Eating to beat diabetes, heart disease, hypertension

They are the three major causes of morbidity and mortality in adult Nigerians. In recent times, diabetes, hypertension, high cholesterol and heart diseases with its attendant complications including stroke, heart attack and kidney damage have been on the increase. But researchers have found that eating functional foods like coconut oil, banana, various beverages, different fruits, specific vegetables, grains, legumes, herbs and spices help fight these chronic diseases. 

Previous studies have shown that a combination of daily intake of coconut oil, local spices, banana, Zobo (sorrel), local bitters such as bitter leaf, scent leaf as well as exercise training would reduce the risk of developing chronic and non communicable diseases like blood pressure, blood sugar (diabetes) and heart diseases.

However, a recent review of functional foods against metabolic syndrome (obesity, diabetes, hypertension and dyslipidemia) and cardiovascular disease published in Trends in Food Science & Technology compiled the most current studies on foods that help fight metabolic syndrome and the scientific evidences to support their use.

This includes functional fats, digestive enzymes inhibitors, various beverages, different fruits, specific vegetables, grains, legumes, herbs and spices that can reduce cardiovascular disease risk, through several cellular mechanisms.

Metabolic syndrome is a condition of at least three of the cardiovascular risk factors: obesity, excessive visceral fat storage, dyslipidemia, hypertension, and hyperglycaemia or Type 2 diabetes. It is a state of insulin resistance, oxidative stress and chronic inflammation.

Cardiovascular disease is the highest cause of death globally. Certain dietary components and over 800 plants help prevent or moderate metabolic syndrome by assisting the body homeostasis mechanisms.

Malaysian researchers led by Suhaila Mohamed and his team at the Institute of BioScience, Universiti Putra Malaysia, wrote: “Functional food and over 800 plants help prevent or reduce metabolic syndrome by assisting the body ho- meostasis mechanisms.

Type II diabetes expresses the decreased disposal of glucose in the peripheral tissues due to insulin resistance, overproduction of glucose by the liver, defects in pancreatic B-cell function and decreased B-cell mass.

Obesity, insufficient physical activity and excess calorie intake are factors contributing to its development. “Excess energy consumption subsequently causes hypoxia (oxygen deficiency) in the adipose tissues.

This induces the adipocytes (fat cells) to secrete pro- inflammatory chemokines (example COX-2, iNOS) that attracts immune cells, macrophages and inflammatory responses.

Besides secreting pro-inflammatory cytokines, the white adipose tissues have endocrine function to produce hormones, lipid metabolism regulators, vascular hemostasis controllers, or comparable system (example leptin, angiotensinogen, adipsin, acylation stimulating protein, adiponectin, retinol-binding protein, TNF-alpha, interleukin 6, plasmin-ogen activator inhibitor-1 and tissue factor).

“Fasting induces adipocyte secretory proteins production, a fibrinogen e angiopoietine related protein, metallothionein and resistin. Resistin induces insulin resistance that links diabetes to obesity, while metallothionein is an antioxidant metal-binding and stress-response protein.

“Culinary plants, herbs and spices are a good source of peroxisome proliferators-activated receptor (PPAR) g ligands. PPARg is a therapeutic drug target for metabolic syndrome.

Pomegranate, apple, clove, cinnamon, thyme, green coffee, bilberry, bay leaves and many other edible plant components bind to PPARg in a competitive ligand binding assay.

Others like nutmeg, licorice, black pepper, holy basil (scent leaf) and sage trans activated PPARg in chimeric GAL4-PPARg-LBD (part of the nuclear receptor structure) system and may function as selective PPARg modulators.

Selective PPARg modulators improve insulin resistance without weight gain and PPARg antagonists exert anti-obesity effects. PPARg activators can inhibit the NF-KB activation and down-regulate the pro-inflammatory cytokines.

” Omega 3 and 6 fats The type and amount of fats consumed affect obesity, insulin resistance and atherosclerosis in animal models.

Chronic soybean, coconut and lard consumption (but not fish oil), reduced serum adiponectin that regulate glucose and fatty acid oxidation.

High saturated fat diets increase calories consumption, retroperitoneal fat, liver glycogen, plasma/liver cholesterol and triacylglycerol levels more than other high calorie fat diets and reduced the anti-atherogenic Paraoxonase 1 activity and glucose tolerance test in rats.

Conjugated linoleic acid but not conjugated linolenic acid consumption reduced rats’ adipose tissues. Although both conjugated linoleic acid and conjugated linolenic acid reduced non-High Density Lipo-protein (HDL) ‘good’-cholesterol, conjugated linolenic acid impaired the insulin function.

Bovine milk contains conjugated linoleic acid, short and medium-chain fatty acids that may have anti-inflammatory, immune enhancing, anti-bacterial, anti-ulcerative colitis, anti-cancer, anti-atherosclerosis and anti-hypertension effects. Free fatty acids mediate adipose tissue signaling through toll-like receptor 4.

The pro-inflammatory mediator expressions are via NF-KB or JNK. JNK bind and phosphorylate c-Jun on Ser-63 and Ser-73 within its transcriptional activation domain and belong to the mitogen-activated protein kinase family, responsive to stress stimuli, example cytokines, ultraviolet irradiation, heat and osmotic shock.

The dietary recommendations to prevent coronary heart disease is to replace trans and saturated fats with non-hydrogenated unsaturated fats; increase omega-3 fatty acids from fish, fish oil supplements, or plant sources to balance omega-6 polyunsaturated oil intake; consume lots of fruits, vegetables, nuts and whole grains and reduce refined grain products.

Human studies showed that monounsaturated fatty acids consumption (MUFA or oleic acid) help inhibit metabolic syndrome, age-related cognitive decline and certain cancers (breast, colorectal and prostate). Oleic acid contents are high in olive oil (70 per cent) and palm olein (50 per cent).

MUFA and phenol-rich plant oils improve cardiovascular risk factors (dyslipidemia, hypertension, endothelial dysfunction, oxidative stress and antithrombotic profiles) and have anti-oxidant and anti-inflammatory properties.

Consuming repeatedly heated oils causes post-prandial inflammation. Natural or added polyphenols-rich oils reduce postprandial inflammation in twenty obese humans in a randomized, crossover study.

Acute supplementation did not affect triacylglycerols or oxidative stress biomarkers of overweight and obese hyper-triglyceridemic men.

Daily consumption of 2 g phytosterol by hyper-cholesterolaemic subjects lowered Low Density Lipo-protein (LDL) ‘bad’-Cholesterol, cholesterol synthesis and increased cholesterol absorption. Obesity, hyper-cholesterol and type 2 diabetes Obesity is associated with systemic oxidative stress, adipokine imbalance and reduced antioxidant defences, leading to dyslipidemia, vascular disease and hepatic steatosis.

Anti-obesity strategies include: (1) increasing physical activity (2) consuming non-starch polysaccharides/fiber and micronutrient-rich plant products, (3) breast-feeding; and (4) reducing energy-dense, micronutrient-poor diets. High protein diets produce greater satiety and weight loss, lower plasma triglyceride, blood pressure and spare lean mass than high carbohydrate diets; with no harmful effects on bone density or renal function.

Some over-the-counter weight loss carbohydrate blocker produced larger testes in animals, while fat-blockers increased soluble pancreatic proteins in growing male rats. Beverages Black Tea (Camellia sinensis) polyphenols (theaflavins, theaflavin 3-O-gallate, theaflavin 30-O-gallate, theaflavin 3,30-O-gallate, epigallocatechin gallate, epicatechin gallate, catechins, 2 quercetin glycosides, quinic acid, and gallic acid and caffeine) inhibits pancreatic lipase. Cocoa powder supplementation reduced body weight gain, obesity-related inflammation, insulin resistance, and fatty liver disease and down-regulated the pro-inflammatory gene expression in the white adipose tissues (WAT) of high-fat diet mice.

Cocoa extract reduced postprandial glucose, plasma free fatty acid and oxidative stress biomarker (8-isoprostane), but did not affect the fasting plasma glucose and insulin level in obese-diabetic rats.

The anti-oxidative cocoa polyphenols can modify glycemic response, lipid profile; decrease platelet aggregation, inflammation and blood pressure. They modulate intestinal inflammation by reducing neutrophil infiltration, pro-inflammatory enzymes and cytokines production.

Cocoa has anti-proliferative, anti-mutagenic, chemo-protective and anti-cariogenic effects, beneficial for preventing cardiovascular and inflammatory diseases, metabolic disorders and cancer. Coffee polyphenols (mono- or di-caffeoyl quinic acids CQA) enhanced energy metabolism and reduced abdominal and liver fat accumulation.

They inhibited lipogenesis (fat synthesis) by down-regulating sterol regulatory element- binding protein (SREBP-1c), acetyl-CoA carboxylase-1 and -2, stearoyl-CoA desaturase-1 and pyruvate dehydrogenase kinase-4 in the liver and reduced infiltration of macrophages into the fat tissues. Coffee mitigated glucose intolerance, hypertension, cardiovascular remodeling and fatty liver without affecting abdominal obesity and dyslipidemia in diet-induced obese rat model.

The chlorogenic acid (5-caffeoyl quinic acid, 5-CQA) inhibits pancreas a-amylase and helps reduce hepatic TG level. Other coffee polyphenols (di-caffeoyl quinic acids, caffeoylquinic acids and feruloyl quinic acids) inhibit maltase, sucrose and pancreatic lipase, to help reduce postprandial hyperglycaemia, hyperinsulinaemia, obesity and cardiovascular disease development.

Caffeine suppresses fat absorption, while neochlorogenic acid and feruloyl quinic acid mixture in green coffee enhanced hepatic carnitine palmitoyltransferase activity to suppress visceral fat accumulation and body weight gain in mice model. Green tea consumption helps to reduce metabolic syndrome and some cancer risk, while benefitting oral health, infections, bone mineral density, fibrosis and neuronal degeneration.

Green tea catechins (w 1 g/day) decreased the body weight of overweight/obese men, without affecting blood pressure or metabolic function biomarkers.

Green tea polyphenols and caffeine apparently interacted synergistically to prolong brown adipose tissue thermogenesis, by sympathetically released noradrenaline.

The catechin-polyphenols inhibit the release of noradrenaline degrading enzyme (catechol-O-methyl-transferase) and caffeine inhibits noradrenaline-induced the cAMP (tissues regulator) degrading enzymes (trancellular phosphodiesterases).

Green tea increase the lipolytic pathway, reduces adipose tissue and low-grade inflammation in high fat diet animal model, to produce anti-obesity, anti-oxidant, hypolipidemic and hepato-protective effects.

Epigallocatechin-3-gallate (EGCG) is the most active catechin in green tea. The green tea catechin gallate was the strongest inhibitor of fatty acid synthase, better than EGCG (epigallocatechin gallate) or epicatechin gallate.

Green tea polyphenols affected the glucose uptake and insulin signaling genes in a high-fructose-diet animal model. Tea and tea polyphenols suppress fatty acid synthase gene by down-regulating EGFR/PI3K/Akt/Sp-1 (a human protein transcription factor) signal transduction pathways.

Akt or Protein Kinase B (PKB) is a serine/threonine-specific protein kinase for various cellular processes example glucose metabolism, apoptosis, and cell proliferation, transcription and cell migration.

White tea, made from the unfermented young shoots of Camellia sinensis protected from sunlight to avoid polyphenol degradation, has higher catechins levels than green tea.

White tea does not reduce food intake, body weight, visceral adiposity, cholesterol lipoprotein profile, but reduces blood triacylglycerols by increasing cecal lipids and oxidative stress in the liver and adipose tissue.

Herbal teas may have comparable or superior phenolic and antioxidant levels to black tea and many suppressed the activity of enzymes involved in metabolic syndrome, namely alpha-amylase, alpha-glucosidase, pancreatic lipase and angiotensin I-converting enzyme (ACE).

Ilex paraguariensis (mate) tea, contains caffeine and antioxidants to produce (i) vasodilating and lipid reduction properties, (ii) antimutagenic effects, (iii) anti-glycation effects (iv) weight reduction properties, (v) lowers LDL-cholesterol levels in humans, synergistic with statins, (vi) pancreatic lipase inhibition, (vii) activation of adenosine-monophosphate-activated protein kinase (AMPK) and uncoupling of electron transport, (viii) anti-inflammatory effects, acting on macrophage migration and inactivating matrix- metalloproteinase.

Fruits Apples consumption improved the lipid and oxidative status of the tissues and organs by producing larger intestinal pool and greater fecal excretion of bile acids in obese rats.

Dietary apples also reduced the retroperitoneal and epididymal adipose tissue weights in rats. Citrus polyphenols (from red orange, grapefruit, orange) produced lipolytic effect (via cAMP-phosphodiesterase inhibition) in overweight human adipocytes, more potently than cyanidin-3 glycoside, narangin or caffeine.

Grapes or grape products contain numerous polyphenols, including the stilbene resveratrol, the flavanol quercetin, catechins and anthocyanins that help mitigate diabetes, by improving B-cell function and protecting against B-cell loss.

Grape-seed procyanidins modulated inflammation on human differentiated adipocytes by inhibiting NF-KB translocation to the nucleus; and reduces IL-6 and MCP-1 expression and enhances the anti-inflammatory adipokine adiponectin production.

Resveratrol formed by injured grapes, produced these benefits: (i) calorie restriction effects, (ii) improved human adipocyte secretion profile in obesity-induced metabolic disorders, (iii) elevated basal glycerol release, (iv) reduced intracellular TG content, (v) increased intracellular lipolysis (vi) down-regulated extra-cellular matrix proteins, (vii) up-regulated processing proteins, (viii) induced protective proteins secretion against cellular stress and apoptosis regulating proteins, (ix) up-regulated adiponectin and ApoE, (x) down-regulated PAI-1 and PEDF secretion which may improve anti- inflammatory processes, (xi) increased insulin sensitivity, (xii) inhibited cyclic adenosine monophosphate-specific phosphodiesterases, and (xiii) activated 5’-adenosine monophosphate-activated kinase.

Vitisin a resveratrol tetramer, strongly and dose dependently reduced (i) adipocyte differentiation and fat accumulation by cell cycle arrest through p21, (ii) PPARg expression (iii) Rb phosphorylation level and (iv) cell cycle at the G1-S phase transition, causing cells to remain in the preadipocyte state.

Hibiscus sabdariffa Linnaeus (Malvaceae)/Zobo, is traditionally used against hypertension, diabetes metabolic syndrome and liver disorders.

Mango peel extracts from Irwin and especially Nam Doc Mai (but not the flesh or Kensington Pride mango peel) inhibited adipogenesis, similar to resveratrol. Food against hypertension Hypertension is a risk factor for apoplectic stroke. ACE regulates blood pressure and ACE inhibition will help reduce hypertension, cardiovascular disease and other related ailments. Foods with anti-hypertensive effects are listed below.

Banana is rich in potassium and is reportedly beneficial for hypetension. Celery is a well-known vegetable that helps reduce blood pressure. Chinese celery reduced the blood pressure of twenty mild essential hypertension patients (B.P. 150/95-179/110 mmHg.) and produced no side effects.

Concord grape juice antioxidant polyphenols reduce inflammation, blood pressure and vascular pathology in individuals with CVD. Extra virgin olive oils, olive leaves, pumpkins, corn, and beans phenolics inhibited a-glucosidase, a-amylase and ACE. Green tea polyphenols and epigallocatechin-3-gallate reduced diastolic blood pressure and improved mood but did not affect insulin sensitivity, insulin secretion or glucose tolerance in a randomized control trial in CVD risk humans.

Partial replacement of dietary carbohydrate with protein helps prevent and treat hypertension. Seaweeds (Wakame, Undaria pinnafitida, Ecklonia stolonifera) peptides and phlorotannin produced vasodilation, cholesterol and blood pressure reduction; powerful ACE inhibition and affect the rennin-angiotensin system in a random, case controlled study on hypertensive humans. Solanum tuberosum extract (but not a-solanine, a-cha-conine or chlorogenic acid) decreased the blood pressure in a noradrenalin-induced hypertensive rats. Beating high blood pressure with a combination of coconut oil and physical exercise Coconut oil is one of the few foods that can be classified as a “superfood.”

Its unique combination of fatty acids can have profound positive effects on health, including fat loss, better brain function and many other remarkable benefits.

Researchers working at the Biotechnology Center at the Federal University of Paraiba in Brazil set out to test the hypothesis that a combination of daily coconut oil intake and exercise training would restore baroreflex sensitivity and reduce oxidative stress, resulting in reduction in blood pressure.

They published their findings today in the journal Applied Physiology, Nutrition, and Metabolism. Their experiments were performed in spontaneously hypertensive rats.

They found that both coconut oil and exercise training were able to reduce weight gain compared to rats that were given saline and were not exposed to the exercise training protocol along the 5 weeks of study. Either coconut oil supplementation or exercise training was shown to reduce blood pressure.

However, only combined coconut oil and exercise training were able to bring the pressure back to normotensive values. The reduction in blood pressure caused by the combination of coconut oil supplementation and exercise training might be explained by the improvement of the reduced baroreflex sensitivity and by the reduction in oxidative stress in the serum, heart and aorta.

“This is an important finding as coconut oil is currently being considered a popular “superfood” and it is being consumed by athletes and the general population who seek a healthy life style,” explained Dr. Valdir de Andrade Braga, co-author of the study.

“The possibility of using coconut oil as an adjuvant to treat hypertension adds to the long list of benefits associated with its consumption. Our next step is to start some clinical trials in order to verify whether we can reproduce those findings in hypertensive human patients.”