HEART DISEASE
RED GRAPE JUICE FOR THE HEART
Flavonoids in red wine and purple grape juice (Vitis vinifera)
have been found to slow the build up of fatty plaques caused
by LDL cholesterol. When 15 patients with coronary artery
disease drank purple grape juice daily for 2 weeks (7cc
per kg of body weight) their arteries dilated an additional
6.4% and oxidation caused by LDL decreased by 34.5%. Other
researchers have found that red grape juice activates the
immune system.
Stein, J.H.
CIRCULATION: J. AMER. HEART ASSOC. 1999, 100 (10)
4250-5
Courtesy AMER. HERB ASSOC.
DIETARY FIBRE, WEIGHT GAIN, AND CARDIOVASCULAR DISEASE
RISK FACTORS IN YOUNG ADULTS
The prevalence of cardiovascular disease (CVD), after declining
steadily since mid-century, has been stable or increasing
over the past decade. Factors known to increase the risk
of CVD include age, obesity, central distribution of body
fat, smoking, physical inactivity, hypertension, dyslipidemias,
and abnormalities in blood clotting factors. Insulin resistance
associated with hyperinsulinemia is common to many of these
risk factors. Therefore, a study was carried out to examine
the role of fibre consumption and its association with insulin
levels, weight gain, and other CVD risk factors compared
with other major dietary components. The study group comprised
2,909 healthy adults aged 18 to 30 years at enrolment. It
was found that after adjustment for potential confounding
factors, dietary fibre showed linear associations from lowest
to highest quintiles of intake with the following: body
weight, waist-to-hip ratio, fasting insulin adjusted for
body mass index, and 2-hour postglucose insulin adjusted
for body mass index. Fibre was also associated with blood
pressure and levels of triglyceride, high-density lipoprotein
cholesterol, low-density lipoprotein cholesterol, and fibrinogen.
In comparison with fibre, intake of fat, carbohydrate, and
protein had inconsistent or weak associations with all CVD
risk factors.
Thus, fibre consumption predicted insulin levels, weight
gain, and other CVD risk factors more strongly than did
total or saturated fat consumption. High fibre diets may
protect against obesity and CVD by lowering insulin levels.
Ludwig, D.S. et al
J.A.M.A. 1999, 282 (16) 1539-46
TEA FLAVONOIDS MAY PROTECT AGAINST ATHEROSCLEROSIS
Epidemiological studies have reported a reduced risk of
coronary heart disease in subjects with a high flavonoid
intake. The protective effect of flavonoids, in particular
flavonols, has been attributed to antioxidant activity.
Tea is the major dietary source for flavonoids in Western
populations. A study was, therefore, carried out to determine
the association of tea intake with aortic atherosclerosis.
The analysis formed part of the Rotterdam Study, a prospective
study of men and women aged 55 years and older. Dietary
intakes were assessed at baseline by a semiquantitative
food frequency questionnaire. Calcified plaques in the abdominal
aorta were radiographically detected after 2 to 3 years
of follow-up. Multivariable analyses showed a significant,
inverse association of tea intake with severe aortic atherosclerosis.
Odds ratios decreased from 0.54 for drinking 125 to 250
mL (1-2 cups) of tea to 0.31 for drinking more than 500
mL/d (4 cups per day). The associations were stronger in
women than in men. Thus, this study indicates a protective
effect of tea drinking against ischemic heart disease.
Geleijnse, J.M. et al
ARCH. INT. MED. 1999, 159 (18) 2170-4
MAGNESIUM - A VITAL MINERAL
Magnesium is a mineral that is abundant both in nature
and in the human body, where it is involved in the activation
of more than 300 enzymes and body chemicals. The Department
of Health has set the Reference Nutrient Intake (RNI) for
magnesium at 300mg per day. However, many nutritionists
now feel that the average world RNI should be set at 450mg
per day. A survey in 1994 showed that 72% of women and 42%
of men aged between 19 and 50, and 89% of females aged 16-18
years do not achieve the RNI for magnesium. Low levels of
magnesium in the diet and in our bodies increase susceptibility
to a variety of diseases, including heart disease, high
blood pressure, kidney stones, cancer, insomnia, PMS, and
menstrual cramps. Signs and symptoms of magnesium deficiency
are fatigue, mental confusion, irritability, weakness, heart
disturbance, problems in nervous conduction and muscle contraction,
muscle cramps, loss of appetite, insomnia and predisposition
to stress. Magnesium is essential for the proper functioning
of the entire cardiovascular system. Because magnesium contributes
greatly to the strength of contraction by heart muscle,
magnesium supplementation has been found to be helpful in
the management of angina, atherosclerosis, intermittent
claudication and high blood pressure.
One of the most important components of any osteoporosis
programme is magnesium. As much as 60% of all magnesium
in the body is found in the bones. A defect of bone crystal
formation in magnesium-deficiency women is thought to be
one of the factors that increase fracture risk.
Magnesium works in many ways to preserve the health of
the nervous system. During times of stress, magnesium stores
are depleted and large amounts of this mineral are lost
in the urine. With its ability to exert a calming effect
on the nervous system together with its muscle relaxing
role, magnesium, taken 30-40 minutes before retiring, may
help those suffering stress or insomnia.
Studies have shown a low intracellular magnesium content
in patients with bronchial asthma. Magnesium deficiency
can also increase the release of histamine into the bloodstream.
Thereby increasing allergic reactivity in general.
Magnesium also plays a central role in the secretion and
action of insulin. Without adequate magnesium levels within
the body’s cells, control over blood sugar levels
is impossible.
Magnesium has also been found to play a role in the aetiology
of migraines, fibromyalgia, PMS, kidney stones and attention
deficit hyperactivity disorder (ADHD).
Williams, E.
NUTRIT. PRACT. 1999,1 (3) 27-9
DIETARY SODIUM INTAKE AND SUBSEQUENT RISK OF CARDIOVASCULAR
DISEASE IN OVERWEIGHT ADULTS
Observational epidemiologic studies have identified an
independent, positive relationship between dietary intake
of sodium and blood pressure. Trials have also demonstrated
that reduced sodium intake leads to a reduction in blood
pressure in both hypertensive and normotensive subjects.
Therefore, a study was carried out to examine the risk of
cardiovascular disease associated with dietary sodium intake
in overweight and non-overweight persons. The study group
consisted of 2,688 overweight and 6,797 non-overweight subjects
aged 25 to 74 years when the survey was conducted in 1971-1975.
Dietary sodium and energy intakes were estimated at baseline
using a single 24-hour dietary recall method.
It was found that for overweight and non-overweight persons,
over an average of 19 years of follow-up, the total number
of documented cases were as follows: 680 stroke events (210
fatal), 1,727 coronary heart disease events (614 fatal),
895 cardiovascular disease deaths, and 2486 deaths from
all causes. Among overweight persons with an average energy
intake of 7,452 kJ, a 100 mmol higher sodium intake was
associated with a 32% increase (relative risk [RR], 1.32)
in stroke incidence, 89% increase (RR, 1.89) in stroke mortality,
44% increase (RR, 1.44) in coronary heart disease mortality,
61% increase (RR, 1.61) in cardiovascular disease mortality,
and 39% increase (RR, 1.39) in mortality from all causes.
Dietary sodium intake was not significantly associated with
cardiovascular disease risk in non-overweight persons. Thus,
high sodium intake is strongly and independently associated
with an increased risk of cardiovascular disease and all-cause
mortality in overweight persons.
He, J. et al
J.A.M.A. 199, 282 (21) 2027-34
COMPARISON OF PAST VERSUS RECENT PHYSICAL ACTIVITY IN
THE PREVENTION OF PREMATURE DEATH AND CORONARY ARTERY DISEASE
During the last four decades many studies have shown that
people who are more active tend to live longer. Exercise
has proven beneficial in many conditions, ranging from osteoporosis
to depression to cerebrovascular disease. An important issue
that has not been studied much is which is more important
in decreasing total and cardiovascular mortality rates:
physical activity that was done long ago or that which was
done more recently? Therefore, researchers assessed activity
levels in 5209 men and women in the Framingham Heart Study
from 1956 to 1958 and again from 1969 to 1973. Cox proportional
hazards regression was used to calculate the relative risk
of being sedentary, both unadjusted and controlling for
smoking, weight, systolic blood pressure, cholesterol, glucose
intolerance, left ventricular hypertrophy, chronic obstructive
pulmonary disease, and cancer. The overall 16-year mortality
rate was 37% for men and 27% for women. When both distant
and recent activity levels were included along with major
cardiovascular risk factors, for recent activity the most
active tertile had lower overall mortality rate than the
least active tertile for men (risk ratio 0.58) and women
(risk ratio 0.61). However, for distant activity there was
no difference in overall mortality rate between the most
and least active tertiles either for men or for women. Thus,
the reduction in overall mortality rates is more associated
with recent activity than distant activity and it appears
that for sedentary patients, it may never be too late to
begin exercising.
Sherman, S.E. et al
AM. HEART J. 1999, 138 (5 pt 1) 900-7
A PROSPECTIVE STUDY OF WALKING AS COMPARED WITH VIGOROUS
EXERCISE IN THE PREVENTION OF CORONARY HEART DISEASE IN
WOMEN
In epidemiologic studies, physical activity has been associated
with a decrease in the risk of coronary heart disease (CHD),
but data on women have been sparse. Therefore, a study was
carried out to determine the effect of walking, as compared
with vigorous exercise, in the prevention of CHD in women.
Participants in the study were free of diagnosed cardiovascular
disease or cancer at the time of entry. During 8 years of
follow-up, 645 incident coronary events (nonfatal myocardial
infarction or death from coronary disease) were documented.
It was found that there was a strong, graded inverse association
between physical activity and the risk of coronary events.
As compared with women in the lowest quintile group for
energy expenditure, women in increasing quintile groups
had age-adjusted relative risks of 0.77, 0.65, 0.54, and
0.46 for coronary events. Walking was inversely associated
with the risk of coronary events. Women who walked the equivalent
of 3 or more hours per week at a brisk pace had a multivariate
relative risk of 0.65 as compared with women who walked
infrequently. Regular vigorous exercise was associated with
similar risk reductions. Additionally, sedentary women who
became active in middle adulthood or later had a lower risk
of coronary events than their counterparts who remained
sedentary. Thus, it appears that both brisk walking and
vigorous exercise are associated with substantial reductions
in the incidence of coronary events among women.
Manson, J.E. et al
N.ENGL.J.MED. 1999, 341 (9) 650-8
AGEING OF THE CARDIOVASCULAR SYSTEM DURING 33 YEARS OF
AEROBIC EXERCISE
With increasing age there is loss of aerobic capacity,
which can result in poorer quality of life, reduced chance
of survival in an emergency and greater potential for developing
hypokinetic diseases. Therefore, a study was carried out
to determine the effect of ageing on the circulatory system
in middle-aged men during 33 years of physical training.
The study group consisted of 15 men initially aged 45 years
who took part in an exercise-training programme for 25-33
years. The aerobic training consisted of swimming, jogging,
walking and cycling 3-4 times per week. Sessions were for
61-70 minutes at 77-84% of heart rate reserve.
There was no change in resting heart rate, blood pressure,
percentage fat or body composition. Minimal cardiovascular
losses at maximal work included 5.8-6.8% in minimal oxygen
uptake per decade, 25 beats in maximum heart rate and 26
beats in heart rate reserve. Thus, exercise training has
a favourable effect on ageing of the cardiovascular system
in older men, resulting in minimal loss of oxygen uptake,
no rise in resting blood pressure and no change in body
composition.
KASCH, F.W. et al
AGE & AGEING 1999, 28 (6) 531-6
HRT AND HEART DISEASE
In a study by Duke University researchers the use of HRT
in postmenopausal women with heart disease is questioned.
The researchers, led by Dr. Karen Alexander, performed an
observational analysis of 1857 postmenopausal women with
coronary artery disease. They found that of 111 patients
who started HRT after a myocardial infarction 33% were subsequently
hospitalised for unstable angina within a year. No deaths
were reported in this group however.
Women who were taking HRT before their first myocardial
infarction and who continued it after a myocardial infarction
also had a high rate of hospitalisation for unstable angina.
A total of 413 patients fell into this category: 21% of
them were admitted for unstable angina within the first
year, and four (1%) of them died.
In contrast, of the 1,333 women who were never on HRT, only
17% were hospitalised for unstable angina in the year after
their heart attack, and 4% of them died. The death rates
were not considered statistically significant across the
groups.
Dr. Alexander said: "While hormone use has benefits
and may still be cardioprotective in women without heart
disease, women who have heart disease probably should not
start using them. We also have no reason to suggest that
women stop using hormones if they develop heart disease."
The Duke University study is the second to challenge the
conventional medical wisdom which assumes that HRT is nearly
always cardioprotective.
BMJ no.7186 p753
CARDIOVASCULAR ACTIVITY OF GARLIC
Garlic (Allium sativum) reduces cardiovascular risk factors,
and is possibly hypolipidaemic. It is hypotensive, lowers
blood viscosity, activates fibrinolysis, is antiplatelet
and antithrombotic, anti-inflammatory and antimicrobial.
Therapeutic indications:
- Clinical trials have indicated treatment and prevention
of coronary artery disease, possibly for hyperlipidaemia
or hypercholesterolaemia; atherosclerosis and mild hypertension.
- May help to prevent cancer, especially of the gastrointestinal
tract.
- Prophylaxis or treatment of infections, and to improve
immunity.
- Bronchial conditions, including inflammatory diseases,
tuberculosis, asthma, and hepato-pulmonary syndrome.
Dosage: Garlic powder preparations, 1-2
tablets per day, containing the equivalent of 5g fresh garlic
standardized to contain 5.7mg alliin.
Combinations: May be advantageously combined
with Ginkgo, fish oil, and globe artichoke.
Adverse reactions: Possibly contact dermatitis,
rarely anaphylactic reaction.
Contra-indications/cautions: With Warfarin
or aspirin, or before surgery.
Kerry Bone,
MEDIHERB PROFESSIONAL REVIEW No. 70, August 1999.
LONG-TERM INTAKE OF DIETARY FIBRE AND DECREASED RISK OF
CORONARY HEART DISEASE AMONG WOMEN
Epidemiological studies of men suggest that dietary fibre
intake protects against coronary heart disease (CHD). Despite
the fact that CHD is the main cause of death amongst women,
data on the association in women is sparse. Therefore, a
study was carried out to investigate the association between
long-term intake of total dietary fibre in addition to fibre
from different sources and the risk of CHD in women. Data
was collected from The Nurses’ Health Study, a prospective
cohort study, over a 10 year period starting in 1984, using
a validated semiquantitative food frequency questionnaire.
68,782 women aged 37-64 years without history of angina,
myocardial infarction (MI), stroke, cancer, hypercholesterolemia
or diabetes, participated in the study. 591 major CHD events
were reported. The age-adjusted relative risk (RR) for major
CHD events was 0.53 (95% confidence interval [CI], 0.40-0.69)
for women in the highest quintile of total dietary fibre
intake (median, 22.9 g/d) compared with women in the lowest
quintile, (median, 11.5 g/d). Only cereal fibre intake was
strongly associated with a reduced risk of CHD.
Wolk, A. et al
J.A.M.A. 1999,281 (21) 1998-2004
LEISURE-TIME PHYSICAL ACTIVITY AND THE RISK OF PRIMARY
CARDIAC ARREST
It is now generally accepted that regular exercise is associated
with an overall reduction in the risk of coronary heart
disease, including sudden cardiac death. However, less understood
is the exercise intensity required to achieve the cardiac
benefit of regular exercise. Therefore, researchers used
data from a population-based case-control study to assess
the associations of regular high-intensity and moderate-intensity
leisure-time physical activity with primary cardiac arrest.
It was found that, compared with subjects who performed
none of the activities, the odds ratio for primary cardiac
arrest from matched analyses was 0.34 among subjects who
performed only gardening activities for more than 60 minutes
per week; 0.27 among subjects who walked for exercise for
more than 60 minutes per week; and 0.34 among subjects who
engaged in any high-intensity activities, after adjustment
for age, smoking, education, diabetes, hypertension, and
health status. The results suggest, therefore, that regular
participation in moderate-intensity activities such as walking
and gardening are associated with a reduced risk of primary
cardiac arrest.
Lemaitre, R.N. et al
ARCH.INTERN.MED. 1999, 159 (7) 686-90
THE EFFECT OF DIETARY OMEGA-3 FATTY ACIDS ON CORONARY
ATHEROSCLEROSIS
Few trials in humans have examined the anti-atherosclerotic
potential of ?-3 fatty acids. Therefore, a study was carried
out to determine the effect of dietary intake of ?-3 fatty
acids on the course of coronary artery atherosclerosis in
humans. Participants in the study were given fish oil concentrate
(55% eicosapentaenoic and docosahexaenoic acids) or a placebo
with a fatty acid composition resembling that of the average
European diet, 6 g/d for 3 months and then 3 g/d for 21
months.
At the end of treatment, 48 coronary segments in the placebo
group showed changes (36 showed mild progression, 5 showed
moderate progression, and 7 showed mild regression) and
55 coronary segments in the fish oil group showed changes
(35 showed mild progression, 4 showed moderate progression,
14 showed mild regression, and 2 showed moderate regression).
Loss in minimal luminal diameter was somewhat less in the
fish oil group and fish oil recipients had fewer cardiovascular
events. Also, low-density lipoprotein cholesterol levels
tended to be greater in the fish oil group.
Thus, dietary intake of ?-3 fatty acids modestly mitigates
the course of coronary atherosclerosis in humans.
Schacky, C. et al
ANN. INTERN. MED. 1999, 130 (7) 554-62
ABDOMINAL ADIPOSITY AND CORONARY HEART DISEASE IN WOMEN
Obesity is well recognised as a major risk factor for coronary
heart disease (CHD) in men and women, but whether regional
fat distribution contributes independently to risk factor
remains unclear. Therefore, a study was carried out to compare
waist-hip ratio (WHR) and waist circumference in determining
the risk of CHD in women. The study group consisted of 44,702
women participating in the Nurses’ Health Study (1986-1994)
who were free of prior CHD, stroke, or cancer in 1986. During
8 years of follow-up there were 320 CHD events (251 myocardial
infarctions and 69 CHD deaths). Higher WHR and greater waist
circumference were independently associated with a significantly
increased age-adjusted risk of CHD. After adjusting for
body mass index (BMI) and other cardiac risk factors, women
with a WHR of 0.88 or higher had a relative risk (RR) of
3.25 for CHD compared with women with a WHR of less than
0.72. A waist circumference of 96.5 cm (38 in) or more was
associated with a RR of 3.06. Additionally, the WHR and
waist circumference were independently strongly associated
with increased risk of CHD also among women with a BMI of
25kg/m2 or less. After adjusting for reported hypertension,
diabetes, and high cholesterol level, a WHR of 0.76 or higher
or waist circumference of 76.2 cm (30 in) or more was associated
with a more than 2-fold higher risk of CHD.
Rexrode, K.M. et al
J.A.M.A. 1998, 280 (21) 1843-48
INTENSIVE LIFESTYLE CHANGES FOR REVERSAL OF CORONARY HEART
DISEASE
The Lifestyle Heart Trial was the first randomised clinical
trial to demonstrate that intensive lifestyle changes may
lead to regression of coronary atherosclerosis after 1 year.
It was extended for a further 4 years to determine the feasibility
of patients to sustain intensive lifestyle changes and the
effects of these lifestyle changes (without lipid-lowering
drugs) on coronary heart disease. The intensive lifestyle
changes included a 10% fat wholefood vegetarian diet, aerobic
exercise, stress management training, smoking cessation
and group psychosocial support.
Twenty (71%) of the 28 patients in the experimental group
made and maintained comprehensive lifestyle changes for
5 years, whereas 15 (75%) of 20 control group patients made
more moderate changes. In the experimental group, the average
percent diameter stenosis at baseline decreased 1.75 absolute
percentage points after 1 year (a 4.5% relative improvement)
and by 3.1 absolute percentage points after 5 years (a 7.9%
relative improvement). In contrast , the average percent
diameter stenosis in the control group increased by 2.3
percentage points after 1 year (a 5.4% relative worsening)
and by 11.8 percentage points after 5 years (a 27.7% relative
worsening) between groups. There were 25 cardiac events
in the experimental group as opposed to 45 events in the
control group during the 5-year follow-up (risk ratio for
any event in the control group, 2.47).
Ornish,D. et al
J.A.M.A. 1998, 280(23) 2001-7
MORTALITY AND LIGHT TO MODERATE ALCOHOL CONSUMPTION AFTER
MYOCARDIAL INFARCTION
Although heavy alcohol consumption increases total mortality,
light to moderate consumption decreases cardiovascular and
all-cause mortality in healthy people. A prospective study
of men with a history of previous myocardial infarction
was carried out to determine the effect of moderate alcohol
intake in relation to mortality. The subjects were men in
the Physicians Health Study cohort who had a previous myocardial
infarction, but no history of cancer, stroke, or liver disease.
Out of the 5358 subjects, during a mean follow-up of 5
years, 920 men died. After adjustment for several potential
confounders, moderate alcohol intake was associated with
a significant decrease in total mortality. Compared to men
who rarely or never drank alcohol, those who drank 1-4 drinks
per month had a relative risk for total mortality of 0.85;
for 2-4 drinks per week, the relative risk was 0.72; for
1 drink per day 0.79; and for 2 or more drinks per day 0.84.
Therefore, men with previous myocardial infarction who consume
small to moderate amounts of alcohol have a lower total
mortality.
Muntwyler, J. et al
LANCET 1998, 352 (9144) 1882-5
BENEFITS OF ARTICHOKE LEAF IN HYPERCHOLESTEROLEMIA
A variety of studies on artichoke (Cynara scolymus L, Asteraceae)
confirm its traditional uses in hypercholesterolemia, dyspepsia
and liver protection. Important constituents include luteolin
and the glycosides scolymoside and cynaroside. In one study
557 patients taking an average of 1.5g artichoke leaf extract
daily experienced a significant decline in serum cholesterol
and triglycerides over a 43-day period. Double-blind, placebo-controlled
clinical trials have shown artichoke extract’s ability
to increase HDL levels and inhibit LDL oxidation.
PHYTOMEDICINE 1997, 4 (4) 369-378
Courtesy HERBALGRAM No. 44, p21-22
FRUIT AND VEGETABLE CONSUMPTION IN LATER LIFE
Fruit and vegetable consumption may reduce the risk of
several chronic diseases, including cancers, cardiovascular
disease, coronary heart disease, hypertension and stroke.
The World Health Organisation therefore recommends the consumption
of at least 400g, or 5 portions of fruit and vegetables
a day. Most adults’ consumption falls short of this
recommendation, so a study was carried out to assess the
levels of fruit and vegetable consumption in elderly people,
and to examine the socio-economic, physical and psychological
factors which influence this consumption. The subject group
was 445 elderly people (aged 65+) living in the East Midlands.
The recommended target of 5 portions of fruit and vegetables
a day was achieved by less than half the respondents: 37%
of those living in the urban area and 51% of those living
in the rural area. Low fruit and vegetable consumption was
particularly associated with being male, smoking and having
low levels of social engagement. Health programmes promoting
fruit and vegetable consumption may not be successfully
reaching elderly people and need to target those particularly
at risk of low consumption.
Johnson, A.E. et al
AGE & AGEING 1998, 27 (6) 723-8
EXCESSIVE DIETARY INTAKE OF VITAMIN A IS ASSOCIATED WITH
REDUCED BONE MINERAL DENSITY AND INCREASED RISK FOR HIP
FRACTURE
Age-adjusted rates of hip fracture incidence vary more
than sevenfold in Europe; the highest rates are found in
northern Europe, particularly Sweden and Norway. When dietary
patterns in Europe were compared, a large variation in vitamin
A intake was found: median intake was up to six-fold higher
in Scandinavian countries than in southern Europe. Therefore,
a study was carried out to investigate whether excessive
dietary intake of vitamin A is associated with decreased
bone mineral density and increased risk for hip fracture
in a group of Swedish women. Retinol intake was estimated
from dietary records and a food frequency questionnaire.
In multivariate analysis, retinol intake was negatively
associated with bone mineral density. For every 1mg increase
in daily intake of retinol, risk for hip fracture increased
by 68%. For intake greater than 1.5 mg/d compared with intake
less than 0.5 mg/d, bone mineral density was reduced by
10% at the femoral neck, 14% at the lumbar spine, and 6%
for the total body and risk for hip fracture was doubled.
Thus, a high dietary intake of retinol seems to be associated
with osteoporosis.
Melhus, H. et al
ANN. INT. MED. 1998, 129 (10) 770-8
EXCESSIVE DIETARY INTAKE OF VITAMIN A IS ASSOCIATED WITH
REDUCED BONE MINERAL DENSITY AND INCREASED RISK FOR HIP
FRACTURE
Age-adjusted rates of hip fracture incidence vary more than
sevenfold in Europe; the highest rates are found in northern
Europe, particularly Sweden and Norway. When dietary patterns
in Europe were compared, a large variation in vitamin A
intake was found: median intake was up to six-fold higher
in Scandinavian countries than in southern Europe. Therefore,
a study was carried out to investigate whether excessive
dietary intake of vitamin A is associated with decreased
bone mineral density and increased risk for hip fracture
in a group of Swedish women. Retinol intake was estimated
from dietary records and a food frequency questionnaire.
In multivariate analysis, retinol intake was negatively
associated with bone mineral density. For every 1mg increase
in daily intake of retinol, risk for hip fracture increased
by 68%. For intake greater than 1.5 mg/d compared with intake
less than 0.5 mg/d, bone mineral density was reduced by
10% at the femoral neck, 14% at the lumbar spine, and 6%
for the total body and risk for hip fracture was doubled.
Thus, a high dietary intake of retinol seems to be associated
with osteoporosis.
Melhus, H. et al
ANN. INT. MED. 1998, 129 (10) 770-8
GARLIC PROLONGS ELASTICITY OF THE AORTA
German researchers studied the effects of long-term garlic
use (Allium sativum L.) on elasticity of the aorta in healthy,
nonsmoking adults. Results suggested that regular long-term
garlic powder intake attenuated age- and pressure-related
increase in aortic stiffness, but the precise mechanism
remains elusive.
Breithaupt-Grogler K. et al,
CIRCULATION 1997, 96 (8) 2649-2655
Courtesy HERBALGRAM No. 43
GINSENG AND WARFARIN
A possible interaction between warfarin and Ginseng (Panax
ginseng) has been reported. A 47-year-old man had been taking
warfarin for 5 years following the insertion of a mechanical
heart valve. His International Normalized Ratio (INR) had
ranged from 3.0 to 4.0 for 9 months. In February 1995 the
patient started taking Ginseng capsules (Ginsana) 3 times
daily. Two weeks later his INR dropped to 1.5. After the
Ginseng was discontinued it returned to 3.3 in 2 weeks,
i.e. the Ginseng appeared to reduce the effectiveness of
the warfarin.
AMERICAN J. HEALTH-SYSTEM PHARMACY 1997, 54, 692-3
Courtesy Kerry Bone, MODERN PHYTOTHERAPIST 1998, Vol. 4,
No. 1, 35
HALF AN HOUR IN SMOKE CAN WEAKEN THE HEART
A new study at the University of Helsinki measured the
levels of antioxidants, including vitmin C, in the blood
of 10 volunteer nonsmokers, before and after spending half
an hour in a smoke-filled room. They found that the smoke
caused a one third reduction in vitamin C levels, starting
90 minutes after exposure and lasting for at least 6 hours.
The total of the blood’s antioxidants, using a TRAP
test (total peroxyl radical trapping potential of serum),
also fell by 31%.
THE TIMES, 26th May, 1998.
IMPAIRMENT OF HEALTH AND QUALITY OF LIFE IN PEOPLE WITH
LARGE WAIST CIRCUMFERENCE
A study was carried out to define the symptoms associated
with excess central fat distribution and to assess the risks
of chronic disorders. A cross-sectional study of 5,887 men
and 7,018 women aged 20-59 years assessed respiratory insufficiency,
low back pain, degree of physical function, presence of
non-insulin-dependent diabetes, and cardiovascular risk
factors. Bodyweight, body-mass index, and waist circumference
were measured by action levels (men; less than action level
1 <94.0 cm, action levels 1-2 94.0-101.9 cm, more than
action level 2 >102.0 cm; women: less than action level
1 <80.0 cm, action levels 1-2 80.0-87.9 cm, more than
action level 2 >88.0 cm). The reference group were people
with waist circumferences lower than action level 1. It
was found that all symptoms and risks increased among participants
higher than action level 2, after adjustment for age and
lifestyle, by 3.1 in men and 2.7 in women for shortness
of breath when walking upstairs; 4.5 and 3.8 for non-insulin
dependent diabetes; and 4.2 and 2.8 for at least one major
cardiovascular risk factor. Above action level 2, compared
with the reference group, men and women were at twice the
risk of difficulties in everyday life, and women were 1.5
times more likely to have low back pain or symptoms of intervertebral
disc herniation. The researchers conclude that waist action
levels could be useful for health promotion to raise awareness
of the need for weight management.
Lean,M.E. et al
LANCET 1998, 351 (9106) 853-56
DIETARY FAT INTAKE AND THE RISK OF CORONARY HEART DISEASE
IN WOMEN
Over 80,000 women aged 34 to 59 years were prospectively
studied to determine the relation between dietary intake
of specific types of fats and the risk of coronary disease.
During 14 years of follow up there were 939 cases of non-fatal
myocardial infarction or death from coronary heart disease.
It was found that for each increase of 5% of energy intake
from saturated fat, as compared with equivalent energy intake
from carbohydrates, was associated with a 17% increase in
the risk of coronary disease (relative risk, 1.17). The
relative risk for a 2% increment in energy intake from trans
unsaturated fat was 1.93; that for a 5% increment in energy
from monounsaturated fat was 0.81; and that for a 5% increment
in energy from polyunsaturated fat was 0.62. Total fat intake
was not significantly related to the risk of coronary disease.
Thus, it is estimated that the replacement of 5% of energy
from saturated fat with energy from unsaturated fats would
reduce risk by 42% and that the replacement of 2% of energy
from trans fat with energy from unhydrogenated, unsaturated
fats would reduce risk by 53%.
Hu, F.B. et al.
N. ENGL. J. MED. 1997, 337 (21) 1491-9
