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This study aimed at assessing the anthropometry, dietary intake and micronutrient status of hypertensive patients attending specialist hospitals in Ondo State, Nigeria. A descriptive case control study was conducted among subjects attending two specialist hospitals located in Akure and Ondo towns. A total of 452 subjects (44.9% males and 55.1% females), was purposely selected from the study centres. A structured questionnaire was designed to collect information on demographic characteristics, socio-economic parameters, nutrition knowledge and dietary intakes of the subjects. The quantities of subjects' dietary intakes were measured using household measurements. Weight, height, systolic (SBP) and diastolic (DBP) blood pressures were measured using electronic bathroom scale, standiometer and sphygmomanometer, respectively. The subject's urine was collected; and vitamin C, sodium, potassium, calcium, zinc and magnesium were determined using standard procedures. The results showed the following means: age 52.4 +/- 2.38 years, weight 66.4 +/- 1.63kg, height 1.64 +/- 0.01m, body mass index (BMI) 24.13 +/- 0.69kg/m2, SBP 124.86 +/- 2.3mmHg and DBP 76.22 +/- 1.86 mmHg. Blood pressure (BP) of the subjects showed that 46.9% had optimal BP, 14.2% normal BP, 11.5% high normal BP, 12.8% mild hypertension, 9.7% moderate hypertension and 4.9% severe hypertension. For BMI, 8.8% were underweight, 47.1% normal, 30.3% overweight, 6.0% obesity class I, 6.0% obesity class II and 1.8% obesity class III. The proportion of hypertensive subjects that were obese was significantly (P = 0.0001) higher than control subjects. Three-fifth of the control subjects had good nutrition knowledge compared to one-fifth of hypertensive subjects. The estimated mean energy intake was 8.46 MJ, protein 93.1g, carbohydrate 314.5g, fat 42.9g, fibres 5.6g and appreciable amount of vitamin C, calcium, zinc, magnesium, sodium and potassium. The subjects' urinary vitamin C concentration was 32.49 +/- 2.53mg; calcium 0.41 +/- 0.06mg, zinc 0.04 +/- 0.01mg; magnesium 4.57 +/- 0.37mg, sodium 8.33 +/- 0.37mg) and potassium 7.45 +/- 0.21mg. Statistically, there were significant differences (P < 0.05) between urinary vitamin C, sodium and potassium concentration (except zinc) of hypertensive patients and the control subjects. Weak correlations were observed between the subjects' systolic (P < 0.05) and diastolic (P < 0.01) BP and age, BMI and magnesium; with inverse correlations between vitamin C, sodium and potassium. The study concluded that hypertension was significantly influenced by BMI of the subjects, which may be an indication of high intake of calories. Therefore, calorie intake should be controlled among the hypertensives.
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PMID:Nutritional knowledge, nutrients intake and nutritional status of hypertensive patients in Ondo State, Nigeria. 1884 81

Growing evidence indicates that insulin resistance and oxidative stress are involved in the pathogenesis of essential hypertension. In insulin-resistant states, like obesity and type 2 diabetes, altered glucose metabolism may lead to increased formation of methylglyoxal and other ketoaldehydes. Animal studies have shown that increased levels of endogenous aldehydes may lead to hypertension and oxidative stress. In animal models, the administration of vitamin C, vitamin B6 or alpha-lipoic acid reduced tissue levels of aldehydes, prevented oxidative stress, and lowered blood pressure. The purpose of this review article is to critically evaluate the available evidence for the role of dietary supplements in hypertension treatment.
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PMID:Is the anti-hypertensive effect of dietary supplements via aldehydes reduction evidence based? A systematic review. 1885 66

Plasma C-reactive protein (CRP) is an inflammatory biomarker that predicts cardiovascular disease. Lowering elevated CRP with statins has reduced the incidence of cardiovascular disease. We investigated whether vitamin C or E could reduce CRP. Healthy nonsmokers (N=396) were randomized to three groups, 1000 mg/day vitamin C, 800 IU/day vitamin E, or placebo, for 2 months. Median baseline CRP was low, 0.85 mg/L. No treatment effect was seen when all participants were included. However, a significant interaction was found, indicating that treatment effect depends on baseline CRP concentration. Among participants with CRP indicative of elevated cardiovascular risk (> or =1.0 mg/L), vitamin C reduced the median CRP by 25.3% vs placebo (p=0.02) (median reduction in the vitamin C group, 0.25 mg/L, 16.7%). These effects are similar to those of statins. The vitamin E effect was not significant. In summary, treatment with vitamin C but not vitamin E significantly reduced CRP among individuals with CRP > or =1.0 mg/L. Among the obese, 75% had CRP > or =1.0 mg/L. Research is needed to determine whether reducing this inflammatory biomarker with vitamin C could reduce diseases associated with obesity. But research on clinical benefits of antioxidants should limit participants to persons with elevations in the target biomarkers.
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PMID:Vitamin C treatment reduces elevated C-reactive protein. 1895 64

This review attempts to delineate the underlying mechanisms leading to the development of hypertension as well as the function of vitamins and minerals in the regulation of blood pressure. Physiological processes that regulate cardiac output and systemic vascular resistance impact on the control of blood pressure. Metabolic abnormalities associated with the tetrad of hypertension, dyslipidaemia, glucose intolerance and obesity share insulin resistance, which might be organ or cell specific, as an underlying feature representing different tissue manifestation of a common cellular ionic defect. As Ca is at the centre of ionic regulation of cellular functions, vitamins involved in Ca regulation have a significant role in the control of blood pressure. The endothelium-dependent vasodilator, NO, is susceptible to oxidative damage. Hence, antioxidant vitamins and related factors regulate blood pressure through protection of NO. Robust evidence for the involvement of vitamin B6 (pyridoxine), vitamin C, vitamin D and vitamin E in the regulation of blood pressure have been reported. The well-known roles of Na, K, Ca, Mg and Cl have been explored further. The action of various vitamins on blood pressure regulation cannot always be explained on the basis of their conventionally recognised "vitamin function". The non-traditional functions of vitamins and their derivatives can be exploited as an adjunct to available pharmacological modalities in the treatment of hypertension.
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PMID:Blood pressure regulation and micronutrients. 1908 15

For at least 40-50,000 years, plants played an important but supplementary role in the animal-dominated diet of Australian Aboriginal (AA) hunter-gatherers. New knowledge of the nutrient composition and the special physiological effects of their foods provides another perspective in the current debate on the composition of the 'prudent' diet and the diet on which humans evolved. In the present paper we have calculated the average nutrient composition of over 800 Aboriginal plant foods (in total and by food group) and highlighted the differences between these and modern cultivated foods. The data enable us to calculate the absolute contribution of plant foods to total food and nutrient intake of traditional living AA. If plants provided 20-40% of the energy in the diet (the most likely range), then plants would have contributed 22-44 g protein, 18-36 g fat, 101-202 g carbohydrate, 40-80 g fibre and 90-180 mg vitamin C in a 12500 kJ (3000 kcal) diet. Since all the carbohydrate came from plant foods, the traditional AA diet would have been relatively low in carbohydrate (especially starch) but high in dietary fibre in comparison with current recommendations. Over half the carbohydrate could have been in the form of sugars derived from fruit and honey. The low glycaemic index of their carbohydrate foods, however, would generate a relatively low demand for insulin secretion and this characteristic may have protected AA from a genetic predisposition to insulin resistance and its consequences (non-insulin-dependent diabetes mellitus, coronary heart disease, obesity). The dietary pattern and active lifestyle of recent hunter-gatherers such as AA may be a reference standard for modem human nutrition and a model for defence against diseases of affluence.
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PMID:Australian aboriginal plant foods: a consideration of their nutritional composition and health implications. 1908 57

The study objective was to evaluate the realization of the reducing diet recommended in the treatment of overweight or obesity (1500 kcal) with regard to the caloric value and the content of basic nutrients, vitamins and bioelements. The study was conducted on a group of 48 women. Daily food rations were evaluated based on a week's dietary register. Results were averaged in each patient and compared to the norms worked out by the Institute of Food and Feeding in Warsaw for subjects with low physical activity. The mean energetic value of the diets was found to meet the requirements. Approximately 50% of the obese women consumed high-protein, low-fat and low-carbohydrate food rations. The analysis of vitamin content in daily food rations showed insufficient intake of vitamin E (in 89.6% of women), thiamin (83.3%), riboflavin (93.7%), niacin (60.4%), vitamin B6 (87.5%), folic acid (89.6%) and vitamin C (72.9%). Vitamin A intake was higher than the recommended norm in 47.9% of women. The lowest realization was noted in the case of potassium (64.6% of rations below the norm), calcium (100% below the norm), magnesium (64.6% below the norm). However, dietary sodium and phosphate content in most obese women exceeded the norms. The intake was too low in the case of iron (in 91.7%), zinc (in 97.9%) and copper (in 100%). It seems that long-term compliance with such a diet requires additional individual supplementation.
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PMID:[Assessment of realization of a reducing diet by obese women during treatment of excessive body mass]. 1914 32

Obesity and smoking represent the leading preventable causes of morbidity and mortality in the United States. This study compared the prevalence of obesity among smokers seeking cessation treatment (n=1,428) vs. a general population (n=4,081) of never smokers, former smoker, and current smokers. Data from treatment-seeking smokers in the Wisconsin Smokers' Health Study (WSHS) and individuals who completed the National Health and Nutrition Examination Survey (NHANES) 2005-2006 were pooled and obesity rates and other health characteristics were compared. The prevalence of obesity was significantly higher among WSHS treatment-seeking smokers (36.8%) vs. NHANES current smokers (29.6%), but the obesity rates of WSHS treatment-seeking smokers did not differ from NHANES former smokers (36.5%) or never smokers (36.5%). Treatment-seeking smokers were more likely to be female and to have higher educational attainment compared to NHANES participants. Analysis of health characteristics revealed that treatment-seeking smokers had higher levels of dietary fiber and vitamin C and lower blood levels of total cholesterol, triglycerides, and fasting glucose compared to NHANES current smokers. Results suggest that treatment-seeking smokers may have a different health profile than current smokers in the general population. Health care providers should be aware of underlying heath issues, particularly obesity, in patients seeking smoking cessation treatment.
Obesity (Silver Spring) 2009 Jun
PMID:Obesity and smoking: comparing cessation treatment seekers with the general smoking population. 1924 76

During aging there is a tendency towards hyperlipidemia and changes in the distribution of lipoproteins. A decline in the functioning of the body's antioxidant defense system is also observed at this time. The objective of this study was to establish the relationship between serum concentrations of total cholesterol and fractions, triglycerides, and Vitamins C and E. 61 adults over 60 years of age were evaluated from January to March, 2006. Nutritional status was diagnosed by BMI (WHO); serum levels of triglycerides (TG), total cholesterol (TC) and fractions (HDL-c and LDL-c) were determined by enzyme method; Vitamin C (colorimetric method) and Vitamin E by HPLC. ATPIII values were used as a reference for risk of TG, TC, HDL, LDL-c, vitamin C: > 0.9 mg/dL (normal), < 0.9 mg/dL (deficit); vitamin E: = 1300 microg/dL (normal), 1300 = microg /dL (deficit). Consumption of vitamins C and E were estimated by the direct weighing method 3 days per week. According to BMI, 19.7% had nutritional deficit, 39.3% overweight, and 11.5% obesity. TG, TC, LDL-c levels were at risk in females, and HDL-c in both genders. Prevalence of risk for heart disease was: TG (45.2%), HDL-c (51.1%), and LDL-c (52.5%). Consumption and serum levels of vitamin E were low in both genders. There was no association between variables. A significant and positive correlation between TG, TC, LDL-C, serum vitamin E, and BMI was observed. The female group showed overweight, hypertriglyceridemia and hypercholesterolemia, HDL-c and LDL-c at risk, and vitamin E deficiency, all of which are important risk factors for cardiovascular disease in this age group.
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PMID:[Relationship between serum lipids and status of vitamin C and E as antioxidants in Venezuelan elderly people]. 1936 97

Whether frail elderly subjects are more insulin resistant (IR) than non-frail is unclear. How obesity, muscle mass, inflammation, hormonal and lipid status, oxidative stress, antioxidant capacity and physical activity influences insulin sensitivity (IS) in frail elderly subjects remains uncertain. We determined (1) whether frail elderly persons are more IR than non-frail elderly and (2) the influence of abdominal fat mass (AFM), muscle mass index (MMI), inflammation (CRP), hormonal (cortisol, free IGF-1, DHEA) and lipid (FFA, triglyceride (TG)) status, oxidative stress (paraoxonase-1 (PON-1), malondialdehyde (MDA)), antioxidant capacity (vitamin C, E) and physical activity (PASE questionnaire) on IS (QUICKI) in 16 frail obese (FO), 17 frail lean (FL) and 21 healthy, non-obese (HN) elderly subjects. IS was lower in FO than FL, but there was no significant difference between HN and FO or FL. There were no significant differences among groups for CRP, cortisol, IGF-1, DHEA, FFA, TG, PON-1, MDA, vitamin C and E and PASE. Age, AFM and MMI significantly correlated with IS. Only AFM and MMI were significant predictors explaining, respectively, 18.5% and 8.5% of the variance in IS. Increased abdominal obesity is associated with IR in frail elderly. Non-obese frail persons are not more IR than their healthy counterparts.
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PMID:Frailty in the elderly is associated with insulin resistance of glucose metabolism in the postabsorptive state only in the presence of increased abdominal fat. 1972 76

Cholesterol gallstones are among the most common gastrointestinal disorders in Western societies. Individuals with gallstones may experience various gastrointestinal symptoms and are also at risk of developing acute or chronic cholecystitis. Cholecystectomy is the most frequently recommended conventional treatment for symptomatic gallstones. Bile acids (ursodeoxycholic acid or chenodeoxycholic acid) are also used in some cases to dissolve radiolucent stones, but these drugs can cause gastrointestinal side effects and there is a high rate of stone recurrence after treatment is discontinued. Lithotripsy is used in some cases in conjunction with ursodeoxycholic acid for patients who have a single symptomatic non-calcified gallstone. There is evidence that dietary factors influence the risk of developing cholesterol gallstones. Dietary factors that may increase risk include cholesterol, saturated fat, trans fatty acids, refined sugar, and possibly legumes. Obesity is also a risk factor for gallstones. Dietary factors that may prevent the development of gallstones include polyunsaturated fat, monounsaturated fat, fiber, and caffeine. Consuming a vegetarian diet is also associated with decreased risk. In addition, identification and avoidance of allergenic foods frequently relieves symptoms of gallbladder disease, although it does not dissolve gallstones. Nutritional supplements that might help prevent gallstones include vitamin C, soy lecithin, and iron. In addition, a mixture of plant terpenes (Rowachol) has been used with some success to dissolve radiolucent gallstones. The gallbladder flush is a folk remedy said to promote the passage of gallstones. While minimal scientific evidence supports the efficacy of this treatment, anecdotal reports suggest the gallbladder flush may be beneficial for some people.
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PMID:Nutritional approaches to prevention and treatment of gallstones. 1980 50


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