Dietary patterns are associated with central adiposity and carotid intima-media thickness in children and adolescents with congenital heart disease

Associations of childhood diet quality scores with arterial stiffness and carotid artery intima-media thickness in adolescence/early adulthood: findings from the ALSPAC cohort

This study examined the relationship between childhood diet quality and arterial stiffness and thickness during adolescence/early adulthood. Participants were from the Avon Longitudinal Study of Parents and Children (ALSPAC) with dietary data at ages 7, 10 and 13 years and pulse wave velocity (PWV) and carotid intima-media thickness (cIMT) at ages 17 and/or 24 years. Diet quality (DQ) was assessed using five scores: a children's Mediterranean-style diet (C-rMED) Z-score, a children's Dietary Inflammatory Z-score (C-DIS), a DASH diet Z-score, a children's Eatwell Guide (C-EWG) Z-score reflecting UK dietary guidelines and a data-driven obesogenic Z-score. Adjusted regression models examined the associations between DQ scores at 7-13 years and PWV and cIMT at 17 and 24 years. In adjusted models, a high v. low Obesogenic Z-score at 7 and 10 years was associated with higher PWV at 17: β 0.07 (95 % CI 0.01, 0.13) and β 0.10 (95 % CI 0.04, 0.16), respectively. A high v. low C-rMED Z-score at 7 years was associated with lower PWV at 17 (β -0.07; 95 % CI -0.14, -0.01). A high (more anti-inflammatory) vs low C-DIS Z-score at 10 years was associated with a lower PWV at 17 years: β -0.06 (95 % CI -0.12, -0.01). No other associations were observed. In conclusion, an Obesogenic dietary pattern in childhood (7-10 years) was related to increased arterial stiffness, while Mediterranean-style and anti-inflammatory diets were related to decreased arterial stiffness in adolescence. This highlights the importance of establishing healthy dietary habits early in life to protect against vascular damage.

Consumption and Breakfast Patterns in Children and Adolescents with Congenital Heart Disease

Little is known about skipping breakfast and breakfast patterns (BP) and their evaluation according to sociodemographic, clinical, lifestyle, cardiometabolic and nutritional data in children and adolescents with congenital heart disease (CHD). This cross-sectional study with 232 children and adolescents with CHD identified the prevalence and patterns of the breakfast, described these according to sociodemographic, clinical and lifestyle characteristics, and assessed their association with cardiometabolic and nutritional markers. Breakfast patterns were identified by principal components, and bivariate and linear regression analysis were applied. Breakfast consumption was observed in 73% of participants. Four BP were identified: pattern 1 "milk, ultra-processed bread, and chocolate milk", pattern 2 "margarine and processed bread", pattern 3 "cold meats/sausages, cheeses and butter/cream" and pattern 4 "fruits/fruit juices, breakfast cereals, yogurts, and homemade cakes/pies and sweet snacks". Family history for obesity and acyanotic CHD were associated with breakfast skipping. Younger participants and greater maternal education were associated with greater adherence to pattern 1 and pattern 4. Older participants and longer post-operative time showed greater adherence to pattern 3. No association between skipping breakfast or BP and cardiometabolic and nutritional markers was observed. Nonetheless, the findings reinforce the need for nutritional guidance for healthy breakfast, aiming to reduce the consumption of ultra-processed foods and to prioritize fresh and minimally processed foods.

Clusters of lifestyle behaviors associated with atherosclerosis risk factors in children and adolescents with congenital heart disease: Floripa CHild Study

Secondary cardiovascular disease is the main cause of mortality in congenital heart disease (CHD) patients. The cardiovascular risk could be widely prevented with adherence to a healthy lifestyle; however, clusters of lifestyle behaviors related to atherosclerosis risk factors in children and adolescents with CHD remain unclear. We aimed to describe the clusters of lifestyle behaviors of children and adolescents with CHD and to evaluate their association with atherosclerosis risk factors. We conducted a cross-sectional study on 227 children and adolescents with CHD (median age:10.02 [IQR:7.08-13.02] years). Dietary intake, physical activity (PA), and sedentary behavior (SB) were evaluated. Clusters of lifestyle behaviors were determined using a two-step cluster analysis. Atherosclerosis risk factors evaluated include body fat mass, central obesity, blood pressure, lipid parameters, glucose, C-reactive protein, and carotid intima-media thickness (cIMT). Multiple logistic regressions were used. The "unhealthy: high SB + low PA" cluster was associated with elevated body fat mass, central obesity, and elevated cIMT. Furthermore, the "unhealthy: low PA + unhealthy eating habits" cluster was associated with elevated body fat mass, central obesity, and elevated glucose. The unhealthier lifestyle behavior clusters were associated with atherosclerosis risk factors in children and adolescents with CHD. Multidisciplinary strategies to promote healthy behaviors are needed to prevent cardiovascular disease in later life.

Using Multiple Statistical Methods to Derive Dietary Patterns Associated with Cardiovascular Disease in Patients with Type 2 Diabetes: Results from a Multiethnic Population-Based Study

Background

There are few reports on the relationship between dietary patterns and cardiovascular disease (CVD) risk in patients with type 2 diabetes (T2D). This study aimed to explore relationships between dietary patterns and CVD risk in the T2D population using multiple statistical analysis methods.

Methods

A total of 2,984 patients with T2D from the Xinjiang Multi-Ethnic Cohort, 555 of whom were suffering from CVD, were enrolled in this study. Participants' dietary intake was measured by the semiquantitative food frequency questionnaire (FFQ). Three statistical methods were used to construct dietary patterns, including principal component analysis (PCA) method, reduced-rank regressions (RRR) method, and partial least-squares regression (PLS) method. Then, the association between dietary patterns and CVD risk in T2D patients was analyzed by logistic regression. After excluding participants with CVD, the associations between dietary patterns and 10-year CVD risk scores were subsequently evaluated to reduce reverse causality.

Results

In this study, four dietary patterns were identified by three methods. Adjustment for confounding factors, subjects with the highest scores on the "high-protein and high-carbohydrate" patterns derived from PCA, RRR, and PLS had higher odds of CVD than those with the lowest scores (OR: 2.89, 95% CI: 2.11-3.96, P _trend < 0.001; OR: 2.96, 95% CI: 2.17-4.03, P _trend < 0.001; OR: 2.01, 95% CI: 1.50-2.70, P _trend < 0.001, respectively). However, the dietary pattern of PCA-prudent was not significantly related to the odds of having CVD in T2D patients (adjusted OR_Q4vsQ1: 0.93, 95% CI: 0.70-1.24, P _trend =0.474). Interestingly, we also found significant associations between "high-protein and high-carbohydrate" patterns and the elevated predicted 10-year CVD risk in T2D patients (all P _trend < 0.05).

Conclusion

The positive correlation between "high-protein and high-carbohydrate" patterns and CVD risk in T2D patients was robust across all three data-driven approaches. These findings may have public health significance, encouraging an emphasis on food choices in the usual diet and promoting nutritional interventions for patients with T2D to prevent CVD.

Accelerated Cardiac Aging in Patients With Congenital Heart Disease

An increasing number of patients with congenital heart disease (CHD) survive into adulthood but develop long-term complications including heart failure (HF). Cellular senescence, classically defined as stable cell cycle arrest, is implicated in biological processes such as embryogenesis, wound healing, and aging. Senescent cells have a complex senescence-associated secretory phenotype (SASP), involving a range of pro-inflammatory factors with important paracrine and autocrine effects on cell and tissue biology. While senescence has been mainly considered as a cause of diseases in the adulthood, it may be also implicated in some of the poor outcomes seen in patients with complex CHD. We propose that patients with CHD suffer from multiple repeated stress from an early stage of the life, which wear out homeostatic mechanisms and cause premature cardiac aging, with this term referring to the time-related irreversible deterioration of the organ physiological functions and integrity. In this review article, we gathered evidence from the literature indicating that growing up with CHD leads to abnormal inflammatory response, loss of proteostasis, and precocious age in cardiac cells. Novel research on this topic may inspire new therapies preventing HF in adult CHD patients.

The Relationship Between Dietary Choices and Health and Premature Vascular Ageing

The paper aims to review the available data about the main mechanisms enabling improvement or accelerating vascular ageing due to food choices, considering recent experimental and clinical data, and emphasising potential implications for clinical practice and therapy. The main food choices which will be discussed are diets rich in fruits and vegetables, the Mediterranean diet, polyunsaturated fatty acids, cocoa, caffeine, tea, meat, dairy products, sodium, and potassium intake.