Issue 2002-2

Ram B Singh (1), ,Jagdish P Sharma (2)Viola Vargova (3), M Moshiri (4) ,Fabien De Meester (5)  Kuniaki Otsuka (6); 1,2Halberg Hospital and Research Center, 
Moradabad, P J 3Safaric University2, Kosice, Slovakia, 4Center of Nutrition Research, Toronto, Canada ,
 5The Tsim Tsoum Institute, Krakow, Poland; 6Tokyo Womens Medical University,Tokyo,Japan
Dr. R.B. Singh, MD
Professor of Medicine, Medical Hospital and Research Center, Civil Lines, Moradabad-10(UP) 244001, India email:
Abstract: Acute coronary syndrome (ACS) is a highly dynamic event, which is associated with marked biochemical dysfunction apart from cardiac damage. 
There is a marked increase in sympathetic activity, oxidative stress, inflammation, dyslipidemia, increase in free fatty acids and deficiency of magnesium and 
potassium as well as antioxidants during ACS. Clinical studies have reported an increased incidence of re-infarction, sudden death, coronary constriction, 
myocardial ischemia and angina, during first quarter of the day when there is rapid withdrawal of vagal activity and increase in sympathetic tone. 
This study included 54 patients of ACS and 85 age and sex matched control subjects. The incidence of subjects consuming large breakfast was significantly greater 
among patients with ACS compared to control subjects (40.7 vs 23.5%, P<001). There was a significant greater incidence of cardiac events in the second quarter 
of the day compared to 4thquarter. Mean serum levels of magnesium, and coenzyme Q10, were significantly lower and mean total cholesterol, triqlycerides,
 were significantly higher in the study group compared to control group. Lp(a), triglycerides, blood glucose, plasma insulin, TBARS, malondialdehyde, 
diene conjugates and TNF-alpha and IL-6 which were significantly greater during acute phase, showed a significant decline, and coenzyme Q, an increase, 
at 4 weeks of follow up, when the acute reactions evoked by MI were controlled. Large breakfast was a predisposing factor of cardiac events in between 
8.00 to 11.00 hours of the day, and it was significantly associated with metabolic reactions. The findings indicate that acute reactions as a result or as 
circadian rhythms appear to be important in the pathogenesis of complications in ACS and that a large breakfast in association with and magnesium deficiency, 
may further trigger the circadian rhythms. However more studies in a large number of subjects would be necessary to confirm our findings.
Key Words: Myocardial infarction, cytokines, inflammation, coenzyme Q10,
How to cite: Singh RB, Sharma, JP, Vargova V, Moshiri M, De Meester F, Otsuka K. Association of magnesium, deficiency and large breakfast with risk of 
acute coronary syndromes. Int J Clin Nutrition 2002; 2: 1-5.
Kumar Kartikey (1), NR Hadi(2),. Bassim M(3), Osama Elmaraghi (4), Medical Hospital and Research Center, Faculty of Medicine, University of Kufa, Kufa, 
Faculty of Medicine, University of AlQadisiyah, Diwaniyah, Iraq, Diabetes Clinic, Kuwait.
Dr NR Hadi, MD,PhD
Faculty of Medicine, University of Kufa, Najaf, Iraq, <>
Abstract: There is evidence that the high intake of some of the nutraceuticals or dietary salt, trans fat and sugar and low intake of fish oil or fish in the diet are 
risk factors for the development of atherosclerosis as well as osteoporotic and hip fractures. Increased intake of fish oil, fish, low fat dairy products, fruits, 
vegetables, legumes and nuts that are rich in ω3 fatty acids (alpha-linolenic acid) have recently been found to be protective against atherosclerosis and osteoporosis. 
This finding raises the possibility that these foods and their nutrients may protect against CVD and hip fracture, and may provide better quality of life. Increased 
risks in co-twins without an index diagnosis suggest that genetic factors and genes/diet interactions may explain the association of CVD with osteoporotic fractures. 
There is evidence that Western diet rich in refined carbohydrates (coke drinks, biscuits, cakes, ice creams), trans fat, high ω6 / low ω3 fats, deficiencies in soluble 
fibers and antioxidants can enhance the expression of about 125 genes, the majority of which are pro-inflammatory. There is increase in AP-1, Egr-1 and NFkB, 
that are transcription factors for inflammation. It is possible that these pro-inflammatory factors can increase the risk of osteoporosis as well 
as of athero-thrombosis, resulting into hip fractures and CVD, respectively. Calcification of vascular walls shares similarities with bone formation and resorption 
processes; in particular, bisphosphonates are known to decrease the progression of osteoporosis, as well as to prevent the development of atherosclerosis, 
thereby reducing total mortality. On the other hand, statins, the cholesterol-lowering drugs are anti-inflammatory and reduce risk of CVD and osteoporotic fractures.
Kew words:  hip fractures, coronary heart disease, chronic diseases, diet.
How to cite: Kartikey K, Hadi NR., Bassim IM, Elmarghi E. Nutritional modulators of inflammation, osteoporosis and atherosclerosis. Int J of Clin Nutrition 2002; 2: 6-10.

P Chattopadhya (1), R B Singh (2), NR Hadi (3), Galal Elkilany (4). 1College of Pharmacy, IFTM, Moradabad, India; 2Medical Hospital and Research Center, 
Moradabad, India; 3University of Kufa, Najaf, Iraq; 4Global Health Care Division, La Place, USA. 
Dr P Chattopadhyay, PhD, FICN, IFTM, College of Pharmacy, IFTM, Moradabad, India
Abstract: There is evidence that coenzyme Q10 (CoQ10) effect in mitigating experimental atherosclerosis in rabbits and rats.The effects of the administration 
of CoQ10 liposomal solution (LI-QSorb, Tishcon, NY,USA) (10 mg/kg per day) group A, n= 8) and placebo (peanut oil 10 mg/kg per day) (group B, n=8) were
 compared over 24 weeks in a randomized, single-blind, controlled trial. In particular rats, after reaching an age of 16 weeks or over, and a weight of 
200-250 grams, received the trans fatty acid rich diet. Baseline total cholesterol (TC, 112+15mg/dl) and HMG CoA reductase (1.98+0.54 IU) enzymes 
were within normal range. After 12 weeks feeding with TFA, there was a significant increase in T-C (407.6+48 vs 410.5+51.7mg/dl) and HMG-CoA 
reductase (5.13+1.6 vs 5.22+1.8 IU) enzyme, TBARS, and MDA in both groups. Intervention with LI-Q-Sorb, after having been fed an experimental 
diet for 24 weeks, was associated with a significant decline in all the parameters of oxidative stress and an increase in plasma levels of vitamin E 
and CoQ in the CoQ group compared to placebo group. These adverse effects were independent of lipid lowering. After 24 weeks, plasma levels of 
HMG-CoA reductase (2.48+1.1 vs 5.51+1.4 IU, P<0.01) showed significant decline in the CoQ group compared to placebo group. Liver cholesterol and T-C 
in blood also showed modest decline in the CoQ group than placebo group (381.3+27 vs 448.5+54mg/dl,).It seems that oxidative stress may be an 
independent cause of increase in HMG-CoA reductase enzyme, and CoQ may be a potential HMG-CoA reductase inhibitor. Cholesterol lowering may 
be a separate action of HMG-CoA reductase inhibitors such as statins.The findings suggest that antioxidant therapy with LI-Q-Sorb  may be used as 
an adjunct to lipid lowering for additional beneficial effects related to HMG-CoA reductase enzyme which may be protective against atherosclerosis and thrombosis.
Key Words. Cholesterol, lipids, oxidative stress, nutraceutical.
How to cite: Chattopadhya P, Singh RB, Hadi NR, Elkilany G. Effects of liposomal coenzyme Q10 (li-q-sorb) on HMG-Coa-reductase enzyme in hyperlipidemic  rats. 
Int J Clin Nutrition 2002; 2: 11-15.

Daniel Pella (1), Viola Vargova (2), MA Niaz (3); OA Bawareed (4), Sergey Chibisov (6), Osama Elmarghi. 1,2Faculty of Medicine, PJ Safari University, 
Kosice, Slovakia; 3Medical Hospital and Research Center, Moradabad, India; 5,6Peoples Friendship University of Russia; Diabetes Care Center, Jahraa, Kuwait.
Dr Osama Elmarghi MD, PhD, Diabetes Care Center, Jahraa, Kuwait, Email: <>
Abstract: Rapid changes in diet and lifestyle with increase in salt, sugar and refined food intake have been associated with a marked increase in the prevalence 
of hypertension as well as mean systolic and diastolic blood pressures in the last three decades, among most of the developing populations of the world . 
Increased intake of alcohol and sedentary behavior may have predisposed obesity which is a major risk factors of pre-hypertension and hypertension causing 
increased burden of hypertension in most countries of the world. The absolute number of hypertensives (>140/90) in India, would be 31.5 million rural and 
34 million urbans, (total=65.5 million). Stage 1, hypertension (>140-159/90-99) 45.5 million and prehypertension (130-139/85-89) with 20% prevalence; 50 million. 
Almost half of the population of the world above 25 years have either prehypertension or hypertension. The Five City Study shows a high prevalence of 
prehypertension and hypertension among Indian urban population from five different regions of India.  The prevalence of prehypertension shows greater rates 
in south (women 31.5%, men 35.1%) and west India (women 30.0%, men 34.7%) compared to north (women 24.6%, men 26.7%) and east India (women 20.9%, 
men 23.5%) as well as central India (women 25.8%, men 28.3%). The overall prevalence of prehypertension (27.2 vs 30.0%, P<0.02) and hypertension (27.2 vs 
30.6%, P<0.02) after pooling of data from the five cities, were significantly greater among men compared to women. Among total number of subjects (n=6940), 
the prevalence of prehypertension and hypertension, respectively were similar (28.6 vs 28.9%). The increased burden of hypertension in the developing countries 
are due to increased intake of western type foods; refined rice, ready prepared foods with increased content of salt, sugar and trans fat and total fat which 
are risk factors of hypertension.
Key Words: western diet, sedentary behavior, salt, alcoholism, obesity.
How to cite: Pella D, Vargova V, Niaz MA, Bawareed OA, Sergey Chibisov S, Elmarghi O. Nutritional risk factors of hypertension and prehypertension: 
the future of cardiovascular protection.Int J Clin Nutrition 2002; 2: 16-20.

Viola Vargova (1), SK Kulshrestha (2), Ram B Singh (3); Vijendra Singh (4), Jan Fedacko,(5),  Daniel Pella, (6), MA Niaz (7).;1,5,6 PJ Safaric University, 
Kosice, Slovakia; 2,4Hindu College, Moradabad, India; 3,7Medical Hospital and Research Center, Moradabad,
Dr MA Niaz, PhD, FICN Medical Hospital and Research Center,Civil Lines, Moradabad-10 (UP)244001, India, Email:<>
Abstract: There is evidence that western type diet, overweight and obesity are important risk factors of death due to cardiovascular disease(CVD) and diabetes. 
However, undernutrition and underweight predispose deaths due to infections. In a previous study, the association of western type diet, body mass index(BMI) 
with causes of deaths among urban decedents. We studied the randomly selected records of death of 2222 (1385 men and 837 women) decedents, aged 25-64 years, 
out of 3034 death records overall from the records at Municipal board. Western type food intake was considered when one fourth of the foods were bread, biscuits, 
cakes, syrups and refined rice (500-600 K Cal/day). Majority of the decedents (n=792,35.6%) (men 31.1%,n=431; and women 43.1%,n=361) had normal BMI of 
18.5-22.9 Kg/m2.The prevalence of underweight victims was 14.2%(n=315), overweight 29.4%(n=654)and obese 20.8%(n=461).There was an overall increase 
in risk factors; western food intake, diabetes mellitus, hypertension, and CAD among overweight and obese victims based on BMI criteria, and the trend 
was significant. BMI and western type food intake were positively associated with significant rising trend in the prevalence of circulatory causes of death, 
both among men and women. Infections and cancers as the cause of death were inversely associated with increase in BMI and western type food intake, 
among both men and women. Among circulatory causes of death, 25.0%(n=108) of the victims had normal BMI (18.5-22.9Kg/m2), which was because of 
victims dying due to rheumatic heart diseases and heart failure. Overweight (>23Kg/m 2) and obesity(>25Kg/m 2) in conjunction with western type food
 intake, are important determinant of mortality due to  CAD and underweight due to infections. Larger studies would be necessary to demonstrate the 
association of BMI with causes of death in India.
Kew words: Diet, body weight, cardiovascular diseases, undernutrition.
How to cite: Vargova V, Kulshrestha SK, Singh RB; Singh V, Fedacko, J,  Association of western type diet with increased mortality and and obesity among 
urban decedents in India. Int J Clin Nutrition 2002; 2: 21-25.