Inflammation and Cardiovascular Disease - Essay Example

Q1. Inflammation and Cardiovascular Disease (CVD) Section The relationship between inflammation and cardiovascular disease. Inflammation is a major risk factor, which promotes the onset and development of cardiovascular disease (Verschuren et. al 863). An increased risk of cardiovascular disease is associated with systemic inflammation, for example, inflammation resulting from untreated infections such as periodontal disease (Berg and Scherer 941). It has been observed that patients with pre-existing inflammatory diseases have a higher risk of cardiovascular disease, for instance, systemic inflammation causes atherosclerosis. Section 2: Anti-inflammatory and heart-healthy foods and nutrients. Garlic and onions have anti-oxidant and anti-inflammatory properties, which promote a healthy heart. Consumption of a diet containing these foods has been associated with a reduction in systolic blood pressure, oxidative stress and vascular inflammation (Vazquez-Prieto et al 5). A study on the effect of garlic on cardiovascular disorders by Banerjee and Maulik (2002) indicates a significant cardio-protective effect. Section 3: Evidence that garlic and onions are anti-inflammatory. Garlic and onions have organosulphur compounds, which have different effects on human health (Hedges & Lister). Consumption of diets rich in garlic and onions may help to counter inflammation (Maffetone 7). Research has shown that these foods inhibit the aggregation of platelets and lower levels of cholesterol (Srinivasan 170; Kochhar 338), which catalyses the production of anti-inflammatory chemicals. They also reduce oxidative stress (Vazquez-Prieto et al 5), which is responsible for the production of inflammation causing free radicals. Moreover, experiments with fructose fed rats (Vazquez-Prieto et al 5) showed that extracts of garlic and onions reverses increased vascular inflammation. Section 4: Comments on anti-inflammatory evidence. The evidence for the anti-inflammatory properties of garlic and onions is precise and clear. It provides a comprehensive basis on the anti-oxidative properties of these foods, which is essential in dealing with chronic inflammation. Section 5: A study design to reinforce the anti-inflammatory properties of garlic and onions. A randomized controlled trial will be used to assess the anti-inflammatory nature of garlic and onions. A sample of participants will be randomly chosen from the population, and their ethical approval will be sought. Those who grant ethical approval will be included in the study. They will then be split and assigned randomly to two equal groups, experimental and control group. The experimental group will be assigned meals containing a specified amount of garlic and onions. On the other hand, the control group will be assigned meals without garlic and onions. The study will ensure compliance such that participants in the control group will not consume garlic and onions during the study period. Pre-test and post-test measurements for blood cholesterol will be taken for all participants. Comparison for the efficacy of garlic and onions will then be made based on these measurements. Q2: CVD Risk Dietary fiber refers to the edible part of plants, which is resistant to digestion and absorption in the small intestine (Lattimer & Haub 1266). Soluble dietary fibers are fibers that dissolve in water to form viscous gels. The increased consumption of dietary fiber is associated with low risk of chronic diseases (Coleman 1), for instance, obesity, type-2 diabetes, cancer and CVD. Soluble dietary fibers such as ?-glucan reduce CVD risk by reducing blood cholesterol (Queenan et al 2). This soluble fiber is common in oats, which have a cholesterol lowering effect. However, despite the clear health benefits, the consumption of dietary fiber has been inhibited by its low palatability (Queenan et al. 2). Section 1: How dietary soluble fiber can lower CVD risk. Dietary soluble fiber reduces the serum cholesterol levels hence lowering CVD risk (Queenan et al. 6). Moreover, the viscosity and digestive properties of dietary soluble fiber decreases the gross energy of food due to low energy density. This has a significant impact on reducing the risk of obesity and diabetes, which are CVD risk factors (Lattimer & Daub 1281). Section 2: Evidence for the recommendation. The intake of dietary soluble fiber has been associated with reduced CVD risk (Pins & Kaur 8; Coleman 1). The fiber protects against CVD through improvement in profile of blood lipid, lowering of blood pressure and reducing inflammation indicators. Oats contain a dietary soluble fiber known as ?-glucan. The cholesterol lowering effect of oats is attributed to this fiber (Queenan et al. 2). The effectiveness of ?-glucan is largely due to its viscous nature (Pomeroy et al. 54). A randomized double blinded trial by Queenan et al. (2007) indicated a significant reduction in LDL cholesterol of hypercholesterolemic subjects. Moreover, ?-glucan has been shown to reduce plasma cholesterol when incorporated into various foods (Pomeroy et al. 51). Section 3: Some dietary modifications that can be made to meet the recommendation. In order to meet the recommendation, high fiber whole grains, legumes, vegetables and fruits such as apples should be incorporated into the diet. However, this should fall within the recommended levels of 0.75-1.7grams per serving. Excessive fiber intake is directly associated with abdominal discomfort, flatulence and diarrhea (Coleman 4). Moreover, excessive alcohol should be avoided as it causes inflammation (Maffetone 8). It is also advisable to avoid trans fats, for instance peanut butter, which hinder the production of anti-inflammatory chemicals. Section 4: Modifications to the recommendations. Despite the health benefits posed by dietary soluble fiber, many citizens continue to succumb to CVD related mortality (Pins & Kaur 8). This is majorly attributed to the low palatability of high soluble fiber foods over extended periods (Queenan et al. 2). Therefore, there is a dire need to develop food products with high soluble fibers that are acceptable to consumers. Moreover, it would be prudent to combat the CVD risk factors such as overweight and obesity, which are more prevalent amongst 66% of American adults (Lattimer & Haub 1270). This means that the consumption of insoluble fibers such as whole rye bread should also be encouraged (Lattimer & Haub 1271). Insoluble fiber also helps to combat type-2 diabetes by increasing insulin sensitivity. Q3: Obesity a) Obesity is defined as the body mass index (BMI) exceeding 30kg/m2. The increased global prevalence has led to obesity being termed ‘chronic’. According to the World Health Organization (2003), approximately 300 million adults are clinically obese. b) Obesity is associated with diet-related chronic diseases such as type-2 diabetes and cardiovascular disease. Increased urbanization has led to decreased consumption of diets with high-complex carbohydrate content. This has given way to consumption of diets with high fat, saturated fats and sugar (Evangelista, Ortiz, Rios-Soto and Urdapilleta 3). Moreover, there has been decreased indulgence in physical activity and indulgence in passive leisure. Obesity is a risk factor for type-2 diabetes as it reduces insulin sensitivity. Additionally, it is a risk factor for high blood pressure, high blood cholesterol and atherosclerosis, which are risk factors for CVD (Government of South Australia 2). c) Metabolically Healthy Obese (MHO) individuals are persons with BMI ? 30kg/m2, but are not at risk of obesity related health complications (National Institute of Health 2). These individuals have normal fasting glucose, lipid profile and blood pressure hence not at risk of chronic diseases. This protection against insulin resistance hinders the development of type-2 diabetes, hypertension and CVD (Gauthier and Ruderman e1). d) “Metabolically obese” normal weight (MONW) individuals are those who have normal weight, but an abnormal metabolic status (Lee 280). These individuals have central obesity (large waist circumference ?80cm and ?90cm for women and men respectively). They are bound to have a high blood pressure and high fasting blood glucose (Choi et al. 2). This abnormal metabolic status increases the risk for type-2 diabetes and CVD for MONW individuals. On the other hand, the MOH individuals are both insulin sensitive and metabolically healthy (Gauthier and Ruderman e1). Therefore, the MONW individual cannot be equated to a MOH individual in terms of being risk prone to chronic diseases. Q4: Relationship between Anti-oxidant Nutrient X (Saponins) and Cancer 1. Experimental studies involving animals (rats and mice) provide the strongest evidence to support that saponins are effective against cancer. Saponins have been evaluated to possess anti-carcinogenic properties. This includes their direct cytotoxicity, bile acid binding and immune modulatory effects (Rao and Sung 717s). An experimental study involving saponins extracted from radix Asparagus membranaceus established their chemotherapeutic effects. The saponins suppressed the growth of colon cancer cells by promoting apoptopsis and inhibiting cell proliferation (Tin et al. 1351). Saponins contained in soy beans have various biological functions, for instance hepatoprotective, anti-cancer and anti-oxidative (Dixit et al. 373). Soybean saponins were shown to inhibit the growth of human carcinoma cells (Rao and Sung 717s). 2. Potentially confounding variables refers to other factors that might influence the results of an experiment. In this context, the anti-carcinogenic effect of soybean might not be a result of saponins but isoflavones (Dixit et al. 376). Moreover, the quality of saponins in plants might degrade, for instance, during processing (Shi et al. 65). This will adversely affect the experimental results by reducing the efficacy of the saponins. 3. Relative risk is a ratio, which compares the risk of disease in exposed persons to the risk in unexposed persons (Songer 16). Essentially, relative risk = (Disease incidence rate in exposed persons) / (Disease incidence rate in unexposed persons). A high reported relative risk (relative risk > 1) implies an increased risk of disease for the unexposed persons. A high relative risk demonstrates a strong association between a disease and exposure but does not imply the existence of a causal relationship (Bailey, Gordis and Green 126). For instance, cigarette smoking causes various diseases hence may not be attributed to the development of cancer. In this regard, it is important to consider the biological and pathological development mechanisms of the disease in order to prove causation. 4. A U-shaped relationship between and anti-oxidant nutrient x and cancer means that there is no linear relationship (lack of correlation). Moreover, it implies that a pair of observations of the two variables corresponds to a common point on a straight line (Schoenbach 183). Studies have shown that the risk of mortality and body weight have a U-shaped relationship (Schoenbach 448). 5. Vegetables contain various phytochemicals, which have anti-oxidative properties. These include vitamins, carotenoids, terpenoids, flavonoids and minerals amongst others. Vitamins E, C and ?-carotene protect against cancer by inhibiting the transformation of normal cells to cancerous cells (Borek 334). A combination of vitamins E and C inhibits apoptosis in human endothelial cells. On the other hand, carotenoids inhibit oxidative damage to cells and stimulate the immune system. In summary, the antioxidants prevent cancer by shielding the cells from damage by free radicals (Govind 37). Therefore, it is advisable to increase vegetable and fruit intake to about 400-600 g/day. Works Cited Bailey, Linda, Gordis, Leon and Green, Michael. Reference Guide on Epidemiology, n.d. Web. 16 Feb. 2012. Banerjee, Sanjay and Maulik, Subir. “Effect of Garlic on Cardiovascular Disorders: A Review.” Nutrition Journal (2002): 1-4. Web. 15 Feb. 2012. Berg, A. and Scherer, P. “Adipose Tissue, Inflammation, and Cardiovascular Disease.” Circulation Research 96. (2005): 939-949. Print. Borek, Carmia. “Dietary Antioxidants and Human Cancer.” Integrative Cancer Therapies 3.4 (2004): 333-341. Print. Coleman, Ellen. Dietary Fiber and Cardiovascular Disease, 2008. Web.15 Feb. 2012. Dixit et al. “Soybeans Constituents and Their Functional Benefits.” Opportunity, Challenge and Scope of Natural Products in Medicinal Chemistry 2011: 367-383. Print. Evangelista, Arlene, Ortiz, Angela, Rios-Soto, Karen and Urdapilleta, Alicia. U.S.A the Fast Food Nation: Obesity as an Epidemic, 2004. Web. 15 Feb. 2012. Gauthier, Marie-Soleil. and Ruderman, Neil. “Adipose Tissue Inflammation and Insulin Resistance: All Obese Humans Are Not Created Equal.” Biochem J 430. 2010: e1-e4. Web. 15 Feb. 2012. Government of South Australia. Healthy Weight Fact Sheet 2: Causes and Consequences of Overweight and Obesity, 2006. Web. 15 Feb. 2012. Govind, Pandey. “Antioxidant vegetables act against cancer and other diseases.” International Journal of Pharmaceutical Studies and Research 2.1 (2011): 32-38. Print. Hedges and Lister. Health Attributes of Allium Species, 2007. Web. 15 Feb. 2012. Kochhar, KP. “Dietary Spices in Health and Diseases (II).” Indian J. Physiol Pharmacol 52.4 (2008): 327-354. Web. 15 Feb. 2012. Lattimer, James. and Haub, Mark. “Effects of Dietary Fiber and Its Components on Metabolic Health.” Nutrients 2. (2010): 1266-1289. Print. Lee, Kayoung. “Metabolically Obese but Normal Weight (MONW) and Metabolically Healthy but Obese (MHO) Phenotypes in Koreans: Characteristics and Health Behaviours.” Asia Pacific Journal of Clinical Nutrition 18.2 (2009): 280-284. Print. Maffetone, Phil. The ABCs of Chronic Inflammation, 2008. Web. 15 Feb. 2012. National Institute of Health. Strategic Plan for NIH Obesity Research: A Report on the NIH Obesity research Task Force, 2011. Web. 15 Feb. 2012. Pins, J. and Kaur, H. “A Review of the Effects of Barley ?-Glucan on Cardiovascular and Diabetic Risk.” Cereal Foods World 51.1 (2006): 8-11. Web. 15 Feb. 2012. Pomeroy et al. “Oat ?-glucan lowers total and LDL-Cholesterol.” Australian Journal of Nutrition and Dietetics (2001) 58:1. Print. Queenan et al., ‘Concentrated oat ?-glucan, a fermentable fiber, lower serum cholesterol in hypercholesterolemic adults in a randomized controlled trial’, Nutrition Journal (2007) 6:6. Print. Rao, A. and Sung, M. “Saponins as Anticarcinogens.” The Journal of Nutrition 1995: 717s-724s. Web. 15 Feb. 2012. Schoenbach, Victor. Understanding the Fundamentals of Epidemiology: An Evolving Text. North Carolina, Chapel Hill. 2000. Print. Shi et al., ‘Kinetic Study of Saponins B Stability in Navy Beans under Different Processing Conditions’, Journal of Food Engineering, 93 (2009): 59-65. Print. Songer, Thomas. “Basic Epidemiology: Measures of Association.” University of Pittsburg. The Aga Khan University, South Asia. n.d. Lecture. Srinivasan, K. “Role of Spices Beyond Food Flavoring: Nutraceuticals with Multiple Health Effects.” Food Reviews International 21 (2005): 167-188. Print. Tin et al. “Astragalus Saponins Induce Growth Inhibition and Apoptosis in Human Colon Cancer.” Carcinogenesis 28.6 (2007): 1347-1355. Print. Vazquez-Prieto et al. “Garlic and Onions Attenuates Vascular Inflammation and Oxidative Stress in Fructose Fed Rats.” Journal of Nutrition and Metabolism 2011: 1-7. Web. 15 Feb. 2012. Verschuren et al. “A Dietary Mixture containing Fish Oil, Resveratrol, Lycopene, Catechins, and Vitamins E and C Reduces Atherosclerosis in Transgenic Mice.” The Journal of Nutrition 141 (2011): 863-869. Print. World Health Organization. Obesity and Overweight, 2003. Web. 15 Feb. 2012. Read More