products such as cinnamon.”

Graves, an adjunct professor of Molecular, Cellular and Developmental Biology, retired from Iowa State University in October 2000 and came to UCSB the same month. He was familiar with UCSB from his days as a visiting professor in the Department of Chemistry during the 1970s and decided to return. He now divides his time between UCSB and the Sansum Institute.

Using nuclear magnetic resonance and mass spectroscopy, the researchers obtained results which allowed them to describe the chemical structure of a molecule with “insulin-like” activity in cinnamon. Graves and others reported earlier that this compound, a proanthocyanidin, can affect insulin signaling in fat cells.

Richard Anderson of the U.S. Department of Agriculture, a former Graves student and the discoverer of the insulin-like activity, recently completed a human study with associates in Pakistan using cinnamon. Promising results were obtained by 30 test subjects with type II diabetes after only 40 days of taking cinnamon. They had a significant decrease in blood glucose, triglycerides, LDL, and cholesterol. The researchers hope that a human trial may begin in the US, possibly in Santa Barbara, using cinnamon and its water-soluble extract to treat type II diabetes.

Type II diabetes is a disease in which the body develops a resistance to insulin, thus preventing the cells from receiving the glucose that they need to function. The work at UCSB is focused on the way cinnamon operates at cellular and molecular levels, looking at how it works with the cell’s insulin receptor and other proteins involved in reactions associated with the action of insulin.

Graves said that other major diseases could possibly be helped by cinnamon. For example one prospect is pancreatic cancer, a disease in which abnormal amounts of insulin are produced by the pancreas in response to the cancer tumor causing insulin resistance in the cells of the body. The resistance prevents glucose availability to the cells. Graves believes that cinnamon might help overcome this resistance. “It’s speculative but exciting,” he said.

Recent studies have shown that insulin resistance may also be involved in neurodegenerative diseases such as Alzheimer’s, according to Graves. A study testing the effects of the “insulin-like” component of cinnamon on protein reactions associated with Alzheimer’s disease is planned at UCSB’s Neuroscience Research Institute (NRI). Graves is working in the NRI lab of John Lew, who studies Alzheimer’s disease.

Graves calls himself a “scientific grandfather” to Lew, since Lew’s major professor, Jery Wang, was a Ph.D. student of Graves at Iowa State University in 1961. Wang later became Lew’s major professor at the University of Calgary.

—————————-
Article adapted by MD Only Weblog from original press release.
—————————-

Contact: Gail Gallessich
gail.g@ia.ucsb.edu
805-893-7220
University of California – Santa Barbara

Cardiac Benefits of Sport

When asked about his personal recipe for old age, Winston Churchill used to answer: “First of all: No sports.” While being a visionary figure in world politics researchers in cardiovascular exercise science today would unanimously reply to his medical hypothesis: “Sorry, you are wrong.”

A large number of long-term observational studies clearly documented that increased levels of average daily physical activity were correlated to a reduced rate of coronary heart disease and reduced cardiac and all-cause mortality. Moderately active persons were 30-40% less likely to die from heart disease as compared to the inactive “couch potato.” Despite this solid epidemiologic evidence, the proportion of people who do not engage in sports at all is ever increasing: About two thirds of all Americans, for example, do not participate in regular leisure-time physical activity. This lack of sports is closely related to the epidemic of other risk factors for future heart attacks: Obesity, diabetes, high blood pressure, and elevated cholesterol levels. Together, these inactivity-related diseases cost about US$76 billion per year to treat in the US.

But physical activity is not only beneficial in healthy people to prevent cardiovascular diseases. Also patients with stable coronary artery disease can extend their life-expectancy by engaging in sports: A recent meta-analysis revealed a significant 27% reduction of total mortality among training patients and a significant 31% reduction in cardiac mortality. Even when compared to sophisticate interventional procedures, exercise training is surprisingly effective in improving the patient’s well-being. In a recent study which randomized patients with coronary 1- or 2-vessel disease to either the standard interventional treatment or to regular exercise training, we found a higher event-free survival in the training group and a similar improvement of cardiac symptoms. This finding confirms again that there is no cardiac gain without the pain of changing your inactive lifestyle.

But how does such a non-specific intervention as exercise training achieve these impressive results? Atherosclerosis – the chronic disease process finally leading to coronary narrowings and heart attacks – begins as a vascular malfunction before plaques develop.

Normally, a healthy vessel dilates and gets larger with increases of blood flow, which is especially important during activity to meet the increased demand for oxygen by the working muscles. In atherosclerosis, the artery loses its ability to dilate under these conditions, which leads to reduced blood supply during exercise. The key mediator which regulates vessel diameter is nitric oxide (NO), which is generated in endothelial cells by a special enzyme called �endothelial nitric oxide synthase� or eNOS. It has been found that NO production is reduced and NO degradation is increased in the early stages of heart disease – leading to endothelial dysfunction.

Exercise training and sports lead to repetitive increases in shear stress on the endothelium and can thereby stimulate the eNOS enzyme to produce more NO. Endothelial dysfunction is rare among active people and occurs later in life as compared to inactive individuals. In the last years we found that patients with stable coronary artery disease often have severe endothelial dysfunction, which can be dramatically improved by a four week training program – to an extent which is comparable with the effects of established medications such as lipid-lowering drugs (i.e. statins). This improvement of vessel dilation increases blood flow to the myocardium and thereby reduces clinical symptoms. In addition, endothelial dysfunction is regarded as the initial step toward atherosclerosis and plaque formation. By treating endothelial dysfunction with regular exercise training we can therefore retard the development of new coronary stenoses.

The key message emerging from these clinical studies is that sports and exercise – in addition to preventing obesity and diabetes – directly improve vascular function and reduce atherosclerosis. Considering that the majority of people do not engage in regular physical activities one can only say: The health of your heart is in your own hands. If you want to protect it: First of all, engage in regular sports activities!

Peer reviewed publication and references

Hambrecht R et al. Percutaneous coronary angioplasty compared with exercise training in patients with stable coronary artery disease: a randomized trial. Circulation. 2004;109(11):1371-8. Hambrecht R et al. Regular physical activity improves endothelial function in patients with coronary artery disease by increasing phosphorylation of endothelial nitric oxide synthase. Circulation. 2003;107(25):3152-8.

Hambrecht R et al. Effect of exercise on coronary endothelial function in patients with coronary artery disease. N Engl J Med. 2000;342(7):454-60.

Reference URL
escardio.org/vpo/ESC_congress_information

SOURCE: http://www.alphagalileo.org

---

Article URL: http://www.medicalnewstoday.com/articles/30172.php

Omega-3 Fatty Acids and Health

Summary of key findings
The polyunsaturated fatty acids alpha-linolenic acid (ALA) and linoleic acid (LA) must come from the diet because they cannot be made by the body. ALA, an omega-3 fatty acid, is converted in the body to the fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). LA, an omega-6 fatty acid, is converted to the fatty acid arachidonic acid (AA).

Most American diets provide more than 10 times as much omega-6 than omega-3 fatty acids. There is general agreement that individuals should consume more omega-3 and less omega-6 fatty acids to promote good health. Good sources of ALA are leafy green vegetables, nuts, and vegetable oils such as canola, soy, and especially flaxseed. Good sources of EPA and DHA are fish and organ meats. LA is found in many foods, including meat, vegetable oils (e.g., safflower, sunflower, corn, soy), and processed foods made with these oils.

EPA and DHA are metabolized through the same biochemical pathways as AA. EPA and AA are precursors for hormone-like agents known as eicosanoids. It is not known whether a desirable ratio of omega-6 to omega-3 fatty acids exists or to what extent high intakes of omega-6 fatty acids interfere with any benefits of omega-3 fatty acid consumption.

Impact on cardiovascular disease: According to both primary and secondary prevention studies, consumption of omega-3 fatty acids, fish, and fish oil reduces all-cause mortality and various CVD outcomes such as sudden death, cardiac death, and myocardial infarction. The evidence is strongest for fish and fish oil supplements.

Impact on heart function: Animal and isolated organ/cell culture studies demonstrate that omega-3 fatty acids affect cellular functions involved in ensuring a normal heart rate and coronary blood flow.

Impact on CVD risk factors: Fish oils can lower blood triglyceride levels in a dose-dependent manner. Fish oils have a very small beneficial effect on blood pressure and possible beneficial effects on coronary artery restenosis after angioplasty and exercise capacity in patients with coronary atherosclerosis.

Impact on asthma: No conclusions could be drawn about the value of omega-3 fatty acid supplements in the prevention or treatment of asthma for adults or children other than the fact that they have an acceptable safety profile.

Impact on other conditions: Omega-3 fatty acids can reduce joint tenderness and need for corticosteroid drugs in rheumatoid arthritis. Data are insufficient to support conclusions about the effects of omega-3 fatty acids on inflammatory bowel disease, renal disease, systemic lupus erythematosus, bone density, and diabetes.

Impact on cognitive function: The quantity and strength of evidence is inadequate to conclude that omega-3 fatty acids protect cognitive function with aging or the incidence or clinical progression of dementia (including Alzheimer’s disease), multiple sclerosis, and other neurological diseases.

Impact on organ transplantation: No conclusive evidence suggests specific benefits of omega-3 fatty acid supplementation on any outcome in any form of organ transplantation. However, available studies are small, have methodological problems, and may not fully apply to current transplantation procedures.

Safety: Adverse events related to consumption of fish-oil or ALA supplements are generally minor and typically gastrointestinal in nature (such as diarrhea). They can usually be eliminated by reducing the dose or discontinuing the supplement.

Conclusion: The health effects of omega-3 fatty acids require further investigation. Each report provides recommendations on specific research needs and how to improve the quality of future studies.

Omega-3 fatty acids protect your heart

Healthy people should eat omega-3 fatty acids to protect their hearts, according to the American Heart Association (AHA) recommendations published in Circulation: Journal of the American Heart Association.

Omega-3 fatty acids are good fats that affect heart health in positive ways. According to AHA they make the blood less likely to form clots that cause heart attack and protect against irregular heartbeats that cause sudden cardiac death.

AHA’s comprehensive report examines the health benefits of omega-3 fatty acids in the context of cardiovascular disease (CVD) risk reduction. Specifically, omega-3 fatty acids –eicosapentaenoic and docosahexaenoic acids (EPA and DHA) and a third kind, alpha-linolenic acid.

People who have elevated triglycerides may need 2 to 4 grams of EPA and DHA per day provided as a supplement, such as organic omega oils without cholesterol or the fishy taste. 

Even the 1 gram/day dose recommended for patients with existing CVD may be more than can readily be achieved through diet alone.  These people should consult their physician to discuss taking supplements to reduce heart disease risk.  Patients taking more than 3 grams of omega-3 fatty acids from supplements should do so only under a physician’s care.  The FDA has noted that high intakes could cause excessive bleeding in some people.

Depending on their stage of life, consumers need to be aware of the benefits of taking omega 3 fatty acids.  Researchers have found that the effects of omega-3 fatty acids on heart disease risk is seen in relatively short periods of time. The research shows that all omega-3 fats have cardioprotective benefits.

Although the mechanisms responsible for omega-3 fatty acids’ reduction of CVD risk are still being studied, research has shown:

• Decreased risk of sudden death and arrhythmia.
• Decreased thrombosis (blood clot).
• Decreased triglyceride levels.
• Decreased growth of atherosclerotic plaque.
• Improved arterial health.
• Lower blood pressure.

AHA lead author of the study is Penny Kris-Etherton, Ph.D., R.D.. Co-authors are William S. Harris, Ph.D., and Lawrence J. Appel, M.D., M.P.H.