Nutrition in Chronocardiology: We are Indebted Professor Franz Halberg

摘要

Franz Halberg had very many experiences in India. The word circadian and chronobiology, chronocardiologyand chronoastrobiology were coined by him. He also discovered that in studies of single daily meals, eating breakfast wasassociated with weight loss compared to dinner, despite similar energy intake. The role of time-adjusted drug intake,especially in the early morning, was also known to ancient Indian physicians. In Ayurveda, drinking of large amounts ofwater in the early morning is advised, which appears to be in an attempt to increase vagal tone due to gastric distention. Acircadian cell cycle resides in every cell, and peripheral timing mechanisms are being documented in molecular biologicterms at about 24-hour (circadian) and higher (ultradian) frequencies, with coordination, in mammals, by the adrenal andthe pineal-hypothalamic-pituitary network. The suprachiasmatic nuclei (SCN) and clock gene contribute to thecoordination of the circadian rhythms' phase and amplitude, in every day life. The SCN are influenced by the dailyalternation between light and darkness directly via the eyes and by plasma melatonin concentrations secreted by the pinealgland, which is a window to both light and geomagnetics. A clinical event occurs when our neuroendocrine timestructures (chronomes) are not able to cope with the adverse effects of stimuli from within or from without, acting, e.g.,via the sympathetic nervous system. Triggering of the neuroendocrines by environmental factors may activate the pinealgland, pituitary functions and adrenal secretions, resulting in adverse effects on circadian variations, heart rate variability(HRV) and blood pressure variability (BPV). Circadian rhythm was known to ancient man from the time of Homoerectusand Homosapiens who use to have intercourse in the early morning hours, before going for hunting to forests, causingincreased secretion of testosterone in the morning as a circadian rhythm. Frey considered the mean distribution of deathsalong the scales of the day and the year. In one industrial population, Pell and D'Allonzo, discussed time-macroscopicallythe occurrence of a peak in the morning hours in a study of acute myocardial infarction (AMI), a proposition alsoascertained and extended to the yearly pattern time-microscopically. The subsequent reports from other countries, theerstwhile Soviet Union and the extensive data by WHO in the report of myocardial infarction Community Registers from19 European centers demonstrated a peak incidence of onset of chest pain due to AMI from 8.00 to 11.00 AM with a ratioof 1:2, approximately. In one study from India, in 605 AMI patients, 39% of those who had Q wave infarction (n=174)had the onset between 6.00 AM to 12.00 noon. A further study from India, among 202 AMI patients, the incidence ofonset of chest pain was highest in the second quarter of the day (41.0%), mainly between 4-8 a.m., followed by the 4thquarter, usually after large meals (28.2%). Emotion was the second most common trigger (43.5%), which was commonestin the patients with onset of chest pain in the second quarter of the day (51.8%). Cold weather was a predisposing factor in29.2% and hot temperature (40°C) was common in 24.7% of the patients. A large meal, especially large breakfast in themorning was an important trigger of AMI in this study. It is possible that modern men can prevent AMI and stroke, if theyeat small super foods breakfast, containing w-3 rich egg, vegetables, fruits, walnuts, almonds, raisins and yogurt which areknown to be protective against cardiovascular diseases.