View point: Anatomy, physiology and pathophysiology of the circadian clock in the liver, gut and the brain

The circadian clock in the brain’s suprachiasmatic nucleus coordinates circadian rhythms and the peripheral clocks, which are capable of independently monitoring normal physiology and metabolism as well as pathophysiology, and allow organismal adaptation to daily environmental cues. Environmental factors such as Western diet, sleep deprivation, and mental stress can influence the functioning of these organs due to circadian disruption. A ketogenic diet can profoundly and differentially affect liver and intestine clocks, resulting in metabolic dysfunctions [1]. The amplitude of clock-controlled genes and BMAL1 chromatin recruitment showed drastic alterations by this diet in the liver, but not in the intestine. Nuclear accumulations of PPARα in both gut and liver cells had different circadian phases. Gut and liver clocks responded in different ways to carbohydrate supplementation versus a ketogenic diet; hence these mechanisms are essential in the pathogenesis of cardio-metabolic diseases (CMDs), such as obesity, metabolic syndrome, diabetes mellitus, coronary artery disease, and hypertension. Disruption of physiological circadian rhythms has been associated with sleep and mood disorders, and there is growing evidence of the harmful consequences of shift work. © 2018 Nova Science Publishers, Inc

Physiological imaging: A new approach for assessment of neuropsychiatric and cardiovascular diseases

Recently, the World Heart Journal reviewed the relation of neuro-cardiac physiology with mental and spiritual health and the role of neuro-imaging in relation to cardiovascular function and other body systems. Advances in functional magnetic resonance imaging (fMRI) and nuclear imaging techniques have become quite important in the diagnosis of neurological diseases and psychological disorders, apart from extended knowledge of pathophysiology of atherosclerosis and vulnerable plaques. 3-dimensional echocardiography (3D-Echo) and multi-detector-row computed tomography have improved our capability to know more about cardiovascular diseases (CVDs). Most individuals experience psychosocial stress on a daily basis as a result of urbanization and industrialization in developed and developing countries. Heavy workloads, job insecurity, living in relative poverty, and competition in business have been associated with increases in mental stress, which in turn can lead to chronic anxiety disorders, such as anxiety and depression. Apart from increases in psychological burden, chronic stress may also be associated with an increased risk of CVDs: atherosclerosis, hypertension, heart failure, and diabetes. Epidemiological studies indicate that subjects with increased stress perception have a substantially higher prevalence of myocardial infarction than controls. Chronic anxiety disorders are associated with oxidative stress and inflammation, which predisposes to coronary atherothrombosis, leading to acute coronary syndrome. Chronic and acute emotional stress and sleep disturbances can damage certain areas of the brain, such as the amygdala and hippocampus that are known to predispose to inflammation in the arteries, leading o atherosclerosis. Recent evidence has demonstrated that chronic anxiety disorders, such as depression may be a risk factor of CVDs and diabetes, which may be associated with tremors in brain areas concerned with related physiological functions. The autonomic nervous system involves the sympathetic activity, which brings about increased catecholamines and cortisol, oxidative stress, and hyperglycemia, and may be pro-inflammatory. Increased parasympathetic activity related to vagal nerve stimulation may be associated with increased release of acetylcholine, a precursor of nitric oxide, which is anti-inflammatory. Acetylcholine is the principal vagal neurotransmitter, which is known to attenuate the release of cytokines, tumor necrosis factor (TNF), interleukin (IL)-1, IL-6 and IL-18, without any adverse effect on the anti-inflammatory cytokine IL-10, in lipopolysaccharide-stimulated human macrophage cultures. Methods such as yoga, meditation, and active prayer can decrease the risk of metabolic syndrome as well as pro-inflammatory cytokines. These studies indicated that emotional health, which appears to be under the influence of spiritual health, can have a positive impact on social and physical health. A regular practice of spiritual activities can improve autonomic functions, possibly due to an increase in cortical thickness with an increase in parasympathetic activity, which can be visualized in certain areas of the brain by neuroimaging studies. Circadian alteration in metabolism in the hypothalamus and cortex, in particular in the medial temporal lobe have been observed in the morning compared to the evening. © 2019 Nova Science Publishers, Inc

Can Omega-3 fatty acids in fish oil, continue to be important in the treatment of cardiovascular diseases?

There has been an enormous increase in ω-6 fatty acid (about 30 g/day) in the diet due to the production of oils from vegetable seeds. Diets with higher ω-6 to ω-3 ratios may contribute to the pathology of metabolic syndrome leading to cardio-metabolic diseases (CMDs) through inflammatory processes and other currently unrecognized mechanisms. Emerging research in animals and human studies indicate that eating excessive amounts of dietary omega-6 fat combined with insufficient amounts of omega-3 fats might be a risk factor for CMDs. However, increased intake of omega-3 fatty acids along with low omega-6, particularly in a prudent dietary pattern may be protective against CMDs. Later studies revealed that omega-3 rich oils such as canola or mustard or fish oil can cause significant decline in mortality and morbidity due to cardiovascular diseases (CVDs). Recent, cohort studies and meta-analysis showed that fish oil which is rich in EPA and DHA failed to cause a significant reduction in mortality due to CVDs. This view point aims to emphasize that a healthy diet rather than single nutrients should be taken into consideration for assessment of their role in the prevention of chronic diseases. © 2018 Nova Science Publishers, Inc

View point. Bisphosphonates, osteoporosis and cardiovascular diseases

[No abstract available

Can climate, weather, cosmos, and environmental degradation predispose to cardiovascular and other diseases?

The internal environment of our body systems interacts with environment in the biosphere and cosmos; the earth rotates around its axis, and around the sun in the cosmos, all living species, including humans, animals and plants, are exposed to storms induced by solar activity, geomagnetic activity, cosmic ray activity and gravitational activity. Magnetic storms may be responsible for changes in climate weather in the biosphere and cosmos as well as on earth which may influence physiology and metabolisms as well as physio-pathogenesis of diseases. Cosmology is the science dealing with knowledge about origin and development of universe, including biology related to the cosmos. Therefore, it is pertinent to call cosmo-biology, when dealing with effects of the cosmos on biological functions. Mental and spiritual health, and also possibly physical and social health, may be under the influence of solar activity, geomagnetic activity and cosmic ray activity that have major effects on space weather and climate in the cosmos. Environmental degradation may disturb magnetic activity in the cosmos, leading to changes in climate with increase in environmental temperatures causing longer summer heat waves that increase mortality, particularly among vulnerable populations such as elderly and poor people, residents of urban heat islands, and people with mental illness. Higher temperatures also increase ozone levels, compromising lung function and exacerbating asthma which may worsen due to earlier and longer pollen seasons, elevating exposure to allergens and increasing allergic sensitization and asthma episodes. Higher temperatures may result in larger and longer forest fires, reducing downwind air quality and increasing hospitalizations for respiratory and cardiovascular conditions like heart attack and sudden death. Increases in temperatures above 40°C may also predispose to heart attack. © 2018, Nova Science Publishers, Inc.. All rights reserved

Effects of circadian restricted feeding on parameters of metabolic syndrome among healthy subjects

Experimental studies indicate that energy homeostasis to the circadian clock at the behavioral, physiological, and molecular levels, emphasize that timing of food intake may play a significant role in the development of obesity and central obesity. Therefore, resetting the circadian clock by circadian energy restriction via food intake in the morning or evening, may be used as a new approach for prevention of obesity, metabolic syndrome and related diseases. After ethical clearance and written, informed consent, free living subjects were included if they volunteered to take most of the total daily meals (approximately 2000 Kcal./day) in the evening (4 weeks) or morning (4 weeks). Of 22 adults, half were randomly selected by computer generated numbers to eat in the morning and the other half in the evening, after 8.00 PM. The eating pattern was changed after 4 weeks of intervention and a 4-week washout period, those who ate in the morning were advised to eat in the evening and vice versa. Validated questionnaires were used to assess food intakes, physical activity, and intake of alcohol and tobacco. Physical examination included measurement of body weight, height, and blood pressure (BP) by sphygmomanometer. Data were regularly recorded blindly, in all subjects at start of study and during follow-up. Blood samples were collected after an overnight fast for analysis of blood glucose and Hb1c. Feeding in the evening was associated with significant increase in body weight by 0.80 kg (P <.001), body mass index (BMI) by 0.30 kg/m2 (P <.001) and waist circumference by 1.13 cm (P <.05). Feeding the same amount of energy in the morning was not associated with any significant change in weight, BMI or waist circumference (P >.500). Lesser increases in all three variables were associated with AM versus PM feeding (P <.05). Systolic BP slightly increased on PM and decreased on AM feeding, with a difference between the two responses of 1.55 mmHg (P <.05). Fasting blood glucose was lower on AM than on PM feeding (74.86 vs. 77.95 mg/dl, paired t = 4.220, P <.001). Hb1C increased on PM feeding by 0.28 (from 4.45 to 4.73; t = 9.176, P <.001), but decreased on AM feeding by 0.077 (from 4.53 to 4.45; t = −6.859, P <.001). The difference in Hb1C response between AM and PM feeding is also statistically significant (t = −11.599, P <.001). Eating in the evening can predispose to obesity, central obesity and increases in fasting blood glucose and Hb1c that are indicators of the metabolic syndrome. By contrast, eating in the morning can decrease Hb1c and systolic BP, indicating that it may be protective against the metabolic syndrome. © 2019, © 2019 Taylor & Francis Group, LLC

Association of diet and depression as risk factors among patients with acute coronary syndromes

Introduction: Coronary risk factors (CRF) and acute coronary syndromes (ACS) are decreasing in developed countries but continue to be a major public health problem. The increased risk of recurrent cardiovascular events ACS are not fully explained by the conventional risk factors alone. This study examines the association of diet and depression as risk factors of ACS. Subjects and Methods: We used a case-control study design including 435 patients with ACS who were compared with 495 age-and gender-matched control subjects. Clinical, electrocardiographic, radiological and laboratory data were obtained in all the patients for confirmation of diagnosis by WHO and AHA criteria. Depression as risk factor of ACS was assessed by validated questionnaires. Western-type and Indo-Mediterranean type food intakes were assessed by food intake records for 7 days, noted in dietary diaries. Multivariate logistic regression analysis was conducted after adjustment of age, gender, and body mass index (BMI) to determine the association of risk factors with ACS. Results: The incidence of depression (19.8 vs. 6.3%, P < 0.001) and increased intake of Western-type foods were significantly more common among ACS cases compared to the control group. The consumption of Indo-Mediterranean foods and blood nitrite concentrations were significantly lower among ACS patients as compared to the control group. After adjustment for age and BMI, depression was positively and strongly associated with ACS (P < 0.001), as shown by odds ratios and their 95% confidence intervals. Depression (males: 0.33 (0.29-0.38)**; females: 0.29 (0.23-0.35)**) and Western-type foods intake (males: 0.44 (0.38-0.53)**; females: 0.47 (0.41-0.53)** were significantly and strongly associated with ACS (P < 0.001). Indo-Mediterranean food intake-0.46 (0.38-0.48)** and females-0.43 (0.37-0.47)* and blood nitrite (males: 0.61 (0.51-0.75)*; females: 0.58 (0.43-0.72)* were inversely and weakly associated with ACS (P < 0.02). A weaker positive association (P < 0.02) of angiotensin converting enzyme (males: 0.57 (0.46-0.68)*, females:-0.43 (0.37-0.47)* with ACS was also found. Conclusion: This study shows that depression, Western-type food consumption and high blood angiotensin converting enzyme were significant risk factors of ACS. Indo-Mediterranean type food intake and blood nitrite showed beneficial effects on risk of ACS. © 2018 Nova Science Publishers, Inc