An educational intervention for improving knowledge, attitude, and practice of dietary salt intake among individuals with hypertension in public sector secondary care facilities, Agra, India, 2021.

We conducted a pre-post intervention study to determine knowledge, attitude, and practice toward dietary salt intake before, immediately, and 1-month after nurse-led one-on-one counseling. We purposively selected three public health facilities in Agra, India, and enrolled all eligible hypertensive patients aged 18-60 under treatment for ≥6 months. Of the 153 patients at the 1-month follow-up, counseling improved knowledge (4% vs. 42%, p < .001), a greater prioritization of a low salt diet (34% vs. 52%, p < .001), and practice of adding less salt to the dough (48% to 41%, p < .001). The counseling intervention improved knowledge, attitude, and practice toward dietary salt intake.

Effects of a Japanese Cuisine-Based Antihypertensive Diet and Fish Oil on Blood Pressure and Its Variability in Participants with Untreated Normal High Blood Pressure or Stage I Hypertension: A Feasibility Randomized Controlled Study.

AIM: The Dietary Approaches to Stop Hypertension (DASH) diet is recommended for lowering blood pressure (BP). Our previous single-arm trial revealed that the Japanese cuisine-based DASH (J-DASH) diet (supplying NaCl 8.0 g per day) reduced BP and improved cardiometabolic biomarkers. The present study's primary objective was to test the feasibility of the J-DASH diet based on its effects on the BP and BP variability of subjects with untreated high-normal BP or stage 1 hypertension. METHODS: The 6-month study period was held from December 2015 to August 2016. The participants were recruited through advertisements in local newspapers and our website and from among randomized participants at Yamaguchi University Hospital. The 2-month treatments included the following: the J-DASH-1 diet 1×/day or the J-DASH-2 diet providing a fish hamburger-patty 2×/day (5 days/week respectively). The control group consumed their usual diets. For the subsequent 4 months, all participants consumed their usual diets. The main outcome measure was the feasibility of the J-DASH diet. We also collected the data of clinic BP and home BP (by automatic BP monitor), cardiometabolic biomarkers, and lifestyle and psychosocial parameters during the intervention phase. We examined behavior changes throughout the study period, and the diets' safety. RESULTS: Fifty-one participants were recruited; following screening, 48 met the inclusion criteria and were randomized by central allocation. Eight participants were eliminated based on exclusion criteria, and the 40 participants were randomly allocated to the J-DASH 1 and J-DASH 2 groups ( n=13 each) and the usual-diet group (n=14). The participants' mean age was 50 years, and 44% were women. The three groups' clinic BP values were not significantly different, but the home BP values were lower in the J-DASH 1 group and lowest in the J-DASH 2 group compared to the usual-diet group and differed significantly among the three groups throughout the study period (p＜0.0001). The home BP variability was significantly lower in the J-DASH groups compared to the usual-diet group throughout the study period ( p＜0.01). The other indices including fish oil showed little differences among the groups throughout the study period. CONCLUSIONS: The J-DASH diet was feasible to improve home BP and stabilize its variability, and it did so more effectively than the participants' usual diets.

Fascículo 1: protocolos de uso do guia alimentar para a população brasileira na orientação alimentar de pessoas adultas com obesidade, hipertensão arterial e diabetes mellitus: bases teóricas e metodológicas - versão preliminar / Issue 1: protocols for the use of the food guide for the Brazilian population in the dietary guidance of adults with obesity, arterial hypertension and diabetes mellitus: theoretical and methodological bases - preliminary version

Este é o primeiro fascículo da série intitulada "Protocolos de Uso do Guia Alimentar para a População Brasileira na orientação alimentar de pessoas adultas com obesidade, hipertensão arterial e diabetes mellitus". Um conjunto de três protocolos compõe essa série que foi elaborada com a finalidade de disseminar as recomendações do Guia Alimentar para a População Brasileira e instrumentalizar a orientação alimentar individualizada pelos profissionais da Atenção Primária à Saúde (APS). O presente fascículo apresenta a base teórica e metodológica utilizada para a construção de cada protocolo, a partir das recomendações do Guia Alimentar adaptadas ao contexto de cada doença.

Management of cardiometabolic complications in polycystic ovary syndrome: Unmet needs.

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder and the most common cause of androgen excess in reproductive-age women. The heterogeneity of the clinical presentation in PCOS patients suggests the involvement of multiples abnormal physiological pathways. In addition, women with PCOS have a high prevalence of cardiometabolic risk factors. Unfortunately, limited effective evidence-based therapeutic agents are available to treat the cardiometabolic complications in PCOS patients. Insights from recent studies highlight the multiple opportunities to deliver timely effective medical care for women with PCOS. This perspective manuscript aims to highlight the unmet need for effective and safe management of the cardiometabolic complications in PCOS patients.

Fully hydrogenated canola oil extends lifespan in stroke-prone spontaneously hypertensive rats.

BACKGROUND: Canola oil (Can) and several vegetable oils shorten the lifespan of stroke-prone spontaneously hypertensive rats (SHRSP). Although similar lifespan shortening has been reported for partially hydrogenated Can, the efficacy of fully hydrogenated oils on the lifespan remains unknown. The present study aimed to investigate the lifespan of SHRSP fed diets containing 10 % (w/w) of fully hydrogenated Can (FHCO) or other oils. METHODS: Survival test: Upon weaning, male SHRSP were fed a basal diet for rodents mixed with one of the test oils -i.e., FHCO, Can, lard (Lrd), and palm oil (Plm) throughout the experiment. The animals could freely access the diet and drinking water (water containing 1 % NaCl), and their body weight, food intake, and lifespan were recorded. Biochemical analysis test: Male SHRSP were fed a test diet with either FHCO, Can, or soybean oil (Soy) under the same condition, except to emphasize effects of fat, that no NaCl loading was applied. Soy was used as a fat source in the basal diet and was set the control group. Blood pressures was checked every 2 weeks, and serum fat levels and histological analyses of the brain and kidney were examined after 7 or 12 weeks of feeding. RESULTS: During the survival study period, the food consumption of FHCO-fed rats significantly increased (15-20 % w/w) compared with that of rats fed any other oil. However, the body weight gain in the FHCO group was significantly less (10-12 %) than that in the control group at 9-11 weeks old. The FHCO (> 180 days) intervention had the greatest effect on lifespan, followed by the Lrd (115 ± 6 days), Plm (101 ± 2 days), and Can (94 ± 3 days) diets. FHCO remarkably decreased the serum cholesterol level compared with Can and the systolic blood pressure from 12 to 16 weeks of age. In addition, while some rats in the Can group exhibited brain hemorrhaging and renal dysfunction at 16 weeks old, no symptoms were observed in the FHCO group. CONCLUSION: This current study suggests that complete hydrogenation decreases the toxicity of Can and even prolongs the lifespan in SHRSP.

Dietary Intervention to Improve Blood Pressure Control: Beyond Salt Restriction.

Lifestyle improvement is a cornerstone of cardiovascular disease prevention and has a relevant effect on blood pressure control. During the last decades the attention of the researcher has focused on low-salt diets as the lifestyle modification most effective in blood pressure reduction. Current international guidelines thus suggest to stress the importance of the implementation of the dietary approach to stop hypertension (DASH) diet and of a low-salt Mediterranean diet to achieve the best results in term of blood pressure decrease. However, salt reduction in diet could be not the only nor the main determinant of blood pressure reduction under dietary treatment. DASH and low-salt Mediterranean diet are also characterized by a high intake of vegetables (NO and polyphenol sources), whole grains, some low-fat dairy products, and low intake of red meat, sugar, and trans-hydrogenated fats. Lacto-ovo vegetarian diet are also per se associated to a significant improvement in blood pressure levels. Moreover, these diets are particularly effective when associated with a significant weight loss. Furthermore, blood pressure can also be lowered by some nutraceuticals (beetroot, magnesium, vitamin C, catechin-rich beverages, lycopene, etc). The aim of this narrative review is to critically resume the most recent evidence supporting a complete approach to dietary counseling for hypertension prevention and management.

Effects of Hesperidin Consumption on the Cardiovascular System in Pre- and Stage 1 Hypertensive Subjects: Targeted and Non-Targeted Metabolomic Approaches (CITRUS Study).

SCOPE: The aim of the present work is to determine new biomarkers of the biological effects of hesperidin in orange juice (OJ) applying a non-targeted metabolomics approach validated by targeted metabolomics analyses of compliance biomarkers. METHODS AND RESULTS: Plasma/serum and urine targeted (HPLC-MS/MS) and untargeted (1 H-NMR) metabolomics signatures are explored in a subsample with pre- and stage-1 hypertension subjects of the CITRUS study (N = 159). Volunteers received 500 mL day-1 of control drink, OJ, or hesperidin-enriched OJ (EOJ) for 12-weeks. A 6-h postprandrial study is performed at baseline. Targeted analyses reveals plasma and urine hesperetin 7-O-ß-d-glucuronide as the only metabolite differing between OJ and EOJ groups after 12-weeks consumption, and in urine is correlated with a decreased systolic blood pressure level. The non-targeted approach shows that after single dose and 12-weeks consumption of OJ and EOJ change several metabolites related with an anti-inflammatory and antioxidant actions, lower blood pressure levels and uremic toxins. CONCLUSIONS: Hesperetin 7-O-ß-d-glucuronide can be a candidate marker for distinguishing between the consumption of different hesperidin doses at 12-weeks consumption as well as a potential agent mediating blood pressure reduction. Moreover, changes in different endogenous metabolites can explain the mechanisms of action and the biological effects of hesperidin consumption.

Urine and Plasma Metabolome of Healthy Adults Consuming the DASH (Dietary Approaches to Stop Hypertension) Diet: A Randomized Pilot Feeding Study.

We aimed to identify plasma and urine metabolites altered by the Dietary Approaches to Stop Hypertension (DASH) diet in a post-hoc analysis of a pilot feeding trial. Twenty adult participants with un-medicated hypertension consumed a Control diet for one week followed by 2 weeks of random assignment to either Control or DASH diet. Non-missing fasting plasma (n = 56) and 24-h urine (n = 40) were used to profile metabolites using untargeted gas chromatography/mass spectrometry. Linear models were used to compare metabolite levels between the groups. In urine, 19 identifiable untargeted metabolites differed between groups at p < 0.05. These included a variety of phenolic acids and their microbial metabolites that were higher during the DASH diet, with many at false discovery rate (FDR) adjusted p < 0.2. In plasma, eight identifiable untargeted metabolites were different at p < 0.05, but only gamma-tocopherol was significantly lower on DASH at FDR adjusted p < 0.2. The results provide insights into the mechanisms of benefit of the DASH diet.

Effects of Chrysophyllum albidum fruit pulp on haemodynamic parameters, pro-inflammatory markers, antioxidant parameters and critical biomolecules associated with hypertension-in vivo.

The effects of Chrysophyllum albidum fruit pulp on haemodynamic parameters, pro-inflammatory markers, antioxidant parameters and critical biomolecules associated with hypertension in vivo were determined. Feeding with supplemented diet with pulp reduced heart rate, mean arterial pressure, systolic and diastolic blood pressure levels of hypertensive-treated groups. Moreover, hypertensive-treated groups fed with fruit pulp supplemented diets had significantly (p < 0.05) lower level of serum pro-inflammatory markers when compared to untreated hypertensive group. Furthermore, feeding with supplemented diet with pulp and captopril administration reduced AChE, BChE, ACE, and arginase activities of hypertensive-treated groups. The fruit pulp supplemented diet also increased antioxidant status of hypertensive-treated groups. This was supported by the histopathological examination of the kidney and heart tissues. These beneficial effects could in part be the explanations of ethnomedicinal uses of the fruit pulp in the management of hypertension. Nevertheless, the higher percentage inclusion of the pulp showed higher antihypertensive effects.

Estratégias alimentares efetivas para o tratamento da hipertensão em adultos / Effective dietary strategies for treating hypertension in adults

Pergunta: Quais são as estratégias alimentares mais efetivas para o tratamento de pessoas com hipertensão? Métodos: As buscas foram realizadas em cinco bases de dados com restrição de ano de publicação (a partir do ano 2010). Foram incluídas revisões sistemáticas em inglês, português e espanhol que avaliaram o efeito de dietas no tratamento da hipertensão na população adulta. Nesta revisão rápida, produzida em dez dias, a seleção, a extração dos artigos e avaliação da qualidade metodológica (por meio do AMSTAR 2) não foram feitas em duplicidade, ou seja, cada trabalho foi avaliado por apenas um(a) dos pesquisadores(as). Resultados: Foram incluídas 21 revisões sistemáticas, a maioria com qualidade metodológica criticamente baixa. Foram identificadas estratégias alimentares relacionadas à redução no consumo de sal ou baixo teor de sódio; dieta DASH; dietas com baixo índice glicêmico; dieta ovo-lacto-vegetarianas; dieta mediterrânea; dieta com restrição de calorias; consumo de alimentos específicos, como extrato de tomate, proteína de soja e óleo de gergelim; consumo de bebidas específicas, como leite com lactobacilos e sucos; e as quais envolveram prescrições de dieta em conjunto com aconselhamento nutricional e outras ações educativas. Em relação aos desfechos de interesse, a maioria dos estudos considerou a redução na pressão arterial sistólica e na pressão arterial diastólica. Embora o desfecho de perda de peso seja relevante para os resultados em relação à hipertensão, não foram extraídas informações dos estudos sobre esse tema. Destacam-se as medidas dietéticas de redução de sódio ou substituição do sal, as quais tiveram importantes resultados com relação à redução da pressão sanguínea. Apenas uma revisão sistemática relatou eventos adversos leves ocorridos ­ gases estomacais e flatulências ­ elacionados ao consumo de leite fermentado com lactobacilos. Conclusão e limitações: Apenas uma revisão sistemática avaliada com qualidade metodológica alta estudou dietas de redução de sódio e encontrou resultados positivos para redução das medidas de pressão arterial. Os demais estudos incluídos nesta revisão, apesar de informarem resultados positivos das dietas de redução de sódio, de substituição do sal, dieta DASH, dietas com baixo índice glicêmico, dieta ovo-lacto-vegetarianas, consumo de alimentos específicos, como extrato de tomate, proteína de soja e óleo de gergelim; consumo de bebidas específicas, como leite com lactobacilos e sucos, nos desfechos relacionados à hipertensão (redução de pressão arterial sistólica e diastólicas), foram avaliados, em sua maioria, com qualidade criticamente baixa ou baixa. Isso significa que o grau de confiança que pode ser atribuído a esses achados é pequeno e, portanto, mais estudos são necessários para afirmar com segurança o efeito das dietas no desfecho hipertensão arterial. Esta revisão rápida possui limitações que precisam ser consideradas na interpretação dos achados, como as restrições relativas à metodologia de sínteses rápidas, com filtros, processos de seleção e extração e critérios de elegibilidade reduzidos. Em relação às limitações dos estudos primários que compõem as revisões sistemáticas incluídas, os autores relataram a existência de heterogeneidade entre os estudos incluídos em relação à composição da dieta, ao tempo de seguimento e mesmo às medidas de hipertensão. Por fim, os resultados aqui apresentados fornecem elementos importantes a serem considerados na construção de estratégias alimentares para o tratamento da hipertensão. Além das intervenções aqui relatadas, é importante ressaltar a necessidade de adaptação das estratégias nutricionais para as diferentes populações e contextos, bem como o levantamento de possíveis barreiras e facilitadores que podem impactar a adesão a diferentes dietas.

Question: What are the most effective dietary strategies for treating people with hypertension? Methods: Searches were carried out in five databases with publication year restriction (from the year 2010). Systematic reviews in English, Portuguese and Spanish that evaluated the effect of diets in the treatment of hypertension in the adult population were included. In this rapid review, produced in ten days, the selection, extraction of articles and assessment of methodological quality (through AMSTAR 2) were not done in duplicate, that is, each work was evaluated by only one of the researchers (at). Results: Twenty-one systematic reviews were included, most of which were of critically low methodological quality. Dietary strategies related to reduced salt intake or low sodium were identified; DASH diet; low glycemic index diets; ovo-lacto-vegetarian diet; Mediterranean diet; calorie-restricted diet; consumption of specific foods, such as tomato paste, soy protein and sesame oil; consumption of specific drinks, such as milk with lactobacilli and juices; and involving dietary prescriptions combined with nutritional guidelines and other educational actions. Regarding the outcomes of interest, most studies considered the reduction in systolic blood pressure and diastolic blood pressure. Although the weight loss outcome is relevant to the results in relation to hypertension, no information was extracted from studies on this topic. Dietary measures to reduce sodium or replace salt stand out, which had important results in reducing blood pressure. Only one systematic review reported mild adverse events ­ stomach gas and flatulence ­ related to the consumption of milk fermented with lactobacilli. Conclusion and limitations: Only one systematic review evaluated with high methodological quality studied diets with reduced sodium and found positive results for the reduction of blood pressure measurements. The other studies included in this review, despite reporting positive results from sodium reduction diets, salt replacement, DASH diet, low glycemic index diets, ovo-lacto-vegetarian diets, consumption of specific foods, such as tomato paste, protein soybean and sesame oil; consumption of specific beverages, such as milk with lactobacilli and juices, on hypertension-related outcomes (reduction in systolic and diastolic blood pressure), were mostly rated as critically low or of poor quality. This means that the degree of confidence that can be attributed to these findings is small and, therefore, further studies are needed to confirm with certainty the effect of diets on the arterial hypertension outcome. This rapid review has limitations that need to be considered when interpreting the findings, such as restrictions on the rapid synthesis methodology, with filters, selection and extraction processes, and reduced eligibility criteria. Regarding the limitations of the primary studies that make up the included systematic reviews, the authors reported the existence of heterogeneity among the included studies in relation to diet composition, follow-up time and even hypertension measurements. Finally, the results presented here provide important elements to be considered in the construction of dietary strategies for the treatment of hypertension. In addition to the interventions reported here, it is important to emphasize the need to adapt nutritional strategies to different populations and contexts, as well as the survey of possible barriers and facilitators that may impact adherence to different diets.

Pregunta: ¿Cuáles son las estrategias dietéticas más efectivas para tratar a las personas con hipertensión? Métodos: Las búsquedas se realizaron en cinco bases de datos con restricción de año de publicación (a partir del año 2010). Se incluyeron revisiones sistemáticas en inglés, portugués y español que evaluaron el efecto de las dietas en el tratamiento de la hipertensión arterial en la población adulta. En esta revisión rápida, realizada en diez días, la selección, extracción de artículos y evaluación de la calidad metodológica (a través de AMSTAR 2) no se hizo por duplicado, es decir, cada trabajo fue evaluado por uno solo de los investigadores (at). Resultados: Se incluyeron veintiuna revisiones sistemáticas, la mayoría de las cuales tenían una calidad metodológica críticamente baja. Se identificaron estrategias dietéticas relacionadas con la ingesta reducida de sal o baja en sodio; Dieta tablero; dietas de bajo índice glucémico; dieta ovo-lacto-vegetariana; Dieta mediterránea; dieta restringida en calorías; consumo de alimentos específicos, como pasta de tomate, proteína de soja y aceite de sésamo; consumo de bebidas específicas, como leche con lactobacilos y jugos; e involucrando prescripciones dietéticas combinadas con guías nutricionales y otras acciones educativas. En cuanto a los resultados de interés, la mayoría de los estudios consideraron la reducción de la presión arterial sistólica y la presión arterial diastólica. Aunque el resultado de la pérdida de peso es relevante para los resultados en relación con la hipertensión, no se extrajo información de los estudios sobre este tema. Destacan las medidas dietéticas para reducir el sodio o sustituir la sal, que tuvieron importantes resultados en la reducción de la presión arterial. Solo una revisión sistemática reportó eventos adversos leves -gases estomacales y flatulencia- relacionados con el consumo de leche fermentada con lactobacilos. Conclusión y limitaciones: Solo una revisión sistemática evaluada con alta calidad metodológica estudió dietas bajas en sodio y encontró resultados positivos para la reducción de las medidas de presión arterial. Los otros estudios incluidos en esta revisión, a pesar de informar resultados positivos de dietas de reducción de sodio, reemplazo de sal, dieta DASH, dietas de bajo índice glucémico, dietas ovo-lacto-vegetarianas, consumo de alimentos específicos, como pasta de tomate, proteína de soja y aceite de sésamo ; el consumo de bebidas específicas, como leche con lactobacilos y jugos, sobre los resultados relacionados con la hipertensión (reducción de la presión arterial sistólica y diastólica), se calificaron en su mayoría como críticamente bajos o de mala calidad. Esto significa que el grado de confianza que se puede atribuir a estos hallazgos es pequeño y, por lo tanto, se necesitan más estudios para confirmar con certeza el efecto de las dietas en el resultado de la hipertensión arterial. Esta revisión rápida tiene limitaciones que deben tenerse en cuenta al interpretar los hallazgos, como restricciones en la metodología de síntesis rápida, con filtros, procesos de selección y extracción y criterios de elegibilidad reducidos. En cuanto a las limitaciones de los estudios primarios que componen las revisiones sistemáticas incluidas, los autores informaron la existencia de heterogeneidad entre los estudios incluidos en relación con la composición de la dieta, el tiempo de seguimiento e incluso las medidas de hipertensión. Finalmente, los resultados aquí presentados aportan elementos importantes a ser considerados en la construcción de estrategias dietéticas para el tratamiento de la hipertensión arterial. Además de las intervenciones reportadas aquí, es importante enfatizar la necesidad de adaptar las estrategias nutricionales a diferentes poblaciones y contextos, así como el levantamiento de posibles barreras y facilitadores que pueden impactar la adherencia a diferentes dietas.

Impact of lifestyle interventions on reducing dietary sodium intake and blood pressure in patients with hypertension: A randomized controlled trial.

OBJECTIVE: The objective of this study is to determine the impact of applying lifestyle intervention in the form of a continuous care model (CCM) on reducing dietary sodium intake and blood pressure (BP) in patients with hypertension. METHODS: This randomized controlled trial was conducted in a 2-group design on a total of 50 patients who were hypertensive (experimental and control) as a pre‒post test study. A healthy lifestyle (emphasizing physical activity and heart-healthy diet) in the form of CCM, which considers the patient as an active agent in the health process, was conducted in the experimental group over a period of 4 months. The mean BP value and dietary sodium intake in both groups were measured at the beginning and the end of the study. RESULTS: The mean sodium intake, the mean systolic BP, and the mean diastolic BP decreased to 2.42±0.73 mm Hg (from 3.12±0.79), 128.4±13.04 mm Hg (from 144.20±13.12), and 79.4±8.93 mm Hg (from 89±9.12), respectively, after the intervention in the experimental group (p=0.021, p<0.001, and p=0.011, respectively). CONCLUSION: Applying lifestyle intervention in the form of CCM may be recommended to reduce dietary sodium intake and mean systolic and diastolic BP in patients who are hypertensive. Considering the fact that lifestyle modifications are quite important regardless of the use of antihypertensive drugs, lifestyle intervention in the form of CCM is recommended to improve patient's adherence to dietary restrictions and consequently, treatment outcomes in patients who are hypertensive.

Effects of Caloric Restriction Diet on Arterial Hypertension and Endothelial Dysfunction.

The most common manifestation of cardiovascular (CV) diseases is the presence of arterial hypertension (AH), which impacts on endothelial dysfunction. CV risk is associated with high values of systolic and diastolic blood pressure and depends on the presence of risk factors, both modifiable and not modifiable, such as overweight, obesity, physical exercise, smoking, age, family history, and gender. The main target organs affected by AH are the heart, brain, vessels, kidneys, and eye retina. AH onset can be counteracted or delayed by adopting a proper diet, characterized by a low saturated fat and sodium intake, a high fruit and vegetable intake, a moderate alcohol consumption, and achieving and maintaining over time the ideal body weight. In this review, we analyzed how a new nutritional approach, named caloric restriction diet (CRD), can provide a significant reduction in blood pressure values and an improvement of the endothelial dysfunction. In fact, CRD is able to counteract aging and delay the onset of CV and neurodegenerative diseases through the reduction of body fat mass, systolic and diastolic values, free radicals production, and oxidative stress. Currently, there are few studies on CRD effects in the long term, and it would be advisable to perform observational studies with longer follow-up.

Low-salt low-protein diet and blood pressure control in patients with advanced diabetic kidney disease and heavy proteinuria.

PURPOSE: To assess the associations between effects of low salt, low protein diet supplemented with keto-analogues (sLPD)-on salt intake, blood pressure (BP) and cardiovascular events (CVEs) in patients with advanced diabetic kidney disease (DKD) and heavy proteinuria. METHODS: Prospective, single-center study (total duration of 15 months), enrolling 92 patients with advanced DKD (median eGFR 11.7 ml/min) and heavy proteinuria (median 4.8 g/g creatininuria). The intervention consisted in a low salt-low protein (0.6 g/kg-day) diet (sLPD) under intensive nutritional counselling, and adjustment of antihypertensive therapy. The endpoints of this sub-analysis were a salt intake ≤ 5 g/day, a mean blood pressure (MAP) ≤ 97 mmHg, corresponding to KDIGO target of 130/80 mmHg, and the rate of CVEs. RESULTS: Salt intake decreased with 2.5 g/day and the proportion of patients reaching the salt intake endpoint increased with 58%. A salt intake ≤ 5 g/day was associated with a reduced MAP, BMI, proteinuria, fractional excretion of sodium, and eGFR, suggesting a salt-related volume contraction but was not related to protein intake. Mean arterial pressure decreased with 13 mmHg. MAP ≤ 97 mmHg was associated with lower proteinuria, salt, and protein intake, but the contribution of salt intake cannot be differentiated from that of protein intake. CVEs occurred in 20% of patients and were independently related to a lower age and MAP, and increased comorbidities. eGFR only minimally declined and no renal adverse events were noted. sLPD was nutritionally safe. CONCLUSIONS: The multifactorial personalized intervention allowed a stable MAP reduction to KDIGO recommended levels (≤ 97 mmHg), related to the decrease in salt and protein intake. However, BP lower than 130/80 mmHg increased the cardiovascular but not the renal risk in heavy proteinuric patients with advanced DKD. TRIAL REGISTRATION NUMBER: 0341507433: NCT03415074. Registered 02/02/2015 in US National Library of Medicine, ClinicalTrials.gov (NCT).

Insights to potential antihypertensive activity of berry fruits.

Hypertension is one of the main risk factors for cardiovascular disease and causes widespread morbidity and mortality worldwide. Although several antihypertensive drugs have been proposed for management of high blood pressure, changing lifestyle, including diet, has attracted interest recently. In this sense, consumption of fruits and vegetables, which are rich in vitamins, minerals, and phytochemicals, has been assigned as an efficient therapeutics. Berry fruits contain various bioactive compounds with potential health implications such as antioxidant, antimicrobial, anticancer, and anti-inflammatory properties. The main mechanisms responsible for antihypertensive activity mainly arise from the activity of flavonoids, minerals, and vitamins, as well as fibers. The objective of this review is to provide a summary of studies regarding the effect of berry fruits on the hypertensive animals and humans. The mechanisms involved in reducing blood pressure by each group of compounds have been highlighted. It can be concluded that berries' bioactive compounds are efficient in mitigation of hypertension through improvement of vascular function, angiotensin-converting enzyme's (ACE) inhibitory activity, increasing endothelial nitric oxide synthase (eNOS) activity, and nitric oxide (NO) production, besides anti-oxidative and anti-inflammatory activities. These fruits can be considered as potential sources of invaluable compounds for development of antihypertensive foods and pharmaceuticals.

Processing method modulates the effectiveness of black beans for lowering blood cholesterol in spontaneously hypertensive rats.

BACKGROUND: Various foods are known to have beneficial effects on health when consumed whole; however, there is a trend towards preparing foods from processed ingredients, and it remains unclear whether the benefits of the whole food are retained. The purpose of this study was therefore to examine whether different processing techniques affect the lowering of cholesterol and the vascular effects of black beans (Phaseolus vulgaris L.). RESULTS: Beans were prepared by overnight soaking and boiling - the standard method - and by micronization, extrusion, or dehulling and boiling, and they were then fine milled. Beans prepared by the standard method were also coarse milled. These five materials were incorporated into semi-purified diets (30% wt/wt) and fed to spontaneously hypertensive rats for 4 weeks. Body weight, blood pressure, and aorta morphology were unaltered by the diets. Fasting total cholesterol was significantly reduced in rats fed micronized beans compared with extruded beans (both fine-milled) or the bean-free diet, while boiling combined with coarse milling lowered low-density lipoprotein (LDL) cholesterol. The lack of cholesterol lowering in rats fed extruded bean compared to micronized was not explained by the amount or composition of dietary fiber or resistant starch. Differences in the polyphenolic profile as determined by high-performance liquid chromatography (HPLC) were also unable to explain the variations in cholesterol-lowering capacity. CONCLUSION: The present study demonstrates that processing of black beans alters the health effects observed with the whole pulse, and suggests that products prepared with processed ingredients will need to be tested empirically to establish whether the biological effects are maintained in vivo. © 2020 Society of Chemical Industry.

Potential hypotensive effects of Umezu polyphenols: a 14-week community-based, double-masked and placebo-controlled trial.

OBJECTIVE: To evaluate blood pressure (BP)-lowering effects of Umezu polyphenols, polyphenols contained in Japanese plums, in a community-based sample by double-masked and placebo-controlled design. METHODS: Seventy-two Japanese community-dwellers who were interested in prevention or control of their BP (preferably high-normal BP or grade I hypertension) but without antihypertensive medication were randomized into Umezu polyphenols or placebo groups. Each subject took 800 mg/day of Umezu polyphenols or placebo for 12 weeks, followed by a 2-week washout period. Their home and office BP were monitored for 14 weeks in a double-masked manner. We analyzed 56 subjects who met the inclusion criteria. RESULTS: Home BP increased gradually in both the groups during the intervention period, while diastolic office BP insignificantly decreased in the intervention group. During the washout period, home systolic BP in the morning elevated only in the intervention group. CONCLUSIONS: The study failed to collect consistent evidence of a clear persistent hypotensive effect of Umezu polyphenols.

Self-monitoring networks for personal and societal health: Dietary patterns, activities, blood pressure and Covid-19.

The contributors to and consequences of disordered health are increasingly complex with sociodemographic, ecological, economic and food system change. But there are opportunities for any adversity to be mitigated by advances in the understanding of human, especially nutritional, ecobiology and in its more accessible and affordable evaluation and monitoring. Viral pandemics are on the rise with climate change and loss of ecosystems. They threaten human civilisation and planetary habitability. Human security is dependent on sustainable livelihoods of which food and water systems are a vital part. We are socioecological beings and depend for our health on biodiversity and the food diversity that ensures; and on connectedness and communication, made more difficult in pandemics. Rapid and accessible point-of-care (POC) tools are now becoming available to compliment other selfmonitoring network approaches, whether checklist or questionnaire, physical, chemical, or biological, for healthcare and nutritional health. They can provide information as several complimentary and interdependent health indices to facilitate personal, group and community action and management plans. This applies to indices of both communicable and non-communicable disease which problems separately and together are compromising health prospects. These indices include ones of physical and mental activities, dietary patterns, metabolites, blood pressure and now the presence and severity of viruses like Covid-19.Of imminent relevance and promise are optically- readable biosensor based strips for nasal, pharyngeal or salivary samples to check viral presence or finger prick blood for immunoglobulins and interleukins. These should allow less socially prohibitive measures to curb viral transmission and promote personal and societal wellbeing.

Relación entre Estado Nutricional e ingesta dietética con pérdida de dientes en pacientes con hipertensión en Padongko Health Centro de la regencia de Barru / Relationship between Nutritional Status and Dietary Intake with Tooth Loss on Hypertension Patients at Padongko Health Center of Barru Regency

Objective: The biggest problems of oral and dental health in Indonesia are the ignorance on the dental and oral hygiene leading to tooth loss, so can highly affect the nutritional status and dietary intake. To discover the relationship between the tooth loss and the hypertension case at Padongko health center of Barru regency. Methods: The research is analytic observation using cross-sectional method. The population of the research is the respondents suffering from the hypertension and tooth loss to determine their nutritional status and dietary intake. The population was the patients with primary hypertension, a purposive sampling technique was applied through path analysis test. Results: Based on the path analysis results, the relationship between nutritional status and hypertension revealed p value=0,562>α=0,05; dietary intake and hypertension showed p value=0,377>α=0,05; therefore, the Ha obtained indicated the existing relationship but not significant. The relationship between nutritional status and tooth loss obtained p value=0,065>α=0,05; dietary intake and tooth loss obtained p value=0,499, in which the Ha obtained had a relationship but not significant. Meanwhile, the relationship between hypertension and tooth loss was indicated by p value=0,001<α=0,05 showing a significant relationship. Conclusion: There is a relationship between nutritional status and dietary intake with tooth loss on hypertension patients, but insignificantly shown

A High Polyphenol Diet Improves Psychological Well-Being: The Polyphenol Intervention Trial (PPhIT).

Mental ill health is currently one of the leading causes of disease burden worldwide. A growing body of data has emerged supporting the role of diet, especially polyphenols, which have anxiolytic and antidepressant-like properties. The aim of the present study was to assess the effect of a high polyphenol diet (HPD) compared to a low polyphenol diet (LPD) on aspects of psychological well-being in the Polyphenol Intervention Trial (PPhIT). Ninety-nine mildly hypertensive participants aged 40-65 years were enrolled in a four-week LPD washout period and then randomised to either an LPD or an HPD for eight weeks. Both at baseline and the end of intervention, participants' lifestyle and psychological well-being were assessed. The participants in the HPD group reported a decrease in depressive symptoms, as assessed by the Beck Depression Inventory-II, and an improvement in physical component and mental health component scores as assessed with 36-Item Short Form Survey. No differences in anxiety, stress, self-esteem or body image perception were observed. In summary, the study findings suggest that the adoption of a polyphenol-rich diet could potentially lead to beneficial effects including a reduction in depressive symptoms and improvements in general mental health status and physical health in hypertensive participants.

Honey and obesity-related dysfunctions: a summary on health benefits.

Honey is a natural product, containing flavonoids and phenolic acids, appreciated for its therapeutic abilities since ancient times. Although the bioactive potential is linked to the composition, that is variable depending on mainly the botanical origin, honey has antioxidant and anti-inflammatory properties. Therefore, honey, administered alone or in combination with conventional therapy, might result useful in the management of chronic diseases that are commonly associated with oxidative stress and inflammation state. Obesity is a metabolic disorder characterized by visceral adiposity. The adipose tissue becomes hypertrophic and undergoes hyperplasia, resulting in a hypoxic environment, oxidative stress and production of pro-inflammatory mediators that can be responsible for other disorders, such as metabolic syndrome and neurodegeneration. Experimental evidence from animals have shown that honey improves glycemic control and lipid profile with consequent protection from endothelial dysfunction and neurodegeneration. The purpose of the present review is to summarize the current literature concerning the beneficial effects of honey in the management of the obesity-related dysfunctions, including neurodegeneration. Based on the key constituents of honey, the paper also highlights polyphenols to be potentially responsible for the health benefits of honey. Further well-designed and controlled studies are necessary to validate these benefits in humans.