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PERIODICAL
FASTING AND CALORIC RESTRICTION FOR LIFE EXTENSION,
DISEASE TREATMENT AND CREATIVITY.
(clinical and experimental data)
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FASTING AND CALORIC RESTRICTION PREVENT AND CURE DISEASES
(Evidence) |
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2005
[1] 1Department of Medicine,
Academic Teaching Hospital Feldkirch, Feldkirch, Austria
[2] 2Vorarlberg Institute for Vascular Investigation
and Treatment (VIVIT), Academic Teaching Hospital
Feldkirch, Feldkirch, Austria.
OBJECTIVE:To prospectively investigate
the impact of total and central obesity on vascular
mortality in patients undergoing coronary angiography.DESIGN:Prospective
cohort study; mean follow-up 2.2 y.SUBJECTS:Men (n=513)
and women (n=243) undergoing coronary angiography
for the evaluation of coronary artery disease.MEASUREMENTS:Body
mass index (BMI) was used as a measure of total obesity;
waist-to-hip ratio (WHR) and waist circumference (WCf)
as measures of central obesity. The primary study
end point was vascular mortality; secondary study
end points were total mortality, major coronary events,
and cumulative vascular events.RESULTS:For both genders,
BMI, WHR, and WCf correlated significantly with fasting
plasma glucose, with HOMA insulin resistance, with
triglycerides, and inversely with HDL cholesterol
(P<0.001 for all correlations). In Cox regression
analysis adjusting for age, gender, smoking, and total
cholesterol, BMI was not associated with any study
end point. In contrast, WHR (standardized adjusted
odds ratios (OR) 2.01, 95% CI 1.02-3.93 for men and
2.63, 95% CI 1.38-5.00 for women), and WCf (OR=2.31,
95% CI 1.16-4.60 for men and 8.71, 95% CI 1.78-42.68
for women) proved independently predictive of vascular
mortality. Additional adjustment for diabetes and
hypertension did not substantially alter these results.
Also, the predictive value of WHR and Wcf was retained
after adjustment for drug treatment and the presence
of significant coronary artery disease at baseline.
Further, WHR and WCf were associated with total mortality,
major coronary events, and cumulative vascular end
points.CONCLUSION:Both total and central obesity are
associated with insulin resistance and with an atherogenic
lipoprotein profile. However, only central obesity
is significantly and independently predictive of the
2-y vascular mortality in coronary patients.International
Journal of Obesity advance online publication, 10
May 2005; doi:10.1038/sj.ijo.0802985.
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2004
Z Instytutu Pielegniarstwa Wydzialu
Ochrony Zdrowia Collegium Medicum Uniwersytetu Jagiellonskiego
w Krakowie.
Mortality rates due to cardiovascular
diseases (CD) in Poland are almost twice higher than
in the European Union countries. The mortality caused
by CD has paid the attention on the fact that it increases
relatively among women in comparison to men. Epidemiological
observations conducted in female groups indicated
that the ischaemic heart disease (IHD) appears more
frequently after menopause. The aim of the study was
to evaluate some IHD risk factors in the group of
women aged 30-65 from Krakow. The study included 95
women, without IHD diagnosis, voluntarily registered
to the practice of nurses group. The menopause occurrence
and selected possible to modify CD risk factors as
a concentration of the total cholesterol, LDL cholesterol,
fasting glucose, C-reactive protein (CRP) and also
blood pressure, body mass index and waist circumference
were assessed. The smoking of tobacco was estimated
by an objective method (the level of carbon monoxide
in breath out--smoke check). The level of depression
was evaluated with the use of Beck Inventory Scale.
The results were calculating using Statistica Pl 6.0
programme. The investigated group, especially women
after natural menopause, had higher CD risk factors
such as: hypercholesterolemia, systolic hypertension,
overweight, tobacco smoking, CRP and depression. The
tobacco smoking appeared more often in the group after
menopause because of other reasons and in the group
of women with regular menstruation. The rate of depression
was also higher among women after menopause because
of other reasons.
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2002
Department of Medicine, Helsinki
University Hospital, Finland.
BACKGROUND: Hypertension-related
diseases are the leading causes of morbidity and mortality
in industrially developed societies. Surprisingly,
68% of all mortality attributed to high blood pressure
(BP) occurs with systolic BP between 120 and 140 mm
Hg and diastolic BP below 90 mm Hg. Dietary and lifestyle
modifications are effective in the treatment of borderline
hypertension. One such lifestyle intervention is the
use of medically supervised water-only fasting as
a safe and effective means of normalizing BP and initiating
health-promoting behavioral changes. METHODS: Sixty-eight
(68) consecutive patients with borderline hypertension
with systolic BP in excess of 119 mm Hg and diastolic
BP less than 91 mm Hg were treated in an inpatient
setting under medical supervision. The treatment program
consisted of a short prefasting period (approximately
1-2 days on average) during which food consumption
was limited to fruits and vegetables followed by medically
supervised water-only fasting (approximately 13.6
days on average). Fasting was followed by a refeeding
period (approximately 6.0 days on average). The refeeding
program consisted of a low-fat, low-sodium, plant-based,
vegan diet. RESULTS: Approximately 82% of the subjects
achieved BP at or below 120/80 mm Hg by the end of
the treatment program. The mean BP reduction was 20/7
mm Hg, with the greatest decrease being observed for
subjects with the highest baseline BP. A linear regression
of BP decrease against baseline BP showed that the
estimated BP below which no further decrease would
be expected was 96.0/67.0 mm Hg at the end of the
fast and 99.2/67.3 mm Hg at the end of refeeding.
These levels are in agreement with other estimates
of the BP below which stroke events are eliminated,
thus suggesting that these levels could be regarded
as the "ideal" BP values. CONCLUSION: Medically supervised
water-only fasting appears to be a safe and effective
means of normalizing BP and may assist in motivating
health-promoting diet and lifestyle changes.
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2001
Department of Clinical Laboratory
Medicine, Hiroshima University School of Medicine,
Japan.
Association between obesity
and hypertension has been well recognized. A reduction
in the body weight of over-weight hypertensive patients
is a recommended lifestyle modification. The purpose
of our study is to examine the relationship of insulin
sensitivity and autonomic nervous activity with reduction
of blood pressure by the calorie restriction. We evaluated
the heart rate variability, nocturnal change of blood
pressure and insulin resistance before and after a
short-term low-calorie diet in 12 overweight essential
hypertensives. After a week of standard diet (2000
kcal), 2 weeks of low-calorie diet (800 kcal) with
normal sodium content induced a significant reduction
in body mass index, triglyceride, fasting immunoreactive
protein, homeostasis model assessment as an index
of insulin resistance, and urinary excretion of sodium
and potassium. Systolic blood pressure was
significantly reduced both in daytime and night-time
after the low-calorie diet (daytime, 134.5+/-6.0 to
122.0+/-4.1 mmHg; night-time, 126.8+/-5.2 to 113.4+/-7.2
mmHg). In daytime, diastolic blood pressure was also
reduced (90.3+/-2.1 to 88.1+/-4.8 mmHg).
Although heart rate was not significantly reduced,
a rise of high frequency in night-time (346+/-82 to
572+/-108 ms2) and a fall of low frequency/high frequency
in day-time (3.5+/-0.4 to 2.6+/-0.1) was significant
after a low-calorie diet. In conclusion, weight loss
by low-calorie diet with a constant intake of sodium,
reduced blood pressure in obese hypertensives by improvement
of vagal nervous activity and insulin resistance..
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1999
Istituto di Medicina Clinica,
Cattedra di Medicina Interna I, University of Ancona,
Ancona, Italy.
The _expression of the natriuretic
peptide clearance receptor is abundant in human and
rat adipose tissue, where it is specifically inhibited
by fasting. In obese hypertensives, plasma atrial
natriuretic peptide (ANP) levels were found to be
lower than in obese normotensives. Therefore, the
increased adipose mass might influence ANP levels
and/or its biological activity. The aim of the present
study was to evaluate whether the humoral, hemodynamic,
and renal effects of exogenous ANP in obese hypertensives
might be enhanced by a very low calorie diet. Eight
obese hypertensives received a bolus injection of
ANP (0.6 mg/kg) after 2 weeks of a normal calorie/normal
sodium diet, and blood pressure (BP), heart rate,
ANP, cGMP, plasma renin activity, and aldosterone
were evaluated for 2 hours before and after the injection.
Diuresis and natriuresis were measured every 30 minutes.
The patients then started a low calorie/normal sodium
diet (510 kcal/150 mmol/d) for 4 days, and then the
ANP injection protocol was repeated. The low calorie
diet induced a slight weight loss (from 90.6+/-1.1
to 87. 7+/-1.2 kg; P<0.01), which was accompanied
by increase of cGMP excretion (from 146.0+/-10.1 to
154.5+/-9.5 nmol/24 h; P<0.05) together with a reduction
of BP (P<0.01 versus basal levels). ANP injection
after diet was followed by an increase of ANP levels
similar to that observed before diet, but plasma cGMP,
diuresis, and natriuresis increased significantly
only after diet. Similarly, the decrease of BP after
ANP administration was significantly higher after
diet (change in mean arterial pressure, -6.4+/-0.7
versus -4. 0+/-0.6 mm Hg; P<0.05) as well as that
of aldosterone (P<0.01). These data show that a low
calorie diet enhances the humoral, renal, and hemodynamic
effects of ANP in obese hypertensives and confirm
the importance of caloric intake in modulating the
biological activity of ANP, suggesting that the natriuretic
peptide system can play a role in the acute changes
of natriuresis and diuresis associated with caloric
restriction.
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1998
Department of Medicine, Helsinki
University Hospital, Finland.
The beneficial effects of weight
loss with a very-low-calorie diet (VLCD) on cardiovascular
risk factors have been reported at the end of energy
restriction. As the effects, especially on blood pressure,
may not remain constant during weight maintenance,
we studied the longer-term effects of weight loss
on 24h ambulatory blood pressure (ABP), lipids, glucose
and insulin. DESIGN: Prospective study of a 17-week
weight loss programme containing an eight-week VLCD
period and follow-up visit at one-year. SUBJECTS:
Twenty-nine moderately obese, normotensive or mildly
hypertensive women. The mean +/- s.d. body mass index
(BMI) was 36.0 +/- 2.6 kg/m2 and mean age 40.3 +/-
8.3 y. RESULTS: In the last week of the VLCD, the
mean (s.d.) weight loss was 12.4 +/- 3.3 kg (P < 0.001),
at the end of the programme 15.1 +/- 4.4 kg (P < 0.001
vs baseline), and at one-year follow-up 10.7 +/- 7.6
kg (P < 0.001 vs baseline). Mean 24 h ABP decreased
8.0/4.6 mmHg (P < 0.001 for both) on the last week
of the VLCD, at the end of the programme, the systolic
ABP decrease was 4.7 mmHg (P < 0.01 vs baseline) and
diastolic 2.1 mmHg (not statistically significant
(NS) vs baseline). At one-year follow-up, the mean
systolic ABP decrease was 4.1 mmHg (P < 0.01 vs baseline)
and mean diastolic 3.0 mmHg (P < 0.05 vs baseline).
Sodium excretion decreased 55 mmol/24 h in the last
VLCD week (P < 0.01) and returned to baseline after
that. At the one-year follow-up, beneficial changes,
compared with baseline, were observed in mean serum
glucose (-0.28 mmol/l, P < 0.05), triglyceride (-0.35
mmol/l, P < 0.01) and HDL cholesterol (+0.16 mmol/l,
P < 0.001). CONCLUSIONS: This weight loss programme
with a VLCD enabled obese subjects to lose weight
and decrease cardiovascular risks. Despite some regain
in weight during follow-up, the beneficial effects
were overall maintained over the year. Sodium intake
tended to increase during follow-up. Information on
sodium restriction should be included in weight loss
programmes.
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1976
A new strain of genetically
obese rat recently obtained in our laboratory exhibits
endogenous hyperlipidemia (marked hypertriglyceridemia
and moderate hypercholesterolemia) and spontaneous
hypertension. The animals die prematurely from kidney
failure or from the complications of atherosclerosis.
A low calorie diet proved to be highly beneficial
to these rats. Body weight declined, obesity diminished,
the hypertriglyceridemia was almost eliminated, and
the hypercholesterolemia was reduced. However, the
hypertensive state was not alleviated. Since the life
span of the rats was greatly prolonged by a low calorie
diet, the latter undoubtedly served to prevent or
arrest the development of renal and vascular disease
in these obese animals.
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