scholarly journals Dietary fibre and cardiovascular health: a review of current evidence and policy

2019 ◽  
Vol 79 (1) ◽  
pp. 61-67 ◽  
Author(s):  
Charlotte Elizabeth Louise Evans
Keyword(s):  
Dietary Fibre ◽  
Cardiovascular Health ◽  
Current Evidence ◽  
Diverse Range ◽  
Beneficial Effects ◽  
Lower Blood ◽  
The Mean ◽  
The Uk ◽  
Small And Large Intestine

Dietary fibre comprises many different, mainly plant-based, compounds that are not fully digested in the human gut. Insoluble fibres include cellulose, hemi-celluloses and lignin and soluble fibres include pectins, β-glucan and hydro-colloids. In the UK, the daily recommended amount has increased to 30 g but only 13 % of men and 4 % of women meet this recommendation. Currently the mean intake for adults is 21 g for men and 17 g for women. There is a wealth of epidemiological evidence based on systematic reviews of trials and cohorts to support the higher fibre recommendation. This includes evidence of reductions in the risk for CVD (both heart disease and stroke) and lower risk of type 2 diabetes, lower blood pressure, lower LDL-cholesterol, as well as some cancers. Beneficial effects of fibre operate via a diverse range of mechanisms throughout the digestive system including the mouth, stomach and small and large intestine; some of which are still not completely understood. The updated recommendation for fibre is a long way from a typical British diet and requires several daily portions of fruit and vegetables and wholegrain foods. Improving dietary fibre intakes will require a variety of actions and policies from stakeholders; however, there is currently more of a focus on reducing sugar than increasing fibre. In order to increase the number of adults meeting the fibre recommendation, social marketing and labelling of high-fibre foods are warranted as well as reformulation and wider availability of wholegrain versions of popular foods.

scholarly journals Physical activity versus metformin for increasing insulin sensitivity in children and adolescents at-risk for type 2 diabetes

2016 ◽  
Vol 85 (2) ◽  
pp. 26-28
Author(s):  
Andrew D Hanna ◽  
Natalie V Scime
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
At Risk ◽  
Insulin Sensitivity ◽  
Children And Adolescents ◽  
Pediatric Population ◽  
Current Evidence ◽  
Beneficial Effects ◽  
Pediatric Populations

Global rates of type 2 diabetes (T2D) among children and adolescents are steadily rising. As such, an increasing amount of attention and research has begun to focus on strategies to prevent this chronic and burdensome disease in pediatric populations. The purpose of this article is to briefly review current evidence pertaining to the effectiveness of physical activity versus metformin in improving insulin sensitivity of children at-risk (ie, obese and/or insulin resistant) for developing T2D. Potential barriers to each preventative intervention will also be discussed. Physical activity, both aerobic and resistance, has demonstrated effectiveness in a moderate number of demographically diverse pediatric studies. However, the pediatric population is already alarmingly sedentary with barriers such as lack of motivation, social stigma and discomfort presenting a challenge. A small number of studies have demonstrated the beneficial effects of metformin in children and adolescents for improved insulin sensitivity. However, longer and larger studies are required to confirm these findings and elucidate upon the long-term safety and efficacy of this pharmaceutical in pediatric populations. While no head-to-head studies examining physical activity and metformin exist in pediatric populations and more research is needed, current evidence seems to favour the use of physical activity given the larger quantity of studies and generalizability of its beneficial effects. Thus, physical activity should be emphasized in clinical and public health practice when targeting at-risk children and adolescents to prevent a T2D diagnosis.

scholarly journals Plasticizers and Cardiovascular Health: Role of Adipose Tissue Dysfunction

2021 ◽  
Vol 11 ◽  
Author(s):  
Mikyla A. Callaghan ◽  
Samuel Alatorre-Hinojosa ◽  
Liam T. Connors ◽  
Radha D. Singh ◽  
Jennifer A. Thompson
Keyword(s):  
Cardiovascular Disease ◽  
Adipose Tissue ◽  
Adverse Effects ◽  
Cardiovascular Health ◽  
The United States ◽  
Current Evidence ◽  
Endocrine Disrupting ◽  
And Function

Since the 1950s, the production of plastics has increased 200-fold, reaching 360 million tonnes in 2019. Plasticizers, additives that modify the flexibility and rigidity of the product, are ingested as they migrate into food and beverages. Human exposure is continuous and widespread; between 75 and 97% of urine samples contain detectable levels of bisphenols and phthalates, the most common plasticizers. Concern over the toxicity of plasticizers arose in the late 1990s, largely focused around adverse developmental and reproductive effects. More recently, many studies have demonstrated that exposure to plasticizers increases the risk for obesity, type 2 diabetes, and cardiovascular disease (CVD). In the 2000s, many governments including Canada, the United States and European countries restricted the use of certain plasticizers in products targeted towards infants and children. Resultant consumer pressure motivated manufacturers to substitute plasticizers with analogues, which have been marketed as safe. However, data on the effects of these new substitutes are limited and data available to-date suggest that many exhibit similar properties to the chemicals they replaced. The adverse effects of plasticizers have largely been attributed to their endocrine disrupting properties, which modulate hormone signaling. Adipose tissue has been well-documented to be a target of the disrupting effects of both bisphenols and phthalates. Since adipose tissue function is a key determinant of cardiovascular health, adverse effects of plasticizers on adipocyte signaling and function may underlie their link to cardiovascular disease. Herein, we discuss the current evidence linking bisphenols and phthalates to obesity and CVD and consider how documented impacts of these plasticizers on adipocyte function may contribute to the development of CVD.

Sexual dysfunction in men and women with diabetes: a mirror of their complications?

2021 ◽  
Vol 17 ◽  
Author(s):  
Andrea Sansone ◽  
Danielle Mollaioli ◽  
Giacomo Ciocca ◽  
Erika Limoncin ◽  
Elena Colonnello ◽  
...  
Keyword(s):  
Sexual Dysfunction ◽  
Cardiovascular Health ◽  
Psychological Symptoms ◽  
Vascular Complications ◽  
Premature Mortality ◽  
Current Evidence ◽  
Sexual Dysfunctions ◽  
Adequate Treatment ◽  
Men And Women ◽  
Beneficial Effects

Background.: Diabetes mellitus (DM), one of the worldwide leading causes of death, is associated with a plethora of micro- and macro-vascular complications which should be carefully investigated and, in case, treated in order to improve quality of life and reduce the risk of premature mortality. Objective: To investigate and report current evidence in regards to the association between sexual dysfunction and diabetes. Methods: A detailed analysis of current literature has been performed on PubMed and Scholar in order to retrieve the most relevant findings pertaining to study topic. Results: Female and male sexual dysfunction often occur in the context of diabetes; while cardiovascular complications are clearly involved, psychosexological factors, endocrine complications, and endothelial dysfunction all contribute to the pathogenesis of sexual dysfunctions. Psychological symptoms are seldom investigated, yet should not be overlooked by the clinician; in fact, an interplay between sexual dysfunctions and depressive symptoms has been reported, and beneficial effects on both conditions might be obtained by adequate psychological support. Sexual dysfunctions can also act as early biomarkers of cardiovascular disease – a phenomenon frequently reported in men, in which erectile dysfunction predicts the development of coronary artery disease. Additionally, drug therapies can act in both directions, with treatments for diabetes possibly improving male sexual function and beneficial effects for cardiovascular health being reported for pro-erectile drugs. Conclusion: Sexual dysfunctions often occur in men and women with diabetes. Investigating micro- and macro-vascular complications might not be enough to prevent the development or worsening of any sexual dysfunction; endocrine and psychological assessment are therefore needed to provide the best chances for adequate treatment.

scholarly journals The Role of Dietary Nitrate and the Oral Microbiome on Blood Pressure and Vascular tone

2020 ◽  
pp. 1-53
Author(s):  
H.S. Alzahrani ◽  
K.G. Jackson ◽  
D.A. Hobbs ◽  
J.A. Lovegrove
Keyword(s):  
Blood Pressure ◽  
Vascular Function ◽  
Vascular Tone ◽  
Cardiovascular Health ◽  
Oral Bacteria ◽  
Oral Microbiome ◽  
Current Evidence ◽  
Dietary Nitrate ◽  
Beneficial Effects

Abstract There is increasing evidence for the health benefits of dietary nitrates including lowering blood pressure and enhancing cardiovascular health. Although commensal oral bacteria play an important role in converting dietary nitrate to nitrite, very little is known about the potential role of these bacteria in blood pressure regulation and maintenance of vascular tone. The main purpose of this review is to present the current evidence on the involvement of the oral microbiome in mediating the beneficial effects of dietary nitrate on vascular function and to identify sources of inter and intra-individual differences in bacterial composition. A systematic approach was used to identify the relevant articles published on PubMed and Web of Science in English from January 1950 until September 2019 examining the effects of dietary nitrate on oral microbiome composition and association with blood pressure and vascular tone. To date, only a limited number of studies have been conducted, with n=9 in humans and n=3 in animals focusing mainly on blood pressure. In general, elimination of oral bacteria with use of a chlorhexidine based antiseptic mouthwash reduced the conversion of nitrate to nitrite and was accompanied in some studies by an increase in blood pressure in normotensive subjects. In conclusion, our findings suggest that oral bacteria may play an important role in mediating the beneficial effects of nitrate-rich foods on blood pressure. Further human intervention studies assessing the potential effects of dietary nitrate on oral bacteria composition and relationship to real time measures of vascular function are needed, particularly in individuals with hypertension and those at risk of developing cardiovascular diseases.

scholarly journals Patient Empowerment Using Electronic Telemonitoring With Telephone Support in the Transition to Insulin Therapy in Adults With Type 2 Diabetes: Observational, Pre-Post, Mixed Methods Study

10.2196/16161 ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. e16161 ◽  
Author(s):  
Helen McGloin ◽  
Dympna O'Connell ◽  
Michele Glacken ◽  
Patsy Mc Sharry ◽  
Denise Healy ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Insulin Therapy ◽  
Patient Empowerment ◽  
Current Evidence ◽  
Telephone Support ◽  
The Mean ◽  
T1 And T2 ◽  
Gp Visits

Background Initiation of insulin therapy for the management of type 2 diabetes can be an unwelcome and distressful development for patients. Current evidence suggests that telemonitoring can help improve glycemic control in type 2 diabetes and can support empowerment to self-manage diabetes. This telemonitoring intervention was underpinned by an empowerment approach. Objective This study aimed to evaluate the clinical effectiveness and feasibility and the patients’ and health care providers’ experiences of a 12-week telemonitoring intervention with telephone support for patients commencing insulin therapy. This paper focuses on the impact on patient empowerment. Methods An observational, pre-post, multimethod, and triangulation design was employed to study a 12-week automated electronic telemonitoring intervention with telephone support from a diabetes clinical nurse specialist (CNS). Forty patients were recruited from the clinic as they were about to commence insulin therapy. In the quantitative arm, biometric data (hemoglobin A1c [HbA1c] and weight) and psychosocial data (diabetes empowerment scale [DES] scores and diabetes distress scale [DDS] scores) were gathered by the research team at baseline (T1), the end of the intervention (T2), and 3 months postintervention (T3). Data on hospital admission and general practitioner (GP) visits were collected for the duration of the study. In the qualitative arm, separate focus group interviews were conducted with the CNS team supporting the intervention (n=2) and patients (n=16). Results Of 39 patients who completed the intervention, 23 (59%) were male. The mean age of the sample was 62.4 years (range 37-80 years). The mean HbA1c (mmol/mol) decreased significantly between T1 and T2 (mean difference [MD] −17.13; P<.001) and T1 and T3 (MD −18.16; P<.001), with no significant impact on weight. In the focus groups, patients reported an increased awareness to self-manage diabetes and feelings of safety and comfort. There were 13% (5/39) of patients who had hypoglycemia on two or more occasions. A significant increase in the mean DES score occurred between T1 and T2 (MD 0.62; P=.001) and T1 and T3 (MD 0.72; P<.001). The mean DDS score decreased between T1 and T2 (MD −0.64; P=.002) and T1 and T3 (MD −0.6; P=.002). The mean patient satisfaction with the intervention was above 4 out of possible 5 on all items on the Telemedicine Satisfaction and Usefulness Questionnaire. We observed a reduction in diabetes clinic attendances and GP visits. A significant increase in workload was reported by the CNS team. Conclusions This intervention had an empowering effect for patients in the self-management of type 2 diabetes and has the potential to meet the need for safer and more effective care in insulin initiation in the community setting. We observed a significant increase in workload for health care staff. Telemonitoring needs to be streamlined with health care delivery and accompanied by adequate support services.

Pharmacokinetic Evaluation of a Newly Introduced Von Willebrand Factor Concentrate At Two London Haemophilia Centres

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 3384-3384
Author(s):  
Oliver Hegener ◽  
Natasha M Wiles ◽  
Anne Wareing ◽  
Bella Madan ◽  
Steve K Austin
Keyword(s):  
Half Life ◽  
Individual Variability ◽  
Advisory Board ◽  
Activity Level ◽  
The Mean ◽  
Group B ◽  
The Uk ◽  
Type 3

Abstract Abstract 3384 Introducing new factor concentrates in VWD patients is complicated by VWD subtype and PK variability. Wilate, a VWF concentrate with a 1:1 VWF: FVIII ratio and has not yet been widely used in the UK. We conducted PK studies with Wilate, to determine its efficacy, peak VWF activity and FVIII levels, and clearance in patients with VWD. Where feasible, we compared the data with previously used concentrate (Haemate-P) handling. 17 VWD patients (4 type 1, 6 type 2, 7 type 3) from two London Haemophilia centres were evaluated. The median age was 36 yrs (range 12– 67 yrs); sex M:F 6:11; mean body weight 73 kg (range 39–122 kg). Seven were blood group O, 1 group AB, 4 group A and 4 group B. The mean dose of Wilate administered was 44 iu/kg VWF: RiCoF (range 17–61). VWF activity, VWF antigen and FVIII levels were measured pre- and post for up to 8 hrs. The mean dose of Wilate required to reach target VWF:RiCof activity level of >65 iu/dl in the type 3 VWD was 49.6 iu/kg, and 38.7 iu/kg in type 2 VWD. Of the type 1 patients mean dosing was 43.0 iu/kg. The median peak VWF:RiCoF activity was 82 iu/dl in type 3 and 115 iu/dl in type 2, and 92 iu/dl in type 1. VWF Antigen levels were 116 iu/dl in type 3, and 164 iu/dl in type 2 and 135 iu/dl in type 1. VWF handling in some individuals was suggestive of increased VWF clearance with a half-life below the suggested half-life of 12 hours. This observation indicates the importance of prolonged PK studies in individual cases. As expected, peak FVIII levels were generally higher with Wilate compared to previously used concentrate (94 iu/dl in type 3 and 82 iu/dl in type 2) but the PK profiles between the products were similar, with some inter-individual variability. In conclusion, Wilate achieves adequate VWF activity and FVIII levels and has similar PK properties to previously used concentrate. However, based on the results of this study prolonged PK assessment appears important in selected cases. Disclosures: Hegener: Octapharma AG: Employment. Austin:Baxter: Advisory Board Other; Pfizer: Advisory Board, Advisory Board Other.

scholarly journals UK Food Standards Agency Workshop Report: the effects of the dietary n-6:n-3 fatty acid ratio on cardiovascular health

2007 ◽  
Vol 98 (6) ◽  
pp. 1305-1310 ◽  
Author(s):  
John C. Stanley ◽  
Rachel L. Elsom ◽  
Philip C. Calder ◽  
Bruce A. Griffin ◽  
William S. Harris ◽  
...  
Keyword(s):  
Fatty Acid ◽  
Cardiovascular Health ◽  
Physiological Function ◽  
Fatty Acid Ratio ◽  
Fatty Acid Intake ◽  
Beneficial Effects ◽  
Food Standards ◽  
Acid Ratio ◽  
The Uk ◽  
Long Chain

This report summarises a workshop convened by the UK Food Standards Agency (FSA) on 11 September 2006 to review the results of three FSA-funded studies and other recent research on effects of the dietary n-6:n-3 fatty acid ratio on cardiovascular health. The objective of this workshop was to reach a clear conclusion on whether or not it was worth funding any further research in this area. On the basis of this review of the experimental evidence and on theoretical grounds, it was concluded that the n-6:n-3 fatty acid ratio is not a useful concept and that it distracts attention away from increasing absolute intakes of long-chain n-3 fatty acids which have been shown to have beneficial effects on cardiovascular health. Other markers of fatty acid intake, that more closely relate to physiological function, may be more useful.

scholarly journals The Physiological and Biochemical Outcomes Associated with a Reflexology Treatment: A Systematic Review

2014 ◽  
Vol 2014 ◽  
pp. 1-16 ◽  
Author(s):  
J. E. M. McCullough ◽  
S. D. Liddle ◽  
M. Sinclair ◽  
C. Close ◽  
C. M. Hughes
Keyword(s):  
Scientific Evidence ◽  
Healthcare Providers ◽  
Current Evidence ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Diverse Range ◽  
Assessment Development ◽  
Review Team ◽  
Randomised Controlled ◽  
The Uk

Background. Reflexology is one of the top forms of complementary and alternative medicine in the UK and is used for healthcare by a diverse range of people. However, it is offered by few healthcare providers as little scientific evidence is available explaining how it works or any health benefits it may confer. The aim of this review was to assess the current evidence available from reflexology randomised controlled trials (RCTs) that have investigated changes in physiological or biochemical outcomes.Methods. Guidelines from the Cochrane Handbook of Systematic Reviews of Interventions were followed: the following databases were searched from inception to December 2013: AMED, CAM Quest, CINAHL Plus, Cochrane Central Register of Controlled Trials, Embase, Medline Ovid, Proquest, and Pubmed. Risk of bias was assessed independently by two members of the review team and overall strength of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation guidelines.Results. Seventeen eligible RCTs met all inclusion criteria. A total of 34 objective outcome measures were analysed. Although twelve studies showed significant changes within the reflexology group, only three studies investigating blood pressure, cardiac index, and salivary amylase resulted in significant between group changes in favour of reflexology. The overall quality of the studies was low.

scholarly journals Lupins and Health Outcomes: A Systematic Literature Review

Nutrients ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 327
Author(s):  
Lesley Bryant ◽  
Anna Rangan ◽  
Sara Grafenauer
Keyword(s):  
Blood Pressure ◽  
Chronic Disease ◽  
Serum Lipids ◽  
Intervention Studies ◽  
Current Evidence ◽  
Nutrient Profile ◽  
Beneficial Effects ◽  
Lupin Protein ◽  
Meta Analyses

Lupins have a unique nutrient profile among legumes and may have beneficial health effects when included in the diet. The aim of this systematic review was to investigate the effects of lupin on a range of health outcome measures. Databases included MEDLINE, Embase and CINAHL, and focused on controlled intervention studies on healthy adults and those with chronic disease such as type 2 diabetes, cardiovascular disease and overweight. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol was followed. Investigated intervention diets utilised whole lupin, lupin protein or lupin fibre, and outcomes were measured by markers of chronic disease, body weight and satiety. Quality assessment of results was performed using the Cochrane revised risk of bias tool. Overall, 21 studies with 998 participants were included: 12 using whole lupin, four used lupin protein and five lupin fibre. Beneficial changes were observed in 71% of studies that measured blood pressure, 83% measuring satiety and 64% measuring serum lipids. Unintended weight loss occurred in 25% of studies. Whole lupin demonstrated more consistent beneficial effects for satiety, glycaemic control and blood pressure than lupin protein or lupin fibre. Heterogeneity, low study numbers and a small participant base indicated further studies are required to strengthen current evidence particularly regarding the protein and dietary fibre components of lupin.

scholarly journals MANAGEMENT OF ENDOCRINE DISEASE: Rationale and current evidence for testosterone therapy in the management of obesity and its complications

2020 ◽  
Vol 183 (6) ◽  
pp. R167-R183
Author(s):  
Bruno Lapauw ◽  
Jean-Marc Kaufman
Keyword(s):  
Metabolic Health ◽  
Sex Hormone Binding Globulin ◽  
Current Evidence ◽  
Metabolic Disturbances ◽  
Safety Issues ◽  
Beneficial Effects ◽  
The Metabolic Syndrome ◽  
Lifestyle Measures ◽  
Intervention Trials

Overt hypogonadism in men adversely affects body composition and metabolic health, which generally improve upon testosterone (TS) therapy. As obese men often display lower serum TS levels, in particular when they present with the metabolic syndrome (MetS) or type 2 diabetes (T2DM), there have been claims that androgen therapy prevents or reverses obesity and improves metabolic health. This has contributed to the increase in TS prescriptions during the past two decades. In this narrative review, based on findings from larger observational studies and randomized controlled intervention trials, we evaluate whether low TS predicts or predisposes to obesity and its metabolic consequences, and whether obese men with low TS are truly hypogonadal. We further describe the mechanisms underlying the bi-directional relationships of TS levels with obesity and metabolic health, and finally assess the evidence for TS therapy in men with obesity, MetS and/or T2DM, considering efficacy, safety concerns and possible alternative approaches. It is concluded that low serum sex hormone-binding globulin and total TS levels are highly prevalent in obese men, but that only those with low free TS levels and signs or symptoms of hypogonadism should be considered androgen deficient. These alterations are reversible upon weight loss. Whether low TS is a biomarker rather than a true risk factor for metabolic disturbances remains unclear. Considering the limited number of sound TS therapy trials have shown beneficial effects, the modest amplitude of these effects, and unresolved safety issues, one cannot in the present state-of-the-art advocate TS therapy to prevent or reverse obesity-associated metabolic disturbances. Instead, the focus should remain on lifestyle measures and management of obesity-related consequences.

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