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Insulin resistance is central to the etiology of the metabolic syndrome cluster of diseases. Evidence suggests that a high-fat diet is associated with insulin resistance, which may be modulated by dietary fatty acid composition. We hypothesized that high saturated fatty acid intake increases insulin and gastric inhibitory polypeptide (GIP) secretion. To clarify the effect of ingested fatty acid composition on glucose levels, we conducted an intervention study to investigate the insulin and plasma GIP responses in 11 healthy women, including a dietary control. Subjects were provided daily control meals (F-20; saturated fatty acids/monounsaturated fatty acids/polyunsaturated fatty acids [S/M/P] ratio, 3:4:3) with 20 energy (E) % fat, followed by 2 isoenergetic experimental meals for 7 days each. These meals comprised 60 E% carbohydrate, 15 E% protein, and 30 E% fat (FB-30; high saturated fatty acid meal; S/M/P, 5:4:1; F-30: reduced saturated fatty acid meal; S/M/P, 3:4:3). On the second day of the F-20 and the last day of F-30 and FB-30, blood samples were taken before and 30, 60, and 120 minutes after a meal tolerance test. The plasma glucose responses did not differ between F-20 and FB-30 or F-30. However, insulin levels were higher after the FB-30 than after the F-20 (P < .01). The GIP response after the FB-30 was higher than that after the F-30 (P < .05). In addition, the difference in the incremental GIP between FB-30 and F-30 correlated significantly and positively with that of the insulin. These results suggest that a high saturated fatty acid content stimulates postprandial insulin release via increased GIP secretion.

Serum and urine samples were randomly collected from residents in two rural areas at different altitudes in Nepal, and were examined for Wuchereria bancrofti antigens and antibodies (IgG4) to filarial antigens, respectively. In Judigaun, located at 900 m in altitude, 25.2% of 238 serum samples were positive for antigen, and 50.8% of 244 urine samples were positive for antibody. The level of IgG4 antibodies was higher among antigen positive individuals than among the antigen negatives. In Kotyang, located at 1100–1300 m, the prevalence of antigenemia was 15.4% of 117 serum samples.

1. The aim of the present study was to investigate the effects of a short (1 day) fast by testing biohumoral variables associated with the human circadian rhythm. 2. Fifteen clinically healthy male volunteers (32 +/- 8 years old) participated in the study. Subjects were fed a control diet for 7 days. The last day was a control day and the following 8th day was the fasting day. Each subject was asked to collect urine seven times over a 24 h period. Chemical and hormonal variables were measured in each fractionated urine specimen. The time- qualified urinary excretion rates were biometrically analysed using conventional and chronobiological methods. 3. During fasting, significant incremental changes were detected in the urinary excretion rates of potassium, aldosterone, 17-hydroxycorticosteroids and adrenaline and significant decremental changes were detected in the excretion rates of sodium, chloride, creatinine, urea nitrogen, uric acid, 17-ketosteroids, noradrenaline and dopamine. The circadian rhythmicity of the variables was well preserved and remained almost stable throughout the fasting phase. 4. Fasting affected the mean oscillatory levels and oscillatory amplitudes of variables, suggesting that nutrients may have played roles as tonic and phasic modulators on the mechanisms that physiologically regulate ircadian rhythmicity.

Insulin resistance is thought to raise blood pressure. Recently, a significant positive relationship between mean blood pressure and plasma leptin levels, but there have been no reports dealing with the relationship between blood pressure and either insulin resistance or serum leptin levels after weight loss. In the present work, we attempted to clarify the relationship between changes in blood pressure and either the serum leptin level or the insulin level in 102 moderately obese females (mean body mass index (BMI), 29.5 +/- 0.5 kg/m2; age, 47.0 +/- 0.9) during a 3 month period. No differences in age, fat-mass, homeostasis model assessment (HOMA), the summation of insulin (sigmaIRI), plasma renin activity (PRA) or 24 h norepinephrine excretion (24hU-NE) were observed between the hypertensive (HT) group (n = 31) and normotensive (NT) group (n = 71) before weight loss, but the basal serum leptin was significantly higher in the HT (16.8 +/- 1.1 ng/ml) than in the NT group (15.2 +/- 0.8 ng/ml), after adjusting for abdominal total fat. After a 3 month weight reduction program, the total abdominal fat, serum leptin and sigmaIRI significantly decreased in both groups. The systolic blood pressure (SBP)/diastolic blood pressure (DBP) significantly decreased from 144/84 to 130/77 mmHg only in the HT but not in the NT group. The PRA decreased in both groups, while the 24hU-NE significantly decreased only in the HT group. The changes in the leptin level were significantly correlated with the changes in both sigmaIRI and HOMA after weight loss in the two groups, respectively. Finally, a statistically significant positive correlation was observed between the changes in the leptin and the changes in the mean blood pressure (MBP) (r = 0.412, p < 0.05) only in the HT group. Multiple regression analysis revealed that the changes in MBP were independently associated with the changes in 24hU-NE and the changes in either sigmaIRI or HOMA in all subjects. However, a statistically significant positive correlation was observed between the changes in MBP and the changes in leptin levels even after adjusting for the total abdominal fat, 24hU-NE and either sigmaIRI or HOMA (both expressed as a percentage of the baseline value) in a multiple regression analysis only in the HT group. These results suggest that leptin may play a role in the pathophysiology of obese hypertension.

It has recently been found that there were very few hypertensives in the inhabitants of one Nepalese village, even though their salt consumption, per capita, was as high as citizens in many western countries. To evaluate the genetic factors involved in this phenomenon, we studied whether they had a special genotype distribution of angiotensin-converting enzyme (ACE) gene I/D polymorphism, which was recently reported to be involved in salt sensitivity. One hundred and thirty-eight subjects were evaluated in Nepal. Only nine subjects (6.5%) in this population were hypertensives (over 140/90 mm Hg) while consuming 11 g salt/day, which confirmed the previous results. The distribution of genotypes and alleles of ACE gene I/D polymorphism was similar to that in the Japanese and Chinese, who had five-times more hypertensives while consuming almost as much salt as Nepalese, but significantly different from those in Caucasians. The present study reports, for the first time, the genotype distribution of ACE gene I/D polymorphism in Nepalese subjects. Furthermore, the results suggest ACE gene polymorphism may not be involved in the 'salt-resistance' in this population.

In a double-blind, placebo-controlled study, thirty-three subjects were allocated to undergo either a 4-week treatment with oral Mg supplementation (Mg(OH)2; 411–548 mg Mg/d) or a placebo. The urinary excretion of Mg increased significantly in both the first 2 weeks and the following 2 weeks of Mg supplementation, while the urinary Na excretion also increased significantly over the experimental period. The systolic and diastolic blood pressure values decreased significantly in the Mg group, but not in the placebo group. The urinary aldosterone excretion and packed cell volume increased significantly during the last 2 weeks of the experimental period compared with the run-in period and first 2 weeks of supplementation. There was a statistically significant positive correlation between the values for urinary noradrenaline excretion and diastolic blood pressure at the end of the supplementation period (both expressed as a percentage of the run-in value). Statistically significant increases in lecithin-cholesterol acyltransferase (EC2.3.1.43; LCAT), HDL-cholesterol and apolipoprotein AI were also observed after Mg supplementation. A significant positive correlation was observed between the levels of LCAT and urinary Mg excretion for the experimental period (expressed as a percentage of the run-in value). The total cholesterol: HDL-cholesterol ratio decreased significantly during the last 2 weeks of Mg supplementation compared with the first 2 weeks and the run-in periods, but this did not occur in the placebo group. These results suggest that Mg supplementation may lower blood pressure through the suppression of the adrenergic activity and possible natriuresis, while also improving the serum lipids through the activation of LCAT in human subjects.

Objective To investigate the effects of chronic smoking on the 24 h blood pressure and heart rate pattern in normotensive subjects. Methods Twenty-five smokers and 25 age-, weight- and height-matched non-smokers, who were all clinically healthy young men, gave their informed consent to undergo non-invasive, automated, ambulatory blood pressure monitoring for 24 h. The smokers in this study consumed on average 25.4 cigarettes per day. The lifestyle of the two groups was comparable because they worked as clerks at the same company. The 24 h blood pressure and heart rate data were analysed according to chronobiological methods. Results Smokers were found to show a statistically significantly higher blood pressure versus non-smokers by day but not by night. Furthermore, smokers showed a slight increase in the mean level of circadian blood pressure rhythm versus non-smokers, accompanied by an amplification of one cyclic component of this periodicity. Conclusions The increase in diumal blood pressure in smokers might be regarded as the haemodynamic effect of chronic smoking in normotensive subjects. Such an effect seems to be substantiated pathophysiologically by an amplitude overmodulation of one of the harmonic components which confer the circadian blood pressure rhythmicity. Because the diumal increase in blood pressure persists for two-thirds of the day-night period, one can argue that this phenomenon in normotensive smokers might be a premonitory sign of future hypertension. Apart from this, one can hypothesize that the diumal increase in blood pressure might itself be a cause of target organ damage, given its consistent within-day duration and daily repetition.

Eating behavior change (EBC) is essential to remedy metabolic syndrome (MetS). We carried out our clinic-based health and nutrition intervention informed by the transtheoretical model (TTM) to promote EBC. In particular, we aimed to foster EBC among individuals who were in the cognitive stage (C-level stage) of their health behavior, in contrast to the model positing that those in C-level stage are less likely to adopt EBC than those in the behavioral stage (B-level stage). The degree of each one's risk for MetS was also examined.The study population comprised 108 adults (38 males aged 58 +/- 10.8 SD and 70 females aged 60 +/- 6.6).SUBJECTS were given instruction and support for over a 3-month period. MetS diagnostic criteria values, dietary intake and TTM were measured before and/or after the intervention. On the basis of their MetS and TTM scores, subjects were classified into two groups according to risk (high or low) and stage (C or B). Multiple linear regression analysis was performed.In both risk groups, EBC stage scores advanced in many subjects, progressing from C to B-level stage. Reduction in abdominal circumference and improvement of the MetS criteria values were also observed particularly in the high-risk group and those in the B-level stage. Stage-specific improvements in physical characteristics, the MetS criteria values and energy intake were likewise seen in both risk groups. Abdominal circumference reduction was negatively and positively correlated with EBC stage scores and fat energy ratio, respectively.From the results, it was proved that improvements of MetS criteria values concomitantly occurred with reduction of eating energy intake, especially fat energy, as well as advance of EBC from C to B-level stage. In addition, we found it effective to let the participants recognize their degrees of risk for MetS.

1. An assessment was made of the extent sodium (Na) and potassium (K) intake can be estimated from Na, K and creatinine (Cr) content of a second morning voiding urine (SMU) specimen collected within 4 h after the first voiding upon awakening but before breakfast in 159 clinically healthy, free-living individuals (20-79 years). The SMU and the rest of 24 h urine specimens for a 3-5 day period were collected. 2. The following equations for estimating 24 h urinary Na (24HUNaV) and K (24HUKV) excretions were developed, and the accuracy and the reliability of these equations were evaluated. Estimated value of 24HUNaV (mEq/day) = 16.3 square root of XNa; estimated value of 24HUKV (mEq/day) = 7.2 square root of XK, where XNa (or XK) = SMUNa (or SMUK)/SMUCr x predicted 24 h urinary Cr excretion. 3. Highly statistically significant correlations were detected between the values estimated and measured for both Na (r = 0.728, P0.001, n = 159) and K (r = 0.780, P0.001, n = 159). 4. These equations were applied to Group 1 subjects, who collected the urine for a single day, and to Group 2, for 3 days. The correlation coefficients between the values estimated and measured for Na and K were 0.531 and 0.443 in Group 1, and 0.821 and 0.590 in Group 2, respectively. No statistically significant differences were observed. 5. The SMU specimens provide a satisfactory alternative to both 24HUNaV and 24HUKV in adults for extensive epidemiological surveys but also for clinical application.

To investigate the nutritional condition in a hilly village (Kotyang) and a suburban village (Bhadrakali) in Nepal and to clarify the possible cause of the difference in total serum cholesterol level between the two groups of villagers habitually eating low fat diets, we carried out a nutrition survey using the 24-h recall method and blood sampling in 403 subjects (204 men and 199 women) in the hilly village and 466 (244 men and 222 women) in the suburban village. Total serum cholesterol was statistically significantly lower in the hilly villagers than in the suburban villagers for both sexes, but HDL-cholesterol was not. In both villages, 82% of the total energy was taken from carbohydrate, 7-8% from fat and 10% from protein. Energy, protein, fiber, potassium, magnesium, monounsaturated fatty acid, polyunsaturated fatty acid, and vitamin A in the hilly villagers were significantly higher than those in the suburban villagers. Total serum cholesterol was significantly associated with age and body fat percentage, suggesting that total serum cholesterol level was not directly associated with total fat intake in these Nepalese people.

This study examined whether charting daily weight patterns can predict weight regain in obese patients. The subjects were 98 moderately obese Japanese women aged 23 to 66 years who were obliged to precisely record their daily weights during the initial 4-month education period, but not thereafter. The patients were followed up at 8, 12, and 16 months. Abdominal fat areas and blood samples were assessed in the outpatient clinic at 0, 4, and 16 months. The standard deviations (SDs) of the differences in body weight between “after waking up” and “after breakfast” (SDa), “after dinner” (SDb), and “before going to bed” (SDc) were calculated, which were parameters reflecting the fluctuations in the daily weight patterns during the first 4 months. SDc, but not SDa or SDb, was correlated positively with weight regain at 8, 12, and 16 months (P = 0.049, P = 0.002, and P = 0.001, respectively). There were significant differences in temporal change in body weight and abdominal visceral fat between the small SDc group (SDc ≤25th percentile) and the large SDc group (SDc >75th percentile), but not for subcutaneous abdominal fat or the serum concentrations of glucose, insulin, or lipids. The results indicate that fluctuation of body weight immediately before going to bed is useful for predicting the rebound in body weight.

We examined the relation between protein intake and blood pressure in a screened cohort in Okinawa, Japan. A total of 1,299 screened subjects, 885 men and 414 women, were examined at the Okinawa General Health Maintenance Association. Daily intake of sodium (Na) and potassium (K) was estimated from Na, K, and creatinine excretion by the method of Kawasaki et al., and daily protein intake was estimated by the method of Maroni et al. as the estimated daily urinary excretion of urea nitrogen. Mean (SD) daily protein intake was 71.8 (18.6) g in men and 54.0 (13.5) g in women, and the mean (SD) daily protein intake per unit kg body weight was 1.1 (0.2) g/kg in men and 1.0 (0.2) g/kg in women. In men, both systolic blood pressure (SBP) and diastolic blood pressure (DBP) were higher in those with lower protein intake (LP;1.0 g/kg/day) than in those with higher protein intake (HP;or = 1.0 g/kg/day) (p0 .05 for DBP). In women, both SBP and DBP were higher in those with LP than in those with HP, but these differences were not statistically significant. However, urinary excretion of both Na and K was lower in those with LP than in those with HP, respectively, both in men and women (p0.0001). In summary, estimated daily protein intake was about 1.1 g/kg in men and 1.0 g/kg in women. Despite the higher urinary excretion of Na, both SBP and DBP tended to be lower in those with higher daily protein intake, particularly in men.

A randomized double-blind placebo-controlled study was conducted on 63 subjects to determine the antihypertensive effect of a vegetable drink in which sardine protein hydrolysates containing a dipeptide, Valyl-Tyrosine (VY), were incorporated. The subjects, consisting of people with mild hypertension, high-normal blood pressure and normal blood pressure, were randomly divided into test (male/female = 25/6, average age 50.1 +/- 10.4 years old) and control groups (26/6, 49.0 +/- 5.0). Each subject in the test group was given 195 g of the vegetable drink containing 0.5 g of sardine peptides (sardine protein hydrolysates) with 0.4 mg of VY (test drink) once a day for 13 weeks in a row, and subjects in the control group were given the same amount of the vegetable drink without sardine peptides (control drink) in the same manner. In the test group, 40 subjects with mild hypertension or high-normal blood pressure (130 mmHgor = systolic blood pressure (SBP)160 mmHg and/or 80 mmHgor = diastolic blood pressure (DBP)100 mmHg) showed a significant decrease in SBP, from 142.0 +/- 10.3 mmHg at the start of the test to 134.4 +/- 11.1 mmHg during the first week of the test period, after which similar values were seen throughout the test period (13 weeks). Compared to the control group, the difference in SBP from baseline was statistically significant in the test group throughout the intake period. DBP also decreased significantly from 88.0 +/- 7.9 mmHg at baseline to 83.5 +/- 8.6 mmHg after 13 weeks. In the control group, SBP and DBP were 140.8 +/- 8.4 mmHg and 90.5 +/- 6.6 mmHg respectively at the start of the test, and neither decreased during the test period. In subjects with normal blood pressure, neither those in the test group nor those in the control group showed a significant change in SBP and DBP during the test period. An excessive ingestion test was performed on 25 subjects with hypertension, mild hypertension, high-normal blood pressure, and normal blood pressure by giving 585 g (3 times the recommended amount of intake) of the test drink for 14 days in a row. As a result, a significant decrease of blood pressure was observed in the hypertension, mild hypertension and high-normal blood pressure groups, but no excessive decline in blood pressure or any side-effects were associated with any subjects during the test period. In the groups with normal blood pressure, the excessive ingestion of the test drink did not affect blood pressure. In these two studies, physical check-ups and biochemical analyses of blood and urine were also conducted in all subjects, and no abnormalities were observed. These results suggest that the test drink containing sardine protein hydrolysates exhibited the antihypertensive effect in only the subjects with mild hypertension or high-normal blood pressure. No adverse effects were observed in either hypertensive or normotensive subjects.

Information regarding daily intake of sodium (Na) is useful for both normotensive and hypertensive subjects. We measured urinary excretion of sodium (U-Na) and urinary excretion of potassium (U-K) to estimate daily salt intake in a cohort of health screening subjects in Okinawa, Japan. Urine samples were obtained from 2,411 subjects (1,554 men and 857 women) who were examined on a half-day dry-doc at the Okinawa General Health Maintenance Association (OGHMA). Four hundred and one subjects were examined twice, once between September and November in 1997, and once between September and November in 1998. The mean U-Na was 182 mEq/day for men and 176 mEq/day for women. The mean U-K was 54 mEq/day for men and 50 mEq/day for women. U-Na was higher in young men, and U-K was lower in young women. In both men and women, smokers had a significantly lower Na excretion compared to nonsmokers. Subjects treated for hypertension had a significantly lower Na excretion (173 mEq/day) compared to subjects not treated for hypertension (192 mEq/day). Our findings suggest that Na excretion in screened subjects in Okinawa is lower than the national average. Sodium excretion, however, was higher in young men than in elderly subjects, and K excretion was lower in young women than in elderly subjects. Both trends are disadvantageous for controlling hypertension.

The purpose of this study was to investigated the effect of weight loss on blood pressure and its related variables in moderately obese Japanese females, including an investigation of the rebound phenomenon. Study I examined the effects of weight loss on blood pressure in 138 moderately obese, nondiabetic females (BMI 29.3±0.3 kg/m2; age, 46.3±0.8 years) during a 3-month therapeutic dietary and exercise program. Study II investigated the effect of weight rebound on blood pressure over an additional 21 months of exercise in 48 subjects from Study I subjects. After 3 months, the BMI significantly decreased to 27.9±0.3 kg/m2. Abdominal total fat, visceral fat (V), and subcutaneous fat (S) also decreased significantly. In addition, the summation of insulin (ΣIRI), plasma glucose (ΣPG) and HOMA during 75 g oral glucose tolerance test also all significantly decreased. Significant decreases in both the SBP and DBP were observed after the 3 month weight reduction program. Multiple regression analysis revealed that the reduction in SBP was significantly and positively associated with the reduction in log ΣIRI and the reduction in log 24h-urinary norepinephrine excretion at the end of Study I. The DBP showed a significantly positive association with the log ΣIRI. With regard to the weight rebound phenomenon, Study II showed that the SBP, DBP and ΣIRI all increased significantly, and a positive correlation was observed between the changes in the SBP and those in the log ΣIRI. However, no such correlation was observed regarding the abdominal total fat and visceral fat during both periods. These results suggest that weight loss therefore caused the BP to decrease due to both an improvement in hyperinsulinemia and a decrease in the adrenergic activity which may be involved in the urinary catecholamine. As a result, hyperinsulinemia is thus considered to play an important role in the pathogenesis of blood pressure due to obesity not only during weight loss, but also during the weight rebound phenomenon. (Hypertens Res 2001; 24: 481-487)

The aim of this study was to evaluate the relationship between changes in abdominal fat areas and the baseline serum leptin levels of Japanese obese women during weight reduction. The study was performed on 100 obese female Japanese volunteers. We measured the BMI and abdominal fat areas (visceral, subcutaneous and total) by magnetic resonance imaging and determined the fasting serum leptin levels before and after a 3 month weight reduction program. We examined whether or not a relationship exists between the baseline leptin levels and the subsequent changes in the abdominal fat areas after a weight reduction program. Multiple linear regression analysis was performed to examine the relationship between the baseline leptin levels and changes in abdominal visceral, subcutaneous, and total fat areas, and demonstrated that the baseline leptin level was a significant predictive factor for changes in the abdominal visceral fat area in both pre and postmenopausal Japanese obese women. We thus concluded the relatively higher baseline leptin levels in Japanese obese women to be associated with a relatively smaller reduction in the amount of abdominal visceral fat after undergoing a weight reduction program.

Background: In 1987, we reported that the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in Nepal was low, as compared to hepatitis A virus (HAV) infection, and that no human T-lymphotropic type-1 (HTLV-1) infection was found in Nepal. Objectives: To determine changes in the prevalence of HAV, HBV, and HCV infections between 1987 and 1996 in inhabitants of Bhadrakali (suburban) and Kotyang (rural) villages in Nepal. Study design: We did a cross-sectional survey of 458 inhabitants of two Nepalese villages, to assess the prevalence of antibody to HAV (anti-HAV), antibody to hepatitis B core antigen (anti- HBc), hepatitis B surface antigen (HBsAg), antibody to HCV (anti-HCV), and antibody to HTLV-I (anti-HTLV-I). Results: Anti-HAV was detected in 454 (99.1 %), HBsAg in 5(1.1 %), anti-HBc in 33 (7.2%) and anti-HCV in 8 (1.7%) of serum samples tested in 1996. Statistically significant differences by gender or age group were nil. The prevalence of HCV infection was significantly higher in 1996 than in 1987 after adjusting for age of subjects living in the two villages (p

A parallel controlled clinical trial was carried out to investigate the effect on blood pressure (BP) of replacing normal salt with mineral salt in seasonings. After a 2-wk run-in period, 21 subjects (10 men and 11 women; age, 66.0+/-7.6 yr) were given mineral salt in seasonings instead of normal salt [mineral salt (MS) group], while 20 subjects (10 men and 10 women; age, 65.9+/-7.4 yr) continued to receive normal salt in seasonings [regular salt (RS) group] for the next 5 wk in the experimental (E) period. In the MS group, systolic (S) and diastolic (D) BP decreased significantly from 134.7+/-17.2/77.2+/-9.7 at baseline (week 0) to 127.3+/-12.0/73.5+/-8.9 mmHg at the end of the E period (week 5), and the reductions in both SBP and DBP were larger in hypertensive subjects than in normotensive subjects in the MS group. The serum sodium and chloride concentrations decreased significantly, while the serum potassium and HDL-cholesterol concentrations increased significantly at week 5. The 24-h urinary sodium excretion decreased, and the 24-h potassium and magnesium excretions increased significantly from week 0 to week 5 in the MS group. In contrast, SBP, DBP, serum chemistry, and urinary electrolyte excretion did not change significantly in the RS group. These findings suggest that the excessive salt content and insufficient potassium and magnesium content of the present Japanese diet could be easily and safely corrected by replacing seasonings prepared with regular salt with those prepared with mineral salt.

Objective To determine the seroprevalence of Helicobacter pylori infection in Nepal. Design H. pylori infection was identified using a specific and sensitive enzyme-linked immunosorbent assay for anti-H. pylori immunoglobulin G. Study population Serum samples were collected from 1142 inhabitants (age range 4–93 years) from two villages: Kotyang, a rural isolated village (250 men, 210 women) and Bhadrakali, a suburban village of Kathmandu (334 men, 348 women). Results The overall prevalence of H. pylori infection was 56.8%, while a significantly higher prevalence was found in the suburban village (Bhadrakali; 67.2%) than in the rural village (Kotyang; 41.5%). This difference was generally reflected by the infection rate in the 10–14-year-old age-group (Bhadrakali, 60% compared with Kotyang, 22.2%). The prevalence of infection significantly increased with age, while no significant difference was found in the prevalence of infection by gender. There was no difference in H. pylori positivity between individuals with and without upper abdominal symptoms in both villages. Conclusion There was a significant regional difference in the seroprevalence of H. pylori within Nepal, which showed lower prevalence in an isolated rural village. This difference was mainly caused by the different acquisition rate in teenagers, thus indicating that the teenage lifestyle of this particular environment seemed to be the major determinant in the acquisition of H. pylori infection in the population.

The aim of this study was to investigate whether there is variation in blood pressure when we reapportion the percentage of total daily salt intake consumed at each of three regular meals. The study was conducted on seven clinically healthy normotensive female subjects who, in Stages LH and DH, consumed two-thirds of the normal daily salt intake (12 g/day) at lunchtime or at dinnertime, respectively. The total daily amounts of nutrients and dietary salt were similar in Stage-R (regulated salt intake), Stage-LH (a high-salt intake at lunchtime), and Stage-DH (a high-salt intake at dinnertime). The blood pressure response to the variation of sodium content in the meals was examined by means of noninvasive automated blood pressure monitoring (ABPM-630; readings every 15 or 30 min over 48h) and chronobiologic analysis. A significant shift of blood pressure circadian rhythm was observed in Stage-LH. Additionally, the 24-h mean level of blood pressure significantly increased when the prevailing salt intake was at lunch, and significantly decreased when the prevailing intake was at dinner. These opposite responses corroborate the view that the blood pressure susceptibility of human beings to salt intake varies during the day, showing its maximal expression at midday. Such a time-dependent sensitivity may be exploited for better nutritional prevention and treatment of arterial hypertension by reappor-tioning the salt intake so that two-thirds is consumed at dinner.

The direct assay of total renin (TRC) and active renin concentration (ARC) is a reality due to the availability of monoclonal antibodies against human renin. Because of this, a study has been performed in order to assess the circadian rhythmicity of TRC and ARC. The study was extended to plasma renin activity (PRA) and plasma aldosterone concentration (PAC) for a more complete assessment of the renin-angiotensin-aldosterone system (RAAS). Twelve clinically healthy subjects (6 males and 6 females, age from 20 to 25 years) volunteered for this study. Time-qualified data series were analysed by means of chronobiological procedures in order to validate the circadian rhythm and to correlate the sinusoidal profiles. The circadian rhythm was validated at a high significance for TRC, ARC, PRA and at a borderline significance for PAC. The periodic oscillations were significantly correlated, demonstrating that TRC, ARC, PRA and PAC cycles oscillate in synchronism during the 24-hour span.