Background Sodium intakes of different populations around the world became of interest after a positive correlation was drawn between dietary sodium intake and prevalence of hypertension. Sri Lanka has adopted a salt reduction strategy to combat high blood pressure in the population with escalation of non-communicable diseases. Objective To measure intake of salt, potassium and sodium/potassium ratio of adults in urban and rural settings. Design A community based study of 328 adults between 30-59 years, including equal numbers from urban and rural sectors. Weight, height and waist circumference were measured. Blood pressure was measured by a standardized automated measurement system and the mean of two readings was used for analysis. 24-hour urine was collected and measured for creatinine, sodium, potassium levels. Results Mean daily salt consumption was 8.3g (95%CI:7.9,8.8), which is 1.6 times higher than WHO recommendation. Mean daily potassium intake was 1,265g (95%CI:1191.0,1339.3), which is 2.8 times lower and sodium/potassium ratio was 4.3 (95%CI:4.2,4.5), which is 7 times higher than WHO recommendation. Daily salt consumption was significantly higher in males (9.0g;95%CI:8.3,9.8) than females (7.7g;95%CI:7.2,8.2); rural (8.9g;95%CI:8.2-9.6,) than urban (7.7g;95%CI:7.2,8.3) with increasing body mass index (8.2g;95%CI:6.1,10.2 to 10.0g;95%CI:8.5,11.6). Systolic blood pressure was significantly positively correlated with high BMI and waist circumference. Conclusions High salt consumption, low potassium intake and high sodium/potassium ratio was found in this population. This information can be used to set targets to reduce salt intake in the population. Need to create awareness to enhance the consumption of potassium rich food while reducing salt intake to minimize future NCD burden.

Levels of isoflavones, biomarkers of soy intake, in 24-hour urine (24U) were inversely related to coronary heart disease (CHD) mortality in the World Health Organization's Cardiovascular Disease and Alimentary Comparison Study. Considering 24 U isoflavone levels were highest and CHD mortality was lowest in the Japanese, who maintained the world's longest life expectancy, the association of regular soy intake with cardiometabolic risk was investigated in Japanese adults (20-49 years old) and elderly (50-79 years old). In multivariate analysis adjusted for age, sex, and drug treatments, mean 24 U isoflavone excretion was significantly inversely associated with insulin resistance in the elderly and significantly associated with blood folate and potassium in the elderly, but also positively associated with 24 U salt in the elderly. These findings indicate that low-salt soy should be recommended to improve glucose metabolism in elderly Japanese.

Adequate vegetable intake is important in reducing the risk of lifestyle-related diseases; however, intake amongst young Japanese adults is poor. This study aimed to assess the effect of daily intake of a commercially available vegetable juice on nutritional status and metabolic syndrome-related markers in healthy young adults. Fifty-one healthy adults (14 men, 37 women), age 20 - 22 years were recruited, and their food and nutritional intake was surveyed using an FFQ based on Food Groups. Subjects were divided into either a control group, who were not administered vegetable juice, or an intervention group, who consumed 200 mL vegetable juice daily for 2 months. Anthropometric data, serum carotenoid concentrations, blood and urinary parameters were measured at baseline and at 2 months. The average intake of vegetables in all subjects at baseline was approximately 140 g/day, less than half the dose recommended by the Japanese government. Total serum carotenoid concentration in the intervention group doubled from baseline after 2 months. In particular, serum concentrations of α-carotene, β-carotene, and lycopene were increased. In the intervention group, 24-hour urinary potassium excretion increased significantly, and 24-hour urinary sodium to potassium ratio decreased significantly. Waist circumference and systolic blood pressure also decreased significantly. Daily intake of a commercial vegetable juice for 2 months improved nutritional status in young adults with inadequate vegetable intake, shown by improved serum carotenoid and urine potassium levels. In addition, intake of vegetable juice may be beneficial in reducing the risk of metabolic syndrome.

Objective: To investigate salt (sodium) and potassium (K) intakes and sodium (Na)/K ratios by 24 hours urine collection (24U) and to compare results in junior high (JH) school students in India and Japan. Design and method: We conducted the Health Examination in JH school students at the Chidambaram, Tamil Nadu, India in 2013. The survey was also conducted in JH school students in Nishinomiya, Japan in 2009–2011. A total of 201 healthy students aged 12–15 years in India and 203 healthy students aged 13–15 years participated. We measured anthropometric indices, body composition by body composition meter (Inbody 430, Biospace), blood pressure (BP) in sitting position after 10 minutes rest by using an automated BP system (HEM 907, Omron). We also conducted 24U and evaluated 24-hr urinary excretion of Na and K. Results: A total of 112 students (average age 13.2 ± 0.7 in 80 boys and 13.1 ± 0.5 in 32 girls in India and 157 students (average age 14.5 ± 0.6 in 48 boys and 14.0 ± 0.8 in 109 girls in Japan completed 24U. Estimated salt intakes (g/day) in Indian boys and girls were 9.3 ± 3.3 and 9.2 ± 3.9, respectively, and 24-hr K excretions (mg/day) in boys and girls were 823.3 ± 295.6 and 775.2 ± 426.9, respectively. 24-hr urinary Na/K ratios (mmol/mmol) in Indian boys and girls were 7.2 ± 2.5 and 8.0 ± 3.2, respectively, which were significantly higher than those in Japan (4.3 ± 1.9 in boys, 4.4 ± 2.2 in girls). Urinary K excretions were significantly higher in Japan (1643.3 ± 693.2 in boys, 1270.3 ± 498.5 in girls). Japanese boys were significantly higher in height and BMI, but body fat percentage was significantly lower than Indian students. Systolic BP was significantly higher in Japanese but diastolic BP was significantly higher in Indian boys. The heart rates were significantly higher in Indian boys and girls than in Japanese. Conclusions: JH school students in India showed significantly lower urinary K excretion and higher urinary Na/K ratios estimated by 24U. These nutrition statuses would be unfavorable for future BP in India.

Background: To assess the prevalence of metabolic syndrome and insulin resistance in an urban and rural population in Sri Lanka.Methods: A cross sectional study conducted in 3 health areas selected randomly, one in rural and 2 in urban. In each sector, 180 adults between 30-59 years equally from both sexes were included. Blood pressure, weight, height and waist circumference were measured in each participant. Fasting blood samples were taken to assess plasma glucose (FPG), triglyceride (TG), high density lipoprotein (HDL), insulin and HbA1C. Insulin resistance was detected by the homeostasis model assessment method (HOMA-IR).Results: From total 345 participants, 46.1% were men and 52.9% women. Prevalence of metabolic syndrome was 25.8% (23.9% in men and 27.4% in women; P = 0.27). Prevalence of each component of MetS in studied population was: 62.9% for central obesity, 28.1% for high TG, 35.9% for low HDL, 40% for high BP, 18.8% for high FPG, 3.9% for high HbA1C, 44.1% for overweight and 9.3% for obesity. Hypeinsulinaemia and insulin resistance was 26.9% and 22.3% respectively. Age, high BMI, waist circumference, FPG, TG, BP, HbA1C, insulin and low HDL significantly higher with subjects with MetS (P = 0.000). Hyperinsulinaemia and insulin resistance was significantly higher in rural sector, obese, centrally obese, high BP and high TG subjects.Conclusion: One fourth of study population had metabolic syndrome, hyperinsulinaemia and insulin resistance. Metabolic syndrome was strongly associated with hyperinsulinaemia and insulin resistance. Need urgent action to reduce risk in developing type-2 diabetes and cardiovascular diseases in this population.DOI: http://dx.doi.org/10.4038/sjdem.v4i1.7241Sri Lanka Journal of Diabetes, Endocrinology and Metabolism 2014; 4: 9-16

Objectives: To evaluate the sweet intake by FFQ (Food Frequency Questionnaire) in Japanese high school girl students and the relation of the intakes with trans fatty acids (TFA) in blood and the risk factors by health survey.

Aim: WHO-coordinated CARDIAC (Cardiovascular Diseases and Alimentary Comparison) Study previously reported individuals excreting Na ≥ the mean of 24 hour urinary (24U) Na of CARDIAC population (CP) and with higher heart rate (HR) ≥ mean HR had significantly higher systolic and diastolic blood pressure (SBP, DBP) than those excreting Na ≥ mean but with HR < mean, indicating possible involvement of impaired reflex suppression of HR by Na induced volume expansion in salt-sensitivity in hypertension. We further investigated the affect of Mg (M) and taurine (T) intakes on salt-sensitive BP rise with increased HR. Methods: From 61 CP in 25 countries, Japanese populations with obviously higher 24UT because of their fish eating custom, and other populations in which M and T were not available, were excluded and 41 CP were used for the following analysis. Results: Among total CP individuals, 708 with 24U Na ≥ mean and HR mean had significantly higher SBP (127.8 ± 0.8) and DBP (78.6 ± 0.8) than SBP (123.6 ± 0.6) and DBP (75.0 ± 0.9) in 1047 with 24 Na ≥ mean and HR < mean. Among 708 males and females with 24UNa and HR ≥ mean, 402 lower M excreters (24UM < mean) showed significantly higher DBP (79.7 ± 0.6) than DBP (76.9 ± 1.0) in 306 higher M excreters (24UM ≥ mean). Among 387 males with 24U Na and HR ≥ mean, 265 lower T excreters (24UT < mean) showed significantly higher SBP (130.0 ± 1.3) and DBP (80.5 ± 0.8) than SBP (125.6 ± 1.7) and DBP (77.0 ± 1.0) in 135 higher T excreters. Conclusion: Salt intake related BP rise with accelerated HR was affected by M and T intakes indicating dietary custom to take more M and T might attenuate salt induced BP rise.

Objective: We conducted the health examination for food education (HEFE) for junior and senior high school students since 2007, and investigated the relationships between the risk of blood pressure (BP) and the result of HEFE in high school boys. Methods: Our HEFE for measuring anthropological indices, checking BP in sitting position after 5 minutes at rest by using an automated BP system, sampling blood, asking questionnaires about birth weight and dietary custom, and collecting 24-hour urine (24U) samples was carried out in 152 healthy Japanese school boys aged 16–18. Fasting blood samples were analyzed for total cholesterol, high density lipoprotein cholesterol (HDL), triglycerides (TG), glucose (Gu) and homocysteine (Hcy). Results: The prevalence of increased BP (≥130/85mmHg), overweight (BMI≥25 kg/m2), dyslipidemia (TG ≥150 mg/dl and/or HDL< 40 mg/dl) and hyperglycosemia (Gu≥100 mg/dl) were 15.8%, 6.6%, 12.6% and 39.1%, respectively. Salt intakes (g/day) estimated by 24U was 9.3 ± 3.5 and 24U Na/K was 4.2 ± 1.5. The results of HEFE were compared in increases BP and normal BP groups. The former showed significantly greater abdominal circumference (p< 0.0001), greater heart rate (p< 0.01), higher Hcy (p< 0.05), lower birth weight (p< 0.05) and greater salt intake (p< 0.05) than the letter. There were significant correlations of Hcy with both systolic and diastolic BP. Conclusion: Even in young school boys higher BP was proven to be related with risks such as abdominal obesity, higher Hcy, higher salt intake and lower birth weight.

Background: Long-term ingestion of foods that contain high levels of antioxidants act to protect against production of excessive oxidation. Endothelial progenitor cells (EPCs) repairing cardiovascular damages are pivotal cells to prolong life span, which are suppressed by oxidative stress. The WHO-CARDIAC Study have demonstrated efficiency of dietary itake of taurine and magnesium (Mg) to prevent cardiovascular diseases. We evaluated influence of life-style and effects of taurine and magnesium supplementations on oxidative stress and EPC function in humans. Design: Seventy healthy men aged 20-30 years were participated in this study. As baseline study, we evaluated vascular endothelial function, nutritional intake. Peripheral blood mononuclear cells were separated to quantify EPC colony formation. Oxidative stress in peripheral blood were evaluated by d-ROMs and BAP tests by FRAS4, and TBARS assay. As nutritional intervention study, participants received 3 g of taurine or 0.34 g of Mg for 2 weeks as a double blind test, then the oxidative stress and EPC colony formation were evaluated. Serum fatty acids were analyzed in serum before and after the supprimentations. Results: Taurine and Mg supplementations significantly increased EPC colony formation and significantly decreased oxidative stress markers as d-ROMs and TBARS in peripheral blood and urinary 8-OHdG. Taurine supplementation significantly increases serum free fatty acids, whereas Mg supplementation did not increase serum unsaturated fatty acids Conclusion: As anti-oxidative nutritions taurine and Mg supplementations elevated EPC function. The anti-oxidative nutritional custom may lead prolongation of life span of human with activation of repairing cells.

BACKGROUND:Estrogen is considered to be cardioprotective, but estrogen replacement therapy for postmenopausal women has not shown results for either primary or secondary cardiovascular event prevention. During normal pregnancy, women have significantly higher levels of estrogen and it may be endogenous estrogen that helps prevent atherosclerosis.METHODS AND RESULTS:The present cross-sectional study examined the association between pregnancy followed by delivery and clinical atherosclerosis using the brachial-ankle pulse wave velocity (PWV). A total of 2,560 women undergoing annual health screening at the Institute of Hyogo Prefecture Health Promotion Association in Japan were recruited. Pregnancy history (the age of menarche/menopause and the number of gravida/para), conventional coronary risk factors, and brachial-ankle PWV were recorded. Multivariate linear regression by stepwise selection analysis demonstrated that women who had 1 or more deliveries had a significantly lower PWV, independent of age and other conventional coronary risk factors.CONCLUSIONS:Pregnancy followed by delivery may decrease arterial stiffness and prevent the progress of atherosclerosis in women. The contribution of such a pregnancy followed by delivery-related decrease in arterial stiffness to the reduction of cardiovascular disease in women should be further evaluated.

Study Population:All Filipino patients 18 years old and above who underwent coronary angiography. Methodology: Data were collected from 277 patients: age, sex, BMI, history of hypertension, diabetes, dyslipidemia, acute coronary syndrome, family history of CAD, lipid panel results, ejection fraction and coronary angiogram results. Results: Among the 277 patients who underwent coronary angiogram, 58.5% were non-obese while 41.5% were obese. The non-obese group comprised older individuals. A significant inverse correlation was noted between BMI and severity and jeopardy scores. Among the risk factors, only the triglyceride level appeared as predictor for the severity and jeopardy scores of CAD. BMI was excluded as a predictor of CAD. Conclusion: Body mass index has a significant negative correlation with the severity of coronary artery disease based on severity Score and jeopardy Score.

Objective Metabolic syndrome, a complex of disorders including insulin resistance, hypertension, and dyslipidemia, is associated with the development of obesity. Obesity also induces macrophage accumulation in adipose tissue. Macrophages produce many of the proinflammatory molecules, such as tumor necrosis factor α (TNF-α), and interleukine-6. Monocyte chemoattractant protein 1 (MCP-1) is released by adipose tissue. However, the underlying mechanisms in nephropathy with obesity have not been elucidated. We hypothesized that MCP-1 enhances the early nephropathy. Design and Methods We measured metabolic parameters in SHR/NDmcr-cp (fak/fak) rats (CP) and compared them with those in their lean littermates (Lean). Serum MCP-1 level was determined. The level of TNF-α in the kidney was also determined as proinflammatry marker. Furthermore, we examined mRNA expressions (MCP-1, and COX2) by using real-time RT-PCR in the kidney and adipose tissue. Protein expressions (PAI-1, PPARγ, eNOS) were measured by western blot analysis. Results At 12 weeks of age, both animals had hypertension because of their background of spontaneously hypertensive rats. Body weight was significantly higher in CP than Lean. CP showed hyperglycemia, hyperinsulinemia, hyperlipidemia, and proteinuria. Serum MCP-1 level was significantly higher in CP than that in Lean, although renal MCP-1 mRNA expression had no difference in both animals. The concentration of TNF-α was increased in CP kidney. PAI-1 protein and COX2 mRNA expression were upregulated in CP kidney, whereas PPAR-γ and eNOS protein expression were downregulated. Conclusions In this study, enhanced MCP-1 may increase infiltration of macrophages and secretion of TNF-α, suggesting that they are important sources of inflammation in the early nephropathy in CP.