Fructose and the link to the metabolic syndrome - di Piero Portincasa e
Leonilde Bonfrate. 31 maggio 2012. Corso di formazione "valore nutrizionale e salutistico di prodotti agroalimentari” - Università degli studi di Bari.
Do fructose-containing sugars lead to adverse health consequences? Results of...Corn Refiners Association
At Experimental Biology 2014, the Sponsored Satellite Program “Sugars and Health Controversies: What Does the Science Say?” held in conjunction with the American Society for Nutrition’s Scientific Sessions took place on Saturday, April 26, 2014.
Panelist John L Sievenpiper, MD, PhD, presented science about sugars and their associated health outcomes.
Predimed study is one of the few truly long term randomized trials with disease and mortality outcomes. It is unique in many ways and will have a strong and lasting impact
This study is the first one to show the effect of dietary intervention in the secondary prevention of CHD. It is meal pattern study even if very often labelled as sole fat modification study
The root cause of chronic diseases, cancer and aging was recently understood. It includes 1- A state of chronic low grade inflammation secondary to hyperglycemia and obesity leading to insulin - leptin resistance. 2- Mitochondrial dysfunction. Diet, Intermittent fasting or its alternative the Metabolic Bariatric Surgery and Exercise play a significant rule in the salvage of these problems. Exercise is any bodily activity that enhances or maintain physical fitness and overall health, Exercise with its Countless Benefits is the logical salvage for a group of diseases related to inactivity . In view of the prevalence, global reach and health effect of these physical inactivity related diseases, the issue should be appropriately described as pandemic, with far-reaching health, economic, social and Environmental consequences.These diseases include, Obesity, Coronary artery disease, Diabetes, Hypertension, Cancer, Depression and anxiety, Arthritis, Osteoporosis, Etc, etc, etc… I think we have no option except doing regular exercises if we seriously search for a salvage to escape the bad and serious consequences of these new life style diseases.
Lyon Diet Heart Study is still considered as the ultimate evidence for the health benefits of Mediterranean diet. Unfortunately its' results have never been re-produced since then. However, PREDIMED trial may change this situation.
Do fructose-containing sugars lead to adverse health consequences? Results of...Corn Refiners Association
At Experimental Biology 2014, the Sponsored Satellite Program “Sugars and Health Controversies: What Does the Science Say?” held in conjunction with the American Society for Nutrition’s Scientific Sessions took place on Saturday, April 26, 2014.
Panelist John L Sievenpiper, MD, PhD, presented science about sugars and their associated health outcomes.
Predimed study is one of the few truly long term randomized trials with disease and mortality outcomes. It is unique in many ways and will have a strong and lasting impact
This study is the first one to show the effect of dietary intervention in the secondary prevention of CHD. It is meal pattern study even if very often labelled as sole fat modification study
The root cause of chronic diseases, cancer and aging was recently understood. It includes 1- A state of chronic low grade inflammation secondary to hyperglycemia and obesity leading to insulin - leptin resistance. 2- Mitochondrial dysfunction. Diet, Intermittent fasting or its alternative the Metabolic Bariatric Surgery and Exercise play a significant rule in the salvage of these problems. Exercise is any bodily activity that enhances or maintain physical fitness and overall health, Exercise with its Countless Benefits is the logical salvage for a group of diseases related to inactivity . In view of the prevalence, global reach and health effect of these physical inactivity related diseases, the issue should be appropriately described as pandemic, with far-reaching health, economic, social and Environmental consequences.These diseases include, Obesity, Coronary artery disease, Diabetes, Hypertension, Cancer, Depression and anxiety, Arthritis, Osteoporosis, Etc, etc, etc… I think we have no option except doing regular exercises if we seriously search for a salvage to escape the bad and serious consequences of these new life style diseases.
Lyon Diet Heart Study is still considered as the ultimate evidence for the health benefits of Mediterranean diet. Unfortunately its' results have never been re-produced since then. However, PREDIMED trial may change this situation.
For a long time, several herbal medicines have been used for the treatment of diabetes in the form of compound drugs. Moreover, after the references made by researchers on diabetes mellitus, investigations on the hypoglycemic activity of compound drugs from medicinal plants have been more important. Although, the molecular mechanisms behind this effect is not much explored yet. There are various approaches to reduce the diabetes effect and its secondary complications, and herbal drugs are more preferred due to its less side effects and low cost. One of the major factors in the development of diabetes and its complications is the damage induced by free radicals. Therefore antidiabetic compounds with antioxidant properties would be more beneficial. It is hypothesized that the insulin mimetic effect, hypoglycemic effect and β-cell function of herbal remedies might add to glucose uptake through improvement in the expression of genes of the glucose transporter (GLUT) family in liver and skeletal muscles. Here we selected some plants with the ability to control blood glucose as well as to modulate some of the mechanisms involved in insulin resistance like β-cell function, glucose transport (GLUT) gene and incretin related
pathways. Therefore, plants remedies may be appealing as an alternative and adjunctive treatment for diabetes mellitus.
The recovery and re-evaluation of the old data on Sydney Diet Heart Study uncovers unexpected outcomes. However, interpret with care because things have changed since 1970s.
Studies on the Osteoprotective and Antidiabetic Activities of Moringa Oleifer...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Fruits and Vegetables in a Healthy Diet by Prof Jaap SeidellKiwifruit Symposium
Prof Jaap Seidell, Full Professor at the VU University Amsterdam, The Netherlands. Presented at the 1st International Symposium on Kiwifruit and Health: http://www.kiwifruitsymposium.org/presentations/fruits-and-vegetables-in-a-healthy-diet/
An epidemic of chronic non-communicable diseases is sweeping the globe. It is afflicting especially vulnerable
groups in urban settings. Upstream factors include societal problems such as loss of social cohesion, chronic stress, poverty and unhealthy food environments.
Alterations of Hepcidin and Interleukin in Diabeticsasclepiuspdfs
Aim: This study was done to determine the levels of hepcidin and interleukin-6 (IL-6) in diabetics. Materials and Methods: The study involved 100 diabetics and 100 apparently normal subjects of the same age group 40–70. The levels of hepcidin and IL-6 were measured with an enzyme-linked immunosorbent assay method. Results: The level of hepcidin and IL-6 significantly increased in the diabetics when compared to the controls (P < 0.05). Conclusion: This study probably indicated a significant increase in serum IL-6 and hepcidin levels in patients with diabetics.
П. Сутерс "Проявления инсулинорезистентности и гликемический контроль в интен...rnw-aspen
Доклад с 15 Межрегиональной научно-практической конференции "Искусственное питание и инфузионная терапия больных в медицине критических состояний" 21-22 мая 2015 г
Join Doc Andrew to see what's new in health research that supports plant based diet recommendations. Share your questions via @DenverWWAD or email FreemanA@njhealth.org
Andrew Freeman, MD, FACC, FACP is a cardiologist and Director of Clinical Cardiology and Operations at National Jewish Health in Denver, Colorado. He holds leadership roles in the American College of Cardiology at the local and national levels. Dr. Freeman founded Denver's chapter of the Walk with a Doc program and heads Walk with a Doc-Colorado.
Walk with a Doc-Denver is a cost-free empowerment initiative powered by people improving their health, local doctors, and other health professionals who prescribe exercise-as-medicine. The mission? To elevate community health--one walk at a time! The program's Saturday walks include expert talks, health screenings, refreshments, and motivational giveaways. For more info visit: http://walkwithadoc.org/our-locations/denver/
Exercise is any bodily activity that enhances or maintain physical fitness and overall health, Exercise with its Countless Benefits is the logical salvage for a group of diseases related to inactivity . In view of the prevalence, global reach and health effect of these physical inactivity related diseases, the issue should be appropriately described as pandemic, with far-reaching health, economic, social and Environmental consequences.These diseases include, Obesity, Coronary artery disease, Diabetes, Hypertension, Cancer, Depression and anxiety, Arthritis, Osteoporosis, Etc, etc, etc… I think we have no option except doing regular exercises if we seriously searching for a salvage to escape the bad and serious consequences of these new life style diseases.
Mitochondrial Medicine Society MitoAction Updates 4.1.16mitoaction
Areas of discussion include: Transplantation in Mito patients, Stroke protocol for MELAS, Standards of care for Mito patients, Centers of Excellence and the need for community involvement/input (v2 slides)
For a long time, several herbal medicines have been used for the treatment of diabetes in the form of compound drugs. Moreover, after the references made by researchers on diabetes mellitus, investigations on the hypoglycemic activity of compound drugs from medicinal plants have been more important. Although, the molecular mechanisms behind this effect is not much explored yet. There are various approaches to reduce the diabetes effect and its secondary complications, and herbal drugs are more preferred due to its less side effects and low cost. One of the major factors in the development of diabetes and its complications is the damage induced by free radicals. Therefore antidiabetic compounds with antioxidant properties would be more beneficial. It is hypothesized that the insulin mimetic effect, hypoglycemic effect and β-cell function of herbal remedies might add to glucose uptake through improvement in the expression of genes of the glucose transporter (GLUT) family in liver and skeletal muscles. Here we selected some plants with the ability to control blood glucose as well as to modulate some of the mechanisms involved in insulin resistance like β-cell function, glucose transport (GLUT) gene and incretin related
pathways. Therefore, plants remedies may be appealing as an alternative and adjunctive treatment for diabetes mellitus.
The recovery and re-evaluation of the old data on Sydney Diet Heart Study uncovers unexpected outcomes. However, interpret with care because things have changed since 1970s.
Studies on the Osteoprotective and Antidiabetic Activities of Moringa Oleifer...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Fruits and Vegetables in a Healthy Diet by Prof Jaap SeidellKiwifruit Symposium
Prof Jaap Seidell, Full Professor at the VU University Amsterdam, The Netherlands. Presented at the 1st International Symposium on Kiwifruit and Health: http://www.kiwifruitsymposium.org/presentations/fruits-and-vegetables-in-a-healthy-diet/
An epidemic of chronic non-communicable diseases is sweeping the globe. It is afflicting especially vulnerable
groups in urban settings. Upstream factors include societal problems such as loss of social cohesion, chronic stress, poverty and unhealthy food environments.
Alterations of Hepcidin and Interleukin in Diabeticsasclepiuspdfs
Aim: This study was done to determine the levels of hepcidin and interleukin-6 (IL-6) in diabetics. Materials and Methods: The study involved 100 diabetics and 100 apparently normal subjects of the same age group 40–70. The levels of hepcidin and IL-6 were measured with an enzyme-linked immunosorbent assay method. Results: The level of hepcidin and IL-6 significantly increased in the diabetics when compared to the controls (P < 0.05). Conclusion: This study probably indicated a significant increase in serum IL-6 and hepcidin levels in patients with diabetics.
П. Сутерс "Проявления инсулинорезистентности и гликемический контроль в интен...rnw-aspen
Доклад с 15 Межрегиональной научно-практической конференции "Искусственное питание и инфузионная терапия больных в медицине критических состояний" 21-22 мая 2015 г
Join Doc Andrew to see what's new in health research that supports plant based diet recommendations. Share your questions via @DenverWWAD or email FreemanA@njhealth.org
Andrew Freeman, MD, FACC, FACP is a cardiologist and Director of Clinical Cardiology and Operations at National Jewish Health in Denver, Colorado. He holds leadership roles in the American College of Cardiology at the local and national levels. Dr. Freeman founded Denver's chapter of the Walk with a Doc program and heads Walk with a Doc-Colorado.
Walk with a Doc-Denver is a cost-free empowerment initiative powered by people improving their health, local doctors, and other health professionals who prescribe exercise-as-medicine. The mission? To elevate community health--one walk at a time! The program's Saturday walks include expert talks, health screenings, refreshments, and motivational giveaways. For more info visit: http://walkwithadoc.org/our-locations/denver/
Exercise is any bodily activity that enhances or maintain physical fitness and overall health, Exercise with its Countless Benefits is the logical salvage for a group of diseases related to inactivity . In view of the prevalence, global reach and health effect of these physical inactivity related diseases, the issue should be appropriately described as pandemic, with far-reaching health, economic, social and Environmental consequences.These diseases include, Obesity, Coronary artery disease, Diabetes, Hypertension, Cancer, Depression and anxiety, Arthritis, Osteoporosis, Etc, etc, etc… I think we have no option except doing regular exercises if we seriously searching for a salvage to escape the bad and serious consequences of these new life style diseases.
Mitochondrial Medicine Society MitoAction Updates 4.1.16mitoaction
Areas of discussion include: Transplantation in Mito patients, Stroke protocol for MELAS, Standards of care for Mito patients, Centers of Excellence and the need for community involvement/input (v2 slides)
In plants, sugar production through the photosynthesis is a vital process. Sugars have an important role in different processes such as cell cycle progression, embryogenesis, seed germination, energy source, senescence etc. Sugar status modulates and coordinates internal regulators and environmental cues that govern growth and development. Plants have evolved a complex mechanistic system to sense different sugars, including sucrose, hexoses, and trehalose. Sugar sensing occurs at the level of individual cells and the responses of such cells must be integrated at the tissue, organ, and plant level. Sugar signalling is also a mechanism that plants use to integrate various internal and external cues to achieve nutrient homeostasis, mediate developmental programs, and stress responses (Li et. al, 2016).
Plants have different type of sugar sensors which sense different form of sugars such as HXK (hexokinase) is a glucose sensor, FBP/FIS1 (fructose-1,6-bisphosphate) is a fructose sensor, RGS1 (regulator of G-protein) is a sucrose and hexose sensor, AtSUT2/SUC3 is a putative sucrose sensor etc. Two energy sensors i.e. SnRK1/AtKIN10 (sugar non-fermentation-related protein kinase) and TOR (target of rapamycin) kinase are also present downstream of sugar perception. Depending on the sugar type and function, four types of sugar signalling pathways are- a) Disaccharide signalling pathways, b) Hexose dependent pathways, c) Energy metabolite and sensors and d) Sugar signalling in the regulation of sugar transporters (Sakr et. al, 2018). The effect of sugars are regulated by different mechanisms at different level such as- a) epigenetic regulation by modifying the DNA methylation, histones modifications etc., b) transcription regulation in which genes are regulated by promoters and cis-acting elements like GC-box, G-box etc. and c) post-transcriptional level of regulation which involves the regulation of rate of mRNA turnover.
Sugar signalling tightly interconnected with the hormones and nitrogen signalling (Ljung et. al, 2015 and Zhang et. al, 2017). Hormone and sugars show both synergistic and antagonistic effects with the each other. Sugars and auxin regulate the C/N ratio through PIF (phytochrome insensitive factor) response and they also regulate the cell cycle by regulating CDKs (cyclin dependent kinases). Similarly the other hormones regulate the different processes like photosynthesis, growth, anthocyanin accumulation etc. along with sugars.
Sugars signalling also interact with the nitrogen. Sugar and nitrogen regulates the nitrogen assimilating enzymes like nitrate reductase (NR) and nitrite reductase (NiR). Nitrogen positively regulates the sugar uptake and assimilation, but it is negatively regulated the sugar assimilates.
The study of sugar sensing and signalling is important because it influence many plant processes directly or indirectly by interacting with other molecules like hormone, nitrogen, phosphorus etc.
Learn about the connection between Polycystic Ovary Syndrome (PCOS) and Metabolic Syndrome. Discover symptoms, associated risks, and effective management strategies to improve your health and well-being.
Who this is for: Health professionals.
Description: Dr. Sheila Bushkin-Bedient will be speaking on the prenatal origins of disease and why we should be focusing on studying possible connections between unconventional natural gas extraction and diabetes, obesity, and cancer.
About the Speaker: Sheila Bushkin is a member of the Institute of Health and the Environment at the State University at Albany, and Concerned Health Professionals of New York. She has been a member of the Medical Society of the State of New York for 15 years. Her specific areas of interest involve environmental health issues, chronic diseases, health concerns of older adults, and CME for physicians.
Hyperphosphatemia in CKD patients; The Magnitude of The Problem - Prof. Alaa ...MNDU net
Hyperphosphatemia in CKD patients; The Magnitude of The Problem
Prof. Alaa Sabry - Professor of Nephrology
Mansoura Nephrology and Dialysis Unit (MNDU) Course
IOSR Journal of Pharmacy and Biological Sciences(IOSR-JPBS) is an open access international journal that provides rapid publication (within a month) of articles in all areas of Pharmacy and Biological Science. The journal welcomes publications of high quality papers on theoretical developments and practical applications in Pharmacy and Biological Science. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
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ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
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Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
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Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
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Primitive, less old, and new olfactory systems with different path
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Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Evaluation of antidepressant activity of clitoris ternatea in animals
Fructose and the link to the metabolic syndrome - di Piero Portincasa e Leonilde Bonfrate
1. Fructose and the link to the metabolic
syndrome
Piero Portincasa, MD, PhD
Leonilde Bonfrate,MD
Department of Internal and Public Medicine
University of Bari Medical School
Bari – Italy
p.portincasa@semeiotica.uniba.it
2. NAFLD: Associated with Metabolic Syndrome
17/09/12
Metabolic Syndrome
Obesity
P. Portincasa, UNIBA
Diabetes
Dyslipidemia
EPIDEMIA DEL III MILLENNIO
6. 6
P. 17/09/1
Portincasa, 2
FRUITS AND VEGETABLES
UNIBA
•
Consumption is inversely related to the risk of coronary
heart disease (CHD) and stroke
The effect of fruit and vegetable intake on risk for coronary heart disease. AU
Joshipura KJ; Hu FB; Manson JE; Stampfer MJ; Rimm EB; Speizer FE; Colditz G;
Ascherio A; Rosner B; Spiegelman D; Willett WC SO Ann Intern Med 2001 Jun
19;134(12):1106-14.
Legume consumption and risk of coronary heart disease in US men and women:
NHANES I Epidemiologic Follow-up Study. AU Bazzano LA; He J; Ogden LG; Loria C;
Vupputuri S; Myers L; Whelton PK SO Arch Intern Med 2001 Nov 26;161(21):2573-8.
7. 7
P. 17/09/1
Portincasa, 2
The effect of fruit and vegetable intake on risk for coronary heart disease. AU Joshipura KJ; Hu FB;
UNIBA
Manson JE; Stampfer MJ; Rimm EB; Speizer FE; Colditz G; Ascherio A; Rosner B; Spiegelman D;
Willett WC SO Ann Intern Med 2001 Jun 19;134(12):1106-14.
•
The Nurses' Health Study and the Health Professionals' Follow-Up
Study
•
84 251 women 34 to 59 yrs of age who for 14 yrs and 42 148 men 40 to
75 yrs followed for 8 yrs
•
Incidence of nonfatal myocardial infarction or fatal coronary heart
disease (1127 cases in women and 1063 cases in men).
•
Diet assessed by using food-frequency questionnaires
•
CONCLUSIONS: Consumption of fruits and
vegetables, particularly green leafy vegetables and
vitamin C-rich fruits and vegetables, appears to have a
8. 8
P. 17/09/1
Portincasa, 2
Fruit and vegetable consumption and stroke: meta-analysis
UNIBA of
cohort studies. He FJ; Nowson CA; MacGregor GA Lancet. 2006
Jan 28;367(9507):320-6.
•
MEDLINE, EMBASE, the Cochrane Library, and bibliographies
of retrieved articles
•
8 studies, 9 independent cohorts
•
257,551 individuals (4917 stroke events), average follow-up of 13
years
•
relative risk of stroke was 0.89 (95% CI 0.83-0.97) for those
with 3 to 5 servings per day, and 0.74 (0.69-0.79) >5 servings
per day.
•
Fruit and vegetables significant protective effect on both
ischaemic and haemorrhagic stroke.
9. 9
P. 17/09/1
Portincasa, 2
UNIBA
Lyn M Steffen Jan 28, 2006, The Lancet, Vol. 367 No. 9507 pp 278-279
10. 10
P. 17/09/1
Portincasa, 2
UNIBA
5 a day!
Lancet. 2006 Jan 28;367(9507):320-6.
13. Dietary fructose
monosaccharide
Fructose
• a free hexose
• as the disaccharide (sucrose:
glucose-fructose)
• in a polymerized form (fructans)
Up to one half of the population
unable to completely absorb a
sucrose
load of 25 g
4 Kcal / g
Glycemic index: 23 (sucrose:
57)
14. According to the USDA database, foods with more fructose than glucose include:
Fructose (grams / Glucose (grams /
Food
100 grams) 100 grams)
High fructose
55 to 90 45 to 10
corn syrup
Sucrose
50 50
(for reference)
Honey 40.9 35.7
Raisins 29.8 27.8
Pears 6.2 2.8
Apples 5.9 2.4
Fruit juice
e.g. Apples, 5 to 7 2 to 3
Pears
Watermelon 3.4 1.6
16. Central administration of fructose
Fructose exerts an orexigenic effect
Seung Hun Cha et al., Proc Natl Acad Sci U S A. November 2008
17. The brain, like the liver, possesses a unique set of
enzymes that enables fructose to bypass the rate-
limiting step in glycolysis and thereby rapidly deplete
ATP in the hypothalamus
The central administration of fructose rapidly lowers
ATP, increases P-AMPK and P-ACC (acetyl-CoA
carboxylase ), and decreases malonyl-CoA in the
hypothalamus, whereas centrally administered glucose
has the inverse effects.
18. FRUCTOSE IN THE LIVER
A high flux of fructose to the liver (the main organ
capable of metabolizing this simple carbohydrate)
1. perturbs glucose metabolism and glucose uptake
pathways (Fructose-induced insulin resistance)
2. leads to a significantly enhanced rate of de novo
lipogenesis and triglyceride (TG) synthesis, driven
by the high flux of glycerol and acyl portions of TG
molecules from fructose catabolism.
NAFLD: Associated with Metabolic Syndrome NAFLD is associated with the metabolic syndrome. The metabolic syndrome is a constellation of disorders, including obesity, type 2 diabetes and dyslipidemia, that often cluster together. The prevalence of insulin resistance is very high in individuals with the metabolic syndrome. Marchesini G, Bugianesi E, Forlani G, Cerrelli F, Lenzi M, Manini R, Natale S, et al. Nonalcoholic fatty liver, steatohepatitis, and the metabolic syndrome. Hepatology 2003;37:917-923. Shirai K. Obesity as the core of the metabolic syndrome and the management of coronary heart disease. Curr Med Res Opin 2004;20:295-304. Miller JL. Insulin resistance syndrome. Description, pathogenesis, and management. Postgrad Med 2003;Spec No:27-34.
Il sonnellino (1982 - olio su tela)
2 TI The effect of fruit and vegetable intake on risk for coronary heart disease. AU Joshipura KJ; Hu FB; Manson JE; Stampfer MJ; Rimm EB; Speizer FE; Colditz G; Ascherio A; Rosner B; Spiegelman D; Willett WC SO Ann Intern Med 2001 Jun 19;134(12):1106-14. BACKGROUND: Many constituents of fruits and vegetables may reduce the risk for coronary heart disease, but data on the relationship between fruit and vegetable consumption and risk for coronary heart disease are sparse. OBJECTIVE: To evaluate the association of fruit and vegetable consumption with risk for coronary heart disease. DESIGN: Prospective cohort study. SETTING: The Nurses' Health Study and the Health Professionals' Follow-Up Study. PARTICIPANTS: 84 251 women 34 to 59 years of age who were followed for 14 years and 42 148 men 40 to 75 years who were followed for 8 years. All were free of diagnosed cardiovascular disease, cancer, and diabetes at baseline. MEASUREMENTS: The main outcome measure was incidence of nonfatal myocardial infarction or fatal coronary heart disease (1127 cases in women and 1063 cases in men). Diet was assessed by using food-frequency questionnaires. RESULTS: After adjustment for standard cardiovascular risk factors, persons in the highest quintile of fruit and vegetable intake had a relative risk for coronary heart disease of 0.80 (95% CI, 0.69 to 0.93) compared with those in the lowest quintile of intake. Each 1-serving/d increase in intake of fruits or vegetables was associated with a 4% lower risk for coronary heart disease (relative risk, 0.96 [CI, 0.94 to 0.99]; P = 0.01, test for trend). Green leafy vegetables (relative risk with 1-serving/d increase, 0.77 [CI, 0.64 to 0.93]), and vitamin C-rich fruits and vegetables (relative risk with 1-serving/d increase, 0.94 [CI, 0.88 to 0.99]) contributed most to the apparent protective effect of total fruit and vegetable intake. CONCLUSIONS: Consumption of fruits and vegetables, particularly green leafy vegetables and vitamin C-rich fruits and vegetables, appears to have a protective effect against coronary heart disease. AD Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA. PMID 11412050 3 TI Legume consumption and risk of coronary heart disease in US men and women: NHANES I Epidemiologic Follow-up Study. AU Bazzano LA; He J; Ogden LG; Loria C; Vupputuri S; Myers L; Whelton PK SO Arch Intern Med 2001 Nov 26;161(21):2573-8. BACKGROUND: Soybean protein and dietary fiber supplementation reduce serum cholesterol in randomized controlled trials. Consumption of legumes, which are high in bean protein and water-soluble fiber, may be associated with a reduced risk of coronary heart disease (CHD). METHODS: A total of 9632 men and women who participated in the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study (NHEFS) and were free of cardiovascular disease (CVD) at their baseline examination were included in this prospective cohort study. Frequency of legume intake was estimated using a 3-month food frequency questionnaire, and incidence of CHD and CVD was obtained from medical records and death certificates. RESULTS: Over an average of 19 years of follow-up, 1802 incident cases of CHD and 3680 incident cases of CVD were documented. Legume consumption was significantly and inversely associated with risk of CHD (P =.002 for trend) and CVD (P =.02 for trend) after adjustment for established CVD risk factors. Legume consumption 4 times or more per week compared with less than once a week was associated with a 22% lower risk of CHD (relative risk, 0.78; 95% confidence interval, 0.68-0.90) and an 11% lower risk of CVD (relative risk, 0.89; 95% confidence interval, 0.80-0.98). CONCLUSIONS: Our study indicates a significant inverse relationship between legume intake and risk of CHD and suggests that increasing legume intake may be an important part of a dietary approach to the primary prevention of CHD in the general population. AD Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1430 Tulane Ave, SL18, New Orleans, LA 70112, USA. jhe@tulane.edu PMID 11718588
2 TI The effect of fruit and vegetable intake on risk for coronary heart disease. AU Joshipura KJ; Hu FB; Manson JE; Stampfer MJ; Rimm EB; Speizer FE; Colditz G; Ascherio A; Rosner B; Spiegelman D; Willett WC SO Ann Intern Med 2001 Jun 19;134(12):1106-14. BACKGROUND: Many constituents of fruits and vegetables may reduce the risk for coronary heart disease, but data on the relationship between fruit and vegetable consumption and risk for coronary heart disease are sparse. OBJECTIVE: To evaluate the association of fruit and vegetable consumption with risk for coronary heart disease. DESIGN: Prospective cohort study. SETTING: The Nurses' Health Study and the Health Professionals' Follow-Up Study. PARTICIPANTS: 84 251 women 34 to 59 years of age who were followed for 14 years and 42 148 men 40 to 75 years who were followed for 8 years. All were free of diagnosed cardiovascular disease, cancer, and diabetes at baseline. MEASUREMENTS: The main outcome measure was incidence of nonfatal myocardial infarction or fatal coronary heart disease (1127 cases in women and 1063 cases in men). Diet was assessed by using food-frequency questionnaires. RESULTS: After adjustment for standard cardiovascular risk factors, persons in the highest quintile of fruit and vegetable intake had a relative risk for coronary heart disease of 0.80 (95% CI, 0.69 to 0.93) compared with those in the lowest quintile of intake. Each 1-serving/d increase in intake of fruits or vegetables was associated with a 4% lower risk for coronary heart disease (relative risk, 0.96 [CI, 0.94 to 0.99]; P = 0.01, test for trend). Green leafy vegetables (relative risk with 1-serving/d increase, 0.77 [CI, 0.64 to 0.93]), and vitamin C-rich fruits and vegetables (relative risk with 1-serving/d increase, 0.94 [CI, 0.88 to 0.99]) contributed most to the apparent protective effect of total fruit and vegetable intake. CONCLUSIONS: Consumption of fruits and vegetables, particularly green leafy vegetables and vitamin C-rich fruits and vegetables, appears to have a protective effect against coronary heart disease. AD Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA. PMID 11412050 3
TI Fruit and vegetable consumption and stroke: meta-analysis of cohort studies. AU He FJ; Nowson CA; MacGregor GA SO Lancet. 2006 Jan 28;367(9507):320-6. BACKGROUND: Increased consumption of fruit and vegetables has been shown to be associated with a reduced risk of stroke in most epidemiological studies, although the extent of the association is uncertain. We quantitatively assessed the relation between fruit and vegetable intake and incidence of stroke in a meta-analysis of cohort studies. METHODS: We searched MEDLINE, EMBASE, the Cochrane Library, and bibliographies of retrieved articles. Studies were included if they reported relative risks and corresponding 95% CIs of stroke with respect to frequency of fruit and vegetable intake. FINDINGS: Eight studies, consisting of nine independent cohorts, met the inclusion criteria. These groups included 257,551 individuals (4917 stroke events) with an average follow-up of 13 years. Compared with individuals who had less than three servings of fruit and vegetables per day, the pooled relative risk of stroke was 0.89 (95% CI 0.83-0.97) for those with three to five servings per day, and 0.74 (0.69-0.79) for those with more than five servings per day. Subgroup analyses showed that fruit and vegetables had a significant protective effect on both ischaemic and haemorrhagic stroke. INTERPRETATION: Increased fruit and vegetable intake in the range commonly consumed is associated with a reduced risk of stroke. Our results provide strong support for the recommendations to consume more than five servings of fruit and vegetables per day, which is likely to cause a major reduction in strokes. AD Blood Pressure Unit, Cardiac and Vascular Sciences, St George's University of London, London, UK. fhe@sgul.ac.uk PMID 16443039
. These observations have implications for dietary recommendations in patients in whom fructose malabsorption is suspected since foods that contain fructose may be well tolerated if they also contain glucose but may be less well tolerated if they also contain sorbitol (although sorbitol itself can cause diarrhea). Thus, it is the net amount of fructose that is important. . These observations have implications for dietary recommendations in patients in whom fructose malabsorption is suspected since foods that contain fructose may be well tolerated if they also contain glucose but may be less well tolerated if they also contain sorbitol (although sorbitol itself can cause diarrhea). Thus, it is the net amount of fructose that is important.
Metabolic pathways of entry of (A) glucose and (B) fructose into the glycolytic pathway of the CNS. GK, glucokinase; KHK, ketohexokinase; DHAP, dihypoxyacetone; Gald, glyceraldehyde.
J Hepatol. 2008 June; 48(6): 993–999. Published online 2008 March 10. doi: 10.1016/j.jhep.2008.02.011. PMCID: PMC2423467 NIHMSID: NIHMS52684 Copyright notice and Disclaimer Fructose Consumption as a Risk Factor for Non-alcoholic Fatty Liver Disease Xiaosen Ouyang, MD,1* Pietro Cirillo, MD,1* Yuri Sautin, PhD,1* Shannon McCall, MD,2‡ James L. Bruchette, ASCP,2‡ Anna Mae Diehl, MD,3‡ Richard J. Johnson, MD,1* and Manal F. Abdelmalek, MD3‡