172 HEALTH & NUTRITION NEWS Vitamins C, E may curb effects of fatty meals V itamins C and E block some of the harmful effects of a high- fat meal on blood vessels. according to findings published in the Nov. 26. 1997. issue of The Journal of the American Medical Association. For the clinical study. Gary D. Plotnick and colleagues at the Uni- versity of Maryland School of Medicine in Baltimore selected 20 healthy hospital employees between the ages of 24 and 54 and examined the short-term effects of a single high-fat meal on endothelial function. The volunteers were randomly given one of three breakfasts: a high-fal meal (900 calories and 50 grams of fat); a low-fat meal (900 calories and zero grams of fat); and a high-fat meal following an oral dose of vita- mins C (1,000 mg) and E (800 IV). Researchers measured vasodilation in an anery in the arm before and after the meals to see any effects on endothelial function. Findings showed that a single high- fat meal decreased endothelial func- tion temporarily for two to four hours, possibly through the accumulation of triglyceride-rich lipoproteins. No reduction occurred with the low-fat meal nor with the high-fat meal plus vitamins. "Pretreatment with antioxidant vitamins eliminated the decrease in endothelial function following the high-fat meal, but did not increase vasodilation after the low-fat meal. This finding suggests that a high-fat meal impairs endothelial function through an oxidative stress mecha- nism that is blocked by pretreatment with antioxidant vitamins," the researchers wrote, concluding, "These findings may explain, in part. the inverse effects of fats and antioxidant vitamin intake on core- nary heart disease risk and may pro- vide a beuer mechanistic approach to antioxidant vitamin administra- tion." Meanwhile. researchers from Den- mark have reported thai a high-fat meal can spark a dramatic rise in a blood coagulation factor, which may increase the risk of death from hean disease and stroke. Their work appeared in the November 1997 issue of Arteriosclerosis, Thrombosis and Vascular Biology. Findings indicated that dietary fat, including monounsaturated fat. may increase heart attack and stroke risk by increasing the activity of blood clotting Factor VII. The paper's authors were Lone Frost Larsen, Peter Marckmann, Else-Marie Blad- bjerg, and Jorgen Jespersen from the Royal Veterinary and Agricultural University, Frederiksberg, Denmark. In the study, 18 healthy young men were fed rive different fat meals. During a period of nine months, the men were given six dif- ferent meal tests, each at least three weeks apart. During each test, the men fasted overnight, then were given a test meal enriched with either rapeseed oil, olive oil, sun- flower oil, palm oil, or butter in the morning and a low-fat meal consist- ing of rice, bananas, and raisins in mid-morning. The high-fat meals contained 42% fat mixed with rice, beef, onion, red pepper, and corn. Nonfasting blood samples were col- lected eight times during the day. All five high-fat test meals caused significant increases in Factor VII, the paper reported. However, the authors said they were unsure how fat promot- ed the sudden activation of the coagu- lation factors in the blood. Although previous studies have suggested that a relationship exists between Factor VII and an immediate rise in triglycerides after consumption of a high-fat meal, the Denmark team found no such association. Fats rich in monounsaturated fatty acids had the same effects as polyun- saturated or saturated fatty acids on the coagulation factors. Researchers noted thai this may be because the study was conducted with Danish men whose normal diets are high in satu- rated fat. "It may be that we need to see what happens in individuals who eat differ- ent dietary fats for a longer period of time," Larsen said. The research team said further study is needed to evaluate why high- fat meals lead to Factor VU activation as well as the long-term effects of dif- ferent edible fats. Another study shows sitostanol ester benefits A University of Helsinki study has found that replacing regular canol a margarine with one containing sitostanol ester substantially lowered blood cholesterol levels in women patients with diagnosed heart disease and even lowered serum cholesterol to normal levels in a third of those stud- ied. Publishing their results in the Dec. 15. 1997, issue of Circulation, Tatu Mieninen and colleagues at the Uni- versity of Helsinki recruited two groups of postmenopausal women with diagnosed heart disease for their study. One group of 22 women ate low-fat diets followed by a similar seven-week diet containing three grams per day of margarine with suostanot ester. For the next seven weeks, the women ate canola oil mar- garine without the sitostanol ester. The second group of len women who were taking the cholesterol-lowering drug simvasrann ate sitosranol margarine for 12 weeks. Although the regular canoln oil margarine reduced cholesterol levels overall by about 5%, the sitostanol ester-enriched spread was much more effective, lowering total blood cholesterol levels by an average of 13% and low-density lipoprotein (LDL) cholesterol by 20%. Combin- ing the sitostanol margarine with drug therapy further reduced total and LDL cholesterol, the study showed. Individuals taking the suostanot ester and drug combination were able to reduce their medication dose and sometimes even to eliminate the need for the drug more often than individu- als only taking the drug, the researchers reported. Sitosranol reduced cholesterol in all of the 32 INFORM. Vol. 9, no. 2 (February 1998)
Transcript
172
HEALTH & NUTRITION NEWS
Vitamins C, E may curb effects of fatty meals
Vitamins C and E block some ofthe harmful effects of a high-fat meal on blood vessels.
according to findings published in theNov. 26. 1997. issue of The Journal ofthe American Medical Association.
For the clinical study. Gary D.Plotnick and colleagues at the Uni-versity of Maryland School ofMedicine in Baltimore selected 20healthy hospital employees betweenthe ages of 24 and 54 and examinedthe short-term effects of a singlehigh-fat meal on endothelial function.The volunteers were randomly givenone of three breakfasts: a high-falmeal (900 calories and 50 grams offat); a low-fat meal (900 calories andzero grams of fat); and a high-fatmeal following an oral dose of vita-mins C (1,000 mg) and E (800 IV).Researchers measured vasodilation inan anery in the arm before and afterthe meals to see any effects onendothelial function.
Findings showed that a single high-fat meal decreased endothelial func-tion temporarily for two to four hours,possibly through the accumulation oftriglyceride-rich lipoproteins. Noreduction occurred with the low-fatmeal nor with the high-fat meal plusvitamins.
"Pretreatment with antioxidantvitamins eliminated the decrease inendothelial function following thehigh-fat meal, but did not increasevasodilation after the low-fat meal.This finding suggests that a high-fatmeal impairs endothelial functionthrough an oxidative stress mecha-nism that is blocked by pretreatmentwith antioxidant vitamins," theresearchers wrote, concluding,"These findings may explain, inpart. the inverse effects of fats andantioxidant vitamin intake on core-nary heart disease risk and may pro-vide a beuer mechanistic approachto antioxidant vitamin administra-tion."
Meanwhile. researchers from Den-mark have reported thai a high-fatmeal can spark a dramatic rise in ablood coagulation factor, which mayincrease the risk of death from hean
disease and stroke. Their workappeared in the November 1997 issueof Arteriosclerosis, Thrombosis andVascular Biology.
Findings indicated that dietary fat,including monounsaturated fat. mayincrease heart attack and stroke riskby increasing the activity of bloodclotting Factor VII. The paper'sauthors were Lone Frost Larsen,Peter Marckmann, Else-Marie Blad-bjerg, and Jorgen Jespersen from theRoyal Veterinary and AgriculturalUniversity, Frederiksberg, Denmark.
In the study, 18 healthy youngmen were fed rive different fatmeals. During a period of ninemonths, the men were given six dif-ferent meal tests, each at least threeweeks apart. During each test, themen fasted overnight, then weregiven a test meal enriched witheither rapeseed oil, olive oil, sun-flower oil, palm oil, or butter in themorning and a low-fat meal consist-ing of rice, bananas, and raisins inmid-morning. The high-fat mealscontained 42% fat mixed with rice,beef, onion, red pepper, and corn.Nonfasting blood samples were col-lected eight times during the day.
All five high-fat test meals causedsignificant increases in Factor VII, thepaper reported. However, the authorssaid they were unsure how fat promot-ed the sudden activation of the coagu-lation factors in the blood. Althoughprevious studies have suggested that arelationship exists between Factor VIIand an immediate rise in triglyceridesafter consumption of a high-fat meal,the Denmark team found no suchassociation.
Fats rich in monounsaturated fattyacids had the same effects as polyun-saturated or saturated fatty acids onthe coagulation factors. Researchersnoted thai this may be because thestudy was conducted with Danish menwhose normal diets are high in satu-rated fat.
"It may be that we need to see whathappens in individuals who eat differ-ent dietary fats for a longer period oftime," Larsen said.
The research team said further
study is needed to evaluate why high-fat meals lead to Factor VU activationas well as the long-term effects of dif-ferent edible fats.
Another study showssitostanol ester benefitsA University of Helsinki study hasfound that replacing regular canol amargarine with one containingsitostanol ester substantially loweredblood cholesterol levels in womenpatients with diagnosed heart diseaseand even lowered serum cholesterol tonormal levels in a third of those stud-ied.
Publishing their results in the Dec.15. 1997, issue of Circulation, TatuMieninen and colleagues at the Uni-versity of Helsinki recruited twogroups of postmenopausal womenwith diagnosed heart disease for theirstudy. One group of 22 women atelow-fat diets followed by a similarseven-week diet containing threegrams per day of margarine withsuostanot ester. For the next sevenweeks, the women ate canola oil mar-garine without the sitostanol ester. Thesecond group of len women who weretaking the cholesterol-lowering drugsimvasrann ate sitosranol margarinefor 12 weeks.
Although the regular canoln oilmargarine reduced cholesterol levelsoverall by about 5%, the sitostanolester-enriched spread was muchmore effective, lowering total bloodcholesterol levels by an average of13% and low-density lipoprotein(LDL) cholesterol by 20%. Combin-ing the sitostanol margarine withdrug therapy further reduced totaland LDL cholesterol, the studyshowed.
Individuals taking the suostanotester and drug combination were ableto reduce their medication dose andsometimes even to eliminate the needfor the drug more often than individu-als only taking the drug, theresearchers reported. Sitosranolreduced cholesterol in all of the 32
INFORM. Vol. 9, no. 2 (February 1998)
women tested, and trimmed amountsof LDL to below 100 milligrams perdeciliter of blood. By contrast. none ofthe women's LDL levels went down tothis level while on the regular low-fatdiet.
Suostenol-comaining margarines,which have been shown to lowerblood cholesterol levels in previousstudies. currently are sold in Finlandby the Raisio Group.
Hardened fats citedin nurses' studyFollow-up data from the Nurses'Health Study indicate that total fatcontent in the diet is not as importantas the type of fat consumed concern-ing the risk of coronary artery disease.
In findings published in the Nov.20. 1997. issue of the Nell' EnglandJournal of Medicine, Frank Hu andWalter C, Willett of the HarvardSchool of Public Health and col-leagues from related Boston. Mas-sachusetts, research centers reportedthat 939 nonfatal myocardial infarc-tions (MI) or deaths from coronaryheart disease (CHD) occurred amongthe more than 80,000 women enrolledsince 1976 in this ongoing prospectivestudy.
Their analysis associated higherdietary intake of saturated fat andtrailS unsaturated fat with increasedrisk of CHD. while higher intake ofmonounsaturated and polyunsaturatedfats was associated with reduced risk.
CHD risk was lowest in those whoconsumed the lowest amounts of transunsaturated fat and the highest intakeof polyunsaturated fats, but reducingoverall fat intake had little effect onthe risk.
The research team estimated thatreplacing 2% of energy from Iransfat in the daily diet with nonhydro-genated. unsaturated fats wouldreduce CHD risk by 53%. In addi-tion. they estimated that replacing5% of energy from saturated fat withmonounsaturated and polyunsaturat-ed fats would reduce heart diseaserisk by 42%.
In an accompanying editorial in thesame journal. Tim Byers of the Uni-
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versity of Colorado in Denver wrote,"There seems to be wide agreementthat Irans fats have adverse effects oncholesterol profiles. yet liule agree-ment about either the magnitude of theproblem or what actions should betaken.
"Reduction in intake of saturatedfats should continue to be a high nutri-tional priority. but taking steps 10reduce the levels of trans fats in ourdiet would seem to be a reasonableadditional goal," he added.
Meanwhile. a study published inthe November issue of Heart has con-cluded that intake of smurated fat anddietary cholesterol is more importantin the etiology of ischemic heart dis-ease (IHD) than the protective effectof dietary fiber.
Jim I. Mann of the University ofOtago in New Zealand and colleaguesat two United Kingdom centersreported findings from a prospectivediet study centering on body massindex and IHD in 10,802 vegetarians,sernivegetarians, and meat eaters inthe United Kingdom over a mean of13 years.
Findings showed that IHD mortali-ty among participants was about halfthat expected for the general popula-tion of England and Wales.Researchers observed that mortalityfor IHD occurred with increasedintake of total and saturated animal fatand dietary cholesterol, whereasdietary fiber, fish and alcohol did notoffer protection.
Leptin's role studied inbody weight regulationScientists at Oregon Health SciencesUniversity have discovered evidenceindicating that certain obese micedevelop a tolerance for leptin, a hor-mone produced by fat cells.
Publishing their results in the Nov.28. 1997, issue of Science, BruceBoston and Roger Cone noted, "It hasbeen known that high levels of leptincorrelate with increased body fat inboth humans and mice. Whereas lowlevels of leptin are associated with lowbody fat. extremely low levels areassociated with starvation and compel
an animal to eat voraciously whenfood becomes available."
Fat cells produce the protein leptinwhich enters the bloodstream andtravels to the brain where it binds withreceptors on nerve cells in thehypothalamus, researchers havefound. "The leptin pathway creates afeedback loop for body weight regula-tion," the authors suggested. Thus.high levels of leptin signal thatenough food has been consumed.whereas very low levels initiate thestarvation response.
It had been hypcthes ized thatincreasing an animal's leptin levelwould turn down appetite. However,Jeffrey Friedman of the RockefellerUniversity recently demonstrated thatseveral types of obese mice, includingthe yellow agouti mouse strain, do norlose weight when they are givenincreased levels of leptin. These micethus appeared resistant to the leptinhormone.
Although Friedman suggested thatanimals may become obese becausethey are unable to respond to fcpun,Boston and Cone said their data implythat obese animals have alreadyresponded to the high leptin level intheir system and simply cannotrespond to additional Jeptin. This rais-es questions about the potential thera-peutic value of leprin for treating obe-sity.
with the amount of body fat of themother. Obese mothers, the studyfound, produce large amounts of lep-tin. while thin mothers produce almostno leptin in their breast milk.
Since its discovery in the early1990s, researchers have been trying tolearn more about leprin's role. Animalstudies have shown that obese miceinjected with lepnn soon lose theirexcess weight.
Although leptin was found inhuman milk. researchers still aren'tsure what role the hormone plays formothers or infants. "Like many hor-mones in breast milk. it is difficult todetermine what it is doing. It may bethat leptin is doing nothing; it may bethat the leptin is just there," accordingto Karen Houseknecht, assistant pro-fessor of animal science at Purdue andadjunct assistant professor ofendocrinology and metabolism at theIndiana University School ofMedicine. who led the study.
Researchers find leptinin human breast milkThe hormone lepun, which may playa role in body metabolism and obesi-ty, has been found in human breastmilk.
In a study of 23 lactating women,researchers at Purdue University. theUniversity of Idaho. and WashingtonState University discovered that thehormone is present in human breastmilk at levels lower than, but correlat-ing with, levels in the mother's blood-stream.
Results. which were published inthe December J 997 issue of Biochem-ical and Biophysical Research Com-munications, also showed that theamount of leptin in the milk correlates
Fatty acids' role in diseasesexplored at U.K. meetingResearchers at Brigham and Women'sHospital. Boston, have developed atheory as to how marine fish-basedfatty acids may reduce inflammation,and thus offer some relief 10 those suf-fering from rheumatoid arthritis.
Reporting results in December atthe British Society of Immunology 5thAnnual Congress in Brighton. UnitedKingdom, Richard Sperling ofBrigham and Women's Hospital notedthai dietary eicosapentaenoic acid(EPA) reduces the production ofleukorriene B4 by neutrophils, bothfrom healthy donors and from patientswith inflammatory disorders.
In addition. a diet rich in EPA andother marine-derived fatty acids hasbeen shown to have other beneficialeffects on neutrophil activity. Forinstance. neutrophils are less likely tomigrate to the site of inflammation, orto release other molecules andenzymes which may cause damage atthese sites.
Noting that a number of studieshave shown that diets enriched inmarine fish oils have a modest benefi-
INFORM. Vol. 9. no. 2 (FebfLlOry 1998)
175
cial effect in patients with rheumatoidarthritis and inflammatory bowel dis-ease, Sperling said these results sug-gest that this is because these oils mayhave a calming effect on neutrophilactivity.
Also speaking at the same congress,Laurence Harbige of the University ofGreenwich and St. Thomas' Hospital,London, United Kingdom. presentedwork centering on the effects of fauyacids in experimental models of multi-ple sclerosis (MS).
Harbige and colleagues have foundthat fauy acids from various plantsand fungi can alter the course of MSin animal models. When fed thesefatty acids in a purified form, rodentswith an experimental disease resem-bling MS did nor develop disease.
The next stage. he noted. is to findout whether this treatment will beeffective in people with MS. A dou-ble-blind clinical trial was to begin atSI. Thomas' Hospital early in 1998 toexplore this question.
"Further rigorous clinical and labo-ratory research is essential before wecan recommend any such treatmentfor MS," Harbige said.
Red wine's resveratrolseen as a phytoestrogenResearchers at the Northwestern Uni-versity Medical School in Chicagohave found that resveratrol-thechemical in red wine believed to helpreduce cardiovascular disease (CVD)risk-is a phytoestrogen.
Resverauul is highly concentratedin the skin of grapes and is abundant inred wine. Because it has a molecularstructure similar to that of the syntheticestrogen diethylstilbestrol. Barry D.Gehm, J. Larry Jameson, and col-leagues at Northwestern investigatedwhether it might have pharmacologicproperties similar to those of estradiol,the major natural human estrogen.
Their results. published in the Dec.9, 1997, Proceedings of the NationalAcademy of Sciences, showed thatresveratrot is estrogenic. At concen-trations similar to those required forits other biological effects. resvermrotactivated expression of both anificial-
Iy introduced "reporter" genes andnaturally occurring estrogen-regulatedgenes in cultured human cells.
The researchers also found thatresverarrol could replace estradiol insupporting the proliferation of certainbreast cancer cells that require estro-gen for growth.
Green tea ingredientkills cancer cellsResearchers at the Case WesternReserve University School ofMedicine in Cleveland, Ohio, havefound an ingredient in green tea thatkills cancer cells.
The ingredient epigallocatechin-3-gallate, is a major constituent of thepolyphenols found in green tea.
In the study reported in the Dec.17, 1997, issue of the Journal of theNational Cancer lnstinue, investiga-tors tested the compound on cancer-ous human and mouse cells of theskin, lymph system, and prostate, andon nonnal human skin cells. In the lesttube, the compound led to apcptosis(programmed cell death) in the cancercells, but left the healthy cellsunharmed.
"We found that this particular com-pound, which is present in the amountof about 200 mg in one cup of greenlea, can kill a variety of cancer cellsthrough apoptosis without affectingthe normal cells," according to HasanMukhtar, a professor of dermatologyat Case Western and senior author ofthe paper. He noted that the polyphc-nol broke the DNA of the cancer cellsinto fragments, a characteristic ofnpoptosis.
Polyphenols induce the demise ofcancer cells, but scientists do not yetknow why this happens, Mukhtar said.He and his colleagues concluded thatthese findings should be further evalu-ated in human trials.
Fatty acids and cancerfindings presentedA supplement 10 the December 1997issue of The American Journal of
Ciinical Nutrition presents the pro-ceedings of a symposium held in June1996 on individual fatty acids andcancer.
Summarizing what is known fromhuman studies on the effects of fattyacids on cancer, Johanna T. Dwyerof Tufts University Schools ofMedicine and Nutrition wrote:"More complete food-compositiondata with respect to fatty acids andmore comprehensive food tables areneeded, as are better methods formeasuring fat intakes, better markersof progression, and more definitiveepidemiologic and clinical studies.At present there is insufficient evi-dence to conclude that specific fanyacids are associated with cancerdevelopment in humans."
She added, "Whether specificfatty acids are associated with cancerdevelopment is a question that willnot be answered definitely until thenext millennium. Much remains tobe learned about the effects, protec-tive or prejudicial, of fatty acids ondevelopment of breast. prostate, andcolon cancers. Specific fatty acidsappear to protect against heart dis-ease, and they may also do so forcertain cancers."
Guest editors of the supplementwere Clement Ip and Kenneth Carroll.Sponsor was ILSI North America. Thesupplement was published by TheAmerican Society for Clinical Nutri-tion Inc., 9650 Rockvi1Je Pike,Bethesda. MD 20814-3998.
Eating fish may reducesudden cardiac death riskEating at least one fish meal perweek may cut in half the risk ofsudden cardiac death in men.according to an article in the Jan. 7,1998, issue of Tire Journal of theAmerican Medical Association(JAMA).
Christine M. Alber! and col-leagues of Brigham and Women'sHospital in Boston, Massachusetts,studied 20,551 male physicians, aged40 to 84 years, in the Physicians'Health Study to investigate the asso-ciation between fish consumption
INFORM. Vol. 9. no. 2 (February 1998)
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HEALTH Be NUTRITION NEWS
and the risk of sudden cardiac death.defined as death within one hour ofthe onset of symptoms.
The researchers found thai eatingfish at least once a week was associ-ated with a 52% lower risk of suddendeath compared with those eating
fish less than once a month. The n-Sfatty acids found in seafood alsowere associated with a reduced riskof sudden death, but less significant-ly. However, fish and n-3 fatty acidconsumption were not linked to riskof heart attack, coronary heart dis-
ease death, or nonsudden cardiacdeath.
Approximately 250,000 suddencardiac deaths occur in the UnitedStates every year. Of the suddendeaths. 55% have no previous historyof heart disease and most die prior toreaching the hospital.
"All levels or fish consumptionwere associated with a decreasedrisk or sudden death, but the size orreduction did not appear to differsubstantially at levels or consump-tion greater than one fish serving perweek, suggesting a threshold effect.This small amount or fish may besufficient to provide an essentialamount or long-chain n-3 polyunsat-urated ratty acid or some unidenti-fied nutrient or both that decreasesudden cardiac death," according tothe researchers. Fatty fish includestuna, salmon. mackerel. and shell-fish.
Tests with red meat, chicken. veg-etables. fruits. dairy, and fried roodsdid not find any association with sud-den cardiac death.
The researchers pointed out thatpart or the association between fishconsumption and a lower risk or sud-den death may be explained by thefact that fish consumption is a markerfor a healthier lifestyle. On the otherhand, fish consumers were more likely10 have high cholesterol or hyperten-sion and a family history of coronaryheart disease.
In an accompanying editorial,Daan Krom hou t of the NationalInstitute of Public Health and theEnvironment in The Netherlandssaid the study did not provide anyclear-CUI answers because no associ-ation was observed with nonsuddencardiac death and coronary heartdisease death. Also, this study dif-fer ed rrom the previous WesternElectric study, which found a signif-icant inverse association betweenfish consumption and coronary heartdisease death and nonsudden cardiacdeath bUI not with sudden cardiacdeath.
The different findings may beattributed to different methods usedfor interpreting data and different defi-nitions of what constitutes "sudden"cardiac death. Kromhout wrote. •
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