Efficacy of using walnuts as statin adjuvants in hypertension management.

BACKGROUND: Due to the widespread unorthodox use of nuts to improve cardiovascular health, this clinical trial was carried out to evaluate the efficacy of walnut as an adjuvant statin in hypertensive subjects. METHOD: A single-blind placebo-controlled randomized clinical trial that lasted for 3 months. Forty-five screened hypertensive subjects on treatment, aged 45-65 years, were randomized into intervention and placebo groups according to their blood pressure defined by the American Heart Association criteria. Fifteen (15) normotensive subjects were also recruited for this study. The participants in the intervention group included daily 7 g of boiled walnut taken as snacks. The study was not controlled for type of diet and frequency of meals in a day. Low-density lipoprotein cholesterol (LDLc) was the primary endpoint for this study. RESULTS: The mean LDLc levels of the intervention groups (84.6 mg/dl and 79.7 mg/dl, respectively) were significantly (p < .005) lower than the placebo (137.6 mg/dl). The high-density lipoprotein cholesterol (HDLc) levels of the intervention groups were significantly higher than the placebo. The mean total cholesterol levels of the intervention groups were significantly lower than the placebo group. The intervention groups recorded a significantly lower systolic and diastolic blood pressure compared to the placebo. The supplementation of walnut significantly decreased the apolipoprotein E (APOE), proprotein convertase subtilisin kexin 9 (PCSK9), and cholesteryl ester transfer protein (CETP) activities relative to the placebo. CONCLUSION: The use of walnut as a statin adjuvant during hypertension treatment reduced LDLc levels within 42.1% and improved HDL levels by 33.6%, and the LDLc decrease related to reduced PCSK9 and APOE activities while the HDLc increase related to reduced CETP activities.

Lettuce-avicularin treatment reverses insulin resistance through stimulation of glycolytic kinases and insulin signaling molecules.

OBJECTIVES: In order to recommend a more effective approach to manage insulin resistance, we monitored the activities of glycolytic kinases, insulin signaling molecules, and incretin hormones and identified the possible targets related to the insulin-sensitizing effects of combined pharmacological and dietary intervention involving avicularin and lettuce. MATERIALS AND METHODS: Insulin resistance was induced in rats with a fructose-rich diet and confirmed from baseline analysis of FBS (>250 mg/dl), insulin (>25 µIU/ml), and HOMA-IR (>10). For 12 weeks, the insulin-resistant rats were treated exclusively with 5000 mg/kg b.w avicularin (DAvi) or by dietary placement on lettuce (DLet) or a combination of both and compared with non-insulin resistant rats. RESULTS: Avicularin reversed alterations in HbA1c and insulin levels. DLet produced no significant effect on the incretins GLP 1 (P=0.909) and GIP (P=0.990), but DAvi slightly stimulated GLP 1 but not GIP. A strong positive correlation was found between improved ß-cell responsiveness and the insulin signaling molecules: Akt2 (r=0.7248), IRS 1 (r=0.5173), and PI3K (r=0.7892). Only the combined avicularin and lettuce reversed the Akt2 levels (P=0.728). The lettuce meal slightly stimulated PI3K but normalized IRS 1 while avicularin treatment slightly stimulated IRS 1 but restored the PI3K levels (P=0.815). The positive correlation between ß-cell responsiveness and hexokinase (r=0.5959), PFK (r=0.6222), and PK (r=0.6591) activities were statistically significant. Alterations in glycolytic kinases were reversed by DLet and in combination with avicularin. CONCLUSION: A combined pharmacological and dietary approach with avicularin and lettuce is required to effectively reverse insulin resistance.

Nutritional modulation of blood pressure and vascular changes during severe menstrual cramps.

OBJECTIVES: This study examined the influence of nutrition on the severity of menstrual pains and associated transient changes in blood pressure (BP) and vascular-health indicators. It has also investigated the influence of nutrition on angiotensin (ANG II) and vascular cell adhesion molecules (VCAM-1). METHODS: A total of 207 university students, aged between 18 and 25 years, were grouped into three groups: a no-dysmenorrhoea (control) group, a moderate dysmenorrhoea (MDys) group, and a severe dysmenorrhoea (SDys) group, using the NRS-11 scale and initial contactin-1 (CNTN-1) levels. The groups were separately fed vegetable, protein, and carbohydrate meals. The meal plan involved three different types of food served three times a day (for breakfast, lunch, and dinner), beginning 48 h before menstruation. RESULTS: We found that 73.9% and 100% of the MDys patients on the protein and carbohydrate diets, respectively, had severe dysmenorrhoea. As many as 69.6% of the SDys patients on vegetable diets experienced no dysmenorrhoea; the BP of 61% of SDys normalised to the standard values of 120/80. The BP of 87% MDys had systolic BP ≥ 130 and ≥90 diastolic BP after carbohydrate meals. On the other hand, 30% of SDys had higher BP after protein meals. With respect to the choice of food, the severity of menstrual pain was positively correlated with ANG II (r = 0.5158) and VCAM-1 (r = 0.5849). ANG-II. Similarly, VCAM-1 were significantly elevated (p < 0.05) in the dysmenorrhoeal participants. The mean VCAM-1 and ANG-II levels of dysmenorrhoeal participants placed on vegetable meals were comparable to the control baseline levels. CONCLUSIONS: This study recommends the intake of a vegetable meal at least 48 h before menstruation as an effective nutritional approach to preventing and managing severe menstrual cramps. This approach can also prevent associated vascular changes. Carbohydrate meals should be avoided at least 48 h before menstruation.

Potentiation of incretin hormones and modulation of metabolic enzymes as possible mechanisms behind the insulin sensitizing effects of cabbage-metformin treatment.

In our study, we treated high fructose diet-induced insulin resistance in rats with any of metformin, cabbage (80%w/w) or combined metformin and cabbage (MetCabb), and observed the activities of glycolysis and gluconeogenesis regulatory enzymes, incretin hormones and other hormones affecting glucose homeostasis. Comparisons were made with normoglycemic noninsulin resistance rats (control) and insulin-resistant untreated rats (INres). Baseline analysis showing elevated fasting blood sugar (>250 mg/dl), insulin (>25 µIU/ml) and HOMA-IR (>10) satisfied the criteria for recruitment into the insulin-resistant groups. Treatment lasted for 12 weeks. HOMA-IR values significantly (P < 0.05) decreased from 24.7 to 5.5 and 10.6 respectively with MetCabb treatment. MetCabb normalized HOMA-IR values and mean ß-cell responsiveness of the INres. Cabbage and metCabb normalized the leptin levels relative to control. The mean fasting blood sugar, insulin, and c-peptide levels with MetCabb treatment reverted to control levels. We found a strong positive linear correlation between the glucagon levels (r = 0.9145) and increasing HOMA-IR values while both incretin hormones; GLP-1 and GIP negatively regressed (r = -0.8084 and -0.8488). MetCab treatment produced comparable values of GLP-1 and GIP to the control. A strong positive correlation was found between the HOMA-IR values and the PEPCK (r = 0.9065), F-1,6-BPase (r = 0.7951), and G-6-Pase (r = 0.7893). The hexokinase (r = -0.807), PFK (r = -0.9151), and PK (r = -0.7448) levels regressed as HOMA-IR values increased. The glycolytic and gluconeogenic enzymes except PEPCK reverted to control levels with MetCabb treatment. Combination of metformin and cabbage was more effective than individual treatments.