While there are some promising trends, such as the wide availability of whole-grain products and fresh fruit, there is an urgent need for improvement. The survey reveals that fewer than one-third of hospitals offer either a daily salad bar or a daily low-fat, cholesterol-free entr?Še. Moreover, a nutritional analysis reveals that many entr?Šes described as healthful by hospitals are actually very high in artery-clogging fat. Sixty-two percent of these "healthiest entr?Še" offerings derived more than 30 percent of calories from fat, and a few derived more than 50 percent of calories from fat.
"With heart disease still the number one killer of Americans and obesity on the rise, it is imperative that hospitals set a good example by providing health-promoting, vegetarian foods to staff, patients, and visitors," says Amy Joy Lanou, Ph.D., senior nutrition scientist. "Hospital fare with a focus on vegetables, beans, and whole grains could help keep visitors and medical staff from becoming patients themselves." Numerous studies published in peer-reviewed journals show that a low-fat vegetarian diet can lower cholesterol, improve insulin sensitivity, reverse heart disease, halt progression of prostate cancer, and provide many other benefits.
In partnership with ADinfinitum, Inc., and Spirit of Women hospital network, PCRM staff created the Healthy Hospital Food Initiative Questionnaire and distributed it to 40 hospitals or hospital systems nationwide. The hospitals surveyed were medium to large community hospitals with 100 beds or more and academic medical centers with at least 500 beds. Data collection occurred between December 1, 2004 and January 31, 2005.
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In the absence of the prostacyclin receptor, mice exhibited elevated blood pressure, the team reported. The animals also suffered exaggerated cardiac fibrosis and heart enlargement. Fibrosis, or scarring of the heart, can lead to arrhythmias and organ failure as the heart loses its ability to pump blood to the body's tissues.
Mice lacking both the prostacyclin and the thromboxane receptors continue to suffer from high blood pressure, but do not develop the other cardiac complications, they found. The results reveal the adverse cardiovascular consequences of thromboxane when left unconstrained by prostacyclin, the team reported. Furthermore, the findings point to the imbalance of blood vessel agents as the culprit behind the most serious cardiac complications in the animals.
The mice represent an extreme example of what might happen in patients taking cox-2 inhibitors, Coffman said. While prostacyclin activity can be substantially reduced in patients taking the painkillers, the animals lacked this important blood component altogether, he explained.
"Our data suggests that therapies that block unrestrained thromboxane actions for example, low doses of aspirin -- might protect against end-organ damage without affecting blood pressure in patients taking cox-2 inhibitors," Coffman said. "However, the practical utility of such an approach would depend on whether such a therapy would retain the gastrointestinal protection afforded by cox-2 inhibitors alone."
The researchers will next explore the effects of cox-2 inhibitors themselves in the salt-sensitive mice. Further study of the animals might also reveal the genetic factors that underlie the predisposition of particular individuals to develop high blood pressure and cardiac complications during therapy with cox-2 inhibitors.
Collaborators on the study include Helene Francois, Krairerk Athirakul, David Howell, Rajesh Dash, Lan Mao and Howard Rockman, of Duke; Hyung-Suk Kim and Beverly Koller of University of North Carolina, Chapel Hill; and Garret Fitzgerald of University of Pennsylvania.
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