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Ma TC, Gao F, Liu XL, Wang CX, Liu Q, Zhou J. Association between dietary inflammatory index and NT-proBNP levels in US adults: A cross-sectional analysis. PLoS One 2024; 19:e0304289. [PMID: 38837950 PMCID: PMC11152272 DOI: 10.1371/journal.pone.0304289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 05/09/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND With cardiovascular diseases standing as a leading cause of mortality worldwide, the interplay between diet-induced inflammation, as quantified by the Dietary Inflammatory Index (DII), and heart failure biomarker NT-proBNP has not been investigated in the general population. METHODS This study analyzed data from the National Health and Nutrition Examination Survey (NHANES) 1999-2004, encompassing 10,766 individuals. The relationship between the DII and NT-proBNP levels was evaluated through multivariable-adjusted regression models. To pinpoint crucial dietary components influencing NT-proBNP levels, the LASSO regression model was utilized. Stratified analyses were then conducted to examine the associations within specific subgroups to identify differential effects of the DII on NT-proBNP levels across diverse populations. RESULTS In individuals without heart failure, a unit increase in the DII was significantly associated with an increase in NT-proBNP levels. Specifically, NT-proBNP levels rose by 9.69 pg/mL (95% CI: 6.47, 12.91; p < 0.001) without adjustments, 8.57 pg/mL (95% CI: 4.97, 12.17; p < 0.001) after adjusting for demographic factors, and 5.54 pg/mL (95% CI: 1.75, 9.32; p = 0.001) with further adjustments for health variables. In participants with a history of heart failure, those in the second and third DII quartile showed a trend towards higher NT-proBNP levels compared to those in the lowest quartile, with increases of 717.06 pg/mL (95% CI: 76.49-1357.63, p = 0.030) and 855.49 pg/mL (95% CI: 156.57-1554.41, p = 0.018). Significant interactions were observed in subgroup analyses by age (<50: β = 3.63, p = 0.141; 50-75: β = 18.4, p<0.001; >75: β = 56.09, p<0.001), gender (men: β = 17.82, p<0.001; women: β = 7.43, p = 0.061),hypertension (β = 25.73, p<0.001) and diabetes (β = 38.94, p<0.001). CONCLUSION This study identified a positive correlation between the DII and NT-proBNP levels, suggesting a robust link between pro-inflammatory diets and increased heart failure biomarkers, with implications for dietary modifications in cardiovascular risk management.
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Affiliation(s)
- Teng-Chi Ma
- The First Affiliated Hospital of Xi’an Jiaotong University, Yulin Hospital, Yulin, Shaanxi, China
| | - Feng Gao
- Department of Cardiology, The Affiliated Hospital of Yan’an University, Yan’an, Shaanxi, China
| | - Xin-Lu Liu
- Department of Cardiology, The Affiliated Hospital of Yan’an University, Yan’an, Shaanxi, China
| | - Chen-Xi Wang
- Department of Cardiology, The Affiliated Hospital of Yan’an University, Yan’an, Shaanxi, China
| | - Qiang Liu
- Department of Cardiology, The Affiliated Hospital of Yan’an University, Yan’an, Shaanxi, China
| | - Jing Zhou
- Department of Cardiology, The Affiliated Hospital of Yan’an University, Yan’an, Shaanxi, China
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Doundoulakis I, Farmakis IT, Theodoridis X, Konstantelos A, Christoglou M, Kotzakioulafi E, Chrysoula L, Siargkas A, Karligkiotis A, Kyprianou G, Mastromanoli E, Soulaidopoulos S, Zafeiropoulos S, Antza C, Tsiachris D, Chourdakis M. Effects of dietary interventions on cardiovascular outcomes: a network meta-analysis. Nutr Rev 2024; 82:715-725. [PMID: 37432782 PMCID: PMC11082588 DOI: 10.1093/nutrit/nuad080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2023] Open
Abstract
CONTEXT Next to a large body of epidemiological observational studies showing that the Mediterranean diet (MD) is an important lifestyle determinant of cardiovascular risk, there is less relevant evidence from well-conducted randomized controlled trials (RCTs) with hard cardiovascular outcomes. OBJECTIVE The objective of the study was to identify the most effective dietary intervention for reducing cardiovascular morbidity and mortality. DATA SOURCES A systematic approach following PRISMA network meta-analyses reporting guidelines was applied to a search of electronic databases (MEDLINE, Cochrane Central Register of Controlled Trials, and Embase) without language restrictions, supplemented by scanning through bibliographies of studies and meetings' abstract material. Inclusion criteria were RCTs conducted in an adult population, investigating the effects of different type of diets or dietary patterns on all-cause mortality and cardiovascular outcomes of interest. DATA EXTRACTION Data extraction for each study was conducted by 2 independent reviewers. DATA ANALYSIS A frequentist network meta-analysis using a random-effects model was conducted. Death from any cardiovascular cause was defined as the primary outcome. A total of 17 trials incorporating 83 280 participants were included in the systematic review. Twelve articles (n = 80 550 participants) contributed to the network meta-analysis for the primary outcome. When compared with the control diet, only the MD showed a reduction in cardiovascular deaths (risk ratio = 0.59; 95% confidence interval, 0.42-0.82). Additionally, MD was the sole dietary strategy that decreased the risk of major cardiovascular events, myocardial infarction, angina, and all-cause mortality. CONCLUSIONS MD may play a protective role against cardiovascular disease and death for primary and also secondary prevention. SYSTEMATIC REVIEW REGISTRATION Center for Open Science, https://doi.org/10.17605/OSF.IO/5KX83.
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Affiliation(s)
- Ioannis Doundoulakis
- First Department of Cardiology, National and Kapodistrian University, “Hippokration” Hospital, Athens, Greece
| | - Ioannis T Farmakis
- Center for Thrombosis and Hemostasis, University Medical Center Mainz, Mainz, Germany
| | - Xenophon Theodoridis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Antonis Konstantelos
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria Christoglou
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evangelia Kotzakioulafi
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Lydia Chrysoula
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Antonis Siargkas
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Apostolos Karligkiotis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Georgia Kyprianou
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Mastromanoli
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stergios Soulaidopoulos
- First Department of Cardiology, National and Kapodistrian University, “Hippokration” Hospital, Athens, Greece
| | - Stefanos Zafeiropoulos
- Elmezzi Graduate School of Molecular Medicine, Northwell Health, Manhasset, New York, USA
- Feinstein Institutes for Medical Research at Northwell Health, Manhasset, New York, USA
| | - Christina Antza
- 3rd Department of Internal Medicine, G.N Papageorgiou, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitris Tsiachris
- First Department of Cardiology, National and Kapodistrian University, “Hippokration” Hospital, Athens, Greece
| | - Michail Chourdakis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Yu L, Wang J, Gong Q, An Y, Chen F, Chen Y, Chen X, He S, Qian X, Chen B, Dong F, Li H, Zhao F, Zhang B, Li G. Influence of a diet and/or exercise intervention on long-term mortality and vascular complications in people with impaired glucose tolerance: Da Qing Diabetes Prevention Outcome study. Diabetes Obes Metab 2024; 26:1188-1196. [PMID: 38168886 DOI: 10.1111/dom.15413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/03/2023] [Accepted: 12/04/2023] [Indexed: 01/05/2024]
Abstract
AIM We aimed to investigate the long-term influence of a diet and/or exercise intervention on long-term mortality and cardiovascular disease (CVD) events. METHODS The Da Qing Diabetes Prevention Study had 576 participants with impaired glucose tolerance (IGT) randomized to diet-only, exercise-only and diet-plus-exercise intervention group and control group. The participants underwent lifestyle interventions for 6 years. The subsequent Da Qing Diabetes Prevention Outcome Study was a prospective cohort study to follow-up the participants for up to 24 years after the end of 6-year intervention. In total, 540 participants completed the follow-up, while 36 subjects lost in follow-up. Cox proportional hazards analysis was applied to assess the influence of lifestyle interventions on targeted outcomes. RESULTS Compared with controls, the diet-only intervention in people with IGT was significantly associated with a reduced risk of all-cause death [hazard ratio (HR) 0.77, 95% confidence interval (CI) (0.61-0.97)], CVD death [HR 0.67, 95% CI (0.46-0.97)] and CVD events [HR 0.72, 95% CI (0.54-0.96)]. The diet-plus-exercise intervention was significantly associated with a decreased risk of all-cause death [HR 0.64, 95% CI (0.48-0.84)], CVD death [HR 0.54, 95% CI (0.30-0.97)] and CVD events [HR 0.68, 95% CI (0.52-0.90)]. Unexpectedly, the exercise-only intervention was not significantly associated with the reduction of any of these outcomes, although there was a consistent trend towards reduction. CONCLUSIONS A diet-only intervention and a diet-plus-exercise intervention in people with IGT were significantly associated with a reduced risk of all-cause death, CVD death and CVD events, while an exercise-only intervention was not. It suggests that diet-related interventions may have a potentially more reliable influence on long-term vascular complications and mortality.
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Affiliation(s)
- Liping Yu
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
| | - Jinping Wang
- Department of Cardiology, Da Qing First Hospital, Da Qing, China
| | - Qiuhong Gong
- Center of Endocrinology, National Center of Cardiology & Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yali An
- Center of Endocrinology, National Center of Cardiology & Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fei Chen
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
| | - Yanyan Chen
- Center of Endocrinology, National Center of Cardiology & Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - XiaoPing Chen
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
| | - Siyao He
- Center of Endocrinology, National Center of Cardiology & Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xin Qian
- Center of Endocrinology, National Center of Cardiology & Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bo Chen
- Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Fen Dong
- Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing, China
| | - Hui Li
- Department of Cardiology, Da Qing First Hospital, Da Qing, China
| | - Fang Zhao
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
| | - Bo Zhang
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
| | - Guangwei Li
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, China
- Center of Endocrinology, National Center of Cardiology & Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Luqman A, Hassan A, Ullah M, Naseem S, Ullah M, Zhang L, Din AU, Ullah K, Ahmad W, Wang G. Role of the intestinal microbiome and its therapeutic intervention in cardiovascular disorder. Front Immunol 2024; 15:1321395. [PMID: 38343539 PMCID: PMC10853344 DOI: 10.3389/fimmu.2024.1321395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 01/08/2024] [Indexed: 02/15/2024] Open
Abstract
The gut microbiome is a heterogeneous population of microbes comprising viruses, bacteria, fungi, and protozoa. Such a microbiome is essential for sustaining host equilibrium, and its impact on human health can be altered by a variety of factors such as external variables, social behavior, age, nutrition, and genetics. Gut microbes' imbalances are related to a variety of chronic diseases including cancer, obesity, and digestive disorders. Globally, recent findings show that intestinal microbes have a significant role in the formation of cardiovascular disease (CVD), which is still the primary cause of fatalities. Atherosclerosis, hypertension, diabetes, inflammation, and some inherited variables are all cardiovascular risk variables. However, studies found correlations between metabolism, intestinal flora, and dietary intake. Variations in the diversity of gut microbes and changes in their activity are thought to influence CVD etiology. Furthermore, the gut microbiota acts as an endocrine organ, producing bioactive metabolites such as TMA (trimethylamine)/TMAO (trimethylamine N-oxide), SCFA (short-chain fatty acids), and bile acids, which have a substantial impact on host wellness and disease by multiple mechanisms. The purpose of this overview is to compile current evidence highlighting the intricate links between gut microbiota, metabolites, and the development of CVD. It focuses on how intestinal dysbiosis promotes CVD risk factors such as heart failure, hypertension, and atherosclerosis. This review explores the normal physiology of intestinal microbes and potential techniques for targeting gut bacteria for CVD treatment using various microbial metabolites. It also examines the significance of gut bacteria in disease treatment, including supplements, prebiotics, probiotics, antibiotic therapies, and fecal transplantation, which is an innovative approach to the management of CVD. As a result, gut bacteria and metabolic pathways become increasingly attractive as potential targets for CVD intervention.
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Affiliation(s)
- Ameer Luqman
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing, China
- JinFeng Laboratories, Chongqing, China
| | - Adil Hassan
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing, China
- JinFeng Laboratories, Chongqing, China
- Chongqing Key Laboratory of Nano/Micro Composite Materials and Devices, Chongqing University of Science and Technology, Chongqing, China
| | - Mehtab Ullah
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing, China
| | - Sahar Naseem
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing, China
| | - Mehraj Ullah
- School of Fermentation Engineering Tianjin University of Science and Technology, Tianjin, China
| | | | - Ahmad Ud Din
- Plants for Human Health Institute, Department of Food, Bioprocessing and Nutrition Sciences, North Carolina State University, Kannapolis, NC, United States
| | - Kamran Ullah
- Department of Biology, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Waqar Ahmad
- Basic Medicine Research Innovation Center for Cardiometabolic Diseases, Ministry of Education, Southwest Medical University, Luzhou, China
| | - Guixue Wang
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing, China
- JinFeng Laboratories, Chongqing, China
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Zhu J, Lyu J, Zhao R, Liu G, Wang S. Gut macrobiotic and its metabolic pathways modulate cardiovascular disease. Front Microbiol 2023; 14:1272479. [PMID: 37822750 PMCID: PMC10562559 DOI: 10.3389/fmicb.2023.1272479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 09/12/2023] [Indexed: 10/13/2023] Open
Abstract
Thousands of microorganisms reside in the human gut, and extensive research has demonstrated the crucial role of the gut microbiota in overall health and maintaining homeostasis. The disruption of microbial populations, known as dysbiosis, can impair the host's metabolism and contribute to the development of various diseases, including cardiovascular disease (CVD). Furthermore, a growing body of evidence indicates that metabolites produced by the gut microbiota play a significant role in the pathogenesis of cardiovascular disease. These bioactive metabolites, such as short-chain fatty acids (SCFAs), trimethylamine (TMA), trimethylamine N-oxide (TMAO), bile acids (BAs), and lipopolysaccharides (LPS), are implicated in conditions such as hypertension and atherosclerosis. These metabolites impact cardiovascular function through various pathways, such as altering the composition of the gut microbiota and activating specific signaling pathways. Targeting the gut microbiota and their metabolic pathways represents a promising approach for the prevention and treatment of cardiovascular diseases. Intervention strategies, such as probiotic drug delivery and fecal transplantation, can selectively modify the composition of the gut microbiota and enhance its beneficial metabolic functions, ultimately leading to improved cardiovascular outcomes. These interventions hold the potential to reshape the gut microbial community and restore its balance, thereby promoting cardiovascular health. Harnessing the potential of these microbial metabolites through targeted interventions offers a novel avenue for tackling cardiovascular health issues. This manuscript provides an in-depth review of the recent advances in gut microbiota research and its impact on cardiovascular health and offers a promising avenue for tackling cardiovascular health issues through gut microbiome-targeted therapies.
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Affiliation(s)
- Junwen Zhu
- Department of Cardiology, The Affiliated Wenling Hospital of Wenzhou Medical University (The First People’s Hospital of Wenling), Zhejiang, China
- College of Bioscience and Biotechnology, Hunan Agricultural University, Changsha, Hunan, China
| | - Jin Lyu
- Department of Pathology, The First People’s Hospital of Foshan, Foshan, Guangdong, China
| | - Ruochi Zhao
- Key Laboratory of Precision Medicine for Atherosclerotic Diseases of Zhejiang Province, Affiliated First Hospital of Ningbo University, Ningbo, China
| | - Gang Liu
- College of Bioscience and Biotechnology, Hunan Agricultural University, Changsha, Hunan, China
| | - Shuangshuang Wang
- Department of Cardiology, The Affiliated Wenling Hospital of Wenzhou Medical University (The First People’s Hospital of Wenling), Zhejiang, China
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Isaakidis A, Maghariki JE, Carvalho-Barros S, Gomes AM, Correia M. Is There More to Olive Oil than Healthy Lipids? Nutrients 2023; 15:3625. [PMID: 37630815 PMCID: PMC10459315 DOI: 10.3390/nu15163625] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/21/2023] [Accepted: 07/27/2023] [Indexed: 08/27/2023] Open
Abstract
The Mediterranean diet is a healthy dietary pattern whose main characteristic is olive oil consumption. The potential health benefits of olive oil have been extensively investigated and the present review provides the more recent clinical evidence supporting the positive impact of olive oil intake on human health. PubMed (n = 227) and Scopus (n = 308) databases were searched for published clinical studies in English over the past six years (October 2016 to December 2022), following key word searches of "olive oil" and "health". Major findings associated olive oil with antioxidant and anti-inflammatory effects, improvement in endothelial function and lipid profile, prevention of obesity, diabetes, cardiovascular and neurodegenerative diseases, and modulation of the gut microbiota. These benefits are attributed to the nutritional composition of olive oil, which has a high content of monounsaturated fatty acids (MUFA) (oleic acid in particular) and minor compounds such as polyphenols (oleuropein and hydroxytyrosol). Although additional research continues to be required, the more recently generated evidence supports the potential of olive oil to contribute beneficially to health and to the prevention and management of a variety of non-communicable diseases, as a consequence of the synergism between its components' complexity.
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Affiliation(s)
- Akritas Isaakidis
- Centro de Biotecnologia e Química Fina (CBQF)-Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal (J.E.M.); (M.C.)
- Department of Nutritional Sciences and Dietetics, International Hellenic University of Thessaloniki, Sindos, 57400 Thessaloniki, Greece
| | - Jane El Maghariki
- Centro de Biotecnologia e Química Fina (CBQF)-Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal (J.E.M.); (M.C.)
| | - Sérgio Carvalho-Barros
- Centro de Biotecnologia e Química Fina (CBQF)-Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal (J.E.M.); (M.C.)
| | - Ana Maria Gomes
- Centro de Biotecnologia e Química Fina (CBQF)-Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal (J.E.M.); (M.C.)
| | - Marta Correia
- Centro de Biotecnologia e Química Fina (CBQF)-Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal (J.E.M.); (M.C.)
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Chen A, Zhang J, Zhang Y. Gut microbiota in heart failure and related interventions. IMETA 2023; 2:e125. [PMID: 38867928 PMCID: PMC10989798 DOI: 10.1002/imt2.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/28/2023] [Accepted: 06/04/2023] [Indexed: 06/14/2024]
Abstract
Heart failure (HF) is a sophisticated syndrome with structural or functional impairment of ventricular filling or ejection of blood, either causing symptoms and signs or being asymptomatic. HF is a major global health issue affecting about 64.3 million people worldwide. The gut microbiota refers to the complex ecosystem of microorganisms, mainly bacteria, in the gut. Studies have revealed that the gut microbiota is associated with many diseases ranging from neurodegenerative diseases to inflammatory bowel disease and cardiovascular diseases. The gut hypothesis of HF suggests that low cardiac output and systemic circulation congestion would cause insufficient intestinal perfusion, leading to ischemia and intestinal barrier dysfunction. The resulting bacterial translocation would contribute to inflammation. Recent studies have refined the hypothesis that changes of metabolites in the gut microbiota have a close relationship with HF. Thus, the gut microbiota has emerged as a potential therapeutic target for HF due to both its critical role in regulating host physiology and metabolism and its pivotal role in the development of HF. This review article aims to provide an overview of the current understanding of the gut microbiota's involvement in HF, including the introduction of the gut hypothesis of HF, its association with HF progression, the potential mechanisms involved mediated by the gut microbiota metabolites, and the impact of various interventions on the gut microbiota, including dietary interventions, probiotic therapy, fecal microbiota transplantation, antibiotics, and so on. While the gut hypothesis of HF is refined with up-to-date knowledge and the gut microbiota presents a promising target for HF therapy, further research is still needed to further understand the underlying mechanisms between gut microbiota and HF, the efficacy of these interventions, and contribute to the health of HF patients.
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Affiliation(s)
- An‐Tian Chen
- Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai HospitalChinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular DiseasesBeijingChina
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai HospitalChinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular DiseasesBeijingChina
| | - Jian Zhang
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai HospitalChinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular DiseasesBeijingChina
- Key Laboratory of Clinical Research for Cardiovascular MedicationsNational Health CommitteeBeijingChina
| | - Yuhui Zhang
- State Key Laboratory of Cardiovascular Disease, Heart Failure Center, Fuwai HospitalChinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular DiseasesBeijingChina
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Shahim B, Kapelios CJ, Savarese G, Lund LH. Global Public Health Burden of Heart Failure: An Updated Review. Card Fail Rev 2023; 9:e11. [PMID: 37547123 PMCID: PMC10398425 DOI: 10.15420/cfr.2023.05] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/10/2023] [Indexed: 08/08/2023] Open
Abstract
Heart failure (HF) is a rapidly growing public health issue with an estimated prevalence of 64 million people globally. Although the incidence of HF has stabilised worldwide and seems to be declining in developed countries, the prevalence is increasing due to the ageing of the population, improved survival after MI and improved treatment and survival of patients with HF. Yet, HF remains associated with high mortality and morbidity, poor quality of life and functional capacity, and confers a substantial burden to the healthcare system. The prevalence, incidence, mortality and morbidity rates reported show geographical variations, depending on the different aetiologies and clinical characteristics observed among patients with HF. In this review, we provide an overview of the global epidemiology of HF with updated data on prevalence, incidence, mortality and morbidity worldwide.
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Affiliation(s)
- Bahira Shahim
- Division of Cardiology, Department of Medicine, Karolinska InstitutetStockholm, Sweden
- Heart and Vascular Theme, Karolinska University HospitalStockholm, Sweden
| | - Chris J Kapelios
- Department of Cardiovascular Medicine, University of Utah Health Sciences CenterSalt Lake City, UT, US
| | - Gianluigi Savarese
- Division of Cardiology, Department of Medicine, Karolinska InstitutetStockholm, Sweden
- Heart and Vascular Theme, Karolinska University HospitalStockholm, Sweden
| | - Lars H Lund
- Division of Cardiology, Department of Medicine, Karolinska InstitutetStockholm, Sweden
- Heart and Vascular Theme, Karolinska University HospitalStockholm, Sweden
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Yang Y, Karampoor S, Mirzaei R, Borozdkin L, Zhu P. The interplay between microbial metabolites and macrophages in cardiovascular diseases: A comprehensive review. Int Immunopharmacol 2023; 121:110546. [PMID: 37364331 DOI: 10.1016/j.intimp.2023.110546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/11/2023] [Accepted: 06/18/2023] [Indexed: 06/28/2023]
Abstract
The gut microbiome has emerged as a crucial player in developing and progressing cardiovascular diseases (CVDs). Recent studies have highlighted the role of microbial metabolites in modulating immune cell function and their impact on CVD. Macrophages, which have a significant function in the pathogenesis of CVD, are very vulnerable to the effects of microbial metabolites. Microbial metabolites, such as short-chain fatty acids (SCFAs) and trimethylamine-N-oxide (TMAO), have been linked to atherosclerosis and the regulation of immune functions. Butyrate has been demonstrated to reduce monocyte migration and inhibit monocyte attachment to injured endothelial cells, potentially contributing to the attenuation of the inflammatory response and the progression of atherosclerosis. On the other hand, TMAO, another compound generated by gut bacteria, has been linked to atherosclerosis due to its impact on lipid metabolism and the accumulation of cholesterol in macrophages. Indole-3-propionic acid, a tryptophan metabolite produced solely by microbes, has been found to promote the development of atherosclerosis by stimulating macrophage reverse cholesterol transport (RCT) and raising the expression of ABCA1. This review comprehensively discusses how various microbiota-produced metabolites affect macrophage polarization, inflammation, and foam cell formation in CVD. We also highlight the mechanisms underlying these effects and the potential therapeutic applications of targeting microbial metabolites in treating CVD.
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Affiliation(s)
- Yongzheng Yang
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Sajad Karampoor
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Rasoul Mirzaei
- Venom and Biotherapeutics Molecules Lab, Medical Biotechnology Department, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Leonid Borozdkin
- Department of Maxillofacial Surgery, I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
| | - Ping Zhu
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong 510100, China.
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10
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Esteban-Fernández A, Villar-Taibo R, Alejo M, Arroyo D, Bonilla Palomas JL, Cachero M, Joaquin C, Méndez Bailón M, Pérez-Rivera JÁ, Romero-Vigara JC, Somoza G. Diagnosis and Management of Malnutrition in Patients with Heart Failure. J Clin Med 2023; 12:3320. [PMID: 37176761 PMCID: PMC10179706 DOI: 10.3390/jcm12093320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 04/30/2023] [Accepted: 05/05/2023] [Indexed: 05/15/2023] Open
Abstract
Heart failure is a disease with an increasingly greater prevalence due to the aging population, the development of new drugs, and the organization of healthcare processes. Malnutrition has been identified as a poor prognostic factor in these patients, very often linked to frailty or to other comorbidities, meaning that early diagnosis and treatment are essential. This paper reviews some important aspects of the pathophysiology, detection, and management of malnutrition in patients with heart failure.
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Affiliation(s)
- Alberto Esteban-Fernández
- Cardiology Department, Severo Ochoa University Hospital, Calle Orellana s/n, 28911 Madrid, Spain
- Faculty of Health Sciences, Valencian International University, 46002 Valencia, Spain
| | - Rocío Villar-Taibo
- Endocrinology Department, Santiago University Clinical Hospital, 15706 Santiago de Compostela, Spain;
| | - Mirian Alejo
- Endocrinology Department, Hospital El Bierzo, 24404 Ponferrada, Spain;
| | - David Arroyo
- Nephrology Department, Gregorio Marañón General University Hospital, 28007 Madrid, Spain;
| | | | - Montserrat Cachero
- Endocrinology Department, Germans Trias i Pujol Hospital, 08916 Badalona, Spain; (M.C.); (C.J.)
| | - Clara Joaquin
- Endocrinology Department, Germans Trias i Pujol Hospital, 08916 Badalona, Spain; (M.C.); (C.J.)
| | - Manuel Méndez Bailón
- Internal Medicine Department, San Carlos Clinical University Hospital, 28034 Madrid, Spain;
| | - José Ángel Pérez-Rivera
- Cardiology Department, Burgos University Hospital, 09006 Burgos, Spain;
- Faculty of Health Sciences, Isabel I University, 09003 Burgos, Spain
| | | | - Gema Somoza
- Geriatric Department, Gregorio Marañón University Hospital, 28007 Madrid, Spain;
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11
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Kwant CT, de Man F, van der Horst FAL, Bogaard HJ, Vonk Noordegraaf A. The UPHILL study: A nutrition and lifestyle intervention to improve quality of life for patients with pulmonary arterial hypertension. Pulm Circ 2023; 13:e12243. [PMID: 37252180 PMCID: PMC10224798 DOI: 10.1002/pul2.12243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 05/03/2023] [Accepted: 05/16/2023] [Indexed: 05/31/2023] Open
Abstract
The aim of the UPHILL study (a nutrition and lifestyle intervention in patients with pulmonary arterial hypertension [PAH]: effect on quality of life [QoL]), was to determine the effect of innovative nutritional interventions on adjustments in nutritional intake and QoL. In this study a group of prevalent PAH patients at a single center in Amsterdam (the Netherlands) was informed about healthy nutrition using a newly designed video e-learning. They were subsequently instructed to follow a healthy diet during dietary intervention. Nutritional intake was assessed using a food frequency questionnaire (HELIUS) and QoL by the short-form (SF)-36 questionnaire. Nutritional parameters were determined in blood samples. Seventeen patients stable under treatment, who had been diagnosed with PAH 7.0 [3.0-14.0] years before, started and completed the intervention (2 males, 15 females; 45.35 ± 13.57 years). Since all patients in the intervention group made behavioral changes in nutritional intake, during study and follow-up, nutritional and lifestyle adaptations persisted. Despite the fact that patients had already high mean scores at baseline for both mental (74.10 [60.51-84.25]) and physical QoL (66.46 [50.21-73.84]), scores improved further during e-learning. Furthermore, patients who realized most nutritional adaptations, had the best improvement in QoL. This pilot study showed that e-learning modules on nutrition provide an unique opportunity to change nutritional intake in PAH patients and by that improve QoL.
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Affiliation(s)
- Chermaine T. Kwant
- Departments of Pulmonary Medicine, Amsterdam UMC, Vrije Universiteit AmsterdamAmsterdam Cardiovascular SciencesAmsterdamThe Netherlands
| | - Frances de Man
- Departments of Pulmonary Medicine, Amsterdam UMC, Vrije Universiteit AmsterdamAmsterdam Cardiovascular SciencesAmsterdamThe Netherlands
| | | | - Harm J. Bogaard
- Departments of Pulmonary Medicine, Amsterdam UMC, Vrije Universiteit AmsterdamAmsterdam Cardiovascular SciencesAmsterdamThe Netherlands
| | - Anton Vonk Noordegraaf
- Departments of Pulmonary Medicine, Amsterdam UMC, Vrije Universiteit AmsterdamAmsterdam Cardiovascular SciencesAmsterdamThe Netherlands
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12
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Satogami K, Katayama Y, Ozaki Y, Taruya A, Taniguchi M, Ota S, Kuroi A, Shiono Y, Tanimoto T, Yamano T, Kitabata H, Ino Y, Tanaka A. Long-term risk stratification for hospitalized patients with acute heart failure at a single rural cardiovascular centre. ESC Heart Fail 2023; 10:1717-1725. [PMID: 36840441 DOI: 10.1002/ehf2.14325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 01/04/2023] [Accepted: 02/07/2023] [Indexed: 02/26/2023] Open
Abstract
AIMS Early risk stratification of patients with acute heart failure (AHF) is critical for appropriate triage and outcome improvement. The serum sodium, blood urea nitrogen, age, serum albumin, systolic blood pressure, and natriuretic peptide level (SOB-ASAP) score can predict in-hospital mortality of AHF. However, the relationship between the SOB-ASAP score and long-term prognosis is unknown. This study investigated the determinants of the long-term prognosis of AHF by evaluating the SOB-ASAP score. METHODS This retrospective cohort study included all patients with acute decompensated heart failure who were admitted to our hospital between April 2017 and March 2018. And those who discharged were analysed retrospectively. The follow-up period was 3 years. Primary end point was all-cause death. RESULTS Total of 140 patients were analysed. The median SOB-ASAP score of entire cohort on admission was 3 points (interquartile range; 1-5). The Kaplan-Meier curve demonstrated that patients in the higher SOB-ASAP group (score ≥3) had a higher incidence of all-cause death (log-rank test; P < 0.001) than those in the lower SOB-ASAP (group score <3). CONCLUSIONS At admission, the SOB-ASAP score may be useful for predicting the long-term prognosis of hospitalized patients with AHF.
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Affiliation(s)
- Keisuke Satogami
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yosuke Katayama
- Department of Cardiology, Shingu Municipal Medical Center, Shingu, Japan
| | - Yuichi Ozaki
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Akira Taruya
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Motoki Taniguchi
- Department of Cardiology, Shingu Municipal Medical Center, Shingu, Japan
| | - Shingo Ota
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Akio Kuroi
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yasutsugu Shiono
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Takashi Tanimoto
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Takashi Yamano
- Department of Cardiology, Shingu Municipal Medical Center, Shingu, Japan
| | - Hironori Kitabata
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yasushi Ino
- Department of Cardiology, Shingu Municipal Medical Center, Shingu, Japan
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
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13
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Mukherjee MS, Han CY, Sukumaran S, Delaney CL, Miller MD. Effect of anti-inflammatory diets on inflammation markers in adult human populations: a systematic review of randomized controlled trials. Nutr Rev 2022; 81:55-74. [PMID: 35831971 DOI: 10.1093/nutrit/nuac045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
CONTEXT Chronic inflammation, characterized by prolonged elevated inflammation markers, is linked to several chronic conditions. Diet can influence the levels of inflammation markers in the body. OBJECTIVE The aim of this systematic review was to assess the effects of anti-inflammatory diets on 14 different inflammation markers in adults. DATA SOURCES This systematic review conducted searches using Medline, PubMed, EMCare, Cochrane, and CINAHL, to locate randomized controlled trials (RCTs). DATA EXTRACTION Two researchers independently screened 1537 RCTs that measured changes in inflammation markers after prescription of an intervention diet. DATA ANALYSIS In total, 20 RCTs were included and assessed qualitatively. The results demonstrated that a Mediterranean diet can bring about statistically significant and clinically meaningful between-group differences in interleukins -1α, -1β, -4, -5, -6, -7, -8, -10, and -18, interferon γ, tumor necrosis factor α, C-reactive protein, and high-sensitivity C-reactive protein, as compared with a control diet. CONCLUSIONS There may be a link between diet, inflammation markers, and disease outcomes in various adult populations. However, further research using consistent RCT protocols is required to determine correlations between diet, specific inflammation markers, and clinically relevant outcomes.
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Affiliation(s)
- Mitali S Mukherjee
- are with the Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Chad Y Han
- are with the Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Shawgi Sukumaran
- are with the College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.,is with the Department of Medical Oncology, Flinders Medical Centre, Bedford Park, South Australia, Australia
| | - Christopher L Delaney
- are with the College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.,is with the Department of Vascular Surgery, Flinders Medical Centre, Bedford Park, South Australia, Australia
| | - Michelle D Miller
- are with the Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
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14
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Gut Microbiota and Cardiovascular System: An Intricate Balance of Health and the Diseased State. LIFE (BASEL, SWITZERLAND) 2022; 12:life12121986. [PMID: 36556351 PMCID: PMC9780831 DOI: 10.3390/life12121986] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/13/2022] [Accepted: 11/18/2022] [Indexed: 11/29/2022]
Abstract
Gut microbiota encompasses the resident microflora of the gut. Having an intricate relationship with the host, it plays an important role in regulating physiology and in the maintenance of balance between health and disease. Though dietary habits and the environment play a critical role in shaping the gut, an imbalance (referred to as dysbiosis) serves as a driving factor in the occurrence of different diseases, including cardiovascular disease (CVD). With risk factors of hypertension, diabetes, dyslipidemia, etc., CVD accounts for a large number of deaths among men (32%) and women (35%) worldwide. As gut microbiota is reported to have a direct influence on the risk factors associated with CVDs, this opens up new avenues in exploring the possible role of gut microbiota in regulating the gross physiological aspects along the gut-heart axis. The present study elaborates on different aspects of the gut microbiota and possible interaction with the host towards maintaining a balance between health and the occurrence of CVDs. As the gut microbiota makes regulatory checks for these risk factors, it has a possible role in shaping the gut and, as such, in decreasing the chances of the occurrence of CVDs. With special emphasis on the risk factors for CVDs, this paper includes information on the prominent bacterial species (Firmicutes, Bacteriodetes and others) towards an advance in our understanding of the etiology of CVDs and an exploration of the best possible therapeutic modules for implementation in the treatment of different CVDs along the gut-heart axis.
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15
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Mutalub YB, Abdulwahab M, Mohammed A, Yahkub AM, AL-Mhanna SB, Yusof W, Tang SP, Rasool AHG, Mokhtar SS. Gut Microbiota Modulation as a Novel Therapeutic Strategy in Cardiometabolic Diseases. Foods 2022; 11:2575. [PMID: 36076760 PMCID: PMC9455664 DOI: 10.3390/foods11172575] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/20/2022] [Accepted: 08/22/2022] [Indexed: 11/19/2022] Open
Abstract
The human gut harbors microbial ecology that is in a symbiotic relationship with its host and has a vital function in keeping host homeostasis. Inimical alterations in the composition of gut microbiota, known as gut dysbiosis, have been associated with cardiometabolic diseases. Studies have revealed the variation in gut microbiota composition in healthy individuals as compared to the composition of those with cardiometabolic diseases. Perturbation of host-microbial interaction attenuates physiological processes and may incite several cardiometabolic disease pathways. This imbalance contributes to cardiometabolic diseases via metabolism-independent and metabolite-dependent pathways. The aim of this review was to elucidate studies that have demonstrated the complex relationship between the intestinal microbiota as well as their metabolites and the development/progression of cardiometabolic diseases. Furthermore, we systematically itemized the potential therapeutic approaches for cardiometabolic diseases that target gut microbiota and/or their metabolites by following the pathophysiological pathways of disease development. These approaches include the use of diet, prebiotics, and probiotics. With the exposition of the link between gut microbiota and cardiometabolic diseases, the human gut microbiota therefore becomes a potential therapeutic target in the development of novel cardiometabolic agents.
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Affiliation(s)
- Yahkub Babatunde Mutalub
- Department of Pharmacology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia or
- Department of Clinical Pharmacology, College of Medical Sciences, Abubakar Tafawa Balewa University, Bauchi 74027, Nigeria
| | - Monsurat Abdulwahab
- Department of Midwifery, College of Nursing Sciences, Abubakar Tafawa Balewa University Teaching Hospital, Bauchi 74027, Nigeria
| | - Alkali Mohammed
- Department of Medicine, College of Medical Sciences, Abubakar Tafawa Balewa University, Bauchi 74027, Nigeria
| | - Aishat Mutalib Yahkub
- College of Medical Sciences, Abubakar Tafawa Balewa University, Bauchi 74027, Nigeria
| | - Sameer Badri AL-Mhanna
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Wardah Yusof
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Suk Peng Tang
- Department of Pharmacology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia or
| | - Aida Hanum Ghulam Rasool
- Department of Pharmacology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia or
| | - Siti Safiah Mokhtar
- Department of Pharmacology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia or
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16
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Franco AD, Morfino P, Aimo A. Plasma acylcarnitine, risk for heart failure or atrial fibrillation, and effects of the Mediterranean diet or obesity. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2022; 75:621-622. [PMID: 35248520 DOI: 10.1016/j.rec.2022.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 01/24/2022] [Indexed: 06/14/2023]
Affiliation(s)
| | - Paolo Morfino
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Alberto Aimo
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy; Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy.
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17
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Costa JO, Aidar FJ, Barbosa JS, Alves LVS, Oliveira VB, de Oliveira LMSM, Rocha RMS, Vieira DADS, Costa IMNBDC, de Souza MFC, Oliveira JLM, Baumworcel L, Neves EB, Díaz-de-Durana AL, Almeida-Santos MA, Sousa ACS. BALANCE Dietary Index in Patients with Heart Failure, and Its Adherence in Sergipe, Brazil. Clin Pract 2022; 12:383-395. [PMID: 35735662 PMCID: PMC9221597 DOI: 10.3390/clinpract12030043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/20/2022] [Accepted: 05/24/2022] [Indexed: 11/16/2022] Open
Abstract
Background: “The effective treatment of Heart Failure (HF) involves care with food intake. Recently, the Ministry of Health created the Brazilian Cardioprotective Diet and its dietary index, BALANCE, which assesses adherence to the standard’s recommendations”. Methods: This observational prospective study is part of the Congestive Heart Failure Registry (VICTIM-CHF) of Aracaju/SE. Observations and data collection took place from April 2018 to February 2021. Sociodemographic and clinical aspects and food consumption were evaluated. Food intake was determined using the food frequency questionnaire. Foods were categorized using the BALANCE dietary index into green, yellow, blue and red food groups. The BALANCE dietary index was obtained using median and interquartile ranges, scores of the Mann–Whitney U test, and associations between clinical variables and the index, through linear regression. Results: Participants included 240 patients with HF (61.12 ± 1.06 years), who were assisted by the Unified Health System (67.5%). Individuals with a partner showed greater adherence to the green food group recommendations (0.09; 0.00–0.17). The lowest adherence to recommendations regarding the blue food group was observed in individuals with excess weight, who had a higher consumption of foods rich in animal protein (0.54; 0.38–0.78). As for the red food group (ultra-processed foods) the highest adherence was observed by patients with diabetes mellitus (0.41; 0.05–0.77). The greatest adherence to the yellow food group, and a higher score, was observed in patients with the smallest left ventricular systolic diameter (LVSD). Conclusions: Being married was directly associated with the consumption of foods in the green group, while being overweight and having diabetes were inversely associated with adherence to the blue and red food groups, respectively. Greater adherence to the yellow food group recommendations was inversely associated with less change in the DSFVE.
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Affiliation(s)
- Jamille Oliveira Costa
- Graduate Program in Health Sciences, Federal University of Sergipe (UFS), Aracaju 49060-676, SE, Brazil; (J.S.B.); (L.V.S.A.); (V.B.O.); (L.M.S.M.d.O.); (R.M.S.R.); (J.L.M.O.); (A.C.S.S.)
- Correspondence:
| | - Felipe J. Aidar
- Group of Studies and Research in Performance, Sport, Health and Paralympic Sports—GEPEPS, Federal University of Sergipe (UFS), São Cristóvão 49100-000, SE, Brazil;
- Graduate Program in Physical Education, Federal University of Sergipe (UFS), São Cristóvão 49100-000, SE, Brazil
- Graduate Program in Physiological Science, Federal University of Sergipe (UFS), São Cristóvão 49100-000, SE, Brazil
| | - Juliana Santos Barbosa
- Graduate Program in Health Sciences, Federal University of Sergipe (UFS), Aracaju 49060-676, SE, Brazil; (J.S.B.); (L.V.S.A.); (V.B.O.); (L.M.S.M.d.O.); (R.M.S.R.); (J.L.M.O.); (A.C.S.S.)
| | - Luciana Vieira Sousa Alves
- Graduate Program in Health Sciences, Federal University of Sergipe (UFS), Aracaju 49060-676, SE, Brazil; (J.S.B.); (L.V.S.A.); (V.B.O.); (L.M.S.M.d.O.); (R.M.S.R.); (J.L.M.O.); (A.C.S.S.)
| | - Victor Batista Oliveira
- Graduate Program in Health Sciences, Federal University of Sergipe (UFS), Aracaju 49060-676, SE, Brazil; (J.S.B.); (L.V.S.A.); (V.B.O.); (L.M.S.M.d.O.); (R.M.S.R.); (J.L.M.O.); (A.C.S.S.)
| | - Larissa Marina Santana Mendonça de Oliveira
- Graduate Program in Health Sciences, Federal University of Sergipe (UFS), Aracaju 49060-676, SE, Brazil; (J.S.B.); (L.V.S.A.); (V.B.O.); (L.M.S.M.d.O.); (R.M.S.R.); (J.L.M.O.); (A.C.S.S.)
| | - Raysa Manuelle Santos Rocha
- Graduate Program in Health Sciences, Federal University of Sergipe (UFS), Aracaju 49060-676, SE, Brazil; (J.S.B.); (L.V.S.A.); (V.B.O.); (L.M.S.M.d.O.); (R.M.S.R.); (J.L.M.O.); (A.C.S.S.)
| | - Diva Aliete dos Santos Vieira
- Department of Nutrition, Campus Prof. Antônio Garcia Filho, Federal University of Sergipe (UFS), Lagarto 49400-000, SE, Brazil;
| | | | - Márcia Ferreira Cândido de Souza
- Graduate Program Professional in Management and Technological Innovation in Health, Federal University of Sergipe, Aracaju 49100-000, SE, Brazil;
| | - Joselina Luzia Menezes Oliveira
- Graduate Program in Health Sciences, Federal University of Sergipe (UFS), Aracaju 49060-676, SE, Brazil; (J.S.B.); (L.V.S.A.); (V.B.O.); (L.M.S.M.d.O.); (R.M.S.R.); (J.L.M.O.); (A.C.S.S.)
- Department of Medicine, Federal University of Sergipe (UFS), São Cristóvão 49100-000, SE, Brazil
- Division of Cardiology, University Hospital of Federal University of Sergipe (UFS), São Cristóvão 49100-000, SE, Brazil
- Clinic and Hospital São Lucas/Rede D’Or São Luiz, Aracaju 49060-676, SE, Brazil; (L.B.); (M.A.A.-S.)
| | - Leonardo Baumworcel
- Clinic and Hospital São Lucas/Rede D’Or São Luiz, Aracaju 49060-676, SE, Brazil; (L.B.); (M.A.A.-S.)
| | - Eduardo Borba Neves
- Graduate Program in Biomedical Engineering, Federal Technological University of Paraná (UTFPR), Curitiba 80230-901, PR, Brazil;
| | - Alfonso López Díaz-de-Durana
- Sports Department, Physical Activity and Sports Faculty-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain;
| | - Marcos Antonio Almeida-Santos
- Clinic and Hospital São Lucas/Rede D’Or São Luiz, Aracaju 49060-676, SE, Brazil; (L.B.); (M.A.A.-S.)
- Graduate Program in Health and Environment, Tiradentes University (UNIT), Aracaju 49010-390, SE, Brazil
| | - Antônio Carlos Sobral Sousa
- Graduate Program in Health Sciences, Federal University of Sergipe (UFS), Aracaju 49060-676, SE, Brazil; (J.S.B.); (L.V.S.A.); (V.B.O.); (L.M.S.M.d.O.); (R.M.S.R.); (J.L.M.O.); (A.C.S.S.)
- Department of Medicine, Federal University of Sergipe (UFS), São Cristóvão 49100-000, SE, Brazil
- Division of Cardiology, University Hospital of Federal University of Sergipe (UFS), São Cristóvão 49100-000, SE, Brazil
- Clinic and Hospital São Lucas/Rede D’Or São Luiz, Aracaju 49060-676, SE, Brazil; (L.B.); (M.A.A.-S.)
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18
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Goni L, Razquin C, Toledo E, Guasch-Ferré M, Clish CB, Babio N, Wittenbecher C, Atzeni A, Li J, Liang L, Dennis C, Alonso-Gómez Á, Fitó M, Corella D, Gómez-Gracia E, Estruch R, Fiol M, Lapetra J, Serra-Majem L, Ros E, Arós F, Salas-Salvadó J, Hu FB, Martínez-González MA, Ruiz-Canela M. Arginine catabolism metabolites and atrial fibrillation or heart failure risk: 2 case-control studies within the Prevención con Dieta Mediterránea (PREDIMED) trial. Am J Clin Nutr 2022; 116:653-662. [PMID: 35575609 PMCID: PMC9437981 DOI: 10.1093/ajcn/nqac139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 04/25/2022] [Accepted: 05/11/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Arginine-derived metabolites are involved in oxidative and inflammatory processes related to endothelial functions and cardiovascular risks. OBJECTIVES We prospectively examined the associations of arginine catabolism metabolites with the risks of atrial fibrillation (AF) or heart failure (HF), and evaluated the potential modifications of these associations through Mediterranean diet (MedDiet) interventions in a large, primary-prevention trial. METHODS Two nested, matched, case-control studies were designed within the Prevención con Dieta Mediterránea (PREDIMED) trial. We selected 509 incident cases and 547 matched controls for the AF case-control study and 326 cases and 402 matched controls for the HF case-control study using incidence density sampling. Fasting blood samples were collected at baseline and arginine catabolism metabolites were measured using LC-tandem MS. Multivariable conditional logistic regression models were applied to test the associations between the metabolites and incident AF or HF. Interactions between metabolites and intervention groups (MedDiet groups compared with control group) were analyzed with the likelihood ratio test. RESULTS Inverse association with incident AF was observed for arginine (OR per 1 SD, 0.83; 95% CI: 0.73-0.94), whereas a positive association was found for N1-acetylspermidine (OR for Q4 compared with Q1 1.58; 95% CI: 1.13-2.25). For HF, inverse associations were found for arginine (OR per 1 SD, 0.82; 95% CI: 0.69-0.97) and homoarginine (OR per 1 SD, 0.81; 95% CI: 0.68-0.96), and positive associations were found for the asymmetric dimethylarginine (ADMA) and symmetric dimethlyarginine (SDMA) ratio (OR per 1 SD, 1.19; 95% CI: 1.02-1.41), N1-acetylspermidine (OR per 1 SD, 1.34; 95% CI: 1.12-1.60), and diacetylspermine (OR per 1 SD, 1.20; 95% CI: 1.02-1.41). In the stratified analysis according to the dietary intervention, the lower HF risk associated with arginine was restricted to participants in the MedDiet groups (P-interaction = 0.044). CONCLUSIONS Our results suggest that arginine catabolism metabolites could be involved in AF and HF. Interventions with the MedDiet may contribute to strengthen the inverse association between arginine and the risk of HF. This trial was registered at controlled-trials.com as ISRCTN35739639.
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Affiliation(s)
- Leticia Goni
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain,IdiSNA (Instituto de Investigación Sanitaria de Navarra), Pamplona, Spain,Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Razquin
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain,IdiSNA (Instituto de Investigación Sanitaria de Navarra), Pamplona, Spain,Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Estefanía Toledo
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain,IdiSNA (Instituto de Investigación Sanitaria de Navarra), Pamplona, Spain,Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Guasch-Ferré
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA,Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, MA, USA
| | - Clary B Clish
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Nancy Babio
- Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain,Institut d'Investigació Sanitària Pere i Virgili, Hospital Universitari Sant Joan de Reus, Reus, Spain
| | - Clemens Wittenbecher
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA,Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany,German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Alessandro Atzeni
- Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain,Institut d'Investigació Sanitària Pere i Virgili, Hospital Universitari Sant Joan de Reus, Reus, Spain
| | - Jun Li
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Liming Liang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA,Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Ángel Alonso-Gómez
- Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, Vitoria-Gasteiz, Spain,University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain
| | - Montserrat Fitó
- Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain
| | - Dolores Corella
- Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Enrique Gómez-Gracia
- Department of Preventive Medicine, University of Malaga, Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Ramón Estruch
- Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Miquel Fiol
- Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Plataforma de Ensayos Clínicos, Instituto de Investigación Sanitaria Illes Balears (IdISBa), Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - Jose Lapetra
- Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - Lluis Serra-Majem
- Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Nutrition Research Group, Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Emilio Ros
- Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Lipid Clinic, Department of Endocrinology and Nutrition, August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Fernando Arós
- Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, Vitoria-Gasteiz, Spain,University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain
| | - Jordi Salas-Salvadó
- Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain,Institut d'Investigació Sanitària Pere i Virgili, Hospital Universitari Sant Joan de Reus, Reus, Spain
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA,Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, MA, USA
| | - Miguel A Martínez-González
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain,IdiSNA (Instituto de Investigación Sanitaria de Navarra), Pamplona, Spain,Centro de Investigacion Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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19
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Franco AD, Morfino P, Aimo A. Acilcarnitina plasmática, riesgo de insuficiencia cardiaca o fibrilación auricular y efectos de la dieta mediterránea o la obesidad. Rev Esp Cardiol 2022. [DOI: 10.1016/j.recesp.2022.01.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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20
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Chang CY, Lee CL, Liu WJ, Wang JS. Association of Adherence to the Mediterranean Diet with All-Cause Mortality in Subjects with Heart Failure. Nutrients 2022; 14:nu14040842. [PMID: 35215491 PMCID: PMC8875916 DOI: 10.3390/nu14040842] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 01/29/2022] [Accepted: 02/15/2022] [Indexed: 12/17/2022] Open
Abstract
We investigated the associations of adherence to the Mediterranean diet with all-cause and cardiovascular mortality in patients with heart failure. We analyzed the National Health and Nutrition Examination Survey (NHANES) participants from 1999 to 2010, with their vital status confirmed through to the end of 2011. The alternate Mediterranean Diet Index (aMED) was used to assess study participants’ adherence to the Mediterranean diet according to information on dietary questionnaires. We conducted weighted Cox proportional hazards regression models to determine the associations of adherence to the Mediterranean diet (aMED ≥ median vs. <median) with all-cause and cardiovascular mortality in participants with a history of heart failure. A total of 832 participants were analyzed, and the median aMED was 3. After a median follow-up of 4.7 years, 319 participants had died. aMED ≥ 3 (vs. <3) was not associated with a lower risk of all-cause (adjusted HR 0.797, 95% CI 0.599–1.059, p = 0.116) and cardiovascular (adjusted HR 0.911, 95% CI 0.539–1.538, p = 0.724) mortality. The findings were consistent across several subgroup populations. Among the components of aMED, a lower intake of red/processed meat was associated with a higher risk of mortality (adjusted HR 1.406, 95% CI 1.011–1.955, p = 0.043). We concluded that adherence to the Mediterranean diet was not associated with a lower risk of all-cause and cardiovascular mortality in participants with a history of heart failure. The higher risk of mortality associated with a lower intake of red/processed meat deserves further investigation.
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Affiliation(s)
- Chih-Yun Chang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (C.-Y.C.); (C.-L.L.)
| | - Chia-Lin Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (C.-Y.C.); (C.-L.L.)
- Department of Medical Research, Taichung Veterans General Hospital, Taichung 40705, Taiwan
- Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
- College of Medicine, National Chung Hsing University, Taichung 40227, Taiwan
| | - Wei-Ju Liu
- Department of Medical Research, Taichung Veterans General Hospital, Taichung 40705, Taiwan
- Correspondence: (W.-J.L.); (J.-S.W.); Tel.: +886-4-23592525 (W.-J.L. & J.-S.W.)
| | - Jun-Sing Wang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan; (C.-Y.C.); (C.-L.L.)
- Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
- College of Medicine, National Chung Hsing University, Taichung 40227, Taiwan
- Rong Hsing Research Center for Translational Medicine, Institute of Biomedical Science, National Chung Hsing University, Taichung 40227, Taiwan
- Correspondence: (W.-J.L.); (J.-S.W.); Tel.: +886-4-23592525 (W.-J.L. & J.-S.W.)
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21
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Dietary Management of Heart Failure: DASH Diet and Precision Nutrition Perspectives. Nutrients 2021; 13:nu13124424. [PMID: 34959976 PMCID: PMC8708696 DOI: 10.3390/nu13124424] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/06/2021] [Accepted: 12/06/2021] [Indexed: 12/14/2022] Open
Abstract
Heart failure (HF) is a major health care burden increasing in prevalence over time. Effective, evidence-based interventions for HF prevention and management are needed to improve patient longevity, symptom control, and quality of life. Dietary Approaches to Stop Hypertension (DASH) diet interventions can have a positive impact for HF patients. However, the absence of a consensus for comprehensive dietary guidelines and for pragmatic evidence limits the ability of health care providers to implement clinical recommendations. The refinement of medical nutrition therapy through precision nutrition approaches has the potential to reduce the burden of HF, improve clinical care, and meet the needs of diverse patients. The aim of this review is to summarize current evidence related to HF dietary recommendations including DASH diet nutritional interventions and to develop initial recommendations for DASH diet implementation in outpatient HF management. Articles involving human studies were obtained using the following search terms: Dietary Approaches to Stop Hypertension (DASH diet), diet pattern, diet, metabolism, and heart failure. Only full-text articles written in English were included in this review. As DASH nutritional interventions have been proposed, limitations of these studies are the small sample size and non-randomization of interventions, leading to less reliable evidence. Randomized controlled interventions are needed to offer definitive evidence related to the use of the DASH diet in HF management.
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22
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Bulló M, Papandreou C, García-Gavilán J, Ruiz-Canela M, Li J, Guasch-Ferré M, Toledo E, Clish C, Corella D, Estruch R, Ros E, Fitó M, Lee CH, Pierce K, Razquin C, Arós F, Serra-Majem L, Liang L, Martínez-González MA, Hu FB, Salas-Salvadó J. Tricarboxylic acid cycle related-metabolites and risk of atrial fibrillation and heart failure. Metabolism 2021; 125:154915. [PMID: 34678258 PMCID: PMC9206868 DOI: 10.1016/j.metabol.2021.154915] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/28/2021] [Accepted: 10/14/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Tricarboxylic acid (TCA) cycle deregulation may predispose to cardiovascular diseases, but the role of TCA cycle-related metabolites in the development of atrial fibrillation (AF) and heart failure (HF) remains unexplored. This study sought to investigate the association of TCA cycle-related metabolites with risk of AF and HF. METHODS We used two nested case-control studies within the PREDIMED study. During a mean follow-up for about 10 years, 512 AF and 334 HF incident cases matched by age (±5 years), sex and recruitment center to 616 controls and 433 controls, respectively, were included in this study. Baseline plasma levels of citrate, aconitate, isocitrate, succinate, malate and d/l-2-hydroxyglutarate were measured with liquid chromatography-tandem mass spectrometry. Multivariable conditional logistic regression models were fitted to estimate odds ratios (OR) and 95% confidence intervals (95% CI) for metabolites and the risk of AF or HF. Potential confounders included smoking, family history of premature coronary heart disease, physical activity, alcohol intake, body mass index, intervention groups, dyslipidemia, hypertension, type 2 diabetes and medication use. RESULTS Comparing extreme quartiles of metabolites, elevated levels of succinate, malate, citrate and d/l-2-hydroxyglutarate were associated with a higher risk of AF [ORQ4 vs. Q1 (95% CI): 1.80 (1.21-2.67), 2.13 (1.45-3.13), 1.87 (1.25-2.81) and 1.95 (1.31-2.90), respectively]. One SD increase in aconitate was directly associated with AF risk [OR (95% CI): 1.16 (1.01-1.34)]. The corresponding ORs (95% CI) for HF comparing extreme quartiles of malate, aconitate, isocitrate and d/l-2-hydroxyglutarate were 2.15 (1.29-3.56), 2.16 (1.25-3.72), 2.63 (1.56-4.44) and 1.82 (1.10-3.04), respectively. These associations were confirmed in an internal validation, except for aconitate and AF. CONCLUSION These findings underscore the potential role of the TCA cycle in the pathogenesis of cardiac outcomes.
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Affiliation(s)
- Mònica Bulló
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; University Hospital of Sant Joan de Reus, Nutrition Unit, Reus, Spain
| | - Christopher Papandreou
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; University Hospital of Sant Joan de Reus, Nutrition Unit, Reus, Spain
| | - Jesus García-Gavilán
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; University Hospital of Sant Joan de Reus, Nutrition Unit, Reus, Spain
| | - Miguel Ruiz-Canela
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; University of Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Navarra, Spain
| | - Jun Li
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Marta Guasch-Ferré
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, MA, USA
| | - Estefanía Toledo
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; University of Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Navarra, Spain
| | - Clary Clish
- Broad Institute of MIT and Harvard University, Cambridge, MA, USA
| | - Dolores Corella
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Ramon Estruch
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Internal Medicine, Department of Endocrinology and Nutrition Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Emilio Ros
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Lipid Clinic, Department of Endocrinology and Nutrition Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Montserrat Fitó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain
| | - Chih-Hao Lee
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Molecular Metabolism (C.-H.L.), Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Kerry Pierce
- Broad Institute of MIT and Harvard University, Cambridge, MA, USA
| | - Cristina Razquin
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; University of Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Navarra, Spain
| | - Fernando Arós
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Department of Cardiology, University Hospital of Alava, Vitoria, Spain
| | - Lluís Serra-Majem
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; Institute of Health Sciences IUNICS, University of Balearic Islands and Hospital Son Espases, Palma de Mallorca, Spain
| | - Liming Liang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Statistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Miguel A Martínez-González
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; University of Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Navarra, Spain; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Statistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jordi Salas-Salvadó
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana, Reus, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain; Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain; University Hospital of Sant Joan de Reus, Nutrition Unit, Reus, Spain.
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23
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Mehmood K, Moin A, Hussain T, Rizvi SMD, Gowda DV, Shakil S, Kamal MA. Can manipulation of gut microbiota really be transformed into an intervention strategy for cardiovascular disease management? Folia Microbiol (Praha) 2021; 66:897-916. [PMID: 34699042 DOI: 10.1007/s12223-021-00926-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 10/03/2021] [Indexed: 02/08/2023]
Abstract
Recent advancement in manipulation techniques of gut microbiota either ex vivo or in situ has broadened its plausible applicability for treating various diseases including cardiovascular disease. Several reports suggested that altering gut microbiota composition is an effective way to deal with issues associated with managing cardiovascular diseases. However, actual translation of gut microbiota manipulation-based techniques into cardiovascular-therapeutic approach is still questionable. This review summarized the evidence on challenges, opportunities, recent development, and future prospects of gut microbiota manipulation for targeting cardiovascular diseases. Initially, issues associated with current cardiovascular diseases treatment strategy, association of gut microbiota with cardiovascular disease, and its influence on cardiovascular drugs were discussed, followed by applicability of gut microbiota manipulation as a cardiovascular disease intervention strategy along with its challenges and future prospects. Despite the fact that the gut microbiota is rugged, interventions like probiotics, prebiotics, synbiotics, fecal microbiota transplantation, fecal virome transplantation, antibiotics, diet changes, and exercises could manipulate it. Advanced techniques like administration of engineered bacteriophages and bacteria could also be employed. Intensive exploration revealed that if sufficiently controlled approach and proper monitoring were applied, gut microbiota could provide a compelling answer for cardiovascular therapy.
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Affiliation(s)
- Khalid Mehmood
- Department of Pharmaceutics, College of Pharmacy, University of Hail, Hail, KSA, Saudi Arabia.,Department of Pharmacy, Abbottabad University of Science and Technology, Havelian, Pakistan
| | - Afrasim Moin
- Department of Pharmaceutics, College of Pharmacy, University of Hail, Hail, KSA, Saudi Arabia
| | - Talib Hussain
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Hail, Hail, KSA, Saudi Arabia
| | - Syed Mohd Danish Rizvi
- Department of Pharmaceutics, College of Pharmacy, University of Hail, Hail, KSA, Saudi Arabia.
| | - D V Gowda
- Department of Pharmaceutics, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysuru, India
| | - Shazi Shakil
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.,Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia
| | - M A Kamal
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia.,Enzymoics 7 Peterlee Place, NSW, 2770, Hebersham, Australia.,Novel Global Community, Educational Foundation, Hebersham, Australia
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24
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Mediterranean Diet and Physical Activity for Successful Aging: An Update for Nutritionists and Endocrinologists. ENDOCRINES 2021. [DOI: 10.3390/endocrines2040034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The constant advancement in the medical field has allowed for the diagnosis and treatment of several health conditions. It has also contributed to increasing the average human lifespan, which is considered an outstanding achievement in history. Nevertheless, the impact of this in an ever-increasing aged population with chronic diseases and, most of the time, with limited and poor quality of life was not considered. Thus, it is imperative to establish strategies to age successfully. In order to do have a better understanding of this crucial issue, this review will analyze the endocrine changes in the elderly. It will present common conditions found in this population, chronic inflammation, and oxidative stress. Additionally, we will explain aging-related metabolic and physical performance decline related to hormone changes and lifestyle modifications. We will propose the Mediterranean diet and some specific guidelines about physical activity as part of the plan to have an active and successful aging process.
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25
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Nuts: Natural Pleiotropic Nutraceuticals. Nutrients 2021; 13:nu13093269. [PMID: 34579146 PMCID: PMC8468443 DOI: 10.3390/nu13093269] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/01/2021] [Accepted: 09/14/2021] [Indexed: 12/14/2022] Open
Abstract
Common nuts (tree nuts and peanuts) are energy-dense foods that nature has gifted with a complex matrix of beneficial nutrients and bioactives, including monounsaturated and polyunsaturated fatty acids, high-quality protein, fiber, non-sodium minerals, tocopherols, phytosterols, and antioxidant phenolics. These nut components synergize to favorably influence metabolic and vascular physiology pathways, ameliorate cardiovascular risk factors and improve cardiovascular prognosis. There is increasing evidence that nuts positively impact myriad other health outcomes as well. Nut consumption is correlated with lower cancer incidence and cancer mortality, and decreased all-cause mortality. Favorable effects on cognitive function and depression have also been reported. Randomized controlled trials consistently show nuts have a cholesterol-lowering effect. Nut consumption also confers modest improvements on glycemic control, blood pressure (BP), endothelial function, and inflammation. Although nuts are energy-dense foods, they do not predispose to obesity, and in fact may even help in weight loss. Tree nuts and peanuts, but not peanut butter, generally produce similar positive effects on outcomes. First level evidence from the PREDIMED trial shows that, in the context of a Mediterranean diet, consumption of 30 g/d of nuts (walnuts, almonds, and hazelnuts) significantly lowered the risk of a composite endpoint of major adverse cardiovascular events (myocardial infarction, stroke, and death from cardiovascular disease) by ≈30% after intervention for 5 y. Impressively, the nut-supplemented diet reduced stroke risk by 45%. As they are rich in salutary bioactive compounds and beneficially impact various health outcomes, nuts can be considered natural pleiotropic nutraceuticals.
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26
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Papandreou C, Bulló M, Hernández-Alonso P, Ruiz-Canela M, Li J, Guasch-Ferré M, Toledo E, Clish C, Corella D, Estruch R, Ros E, Fitó M, Alonso-Gómez A, Fiol M, Santos-Lozano JM, Serra-Majem L, Liang L, Martínez-González MA, Hu FB, Salas-Salvadó J. Choline Metabolism and Risk of Atrial Fibrillation and Heart Failure in the PREDIMED Study. Clin Chem 2021; 67:288-297. [PMID: 33257943 DOI: 10.1093/clinchem/hvaa224] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 09/02/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Few studies have examined the associations of trimethylamine-N-oxide (TMAO) and its precursors (choline, betaine, dimethylglycine, and L-carnitine) with the risk of atrial fibrillation (AF) and heart failure (HF). This study sought to investigate these associations. METHODS Prospective associations of these metabolites with incident AF and HF were examined among participants at high cardiovascular risk in the PREDIMED study (PREvención con DIeta MEDiterránea) after follow-up for about 10 years. Two nested case-control studies were conducted, including 509 AF incident cases matched to 618 controls and 326 HF incident cases matched to 426 controls. Plasma levels of TMAO and its precursors were semi-quantitatively profiled with liquid chromatography tandem mass spectrometry. Odds ratios were estimated with multivariable conditional logistic regression models. RESULTS After adjustment for classical risk factors and accounting for multiple testing, participants in the highest quartile vs. the lowest quartile of baseline choline and betaine levels had a higher risk of AF [OR (95% CI): 1.85 (1.30-2.63) and 1.57 (1.09-2.24), respectively]. The corresponding OR for AF for extreme quartiles of dimethylglycine was 1.39 (0.99-1.96). One SD increase in log-transformed dimethylglycine was positively associated with AF risk (OR, 1.17; 1.03-1.33). The corresponding ORs for HF for extreme quartiles of choline, betaine, and dimethylglycine were 2.51 (1.57-4.03), 1.65 (1.00-2.71) and 1.65 (1.04-2.61), respectively. TMAO and L-carnitine levels were not associated with AF or HF. CONCLUSIONS Our findings support the role of the choline metabolic pathway in the pathogenesis of AF and HF.
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Affiliation(s)
- Christopher Papandreou
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain.,Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institut de Salud Carlos III, Madrid, Spain.,University Hospital of Sant Joan de Reus, Nutrition Unit, Reus, Spain
| | - Mònica Bulló
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain.,Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institut de Salud Carlos III, Madrid, Spain.,University Hospital of Sant Joan de Reus, Nutrition Unit, Reus, Spain
| | - Pablo Hernández-Alonso
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain.,Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institut de Salud Carlos III, Madrid, Spain.,University Hospital of Sant Joan de Reus, Nutrition Unit, Reus, Spain
| | - Miguel Ruiz-Canela
- Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institut de Salud Carlos III, Madrid, Spain.,University of Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Navarra, Spain
| | - Jun Li
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Marta Guasch-Ferré
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.,Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Estefanía Toledo
- Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institut de Salud Carlos III, Madrid, Spain.,University of Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Navarra, Spain
| | - Clary Clish
- Broad Institute of MIT and Harvard University, Cambridge, MA
| | - Dolores Corella
- Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institut de Salud Carlos III, Madrid, Spain.,Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Ramon Estruch
- Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institut de Salud Carlos III, Madrid, Spain.,Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Emilio Ros
- Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institut de Salud Carlos III, Madrid, Spain.,Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Montserrat Fitó
- Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institut de Salud Carlos III, Madrid, Spain.,Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, Barcelona, Spain
| | - Angel Alonso-Gómez
- Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institut de Salud Carlos III, Madrid, Spain.,Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Miquel Fiol
- Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institut de Salud Carlos III, Madrid, Spain.,Institute of Health Sciences IUNICS, University of Balearic Islands and Hospital Son Espases, Palma de Mallorca, Spain
| | - José M Santos-Lozano
- Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institut de Salud Carlos III, Madrid, Spain.,Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, San Pablo Health Center, Sevilla, Spain
| | - Lluís Serra-Majem
- Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institut de Salud Carlos III, Madrid, Spain.,Research Institute of Biomedical and Health Sciences IUIBS, University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Liming Liang
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Miguel A Martínez-González
- Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institut de Salud Carlos III, Madrid, Spain.,University of Navarra, Department of Preventive Medicine and Public Health, Pamplona, Spain.,Navarra Institute for Health Research (IdiSNA), Pamplona, Navarra, Spain.,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Jordi Salas-Salvadó
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, Reus, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain.,Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institut de Salud Carlos III, Madrid, Spain.,University Hospital of Sant Joan de Reus, Nutrition Unit, Reus, Spain
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Abstract
Nutrition is the primary source of energy production for myocardial contractility and to maintaining cardiac efficiency. Although many studies provided evidence of the benefits of nutritional intervention in chronic heart failure patients (CHF), these effects are not still completely understood. We searched in PubMed and Embase articles related to the following keywords: "chronic heart failure" with "diet," "nutrition," "insulin resistance," and "caloric restriction." Of the 975 retrieved articles, 20 have been selected. The primary endpoint was the left ventricular (LV) function and the secondary mortality rate in HF patients. Some studies showed that the Mediterranean diet (MedDiet) had a beneficial effect on cardiac function, while others did not find any positive impact. Nutritional supplements and hypercaloric intake had positive effects on underweight HF patients, while hypocaloric diet was beneficial in obese HF patients improving glucose control and cardiac function. The effect of MedDiet in HF patients showed conflicting results. Changes in the dietary pattern can reduce the evolution of HF, considering not only the quality of food but also the caloric intake. The discriminant factor to prescribe a diet regime in HF patients is represented by body mass index (BMI). A well-balanced caloric diet represents an effective therapy in overweight HF patients to reduce the mortality rate. Long-term studies evaluating cause-effect of energy and macronutrients intake on cardiac function in HF patients are necessary.
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Affiliation(s)
- Vittorio Emanuele Bianchi
- Endocrinology and Metabolism, Clinical Center Stella Maris, Strada Rovereta, 42-47891 Falciano, Falciano, San Marino.
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Milton-Laskibar I, Martínez JA, Portillo MP. Current Knowledge on Beetroot Bioactive Compounds: Role of Nitrate and Betalains in Health and Disease. Foods 2021; 10:foods10061314. [PMID: 34200431 PMCID: PMC8229785 DOI: 10.3390/foods10061314] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/04/2021] [Accepted: 06/05/2021] [Indexed: 12/22/2022] Open
Abstract
An increase in the prevalence of noncommunicable chronic diseases has been occurring in recent decades. Among the deaths resulting from these conditions, cardiovascular diseases (CVD) stand out as the main contributors. In this regard, dietary patterns featuring a high content of vegetables and fruits, such as the Mediterranean and the DASH diets, are considered beneficial, and thus have been extensively studied. This has resulted in growing interest in vegetable-derived ingredients and food-supplements that may have potential therapeutic properties. Among these supplements, beetroot juice, which is obtained from the root vegetable Beta vulgaris, has gained much attention. Although a significant part of the interest in beetroot juice is due to its nitrate (NO3-) content, which has demonstrated bioactivity in the cardiovascular system, other ingredients with potential beneficial properties such as polyphenols, pigments and organic acids are also present. In this context, the aim of this review article is to analyze the current knowledge regarding the benefits related to the consumption of beetroot and derived food-supplements. Therefore, this article focuses on nitrate and betalains, which are considered to be the major bioactive compounds present in beetroot, and thus in the derived dietary supplements.
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Affiliation(s)
- Iñaki Milton-Laskibar
- Precision Nutrition and Cardiometabolic Health Program, IMDEA—Food Institute (Madrid Institute for Advanced Studies), Campus of International Excellence (CEI) UAM + CSIC, Spanish National Research Council, 28049 Madrid, Spain;
- CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain;
- Correspondence: ; Tel.: +34-917278100
| | - J. Alfredo Martínez
- Precision Nutrition and Cardiometabolic Health Program, IMDEA—Food Institute (Madrid Institute for Advanced Studies), Campus of International Excellence (CEI) UAM + CSIC, Spanish National Research Council, 28049 Madrid, Spain;
- CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain;
| | - María P. Portillo
- CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III (ISCIII), 28029 Madrid, Spain;
- Nutrition and Obesity Group, Department of Nutrition and Food Science, Faculty of Pharmacy and Lucio Lascaray Research Centre, University of the Basque Country (UPV/EHU), 01006 Vitoria-Gasteiz, Spain
- BIOARABA Health Research Institute, 01006 Vitoria-Gasteiz, Spain
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29
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Barteková M, Adameová A, Görbe A, Ferenczyová K, Pecháňová O, Lazou A, Dhalla NS, Ferdinandy P, Giricz Z. Natural and synthetic antioxidants targeting cardiac oxidative stress and redox signaling in cardiometabolic diseases. Free Radic Biol Med 2021; 169:446-477. [PMID: 33905865 DOI: 10.1016/j.freeradbiomed.2021.03.045] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/22/2021] [Accepted: 03/25/2021] [Indexed: 12/12/2022]
Abstract
Cardiometabolic diseases (CMDs) are metabolic diseases (e.g., obesity, diabetes, atherosclerosis, rare genetic metabolic diseases, etc.) associated with cardiac pathologies. Pathophysiology of most CMDs involves increased production of reactive oxygen species and impaired antioxidant defense systems, resulting in cardiac oxidative stress (OxS). To alleviate OxS, various antioxidants have been investigated in several diseases with conflicting results. Here we review the effect of CMDs on cardiac redox homeostasis, the role of OxS in cardiac pathologies, as well as experimental and clinical data on the therapeutic potential of natural antioxidants (including resveratrol, quercetin, curcumin, vitamins A, C, and E, coenzyme Q10, etc.), synthetic antioxidants (including N-acetylcysteine, SOD mimetics, mitoTEMPO, SkQ1, etc.), and promoters of antioxidant enzymes in CMDs. As no antioxidant indicated for the prevention and/or treatment of CMDs has reached the market despite the large number of preclinical and clinical studies, a sizeable translational gap is evident in this field. Thus, we also highlight potential underlying factors that may contribute to the failure of translation of antioxidant therapies in CMDs.
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Affiliation(s)
- Monika Barteková
- Institute for Heart Research, Centre of Experimental Medicine, Slovak Academy of Sciences, 84104 Bratislava, Slovakia; Institute of Physiology, Faculty of Medicine, Comenius University in Bratislava, 81372 Bratislava, Slovakia.
| | - Adriana Adameová
- Institute for Heart Research, Centre of Experimental Medicine, Slovak Academy of Sciences, 84104 Bratislava, Slovakia; Department of Pharmacology and Toxicology, Faculty of Pharmacy, Comenius University in Bratislava, 83232 Bratislava, Slovakia
| | - Anikó Görbe
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, 1085 Budapest, Hungary; Pharmahungary Group, 6722 Szeged, Hungary
| | - Kristína Ferenczyová
- Institute for Heart Research, Centre of Experimental Medicine, Slovak Academy of Sciences, 84104 Bratislava, Slovakia
| | - Oľga Pecháňová
- Institute of Normal and Pathological Physiology, Centre of Experimental Medicine, Slovak Academy of Sciences, 81371 Bratislava, Slovakia
| | - Antigone Lazou
- Laboratory of Animal Physiology, School of Biology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Naranjan S Dhalla
- Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, And Department of Physiology & Pathophysiology, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB R3E 0W2, Canada
| | - Péter Ferdinandy
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, 1085 Budapest, Hungary; Pharmahungary Group, 6722 Szeged, Hungary
| | - Zoltán Giricz
- Department of Pharmacology and Pharmacotherapy, Semmelweis University, 1085 Budapest, Hungary; Pharmahungary Group, 6722 Szeged, Hungary
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30
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Heart failure with mid-range ejection fraction and the effect of β-blockers after acute myocardial infarction. Heart Vessels 2021; 36:1848-1855. [PMID: 34021384 DOI: 10.1007/s00380-021-01876-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 05/14/2021] [Indexed: 10/21/2022]
Abstract
There is currently an ongoing debate about the 'grey area' of heart failure with mid-range ejection fraction (HFmrEF). We evaluated characteristics, prognosis, and the effect of β-blockers on clinical outcomes in patients with HFmrEF after acute myocardial infarction (AMI). We included a total of 10,785 patients and divided them into three groups: EF 40-49% (HFmrEF; n = 2717; reference); EF < 40% (reduced EF [HFrEF]; n = 1194); and EF ≥ 50% (preserved EF [HFpEF]; n = 6874). The primary outcome was 2-year all-cause mortality. HFmrEF was intermediate between HFrEF and HFpEF for baseline characteristics. The risk of all-cause mortality was lower for HFmrEF patients compared to HFrEF patients (adjusted hazard ratio [HR] 0.710; 95% confidence interval [CI] 0.544-0.927; P = 0.012). However, HFmrEF patients tended to be at higher risk for 2-year all-cause mortality than HFpEF patients (adjusted HR 1.235; 95% CI 0.989-1.511; P = 0.090). β-blockers were associated with reductions in all-cause mortality for the entire cohort (adjusted HR 0.760; 95% CI 0.592-0.975; P = 0.031). β-blockers were effective in patients with HFrEF (adjusted HR 0.667; 95% CI 0.471-0.944; P = 0.022), tended to be effective in patients with HFmrEF (adjusted HR 0.665; 95% CI 0.426-1.038; P = 0.072), but not effective in patients with HFpEF (adjusted HR 0.852; 95% CI 0.548-1.326; P = 0.478; interaction P = 0.026). In conclusion, clinical profiles and prognosis of patients with post-AMI HFmrEF are largely intermediate between HFrEF and HFpEF. β-blockers reduced or tended to reduce 2-year all-cause mortality in patients with HFrEF or HFmrEF, respectively, but not those with HFpEF after AMI.
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31
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Grammatikopoulou MG, Nigdelis MP, Theodoridis X, Gkiouras K, Tranidou A, Papamitsou T, Bogdanos DP, Goulis DG. How fragile are Mediterranean diet interventions? A research-on-research study of randomised controlled trials. BMJ Nutr Prev Health 2021; 4:115-131. [PMID: 34308119 PMCID: PMC8258081 DOI: 10.1136/bmjnph-2020-000188] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 02/04/2021] [Accepted: 02/13/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction The Mediterranean diet (MD) is a traditional regional dietary pattern and a healthy diet recommended for the primary and secondary prevention of various diseases and health conditions. Results from the higher level of primary evidence, namely randomised controlled trials (RCTs), are often used to produce dietary recommendations; however, the robustness of RCTs with MD interventions is unknown. Methods A systematic search was conducted and all MD RCTs with dichotomous primary outcomes were extracted from PubMed. The fragility (FI) and the reverse fragility index (RFI) were calculated for the trials with significant and non-significant comparisons, respectively. Results Out of 27 RCTs of parallel design, the majority failed to present a significant primary outcome, exhibiting an FI equal to 0. The median FI of the significant comparisons was 5, ranging between 1 and 39. More than half of the comparisons had an FI <5, indicating that the addition of 1–4 events to the treatment arm eliminated the statistical significance. For the comparisons with an FI=0, the RFI ranged between 1 and 29 (Median RFI: 7). When the included RCTs were stratified according to masking, the use of a composite primary endpoint, sample size, outcome category, or dietary adherence assessment method, no differences were exhibited in the FI and RFI between groups, except for the RFI among different compliance assessment methods. Conclusions In essence, the present study shows that even in the top tiers of evidence hierarchy, research on the MD may lack robustness, setting concerns for the formulation of nutrition recommendations.
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Affiliation(s)
- Maria G Grammatikopoulou
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Central Macedonia, Greece.,Rheumatology and Clinical Immunology, Faculty of Health Sciences, University of Thessaly, Larissa, Greece.,Nutritional Sciences & Dietetics, Faculty of Health Sciences, International Hellenic University, Thessaloniki, Greece
| | - Meletios P Nigdelis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Central Macedonia, Greece
| | - Xenophon Theodoridis
- Rheumatology and Clinical Immunology, Faculty of Health Sciences, University of Thessaly, Larissa, Greece.,Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Central Macedonia, Greece
| | - Konstantinos Gkiouras
- Rheumatology and Clinical Immunology, Faculty of Health Sciences, University of Thessaly, Larissa, Greece.,Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Central Macedonia, Greece
| | - Antigoni Tranidou
- Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Central Macedonia, Greece.,Department of Endocrinology, Diabetes and Metabolism, Hippokration General Hospital of Thessaloniki, Thessaloniki, Central Macedonia, Greece
| | - Theodora Papamitsou
- Laboratory of Histology and Embryology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Central Macedonia, Greece
| | - Dimitrios P Bogdanos
- Rheumatology and Clinical Immunology, Faculty of Health Sciences, University of Thessaly, Larissa, Greece.,Division of Transplantation, Immunology and Mucosal Biology, MRC Centre for Transplantation, School of Medical Education, King's College London, London, UK
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Central Macedonia, Greece
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32
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Lee Y, Im E. Regulation of miRNAs by Natural Antioxidants in Cardiovascular Diseases: Focus on SIRT1 and eNOS. Antioxidants (Basel) 2021; 10:antiox10030377. [PMID: 33802566 PMCID: PMC8000568 DOI: 10.3390/antiox10030377] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/22/2021] [Accepted: 02/26/2021] [Indexed: 02/07/2023] Open
Abstract
Cardiovascular diseases (CVDs) are the most common cause of morbidity and mortality worldwide. The potential benefits of natural antioxidants derived from supplemental nutrients against CVDs are well known. Remarkably, natural antioxidants exert cardioprotective effects by reducing oxidative stress, increasing vasodilation, and normalizing endothelial dysfunction. Recently, considerable evidence has highlighted an important role played by the synergistic interaction between endothelial nitric oxide synthase (eNOS) and sirtuin 1 (SIRT1) in the maintenance of endothelial function. To provide a new perspective on the role of natural antioxidants against CVDs, we focused on microRNAs (miRNAs), which are important posttranscriptional modulators in human diseases. Several miRNAs are regulated via the consumption of natural antioxidants and are related to the regulation of oxidative stress by targeting eNOS and/or SIRT1. In this review, we have discussed the specific molecular regulation of eNOS/SIRT1-related endothelial dysfunction and its contribution to CVD pathologies; furthermore, we selected nine different miRNAs that target the expression of eNOS and SIRT1 in CVDs. Additionally, we have summarized the alteration of miRNA expression and regulation of activities of miRNA through natural antioxidant consumption.
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Affiliation(s)
| | - Eunok Im
- Correspondence: ; Tel.: +82-51-510-2812; Fax: +82-51-513-6754
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33
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Gut Microbiome and Precision Nutrition in Heart Failure: Hype or Hope? Curr Heart Fail Rep 2021; 18:23-32. [DOI: 10.1007/s11897-021-00503-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/21/2021] [Indexed: 02/06/2023]
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34
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Abstract
PURPOSE OF REVIEW The aim of this study was to briefly summarize the contribution of the PREDIMED (PREvención con DIeta MEDiterránea) trial on cardiovascular evidence and examine in depth its groundbreaking trajectory.PREDIMED was conducted during 2003-2010 and represented the largest primary prevention trial ever testing the effects of changes in a complete food pattern (namely, the Mediterranean diet) on cardiovascular disease (CVD). Major contributions relied on the relevant changes in the food pattern attained by the behavioural intervention and their robust effect in reducing hard clinical end-points. Given some potential concerns, which were appropriately addressed with supporting analyses, this review is timely and relevant. RECENT FINDINGS PREDIMED has continued contributing to the existing literature with extensive, robust and abundant new evidence on the benefits of the Mediterranean diet, particularly on cardiovascular health, including recent studies using high-throughput metabolomic techniques. After robustly addressing some controversies, the conclusions of the original trial remained unaltered. SUMMARY The Mediterranean diet represents an effective and robust nutritional strategy against CVD in high cardiovascular risk populations. Recent findings from the PREDIMED have identified a metabolic signature of the Mediterranean diet that can objectively determine dietary adherence and predict CVD risk. This metabolomic signature opens up a new era for nutritional epidemiology and personalized nutrition.
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Affiliation(s)
- César I Fernández-Lázaro
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra
- IdiSNA, Navarra Institute for Health Research, Pamplona
- Centro de Investigación Biomédica en Red Área de Fisiología de la Obesidad y la Nutrición (CIBEROBN), Madrid, Spain
| | - Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra
- IdiSNA, Navarra Institute for Health Research, Pamplona
- Centro de Investigación Biomédica en Red Área de Fisiología de la Obesidad y la Nutrición (CIBEROBN), Madrid, Spain
| | - Miguel Ángel Martínez-González
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra
- IdiSNA, Navarra Institute for Health Research, Pamplona
- Centro de Investigación Biomédica en Red Área de Fisiología de la Obesidad y la Nutrición (CIBEROBN), Madrid, Spain
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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35
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Strengers JG, den Ruijter HM, Boer JMA, Asselbergs FW, Verschuren WMM, van der Schouw YT, Sluijs I. The association of the Mediterranean diet with heart failure risk in a Dutch population. Nutr Metab Cardiovasc Dis 2021; 31:60-66. [PMID: 33127254 DOI: 10.1016/j.numecd.2020.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 07/09/2020] [Accepted: 08/03/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS It is still unclear whether a healthy diet can prevent heart failure (HF). Therefore, this study aimed to investigate the association between adherence to a Mediterranean-style diet, reflected by modified Mediterranean Diet Scores (mMDS), and the incidence of HF in men and women. METHODS AND RESULTS This observational study comprised 9316 men and 27,645 women from the EPIC-NL cohort free from cardiovascular disease at baseline. Dietary intakes were assessed using a validated food frequency questionnaire. mMDS was calculated using a 9-point scale based on consumption of vegetables, legumes, fruit, nuts, seeds, grains, fish, fat ratio, dairy, meat and alcohol. HF events were ascertained by linkage to nation-wide registries. Multivariable Hazard Ratios (HR) and 95% confidence intervals (CI) were estimated by Cox proportional hazards regression models. Over a median follow-up of 15 years (IQR 14-16), 633 HF events occurred: 144 in men (1.5%) and 489 in women (1.8%). The median mMDS was 4 (IQR 3-5). There was significant effect modification by sex (P-value for interaction <0.001), therefore results are stratified for men and women. For men, a higher mMDS associated with lower HF risk (HR: 0.88; 95% CI: 0.79, 0.98 per point increase in mMDS; HR upper category: 0.53; 95% CI: 0.33, 0.86), whereas no association was found in women (HR: 0.98; 95% CI: 0.93, 1.04 per point increase; HR upper category: 1.07; 95% CI: 0.83, 1.36). CONCLUSION Adherence to a Mediterranean-style diet may reduce HF risk, particularly in men. The underlying reasons for the differences in findings between men and women need further study.
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Affiliation(s)
- Julia G Strengers
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - Hester M den Ruijter
- Department of Experimental Cardiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Jolanda M A Boer
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Folkert W Asselbergs
- Department of Cardiology, Division Heart & Lungs, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands; Institute of Cardiovascular Science and Institute of Health Informatics, Faculty of Population Health Sciences, University College London, London, United Kingdom
| | - W M Monique Verschuren
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands; Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Yvonne T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Ivonne Sluijs
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Wittenbecher C, Eichelmann F, Toledo E, Guasch-Ferré M, Ruiz-Canela M, Li J, Arós F, Lee CH, Liang L, Salas-Salvadó J, Clish CB, Schulze MB, Martínez-González MÁ, Hu FB. Lipid Profiles and Heart Failure Risk: Results From Two Prospective Studies. Circ Res 2020; 128:309-320. [PMID: 33272114 DOI: 10.1161/circresaha.120.317883] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
RATIONALE Altered lipid metabolism has been implicated in heart failure (HF) development, but no prospective studies have examined comprehensive lipidomics data and subsequent risk of HF. OBJECTIVE We aimed to link single lipid metabolites and lipidomics networks to the risk of developing HF. METHODS AND RESULTS Discovery analyses were based on 216 targeted lipids in a case-control study (331 incident HF cases and 507 controls, matched by age, sex, and study center), nested within the PREDIMED (Prevención con Dieta Mediterránea) study. Associations of single lipids were examined in conditional logistic regression models. Furthermore, lipidomics networks were linked to HF risk in a multistep workflow, including machine learning-based identification of the HF-related network clusters, and regression-based discovery of the HF-related lipid patterns within these clusters. If available, significant findings were externally validated in a subsample of the EPIC-Potsdam cohort (2414 at-risk participants, including 87 incident HF cases). After confounder-adjustments, 2 lipids were significantly associated with HF risk in both cohorts: CER (ceramide) 16:0 (relative risk [RR] per SD in PREDIMED, 1.28 [95% CI, 1.13-1.47]) and phosphatidylcholine 32_0 (RR per SD in PREDIMED, 1.23 [95% CI, 1.08-1.41]). Additionally, lipid patterns in several network clusters were associated with HF risk in PREDIMED. Adjusted for standard risk factors, an internally cross-validated score based on the significant HF-related lipids that were identified in the network analysis in PREDIMED was associated with a higher HF risk (20 lipids, RR per SD, 2.33 [95% CI, 1.93%-2.81%). Moreover, a lipid score restricted to the externally available lipids was significantly associated with HF incidence in both cohorts (6 lipids, RRs per SD, 1.30 [95% CI, 1.14-1.47] in PREDIMED, and 1.46 [95% CI, 1.17-1.82] in EPIC-Potsdam). CONCLUSIONS Our study identified and validated 2 lipid metabolites and several lipidomics patterns as potential novel biomarkers of HF risk. Lipid profiling may capture preclinical molecular alterations that predispose for incident HF. Registration: URL: https://www.isrctn.com/ISRCTN35739639; Unique identifier: ISRCTN35739639.
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Affiliation(s)
- Clemens Wittenbecher
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (C.W., M.G.-F., J.L., C.-H.L., M.A.M.-G., F.B.H.).,Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (C.W., F.E., M.B.S.).,German Center for Diabetes Research (DZD), Neuherberg, Germany (C.W., F.E., M.B.S.)
| | - Fabian Eichelmann
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (C.W., F.E., M.B.S.).,German Center for Diabetes Research (DZD), Neuherberg, Germany (C.W., F.E., M.B.S.)
| | - Estefanía Toledo
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (E.T., M.R.-C., M.A.M.-G.).,IdiSNA (Instituto de investigación Sanitaria de Navarra), Pamplona, Spain (E.T., M.R.-C., M.A.M.-G.).,CIBER Fisiopatología de la Obesidad y Nutricion (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain (E.T., M.R.-C., F.A., J.S.-S., M.A.M.-G.)
| | - Marta Guasch-Ferré
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (C.W., M.G.-F., J.L., C.-H.L., M.A.M.-G., F.B.H.).,Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, MA (M.G.-F., F.B.H.)
| | - Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (E.T., M.R.-C., M.A.M.-G.).,IdiSNA (Instituto de investigación Sanitaria de Navarra), Pamplona, Spain (E.T., M.R.-C., M.A.M.-G.).,CIBER Fisiopatología de la Obesidad y Nutricion (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain (E.T., M.R.-C., F.A., J.S.-S., M.A.M.-G.)
| | - Jun Li
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (C.W., M.G.-F., J.L., C.-H.L., M.A.M.-G., F.B.H.)
| | - Fernando Arós
- CIBER Fisiopatología de la Obesidad y Nutricion (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain (E.T., M.R.-C., F.A., J.S.-S., M.A.M.-G.).,Department of Cardiology, University Hospital of Alava, Vitoria, Spain (F.A.)
| | - Chih-Hao Lee
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (C.W., M.G.-F., J.L., C.-H.L., M.A.M.-G., F.B.H.).,Department of Molecular Metabolism (C.-H.L.), Harvard T.H. Chan School of Public Health, Boston, MA
| | - Liming Liang
- Department of Epidemiology (L.L., F.B.H.), Harvard T.H. Chan School of Public Health, Boston, MA.,Department of Biostatistics (L.L.), Harvard T.H. Chan School of Public Health, Boston, MA
| | - Jordi Salas-Salvadó
- CIBER Fisiopatología de la Obesidad y Nutricion (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain (E.T., M.R.-C., F.A., J.S.-S., M.A.M.-G.).,Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, Reus, Spain (J.S.-S.).,Institut d'Investigació Sanitària Pere Virgili (IISPV), University Hospital of Sant Joan de Reus, Nutrition Unit, Reus, Spain (J.S.-S.)
| | - Clary B Clish
- Broad Institute of MIT and Harvard, Cambridge, MA (C.B.C.)
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany (C.W., F.E., M.B.S.).,German Center for Diabetes Research (DZD), Neuherberg, Germany (C.W., F.E., M.B.S.).,Institute of Nutritional Science, University of Potsdam, Germany (M.B.S.)
| | - Miguel Ángel Martínez-González
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (C.W., M.G.-F., J.L., C.-H.L., M.A.M.-G., F.B.H.).,Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain (E.T., M.R.-C., M.A.M.-G.).,IdiSNA (Instituto de investigación Sanitaria de Navarra), Pamplona, Spain (E.T., M.R.-C., M.A.M.-G.).,CIBER Fisiopatología de la Obesidad y Nutricion (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain (E.T., M.R.-C., F.A., J.S.-S., M.A.M.-G.)
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA (C.W., M.G.-F., J.L., C.-H.L., M.A.M.-G., F.B.H.).,Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, MA (M.G.-F., F.B.H.).,Department of Epidemiology (L.L., F.B.H.), Harvard T.H. Chan School of Public Health, Boston, MA
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Carbone S, Billingsley HE, Rodriguez-Miguelez P, Kirkman DL, Garten R, Franco RL, Lee DC, Lavie CJ. Lean Mass Abnormalities in Heart Failure: The Role of Sarcopenia, Sarcopenic Obesity, and Cachexia. Curr Probl Cardiol 2020; 45:100417. [PMID: 31036371 PMCID: PMC11146283 DOI: 10.1016/j.cpcardiol.2019.03.006] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 03/24/2019] [Indexed: 02/07/2023]
Abstract
The role of body composition in patients with heart failure (HF) has been receiving much attention in the last few years. Particularly, reduced lean mass (LM), the best surrogate for skeletal muscle mass, is independently associated with abnormal cardiorespiratory fitness (CRF) and muscle strength, ultimately leading to reduced quality of life and worse prognosis. While in the past, reduced CRF in patients with HF was thought to result exclusively from cardiac dysfunction leading to reduced cardiac output at peak exercise, current evidence supports the concept that abnormalities in LM may also play a critical role. Abnormalities in the LM body composition compartment are associated with the development of sarcopenia, sarcopenic obesity, and cachexia. Such conditions have been implicated in the pathophysiology and progression of HF. However, identification of such conditions remains challenging, as universal definitions for sarcopenia, sarcopenic obesity, and cachexia are lacking. In this review article, we describe the most common body composition abnormalities related to the LM compartment, including skeletal and respiratory muscle mass abnormalities, and the consequences of such anomalies on CRF and muscle strength in patients with HF. Finally, we discuss the potential nonpharmacologic therapeutic strategies such as exercise training (ie, aerobic exercise and resistance exercise) and dietary interventions (ie, dietary supplementation and dietary patterns) that have been implemented to target body composition, with a focus on HF.
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Papadaki A, Nolen-Doerr E, Mantzoros CS. The Effect of the Mediterranean Diet on Metabolic Health: A Systematic Review and Meta-Analysis of Controlled Trials in Adults. Nutrients 2020; 12:nu12113342. [PMID: 33143083 PMCID: PMC7692768 DOI: 10.3390/nu12113342] [Citation(s) in RCA: 107] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 10/27/2020] [Accepted: 10/28/2020] [Indexed: 12/20/2022] Open
Abstract
The Mediterranean diet (MD) may provide metabolic benefits but no systematic review to date has examined its effect on a multitude of outcomes related to metabolic health. This systematic review with meta-analysis (International Prospective Register of Systematic Reviews, PROSPERO; number CRD42019141459) aimed to examine the MD’s effect on metabolic syndrome (MetSyn) incidence, components and risk factors (primary outcomes), and incidence and/or mortality from MetSyn-related comorbidities and receipt of pharmacologic treatment for MetSyn components and comorbidities (secondary outcomes). We searched Pubmed, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science for controlled trials published until June 2019, comparing the MD with no treatment, usual care, or different diets in adults. Studies not published in English and not promoting the whole MD were excluded. Two authors independently extracted data and assessed risk of bias using the Cochrane Collaboration’s and Risk of Bias in non-randomised studies (ROBINS-I) tools. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Random-effects meta-analyses, subgroup analyses and meta-regressions were performed, and heterogeneity was quantified using the I2 statistic. We identified 2654 reports and included 84 articles reporting 57 trials (n = 36,983). In random effects meta-analyses, the MD resulted in greater beneficial changes in 18 of 28 MetSyn components and risk factors (body weight, body mass index, waist circumference, systolic and diastolic blood pressure, glucose, insulin, homeostatic model assessment of insulin resistance (HOMA-IR) index, total-, low-density lipoprotein (LDL)- and high-density lipoprotein (HDL)-cholesterol, triglycerides, alanine transaminase, hepatic fat mass, C-reactive protein, interleukin-6, tumour necrosis factor-a, and flow-mediated dilatation) and lower risk of cardiovascular disease incidence (risk ratio (RR) = 0.61, 95% confidence intervals (CI) 0.42–0.80; I2 = 0%), and stroke (RR = 0.67, 95% CI 0.35–0.98; I2 = 0%). Only six studies reported effects on pharmacotherapy use, and pooled analysis indicated no differences between diet groups. Lack of consistency in comparator groups and other study characteristics across studies resulted in high heterogeneity for some outcomes, which could not be considerably explained by meta-regressions. However, a consistent direction of beneficial effect of the MD was observed for the vast majority of outcomes examined. Findings support MD’s beneficial effect on all components and most risk factors of the MetSyn, in addition to cardiovascular disease and stroke incidence. More studies are needed to establish effects on other clinical outcomes and use of pharmacotherapy for MetSyn components and comorbidities. Despite the high levels of heterogeneity for some outcomes, this meta-analysis enabled the comparison of findings across studies and the examination of consistency of effects. The consistent direction of effect, suggesting the MD’s benefits on metabolic health, supports the need to promote this dietary pattern to adult populations.
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Affiliation(s)
- Angeliki Papadaki
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol BS8 1TZ, UK;
- Division of Endocrinology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA;
| | - Eric Nolen-Doerr
- Division of Endocrinology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA;
- Department of Endocrinology, Boston VA Healthcare System, Boston, MA 02130, USA
| | - Christos S. Mantzoros
- Division of Endocrinology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA;
- Department of Endocrinology, Boston VA Healthcare System, Boston, MA 02130, USA
- Correspondence: ; Tel.: +1-(0)617-667-8636
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Molecular Mechanisms of SGLT2 Inhibitor on Cardiorenal Protection. Int J Mol Sci 2020; 21:ijms21217833. [PMID: 33105763 PMCID: PMC7660105 DOI: 10.3390/ijms21217833] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 10/20/2020] [Accepted: 10/20/2020] [Indexed: 12/14/2022] Open
Abstract
The development of sodium-glucose transporter 2 inhibitor (SGLT2i) broadens the therapeutic strategies in treating diabetes mellitus. By inhibiting sodium and glucose reabsorption from the proximal tubules, the improvement in insulin resistance and natriuresis improved the cardiovascular mortality in diabetes mellitus (DM) patients. It has been known that SGLT2i also provided renoprotection by lowering the intraglomerular hypertension by modulating the pre- and post- glomerular vascular tone. The application of SGLT2i also provided metabolic and hemodynamic benefits in molecular aspects. The recent DAPA-CKD trial and EMPEROR-Reduced trial provided clinical evidence of renal and cardiac protection, even in non-DM patients. Therefore, the aim of the review is to clarify the hemodynamic and metabolic modulation of SGLT2i from the molecular mechanism.
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40
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Papandreou C, Hernández-Alonso P, Bulló M, Ruiz-Canela M, Li J, Guasch-Ferré M, Toledo E, Clish C, Corella D, Estruch R, Cofán M, Fitó M, Razquin C, Arós F, Fiol M, Santos-Lozano JM, Serra-Majem L, Liang L, Martínez-González MA, Hu FB, Salas-Salvadó J. High Plasma Glutamate and a Low Glutamine-to-Glutamate Ratio Are Associated with Increased Risk of Heart Failure but Not Atrial Fibrillation in the Prevención con Dieta Mediterránea (PREDIMED) Study. J Nutr 2020; 150:2882-2889. [PMID: 32939552 PMCID: PMC7675032 DOI: 10.1093/jn/nxaa273] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 06/26/2020] [Accepted: 08/13/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Although the association between glutamate and glutamine in relation to cardiometabolic disorders has been evaluated, the role of these metabolites in the development of atrial fibrillation (AF) and heart failure (HF) remains unknown. OBJECTIVES We examined associations of glutamate, glutamine, and the glutamine-to-glutamate ratio with AF and HF incidence in a Mediterranean population at high cardiovascular disease (CVD) risk. METHODS The present study used 2 nested case-control studies within the PREDIMED (Prevención con Dieta Mediterránea) study. During ∼10 y of follow-up, there were 509 AF incident cases matched to 618 controls and 326 HF incident cases matched to 426 controls. Plasma concentrations of glutamate and glutamine were semiquantitatively profiled with LC-tandem MS. ORs were estimated with multivariable conditional logistic regression models. RESULTS In fully adjusted models, per 1-SD increment, glutamate was associated with a 29% (95% CI: 1.08, 1.54) increased risk of HF and glutamine-to-glutamate ratio with a 20% (95% CI: 0.67, 0.94) decreased risk. Glutamine-to-glutamate ratio was also inversely associated with HF risk (OR per 1-SD increment: 0.80; 95% CI: 0.67, 0.94) when comparing extreme quartiles. Higher glutamate concentrations were associated with a worse cardiometabolic risk profile, whereas a higher glutamine-to-glutamate ratio was associated with a better cardiometabolic risk profile. No associations between the concentrations of these metabolites and AF were observed. CONCLUSIONS Our findings suggest that high plasma glutamate concentrations possibly resulting from alterations in the glutamate-glutamine cycle may contribute to the development of HF in Mediterranean individuals at high CVD risk.This trial was registered at www.isrctn.com as ISRCTN35739639.
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Affiliation(s)
- Christopher Papandreou
- Biochemistry and Biotechnology Department, Human Nutrition Unit, Rovira i Virgili University, Reus, Spain,Pere i Virgili Health Research Institute (IISPV), Reus, Spain,CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain,Human Nutrition Unit, University Hospital of Sant Joan de Reus, Reus, Spain
| | - Pablo Hernández-Alonso
- Biochemistry and Biotechnology Department, Human Nutrition Unit, Rovira i Virgili University, Reus, Spain,Pere i Virgili Health Research Institute (IISPV), Reus, Spain,CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain,Human Nutrition Unit, University Hospital of Sant Joan de Reus, Reus, Spain
| | - Mònica Bulló
- Biochemistry and Biotechnology Department, Human Nutrition Unit, Rovira i Virgili University, Reus, Spain,Pere i Virgili Health Research Institute (IISPV), Reus, Spain,CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain,Human Nutrition Unit, University Hospital of Sant Joan de Reus, Reus, Spain
| | - Miguel Ruiz-Canela
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain,Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Jun Li
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA,Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Marta Guasch-Ferré
- Biochemistry and Biotechnology Department, Human Nutrition Unit, Rovira i Virgili University, Reus, Spain,Pere i Virgili Health Research Institute (IISPV), Reus, Spain,Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA,Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Estefanía Toledo
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain,Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Clary Clish
- Broad Institute of MIT and Harvard University, Cambridge, MA, USA
| | - Dolores Corella
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain,Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Ramon Estruch
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain,Department of Internal Medicine, Hospital Clinic, University of Barcelona,, Barcelona, Spain,August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Montserrat Cofán
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain,August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain,Lipid Clinic, Department of Endocrinology and Nutrition, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Montserrat Fitó
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain,Cardiovascular and Nutrition Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Cristina Razquin
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain,Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Fernando Arós
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain,Department of Cardiology, University Hospital of Alava, Vitoria, Spain
| | - Miquel Fiol
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain,Institute of Health Sciences IUNICS, Health Research Institute of the Balearic Islands, Son Espases Hospital, Palma de Mallorca, Spain
| | - José M Santos-Lozano
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain,Department of Family Medicine, Seville Primary Care Health District, San Pablo Health Center, Seville, Spain
| | - Lluís Serra-Majem
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain,Research Institute of Biomedical and Health Sciences IUIBS, University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Liming Liang
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA,Department of Statistics, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Miguel A Martínez-González
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Institute of Health Carlos III, Madrid, Spain,Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain,Navarra Institute for Health Research (IdiSNA), Pamplona, Spain,Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Frank B Hu
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA,Channing Division for Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA,Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
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Billingsley HE, Hummel SL, Carbone S. The role of diet and nutrition in heart failure: A state-of-the-art narrative review. Prog Cardiovasc Dis 2020; 63:538-551. [PMID: 32798501 PMCID: PMC7686142 DOI: 10.1016/j.pcad.2020.08.004] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 08/09/2020] [Indexed: 02/07/2023]
Abstract
Heart Failure (HF) incidence is increasing steadily worldwide, while prognosis remains poor. Though nutrition is a lifestyle factor implicated in prevention of HF, little is known about the effects of macro- and micronutrients as well as dietary patterns on the progression and treatment of HF. This is reflected in a lack of nutrition recommendations in all major HF scientific guidelines. In this state-of-the-art review, we examine and discuss the implications of evidence contained in existing randomized control trials as well as observational studies covering the topics of sodium restriction, dietary patterns and caloric restriction as well as supplementation of dietary fats and fatty acids, protein and amino acids and micronutrients in the setting of pre-existing HF. Finally, we explore future directions and discuss knowledge gaps regarding nutrition therapies for the treatment of HF.
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Affiliation(s)
- Hayley E Billingsley
- Department of Kinesiology & Health Sciences, College of Humanities & Sciences, Virginia Commonwealth University, Richmond, VA, United States of America; VCU Pauley Heart Center, Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Scott L Hummel
- University of Michigan Frankel Cardiovascular Center, Ann Arbor, MI, United States of America; Ann Arbor Veterans Affairs Health System, Ann Arbor, MI, United States of America
| | - Salvatore Carbone
- Department of Kinesiology & Health Sciences, College of Humanities & Sciences, Virginia Commonwealth University, Richmond, VA, United States of America; VCU Pauley Heart Center, Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, United States of America.
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Martin-Conty JL, Martin-Rodríguez F, Criado-Álvarez JJ, Castillo-Sarmiento CA, Maestre-Miquel C, Mohedano-Moriano A, Polonio-López B, Durantez-Fernández C, Castro-Villamor MÁ, Viñuela A. How Health Habits Influence the Physiological Response During a Physical Activity in Extreme Temperatures? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176374. [PMID: 32882968 PMCID: PMC7503269 DOI: 10.3390/ijerph17176374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 08/30/2020] [Accepted: 08/31/2020] [Indexed: 11/21/2022]
Abstract
Background: The purpose of the study was to determine to what degree the health habits of university students influence their physiological response during a 10-min high-intensity exercise. Methods: We conducted a cross-sectional cohort study with 59 health science students, in which we analyzed their adherence to a Mediterranean and low-fat diet, as well as their activity levels. We correlated these factors with the physiological response (lactic acid and heart rate) and a series of anthropometric parameters in intense physical activity (cardiopulmonary resuscitation (CPR) for 10 min) in three scenarios: extreme cold, extreme heat and a control situation at room temperature. Results: The results of this study demonstrate that in university students, a greater adherence to the Mediterranean diet was associated with a better response to physical exercise, in this case, 10-min CPR, in hostile environments. Conclusions: Following healthy eating guidelines improves physical performance and delays the appearance of fatigue; both are important aspects for a better performance of CPR.
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Affiliation(s)
- José Luis Martin-Conty
- Faculty of Health Sciences, Universidad de Castilla-La Mancha, 45600 Talavera de la Reina, Spain; (J.L.M.-C.); (J.J.C.-Á.); (A.M.-M.); (B.P.-L.); (C.D.-F.); (A.V.)
| | - Francisco Martin-Rodríguez
- Advanced Clinical Simulation Center, School of Medicine, Universidad de Valladolid, 47005 Valladolid, Spain; (F.M.-R.); (M.Á.C.-V.)
| | - Juan José Criado-Álvarez
- Faculty of Health Sciences, Universidad de Castilla-La Mancha, 45600 Talavera de la Reina, Spain; (J.L.M.-C.); (J.J.C.-Á.); (A.M.-M.); (B.P.-L.); (C.D.-F.); (A.V.)
- Integrated Care Management of Talavera de la Reina, Health Services of Castilla-La Mancha (SESCAM), 45600 Talavera de la Reina, Spain
| | | | - Clara Maestre-Miquel
- Faculty of Health Sciences, Universidad de Castilla-La Mancha, 45600 Talavera de la Reina, Spain; (J.L.M.-C.); (J.J.C.-Á.); (A.M.-M.); (B.P.-L.); (C.D.-F.); (A.V.)
- Correspondence: ; Tel.: +34-619653361
| | - Alicia Mohedano-Moriano
- Faculty of Health Sciences, Universidad de Castilla-La Mancha, 45600 Talavera de la Reina, Spain; (J.L.M.-C.); (J.J.C.-Á.); (A.M.-M.); (B.P.-L.); (C.D.-F.); (A.V.)
| | - Begoña Polonio-López
- Faculty of Health Sciences, Universidad de Castilla-La Mancha, 45600 Talavera de la Reina, Spain; (J.L.M.-C.); (J.J.C.-Á.); (A.M.-M.); (B.P.-L.); (C.D.-F.); (A.V.)
| | - Carlos Durantez-Fernández
- Faculty of Health Sciences, Universidad de Castilla-La Mancha, 45600 Talavera de la Reina, Spain; (J.L.M.-C.); (J.J.C.-Á.); (A.M.-M.); (B.P.-L.); (C.D.-F.); (A.V.)
| | - Miguel Ángel Castro-Villamor
- Advanced Clinical Simulation Center, School of Medicine, Universidad de Valladolid, 47005 Valladolid, Spain; (F.M.-R.); (M.Á.C.-V.)
| | - Antonio Viñuela
- Faculty of Health Sciences, Universidad de Castilla-La Mancha, 45600 Talavera de la Reina, Spain; (J.L.M.-C.); (J.J.C.-Á.); (A.M.-M.); (B.P.-L.); (C.D.-F.); (A.V.)
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Bianchi VE. Caloric restriction in heart failure: A systematic review. Clin Nutr ESPEN 2020; 38:50-60. [PMID: 32690177 DOI: 10.1016/j.clnesp.2020.04.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 04/17/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND AIMS Nutrition exerts a determinant role in maintaining cardiac function, regulating insulin and mitochondrial efficiency, that are essential to support energy production for contractility. In patients with heart failure (HF), myocardial tissue efficiency is reduced because of decreased mitochondrial oxidative capacity. In HF conditions, cardiomyocytes shift toward glucose and a reduction in fatty acid utilization. Calorie restriction induces weight loss in obese patients and can be beneficial in some HF patients, although this has generated some controversy. This study aims to evaluate the impact of the CR diet on myocardial efficiency in HF patients. METHODS On Pubmed and Embase, articles related to the keywords: "chronic heart failure" with "diet," "nutrition," "insulin resistance," and "caloric restriction" have been searched, Studies, including exercise or food supplementation, were excluded. RESULTS The retrieved articles showed that weight loss, through the activation of insulin and various kinase pathways, regulates the efficiency of myocardial tissue. In contrast, insulin resistance represents a strong cardiovascular risk factor that reduces myocardial function. CONCLUSION CR diet represents the first therapy in overweight HF patients, both with preserved ejection fraction (HFpEF) and with reduced ejection fraction (HFrHF) because reducing body fat, the myocardial function increased. Insulin activity is the critical hormone that regulates mitochondrial function and cardiac efficiency. However, a severely restricted diet may represent a severe risk factor correlated with all-cause mortality, particularly in underweight HF patients. Long-term studies conducted on large populations are necessary to evaluate the effects of CR on myocardial function in HF patients.
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Xu H, Wang X, Feng W, Liu Q, Zhou S, Liu Q, Cai L. The gut microbiota and its interactions with cardiovascular disease. Microb Biotechnol 2020; 13:637-656. [PMID: 31984651 PMCID: PMC7111081 DOI: 10.1111/1751-7915.13524] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 11/22/2019] [Accepted: 11/23/2019] [Indexed: 12/13/2022] Open
Abstract
The intestine is colonized by a considerable community of microorganisms that cohabits within the host and plays a critical role in maintaining host homeostasis. Recently, accumulating evidence has revealed that the gut microbial ecology plays a pivotal role in the occurrence and development of cardiovascular disease (CVD). Moreover, the effects of imbalances in microbe-host interactions on homeostasis can lead to the progression of CVD. Alterations in the composition of gut flora and disruptions in gut microbial metabolism are implicated in the pathogenesis of CVD. Furthermore, the gut microbiota functions like an endocrine organ that produces bioactive metabolites, including trimethylamine/trimethylamine N-oxide, short-chain fatty acids and bile acids, which are also involved in host health and disease via numerous pathways. Thus, the gut microbiota and its metabolic pathways have attracted growing attention as a therapeutic target for CVD treatment. The fundamental purpose of this review was to summarize recent studies that have illustrated the complex interactions between the gut microbiota, their metabolites and the development of common CVD, as well as the effects of gut dysbiosis on CVD risk factors. Moreover, we systematically discuss the normal physiology of gut microbiota and potential therapeutic strategies targeting gut microbiota to prevent and treat CVD.
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Affiliation(s)
- Hui Xu
- Cardiovascular Centerthe First Hospital of Jilin UniversityChangchun130021China
- Pediatric Research InstituteDepartment of Pediatricsthe University of LouisvilleLouisvilleKY40202USA
| | - Xiang Wang
- Cardiovascular Centerthe First Hospital of Jilin UniversityChangchun130021China
| | - Wenke Feng
- Department of Pharmacology and Toxicologythe University of Louisville School of MedicineLouisvilleKY40202USA
- Division of Gastroenterology, Hepatology and NutritionDepartment of Medicinethe University of Louisville School of MedicineLouisvilleKY40202USA
| | - Qi Liu
- Department of Pharmacology and Toxicologythe University of Louisville School of MedicineLouisvilleKY40202USA
- Division of Gastroenterology, Hepatology and NutritionDepartment of Medicinethe University of Louisville School of MedicineLouisvilleKY40202USA
- The Second Affiliated Hospital of Wenzhou Medical UniversityWenzhou325035China
| | - Shanshan Zhou
- Cardiovascular Centerthe First Hospital of Jilin UniversityChangchun130021China
| | - Quan Liu
- Cardiovascular Centerthe First Hospital of Jilin UniversityChangchun130021China
| | - Lu Cai
- Pediatric Research InstituteDepartment of Pediatricsthe University of LouisvilleLouisvilleKY40202USA
- Department of Pharmacology and Toxicologythe University of Louisville School of MedicineLouisvilleKY40202USA
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Sánchez-Sánchez ML, García-Vigara A, Hidalgo-Mora JJ, García-Pérez MÁ, Tarín J, Cano A. Mediterranean diet and health: A systematic review of epidemiological studies and intervention trials. Maturitas 2020; 136:25-37. [PMID: 32386663 DOI: 10.1016/j.maturitas.2020.03.008] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 03/15/2020] [Accepted: 03/24/2020] [Indexed: 12/20/2022]
Abstract
Diet is a crucial variable for a healthy life. A rapidly growing number of studies in recent years support the hypothesis that the Mediterranean diet (MedDiet) has a beneficial effect on certain body systems, but the highly varied objectives and quality of these publications warrants an updated assessment. In the present review we performed a comprehensive evaluation of current evidence on the impact of the MedDiet on human health, assessing its effect on the incidence or progression of the main non-communicable diseases and their intermediate outcomes and risk factors. We scrutinised the clinical evidence from observational studies and randomised controlled trials. Cardiovascular disease was the condition with most information. The MedDiet showed a general preventive effect, which was reproduced to varying degrees for certain intermediate cardiovascular outcomes such as blood pressure, lipids, obesity, metabolic syndrome and diabetes. Benefits were also found for several types of cancer, brain function (including cognition, mood and to a lesser extent Parkinson's disease) and mortality. The quality of the published evidence was, however, generally moderate or low. In conclusion, the MedDiet shows a favourable impact on health. General adoption of a MedDiet is concordant with current policies promoting healthy and sustainable nutrition worldwide. Nonetheless, more high-quality research is needed to improve the consistency of the findings.
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Affiliation(s)
| | - Alicia García-Vigara
- Service of Obstetrics and Gynecology, Hospital Clínico Universitario - INCLIVA, Av. Blasco Ibáñez 17, 46010, Valencia, Spain.
| | - Juan José Hidalgo-Mora
- Service of Obstetrics and Gynecology, Hospital Clínico Universitario - INCLIVA, Av. Blasco Ibáñez 17, 46010, Valencia, Spain.
| | - Miguel-Ángel García-Pérez
- Department of Genetics, Faculty of Biological Sciences, University of Valencia, Burjassot, and INCLIVA, Av. Blasco Ibáñez 17, 46010, Valencia, Spain.
| | - Juan Tarín
- Department of Cellular Biology, Functional Biology and Physical Anthropology, Faculty of Biological Sciences, University of Valencia, Burjassot, 46100, Valencia, Spain.
| | - Antonio Cano
- Service of Obstetrics and Gynecology, Hospital Clínico Universitario - INCLIVA, Av. Blasco Ibáñez 17, 46010, Valencia, Spain; Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Av. Blasco Ibáñez 15, 46010, Valencia, Spain.
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Lara KM, Levitan EB, Gutierrez OM, Shikany JM, Safford MM, Judd SE, Rosenson RS. Dietary Patterns and Incident Heart Failure in U.S. Adults Without Known Coronary Disease. J Am Coll Cardiol 2020; 73:2036-2045. [PMID: 31023426 PMCID: PMC6501554 DOI: 10.1016/j.jacc.2019.01.067] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 12/20/2018] [Accepted: 01/22/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Dietary patterns and associations with incident heart failure (HF) are not well established in the United States. OBJECTIVES The purpose of this study was to determine associations of 5 dietary patterns with incident HF hospitalizations among U.S. adults. METHODS The REGARDS (REasons for Geographic and Racial Differences in Stroke) trial is a prospective cohort of black and white adults followed from 2003 to 2007 through 2014. Inclusion criteria included completion of a food frequency questionnaire and no baseline coronary heart disease or HF. Five dietary patterns (convenience, plant-based, sweets, Southern, and alcohol/salads) were derived from principal component analysis. The primary endpoint was incident HF hospitalization. RESULTS This study included 16,068 participants (mean age 64.0 ± 9.1 years, 58.7% women, 33.6% black participants, 34.0% residents of the stroke belt). After a median of 8.7 years of follow-up, 363 participants had incident HF hospitalizations. Compared with the lowest quartile, the highest quartile of adherence to the plant-based dietary pattern was associated with a 41% lower risk of HF in multivariable-adjusted models (hazard ratio: 0.59; 95% confidence interval: 0.41 to 0.86; p = 0.004). Highest adherence to the Southern dietary pattern was associated with a 72% higher risk of HF after adjusting for age, sex, and race and for other potential confounders (education, income, region of residence, total energy intake, smoking, physical activity, and sodium intake; hazard ratio: 1.72; 95% confidence interval: 1.20 to 2.46; p = 0.005). However, the association was attenuated and no longer statistically significant after further adjusting for body mass index in kg/m2, waist circumference, hypertension, dyslipidemia, diabetes mellitus, atrial fibrillation, and chronic kidney disease. No statistically significant associations were observed with incident HF with reduced or preserved ejection fraction hospitalizations and the dietary patterns. No associations were observed with the other 3 dietary patterns. CONCLUSIONS Adherence to a plant-based dietary pattern was inversely associated with incident HF risk, whereas the Southern dietary pattern was positively associated with incident HF risk.
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Affiliation(s)
- Kyla M Lara
- Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Emily B Levitan
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Orlando M Gutierrez
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - James M Shikany
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Monika M Safford
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York
| | - Suzanne E Judd
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Robert S Rosenson
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, New York
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Abstract
Advances in our understanding of how the gut microbiota contributes to human health and diseases have expanded our insight into how microbial composition and function affect the human host. Heart failure is associated with splanchnic circulation congestion, leading to bowel wall oedema and impaired intestinal barrier function. This situation is thought to heighten the overall inflammatory state via increased bacterial translocation and the presence of bacterial products in the systemic blood circulation. Several metabolites produced by gut microorganisms from dietary metabolism have been linked to pathologies such as atherosclerosis, hypertension, heart failure, chronic kidney disease, obesity, and type 2 diabetes mellitus. These findings suggest that the gut microbiome functions like an endocrine organ by generating bioactive metabolites that can directly or indirectly affect host physiology. In this Review, we discuss several newly discovered gut microbial metabolic pathways, including the production of trimethylamine and trimethylamine N-oxide, short-chain fatty acids, and secondary bile acids, that seem to participate in the development and progression of cardiovascular diseases, including heart failure. We also discuss the gut microbiome as a novel therapeutic target for the treatment of cardiovascular disease, and potential strategies for targeting intestinal microbial processes.
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Affiliation(s)
- W H Wilson Tang
- Center for Microbiome & Human Health, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA. .,Department for Cellular & Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA. .,Center for Clinical Genomics, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA. .,Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA. .,Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland, OH, USA.
| | - Daniel Y Li
- Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland, OH, USA
| | - Stanley L Hazen
- Center for Microbiome & Human Health, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.,Department for Cellular & Molecular Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.,Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA.,Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Cleveland, OH, USA
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Experimental Outcomes of the Mediterranean Diet: Lessons Learned from the Predimed Randomized Controlled Trial. Nutrients 2019; 11:nu11122991. [PMID: 31817731 PMCID: PMC6949939 DOI: 10.3390/nu11122991] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 11/07/2019] [Accepted: 11/15/2019] [Indexed: 12/30/2022] Open
Abstract
The Mediterranean Diet (MD) is, culturally and historically, the nutritional pattern shared by people living in the olive-tree growing areas of the Mediterranean basin. It is of great importance for its potential preventive effect against cardiovascular diseases (CVDs). The PREvención con DIeta MEDiterránea (PREDIMED) study, a Spanish multicentre randomised controlled trial (RCT), was designed to assess the long-term effects of the MD, without any energy restriction, on the incidence of CVD in individuals at high cardiovascular (CV) risk. Since its inception, it gave a great contribution to the available literature on the issue. It is well known that, in the field of the health sciences, RCTs provide the best scientific evidence. Thus, the aim of the present review is to analyse the results of the RCTs performed within the frame of the PREDIMED study. Our findings showed that MD has beneficial effects in the primary prevention of CVDs, diabetes and in the management of metabolic syndrome.
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Minelli P, Montinari MR. The Mediterranean Diet And Cardioprotection: Historical Overview And Current Research. J Multidiscip Healthc 2019; 12:805-815. [PMID: 31632049 PMCID: PMC6776290 DOI: 10.2147/jmdh.s219875] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 08/23/2019] [Indexed: 01/27/2023] Open
Abstract
Ancient Greece was the cradle of the Mediterranean food tradition, characterized by the Mediterranean "eternal trinity" wheat - olive oil - wine, the very essence of the country's traditional agricultural and dietary regime, enriched by a culture of sharing and commensality. This food model, subsequently adopted and spread by the Romans, was rediscovered at the end of the Second World War by two American researchers, Leland Allbaugh and Ancel Keys. With the famous Seven Countries Study, Keys demonstrated for the first time that populations practicing a Mediterranean diet - such as the Greeks and southern Italians - showed low mortality rates from ischemic heart disease compared to the peoples of Northern Europe and North America. Since then, numerous subsequent epidemiological studies and randomized clinical trials have confirmed the beneficial effects of the Mediterranean diet both in primary and secondary prevention of cardiovascular diseases. This review will focus on the origins of the Mediterranean diet from its roots and its relationship to cardiovascular disease, with a brief overview of the nutritional mechanisms that influence atherosclerosis.
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Affiliation(s)
- Pierluca Minelli
- Faculty of Medicine and Surgery “A. Gemelli”, Catholic University of the Sacred Heart, Rome, Italy
| | - Maria Rosa Montinari
- Department of Biological and Environmental Science and Technology, University of Salento, Lecce, Italy
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Metabolic and Vascular Effect of the Mediterranean Diet. Int J Mol Sci 2019; 20:ijms20194716. [PMID: 31547615 PMCID: PMC6801699 DOI: 10.3390/ijms20194716] [Citation(s) in RCA: 119] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 09/18/2019] [Accepted: 09/21/2019] [Indexed: 12/17/2022] Open
Abstract
Several studies indicated how dietary patterns that were obtained from nutritional cluster analysis can predict disease risk or mortality. Low-grade chronic inflammation represents a background pathogenetic mechanism linking metabolic risk factors to increased risk of chronic degenerative diseases. A Mediterranean diet (MeDi) style has been reported as associated with a lower degree of inflammation biomarkers and with a protective role on cardiovascular and cerebrovascular events. There is heterogeneity in defining the MedDiet, and it can, owing to its complexity, be considered as an exposome with thousands of nutrients and phytochemicals. Recently, it has been reported a novel positive association between baseline plasma ceramide concentrations and cardiovascular events and how adherence to a Mediterranean Diet-style may influence the potential negative relationship between elevated plasma ceramide concentrations and cardiovascular diseases (CVD). Several randomized controlled trials (RCTs) showed the positive effects of the MeDi diet style on several cardiovascular risk factors, such as body mass index, waist circumference, blood lipids, blood pressure, inflammatory markers and adhesion molecules, and diabetes and how these advantages of the MeDi are maintained in comparison of a low-fat diet. Some studies reported a positive effect of adherence to a Mediterranean Diet and heart failure incidence, whereas some recent studies, such as the PREDIMED study, showed that the incidence of major cardiovascular events was lower among those assigned to MeDi supplemented with extra-virgin olive oil or nuts than among those assigned to a reduced-fat diet. New studies are needed to better understand the molecular mechanisms, whereby the MedDiet may exercise its effects. Here, we present recent advances in understanding the molecular basis of MedDiet effects, mainly focusing on cardiovascular diseases, but also discussing other related diseases. We review MedDiet composition and assessment as well as the latest advances in the genomic, epigenomic (DNA methylation, histone modifications, microRNAs, and other emerging regulators), transcriptomic (selected genes and whole transcriptome), and metabolomic and metagenomic aspects of the MedDiet effects (as a whole and for its most typical food components). We also present a review of the clinical effects of this dietary style underlying the biochemical and molecular effects of the Mediterranean diet. Our purpose is to review the main features of the Mediterranean diet in particular its benefits on human health, underling the anti-inflammatory, anti-oxidant and anti-atherosclerotic effects to which new knowledge about epigenetic and gut-microbiota relationship is recently added.
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