Study: Food as medicine in cardiovascular diseases

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Reference Velmurugan S, Gan JM, Rathod KS, et al. Food nitrate improves vascular function in patients with hypercholesterolemia: a randomized, double -blind, placebo -controlled study. Am jlin nutr. 2016; 103 (1): 25-38. Design randomized, double -blind, placebo -controlled parallel study; The participants received 1: 1 either 250 ml, of course, nitrate-rich beetroot juice or placebo-nitrate-detoured beetroot juice once a day for 6 weeks. Participants in nine and sixty, non-smoking, non-diabetic, otherwise healthy hypercholesterolemic men and women between the ages of 18 and 80 with a body mass index (BMI) (in KG/M2) from 18.5 to 40 were recruited (final full data records of 65 participants). The inclusion criteria included a total cholesterol in the serum> ...
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reference

Velmurugan S, Gan JM, Rathod KS, et al. Food nitrate improves vascular function in patients with hypercholesterolemia: a randomized, double -blind, placebo -controlled study. bin j clin nutr . 2016; 103 (1): 25-38.

Design

randomized, double -blind, placebo -controlled parallel study; According to the random principle, either 250 ml of naturally nitratreichen beetroot juice or placebo-nitrate-resealed beetroot juice once a day for 6 weeks.

participant

nine-nine-like non-smoking, non-diabetic, otherwise healthy hypercholesterineemic men and women between the ages of 18 and 80 with a body mass index (BMI) (in KG/m2) from 18.5 to 40 were recruited (final complete data records of 65 participants). The inclusion criteria included a total cholesterol in the serum> 6.0 mmol/l (232 mg/dl) or any increase in low-density lipoprotein cholesterol (LDL-C) or triglycerides with a QRISK 2-score for cardiovascular diseases; National Health Service). > 15%. All participants were expected to take no statins or other cholesterol -lowering medication for at least 2 months before screening.

study parameters evaluated

  • flowed dilation
  • Blood tile reactivity
  • arterial pulse wave speed
  • pulse wave analysis
  • Concentrations of nitrogen monoxide metabolites

target parameter

The primary endpoint was the absolute percentage change in the ultrasonic flow mediated dilation (FMD) 6 weeks after the start of the course.
The following measures were one of the secondary endpoints:
  • Interior comparison of the MKS reaction at the beginning of the course and after 6 weeks
  • evaluation of the change 6 weeks after the baseline of the thrombocyte reactivity
  • arterial pulse wave speed and pulse wave analysis
  • Changes to nitrogen oxide metabolite concentrations
  • changes in the composition of the saliva microbioma

important knowledge

food nitrate led to an absolute increase in the MKS reaction by 1.1 %, which corresponds to an improvement by 24 % compared to the initial value, with a deterioration of 0.3 % in the placebo group ( p <0.001).

secondary findings

Compared to the placebo group, the study found that the nitrate group had small but significant improvements in the following measures:
  • aortic pulse wave speed: acceptance by 0.22 m/s [95% Confidence interval (CI): -0.4 to -0.3] shows a trend ( p = 0.06) for improvement
  • Thrombocyten-monozyten aggregate: 7.6 %reduction in the nitrate group, compared to a 10.1 %increase in the placebo group ( p = 0.004)
  • stimulated P-Selectin expression: statistically significant reductions ( p <0.05); No significant changes in the unimignium expression
In addition, nitrate treatment changed saliva microbioma, while the placebo did not do this ( p <0.01). Finally, no adverse effects of dietary nitrate were found in the treatment group.

practice implications

How the best rated and preventive strategies for cardiovascular diseases (CVD) can still be optimized is still a complicated and hardly agreed grouping of opinions and approaches. 1 This problem can partially be attributed to overemphasizing the measurement and modification of cholesterol-related biomarkers. LDL-C and related markers remain a main focus of risk assessment and targeted treatment. However, further evidence of the lack of reliability of this strategy is that the latest treatment guidelines have given up stricter aspects of these goals, since there is a lack of evidence of improved results.
Perhaps, at least to a certain extent, it can lead to an incomplete overall approach if we focus on our attention to the standard risk calculation, together with the treatment of basic lipid-related markers.
If we focus our attention on the standard risk calculation together with the treatment of basic lipid -related markers, this can lead to an incomplete overall approach.
Flow-Mediated Dilation (FMD), a method for assessing the endothelial function, together with more advanced biomarker tests such as highly sensitive C-reactive protein (HS-CRP), lipoprotein-associated phospholipase A2 (LP-PLA2), asymmetrical dimethylarginine (ADMA) and other areas A core group of newer, less proven options that could help to round off a more complete picture.
The process of atherogenesis is certainly complicated and multifactorial, and lipid -related markers play a role. Finally, some of the triggering steps in the process of atherosclerosis would not be technically possible without the presence of an atherogenic, cholesterol-supporting molecule in the vascular wall. 3 Statistical analyzes have shown that excessive dependence on these markers can be overlooked that many CVD cases are overlooked until too late is.
In fact, the endothelial dysfunction, the primary process measured in our current study using FMD, is demonstrably available long before other signs of atherosclerosis and can be the turning point through which all other accepted risk factors for cardiovascular diseases have.
In addition, an in-depth analysis of the entire process shows that the role of atherogenic lipoproteins, although important, may play a secondary role, while certain nutrient deficiencies and the resulting increased susceptibility to vascular violations and/or increased susceptibility to endothelial dysfunction can play a role.
Therefore, it seems reasonable to consider evaluation and treatment strategies that go beyond this focus on lipid management and begin to tackle the process of atherosclerosis in its earliest stages and from as many angles as possible. One possibility can be the increase in nitrate, including from these nitrate -rich foods: 8
  • rocket
  • rhubarb
  • Coriander
  • Butterblattsalat
  • Spring green
  • basil
  • beet green
  • Eichblattsalat
  • Swiss chard
  • beet
The findings have so far indicated that the assessment and optimization of vascular health and function is of the greatest importance in order to achieve the best possible results.

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