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Atrial Fibrillation Alternatives

June 4, 2015 Written by JP       [Font too small?]

The consistent, rhythmic beating of the heart is something most of us take for granted. This is not a criticism or judgement. It makes perfect sense that we expect our hearts to keep pumping blood in much the same way as we predict our lungs will help us breathe day in and day out. Likewise, hair and nails grow without any consideration. Even muscles move without any meaningful cognitive incentive. It’s the body’s job to function in a predictable manner and it usually does. That is, until it doesn’t. Atrial fibrillation is just such an example, where the heart decides to occasionally beat to the rhythm of a different drummer.

A primary function of muscles, of which the heart is one, is to contract and relax appropriately. In the case of atrial fibrillation (AFib), the top chambers of the heart sometimes behave in an irregular manner. The consequence of this sporadic abnormality is a pooling of blood that is supposed to flow freely. When blood collects and/or circulation slows down, the likelihood of clotting increases. Excess clotting is associated with heart attack and stroke risk. For this reason, many cardiologists prescribe “blood thinners” and medications that affect heart rate, such as beta- and calcium channel blockers. In some instances, addressing potential causes of AFib, including hyperthyroidism, is part of the current standard of care as well.

In addition to the conventional options mentioned above, several AFib alternatives and complementary strategies have emerged in the medical literature. For instance, in previous columns, I’ve documented the potential of acupuncture and high intensity interval training as possible adjuncts to improve treatment outcomes. But, please note that AFib is a serious condition which requires serious management or treatment – whether conventional, integrative or natural. Do not take AFib lightly. Be informed. Be proactive. Find the best treatment program for you.

Step 1: Lose Excess Weight - Several studies report that weight reduction dramatically lowers AFib episode duration, frequency and severity. Another benefit is that healthy weight loss actually improves cardiac structure in patients with AFib. In other words, losing weight protects against the symptoms and promotes healing of the heart.

Step 2: Eat Mediterranean-Style - A recent study in the journal Europace found that consuming a Mediterranean diet does not pose a threat to those taking a common form of blood thinning medication known as Vitamin K antagonists. This is great news because there is a considerable amount of research indicating that a Mediterranean-style diet, rich in fruits, magnesium, nuts, olive oil and vegetables, addresses many risk factors linked to AFib, such as excessive blood clotting, oxidative stress and magnesium deficiency.

Step 3: Practice Yoga - The scientific literature is flooded with articles demonstrating the cardioprotective effects of yoga in healthy and high risk individuals. And, over the past few years, new research has specifically established a role for yoga in the holistic management of AFib. Best of all, yoga supports a healthy cardiovascular system in multiple ways including: a) positively modulating heart rhythm and rate aka parasympathetic and sympathetic activity; b) lowering blood pressure; and c) reducing psychological stress and associated mood considerations such as anxiety and depression.

Step 4: CoQ10 Supplementation - A brand new study in the Journal of Investigative Medicine discovered that coenzyme Q10, an antioxidant supplement long used in integrative cardiology, may powerfully complement standard care for AFib. In this particular research, patients receiving CoQ10 were over 3.5 times less likely to have an AFib episode over the course of a 12 month monitoring period compared to a placebo. Additionally, CoQ10 has been shown to enhance the benefits of a traditional Mediterranean diet by promoting DNA repair.

Step 5: Putting It All Together - If you’re overweight, adopt a health promoting weight loss strategy. Incorporating foods and ingredients common to the Mediterranean diet appears wise. Consider supplementing with CoQ10, taken with meals, for even greater protection. Add in a little or lot of yoga to the mix. If you don’t need to lose weight, you can still adopt these very same practices in a slightly modified form – fewer caloric or dietary restrictions. But, keep an eye on your weight as time goes on. Even minor weight gain can tip the AFib scale out of your favor. Finally, examine other natural remedies such as acupuncture and lemon balm if necessary.

In closing, I want to point out something that many of you may not know. Regularly, I post updates to my older columns in the “Comments & Updates” section at the bottom of each page. If you primarily read my new columns via email, you’re likely missing out on the latest scoops I uncover on my daily data hunt. But, I want you all to get the most of this site. So, be sure to look out for anything new I find that may benefit you and yours. Be well!

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

To learn more about the studies referenced in today’s column, please click on the following links:

Study 1 - Effect of Weight Reduction & Cardiometabolic Risk Factor Management (link)

Study 2 - Impact of Weight Reduction on Pericardial Adipose Tissue Cardiac (link)

Study 3 – Long-Term Effect of Goal-Directed Weight Management in an Atrial (link)

Study 4 - Relationship Between Mediterranean Diet & Time in Therapeutic Range … (link)

Study 5 - Does Mediterranean Diet Reduce Cardiovascular Events and Oxidative (link)

Study 6 - Mediterranean Diet Reduces Thromboxane A2 Production in Atrial (link)

Study 7 - Extra Virgin Olive Oil Consumption Reduces Risk of Atrial Fibrillation (link)

Study 8 - Dietary Magnesium Deficiency Induces Heart Rhythm Changes, Impairs (link)

Study 9 - Pivotal Role of Mediterranean Dietary Regimen in the Increase of Serum (link)

Study 10 - Effects of 1-Year Yoga on Cardiovascular Risk Factors in Middle-Aged (link)

Study 11 - Effect of Yoga Therapy on Heart Rate, Blood Pressure and Cardiac (link)

Study 12 - Effect of Pranayama (Breathing Exercise) on Arrhythmias in the Human (link)

Study 13 - Heart Palpitation Relief with Melissa Officinalis Leaf Extract: Double (link)

Yoga Practice May Reduce the Number of AFib Episodes

Source: Am Coll Cardiol 2013 Mar 19;61(11):1177-82 (link)

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15 Comments & Updates to “Atrial Fibrillation Alternatives”

  1. JP Says:

    Update 06/04/15:

    http://www.ncbi.nlm.nih.gov/pubmed/25632790

    Przegl Lek. 2014;71(9):495-8.

    Acute caffeine poisoning resulting in atrial fibrillation after guarana extract overdose.

    Guarana (Paullinia cupana) is the climbing vine native to Amazon Basin, characterized by high caffeine content in its seeds. Guarana extract is a common ingredient of energy drinks used in order to boost energy and physical endurance and increase alertness. Severe caffeine intoxication is rare, but may be life-threatening mostly due to supraventricular and ventricular dysrhythmias.

    OBJECTIVES: We present the case of intentional caffeine poisoning after ingestion of tablets containing guarana extract, complicated by atrial fibrillation.

    CASE REPORT: A 44-year-old man with no significant medical history was admitted to hospital about 21 h after ingestion of guarana extract containing 1.6 g of caffeine. Typical symptoms of caffeine toxicity, i.e. nausea, vomiting, anxiety and palpitaions, occurred shortly after ingestion. On admission, he was conscious, with blood pressure of 136/86 mmHg, heart rate of 106-113 beats per minute, fever of 37.8 °C, and symmetrically increased deep tendon reflexes. QTc interval in electrocardiogram was prolonged to 0.542 s. Laboratory tests revealed hypokalemia, hyperglycemia, leukocytosis, as well as elevated creatinine and creatine phosphokinase levels. Approximately 45 h post ingestion, the patient developed atrial fibrillation with fast ventricular rhythm. Tachydysrythmia subsided after infusion of amiodarone and restoration of electrolyte balance. Echocardiogram revealed presence of asymmetrical hypertrophy of the left ventricle with the systolic anterior motion of the mitral valve and normal left ventricular outflow tract gradient suggesting non-obstructive hypertrophic cardiomyopathy.

    CONCLUSION: Acute caffeine poisoning may result in atrial fibrillation, especially in predisposed patients with underlying hypertrophic cardiomyopathy.

    Be well!

    JP

  2. JP Says:

    Update 06/04/15:

    http://biomedgerontology.oxfordjournals.org/content/70/1/78.abstract

    J Gerontol A Biol Sci Med Sci. 2015 Jan;70(1):78-84.

    Effects of the Mediterranean diet supplemented with coenzyme q10 on metabolomic profiles in elderly men and women.

    BACKGROUND: Characterization of the variations in the metabolomic profiles of elderly people is a necessary step to understand changes associated with aging. This study assessed whether diets with different fat quality and supplementation with coenzyme Q10 (CoQ) affect the metabolomic profile in urine analyzed by proton nuclear magnetic resonance spectroscopy from elderly people.

    METHODS: Ten participants received, in a cross-over design, four isocaloric diets for 4-week periods each: Mediterranean diet supplemented with CoQ (Med + CoQ diet); Mediterranean diet; Western diet rich in saturated fat diet; low-fat, high-carbohydrate diet enriched in n-3 polyunsaturated fat.

    RESULTS: Multivariate analysis showed differences between diets when comparing Med + CoQ diet and saturated fat diet, with greater hippurate urine levels after Med + CoQ diet and higher phenylacetylglycine levels after saturated fat diet in women. Following consumption of Med + CoQ, hippurate excretion was positively correlated with CoQ and β-carotene plasma levels and inversely related to Nrf2, thioredoxin, superoxide dismutase 1, and gp91(phox) subunit of NADPH oxidase gene expression. After saturated fat diet consumption, phenylacetylglycine excretion was inversely related to CoQ plasma level and positively correlated with isoprostanes urinary level.

    CONCLUSIONS: The association between hippurate excretion and antioxidant biomarkers along with the relationship between phenylacetylglycine excretion and oxidant biomarkers suggests that the long-term consumption of a Med + CoQ diet could be beneficial for healthy aging and a promising challenge in the prevention of processes related to chronic oxidative stress, such as cardiovascular and neurodegenerative disease.

    Be well!

    JP

  3. JP Says:

    Update 06/04/15:

    http://www.jams-kpi.com/article/S2005-2901%2814%2900183-6/fulltext

    J Acupunct Meridian Stud. 2015 Apr;8(2):94-8.

    Acupuncture regulates the heart rate variability.

    Acupuncture is widely used in clinical practice. According to traditional acupuncture theory, the Neiguan acupoint (PC6) is one of the most commonly used acupoints and is indicated for treating cardiovascular-related disorders. We present the case of a 27-year-old female who had been diagnosed with ventricular septal defect and had undergone surgery to repair the defect at the age of 11 years. The patient had no obvious symptoms, such as palpitations and difficulty breathing. However, while performing electrocardiography (ECG), we found that she suffered from arrhythmia, and therefore, we treated her by acupuncture at the left PC6. An ECG monitor was used to record data during the entire acupuncture procedure, which was divided into the following three segments: prior to, during, and after acupuncture. Various indices of heart rate variability (HRV) were then determined and analyzed. The results indicate that acupuncture can regulate the HRV effectively; however, more studies are needed to confirm this finding.

    Be well!

    JP

  4. JP Says:

    Update 06/30/15:

    http://www.sciencedirect.com/science/article/pii/S2213231715000506

    Redox Biol. 2015 Jun 3;5:301-307.

    The correlations of glycated hemoglobin and carbohydrate metabolism parameters with heart rate variability in apparently healthy sedentary young male subjects.

    INTRODUCTION: Sedentary lifestyle is a major risk factor for diabetes, cardiovascular and many other age-related diseases. Heart rate variability (HRV) reflects the function of regulatory systems of internal organs and may sensitively indicate early metabolic disturbances. We hypothesize that quantitative and qualitative changes of HRV in young subjects may reflect early metabolic derangements responsible for further development of clinically significant disease.
    AIM:

    The aim of our study was to determine whether the parameters of carbohydrate metabolism (fasting blood glucose, HBA1c and surrogate insulin sensitivity/resistance indices) correlate with anthropometric data and HRV.

    METHODS: The study group consisted of 30 healthy sedentary male subjects aged 20-40, nonsmokers, mainly office and research employees, medical staff and students. Athletes, actively training more than one hour per week, severely obese and men of physical work were excluded from the study. HRV parameters were derived from short term ECG records (five minutes intervals) in supine position and during orthostatic test. Anthropometric data included height, weight, body mass index (BMI), age and body composition (estimation by bioelectric impedance method). The fasting blood glucose, insulin and C-peptide, homeostatic model assessment (HOMA-IR) index and glycated hemoglobin (HbA1c) were evaluated. Linear correlation coefficient (r) was calculated using Statistica 10.0 software.

    RESULTS AND DISCUSSION: HOMA-IR index correlated positively with body weight, visceral fat and BMI (p=0.047, 0.027 and 0.017 respectively). In supine position pNN50 positively correlated with glucose/insulin ratio (p=0.011) and heart rate with HOMA-IR (p=0.006). In orthostatic test negative correlations of HBA1c with standard deviation, total and low frequency power were determined (p=0.034, 0.400 and 0.403 respectively), which indicates a gradual worsening of functional capacity of cardiovascular system with low-grade increase (under the conventional threshold) of HBA1c.

    CONCLUSIONS: In apparently healthy sedentary subjects HRV reduction correlates with the age advancement, subclinical deteriorations of carbohydrate metabolism and excessive fat accumulation.

    Be well!

    JP

  5. JP Says:

    Updated 07/15/15:

    http://www.ncbi.nlm.nih.gov/pubmed/26170587

    Int J Yoga. 2015 Jul-Dec;8(2):96-102.

    Resting heart rate variability after yogic training and swimming: A prospective randomized comparative trial.

    CONTEXT: Resting heart rate variability (HRV) is a measure of the modulation of autonomic nervous system (ANS) at rest. Increased HRV achieved by the exercise is good for the cardiovascular health. However, prospective studies with comparison of the effects of yogic exercises and those of other endurance exercises like walking, running, and swimming on resting HRV are conspicuous by their absence.

    AIMS: Study was designed to assess and compare the effects of yogic training and swimming on resting HRV in normal healthy young volunteers.

    SETTINGS AND DESIGN: Study was conducted in Department of Physiology in a medical college. Study design was prospective randomized comparative trial.

    SUBJECTS AND METHODS: One hundred sedentary volunteers were randomly ascribed to either yoga or swimming group. Baseline recordings of digital electrocardiogram were done for all the subjects in cohorts of 10. After yoga training and swimming for 12 weeks, evaluation for resting HRV was done again.

    STATISTICAL ANALYSIS USED: Percentage change for each parameter with yoga and swimming was compared using unpaired t-test for data with normal distribution and using Mann-Whitney U test for data without normal distribution.

    RESULTS: Most of the HRV parameters improved statistically significantly by both modalities of exercise. However, some of the HRV parameters showed statistically better improvement with yoga as compared to swimming.

    CONCLUSION: Practicing yoga seems to be the mode of exercise with better improvement in autonomic functions as suggested by resting HRV.

    Be well!

    JP

  6. JP Says:

    Updated 09/23/15:

    http://www.biomedcentral.com/1741-7015/13/207

    BMC Medicine 2015, 13:207

    Coffee consumption is not associated with increased risk of atrial fibrillation: results from two prospective cohorts and a meta-analysis

    Background: Whether coffee consumption affects the risk of developing atrial fibrillation (AF) remains unclear. We sought to investigate the association between coffee consumption and incidence of AF in two prospective cohorts, and to summarize available evidence using a meta-analysis.

    Methods: Our study population comprised 41,881 men in the Cohort of Swedish Men and 34,594 women in the Swedish Mammography Cohort who had provided information on coffee consumption in 1997 and were followed up for 12 years. Incident cases of AF were ascertained by linkage with the Swedish Hospital Discharge Register. For the meta-analysis, prospective studies were identified by searching PubMed and Embase through 22 July 2015, and by reviewing the reference lists of retrieved articles. Study-specific relative risks were combined using a random effects model.

    Results: We ascertained 4,311 and 2,730 incident AF cases in men and women, respectively, in the two cohorts. Coffee consumption was not associated with AF incidence in these cohort studies. The lack of association was confirmed in a meta-analysis, including six cohort studies with a total of 10,406 cases of AF diagnosed among 248,910 individuals. The overall relative risk (95 % confidence interval) of AF was 0.96 (0.84–1.08) for the highest versus lowest category of coffee consumption, and 0.99 (0.94–1.03) per 2 cups/day increment of coffee consumption.

    Conclusions: We found no evidence that coffee consumption is associated with increased risk of AF.

    Be well!

    JP

  7. JP Says:

    Updated 09/28/15:

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4566779/

    J Intercult Ethnopharmacol. 2015 Apr-Jun;4(2):134-7.

    Single session of integrated “silver yoga” program improves cardiovascular parameters in senior citizens.

    AIM AND OBJECTIVE: This pilot study was carried out to determine cardiovascular effects of a single session of an integrated “silver yoga” program in senior citizens of Serene Pelican Township, Pondicherry.

    MATERIALS AND METHODS: Heart rate (HR) and blood pressure (BP) measurements were recorded in 124 senior citizens (75 female, 49 male) with mean age of 67.19 ± 10.61 year who attended an integrated “Silver Yoga” program at Centre for Yoga Therapy, Education and Research from August to October 2014. Participants practiced the protocol that was specially designed for senior citizens, keeping in mind their health status and physical limitations. This included simple warm-ups (jathis), breath body movement coordination practices (kriyas), static stretching postures (asanas), breathing techniques (pranayamas), relaxation and simple chanting. Non-invasive BP apparatus was used to record the HR, systolic (SP) and diastolic pressure (DP) before and after the 60 min sessions. Pulse pressure (PP), mean pressure (MP), rate-pressure product (RPP) and double product (DoP) indices were derived from the recorded parameters. Student’s paired t-test was used to compare data that passed normality testing by Kolmogorov-Smirnov Test and Wilcoxon matched-pairs signed-ranks test for those that did not. P < 0.05 were accepted as indicating significant differences for pre-post comparisons.

    RESULTS: All parameters witnessed a reduction following the single session. This was statistically more significant (P < 0. 0001) in HR, RPP and DoP while it was also significant (P < 0.01 and P < 0.05) in SP and PP, respectively. The decrease in MP just missed significance (P = 0.054) while it was not significant in DP.

    CONCLUSION: There is a healthy reduction in HR, BP and derived cardiovascular indices following a single yoga session in geriatric subjects. These changes may be attributed to enhanced harmony of cardiac autonomic function as a result of coordinated breath-body work and mind-body relaxation due to an integrated “Silver Yoga” program.

    Be well!

    JP

  8. JP Says:

    Updated 12/26/15:

    http://www.journalofarrhythmia.com/article/S1880-4276%2815%2900063-0/fulltext

    J Arrhythm. 2015 Dec;31(6):337-8.

    The impact of yoga on atrial fibrillation: A review of The Yoga My Heart Study.

    Atrial fibrillation is a common arrhythmia affecting thousands of individuals worldwide. It is a conduction disorder that causes the heart to beat irregularly and rapidly. There are a few medical approaches to manage this costly health care burden: antiarrhythmics to maintain normal sinus rhythm, beta blockers to achieve rate control while allowing atrial fibrillation to persist, and electro-physiologic intervention for rate and rhythm control. These treatments can be costly and are not without side effects. Yoga, an intervention that is available to people worldwide, has shown some promise in combating this widespread heart disorder.

    Be well!

    JP

  9. JP Says:

    Updated 12/26/15:

    http://cpr.sagepub.com/content/early/2015/12/23/2047487315624524.abstract

    Eur J Prev Cardiol. 2015 Dec 23.

    Risk of atrial fibrillation associated with coffee intake: Findings from the Danish Diet, Cancer, and Health study.

    BACKGROUND: There have been discrepant findings on whether coffee consumption is associated with the rate of developing atrial fibrillation (AF).

    METHODS AND RESULTS: We used data on 57,053 participants (27,178 men and 29,875 women) aged 50-64 years in the Danish Diet, Cancer and Health study. All participants provided information on coffee intake via food-frequency questionnaires at baseline. Incident AF was identified using nationwide registries. During a median follow-up of 13.5 years, 3415 AF events occurred. Compared with no intake, coffee consumption was inversely associated with AF incidence, with multivariable-adjusted hazard ratios of 0.93 (95% confidence interval [CI] 0.74-1.15) for more than none to <1 cup/day, 0.88 (95% CI 0.71-1.10) for 1 cup/day, 0.86 (95% CI 0.71-1.04) for 2-3 cups/day, 0.84 (95% CI 0.69-1.02) for 4-5 cups/day, 0.79 (95% CI 0.64-0.98) for 6-7 cups/day and 0.79 (95% CI 0.63-1.00) for >7 cups/day (p-linear trend = 0.02).

    CONCLUSIONS: In this large population-based cohort study, higher levels of coffee consumption were associated with a lower rate of incident AF.

    Be well!

    JP

  10. JP Says:

    Updated 04/04/16:

    http://www.advances.am.wroc.pl/pdf/2016/25/1/51.pdf

    Adv Clin Exp Med. 2016 Jul-Aug;25(1):51-7.

    Low-Level Vitamin D Is Associated with Atrial Fibrillation in Patients with Chronic Heart Failure.

    BACKGROUND: Atrial fibrillation (AF) frequently accompanies heart failure (HF), and causes exacerbation of symptoms and treatment failure in such patients. Vitamin D was recently suggested to be an important mediator of cardiovascular disease, including HF.

    OBJECTIVES: The aim of this study was to evaluate the relationship between vitamin D deficiency and AF in patients with chronic HF.

    MATERIAL AND METHODS: The study included 180 chronic HF patients that were divided into 2 groups based on having sinus rhythm [AF (-) group] or chronic AF [AF (+) group]. Vitamin D status was assessed via measurement of the serum 25-hydroxyvitamin D (25[OH]D) concentration.

    RESULTS: Mean age of the patients was 66 ± 8.7 years and 53.9% were male. There weren’t any significant differences in age, gender, body mass index, etiology or chronic HF stage between the 2 groups. The vitamin D level in the AF (+) group was significantly lower than in the AF (-) group (11.05 ng/mL vs. 20 ng/mL, p < 0.001) and the parathyroid hormone level was significantly higher in the AF (+) group (76.7 vs. 55 pq mL, p < 0.001). The left atrium to body surface area ratio (LA/BSA) was significantly higher in the AF (+) group (45.03 mm/m2 vs. 42.05 mm/m2, p < 0.01). Independent predictors (based on multiple regression) of AF were vitamin D level (OR = 0.854, 95% CI: 0.805-0.907, p < 0.001) and LA/BSA ratio (OR = 1.077, 95% CI: 1.003-1.156, p < 0.05). The optimal vitamin D cut-off value for the prediction of AF was 16.50 ng/mL, with a sensitivity of 76.0% and specificity of 65.5% (AUC = 0.75, 95% CI: 0.67-0.82).

    CONCLUSIONS: A low plasma vitamin D concentration was strongly associated with AF in patients with chronic HF.

    Be well!

    JP

  11. JP Says:

    Updated 06/11/16:

    onlinelibrary.wiley.com/doi/10.1002/clc.22552/full

    Clin Cardiol. doi: 10.1002/clc.22552

    Association of Physical Fitness With the Risk of Atrial Fibrillation: A Systematic Review and Meta-Analysis.

    Several studies have investigated the role of physical fitness in atrial fibrillation (AF), but the results remain controversial. We aimed to estimate the association between physical fitness and risk of AF. We comprehensively retrieved data from the Cochrane Library, PubMed, and Embase databases until February 29, 2016, for studies evaluating the association of physical fitness with the risk of AF. Data were abstracted from included studies, and effect estimates were pooled using a random-effects model. Six studies with a total of 205 094 participants and 15 919 AF cases fulfilled the inclusion criteria. When physical fitness was assessed as a continuous variable, per incremental increase of physical fitness was associated with a 9% reduced risk of AF (risk ratio [RR]: 0.91, 95% confidence interval [CI]: 0.84-1.00, P = 0.05). When physical fitness was assessed as a categorical variable, the risk of AF was significantly reduced (RR: 0.51, 95% CI: 0.28-0.91, P = 0.02) in individuals with the highest level of physical fitness compared with those with the lowest level. The intermediate vs the lowest level of physical fitness was associated with a 28% reduced risk of AF (RR: 0.72, 95% CI: 0.56-0.93, P = 0.01). The sensitivity analysis indicated that these results were stable. Notably, there was evidence of statistical heterogeneity across studies; therefore, we should interpret the results cautiously. In conclusion, published literature supports that a higher level of physical fitness is associated with a lower risk of AF. Further studies should be performed to confirm these findings.

    Be well!

    JP

  12. JP Says:

    Updated 09/19/16:

    http://www.ncbi.nlm.nih.gov/pubmed/27633625

    J Phys Act Health. 2016 Aug 24:1-14.

    Impact of Hot Yoga on Arterial Stiffness and Quality of Life in Normal and Overweight/Obese Adults.

    BACKGROUND: Obesity is associated with arterial stiffening and diminished quality of life. Bikram yoga may be a feasible alternative to traditional exercise among obese individuals. Accordingly, the purpose of this study was to investigate the impact of Bikram yoga, a heated style of hatha yoga, on arterial stiffness in normal and overweight/obese adults.

    METHODS: Forty three (23 normal body mass index or BMI; 20 overweight/obese) apparently heathy participants completed an 8-week Bikram yoga intervention. Body composition was estimated via dual energy x-ray absorptiometry (DXA), arterial stiffness was measured via brachial-ankle pulse wave velocity and health-related quality of life was assessed via RAND 36-Item Short Form survey at baseline and at the end of the 8-week intervention.

    RESULTS: After the intervention, brachial-ankle pulse wave velocity decreased (p<0.05) in overweight/obese participants while no such changes were observed in normal BMI participants. In the quality of life measures, emotional well-being improved (p<0.05) in both groups, and general health improved (p<0.05) only in the normal weight BMI group.

    CONCLUSION: Bikram yoga ameliorates arterial stiffness in overweight/obese adults and can positively impact quality of life regardless of BMI.

    Be well!

    JP

  13. JP Says:

    Updated 10/02/16:

    http://www.impactjournals.com/oncotarget/index.php?journal=oncotarget&page=article&op=view&path%5B%5D=12243&path%5B%5D=38761

    Oncotarget. 2016 Sep 24.

    Low-dose green tea intake reduces incidence of atrial fibrillation in a Chinese population.

    The aim of the present study was to assessthe association between green tea intake and incidence of atrial fibrillation (AF) in a Chinese population. A total of 801 (mean age: 62 years; 56% male) subjects were enrolled: 401 AF patients and 400 controls. All subjects completed a questionnaire and the associations between their green tea drinking habits and incidence of AF were assessed using the odds ratio (OR) and binary logistic regression. After multivariate adjustment, green tea intake presented as a protective factor against the incidence of AF (OR: 0.349, 95% CI: 0.253-0.483, P < 0.001). The green tea protection showed downward trend with increasing green tea intake (P for the trend= 0.001). Low frequency, low concentration, short-term tea consumption was classified as low-dose green tea intake. Green tea intake decreased the incidence of both paroxysmal AF (OR: 0.307, 95% CI: 0.216-0.436, P < 0.001) and persistent AF (OR: 0.355, 95% CI: 0.261-0.482, P < 0.001) and may be associated with a decreased incidence of AF. This study suggests that low-dose green tea intake strongly protects against AF.

    Be well!

    JP

  14. JP Says:

    Updated 06/08/17:

    http://jaha.ahajournals.org/content/6/6/e005784.long

    J Am Heart Assoc. 2017 Jun 5;6(6).

    Gut-Derived Serum Lipopolysaccharide is Associated With Enhanced Risk of Major Adverse Cardiovascular Events in Atrial Fibrillation: Effect of Adherence to Mediterranean Diet.

    BACKGROUND: Gut microbiota is emerging as a novel risk factor for atherothrombosis, but the predictive role of gut-derived lipopolysaccharide (LPS) is unknown. We analyzed (1) the association between LPS and major adverse cardiovascular events (MACE) in atrial fibrillation (AF) and (2) its relationship with adherence to a Mediterranean diet (Med-diet).

    METHODS AND RESULTS: This was a prospective single-center study including 912 AF patients treated with vitamin K antagonists (3716 patient-years). The primary end point was a composite of MACE. Baseline serum LPS, adherence to Med-diet (n=704), and urinary excretion of 11-dehydro-thromboxane B2 (TxB2, n=852) were investigated. Mean age was 73.5 years; 42.9% were women. A total of 187 MACE (5.0% per year) occurred: 54, 59, and 74 in the first, second, and third tertile of LPS, respectively (log-rank test P=0.004). Log-LPS (hazard ratio 1.194, P=0.009), age (hazard ratio 1.083, P<0.001), and previous cerebrovascular (hazard ratio 1.634, P=0.004) and cardiac events (hazard ratio 1.822, P<0.001) were predictors of MACE. In the whole cohort, AF (versus sinus rhythm) (β 0.087, P=0.014) and low-density lipoprotein cholesterol (β 0.069, P=0.049) were associated with circulating LPS. Furthermore, Med-diet score (β -0.137, P<0.001) was predictive of log-LPS, with fruits (β -0.083, P=0.030) and legumes (β -0.120, P=0.002) negatively associated with log-LPS levels. Log-LPS and log-TxB2 were highly correlated (r=0.598, P<0.001). Log-LPS (β 0.574, P<0.001) and Med-diet score (β -0.218, P<0.001) were significantly associated with baseline urinary excretion of TxB2.

    CONCLUSIONS: In this cohort of AF patients, LPS levels were predictive of MACE and negatively affected by high adherence to Med-diet. LPS may contribute to MACE incidence in AF by increasing platelet activation.

    Be well!

    JP

  15. JP Says:

    Updated 11/06/17:

    http://www.mdpi.com/2072-6643/9/11/1190/htm

    Nutrients 2017, 9(11), 1190

    Red Wine, Resveratrol and Atrial Fibrillation

    Abstract: Atrial fibrillation (AF) is a common cardiac arrhythmia that is associated with increased risk for cardiovascular disease and overall mortality. Excessive alcohol intake is a well-known risk factor for AF, but this correlation is less clear with light and moderate drinking. Besides, low doses of red wine may acutely prolong repolarization and slow cardiac conduction. Resveratrol, a bioactive polyphenol found in grapes and red wine, has been linked to antiarrhythmic properties and may act as an inhibitor of both intracellular calcium release and pathological signaling cascades in AF, eliminating calcium overload and preserving the cardiomyocyte contractile function. However, there are still no clinical trials at all that prove that resveratrol supplementation leads to improved outcomes. Besides, no observational study supports a beneficial effect of light or moderate alcohol intake and a lower risk of AF. The purpose of this review is to briefly describe possible beneficial effects of red wine and resveratrol in AF, and also present studies conducted in humans regarding chronic red wine consumption, resveratrol, and AF.

    Be well!

    JP

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