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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 | Fedacko J.,Pj Safaric University | Vargova V.,Pj Safaric University | Kumar A.,Government Medical College | And 4 more authors.
Acta Cardiologica | Year: 2011

Introduction: The exact causes of death in India are not known because autopsy studies are difficult to conduct due to religious considerations. There are rapid changes in diet and lifestyle amongst social classes causing changes in the pattern of risk factors and mortality. In the present study, we attempt to develop a verbal autopsy questionnaire based on medical records and interview of a family member, for the assessment of causes of death, social class, tobacco consumption and dietary intakes among urban decedents in north India. Methods: For the period 1999-2001, we studied the randomly selected records of death of 2222 (1385 men and 837 women) decedents, aged 25-64 years, out of 3034 death records overall from the records at the Municipal Corporation, Moradabad. Families of these decedents were contacted individually to find out the causes of death, by scientist- administered, informed-consented, verbal autopsy questionnaire, completed with the help of the spouse and local treating doctor practicing in the appropriate health care region. 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. Tobacco consumption of the victim was studied by a questionnaire administered to family members. Social classes were assessed by a questionnaire based on attributes of per capita income, occupation, education, housing and ownership of consumer luxury items in the household. The diagnoses of overweight and obesity were based on the new WHO and International College of Nutrition criteria. Results: Cardiac diseases (23.4%, n = 520) including coronary artery disease (10%), valvular heart disease (7.2%, n = 160), diabetic heart disease (2.2%, n = 49), sudden cardiac death and inflammatory cardiac disease, each (2.0%, n = 44) were the most common causes of deaths as reported using the modified verbal autopsy questionnaire. Brain diseases including stroke (7.8%, n = 175) and inflammatory brain disease were reported amongst 1.9% (n = 42) victims. Thus, NCDs (37.0%, n = 651); circulatory diseases (31.2%, n = 695) including stroke and cardiac diseases, and malignant neoplasms (5.8%, n = 131) emerged as the most common causes of death. Injury and accidents (14.0%, n = 313) including fire, falls and poisonings were also common. Miscellaneous causes of death were observed amongst 8.5% (n = 189) of victims. Pregnancy and perinatal causes (0.72%, n = 15) were not commonly recorded in our study. Renal diseases (11.2%, n = 250), pulmonary diseases (22.3%, n = 495) and liver diseases (4.8%, n =107) were also commonly recorded causes of death. It is clear that causes of death related to various body systems can be more accurately assessed by the modified verbal autopsy questionnaire. Circulatory diseases as the cause of mortality were significantly more common among higher social classes (1-3) than in lower social classes (4 and 5) who died more often, due to infections. Death due to coronary disease, stroke, hypertension, diabetes and obesity were significantly more common among higher social classes 1-3 and among victims with higher body mass index (BMI) compared to social class 4 and 5 who had lower BMI. Conclusions: This study indicates that causes of death, social class, tobacco and dietary intakes, can be accurately assessed by a modified verbal autopsy questionnaire based on medical records and by interview of family members. Circulatory diseases, injury-accidents and malignant diseases have become the major causes of death in India, apart from infections.


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.


Takahashi T.,Fukuoka Women's University | Toda E.,Tokai University | Singh R.B.,Halberg Hospital and Research Institute | Singh R.B.,Tsim Tsoum Institute | And 4 more authors.
Open Nutraceuticals Journal | Year: 2011

The protein intake during the Palaeolithic period has been estimated to be two and a half fold greater than current recommendations. Hydrogen, nitrogen, oxygen and carbon atoms are important components of essential and nonessential amino acids which are components of proteins. These simple molecules play an important role in the human body. The 22 known amino acids, essential and nonessential, affect a broad range of physical and mental processes.Recent studies indicate that amino acids are cell signalling molecules as well as being regulators of gene expression and the protein phosphorylation cascade. The majority of the neurotransmitters is composed of amino acids and can influence biological functions related to brain-body interactions. Amino acids are key precursors for syntheses of hormones and low-molecular weight nitrogenous substances with each having enormous biological importance. Physiological concentrations of amino acids and their metabolites; nitric oxide, polyamines, glutathione, taurine, thyroid hormones, and serotonin are required for the biological functions in our body. These metabolites are known to be protective against cardiovascular diseases and degenerative diseases of the brain. However, increased concentrations of amino acids and their products (e.g., ammonia, homocysteine, and asymmetric dimethylarginine) are pathogenic factors for neurological disorders, oxidative stress and cardiovascular disease. Glutamate is a nonessential amino acid present in many foods that is considered protective against obesity and cardiovascular diseases. Therefore a balance between amino acids and other nutrients appears to be important for normal physiological functions without any adverse effects. © Takahashi et al.


Pati S.,Indian Institute of Public Health | Singh R.B.,Halberg Hospital and Research Institute | Fedacko J.,Safaric University | Vargova V.,Safaric University | And 4 more authors.
World Heart Journal | Year: 2012

Introduction: Prospective cohort studies indicate that prudent dietary patterns can be protective against mortality from cardiovascular and malignant diseases. In the present study, we examine the association of dietary patterns with causes of deaths due to cardiovascular diseases (CVDs) and other chronic diseases 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 due to CVDs and other chronic diseases were assessed by a questionnaire based on available hospital records and a modified WHO verbal autopsy questionnaire. Dietary intakes of the deceased 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 prudent foods was significantly greater for deaths due to 'injury' and miscellaneous causes compared to deaths due to CVDs and other chronic diseases. Multivariate logistic regression analysis revealed that after adjustment of 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 (OR, CI 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 body mass index were positively associated with deaths due to NCDs. Conclusions: Increased intake of Western type foods and decline in prudent foods intake may be a risk factor for deaths due to CVDs and other chronic diseases. © Nova Science Publishers, Inc.


Sergey C.,Peoples' Friendship University of Russia | Singh R.B.,Tsim Tsoum Institute | Wilzynsca A.,Tsim Tsoum Institute | De Meester F.,Tsim Tsoum Institute
Open Nutraceuticals Journal | Year: 2011

There is marked increase in our knowledge about the role of the environmental factors in the global dimensions of the noncommunicable diseases (NCD) including cardiovascular diseases (CVDs). Recent studies indicate that there is coexistence of nutritional deficiencies and appreciable over-nutrition in association with sedentary behavior due to urbanization and industrialization. Environmental factors including helio-magnetic fluctuations may result into inflammatory dysfunctions in various biological systems. These dysfunctions can manifest in the form of central obesity and overweight in developing countries as well as in high income countries. The Global Burden of Disease Study clearly showed that the gratifying gains in cardiovascular health occurred in developed countries, in association with an epidemic of CVD in the developing world. Singh et al., proposed, modifying the previous hypothesis, that overweight comes first in conjunction with inflammation, hyperinsulinemia, increased angiotensin activity, vascular variability disorders and central obesity followed by glucose intolerance, type 2 diabetes, hypertension, low HDL and hypertriglyceridemia (Metabolic syndrome).This sequence is followed by coronary artery disease(CAD), gall stones and cancers and finally dental caries, gastrointestinal diseases, bone and joint diseases, degenerative diseases of the brain and psychological disorders, during transition from poverty to affluence. It seems that all the NCDs are mediated by inflammation due to interaction of biological systems with environmental factors, including heliomagnetic fluctions. As people become rich, they begin to increase their intake of proinflammatory refined foods; dietary w-6 and trans fat, salt and sugar in the form of ready prepared foods, syrups, dairy products and flesh foods in place of grain and vegetable based diet. There is a greater use of automobiles, television vewing and decrease in sports, walking and dancing as recreation which also enhances the inflammation, dyslipidemia and obesity. These changes in the diet and lifestyle in conjunction with mental strain, and increase in tobacco and alcohol intake as well as heliomagnetic fluctuations, appear to be primary risk factors in the pathogenesis of inflammation and dyslipidemia leading to NCDs. © Sergey et al.


Singh R.B.,Tsim Tsoum Institute | Demeester F.,Tsim Tsoum Institute | Wilczynska A.,Tsim Tsoum Institute
Cardiology Research and Practice | Year: 2010

The Tsim Tsoum Concept means that humans evolved on a diet in which nature recommends to ingest fatty acids in a balanced ratio (polyunsaturated(P): saturated(S)=w-6:w-3=1:1)as part of dietary lipid pattern where monounsaturated fatty acids(MUFA) is the major fatty acid(P:M:S=1:6:1) in the background of other dietary factors; antioxidants, vitamins, minerals and fiber as well as physical activity and low mental stress. Several hundred years ago, our diet included natural foods; fruits, vegetables, green vegetables, seeds, eggs and honey. Fish, and wild meat were also available to pre-agricultural humans which shaped modern human genetic nutritional requirement. Cereal grains (refined), and vegetable oils that are rich in w-6 fatty acids are relatively recent addition to the human diet that represent dramatic departure from those foods to which we are adapted. Excess of linoleic acid, trans fatty acids (TFA), saturated and total fat as well as refined starches and sugar are proinflammatory. Low dietary MUFA and n-3 fatty acids and other long chain polyunsarurated fatty acids (LCPUFA) are important in the pathogenesis of metabolic syndrome. Increased sympathetic activity with greater secretion of neurotransmitters in conjunction of underlying long chain PUFA deficiency, and excess of proinflammatory nutrients, may damage the neurons via proinflammatory cytokines, in the ventromedial hypothalamus and insulin receptors in the brain.Since, 3050 of the fatty acids in the brain are LCPUFA, especially omega-3 fatty acids, which are incorporated in the cell membrane phospholipids, it is possible that their supplementation may be protective.Blood lipid composition does reflect one's health status: (a) circulating serum lipoproteins and their ratio provide information on their atherogenicity to blood vessels and (b) circulating plasma fatty acids, such as w-6/w-3 fatty acid ratio, give indication on proinflammatory status of blood vessels, cardiomyocytes, liver cells and neurones; (a) and (b) are phenotype-related and depend on genetic, environmental and developmental factors. As such, they appear as universal markers for holistic health and these may be important in the pathogenesis of cardiovascular diseases and cancer, which is the main consideration of Tsim Tsoum concept. Copyright © 2010 R. B. Singh et al.


PubMed | Tsim Tsoum Institute
Type: | Journal: Cardiology research and practice | Year: 2010

The Tsim Tsoum Concept means that humans evolved on a diet in which nature recommends to ingest fatty acids in a balanced ratio (polyunsaturated(P) : saturated(S) =w-6 : w-3 = 1 : 1)as part of dietary lipid pattern where monounsaturated fatty acids(MUFA) is the major fatty acid(P : M : S = 1 : 6 : 1) in the background of other dietary factors; antioxidants, vitamins, minerals and fiber as well as physical activity and low mental stress. Several hundred years ago, our diet included natural foods; fruits, vegetables, green vegetables, seeds, eggs and honey. Fish, and wild meat were also available to pre-agricultural humans which shaped modern human genetic nutritional requirement. Cereal grains (refined), and vegetable oils that are rich in w-6 fatty acids are relatively recent addition to the human diet that represent dramatic departure from those foods to which we are adapted. Excess of linoleic acid, trans fatty acids (TFA), saturated and total fat as well as refined starches and sugar are proinflammatory. Low dietary MUFA and n-3 fatty acids and other long chain polyunsarurated fatty acids (LCPUFA) are important in the pathogenesis of metabolic syndrome. Increased sympathetic activity with greater secretion of neurotransmitters in conjunction of underlying long chain PUFA deficiency, and excess of proinflammatory nutrients, may damage the neurons via proinflammatory cytokines, in the ventromedial hypothalamus and insulin receptors in the brain.Since, 30-50% of the fatty acids in the brain are LCPUFA, especially omega-3 fatty acids, which are incorporated in the cell membrane phospholipids, it is possible that their supplementation may be protective.Blood lipid composition does reflect ones health status: (a) circulating serum lipoproteins and their ratio provide information on their atherogenicity to blood vessels and (b) circulating plasma fatty acids, such as w-6/w-3 fatty acid ratio, give indication on proinflammatory status of blood vessels, cardiomyocytes, liver cells and neurones; (a) and (b) are phenotype-related and depend on genetic, environmental and developmental factors. As such, they appear as universal markers for holistic health and these may be important in the pathogenesis of cardiovascular diseases and cancer, which is the main consideration of Tsim Tsoum concept.

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