Effect of sesame seed on lipid profile and redox status in hyperlipidemic patients Antihypertensive and antioxidant effects of dietary black sesame meal in pre-hypertensive humans Sesame supplementation does not improve cardiovascular disease risk markers in overweight men and women. Ardeh (Sesamum indicum) could improve serum triglycerides and atherogenic lipid parameters in type 2 diabetic patients: a randomized clinical trial. A pilot study of open label sesame oil in hypertensive diabetics. Effect of Sesame Oil on Diuretics or ß-blockers in the Modulation of Blood Pressure, Anthropometry, Lipid Profile, and Redox Status Sesame ingestion affects sex hormones, antioxidant status, and blood lipids in postmenopausal women. Olive and Sesame Oil Effect on Lipid Profile in Hypercholesterolemic Patients, Which Better? Linoleic Acid, Other Fatty Acids, and the Risk of Stroke Conjugated linoleic acid improves glycemic response, lipid profile, and oxidative stress in obese patients with non-alcoholic fatty liver disease: a randomized controlled clinical trial Effects of high- and low-isoflavone soyfoods on blood lipids, oxidized LDL, homocysteine, and blood pressure in hyperlipidemic men and women. Beneficial effects of a soy-based dietary supplement on lipid levels and cardiovascular risk markers in type 2 diabetic subjects. Lipid-lowering effect of polyunsaturated fatty acids in hemodialysis patients. Effect of long-term treatment with antioxidants (vitamin C, vitamin E, coenzyme Q10 and selenium) on arterial compliance, humoral factors and inflammatory markers in patients with multiple cardiovascular risk factors Relation of Consumption of Vitamin E, Vitamin C, and Carotenoids to Risk for Stroke among Men in the United States Dietary fats and dietary cholesterol and risk of stroke in women. Effect of an Indo-Mediterranean diet on progression of coronary artery disease in high risk patients (Indo-Mediterranean Diet Heart Study): a randomised single-blind trial
Pre- clinical studies suggest that sesame and its lignans induce beneficial changes in risk factors related to cardiovascular disease . This study was design ed to investigate the effects of sesame on reducing serum lipids and enhancing antioxidant capacity in 38 hyperlipidemic patients who were divided into two groups r and omly . For all individuals along the 60 days of study period , the same drug treatments were considered . Intervention group patients were supposed to eat 40 g white sesame seeds daily , and instead of these calories , 240 kcal was removed from their diet . Anthropometric measurements including height , weight and body mass index ( BMI ) were measured . We assessed lipid profile and oxidative stress indicators such as glutathione peroxidase ( GPX ) , superoxide dismutase ( SOD ) and thiobarbituric acid reactive substances ( TBARS ) before and after the intervention . Significant differences among and between the groups were determined by independent t-test and paired sample t-test using 13th version of statistical package for the social sciences . The results showed that the diet with sesame significantly decreased the levels of serum total cholesterol ( TC ) and low-density lipoprotein cholesterol ( LDL-C ) and TC/HDL-C ratio . Lipid peroxidation ( TBARS ) decreased while the activities of GPX and SOD were increased . There were no significant changes in anthropometric indexes such as weight and BMI after consumption of sesame . The results suggested that sesame seed supplementation decreased serum TC , LDL-C and lipid peroxidation , and increased antioxidant status in hyperlipidemic patients Background It has been known that hypertension is an independent risk factor for cardiovascular disease ( CVD ) . CVD is the major cause of morbidity and mortality in developed and developing countries . Elevation of blood pressure ( BP ) increases the adverse effect for cardiovascular outcomes . Prevention of increased BP plays a crucial role in a reduction of those outcomes , leading to a decrease in mortality . Therefore , the purpose of this study was to investigate the effects of dietary black sesame meal on BP and oxidative stress in individuals with prehypertension . Methods Twenty-two women and eight men ( aged 49.8 ± 6.6 years ) with prehypertension were r and omly divided into two groups , 15 subjects per group . They ingested 2.52 g black sesame meal capsules or placebo capsules each day for 4 weeks . Blood sample s were obtained after overnight fasting for measurement of plasma lipid , malondialdehyde ( MDA ) and vitamin E levels . Anthropometry , body composition and BP were measured before and after 4-week administration of black sesame meal or a placebo . Results The results showed that 4-week administration of black sesame meal significantly decreased systolic BP ( 129.3 ± 6.8 vs. 121.0 ± 9.0 mmHg , P < 0.05 ) and MDA level ( 1.8 ± 0.6 vs. 1.2 ± 0.6 μmol/L , P < 0.05 ) , and increased vitamin E level ( 29.4 ± 6.0 vs. 38.2 ± 7.8 μmol/L , P < 0.01 ) . In the black sesame meal group , the change in SBP tended to be positively related to the change in MDA ( R = 0.50 , P = 0.05 ) , while the change in DBP was negatively related to the change in vitamin E ( R = -0.55 , P < 0.05 ) . There were no correlations between changes in BP and oxidative stress in the control group . Conclusions These results suggest the possible antihypertensive effects of black sesame meal on improving antioxidant status and decreasing oxidant stress . These data may imply a beneficial effect of black sesame meal on prevention of CVD BACKGROUND AND AIMS Pre- clinical studies suggest that sesame and its lignans induce beneficial changes in risk factors related to cardiovascular disease and increase the bioavailability of mammalian lignans . However , only very few intervention trials have investigated the potential bioactivities of sesame in humans . We aim ed to investigate the effects of sesame supplementation in humans on blood lipids , blood pressure , systemic oxidative stress , inflammatory biomarkers and mammalian lignan metabolism . METHODS AND RESULTS We conducted a r and omized , placebo-controlled cross-over intervention trial at a university research centre . Overweight or obese men and women ( n=33 ) consumed 25g/d of sesame ( approximately 50mg/d of sesame lignan ) and an iso-caloric placebo matched for macronutrient composition for 5 wks each . Each intervention period was preceded by a 4-wk washout period . Blood lipid profiles , day time ambulatory blood pressure , oxidative stress and inflammatory biomarkers and urinary mammalian lignans were measured before and after each intervention . Results are presented as the effect of sesame supplementation relative to placebo .  Urinary excretion of the mammalian lignans , enterolactone and enterodiol , increased by approximately 8-fold ( P<0.001 ) . Blood lipids and blood pressure were not altered . In addition , markers of systemic inflammation ( C-reactive protein , interleukin-6 , tumor necrosis factor-alpha ) and lipid peroxidation ( F(2)-isoprostanes ) were not affected . CONCLUSION Supplementation with 25g/d of sesame can significantly increase the exposure to mammalian lignans . However , this did not cause any improvement in markers of cardiovascular disease risk in overweight or obese men and women BACKGROUND Data suggest that sesame seeds have properties beneficial to modulating lipid disorders and decreasing cardiovascular disease ( CVD ) risk factors . The aim of this study was to investigate the effects of Ardeh , paste of ground unhulled sesame seeds , on lipid profiles and atherogenic lipid parameters . METHODS This r and omized clinical trial included 41 patients with type 2 diabetes , who were r and omly assigned to one of the two groups : group A ( Ardeh 28 g/d , n = 21 ) and group B ( control , n = 20 ) . After an initial two-week washout period , the patients in group A , replaced a part of their usual breakfast with two tablespoon ( tbsp ) ( ~ 28 g ) Ardeh , while group B patients continued the usual breakfast meal for six weeks ; energy content of both breakfast meals was maintained in the same range . Anthropometric measures , blood pressure , serum levels of total cholesterol ( TC ) , triglycerides ( TG ) , LDL-C , HDL-C , and atherogenic index of plasma ( AIP ; log TG/HDL-C ) , TC/HDL-C ratio , and LDL/HDL-C ratio were determined at baseline and six weeks later . RESULTS After six weeks , there were significant decreases in serum TG ( 15.3 mg/dL ) and AIP ( 39 % ) in group A. Moreover , slight decreases in serum TC , LDL-C , and other atherogenic lipid parameters and a mild increase in HDL-C also were observed during Ardeh supplementation . Anthropometric measures and blood pressure were unchanged during the study period in both groups . CONCLUSION Ardeh could have favorable effects in decreasing CVD risk factors in type 2 diabetics The objective of this study was to investigate the effect of sesame oil in hypertensive diabetics medicated with atenolol ( beta-blocker ) and glibenclamide ( sulfonylurea ) .  This open label trial with two intervention periods comprised 22 male and 18 female patients , 45 - 65 years old , with mild to moderate hypertension and diabetes .  Sesame oil ( Idhayam Gingelly oil , V.V.V. & Sons , Virudhunagar , Tamilnadu , India ) was supplied to the patients , who were instructed to use it in place of other cooking oils for 45 days . Blood pressure ( BP ) , anthropometric measurements , plasma glucose , glycated hemoglobin ( HbA1c ) , lipid profiles [ total cholesterol , low-density lipoprotein cholesterol ( LDL-C ) , and high-density lipoprotein cholesterol , and triglycerides ( TG ) ] , lipid peroxidation [ thiobarbituric acid-reactive substances ( TBARS ) ] , electrolytes ( sodium , potassium , and chloride ) , and enzymic ( superoxide dismutase , glutathione peroxidase , and catalase ) and nonenzymic ( vitamin C , vitamin E , beta-carotene , and reduced glutathione ) antioxidants were measured at baseline and after 45 days of sesame oil substitution . The same patients were then switched over to other oils like palm or groundnut oils as their regular oils at r and om for another 45 days , and the investigations were carried out again at the end . Systolic and diastolic BP decreased remarkably . When oil substitution was withdrawn , BP values rose again . Body weight , body mass index , girth of waist , girth of hip , and waist : hip ratio were reduced upon substitution of sesame oil .  Plasma glucose , HbA1c , TC , LDL-C , and TG were decreased . TBARS level was reduced , while the activities of enzymic and the levels of nonenzymic antioxidants were increased . Plasma sodium levels were reduced , while potassium levels were elevated . These results indicate that substitution of sesame oil as the sole edible oil has an additive effect in further lowering BP and plasma glucose in hypertensive diabetics The study was undertaken to investigate the effect of sesame oil in hypertensive patients who were on antihypertensive therapy either with diuretics ( hydrochlorothiazide ) or ß-blockers ( atenolol ) . Thirty-two male and 18 female patients aged 35 to 60 years old were supplied sesame oil ( Idhayam gingelly oil ) and instructed to use it as the only edible oil for 45 days . Blood pressure , anthropometry , lipid profile , lipid peroxidation , and enzymic and non-enzymic antioxidants were measured at baseline and after 45 days of sesame oil substitution . Substitution of sesame oil brought down systolic and diastolic blood pressure to normal . The same patients were asked to withdraw sesame oil consumption for another 45 days , and the measurements were repeated at the end of withdrawal period . Withdrawal of sesame oil substitution brought back the initial blood pressure values . A significant reduction was noted in body weight and body mass index ( BMI ) upon sesame oil substitution . No significant alterations were observed in lipid profile except triglycerides . Plasma levels of sodium reduced while potassium elevated upon the substitution of sesame oil .  Lipid peroxidation ( thiobarbituric acid reactive substances [ TBARS ] ) decreased while the activities of superoxide dismutase ( SOD ) , catalase ( CAT ) , and the levels of vitamin C , vitamin E , ß-carotene , and reduced glutathione ( GSH ) were increased . The results suggested that sesame oil as edible oil lowered blood pressure , decreased lipid peroxidation , and increased antioxidant status in hypertensive patients Sesame ingestion has been shown to improve blood lipids in humans and antioxidative ability in animals . Sesamin , a sesame lignan , was recently reported to be converted by intestinal microflora to enterolactone , a compound with estrogenic activity and also an enterometabolite of flaxseed lignans , which are known to be phytoestrogens . Whether sesame can be a source of phytoestrogens is unknown . This study was design ed to investigate the effect of sesame ingestion on blood sex hormones , lipids , tocopherol , and ex vivo LDL oxidation in postmenopausal women . Twenty-six healthy subjects attended , and 24 completed , this r and omized , placebo-controlled , crossover study . Half of them consumed 50 g sesame seed powder daily for 5 wk , followed by a 3-wk washout period , then a 5-wk 50-g rice powder placebo period . The other half received the 2 supplements in reverse order . After sesame treatment , plasma total cholesterol ( TC ) , LDL-C , the ratio of LDL-C to HDL-C , thiobarbituric acid reactive substances in oxidized LDL , and serum dehydroepi and rosterone sulfate decreased significantly by 5 , 10 , 6 , 23 , and 18 % , respectively . The ratio of alpha- and gamma-tocopherol to TC increased significantly by 18 and 73 % , respectively . All of these variables differed significantly between the 2 treatments . Serum sex hormone-binding globulin and urinary 2-hydroxyestrone ( n = 8) increased significantly by 15 and 72 % , respectively , after sesame treatment , and these concentrations tended to differ ( P = 0.065 and P = 0.090 , respectively ) from those after the placebo treatment . These results suggest that sesame ingestion benefits postmenopausal women by improving blood lipids , antioxidant status , and possibly sex hormone status Background : The study on natural substances especially , dietary components such as liquid oils affecting cholesterol can be important for therapeutic propose . Sesame seeds with various biomedical actions can be control the hypercholesterolemia . On the other h and , olive oil has a wide range of therapeutic effect on lipid profile in human . The aim of this study is to evaluate and compare lipid profile changes after olive and sesame oils consumption in hypercholesterolemia . Methods : This study was a clinical r and omized trial that was performed via parallel design on 48 patients . The patients were r and omly allocated in to two groups : A : olive oil and B : sesame oil . After 1 month prescription of Step I National Cholesterol Education Program diet , patients consumed 4 table spoons aprox . 60 g ) of refined olive or sesame oil daily as an exchange of other oils , for 1 month . Lipid profiles The P < 0.05 was considered as significant difference . Results : Out of 48 patients , 24 ( 50 % ) were men . The mean age was 41.7 ± 8.3 years . The mean of total cholesterol , triglyceride ( TG ) , low density lipoprotein ( LDL ) , cholesterol , and high density lipoprotein ( HDL ) cholesterol , before oil consumption was 224.5 ± 22 , 256 ± 132 , 132.6 ± 9 , and 44.5 ± 11 mg/dl . After olive oil  consumption cholesterol , TG , LDL-C , weight , waist and BMI were decreased and HDL-C was increased . After sesame oil  consumption cholesterol , TG , LDL-C were significantly decreased . Weight , waist were decreased and HDL-C was increased ( P > 0.05 ) . Conclusions : Sesame oil had equivalent effect on lipid profile in comparison olive oil and lipid profile improvement was better in sesame oil in LDL-C and TG Background and Purpose — The role of serum fatty acids as a risk factor for stroke and stroke subtypes is largely unknown . Methods — A prospect i ve nested case-control study of Japanese 40 to 85 years of age was conducted through the use of  frozen serum sample s  from 7450 participants in cardiovascular risk surveys collected from 1984 to 1989 for 1 community and 1989 to 1992 for the other 2 communities . By the end of 1998 , we identified 197 incident strokes whose subtypes were confirmed by imaging studies . Three controls per case were selected by matching for sex , age , community , year of serum storage , and fasting status . Results — Compared with controls , total ( n=197 ) , hemorrhagic ( n=75 ) , and ischemic ( n=122 ) strokes had similar proportions of n3 polyunsaturated fatty acids , lower proportions of linoleic and arachidonic acids , and higher proportions of saturated and monosaturated acids , determined by gas chromatography . The multivariate odds ratios associated with a 1-SD increase in linoleic acid ( 5 % ) after adjustment for hypertension , diabetes , serum total cholesterol , and other cardiovascular risk factors were 0.72 [ 95 % confidence interval ( CI ) , 0.59 to 0.89 ] for total stroke , 0.66 ( 95 % CI , 0.49 to 0.88 ) for ischemic stroke , 0.63 ( 95 % CI , 0.46 to 0.88 ) for lacunar infa rct ion , and 0.81 ( 95 % CI , 0.59 to 1.12 ) for hemorrhagic stroke . The respective odds ratios for saturated fatty acids ( 4 % ) were 1.13 ( 95 % CI , 1.05 to 1.65 ) , 1.35 ( 95 % CI , 1.01 to 1.79 ) , 1.44 ( 95 % CI , 1.03 to 2.01 ) , and 1.21 ( 95 % CI , 0.82 to 1.80 ) . Further adjustment for other fatty acids attenuated these relations , but the relation between linoleic acid and risk of ischemic stroke remained statistically significant . Conclusions — A higher intake of linoleic acid may protect against ischemic stroke , possibly through potential mechanisms of decreased blood pressure , reduced platelet aggregation , and enhanced deformability of erythrocyte cells Aim To investigate if conjugated linoleic acid supplementation ( CLA ) affects metabolic factors and oxidative stress in non-alcoholic fatty liver disease ( NAFLD ) . Methods The study was a r and omized , controlled clinical trial conducted in specialized and subspecialized clinics of Tabriz University of Medical Sciences from January 2014 to March 2015 . 38 obese NAFLD patients were r and omly allocated into either the intervention group , receiving three 1000 mg softgel of CLA with a weight loss diet and 400 IU vitamin E , or into the control group , receiving only weight loss diet and 400 IU vitamin E for eight weeks . Dietary data and physical activity , as well as anthropometric , body composition , metabolic factors , and oxidative stress were assessed at baseline and at the end of the study . Results Weight , body composition , and serum oxidative stress , insulin , and lipid profile significantly improved in both groups , while hemoglobin A1c ( HbA1c ) levels ( P = 0.004 ) , total cholesterol to high density lipoprotein ratio ( P = 0.008 ) , low density lipoprotein to high density lipoprotein ratio ( LDL/HDL ) ( P = 0.002 ) , and alanine aminotransferase to aspartate aminotransferase ( ALT/AST ) ratio ( P = 0.025 ) significantly decreased in the intervention group . At the end of the study , fat mass ( P = 0.001 ) , muscle mass ( P = 0.023 ) , total body water ( P = 0.004 ) , HbA1c ( P < 0.001 ) , triglycerides ( P = 0.006 ) , LDL/HDL ratio ( P = 0.027 ) , and ALT/AST ratio ( P = 0.046 ) were significantly better in the CLA group than in the control group . Conclusion CLA improved insulin resistance , lipid disturbances , oxidative stress , and liver function in NAFLD . Therefore , it could be considered as an effective complementary treatment in NAFLD . Registration number : I RCT 2014020516491N1 BACKGROUND Many of the benefits of soy have been attributed to soy isoflavones . OBJECTIVE The objective was to determine the effects of high- and low-isoflavone soy-protein foods on both lipid and nonlipid risk factors for coronary artery disease ( CAD ) . METHODS Forty-one hyperlipidemic men and postmenopausal women participated in a study with three 1-mo diets : a low-fat dairy food control diet and high- ( 50 g soy protein and 73 mg isoflavones daily ) and low- ( 52 g soy protein and 10 mg isoflavones daily ) isoflavone soyfood diets . All 3 diets were very low in saturated fat ( < 5 % of energy ) and cholesterol ( < 50 mg/d ) . Fasting blood sample s were drawn and blood pressure was measured at the start and end of each diet . RESULTS No significant differences were seen between the high- and low-isoflavone soy diets . Compared with the control diet , however , both soy diets result ed in significantly lower total cholesterol , estimated CAD risk , and ratios of total to HDL cholesterol , LDL to HDL cholesterol , and apolipoprotein B to A-I. No significant sex differences were observed , except for systolic blood pressure , which in men was significantly lower after the soy diets than after the control diet . On the basis of blood lipid and blood pressure changes , the calculated CAD risk was significantly lower with the soy diets , by 10.1 + /- 2.7 % . CONCLUSION Substitution of soyfoods for animal products , regardless of isoflavone concentration , reduces the CAD risk because of both modest reductions in blood lipids and reductions in oxidized LDL , homocysteine , and blood pressure OBJECTIVE Consumption of soy protein has recently been shown to improve the blood lipid levels in nondiabetic subjects . The purpose of this study was to evaluate if a dietary supplement of soy protein , isoflavones , and cotyledon fiber ( Abalon ) affects cardiovascular risk markers , blood glucose , and insulin levels in type 2 diabetic subjects . RESEARCH DESIGN AND METHODS Twenty type 2 diabetic subjects participated in a crossover trial . They were r and omized to double-blind supplementation for 6 weeks with Abalon ( soy protein [ 50 g/day ] with high levels of isoflavones [ minimum 165 mg/day ] and cotyledon fiber [ 20 g/day ] ) or placebo ( casein [ 50 g/day ] and cellulose [ 20 g/day ] ) , separated by a 3-week wash-out period . RESULTS The results are expressed as means + /- SD . The percentage mean treatment difference between Abalon and placebo demonstrated significantly lower mean values after Abalon for LDL cholesterol ( 10 + /- 15 % , P < 0.05 ) , LDL/UHDL ratio ( 12 + /- 18 % , P < 0.05 ) , apolipoprotein ( apo ) B100 ( 30 + /- 38 % , P < 0.01 ) , triglycerides ( 22 + /- 10 % , P < 0.05 ) , and homocysteine ( 14 + /- 21 % , P < 0.01 ) , whereas the total cholesterol value tended to be less significant but still lower ( 8 + /- 15 % , P < 0.08 ) . No change occurred in HDL cholesterol , apo B100/apo A1 ratio , plasminogen activator inhibitor 1 , factor VIIc , von Willebr and factor , fibrinogen , lipoprotein(a ) , glucose , HbA1c , or 24-h blood pressure . CONCLUSIONS These results indicate beneficial effects of dietary supplementation with Abalon on cardiovascular risk markers in type 2 diabetic subjects . This improvement is seen even in individuals with near-normal lipid values In this r and omized and placebo-controlled trial , safety and lipid-lowering effect of fish and corn oils rich in polyunsaturated fatty acids compared with sesame oil that is mainly saturated were studied in 60 hemodialysis cases allocated to 4 different treatment groups . Each group ( n = 15 ) received either fish oil ( 1.5 g ) , corn oil ( 4.5 g ) , sesame oil ( 4.5 g ) , or placebo , daily . Serum triglyceride , cholesterol , low density lipoprotein cholesterol ( LDL-c ) , and high density lipoprotein cholesterol ( HDL-c ) were measured before and after 2 months of therapy . Serum HDL-c increased , but LDL-c decreased significantly after fish and corn oil therapy . In addition , serum triglyceride decreased significantly after supplementary fish oil . The ratios of LDL-c to HDL-c , total cholesterol to HDL-c , and triglyceride to HDL-c decreased significantly after fish and corn oil therapy . Sesame oil had no significant effect on the lipid profile of hemodialysis patients . Our results suggest that short-term low-dose supplementary polyunsaturated fatty acids are safe and beneficial for the lipid abnormalities of hemodialysis patients Background Antioxidant supplementations have the potential to alleviate the atherosclerotic damage caused by excessive production of reactive oxygen species ( ROS ) . The present study evaluated the effects of prolonged antioxidant treatment on arterial elasticity , inflammatory and metabolic measures in patients with multiple cardiovascular risk factors . Methods Study participants were r and omly assigned to two groups . Group 1 received oral supplementation with 2 capsules per day of Mid Life Guard , SupHerb , Israel . In each capsule vitamin C ( 500 mg ) vitamin E ( 200 iu ) , co-enzyme Q10 ( 60 mg ) and selenium ( 100 mcg ) , Group 2 received matching placebo(SupHerb ) for 6 months . Patients were evaluated for lipid profile , HbA1C , insulin , C-peptide , hs-CRP , endothelin , aldosterone , plasma renin activity and Homeostasis model assessment -insulin resistance ( HOMA-IR ) . Arterial elasticity was evaluated using pulse wave contour analysis ( HDI CR 2000 , Eagan , Minnesota ) . Results Antioxidant-treated patients exhibited significant increases in large arterial elasticity index ( LAEI ) as well as small arterial elasticity index ( SAEI ) . A significant decline HbA1C and a significant increase in HDL-cholesterol were also observed . In the placebo group , significant changes in LAEI , SAEI or metabolic measures were not observed . Conclusions Antioxidant supplementation significantly increased large and small artery elasticity in patients with multiple cardiovascular risk factors . This beneficial vascular effect was associated with an improvement in glucose and lipid metabolism as well as decrease in blood pressure Considerable evidence supports the hypothesis that vitamin E reduces the risk for atherosclerosis ( 1 ) . Vitamin E inhibits the proliferation of smooth-muscle cells in vitro ( 2 ) and increases the resistance of low-density lipoprotein to oxidation when it is added to plasma or administered to humans ( 3 , 4 ) . Furthermore , platelets from persons taking vitamin E supplements  had markedly reduced adhesiveness to collagen ( 5 ) . Consistent with these findings , vitamin E intake has been inversely associated with risk for coronary heart disease ( 6 - 8 ) and for peripheral arterial disease ( 9 ) and with carotid artery wall thickness ( 10 , 11 ) . Risk for ischemic stroke also increases with atherosclerosis and might therefore be reduced by vitamin E. However , few studies have addressed the relation between vitamin E and risk for ischemic stroke , and those that have been done were small , had little variation in vitamin E intake , or did not distinguish between ischemic and hemorrhagic stroke ( 12 - 15 ) . Risk for hemorrhagic stroke is unlikely to be reduced by high doses of vitamin E and could even be increased by the reduced platelet adhesion that these doses cause ( 5 ) . The most informative previous studies a large r and omized trial in men ( 16 , 17 ) and a prospect i ve investigation in women (6)supported a modest beneficial effect of vitamin E with respect to ischemic stroke , but the results were not statistically significant . Moreover , in the trial in men ( 16 ) , this apparent benefit was offset by an increased risk for hemorrhagic stroke . Like vitamin E , vitamin C and carotenoids have antioxidant properties ( 18 , 19 ) and have been hypothesized to reduce risk for stroke , but epidemiologic evidence to support these hypotheses is limited ( 14 - 17 , 20 - 22 ) . Of the carotenoids , we considered -carotene , -carotene , lutein , and lycopene because they are present in relatively large amounts in the diet and have distinct antioxidant properties ( 23 ) . Our primary hypothesis was that high intake of these antioxidants would reduce risk for ischemic stroke . We report here the associations between intakes of vitamin E , vitamin C , and specific carotenoids and risks for ischemic and hemorrhagic stroke in a large cohort of men in the United States . Methods Study Sample The Health Professionals Follow-up Study began in 1986 , when 51 529 health professionals 40 to 75 years of age [ 24 ] completed a 131-item food-frequency question naire and supplied information about medical history and lifestyle . Follow-up question naires were sent every 2 years so that we could up date information on potential risk factors , including use of vitamin supplements , and identify newly diagnosed cases of stroke and other diseases . We excluded from analysis 1595 men who did not have 1 ) a daily caloric intake between 800 and 4200 kcal and 2 ) fewer than 70 blanks ( among 131 listed food items ) on the food-frequency question naire . We also excluded men with previous myocardial infa rct ion , angina , coronary artery surgery , stroke , transient ischemic attack , peripheral arterial disease , or diabetes . We followed the 43 738 eligible men for incidence of stroke for 8 years . The average response rate for the 2-year follow-up cycles was more than 94 % . Nonresponding participants who were not matched to the National Death Index were assumed to be alive . This study was approved by the institutional review board of the Harvard School of Public Health . Assessment of Diet and Other Exposure Variables On the 1986 question naire , we asked about 1 ) the average frequency of intake over the previous year of specified portions of 131 foods and 2 ) the use of vitamin and mineral supplements . We specifically asked about dose and duration of use of multivitamin , vitamin E , and vitamin C supplements . Nutrient calculations took into account the specific br and s of breakfast cereal and multivitamin supplements reported by each participant . We assessed the question naire 's validity in a r and om sample of 127 men who completed two 1-week diet records ( 25 ) ; 121 of these men also provided blood sample s ( 26 , 27 ) . The correlations between the food-frequency assessment s of intake and plasma concentrations were 0.51 for -tocopherol , 0.47 for -carotene and lycopene , 0.35 for -carotene , and 0.40 for lutein . These correlations were similar to those seen between plasma levels of these nutrients and intake of these nutrients as estimated by the two 1-week diet records ( 25 ) , and they support the validity of the food-frequency question naire . Even if dietary measurements were perfect , vitamin intake and plasma levels would not be highly correlated because multiple factors contribute to between-person variations in plasma vitamin levels . The correlation between the food-frequency and diet-record assessment s was 0.92 for both vitamin C and vitamin E ( 25 ) . In 1986 , in addition to reporting on diet , participants were asked to report their usual systolic and diastolic blood pressures and whether they had physician-diagnosed hypertension . The validity of these variables has been documented ( 28 ) . Other potential risk factors for stroke that were assessed at baseline and in the follow-up question naire included smoking history , body mass index , history of hypercholesterolemia , physical activity , parental history of myocardial infa rct ion , and alcohol consumption . Events End points were fatal or nonfatal stroke occurring between the return of the baseline question naire and 31 January 1994 . If a participant reported an incident stroke on a follow-up question naire , we asked for permission to review that participant 's medical records . Strokes were confirmed if they were characterized by a typical neurologic defect of sudden or rapid onset that lasted at least 24 hours and was attributable to a cerebrovascular event . Strokes caused by infection or neoplasia were excluded . Review s were conducted by physicians who had no knowledge of participants ' risk factor status . Strokes were subclassified , according to the criteria of the National Survey of Stroke , as due to ischemia ( embolism or thrombosis ) , subarachnoid hemorrhage , intracerebral hemorrhage , or an unknown cause ( 29 ) . If no records could be obtained , a stroke was considered probable if it necessitated hospitalization and was corroborated by additional information provided in a letter or interview . Deaths were initially reported by next-of-kin , coworkers , postal authorities , or the National Death Index . Fatal strokes were confirmed by medical records ( 84 % ) or autopsy reports ( 2 % ) or were considered probable if medical records or autopsy reports could not be obtained and stroke was listed as the underlying cause of death on the death certificate ( 14 % ) . Statistical Analysis Participants contributed follow-up time from the return of the 1986 question naire to the occurrence of a confirmed stroke or death or 31 January 1994 . Men who had nonfatal myocardial infa rct ion or coronary surgery during the follow-up period were retained in the analysis . Intake of vitamin E and other nutrients was energy-adjusted to 2000 kcal/d ( 30 ) . Relative risks were calculated by dividing the incidence of stroke among men in each quintile of energy-adjusted vitamin E intake at baseline by the incidence of stroke among men in the lowest quintile of intake . Similar calculations were done for the other nutrients . Quintiles were used to avoid assumptions about the shape of the dose-response relation and to provide sufficient power to compare men in the extreme categories of intake . For vitamin E , vitamin C , and -carotene , additional analyses separately considered supplemental and dietary intake . We adjusted relative risks for age ( in 5-year categories ) ( 31 ) and used the Mantel extension test ( 32 ) to test for linear trends . To adjust for other risk factors , we used pooled logistic regression with 2-year intervals . Where the probability of an event within an interval is small , this method is equivalent to a Cox proportional-hazards analysis ( 33 ) . The multivariate models included the following as covariates : calendar time ( in 2-year intervals ) , total energy intake ( continuous variable ) , smoking ( current ; past ; or 1 to 14 , 15 to 24 , and 25 cigarettes/d ) , alcohol consumption ( < 5 , 5 to 9 , 10 to 14 , 15 to 29 , or 30 g/d ) , history of hypertension , history of hypercholesterolemia , parental history of myocardial infa rct ion before 65 years of age , profession , and quintiles of body mass index and physical activity . In these models , we evaluated monotonic trends by using the median value of each category and modeling it as a continuous variable . Analyses were also conducted to up date dietary intake and other covariates during follow-up . In these analyses , the incidence of stroke in 1986 - 1990 was related to vitamin and carotenoid intake reported in 1986 , whereas the incidence of stroke in 1990 - 1994 was related to the average intake reported in 1986 and 1990 . Because dietary changes made after the development of intermediate end points , such as coronary heart disease , peripheral arterial disease , transient ischemic attacks , diabetes , and hypercholesterolemia , may confound the associations between diet and disease ( 34 ) , we repeated the analyses without updating information on diet for men who reached an intermediate end point before completing the 1990 dietary question naire . All P values are two-sided . Role of the Funding Source The National Institutes of Health had no role in the collection , analysis , or interpretation of the data or in the decision to su bmi t the paper for publication . Results During 323 394 person-years of follow-up , we documented 328 strokes : 210 ischemic , 70 hemorrhagic , and 48 unclassified . Fifty of the 328 strokes were fatal . The distribution of risk factors for stroke differed somewhat by vitamin E , vitamin C , and -carotene intake ( Table 1 ) . Men in the top quintiles of vitamin E or vitamin C intakemost of whom used multivitamin or specific vitamin supplementswere less likely to smoke , were more likely to use aspirin , and were BACKGROUND Whether intakes of dietary fat and cholesterol are associated with risk of stroke remain unclear . We examined the associations between intakes of total fat , specific types of fat , and cholesterol and risk of stroke  in a prospect i ve cohort of women . METHODS The study population consisted of 34,670 women , aged 49 - 83 years , in the Swedish Mammography Cohort who were free of cardiovascular disease and completed a food-frequency question naire in 1997 . Cox proportional hazard regression models were used to estimate relative risks ( RR ) with 95 % confidence intervals ( CI ) . RESULTS During a mean follow-up of 10.4 years , we ascertained 1680 stroke events , including 1310 cerebral infa rct ions , 233 hemorrhagic strokes , and 137 unspecified strokes . After adjustment for other stroke risk factors , intake of long-chain omega-3 polyunsaturated fatty acids ( PUFA ) was inversely associated with risk of total stroke . The multivariable RR of total stroke for the highest compared with the lowest quintile of long-chain omega-3 PUFA intake was 0.84 ( 95 % CI , 0.72 - 0.99 ; P for trend=0.04 ) .  Dietary cholesterol  was positively associated with risk of total stroke ( highest versus lowest quintile : RR=1.20 ; 95 % CI , 1.00 - 1.44 ; P for trend=0.01 ) and cerebral infa rct ion ( corresponding RR=1.29 ; 95 % CI , 1.05 - 1.58 ; P for trend=0.004 ) . Total fat , saturated fat , monounsaturated fat , polyunsaturated fat , α-linolenic acid , and omega-6 PUFA intakes were not associated with stroke . CONCLUSIONS These findings suggest that intake of long-chain omega-3 PUFAs is inversely associated with risk of stroke , whereas dietary cholesterol is positively associated with risk BACKGROUND The rapid emergence of coronary artery disease ( CAD ) in south Asian people is not explained by conventional risk factors . In view of cardioprotective effects of a Mediterranean style diet rich in alpha-linolenic acid , we assessed the benefits of this diet for patients at high risk of CAD . METHODS We did a r and omised , single-blind trial in 1000 patients with angina pectoris , myocardial infa rct ion , or surrogate risk factors for CAD . 499 patients were allocated to a diet rich in whole grains , fruits , vegetables , walnuts , and almonds . 501 controls consumed a local diet similar to the step I National Cholesterol Education Program ( NCEP ) prudent diet . FINDINGS The intervention group consumed more  fruits , vegetables , legumes , walnuts , and almonds  than did controls ( 573 g [ SD 127 ] vs 231 g [ 19 ] per day p<0.001 ) . The intervention group had an increased intake of whole grains and mustard or soy bean oil . The mean intake of alpha-linolenic acid was two-fold greater in the intervention group ( 1.8 g [ SD 0.4 ] vs 0.8 g [ 0.2 ] per day , p<0.001 ) . Total cardiac end points were significantly fewer in the intervention group than the controls ( 39 vs 76 events , p<0.001 ) . Sudden cardiac deaths were also reduced ( 6 vs 16 , p=0.015 ) , as were non-fatal myocardial infa rct ions ( 21 vs 43 , p<0.001 ) . We noted a significant reduction in serum cholesterol concentration and other risk factors in both groups , but especially in the intervention diet group . In the treatment group , patients with pre-existing CAD had significantly greater benefits compared with such patients in the control group . INTERPRETATION An Indo-Mediterranean diet that is rich in alpha-linolenic acid might be more effective in primary and secondary prevention of CAD than the conventional step I NCEP prudent diet
It was concluded that sesame consumption can significantly reduce blood TAG levels but there is insufficient evidence to support its hypocholesterolaemic effects .
Increased plasma lipid profiles are among the most important risk factors of CHD and stroke .
Sesame contains considerable amounts of vitamin E , MUFA , fibre and lignans , which are thought to be associated with its plasma lipid-lowering properties .