Health and Weight - Life Style, Nutrition and Exercise: June 2024

Thursday, June 27, 2024

Varicose Veins - Issues

Causes

Weak or damaged valves can lead to varicose veins. Arteries carry blood from the heart to the rest of the body. Veins return blood from the rest of the body to the heart. To return blood to the heart, the veins in the legs must work against gravity.

Muscle contractions in the lower legs act as pumps, and elastic vein walls help blood return to the heart. Tiny valves in the veins open as blood flows toward the heart, then close to stop blood from flowing backward. If these valves are weak or damaged, blood can flow backward and pool in the veins, causing the veins to stretch or twist.

https://www.mayoclinic.org/diseases-conditions/varicose-veins/symptoms-causes/syc-20350643

Vain Diseases or Problems

case of iliac vein compression: a mid-40s woman who suffered from leg and buttock heaviness and achiness.

Authors: Back Kim MD & Tae An Choi, ANP-BC

Heart Vein NYC, New York, New York

https://www.heartveinnyc.com/case-studies/case-of-iliac-vein-compression-a-mid-40s-woman-who-suffered-from-leg-and-buttock-heaviness-and-achiness/

https://www.jvsvenous.org/article/S2213-333X(18)30419-0/fulltext

Diet for Varicose Veins

https://www.blogaberry.com/health-and-fitness/how-a-therapeutic-diet-can-also-heal-painful-varicose-veins/

Exercises for Varicose Veins

https://heritagehospitals.com/blog/10-best-exercises-for-varicose-veins/

https://njvvc.com/how-exercise-promotes-healthy-veins/

ud. 6.2.2024

pub. 14.12.2022

Tuesday, June 25, 2024

Flow-mediated dilation - FMD

Flow-mediated dilation (FMD) refers to dilation (widening) of an artery when blood flow increases in that artery. The primary cause of FMD is release of nitric oxide by endothelial cells.

Normotensive overweight/obese patients who were salt restricted for six weeks showed an endothelin 1 (ET-1) decrease of 14% associated with a 45% increase in FMD.

Endothelin-1 (ET-1) is a peptide that plays a crucial role in regulating various physiological processes in the human body. It is primarily produced and secreted by endothelial cells, which are the cells that line the inner walls of blood vessels. ET-1 is a potent vasoconstrictor, meaning it causes blood vessels to constrict or narrow. ET-1 has been shown to be one of the most potent vasoconstrictors.1

https://www.astrazeneca.com/what-science-can-do/topics/disease-understanding/endothelin-1.html

https://en.wikipedia.org/wiki/Flow-mediated_dilation

Brachial Artery Flow-Mediated Dilation in Healthy Men, Men with Risk Factors, and Men with Acute Myocardial Infarction. Importance of Occlusion-Cuff Position

https://www.revespcardiol.org/en-brachial-artery-flow-mediated-dilation-in-articulo-13038881

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

Exercise Therapy in the Management of Peripheral Arterial Disease.

pdf

by AO Hallak · 2023 · flow-mediated dilation, consistent with an improvement in endothelial health

https://www.mcpiqojournal.org/article/S2542-4548(23)00056-5/pdf

Another study of endothelial function in patients with CAD and post-myocardial infarction revealed improved endothelial function after ET, regardless of the type of training. However, the improvement

noticed disappeared after 1 month of detraining.

February 23, 2024

30-Day Atorvastatin Improved Brachial Artery FMD in Patients With HFpEF, but More Research Is Needed

https://www.ajmc.com/view/30-day-atorvastatin-improved-brachial-artery-fmd-in-patients-with-hfpef-but-more-research-is-needed

Long-term Successful Weight Loss Improves Vascular Endothelial Function in Severely Obese Individuals

Sherman J. Bigornia, Melanie M. Mott, Donald T. Hess, Caroline M. Apovian, Marie E. McDonnell, Mai-Ann Duess, Matthew A. Kluge … See all authors

First published: 06 September 2012 https://doi.org/10.1038/oby.2009.482

https://onlinelibrary.wiley.com/doi/full/10.1038/oby.2009.482

Weight Reduction With Very-Low-Caloric Diet and Endothelial Function in Overweight Adults: Role of Plasma Glucose

Maria Raitakari, Thomas Ilvonen, Markku Ahotupa, Terho Lehtimäki, Aimo Harmoinen, Pauli Suominen, Juhani Elo, Jaakko Hartiala, and Olli T. RaitakariAUTHOR INFO & AFFILIATIONS

Arteriosclerosis, Thrombosis, and Vascular Biology

Volume 24, Number 1

https://doi.org/10.1161/01.ATV.0000109749.11042.7

The vascular endothelium plays an important role in the regulation of arterial tone, thrombosis, and inflammation.

Endothelial dysfunction may predispose arteries to the development of atherosclerotic lesions and is pathophysiologically linked to acute cardiovascular syndromes.1 A common condition that gives rise to endothelial dysfunction is obesity. Endothelial-dependent vascular responses to both agonist-stimulated2,3 and flow-mediated vasodilation4 have been shown to be blunted in obese individuals.

https://www.ahajournals.org/doi/10.1161/01.atv.0000109749.11042.7c

Atherosclerotic lesions

Atherosclerosis

Aldons J. Lusis

The early lesions of atherosclerosis consist of subendothelial accumulations of cholesterol-engorged macrophages, called ‘foam cells’. In humans, such ‘fatty streak’ lesions can usually be found in the aorta in the first decade of life, the coronary arteries in the second decade, and the cerebral arteries in the third or fourth decades.

Fatty streaks are not clinically significant, but they are the precursors of more advanced lesions characterized by the accumulation of lipid-rich necrotic debris and smooth muscle cells (SMCs). Such ‘fibrous lesions’ typically have a ‘fibrous cap’ consisting of SMCs and extracellular matrix that encloses a lipid-rich ‘necrotic core’. Plaques can become increasingly complex, with calcification, ulceration at the luminal surface, and haemorrhage from small vessels that grow into the lesion from the media of the blood vessel wall. Advanced lesions can grow sufficiently large to block blood flow.

The most important clinical complication is an acute occlusion due to the formation of a thrombus or blood clot, resulting in myocardial infarction or stroke. Usually, the thrombus formation (thrombosis) occurs due to rupture or erosion of the lesion.

Arteries in Human Body

Abdomen arteries

The abdominal arteries include:

Celiac trunk. Branching off from the abdominal aorta, the celiac trunk divides into smaller arteries that supply organs such as the stomach, liver, and spleen.

Superior mesenteric. Also branching off of the abdominal aorta, it sends blood to the small intestine, pancreas, and most of the large intestine.

Inferior mesenteric. Like the superior mesenteric artery, this artery also branches off of the abdominal aorta and supplies blood to the last portion of the large intestine, which includes the rectum.

Inferior phrenic. These are paired arteries that supply blood to the diaphragm.

Adrenal. The adrenal arteries are paired arteries that send blood to the adrenal glands.

Renal. These paired arteries deliver blood to the kidneys.

Lumbar. These paired arteries send blood to the vertebrae and spinal cord.

Gonadal. The gonadal arteries are paired arteries that send blood to the testes in males and the ovaries in females.

Common iliac. This branch of the abdominal aorta divides into the internal and external iliac arteries.

Internal iliac. Derived from the common iliac artery, this artery supplies blood to the bladder, pelvis, and external portion of the genitals. It also supplies the uterus and vagina in females.

External iliac. Also arising from the common iliac artery, this artery eventually becomes the femoral artery.

Arteries of the legs

Leg arteries include:

Femoral. Derived from the external iliac artery, this artery supplies blood to the thigh and divides into the various smaller arteries that supply the legs.

Genicular. This supplies blood to the knee region.

Popliteal. This is the name given to the femoral artery as it passes below the knee.

Anterior and posterior tibial. Derived from the popliteal artery, these arteries supply blood to the lower portion of the leg. When they reach the ankle, they divide further to supply the ankle and foot region.

https://www.healthline.com/health/arteries-of-the-body

Monday, June 24, 2024

Lymphoedema - Overview and Bibliography

Lymphoedema (LE) is a debilitating condition with the chronic accumulation of interstitial fluid. 1 The permanent pitting stage 2 oedema can evolve into stage 3 non‐pitting oedema with fibrosis and adipose tissue enlargement if remains untreated. Proper control of LE results in ameliorated immune surveillance, less propensity for microbial infections, better function and quality of life. 1 Subsequent to intensive decongestion the application of medical compression stocking (MCS) maintains long‐term volume reduction. 1

ESC Heart Fail. 2021 Oct; 8(5): 4328–4333. Published online 2021 Jul 20. doi: 10.1002/ehf2.13487

PMCID: PMC8497360PMID: 34288554

The effects of lower body compression on left ventricular rotational mechanics in lymphoedema (from the MAGYAR‐Path Study)

Attila Nemes, 1 Árpád Kormányos, 1 Péter Domsik, 1 Anita Kalapos, 1 Lajos Kemény, 2 and Győző Szolnokycorresponding author 2

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8497360/

Overview of the Lymphatic System

ByJames D. Douketis, MD, McMaster University

Reviewed/Revised Apr 2024

https://www.msdmanuals.com/en-in/home/heart-and-blood-vessel-disorders/lymphatic-disorders/overview-of-the-lymphatic-system

Physical treatment for lymphoedema

Process Effect

Exercise Dynamic muscle contractions encourage both passive (movement of lymph along tissue planes and non-contractile lymph vessels) and active (increased contractility of collecting lymph vessels) drainage

Compression (hosiery) Opposes capillary filtration Acts as a counterforce to muscle contractions (so generating greater interstitial pressure changes)

Manual lymphatic drainage Form of massage that stimulates lymph flow in more proximal, normally draining lymphatics to “siphon” lymph from congested areas (particularly trunk)

Multilayer bandaging Used as an intensive treatment in combination with exercise to reduce large, misshapen lower limbs and permit subsequent maintenance treatment with hosiery

Pneumatic compression Softens and reduces limb volume but can forcibly displace fluid into trunk and genitalia. Hosiery must always be worn afterwards

Elevation Does not stimulate lymph drainage but lowers venous pressure and therefore filtration, allowing lymph drainage to catch up

BMJ. 2000 Jun 3; 320(7248): 1527–1529. doi: 10.1136/bmj.320.7248.1527

PMCID: PMC1118110PMID: 10834903

ABC of arterial and venous disease

Swollen lower limb—2: Lymphoedema

Peter S Mortimer

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1118110/

What are physical treatments for lymphedema?

Lymphedema treatment typically includes a combination of physical therapy and garments or bandaging. It moves fluid from areas affected by lymphedema. After physical therapy for lymphedema, it’s very important to use garments or bandaging after therapy to maintain the treatment’s effect.

Physical treatments for lymphedema.

Compression garments: Compression garments may be socks, sleeves or wraps that have pressure to move fluid from your tissues into circulation. This reduces swelling.

Physical therapy: It is a gentle form of massage to stimulate circulation. This is manual lymphatic drainage (MLD). The therapists may teach you how to perform this massage on your own.

Multilayer compression bandaging: If you’ve ever sprained an ankle, you may have put a short stretch bandage on your ankle to keep it from swelling. Multilayer compression bandaging acts the same way on your lymphedema. The bandages put pressure on your tissues, moving fluid back into circulation.

Compression devices: These pneumatic compression pumps provide on-and-off pressure to keep fluid moving through your lymph vessels and veins so it doesn’t build up in your arms, legs and other parts of your body. The devices work by connecting the pump to a sleeve that wraps around your affected areas. The pump drives a regular cycle of pressure that inflates and deflates the sleeve. Compression pumps may also reduce complications of lymphedema.

Elevation: Gravity plays a role in lymphedema symptoms. You should try to keep the affected area of your body elevated as much as possible.

Exercise: Physical exercise is important to stimulate lymphatic drainage.

https://my.clevelandclinic.org/health/diseases/8353-lymphedema Good article.

Indian J Physiol Pharmacol . 2002 Jan;46(1):111-4.

Left ventricular function in varicose veins

K Singh, S Sood

PMID: 12024949

Abstract

Left ventricular function (LVF) was evaluated noninvasively by recording systolic time intervals (STIs) in 25 patients suffering from varicose veins (VV) of lower limbs and compared with 25 age--sex matched controls. STI was measured from simultaneous recordings of electrocardiogram (ECG), carotid arterial pulse (CAP) and phonocardiogram (PCG). The left ventricular ejection time (LVET) was significantly shortened with marked increase in pre-ejection period (PEP) and increase in PEP/LVET ratio (P < 0.001) without any variation in electromechanical systoles (QS2) in VV patients compared to controls. These changes in STI suggest contractility of heart is adversely affected in VV patients.

https://pubmed.ncbi.nlm.nih.gov/12024949/

All-Ireland Lymphoedema Guidelines 2022

https://assets.hse.ie/media/documents/ncr/lymphoedema-guidelines.pdf

Oedema Assessment

https://www.physio-pedia.com/Oedema_Assessment

Love, Lymphedema and Heart Health

BY ARIA HEALTH

FEBRUARY 14, 2023

Lymphedema and the heart are related in several ways. Lymphedema is the swelling of limbs due to a buildup of lymphatic fluid, which can put an increased strain on the heart. This happens because the heart has to work harder to pump blood and circulate it throughout the body, including the affected limb.

https://ariahealth.com/blog/love-lymphedema-and-heart-health/

Open Access Article

Effect of an Enhanced Self-Care Protocol on Lymphedema Status among People Affected by Moderate to Severe Lower-Limb Lymphedema in Bangladesh, a Cluster Randomized Controlled Trial

by Janet Douglass 1,*ORCID,Hayley Mableson 1,2,Sarah Martindale 1,Sanya Tahmina Jhara 3,Mohammad Jahirul Karim 3,Muhammad Mujibur Rahman 3,Abdullah Al Kawsar 3,Abul Khair 3,ASM Sultan Mahmood 3,AKM Fazlur Rahman 4,Salim Mahmud Chowdhury 4,Susan Kim 5,Hannah Betts 1,Mark Taylor 1 andLouise Kelly-Hope 1

Journals JCM Volume 9 Issue 8 10.3390/jcm9082444

Background: Lymphatic filariasis (LF) is a major cause of lymphedema, affecting over 16 million people globally. A daily, hygiene-centered self-care protocol is recommended and effective in reducing acute attacks caused by secondary infections. It may also reverse lymphedema status in early stages, but less so as lymphedema advances.

This study offers the first evidence for including lymphatic stimulating activities in recommended self-care for people affected by moderate and severe LF-related lymphedema.

Patients and their caregivers are taught the core components of self-care including washing and drying the affected body parts twice per day, attending to entry lesions and interdigital lesions, range of motion exercises, and limb elevation.

https://www.mdpi.com/2077-0383/9/8/2444

Sloan Kettering Institute

Other ways to reduce risk

Try to avoid crossing your legs as much as possible.

Wear sunscreen with an SPF of 30 or higher to protect your skin from sunburns.

Try to maintain your ideal weight.

Minimize your salt intake. Salt can cause swelling, which may overwhelm your lymphatic system.

https://www.mskcc.org/cancer-care/patient-education/reducing-risk-lymphedema

Ud. 25.6.2024

Pub. 11.6.2024

Sunday, June 23, 2024

Diet Break - Diet Restriction for Weight Loss - Full Weight Maintenance Diet in Alternate Periods

Weight Loss Strategy of Taking 2-week Dieting Breaks - Benefits

If you’re dieting, taking 2 weeks diet breaks could help you to lose the pounds and keep them off.

This is the conclusion of a new study.

https://www.medicalnewstoday.com/articles/319474

Weight loss in body building

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10170537/

Caloric Titration Method works

Lose 1% of the body weight. Maintain the new weight for about a week. This period of weight maintenance allows the individual to eat more or perhaps exercise less than they would while trying to lose weight.

Then achieve another decrease of 1% in body weight, followed by another “break” (weight maintenance).

Follow this routine until the final weight-loss goal is achieved.

Dr Nicholas Fuller is a Research Fellow at the Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders at the Charles Perkins Centre.

https://www.sydney.edu.au/news-opinion/news/2017/04/13/taking-a-diet-break-can-help-weight-loss.html

Wednesday, June 19, 2024

Gastric Secretions - Gastric Fluids Daily Produced

I read somewhere that daily 5 gallons of water is dumped into the intestine. So enquired further.

Daily Fluid Secretion

Volumes (ml/day) Composition Regulation

Oral secretions

1500 ml

99.8% water; low in sodium

high in calcium and phosphate to help remineralise tooth enamel

Mucin, IgA, amylase, lipase

Stimulated by eating; markedly decreased in patients who are fasted, asleep, sedated or intubated

Oesophageal secretions

Minimal

Thick bicarbonate-rich mucus

Vagal regulation

Gastric acid

2000 ml

Cl- 170mmol/L, K+ 12-20 mmol/L

pH ~ 1.5

Mucus, pepsin, gastric lipase, intrinsic factor

Stimulated by gastrin, histamine, and vagal activity (M3 receptors)

Inhibited by somatostatin, VIP, cholecystokinin and secretin

Bile

600 ml

95% water; concentrated (~ 600 mOsm/kg), alkaline (pH ~ 7.5-8.0)

Bile acids, phospholipids, cholesterol and bilirubin

Secretion is increased by catecholamines, secretin, cholecystokinin, gastrin and glucagon

Release from the gallbladder is mainly mediated by cholecystokinin

Pancreatic exocrine secretions

2500 ml

Isotonic with plasma, but markedly alkaline (pH up to 8.3)

Cl- 30mmol, HCO3- 140 mmol

Enzymes: lipase, amylase, trypsin, numerous others

Stimulated by vagus, enteropancreatic reflexes, gastrin, cholecystokinin, and secretin

Inhibited by sympathetic stimulation and somatostatin

Intestinal secretions

2000 ml

Bicarbonate-rich mucus

pH ~ 7.5-8.0

Mainly originating from the duodenum

Stimulated by gastrin, histamine, and vagal activity (M3 receptors)

Inhibited by somatostatin, VIP, cholecystokinin and secretin

https://derangedphysiology.com/main/cicm-primary-exam/required-reading/gastrointestinal-system/Chapter%20110/composition-volumes-and-regulation-gastrointestinal-secretions

Wednesday, June 12, 2024

Lymphedema Massaging Techniques

Lymphatic Self Massage - Step 10: Ankle and Foot Technique [Part 18 of 20]

https://www.youtube.com/watch?v=4eOYibT8iP4

Complete Playlist

https://www.youtube.com/watch?v=V0ayXBAXWqI&list=PLWYuRSjQI5zFVs3G8BGTJmU2RdBCnJgHv&index=1

Notes

https://www.uhn.ca/PatientsFamilies/Health_Information/Health_Topics/Documents/How_to_Do_Self_Lymphatic_Massage_Lower_Body.pdf

https://healthcare.msu.edu/_assets/documents/lymphedema/LymphedemaSelfMassageHandout2021_Lower.pdf

Lymphatic Massage

University of Michigan

PDF

A light touch manual therapy technique using different gentle and slow hand movements. ○ Assists the lymphatic system function by promoting lymphangiomotoricty ...

24 pages

https://medicine.umich.edu/sites/default/files/content/downloads/Rogers%20Gina%20December%207%20Lymphatic%20Massage.pdf

Lymphedema Treatment in Physical Therapy

PDH Academy

PDF

Course Abstract. This course refreshes and refines the learner's understanding of lymphedema and lymphedema treatment. It opens with a review of the ...

64 pages

https://pdhacademy.com/wp-content/uploads/2018/08/Lymphedema-COURSE-PDF.pdf

Endothelial Health - Impairment to Endothelial Function

Endothelial Health

The Importance of Endothelial Health!

The 1998 Nobel Prize in Medicine was awarded to three American researchers who discovered how endothelium produces a gas that actually regulates your entire cardiovascular system. The gas is Nitric Oxide – the master signaling molecule of your entire cardiovascular system.

This health information webinar will teach you how to effectively nourish your endothelium for proper nitric oxide production, which has the potential to significantly improve cardiovascular health.

https://www.youtube.com/watch?v=2MQCDQgojLg

Watch the above YouTube video to learn how and why!

https://no-more-heart-disease.com/endothelial-health/

Endothelial Function and Cardiovascular Disease

Cardiology University of Washington

8 Oct 2021 University of Washington Cardiovascular Grand Rounds 2021-2022

Francis Kim, MD

Learning Objectives:

-State why endothelial function is important for cardiologists

-Describe how endothelial function is measured

-Describe mechanisms of endothelial dysfunction

https://www.youtube.com/watch?v=s6Geqf9YWe0

Nitric Oxide - Enabler of Cardio Vascular Health

https://oldageindia.blogspot.com/2016/11/nitric-oxide-enable-of-cardio-vascular.html

The American Journal of Clinical Nutrition

Volume 93, Issue 3, March 2011, Pages 500-505

The American Journal of Clinical Nutrition

Endothelial function is impaired after a high-salt meal in healthy subjects1,2,3

Author links open overlay panelDickinson Kacie M, Clifton Peter M, Keogh Jennifer B

https://www.sciencedirect.com/science/article/pii/S0002916523022219

Dietary Sodium Restriction Reverses Vascular Endothelial Dysfunction in Middle-Aged/Older Adults With Moderately Elevated Systolic Blood Pressure

FREE ACCESS

Hypertension

Kristen L. Jablonski, Matthew L. Racine, Candace J. Geolfos, Phillip E. Gates, Michel Chonchol, Matthew B. McQueen, and Douglas R. Seals

J Am Coll Cardiol. 2013 Jan, 61 (3) 335–343

Clinical significance

The concept that high sodium intake has adverse CV effects independent of BP has been advanced previously (9,12). High dietary sodium impairs EDD even in rodents that are salt-resistant and, thus, do not exhibit increases in BP in response to a high-salt diet (13,18,20). Acute impairment of EDD in normotensive adults after sodium loading also is BP independent (11), and adults with elevated SBP who report lower sodium intake have enhanced EDD independent of BP (16). The present results extend these findings to sodium restriction and lend support to the overall hypothesis that sodium intake not only elevates BP but also exerts other adverse influences (12). The effects of sodium restriction on endothelial function reported here also complement previous findings that reducing sodium intake can rapidly de-stiffen large elastic arteries (21), another independent vascular risk factor for CVD (40). The improvements in these 2 common forms of arterial dysfunction, both predictors of CV events (3,4,40), suggest that DSR has strong potential for reducing CVD risk via broad vasculoprotective effects.

https://www.jacc.org/doi/10.1016/j.jacc.2012.09.010

Recent Research - Deadly Arrhythmia Trifecta: Salt, Swelling, and Leaky Sodium Channels

24 MAY 2022

Our new findings demonstrate that controlling blood sodium could help Long QT patients prevent dangerous arrhythmias,” - Steven Poelzing, Associate professor at the Fralin Biomedical Research Institute.

Some Long QT syndrome patients are born with the disease, while others develop it as a result of natural aging, certain medications, tissue swelling, or heart disease.

As humans naturally age, heart muscle cells grow and require more calcium to contract. To sustain elevated calcium levels, heart muscle cells also need more sodium. As a result, the aging human heart naturally adapts ‘leaky’ sodium channels, allowing more sodium to enter the cell.

Long QT is diagnosed when the length of time it takes for a heartbeat to drop from its peak to baseline, the QT interval, is extended on an electrocardiogram reading.

“Our data suggests that the combination of tissue edema, elevated blood sodium, and faulty sodium channels trigger deadly heart arrhythmias,”

“Bringing the concept closer to the clinical setting will require teaching cardiologists on how parameters related to perinexal expansion and extracellular sodium levels may be monitored in a clinical environment.”

https://news.vt.edu/articles/2022/05/scientists-detect-deadly-arrhythmia-trifecta--salt--swelling--an.html

ORIGINAL RESEARCH article

Front. Nutr., 06 April 2023

Sec. Clinical Nutrition

Volume 10 - 2023 | https://doi.org/10.3389/fnut.2023.1073626

Evaluating the association between dietary salt intake and the risk of atrial fibrillation using Mendelian randomization

Sicen Wang1 Ye Cheng1,2 Qi Zheng3 Xin Su2* Yingjian Deng2*

https://www.frontiersin.org/articles/10.3389/fnut.2023.1073626/full

Nutrients. 2020 Dec; 12(12): 3714. Published online 2020 Nov 30. doi: 10.3390/nu12123714

PMCID: PMC7761364PMID: 33266329

Left Ventricular Mass Reduction by a Low-Sodium Diet in Treated Hypertensive Patients †

Natale Musso,* Federico Gatto, Federica Nista, Andrea Dotto, Zhongyi Shen, and Diego Ferone

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7761364/

Abstract

Objective: To evaluate the left ventricular mass (LVM) reduction induced by dietary sodium restriction.

Patients and Methods: 138 treated hypertensives were given a simple sodium-restricted diet was advised. They had to avoid common salt loads, such as cheese and salt-preserved meat, and were switched from regular to salt-free bread.

Blood pressure (BP), 24-h urinary sodium (UNaV) and LVM were recorded at baseline, after 2 months. and after 2years.

Results:

In 76 patients UNaV decreased in the recommended range after 2 months and remained low at 2 years. In 62 patients UNaV levels decreased after 2 months and then increased back to baseline at 2 years.

The first group followed the diet advice for the long period. The second group did not follow the diet advice strictly.

Initially the two groups did not differ in terms of BP (134.3 ± 16.10/80.84 ± 12.23 vs. 134.2 ± 16.67/81.55 ± 11.18 mmHg, mean ± SD), body weight (72.64 ± 15.17 vs. 73.79 ± 12.69 kg), UNaV (161.0 ± 42.22 vs. 158.2 ± 48.66 mEq/24 h), and LVM index (LVMI; 97.09 ± 20.42 vs. 97.31 ± 18.91 g/m2).

After 2years. they did not differ in terms of BP (125.3 ± 10.69/74.97 ± 7.67 vs. 124.5 ± 9.95/75.21 ± 7.64 mmHg) and body weight (71.14 ± 14.29 vs. 71.50 ± 11.87 kg).

Significant differences were seen for UNaV (97.3 ± 23.01 vs. 152.6 ± 49.96 mEq/24 h) and LVMI (86.38 ± 18.17 vs. 103.1 ± 21.06 g/m2).

Multiple regression analysis: UNaV directly and independently predicted LVMI variations, either as absolute values (R2 = 0.369; β = 0.611; p < 0.001), or changes from baseline to +2years. (R2 = 0.454; β = 0.677; p < 0.001).

The prevalence of left ventricular hypertrophy decreased (29/76 to 15/76) in the first group while it increased in the less compliant patients (25/62 to 36/62; Chi2 p = 0.002). Conclusion: LVM seems linked to sodium consumption in patients already under proper BP control by medications.

The regression of the left ventricular mass, and the reversal of LVH, in severe hypertension under dietary sodium restriction is availabe in the existing research literature. In the papers by Walther Kempner, the rice-fruit diet, with its very low-sodium content, could normalize both the BP values and the cardiac mass. More recently, in hypertensive patients who actually restricted their sodium consumption, a reduction of the left ventricular mass was observed, even approaching the best pharmacological effect. Conversely, an increase in sodium/potassium ratio was associated with a higher LVMI in pre-hypertensive and hypertensive patients. The association between sodium intake and worsening of cardiac mass has been receiving widespread attention. The known linear relations between sodium intake and cardiovascular risk and between UNaV and LVH have even shown a stepwise increase, irrespective of BP values.

Experimental data attribute the sodium-induced LVH to actions mediated by the renin-angiotensin system without an increased sympathetic tone. Furthermore, the restriction of alimentary sodium reduces central BP independently of changes in peripheral BP. It follows that a high central BP, a stronger and independent predictor of cardiovascular morbidity and mortality, can induce a cardiac damage unrelated with peripheral BP.

Published On 11 Dec 2018

Too Much Salt In Diet Can Cause Irregular Heartbeat

Written By Medha Baranwal

After accounting for several other risk factors -- including age, body fat, blood pressure, and smoking -- the researchers found that salt consumption was independently associated with the risk of atrial fibrillation.

https://speciality.medicaldialogues.in/too-much-salt-in-diet-can-cause-irregular-heartbeat

How Much Salt Should You Eat if there is a heart related problem?

If you’re living with congestive heart failure, it’s best if you limit the sodium in your diet to less than 1,500 milligrams a day.

That’s far less than the amount recommended for normal people -- 2,300 milligrams. But many Americans are taking 3,400 milligrams.

https://www.webmd.com/heart-disease/heart-failure/low-sodium-eating

Dietary Sodium Intake in Heart Failure

Originally published24 Jul 2012

Americans consume ≈3700 mg sodium daily,11 whereas the US Department of Agriculture and the Department of Health and Human Services recommend 2300 mg daily intake for the general population, with a stricter recommendation of 1500 mg/d for those >50 years of age, blacks, or individuals with hypertension, diabetes mellitus, or chronic kidney disease.

https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.111.062430

Dietary Sodium Restriction Reverses Vascular Endothelial Dysfunction in Middle-Aged/Older Adults With Moderately Elevated Systolic Blood Pressure

FREE ACCESS

Hypertension

Kristen L. Jablonski, Matthew L. Racine, Candace J. Geolfos, Phillip E. Gates, Michel Chonchol, Matthew B. McQueen, and Douglas R. Seals

J Am Coll Cardiol. 2013 Jan, 61 (3) 335–343

Clinical significance

https://www.jacc.org/doi/10.1016/j.jacc.2012.09.010

Ud. 12.6.2024

Pub. 31.5.2024

Tuesday, June 11, 2024

Excess Salt May Make Arteries Stiff and Cause Vascular Problems

Data from both animal and human studies provide evidence that salt impairs endothelial function and increases arterial stiffness independent of blood pressure.
Vascular Effects of Dietary Salt
David G. Edwards and William B. Farquhar
Curr Opin Nephrol Hypertens. Author manuscript; available in PMC 2017 May 15.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5431073/

Heart failure and salt: The great debate

December 18, 2018

https://www.health.harvard.edu/blog/heart-failure-and-salt-the-great-debate-2018121815563

Vascular Stiffness in Aging and Disease

REVIEW article

Front. Physiol., 07 December 2021

Sec. Vascular Physiology

https://doi.org/10.3389/fphys.2021.762437

This article is part of the Research Topic

Cardiovascular Remodeling in Aging and Disease

https://www.frontiersin.org/articles/10.3389/fphys.2021.762437/full

Effects of Sodium Intake on Health and Performance in Endurance and Ultra-Endurance Sports

by Eleftherios Veniamakis 1,Georgios Kaplanis 1,Panagiotis Voulgaris 1 andPantelis T. Nikolaidis 2,*ORCID

Department of Nutrition and Dietetics, Hellenic Mediterranean University, 72300 Sitia, Greece

School of Health and Caring Sciences, University of West Attica, 12243 Athens, Greece

Author to whom correspondence should be addressed.

Academic Editor: Alberto Pérez-López

Int. J. Environ. Res. Public Health 2022, 19(6), 3651; https://doi.org/10.3390/ijerph19063651

Received: 26 January 2022 / Revised: 3 March 2022 / Accepted: 8 March 2022 / Published: 19 March 2022

https://www.mdpi.com/1660-4601/19/6/3651/htm

Dietary Sodium Restriction Reverses Vascular Endothelial Dysfunction in Middle-Aged/Older Adults With Moderately Elevated Systolic Blood Pressure

FREE ACCESS

Hypertension

Kristen L. Jablonski, Matthew L. Racine, Candace J. Geolfos, Phillip E. Gates, Michel Chonchol, Matthew B. McQueen, and Douglas R. Seals

J Am Coll Cardiol. 2013 Jan, 61 (3) 335–343

Clinical significance

https://www.jacc.org/doi/10.1016/j.jacc.2012.09.010

ud. 12.6.2024, 24.9.2022, 17.9.2022

pub. 25.9.2019

23 BMI - Risk Factor for Cardiovascular Problems for Indians and Asians - Don't Allow Your Weight to Increase and Cross 23 BMI

BMI above 23 is a risk factor for cardiovascular and metabolic disorders. Please note. Do not allow weight to increase and cross 23 BMI.

Diabetes is metabolic disorder. Triglycerides and Cholesterol are also metabolic disorders and have the foundation in food habits causing diabetes.

Increase in blood pressure indicates that a permanent problem in blood flow occurred in the blood pipes or vessels. When the problem occurs in main arteries, various pain symptoms appear. When the problem is in minor arteries, only blood pressure is the visible measurement.

Discussion Regarding 23 BMI

It is clear that increased body weight is a risk factor for type 2 diabetes. The relationship between body weight and type 2 diabetes is more properly attributable to the quantity and distribution of body fat . Abdominal circumference and waist and hip measurements are highly correlated with cardiometabolic risk.

The measurement of body weight with various corrections for height is frequently used to assess risk for obesity-related diseases because it is the most economical and practical approach in both clinical and epidemiologic settings. The most commonly used measure is Quetelet’s index or BMI, defined as weight ÷ height2, with weight in kilograms and height in meters.

There is a propensity for Asians to develop visceral versus peripheral adiposity, which is more closely associated with insulin resistance and type 2 diabetes than overall adiposity. Asians of both sexes have been shown to have a higher percentage of body fat at any given BMI level compared with non-Hispanic whites; this suggests differences in body composition that may contribute to variations in diabetes prevalence.

In 2004, data from the Behavioral Risk Factor Surveillance System (BRFSS) showed that the odds of prevalent diabetes were 60% higher for Asian Americans than non-Hispanic whites after adjusting for BMI, age, and sex (23). The National Health Interview Survey (NHIS; 1997–2008 data) found that the odds of prevalent diabetes were 40% higher in Asian Americans relative to non-Hispanic whites after adjusting for differences in age and sex. In fully adjusted logistic regression models including an adjustment for BMI as a categorical variable (underweight/normal weight: BMI <23 kg/m2, overweight: 23 ≤ BMI < 27.5 kg/m2, and obese: BMI ≥27.5 kg/m2), Asian Americans remained 30–50% more likely to have diabetes than their non-Hispanic white counterparts.

Thus in the Diabetes Prevention Program (DPP), a BMI value of 22 kg/m2 was selected as the eligibility BMI for Asians.

The diagnostic cutoff for overweight BMI in India (48) is 23 kg/m2.

BMI cut points with a sensitivity of 80% fall consistently between 23–24 kg/m2 for nearly all Asian American subgroups (with levels slightly lower for Japanese). This makes a rounded cut point of 23 kg/m2 practical

ADA Recommendation

Testing for diabetes should be considered for all Asian American adults who present with a BMI of ≥23 kg/m2.

https://diabetesjournals.org/care/article/38/1/150/37769/BMI-Cut-Points-to-Identify-At-Risk-Asian-Americans

48.Misra A, Chowbey P, Makkar BM, et alConcensus Group. Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians and recommendations for physical activity, medical and surgical management. J Assoc Physicians India 2009;57:163–170

[PDF] researchgate.net

[PDF] Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians and recommendations for physical activity …

A Misra, P Chowbey, BM Makkar, NK Vikram, JS Wasir… - Japi, 2009 - researchgate.net

Asian Indians exhibit unique features of obesity; excess body fat, abdominal adiposity,

increased subcutaneous and intra-abdominal fat, and deposition of fat in ectopic sites (liver,

muscle, etc.). Obesity is a major driver for the widely prevalent metabolic syndrome and type

2 diabetes mellitus (T2DM) in Asian Indians in India and those residing in other countries.

Based on percentage body fat and morbidity data, limits of normal BMI are narrower and

lower in Asian Indians than in white Caucasians. In this consensus statement, we present …

https://www.researchgate.net/profile/Janaki-Srinath-Puskuri/publication/325404564_Consensus_Statement_for_Diagnosis_of_Obesity_Abdominal_Obesity_and_the_Metabolic_Syndrome_for_Asian_Indians_and_Recommendations_for_Physical_Activity_Medical_and_Surgical_Management/links/5b0c416a0f7e9b1ed7fbabc2/Consensus-Statement-for-Diagnosis-of-Obesity-Abdominal-Obesity-and-the-Metabolic-Syndrome-for-Asian-Indians-and-Recommendations-for-Physical-Activity-Medical-and-Surgical-Management.pdf