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Biomedical subjects

S S Rastogi

Publications and source records attributed to S S Rastogi.

At least 19 recordsLinked to original sources
PubMed1998

Prevalence of type 2 diabetes mellitus and risk of hypertension and coronary artery disease in rural and urban population with low rates of obesity.

OBJECTIVE: To compare the prevalence of type 2 diabetes mellitus (DM) and coronary artery disease (CAD) and hypertension in DM in the rural and urban populations of north India. DESIGN AND METHODS: Two populations of the same ethnic background were randomly selected for this cross sectional survey. There were 1769 rural (894 men, 875 women) and 1806 urban subjects (904 men, 902 women) between 25-64 years of age. The survey methods included fasting and 2 h blood glucose and electro-cardiogram and blood pressure measurement of all subjects. RESULTS: Using the criteria of World Health Organization, the prevalence of diabetes mellitus (6.0 vs 2.8%) hypertension (24.0 vs 17.0%) and CAD (9.0 vs 3.2%) was significantly (P<0.001) higher in urban compared to rural subjects. Hypertension and CAD were significantly more frequent among subjects with diabetes compared to nondiabetes. The association of CAD and hypertension with diabetes was greater in urban than rural subjects. Excess body weight and obesity, central obesity, sedentary lifestyle, higher visible fat intake (>25 g/day), and social class 1-3 (higher and middle) were significantly associated with diabetes. Multivariate logistic regression analysis showed that after adjustment of age and sex, body mass index, central obesity, sedentary lifestyle and higher visible fat intake and alcohol intake in men were significant risk factors of diabetes among all the sub-groups. CONCLUSIONS: The study showed a high prevalence of diabetes in urban north Indian population compared to rural subjects in the same ethnic group. CAD and hypertension were significantly associated with diabetes more in urban than rural subjects. The findings suggest that higher body mass index, waist-hip ratio and visible fat intake and sedentary lifestyle were risk factors of diabetes.

Adult↗
PubMed1998

Association of low plasma concentrations of antioxidant vitamins, magnesium and zinc with high body fat per cent measured by bioelectrical impedance analysis in Indian men.

This cross-sectional study was conducted to determine the association of high body fat per cent measured by bioelectric impedance analysis with known risk factors of obesity as well as with serum levels of vitamins, trace elements and magnesium and oxidative stress in an urban population in India. There were 850 men aged 25-64 years, randomly selected from the city of Moradabad. Subjects were divided into high body fat per cent (n = 357), over fat per cent (n = 230), desirable fat (n = 200) and low fat (n = 63) based on criteria of body fat per cent analysis. The prevalence of central obesity, sedentary lifestyle, family history and higher visible fat intake showed significant association with higher over fat per cent. Postprandial plasma insulin and glucose and serum iron and oxidative stress were significantly higher and plasma levels of vitamin C and E and serum zinc/insulin ratio as well as serum magnesium/insulin ratio showed inverse association with high body fat per cent. Multivariate logistic regression analysis after adjustment of age showed a significant positive association of body mass index (odds ratio 0.97), sedentary lifestyle (odds ratio 1.12) and serum iron (OR 1.00) with higher body fat per cent. Zinc (OR 1.03), magnesium (OR 1.02), vitamins C (OR 1.08 and E (OR 1.09) deficiency were risk factors of higher body per cent and central obesity. It is possible that some Indian men can benefit by increased intake of zinc, magnesium, vitamin C and vitamin E in conjunction with lifestyle changes.

Adult↗
PubMed1998

Prevalence and determinants of central obesity and age-specific waist:hip ratio of people in five cities: the Indian Women's Health Study.

OBJECTIVE: To study the prevalence of central obesity and age-specific waist:hip ratio of urban women from five Indian cities. DESIGN AND SETTING: Cross-sectional surveys were conducted in 6-12 urban streets in different parts of India using similar methods of sample selection and criteria of diagnosis. SUBJECTS AND METHODS: We randomly selected 3212 women, aged 25-64 years, from Moradabad (n = 902), Trivandrum (n = 760), Calcutta (n = 365), Nagpur (n = 405), and Bombay (n = 780). Evaluation was by a questionnaire administered by a physician and a dietician, a physical examination, and anthropometric measurements. RESULTS: The overall prevalence of central obesity among the total number of women was 55.0%, with the highest prevalence in Calcutta (62.2%) and the lowest in Bombay (47.4%). Waist:hip ratio was 0.85 +/- 0.13 (mean +/- SD) with the highest ratio for women in Calcutta (0.87 +/- 0.12) and the lowest for women in Moradabad (0.84 +/- 0.16). After pooling of data from all five cities, multivariate logistic regression analysis showed that, regardless of age, body mass index (> 23 kg/m2; odds ratio 1.12), sedentary lifestyle (odds ratio 2.51), and family history of obesity (odds ratio 2.15) were strongly associated with central obesity. Excess intake of fat was weakly associated with central obesity but age was not a risk factor for central obesity, although the prevalence was highest among those aged over 55 years in Moradabad, Calcutta, and Nagpur. CONCLUSIONS: The overall prevalence of central obesity among the urban women of India has increased, more so in Calcutta and Trivandrum. Body mass index, sedentary lifestyle, and family history of excess intake of fat were significant risk factors for central obesity.

Adult↗
PubMed1997

Antioxidant effects of lovastatin and vitamin E on experimental atherosclerosis in rabbits.

The effects of the administration of vitamin E (10 mg/day) plus lovastatin (2 mg/day; group A, n = 10), lovastatin alone (2 mg/day; group B, n = 10), and placebo (group C, n = 10) were compared over 24 weeks in a randomized, single-blind controlled trial. All groups of rabbits received a trans fatty acid (TFA)-rich diet (5-10 g/day) for 36 weeks. Treatment with vitamin E plus lovastatin (group A) and lovastatin (group B) started after 12 weeks of administration of TFA-rich diet was associated with a significant but similar decline in serum cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides in both groups at 36 weeks. Lipid peroxides and diene conjugates showed a significant decline in association with a significant increase in the plasma level of vitamin E in group A rabbits at 36 weeks. However, the lovastatin group B showed a lesser but significant decrease in lipid peroxides and diene conjugates at 36 weeks, indicating that lovastatin may have antioxidant activity. In control group C, the increase in blood lipids and oxidative stress at 36 weeks was much greater than the decrease in groups A and B. After experimental lipid peroxidation at 24 weeks in all of the rabbits, 2 of 10 group B and 3 of 10 group C rabbits died due to coronary thrombosis; there were no deaths in group A. Thus antioxidant therapy with vitamin E can provide protection against death due to free radical stress. Aortic lipids and sudanophilia indicating athorosclorosis were significantly lower in groups A and B than in group C. The atherosclerotic coronary plaque sizes were significantly smaller in group A (18.5 +/- 3.6 microns) than in groups B (41.6 +/- 4.2 microns) and C (85 +/- 6.7 microns). Aortic plaque sizes were also smaller in group A than in group B and C. It is possible that antioxidant therapy with vitamin E, as an adjunct to lipid lowering with lovastatin, can provide additional benefit in the inhibition of oxidative stress and atherosclerosis. The antioxidant activity of lovastatin has not been reported, to our knowledge.

Animals↗
PubMed1997

Epidemiological study of hypertension and its determinants in an urban population of North India.

OBJECTIVES: To determine age-specific prevalence of hypertension and blood pressure (BP) levels in relation to diet and lifestyle factors in North Indians. DESIGN AND SETTING: Cross-sectional survey in 20 randomly selected streets in Moradabad, North India. SUBJECTS AND METHODS: A total of 1806 subjects from North India (904 males and 902 females) age range 25-64 years. The survey methods were as follows: dietary diaries for 7 days food intake record; BP measurements; physician administered questionnaire and anthropometric measurements. Diagnosis of hypertension was based on new World Health Organization/International Society of Hypertension (WHO/ISH) criteria. Risk factors were assessed based on WHO guidelines. RESULTS: The prevalence of hypertension according to WHO/ISH criteria was 23.7% and by old WHO criteria 13.3%. In the WHO/ISH hypertensive group, isolated diastolic hypertension was present in 47.3% males and 40.6% females. Males have a slightly higher prevalence than females in the young age group, however, the prevalence rates are comparable in the older age groups. In both sexes, the prevalence rates and BP level increased with older age. Multivariate analysis revealed that age, higher body mass index, central obesity and higher socioeconomic status were independently and strongly associated with hypertension in both sexes. Higher dietary fat and salt intake and lower physical activity were weakly but significantly associated with hypertension. CONCLUSION: Association of higher socioeconmic status, higher body mass index and central obesity in North Indian adults with higher fat intake, lower physical activity and higher prevalence and level of hypertension indicate that these populations may benefit by decreasing the dietary fat intake and increasing physical activity, with an aim to decrease central obesity for decreasing hypertension in North Indians.

Adult↗
PubMed1997

Blood pressure trends, plasma insulin levels and risk factors in rural and urban elderly populations of north India.

OBJECTIVE: To compare the prevalence of hypertension and its risk factors with age-specific blood pressures in rural and urban subjects. DESIGN AND SETTING: A cross-sectional survey of two randomly selected villages and 20 randomly selected streets in Moradabad, north India. SUBJECTS AND METHODS: The subjects were 255 rural people (140 men, 115 women) and 311 urban people (172 men, 139 women) aged 60-84 years. The survey methods were questionnaires, blood pressure and anthropometric measurements and electrocardiography. RESULTS: The mean +/- SD blood pressures, both systolic (137.7 +/- 13 versus 131.2 +/- 12 mmHg) and diastolic (89.8 +/- 41 versus 85.8 +/- 9 mmHg) were significantly higher in urban men than they were in rural men. Similar differences between systolic (135.6 +/- 11 versus 129.2 +/- 10 mmHg) and diastolic (90 +/- 10 versus 87.6 +/- 9 mmHg) blood pressures were found among urban and rural women, respectively. A significant correlation between systolic blood pressures and increasing age was observed both for rural and for urban subjects of both sexes. The overall prevalences of hypertension based on World Health Organization criteria (17.6 versus 5.0%) and Joint National Committee fifth report criteria (34.0 versus 10.1%) were significantly higher among urban than they were among rural subjects. Multivariate logistic regression analysis revealed that age, body mass index, central obesity, glucose intolerance, 2 h plasma insulin and triglyceride level were associated independently with hypertension. CONCLUSIONS: The findings indicate that urban subjects had higher blood pressures than did rural subjects and that age, body mass index, central obesity and 2 h plasma insulin levels were significant risk factors for hypertension in an elderly population.

Age Factors↗
PubMed1997

Diet and lifestyle guidelines and desirable levels of risk factors for the prevention of diabetes and its vascular complications in Indians: a scientific statement of The International College of Nutrition. Indian Consensus Group for the Prevention of Diabetes.

BACKGROUND: There has been a rapid increase in the prevalence of diabetes and cardiovascular disease in India, in association with rapid changes in diet and lifestyle. In adults, the prevalence of diabetes, hypertension and coronary artery disease is two- to threefold greater in the urban population than in rural populations; it is associated with modest insulin resistance in urban groups. METHODS: In response to a proposal by the International College of Nutrition that specialist experts should develop consensus recommendations for the prevention of chronic diseases, Indian specialists in diabetes and vascular disease have collaborated to produce guidelines relevant to the population of India. RECOMMENDATIONS: Because Indian urban populations have a modest increase in overweight and low rates of obesity in association with the rapid emergence of diabetes and cardiovascular risk, a body mass index of 21 kg/m2 should be considered safe, with a range of 19-23 kg/m2 acceptable; > 23 kg/m2 should be considered overweight, and > 25 kg/m2 should be taken to indicate obesity. A waist:hip ratio > 0.88 in males and > 0.85 in females should be considered to indicate central obesity, because the prevalence of coronary disease, hypertension and associated disturbances of insulin resistance are more common above these limits. For the prevention of vascular disease, there is general international consensus that the desirable serum concentration of cholesterol should be < 170 mg/dl (> 4.42 mmol/l), which may also be optimal for Indians; values between 170 and 200 mg/dl (4.42-5.2 mmol/l) should be considered borderline. The critical values for low density lipoprotein cholesterol may be < 90 mg/dl (ideal), 90-110 mg/dl (borderline high) and > 110 mg/dl (high) (< 2.32, 2.32-2.84 and > 2.84 mmol/l, respectively). Fasting triglycerides should be < 150 mg/dl (< 1.69 mmol/l) and high-density lipoprotein cholesterol > 35 mg/dl (> 0.9 mmol/l). The limit for the total energy derived from fat intake should be < 21%/day (7% each for saturated, polyunsaturated and mono-unsaturated fatty acids). The carbohydrate intake should provide more than 65% of daily energy, mainly from complex carbohydrates. A daily dietary intake of 400 g fruits, vegetables and legumes, 400 g cereals, in conjunction with 25 g soya bean or mustard or canola oils (rich in n-3 fatty acids) in place of fats rich in saturated fat, may be protective against diabetes and vascular disease. Moderate physical activity with the aim of burning 300 Kcal/day (> 1255 KJ/day), and cessation of tobacco and alcohol consumption, may provide an effective programme for prevention of diabetes and its vascular complications in Indians.

Adult↗
PubMed1996

Usefulness of antioxidant vitamins in suspected acute myocardial infarction (the Indian experiment of infarct survival-3)

In a randomized, double-blind, placebo-controlled trial, the effects of combined treatment with the antioxidant vitamins A (50,000 IU/day), vitamin C (1,000 mg/day), vitamin E (400 mg/day), and beta-carotene (25 mg/day) were compared for 28 days in 63 (intervention group) and 62 (placebo group) patients with suspected acute myocardial infarction. After treatment with antioxidants, the mean infarct size (creatine kinase and creatine kinase-MB gram equivalents) was significantly less in the antioxidant group than in the placebo group. Serum glutamic-oxaloacetic transaminase decreased by 45.6 IU/dl in the antioxidant group versus 25.8 IU/dl in the placebo group (p < 0.02). Cardiac enzyme lactate dehydrogenase increased slightly (88.6 IU/dl) in the antioxidant group compared with that in the placebo group (166.5 IU/dl) (p < 0.01). QRS score in the electrocardiogram was significantly less in the antioxidant than in the placebo group. The following levels increased in the antioxidant group versus the placebo group, respectively: plasma levels of vitamin E increased by 8.8 and 2.2 mumol/L (p < 0.01), vitamin C increased by 12.6 and 4.2 mumol/L (p < 0.01), beta-carotene increased by 0.28 and 0.06 mumol/L (p < 0.01), and vitamin A increased by 0.36 and 0.12 mumol/L (p < 0.01). Serum lipid peroxides decreased by 1.22 pmol/ml in antioxidant versus 0.22 pmol/ml in the placebo group (p < 0.01). Angina pectoris, total arrhythmias, and poor left ventricular function occurred less often in the antioxidant group. Cardiac end points were significantly less in the antioxidant group (20.6% vs 30.6%, respectively). These results suggest that combined treatment with antioxidant vitamins A, E, C, and beta-carotene in patients with recent acute myocardial infarction may be protective against cardiac necrosis and oxidative stress, and could be beneficial in preventing complications and cardiac event rate in such patients.

Adult↗
PubMed1996

Effect of diet and moderate exercise on central obesity and associated disturbances, myocardial infarction and mortality in patients with and without coronary artery disease.

OBJECTIVE: To test whether a fat modified and fruit and vegetable enriched diet in conjunction with moderate physical activity reduces the cardiac event rate in patients with coronary artery disease (CAD) and its risk factors in an urban setting in India. SUBJECTS AND METHODS: 480 patients either with CAD or with risk factors. Those with definite or possible CAD including angina pectoris (n = 210) based on World Health Organization criteria and patients with risk factors were assigned to diet A (n = 231) or diet B (n = 232) for a period of 3 years. Both groups were advised to follow a fat modified diet. Group A was also advised to consume at least 400 g/day of fruits, vegetables and legumes according to World Health Organization advice and include moderate physical activity. RESULTS: Waist-hip ratios, fasting and post-prandial blood glucose, plasma insulin levels, blood pressure and weight fell significantly in patients in group A compared with those in group B. While triglycerides in group A showed a significant decrease, high density lipoprotein cholesterol showed a significant increase. Both groups showed a significant reduction in total and low density lipoprotein cholesterol, although the decrease was greater in group A than group B. Central obesity decreased by 6.2% in group A vs. 1.2% in group B, 95% confidence interval of difference 2.3 to 7.8. The incidence of cardiac events was significantly lower in group A than group B (29 vs. 43 patients, p < 0.01). All-cause mortality also significantly declined in group A compared with group B (16 vs. 24 died, p < 0.05). The group A patients with better adherence to exercise and diet showed greater reduction in central obesity and greater decline in cardiac event rates and total mortality compared to control group B. CONCLUSIONS: It is possible that moderate physical activity in conjunction with dietary changes in patients with CAD may cause substantial reductions in central obesity and associated disturbances corresponding to a significant decrease in cardiac events and mortality during the follow-up of 3 years.

Blood Glucose↗
PubMed1996

A randomised, double-blind, placebo-controlled trial of L-carnitine in suspected acute myocardial infarction.

In a randomised, double-blind placebo-controlled trial, the effects of the administration of oral L-carnitine (2 g/day) for 28 days were compared in the management of 51 (carnitine group) and 50 (placebo group) patients with suspected acute myocardial infarction. At study entry, the extent of cardiac disease, cardiac enzymes and lipid peroxides were comparable between the groups, although both groups showed an increase in cardiac enzymes and lipid peroxides. At the end of the 28-day treatment period, the mean infarct size assessed by cardiac enzymes showed a significant reduction in the carnitine group compared to placebo. Electrocardiographic assessment of infarct size revealed that the QRS-score was significantly less in the carnitine group compared to placebo (7.4 +/- 1.2 vs 10.7 +/- 2.0), while serum aspartate transaminase and lipid peroxides showed significant reduction in the carnitine group. Lactate dehydrogenase measured on the sixth or seventh day following infarction showed a smaller rise in the carnitine group compared to placebo. Angina pectoris (17.6 vs 36.0%), New York Heart Association class III and IV heart failure plus left ventricular enlargement (23.4 vs 36.0%) and total arrhythmias (13.7 vs 28.0%) were significantly less in the carnitine group compared to placebo. Total cardiac events including cardiac deaths and nonfatal infarction were 15.6% in the carnitine group vs 26.0% in the placebo group. It is possible that L-carnitine supplementation in patients with suspected acute myocardial infarction may be protective against cardiac necrosis and complications during the first 28 days.

Administration, Oral↗
PubMed1995

Epidemiologic study of diet and coronary risk factors in relation to central obesity and insulin levels in rural and urban populations of north India.

In a population survey of 162 rural and 152 urban subjects aged 26-65 years at Moradabad, the findings are compared with existing data on Indian immigrants to Britain and United States. In comparison with rural subjects, urban subjects had a higher prevalence of coronary artery disease (8.6 vs. 3.0%) and diabetes (7.9 vs 2.5%), higher blood pressures, total and low density lipoprotein cholesterol, triglycerides and postprandial 2-h blood glucose and plasma insulin similar to observations made in UK in immigrants compared to Europeans. Fasting plasma insulin and high density lipoprotein cholesterol levels in urban subjects were comparable with rural subjects. Mean body weights were significantly higher in urban women, but not in men, than in rural subjects. However the body mass index (22.9 +/- 4.2 vs. 21.6 +/- 2.4 kg/m2) and waist-hip girth ratio (0.89 +/- 0.10 vs. 0.86 +/- 0.07) were significantly higher in urban men compared to rural men without such differences in women. Underlying these differences in risk factors, urban subjects had three times better socioeconomic status than rural subjects and were eating higher total and saturated fat, cholesterol and refined carbohydrates and lower total and complex carbohydrates compared to rural men and women. Energy expenditure during routine and spare time physical activity was significantly higher in rural compared to urban subjects. Those patients who had risk factors, showed lesser physical activity and had greater adverse factors in the diet compared to subjects without risk factors. Body mass index and waist-hip girth ratio in patients with risk factors were significantly higher than in subjects without risk factors. The findings suggest that decreased consumption of total and saturated fat and increased physical activity may be useful for prevention of coronary artery disease among urbans as well as in immigrants.

Adult↗
PubMed1995

Effect of antioxidant-rich foods on plasma ascorbic acid, cardiac enzyme, and lipid peroxide levels in patients hospitalized with acute myocardial infarction.

OBJECTIVE: To determine whether a fat- and energy-reduced diet rich in antioxidant vitamins C and E, beta carotene, and soluble dietary fiber reduces free-radical stress and cardiac enzyme level and increases plasma ascorbic acid level 1 week after acute myocardial infarction. DESIGN: Randomized, single blind, controlled study. SETTING: Primary- and secondary-care research center for patients with myocardial infarction. SUBJECTS: All subjects with suspected acute myocardial infarction (n = 505) were considered for entry to the study. Subjects with definite or possible acute myocardial infarction and unstable angina (according to World Health Organization criteria) were assigned to either an intervention diet (n = 204) or a control diet (n = 202) within 48 hours of symptoms of infarction. INTERVENTIONS: Intervention and control groups were advised to consume a fat-reduced, oil-substituted diet. The intervention group was also advised to eat more fruits, vegetable soup, pulses, and crushed almonds and walnuts mixed with skim milk. MAIN OUTCOME MEASURES: Reduction in plasma lipid peroxide and lactate dehydrogenase cardiac enzyme levels, increase in plasma ascorbic acid level, and compliance with diet, especially with vitamin C intake as determined by chemical analysis. STATISTICAL ANALYSIS: A two-sample t test using one-way analysis of variance for comparison of data. RESULTS: Plasma lipid peroxide level decreased significantly in the intervention group compared with the control group (0.59 pmol/L in the intervention group and 0.10 pmol/L in the control group; 95% confidence interval of difference = 0.19 to 0.83). Lactate dehydrogenase level increased less in the intervention group than in the control group (427.7 vs 561.2 U/L; confidence interval of difference = 82.9 to 184.7). Plasma ascorbic acid level increased more in the intervention group than in the control group (23.38 vs 7.95 mumol/L; confidence interval of difference = 12.85 to 26.13). APPLICATIONS/CONCLUSIONS: Consumption of an antioxidant-rich diet may reduce the plasma levels of lipid peroxide and cardiac enzyme and increase the plasma level of ascorbic acid. Antioxidant-rich foods may reduce myocardial necrosis and reperfusion injury induced by oxygen free radicals.

Analysis of Variance↗
PubMed1995

Epidemiological study of coronary artery disease and its risk factors in an elderly urban population of north India.

OBJECTIVE: In view of the rapid increase in the prevalence of coronary artery disease (CAD) in developing countries, our aim was to determine the prevalence of CAD and its risk factors and lifestyle factors in an elderly population from north India. METHODS: A random sample of 595 elderly subjects between 50 to 84 years of age was obtained from the urban population of Moradabad. The response rate was 90.1%. The survey methods included a questionnaire containing information on 7-day food intake, other lifestyle factors, Rose questionnaire for diagnosis of angina pectoris, a standard 12-lead electrocardiogram, blood pressure measurements and blood examination. RESULTS: The total prevalence of CAD based on clinical history and electrocardiogram was 121/1000 (95% CI 72 to 165). The prevalence rate was slightly higher in males (130/1000) than in females (110/1000). The prevalence of CAD based on the Rose questionnaire was 57/1000 and based on electrocardiogram in 561 asymptomatic subjects was 67/1000. CAD was significantly higher in the elderly (65 to 84 years) group than in the middle-aged (50 to 64 years) group (168 vs. 97 per 1000), respectively. While the prevalence of hypertension was significantly higher in the elderly than middle-aged group respectively (214 vs. 168 per 1000), the prevalence of central obesity was significantly higher in the middle-aged than elderly group (674 vs. 632 per 1000). Other risk factors including smoking were comparable in the two subgroups. Prevalence of major risk factors and central obesity were significantly higher among patients with CAD than in the rest of the subjects. Prevalence of CAD was significantly higher in the middle and higher socio-economic groups compared to the lower income group. These higher income groups were also eating significantly higher amounts of visible fat and had a higher prevalence of physical inactivity (93.3%) compared to the lower income group. CONCLUSIONS: CAD and its risk factors such as hypertension, hypercholesterolemia, diabetes and central obesity are of sufficient magnitude in the elderly population of India to be a major public health problem. The findings also indicate that CAD is more commonly associated with middle and higher socio-economic status which may be due to greater consumption of dietary fat and more sedentariness compared to lower socioeconomic groups.

Aged↗
PubMed1995

Effect of low energy diet and weight loss on major risk factors, central obesity and associated disturbances in patients with essential hypertension.

Obesity, especially central, increases the risk of hypertension, hypertriglyceridaemia and diabetes to a significant extent. To determine whether dietary weight reduction can reduce blood pressure (BP) and other cardiovascular risk factors, 217 hypertensives were randomised to receive either 1600 Kcal/day diet (group A, n = 108) or the usual 2100 Kcal/day diet (group B, n = 109). Sodium intake and physical activity were kept similar in both groups. After 16 weeks of follow-up, patients in group A received significantly less energy leading to a 2.8 kg net reduction in mean weight in association with a significant net decrease in mean SBP and DBP (7.5/6.5 mm Hg) compared with nonsignificant changes in group B. There was a significant net decrease in mean total cholesterol (7.0%), low-density lipoprotein (LDL)-cholesterol (7.9%) and triglycerides (8.0%), with a significant net increase in high-density lipoprotein (HDL)-cholesterol (4.0%) in group A compared with group B. New risk factors such as glucose intolerance (8.0%) and central obesity (waist-hip girth ratio, 0.021) showed a significant net reduction compared with group B. Patients with central obesity and other associated disturbances showed maximal reduction in BP and other cardiovascular risk factors with a significantly greater increase in HDL-cholesterol. Mean doses of drugs were similar at entry to the study as well as after 16 weeks in both groups. It is possible that weight reduction due to a low caloric diet can moderate central obesity and associated disturbances in hypertensive subjects.

Antihypertensive Agents↗
PubMed1995

Epidemiologic study of central obesity, insulin resistance and associated disturbances in the urban population of North India.

Central obesity in association with insulin resistance is a strong predictor of coronary artery disease (CAD) in South Asians; however the prevalence of central obesity and insulin resistance in Indians are unknown. Anthropometric measurements, dietary intakes, physical activity and prevalence of risk factors and CAD were obtained in 152 adults between 26-65 years of age (80 males, 72 females) selected by random sampling from urban population of Moradabad. The overall prevalence of central obesity was 539 per 1000 adults including 56.2% in males and 51.3% in females. The prevalence of glucose intolerance, diabetes mellitus, hypertension, hypertriglyceridemia and CAD were significantly higher in the higher quintiles of WHR above 0.88 compared to lower quintiles. Fasting and postprandial glucose, plasma insulin and triglycerides as well s total cholesterol and blood pressure were significantly higher in each of the upper quintile of WHR with increase in WHR compared to lowest quintile of WHR below 0.81. These findings indicate the existence of a modest degree of insulin resistance with a modest tendency to central obesity in the urban population of North India. The prevalence of CAD was significantly (p < 0.01) higher among subjects with central obesity than in non-obese subjects (21.5 vs 3.2%). Underlying these findings, the prevalence of central obesity was significantly greater among sedentary and mild activity group compared to moderate and heavy activity group and per day energy expenditure during activity in the upper quintiles with WHR > 0.88 was significantly less compared to energy expenditure in lower quintiles of WHR. Similarly dietary fat intake in the upper quintiles of WHR was also significantly higher than in the lower quintiles of WHR. These findings suggest that populations with higher prevalence of central obesity and CAD may be benefited with an aim to decrease central obesity.

Adult↗
PubMed1994

Dietary and serum magnesium levels in patients with acute myocardial infarction, coronary artery disease and noncardiac diagnoses.

OBJECTIVE: To study the relation of dietary and serum levels of magnesium (Mg) in acute myocardial infarction (AMI) and its complications in relation to noncardiac diagnoses. METHODOLOGY: Case control study in a primary and secondary care center for AMI patients. The study included 460 subjects with definite AMI (n = 335, group A), possible AMI (n = 64, group B), unstable angina (n = 19, group C) and controls with noncardiac chest pain (n = 42, group D). Demographic variables, dietary intake, and clinical and biochemical data were compared. Mean age, sex, body weight, and body mass index were comparable in all the groups. RESULTS: Dietary fat and cholesterol intakes were significantly higher and carbohydrate intakes were lower in group A, B and C patients with coronary artery disease compared to control group D. Dietary consumption of Mg was comparable in all groups; however, in 85 patients in group A (272.5 mg/day) and 17 in group B (280.4 mg/day) in whom ventricular arrhythmias were present, Mg intake was relatively lower compared to control group D (316.6 mg/day). Serum Mg levels in group A (1.66 mEq/L), B (1.65 mEq/L), and C (1.66 mEq/L) were within normal (1.74 mEq/L) limits, but were significantly lower than in control group D. CONCLUSIONS: Lower serum Mg in group A, B and C patients was attributed to increased demand during AMI, although in patients with complications (ventricular arrhythmias), Mg deficiency may in part result from relatively lower Mg intake, a hypothesis which requires further study.

Arrhythmias, Cardiac↗
PubMed1994

Diet, antioxidant vitamins, oxidative stress and risk of coronary artery disease: the Peerzada Prospective Study.

The prevalence of coronary artery (CAD) disease in the Indian urban population is comparable to British population. Dietary intakes, antioxidant vitamins, prevalence of risk factors and CAD, were studied in a random sample of 152 adult urban subjects between 26-65 years of age (80 males, 72 females) from Peerzada street, Moradabad and compared with Indian immigrants to U.K. and a British comparison group. There was no significant relation with vitamin A. Smoking and diabetes were the confounding factors. Plasma antioxidant vitamin C (21.6 +/- 3.3 vs 42.5 +/- 4.5 mumol/L), vitamin E (15.2 +/- 2.8 vs 21.4 +/- 3.2 mumol/L) and beta-carotene (0.33 +/- 0.6 vs 0.55 +/- 0.08 mumol/L) were significantly lowered and lipid peroxides higher (2.82 +/- 0.22 vs 1.3 +/- 0.20 nmol/ml) in patients with CAD compared to subjects without any risk factors. The relation between low plasma level of vitamin C and E levels and carotene remained independently and inversely related after adjustment for smoking, diabetes and other risk factors. Regression analysis showed that after adjustment. Odd's ratio for carotene (1.82, 95% C.I. 0.50 to 3.72), vitamin C (2.23, 95% C.I. 1.14 to 5.26) and vitamin E (2.35, 95% C.I. 1.29 to 5.30) were significantly related to CAD. Underlying these changes, dietary intake of vitamin A, E, C and beta-carotene was significantly less in patients with CAD. Vitamin C and beta-carotene intake were less in smokers and diabetes. Compared with British population, the Indian urbans consumed less total and saturated fat and cholesterol and more polyunsaturated fat and complex carbohydrates. The plasma total and low density lipoprotein cholesterol levels were less in Indian urbans compared to Britons and so were mean body weight, body mass index and waist-hip ratio. Plasma insulin levels were comparable. The fatty acid composition of the diet, blood lipids, central obesity and insulin levels do not appear to account for high rates of CAD among Indians. The findings suggest that urban population in India may benefit from eating diets rich in antioxidant vitamin C, E and beta-carotene.

Adult↗