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Keshani M, Feizi A, Askari G, Sharma M, Bagherniya M. Effects of therapeutic lifestyle change diets on blood lipids, lipoproteins, glycemic parameters, and blood pressure: a systematic review and meta-analysis of clinical trials. Nutr Rev 2024; 82:176-192. [PMID: 37352395 DOI: 10.1093/nutrit/nuad051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2023] Open
Abstract
CONTEXT Cardiovascular disease is the leading cause of death worldwide. Low-calorie, low-fat therapeutic diets (TDs) developed by the US National Cholesterol Education Program, ie, the Step I and II diets and the therapeutic lifestyle changes diet, are approximately similar and are the initial therapeutic interventional approaches for lifestyle modification. OBJECTIVE This systematic review with meta-analysis was undertaken to evaluate the effects of TDs diet on blood lipids, apolipoprotein A-1, apolipoprotein B, blood pressure, fasting blood glucose, and insulin. DATA SOURCES A comprehensive search of the PubMed/MEDLINE, Web of Science, Scopus, and Google Scholar databases until October 2022 was performed to identify clinical trials investigating the effects of TDs on the aforementioned parameters. DATA EXTRACTION One investigator screened the records and extracted data, and another reviewed the extracted data. DATA ANALYSIS A total of 910 records were retrieved. After records were screened for eligibility, 34 clinical trials met the inclusion criteria. The pooled analysis from the random-effects model revealed a significant reduction in total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, apolipoprotein A-1, and apolipoprotein B in the TD intervention group vs the control group. The overall effects of TDs on fasting blood glucose, insulin, and blood pressure were not significant, but the results of subgroup analysis revealed a significant reduction in fasting blood glucose with the Step II diet and an intervention duration of more than 24 weeks. For blood pressure, the Step I diet and an intervention duration of more than 24 weeks resulted in significant reduction. There was no evidence of publication bias, but strong heterogeneity was observed. CONCLUSION Therapeutic diets have promising effects on lipid profile parameters, glycemic indexes, and blood pressure, which can promote cardiovascular health. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42021259355.
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Affiliation(s)
- Mahdi Keshani
- Student Research Committee, Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
- Nutrition and Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gholamreza Askari
- Nutrition and Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Manoj Sharma
- Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, Las Vegas, Nevada, USA
| | - Mohammad Bagherniya
- Nutrition and Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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Charoenwoodhipong P, Holt RR, Keen CL, Hedayati N, Sato T, Sone T, Hackman RM. The Effect of Hokkaido Red Wines on Vascular Outcomes in Healthy Adult Men: A Pilot Study. Nutrients 2023; 15:4054. [PMID: 37764837 PMCID: PMC10535196 DOI: 10.3390/nu15184054] [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: 08/17/2023] [Revised: 09/07/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
Moderate red wine intake has been associated with lower cardiovascular mortality, due in part to the intake of polyphenols and anthocyanins, whose content can vary from varietal and year of harvest. This study assessed the vascular effects in response to a single intake of 2015 and 2018 Zweigelt red wines from Hokkaido, Japan. Healthy men were randomly assigned to consume 240 mL each of a red wine, or a sparkling white grape juice as a control in a randomized three-arm cross-over design with a 7 day washout between arms. The augmentation index (AI; a measure of arterial stiffness) and AI at 75 beats/min (AI75), reactive hyperemia index, systolic and diastolic blood pressure (SBP and DBP, respectively), and platelet reactivity were assessed at baseline and two and four hours after each beverage intake. Changes from the baseline were analyzed using a linear mixed model. Significant treatment effects (p = 0.02) were observed, with AI 13% lower after the intake of the 2015 or 2018 vintages compared to the control. Intake of the 2018 vintage reduced SBP and DBP (-4.1 mmHg and -5.6 mmHg, respectively; p = 0.02) compared to the 2015 wine and the control drink. The amount of hydroxytyrosol in the 2018 wine was almost twice the amount as in the 2015 wine, which may help explain the variable blood pressure results. Future studies exploring the vascular effects of the same red wine from different vintage years and different phenolic profiles are warranted.
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Affiliation(s)
| | - Roberta R. Holt
- Department of Nutrition, University of California Davis, Davis, CA 95616, USA; (P.C.)
| | - Carl L. Keen
- Department of Nutrition, University of California Davis, Davis, CA 95616, USA; (P.C.)
- Department of Internal Medicine, University of California Davis, Sacramento, CA 95817, USA
| | - Nasim Hedayati
- Division of Vascular Surgery, Department of Surgery, University of California Davis, Sacramento, CA 95817, USA
| | - Tomoyuki Sato
- Research Faculty of Agriculture, Hokkaido University, Sapporo 060-8589, Hokkaido, Japan
| | - Teruo Sone
- Research Faculty of Agriculture, Hokkaido University, Sapporo 060-8589, Hokkaido, Japan
| | - Robert M. Hackman
- Department of Nutrition, University of California Davis, Davis, CA 95616, USA; (P.C.)
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Barber TM, Kabisch S, Pfeiffer AFH, Weickert MO. The Effects of the Mediterranean Diet on Health and Gut Microbiota. Nutrients 2023; 15:2150. [PMID: 37432307 DOI: 10.3390/nu15092150] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/25/2023] [Accepted: 04/29/2023] [Indexed: 07/12/2023] Open
Abstract
The Mediterranean Diet (MD) is plant-based and consists of multiple daily portions of vegetables, fruit, cereals, and olive oil. Although there are challenges with isolating the MD from the typical Mediterranean lifestyle and culture (including prolonged 'social' meals and siestas), much evidence supports the health benefits of the MD that include improved longevity, reduced metabolic risk of Diabetes Mellitus, obesity, and Metabolic Syndrome, reduced risk of malignancy and cardiovascular disease, and improved cognitive function. The MD is also associated with characteristic modifications to gut microbiota, mediated through its constituent parts (primarily dietary fibres, extra virgin olive oil, and polyunsaturated fatty acids [including ω-3]). These include enhanced growth of species that produce short-chain fatty acids (butyrate), such as Clostridium leptum and Eubacterium rectale, enhanced growth of Bifidobacteria, Bacteroides, and Faecalibacterium prausnitzii species, and reduced growth of Firmicutes and Blautia species. Such changes in gut microbiota are known to be associated favourably with inflammatory and oxidative status, propensity for malignancy and overall metabolic health. A key challenge for the future is to explore the extent to which the health benefits of the MD are mediated by such changes to gut microbiota. The MD confers both health and environmental benefits. Adoption of the MD should perhaps be encouraged and facilitated more generally and not just restricted to populations from Mediterranean regions. However, there are key challenges to this approach that include limited perennial availability of the constituent parts of the MD in some non-Mediterranean regions, intolerability of a high-fibre diet for some people, and potential cultural disconnects that juxtapose some traditional (including Western) diets with the MD.
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Affiliation(s)
- Thomas M Barber
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry CV2 2DX, UK
- NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK
| | - Stefan Kabisch
- Department of Endocrinology, Diabetes and Nutrition, Campus Benjamin Franklin, Charité University Medicine, Hindenburgdamm 30, 12203 Berlin, Germany
- Deutsches Zentrum für Diabetesforschung e.V., Geschäftsstelle am Helmholtz-Zentrum München, Ingolstädter Landstraße, 85764 Neuherberg, Germany
| | - Andreas F H Pfeiffer
- Department of Endocrinology, Diabetes and Nutrition, Campus Benjamin Franklin, Charité University Medicine, Hindenburgdamm 30, 12203 Berlin, Germany
- Deutsches Zentrum für Diabetesforschung e.V., Geschäftsstelle am Helmholtz-Zentrum München, Ingolstädter Landstraße, 85764 Neuherberg, Germany
| | - Martin O Weickert
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry CV2 2DX, UK
- NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK
- Centre for Sport, Exercise and Life Sciences, Faculty of Health & Life Sciences, Coventry University, Coventry CV2 2DX, UK
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Fatima K, Rashid AM, Memon UAA, Fatima SS, Javaid SS, Shahid O, Zehri F, Obaid MA, Ahmad M, Almas T, Minhas AMK. Mediterranean Diet and its Effect on Endothelial Function: A Meta-analysis and Systematic Review. Ir J Med Sci 2023; 192:105-113. [PMID: 35192097 PMCID: PMC9892125 DOI: 10.1007/s11845-022-02944-9] [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: 12/04/2021] [Accepted: 02/01/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Endothelial dysfunction serves as an early marker for the risk of cardiovascular disease (CVD); therefore, it is a site of therapeutic interventions to reduce the risk of CVD. AIMS To examine the effect of the Mediterranean diet (MedDiet), as an intervention, on structural and functional parameters of endothelial function, and how it may reduce the risk of CVD and associated mortality. METHODS Medline database was searched for randomized controlled trials. Random-effects meta-analysis was conducted on 21 independent datasets. Meta-regression and subgroup analysis were performed to assess whether the effect of MedDiet was modified by health status (healthy subjects or with increased CVD risk), type of MedDiet intervention (alone or combined), type of parameter (functional or structural), study design (cross-over or parallel), BMI, age, and study duration. Our study used sample size, mean, and standard deviation of endothelial function measurements for both MedDiet intervention and control in the analyses. RESULTS Inverse relationship between endothelial function and intake of MedDiet was observed (SMD: 0.34; 95% CI: 0.16, 0.52; P = 0.0001). Overall, MedDiet increased FMD by 1.39% (95% CI: 0.47, 2.19; P < 0.001). There was a significant improvement in endothelial function in both healthy patients and in those with an increased risk of CVD. No significant variation was observed in the effects of MedDiet on endothelial function, due to study design or type of intervention. CONCLUSIONS These findings support that MedDiet can reduce the risk of CVD by improving endothelial function.
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Affiliation(s)
- Kaneez Fatima
- grid.412080.f0000 0000 9363 9292Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Ahmed Mustafa Rashid
- grid.415944.90000 0004 0606 9084Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Usama Abdul Ahad Memon
- grid.415944.90000 0004 0606 9084Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Syeda Sidra Fatima
- grid.412080.f0000 0000 9363 9292Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Syed Sarmad Javaid
- grid.415944.90000 0004 0606 9084Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Omema Shahid
- grid.413093.c0000 0004 0571 5371Department of Medicine, Ziauddin Medical University, Karachi, Pakistan
| | - Fazila Zehri
- grid.412080.f0000 0000 9363 9292Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Muhammad Adil Obaid
- grid.415944.90000 0004 0606 9084Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan
| | - Mahlika Ahmad
- grid.413093.c0000 0004 0571 5371Department of Medicine, Ziauddin Medical University, Karachi, Pakistan
| | - Talal Almas
- grid.4912.e0000 0004 0488 7120Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Abdul Mannan Khan Minhas
- grid.414961.f0000 0004 0426 4740Department of Internal Medicine, Forrest General Hospital, Hattiesburg, MS USA
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Moore E, Fadel A, Lane KE. The effects of consuming a Mediterranean style diet on associated COVID-19 severity biomarkers in obese/overweight adults: A systematic review. Nutr Health 2022; 28:647-667. [PMID: 36131504 PMCID: PMC9494166 DOI: 10.1177/02601060221127853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background: COVID-19 severity is strongly associated with high Body Mass Index (BMI) (≥25kg/m2) amongst adults and elevated inflammatory markers have enabled prediction of disease progression. The composition of a Mediterranean diet provides favourable outcomes on weight reduction and inflammatory markers. Aim: This systematic review aimed to investigate the effects of consuming a Mediterranean diet on BMI and inflammatory markers of obese/overweight adults (≥18 years) at risk of developing severe COVID-19 outcomes. Methods: PubMed Central, Cochrane Library and MEDLINE databases were searched to identify randomised controlled trials published between January 2010 to August 2021 evaluating the impact of Mediterranean diet on BMI and inflammatory markers in overweight/obese adults. The review followed the PRISMA checklist, used Cochrane Collaboration search strategies, and is PROSPERO registered (CRD42021277070). Two authors independently screened and evaluated studies for methodological quality. Papers were extracted and included based eligibility, despite risk of bias scores. Results: Of 65 extracted records, six studies met the eligibility criteria and were included. Reductions in BMI, TNF-α, IL-6 and hs-CRP were reported amongst most findings, the majority of which were significant. Conclusion: The main findings indicate a hypocaloric, fibre dense Mediterranean diet is a short-term (<4 months) mitigation strategy to significantly reduce BMI and inflammatory markers amongst overweight/obese adults at risk of developing severe COVID-19 outcomes. Further research is now needed to examine the role of Mediterranean diet in COVID-19 prevalence, severity, morbidity and mortality.
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Affiliation(s)
- Ella Moore
- Research Institute for Sport and Exercise Science,
School of Sport and Exercise Sciences, Liverpool John Moores
University, Liverpool, UK
| | - Abdulmannan Fadel
- Research Institute for Sport and Exercise Science,
School of Sport and Exercise Sciences, Liverpool John Moores
University, Liverpool, UK
| | - Katie E. Lane
- Research Institute for Sport and Exercise Science,
School of Sport and Exercise Sciences, Liverpool John Moores
University, Liverpool, UK
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Coura AGL, de Arruda Neta ADCP, de Lima RLFC, Bersch-Ferreira ÂC, Weber B, Vianna RPDT. Tracking of Dietary Patterns in the Secondary Prevention of Cardiovascular Disease after a Nutritional Intervention Program-A Randomized Clinical Trial. Nutrients 2022; 14:4716. [PMID: 36432401 PMCID: PMC9695891 DOI: 10.3390/nu14224716] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/24/2022] [Accepted: 11/01/2022] [Indexed: 11/11/2022] Open
Abstract
Individuals with a history of previous cardiovascular events have an increased risk of mortality and morbidity, so adherence to a healthy dietary pattern is essential. We aimed to evaluate and compare dietary patterns between the control and the experimental group from the BALANCE Program. A total of 2360 individuals aged 45 years or older with previous cardiovascular disease were included. The individuals were randomized into two groups: intervention (dietary prescription with nutritional recommendations, nutritional education program based on playful strategies, suggestions of typical and accessible Brazilian foods and intensive monitoring) and control (conventional nutritional counseling). The dietary patterns were identified using factor analysis with the principal component extraction method, and the t-Student tests and ANOVA test were performed to evaluate the associated factors. Four dietary patterns were identified for both groups: "Traditional", "Snack", "Western", "Cardioprotective". There was an increase in the variances of the "Cardioprotective" pattern in both groups. Regarding the "Western" pattern, there was a significant reduction in the variances of the experimental group (10.63% vs. 8.14%). Both groups had improvements in eating habits, especially in the first year of follow-up. The greater increase in adherence to the traditional and cardioprotective pattern in the experimental group justifies the initiative of the BALANCE program.
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Effect of pecan nuts and extra-virgin olive oil on glycemic profile and nontraditional anthropometric indexes in patients with coronary artery disease: a randomized clinical trial. Eur J Clin Nutr 2021; 76:827-834. [PMID: 34811509 DOI: 10.1038/s41430-021-01045-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 10/21/2021] [Accepted: 10/27/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES The influence of cardioprotective foods on nontraditional indexes related to dysglycemia and body fat distribution is unknown in individuals with coronary artery disease (CAD). This study aimed to evaluate the effect of a healthy diet supplemented with pecan nuts or extra-virgin olive oil on glycemic profile and adipose tissue dysfunction assessed by anthropometric indexes in patients with stable CAD. SUBJECTS/METHODS In a randomized, pragmatic, parallel clinical trial lasting 12 weeks, 204 individuals were allocated to three interventions: a healthy diet (control group [CG], n = 67), a healthy diet plus 30 g/day of pecan nuts (pecan nut group [PNG], n = 68), or a healthy diet plus 30 mL/day of extra-virgin olive oil (olive oil group [OOG], n = 69). Triglyceride-glucose (TyG) index (primary outcome) and other markers of glycemic profile were evaluated, and nontraditional anthropometric indexes as well. Diet quality was assessed according to the Alternate Healthy Eating Index (mAHEI). RESULTS After adjustment for baseline values, use of antidiabetic drugs and insulin, there were no differences in both glycemic and anthropometric profiles according to groups at the end of the study. PNG improved the quality of the diet in comparison to other groups (final mAHEI scores: CG: 19 ± 7.5; PNG: 26 ± 8; OOG: 18.9 ± 6; P < 0.001). CONCLUSIONS There was no difference regarding glycemic and anthropometric parameters according to interventions in patients with stable CAD. However, adding pecan nuts to a healthy diet may improve its quality. Further studies must be conducted considering dietary interventions on secondary cardiovascular prevention setting. CLINICAL TRIALS IDENTIFIER NUMBER NCT02202265. First Posted: July 2014; Last Update: September 2020.
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Marcadenti A, Weber B, Bersch-Ferreira AC, Machado RHV, Torreglosa CR, de Sousa Lara EM, da Silva LR, Santos RHN, Miyada DHK, Sady ERR, Costa RP, Piegas L, de Abreu-Silva EO, de Quadros AS, Weschenfelder C, Dos Santos JL, Souza GC, Parahiba SM, Fayh APT, Bezerra DS, Carvalho APPF, Machado MMA, Vasconcelos SML, Araújo J, de Figueiredo Neto JA, Dias LPP, Nagano FEZ, de Almeida CCP, Moreira ASB, Gapanowicz DP, Purgatto E, Rogero MM, Sampaio GR, da Silva Torres EAF, Duarte GBS, Cavalcanti AB. Effects of a Brazilian cardioprotective diet and nuts on cardiometabolic parameters after myocardial infarction: study protocol for a randomized controlled clinical trial. Trials 2021; 22:582. [PMID: 34470656 PMCID: PMC8411551 DOI: 10.1186/s13063-021-05494-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 07/27/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Nut consumption has been related to improvements on cardiometabolic parameters and reduction in the severity of atherosclerosis mainly in primary cardiovascular prevention. The objective of this trial is to evaluate the effects of the Brazilian Cardioprotective Diet (DIeta CArdioprotetora Brasileira, DICA Br) based on consumption of inexpensive locally accessible foods supplemented or not with mixed nuts on cardiometabolic features in patients with previous myocardial infarction (MI). METHODS DICA-NUTS study is a national, multicenter, randomized 16-week follow-up clinical trial. Patients over 40 years old with diagnosis of previous MI in the last 2 to 6 months will be recruited (n = 388). A standardized questionnaire will be applied to data collection and blood samples will be obtained. Patients will be allocated in two groups: Group 1: DICA Br supplemented with 30 g/day of mixed nuts (10 g of peanuts, 10 g of cashew, 10 g of Brazil nuts); and Group 2: only DICA Br. The primary outcome will consist of LDL cholesterol means (in mg/dL) after 16 weeks of intervention. Secondary outcomes will consist of other markers of lipid profile, glycemic profile, and anthropometric data. DISCUSSION It is expected that DICA Br supplemented with mixed nuts have superior beneficial effects on cardiometabolic parameters in patients after a MI, when compared to DICA Br. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT03728127 . First register: November 1, 2018; Last update: June 16, 2021. World Health Organization Universal Trial Number (WHO-UTN): U1111-1259-8105.
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Affiliation(s)
- Aline Marcadenti
- HCor Research Institute (IP-HCor), Hospital do Coração (HCor), Abílio Soares Street, 250, 12th floor, São Paulo, SP, Zip Code 04004-050, Brazil.
- Graduate Program in Health Sciences (Cardiology), Instituto de Cardiologia/Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre, Rio Grande do Sul, Brazil.
| | - Bernardete Weber
- HCor Research Institute (IP-HCor), Hospital do Coração (HCor), Abílio Soares Street, 250, 12th floor, São Paulo, SP, Zip Code 04004-050, Brazil
| | - Angela Cristine Bersch-Ferreira
- HCor Research Institute (IP-HCor), Hospital do Coração (HCor), Abílio Soares Street, 250, 12th floor, São Paulo, SP, Zip Code 04004-050, Brazil
| | - Rachel Helena Vieira Machado
- HCor Research Institute (IP-HCor), Hospital do Coração (HCor), Abílio Soares Street, 250, 12th floor, São Paulo, SP, Zip Code 04004-050, Brazil
| | - Camila Ragne Torreglosa
- HCor Research Institute (IP-HCor), Hospital do Coração (HCor), Abílio Soares Street, 250, 12th floor, São Paulo, SP, Zip Code 04004-050, Brazil
| | - Enilda Maria de Sousa Lara
- Health Knowledge Implementation Laboratory (LICS), Hospital do Coração (HCor), São Paulo, São Paulo, Brazil
| | - Lucas Ribeiro da Silva
- HCor Research Institute (IP-HCor), Hospital do Coração (HCor), Abílio Soares Street, 250, 12th floor, São Paulo, SP, Zip Code 04004-050, Brazil
| | - Renato Hideo Nakagawa Santos
- HCor Research Institute (IP-HCor), Hospital do Coração (HCor), Abílio Soares Street, 250, 12th floor, São Paulo, SP, Zip Code 04004-050, Brazil
| | - Debora Harumi Kodama Miyada
- HCor Research Institute (IP-HCor), Hospital do Coração (HCor), Abílio Soares Street, 250, 12th floor, São Paulo, SP, Zip Code 04004-050, Brazil
| | - Erica Regina Ribeiro Sady
- HCor Research Institute (IP-HCor), Hospital do Coração (HCor), Abílio Soares Street, 250, 12th floor, São Paulo, SP, Zip Code 04004-050, Brazil
| | - Rosana Perim Costa
- HCor Research Institute (IP-HCor), Hospital do Coração (HCor), Abílio Soares Street, 250, 12th floor, São Paulo, SP, Zip Code 04004-050, Brazil
| | - Leopoldo Piegas
- Division of Cardiology, Hospital do Coração (HCor), São Paulo, São Paulo, Brazil
| | - Erlon Oliveira de Abreu-Silva
- HCor Research Institute (IP-HCor), Hospital do Coração (HCor), Abílio Soares Street, 250, 12th floor, São Paulo, SP, Zip Code 04004-050, Brazil
- Division of Cardiology, Hospital do Coração (HCor), São Paulo, São Paulo, Brazil
- Hemodynamics Service, Hospital do Servidor Público Estadual (HSPE), São Paulo, São Paulo, Brazil
| | - Alexandre Schaan de Quadros
- Graduate Program in Health Sciences (Cardiology), Instituto de Cardiologia/Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre, Rio Grande do Sul, Brazil
| | - Camila Weschenfelder
- Graduate Program in Health Sciences (Cardiology), Instituto de Cardiologia/Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre, Rio Grande do Sul, Brazil
| | - Júlia Lorenzon Dos Santos
- Graduate Program in Health Sciences (Cardiology), Instituto de Cardiologia/Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre, Rio Grande do Sul, Brazil
| | - Gabriela Corrêa Souza
- Division of Nutrition, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
- Post-Graduation Program in Food, Nutrition and Health, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Suena Medeiros Parahiba
- Post-Graduation Program in Food, Nutrition and Health, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Ana Paula Trussardi Fayh
- Department of Nutrition, Universidade Federal do Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Danielle Soares Bezerra
- Faculty of Health Science of Trairi, Universidade Federal do Rio Grande do Norte (FACISA-UFRN), Santa Cruz, Rio Grande do Norte, Brazil
| | | | - Malaine Morais Alves Machado
- Clinical Nutrition Unit, Hospital de Clínicas, Universidade Federal de Goiás (HC-UFG/EBSERH), Goiânia, Goiás, Brazil
| | | | - Jéssika Araújo
- Faculty of Nutrition, Universidade Federal de Alagoas (UFAL), Maceió, Alagoas, Brazil
| | | | | | | | | | | | | | - Eduardo Purgatto
- Department of Food Science and Experimental Nutrition/Food Research Center, Faculty of Pharmaceutical Sciences, Universidade de São Paulo (USP), São Paulo, São Paulo, Brazil
| | - Marcelo Macedo Rogero
- Department of Nutrition, School of Public Health, Universidade de São Paulo (USP), São Paulo, São Paulo, Brazil
| | - Geni Rodrigues Sampaio
- Department of Nutrition, School of Public Health, Universidade de São Paulo (USP), São Paulo, São Paulo, Brazil
| | | | - Graziela Biude Silva Duarte
- Department of Food Science and Experimental Nutrition, Faculty of Pharmaceutical Science, Universidade de São Paulo (USP), São Paulo, São Paulo, Brazil
| | - Alexandre Biasi Cavalcanti
- HCor Research Institute (IP-HCor), Hospital do Coração (HCor), Abílio Soares Street, 250, 12th floor, São Paulo, SP, Zip Code 04004-050, Brazil
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Effects of supplementing a healthy diet with pecan nuts or extra-virgin olive oil on inflammatory profile of patients with stable coronary artery disease: a randomised clinical trial. Br J Nutr 2021; 127:862-871. [PMID: 33971993 DOI: 10.1017/s0007114521001513] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The consumption of nuts and extra-virgin olive oil has been associated with suppression of inflammatory pathways that contribute to atherosclerosis, but its role on the modulation of the inflammatory profile in patients with established coronary artery disease (CAD) is unclear. The aim of this study was to evaluate the effects of adding pecan nuts or extra-virgin olive oil to a healthy diet on inflammatory markers in patients with stable CAD. In this randomised clinical trial, 204 patients were enrolled to three study groups: sixty seven to control group (CG: healthy diet), sixty eight to pecan nuts group (PNG: 30 g/d of pecans + healthy diet) and sixty nine to extra-virgin olive oil group (OOG: 30 ml/d of extra-virgin olive oil + healthy diet). High-sensitivity C-reactive protein (hs-CRP, in mg/l), fibrinogen (mg/dl), IL 2, 4, 6, 10 (pg/ml) and interferon-γ (IFN-γ, in pg/ml), IL-6/IL-10, IL-2/IL-4 and IFN-/γIL-4 ratios were evaluated at baseline and after the follow-up (12 weeks). As main results, after adjustment for sex, statin used and relative body weight variation, there were no differences between groups regarding inflammatory markers at the end of the study. IL-6 levels (primary outcome) were reduced in 12 weeks when compared with baseline in all study groups (CG: difference: -0·593 (se = 0·159) pg/dL; PNG: difference: -0·335 (se = 0·143) pg/dl; OOG: IL-6 difference: -0·325 (se = 0·143) pg/dl). In conclusion, there was no significant effect of including pecan nuts or extra virgin olive oil to a healthy diet on inflammatory markers in individuals with CAD.
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Bersch-Ferreira AC, Hall WL, Santos RHN, Torreglosa CR, Sampaio G, Tereza da Silva J, Alves R, Ross MB, Gehringer MO, Kovacs C, Marcadenti A, Magnoni D, Weber B, Rogero MM. The effect of the a regional cardioprotective nutritional program on inflammatory biomarkers and metabolic risk factors in secondary prevention for cardiovascular disease, a randomised trial. Clin Nutr 2021; 40:3828-3835. [PMID: 34130029 DOI: 10.1016/j.clnu.2021.04.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 01/28/2021] [Accepted: 04/19/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND & AIMS To evaluate the effect of the Brazilian Cardioprotective Diet Program (BALANCE Program) on inflammatory biomarkers, involved in the pathophysiology of the atherosclerosis, on inflammatory biomarkers, cardiovascular risk factors, and on plasma fatty acids in cardiovascular disease secondary prevention patients. METHODS In this substudy of the BALANCE Program randomized clinical trial, a total of 369 patients aged 45 years or older, who have experienced cardiovascular disease in the previous 10 years, were included. These patients were randomized into two groups and followed up for six months: BALANCE Program group and control group (conventional nutrition advice). In the initial and six-month final visits, anthropometry (body weight, height and waist circumference), food intake evaluation by 24-h dietary recall, plasma inflammatory biomarkers (IL-6, IL-8, IL-10, IL-12, tumor necrosis factor-α, adiponectin, and C-reactive protein levels), blood pressure, glycemia, insulinemia, lipid profile, and plasma fatty acids levels were evaluated. RESULTS The BALANCE Program group showed increased plasma alpha-linolenic acid levels (P = 0.008), reduction in waist circumference (P = 0.049) and BMI (P = 0.032). No difference was observed among plasma inflammatory biomarkers and clinical data. CONCLUSION After six months of follow-up, BALANCE Program led to a significant reduction on BMI and waist circumference in individuals in secondary prevention for cardiovascular disease. Although plasmatic alpha-linolenic acid has increased, there was no impact on plasma inflammatory biomarkers. CLINICAL TRIAL REGISTRATION NCT01620398.
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Affiliation(s)
- Angela C Bersch-Ferreira
- Research Institute-HCor, São Paulo, Brazil; Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Wendy L Hall
- Department of Nutritional Sciences, Faculty of Life Sciences & Medicine, Kings College, London, England
| | | | - Camila R Torreglosa
- Research Institute-HCor, São Paulo, Brazil; Program in Global Health and Sustainability, University of São Paulo, São Paulo, SP, Brazil
| | - Geni Sampaio
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | | | - Renata Alves
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil; Department of Clinical Nutrition at Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil
| | - Maria Beatriz Ross
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | | | - Cristiane Kovacs
- Department of Clinical Nutrition at Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil
| | - Aline Marcadenti
- Research Institute-HCor, São Paulo, Brazil; Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Daniel Magnoni
- Department of Clinical Nutrition at Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil
| | | | - Marcelo Macedo Rogero
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil.
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11
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Wu PY, Chen KM, Tsai WC. The Mediterranean Dietary Pattern and Inflammation in Older Adults: A Systematic Review and Meta-analysis. Adv Nutr 2021; 12:363-373. [PMID: 33002104 PMCID: PMC8009747 DOI: 10.1093/advances/nmaa116] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 06/23/2020] [Accepted: 08/26/2020] [Indexed: 01/19/2023] Open
Abstract
This systematic review and meta-analysis aimed to explore the association between the Mediterranean dietary pattern and inflammation in older adults. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. A search of the literature was conducted up to June 2020 in 7 electronic databases, namely PubMed, Embase, Web of Science, Scopus, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and ProQuest. The Joanna Briggs Institute Critical Appraisal Checklists and the Newcastle-Ottawa Scale were used to assess the methodological quality. The overall standardized mean difference (SMD) and 95% CIs were estimated in random-effects meta-analyses. Thirteen studies were identified as having acceptable quality and were included in this systematic review: 3 randomized controlled trials (RCTs), 1 quasi-experimental study, 1 cohort study, and 8 cross-sectional studies. The circulating C-reactive protein (CRP) concentration was the most common inflammation indicator used. Results of the meta-analysis on 5 cross-sectional studies revealed a significant inverse association between the Mediterranean dietary pattern and inflammation as assessed by CRP (SMD = -0.26; 95% CI: -0.41, -0.11; P < 0.001). Other studies that investigated a variety of inflammation indicators other than CRP showed mixed results with regard to the relation between the Mediterranean dietary pattern and inflammation in older adults. Our findings suggest that the Mediterranean dietary pattern may be associated with lower inflammation in older adults. However, more long-term RCTs are required to demonstrate the effects of the Mediterranean dietary pattern on multiple inflammation parameters in older adults. The study has been registered on PROSPERO (#CRD42020140145).
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Affiliation(s)
- Pei-Yu Wu
- Center for Long-term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Kuei-Min Chen
- Center for Long-term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Wan-Chi Tsai
- Department of Medical Laboratory Science and Biotechnology, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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12
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Alves da Silva R, Bersch-Ferreira ÂC, Gehringer MO, Ross-Fernandes MB, Kovacs do Amaral C, Lin Wang HT, Lima PH, de Lima PA, França JÍ, Weber B, Magnoni CD, Rogero MM. Effect of qualitative and quantitative nutritional plan on gene expression in obese patients in secondary prevention for cardiovascular disease. Clin Nutr ESPEN 2021; 41:351-359. [PMID: 33487289 DOI: 10.1016/j.clnesp.2020.11.002] [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: 04/21/2020] [Revised: 10/29/2020] [Accepted: 11/01/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND & AIMS Diet is a modifiable risk factor, which may influence the gene expression and the concentration of inflammatory biomarkers related to obesity and atherosclerosis. In this substudy from Brazilian Cardioprotective Nutritional (BALANCE) Program, we hypothesized that a nutritional intervention based on the usual Brazilian diet modulates the expression of genes involved with atherosclerosis and inflammatory biomarkers in male patients, in the secondary prevention for cardiovascular disease. METHODS Six male patients, aged 45 years or older, obese, were selected to follow a qualitative-quantitative food plan for 6 months. Glycemia, insulinemia, lipid profile, plasma concentration of inflammatory biomarkers (interleukin (IL) -1β), IL-6, IL-8, IL-10, IL-12, tumor necrosis factor alpha, C-reactive protein and adiponectin, and expression of 84 atherosclerosis-related genes in total peripheral blood cells, were measured. RESULTS After nutritional intervention, the participants reduced weight (p < 0.04), waist circumference (p < 0.04), Homeostasis Model Assessment index for insulin resistance (p = 0.046) and overall leukocyte count (p = 0.046) and neutrophils (p = 0.028). There was no significant modification in the plasma concentration of the inflammatory biomarkers, however, there was a significant increase in the expression of Apo A1 (p = 0.011), ELN (p = 0.017) and IL4 (p = 0.037) genes. CONCLUSIONS The BALANCE Program, the qualitative-quantitative food plan composed of Brazilian usual foods, did not reduce the concentration of inflammatory biomarkers, but increased in total peripheral blood cells the expression of genes involved in reducing the risk of cardiometabolic in obese patients, in secondary prevention for cardiovascular disease. The clinical trial is registered at https://clinicaltrials.gov/ and the unique identifier is NCT01620398.
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Affiliation(s)
- Renata Alves da Silva
- Department of Clinical Nutrition, Instituto Dante Pazzanese de Cardiologia, 04012-090, São Paulo, SP, Brazil.
| | | | - Marcella Omena Gehringer
- Nutritional Genomics and Inflammation Laboratory, Department of Nutrition, School of Public Health, University of São Paulo, 01246-904, São Paulo, Brazil.
| | - Maria Beatriz Ross-Fernandes
- Nutritional Genomics and Inflammation Laboratory, Department of Nutrition, School of Public Health, University of São Paulo, 01246-904, São Paulo, Brazil.
| | - Cristiane Kovacs do Amaral
- Department of Clinical Nutrition, Instituto Dante Pazzanese de Cardiologia, 04012-090, São Paulo, SP, Brazil.
| | - Hui-Tzu Lin Wang
- Department of Clinical Nutrition, Instituto Dante Pazzanese de Cardiologia, 04012-090, São Paulo, SP, Brazil.
| | - Paula Helena Lima
- Department of Clinical Nutrition, Instituto Dante Pazzanese de Cardiologia, 04012-090, São Paulo, SP, Brazil.
| | - Patrícia Azevedo de Lima
- Nutritional Genomics and Inflammation Laboratory, Department of Nutrition, School of Public Health, University of São Paulo, 01246-904, São Paulo, Brazil.
| | - João Ítalo França
- Department of Clinical Nutrition, Instituto Dante Pazzanese de Cardiologia, 04012-090, São Paulo, SP, Brazil.
| | - Bernardete Weber
- Research Institute - Hospital do Coração, 04005-000, São Paulo, SP, Brazil.
| | - Carlos Daniel Magnoni
- Department of Clinical Nutrition, Instituto Dante Pazzanese de Cardiologia, 04012-090, São Paulo, SP, Brazil.
| | - Marcelo Macedo Rogero
- Nutritional Genomics and Inflammation Laboratory, Department of Nutrition, School of Public Health, University of São Paulo, 01246-904, São Paulo, Brazil.
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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: 110] [Impact Index Per Article: 27.5] [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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14
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Mediterranean Diet and Endothelial Function: A Review of its Effects at Different Vascular Bed Levels. Nutrients 2020; 12:nu12082212. [PMID: 32722321 PMCID: PMC7469011 DOI: 10.3390/nu12082212] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 07/21/2020] [Accepted: 07/23/2020] [Indexed: 12/24/2022] Open
Abstract
The Mediterranean diet has recently been the focus of considerable attention as a palatable model of a healthy diet. Its influence on many cardiovascular risk factors, combined with its proven effect in reducing the risk of cardiovascular events in primary prevention, has boosted scientific interest in this age-old nutritional model. Many of the underlying mechanisms behind its health-giving effects have been revealed, from the modulation of the microbiota to the function of high-density lipoproteins (HDL), and it seems to deliver its health benefits mainly by regulating several key mechanisms of atherosclerosis. In this review, we will review the evidence for its regulation of endothelial function, a key element in the early and late stages of atherosclerosis. In addition, we will assess studies which evaluate its effects on the functioning of different arterial territory vessels (mainly the microvascular, peripheral and central vascular beds), focusing mainly on the capillary, brachial and carotid arteries. Finally, we will evaluate the molecular mechanisms which may be involved.
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15
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Aparecida Silveira E, Danésio de Souza J, dos Santos Rodrigues AP, Lima RM, de Souza Cardoso CK, de Oliveira C. Effects of Extra Virgin Olive Oil (EVOO) and the Traditional Brazilian Diet on Sarcopenia in Severe Obesity: A Randomized Clinical Trial. Nutrients 2020; 12:E1498. [PMID: 32455620 PMCID: PMC7284637 DOI: 10.3390/nu12051498] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/08/2020] [Accepted: 05/12/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Nutritional interventions may have positive effects on sarcopenia and body composition. OBJECTIVE to evaluate the effectiveness of extra virgin olive oil (EVOO) consumption and a healthy traditional Brazilian diet (DieTBra) on improving sarcopenia indicators and reducing total body fat in severe obesity. METHODS A randomized controlled trial registered at ClinicalTrials.gov (NCT02463435) conducted with 111 severely obese participants randomized into three treatment groups-(1) EVOO (52 mL/day), (2) DieTBra, (3) DieTBra + EVOO (52 mL/day)-for 12 weeks. Body composition was assessed by dual-energy X-ray absorptiometry and sarcopenia by walking speed and handgrip strength. RESULTS Significant reductions in total body fat (p = 0.041) and body weight (p = 0.003) were observed in the DieTBra group. In the DietBra + olive oil group there was also a significant reduction in body weight (0.001) compared to the olive oil-only group. ANCOVA analyses showed reductions in total body fat in the DieTBra (p = 0.016) and DieTBra + olive oil (p = 0.004) groups. Individuals in the DieTBra group had significant improvements in their walking speed (p = 0.042) and handgrip strength (p = 0.044). CONCLUSIONS DieTBra contributes to improvements in handgrip strength, walking speed, and total body fat in severely obese adults. The major study was registered at ClinicalTrials.gov (NCT02463435).
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Affiliation(s)
- Erika Aparecida Silveira
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia 74605-220, Goias, Brazil; (J.D.d.S.); (A.P.d.S.R.)
- Affiliate Academic at the Department of Epidemiology & Public Health, Institute of Epidemiology & Health Care, University College London, London WC1E 6BT, UK
| | - Jacqueline Danésio de Souza
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia 74605-220, Goias, Brazil; (J.D.d.S.); (A.P.d.S.R.)
| | - Ana Paula dos Santos Rodrigues
- Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goias, Goiânia 74605-220, Goias, Brazil; (J.D.d.S.); (A.P.d.S.R.)
| | - Ricardo M. Lima
- Faculty of Physical Education, University of Brasília, Darcy Ribeiro University Campus, Brasília CEP 70910-900, Distrito Federal, Brazil;
| | - Camila Kellen de Souza Cardoso
- School of Social Sciences and Health, Nutrition Course, Pontifical Catholic University of Goias, Goiânia 74605-020, Brazil;
| | - Cesar de Oliveira
- Department of Epidemiology & Public Health, University College London, London WC1E 6BT, UK;
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16
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Shannon OM, Mendes I, Köchl C, Mazidi M, Ashor AW, Rubele S, Minihane AM, Mathers JC, Siervo M. Mediterranean Diet Increases Endothelial Function in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Nutr 2020; 150:1151-1159. [PMID: 32027740 DOI: 10.1093/jn/nxaa002] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 11/11/2019] [Accepted: 01/03/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The endothelium plays a key role in the maintenance of vascular health and represents a potential physiological target for dietary and other lifestyle interventions designed to reduce the risk of cardiovascular diseases (CVD) including stroke or coronary heart disease. OBJECTIVE To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating the effects of the Mediterranean dietary pattern (MedDiet) on endothelial function. METHODS Medline, Embase, and Scopus databases were searched from inception until January 2019 for studies that met the following criteria: 1) RCTs including adult participants, 2) interventions promoting the MedDiet, 3) inclusion of a control group, and 4) measurements of endothelial function. A random-effects meta-analysis was conducted. Metaregression and subgroup analyses were performed to identify whether effects were modified by health status (i.e., healthy participants versus participants with existing comorbidities), type of intervention (i.e., MedDiet alone or with a cointervention), study duration, study design (i.e., parallel or crossover), BMI, and age of participants. RESULTS Fourteen articles reporting data for 1930 participants were included in the meta-analysis. Study duration ranged from 4 wk to 2.3 y. We observed a beneficial effect of the MedDiet on endothelial function [standardized mean difference (SMD): 0.35; 95% CI: 0.17, 0.53; P <0.001; I2 = 73.68%]. MedDiet interventions improved flow-mediated dilation (FMD)-the reference method for noninvasive, clinical measurement of endothelial function-by 1.66% (absolute change; 95% CI: 1.15, 2.17; P <0.001; I2 = 0%). Effects of the MedDiet on endothelial function were not modified by health status, type of intervention, study duration, study design, BMI, or age of participants (P >0.05). CONCLUSIONS MedDiet interventions improve endothelial function in adults, suggesting that the protective effects of the MedDiet are evident at early stages of the atherosclerotic process with important implications for the early prevention of CVD. This study has the PROSPERO registration number: CRD42018106188.
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Affiliation(s)
- Oliver M Shannon
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, United Kingdom
| | - Inês Mendes
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, United Kingdom
| | - Christina Köchl
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, United Kingdom
| | - Mohsen Mazidi
- Department of Biology and Biological Engineering, Food and Nutrition Science, Chalmers University of Technology, Gothenburg, Sweden
| | - Ammar W Ashor
- Department of Internal Medicine, College of Medicine, Mustansiriyah University, Baghdad, Iraq
| | - Sofia Rubele
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, United Kingdom.,Faculty of Medicine & Surgery, University of Verona, Italy
| | - Anne-Marie Minihane
- Norwich Medical School, Bob Champion Research & Education, University of East Anglia, United Kingdom
| | - John C Mathers
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, United Kingdom
| | - Mario Siervo
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, United Kingdom.,School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, United Kingdom
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Lorenzon dos Santos J, Schaan de Quadros A, Weschenfelder C, Bueno Garofallo S, Marcadenti A. Oxidative Stress Biomarkers, Nut-Related Antioxidants, and Cardiovascular Disease. Nutrients 2020; 12:nu12030682. [PMID: 32138220 PMCID: PMC7146201 DOI: 10.3390/nu12030682] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/25/2020] [Accepted: 03/02/2020] [Indexed: 02/06/2023] Open
Abstract
Atherosclerosis is related to fat accumulation in the arterial walls and vascular stiffening, and results in acute coronary syndrome which is commonly associated with acute myocardial infarction. Oxidative stress participates in the pathogenesis of atherosclerosis. Thus, the inclusion of food sources of dietary antioxidants, such as different kinds of nuts, may improve biomarkers related to oxidative stress, contributing to a possible reduction in atherosclerosis progression. This article has briefly highlighted the interaction between oxidative stress, atherosclerosis, and cardiovascular disease, in addition to the effect of the consumption of different nuts and related dietary antioxidants—like polyphenols and vitamin E—on biomarkers of oxidative stress in primary and secondary cardiovascular prevention. Studies in vitro suggest that nuts may exert antioxidant effects by DNA repair mechanisms, lipid peroxidation prevention, modulation of the signaling pathways, and inhibition of the MAPK pathways through the suppression of NF-κB and activation of the Nrf2 pathways. Studies conducted in animal models showed the ability of dietary nuts in improving biomarkers of oxidative stress, such as oxLDL and GPx. However, clinical trials in humans have not been conclusive, especially with regards to the secondary prevention of cardiovascular disease.
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Affiliation(s)
- Julia Lorenzon dos Santos
- Graduate Program in Health Sciences (Cardiology), Institute of Cardiology of Rio Grande do Sul/University Foundation of Cardiology (IC/FUC), Princesa Isabel Avenue, 395, Porto Alegre, 90040-371 Rio Grande do Sul, Brazil; (J.L.d.S.); (A.S.d.Q.); (C.W.); (S.B.G.)
| | - Alexandre Schaan de Quadros
- Graduate Program in Health Sciences (Cardiology), Institute of Cardiology of Rio Grande do Sul/University Foundation of Cardiology (IC/FUC), Princesa Isabel Avenue, 395, Porto Alegre, 90040-371 Rio Grande do Sul, Brazil; (J.L.d.S.); (A.S.d.Q.); (C.W.); (S.B.G.)
| | - Camila Weschenfelder
- Graduate Program in Health Sciences (Cardiology), Institute of Cardiology of Rio Grande do Sul/University Foundation of Cardiology (IC/FUC), Princesa Isabel Avenue, 395, Porto Alegre, 90040-371 Rio Grande do Sul, Brazil; (J.L.d.S.); (A.S.d.Q.); (C.W.); (S.B.G.)
| | - Silvia Bueno Garofallo
- Graduate Program in Health Sciences (Cardiology), Institute of Cardiology of Rio Grande do Sul/University Foundation of Cardiology (IC/FUC), Princesa Isabel Avenue, 395, Porto Alegre, 90040-371 Rio Grande do Sul, Brazil; (J.L.d.S.); (A.S.d.Q.); (C.W.); (S.B.G.)
| | - Aline Marcadenti
- Graduate Program in Health Sciences (Cardiology), Institute of Cardiology of Rio Grande do Sul/University Foundation of Cardiology (IC/FUC), Princesa Isabel Avenue, 395, Porto Alegre, 90040-371 Rio Grande do Sul, Brazil; (J.L.d.S.); (A.S.d.Q.); (C.W.); (S.B.G.)
- HCor Research Institute, Coracao Hospital (IP-HCor), Abílio Soares Street, 250, 04004-05 São Paulo, Brazil
- Correspondence: ; Tel.: +55-(11)-3053-6611 (ext. 3558)
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Cardoso CKDS, Santos ASEADC, Rosa LPDS, Mendonça CR, Vitorino PVDO, Peixoto MDRG, Silveira ÉA. Effect of Extra Virgin Olive Oil and Traditional Brazilian Diet on the Bone Health Parameters of Severely Obese Adults: A Randomized Controlled Trial. Nutrients 2020; 12:E403. [PMID: 32032997 PMCID: PMC7071276 DOI: 10.3390/nu12020403] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 01/22/2020] [Accepted: 01/28/2020] [Indexed: 12/11/2022] Open
Abstract
Dietary interventions can stabilize and/or reverse bone mass loss. However, there are no reports on its effects on bone mineral density (BMD) in severely obese people, despite the vulnerability of this group to bone loss. We examine the effect of extra virgin olive oil supplementation and the traditional Brazilian diet (DieTBra) on BMD and levels of calcium, vitamin D, and parathyroid hormone (PTH) in severely obese adults. A randomized controlled trial followed-up with severely obese adults (n = 111, with mean body mass index 43.6 kg/m2 ± 4.5 kg/m2) for 12 weeks. Study participants received either olive oil (52 mL/day), DieTBra, or olive oil + DieTBra (52 mL/day + DieTBra). BMD was assessed by total spine and hip dual-energy X-ray absorptiometry. After interventions, BMD means for total spine (p = 0.016) and total hip (p = 0.029) were higher in the DieTBra group than in the olive oil + DieTBra group. Final mean calcium levels were higher in the olive oil group compared to the olive oil + DieTBra group (p = 0.026). Findings suggest that DieTBra and extra virgin olive oil have positive effects on bone health in severely obese adults. The major study was registered at ClinicalTrials.gov (NCT02463435).
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Affiliation(s)
- Camila Kellen de Souza Cardoso
- The Postgraduate Program in Health Sciences, School of Social Sciences and Health, Nutrition Course, Pontifical Catholic University of Goiás, Goiânia, 74605-020 Goiás, Brazil;
| | - Annelisa Silva e Alves de Carvalho Santos
- The Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiânia, 74605-220 Goiás, Brazil; (A.S.e.A.d.C.S.); (L.P.d.S.R.); (C.R.M.)
| | - Lorena Pereira de Souza Rosa
- The Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiânia, 74605-220 Goiás, Brazil; (A.S.e.A.d.C.S.); (L.P.d.S.R.); (C.R.M.)
| | - Carolina Rodrigues Mendonça
- The Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiânia, 74605-220 Goiás, Brazil; (A.S.e.A.d.C.S.); (L.P.d.S.R.); (C.R.M.)
| | - Priscila Valverde de Oliveira Vitorino
- The Postgraduate Program in Health Sciences, Professor of the School of Social Sciences and Health, Pontifical Catholic University of Goiás, Goiânia, 74605-020 Goiás, Brazil;
| | - Maria do Rosário Gondim Peixoto
- The Postgraduate Program Nutrition and Health, Faculty of Nutrition, Federal University of Goiás, Goiânia, 74605-220 Goiás, Brazil;
| | - Érika Aparecida Silveira
- The Postgraduate Program in Health Sciences, Faculty of Medicine, Federal University of Goiás, Goiânia, 74605-220 Goiás, Brazil; (A.S.e.A.d.C.S.); (L.P.d.S.R.); (C.R.M.)
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19
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Campos VP, Portal VL, Markoski MM, Quadros AS, Bersch-Ferreira ÂC, Garavaglia J, Marcadenti A. Effects of a healthy diet enriched or not with pecan nuts or extra-virgin olive oil on the lipid profile of patients with stable coronary artery disease: a randomised clinical trial. J Hum Nutr Diet 2019; 33:439-450. [PMID: 31856379 DOI: 10.1111/jhn.12727] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND The present study aimed to assess the effect of a healthy diet, enriched or not with pecan nuts or extra-virgin olive oil, on the lipid profile of patients with stable coronary artery disease (CAD). METHODS This was a randomised clinical trial conducted for 12 weeks with patients aged between 40 and 80 years with stable CAD for more than 60 days. Individuals were randomised into groups [control group (CG) with 67 patients, pecan nut group (PNG) with 68 patients and olive oil group (OOG) with 69 patients]. The CG was prescribed a healthy diet according to the nutritional guidelines; the PNG was prescribed the same healthy diet plus 30 g day-1 of pecan nuts; and the OOG was prescribed a healthy diet plus 30 mL day-1 of extra-virgin olive oil. RESULTS In total, 204 subjects were submitted to an intention-to-treat analysis. After adjustment for baseline values and type of statin used, there was no difference regarding low-density lipoprotein (LDL)-cholesterol (primary outcome), high-density lipoprotein (HDL)-cholesterol, LDL-cholesterol/HDL-cholesterol ratio and HDL-cholesterol/triglycerides ratio according to groups. However, the PNG exhibited a significant reduction in non-HDL-cholesterol levels [PNG: 114.9 (31) mg dL-1 ; CG: 127 (33.6) mg dL-1 ; OOG: 126.6 (37.4) mg dL-1 ; P = 0.033] and in the total cholesterol/HDL-cholesterol ratio [PNG: 3.7 (0.7); CG: 4.0 (0.8); OOG: 4.0 (0.8); P = 0.044] compared to the CG and OOG. CONCLUSIONS Supplementing a healthy diet with 30 g day-1 of pecan nuts for 12 weeks did not improve LDL-cholesterol levels but may improve other lipid profile markers in patients with stable CAD.
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Affiliation(s)
- V P Campos
- Graduate Program in Health Sciences (Cardiology), Institute of Cardiology of Rio Grande do Sul/University Foundation of Cardiology (IC/FUC), Porto Alegre, Brazil
| | - V L Portal
- Graduate Program in Health Sciences (Cardiology), Institute of Cardiology of Rio Grande do Sul/University Foundation of Cardiology (IC/FUC), Porto Alegre, Brazil
| | - M M Markoski
- Graduate Program in Nutrition Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil.,Graduate Program in Biosciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - A S Quadros
- Graduate Program in Health Sciences (Cardiology), Institute of Cardiology of Rio Grande do Sul/University Foundation of Cardiology (IC/FUC), Porto Alegre, Brazil
| | | | - J Garavaglia
- Graduate Program in Nutrition Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - A Marcadenti
- Graduate Program in Health Sciences (Cardiology), Institute of Cardiology of Rio Grande do Sul/University Foundation of Cardiology (IC/FUC), Porto Alegre, Brazil.,Graduate Program in Nutrition Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil.,HCor Research Institute, Coracao Hospital (IP-HCor), São Paulo, Brazil
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Mayr HL, Tierney AC, Kucianski T, Thomas CJ, Itsiopoulos C. Australian patients with coronary heart disease achieve high adherence to 6-month Mediterranean diet intervention: preliminary results of the AUSMED Heart Trial. Nutrition 2019; 61:21-31. [DOI: 10.1016/j.nut.2018.10.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 10/14/2018] [Accepted: 10/23/2018] [Indexed: 02/06/2023]
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Rees K, Takeda A, Martin N, Ellis L, Wijesekara D, Vepa A, Das A, Hartley L, Stranges S. Mediterranean-style diet for the primary and secondary prevention of cardiovascular disease. Cochrane Database Syst Rev 2019; 3:CD009825. [PMID: 30864165 PMCID: PMC6414510 DOI: 10.1002/14651858.cd009825.pub3] [Citation(s) in RCA: 114] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND The Seven Countries study in the 1960s showed that populations in the Mediterranean region experienced lower coronary heart disease (CHD) mortality probably as a result of different dietary patterns. Later observational studies have confirmed the benefits of adherence to a Mediterranean dietary pattern on cardiovascular disease (CVD) risk factors but clinical trial evidence is more limited. OBJECTIVES To determine the effectiveness of a Mediterranean-style diet for the primary and secondary prevention of CVD. SEARCH METHODS We searched the following electronic databases: the Cochrane Central Register of Controlled Trials (CENTRAL; 2018, Issue 9); MEDLINE (Ovid, 1946 to 25 September 2018); Embase (Ovid, 1980 to 2018 week 39); Web of Science Core Collection (Thomson Reuters, 1900 to 26 September 2018); DARE Issue 2 of 4, 2015 (Cochrane Library); HTA Issue 4 of 4, 2016 (Cochrane Library); NHS EED Issue 2 of 4, 2015 (Cochrane Library). We searched trial registers and applied no language restrictions. SELECTION CRITERIA We selected randomised controlled trials (RCTs) in healthy adults and adults at high risk of CVD (primary prevention) and those with established CVD (secondary prevention). Both of the following key components were required to reach our definition of a Mediterranean-style diet: high monounsaturated/saturated fat ratio (use of olive oil as main cooking ingredient and/or consumption of other traditional foods high in monounsaturated fats such as tree nuts) and a high intake of plant-based foods, including fruits, vegetables and legumes. Additional components included: low to moderate red wine consumption; high consumption of whole grains and cereals; low consumption of meat and meat products and increased consumption of fish; moderate consumption of milk and dairy products. The intervention could be dietary advice, provision of relevant foods, or both. The comparison group received either no intervention, minimal intervention, usual care or another dietary intervention. Outcomes included clinical events and CVD risk factors. We included only studies with follow-up periods of three months or more defined as the intervention period plus post intervention follow-up. DATA COLLECTION AND ANALYSIS Two review authors independently assessed studies for inclusion, extracted data and assessed risk of bias. We conducted four main comparisons:1. Mediterranean dietary intervention versus no intervention or minimal intervention for primary prevention;2. Mediterranean dietary intervention versus another dietary intervention for primary prevention;3. Mediterranean dietary intervention versus usual care for secondary prevention;4. Mediterranean dietary intervention versus another dietary intervention for secondary prevention. MAIN RESULTS In this substantive review update, 30 RCTs (49 papers) (12,461 participants randomised) and seven ongoing trials met our inclusion criteria. The majority of trials contributed to primary prevention: comparisons 1 (nine trials) and 2 (13 trials). Secondary prevention trials were included for comparison 3 (two trials) and comparison 4 (four trials plus an additional two trials that were excluded from the main analyses due to published concerns regarding the reliability of the data).Two trials reported on adverse events where these were absent or minor (low- to moderate-quality evidence). No trials reported on costs or health-related quality of life.Primary preventionThe included studies for comparison 1 did not report on clinical endpoints (CVD mortality, total mortality or non-fatal endpoints such as myocardial infarction or stroke). The PREDIMED trial (included in comparison 2) was retracted and re-analysed following concerns regarding randomisation at two of 11 sites. Low-quality evidence shows little or no effect of the PREDIMED (7747 randomised) intervention (advice to follow a Mediterranean diet plus supplemental extra-virgin olive oil or tree nuts) compared to a low-fat diet on CVD mortality (hazard ratio (HR) 0.81, 95% confidence interval (CI) 0.50 to 1.32) or total mortality (HR 1.0, 95% CI 0.81 to 1.24) over 4.8 years. There was, however, a reduction in the number of strokes with the PREDIMED intervention (HR 0.60, 95% CI 0.45 to 0.80), a decrease from 24/1000 to 14/1000 (95% CI 11 to 19), moderate-quality evidence). For CVD risk factors for comparison 1 there was low-quality evidence for a possible small reduction in total cholesterol (-0.16 mmol/L, 95% CI -0.32 to 0.00) and moderate-quality evidence for a reduction in systolic (-2.99 mmHg (95% CI -3.45 to -2.53) and diastolic blood pressure (-2.0 mmHg, 95% CI -2.29 to -1.71), with low or very low-quality evidence of little or no effect on LDL or HDL cholesterol or triglycerides. For comparison 2 there was moderate-quality evidence of a possible small reduction in LDL cholesterol (-0.15 mmol/L, 95% CI -0.27 to -0.02) and triglycerides (-0.09 mmol/L, 95% CI -0.16 to -0.01) with moderate or low-quality evidence of little or no effect on total or HDL cholesterol or blood pressure.Secondary preventionFor secondary prevention, the Lyon Diet Heart Study (comparison 3) examined the effect of advice to follow a Mediterranean diet and supplemental canola margarine compared to usual care in 605 CHD patients over 46 months and there was low-quality evidence of a reduction in adjusted estimates for CVD mortality (HR 0.35, 95% CI 0.15 to 0.82) and total mortality (HR 0.44, 95% CI 0.21 to 0.92) with the intervention. Only one small trial (101 participants) provided unadjusted estimates for composite clinical endpoints for comparison 4 (very low-quality evidence of uncertain effect). For comparison 3 there was low-quality evidence of little or no effect of a Mediterranean-style diet on lipid levels and very low-quality evidence for blood pressure. Similarly, for comparison 4 where only two trials contributed to the analyses there was low or very low-quality evidence of little or no effect of the intervention on lipid levels or blood pressure. AUTHORS' CONCLUSIONS Despite the relatively large number of studies included in this review, there is still some uncertainty regarding the effects of a Mediterranean-style diet on clinical endpoints and CVD risk factors for both primary and secondary prevention. The quality of evidence for the modest benefits on CVD risk factors in primary prevention is low or moderate, with a small number of studies reporting minimal harms. There is a paucity of evidence for secondary prevention. The ongoing studies may provide more certainty in the future.
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Affiliation(s)
- Karen Rees
- University of WarwickDivision of Health Sciences, Warwick Medical SchoolCoventryUKCV4 7AL
| | - Andrea Takeda
- University College LondonInstitute of Health Informatics ResearchLondonUK
| | - Nicole Martin
- University College LondonInstitute of Health Informatics ResearchLondonUK
| | - Leila Ellis
- University of WarwickDivision of Health Sciences, Warwick Medical SchoolCoventryUKCV4 7AL
| | - Dilini Wijesekara
- University of WarwickDivision of Health Sciences, Warwick Medical SchoolCoventryUKCV4 7AL
| | - Abhinav Vepa
- University of WarwickDivision of Health Sciences, Warwick Medical SchoolCoventryUKCV4 7AL
| | - Archik Das
- University of WarwickDivision of Health Sciences, Warwick Medical SchoolCoventryUKCV4 7AL
| | | | - Saverio Stranges
- Schulich School of Medicine and Dentistry, Western UniversityDepartment of Epidemiology and BiostatisticsLondonCanada
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Gao M, Wang F, Shen Y, Zhu X, Zhang X, Sun X. Trajectories of Mediterranean Diet Adherence and Risk of Hypertension in China: Results from the CHNS Study, 1997⁻2011. Nutrients 2018; 10:E2014. [PMID: 30572651 PMCID: PMC6315578 DOI: 10.3390/nu10122014] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 12/11/2018] [Accepted: 12/14/2018] [Indexed: 12/16/2022] Open
Abstract
Evidence indicates that longitudinal changes in dietary patterns may predict variations in blood pressure (BP) and risk of incident hypertension. We aimed to identify distinct trajectories in the levels of Mediterranean diet adherence (MDA) in China and explore their association with BP levels and hypertension risk using the China Health and Nutrition Survey 1997⁻2011 data. Three levels of MDA were constructed. The trajectories in these levels were constructed using group-based trajectory modeling. A Cox proportional hazards model was used to measure the association between MDA trajectory groups and the risk of incident hypertension after adjusting for covariates. Finally, 6586 individuals were included. Six distinct MDA trajectory groups were identified: persistently low and gradual decline; rapidly increasing and stabilized; persistently moderate; slightly increasing, steady, and acutely descending; slightly decreasing and acutely elevated; and persistently high. The systolic BP and diastolic BP were significantly lower in trajectory groups with rapidly increasing and stabilized MDA; slightly increasing, steady, and acutely descending MDA; and persistently high MDA. Cox regression analysis showed that the risks of developing hypertension were relatively lower in the group with slightly increasing, steady, and acutely descending MDA (hazard ratio (HR) = 0.17, 95% confidence interval (CI): 0.09⁻0.32) and the group with rapidly increasing and stabilized MDA (HR = 0.32, 95% CI: 0.23⁻0.42), but the risk was the highest in the trajectory with persistently moderate MDA (HR = 0.96, 95% CI: 0.84⁻1.08). In conclusion, MDA in China was categorized into six distinct trajectory groups. BP was relatively lower in trajectory groups with initially high or increasing MDA levels. Greater MDA was significantly associated with a lower risk of developing hypertension.
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Affiliation(s)
- Min Gao
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing 100191, China.
| | - Fengbin Wang
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing 100191, China.
| | - Ying Shen
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing 100191, China.
| | - Xiaorou Zhu
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing 100191, China.
| | - Xing Zhang
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing 100191, China.
| | - Xinying Sun
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing 100191, China.
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23
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Jaacks LM, Sher S, Staercke CD, Porkert M, Alexander WR, Jones DP, Vaccarino V, Ziegler TR, Quyyumi AA. Pilot randomized controlled trial of a Mediterranean diet or diet supplemented with fish oil, walnuts, and grape juice in overweight or obese US adults. BMC Nutr 2018; 4:26. [PMID: 30271610 PMCID: PMC6159217 DOI: 10.1186/s40795-018-0234-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background The 2015–2020 Dietary Guidelines for Americans recommend a Mediterranean-type diet as one of three healthful eating patterns. However, only one previous trial has evaluated the effects of a Mediterranean diet intervention in a US sample population. Methods To address this gap, we conducted a pilot, non-blinded, 8-week randomized controlled trial on the comparative efficacy of consumption of a Mediterranean diet or a diet supplemented with fish oil, walnuts, and grape juice versus controls. Participants (overweight or obese US adults; 73% female and mean age 51 years) were randomly assigned to one of three groups: (1) Mediterranean diet; (2) habitual high-fat American-type diet supplemented with fish oil, walnuts, and grape juice; or (3) habitual high-fat American-type diet (controls). Intent-to-treat analysis of within-subject differences (Student’s paired t-test or Wilcoxon sign ranks test) and between-subject differences (mixed-effects models with a group-by-time interaction term, adjusted for baseline health outcome) was conducted. Results Participants in the Mediterranean diet arm (n = 11) had significantly greater weight loss despite no significant change in total caloric intake, and lower plasma cystine, indicative of decreased oxidative stress, compared to controls (n = 9) at both 4 and 8 weeks. Compared to controls, they also had significantly lower total cholesterol and low-density lipoprotein cholesterol levels at 4 weeks. Participants in the supplement arm (n = 10) had significantly lower adiponectin levels compared to controls at 4 weeks. No significant improvements in endothelial function or inflammatory biomarkers were observed in either intervention group compared to controls. Conclusion These results suggest that adopting a dietary pattern reflecting a Mediterranean diet improves weight and cardio-metabolic health among overweight or obese US adults, and may be more beneficial than supplementing habitual American diets with fish oil, walnuts, and grape juice. Trial registration ClinicalTrials.gov NCT00166088. Registered 14 September 2005.
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Affiliation(s)
- Lindsay M Jaacks
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Building 1, Room 1211, Boston, MA 02115, USA
| | - Salman Sher
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30307, USA
| | - Christine De Staercke
- Hemostasis Laboratory Branch, Division of Blood Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA
| | | | - Wayne R Alexander
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30307, USA
| | - Dean P Jones
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30307, USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Thomas R Ziegler
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30307, USA
| | - Arshed A Quyyumi
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30307, USA
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Mayr HL, Thomas CJ, Tierney AC, Kucianski T, George ES, Ruiz-Canela M, Hebert JR, Shivappa N, Itsiopoulos C. Randomization to 6-month Mediterranean diet compared with a low-fat diet leads to improvement in Dietary Inflammatory Index scores in patients with coronary heart disease: the AUSMED Heart Trial. Nutr Res 2018; 55:94-107. [PMID: 29754829 DOI: 10.1016/j.nutres.2018.04.006] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 03/20/2018] [Accepted: 04/10/2018] [Indexed: 12/14/2022]
Abstract
A higher dietary inflammatory index (DII®) score is associated with inflammation and incidence of coronary heart disease (CHD). We hypothesized that a Mediterranean diet (MedDiet) intervention would reduce DII score. We assessed dietary data from a randomized controlled trial comparing 6-month MedDiet versus low-fat diet intervention, in patients with CHD. We aimed to determine the DII scores of the prescribed diets' model meal plans, followed by whether dietary intervention led to lower (i.e., more anti-inflammatory) DII scores and consequently lower high sensitivity C-reactive protein (hs-CRP) and interleukin-6 (hs-IL-6). DII scores were calculated from 7-day food diaries. The MedDiet meal plan had a markedly lower DII score than the low-fat diet meal plan (-4.55 vs. -0.33, respectively). In 56 participants who completed the trial (84% male, mean age 62 ± 9 years), the MedDiet group significantly reduced DII scores at 6 months (n = 27; -0.40 ± 3.14 to -1.74 ± 2.81, P = .008) and the low-fat diet group did not change (n = 29; -0.17 ± 2.27 to 0.05 ± 1.89, P = .65). There was a significant post-intervention adjusted difference in DII score between groups (compared to low-fat, MedDiet decreased by -1.69 DII points; P = .004). When compared to the low-fat diet, the MedDiet non-significantly reduced hs-IL-6 (-0.32 pg/mL, P = .29) and increased hs-CRP (+0.09 mg/L, P = .84). These findings demonstrated that MedDiet intervention significantly reduced DII scores compared to a low-fat diet. However, in this small cohort of patients with CHD this did not translate to a significant improvement in measured inflammatory markers. The effect of improvement in DII with MedDiet should be tested in larger intervention trials and observational cohorts.
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Affiliation(s)
- Hannah L Mayr
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia, 3086; Department of Nutrition and Dietetics, Northern Health, Melbourne, Victoria, Australia, 3076.
| | - Colleen J Thomas
- Department of Physiology, Anatomy and Microbiology, School of Life Sciences, La Trobe University, Melbourne, Victoria, Australia, 3086.
| | - Audrey C Tierney
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia, 3086; School of Allied Health, University of Limerick, Limerick, V94 T9PX, Ireland.
| | - Teagan Kucianski
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia, 3086.
| | - Elena S George
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia, 3086; School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia.
| | - Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Madrid, Spain.
| | - James R Hebert
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; Connecting Health Innovations LLC, Columbia, SC 29201, USA.
| | - Nitin Shivappa
- Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA; Connecting Health Innovations LLC, Columbia, SC 29201, USA.
| | - Catherine Itsiopoulos
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia, 3086.
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Mayr HL, Tierney AC, Thomas CJ, Ruiz-Canela M, Radcliffe J, Itsiopoulos C. Mediterranean-type diets and inflammatory markers in patients with coronary heart disease: a systematic review and meta-analysis. Nutr Res 2017. [PMID: 29540268 DOI: 10.1016/j.nutres.2017.10.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The health benefits of a Mediterranean diet are thought to be mediated via its anti-inflammatory effects; however, the anti-inflammatory effect of this diet is unclear in patients who have already developed coronary heart disease (CHD). This systematic review and meta-analysis assessed the effect of Mediterranean-type diets on cytokines and adipokines in patients with CHD. An electronic search of the literature was conducted up to October 2016 using PubMed, Scopus, Web of Science, and Cochrane Library. Eleven of the 435 articles identified met eligibility criteria. Four observational studies reported significant inverse associations between Mediterranean-type diet scores and inflammatory cytokines. Five clinical trials (4 in non-Mediterranean countries) demonstrated nonsignificant reductions, and 2 trials conducted in Spain demonstrated significant reductions in C-reactive protein with a Mediterranean-type diet. Random effects meta-analysis of 4 controlled trials detected a nonsignificant difference in final mean value of C-reactive protein with Mediterranean-type diet vs low-fat diet. Despite promising findings from observational studies, this review demonstrated mostly nonsignificant effects of Mediterranean-type diet interventions on inflammatory cytokines and no effect in comparison to low-fat diets in controlled trials conducted primarily in Mediterranean populations. Therefore, randomized controlled trials of a traditional Mediterranean diet in non-Mediterranean populations and with multiple inflammatory biomarkers are needed in the high-risk CHD patient group.
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Affiliation(s)
- Hannah L Mayr
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia, 3086; Department of Nutrition and Dietetics, Northern Health, Melbourne, Victoria, Australia, 3076..
| | - Audrey C Tierney
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia, 3086.
| | - Colleen J Thomas
- Department of Physiology, Anatomy and Microbiology, School of Life Sciences, La Trobe University, Melbourne, Victoria, Australia, 3086.
| | - Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, University of Navarra, Navarra, Pamplona, Spain, 1, 31008.
| | - Jessica Radcliffe
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia, 3086.
| | - Catherine Itsiopoulos
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia, 3086.
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Godos J, Sinatra D, Blanco I, Mulè S, La Verde M, Marranzano M. Association between Dietary Phenolic Acids and Hypertension in a Mediterranean Cohort. Nutrients 2017; 9:nu9101069. [PMID: 28953227 PMCID: PMC5691686 DOI: 10.3390/nu9101069] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 09/22/2017] [Accepted: 09/22/2017] [Indexed: 01/02/2023] Open
Abstract
Background: Certain foods rich in phenolic acids have been shown to reduce the risk of hypertension, but evidence from epidemiological studies focused on dietary phenolic acid intake is scarce. The aim of this study was to determine the association between dietary phenolic acid intake, as well as their major food sources, and hypertension in a Mediterranean cohort. Methods: Demographic and dietary data of 2044 adults living in Southern Italy were collected. Food frequency questionnaires and Phenol-Explorer were used to calculate dietary intake of polyphenols. Multivariate logistic regression analyses were used to test associations. Results: The mean intake of total phenolic acids in the cohort was 362.6 mg/day. Individuals in the highest quartile of phenolic acid intake (median intake = 522.2 mg/day) were less likely to have hypertension (OR (odds ratio) = 0.68, 95% CI (confidence interval): 0.46, 1.00). When taking into account individual subclasses of phenolic acids, only hydroxyphenylacetic acid was inversely associated with hypertension (highest vs. lowest quartile, OR = 0.63, 95% CI: 0.40, 0.96). Among dietary sources of phenolic acids considered in the analysis, only beer was significantly inversely associated with hypertension (highest vs. lowest quartile, OR = 0.32, 95% CI: 0.15, 0.68). Conclusions: The findings of this study suggest that dietary phenolic acids may be inversely associated with hypertension, irrespectively of their dietary source.
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Affiliation(s)
- Justyna Godos
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, 95123 Catania, Italy.
| | - Dario Sinatra
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, 95123 Catania, Italy.
| | - Isabella Blanco
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, 95123 Catania, Italy.
| | - Serena Mulè
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, 95123 Catania, Italy.
| | - Melania La Verde
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, 95123 Catania, Italy.
| | - Marina Marranzano
- Department of Medical and Surgical Sciences and Advanced Technologies "G.F. Ingrassia", University of Catania, 95123 Catania, Italy.
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Yu E, Ruiz-Canela M, Hu FB, Clish CB, Corella D, Salas-Salvadó J, Hruby A, Fitó M, Liang L, Toledo E, Ros E, Estruch R, Gómez-Gracia E, Lapetra J, Arós F, Romaguera D, Serra-Majem L, Guasch-Ferré M, Wang DD, Martínez-González MA. Plasma Arginine/Asymmetric Dimethylarginine Ratio and Incidence of Cardiovascular Events: A Case-Cohort Study. J Clin Endocrinol Metab 2017; 102:1879-1888. [PMID: 28323949 PMCID: PMC6283443 DOI: 10.1210/jc.2016-3569] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 02/27/2017] [Indexed: 01/03/2023]
Abstract
Context Arginine, its methylated metabolites, and other metabolites related to the urea cycle have been independently associated with cardiovascular risk, but the potential causal meaning of these associations (positive for some metabolites and negative for others) remains elusive due to a lack of studies measuring metabolite changes over time. Objective To examine the association between baseline and 1-year concentrations of urea cycle metabolites and cardiovascular disease (CVD) in a case-cohort setting. Design A case-cohort study was nested within the Prevención con Dieta Mediterránea trial. We used liquid chromatography-tandem mass spectrometry to assess metabolite levels at baseline and after 1-year follow-up. The primary CVD outcome was a composite of myocardial infarction, stroke and cardiovascular death. We used weighted Cox regression models (Barlow weights) to estimate multivariable-adjusted hazard ratios (HRs) and their 95% confidence intervals (CIs). Setting Multicenter randomized trial in Spain. Participants Participants were 984 participants accruing 231 events over 4.7 years' median follow-up. Main Outcome Measure Incident CVD. Results Baseline arginine/asymmetric dimethylarginine ratio [HR per standard deviation (SD) = 0.80; 95% CI, 0.67 to 0.96] and global arginine availability [arginine / (ornithine + citrulline)] (HR per SD = 0.83; 95% CI, 0.69 to 1.00) were significantly associated with lower risk of CVD. We observed no significant association for 1-year changes in these ratios or any effect modification by the Mediterranean diet (MD) intervention. Conclusions A higher baseline arginine/asymmetric dimethylarginine ratio was associated with lower CVD incidence in a high cardiovascular risk population. The intervention with the MD did not change 1-year levels of these metabolites.
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Affiliation(s)
- Edward Yu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115
| | - Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, University of Navarra, and Instituto de Investigacion Sanitaria de Navarra (IdiSNA), University of Navarra, 31008 Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115
| | - Clary B Clish
- Broad Institute of Massachusetts Institute of Technology and Harvard University, Cambridge, Massachusetts 02142
| | - Dolores Corella
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Preventive Medicine, University of Valencia, 46010 Valencia, Spain
| | - Jordi Salas-Salvadó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Human Nutrition Unit, Institut d'Investigació Sanitària Pere Virgili (IISPV), University Hospital of Sant Joan de Reus, Universitat Rovira i Virgili, 43201 Reus, Spain
| | - Adela Hruby
- Jean Mayer United States Department of Agriculture (USDA) Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts 02111
| | - Montserrat Fitó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Cardiovascular and Nutrition Research Group, Institut de Recerca Hospital del Mar, 08028 Barcelona, Spain
| | - Liming Liang
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115
| | - Estefanía Toledo
- Department of Preventive Medicine and Public Health, University of Navarra, and Instituto de Investigacion Sanitaria de Navarra (IdiSNA), University of Navarra, 31008 Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Emilio Ros
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, 08007 Barcelona, Spain
| | - Ramón Estruch
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, 08007 Barcelona, Spain
| | - Enrique Gómez-Gracia
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Preventive Medicine, University of Malaga, 29016 Malaga, Spain
| | - José Lapetra
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Family Medicine, Research Unit, Primary Care Division of Sevilla, 41004 Sevilla, Spain
| | - Fernando Arós
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Cardiology, University Hospital Araba, 01009 Vitoria, Spain
| | - Dora Romaguera
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria de Palma (IdISPa), Hospital Universitari Son Espases, 07120 Palma de Mallorca, Spain
| | - Lluís Serra-Majem
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Research Institute of Biomedical and Health Sciences, University of Las Palmas de Gran Canaria, 35001 Las Palmas, Spain
| | - Marta Guasch-Ferré
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115
| | - Dong D Wang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115
| | - Miguel A Martínez-González
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115
- Department of Preventive Medicine and Public Health, University of Navarra, and Instituto de Investigacion Sanitaria de Navarra (IdiSNA), University of Navarra, 31008 Pamplona, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, 28029 Madrid, Spain
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DdaR (PA1196) Regulates Expression of Dimethylarginine Dimethylaminohydrolase for the Metabolism of Methylarginines in Pseudomonas aeruginosa PAO1. J Bacteriol 2017; 199:JB.00001-17. [PMID: 28167521 DOI: 10.1128/jb.00001-17] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 01/31/2017] [Indexed: 11/20/2022] Open
Abstract
Dimethylarginine dimethylaminohydrolases (DDAHs) catalyze the hydrolysis of methylarginines to yield l-citrulline and methylamines as products. DDAHs and their central roles in methylarginine metabolism have been characterized for eukaryotic cells. While DDAHs are known to exist in some bacteria, including Streptomyces coelicolor and Pseudomonas aeruginosa, the physiological importance and genetic regulation of bacterial DDAHs remain poorly understood. To provide some insight into bacterial methylarginine metabolism, this study focused on identifying the key elements or factors regulating DDAH expression in P. aeruginosa PAO1. First, results revealed that P. aeruginosa can utilize NG ,NG -dimethyl-l-arginine (ADMA) as a sole source of nitrogen but not carbon. Second, expression of the ddaH gene was observed to be induced in the presence of methylarginines, including NG -monomethyl-l-arginine (l-NMMA) and ADMA. Third, induction of the ddaH gene was shown to be achieved through a mechanism consisting of the putative enhancer-binding protein PA1196 and the alternative sigma factor RpoN. Both PA1196 and RpoN were essential for the expression of the ddaH gene in response to methylarginines. On the basis of the results of this study, PA1196 was given the name DdaR, for dimethylarginine dimethylaminohydrolase regulator. Interestingly, DdaR and its target ddaH gene are conserved only among P. aeruginosa strains, suggesting that this particular Pseudomonas species has evolved to utilize methylarginines from its environment.IMPORTANCE Methylated arginine residues are common constituents of eukaryotic proteins. During proteolysis, methylarginines are released in their free forms and become accessible nutrients for bacteria to utilize as growth substrates. In order to have a clearer and better understanding of this process, we explored methylarginine utilization in the metabolically versatile bacterium Pseudomonas aeruginosa PAO1. Our results show that the transcriptional regulator DdaR (PA1196) and the sigma factor RpoN positively regulate expression of dimethylarginine dimethylaminohydrolases (DDAHs) in response to exogenous methylarginines. DDAH is the central enzyme of methylarginine degradation, and its transcriptional regulation by DdaR-RpoN is expected to be conserved among P. aeruginosa strains.
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Eichelmann F, Schwingshackl L, Fedirko V, Aleksandrova K. Effect of plant-based diets on obesity-related inflammatory profiles: a systematic review and meta-analysis of intervention trials. Obes Rev 2016; 17:1067-1079. [PMID: 27405372 DOI: 10.1111/obr.12439] [Citation(s) in RCA: 121] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 05/11/2016] [Accepted: 05/23/2016] [Indexed: 12/24/2022]
Abstract
Plant-based dietary interventions have been proposed to reduce obesity induced chronic low-grade inflammation and hence prevent chronic disease risk; however, human evidence remains unclear. This systematic review and meta-analysis of intervention trials aimed to assess the effect of plant-based diets on obesity-related inflammatory biomarker profiles. Medline, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) were searched for articles published until January 2016 and mean differences in biomarkers of inflammatory status were assessed for: C-reactive protein (CRP), interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-ɑ), soluble intercellular adhesion molecule 1 (sICAM), leptin, adiponectin and resistin. Of initially identified 2,583 publications, 29 met the meta-analysis inclusion criteria [a total of 2,689 participants]. Consumption of plant-based diets was associated with a reduction in the mean concentrations of the following biomarkers: CRP [effect size, -0.55 mg/l, 95% confidence intervals (CI): -0.78; -0.32, I2 = 94.4%], IL-6 [effect size, -0.25 ng/l, 95% CI: -0.56; 0.06, I2 = 74%], and, to some degree, sICAM (-25.07 ng/ml [95% CI: -52.32; 2.17, I2 = 93.2%]). No substantial effects were revealed for TNF-ɑ, resistin, adiponectin and leptin. Plant-based diets are associated with an improvement in obesity-related inflammatory profiles and could provide means for therapy and prevention of chronic disease risk.
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Affiliation(s)
- F Eichelmann
- Nutrition, Immunity and Metabolism Start-up Lab, Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
| | - L Schwingshackl
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
| | - V Fedirko
- Department of Epidemiology, Rollins School of Public Health, Winship Cancer Institute, Emory University, USA
| | - K Aleksandrova
- Nutrition, Immunity and Metabolism Start-up Lab, Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany.
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Portal VL, Markoski MM, Quadros ASD, Garofallo S, Santos JLD, Oliveira A, Wechenfelder C, Campos VPD, Souza PALD, Machado L, Marcadenti A. Effect of polymorphisms in the CD36 and STAT3 genes on different dietary interventions among patients with coronary artery disease: study protocol for a randomized controlled trial. Trials 2016; 17:437. [PMID: 27596284 PMCID: PMC5011844 DOI: 10.1186/s13063-016-1564-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 08/21/2016] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Cardiovascular disease has become a major health problem, and it has been associated with both environmental and genetic factors. Studies have shown that the Mediterranean Diet (MeDiet), or its components such as nuts and olive oil, may be strongly associated with the improvement of cardiovascular risk factors in specific populations. The purpose of the GENUTRI study is to investigate the interaction of genetics with cardiovascular risk factors in a non-Mediterranean population with coronary artery disease (CAD) according to three different diets: rich in pecan nuts, in extra-virgin olive oil or a control diet. METHODS/DESIGN The GENUTRI study is a single-center, randomized, open-label, parallel-group, 12-week pragmatic clinical trial conducted in patients aged 40 to 80 years and diagnosed with CAD. A standardized questionnaire will be applied to data collection and a blood sample will be obtained for lipid, glycemic and inflammatory profile evaluation. Polymorphisms in the CD36 and STAT3 genes will be detected using the TaqMan® SNP Genotyping Assay. Patients will be allocated in three groups: group 1: 30 g/day of pecan nuts; group 2: 30 ml/day of olive oil; and group 3: control diet. The primary outcome will consist of changes in LDL-cholesterol (in mg/dl) after 12 weeks of intervention. DISCUSSION Studies have shown the beneficial effects of diets rich in nuts and olive oil mainly in the Mediterranean population. GENUTRI is a clinical trial focusing on the effects of nuts or olive oil supplementation in Brazilian individuals. Additionally, we will try to demonstrate that genetic polymorphisms linked to cardiovascular disease may modulate the effects of different diets on biochemical and inflammatory markers among these subjects. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02202265 (registered on 18 July 2014: first version).
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Affiliation(s)
- Vera Lucia Portal
- Postgraduate Program in Health Sciences: Cardiology, Institute of Cardiology of the Rio Grande do Sul (IC/FUC), Porto Alegre, Brazil
| | - Melissa Medeiros Markoski
- Postgraduate Program in Health Sciences: Cardiology, Institute of Cardiology of the Rio Grande do Sul (IC/FUC), Porto Alegre, Brazil
| | - Alexandre Schaan de Quadros
- Postgraduate Program in Health Sciences: Cardiology, Institute of Cardiology of the Rio Grande do Sul (IC/FUC), Porto Alegre, Brazil
| | - Sílvia Garofallo
- Postgraduate Program in Health Sciences: Cardiology, Institute of Cardiology of the Rio Grande do Sul (IC/FUC), Porto Alegre, Brazil
| | - Julia Lorenzon dos Santos
- Postgraduate Program in Health Sciences: Cardiology, Institute of Cardiology of the Rio Grande do Sul (IC/FUC), Porto Alegre, Brazil
| | - Aline Oliveira
- Postgraduate Program in Health Sciences: Cardiology, Institute of Cardiology of the Rio Grande do Sul (IC/FUC), Porto Alegre, Brazil
| | - Camila Wechenfelder
- Postgraduate Program in Health Sciences: Cardiology, Institute of Cardiology of the Rio Grande do Sul (IC/FUC), Porto Alegre, Brazil
| | - Viviane Paiva de Campos
- Postgraduate Program in Health Sciences: Cardiology, Institute of Cardiology of the Rio Grande do Sul (IC/FUC), Porto Alegre, Brazil
| | - Priscilla Azambuja Lopes de Souza
- Postgraduate Program in Health Sciences: Cardiology, Institute of Cardiology of the Rio Grande do Sul (IC/FUC), Porto Alegre, Brazil
| | - Luana Machado
- Postgraduate Program in Health Sciences: Cardiology, Institute of Cardiology of the Rio Grande do Sul (IC/FUC), Porto Alegre, Brazil
| | - Aline Marcadenti
- Postgraduate Program in Health Sciences: Cardiology, Institute of Cardiology of the Rio Grande do Sul (IC/FUC), Porto Alegre, Brazil
- Department of Nutrition, Federal University of Health Sciences of Porto Alegre (UFCSPA), 245 Sarmento Leite Street, Porto Alegre, RS 90050-170 Brazil
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Bédard A, Corneau L, Dodin S, Lemieux S. Sex Differences in the Effects of Repeated Taste Exposure to the Mediterranean Diet: A 6-month Follow-up Study. CAN J DIET PRACT RES 2016; 77:125-32. [PMID: 26916988 DOI: 10.3148/cjdpr-2015-052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
PURPOSE To determine whether an intervention based mainly on exposure to the Mediterranean diet (MedDiet), along with recommendations and tools for encouraging healthy eating, lead to different effects on dietary adherence and body weight management six months post-intervention in Canadian men and women. METHODS Thirty-eight males and 32 premenopausal females (all aged 24-53 years) were exposed to the same 4-week experimental MedDiet during which all foods were provided to participants. Participants also received some recommendations and tools to adhere to a healthy way of eating, with no other contact until the 6-month follow-up visit. RESULTS Compared with baseline, the Mediterranean score (MedScore) increased at the end of the 6-month follow-up (time effect P = 0.003), with no sex difference (sex-by-time interaction P = 0.97). With regard to MedScore components, sex differences were observed with males reporting changes in more dietary food groups than females. Although the intervention was not focused on body weight management, compared with baseline, BMI decreased during the intervention in both males and females; however, only females maintained the lower BMI 6 months after the intervention. CONCLUSIONS Exposure to the MedDiet for a short duration promotes the adherence to this food pattern in both sexes and helps in the management of body weight, especially in females.
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Affiliation(s)
- Alexandra Bédard
- a Institut sur la nutrition et les aliments fonctionnels (INAF), 2440 boulevard Hochelaga, Université Laval, QC G1V 0A6.,b École de Nutrition, Pavillon Paul-Comtois, 2425 rue de l'Agriculture, Université Laval, QC G1V 0A6
| | - Louise Corneau
- a Institut sur la nutrition et les aliments fonctionnels (INAF), 2440 boulevard Hochelaga, Université Laval, QC G1V 0A6
| | - Sylvie Dodin
- a Institut sur la nutrition et les aliments fonctionnels (INAF), 2440 boulevard Hochelaga, Université Laval, QC G1V 0A6.,c Département d'obstétrique et de gynécologie, Pavillon Ferdinand-Vandry, 1050 Avenue de la médecine, Université Laval, QC G1V 0A6
| | - Simone Lemieux
- a Institut sur la nutrition et les aliments fonctionnels (INAF), 2440 boulevard Hochelaga, Université Laval, QC G1V 0A6.,b École de Nutrition, Pavillon Paul-Comtois, 2425 rue de l'Agriculture, Université Laval, QC G1V 0A6
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Cell Therapy in Ischemic Heart Disease: Interventions That Modulate Cardiac Regeneration. Stem Cells Int 2016; 2016:2171035. [PMID: 26880938 PMCID: PMC4736413 DOI: 10.1155/2016/2171035] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 10/26/2015] [Accepted: 11/10/2015] [Indexed: 12/15/2022] Open
Abstract
The incidence of severe ischemic heart disease caused by coronary obstruction has progressively increased. Alternative forms of treatment have been studied in an attempt to regenerate myocardial tissue, induce angiogenesis, and improve clinical conditions. In this context, cell therapy has emerged as a promising alternative using cells with regenerative potential, focusing on the release of paracrine and autocrine factors that contribute to cell survival, angiogenesis, and tissue remodeling. Evidence of the safety, feasibility, and potential effectiveness of cell therapy has emerged from several clinical trials using different lineages of adult stem cells. The clinical benefit, however, is not yet well established. In this review, we discuss the therapeutic potential of cell therapy in terms of regenerative and angiogenic capacity after myocardial ischemia. In addition, we addressed nonpharmacological interventions that may influence this therapeutic practice, such as diet and physical training. This review brings together current data on pharmacological and nonpharmacological approaches to improve cell homing and cardiac repair.
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Schwingshackl L, Christoph M, Hoffmann G. Effects of Olive Oil on Markers of Inflammation and Endothelial Function-A Systematic Review and Meta-Analysis. Nutrients 2015; 7:7651-75. [PMID: 26378571 PMCID: PMC4586551 DOI: 10.3390/nu7095356] [Citation(s) in RCA: 158] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Revised: 07/30/2015] [Accepted: 09/06/2015] [Indexed: 11/16/2022] Open
Abstract
The aim of the present systematic review was to synthesize data from randomized controlled trials investigating the effects of olive oil on markers of inflammation or endothelial function. Literature search in electronic databases Cochrane Trial Register, EMBASE, and MEDLINE was performed. Thirty studies enrolling 3106 participants fulfilled the selection criteria. Pooled effects of different interventions were assessed as mean difference using a random effects model. Olive oil interventions (with daily consumption ranging approximately between 1 mg and 50 mg) resulted in a significantly more pronounced decrease in C-reactive protein (mean difference: −0.64 mg/L, (95% confidence interval (CI) −0.96 to −0.31), p < 0.0001, n = 15 trials) and interleukin-6 (mean difference: −0.29 (95% CI −0.7 to −0.02), p < 0.04, n = 7 trials) as compared to controls, respectively. Values of flow-mediated dilatation (given as absolute percentage) were significantly more increased in individuals subjected to olive oil interventions (mean difference: 0.76% (95% CI 0.27 to 1.24), p < 0.002, n = 8 trials). These results provide evidence that olive oil might exert beneficial effects on endothelial function as well as markers of inflammation and endothelial function, thus representing a key ingredient contributing to the cardiovascular-protective effects of a Mediterranean diet. However, due to the heterogeneous study designs (e.g., olive oil given as a supplement or as part of dietary pattern, variations in control diets), a conservative interpretation of the results is necessary.
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Affiliation(s)
- Lukas Schwingshackl
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Athanstraße 14 (UZAII), Vienna A-1090, Austria; E-Mails: (L.S.); (M.C.)
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany
| | - Marina Christoph
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Athanstraße 14 (UZAII), Vienna A-1090, Austria; E-Mails: (L.S.); (M.C.)
| | - Georg Hoffmann
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Athanstraße 14 (UZAII), Vienna A-1090, Austria; E-Mails: (L.S.); (M.C.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +43-1-4277-54950; Fax: +43-1-4277-9549
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Barbour JA, Howe PRC, Buckley JD, Bryan J, Coates AM. Effect of 12 Weeks High Oleic Peanut Consumption on Cardio-Metabolic Risk Factors and Body Composition. Nutrients 2015; 7:7381-98. [PMID: 26404365 PMCID: PMC4586538 DOI: 10.3390/nu7095343] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 08/13/2015] [Accepted: 08/21/2015] [Indexed: 01/25/2023] Open
Abstract
Epidemiological evidence indicates an inverse association between nut consumption and obesity, inflammation, hyperlipidaemia and glucose intolerance. We investigated effects of high oleic peanut consumption vs. a nut free diet on adiposity and cardio-metabolic risk markers. In a randomised cross-over design, 61 healthy subjects (65 ± 7 years, body mass index (BMI) 31 ± 4 kg/m²) alternated either high oleic peanuts (15%-20% of energy) or a nut free diet for 12 weeks. Body composition and mass, waist circumference, C-reactive protein (CRP), lipids, glucose and insulin were assessed at baseline and after each phase. Repeated measures analysis of variance (ANOVA) compared the two diets. Consistent with other nut studies, there were no differences in lipids, CRP, glucose and insulin with peanut consumption. In contrast, some reports have demonstrated benefits, likely due to differences in the study cohort. Energy intake was 10% higher (853 kJ, p < 0.05), following peanut consumption vs. control, attributed to a 30% increase in fat intake (p < 0.001), predominantly monounsaturated (increase 22 g, p < 0.05). Despite greater energy intake during the peanut phase, there were no differences in body composition, and less than predicted increase (0.5 kg) in body weight for this additional energy intake, possibly due to incomplete nutrient absorption and energy utilisation.
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Affiliation(s)
- Jayne A Barbour
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, G.P.O. Box 2471, Adelaide, South Australia 5001, Australia.
| | - Peter R C Howe
- Clinical Nutrition Research Centre, University of Newcastle (PRCH), University Drive Callaghan, New South Wales 2308, Australia.
| | - Jonathan D Buckley
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, G.P.O. Box 2471, Adelaide, South Australia 5001, Australia.
| | - Janet Bryan
- Department of Psychology, Social Work and Social Policy, University of South Australia, G.P.O. Box 2471, Adelaide, South Australia 5001, Australia.
| | - Alison M Coates
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, G.P.O. Box 2471, Adelaide, South Australia 5001, Australia.
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Lau KK, Wong YK, Chan YH, Li OY, Lee PYS, Yuen GG, Wong YK, Tong S, Wong D, Chan KH, Cheung RTF, Siu CW, Ho SL, Tse HF. Mediterranean-style diet is associated with reduced blood pressure variability and subsequent stroke risk in patients with coronary artery disease. Am J Hypertens 2015; 28:501-7. [PMID: 25352231 DOI: 10.1093/ajh/hpu195] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND PURPOSE The Mediterranean-style diet is widely advocated for the prevention of cardiovascular diseases (CVD). Meanwhile, blood pressure variability (BPV) is a novel risk factor for CVD. It is unknown whether dietary pattern plays a role in modulating BPV. METHODS We prospectively followed-up 274 consecutive patients with stable coronary artery disease (CAD). The Mediterranean diet score (MDS) was derived for all individuals upon recruitment, blood pressure (BP) was measured during each subsequent clinic visit and the visit-to-visit BPV was calculated. The occurrence of major adverse cardiovascular events (MACEs) and all-cause mortality was monitored. RESULTS After a mean follow-up of 77±12 months, 16.1% of the study population developed MACEs. About 11.3% died from all causes. Patients who developed MACEs or all-cause mortality had a greater systolic BPV compared to those who did not develop an adverse event. Patients who developed a MACE had a lower MDS and further analysis revealed those who developed a stroke had a lower MDS compared with those who did not develop a stroke, but there were no significant differences in MDS between CAD patients with or without subsequent acute coronary syndrome, cardiovascular, or all-cause mortality. After adjusting for confounding variables, a high MDS was an independent predictor for low systolic BPV (B -0.74, 95% confidence interval -1.27 to -0.21, P < 0.01) and was noted to be protective against subsequent development of stroke (hazards ratio 0.48, 95% confidence interval 0.24 to 0.94, P = 0.03). CONCLUSIONS Among patients with CAD, a higher MDS is associated with a lower visit-to-visit BPV and with lower stroke risk.
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Affiliation(s)
- Kui-Kai Lau
- Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong
| | - Yuen-Kwun Wong
- Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong
| | - Yap-Hang Chan
- Cardiology Division, Department of Medicine, The University of Hong Kong, Hong Kong
| | - Oi-Yi Li
- Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong
| | - Philip Yat-Sing Lee
- Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong
| | - Gabrielle G Yuen
- Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong
| | - Yee-Kiu Wong
- Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong
| | - Samuel Tong
- Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong
| | - Dicken Wong
- Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong
| | - Koon-Ho Chan
- Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong
| | | | - Chung-Wah Siu
- Cardiology Division, Department of Medicine, The University of Hong Kong, Hong Kong
| | - Shu-Leong Ho
- Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong
| | - Hung-Fat Tse
- Cardiology Division, Department of Medicine, The University of Hong Kong, Hong Kong.
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Joris PJ, Zeegers MP, Mensink RP. Weight loss improves fasting flow-mediated vasodilation in adults: a meta-analysis of intervention studies. Atherosclerosis 2014; 239:21-30. [PMID: 25568949 DOI: 10.1016/j.atherosclerosis.2014.12.056] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 11/07/2014] [Accepted: 12/09/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND Obesity is associated with vascular endothelial dysfunction. Effects of weight loss on endothelial function are however not clear. Therefore, we performed a meta-analysis to quantify effects of weight loss on flow-mediated vasodilation (FMD) of the brachial artery, a measurement of endothelial function. METHODS Studies with experimental (RCTs) and quasi-experimental designs published before June 2014 were identified by a systematic search. Changes in FMD were defined as the difference between measurements before and after the study. For RCTs, changes were corrected for those in the no-weight loss control group. Summary estimates of weighted mean differences (WMDs) in FMD and 95% confidence intervals (CIs) were calculated using random-effect meta-analyses. The impact of subject characteristics, type of weight-loss treatment, and dietary composition on changes in FMD was also investigated. RESULTS Four RCTs involving 265 subjects were included. Weight loss increased FMD vs. control by 3.29% (95% CI: 0.98-5.59%; P = 0.005; mean weight loss: 8.6 kg). A total of 1517 subjects participated in 33 studies with 49 relevant study arms. It was estimated that each 10 kg decrease in body weight increased fasting FMD by 1.11% (95% CI: 0.47-1.76%; P = 0.001). Effects were more pronounced when participants had coexisting obesity-related morbidities. Also, effects may be larger when subjects received low-fat diets or weight-reduction regimens including exercise therapy or weight-loss medication. CONCLUSION Weight loss significantly improves fasting FMD in adults, which is a risk marker for cardiovascular disease. Effects may depend on subject characteristics, type of weight-loss treatment, and dietary composition.
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Affiliation(s)
- Peter J Joris
- Department of Human Biology, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands; Top Institute of Food and Nutrition (TIFN), Wageningen, The Netherlands.
| | - Maurice P Zeegers
- Department of Complex Genetics, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - Ronald P Mensink
- Department of Human Biology, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands; Top Institute of Food and Nutrition (TIFN), Wageningen, The Netherlands.
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Abstract
Various indices and scores based on admittedly healthy dietary patterns or food guides for the general population, or aiming at the prevention of diet-related diseases have been developed to assess diet quality. The four indices preferred by most studies are: the Diet Quality Index; the Healthy Eating Index; the Mediterranean Diet Score; and the Overall Nutritional Quality Index. Other instruments based on these indices have been developed and the words 'adapted', 'revised', or 'new version I, II or III' added to their names. Even validated indices usually find only modest associations between diet and risk of disease or death, raising questions about their limitations and the complexity associated with measuring the causal relationship between diet and health parameters. The objective of this review is to describe the main instruments used for assessing diet quality, and the applications and limitations related to their use and interpretation.
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Delgado-Lista J, Perez-Martinez P, Garcia-Rios A, Perez-Caballero AI, Perez-Jimenez F, Lopez-Miranda J. Mediterranean Diet and Cardiovascular Risk: Beyond Traditional Risk Factors. Crit Rev Food Sci Nutr 2014; 56:788-801. [DOI: 10.1080/10408398.2012.726660] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Abstract
Nuts are rich in many nutrients that can benefit multiple cardiometabolic functions, including arterial compliance, blood pressure, inflammation, glucoregulation and endothelial vasodilatation. Impaired vasodilatation may contribute to impaired cognitive performance due to poor cerebral perfusion. The present narrative review examines associations between nut consumption, vascular health and cognitive function. It includes a systematic search which identified seventy-one epidemiological or intervention studies in which effects of chronic nut consumption on blood pressure, glucoregulation, endothelial vasodilator function, arterial compliance, inflammatory biomarkers and cognitive performance were evaluated. Weighted mean changes were estimated where data were available; they indicate that nut consumption reduces blood pressure and improves glucoregulation, endothelial vasodilator function and inflammation, whilst a limited number of studies suggest that nut consumption may also improve cognitive performance. Further clinical trials are warranted to explore relationships between nut consumption, endothelial function and cognitive function.
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Gotsis E, Anagnostis P, Mariolis A, Vlachou A, Katsiki N, Karagiannis A. Health benefits of the Mediterranean Diet: an update of research over the last 5 years. Angiology 2014; 66:304-18. [PMID: 24778424 DOI: 10.1177/0003319714532169] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The Mediterranean Diet (MedDiet) has been reported to be protective against the occurrence of several diseases. Increasing evidence suggests that the MedDiet could counter diseases associated with chronic inflammation, including metabolic syndrome, atherosclerosis, cancer, diabetes, obesity, pulmonary diseases, and cognition disorders. Adoption of a MedDiet was associated with beneficial effects on the secretion of anti-inflammatory cytokines, antioxidant cellular and circulating biomarkers as well as with regulation of gene polymorphisms involved in the atherosclerotic process. The MedDiet has been considered for the prevention of cardiovascular and other chronic degenerative diseases focusing on the impact of a holistic dietary approach rather than on single nutrients. Epidemiological dietary scores measuring adherence to a MedDiet have been developed. This narrative review considers the results of up-to-date clinical studies (with a focus on the last 5 years) that evaluated the effectiveness of the MedDiet in reducing the prevalence of chronic and degenerative diseases.
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Affiliation(s)
- Efthymios Gotsis
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | - Panagiotis Anagnostis
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | | | - Athanasia Vlachou
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | - Niki Katsiki
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
| | - Asterios Karagiannis
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippokration Hospital, Thessaloniki, Greece
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McKenney JM, Jenks BH, Shneyvas E, Brooks JR, Shenoy SF, Cook CM, Maki KC. A Softgel Dietary Supplement Containing Esterified Plant Sterols and Stanols Improves the Blood Lipid Profile of Adults with Primary Hypercholesterolemia: A Randomized, Double-Blind, Placebo-Controlled Replication Study. J Acad Nutr Diet 2014; 114:244-249. [DOI: 10.1016/j.jand.2013.09.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 09/11/2013] [Indexed: 10/26/2022]
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Lopez-Garcia E, Rodriguez-Artalejo F, Li TY, Fung TT, Li S, Willett WC, Rimm EB, Hu FB. The Mediterranean-style dietary pattern and mortality among men and women with cardiovascular disease. Am J Clin Nutr 2014; 99:172-80. [PMID: 24172306 PMCID: PMC3862454 DOI: 10.3945/ajcn.113.068106] [Citation(s) in RCA: 129] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 10/17/2013] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The role of the Mediterranean diet among individuals with previous cardiovascular disease (CVD) is uncertain. OBJECTIVE The aim of this study was to assess the association between the Alternate Mediterranean Diet (aMED) score and all-cause, cardiovascular, and cancer mortality in men and women with CVD from the Health Professionals Follow-Up Study and the Nurses' Health Study. DESIGN This study included 6137 men and 11,278 women with myocardial infarction, stroke, angina pectoris, coronary bypass, and coronary angioplasty. Diet was first assessed in 1986 for men and in 1980 for women with a food-frequency questionnaire (FFQ) and then repeatedly every 2-4 y. Cumulative consumption was calculated with all available FFQs from the diagnosis of CVD to the end of the follow-up in 2008. RESULTS During a median follow-up of 7.7 y (IQR: 4.2-11.8) for men and 5.8 y (IQR: 3.8-8.0) for women, we documented 1982 deaths (1142 from CVD and 344 from cancer) among men and 1468 deaths (666 from CVD and 197 from cancer) among women. In multivariable Cox regression models, the pooled RR of all-cause mortality from a comparison of the top with the bottom quintiles of the aMED score was 0.81 (95% CI: 0.72, 0.91; P-trend < 0.001). The corresponding pooled RR for CVD mortality was 0.85 (95% CI: 0.67, 1.09; P-trend = 0.30), for cancer mortality was 0.85 (95% CI: 0.65, 1.11; P-trend = 0.10), and for other causes was 0.79 (95% CI: 0.65, 0.97; P-trend = 0.01). A 2-point increase in adherence to the aMED score was associated with a 7% (95% CI: 3%, 11%) reduction in the risk of total mortality. CONCLUSION Adherence to a Mediterranean-style dietary pattern was associated with lower all-cause mortality in individuals with CVD.
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Affiliation(s)
- Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain (EL-G and FR-A); CIBER of Epidemiology and Public Health (EL-G and FR-A) and the Departments of Nutrition (TYL, TTF, SL, WCW, EBR, and FBH) and Epidemiology (WCW, EBR, and FBH), Harvard School of Public Health, Boston, MA; the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (TYL, WCW, EBR, and FBH); and the Programs in Nutrition, Simmons College, Boston, MA (TTF)
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Servillo L, D'Onofrio N, Longobardi L, Sirangelo I, Giovane A, Cautela D, Castaldo D, Giordano A, Balestrieri ML. Stachydrine ameliorates high-glucose induced endothelial cell senescence and SIRT1 downregulation. J Cell Biochem 2013; 114:2522-30. [DOI: 10.1002/jcb.24598] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 05/14/2013] [Indexed: 01/13/2023]
Affiliation(s)
- Luigi Servillo
- Department of Biochemistry; Biophysics and General Pathology; Second University of Naples; Naples; Italy
| | - Nunzia D'Onofrio
- Department of Biochemistry; Biophysics and General Pathology; Second University of Naples; Naples; Italy
| | - Lara Longobardi
- Department of Pediatrics; University of North Carolina at Chapel Hill; Chapel Hill; North Carolina; 27599
| | - Ivana Sirangelo
- Department of Biochemistry; Biophysics and General Pathology; Second University of Naples; Naples; Italy
| | - Alfonso Giovane
- Department of Biochemistry; Biophysics and General Pathology; Second University of Naples; Naples; Italy
| | - Domenico Cautela
- Stazione Sperimentale per le Industrie delle Essenze e dei derivati dagli Agrumi (SSEA); Azienda Speciale della Camera di Commercio di Reggio Calabria; RC; Italy
| | - Domenico Castaldo
- Stazione Sperimentale per le Industrie delle Essenze e dei derivati dagli Agrumi (SSEA); Azienda Speciale della Camera di Commercio di Reggio Calabria; RC; Italy
| | | | - Maria Luisa Balestrieri
- Department of Biochemistry; Biophysics and General Pathology; Second University of Naples; Naples; Italy
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Carter P, Achana F, Troughton J, Gray LJ, Khunti K, Davies MJ. A Mediterranean diet improves HbA1c but not fasting blood glucose compared to alternative dietary strategies: a network meta-analysis. J Hum Nutr Diet 2013; 27:280-97. [PMID: 23790149 DOI: 10.1111/jhn.12138] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- P. Carter
- Diabetes Research Unit; Leicester Diabetes Centre; Leicester General Hospital; University of Leicester; Leicester UK
| | - F. Achana
- Department of Health Sciences; Leicester Diabetes Centre; Leicester General Hospital; University of Leicester; Leicester UK
| | - J. Troughton
- Diabetes Research Unit; Leicester Diabetes Centre; Leicester General Hospital; University of Leicester; Leicester UK
| | - L. J. Gray
- Department of Health Sciences; Leicester Diabetes Centre; Leicester General Hospital; University of Leicester; Leicester UK
| | - K. Khunti
- Diabetes Research Unit; Leicester Diabetes Centre; Leicester General Hospital; University of Leicester; Leicester UK
| | - M. J. Davies
- Diabetes Research Unit; Leicester Diabetes Centre; Leicester General Hospital; University of Leicester; Leicester UK
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Servillo L, Giovane A, Cautela D, Castaldo D, Balestrieri ML. The methylarginines NMMA, ADMA, and SDMA are ubiquitous constituents of the main vegetables of human nutrition. Nitric Oxide 2013; 30:43-8. [PMID: 23438481 DOI: 10.1016/j.niox.2013.02.080] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 02/05/2013] [Accepted: 02/08/2013] [Indexed: 01/16/2023]
Abstract
Endogenous methylarginines, N(G),N(G)-dimethyl-L-arginine (asymmetric dimethylarginine, ADMA), N(G)-N('G)-dimethyl-L-arginine (symmetric dimethylarginine; SDMA), and N(G)-monomethyl-L-arginine (monomethylarginine; NMMA) are supposed to be produced in human body through the methylation of protein arginine residues by protein arginine methyltransferases (PRMT) and released during proteolysis of the methylated proteins. Micromolar concentration of ADMA and NMMA can compete with arginine for nitric oxide synthase (NOS) reducing nitric oxide (NO) formation, whereas SDMA does not. Indeed, increased ADMA and SDMA plasma levels or a decreased arginine/ADMA ratio is related with risk factors for chronic kidney disease and cardiovascular disease. To the best of our knowledge the exogenous presence of methylarginines, like that in fruits and vegetables, has never been described so far. Here, we report the finding that methylarginines are ubiquitous in vegetables which represent an important part of human daily diet. Some of these vegetables contain discrete amounts of ADMA, SDMA, and NMMA. Specifically, among the vegetables examined, soybean, rye, sweet pepper, broad bean, and potato contain the highest ADMA and NMMA mean levels. Our results establish that the three methylarginines, in addition to being produced endogenously, can also be taken daily through the diet in conspicuous amounts. We propose that the contribution of the methylarginines contained in the vegetables of daily diet should be taken into account when the association between vegetable assumption and their levels is evaluated in clinical studies. Furthermore, a comprehensive understanding on the role of the digestive breakdown process and intestinal absorption grade of the methylarginines contained in vegetables is now needed.
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Affiliation(s)
- Luigi Servillo
- Dipartimento di Biochimica, Biofisica e Patologia Generale - Seconda Università degli Studi di Napoli, via L. De Crecchio 7, 80138 Naples, Italy.
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Weber B, Galante AP, Bersch-Ferreira AC, Torreglosa CR, Carvalho VO, Victor EDS, Espírito-Santo JAD, Ross-Fernandes MB, Soares RM, Costa RP, Lara EDS, Buehler AM, Berwanger O. Effects of Brazilian Cardioprotective Diet Program on risk factors in patients with coronary heart disease: a Brazilian Cardioprotective Diet randomized pilot trial. Clinics (Sao Paulo) 2012; 67:1407-14. [PMID: 23295594 PMCID: PMC3521803 DOI: 10.6061/clinics/2012(12)10] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Revised: 08/10/2012] [Accepted: 08/20/2012] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To evaluate the effectiveness of the Brazilian Cardioprotective Diet Program in reducing blood pressures, fasting glucose levels and body mass indices in patients with established atherothrombotic disease. METHOD This randomized controlled pilot trial included outpatients who were over 45 years of age with atherothrombotic cardiovascular disease. Group A, who received the Brazilian Cardioprotective Diet Program, had weekly sessions with dietitians. Groups B and C received the usual dietary therapy that is given to patients with cardiovascular diseases as proposed by the Brazilian guidelines. This diet had the same nutrient profile as that given to Group A, but it was customized by the integration of typical Mediterranean foods. The difference between Groups B and C was the number of sessions with the dietitian. Group B received weekly sessions, while group C only had monthly sessions. ClinicalTrials.gov: NCT 01453166. RESULTS There was a greater reduction in systolic (7.8%) and diastolic (10.8%) blood pressures in Group A compared with Group B (2.3% and 7.3%), and Group C (3.9% and 4.9%, respectively). Fasting glucose decreased by 5.3% and 2% in Groups A and B, respectively. Fasting glucose increased by 3.7% in Group C. The BMIs decreased by 3.5% and 3.3% in Groups A and B, respectively. Group C did not present with any changes in BMI. However, none of these data showed statistical differences between the groups, which is methodologically acceptable in pilot trials. CONCLUSIONS The Brazilian Cardioprotective Diet Program seems to be more effective in reducing blood pressures, fasting glucose levels, weights and BMIs in patients with previous cardiovascular disease compared with the diet that has been proposed by the Brazilian guidelines.
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Affiliation(s)
- Bernardete Weber
- Hospital do Coração (IEP-HCor), Research Institute, São Paulo/SP, Brazil.
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Whelton S, Chow GV, Ashen D, Blumenthal RS. Dyslipidemia Management for Secondary Prevention in Women with Cardiovascular Disease: What Can We Expect From Non-pharmacologic Strategies? CURRENT CARDIOVASCULAR RISK REPORTS 2012; 6:443-449. [PMID: 23110241 DOI: 10.1007/s12170-012-0254-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Cardiovascular disease is the leading cause of death in women and the treatment of dyslipidemia is a cornerstone of secondary prevention. Pharmacologic therapy with statins can lower LDL-C by 30-50% and reduce the risk of recurrent coronary heart disease in both men and women. While significant reductions in LDL-C can be achieved with statin therapy, diet and lifestyle modification remain an essential part of the treatment regimen for cardiovascular disease. Moreover, a large proportion of the U.S. population is sedentary, overweight, and does not consume a heart-healthy diet. Non-pharmacologic treatment strategies also improve other cardiovascular risk factors and are generally easily accessible. In this review, we examine the effect of non-pharmacologic therapy on lipids as part of the secondary prevention strategy of cardiovascular disease in women.
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Affiliation(s)
- Seamus Whelton
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD ; Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD
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