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Singh R.B.,The Tsim Tsoum Institute | De Meester F.,The Tsim Tsoum Institute | Wilczynska A.,The Tsim Tsoum Institute
World Heart Journal | Year: 2012

Background. Epidemiological studies indicate that social determinants of health such as lifestyle and food consumption patterns may be important in the pathogenesis of non-communicable diseases (NCDs) including cardiovascular diseases (CVDs), diabetes mellitus, chronic lung diseases and cancer and all-cause mortality. The United Nations had a high level meeting in Sept 2011 to explore strategies for prevention of these four NCDs in view of this rapidly moving disaster. Methods. Internet search of PubMed and discussion with experts. Results. In developed countries, when people learned the methods of prevention, there was a decrease in CVDs and cardiovascular mortality. However, a large number of people continue to suffer from NCDs due to increase in obesity resulting in an increase in the metabolic syndrome in both developed and developing economies. The Western diet is generally pro-atherogenic characterized with energy dense, refined, ready-prepared foods with a high glycemic index and unhealthy lipids poor in w-3 fatty acids, phytochemicals and fiber. A high omega-6/omega-3 ratio, as found in today's Western diets, promotes the risk of NCDs. These diets are rich in total fat, trans fat, refined carbohydrates and the w-6/w-3 fatty acid ratio varies from 20-50 in various countries.Increased intake of such diets is associated with the proinflammatory state in our body, with increase in oxidative stress, free fatty acids and triglycerides; resulting in endothelial dysfunction, leading to CVDs and other chronic diseases. Both omega-6 and omega-3 fatty acids influence gene expression. Omega-3 fatty acids have strong anti-inflammatory effects whereas w-6 fatty acids are proinflammatory. A high w-6/w-3 ratio of the diets and tissues have been reported as a risk factor for coronary artery disease (CAD), hypertension, atherosclerosis, stroke, Type 2 diabetes mellitus, cancer, and other chronic diseases. Increased dietary intake of w-6 fatty acid significantly enhances the apparent atherogenic effect of genotype, whereas increased dietary intake of omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) blunts this effect. Recent studies indicate that dietary omega-6 fatty acids promote, whereas marine omega-3 fatty acids EPA and DHA inhibit, leukotrienes-, thromboxanes-, prostaglandins-mediated tissue inflammation thereby leading to the pathogenesis of NCDs. Conclusions. It seems that proinflammatory diets and inflammation in the tissue are the main issues for development of metabolic syndrome and other NCDs. It is possible that new approaches including Mediterranean diet rich in fruits, vegetables, nuts, canola oil, and olive oil characterized with low w-6/w-3 ratio in the diet, can modulate inflammation and may be protective against CVDs and other chronic diseases. © Nova Science Publishers, Inc.


Aldabbagh L.A.,University of Kufa | Hmood A.R.,Kerbela University | Hadi N.R.,University of Kufa | Gupta N.,Bharat Heavy Electricals Ltd. | Singh R.B.,The Tsim Tsoum Institute
World Heart Journal | Year: 2015

Background and objective: The prevalence of type 2 diabetes mellitus (T2DM) is increasing globally. About 80% of patients with T2DM die prematurely of cardiovascular diseases (CVD, i.e., cardiac disease, plus vascular disease, plus cerebrovascular disease) and their complications. The early detection of coronary artery disease (CAD) has been documented to play a major role to prevent its full blown picture and its complications. The myocardial ischemia could be silent, particularly amongst patients with T2DM. One technique to detect silent myocardial ischemia (SMI) is 48-hour ambulatory electrocardiographic monitoring. Herein we study the prevalence of SMI in newly diagnosed patients with T2DM using 48-hour ambulatory electrocardiographic (ECG) monitoring. Methods: In this cross-sectional study, 183 asymptomatic newly diagnosed patients with T2DM without any evidence of CVD were screened in our clinic. Out of 183 patients, 128 eligible patients, 92 (72%) males and 36 (28%) females, aged 24-63 years (mean age: 40.6 ± 11.8 years), signed the informed consent. These patients were subjected to a full history and complete physical examination; thereafter, they were subjected to ECG examination. Blood samples were obtained for laboratory testing for analysis of HDL, LDL, and HbA1c. Patients were then subjected to 48-hour ambulatory electrocardiographic monitoring. Results: The average HbA1C of the study population was 7.7±1.6%. Of the studied patients (29% were smokers), the 48-hour ambulatory electrocardiographic monitoring was found to be satisfactory for analysis in 100 patients. Out of these 100 monitoring records, 86 (86%) had normal 48-hour Holter monitoring, while 12 (12%) had silent myocardial ischemic ECG changes. Of these 12 patients with abnormal results, 4 patients (4%) had anterior wall and 8 (8%) inferior wall changes, with or without lateral wall changes. The results of the 48-hour Holter monitoring indicating silent myocardial ischemia demonstrate that it is significantly associated with newly diagnosed asymptomatic T2DM, high systolic blood pressure (p = 0.009), smoking (p = 0.001), dyslipidemia (p = 0.001), and obesity. Conclusion: The prevalence of SMI in newly diagnosed T2DM is fairly high (12%) in our subjects. All subjects with SMI had one or more other risk factor for CAD, like dyslipidemia, hypertension or smoking. The findings are of paramount significance as they carry enormous potential for secondary prevention. © 2015 Nova Science Publishers, Inc.


Singh R.B.,The Tsim Tsoum Institute | Takahashi T.,Fukuoka Women's University | Tokunaga M.,Fukuoka Women's University | Wilczynska A.,The Tsim Tsoum Institute | And 9 more authors.
Open Nutraceuticals Journal | Year: 2014

Background: Brain-derived neurotrophic factor (BDNF) is a major neurotrophin which may have promise to be a nutraceutical of this decade. It has a documented role in neurogenesis, angiogenesis, and neuronal survival. BDNF can have beneficial effects on several cardio-metabolic and neuro-psychiatric disorders, indicating that it is important in brain-body interactions. Diet and lifestyle factors may also have an influence on BDNF levels. In this review, we examine the beneficial role of BDNF on risk factors of vascular diseases, type 2 diabetes mellitus and anxiety disorders. Methods: Internet search and discussion with peer colleagues. Results: Majority of the BDNF (70-80%) is derived from dendrite of neurons but it is also present in other body tissues. BDNF controls the food intake and appetite as well as lipid and glucose metabolism. Sedentary behavior and tobacco intake may be associated with BDNF deficiency. Lower serum concentration of BDNF and higher vascular endothelial growth factor (VEGF) concentrations were associated with increased risk of incident stroke/TIA. BDNF may serve as an intermediate biomarker for subclinical vascular disease and may also have biological potential to serve as a therapeutic target for primary and secondary prevention of vascular diseases, as well as clinical and subclinical vascular brain disease. BDNF deficiency has been observed in association with anxiety, depression, insomnia, dementia, insulin resistance, type 2 diabetes and vascular diseases. The phenotypes associated with insulin resistance are at increased risk for developing cognitive decline and neuro-degeneration resulting in vascular dementia, and depression as well as diabetes mellitus and metabolic syndrome, which are risk factors for CVDs. BDNF may be administered as nutraceutical due to its protective influence on BDNF concentrations, insulin receptors and hypothalamic dysfunction leading to beneficial effects on cardiovascular risk and neuropsychological dysfunction. It is proposed that omega-3 fatty acids and moderate physical activity may enhance BDNF release. Conclusions: It is possible that circulating BDNF deficiency is a risk factor for obesity, CVDs and diabetes as well as risk factor for neuropsychiatric diseases. BDNF administration may modify the risk of clinical and subclinical stroke, depression, and dementia as well as of obesity and type 2 diabetes. © Singh et al.


Sarrafi-Zadeh S.,University of Mysore | Singh R.B.,The Tsim Tsoum Institute | de Meester F.,The Tsim Tsoum Institute | Wilczynska A.,The Tsim Tsoum Institute | And 2 more authors.
Open Nutraceuticals Journal | Year: 2012

Background: Clinical evidence indicates that insufficient sleep and poor sleep quality appear to be common consequences of shift work. These rhythms appear to have independent influence on the function of the endocrine system, circadian brain function and gastrointestinal tract. Insufficient sleep and its poor quality due to shift work interfere with beta cells, leptin and ghrelin functioning, resulting in factors for the development and exacerbation of insulin resistance. Human studies found that insufficient sleep alters the levels of leptin and ghrelin, two hormones involved in the regulation of appetite and body fat. Leptin, released by fat cells, signals the brain to feel satiety. Ghrelin, produced in the stomach, signals hunger. Investigations reported that temporarily sleep-deprived individuals experienced hormonal changes along with greater cravings for sweet and fatty foods. A further reason for their cravings is related to the stress hormone cortisol, which can rise with sleep deprivation and contribute to hunger. In addition to altered hormone levels, people who stay awake longer have more opportunity to eat, and late-night eating often includes high-caloric foods. Weight gain is only one of the many side effects of insufficient sleep, but it can lead to long-term health problems, including diabetes. Although more sleep will not automatically result in weight loss, sufficient sleep and a regular sleep schedule are critical in controlling appetite and promoting a healthy eating pattern. Research on sleep and appetite reveals a consistent link between a lower amount of sleep and a higher body mass index (BMI), a ratio of weight-to-height that indicates overweight. Studies showed those who slept less than eight hours a night were more likely to be overweight. Methods: Internet search and discussion with colleagues. Results: Recent research indicates that disruption of sleep can influence food intake and food and nutrients can influence sleep. There is evidence that high protein and carbohydrates meals can influence moods, attention and concentration among normal adult subjects with respect to age, gender and meal time. Women reported greater sleepiness after two hours of carbohydrate meal as opposed to a protein meal. On the other hand men reported greater calmness after a carbohydrate as opposed to a protein meal. Age of subjects may also influence the response to meals. After a carbohydrate or protein rich breakfast, persons older than 40 years felt more tense and less calm with a protein-rich than carbohydraterich meal. In general older subjects preferred carbohydrate than protein meals. Carbohydrate meals are also reported to impair objective performance; carbohydrate rich foods either in breakfast or lunch have exhibited negative influence on neural response such as impaired objective performance and poor sustained attention. A meal consumed close to bedtime is associated with sleep disturbances. Further, solid foods as well as large meals may cause more sleepiness than liquid foods. Studies have also shown that the larger the meal, the sleepier the person thereafter. In the evening the sleepfacilitating effects of carbohydrates may be beneficial. However, manipulation in the energy content of meals for a single day may cause increase in markedly different levels of insulin without changes in plasma glucose. Conclusions: The findings indicate that food intake can influence sleep and disruption of sleep can cause increased consumption of fast ready-prepared foods which have adverse effects resulting in obesity, diabetes and CVDs. © Sarrafi-Zadeh et al; Licensee Bentham Open.


Singh R.B.,Halberg Hospital and Research Institute | de Meester F.,The Tsim Tsoum Institute | Wilson D.W.,Durham University
Open Nutraceuticals Journal | Year: 2012

Background: The Paleolithic diet with fruits, vegetables, roots, leaves, seeds, honey, meat, fish and eggs provided low w-6/w-3 ratio of fatty acids, high monounsaturated fatty acids, fiber, phytochemical antioxidants and proteins. Recent studies indicate that diets similar to Paleolithic diet have anti-inflammatory potential, whereas Western diet, with refined carbohydrates, high w-6/w-3 ratio of fatty acids, lower protein, high in saturated trans and w-6 fat, has proinflammatory effects. Foods that comply with the Paleolithic diet promote a balanced ratio of omega-6 and omega-3 fatty acids (w6:w3-PUFAs = 1:1) in serum total lipids and, in turn, a 25% proportion of w-6 in blood total highly unsaturated fatty acids (HUFAs). Further evidence suggest that walnuts and almonds can decrease heart disease risk due to their hypolipidemic and antiinflammatory effects. Such diet can also enhance immunity and adaptation due to decrease in inflammation. A metaanalysis of prospective cohort studies demonstrated that an increased consumption of fruit and vegetables from less than 3 to more than 5 servings / day is related to a 17% reduction in CAD risk, whereas an increased intake from 3 to 5 servings/day is associated with a smaller and borderline significant reduction. These results provide evidence supporting that 5 or more servings per day of fruit and vegetables, are needed to protect from noncommunicable diseases in general, and cardiovascular diseases (CVDs) in particular. There is evidence that a Mediterranean diet (fruits, vegetables, nuts, olive oil, whole grains) and Indo-Mediterranean diets (whole grains and mustard oil, vegetable, fruits and nuts) may be protective in patients with high risk of CVD. In some of these studies, soup rich in nuts, raisins, vegetables, tomato, carrot and mustard oil+olive oil as well as yogurt containing nuts and raisins have been used in the treatment of acute coronary syndrome, resulting into significant reduction in cardiac events and mortality. © Singh et al.


Singh R.B.,Halberg Hospital and Research Institute | Hristova K.,National Heart Hospital | Gligorijevic T.,University of Belgrade | De Meester F.,The Tsim Tsoum Institute | And 10 more authors.
World Heart Journal | Year: 2015

Apart from the sympathetic and parasympathetic nerves, the pituitary and pineal glands and the suprachiasmatic nucleus are also involved in determining autonomic functions. Western diet, autonomic dysfunction and obesity are further associated with sympathetic activation that promotes atherosclerosis, end-organ damage, and hypertension. Experimental sites indicate that high-fatinduced weight gain in rats elevates plasma leptin at 1 to 3 days after the onset of calorie-dense diets, and that dietinduced overfeeding may increase sympathetic activity within 1 week after the onset of the regimen. It has been shown, for the first time, that the high-fat, cafeteria-style diet stimulates sustained increases in lumbar sympathetic neural drive in rats. Halberg demonstrated for the first time in 1973 that eating dinner was associated with relative weight gain, whereas eating the same amount of calories as breakfast was linked to relative weight loss in humans and death in animals. There appear to be independently variable effects on circadian physiology and metabolism in association with circadian restriction of feeding to a particular time of the day and during caloric restriction. Apart from these markers related to energy, circadian alteration in metabolism of nutrients, omega-3 fatty acids, flavonoids, B vitamins and coenzyme Q10 may be important in autonomic functions. © 2015 Nova Science Publishers, Inc.


Wilson D.W.,Durham University | de Meester F.,The Tsim Tsoum Institute | Singh R.B.,Halberg Hospital and Research Institute | Gerasimova E.,Voronezh State Medical Academy
World Heart Journal | Year: 2013

Background. Following the emergence of cosmic spacetime, fundamental particles, mass, gravity and radiation that led to the formation of Earth, the origin of life occurred probably with the emergence of the protocell. The functions of this protocell were under influence of geophysical forces and solar periodicities resulting in circadian and other frequency rhythms in biological systems integrated with the external environment i.a. comprising nutrients. Methods. Internet search and discussion with colleagues. Results. The discourse in space-time, fundamental particles, gravity, mass and radiation allows progression towards periodic events in parts of the observable universe and of relevance to this paper, in life itself. Conclusions. Diet and lifestyle factors and geophysical cycles may trigger the circadian system and adversely affect cardiovascular events. © 2013 Nova Science Publishers, Inc.


Singh R.B.,Halberg Hospital and Research Institute | Tokunaga M.,Fukuoka Women's University | Takahashi T.,Fukuoka Women's University | Wilson D.W.,Pharmacy and Health | And 2 more authors.
Open Nutraceuticals Journal | Year: 2013

Two patients presented with positive hepatitis B virus antigen reactivity. Both the patients had medical records indicating clinical and biochemical manifestations of viral hepatitis. Treatment with coenzyme Q10 and w-3 fatty acids was associated with reversal of antigenicity causing negative hepatitis B antigen reactivity. © Singh et al.; Licensee Bentham Open.


Singh R.B.,The Tsim Tsoum Institute | de Meester F.,The Tsim Tsoum Institute | Wilczynska A.,The Tsim Tsoum Institute | Wilson D.W.,Durham University | Hungin A.P.,Durham University
World Heart Journal | Year: 2011

Background. Obesity and type 2 diabetes mellitus have become major health problems in both developing and developed countries. The exact pathogenesis of obesity and type 2 diabetes mellitus that are components of metabolic syndrome is not known. Method. Perspectives, rather than formal review, were derived from a structured literature search essentially based on selected key words, vide infra, using Medline, PubMed and other personal bibliographies. Results. Physical inactivity and increased intake of energy in association with gene expression are common predisposing factors for obesity and metabolic syndrome. Apart from these factors, brain-related mechanisms concerned with the hypothalamus and vagus nerve have been implicated in such pathogenesis. The role of liver and beta cells of the pancreas and their interactions with the hypothalamus and vagus nerve are important mechanisms to explain the behavioural factors in the pathogenesis of metabolic syndrome. It seems that a neuronal pathway consisting of the afferent vagus from the liver and efferent sympathetic nerves to adipose tissues appear to be involved in the regulation of energy expenditure, systemic insulin sensitivity, glucose metabolism, and fat distribution between the liver and the peripheral tissues. Therefore, it is likely that the liver conveys information regarding energy balance to the brain via the afferent vagus, whereas leptin could be a humoral signal to the brain from the adipocytes. It is possible that the brain receives information from several tissues and organs via both humoral and neuronal pathways, which it integrates to produce an appropriate response; sympathetic nervous system activation and or parasympathetic modulation to maintain energy homeostasis. In this connection, the role of w-6/w-3 fatty acids ratio on liver-pancreas and brain function in relation to the Tsim Tsoum concept appears to be very interesting because it places emphasis on mind-body connection/interactions in the pathogenesis of obesity and diabetes. Omega-3 fatty acids can also improve neuronal efficiency causing improvement in attention, cognitive performance,mood-state and in the electroencephalographic alpha and theta oscillations which are indicators of memory function. Treatment of type 2 diabetes mellitus and coronary atherosclerosis with an ω-3 fatty acid rich Mediterranean diet may be protective by their direct effect as well as by their influence on the hypothalamic and vagal connections. Conclusions. It is possible that liver and pancreas via vagus nerve and hypothalamic connections as well as via humoral mechanisms can influence energy metabolism and food intake to maintain energy homeostasis which may have an independent effect on the development of obesity, type 2 diabetes and metabolic syndrome.ω-3 fatty acids may also have an independent effect on liver-pancreatic beta cells and brain connections © Nova Science Publishers, Inc.


Singh R.B.,Halberg Hospital and Research Institute | Takahashi T.,Fukuoka Women's University | Nakaoka T.,Tokyo Women's Medical University | Otsuka K.,Tokyo Women's Medical University | And 12 more authors.
Open Nutraceuticals Journal | Year: 2013

The food and nutrient intake among Paleolithic Homo sapiens, hunter-gatherers and among Asian and Homo economicus Western populations shows marked variations. Economic development and affluence may be associated with a decrease in the consumption of omega-3 fatty acids, vitamins, antioxidants and amino acids and significant increase in the intakes of carbohydrates, (mainly refined), fat (saturated, trans fat and linoleic acid) and salt compared to the Paleolithic period. The protein or amino acid intake was 2.5 fold greater (33 vs. 13%) in the Paleolithic diet Homo sapiens compared to modern Western diet consumed by Homo economicus populations. Approximately 10,000 years ago, prior to the Agricultural Revolution, our diet was based on an enormous variety of wild plants. However, today about 17% of plant species provide 90% of the world's food supply which is mainly contributed by grains produced by fertilizer based on rapidly grown crops which may result in a decrease in nutrient density and increase in energy. Wheat, corn and rice account for three fourths of the world's grain production on which humans are dependent for their food supply. Grains are high in omega-6 fatty acids and carbohydrates and low in omega-3 fatty acids and antioxidants compared to leafy green vegetables. It has been estimated that diet of Homo sapiens was characterized by higher intakes by essential and nonessential amino acids, calcium, potassium, magnesium, flavonoids and w-3 fatty acids whereas modern Western diet of Homo economicus has excess of energy-rich refined carbohydrates, w-6, trans fat and saturated fat and low in protective nutrients. The consumption of such diets in wealthy countries in conjunction with sedentary behavior is associated with increased prevalence of morbidity and mortality due to noncommunicable diseases (NCDs). © Singh et al.

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