This particular slice of WHI followed 48, 000 women over the age of 50 from 1993 to 2005. Half were asked to follow a low-fat diet, and the other half were asked to follow their usual diet. So, how did the low-fat diet women fare over the long-haul?

The half who were asked to go on a low-fat diet, aimed for 20% of of their calories to come from fat. The low-fat group was also told to eat 5 or more servings of fruits and vegetables everyday, as well as 6 servings of grains. There were group meetings with nutrition and behavior modification training in the low-fat group, but basically, everyone was on their own.

After 8 years, the women in the low-fat group did not have a decreased risk of diabetes. Fortunately, they did not have an increased risk of diabetes either: it was a concern since high-carbohydrate diets may increase someone’s risk of diabetes. Weight loss, regardless of the group, was associated with a lower risk of developing diabetes.

On average, the women in the low-fat group weighed 2 pounds less than the group eating their normal diet at the end of eight years. Two pounds after eight year of dieting!  Not much of a diet in my opinion. (There have been other studies showing low-fat diets can result weight loss, but only when the diet includes an exercise program.)

So, do low-fat diets reduce your risk of diabetes?  No, low-fat diets do not lower you risk of developing diabetes. Losing weight reduces your chances of developing diabetes. There is nothing magic about a low-fat diet.

If you are interested in reading more about how the whole low-fat craze came about, this article by Gary Taubes is educational and fascinating.  It may be more information than you prepared to digest, but it may free you from your guilt if you feel like eating a piece of cheese. http://www.nasw.org/awards/2001/01Taubesarticle1.htm

*Tinker, LF, et al. Low-Fat Dietary Pattern and Risk of Treated Diabetes Mellitus in Post-menopausal Women: The Women’s Health Initiative Randomized Controlled Dietary Modification Trial. Arch Intern Med/Vol 168 (No14), July 28, 2008

Low-carbohydrate diets (Atkins) work. People lose weight. Blood pressure improves. Cholesterol levels, especially triglycerides, come down. Sounds great, but is there any other information to the contrary?

This study (Benefit of Low-Fat Over Low-Carbohydrate Diet on endothelial Health in Obesity*) looked at Flow-Mediated Brachial Artery Dilation (FMBAD), which is a marker for the health of the cells lining your arteries. Your arteries need to be pliable and flexible. They need to dilate when there is increased blood flow, for example, when you exercise. An impaired FMBAD is associated with the development of cardiovascular disease over time.

This wasn’t a big study. The researchers put 20 healthy, but obese, people on one of two diets: low-fat or low-carbohydrate (Atkins). At 30% fat, the low-fat diet wasn’t really very low in fat content. Thirty percent of daily calories from fat is in-line with the American Heart Association recommendations.

This wasn’t a long study either: only 6 weeks.

Everyone lost weight. Blood pressures improved. Cholesterol did not change in either group after 6 weeks. Triglycerides improved in the low-carbohydrate group (Atkins) as it always does. Fasting insulin (a marker for pre-diabetes) also improved in the low-carb group.

The problem in the low-carbohydrate group was a decline in FMBAD.

Yes, the study was only 6 weeks in duration. Yes, there were only 20 patients. But, maybe we can draw some broad conclusions. Low-carbohydrate is a great diet, especially for diabetics, but you may not want to stay on it forever. We don’t know what the decline in FMBAD means for you over a lifetime.

* Phillips SA, et al. Hypertension, Feb 2008;51:376

This list is compiled from a lecture at an obesity conference which I attended*. Although careful when I prescribe medications to my overweight patients, some of the medications on this list were a surprise to me.

Diabetes Medications

Insulin

In people with Type 2 Diabetes (Adult Onset Diabetes Mellitus), insulin is notorious for causing weight gain. Insulin makes you hungry. You eat. You gain weight. The more weight you gain, the more insulin you need over time. It is a vicious cycle.

If you have Type 2 Diabetes, and are overweight, and are on insulin, you might be able to wean yourself off the insulin. It is a huge project. You need to be very vigilant about what and how much you eat. Don’t do this at home without direction. You will need very close supervision by your physician.

Thiazolidinediones (TZD’s )

Actos® (Pioglitazone) and Avandia® (Rosiglitazone) are the only two medications in this class of medications used to treat diabetes. Avandia® recently had some bad press. If you are on a TZD, you are probably on Actos®. TZD’s cause a bit of weight gain. Don’t stop your Actos® yet! The medications in this class have a very important role in controlling blood sugar. They may also help to decrease the amount of fat in your liver and belly, which is a very good thing. If you are serious about losing weight, there are other medications for diabetes to consider. Byetta®, Victoza®, and Glucophage® all help people lose a bit of weight. Januvia® is another medication, but it has no effect on weight.

Sulfonylureas

These medications stimulate the pancreas to secrete insulin. This is a double edge sword. First of all, insulin makes people hungry. That is what insulin does, so, people gain weight. Secondly, under normal conditions in healthy people, insulin secretion is coordinated with your meals. When you eat, you pancreas secretes insulin. If you take a sulfonylurea, your pancreas secretes insulin off-schedule. If your stomach is empty when your pancreas secretes insulin, your blood sugar drops. Then, you become light-headed and need to eat a candy to bring your sugars back up. People end up gaining weight in the long run. Medications in this class include Glucotrol® (glipizide), Diabinase® (chlorpropamide), Diabeta® (glyburide) and Micronase® (also glyburide). Many physicians have stopped prescribing Sulfonylureas. There are better medications now for the treatment of diabetes.

No matter what medications you take for your diabetes, what and how much you eat are the keys to controlling your blood sugar in Type 2 Diabetes.

Beta-Blockers

These medications are used to treat hypertension (high blood pressure.) Beta-blockers also slow down how fast you heart beats. For people whose heart rate is too fast, for example people with atrial fibrillation, these medications are used to slow the heart down. This class of medication is also used in congestive heart failure, and to prevent migraine headaches. If you have atrial fibrillation and are on a beta-blocker, well, there isn’t much you can do. You need to stay on your beta-blocker.  On the other hand, if you are on a beta-blocker for hypertension, there are many other medications that do a better job at controlling blood pressure, without causing weight gain.

Psychiatric Medications

One could write a book on this subject alone because there are so many psychiatric medications that cause weight gain. Lithium, valproic acid, anti-psychotics and tricyclic anti-depressants all can cause weight gain. Lithium is used for people with Bipolar Disease (manic-depression.) Valproic acid is a mood stabilizer used in depression. Anti-psychotics are notorious for causing weight gain, especially Zyprexa®.

If not outright weight gain, these medications make it difficult to lose weight. If you are on any of these medications and are obese, work with your psychiatrist to try a different medication. Of course, this is easier said than done. Many of my patients are on psychiatric medications. No one wants to try something different. Each one is so happy to have their depression, or mania, or hallucinations controlled. I can’t blame them for being reluctant to change.

Antihistamines

A little know fact about antihistamines is that they can cause weight gain. HIV-treating physicians know this fact. We prescribe an antihistamine, cyproheptadine (Periactin®), to our patients who need to gain weight.

During allergy season, you are between a rock and a hard spot. You need your antihistamine to control your sneezing and stuffy sinuses. If you can’t do without, the least you can do is avoid overuse of your anti-histamines.

Birth Control Injections

Birth control injections can cause weight gain.  Again, you are between a rock and a hard spot. You need a form of birth control. On the other hand, if you are overweight or obese and are gaining weight from the injections, think about an alternative form of contraception.

Prednisone

People who take prednisone for asthma or for an autoimmune disease will tell you how hungry they become after a dose. If you have a disease which requires prednisone therapy, you may have no other options.

Prednisone is life saving for people with severe asthma. There are all kinds of inhalers that help prevent asthma attacks, but when a severe asthma attack strikes, prednisone is the answer. If you have frequent asthma attacks, get to a pulmonologist. Maybe a different set of inhalers can prevent some of the exacerbations.

For some autoimmune diseases, there are new medications called “immune modulators.” These might be an option for some people with diseases like Rheumatoid Arthritis.

Whether you take prednisone for asthma or for an autoimmune disease, take the lowest possible dose, and explore other treatment options.

Opiates

People who need to take high doses of opiates for pain will notice a slow and steady weight gain over time. If you have a chronic pain condition, you need to be under the care of a pain specialist or a physiatrist (a physician who specializes in Rehabilitation Medicine.) Pain is so difficult to treat, but there are other options now. Epidural injections, nerve blocks, implantable stimulators, can all help lessen the pain. There are adjuvant medications, i.e., medications used in addition to the opiates, which can also help lessen the pain by calming nerve-endings. A multi-faceted approach might help you to lower the dose of your opiates. Obviously, you don’t want to be on opiates forever, and you don’t want to be in pain for the rest of your life either. In any event, if you are overweight or obese and are on long-term opiate therapy, it’s time to try a different approach.

* The lecture was given by Norman Sussman, M.D., a clinical professor of Psychiatry at New York University Medical Center.

Although it may not make any sense, diet soda may contribute to the development of diabetes. This study did not look at diabetes specifically, but looked at “Metabolic Syndrome.” Some of you may remember Metabolic Syndrome as “Syndrome X”. The name was changed a few years ago.

Metabolic Syndrome is a cluster of metabolic abnormalities: 1) prediabetes or diabetes, 2) large waist size (dreaded belly fat) 3) hypertension or prehypertension, 4) high triglycerides (a form of fat in the blood) and 5) low HDL (HDL is good cholesterol). Someone with 3 of the 5 abnormalities is considered to have Metabolic Syndrome. All the components run together: diabetes, hypertension and a bad cholesterol profile. They are part of the same disease process. People with Metabolic Syndrome are at high risk, over time, to suffer heart attacks and strokes.

In order to answer the question of whether diet soda is associated with Metabolic Syndrome, the authors looked at people participating in the Framingham Offspring Study. You may remember the original Framingham Study: people living in Framingham, Massachusetts were followed for years starting in 1948, to look at risk factors for heart disease. The Framingham Offspring Study is following the children of the original Framingham Study volunteers.

The researchers weren’t only looking at diet soda in this study. They were looking at regular and diet soda both, as well as other risk factors for Metabolic Syndrome. To answer the soda question, people were asked to estimate their daily soda consumption for the prior year on a questionnaire. The researchers looked at the question of diet versus regular soda through a separate questionnaire called a “Food Frequency Questionnaire”. These Food Frequency Questionnaires ask people to document everything they eat or drink for a few days in a row.

As you can imagine, when you have so many volunteers, and so much data from the various questionnaires, the numbers were sliced and diced in a variety of ways. In broad brush-strokes, soda is associated with the development of Metabolic Syndrome, regardless of whether the soda was regular or diet.

Let’s look at the data more carefully. If you just do a cross-sectional slice, there was 48% more Metabolic Syndrome in those who drank one or more soft drinks every day when compared to those who drank less than one a day. Cross-sectional studies are when you take the next 100 people walking down the street, and count how many have Metabolic Syndrome. Cross-sectional studies give you numbers on prevalence. Metabolic Syndrome is 48% more prevalent in frequent soda drinkers than in infrequent soda drinkers.

Next, let’s look at “incidence”. Take the next 100 people walking down the street and follow them for 4 years to see how many develop Metabolic Syndrome. The 4-year incidence (the chance of developing Metabolic Syndrome over 4 years) is 44% percent higher in soda drinkers. That 44% number was in the news. Impressive! If you look at the actual numbers, it is not so impressive: 18.7% versus 22.6% I was actually surprised that the risk over time was so low, until reading the article more carefully. First of all, from the original 5000 offspring in 1971, 900 were excluded from this study because they already had cardiovascular disease. Of the remainder, 1/3 of the volunteers were excluded from the study because they already had Metabolic Syndrome. Close to half of the initial volunteers were excluded from the study because they already had Metabolic Syndrome!

What this tells me is the risk of developing Metabolic Syndrome is much higher than 22.6%. No one starts drinking soda at age 50. It starts much earlier. Then all those soda-drinkers are excluded from the analysis because they already developed Metabolic Syndrome. This study underestimates the risk of developing Metabolic Syndrome from soda.

Regardless of whether the risk is underestimated, soda, diet and regular, is associated with the development of Metabolic Syndrome.

The researchers had a few ideas as to why this is so. Regular soda is obvious. Extra calories leads to weight gain which leads to Metabolic Syndrome. Sweet liquids don’t turn off our hunger center in the brain the way food does. Plus, there may be something about high fructose corn syrup, which our body can’t digest as well, so it causes more metabolic abnormalities than cane sugar. Diet soda is not so obvious as to why it is associated with the development of Metabolic Syndrome. One theory is called “conditioning”. From drinking sweet drinks all day long, our bodies become accustomed to the sweet flavor and when it is time to eat food, we go for sweets. You know this is true. Think of all your lucky friends who don’t have a taste for sweets, and your other friends with a sweet tooth. To digress a moment, I read an article about the CEO of Applebee’s. She said that through the years, they have needed to change the recipes for their desserts. They can’t make desserts sweet enough to satisfy their customers!

Another theory has to do with something called advanced glycation end products (AGE’s), which are in the caramel coloring of cola’s. AGE’s may be involved in the development prediabetes. See the separate article on AGE’s coming soon. Reducing AGE’s in your diet is important, especially for diabetics.

Lastly, the researchers noticed that the soda drinkers were not as health-conscious as their non-soda-drinking counterparts. The soda drinkers tended to eat more calories, more saturated fat, more trans-fats, and were more likely to smoke. The researchers adjusted their numbers to account for the fats, and the calories and the smoking. Even then, whether diet or regular, soda was strongly associated with the development of Metabolic Syndrome.

Whatever the reason, the advice is clear. Don’t drink soda. Don’t drink regular soda. Don’t drink diet soda.

* Dhingra R, et al. Soft Drink Consumption and Risk of Developing Cardiometabolic Risk Factors and the Metabolic Syndrome in Middle-Aged Adults in the Community, Circulation 2007; 116; 480-488

This cohort study, “Atherosclerosis Risk in Community”, abbreviated ARIC. Similar to the Framingham study, this study is following people over time to define risk factors for heart disease.A “cohort” study follows a group of people over time. Usually the people in the study have something in common: age or race or a particular disease. For example, there are cohort studies following people with HIV over time to monitor for long-term complications of both the disease and the medications. A cohort study can give us information about associations, but can not tell us anything about cause-and-effect. We can learn from cohort studies that soda is associated with the development of diabetes. We can’t say that soda causes diabetes. In order to make a strong statement about cause and effect, we would need a randomized trial where half of the participants drank soda and the other half did not drink soda.

Back to the issue at hand, in the ARIC, close to 16,000 middle-aged adults living in North Carolina, Mississippi, Maryland and Minnesota were followed, starting in the late 1980’s. Every three years, people came in for physical exams and completed food-frequency questionnaires.

For this particular slice of the ARIC study, people starting out with Metabolic Syndrome or heart disease were excluded from the analysis. That makes sense. If you are trying to figure out the risk factors for the development of Metabolic Syndrome by following people over time (prospective study), you can’t include people who already have it. You could look at the people with Metabolic Syndrome, then look back to see what they ate (retrospective study), but this study was not a retrospective study. Around 6,000 people were excluded from entering the study because they already had Metabolic Syndrome! The researchers ended up with 9,514 volunteers.

Remember what Metabolic Syndrome is. It is a cluster of diseases: 1) diabetes or pre-diabetes, 2) hypertension or pre-hypertension, 3) large waist size, 4) low HDL (HDL is good cholesterol) and 5) high triglycerides (a form of fat in the blood). Three of these five would give you a diagnosis of Metabolic Syndrome. As you see, I tend to clump Metabolic Syndrome and Diabetes together, just for the purposes of making things clearer and easier to read. Wherever you see the word “Metabolic Syndrome”, replace it with “Diabetes” or visa versa, and you will get the picture. People with Metabolic Syndrome are at high risk to die earlier from heart disease and strokes. We want to avoid Metabolic Syndrome, so let’s see if there are any hints from this study.

Over 9 years of follow-up, 40% of the 9514 volunteers developed Metabolic Syndrome. Wow! If you include the excluded people who started out with Metabolic Syndrome, 60% of those middle-aged volunteers had or ended up with Metabolic Syndrome.

Let’s look at what the people who developed Metabolic Syndrome ate, and what the others did not eat. First of all, the big meat eaters were at higher risk. Hamburgers, hot dogs and processed meats were the worst offenders. Fried foods, also bad. Cheese was good! Yes, dairy products seemed to protect against the development of Metabolic Syndrome! This is not news, or at least it should not be news. We’ve seen this in other studies, where a serving or two of dairy every day seems to protect against weight gain. Also, remember that cheese and yogurt are both an integral part of the Mediterranean diet.

The researchers were disappointed because they thought that fruits, vegetables and whole grains would be protective. There was no association one way or another. Remember though, there are plenty of other studies which show fruits, vegetables and whole grains protect against the development of diabetes and Metabolic Syndrome.

Soda gets complicated. Regular sweetened soda was associated with the development of Metabolic Syndrome. When the researchers took age and weight into account (both are risk factors for Metabolic Syndrome), soda was no longer associated with Metabolic Syndrome. We’ve seen this before also. Remember the large study in African American women. It wasn’t the soda; it was the weight gain from the soda that was associated with Metabolic Syndrome. In short, soda does not cause Metabolic Syndrome, but soda contributes to weight gain. The culprit is the weight gain, not the soda, for the development of Metabolic Syndrome.

The big surprise was the very strong association of diet soda with Metabolic Syndrome.  Even after adjusting for all potential variables, people who drank diet soda were at 34% increased risk of developing Metabolic Syndrome. We have seen this before in other studies. Diet soda is associated with the development of Metabolic Syndrome. For more information, see the article on this site entitled “Can Diet Soda Cause Diabetes?”

The advice is clear. Don’t drink soda. Drink milk. Eat cheese.

* Lutsey PL, et al. Circulation 2008;117;754-761. Dietary Intake and the Development of the Metabolic Syndrome: The Atherosclerosis Risk in Community Study

It is not easy, but it is possible, to  eat the same amount of Vitamin K every day.  It just takes a bit of extra thought when you are preparing your meals. The USDA web site has a list of the Vitamin K content of foods, so that you can estimate the amount of greens you can eat from day to day, and still keep your Vitamin K intake level. This first link is sorted by Vitamin K content , and this second link is sorted alphabetically.

If you do choose to eats greens every day, take it seriously and be careful. There is a very, very good reason why you are on Coumadin, and it is simply not worth the risk if you cannot be consistent.

To do this, researchers took 3 groups of young mice. The first group ate “standard” mouse chow and gained a “standard” amount of weight as they matured. The second and third groups were fed a high-fat diet and grew up to be rotund adult mice. However, the high-fat group supplemented with maté tea gained half as much weight as the high-fat group not given maté tea. As an added bonus, their livers contained 30% less fat. (This is good: fat in the liver is bad.)

The researchers also did some experiments looking at the metabolism of the mice given the tea. It seems as though yerbe maté interferes with the metabolism of dietary fat, perhaps in the same way orlistat (brand name, Alli®) does.

So, if you are trying to control your weight, drinking a cup or two of maté tea every day is a possibility. Yerba maté has more anti-oxidants than green tea, and is as high polyphenols as red wine!

Like so many things in life, don’t go overboard. Don’t buy maté extract pills, since we do not know the effect of high doses in the body over time. And, if you are sensitive to caffeine, don’t drink maté late in the day. Some versions of the tea contain a pretty hefty dose of caffeine and may keep you awake at night.

For more general information about yerbe maté, go to the Wikipedia web page, http://en.wikipedia.org/wiki/Yerba_maté. You will also see that there is some concern about cancer and yerbe maté. It might only if the leaves were fire-roasted, or if you drink the tea boiling hot, which would damage the sensitive lining of your throat and esophagus. But, I think it also points out something that many researchers (and I) believe. If you overuse anti-oxidants, they turn into an oxidant. You do more harm than good to your body.

Martins, F, et al. Maté Tea Inhibits In Vitro Pancreatic Lipase Activity and Has Hypolipidemic Effect on High-fat Diet-induced Obese Mice. Obesity (2009) Vol 18 (1)

Along those same lines, a scientific study* that looked at once-a-year high dose Vitamin D supplementation in older women was recently published.  The intervention group of the study received 500,000 international units of cholecalciferol (D3) once a year, and actually experienced more falls and fractures than the placebo group that received no supplementation.  The lesson to be learned is Vitamin D is important, but don’t take it all at once, once a year.

* Sanders, K. M., A.L. Stuart, E.J. Williamson, J. A. Simpson, M. A. Kotowicz, D. Young, G. C. Nicholson “Annual High-Dose Oral Vitamin D and Falls and Fractures in Older Women: A Randomized Controlled Trial” JAMA 2010;303(18):1815-1822

http://www.readingtoknow.com/2010/05/skinny-is-overrated-by-danielle-milano.html

http://kathmeista.blogspot.com/2010/05/skinny-is-overrated-review.html

These reviews were done by people who love to read, and post reviews,not for money, but for their love of books.

To answer this question, we need to backtrack a bit first. No one is sure whether it is the alcohol or the antioxidants in wine that protect our hearts. For a time, people believed it was the resveratrol in wine that accounted for the French Paradox: the paradox being that the French people eat a high-fat diet but don’t have high rates of heart disease.  But, not all wines are created equally: some have more resveratrol than others. Grape vines under stress (for example, when under attack by fungus) produce resveratrol. As such, wines from upstate New York have high levels of this antioxidant because of the cold, damp climate. Red wine has more resveratrol than white wine, because this antioxidant is found in the skin. Red wine is fermented with the skins, but white wine is not. But, whether red or white, from California or New York, there simply is not much resveratrol in wine.  So, should we buy resveratrol supplements at the health food store for a longer healthier, life?

The first article, “A Low Dose of Dietary Resveratrol Partially Mimics Calorie Restriction and Retards Aging Parameters in Mice” can be accessed on the free online scientific journal www.PLosOne.org. The article is not an easy read, even for a physician.  In the study, researchers compared three groups of mice: 1) a control group fed a regular diet of mouse chow, 2) a group of mice fed a regular diet plus a daily supplement of resveratrol, and 3) a “calorie restricted” group.

And now we must digress to explain why there was a “calorie restricted” group of mice in the study.  Mice put on a diet live 30% longer than mice fed a regular diet. Taking in fewer calories activates a gene that slows aging, and the mice live longer.  This gene is called SIRT1, which is thankfully short for “silent mating type information regulation 2 homolog 1.” Since new genes are being discovered every day, there needed to be an organized way to name the genes to avoid duplicate or confusing names. An organization called the “HUGO Gene and Nomenclature Committee” gives “unique and meaningful names to every human gene.” And thus, we have SIRT1.

Hoping that calorie restriction actives SIRT1 and helps people live longer too, there is a whole “CR” movement out there, where people are eating fewer calories, not to lose weight, but to live longer.

The purpose of this study in mice was to see if resveratrol and calorie restriction have the same effects at the genetic and biochemical level. It isn’t clear that resveratrol will help mice live a longer life, the same way calorie restriction does. Mice given a regular diet plus a resveratrol supplement do not live 30% longer. But, under certain circumstances, reveratrol can help mice live longer. Mice given a high-fat diet die young, but you can extend their life with resveratrol!

This particular study we are looking at today did not measure longevity because the mice were sacrificed at 30 months in order to look at changes in genes and metabolism. When sacrificed, the resveratrol-mice looked a lot like the CR-mice. Heart function was preserved. Age-related changes to genes were prevented. Insulin sensitivity was preserved. (This is good: you want to be sensitive to the effects of insulin.)  In general, age-related changes in the heart, brain and muscle of the mice seemed to be slowed by the reveratrol. However, there were no changes in SIRT1 in any of the resveratrol-treated mice. A surprise, but the researchers did not seem concerned. There were many, many other gene changes that overlapped between CR and resveratrol, which confirmed their suspicions that resveratrol slows aging much in the same manner as CR, but it does it in a way other than SIRT1.

Surprisingly, there was more oxidative stress in brains and muscle of the resveratrol-mice.  And, although there were fewer tumors in the CR-mice, there were just as many tumors in the resveratrol-mice as in the mice fed a regular diet.

After reading the first ¾ of the article, I was ready to run to the health food store to buy resveratrol. The increase in oxidative stress made me stop and think for a minute.  An increase in oxidative stress is not good, and actually may increase your rate of “aging.” If you are going to take a resveratrol supplement, be sure to supplement yourself with an anti-oxidant also. Which anti-oxidant to use with resveratrol? I could not begin to guess.

Instead of resveratrol, what about grape powder? You can buy that in the health food store too. There was a study done in rats with hypertension. Certain strains of rats develop hypertension if they are given a diet high in salt. Over time, in people and in rodents, the elevated blood pressure causes damage to the heart muscle with scar tissue formation. Interestingly, this study had three groups of rats. All three groups were fed a high-salt diet, and all developed hypertension. The control group was given the high-salt diet without any other intervention. They developed hypertension and heart problems, as expected. A second group was treated with an anti-hypertensive medication, hydralazine, which helped to control their blood pressure. Despite the treatment with blood pressure medication, these rats developed scar tissue in their heart anyway. The third group of rats ate the same high-salt diet as the other two groups, but was given grape extract instead of the hydralazine.  Their blood pressure was better than the animals not given medication, but not as good as good as those given the hydralazine. Amazingly, when the researchers studied the hearts of the rats given the grape extract, there was far less damage than what would have been expected from the high salt-diet. Even the hydralazine group had more inflammation and more scar tissue in their heart muscles than the grape extract group. Something in the grape powder protected the hearts of the animals.

So, if we can draw a parallel between rodents (after all, they are mammals) and people, perhaps people with hypertension should be taking a grape extract. I am not one to push supplements, since we don’t know the effects of high doses over a long period of time. Perhaps, you could eat grapes instead. Grapes have been a part of the Mediterranean diet for millennium, and have withstood the test of time. The conquistadores left Europe looking for the Fountain of Youth, but it was right under their noses back home…in the grapes.

But, to achieve the same level of anti-oxidants as in the grape extract, you would have to eat 120 grapes a day. That is a lot of grapes. But, the authors of the article weren’t trying to push grapes or grape extract, per se. It is known that a diet high in fruits and vegetables improves blood pressure, but no one knows whether that will translate into better heart function in the long run. This was a first step to show that anti-oxidants, i.e., fruits and vegetables, not only improve blood pressure but also improve the function of your heart through the years.

• Barger JL, Kayo T, Vann JM, Arias EB, Wang J, et al. (2008) A Low Dose of Dietary Resveratrol Partically Mimics Calorie Restriction and Retards Aging Parameters in Mice. PLos ONE 3(6): e2264. Doi:10.1371/journal.pone.0002264

• Seymore EM, et al. Chronic Intake of a Phytochemical Emriched Diet Reduces Cardiac Fibrosis and Diastolic Dysfunction Caused by Prolonged Salt-Sensitive Hypertension. J Gerontology Biological Sciences 2008; 63A(10): 1034-42