Nutrition in Chronocardiology: We are Indebted Professor Franz Halberg

Abstract

Franz Halberg had very many experiences in India. The word circadian and chronobiology, chronocardiology and chronoastrobiology were coined by him. He also discovered that in studies of single daily meals, eating breakfast was associated 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 of water in the early morning is advised, which appears to be in an attempt to increase vagal tone due to gastric distention. A circadian cell cycle resides in every cell, and peripheral timing mechanisms are being documented in molecular biologic terms at about 24-hour (circadian) and higher (ultradian) frequencies, with coordination, in mammals, by the adrenal and the pineal-hypothalamic-pituitary network. The suprachiasmatic nuclei (SCN) and clock gene contribute to the coordination of the circadian rhythms' phase and amplitude, in every day life. The SCN are influenced by the daily alternation between light and darkness directly via the eyes and by plasma melatonin concentrations secreted by the pineal gland, which is a window to both light and geomagnetics. A clinical event occurs when our neuroendocrine time structures (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 pineal gland, 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 Homoerectus and Homosapiens who use to have intercourse in the early morning hours, before going for hunting to forests, causing increased secretion of testosterone in the morning as a circadian rhythm. Frey considered the mean distribution of deaths along the scales of the day and the year. In one industrial population, Pell and D'Allonzo, discussed time-macroscopically the occurrence of a peak in the morning hours in a study of acute myocardial infarction (AMI), a proposition also ascertained and extended to the yearly pattern time-microscopically. The subsequent reports from other countries, the erstwhile Soviet Union and the extensive data by WHO in the report of myocardial infarction Community Registers from 19 European centers demonstrated a peak incidence of onset of chest pain due to AMI from 8.00 to 11.00 AM with a ratio of 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 of onset of chest pain was highest in the second quarter of the day (41.0%), mainly between 4-8 a.m., followed by the 4 th quarter, usually after large meals (28.2%). Emotion was the second most common trigger (43.5%), which was commonest in the patients with onset of chest pain in the second quarter of the day (51.8%). Cold weather was a predisposing factor in 29.2% and hot temperature (40°C) was common in 24.7% of the patients. A large meal, especially large breakfast in the morning was an important trigger of AMI in this study. It is possible that modern men can prevent AMI and stroke, if they eat small super foods breakfast, containing w-3 rich egg, vegetables, fruits, walnuts, almonds, raisins and yogurt which are known to be protective against cardiovascular diseases.