ABSTRACT
Background: Increasing vegetable intake is recommended for promoting health in communities. This study investigated the effects of nutrition education on vegetable intake and the factors associated with changes in vegetable intake among residents of Okinawa. MethodsâandâResults: Subjects (n=1,345; mean [±SD] age 56.8±14.6 years; 40.5% male) were recruited from among local residents participating in the Yui Kenko Project. Subjects completed the brief-type self-administered diet history questionnaire (BDHQ) and questionnaires on socioeconomic demographics and social capital. Subjects were divided into 2 groups according to residential area, namely south Okinawa (n=679), where local health promotion activities have been undertaken since the early 2000s, and central Okinawa (n=666). Survey results were fed back to each subject, and health lectures were then conducted at local community centers. After 1 year, the BDHQ was repeated to investigate changes in vegetable and nutritional parameters. After the intervention, residents of south Okinawa increased their crude and energy-adjusted vegetable intake (P<0.05), whereas residents of central Okinawa showed decreased vegetable intake (P<0.05). Univariable and multivariable regression models indicated that, in south Okinawa, participation in local health promotion activities and agreement with general trust were positively correlated with changes in energy-adjusted vegetable intake, whereas in central Okinawa no correlations were observed. Conclusions: The status of social capital should be taken into account when implementing initiatives to increase vegetable intake in communities.
ABSTRACT
BACKGROUND: The left ventricular functional recovery by beta-blocker therapy is now attributed to time-dependent biologic effects on cardiomyocytes. METHODS AND RESULTS: To elucidate the cellular mechanism of these biologic effects, we treated 9 patients with dilated cardiomyopathy for 4 months with beta-blockers and examined the gene expressions linked to an improvement of left ventricular ejection fraction (EF). Gene expressions of the biopsied right ventricular endomyocardium were assessed by real-time reverse transcription-polymerase chain reaction. A decrease in beta-myosin heavy chain (1.23+/-0.49 versus 0.86+/-0.45, P<.05) was observed 4 months after the administration of beta-blockers. The expression levels of both sarcoplasmic reticulum Ca(2+) ATPase (SERCA) (0.80+/-0.28 versus 1.39+/-0.44, P<.01) and phospholamban (PLB) (0.49+/-0.08 versus 0.88+/-0.34, P<.05) increased, whereas the expression levels of Na(+)-Ca(2+) exchanger (NCX), beta-adrenoreceptor kinase 1, and ryanodine receptor 2 were unchanged. The SERCA/NCX ratio (0.68+/-0.14 versus 0.96+/-0.33, P<.05) also increased. The increase in SERCA mRNA expression correlated with the degree of changes in EF (%deltaEF) (r=0.679, P<.05), and none of changes in these genes expression correlated with changes in the plasma brain natriuretic peptide concentration. CONCLUSIONS: The functional recovery resulting from beta-blockers may be associated with the restoration of the unfavorable gene expression that controls Ca(2+) handlings in the failing heart.
Subject(s)
Adrenergic beta-Antagonists/therapeutic use , Gene Expression Regulation/drug effects , Heart Failure/drug therapy , Myocardium/chemistry , Myocardium/pathology , Adult , Aged , Biomarkers/blood , Calcium-Binding Proteins/biosynthesis , Calcium-Binding Proteins/drug effects , Calcium-Transporting ATPases/biosynthesis , Calcium-Transporting ATPases/drug effects , Cardiomyopathy, Dilated/complications , Cardiomyopathy, Dilated/drug therapy , Cardiomyopathy, Dilated/genetics , Cyclic AMP-Dependent Protein Kinases/drug effects , Cyclic AMP-Dependent Protein Kinases/metabolism , Female , Heart Failure/etiology , Heart Failure/physiopathology , Humans , Japan , Male , Middle Aged , Myocardial Contraction/drug effects , Myosin Heavy Chains/biosynthesis , Myosin Heavy Chains/drug effects , Natriuretic Peptide, Brain/blood , Natriuretic Peptide, Brain/drug effects , RNA, Messenger/drug effects , RNA, Messenger/metabolism , Ryanodine Receptor Calcium Release Channel/drug effects , Ryanodine Receptor Calcium Release Channel/metabolism , Sarcoplasmic Reticulum Calcium-Transporting ATPases , Sodium-Calcium Exchanger/drug effects , Sodium-Calcium Exchanger/metabolism , Stroke Volume/drug effects , Treatment Outcome , Ventricular Function, Left/drug effects , beta-Adrenergic Receptor KinasesABSTRACT
The tolerability and effectiveness of amiodarone in patients with advanced heart failure (HF) who are intolerant of beta-blockers was investigated in 22 patients (13 with and 9 without 180+/-26 mg/day of amiodarone). Heart rate (HR), blood pressure (BP), left ventricular diastolic dimension and fractional shortening (FS) using echocardiography, plasma atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP) and norepinephrine concentrations were determined at baseline and after 1 and 3 months of therapy. Although 9 patients tolerated amiodarone without any signs of HF, it was exacerbated in 4 patients. In 10 patients taking amiodarone who could be followed medically for 3 months, HR decreased after 1 month and remained unchanged until after 3 months (81+/-12 vs 65+/-7 vs 65+/-7beats/min), accompanied by decreased concentration of BNP (688+/-485 vs 392+/-203 vs 261+/-192pg/ml). FS increased significantly only after 3 months (0.12+/-0.05 vs 0.14+/-0.05 vs 0.16+/-0.04). Amiodarone may be used in patients with advanced HF who are intolerant of beta-blockers.
