A randomised controlled trial to investigate the effect of a high fibre diet on blood pressure and plasma fibrinogen.

Two hundred and one subjects (147 men and 54 women) were randomly allocated to either a high cereal fibre diet or a low cereal fibre diet for four weeks. Each group then followed the alternative diet for a further four weeks. Cereal fibre intakes were 19g/d (31 g/d 21 g/d total fibre) and 6g/d (19g/d total fibre) on the high and low fibre diets respectively (p less than 0.001). Energy, protein, fat, carbohydrate, and alcohol intakes calculated from weighed intake records did not differ between the two diets, although there was a slight difference in body weight, the mean being 0.3 kg heavier at the end of the high fibre period. The high cereal fibre diet had no detectable effect on blood pressure or plasma fibrinogen.

Alcohol and high-density-lipoprotein cholesterol: a randomized controlled trial.

1. A randomized controlled trial of cross-over design was set up to examine the effect of alcohol on blood lipids and certain haematological variates relevant to ischaemic heart disease. 2. One hundred subjects drank some alcohol for 4 weeks (mean intake 18.4 g/d) and abstained totally for 4 weeks, the order of these periods being randomized. 3. Alcohol appeared to produce a rise of 7% in serum high-density-lipoprotein (HDL) cholesterol, probably due to a rise in the HDL2 subfraction. 4. No significant change was detected in plasma fibrinogen or the other haematological indices. 5. These results are consistent with the hypothesis that a moderate intake of alcohol confers some protection against heart disease.

Hypocholesterolaemia in cancer and other causes of death in the mentally handicapped.

Serum cholesterol levels were estimated in 313 mentally handicapped patients who subsequently died from various causes. Although cholesterol levels in the mentally handicapped are lower than those in the general population, it was found that there was still an association between relatively low serum cholesterol values and mortality due to cancer of the colon. Similarly, patients who died from myocardial infarction had relatively high serum cholesterol levels. The mechanism of the relationship between hypocholesterolaemia and cancer of the colon is unclear, but the increasing longevity of the mentally handicapped is an important factor which has contributed to a rising incidence of cancers, particularly gastrointestinal forms, in this group.

Dietary determinants of lipoproteins, total cholesterol, viscosity, fibrinogen, and blood pressure.

High-density lipoprotein cholesterol, low-density lipoprotein cholesterol, total cholesterol, viscosity, fibrinogen, and blood pressure were determined in 117 men aged 44 to 60 yr selected from the general population who also completed 7-day weighed dietary records. Associations between these measurements and a number of dietary factors were assessed by multiple regression analysis, allowing where necessary for the effects of age, body mass index, and smoking habit. High-density lipoprotein cholesterol was associated positively with both alcohol and fish consumption and negatively with saturated fat intake. High-density lipoprotein cholesterol expressed as a percentage of total cholesterol was associated negatively with the percentage of energy from fat and positively with fish consumption. Low-density lipoprotein cholesterol was associated positively with the percentage of energy from fat and negatively with fish consumption. Fibrinogen and systolic blood pressure were inversely related to cereal fiber intake.

A comparison of the erythrocyte sedimentation rate and plasma viscosity in detecting changes in plasma proteins.

The Westergren erythrocyte sedimentation rate (ESR) and plasma viscosity were compared in 114 patients and their correlations with total and differential plasma protein fractions were analysed. There is a linear correlation between these two screening tests. Higher correlation coefficients were obtained between the plasma viscosity and fibrinogen and alpha and gamma globulins than with the ESR. Albumin affected the two tests in opposite directions. The ESR was falsely increased by a fall in haemoglobulin even within two standard deviations from the mean. Both tests gave an appreciable number of incorrect values--the plasma viscosity in 21 cases and the ESR in 33. The cause for these is discussed. It is concluded that the plasma viscosity is the more sensitive and reliable measure of changes in acute phase protein reactants and more useful for monitoring clinical progress.

Platelet counts during normal pregnancy.

Eleven reports of platelet counts were found in the literature which reported a progressive increase, no change, or a progressive fall during pregnancy. The counts had been made using venous or capillary blood, with either simple dilution or red cell lysis prior to enumeration in a haemocytometer, with or without phase-contrast microscopy. It was therefore decided to examine whole blood platelet counts taken during normal pregnancy. Results from 405 venous blood samples, using an electronic platelet counter, confirmed the finding of a significant progressive fall in platelet counts during normal pregnancy, the lowest counts falling in some women outside the recognized normal range of values.

The efficacy of long-term oral anticoagulant therapy and its laboratory assessment.

The activated partial thromboplastin time is compared with the corresponding prothrombin ratio in 6378 samples of platelet-poor plasma from 446 patients treated for a total of more than 4500 patient/months with oral anticoagulatnts. A relative decrease in the activated partial thromboplastin time following deep vein thrombosis is described, which tends to become less obvious during the first year of treatment and is greater in older patients. Although this relative decrease is also found in patients treated after cerebrovascular accidents, it is not found in patients treated after myocardial infarction or in patients with mitral valve disease treated prophylactically with long-term oral anticoagulants. It is though possible that these changes following deep vein thrombosis might be useful in helping to determine the duration of oral anticoagulant treatment.