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Onvani S, Haghighatdoost F, Surkan PJ, Larijani B, Azadbakht L. Adherence to the Healthy Eating Index and Alternative Healthy Eating Index dietary patterns and mortality from all causes, cardiovascular disease and cancer: a meta-analysis of observational studies. J Hum Nutr Diet 2016; 30:216-226. [DOI: 10.1111/jhn.12415] [Citation(s) in RCA: 118] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- S. Onvani
- Food Security Research Center; Isfahan University of Medical Sciences; Isfahan Iran
- Department of Community Nutrition; School of Nutrition and Food Science; Isfahan University of Medical Sciences; Isfahan Iran
| | - F. Haghighatdoost
- Food Security Research Center; Isfahan University of Medical Sciences; Isfahan Iran
- Department of Community Nutrition; School of Nutrition and Food Science; Isfahan University of Medical Sciences; Isfahan Iran
| | - P. J. Surkan
- Department of International Health; Johns Hopkins School of Public Health; Baltimore MD USA
| | - B. Larijani
- Endocrinology and Metabolism Research Center; Endocrinology and Metabolism Clinical Sciences Institute; Tehran University of Medical Sciences; Tehran Iran
| | - L. Azadbakht
- Food Security Research Center; Isfahan University of Medical Sciences; Isfahan Iran
- Department of Community Nutrition; School of Nutrition and Food Science; Isfahan University of Medical Sciences; Isfahan Iran
- Diabetes Research Center; Endocrinology and Metabolism Clinical Sciences Institute; Tehran University of Medical Sciences; Tehran Iran
- Department of Community Nutrition; School of nutritional Sciences and Dietetics; Tehran University of Medical Sciences; Tehran Iran
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Mostofsky E, Mukamal KJ, Giovannucci EL, Stampfer MJ, Rimm EB. Key Findings on Alcohol Consumption and a Variety of Health Outcomes From the Nurses' Health Study. Am J Public Health 2016; 106:1586-91. [PMID: 27459455 DOI: 10.2105/ajph.2016.303336] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVES To review critical contributions from the Nurses' Health Study (NHS) on alcohol consumption and health outcomes. METHODS We performed a narrative review of NHS (1980-2012) and NHS II (1989-2011) publications. RESULTS Using detailed information on self-reported alcohol drinking patterns obtained approximately every 4 years combined with extensive information on diet, lifestyle habits, and physician-diagnosed health conditions, NHS investigators have prospectively examined the risks and benefits associated with alcohol consumption. Moderate intake, defined as up to 1 drink a day, is associated with a lower risk of hypertension, myocardial infarction, stroke, sudden cardiac death, gallstones, cognitive decline, and all-cause mortality. However, even moderate intake places women at higher risk for breast cancer and bone fractures, and higher intake increases risk for colon polyps and colon cancer. CONCLUSIONS Regular alcohol intake has both risks and benefits. In analyses using repeated assessments of alcohol over time and deaths from all causes, women with low to moderate intake and regular frequency (> 3 days/week) had the lowest risk of mortality compared with abstainers and women who consumed substantially more than 1 drink per day.
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Affiliation(s)
- Elizabeth Mostofsky
- Elizabeth Mostofsky is with the Department of Epidemiology, Harvard T. H. Chan School of Public Health, and the Cardiovascular Epidemiology Research Unit, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA. Kenneth J. Mukamal is with the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center. Kenneth J. Mukamal is also with the Department of Nutrition, Harvard T. H. Chan School of Public Health. Ed L. Giovannucci, Meir J. Stampfer, and Eric B. Rimm are with the Department of Nutrition, Harvard T. H. Chan School of Public Health and the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston
| | - Kenneth J Mukamal
- Elizabeth Mostofsky is with the Department of Epidemiology, Harvard T. H. Chan School of Public Health, and the Cardiovascular Epidemiology Research Unit, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA. Kenneth J. Mukamal is with the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center. Kenneth J. Mukamal is also with the Department of Nutrition, Harvard T. H. Chan School of Public Health. Ed L. Giovannucci, Meir J. Stampfer, and Eric B. Rimm are with the Department of Nutrition, Harvard T. H. Chan School of Public Health and the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston
| | - Ed L Giovannucci
- Elizabeth Mostofsky is with the Department of Epidemiology, Harvard T. H. Chan School of Public Health, and the Cardiovascular Epidemiology Research Unit, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA. Kenneth J. Mukamal is with the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center. Kenneth J. Mukamal is also with the Department of Nutrition, Harvard T. H. Chan School of Public Health. Ed L. Giovannucci, Meir J. Stampfer, and Eric B. Rimm are with the Department of Nutrition, Harvard T. H. Chan School of Public Health and the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston
| | - Meir J Stampfer
- Elizabeth Mostofsky is with the Department of Epidemiology, Harvard T. H. Chan School of Public Health, and the Cardiovascular Epidemiology Research Unit, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA. Kenneth J. Mukamal is with the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center. Kenneth J. Mukamal is also with the Department of Nutrition, Harvard T. H. Chan School of Public Health. Ed L. Giovannucci, Meir J. Stampfer, and Eric B. Rimm are with the Department of Nutrition, Harvard T. H. Chan School of Public Health and the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston
| | - Eric B Rimm
- Elizabeth Mostofsky is with the Department of Epidemiology, Harvard T. H. Chan School of Public Health, and the Cardiovascular Epidemiology Research Unit, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA. Kenneth J. Mukamal is with the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center. Kenneth J. Mukamal is also with the Department of Nutrition, Harvard T. H. Chan School of Public Health. Ed L. Giovannucci, Meir J. Stampfer, and Eric B. Rimm are with the Department of Nutrition, Harvard T. H. Chan School of Public Health and the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston
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Neelakantan N, Naidoo N, Koh WP, Yuan JM, van Dam RM. The Alternative Healthy Eating Index Is Associated with a Lower Risk of Fatal and Nonfatal Acute Myocardial Infarction in a Chinese Adult Population. J Nutr 2016; 146:1379-86. [PMID: 27306893 PMCID: PMC4926855 DOI: 10.3945/jn.116.231605] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 05/09/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Indexes to quantify adherence to recommended dietary patterns have been developed for Western populations, but it is unclear whether these indexes can predict acute myocardial infarction (AMI) in Asian populations. OBJECTIVES We aimed to investigate the association between the Alternative Healthy Eating Index (AHEI)-2010 and risk of AMI and to evaluate potential mediation by traditional cardiovascular risk factors in a Chinese population. METHODS A nested case-control study in 751 incident cases of AMI (564 nonfatal and 288 fatal) and 1443 matched controls was conducted within the prospective Singapore Chinese Health Study, a cohort of ethnic Chinese men and women aged 45-75 y. At baseline, habitual diet was assessed by using a validated, semiquantitative food-frequency questionnaire. AMI cases were ascertained via linkage with nationwide hospital databases (confirmed through medical record review) and the Singapore Birth and Death Registry. We evaluated the association between the AHEI-2010 and cardiovascular risk factors, including glycated hemoglobin, high-sensitivity C-reactive protein, creatinine, plasma lipids (LDL and HDL cholesterol, triglycerides), and blood pressure. ORs and 95% CIs were computed by using multivariable-adjusted conditional logistic regression models. RESULTS Higher AHEI-2010 scores were associated with a lower risk of AMI (OR for the highest quartile compared with the lowest quartile: 0.62; 95% CI: 0.47, 0.81; P-trend < 0.001), with similar associations for fatal (OR: 0.60; 95% CI: 0.39, 0.94; P-trend = 0.009) and nonfatal (OR: 0.59; 95% CI: 0.43, 0.81; P-trend = 0.002) AMI. This association was only slightly attenuated after adjustment for potential biological intermediates (OR: 0.64; 95% CI: 0.48, 0.86; P-trend = 0.003). CONCLUSIONS Adherence to dietary recommendations as reflected in the AHEI-2010 was associated with a substantially lower risk of fatal and nonfatal AMI in an Asian population, and this association was largely independent of traditional cardiovascular risk factors.
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Affiliation(s)
| | - Nasheen Naidoo
- Department of Pathology, Stellenbosch University, Cape Town, South Africa
| | - Woon-Puay Koh
- Saw Swee Hock School of Public Health and,Duke-NUS Graduate Medical School, Singapore
| | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences, University of Pittsburgh Cancer Institute, and,Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA; and
| | - Rob M van Dam
- Saw Swee Hock School of Public Health and Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
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Berstad P, Botteri E, Larsen IK, Løberg M, Kalager M, Holme Ø, Bretthauer M, Hoff G. Lifestyle changes at middle age and mortality: a population-based prospective cohort study. J Epidemiol Community Health 2016; 71:59-66. [PMID: 27312250 DOI: 10.1136/jech-2015-206760] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 05/27/2016] [Accepted: 05/31/2016] [Indexed: 11/04/2022]
Abstract
BACKGROUND The effect of modifying lifestyle at middle age on mortality has been sparsely examined. METHODS Men and women aged 50-54 years randomised to the control group (no intervention) in the population-based Norwegian Colorectal Cancer Prevention trial were asked to fill in lifestyle questionnaires in 2001 and 2004. Lifestyle scores were estimated ranging from 0 (poorest) to 4 (best) based on health recommendations (non-smoking, daily physical activity, body mass index <25.0 kg/m2 and healthy diet). Outcomes were all-cause, cancer and cardiovascular mortality before 31 December 2013. RESULTS Of the 6886 attainable individuals included in the study, 4211 (61%) responded to the baseline questionnaire in 2001. After a median follow-up of 12.3 years, 226 (5.4%) of the baseline questionnaire responders died; 110 (49%) from cancer and 32 (14%) from cardiovascular disease. For each increment in lifestyle score in 2001, a 21% lower all-cause mortality was observed (HR 0.79, 95% CI 0.67 to 0.94, adjusted for age, sex, occupational working hours and chronic disease or pain during 3 years before enrolment). A one-point increase in lifestyle score from 2001 to 2004 was associated with a 38% reduction in all-cause mortality (adjusted HR 0.62, CI 0.45 to 0.84). The group reporting lifestyle change from score 0-1 (unfavourable) in 2001 to score 2-4 (favourable) in 2004 had 4.8 fewer deaths per 1000 person years, compared with the group maintaining an 'unfavourable' lifestyle (adjusted HR 0.31, CI 0.13 to 0.70 for all-cause mortality). CONCLUSIONS Favourable lifestyle changes at age 50-60 years may prevent early death. TRIAL REGISTRATION NCT00119912; pre-results.
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Affiliation(s)
- Paula Berstad
- Department of Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway.,Telemark Hospital, Skien, Norway
| | - Edoardo Botteri
- Department of Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway.,Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
| | - Inger Kristin Larsen
- Department of Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway
| | - Magnus Løberg
- Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway.,Department of Transplantation Medicine, K. G. Jebsen Center for Colorectal Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Mette Kalager
- Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway.,Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Øyvind Holme
- Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway.,Sørlandet Hospital, Kristiansand, Norway
| | - Michael Bretthauer
- Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway.,Department of Transplantation Medicine, K. G. Jebsen Center for Colorectal Cancer Research, Oslo University Hospital, Oslo, Norway.,Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Geir Hoff
- Department of Colorectal Cancer Screening, Cancer Registry of Norway, Oslo, Norway.,Telemark Hospital, Skien, Norway.,Department of Health Management and Health Economics, Institute of Health and Society, University of Oslo, Oslo, Norway.,Department of Transplantation Medicine, K. G. Jebsen Center for Colorectal Cancer Research, Oslo University Hospital, Oslo, Norway
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Li S, Fonarow GC, Mukamal KJ, Liang L, Schulte PJ, Smith EE, DeVore A, Hernandez AF, Peterson ED, Bhatt DL. Sex and Race/Ethnicity–Related Disparities in Care and Outcomes After Hospitalization for Coronary Artery Disease Among Older Adults. Circ Cardiovasc Qual Outcomes 2016; 9:S36-44. [DOI: 10.1161/circoutcomes.115.002621] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Aspry K, Wu WC, Salmoirago-Blotcher E. Cardiac Rehabilitation in Patients with Established Atherosclerotic Vascular Disease: New Directions in the Era of Value-Based Healthcare. Curr Atheroscler Rep 2016; 18:10. [PMID: 26803511 DOI: 10.1007/s11883-016-0561-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Exercise-based cardiac rehabilitation (CR) is associated with significant improvements in coronary disease outcomes, but has been underutilized. However, new developments within the field, some spurred by healthcare reform and the transition to more accountable and coordinated care, offer hope for closing the large CR treatment gap. This review presents new CR-related research, policy, and analyses, and discusses how evolving eligibility criteria, referral processes, performance measures, care models, and delivery and payment options could increase CR utilization over the next decade and enable this life-saving secondary prevention intervention to thrive in the era of value-based health care.
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Affiliation(s)
- Karen Aspry
- Alpert Medical School of Brown University, Providence, RI, USA. .,Lifespan Cardiovascular Institute, Providence, RI, USA. .,Center for Cardiac Fitness, Miriam Hospital, Providence, RI, USA. .,Lifespan Cardiovascular Institute, 1454 South County Trail-Suite 200, East Greenwich, RI, 02818, USA.
| | - Wen-Chih Wu
- Alpert Medical School of Brown University, Providence, RI, USA.,Lifespan Cardiovascular Institute, Providence, RI, USA.,Center for Cardiac Fitness, Miriam Hospital, Providence, RI, USA.,Providence VA Medical Center, Providence, RI, USA
| | - Elena Salmoirago-Blotcher
- Alpert Medical School of Brown University, Providence, RI, USA.,Center for Preventive and Behavioral Medicine, Miriam Hospital, Providence, RI, USA
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Abstract
Nutrition plays an increasingly significant role in lifestyle strategies for cardiovascular prevention. Foods and dietary patterns that encompass specific foods and beverages and their combinations, with synergies among their components, are the subject of much epidemiologic and clinical research in relation to health issues, including cardiovascular disease. Foods with the highest evidence for beneficial effects on cardiovascular outcomes (mainly fatal and nonfatal coronary artery disease and stroke) and intermediate risk markers (principally cholesterol and blood pressure) are fruits and vegetables, legumes, nuts, whole grains, dairy products, fish, and alcohol consumed in moderation. Epidemiologic and clinical trial evidence on cardiovascular health issues is reviewed for these foods and for the dietary pattern with the highest probability of a causal link with cardiovascular protection, namely the Mediterranean diet. When pertinent, mechanisms of protection derived from specific nutrients in foods are also examined. The explosion of knowledge in cardioprotective foods and diets needs to be translated to the public, as dietary quality is still far from optimal in large segments of the population.
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Sotos-Prieto M, Bhupathiraju SN, Mattei J, Fung TT, Li Y, Pan A, Willett WC, Rimm EB, Hu FB. Changes in Diet Quality Scores and Risk of Cardiovascular Disease Among US Men and Women. Circulation 2015; 132:2212-9. [PMID: 26644246 PMCID: PMC4673892 DOI: 10.1161/circulationaha.115.017158] [Citation(s) in RCA: 154] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 09/17/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Adherence to several diet quality scores, including the Alternative Healthy Eating Index, Alternative Mediterranean Diet score, and Dietary Approach to Stop Hypertension, has been associated with lower risk of cardiovascular disease (CVD), but little is known about how changes in these scores over time influence subsequent CVD risk. METHODS AND RESULTS We analyzed the association between 4-year changes in the 3 diet quality scores (Alternative Healthy Eating Index, Alternative Mediterranean Diet score, and Dietary Approach to Stop Hypertension) and subsequent cardiovascular disease (CVD) risk among 29 343 men in the Health Professionals Follow-up Study and 51 195 women in the Nurses' Health Study (1986-2010). During 1 394 702 person-years of follow-up, we documented 11 793 CVD cases. Compared with participants whose diet quality remained relatively stable in each 4-year period, those with the greatest improvement in diet quality scores had a 7% to 8% lower CVD risk in the subsequent 4-year period (pooled hazard ratio, 0.92 [95% confidence interval (CI), 0.87-0.99] for the Alternative Healthy Eating Index; 0.93 [95% CI, 0.85-1.02] for the Alternative Mediterranean Diet score; and 0.93 [95% CI, 0.87-0.99] for the Dietary Approach to Stop Hypertension; all P for trend <0.05). In the long term, increasing the diet scores from baseline to the first 4-year follow-up was associated with lower CVD risk during the next 20 years (7% [95% CI, 1-12] for the Alternative Healthy Eating Index, and 9% [95% CI, 3-14] for the Alternative Mediterranean Diet score). A decrease in diet quality scores was associated with significantly elevated risk of CVD in subsequent time periods. CONCLUSIONS Improving adherence to diet quality scores over time is associated with significantly lower CVD risk in both the short term and long term.
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Affiliation(s)
- Mercedes Sotos-Prieto
- From the Departments of Nutrition (M.S.-P., S.N.B., J.M., T.T.F., Y.L., W.C.W., E.B.R., F.B.H.) and Epidemiology (W.C.W., E.B.R., F.B.H.), Harvard T.H. Chan School of Public Health, Boston, MA; Simmons College, Boston, MA (T.T.F.); Department of Epidemiology and Biostatistics and MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (A.P.); and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (W.C.W., E.B.R., F.B.H.)
| | - Shilpa N Bhupathiraju
- From the Departments of Nutrition (M.S.-P., S.N.B., J.M., T.T.F., Y.L., W.C.W., E.B.R., F.B.H.) and Epidemiology (W.C.W., E.B.R., F.B.H.), Harvard T.H. Chan School of Public Health, Boston, MA; Simmons College, Boston, MA (T.T.F.); Department of Epidemiology and Biostatistics and MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (A.P.); and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (W.C.W., E.B.R., F.B.H.)
| | - Josiemer Mattei
- From the Departments of Nutrition (M.S.-P., S.N.B., J.M., T.T.F., Y.L., W.C.W., E.B.R., F.B.H.) and Epidemiology (W.C.W., E.B.R., F.B.H.), Harvard T.H. Chan School of Public Health, Boston, MA; Simmons College, Boston, MA (T.T.F.); Department of Epidemiology and Biostatistics and MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (A.P.); and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (W.C.W., E.B.R., F.B.H.)
| | - Teresa T Fung
- From the Departments of Nutrition (M.S.-P., S.N.B., J.M., T.T.F., Y.L., W.C.W., E.B.R., F.B.H.) and Epidemiology (W.C.W., E.B.R., F.B.H.), Harvard T.H. Chan School of Public Health, Boston, MA; Simmons College, Boston, MA (T.T.F.); Department of Epidemiology and Biostatistics and MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (A.P.); and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (W.C.W., E.B.R., F.B.H.)
| | - Yanping Li
- From the Departments of Nutrition (M.S.-P., S.N.B., J.M., T.T.F., Y.L., W.C.W., E.B.R., F.B.H.) and Epidemiology (W.C.W., E.B.R., F.B.H.), Harvard T.H. Chan School of Public Health, Boston, MA; Simmons College, Boston, MA (T.T.F.); Department of Epidemiology and Biostatistics and MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (A.P.); and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (W.C.W., E.B.R., F.B.H.)
| | - An Pan
- From the Departments of Nutrition (M.S.-P., S.N.B., J.M., T.T.F., Y.L., W.C.W., E.B.R., F.B.H.) and Epidemiology (W.C.W., E.B.R., F.B.H.), Harvard T.H. Chan School of Public Health, Boston, MA; Simmons College, Boston, MA (T.T.F.); Department of Epidemiology and Biostatistics and MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (A.P.); and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (W.C.W., E.B.R., F.B.H.)
| | - Walter C Willett
- From the Departments of Nutrition (M.S.-P., S.N.B., J.M., T.T.F., Y.L., W.C.W., E.B.R., F.B.H.) and Epidemiology (W.C.W., E.B.R., F.B.H.), Harvard T.H. Chan School of Public Health, Boston, MA; Simmons College, Boston, MA (T.T.F.); Department of Epidemiology and Biostatistics and MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (A.P.); and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (W.C.W., E.B.R., F.B.H.)
| | - Eric B Rimm
- From the Departments of Nutrition (M.S.-P., S.N.B., J.M., T.T.F., Y.L., W.C.W., E.B.R., F.B.H.) and Epidemiology (W.C.W., E.B.R., F.B.H.), Harvard T.H. Chan School of Public Health, Boston, MA; Simmons College, Boston, MA (T.T.F.); Department of Epidemiology and Biostatistics and MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (A.P.); and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (W.C.W., E.B.R., F.B.H.)
| | - Frank B Hu
- From the Departments of Nutrition (M.S.-P., S.N.B., J.M., T.T.F., Y.L., W.C.W., E.B.R., F.B.H.) and Epidemiology (W.C.W., E.B.R., F.B.H.), Harvard T.H. Chan School of Public Health, Boston, MA; Simmons College, Boston, MA (T.T.F.); Department of Epidemiology and Biostatistics and MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (A.P.); and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (W.C.W., E.B.R., F.B.H.).
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Sijtsma FPC, Soedamah-Muthu SS, de Hoon SEM, Jacobs DR, Kromhout D. Healthy eating and survival among elderly men with and without cardiovascular-metabolic diseases. Nutr Metab Cardiovasc Dis 2015; 25:1117-1124. [PMID: 26610653 DOI: 10.1016/j.numecd.2015.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 08/25/2015] [Accepted: 08/31/2015] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND AIMS The strength of the associations of dietary scores with cardiovascular disease (CVD) and all-cause mortality in elderly vary considerably between a priori scores. To assess whether healthy eating lowers the risk of CVD and all-cause mortality among elderly men. METHODS AND RESULTS The Zutphen Elderly Study (age 65-84 years) was divided into men with (n = 210) and without (n = 616) cardiovascular-metabolic diseases at baseline in 1985. Diet was assessed with the cross-check dietary history method. We created the "Dutch Healthy Nutrient and Food Score" (DHNaFS) and the "Dutch Undesirable Nutrient and Food Score" (DUNaFS). Associations of the scores with CVD and all-cause mortality were assessed using multivariable Cox regression models. Associations of scores with life years gained used general linear models. During a median follow-up of 10.6 years (IQR 5.8-15.9) 806 participants died, of whom 359 from CVD. In all men, diet scores did not predict death. Among men with cardiovascular-metabolic diseases, DHNaFS was associated with lower CVD (HR: 0.57; 95% CI: 0.35-0.93) and all-cause mortality risk (HR: 0.64; 95% CI: 0.44-0.94) comparing the highest vs. the lowest score tertiles. Men with cardiovascular-metabolic diseases in the highest vs. the lowest tertile of the DHNaFS lived approximately 2.5 years longer. The DHNaFS was not associated with CVD and all-cause mortality in men without cardiovascular-metabolic diseases. The DUNaFS was not associated with any of the outcomes. CONCLUSION A high quality diet was associated with a 40% lower mortality risk and 2.5 years longer life expectancy in elderly men with, but not without, cardiovascular-metabolic diseases.
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Affiliation(s)
- F P C Sijtsma
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - S S Soedamah-Muthu
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
| | - S E M de Hoon
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - D R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA; The Department of Nutrition, University of Oslo, Oslo, Norway
| | - D Kromhout
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands; Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
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Sijtsma FPC, Soedamah-Muthu SS, de Goede J, Oude Griep LM, Geleijnse JM, Giltay EJ, de Boer MJ, Jacobs DR, Kromhout D. Healthy eating and lower mortality risk in a large cohort of cardiac patients who received state-of-the-art drug treatment. Am J Clin Nutr 2015; 102:1527-33. [PMID: 26490494 PMCID: PMC4658460 DOI: 10.3945/ajcn.115.112276] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 09/15/2015] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Little is known about dietary scores and mortality risk in cardiac patients who are well treated with drugs with attendant relatively low risk of cardiovascular diseases (CVDs). OBJECTIVE We assessed whether healthy eating lowers the risk of CVD and all-cause mortality in cardiac patients. DESIGN We included 4307 patients from the Alpha Omega Trial aged 60-80 y with a clinically diagnosed myocardial infarction and monitored mortality for 10 y. Diet was assessed at baseline (2002-2006) with a validated 203-item food-frequency questionnaire. We created 2 dietary scores on the basis of nonoverlapping sets of foods: the Dutch Healthy Nutrient and Food Score (DHNaFS) and the Dutch Undesirable Nutrient and Food Score (DUNaFS). The associations of both dietary scores with CVD and all-cause mortality were assessed by using multivariable-adjusted Cox regression models. RESULTS The median time after myocardial infarction at baseline was 3.7 y (IQR: 1.7-6.3 y). During a median of 6.5 y of follow-up (IQR: 5.3-7.6 y), 801 patients died; 342 of those died of CVD. One patient was lost to follow-up. A substantially higher average amount of DHNaFS foods (∼1750 g/d) than DUNaFS foods (∼650 g/d) was consumed. Almost all patients received drug treatment: 86% used statins, 90% used antihypertensive medication, and 98% used antithrombotic medication. Patients in the fifth quintile of the DHNaFS had a 30% (HR: 0.70; 95% CI: 0.55, 0.91) lower CVD risk and a 32% (HR: 0.68; 95% CI: 0.47, 0.99) lower all-cause mortality risk than did patients in the first quintile. The DUNaFS was unrelated to both CVD and all-cause mortality. CONCLUSION Beyond state-of-the-art drug treatment, healthy eating was associated with a lower risk of CVD and all-cause mortality in cardiac patients. This trial was registered at clinicaltrials.gov as NCT00127452.
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Affiliation(s)
- Femke P C Sijtsma
- Division of Human Nutrition, Wageningen University, Wageningen, Netherlands
| | | | - Janette de Goede
- Division of Human Nutrition, Wageningen University, Wageningen, Netherlands
| | - Linda M Oude Griep
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom
| | | | - Erik J Giltay
- Department of Psychiatry, Leiden University Medical Center, Leiden, Netherlands
| | - Menko Jan de Boer
- Department of Cardiology, Radboud University Medical Center Nijmegen, Nijmegen, Netherlands
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN; and Department of Nutrition, University of Oslo, Oslo, Norway
| | - Daan Kromhout
- Division of Human Nutrition, Wageningen University, Wageningen, Netherlands
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Han CY, Colega M, Quah EPL, Chan YH, Godfrey KM, Kwek K, Saw SM, Gluckman PD, Chong YS, Chong MFF. A healthy eating index to measure diet quality in pregnant women in Singapore: a cross-sectional study. BMC Nutr 2015. [DOI: 10.1186/s40795-015-0029-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
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Gerber Y, Weston SA, Jiang R, Roger VL. The changing epidemiology of myocardial infarction in Olmsted County, Minnesota, 1995-2012. Am J Med 2015; 128:144-51. [PMID: 25261010 PMCID: PMC4306650 DOI: 10.1016/j.amjmed.2014.09.012] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Revised: 09/10/2014] [Accepted: 09/10/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND Contemporary data on the epidemiology of myocardial infarction in the population are limited and derived primarily from cohorts of hospitalized myocardial infarction patients. We assessed temporal trends in incident and recurrent myocardial infarction, with further partitioning of the rates into prehospital deaths and hospitalized events, in a geographically defined community. METHODS All myocardial infarction events recorded among Olmsted County, Minnesota residents aged 25 years and older from 1995-2012, including prehospital deaths, were classified into incident and recurrent. Standardized rates were calculated and temporal trends compared. RESULTS Altogether, 5258 myocardial infarctions occurred, including 1448 (27.5%) recurrences; 430 (8.2%) prehospital deaths were recorded. Among hospitalized events, recurrent myocardial infarction was associated with greater mortality risk than incident myocardial infarction (age-, sex-, and year-adjusted hazard ratio, 1.49; 95% confidence interval, 1.37-1.61). Although the overall rate of myocardial infarction declined over time (average annual percent change, -3.3), the magnitude of the decline varied widely. Incident hospitalized myocardial infarction rate fell 2.7%/y, compared with decreases of 1.5%/y in recurrent hospitalized myocardial infarction, 14.1%/y in prehospital fatal incident myocardial infarction, and 12.3%/y in prehospital fatal recurrent myocardial infarction (all P for diverging trends < .05). These trends resulted in an increasing proportion of recurrences among hospitalized myocardial infarctions (25.3% in 1995-2000, 26.8% in 2001-2006, and 29.0% in 2007-2012, Ptrend = .02). CONCLUSIONS Over the past 18 years, a heterogeneous decline in myocardial infarction rates occurred in Olmsted County, resulting in transitions from incident to recurrent events and from prehospital deaths to hospitalized myocardial infarctions. Recurrent myocardial infarction confers a worse prognosis, thereby stressing the need to optimize prevention strategies in the population.
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Affiliation(s)
- Yariv Gerber
- Department of Health Sciences Research, Department of Medicine, Mayo Clinic, Rochester, Minn; Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, Israel
| | - Susan A Weston
- Department of Health Sciences Research, Department of Medicine, Mayo Clinic, Rochester, Minn
| | - Ruoxiang Jiang
- Department of Health Sciences Research, Department of Medicine, Mayo Clinic, Rochester, Minn
| | - Véronique L Roger
- Department of Health Sciences Research, Department of Medicine, Mayo Clinic, Rochester, Minn; Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic, Rochester, Minn.
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63
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Li S, Flint A, Pai JK, Forman JP, Hu FB, Willett WC, Rexrode KM, Mukamal KJ, Rimm EB. Low carbohydrate diet from plant or animal sources and mortality among myocardial infarction survivors. J Am Heart Assoc 2014; 3:e001169. [PMID: 25246449 PMCID: PMC4323805 DOI: 10.1161/jaha.114.001169] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 08/26/2014] [Indexed: 12/14/2022]
Abstract
BACKGROUND The healthiest dietary pattern for myocardial infarction (MI) survivors is not known. Specific long-term benefits of a low-carbohydrate diet (LCD) are unknown, whether from animal or vegetable sources. There is a need to examine the associations between post-MI adherence to an LCD and all-cause and cardiovascular mortality. METHODS AND RESULTS We included 2258 women from the Nurses' Health Study and 1840 men from the Health Professional Follow-Up Study who had survived a first MI during follow-up and provided a pre-MI and at least 1 post-MI food frequency questionnaire. Adherence to an LCD high in animal sources of protein and fat was associated with higher all-cause and cardiovascular mortality (hazard ratios of 1.33 [95% CI: 1.06 to 1.65] for all-cause mortality and 1.51 [95% CI: 1.09 to 2.07] for cardiovascular mortality comparing extreme quintiles). An increase in adherence to an animal-based LCD prospectively assessed from the pre- to post-MI period was associated with higher all-cause mortality and cardiovascular mortality (hazard ratios of 1.30 [95% CI: 1.03 to 1.65] for all-cause mortality and 1.53 [95% CI: 1.10 to 2.13] for cardiovascular mortality comparing extreme quintiles). An increase in adherence to a plant-based LCD was not associated with lower all-cause or cardiovascular mortality. CONCLUSIONS Greater adherence to an LCD high in animal sources of fat and protein was associated with higher all-cause and cardiovascular mortality post-MI. We did not find a health benefit from greater adherence to an LCD overall after MI.
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Affiliation(s)
- Shanshan Li
- Department of Epidemiology, Harvard School of Public Health, Boston, MA (S.L., A.F., F.B.H., W.C.W., E.B.R.)
| | - Alan Flint
- Department of Epidemiology, Harvard School of Public Health, Boston, MA (S.L., A.F., F.B.H., W.C.W., E.B.R.)
- Department of Nutrition, Harvard School of Public Health, Boston, MA (A.F., F.B.H., W.C.W., E.B.R.)
| | | | - John P. Forman
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (J.P.F., F.B.H., W.C.W., E.B.R.)
| | - Frank B. Hu
- Department of Epidemiology, Harvard School of Public Health, Boston, MA (S.L., A.F., F.B.H., W.C.W., E.B.R.)
- Department of Nutrition, Harvard School of Public Health, Boston, MA (A.F., F.B.H., W.C.W., E.B.R.)
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (J.P.F., F.B.H., W.C.W., E.B.R.)
| | - Walter C. Willett
- Department of Epidemiology, Harvard School of Public Health, Boston, MA (S.L., A.F., F.B.H., W.C.W., E.B.R.)
- Department of Nutrition, Harvard School of Public Health, Boston, MA (A.F., F.B.H., W.C.W., E.B.R.)
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (J.P.F., F.B.H., W.C.W., E.B.R.)
| | - Kathryn M. Rexrode
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (K.M.R.)
| | - Kenneth J. Mukamal
- Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Brookline, MA (K.J.M.)
| | - Eric B. Rimm
- Department of Epidemiology, Harvard School of Public Health, Boston, MA (S.L., A.F., F.B.H., W.C.W., E.B.R.)
- Department of Nutrition, Harvard School of Public Health, Boston, MA (A.F., F.B.H., W.C.W., E.B.R.)
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (J.P.F., F.B.H., W.C.W., E.B.R.)
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George SM, Ballard-Barbash R, Manson JE, Reedy J, Shikany JM, Subar AF, Tinker LF, Vitolins M, Neuhouser ML. Comparing indices of diet quality with chronic disease mortality risk in postmenopausal women in the Women's Health Initiative Observational Study: evidence to inform national dietary guidance. Am J Epidemiol 2014; 180:616-25. [PMID: 25035143 PMCID: PMC4157698 DOI: 10.1093/aje/kwu173] [Citation(s) in RCA: 195] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 06/04/2014] [Indexed: 02/07/2023] Open
Abstract
Poor diet quality is thought to be a leading risk factor for years of life lost. We examined how scores on 4 commonly used diet quality indices-the Healthy Eating Index 2010 (HEI), the Alternative Healthy Eating Index 2010 (AHEI), the Alternate Mediterranean Diet (aMED), and the Dietary Approaches to Stop Hypertension (DASH)-are related to the risks of death from all causes, cardiovascular disease (CVD), and cancer among postmenopausal women. Our prospective cohort study included 63,805 participants in the Women's Health Initiative Observational Study (from 1993-2010) who completed a food frequency questionnaire at enrollment. Cox proportional hazards models were fit using person-years as the underlying time metric. We estimated multivariate hazard ratios and 95% confidence intervals for death associated with increasing quintiles of diet quality index scores. During 12.9 years of follow-up, 5,692 deaths occurred, including 1,483 from CVD and 2,384 from cancer. Across indices and after adjustment for multiple covariates, having better diet quality (as assessed by HEI, AHEI, aMED, and DASH scores) was associated with statistically significant 18%-26% lower all-cause and CVD mortality risk. Higher HEI, aMED, and DASH (but not AHEI) scores were associated with a statistically significant 20%-23% lower risk of cancer death. These results suggest that postmenopausal women consuming a diet in line with a priori diet quality indices have a lower risk of death from chronic disease.
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Affiliation(s)
- Stephanie M. George
- Correspondence to Dr. Stephanie M. George, 9609 Medical Center Drive, Room 3E408, MSC 9762, Bethesda, MD 20892-9762 (e-mail: )
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65
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Yu D, Zhang X, Xiang YB, Yang G, Li H, Gao YT, Zheng W, Shu XO. Adherence to dietary guidelines and mortality: a report from prospective cohort studies of 134,000 Chinese adults in urban Shanghai. Am J Clin Nutr 2014; 100:693-700. [PMID: 24944055 PMCID: PMC4095665 DOI: 10.3945/ajcn.113.079194] [Citation(s) in RCA: 105] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND A higher adherence to dietary recommendations, such as the Dietary Approaches to Stop Hypertension (DASH) and the Alternative Healthy Eating Index (AHEI), has been associated with lower morbidity and mortality from chronic diseases in Western populations. However, the health benefits of following the Dietary Guidelines for Chinese remain unknown. OBJECTIVE We examined adherence to the Chinese Food Pagoda (CHFP) in association with total and cause-specific mortality and compared associations with those of the DASH and AHEI. DESIGN Participants included 61,239 men and 73,216 women (aged 40-74 y) from 2 population-based prospective studies in Shanghai, China. Habitual dietary intakes were assessed at baseline in-person interviews by using validated food-frequency questionnaires. Deaths and underlying causes were identified through the Shanghai Vital Statistics Registry and follow-up home visits. RESULTS We documented 2954 deaths in men and 4348 deaths in women during mean follow-ups of 6.5 and 12.0 y, respectively. A higher CHFP score was associated with lower total mortality with multivariable-adjusted HRs of 0.67 (95% CI: 0.60, 0.75) in men and 0.87 (95% CI: 0.80, 0.95) in women when extreme quartiles were compared (both P-trend < 0.005). Decreased risks associated with a higher CHFP score were observed for cardiovascular disease, cancer, and diabetes mortality, particularly in men. A significantly lower total mortality was shown for adherence to specific recommendations on vegetables, fruit, legumes, fish, and eggs but not grains, dairy, meat, fat, and salt. A higher DASH score and AHEI also predicted lower mortality from all causes, cardiovascular disease, and diabetes but not cancer. CONCLUSIONS A greater compliance with Chinese or US dietary guidelines is associated with lower total mortality in Chinese adults. Favorable associations are more evident in men than women and more consistent for cardiometabolic mortality than cancer mortality.
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Affiliation(s)
- Danxia Yu
- From the Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN (DY, XZ, GY, WZ and X-OS), and the Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China (Y-BX, HL, and Y-TG)
| | - Xianglan Zhang
- From the Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN (DY, XZ, GY, WZ and X-OS), and the Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China (Y-BX, HL, and Y-TG)
| | - Yong-Bing Xiang
- From the Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN (DY, XZ, GY, WZ and X-OS), and the Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China (Y-BX, HL, and Y-TG)
| | - Gong Yang
- From the Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN (DY, XZ, GY, WZ and X-OS), and the Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China (Y-BX, HL, and Y-TG)
| | - Honglan Li
- From the Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN (DY, XZ, GY, WZ and X-OS), and the Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China (Y-BX, HL, and Y-TG)
| | - Yu-Tang Gao
- From the Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN (DY, XZ, GY, WZ and X-OS), and the Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China (Y-BX, HL, and Y-TG)
| | - Wei Zheng
- From the Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN (DY, XZ, GY, WZ and X-OS), and the Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China (Y-BX, HL, and Y-TG)
| | - Xiao-Ou Shu
- From the Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN (DY, XZ, GY, WZ and X-OS), and the Department of Epidemiology, Shanghai Cancer Institute, Shanghai, China (Y-BX, HL, and Y-TG)
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Schwenke DC. Nutrient-rich fruits and vegetables: key for preventing cardiovascular and all-cause mortality in those with pre-existing cardiovascular disease? Curr Opin Lipidol 2014; 25:317-8. [PMID: 25003739 DOI: 10.1097/mol.0000000000000102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Dawn C Schwenke
- aResearch Health Scientist, Research Service, Phoenix VA Healthcare System, Phoenix, Arizona bResearch Professor, College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
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Abstract
PURPOSE OF REVIEW Following a myocardial infarction, lipid-lowering therapy is an established intervention to reduce the risk of recurrent cardiovascular events. Prior studies show a need to improve clinical practice in this area. Here, we review the latest research and perspectives on improving postmyocardial infarction lipid control. RECENT FINDINGS Dyslipidemia and myocardial infarction remain leading causes of global disability and premature mortality throughout the world. The processes of care in lipid control involve multiple patient-level, provider-level, and healthcare system-level factors. They can be challenging to coordinate. Recent studies show suboptimal use of early high-intensity statin therapy and overall lipid control following myocardial infarction. Encouragingly, lipid control has improved over the last decade. Implementation science has identified checklists as an effective tool. At the top of the checklist for reducing atherogenic lipids and recurrent event risk postmyocardial infarction is early high-intensity statin therapy. Smoking cessation and participation in cardiac rehabilitation are also priorities, as are lifestyle counseling, promotion of medication adherence, ongoing lipid surveillance, and medication management. SUMMARY Optimizing lipid control could further enhance clinical outcomes after myocardial infarction.
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Diets to prevent coronary heart disease 1957-2013: what have we learned? Am J Med 2014; 127:364-9. [PMID: 24384466 DOI: 10.1016/j.amjmed.2013.12.014] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 12/02/2013] [Accepted: 12/02/2013] [Indexed: 11/22/2022]
Abstract
Our understanding of the potential cardioprotective properties of nutrition is relatively recent, with most relevant studies completed in the last several decades. During that time, there has been an evolution in the focus of nutritional intervention. Early trials emphasized reduction of dietary fat with the goal of preventing heart disease by reducing serum cholesterol. Results from trials focused exclusively on dietary fat reduction were disappointing, prompting subsequent studies incorporating a whole diet approach with a nuanced recommendation for fat intake. The Mediterranean-style diet, with a focus on vegetables, fruit, fish, whole grains, and olive oil, has proven to reduce cardiovascular events to a degree greater than low-fat diets and equal to or greater than the benefit observed in statin trials.
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