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Total antioxidant capacity of diet inversely related to inflammatory marker
A study published in the May 2005 issue of the British Journal of Nutrition found that as the total antioxidant capacity of the diet increases, levels of C-reactive protein go down.
Researchers at the University of Parma in Italy enrolled 243 men and women who previously participated in a diabetes and cardiovascular disease survey and follow up. In the current study, the subjects completed three day dietary records which were analyzed to determine the total antioxidant capacity (TAC) of the food and beverages consumed. Physical examinations which included medical history taking, measurement of height, weight, waist circumference and blood pressure, and blood testing for the inflammatory marker C-reactive protein (CRP), cholesterol and other values, were conducted on all participants.
In this study, red wine, fruits, fruit juices, coffee, cereals and vegetables were major sources of dietary antioxidants. The researchers found that the total antioxidant capacity of the diet was significantly higher in men and women who had low plasma C-reactive protein levels than in those whose CRP levels were considered high at 4.2 milligrams per liter and higher. Individuals whose CRP levels were high had increased levels of white blood cells, greater weights and waist circumferences, less insulin sensitivity, lower levels of HDL and beta-carotene, and were more likely to have hypertension than those whose CRP levels were low. Individuals with hypertension had higher levels of CRP across all levels of dietary total antioxidant capacity, with those whose diets were in the top 25% of total antioxidant capacity having CRP levels comparable to those of participants without hypertension whose dietary levels were in the lowest one-fourth.
The anti-inflammatory properties of certain antioxidants has been attributed to their ability to lower nuclear factor kappa beta (NF-kb) DNA-binding activity. Activation of NF-kb is promoted by oxidative stress and results in increased vascular endothelial cellular adhesion molecules and the production of C-reactive protein by the liver induced by tumor necrosis factor-alpha and interleukin-6. The significant association of dietary total antioxidant capacity with inflammation in view of the fact that only three days worth of dietary information was evaluated could indicate that the participants’ diets were relatively similar over time, or that the effect of dietary antioxidants has a short time of induction, which the authors state would suggest a pharmacological effect. This anti-inflammatory effect could be one of the mechanisms by which fruits, vegetables and red wine have been shown to be protective against cardiovascular disease, and could be especially important for individuals with hypertension.
Several basic concepts are often ignored despite being relevant to the treatment of hypertensive patients and associated cardiovascular disease. Although people often consider hypertension as a disease, it is a symptom. It is one sign of a developing or existing disease. It is a warning of the manifestation of a disease. Approximately 90% of the time, the underlying cause(s) of hypertension are unknown and, thus, the condition is named as essential hypertension. Commonly, physicians are told that by eliminating the hypertension, that is, by merely reducing blood pressure, the increased risk and mortality associated with underlying cardiovascular disease will be reversed. Unfortunately, the cumulative experience of over two decades of worldwide clinical trials indicates that getting rid of only one aspect of hypertensive disease, the elevated blood pressure, reduces only part of the cardiovascular risk associated with hypertension.
CRP is a marker for systemic inflammation. CRP levels indicate chronic low-grade inflammation, with linkage to blood vessel damage and vascular disease (Pasceri et al. 2000). When CRP levels are factored in along with hypertension, there is significant improvement in predicting cardiac health. CRP is more than a measurable antecedent preceding a cardiac problem. CRP acts directly upon the blood vessels to activate adhesion molecules in endothelial cells: the intercellular adhesion molecule (ICAM-1) and the vascular cell adhesion molecule (VCAM-1). VCAM-1 may be an early molecular marker of lesion-prone areas to experimental hypercholesterolemia. CRP appears intricately involved in the inflammatory process, a target for the treatment of atherosclerosis (Pasceri et al. 2000).
We believe that damaged vascular endothelial cells contribute to and perpetuate hypertensive vascular disease, which then progresses to many of the more serious, well-recognized cardiovascular disorders. We believe the most immediate key is control of the diet (especially salt intake) and control of the kinds of fat consumed. We cannot overemphasize the importance of avoiding trans -fatty acids, saturated fats, and sugar in favor of omega-3 essential fatty acids, particularly DHA. It is important to get the right combination of GLA, DHA, EPA, monounsaturated fats, fat-soluble antioxidant nutrients (such as coenzyme Q10 and vitamin E), natural vasodilators (arginine), and a good diet based on fruits and vegetables. Such a diet or supplementary dietary protocol will likely reduce the incidence of hypertension and stop the disease progression at it source.
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