Type and effectiveness of community-based interventions in improving knowledge related to cardiovascular diseases and risk factors: A systematic review

Dietary outcomes of community-based CVD preventive interventions: a systematic review and meta-analysis

OBJECTIVE

We aimed to synthesise available evidence on the effects of community-based interventions in improving various dietary outcome measures.

DESIGN

Systematic review and meta-analysis.

SETTING

We searched databases including Medline, EMBASE, PSYCINFO, CINAHL and the Cochrane registry for studies reported between January 2000 and June 2022. The methodological quality of the included studies was evaluated using the Cochrane risk of bias tools for each study type. For some of the outcomes, we pooled the effect size using a random-effects meta-analysis.

PARTICIPANTS

A total of fifty-one studies, thirty-three randomised and eighteen non-randomised, involving 100 746 participants were included.

RESULTS

Overall, thirty-seven studies found a statistically significant difference in at least one dietary outcome measure favouring the intervention group, whereas fourteen studies found no statistically significant difference. Our meta-analyses indicated that, compared with controls, interventions were effective in decreasing daily energy intake (MJ/d) (mean difference (MD): -0·25; 95 % CI: -0·37, -0·14), fat % of energy (MD: -1·01; 95 % CI: -1·76, -0·25) and saturated fat % of energy (MD: -1·54; 95 % CI: -2·01, -1·07). Furthermore, the interventions were effective in improving fibre intake (g/d) (MD: 1·08; 95 % CI: 0·39, 1·77). Effective interventions use various strategies including tailored individual lifestyle coaching, health education, health promotion activities, community engagement activities and/or structural changes.

CONCLUSION

This review shows the potential of improving dietary patterns through community-based CVD preventive interventions. Thus, development and implementation of context-specific preventive interventions could help to minimise dietary risk factors, which in turn decrease morbidity and mortality due to CVD and other non-communicable diseases.

Cardiovascular risk in adults with different levels of physical activity

BACKGROUND

Physical inactivity is a behavioral and modifiable risk factor for cardiovascular disease. We aimed to assess the association of walking or moderate to vigorous physical activity of various durations with cardiovascular risk in age and sex groups of the adult general population.

METHODS

This research was a secondary analysis of cross-sectional data from a Brazilian cohort study (2009 to 2014) on the general population in an urban area. Overall, 1208 patients (48.2% males) aged 20-59 years [mean (SD) age = 38.8 (12.0) years] were included.

RESULTS

We developed two well-fitted logistic models for investigating the main and interaction effects of physical activity; C-statistic = 74.1 and 80.4, respectively. Older age groups showed a higher association with the risk of cardiovascular disease, adjusted odds ratio OR (95%CI) = 5.28 (2.69, 10.76) for age ≥ 50 years. Walking < 150 min/w was not significant for all age groups (all P ≥ 0.139) compared with the base category (20-29 years). Also, moderate to vigorous physical activity < 150 min/w was not associated with lower cardiovascular risk. However, for moderate to vigorous physical activity ≥ 150 min/w, our results were indicative of a significant protective role for people in 30-39 and ≥ 50 age ranges; OR = 0.20 (0.09, 0.46) and 0.22 (0.10, 0.48), respectively (both P < 0.001).

CONCLUSION

Our study did not suggest a protective role for walking. However, moderate to vigorous physical activity ≥ 150 min/w was associated with a lower risk of cardiovascular disease in older patients.

Adverse Childhood Experiences and Cardiovascular Risk among Young Adults: Findings from the 2019 Behavioral Risk Factor Surveillance System

Background: Heart disease is the fourth leading cause of death for young adults aged 18-34 in the United States. Recent research suggests that adverse childhood experiences (ACEs) may shape cardiovascular health and its proximate antecedents. In the current study, we draw on a contemporary, national sample to examine the association between ACEs and cardiovascular health among young adults in the United States, as well as potential mediating pathways. Methods: The present study uses data from the 2019 Behavioral Risk Factor Surveillance System (BRFSS) to examine associations between ACEs and cardiovascular risk, as well as the role of cumulative disadvantage and poor mental health in these associations. Results: Findings indicate that young adults who have experienced a greater number of ACEs have a higher likelihood of having moderate to high cardiovascular risk compared to those who have zero or few reported ACEs. Moreover, both poor mental health and cumulative disadvantage explain a significant proportion of this association. Conclusions: The present findings suggest that young adulthood is an appropriate age for deploying prevention efforts related to cardiovascular risk, particularly for young adults reporting high levels of ACEs.