The role of dietary fats for preventing cardiovascular disease. A review.

At the present, there is a pandemic of chronic non-communicable disease (NCD) affecting most countries of the world. The World Health Organisation (WHO) has identified the main contributing determinants to be cardiovascular disease (CVD), diabetes, malignant cancer and chronic disease of the respiratory system. Unhealthy nutrition, as well as other adverse lifestyle health behaviour are recognised to be part of the prime factors responsible. According to WHO guidelines, a healthy lifestyle should include substituting saturated fatty acids (SFAs) with polyunsaturated fatty acids (PUFAs) together with eliminating trans-fatty acids from the diet and limiting the intake of refined carbohydrates in conjunction with increasing the consumption of fruit, vegetables, nuts and wholegrain cereal products. Recent studies on the relations between CVD prevention and dietary fats have been however unclear. The present study thus aims to provide a review of current evidence and opinion on the type of dietary fat most appropriate for preventing arteriosclerosis. The adoption of dated recommendations on the need to increase dietary PUFA in both Northern Europe and America has led to n-6 PUFAs being predominant in diets as compared to n-3 PUFAs. This disproportion may have caused mortality to rise, due to CVD, as a result of arteriosclerosis in these countries. In contrast, a traditional Mediterranean diet yields a PUFA n-6/n-3 ratio of 2:1, which is much lower than for the aforementioned northern countries. Some authors however consider that assessing this ratio is irrelevant and that decreasing n-6 PUFA may be harmful. Such differences of opinion leads to confusion in adopting an effective approach for arteriosclerosis management regarding dietary n-6/n-3 ratios. Moreover, recent studies have added much controversy to the notion that the characteristics of SFAs are responsible for arteriosclerosis. These found that replacing dietary SFAs with carbohydrates did not reduce the risk of ishaemic heart disease (IHD). Furthermore, changing to monounsaturated fatty acids (MUFAs) gave equivocal findings, but only changing to PUFAs reduced the risk of IHD. This last statement however requires qualification in that dietary n-6 PUFAs increases the risk of IHD. It is only the n-3 PUFAs that are beneficial. Up till now these controversies remain unsolved. It is however noteworthy that adopting a Mediterranean diet reduces IHD mortality. This is explained by a low consumption of SFAs but high intake of unsaturated fatty acids including n-3 PUFAs, and is linked to choosing the right vegetable fats. Oils that contain alpha-linoleic acid (ALA) are to be preferred in the diets of northern countries.

[Nutrition in prevention of age-related macular degeneration]. / Zywienie w profilaktyce zwyrodnienia plamki zóltej.

In the developed countries nowadays, there is an epidemy of age-related macular degeneration (AMD), what is caused by aging of the populations. Macular concentration of lutein and zeaxantin decreases with age, what exacerbates harmful effect of blue light on photoreceptors. Lutein and zeaxantin act as a filter of the high energy blue light. Besides, these carotenoids are strong antioxidants and neutralize light-generated free radicals. Plant foods are the exclusive dietary sources of the carotenoids. Macular lutein and zeaxantin concentrations are related to their consumption. Their average intake in the European countries is several times lower than 6 mg daily, what is the estimated recommended intake. The important role of high lutein and zeaxantin diet in AMD prevention is suggested. However, the results of the hitherto research are inconsistent. Use of lutein and zeaxantin supplements in patients with AMD resulted in sight improvement, what suggests the effeciveness of the supplements use both in prevention and treatment. However, there is a need of further research.

[Health properties of shark oil]. / Wlasciwosci zdrowotne oleju z rekina.

Fish oils are the source of nutrients important for health maintenance. The most significant are essential fatty acids (EFA) of n-3 family, alkylglycerols and squalene. N-3 EFA are of great importance in atherosclerosis prevention. Alkylglycerols and squalene are modulators of immunity to infections and cancer. Shark liver oil contains great amounts of alkylglycerols and squalene, and moderate of n-3 EFA. Therefore, it is used as an adjunctive agent in cancer therapy, especially in radiotherapy, and in the treatment of infectious diseases.

Comparison of combined statin-fibrate treatment to monotherapy in patients with mixed hyperlipidemia.

BACKGROUND: Statins are the preferred drugs for the treatment of hypercholesterolemia, and fibrates for hypertriglyceridemia. In patients with mixed hyperlipidemia, monotherapy with one of these agents may not be effective and combined treatment may be preferable. AIM: To compare retrospectively the efficacy and safety of combined statin-fibrate treatment in patients with mixed hyperlipidemia in whom previous monotherapy with one of these agents occurred ineffective. METHODS AND RESULTS: The initial study group consisted of 327 patients who received micronised fenofibrate and 93 patients who received simvastatin for 12 months. Both agents caused significant changes in lipid profile. Following fibrate therapy, total cholesterol (TC), LDL-cholesterol (LDL-C) and triglyceride (TG) levels decreased by 27.9%, 28.2% and 58%, respectively, and following simvastatin therapy by 33.6%, 42.8% and 37.5%, respectively. The HDL-cholesterol (HDL-C) level increased after fenofibrate by 14.8% and remained unchanged following simvastatin therapy. The TC/HDL-C ratio decreased following fenofibrate by 35.6%, and following simvastatin by 35.3%. In some patients the required reduction in lipid parameters was not achieved fenofibrate or simvastatin. Subsequently, 93 patients underwent combined therapy by adding a second agent (simvastatin in a dose of 20 mg/day or fenofibrate in a dose of 200 mg per day) which was continued for another 12 months. The addition of simvastatin to fenofibrate decreased TC, LDL-C and TG levels by 35.5%, 42.1% and 59.6%, respectively in comparison to before treatment volumes. HDL-C level was increased by 11.1%, and TC/HDL-C ratio decreased by 45.3%. The addition of fenofibrate to simvastatin decreased TC, LDL-C and TG levels by 39.3%, 48.9% and 51,6%, respectively. HDL-C level was increased by 13.4%, and TC/HDL-C ratio decreased by 49.3%. No clinical side effects nor an increase in the transaminase levels, requiring termination of the treatment, were observed. CONCLUSIONS: Combined therapy with 20 mg of simvastatin and 200 mg of micronised fenofibrate is highly effective and safe in patients with mixed hyperlipidemia.

Reduction of cardiovascular mortality in Poland and changes in dietary patterns.

BACKGROUND: A decrease in mortality due to cardiovascular diseases has been recently documented in Poland. AIM: To assess changes in dietary patterns in Poland in the 90's. METHODS: The Central Statistical Office data on food consumption from the years 1989-2000 were analysed. The energy and fatty acid content in the consumed food were calculated with the use of the national food composition tables. RESULTS: A decrease in the consumption of butter by 52%, other animal fats by 20%, milk by 27%, beef by 57% and potatoes by 8% was noted. On the other hand, the consumption of vegetable fat increased by 100%, poultry by 70% and fruit by 64%. Changes in the consumption of cereal products, vegetables, pork, eggs and sugar were insignificant. A decrease of 19% in the consumption of saturated fatty acids and an increase of 32% in the intake of the polyunsaturated fatty acids were found. CONCLUSIONS: Changes in dietary patterns explain, at least in part, a marked reduction in cardiovascular mortality recently observed in Poland.

[Risk factors for ischemic heart disease and glycosaminoglycans (GAG's) in plasma in atherosclerosis obliterans]. / Czynniki ryzyka choroby niedokrwiennej serca i glikozoaminoglikany w surowicy w atherosclerosis obliterans.

UNLABELLED: GAGs (glycosoaminoglycans) derive from damaged artery endothelium cells. Theoretically their concentration could be used to measure the level of atherosclerosis process. The aim of the study was to estimate the concentration of glucosamine and galactosamine in plasma in patients with AO in comparison to the main risk factors of CHD: smoking, hyperlipidemia, hypertension. INVESTIGATED GROUP: the subject of the study were 35 men and 26 women suffering from AO. The control group comprised 20 men and 28 women. People from both groups were 36-65 years old. The concentration of glucosamine and galactosamine were determined by automatic amino acid analyzer LC 6001 Biotronic. The lipids in plasma were determined by conventional methods. Results 100% of men and 81% of women with AO were smokers to compare 70% and 17% in the control group. Systolic blood pressure in men with AO was 134 +/- 13 mm Hg and in women 136 +/- 16 mm Hg. In the control groups they were respectively 122 +/- 10 mm Hg and 124 +/- 10 mm Hg. The difference between the groups is statistically significant. Diastolic and systolic pressures in women with AO were higher then in the control group. In men with AO systolic pressure, but not diastolic pressure, was higher than in the control group. It was observed that in women with AO the concentration of total cholesterol, LDL-chol, apo B in serum, apo B in LDL, TG, TC-HDL-chol/HDL-chol, LDL/HDL were higher, HDL-chol was lower in comparison with the control group. In men with AO total cholesterol, LDL-chol/HDL-chol and TC-HDL-chol/HDL-chol were higher then in the control group, HDL-chol was lower. 80% of women and 74% of men with AO suffered from hyperlipidemia compared with 36% and 60% in the control group respectively. Mixed hyperlipidemia was the most important factor differentiating patients with AO and the control group, when compared to other types of hyperlipidemia. The coexistence of risk factors was more frequently observed in patient with AO then in the control group. Differences in concentrations of glucosamine and galactosamine between the patients with AO and the control group were not statistically significant in women and only slightly statistically significant in men. CONCLUSIONS: Classical risk factors of CHD differentiate patients with AO from the healthy people. The concentrations of glucosamine and galactosamine in plasma cannot be used to determine the atherosclerosis process.