Salvatore Verga

Effects of red orange juice intake on endothelial function and inflammatory markers in adult subjects with increased cardiovascular risk

BACKGROUND Oxidative and inflammatory stresses are involved in the pathogenesis of atherosclerosis. The consumption of fruit and vegetables is associated with improved health and reduced cardiovascular risk. Red oranges have a high content of antioxidant and antiinflammatory substances, but there is a paucity of data concerning their effects on cardiovascular biomarkers in subjects with increased cardiovascular risk. OBJECTIVE We investigated the effect of red orange juice intake on endothelial function, oxidative stress, and markers of inflammation in subjects with increased cardiovascular risk. DESIGN Nineteen nondiabetic subjects with increased cardiovascular risk (aged 27-56 y) were included in a randomized, placebo-controlled, single-blind crossover study and compared with 12 healthy, nonobese control subjects. In 2 periods of 7 d each with a 3-d interval, each participant alternatively received 500 mL red orange juice/d and 500 mL placebo/d in a random sequence. All measurements were performed in the morning after overnight fasting. RESULTS Endothelial function, which was measured as flow-mediated dilation, significantly improved and was normalized (5.7% compared with 7.9%; P < 0.005) after 1 wk of red orange juice consumption. Similarly, concentrations of high-sensitivity C-reactive protein, IL-6, and TNF-α significantly decreased (P < 0.001). Red orange juice had no significant effect on nitric oxide plasma concentrations. CONCLUSION A 7-d consumption of red orange juice ameliorates endothelial function and reduces inflammation in nondiabetic subjects with increased cardiovascular risk. This trial was registered at biomedcentral.com as ISRCTN39987296.

Acute effects of coffee on endothelial function in healthy subjects

Background/Objectives:Coffee is the most widely consumed beverage in the world, but its effect on the cardiovascular system has not been fully understood. Coffee contains caffeine and antioxidants, which may influence endothelial function, both of which have not yet been investigated. The objective of this study was to investigate the acute effects of coffee on endothelial function measured by brachial artery flow-mediated dilation (FMD).Subjects/Methods:A total of 20 (10 males and 10 females) healthy non-obese subjects underwent a double-blind, crossover study. Subjects ingested one cup of caffeinated (CC) and one cup of decaffeinated (DC) Italian espresso coffee in random order at 5- to 7-day intervals.Results:Following CC ingestion, FMD decreased progressively and significantly (mean±s.e.m.: 0 min, 7.7±0.6; 30 min, 6.3±0.7; 60 min, 6.0±0.8%; ANOVA (analysis of variance), P<0.05), but it did not significantly increase after DC ingestion (0 min, 6.9±0.6; 30 min, 8.1±0.9; 60 min, 8.5±0.9%; P=0.115). Similarly, CC significantly increased both systolic and diastolic blood pressure; this effect was not observed after DC ingestion. Blood glucose concentrations remained unchanged after ingestion of both CC and DC, but insulin (0 min, 15.8±0.9; 60 min, 15.0±0.8 μU/ml; P<0.05) and C-peptide (0 min, 1.25±0.09; 60 min, 1.18±0.09 ng/ml; P<0.01) blood concentrations decreased significantly only after CC ingestion.Conclusions:CC acutely induced unfavorable cardiovascular effects, especially on endothelial function. In the fasting state, insulin secretion is also likely reduced after CC ingestion. Future studies will determine whether CC has detrimental clinically relevant effects, especially in unhealthy subjects.

Glycaemic variability using continuous glucose monitoring and endothelial function in the metabolic syndrome and in Type 2 diabetes.

Diabet. Med. 27, 872–878 (2010)

Effects of hypocaloric very-low-carbohydrate diet vs. Mediterranean diet on endothelial function in obese women.

Background  Obesity is a cardiovascular risk factor associated with endothelial dysfunction, but the effect of different weight loss strategies on endothelial function is not known. The effect of diet on endothelial function in two hypocaloric diets, a very‐low‐carbohydrate diet (A) and a Mediterranean diet (M), was measured by brachial artery flow‐mediated dilation (FMD).

Association of dietary patterns with insulin resistance and clinically silent carotid atherosclerosis in apparently healthy people

BACKGROUND/OBJECTIVES:Dietary habits are important determinants of individual cardiovascular and metabolic risk. This study investigated the association between dietary patterns and asymptomatic carotid atherosclerosis, defined as the presence of plaques and/or increased intima–media thickness, and metabolic biomarkers of insulin resistance, including the homeostasis model assessment of insulin resistance (HOMA-IR) and the trygliceride/high-density lipoprotein (HDL)-cholesterol (Tg/HDL) ratio in a cohort of adults without known diabetes or atherosclerotic cardiovascular disease.SUBJECTS/METHODS:Nine hundred and twenty-nine randomly selected participants were cross-sectionally investigated. Each participant answered a food frequency questionnaire, and underwent high-resolution ultrasonographic evaluation of both carotid arteries. Laboratory blood measurements were obtained in a subsample of 507 participants.RESULTS:A dietary pattern that could be defined as unhealthy (high consumption of soft drinks, fried foods, seed oils, cured meats, butter, red meat and sweets) was identified in 21% of the cohort, whereas 34% of the cohort exhibited a dietary pattern that resembled the Mediterranean diet (high intakes of fruit, milk and cheese, olive oil, vegetables, pasta and bread). Intermediate habits characterized the remaining 45%. After adjusting for age, body mass index (BMI), waist circumference, glycated hemoglobin (HbA1c) and hypertension on treatment, the Mediterranean dietary pattern was associated with significantly lower HOMA-IR (β-coefficient=−0.51; P=0.003). After adjusting for gender, BMI and HbA1c, the unhealthy dietary pattern was associated with a significantly higher Tg/HDL-cholesterol ratio (β-coefficient=0.43; P=0.006). No significant association was found between dietary patterns and carotid atherosclerosis.CONCLUSIONS:This study suggests that, independent of measures of adiposity, a Mediterranean dietary pattern is associated with lower insulin resistance.

Low relative resting metabolic rate and body weight gain in adult Caucasian Italians

OBJECTIVE:To investigate the relationship between resting metabolic rate (RMR) and subsequent changes in body size and degree of fatness in a group of adult Caucasian Italians.DESIGN:Prospective, longitudinal, observational study.SUBJECTS:In total, 155 subjects (72 males and 83 females, age range: 18–55 y; BMI: 17.5–63.4 kg/m2) were evaluated. In total, 43 (26 m and 17 f; BMI: 28.9±1.1 kg/m2, mean±s.e.m.) of them were reassessed 10–12 y later.MEASUREMENTS:Anthropometric and body composition (bioimpedance analysis) parameters and RMR (indirect calorimetry) were taken at baseline and after 10–12 y.RESULTS:Subjects (15 m, 8 f) who gained body weight (arbitrarily defined as a change in body weight ≥5 kg) had baseline BMI (29.9±1.8 vs 28.0±1.4; P=NS) and body composition in terms of fat mass (FM%) and fat-free mass (FFM kg) comparable to those of the subjects (11 m, 9 f) whose body weight remained stable. Baseline RMR was significantly lower in subjects who gained weight than in those who did not (108±2.1 vs 122±3.1 kJ/kg-FFM 24 h; P<0.001), although it did not differ significantly between the two groups (119±2 vs 121±2 kJ/kg-FFM 24 h; P=NS) 10–12 y later. Baseline RMR was inversely correlated to both change in body weight (r=−0.57; P<0.001) and FM (r=−0.50; P<0.001).CONCLUSION:A low RMR normalized for FFM appears to be associated with body weight gain in the long run in adult Caucasian Italians.

Dose-dependent effects of decaffeinated coffee on endothelial function in healthy subjects

Background/Objectives:Coffee is known to contain antioxidant substances whose effects may be blunted because of caffeine that may unfavorably affect the cardiovascular system. This study was designed to investigate the acute dose-dependent effects of decaffeinated coffee (DC) on endothelial function measured by the brachial artery flow-mediated dilation (FMD).Subjects/Methods:A total of 15 (8 men and 7 women) healthy nonobese subjects underwent a single-blind, crossover study. Subjects ingested one and two cups of decaffeinated Italian espresso coffee in random order at 5- to 7-day intervals.Results:In the hour following the ingestion of two cups of DC, FMD increased (mean±s.e.m.): 0 min, 7.4±0.7%; 30 min, 8.0±0.6%; 60 min, 10.8±0.8%; P<0.001) as compared to consumption of one cup of DC (0 min, 6.9±0.7%; 30 min, 8.4±1.2%; 60 min, 8.5±1.1%; 3 × 2 repeated-measures analysis of variance: P=0.037 for time × treatment effect). Blood pressure did not differ between groups, and basal heart rate was lower in the two-cup group at baseline and 60 min.Conclusions:The present study demonstrated a significant acute favorable dose-dependent effect of decaffeinated espresso coffee on endothelial function. Further studies are needed to investigate the effects of chronic use of DC especially with respect to caffeinated coffee and in subjects with cardiovascular diseases.

Resting energy expenditure and body composition in morbidly obese, obese and control subjects

Resting energy expenditure (REE) was investigated by indirect calorimetry in relation to body composition and to different degrees of obesity in order to assess if a defective energy expenditure contributes to extra body fat accumulation. Differences were found between control subjects (group C; BMI 23±0.5 kg/m2, REE 5890±218 kJ/day; mean±SEM) and obese subjects (group O; BMI 34.2±0.9 kg/m2, REE 7447±360 kJ/day;P<0.0001) and between group C and morbidly obese subjects (group MO; BMI 49.9±1.6 kg/m2, REE 8330±360 kJ/day;P<0.0001); REE was not significantly different between groups O and MO. Body composition data were obtained by means of body impedance analysis. Even though group MO had a fat mass higher than group O, body cell mass, the metabolically active body compartment, was similar in groups O and MO, and this fact may have contributed to the similar REE in the two groups. Multiple regression analysis gave the following equation as the best predictor of REE: REE (kJ/day)+1591±49BW+74BCM−737G (R2=0.88), where BW is body weight, BCM is body cell mass andG is a dummy variable coding group membership (group C=1; group O=2; group MO=3). Thus the analysis showed a negative impact of obesity on REE beyond body composition variables.

Validation of a food frequency questionnaire for use in Italian adults living in Sicily.

Abstract The objective of this study was to validate two interviewer-led food frequency questionnaires (FFQs) of very different lengths: a medium-length FFQ (medium-FFQ) of 36 items and a short-length FFQ (short-FFQ) of 18 items, intending to measure levels of intakes in a local population. Both FFQs were validated against intakes derived from a 3-day dietary record (3-day DR). Sixty-five non-diabetic adults with no known cardiovascular, renal or other systemic diseases were included. High correlation coefficients between the FFQ and the 3-day DR (0.45–0.73) were observed for energy intake, carbohydrates and lipid and protein intake. Bland–Altman plots showed good agreement between the methods. Low (0.26–0.37) correlation coefficients of the different nutrient intakes obtained with the short-FFQ and the 3-day DR were observed, with the exception of alcohol intake (rho = 0.49). This study showed promising evidence for the use of a medium-FFQ as a potentially useful tool for investigating the relationship between habitual diet and diseases in clinical and research settings.

Influences of obesity and weight loss on thyroid hormones. A 3–3.5-year follow-up study on obese subjects with surgical bilio-pancreatic by-pass

The effects of changing body size, energy intake and substrate oxidation on serum T4, FT4, T3, FT3 and TSH were investigated in ten morbidly obese subjects (4 men/6 women; age: 37±6 years; BMI: 53.8±6.5 kg/m2; mean±SD) who had undergone a surgical bilio-pancreatic by-pass in orderto reduce their body weight. The starting value of serum FT3 was inversely related to the BMI (r= −0.63; p<0.05). After 1–3 months, all the subjects were losing weight and their intake of carbohydrates was almost negligible; at this time a significant reduction of T3 (−14.6%; p<0.0001), T4 (−19.5%; p<0.0001), and FT3 (−10.5%; p<0.001) was observed. Nine to 16 months after surgery, all the subjects were still losing weight, although there was no carbohydrate restriction; T3, T4, and FT3 were lower than prior to surgery but were beginning to increase. Finally, after 36–42 months the body weight of all the patients had been stable for at least the previous six months (final BMI: 32.9±4.1) and their body composition, as assessed by bio-impedance, was almost normal; only the concentrations of FT3 proved to be significantly lower than the basal value (−11.2%; p<0.03). The change in FT3 proved to be independently influenced by the degree of fat malabsorption but not by changes in any of the physical characteristics considered. All values were always in the normal range; FT4 and TSH did not change significantly during the whole period of study. The final concentrations of TSH proved to be independently related to the postabsorptive protein oxidation (g/24h) (TSH=2.37–0.018 protein oxidation). These results would suggest that nutritional factors have some influence on the blood levels of thyroid hormones, especially of FT3, while the removal of obesity does not seem to have any independent effect in the long-run.