J.R.L. Masarei

Effects of alcohol and caloric restrictions on blood pressure and serum lipids in overweight men.

We have examined the independent and combined effects on blood pressure and blood lipids of alcohol restriction and weight loss in overweight male drinkers with a view to assessing overall effects on cardiovascular risk of two widely promoted nonpharmacological approaches for hypertension. Eighty-six men with a mean age of 44.3 years, a mean regular alcohol intake of 440 ml/wk (five or six standard drinks per day), a mean blood pressure of 137.4 mm Hg systolic and 84.8 mm Hg diastolic, and a mean body mass of 92.5 kg entered a controlled two-way factorial study. The subjects were randomly assigned to four groups for an 18-week intervention in which members of two groups drank only low-alcohol beer, thereby reducing their alcohol intake by 374 ml/wk, while those of the other two groups continued their normal alcohol intake. Within the low and normal alcohol intake groups subjects either continued their usual diet or reduced their caloric intake by 4,200-6,300 kJ/day (1,000-1,500 kcal/day) (with protein, fat, and carbohydrate provided as 15%, 30%, and 55% of total calories, respectively). Calorie reduction and alcohol restriction caused weight losses of 7.5 (p less than 0.001) and 2.1 (p less than 0.01) kg, respectively. Calorie reduction and alcohol restriction were associated with decreases in systolic blood pressure of 5.4 (p less than 0.001) and 4.8 (p less than 0.01) mm Hg, respectively, and in diastolic blood pressure of 4.2 (p less than 0.001) and 3.3 (p less than 0.01) mm Hg, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Relationship of plasma HDL-Cholesterol to testosterone, estradiol, and sex-hormone-binding globulin levels in men and women

The significance of sex hormone levels in determining variation in high-density lipoprotein cholesterol (HDL-C) concentrations was studied in healthy Seventh Day Adventists (vegetarians) and Mormons. These groups were selected to avoid the confounding effects of alcohol consumption and cigarette smoking on HDL-C concentrations. Multivariate analysis showed that testosterone has a strong negative association with HDL-C in men (t = 3.99, P less than 0.001) and women (t = 2.04, P less than 0.05) when controlled for other variables including the concentration of sex-hormone-binding globulin (SHBG). Sex-hormone-binding globulin showed an independent positive association with HDL-C in men (P less than 0.001) and women (P less than 0.001). We postulate that the sex hormones affect HDL-C levels by regulating the activities of two important enzymes involved in the production and catabolism of HDL, namely, lipoprotein lipase and hepatic endothelial lipase. Other factors contributing independently to variation in HDL-C levels in this study were, in men, age and triglyceride, and in women, apoprotein-HDL, triglyceride, systolic blood pressure, heart rate, body mass index, and triceps skinfold thickness. Plasma estradiol concentrations were not significantly associated in either sex.

Effects of Alcohol Consumption on Serum Lipoprotein-Lipid and Apolipoprotein Concentrations Results from an Intervention Study in Healthy Subjects

Serum levels of cholesterol, triglyceride, cholesterol in low density lipoprotein (LDL) and in high density lipoprotein (HDL) and its major subfractions, and of apolipoproteins A-I, A-II and B were measured in 48 healthy men at the end of two 6-week periods in which they consumed normal alcohol (5.0%, v/v) or low alcohol (0.9%, v/v) beer, respectively. Other dietary and behavioural variables were kept constant. Mean levels of triglyceride, HDL cholesterol, HDL2- and HDL3 cholesterol, and apolipoproteins A-I and A-II were higher at the end of the normal compared with the low alcohol periods, and levels of LDL cholesterol were lower. Body weight was greater at the end of the normal alcohol period than at the end of the period of low alcohol but multiple regression analysis suggested that the changes in lipoprotein-lipid and apolipoprotein levels were due primarily to the change in alcohol consumption rather than concomitant changes in body weight. This study confirms an effect of alcohol on both major subfractions of HDL and on its major apolipoproteins.

Leukocyte and platelet function and eicosanoid production in subjects with hypercholesterolaemia

A group of 22 subjects with type IIA hypercholesterolaemia (mean serum cholesterol = 8.3 +/- 0.3 mmol/l) were sex, age and weight matched with 22 control subjects (mean serum cholesterol = 4.5 +/- 0.1 mmol/l). Diastolic blood pressure was significantly higher in hypercholesterolaemic subjects (79.2 +/- 1.4 mm Hg) than in control subjects (71.9 +/- 1.4 mm Hg). While the high cholesterol group had 52% greater thromboxane production in clotted whole blood than controls this difference was not significant, and the platelet aggregation and serotonin secretion response to doses of collagen, ADP and arachidonic acid were similar between the 2 groups. Polymorphonuclear leukocyte (PMN) chemiluminescence (used as a measure of reactive oxygen species production) in response to low doses of the chemotactic-peptide FMLP and opsonized zymosan was significantly greater in high cholesterol subjects compared to their matched controls. The production of platelet activating factor (PAF) by calcium ionophore (2.5 micrograms) stimulated PMN isolated from hypercholesterolaemic subjects (11.5 +/- 1.4 ng/10(6) cells) was significantly greater than PAF production by cells from the control group (8.3 +/- 1.0 ng/10(6) cells). Leukotriene B4 release by PMN in response to calcium ionophore did not differ between the 2 groups. These data suggest a degree of leukocyte activation in hypercholesterolaemic subjects compared to controls with normal cholesterol. In addition, plasma levels of lyso-PAF were higher in high cholesterol subjects (317 +/- 21 ng/ml) compared to their matched controls (271 +/- 18 ng/ml) perhaps indicating increased plasma acetylhydrolase activity in subjects with raised cholesterol levels. Recently described biological activity for lyso PAF suggests a possible role for this substance in atherogenesis.(ABSTRACT TRUNCATED AT 250 WORDS)

The combined effects of aerobic exercise and alcohol restriction on blood pressure and serum lipids : a two-way factorial study in sedentary men

Objectives To determine whether vigorous exercise and alcohol restriction have additive and independent effects in reducing blood pressure in sedentary male alcohol drinkers. Also to assess whether 4 weeks of vigorous exercise could offset the fall in high-density lipoprotein cholesterol (HDL-cholesteroI) usually observed after alcohol restriction. Design Seventy-five sedentary men were randomly assigned to drink low-alcohol beer or continue their normal drinking habits. Within these two groups subjects were further assigned either to a vigorous exercise programme of three 30-min sessions a week of cycling at 60-70% of maximum workload or to a control light-exercise programme. Results Seventy-two subjects completed the trial. Alcohol consumption fell by 85% in the low-alcohol group. Fitness increased by 10% following vigorous exercise, with a significant improvement in maximum oxygen uptake. After adjustment for weight loss, a significant effect of alcohol restriction in reducing both systolic and diastolic blood pressure was demonstrated. There was no effect of vigorous exercise on blood pressure. Serum total cholesterol, low-density lipoprotein cholesterol and apolipoprotein B were not influenced by alcohol restriction or vigorous exercise. However, alcohol restriction significantly reduced triglyceride, HDL-cholesteroI, its subfractions HDL2-cholesterol and HDL3-cholesterol, and its major apolipoproteins apo A-l and apo A-ll. These reductions were unaffected by moderate exercise. Conclusions This study provides further evidence that alcohol restriction results in reductions in blood pressure in men who are regular alcohol drinkers. However, a simultaneous increase in fitness did not lead to lower blood pressures than those achieved with alcohol restriction alone, and was unable to offset alcohol-related falls in HDL-cholesteroI, its subfractions and its major apolipoproteins.

Plasma calcium and cortisol as predisposing factors to alcohol related blood pressure elevation.

Mechanisms by which alcohol consumption might cause hypertension were examined in 30 pairs of healthy drinking (greater than 275 g ethanol per week) and teetotal men closely matched for age and obesity. Both systolic and diastolic blood pressures were significantly higher in the drinkers. Plasma calcium levels correlated with diastolic blood pressures (r = 0.51, P = 0.004) in drinkers only. After adjusting for plasma albumin, diastolic pressures increased by 6.9 mmHg for each 0.1 mM increment of plasma calcium. It is proposed that regular alcohol consumption predisposes to hypertension by facilitating calcium accumulation in cells involved in blood pressure regulation. In the combined population of drinkers and teetotallers plasma cortisol correlated positively with diastolic pressure (r = 0.35, P = 0.012) and negatively with plasma potassium (r = -0.38, P = 0.006); this suggests a role for the pituitary/adrenal axis as a significant determinant of blood pressure differences between healthy subjects.

Dietary fish oils increase serum lipids in insulin-dependent diabetics compared with healthy controls

The effect of daily dietary supplementation with fish oil on serum lipids and platelet total phospholipid fatty acids was examined in male normolipidemic insulin-dependent diabetics and normal controls. They were given 15 g/d of fish oil as Max EPA (equivalent to 2.7 g/d of eicosapentaenoic acid) for 3 weeks. The diabetics showed a rise in total cholesterol, attributable to increases in LDL- and HDL-cholesterol. The increase in HDL-cholesterol was largely due to a rise in its HDL2 subclass. There was also a decrease in triglycerides in both groups. Similar changes in lipids were seen in the normal controls, although these were not significant. The more pronounced effect in diabetics suggests an altered metabolic response to omega-3 fatty acids in that disorder. However, the results indicate that the possible detrimental effect of the rise in total and LDL-cholesterol following fish oil may be offset by the increase in the protective HDL2 subclass.

Controlled comparison of effects of exercise and alcohol on blood pressure and serum high density lipoprotein cholesterol in sedentary males.

1. Seventy‐two sedentary male drinkers, aged 20–45 years, and with mean blood pressure (BP) at entry of 132±1.2/73±0.9 mmHg, completed a 4 week study during which they were assigned randomly to either drink a low alcohol beer (effectively reducing their weekly alcohol intake from 481±47 mL to 52±5 mL) or to continue their normal drinking habits.

Fish oil-induced changes in apolipoproteins in IDDM subjects

The aim of this study was to examine the effect of Max EPA (a commercially available fish oil preparation) on serum cholesterol lipoproteins and apolipoproteins in insulin-dependent diabetic (IDDM) men with dosages that were likely to be acceptable to patients. Twenty-two male IDDM patients aged 20–41 yr, 6 of whom had retinopathy, were recruited from the Royal Perth Hospital diabetic clinic. After screening, subjects were divided into three groups. Six of the subjects without retinopathy were randomly selected and allocated to a control group. The remaining 16 patients (10 without and 6 with retinopathy) received a fish oil supplement. All subjects were advised to maintain their usual dietary patterns. Sixteen patients, including the 6 with retinopathy, were instructed to take 15 Max EPA fish oil capsules/day with meals. Patients in the control group did not take Max EPA. Three weeks of Max EPA supplementation without other dietary modification led to a significant rise in total cholesterol (P < 0.01), which could be accounted for by increases in low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol. The increase in HDL cholesterol was explained by a 33% rise (P < 0.001) in its HDL2 subclass. Changes in apolipoproteins were examined and showed that the level of apolipoprotein A-l increased after ingestion of fish oil and correlated significantly (P < 0.05) with the rise in HDL cholesterol. Apolipoprotein A-ll showed a significant fall at the end of Max EPA intake in a subgroup of patients with retinopathy, and this correlated significantly (P < 0.05) with the fall in HDL3 cholesterol observed at this time. A significant rise in apolipoprotein B (P < 0.05) was correlated with the rise in LDL cholesterol. Possible adverse effects of the increase in both total and LDL cholesterol after 15 g/day Max EPA may be compensated for by a rise in the protective HDL2 subclass. However, in view of this hypercholesterolemic effect and evidence that suggests that LDL apolipoprotein B may be a risk factor for coronary heart disease, these findings raise questions regarding the safety of fish oils in patients with IDDM.

Relationships between age, body weight, physical fitness and sex-hormone-binding globulin capacity

The associations between sex-hormone-binding globulin capacity (SHBG), age, body mass index (BMI), and physical fitness have been studied in 34 men and 36 women. Multivariate analysis was used to look for independent associations with SHBG. The data indicate that when controlled for a number of other factors SHBG levels are related, in men but not in women, to age (positively, p less than 0.001) and BMI (negatively, p less than 0.001).