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Singh R.B.,Halberg Hospital and Research Institute | Anjum B.,KGMU | Takahashi T.,Fukuoka Women's University | Martirosyan D.M.,Functional Food Center Inc. | And 5 more authors.
World Heart Journal | Year: 2012

Background: The pathways for development of noncommunicable diseases (NCDs) are sedentary behaviour, common dietary habits of the Western world, tobacco use, stress, and alcoholism among individuals and populations with underlying lack of general and health education. However, some experts have observed that poverty is the primary cause of disability and deaths due to NCDs. This study examines the association of social class and social determinants of health as risk factors for deaths due to NCDs. Subjects and methods: Randomly selected death records of 2,222 (1,385 men and 837 women) decedents, aged 25-64 years at time of death, out of 3,034 death records, were studied by verbal autopsy questionnaires, during 1999-2001 from the records at the Municipal Corporation in Moradabad. All the risk factors were assessed by questionnaires which werecompleted with the help of the victim's spouse and a local treating doctor practising in the concerned field. Social classes were assessed, based on attributes of per capita income, occupation, education, housing, and ownership of consumer luxury items in the household. Poverty was considered if the total family income was

Fedacko J.,Safaric University | Vargova V.,Safaric University | Singh R.B.,Halberg Hospital and Research Institute | Anjum B.,University of Lucknow | And 6 more authors.
Open Nutraceuticals Journal | Year: 2012

Introduction: There is evidence that the Western type of diet has adverse effects, and prudent dietary patterns may have beneficial effects against deaths from cardiovascular and other chronic diseases. In the present study, we examine the association of dietary patterns with causes of deaths among urban decedents in north India. Subjects and Methods: Randomly selected records of death of 2222 (1385 men and 837 women) decedents, aged 25-64 years, were examined. Clinical data and causes of death were assessed by a questionnaire based on available hospital records and a modified WHO verbal autopsy questionnaire. Dietary intakes of the dead individuals were estimated by finding out the food intake of the spouse from 3-day dietary diaries and by asking probing questions about differences in food intake by the decedents. Results: The score for intake of prudent foods was significantly greater and the ratio of w-6/w-3 fatty acids of the diet significantly lower for deaths due to 'injury' and accidental causes compared to deaths due to non-communicable diseases (NCD). Multivariate logistic regression analysis revealed that after adjustment for age, total prudent foods (OR,CI: 1.11;1.06-1.18 men; 109;1.04-1.16 women) as well as fruits, vegetables, legumes and nuts (1.07; 1.02-1.12 men; 1.05; 1.99-1.11 women) were independently, inversely associated whereas Western type foods (1.02; 0.95-1.09 men; 1.00; 0.94-1.06 women); meat and eggs(1.00-0.94-1.06 men; 0.98; 0.93-1.04 women) and refined carbohydrates (0.98; 0.91-1.05 men, 0.95; 0.89-1.02 women) and high w-6/w-3 ratio of fatty acids were positively associated with deaths due to NCDs. Conclusions: Increased intake of high w-6/w-3 ratio Western type foods and decline in prudent foods intake may be a risk factor for deaths due to NCDs. © Fedacko et al.

Singh R.B.,Halberg Hospital and Research Institute | Fedacko J.,Safaric University | Pella D.,Safaric University | Macejova Z.,Safaric University | And 9 more authors.
Acta Cardiologica | Year: 2011

Background There are few studies detailing the prevalence of prehypertension and hypertension in India. Methods Men and women, over 25 years of age were included. After completion of a dietitian-administered questionnaire followed evaluation by a physician, physical examination and blood pressure measurement. Cross-sectional survey screened 6940 subjects, (3507 men (M), 3433 women (W): 1993-96) from cities located in five corners of India (Kolkata, n = 900; Nagpur, n = 894; Mumbai, n = 1542; Thiruanantpuram, n = 1602; Moradabad, n = 2002). Prehypertension (BP 130-139/85-89 mm Hg) and hypertension (BP ≥ 140/90 mm Hg) were diagnosed according to the European Society of Cardiology criteria. Results Prevalence of prehypertension and hypertension, respectively, was significantly greater in South India (Trivandrum: W 31.5; 31.9%; M 35.1; 35.5%) and West India (Mumbai: W 30.0; 29.1%; M 34.7; 35.6%) compared to North India (Moradabad: W 24.6; 24.5%; M 26.7; 27.0%) and East India (Kolkata: W 20.9; 22.4%; M 23.5; 24.0%). Subjects with prehypertension and hypertension were older, had a higher BMI, central obesity and a sedentary lifestyle. They had a higher salt and alcohol intake, with greater oral contraceptive usage (W). Multivariable logistic regression analysis revealed strong positive associations of hypertension with age, central obesity, BMI, sedentary lifestyle, salt and alcohol intake and oral contraceptive usage (W). Fruit, vegetable and legume intake showed inverse associations, tobacco intake showed none. One in four with hypertension was aware of their diagnosis and of those receiving treatment, one in three had well-controlled hypertension. Conclusions There is little awareness that prehypertension and hypertension are public health issues in India. Ageing population, central obesity, sedentary lifestyle, excessive salt and alcohol, lower fruit, vegetable and legumes intake increase risk for blood pressure elevation.

Singh R.B.,Halberg Hospital and Research Institute | Reddy K.K.,Tirupati University | Fedacko J.,Safaric University | de Meester F.,Tsim Tsoum Institute | And 2 more authors.
Open Nutraceuticals Journal | Year: 2011

Nutritional status has been implicated to be in the pathogenesis of noncommunicable diseases and long-term worldwide survival. In this relevance, the teachings of Bhagwatgita, Upanishads and Indian Vedas appear to be as old as 'Human Civilization'. The dietary formulations concomitant with relevant prescriptions provided in these scriptures appear to be as scientific as observed in cohort studies and intervention trials. These studies confirm the ancient concept reflecting that fruits, vegetables, whole grains, nuts, and milk were quite protective. In this review, the traditional concepts of nutrition to western literature have been duly introduced. © R.B. Singh; Licensee Bentham Open.

Hristova K.,Sofia University | Singh R.B.,Halberg Hospital and Research Institute | Fedacko J.,Safaric University | Toda E.,Tokai University | And 6 more authors.
World Heart Journal | Year: 2013

Introduction. Recent evidence shows that chronic heart failure (CHF) is a major cause of morbidity and mortality. The prognosis in CHF may be dependent on cause, severity and presence of risk factors and drug therapy. In the present study, we examine the causes, risk factors, class and oxidative stress among CHF patients. Subjects and methods. Of 127 patients with CHF, 2 were excluded and the remaining 125 patients (Men 61, women 64) with different aetiologies of CHF, and 250 age and sex matched control subjects, were evaluated in this case study. Severity of disease based on the New York Heart Association (NYHA) standards fell within functional classes II to IV. The diagnosis of HF was based on clinical manifestations as well as on echocardiographic heart enlargement. Results. The causes of CHF were; CAD (n=34, 27.2%), hypertensive heart disease (n=10, 8.0%),valvular heart disease (n=40, 32.0%) and idiopathic dilated cardiomyopathy (n=38, 30.4%).Risk factors of HF were; CAD (n=52, 41.6%), hypertension (>140/90mmHg) (n=54, 43.2%), diabetes mellitus (n=12, 9.6%), obesity (n=43, 34.4%) and albuminurea (n=12,9.6%). Echocardiographic ejection fraction was 39.1±8.2% (mean±SD)in the study group, indicating class II-IV heart failure. There was a significant increase in biomarkers of oxidative stress, among HF patients compared to healthy subjects. Conclusions. The findings indicate that HF has become a public health problem. The causes of HF appear to be CAD, cardiomyopathy and valvular heart disease. Severity of CHF, aetiology; CAD and cardiomyopathy appear to be important for increased oxidative stress among these patients. © Nova Science Publishers, Inc.

Singh R.B.,Halberg Hospital and Research Institute | Halberg F.,University of Minnesota | Cornelissen G.,University of Minnesota | Siegelova J.,Masaryk University | And 5 more authors.
World Heart Journal | Year: 2013

That exercise effects are circadian stage dependent and that exercise at the wrong circadian stages can induce a Vascular Variability Disorder (VVD) has been documented earlier. Herein we show how statistically significant results can be obtained with a simple individualized design, that can be self-applied by everybody to optimize a desired effect by Chronobiologically-interpreted Ambulatory Blood Pressure (BP) and heart rate (HR) Monitoring C-ABPM). A 68-year old internist cardiologist monitored himself at halfhourly intervals, with interruptions, for 3-to7-day sessions, exercise timing being kept the same within a given session and changed from one session to another. Exercise training in the morning was associated with lowest BP and HR MESORs (Midline Estimating Statistic Of Rhythm, a rhythm-adjusted mean) as compared to exercise done at mid-day, late afternoon or in the evening. We review some of the literature, speculate about its meaning, yet do not stray beyond a single case in our conclusions for everybody: it seems possible and desirable to personalize exercise at a time of pertinence rather than convenience. One shoe or one timing does not fit all. © Nova Science Publishers, Inc.

Hristova K.,Sofia University | Cornelissen G.,University of Minnesota | Fedacko J.,Safaric University | Singh R.B.,Halberg Hospital and Research Institute
World Heart Journal | Year: 2014

Background: Synchronization of organisms with their environment along the 24-hour scale is mediated by circadian clocks. This cell-autonomous mechanism has been identified within all cardiovascular-relevant cell types, including cardiomyocytes. Subjects and Methods: The study aims to assess the circadian pattern in the contractility of the left ventricle (LV), using myocardial deformation imaging. The study involved 11 clinically healthy volunteers (mean age 38y ±10), including 4 men (mean age 30.5y ±12.4) and 7 women (mean age 42.7y ±4.8). Automated quantification of LV systolic function by measurement of LV systolic strain from speckle-tracking echocardiography was used. Echocardiography was performed with a commerciallyavailable standard ultrasound scanner, and a 2.5-MHz transducer. All images were obtained at a rate of 50 to 70 frames/s. Strain and twist/untwist measurements were performed offline with dedicated automated software. Results: In health, global longitudinal strain (GLS) varied from −22.35% to −22.87%, global circumferential strain (GCS) from −18.41% to −21.50%, and global radial strain (GRS) from 36.75% to 42.30%. LV twist (LVT) ranged from 8.33° to 10.77° and untwist rate (LVUR) from −87.45°/s to −71.49°/s. Overall, highest values for GLS, GRS, and LVT occurred around 06:00 and overall lowest values of GRS and LVT around 18:00. Considering results from all 6 walls as independent replications, a statistically significant circadian rhythm was found for both regional circumferential strain (P<0.001) and for radial strain (P=0.002). Discussion and Conclusion: This study assessed global physiological consequences of the circadian clock specifically within the myocardial deformation. Apart from influences of the cardiomyocyte circadian clock on heart rate and the responsiveness of the heart to an increased workload, evidence is provided herein for the circadian stage-dependence of regional deformation, an important result pertaining to global ventricular function. © 2014 Nova Science Publishers, Inc.

Pischke C.R.,Institute for Epidemiology and Prevention Research | Zeeb H.,Institute for Epidemiology and Prevention Research | Van Hal G.,University of Antwerp | Vriesacker B.,University of Antwerp | And 12 more authors.
BMC Public Health | Year: 2012

Background: Incorrect perceptions of high rates of peer alcohol and tobacco use are predictive of increased personal use in student populations. Correcting misperceptions by providing feedback has been shown to be an effective intervention for reducing licit drug use. It is currently unknown if social norms interventions are effective in preventing and reducing illicit drug use in European students. The purpose of this paper is to describe the design of a multi-site cluster controlled trial of a web-based social norms intervention aimed at reducing licit and preventing illicit drug use in European university students. Methods/Design. An online questionnaire to assess rates of drug use will be developed and translated based on existing social norms surveys. Students from sixteen universities in seven participating European countries will be invited to complete the questionnaire. Both intervention and control sites will be chosen by convenience. In each country, the intervention site will be the university that the local principal investigator is affiliated with. We aim to recruit 1000 students per site (baseline assessment). All participants will complete the online questionnaire at baseline. Baseline data will be used to develop social norms messages that will be included in a web-based intervention. The intervention group will receive individualized social norms feedback. The website will remain online during the following 5 months. After five months, a second survey will be conducted and effects of the intervention on social norms and drug use will be measured in comparison to the control site. Discussion. This project is the first cross-national European collaboration to investigate the feasibility of a social norms intervention to reduce licit and prevent illicit drug use among European university students. Final trial registration number. DRKS00004375 on the 'German Clinical Trials Register'. © 2012 Pischke et al.; licensee BioMed Central Ltd.

Fedacko J.,University of P.J. Šafarik | Pella D.,University of P.J. Šafarik | Fedackova P.,University of P.J. Šafarik | Vargova V.,University of P.J. Šafarik | And 3 more authors.
Open Nutraceuticals Journal | Year: 2011

Background: Several cardiovascular, neurological and other diseases are associated with coenzyme Q10(CoQ) deficiency. The objective is to evaluate possible benefits of ubiquinone supplementation in cardiovascular diseases and degenerative diseases of the brain. Methods: An internet search in PubMed, Vitasearch, In Circulation. Net, till 2008, discussions with colleagues, own experiences. Results: Ubiquinone (Coenzyme Q10) deficiency has been observed in several cardiovascular and neurological diseases. CoQ10 has strong influence on lipid metabolism, oxidation of blood lipids, vascular inflammation and on the cell membranes of cardiac and arterial cells and neurons. These pathogenetic mechanisms seem to be important in patients with neurological and cardiac disease as well as in brain-heart connection. Its supplementation has several beneficial effects including the stabilisation of atherosclerotic plaque and decreasing the size of myoacardial infarction and the protection of neurons. Antioxidant properties of CoQ10 are responsible for the prevention of many drug side effects. Several studies have suggested the beneficial effect of CoQ10 in neuro-cardiovascular diseases, that will require further confirmation. Adverse effects such as nausea and vomiting may be reduced by using highly bio-available brands, that reduce the oral dosage of COQ. Conclusions: CoQ10 is still in the investigational stages and the list of possible indications related to brain and heart diseases and their linkage, appears to be quite extensive. There is still the need for a number of large, double blind multicenter, randomized, controlled clinical trials, in order to confirm the possible beneficial effects of CoQ10 supplementation in different neurocardiological conditions. © Fedacko et al.

Singh R.B.,Medical Hospital and Research Center | Fedacko J.,Safaric University | Vargova V.,Safaric University | Pella D.,Safaric University | And 2 more authors.
World Heart Journal | Year: 2012

Background: Epidemiological studies indicate that high w-6 and low w-3 fatty acids in the diet may have adverse effects on cardiovascular diseases (CVDs). However, a low w-6/w-3 ratio diet by increasing w-3 and by decreasing w-6 fatty acid in the Paleolithic style diet can cause significant decline in cardiovascular and all-cause mortality. Subjects and Methods: A randomized, single blind, controlled trial was carried out on 406 patients with acute coronary syndromes (ACS) diagnosed following WHO criteria. An experimental intervention group received Paleolithic style diet characterized by fruits, vegetables, whole grains, almonds and walnuts and the control group had their fat modified according to the National Cholesterol Education Program Step 1 (prudent) diet. Main outcome measures were compliance with experimental diets at one year and all-cause mortality and its association with w-6/w-3 fatty acid ratio after a follow up of two years. These data have not been reported in earlier publications. Results: The experimental group received significantly greater amount of fruits, vegetables and whole grains, nuts and mustard oil and lower amount of refined bread, biscuits and sugar and butter and clarified butter compared to control diet group at one year of follow up. Total adherence score to Paleolithic style diet and prudent diet were significant in both the groups. Omega-6/Omega-3 fatty acid ratio of the diet which was much higher before entry to the study (32.5±3.3), was brought down to significantly lower content in the Paleolithic style diet group A (n = 204, compared to control group diet B (n = 202) at entry to the study (3.5± 0.76 vs. 24.0± 2.4 KJ/day, p<0.001). The fatty acid ratio remained significantly much lower in the experimental group compared to control group after one year of follow up (4.4±0.56 vs. 22.3±2.1,KJ/day, p<0.001). Total mortality was 14.7% in the Paleolithic style diet group and 25.2% in the control group, after a follow up of two years. The association w-6/w-3 ratio of fatty acids with mortality showed a gradient in both the groups independently, as well as among total number of deaths. A lower w-6/w-3 ratio of fatty acids from 1-10 was associated with a significantly lower mortality whereas increase in w-6/w-3 fatty acid ratio to more than 10 was associated with an increasing trend in mortality; 1.7% at ratio less than 5 and 19.9% at ratio 30. Conclusions: A Paleolithic style diet characterized with fruits, vegetables, nuts, whole grains and mustard oil with low w-6/w-3 fatty acids ratio <5, is more effective in causing significant decline in cardiovascular and all-cause mortality compared to prudent diet in the secondary prevention of coronary artery disease. The association of mortality was consistent with increase in w-6/w-3 fatty acid ratio in the diets in both the groups and the trends were highly significant. © 2012 Nova Science Publishers, Inc.

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