X-Message-Number: 26250
Date: Thu, 26 May 2005 18:08:42 -0700 (PDT)
From: Doug Skrecky <>
Subject: avoiding cardiovascular disease

[Alpha-linolenic acid, black rice, broccoli, fish, garlic, nuts,
olive oil, pomegranate, red rice, sesame oil, and taurine may help
avoid cardiovascular disease.]

J Nutr. 2001 May;131(5):1421-6.
Red and black rice decrease atherosclerotic plaque formation and
increase antioxidant status in rabbits.
The influence of white, red and black rice consumption on
atherosclerotic plaque formation induced by hypercholesterolemia was
investigated in rabbits. Male rabbits (n = 36) were divided into
five groups. They were fed a normal laboratory purified diet (normal
group, n = 6), a high cholesterol (0.5 g/100 g) diet (HC group, n = 6),
a high cholesterol diet with 30 g/100 g white rice (WR group, n = 8),
30 g/100 g red rice (RR group, n = 8), or 30 g/100 g black rice (BR
group, n = 8) for 10 wk. Blood samples were collected for lipid
measurements and aorta were removed for assessment of atherosclerotic
plaques at the end of the protocol. The oxidant and antioxidant
status of blood, erythrocytes, liver and aorta was evaluated. The
area of atherosclerotic plaque was 50% lower in rabbits fed the red
or black rice diets than in those fed the white rice diet. Compared
with the HC and WR groups, serum HDL cholesterol and apolipoprotein
(apo) A-I concentration were greater (P < 0.05) in the RR and BR
groups. Liver reactive oxygen species (ROS) and aortic
malondialdehyde (MDA) were significantly lower, and the liver total
antioxidative capacity (TAC) and erythrocyte superoxide dismutase
(SOD) activity were significantly higher in the RR and BR groups
compared with the HC and WR groups. Red or black rice consumption
reduced or retarded the progression of atherosclerotic plaque
development induced by dietary cholesterol. The enhanced serum HDL
cholesterol and apo A-I concentrations, and the increased antioxidant
and decreased oxidative status may be mechanisms of the
antiatherogenic effect of red or black rice.

Clin Nutr. 2004 Jun;23(3):423-33
Pomegranate juice consumption for 3 years by patients with carotid
artery stenosis reduces common carotid intima-media thickness,
blood pressure and LDL oxidation.
Dietary supplementation with polyphenolic antioxidants to animals
was shown to be associated with inhibition of LDL oxidation and
macrophage foam cell formation, and attenuation of atherosclerosis
development. We investigated the effects of pomegranate juice (PJ,
which contains potent tannins and anthocyanins) consumption by
atherosclerotic patients with carotid artery stenosis (CAS) on the
progression of carotid lesions and changes in oxidative stress and
blood pressure. Ten patients were supplemented with PJ for 1 year
and five of them continued for up to 3 years. Blood samples were
collected before treatment and during PJ consumption. In the control
group that did not consume PJ, common carotid intima-media thickness
(IMT) increased by 9% during 1 year, whereas, PJ consumption resulted
in a significant IMT reduction, by up to 30%, after 1 year. The
patients' serum paraoxonase 1 (PON 1) activity was increased by 83%,
whereas serum LDL basal oxidative state and LDL susceptibility to
copper ion-induced oxidation were both significantly reduced, by 90%
and 59%, respectively, after 12 months of PJ consumption, compared to
values obtained before PJ consumption. Furthermore, serum levels of
antibodies against oxidized LDL were decreased by 19%, and in parallel
serum total antioxidant status (TAS) was increased by 130% after 1
year of PJ consumption. Systolic blood pressure was reduced after 1
year of PJ consumption by 21% and was not further reduced along 3
years of PJ consumption. For all studied parameters, the maximal
effects were observed after 1 year of PJ consumption. Further
consumption of PJ, for up to 3 years, had no additional beneficial
effects on IMT and serum PON1 activity, whereas serum lipid
peroxidation was further reduced by up to 16% after 3 years of PJ
consumption. The results of the present study thus suggest that PJ
consumption by patients with CAS decreases carotid IMT and systolic
blood pressure and these effects could be related to the potent
antioxidant characteristics of PJ polyphenols.

Arch Intern Med. 2002 Jun 24;162(12):1382-7.
Nut consumption and decreased risk of sudden cardiac death in the
Physicians' Health Study.
BACKGROUND: Dietary nut intake has been associated with a reduced
risk of coronary heart disease mortality; however, the mechanism is
unclear. Since components of nuts may have antiarrhythmic properties,
part of the benefit may be due to a reduction in sudden cardiac
death. METHODS: We prospectively assessed whether increasing
frequency of nut consumption, as ascertained by an abbreviated food
frequency questionnaire at 12 months of follow-up, was associated
with a lower risk of sudden cardiac death and other coronary heart
disease end points among 21 454 male participants enrolled in the US
Physicians' Health Study. Participants were followed up for an
average of 17 years. RESULTS: Dietary nut intake was associated with
a significantly reduced risk of sudden cardiac death after
controlling for known cardiac risk factors and other dietary habits
(P for trend,.01). Compared with men who rarely or never consumed
nuts, those who consumed nuts 2 or more times per week had reduced
risks of sudden cardiac death (relative risk, 0.53; 95% confidence
interval, 0.30-0.92) and total coronary heart disease death (relative
risk, 0.70; 95% confidence interval, 0.50-0.98). In contrast, nut
intake was not associated with significantly reduced risks of
nonsudden coronary heart disease death or nonfatal myocardial
infarction. CONCLUSION: These prospective data in US male physicians
suggest that the inverse association between nut consumption and
total coronary heart disease death is primarily due to a reduction
in the risk of sudden cardiac death.

Curr Atheroscler Rep. 1999 Nov;1(3):204-9.
Nut consumption and risk of coronary heart disease: a review of
epidemiologic evidence.
Traditionally nuts have been perceived as an unhealthy food because
of their high fat content. However, recent accumulative evidence
suggests that frequent consumption of nuts may be protective against
coronary heart disease (CHD). So far, five large prospective cohort
studies (the Adventist Health Study, the Iowa Women Health Study, the
Nurses' Health Study, the Physicians' Health Study, and the CARE Study)
have examined the relation between nut consumption and the risk of CHD
and all have found an inverse association. In addition, several
clinical studies have observed beneficial effects of diets high in nuts
(including walnuts, peanuts, almonds, and other nuts) on blood lipids.
The beneficial effects of nut consumption observed in clinical and
epidemiologic studies underscore the importance of distinguishing
different types of fat. Most fats in nuts are mono- and polyunsaturated
fats that lower low-density lipoprotein cholesterol level. Based on the
data from the Nurses' Health Study, we estimated that substitution of
the fat from 1 ounce of nuts for equivalent energy from carbohydrate in
an average diet was associated with a 30% reduction in CHD risk and the
substitution of nut fat for saturated fat was associated with 45%
reduction in risk. Given the strong scientific evidence for the
beneficial effects of nuts, it seems justifiable to move nuts to a more
prominent place in the United States Department of Agriculture Food
Guide Pyramid. Regular nut consumption can be recommended in the context
of a healthy and balanced diet.

Clin Nutr. 2004 Oct;23(5):1113-21
Virgin olive oil reduces blood pressure in hypertensive elderly
subjects.
BACKGROUND & AIMS: Hypertension is one of the most important risk
factors for coronary heart disease. Recent studies have pointed out
the possibility that virgin olive oil (VOO) may lower blood pressure
in hypertensive (HT) subjects. However, until the date there is
scarce information regarding elderly people. The present study was
designed to assess the effect of dietary VOO on blood pressure in
medically treated hypertensive elderly patients. METHODS: 31
medically treated HT elderly patients and 31 normotensive (NT)
elderly volunteers participated in a randomized sequential dietary
intervention. Subjects consumed diets enriched in sunflower oil (SO)
or VOO for 4 weeks each with a 4-week washout period between them.
RESULTS: VOO reduced total and LDL-cholesterol in NT but not in HT
(P < 0.01) and the concentrations were lower than in the group
consuming SO. In contrast, no significant differences were found in
the levels of tocopherols among the groups studied. Iron-induced
oxidation of LDL resulted in a complete loss of monoacylglycerols
(MG) and diacylglycerols (DG) and a reduction in triacylglycerols
(TG) (60-80%), which was found to be greater in HT (P < 0.01) with
no effect of diet. VOO consumption normalized systolic pressure in
the HT group (136 +/- 10 mmHg) compared to SO (150 +/- 8 mmHg).
CONCLUSION: Dietary VOO proved to be helpful in reducing the
systolic pressure of treated HT elderly subjects. However, a greater
resistance to the lowering effect of VOO of total and
LDL-cholesterol and a greater susceptibility to TG oxidation was
detected in these patients.


Asia Pac J Clin Nutr. 2004;13(Suppl):S107
Impact of sesame oil on nifedipine in modulating oxidative stress
and electrolytes in hypertensive patients.
The aim of the study was to investigate the effect of sesame oil as
sole edible oil in hypertensive patients who were on medication with
nifedipine, a calcium channel blocker. A sample of 396 hypertensive
patients (aged 58 +/- 3.8 years; 215 men and 181 women) participated
in this study. Forty patients were treated only with nifedipine while
three hundred and fifty six patients were treated with nifedipine and
instructed to use sesame oil in place of other edible oils for 60 days.
The consumption of sesame oil remarkably reduced the (systolic and
diastolic blood pressure from 166 +/- 4.2 and 101 +/- 3.1 to 134.2 +/-
3.4 and 84.6 +/- 3.0 respectively) blood pressure. The dosage of the
drug also reduced, as there was a fall in blood pressure during sesame
oil consumption. Plasma levels of sodium decreased while potassium and
chloride increased significantly. Lipid peroxidation (thiobarbituric
acid reactive substances) level significantly decreased while
activities of enzymic (superoxide dismutase, glutathione peroxidase
and catalase) and concentrations of non-enzymic antioxidants (vitamin
C, vitamin E, beta-carotene and reduced glutathione) increased in
nifedipine - sesame oil group. Nifedipine group showed a significant
reduction in blood pressure, lipid peroxidation and improvement in
reduced glutathione, however, the values are significantly lower than
nifedipine - sesame oil group. These results suggest that dietary
substitution of sesame oil, in nifedipine-taking hypertensive patients,
has an additive effect in the reduction of blood pressure and plays an
important role in the modulation of electrolytes and in the reduction
of lipid peroxidation and elevation of antioxidants.

Atherosclerosis. 1999 May;144(1):237-49.
The antiatherosclerotic effect of Allium sativum.
In a randomized, double-blind, placebo-controlled clinical trial,
the plaque volumes in both carotid and femoral arteries of 152
probationers were determined by B-mode ultrasound. Continuous
intake of high-dose garlic powder dragees reduced significantly
the increase in arteriosclerotic plaque volume by 5-18% or even
effected a slight regression within the observational period of
48 months. Also the age-dependent representation of the plaque
volume shows an increase between 50 and 80 years that is diminished
under garlic treatment by 6-13% related to 4 years. It seems even
more important that with garlic application the plaque volume in
the whole collective remained practically constant within the
age-span of 50-80 years. These results substantiated that not only
a preventive but possibly also a curative role in arteriosclerosis
therapy (plaque regression) may be ascribed to garlic remedies.

Am J Epidemiol. 1999 May 15;149(10):943-9.
Dietary flavonoid intake and risk of cardiovascular disease in
postmenopausal women.
Flavonoids, a group of phenolic compounds found in fruits and
vegetables, are known to have antioxidant properties. They prevent
low density lipoprotein oxidation in vitro and thus may play a role
in the prevention of coronary heart disease (CHD). In 1986, in a
prospective study of 34,492 postmenopausal women in Iowa, the
authors examined the association of flavonoid intake with CHD and
stroke mortality. Over 10 years of follow-up, 438 deaths from CHD
and 131 deaths from stroke were documented. Total flavonoid intake
was associated with a decreased risk of CHD death after adjusting
for age and energy intake (p for trend = 0.04). This association
was attenuated after multivariate adjustment. However, decreased
risk was seen in each category of intake compared with the lowest.
Relative risks and 95% confidence intervals of CHD death from
lowest to highest intake category were 1.0, 0.67 (95% confidence
interval (CI) 0.49-0.92), 0.56 (95% CI 0.39-0.79), 0.86 (95%
CI 0.63-1.18), and 0.62 (95% CI 0.44-0.87).There was no association
between total flavonoid intake and stroke mortality (p for trend =
0.83). Of the foods that contributed the most to flavonoid intake
in this cohort, only broccoli was strongly associated with reduced
risk of CHD death. The data of this study suggest that flavonoid
intake may reduce risk of death from CHD in postmenopausal women.

Clin Exp Pharmacol Physiol. 2004 Dec;31 Suppl 2:S20-3.
FISH and LIFESTYLE-RELATED DISEASE PREVENTION: EXPERIMENTAL AND
EPIDEMIOLOGICAL EVIDENCE FOR ANTI-ATHEROGENIC POTENTIAL OF TAURINE.
Summary 1. Taurine supplementation attenuated the development of
hypertension and stroke in stroke-prone spontaneously hypertensive
rats (SHRSP). 2. WHO-CARDIAC (Cardiovascular Diseases Alimentary
Comparison) study revealed wide differences in 24-h urinary taurine
excretion, which were inversely associated with age-adjusted
mortality rates of coronary heart diseases (CHD). 3.
Hypercholesterolemia as well as arterial fat deposition related to
the cause of CHD was attenuated by dietary taurine supplementation
in SHRSP on high-fat cholesterol diet. 4. Taurine affected the
gene expression of 7alpha-hydroxylase and thus regulated serum
cholesterol level through the control of the rate limiting step of
cholesterol excretion into bile acids. 5. Taurine attenuated
atherogenesis due to the control of oxidative stress through the
inhibition of the production of oxidative LDL and to its scavenger
effect on hypochlorous acid (HOCl) from leucocytes and macrophages.
6. Taurine may act as an immunomodulator of cytokine production,
which is involved in atherogenesis.

Am J Clin Nutr. 2004 Sep;80(3):626-32.
Fish intake is associated with a reduced progression of coronary
artery atherosclerosis in postmenopausal women with coronary
artery disease.
BACKGROUND: Higher intakes of fish and n-3 fatty acids are
associated with a reduced risk of cardiovascular events and
mortality. However, limited data exist on the effect of fish
intake on actual measures of progression of coronary artery
atherosclerosis. OBJECTIVE: The aim was to examine the association
between fish intake and the progression of coronary artery
atherosclerosis in women with coronary artery disease. DESIGN:
This was a prospective cohort study of postmenopausal women
(n = 229) participating in the Estrogen Replacement and
Atherosclerosis trial. Usual fish intake was estimated at baseline
with a food-frequency questionnaire. Quantitative coronary
angiography was performed at baseline and after 3.2 +/- 0.6
(x +/- SD) y to evaluate changes in the mean minimum coronary
artery diameter, the mean percentage of stenosis, and the
development of new coronary lesions. RESULTS: Compared with
lower fish intakes, consumption of > or =2 servings of fish or >
or =1 serving of tuna or dark fish per week was associated with
smaller increases in the percentage of stenosis (4.54 +/- 1.37%
compared with -0.06 +/- 1.59% and 5.12 +/- 1.48% compared with
0.35 +/- 1.47%, respectively; P < 0.05 for both) in diabetic
women after adjustments for age, cardiovascular disease risk
factors, and dietary intakes of fatty acids, cholesterol, fiber,
and alcohol. These associations were not significant in
nondiabetic women. Higher fish consumption was also associated
with smaller decreases in minimum coronary artery diameter and
fewer new lesions. CONCLUSIONS: Consumption of fish is associated
with a significantly reduced progression of coronary artery
atherosclerosis in women with coronary artery disease.

Am J Clin Nutr. 1999 May;69(5):890-7.
Dietary intake of alpha-linolenic acid and risk of fatal ischemic
heart disease among women.
BACKGROUND: Experimental studies in laboratory animals and humans
suggest that alpha-linolenic acid (18:3n-3) may reduce the risk
of arrhythmia. OBJECTIVE: The objective was to examine the
association between dietary intake of alpha-linolenic acid and
risk of fatal ischemic heart disease (IHD). DESIGN: This was a
prospective cohort study. The intake of alpha-linolenic acid was
derived from a 116-item food-frequency questionnaire completed in
1984 by 76283 women without previously diagnosed cancer or
cardiovascular disease. RESULTS: During 10 y of follow-up, we
documented 232 cases of fatal IHD and 597 cases of nonfatal
myocardial infarction. After adjustment for age, standard coronary
risk factors, and dietary intake of linoleic acid and other
nutrients, a higher intake of alpha-linolenic acid was associated
with a lower relative risk (RR) of fatal IHD; the RRs from the
lowest to highest quintiles were 1.0, 0.99, 0.90, 0.67, and 0.55
(95% CI: 0.32, 0.94; P for trend = 0.01). For nonfatal myocardial
infarction there was only a modest, nonsignificant trend toward a
reduced risk when extreme quintiles were compared (RR: 0.85; 95%
CI: 0.61, 1.19; P for trend = 0.50). A higher intake of oil and
vinegar salad dressing, an important source of alpha-linolenic
acid, was associated with reduced risk of fatal IHD when women
who consumed this food > or =5-6 times/wk were compared with those
who rarely consumed this food (RR: 0.46; 95% CI: 0.27, 0.76; P for
trend = 0.001). CONCLUSIONS: This study supports the hypothesis
that a higher intake of alpha-linolenic acid is protective against
fatal IHD. Higher consumption of foods such as oil-based salad
dressing that provide polyunsaturated fats, including alpha-linolenic
acid, may reduce the risk of fatal IHD.

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