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In a study published in the Journal of Nutrition, researchers evaluated the effects of grape polyphenols in adult men classified with metabolic syndrome. Metabolic syndrome is a name for a group of risk factors that occur together and increase the risk for coronary artery disease, stroke, and type 2 diabetes.
Participants in this double-blind, crossover study included 24 men aged 30-70 years of age who were randomly assigned to consume either a grape polyphenol product or a placebo for 30 days. There was a 3 week wash-out period between treatments. The men maintained their normal physical activity level and normal diet. They also were told to avoid polyphenol-rich food during the trial period.
At the end of each dietary period, blood pressure was measured and several different tests were used to analyze vascular function. When compared to the placebo period, the grape polyphenol treatment period resulted in lower systolic blood pressure and an increased blood flow in the brachial (arm) arteries. An indicator of blood platelet “stickiness”, known as sICAM-1, was also reduced during the polyphenol treatment period.
The results of this study indicate that grape polyphenols may positively influence vasorelaxation, blood pressure, and lower circulating cell adhesion molecules, improving overall vascular health and function, especially in men with metabolic syndrome.
Barona J, Aristizabal JC, Blesso CN, Volek JS, Fernandez ML. Grape polyphenols reduce blood pressure and increase flow-mediated vasodilation in men with metabolic syndrome. J Nutr. 2012;142(9):1626-32.

For those with diabetes, folic acid supplementation may be beneficial in reducing the risk of stroke.

 

Folic acid is a derivative of folate (an essential B vitamin) and is an essential nutrient which has been linked to numerous health benefits. It is important enough that many governments require grains to be fortified with folate/folic acid to provide their citizens with regular, daily access to this important vitamin.
In countries with low access to folate, research has demonstrated an incredible reduction of incidences of neural tube defects (NTDs) in infants whose mothers had access to folic acid supplementation during pregnancy. Folic acid supplementation has proven to be a safe, inexpensive, and effective way to reduce the risk of NTDs and other birth defects in third-world countries and at-risk populations all around the world.
Folic acid supplementation has also been purported to improve heart health. The American Heart Association (AHA) published an article last year exploring the decrease in congenital heart defects associated with folic-acid supplementation and folic-acid-fortified foods. This connection between the B vitamin and heart health suggests that folic acid can work preventatively with regards to stroke and myocardial infarction, otherwise known as heart attack.
Diabetes, which is characterized by high blood glucose concentrations during and after periods of fasting, is a known risk factor for stroke. Researchers at several universities and hospitals in China hypothesized about the link between folic acid supplementation and the first stroke associated with elevated blood glucose levels. They performed a randomized double-blind study over the course of several years.
Participants in this study were men and women between the ages of 45 and 75 with hypertension, who were diagnosed as diabetic (type 2 diabetes mellitus) or normoglycemic prior to the study.
The subjects were provided with either a daily oral dose of 10mg enalapril and 0.8mg folic acid, or 10 mg enalapril only. Follow-up visits for each participant were scheduled every three months for the duration of the study (median duration = 4.5 years).
Results indicate that, for any given glucose category (hypoglycemic, normoglycemic, diabetic), risk of stroke was significantly reduced by folic acid supplementation. Those with fasting glucose blood levels indicating diabetes showed the greatest risk reduction due to folic acid supplementation.
From the results of this study, it can be inferred that folic acid supplementation may be beneficial in reducing the risk of stroke for those with diabetes. Increasing the amount of folic in the diet should be a priority for everyone; however, without regular access to folate-fortified grains, this goal can be hard to achieve. Folic acid supplements can be a great way to regularly meet the daily recommended value of this essential nutrient.
Xu RB, Kong X, Xu BP, et al. Longitudinal association between fasting blood glucose concentrations and first stroke in hypertensive adults in China: effect of folic acid intervention.
The American Journal of Clinical Nutrition. 2017;105(3):564-570. doi:10.3945/ajcn.116.145656. Folic acid fortified food linked to decrease in congenital heart defects.

 

Hydroxytyrosol is thought to be the main antioxidant compound in olive fruit, and it is believed to play a significant role in many of the health benefits attributed to olive oil. Previous research has linked the compound to cardiovascular benefits, typically reductions in LDL or “bad” cholesterol. Data has also suggested the compound may boost eye health and reduce the risk of macular degeneration.

Spanish researchers reported these results in the British Journal of Nutrition. Twenty-two healthy volunteers between 20 and 45 years of age and with a BMI between 18 and 33 kg/m2 were recruited. Volunteers were randomly assigned to receive 10 to 15 grams per day of hydroxytyrosol-enriched sunflower oil or non-enriched sunflower oil for three weeks. The former provided a daily hydroxytyrosol dose of between 45 and 50 mg. After the initial three week period, volunteers had two weeks of no intervention before crossing over to receive the other intervention.

Results showed no changes in total, LDL, or HDL-cholesterol between the groups. However, consumption of the hydroxytyrosol-enriched sunflower oil produced significant reductions in oxidized LDL from 79.8 units per liter at the start of the study to 64.1 U/l after three weeks, compared to an increase from 72.7 to 86.4 U/l during the control phase. Furthermore, the activity of arylesterase increased from 235.2 to 448.9 U/l during the hydroxytyrosol phase, compared with an increase from 204.1 to 310.3 U/l during the control phase.

The researchers reported that although hydroxytyrosol-enriched sunflower oil did not significantly reduce LDL-cholesterol or increase HDL-cholesterol, it acted as a functional food by increasing arylesterase activity and reducing oxidized LDL. Oxidized LDL is believed to be a major player in promoting atherosclerosis (the build-up of fatty plaques in arteries) and general cardiovascular disease. Based on these results, dietary sources of hydroxytyrosol appear to be capable of reducing certain risk factors associated with coronary artery disease.

Vazquez-Velasco M, et al. Effects of hydroxytyrosol-enriched sunflower oil consumption on CVD risk factors. 2010. Br J Nutr.

Age-Related Macular Degeneration (AMD) is the most common cause of vision loss in developed countries. This degenerative eye disease causes damage to the macula (central retina) of the eye, impairing central vision. People affected by AMD have difficulty reading, driving and performing activities that require clear central vision. Many factors contribute to the development of AMD, including aging, genetics, diet, and smoking. The macula is a yellow oval-shaped pigmented area located near the center of the retina. Structures within the macula are specialized to provide high-acuity vision. Lutein and zeaxanthin are found in high concentrations here, giving the macula its yellow color. This protective layer, known as macular pigment, filters harmful high-energy blue wavelengths of light preventing damage to the retina, cones, and rods.

Numerous published studies have previously reported a link to intakes of lutein and zeaxanthin and AMD risk; however, the research has been mostly inconsistent. In this newly published prospective study, researchers used two decades of data involving more than 100,000 participants from the Nurses’ Health Study and the Health Professionals Follow-up Study. All participants were aged 50 years or older and were free of diagnosed AMD, diabetes mellitus, cardiovascular disease, and cancer (except non-melanoma skin cancer) at baseline. The researcher’s analyzed carotenoid intake based on dietary food frequency questionnaires at baseline and follow-up, and then calculated predicted plasma carotenoid scores. The results of this study found that participants with the highest average plasma lutein and zeaxanthin levels had a 40% reduced risk of developing advanced AMD compared to those with the lowest average levels. “Lutein and zeaxanthin form macular pigments that may protect against AMD by reducing oxidative stress, absorbing blue light, and stabilizing cell membranes,” the authors explain.

Dark green leafy vegetables are the primary dietary sources of lutein and zeaxanthin, but they are also found in some other colorful fruits and vegetables. Average dietary intake in the U.S. is only about 1-3 mg/day, far below the amount most studies indicate as a minimum needed to decrease risk of AMD. “Because other carotenoids may also have a protective role, a public health strategy of increasing the consumption of a wide variety of fruits and vegetables rich in carotenoids could be most beneficial and is compatible with current dietary guidelines,” the authors concluded.

JAMA Ophthalmol. 2015;133(12):1415-1424.

An analysis of 70 trials reveals that omega-3 supplementation may be as effective at reducing blood pressure as other lifestyle intervention.

Nearly 4 out of 10 Australian adults have elevated blood pressure, which is linked to an increased risk of strokes, coronary heart disease, and total mortality.  A recent metaanalysis published in the American Journal of Hypertension analyzed 70 RCT trials to determine the effect of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on blood pressure.

Weighted differences were used to separate individuals into an EPA+DHA group and a placebo group. All of the studies combined resulted in a 1.52 mm Hg reduction in systolic blood pressure and a 0.99 mm Hg reduction in diastolic blood pressure for the EPA+DHA group over the placebo group.

Additional data was used to further separate these into subgroups for additional analysis. This revealed even stronger effects of EPA+DHA, where a 4.51 mm Hg reduction in systolic blood pressure and a 3.05 mm Hg reduction in diastolic blood pressure were observed among untreated hypertensive subjects. In this subgroup, EPA+DHA treatment was as effective, or more effective, at lowering blood pressure than other lifestyle-intervention including increasing physical activity and restricting alcohol and sodium.

These results continue to build on prior evidence showing that omega-3 fatty acids may play a role in helping individuals control their blood pressure. One of the authors, Dominik Alexander, PhD, noted that “when measuring blood pressure, even small reductions can have a significant clinical impact.” A 2 mm Hg reduction in blood pressure reduces stroke mortality by 6%, coronary heart disease mortality by 4%, and total mortality by 3%.

Overall, available evidence from randomised controlled trials (RCT) indicates that provision of EPA+DHA reduces systolic blood pressure, while provision of ≥2 grams reduces diastolic blood pressure.

Source:
Miller, P.E. et al. Am J Hypertens. 2014 Mar 6. [Epub ahead of print] PMID:24610882

 

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elerly-womanThere are numerous studies reporting the health benefits of increased fish consumption and higher intakes of the long-chain omega-3 polyunsaturated fatty acids (PUFA) such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

The National Heart Foundation of Australia recommends that, to lower the risk of cardiovascular disease, all adult Australians should consume 500 mg/day of combined EPA and DHA through 2–3 serves (150g serve) of oily fish per week and fish oil supplementation. For older adults, the risk of cardiovascular disease is higher; therefore, dietary strategies including increased intake of fish and omega-3 PUFA to reduce risk are necessary.

In the latest cross-sectional survey, 854 Australians (>= 51 yrs of age) were randomly selected to complete either an online survey or telephone interview. The survey included the quantitative fish frequency questionnaire and open- and closed-ended survey questions on demographics and supplement usage.

The survey found that on average:
•             The frequency of finfish/seafood consumption was 1.7 times per week (median intake 173 g);
•             13% never consumed finfish/seafood, or consumed less than once per month;
•             34% ate any type of finfish/seafood more than two times per week;
•             Only 28% consumed just 500 mg long-chain omega-3 PUFA per day from finfish/seafood alone;
•             The mean daily intake of long-chain omega-3 PUFA was 508 mg;

These data indicate that trends in fish intake in Australia are increasing. Although this is encouraging, the current survey still found that only 44% consumed finfish/seafood at least twice per week.  Among older Australians, the current fish consumption is low and many do not meet the current recommendations. Strategies to enhance intake to meet dietary recommendations in this older age group are required.

Source: Grieger, J A et al. Nutrition & Dietetics 2013; 70: 227–235

 

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There are numerous studies reporting the health benefits of increased fish consumption and higher intakes of the long-chain omega-3  (PUFA) such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). The National Heart Foundation of Australia recommends that, to lower the risk of cardiovascular disease, all adult Australians should consume 500 mg/day of combined EPA and DHA through 2–3 serves (150g serve) of oily fish per week and fish oil supplementation. For older adults, the risk of cardiovascular disease is higher; therefore, dietary strategies including increased intake of fish and omega-3 PUFA to reduce risk are necessary.

In the latest cross-sectional survey, 854 Australians (>= 51 yrs of age) were randomly selected to complete either an online survey or telephone interview. The survey included the quantitative fish frequency questionnaire and open- and closed-ended survey questions on demographics and supplement usage.

The survey found that on average:
•             The frequency of finfish/seafood consumption was 1.7 times per week (median intake 173 g);
•             13% never consumed finfish/seafood, or consumed less than once per month;
•             34% ate any type of finfish/seafood more than two times per week;
•             Only 28% consumed just 500 mg long-chain omega-3 PUFA per day from finfish/seafood alone;
•             The mean daily intake of long-chain omega-3 PUFA was 508 mg;

These data indicate that trends in fish intake in Australia are increasing. Although this is encouraging, the current survey still found that only 44% consumed finfish/seafood at least twice per week.  Among older Australians, the current fish consumption is low and many do not meet the current recommendations. Strategies to enhance intake to meet dietary recommendations in this older age group are required.

Source: Grieger, J A et al. Nutrition & Dietetics 2013; 70: 227–235

 

 

Cereal fiber is associated with a host of health benefits.  Individuals consuming little fibres would benefit from increasing their dietary intake of whole grain foods high in fibre.

Cereals, also called grains, are grasses from which the seed is removed for consumption. Cereals commonly consumed are rice, wheat, maize, barley, rye, oats, millet and sorghum; of these, barley and rye contain the most fiber per gram of edible portion; rice and millet the least.  Numerous studies reveal the cardiovascular benefits of consuming cereal fiber through multiple mechanisms.  These benefits are likely achieved through multiple metabolic pathways: by reducing weight and waist circumference, body mass index (BMI), percent body fat; improving glucose metabolism and insulin sensitivity; and lowering the risk of metabolic syndrome and diabetes.

Epidemiological evidence suggests that 3 g or more per day of β-glucan from oats or barley or 7 g or more per day of soluble fiber from psyllium can reduce the risk of coronary heart disease.  14 g/day of inulin-type fructans, added to foods and beverages, may modestly decrease serum triacylglycerols. Consumption of whole grains confers not only the benefits of cereal fiber, but also those from a wide range of other protective compounds, including vitamins, minerals, antioxidants, phytosterols, unsaturated fatty acids, phytin, and lignans.

Recent estimates are that 36% of the U.S. population falls below the minimum recommended intake for grains and 99% falls below the recommendation for whole grains.  In addition, 90% of the U.S. population does not consume enough dietary fiber.  It is recommended that individuals consuming little cereal fiber should increase consumption of whole grains, as well as beans, peas and vegetables, fruits and other foods with naturally occurring fiber, to help increase fiber intake.  For those individuals adjusting to the texture and palatability of whole grains, turning to added-fiber products rich in β-glucan and psyllium may allow them to reach their fiber goals without increasing caloric intake.

Source:
Chuang S-chun et al; Am J Clin Nutr. 2012 Jul; 96(1):164-74.

A recent meta-analysis of randomized controlled trials suggests that CoQ10 supplementation may improve the ejection fraction of patients with congestive heart failure.

CoQ10 (ubiquinone) is an antioxidant that has been used to help improve functional status during congestive heart failure (CHF). Several clinical trials have examined the effects of CoQ10 on CHF, but some of the research has been inconclusive.

In a recently published paper in the American Journal of Clinical Nutrition, researchers conducted a meta-analysis to evaluate the effect of CoQ10 supplementation on ejection fraction (EF) and functional improvements of patients with CHF.

A systematic review of the research literature was performed using databases that included Medline, Embase, Cochrane Central Register of Controlled Trials, and examination of references from other selected studies. Included studies were randomized controlled trials of CoQ10 supplementation that reported EF or specific functional improvements as a primary outcome.

When all studies were pooled, supplementation with CoQ10 resulted in a net change of 3.67% in the EF and a trend in functional improvements. Cross-over studies of 12 weeks or more, daily dosages of at least 100 mg CoQ10, and patients with less severe CHF showed the most significant improvements in EF and health outcomes.

This meta-analysis of randomized controlled trials suggests that CoQ10 supplementation may improve the EF of patients with CHF. However additional well-designed studies with a more diverse population are needed.

Source:
Fotino AD, Thompson-Paul AM, Bazzano LA. Am J Clin Nutr 2013 Feb;97(2):268-75.

A meta-analysis of twenty-nine randomized controlled clinical trials shows a significant decrease in blood pressure with supplemental vitamin C

High blood pressure is a leading cause of cardiovascular disease in the US that affects approximately 1/3 of all adult Americans according to the American Heart Association.  In observational studies, increased vitamin C intake, vitamin C supplementation, and higher blood concentrations of vitamin C are associated with lower blood pressure (BP).  Reductions as little as 0.8 to 2 mmHg in systolic blood pressure have shown clinically significant results in reducing the risk of heart disease, heart failure, and stroke.  However, evidence for blood pressure–lowering effects of vitamin C in clinical trials is inconsistent.  A meta-analysis of 29 clinical trials was conducted to exam the effects of vitamin C supplementation on BP.

Twenty-nine clinical trials met eligibility criteria for the analysis.  The median oral dose of vitamin C was 500 mg/day, the median duration of the trials was 8 weeks, and trial size ranged from 10 to 120 participants.  Statistical analysis of the data showed a decrease in systolic and diastolic blood pressure in both normotensive and hypertensive individuals. The changes in normotensive individuals averaged -3.84 mm Hg and -1.48 mm Hg for systolic blood pressure and diastolic blood pressure respectively. The change observed in hypertensive individuals was even greater, with corresponding reductions in systolic blood pressure and diastolic blood pressure of -4.85 mm Hg and -1.67 mm Hg.

In conclusion, this study showed that vitamin C supplementation reduced SBP and DBP in short-term trials.  However the authors note that before vitamin C can be recommended as a form of treatment for the prevention of hypertension or as adjuvant antihypertensive therapy, further studies must be performed that include larger sample sizes, with longer duration, and with attention to quality of BP assessment.
Source: Juraschek SP, et al. Am J Clin Nutr. 2012 May; 95(5):1079-88. 8

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