Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:

Monday, February 13, 2017

Mediterranean Diet Boosts HDL Function

Pretty much useless information. They don't point to a SPECIFIC diet protocol. But it is great conscious laundering for them, thinking they are providing help.
  • by
    Staff Writer, MedPage Today
  • This article is a collaboration between MedPage Today® and:
    Medpage Today

Action Points

  • Adherence to a traditional Mediterranean diet (TMD) enriched with virgin olive oil improved HDL function in humans, according to a year-long dietary study.
  • Note that the data indicated a dissociation between the effects of a TMD on HDL-C levels, which trended lower, versus effects on HDL cholesterol efflux capacity (CEC), which was significantly increased.
A Mediterranean diet rich in virgin olive oil improved high-density lipoprotein (HDL) function in individuals with high-cardiovascular risk, reported researchers.
Compared with both a traditional Mediterranean diet (TMD) enriched with nuts and a low-fat control diet, adherence to a TMD enriched with olive oil decreased cholesteryl ester transfer protein activity (relative to baseline, P=0.028), reported Montserrat Fitó, MD, PhD, coordinator of the Cardiovascular Risk and Nutrition Research Group at the Hospital del Mar Medical Research Institute in Barcelona, and colleagues.
It also increased HDL's ability to esterify cholesterol, paraoxonase-1 arylesterase activity, and HDL vasodilatory capacity (relative to control, P=0.039, P=0.012, and P=0.026, respectively), they wrote in Circulation.
"Following a Mediterranean diet rich in virgin olive oil could protect our cardiovascular health in several ways, including making our 'good cholesterol' work in a more complete way," Fitó stated in a press release.
Writing in an accompanying editorial, Daniel J. Radar, MD, of the University of Pennsylvania in Philadelphia, noted that the findings increase understanding of how dietary intervention can affect HDL functionality.
"Hernáez et al demonstrate a dissociation between the effects of a TMD on HDL-C levels (trending lower) versus on HDL CEC [cholesterol efflux capacity] (significantly higher) and greater positive effects of the TMD on CEC compared with those of a low-fat diet.
"Although efforts to promote HDL CEC through pharmacological means are still in clinical development, these results indicate that a Mediterranean diet is a practical lifestyle-focused approach to improving HDL function and has the proven benefit of reducing cardiovascular risk and the potential to reduce the progression of age-related macular degeneration. Whether promotion of HDL CEC causally contributes to the benefits of the Mediterranean diet remains to be established," he wrote online.
Fitó and colleagues randomly selected a subsample of 296 people at high risk of cardiovascular disease among those participating in the PREDIMED (PREvención con DIeta MEDiterránea) study. The participants (mean age 66) provided blood samples at both the beginning and the end of the 1-year study period. They were randomly assigned to one of three diets:
  • A traditional Mediterranean diet enriched with virgin olive oil (about 4 tablespoons) each day (n=100)
  • A traditional Mediterranean diet enriched with extra nuts (about a fistful) each day (n=100)
  • A healthy "control" diet that reduced consumption of red meat, processed food, high-fat dairy products and sweets (n=96)
Both Mediterranean diets emphasized fruits, vegetables, legumes, and whole grains, as well as moderate amounts of fish and poultry.
Using statistical analyses, Fitó's team assessed the effects of both TMDs on the role of HDL particles on reverse cholesterol transport (cholesterol efflux capacity, HDL ability to esterify cholesterol, and cholesteryl ester transfer protein activity), HDL antioxidant properties (paraoxonase-1 arylesterase activity and total HDL antioxidant capacity on low-density lipoproteins), and HDL vasodilatory capacity (HDL ability to induce the release of nitric oxide in endothelial cells).
The researchers also studied the effects of a TMD on several HDL quality-related characteristics (HDL particle oxidation, resistance against oxidative modification, main lipid and protein composition, and size distribution).
Fitó and colleagues found a decline in total cholesterol levels among those on the low-fat control diet (P=0.039 and P=0.007 relative to baseline and the TMD olive oil, respectively) -- mainly due to a decrease in LDL cholesterol levels (P=0.019 and P=0.004 relative to baseline and the TMD olive oil, respectively).
The TMD with olive oil and with nuts both increased cholesterol efflux capacity relative to baseline (P=0.018 and P=0.013, respectively), but the low-fat diet did not yield significant results.
Additionally, the content of triglycerides in HDL core decreased significantly after both the TMD olive oil and TMD nuts interventions compared with the low-fat diet (P=0.027 and P=0.035, respectively).
All three diets increased the percentage of large HDL particles (relative to baseline, P<0 .001="" p=""> Fitó and colleagues wrote they were surprised that the low-fat diet, which was rich in fruits and vegetables just like the Mediterranean diets, had a negative impact on HDL's anti-inflammatory properties.
They also discussed several possible explanations for the TMD-mediated increase in HDL functionality, including an improvement in the oxidative status of the lipoprotein and a better HDL composition profile.
Radar, too, had several theories for the differences observed between the TMD and the low-fat diet: "One possible difference is alcohol intake. The TMD participants were instructed that 'when the volunteer consumed alcohol, to moderately drink red wine (1 small glass/meal),' whereas the low-fat diet participants were given no similar instructions. Alcohol consumption is known to influence HDL-C levels and has been shown in a small experimental study to promote CEC."
The researchers concluded that "further studies are warranted to investigate the mechanism by which the TMD improves HDL function and whether these properties convey cardioprotective effects."
"Our study could be useful to remind that the Mediterranean Diet is beneficial even through unexpected mechanisms, highlighting again the importance of taking care of our cardiovascular health through a simple and cheap way such as a healthy diet," Fitó explained to MedPage Today.
Studying the cardioprotective mechanisms of an antioxidant-rich diet may contribute to the development of future therapeutic targets oriented to improve HDL functions, he added.
Study limitations were the inclusion of elderly people at high cardiovascular risk which may prevent extrapolation of the results to the general population.
Fitó noted a final limitation: "Some of the techniques used to measure HDL functions, although they were non-invasive and highly-sensitive, were in vitro simulations of processes that happen in our arteries (such as the removal of cholesterol or the ability of HDLs to induce the relaxation of blood vessels). These tests may not fully reflect the real complexity of the previous cardiovascular phenomena," he wrote to MedPage Today.

This work was funded by Agència de Gestió d'Ajuts Universitaris i de Recerca, CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, and the Spanish Ministry of Education, Culture and Sport.
The researchers reported no financial disclosures of interest.

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