Obesity Complication of Deep Vein Thrombosis

By Kyle J. Norton

 Obesity is defined as a medical condition of excess body fat has accumulated overtime, while overweight is a condition of excess body weight relatively to the height. According to the Body Mass Index(BMI), a BMI between 25 to 29.9 is considered over weight, while a BMI of over 30 is an indication of obesity. According to the statistic, 68% of American population are either overweight or obese. 

How to calculate your BMI indexBMI= weight (kg)/ height (m2)

 Deep Vein Thrombosis is defined as a condition of blood clot in one of the deep veins of the body, especially in veins of the leg or pelvis that can lead to pain and swelling. it is not life threatening but obstruction of the blood flow in major organ may have a D. How dangerous consequence.

The Association of  Obesity and Deep Vein Thrombosis
According "Recent korean perspective of deep vein thrombosis after total knee arthroplasty" by Kim KI, Cho KY, Jin W, Khurana SS, Bae DK., in a study of 311 consecutive knees in 227 patients for total knee arthroplasty, posted in PubMed, researchers found that there were 9 cases (3.03%) of proximal DVT, 70 cases (23.57%) of distal DVT, and no symptomatic pulmonary embolism. Although this cohort had limited number of patients by a single surgeon, there is still low incidence of proximal DVT in Koreans with rare pulmonary embolism occurrence compared with those of the Western. High postoperative d-dimer levels were correlative, but no appropriate cutoff value was found. Obesity was a significant associated risk factor.

2. According to the study of "Influence of lipids and obesity on haemorheological parameters in patients with deep vein thrombosis" by Vayá A, Falcó C, Simó M, Ferrando F, Mira Y, Todolí J, España F, Corella D., posted in PubMed, researchers concluded that obesity were also independently associated with a greater risk of DVT. The  results suggest that increased EA (erythrocyte aggregation) constitute an independent risk factor for DVT. However, when associated to hyperlipidaemia and obesity it further increases thrombotic risk.

3. In the study of in 665 patients (701 ankles) who underwent primary total ankle replacementof the abstract of "Risk factors for symptomatic deep-vein thrombosis in patients after total ankle replacement who received routine chemical thromboprophylaxis" by Barg A, Henninger HB, Hintermann B., posted in PubMed, researchers indicated that osing a logistic multiple regression model we identified obesity, a previous venous thromboembolic event and the absence of full post-operative weight-bearing as independent risk factors for developing a symptomatic DVT. The incidence of symptomatic DVT after total ankle replacement and use of low-molecular-weight heparin is comparable with that in patients undergoing total knee or hip replacement.

4. According to the study of "Deep-vein thrombosis is associated with large uterine fibroids" by Shiota M, Kotani Y, Umemoto M, Tobiume T, Tsuritani M, Shimaoka M, Hoshiai H., posted in PubMed, researchers wrote in abstract that Pulmonary thromboembolism (PE) may occur upon a patient's first postoperative attempt of ambulation. PE is a serious complication, often leading to shock or sudden death. Reported rates of PE following gynecologic surgery are between 0.3% and 0.8%, while the incidence of postoperative deep-vein thrombosis (DVT), the major cause of PE, is between 17% and 20%. Therefore, effective preventive measures, such as preoperative assessment for asymptomatic DVT, should be considered. It is well known that DVT and/or PE are associated with large uterine fibroids, the common, benign tumor of myometrium. Here, to establish the statistical relationship between DVT risk and uterine fibroid size/weight, we assessed the preoperative DVT rate with respect to three possible risk factors: age, obesity level, and uterine size/weight.

5. In the study of 843 Japanese patients with a preoperative diagnosis of benign ovarian tumor who underwent tumorectomy or adnexectomy at our institution between July 2003 and December 201 of "Risk factors for deep-vein thrombosis and pulmonary thromboembolism in benign ovarian tumor" by Shiota M, Kotani Y, Umemoto M, Tobiume T, Tsuritani M, Shimaoka M, Hoshiai H., posted in PubMed, researchers concluded that patience with age ≥ 50 years and BMI > 25 are independent risk factors for preoperative DVT in Japan.

6. Etc.

 Treatments of Obesity and Deep Vein Thrombosis
1. According to the abstract of "Management of deep vein thrombosis to reduce the incidence of post-thrombotic syndrome" by Lowe GD., posted in PubMed, researchers found that DVT should be individually assessed for the benefits and risks of continued oral anticoagulation, including patient preferences. Risk factors for recurrent DVT include active cancer, pregnancy, continued use of oral oestrogens, male sex, obesity, recurrent thrombosis, established PTS, permanent inferior vena caval filters, residual DVT, high fibrin d-dimer and other thrombophilias. Early walking, continued high levels of physical activity and wearing compression stockings for up to two years may also reduce the risk of PTS.

2. On the study of "Predictors of chronic disease at midlife and beyond--the health risks of obesity" by Nejat EJ, Polotsky AJ, Pal L., posted in PubMed, researchers indicated that A burgeoning pandemic of obesity is well characterized. 41% of U.S. adults are projected to be obese by 2015 and obesity, a potentially modifiable risk, is emerging as a leading predictor of lifetime health. The wide spectrum of morbidities related to excess body mass includes risks for diabetes, hypertension, coronary artery disease, dyslipidemia, malignancy, venous thrombosis, degenerative joint disease, pulmonary compromise, sleep apnea, cholelithiasis, depression and overall reduced quality of life....... Aggressive efforts must be targeted towards population-based strategies to educate and sensitize all generations on contributors to and sequelae of excess body mass as obesity represents one of the few modifiable factors that impact on the quantity and quality of lifespan.

3. Etc.

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At Last! The Natural PCOS Diet

A Naturopath’s Easy Step-by-Step Guide to Overcome PCOS
by Qualified Australian Naturopath And Hormone Health Expert

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The Best Finger food without messy fingers: Cherry Tomatoes with Cheese

Recipe attributed to 30 minutes vegetarian recipes by Marie-laude Morin, Publisher Robert Rose at www,robertrose.ca


Finger food without messy fingers, each tomato is an hors d'oeuvre.
Tips:
Pignuts are the seeds of pinecones. They are fantastic nuts that becomes flavorful once they are toasted.
2 tbsp. pine nuts  30mL
25 cherry tomatoes   25
1/2 cup cream cheese softened  125 mL
Fresh parsley sprigs
1, In a skillet over medium heat, toast pine nuts, stirring constantly for 2 to 5 minutes or until golden and fragrant.
2. Cut top of cherry tomatoes. Remove seeds with small spoon.
3. In a bowl mash together cream cheese. Fill tomatoes with cream cheese mixture and place on serving platter. Garnish with a few frigs of parsley for color.
Variation: Cherry tomatoes with zesty cheese
mash 1/4 tsp. (1mL) smoke paprika and 1tsp. (5mL0 Grated lemon zest into cream cheese before adding pine nuts. make 25.
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The Best topping for pancakes or hot cereal: Breakfast Berry Compote

Everyday Italian by Jean Pare and Sophia De Luca (Original series), Publisher Company's Coming.
You can view their website at www.companycoming.com

Balsami vinegar heightens the berry flavors in this tart topping for pancakes or hot cereal. Also good served chilled over roll or bread.
Frozen mixed berries, thawed  1 cup  250mL
Sliced fresh strawberries  1 cup  250mL
Mixed fruit (or berry) jam  1/2 cup  125mL
balsamic vinegar  2tbsp.  30mL
Ground cinnamon 1/4tsp.  1mL
Combine all 5 ingredients in medium saucepan. Cook uncovered on medium for about 5 minutes, stirring occasionally, until mixture comes to a boil. Makes about 2 cups (500mL).

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Hormone Adionection - The risk of Obesity and Complications

By Kyle J. Norton

Recent study from the renowned institutions suggested that protein Adiponectin may be associated to risk of obesity. Adionection is a protein with function involved in regulating glucose levels as well as fatty acid breakdown. Therefore, it plays a causative role in the development of insulin resistance and cardiovascular disease, through probably mediated the metabolic effects of FGF21, a metabolic hormone, on glucose homeostasis and insulin sensitivity(1a).

Obesity is defined as a medical condition of excess body fat accumulated overtime, while overweight is a condition of excess body weight relatively to the height. According to the Body Mass Index(BMI), a BMI between 25 to 29.9 is considered over weight, while a BMI of over 30 is an indication of obesity. According to the statistic, 68% of American population are either overweight or obese. 

In a study of all the fourth-grade school children (9 or 10 years of age) in the town of Ina during 2005-2008 (N = 1675), Japan, lower levels of adiponectin complexes were associated to in the abdominal obesity group than in the non-abdominal obesity group regardless of sex. In fact the impact of abdominal obesity was larger in boys than in girls(1).

Indeed, the alternation and mutation of adiponectin gene were also found to contribute to the genetic risk towards the development of  obesity, in the south Indian population study by the Madras Diabetes Research Foundation-ICMR Advanced Centre for Genomics of Type 2 Diabetes and Dr. Mohan's Diabetes Specialities Centre(2).

But in the study of calorie-restricted low-fat and low-carbohydrate diets (LFD and LCD among overweight and obese premenopausal women, researchers suggested that in these diet patterns serum leptin, but not adiponectin is found to effect on obesity's complications(3). In support of the above, the West China Medical School study showed that Leptin, the product of the obese gene, is an adipocyte-secreted protein hormone playing a key role in the progression of obesity(4)

The Russian study indicated the evaluation of metabolic disorders and adipokine synthesis in obese patients may optimize the diagnosis of type 2 diabetes mellitus and cardiovascular diseases and to personalize diet therapy(5).

Adiponectin receptor 1 agonists, matairesinol, arctiin, (-)-arctigenin and gramine, may be potential drug-candidates for hypoadiponectin related diseases, such as obesity(6)

Taken altogether, adipokine  synthesis is associated to risk of obesity, but the question of low level of adiponectin induces obesity or obesity causes lower levels of adiponectin remains largely unknown. Leptin, another member of adipokine  may be used as biomarker in management of the progression of the disease and its complications. As always, all articles written by Kyle J. Norton are for information & education only, please consult your Doctor & Related field specialist before applying
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References
(1a) Adiponectin mediates the metabolic effects of FGF21 on glucose homeostasis and insulin sensitivity in mice by Lin Z¹, Tian H, Lam KS, Lin S, Hoo RC, Konishi M, Itoh N, Wang Y, Bornstein SR, Xu A, Li X.(PubMed)

(1) Abdominal obesity and serum adiponectin complexes among population-based elementary school children in Japan: a cross-sectional study by Ochiai H¹, Shirasawa T, Nishimura R, Nanri H, Ohtsu T, Hoshino H, Tajima N, Kokaze A.(PubMed)
(2) Genetic association of ADIPOQ gene variants with type 2 diabetes, obesity and serum adiponectin levels in south Indian population by Ramya K¹, Ayyappa KA, Ghosh S, Mohan V, Radha V.(PubMed)
(3) Favorable effects of low-fat and low-carbohydrate dietary patterns on serum leptin, but not adiponectin, among overweight and obese premenopausal women: a randomized trial by Llanos AA¹, Krok JL², Peng J³, Pennell ML³, Olivo-Marston S¹, Vitolins MZ³, Degraffinreid CR², Paskett ED(PubMed)
(4) Synthesis and biological evaluation of novel urea- and guanidine-based derivatives for the treatment of obesity-related hepatic steatosis by Liang X¹, Pei H², Ma L³, Ran Y⁴, Chen J⁵, Wang G⁶, Chen L⁵.(PubMed)
(5) [Adipokines and the metabolism of key nutrients in patients with obesity].

[Article in Russian] by Kirillova OO, Vorozhko IV, Gapparova KM, Chekhonina IuG, Sentsova TB, Tutel'ian VA.(PubMed)
(6) Identification of adiponectin receptor agonist utilizing a fluorescence polarization based high throughput assay by Sun Y¹, Zang Z, Zhong L, Wu M, Su Q, Gao X, Zan W, Lin D, Zhao Y, Zhang Z.(PubMed)

Egg and scallion fried rice

Recipe attributed to 125 best  Chinese recipes by Bill Jones and Stephen Wong, published by Robert Rose.

1 tbsp. vegetable oil  15 mL
1 egg, beaten  1
salt and pepper to taste
1 tbsp. minced ginger root  15mL
2 green onions, finely chopped   2
2tbsp. chicken stock   25mL
2 tbsp. red bell pepper, finely chopped  25mL
3 cups cooked rice  750mL
salt and pepper to taste
1. in a non stick wok or large skillet, heat 1/2 tbsp. (7mL) oil over medium heat. Add eggs and cook to make a thin omelet by swirling the pan so the eggs flow onto as large as possible. Season lightly with salt and pepper. Remove, chopped coarsely and set aside.
2. heat remaining oil in wok over medium heat. Add ginger root and onions; stir-fry until fragrant, about 30 seconds. Add stock and red pepper; stir briefly. Add rice; stir-fry until well mixed and the grains are separated, about 2 minutes. Ass omelet pieces and stir to mix well. Season with salt and pepper; stir to mix. Serve immediately. Serving 4.
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The Quick and Healthy recipe: Sweet pepper crostini

Recipe attributed to Everyday Italian by Jean Pare and Sophia De Luca (Original series), Publisher Company's Coming.
You can view their website at www.companycoming.com

Easy and versatile recipe are the best friend of any cook. This recipe comes together quickly and can be served hot or cold. Goat cheese and fresh basil add a special touch.
Olive oil  1tbsp.  15mL
Thinly sliced red pepper  11/2 cups  375 mL
Thinly sliced yellow pepper  1/12 cup  375mL
Garlic cloves, thinly sliced  3   3
Salt sprinkle
Pepper, sprinkle
Whole wheat baguette bread slices, cut diagonally 1/4 inch (6mm) thick  18    18
Goat (Chevre) cheese, cut up  3Oz.  85g
Finely shredded basil  2tbsp.  30mL
Heat olive oil in large frying pan on medium. Add next 5 ingredients. Cook to about 15 minutes, stirring occasionally, until peppers are softened.
Arrange bread slices on ungreased baking sheet. Broil on top rack in oven for about 1 minute per side until golden.
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Papaya and Diabetes

 People with Type II Diabetes may be thinking to add whole food papaya into their diet. the recent study suggested(1) ,
The finding not only showed the effectiveness of unripe pawpaw fruit (Carica papaya) in inhibition α-amylase, α-glucosidase, but also induced lipid peroxidation in a dose-dependent manner, in rat pancreas(1).
The key enzymes of α-amylase, α-glucosidase, involved in the digestion of carbohydrates, have been linked to onset of type 2 diabetes. Inhibition of these enzymes can significantly reduce the post-prandial increase of blood glucose and have been considered by therapists in use for management of blood glucose level in type 2 diabetic and borderline patients(2).

In streptozotocin-induced diabetic rats study, the aqueous extract of leaves of C. papaya administered strongly controlled blood glucose levels(3), through prevention of hepatocyte disruption, as well as accumulation of glycogen and lipids via its hypoglycemic and antioxidant effect(4)

Diabetes is defined as a condition caused by insufficient insulin entering the bloodstream to regulate the glucose. It is either caused by cells in pancreas dying off or receptor sites clogged up by fat and cholesterol. In some cases, diabetes is also caused by allergic reactions of cells in the immune system.

In a new study, conducted by the researchers at the Davis Heart and Lung Research Institute, fermented papaya preparation was tested whether it improves dermal wound healing outcomes in adult diabetic mice by preventing the  risk of infections(5).
The result was astonishing, the fermentation not only up regulated the Sp1 DNA binding activity(modulating the cellular response to DNA damage) in Peripheral blood mononuclear cells (PBMC) but also the protein and mRNA expression of Rac2(regulates a number of cellular functions)(5).

A randomized controlled clinical trial conducted at the Cardiac Centre, ANDI Centre of Excellence for Biomedical and Biomaterials Research and Department of Biosciences University of Mauritius, showed that oral administration of 6g FPP®/day for a period of 14 weeks could improve the general health status of several organs targeted by oxidative stress during diabetes and suggested that the supplement may be used in the management the complications of diabetes such as cardiovascular disease, neurological disease and other conditions worsened by overt inflammation and oxidative stress(6).

Taken altogether, unripe, fermented papaya and its' leaves may be effective in diabetic management  through controlling the levels of glucose and  reduced risk of complications.

Some Western researchers insisted that large sample size and multi center studies are necessary to validate its effectiveness by identifying the ingredients which are comparable to recently pharmaceutical medicine in use because geography, environment, time of harvest, etc. may influence the concentration of the food cultivation.
 In fact, herbalists have longly acknowledged that the external factors (mentioned above) may alter the quality of the herbs and foods by classifying these difference either through price or formula differentiation. In deed, the effectiveness with little or no adverse side effects of the formula is not the concentration of individual herb and a herb itself but the interaction of all ingredients in a herb and herbs in the same formula. Extracting only one ingredient of the herb for treatment of certain diseases may be effective but enhanced complicative consequences. As always, all articles written by Kyle J. Norton are for information & education only, please consult your Doctor & Related field specialist before applying.


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References
(1) Inhibition of key enzymes linked to type 2 diabetes and sodium nitroprusside-induced lipid peroxidation in rat pancreas by water-extractable phytochemicals from unripe pawpaw fruit (Carica papaya) by Oboh G, Olabiyi AA, Akinyemi AJ, Ademiluyi AO.(PubMed)
(2) Natural products as alpha-amylase and alpha-glucosidase inhibitors and their hypoglycaemic potential in the treatment of diabetes: an update by Tundis R¹, Loizzo MR, Menichini F.(PubMed)
(3) Antihyperglycemic and hypolipidemic activities of aqueous extract of Carica papaya Linn. leaves in alloxan-induced diabetic rats by Maniyar Y, Bhixavatimath P.(PubMed)
(4) Hypoglycemic effect of Carica papaya leaves in streptozotocin-induced diabetic rats by Juárez-Rojop IE¹, Díaz-Zagoya JC, Ble-Castillo JL, Miranda-Osorio PH, Castell-Rodríguez AE, Tovilla-Zárate CA, Rodríguez-Hernández A, Aguilar-Mariscal H, Ramón-Frías T, Bermúdez-Ocaña DY.(PubMed)
(5) Correction of aberrant NADPH oxidase activity in blood-derived mononuclear cells from type II diabetes mellitus patients by a naturally fermented papaya preparation by Dickerson R¹, Deshpande B, Gnyawali U, Lynch D, Gordillo GM, Schuster D, Osei K, Roy S.(PubMed)
(6) Effects of a short term supplementation of a fermented papaya preparation on biomarkers of diabetes mellitus in a randomized Mauritian population by Somanah J¹, Aruoma OI, Gunness TK, Kowelssur S, Dambala V, Murad F, Googoolye K, Daus D, Indelicato J, Bourdon E, Bahorun T.(PubMed)