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Monday, March 4, 2019

Eating how much Nuts is Safe for you?

Posted by Dr Prahallad Panda on 9:43 AM Comments


It is generally accepted that eating nuts keep heart healthy. Generally, nuts contain fats, though unsaturated (Good Fat), high in energy; consuming a lot, may not be a good idea. Let’s have an idea about the amount of nuts to be consumed safely.

Can eating nuts help heart?

A number of researches suggest that nuts are heart friendly. However, the evidences are still inconclusive. But, unless someone is allergic to nuts, it is a great idea to have nuts in snacks and include as part of heart-healthy balanced diet.
Nuts may help by mobilizing the low-density lipoproteins (LDL, or "bad") cholesterol to liver for metabolism. LDL plays a major role in the development of plaque that builds up on the blood vessels. Eating nuts has also been linked to lower levels of inflammation linked to heart disease.
Eating nuts may also reduce risk of developing blood clots in the arteries of heart by improving the inner lining (endothelium) of the coronary (heart arteries) arteries.

What's in nuts that might make them heart healthy?

Besides being packed with protein, most nuts contain at least some of these heart-healthy substances:
  • Unsaturated fats. It's not entirely clear why, but it's thought that the "good" fats in nuts — both monounsaturated and polyunsaturated fats, lower bad cholesterol levels. Omega-3 fatty acids is one of the polyunsaturated fatty acids, found in many kinds of fishes, but many nuts are also rich in omega-3 fatty acids.
  • Fiber. All nuts contain fiber, which helps lower cholesterol. Fiber, as not digested in full, makes tummy feel full and decreases appetite; hence, intake of food gets reduced. Dietary fibers also have many health benefits.
  • Vitamin E. Vitamin E may help stop the development of plaques in arteries, which can narrow them. Plaque development in arteries can lead coronary artery disease, leading to a heart attack.
  • Plant sterols. Some nuts contain plant sterols, a substance that can help lower cholesterol.
  • L-arginine. Nuts are also a source of l-arginine, which is a substance that may help improve the health of arterial walls by making them more flexible and less prone to blood clots that can block blood flow.

What amount of nuts is considered healthy?

As much as 80 percent of a nut is fat. Even though most of this fats are healthy, are packed with a lot of calories (One gram of fat yields 9 Calories, whereas, one gram of glucose/protein yields 4 calories) . That's why, one should eat nuts in moderation. Ideally, you should use nuts as a substitute for saturated fats, such as those found in meats, eggs and dairy products.
The American Heart Association recommends eating about four servings of unsalted nuts a week. Select raw or dry-roasted nuts, rather than those cooked in oil.
A serving is a small handful (1.5 ounces; one ounce is 28. 4 grams) of whole nuts or 2 tablespoons of nut butter. But again, do this as part of a heart-healthy diet. Just eating nuts and not cutting back on saturated fats found in many dairy and meat products won't do your heart any good.

Does it matter what kind of nuts you eat?

The type of nuts you choose to eat probably doesn't matter much. Most nuts appear to be generally healthy, though some may have more heart-healthy nutrients than others. For example, walnuts contain high amounts of omega-3 fatty acids.
Almonds, macadamia nuts, hazelnuts and pecans are other nuts that appear to be quite heart healthy. And peanuts — which are technically not a nut, but a legume, like beans — seem to be relatively healthy.

Keep in mind, you could end up canceling out the heart-healthy benefits of nuts if they're covered with chocolate, sugar or salt.
Here's some nutrition information on common types of nuts. All calorie and fat content measurements are for 1 ounce, or 28.4 grams (g), of unsalted nuts.
Type of nut
Calories
Total fat
Almonds, dry-roasted
170
14.9 g
Almonds, raw
164
14.2 g
Brazil nuts, raw
187
19 g
Cashews, dry-roasted
163
13.1 g
Chestnuts, roasted
69
0.6 g
Hazelnuts (filberts), dry-roasted
183
17.7 g
Hazelnuts (filberts), raw
178
17.2 g
Macadamia nuts, dry-roasted
204
21.6 g
Macadamia nuts, raw
204
21.5 g
Peanuts, dry-roasted
166
14.1 g
Pecans, dry-roasted
201
21.1 g
Pistachios, dry-roasted
162
13 g
Walnuts, halved
185
18.5 g

How about nut oils? Are they healthy, too?

Nut oils are also a good source of healthy nutrients, but they lack the fiber found in whole nuts. Walnut oil is the highest in omega-3s.
Consider using nut oils in homemade salad dressing or in cooking. When cooking with nut oils, remember that they respond differently to heat than do vegetable oils.
Nut oil, if overheated, can become bitter. Just like with nuts, use nut oil in moderation, as the oils are high in fat and calories.
The original article was published in MyoClinic, which can be accessed here.
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Thursday, January 17, 2019

Whether Aspirin or Statin in Primary Prevention or Cardiovascular Disease (CVD

Posted by Dr Prahallad Panda on 8:16 PM Comments


Aspirin, chemically acetylsalicylic acid, has been a trusted pal of health-care providers for more than 100 years by now. Many beneficial effects, including benefits in certain heart diseases & colo-rectal cancer, came to light in the recent past, adding many feathers to its’ cap.
Aspirin has been a staple of primary prevention of cardiovascular disease (CVD) in at-risk populations based on recommendations by major organizations including the American Heart Association (AHA) together with the American College of Cardiology (ACC), US Preventive Services Task Force (USPSTF) and others. Accordingly, aspirin became one of the most commonly used medications for primary prevention of CVD, and it is estimated that 40% of US adults over 50 years of age use aspirin for this purpose.
The AHA Prevention Guidelines published in 1997 did not recommend aspirin use for primary prevention, citing the need for additional research. Major primary prevention studies completed from 1988 to 2001, including the British Doctors Study (BDS), US Physicians' Health Study (PHS), Thrombosis Prevention Trial (TPT), Hypertension Optimal Treatment (HOT) and low-dose aspirin trial of the Primary Prevention Project (PPP) trials, led the USPSTF and AHA to adopt recommendations for aspirin (75-100 mg/day, or 325 mg every other day) for primary prevention in 2002, particularly for high-risk individuals (5-year CVD risk ≥3%).
However, more recent studies did not demonstrate clear benefit of aspirin, including the Prevention of Progression of Arterial Disease and Diabetes (POPADAD), Japanese Primary Prevention of Atherosclerosis with Aspirin for Diabetes (JPAD), Aspirin for Asymptomatic Atherosclerosis (AAA) and Japanese Primary Prevention Project (JPPP). In 2016, the USPSTF Guidelines were pared back, recommending aspirin for CVD and colorectal cancer prevention in adults aged 50 to 59 with a 10-year ASCVD risk of at least 10% without increased risk of bleeding and with life expectancy of at least 10 years (Grade B). Aspirin use in adults aged 60 to 69 who have the same risk requires an individualized approach based on a weaker recommendation (Grade C).
The recent contribution of the ARRIVE (Aspirin to Reduce Risk of Initial Vascular Events) , ASCEND (A Study of Cardiovascular Events in Diabetes) and ASPREE (Aspirin in Reducing Events in the Elderly) trials provides useful insight into the role of aspirin use for primary prevention in the modern era, when there is decrease in smoking, better control of cholesterol, lifestyle modification & increased use of statins.
It can be concluded that for primary prevention, in which risk is determined largely by age and the presence or absence of diabetes, the benefit–risk ratio for prophylactic aspirin in current practice is exceptionally small.
In contrast, for secondary prevention, in which risk is determined largely by the extent of atherosclerotic disease, the benefits of aspirin outweigh the risks of bleeding. Visit the NEJM here.
Therefore, beyond diet maintenance, exercise, and smoking cessation, the best strategy for the primary prevention of cardiovascular disease may simply be to replace aspirin with a statin.
Its’ use can be narrowed to the highest-risk populations, including individuals aged 40 to 70 years old without diabetes with 10-year ASCVD ≥20% or patients with diabetes with ASCVD ≥10%, provided they are not at high-risk of bleeding.See the ACC recommendation. 

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Saturday, July 28, 2018

USFDA Approved Tafenoquine for Radical Cure of Vivax Malaria

Posted by Dr Prahallad Panda on 7:32 PM Comments


The FDA approved tafenoquine (Krintafel, GSK) for the "radical cure" of Plasmodium vivax malaria in patients, ages ≥16 years, who are receiving anti-malarial therapy for acute infection, the manufacturer GlaxoSmithKline (GSK) announced.


Life Cycle of P. Vivax



At present, Primaquine is the only FDA approved drug prescribed for 14 days for the radical cure of Vivax Malaria. Tafenoquine 300 will be a single dose therapy for patients over 16 years.   






The newly approved drug is contraindicated for patients who are allergic to tafenoquine or other 8-aminoquinoline-containing agents, as well as for those who are glucose-6-phosphate dehydrogenase (G6PD) deficient. Patients should be tested if their status is unknown.
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