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Chrysant SG, Chrysant GS. Olive Oil Consumption and Cardiovascular Protection: Mechanism of Action. Cardiol Rev 2024; 32:57-61. [PMID: 35290249 DOI: 10.1097/crd.0000000000000449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Cardiovascular diseases (CVDs) are still the leading cause of death and disability worldwide, and they could be prevented by a diet modification and a healthy lifestyle. Dietary modifications include a reduction in the consumption of saturated fatty acids and replacing them with mono or polyunsaturated fatty acids. Olive oil is a monounsaturated fatty acid and its increased consumption has been associated with a significant reduction of CVDs. Its significant cardiovascular benefits have been attributed to its high content of vitamin E, polyphenols, and other ingredients that possess significant anti-inflammatory and antioxidant properties. Several prospective and epidemiological studies have reported an inverse association between olive oil consumption and the incidence of CVD, hypertension, and type 2 diabetes mellitus. Also, a seminal study demonstrated that the use of a Mediterranean diet, which is rich in olive oil, fruits, vegetables, and fish, and low in red meat, was associated with significant reductions in CVD and mortality. However, despite its proven cardiovascular benefits, olive oil is scarcely used in the United States and other Western countries. To determine the current use of olive oil in the United States and other Western countries, a Medline search of the English literature between 2012 and January 2022 was conducted, and 36 pertinent articles were selected. The data from these articles, together with collateral literature, will be discussed in this concise review.
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Affiliation(s)
- Steven G Chrysant
- From the Departments of Cardiology University of Oklahoma Health Sciences Center
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Baratta F, Cammisotto V, Tozzi G, Coronati M, Bartimoccia S, Castellani V, Nocella C, D’Amico A, Angelico F, Carnevale R, Pignatelli P, Del Ben M. High Compliance to Mediterranean Diet Associates with Lower Platelet Activation and Liver Collagen Deposition in Patients with Nonalcoholic Fatty Liver Disease. Nutrients 2022; 14:nu14061209. [PMID: 35334864 PMCID: PMC8952322 DOI: 10.3390/nu14061209] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 01/27/2023] Open
Abstract
The Mediterranean diet (Med-Diet) is considered the most effective dietary patterns to obtain weight loss in NAFLD patients. Previous evidence suggested that Med-Diet adherence could reduce cardiovascular risk and have a beneficial effect on NAFLD severity. Aim of the study was to investigate the relationship between Med-Diet adherence, platelet activation (PA), and liver collagen deposition. The study was performed in 655 consecutive NAFLD outpatients from the PLINIO study, a prospective observational cohort study aimed to identify non-conventional predictors of liver fibrosis progression in NAFLD. PA was measured by the serum thromboxane B2 (TxB2), and liver collagen deposition by N-terminal propeptide of type III collagen (Pro-C3). Adherence to the Med-diet was investigated by a short nine-item validated dietary questionnaire. Patients with high Med-Diet adherence were older and had less metabolic syndrome and lower serum triglycerides, GGT, TxB2, and Pro-C3. At multivariate regression analyses, in the linear model, the Med-Diet score negatively correlated with both TxB2 (Beta = −0.106; p = 0.009) and Pro-C3 (Beta = −0.121; p = 0.002) and in the logistic model high adherence inversely correlated with higher TxB2 tertiles (II tertile: OR = 0.576, p = 0.044; III tertile: OR = 0.556, p = 0.026) and Pro-C3 tertile (III tertile: OR = 0.488, p = 0.013). Low consumption of red meat inversely correlated with higher TxB2 tertile (II tertile: OR = 0.448, p < 0.001, III tertile: OR = 0.567, p = 0.004). In conclusion, NAFLD patients with high adherence to the Med-Diet show lower PA and liver collagen deposition, suggesting a protective role of the Med-Diet against NAFLD progression and cardiovascular risk. In addition, the correlation between TxB2 and Pro-C3 suggests a link between NAFLD severity and cardiovascular risk.
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Affiliation(s)
- Francesco Baratta
- Department of Clinical Internal, Anaesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy; (V.C.); (M.C.); (C.N.); (P.P.); (M.D.B.)
- Correspondence:
| | - Vittoria Cammisotto
- Department of Clinical Internal, Anaesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy; (V.C.); (M.C.); (C.N.); (P.P.); (M.D.B.)
| | - Giulia Tozzi
- Division of Metabolism and Research Unit of Metabolic Biochemistry, Department of Pediatrics, IRCCS Bambino Gesù Children’s Hospital, 00146 Rome, Italy;
| | - Mattia Coronati
- Department of Clinical Internal, Anaesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy; (V.C.); (M.C.); (C.N.); (P.P.); (M.D.B.)
| | - Simona Bartimoccia
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy; (S.B.); (R.C.)
| | - Valentina Castellani
- Department of General Surgery and Surgical Speciality “Paride Stefanini”, Sapienza University of Rome, 00161 Rome, Italy;
| | - Cristina Nocella
- Department of Clinical Internal, Anaesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy; (V.C.); (M.C.); (C.N.); (P.P.); (M.D.B.)
| | - Alessandra D’Amico
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy;
| | - Francesco Angelico
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00161 Rome, Italy;
| | - Roberto Carnevale
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 04100 Latina, Italy; (S.B.); (R.C.)
- Mediterranea Cardiocentro, 80122 Napoli, Italy
| | - Pasquale Pignatelli
- Department of Clinical Internal, Anaesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy; (V.C.); (M.C.); (C.N.); (P.P.); (M.D.B.)
- Mediterranea Cardiocentro, 80122 Napoli, Italy
| | - Maria Del Ben
- Department of Clinical Internal, Anaesthesiological and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy; (V.C.); (M.C.); (C.N.); (P.P.); (M.D.B.)
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Sagris M, Vardas EP, Theofilis P, Antonopoulos AS, Oikonomou E, Tousoulis D. Atrial Fibrillation: Pathogenesis, Predisposing Factors, and Genetics. Int J Mol Sci 2021; 23:ijms23010006. [PMID: 35008432 PMCID: PMC8744894 DOI: 10.3390/ijms23010006] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/07/2021] [Accepted: 12/15/2021] [Indexed: 02/07/2023] Open
Abstract
Atrial fibrillation (AF) is the most frequent arrhythmia managed in clinical practice, and it is linked to an increased risk of death, stroke, and peripheral embolism. The Global Burden of Disease shows that the estimated prevalence of AF is up to 33.5 million patients. So far, successful therapeutic techniques have been implemented, with a high health-care cost burden. As a result, identifying modifiable risk factors for AF and suitable preventive measures may play a significant role in enhancing community health and lowering health-care system expenditures. Several mechanisms, including electrical and structural remodeling of atrial tissue, have been proposed to contribute to the development of AF. This review article discusses the predisposing factors in AF including the different pathogenic mechanisms, sedentary lifestyle, and dietary habits, as well as the potential genetic burden.
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Affiliation(s)
- Marios Sagris
- 1st Cardiology Clinic, ‘Hippokration’ General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.P.V.); (P.T.); (A.S.A.); (E.O.); (D.T.)
- Correspondence: ; Tel.: +30-213-2088099; Fax: +30-213-2088676
| | - Emmanouil P. Vardas
- 1st Cardiology Clinic, ‘Hippokration’ General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.P.V.); (P.T.); (A.S.A.); (E.O.); (D.T.)
- Department of Cardiology, General Hospital of Athens “G. Gennimatas”, 11527 Athens, Greece
| | - Panagiotis Theofilis
- 1st Cardiology Clinic, ‘Hippokration’ General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.P.V.); (P.T.); (A.S.A.); (E.O.); (D.T.)
| | - Alexios S. Antonopoulos
- 1st Cardiology Clinic, ‘Hippokration’ General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.P.V.); (P.T.); (A.S.A.); (E.O.); (D.T.)
| | - Evangelos Oikonomou
- 1st Cardiology Clinic, ‘Hippokration’ General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.P.V.); (P.T.); (A.S.A.); (E.O.); (D.T.)
- 3rd Department of Cardiology, “Sotiria” Thoracic Diseases Hospital of Athens, University of Athens Medical School, 11527 Athens, Greece
| | - Dimitris Tousoulis
- 1st Cardiology Clinic, ‘Hippokration’ General Hospital, School of Medicine, National and Kapodistrian University of Athens, 11528 Athens, Greece; (E.P.V.); (P.T.); (A.S.A.); (E.O.); (D.T.)
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Neckář J, Alánová P, Olejníčková V, Papoušek F, Hejnová L, Šilhavý J, Behuliak M, Bencze M, Hrdlička J, Vecka M, Jarkovská D, Švíglerová J, Mistrová E, Štengl M, Novotný J, Ošťádal B, Pravenec M, Kolář F. Excess ischemic tachyarrhythmias trigger protection against myocardial infarction in hypertensive rats. Clin Sci (Lond) 2021; 135:2143-2163. [PMID: 34486670 DOI: 10.1042/cs20210648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/17/2021] [Accepted: 09/03/2021] [Indexed: 11/17/2022]
Abstract
Increased level of C-reactive protein (CRP) is a risk factor for cardiovascular diseases, including myocardial infarction and hypertension. Here, we analyzed the effects of CRP overexpression on cardiac susceptibility to ischemia/reperfusion (I/R) injury in adult spontaneously hypertensive rats (SHR) expressing human CRP transgene (SHR-CRP). Using an in vivo model of coronary artery occlusion, we found that transgenic expression of CRP predisposed SHR-CRP to repeated and prolonged ventricular tachyarrhythmias. Excessive ischemic arrhythmias in SHR-CRP led to a significant reduction in infarct size (IS) compared with SHR. The proarrhythmic phenotype in SHR-CRP was associated with altered heart and plasma eicosanoids, myocardial composition of fatty acids (FAs) in phospholipids, and autonomic nervous system imbalance before ischemia. To explain unexpected IS-limiting effect in SHR-CRP, we performed metabolomic analysis of plasma before and after ischemia. We also determined cardiac ischemic tolerance in hearts subjected to remote ischemic perconditioning (RIPer) and in hearts ex vivo. Acute ischemia in SHR-CRP markedly increased plasma levels of multiple potent cardioprotective molecules that could reduce IS at reperfusion. RIPer provided IS-limiting effect in SHR that was comparable with myocardial infarction observed in naïve SHR-CRP. In hearts ex vivo, IS did not differ between the strains, suggesting that extra-cardiac factors play a crucial role in protection. Our study shows that transgenic expression of human CRP predisposes SHR-CRP to excess ischemic ventricular tachyarrhythmias associated with a drop of pump function that triggers myocardial salvage against lethal I/R injury likely mediated by protective substances released to blood from hypoxic organs and tissue at reperfusion.
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Affiliation(s)
- Jan Neckář
- Laboratory of Developmental Cardiology, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
- Centre for Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
| | - Petra Alánová
- Laboratory of Developmental Cardiology, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Veronika Olejníčková
- Laboratory of Developmental Cardiology, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
- Institute of Anatomy, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - František Papoušek
- Laboratory of Developmental Cardiology, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Lucie Hejnová
- Department of Physiology, Faculty of Science, Charles University, Prague, Czech Republic
| | - Jan Šilhavý
- Laboratory of Genetics of Model Diseases, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Michal Behuliak
- Laboratory of Experimental Hypertension, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Michal Bencze
- Laboratory of Experimental Hypertension, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Jaroslav Hrdlička
- Laboratory of Developmental Cardiology, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Marek Vecka
- 4th Department of Medicine, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Dagmar Jarkovská
- Biomedical Centre, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
| | - Jitka Švíglerová
- Biomedical Centre, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
| | - Eliška Mistrová
- Biomedical Centre, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
| | - Milan Štengl
- Biomedical Centre, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
| | - Jiří Novotný
- Department of Physiology, Faculty of Science, Charles University, Prague, Czech Republic
| | - Bohuslav Ošťádal
- Laboratory of Developmental Cardiology, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - Michal Pravenec
- Laboratory of Genetics of Model Diseases, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
| | - František Kolář
- Laboratory of Developmental Cardiology, Institute of Physiology of the Czech Academy of Sciences, Prague, Czech Republic
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Hernáez Á, Lassale C, Castro-Barquero S, Ros E, Tresserra-Rimbau A, Castañer O, Pintó X, Vázquez-Ruiz Z, Sorlí JV, Salas-Salvadó J, Lapetra J, Gómez-Gracia E, Alonso-Gómez ÁM, Fiol M, Serra-Majem L, Sacanella E, Razquin C, Corella D, Guasch-Ferré M, Cofán M, Estruch R. Mediterranean Diet Maintained Platelet Count within a Healthy Range and Decreased Thrombocytopenia-Related Mortality Risk: A Randomized Controlled Trial. Nutrients 2021; 13:559. [PMID: 33567733 PMCID: PMC7915168 DOI: 10.3390/nu13020559] [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: 01/08/2021] [Revised: 02/03/2021] [Accepted: 02/03/2021] [Indexed: 12/18/2022] Open
Abstract
There is little information on the dietary modulation of thrombosis-related risk factors such as platelet count. We aimed to assess the effects of Mediterranean diet (MedDiet) on platelet count and related outcomes in an older population at high cardiovascular risk. In participants of the PREDIMED (PREvención con DIeta MEDiterránea) study, we assessed whether an intervention with a MedDiet enriched with extra-virgin olive oil or nuts, relative to a low-fat control diet, modulated platelet count (n = 4189), the risk of developing thrombocytosis and thrombocytopenia (n = 3086), and the association between these alterations and all-cause mortality (median follow-up time: 3.0 years). Although platelet count increased over time (+0.98·109 units/L·year [95% confidence interval: 0.12; 1.84]), MedDiet interventions moderated this increase, particularly in individuals with near-high baseline count (both MedDiets combined: -3.20·109 units/L·year [-5.81; -0.59]). Thrombocytopenia incidence was lower in the MedDiet interventions (incidence rates: 2.23% in control diet, 0.91% in MedDiets combined; hazard ratio: 0.44 [0.23; 0.83]). Finally, thrombocytopenia was associated with a higher risk of all-cause mortality (hazard ratio: 4.71 [2.69; 8.24]), but this relationship was attenuated in those allocated to MedDiet (p-interaction = 0.018). In brief, MedDiet maintained platelet counts within a healthy range and attenuated platelet-related mortality in older adults at high cardiovascular risk.
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Affiliation(s)
- Álvaro Hernáez
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (S.C.-B.); (E.R.); (E.S.); (M.C.); (R.E.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Blanquerna School of Health Sciences, Universitat Ramon Llull, 08025 Barcelona, Spain
- Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, 0473 Oslo, Norway
| | - Camille Lassale
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
| | - Sara Castro-Barquero
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (S.C.-B.); (E.R.); (E.S.); (M.C.); (R.E.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain
| | - Emilio Ros
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (S.C.-B.); (E.R.); (E.S.); (M.C.); (R.E.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, 08036 Barcelona, Spain
| | - Anna Tresserra-Rimbau
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Department of Nutrition, Food Science and Gastronomy, XaRTA, INSA, Faculty of Pharmacy and Food Sciences, University of Barcelona, 08028 Barcelona, Spain
- Unitat de Nutrició Humana, Departament de Bioquimica i Biotecnologia, Universitat Rovira i Virgili, Hospital Universitari Sant Joan de Reus, 43201 Reus, Spain
- Institut d’Investigació Pere Virgili (IISPV), 43204 Reus, Spain
| | - Olga Castañer
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
| | - Xavier Pintó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Lipids and Vascular Risk Unit, Internal Medicine Service, Hospital Universitario de Bellvitge, 08907 L’Hospitalet de Llobregat, Spain
| | - Zenaida Vázquez-Ruiz
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Department of Preventive Medicine and Public Health, Universidad de Navarra, 31008 Pamplona, Spain
| | - José V. Sorlí
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Department of Preventive Medicine, Universidad de Valencia, 46010 Valencia, Spain
| | - Jordi Salas-Salvadó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Unitat de Nutrició Humana, Departament de Bioquimica i Biotecnologia, Universitat Rovira i Virgili, Hospital Universitari Sant Joan de Reus, 43201 Reus, Spain
- Institut d’Investigació Pere Virgili (IISPV), 43204 Reus, Spain
| | - José Lapetra
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Research Unit, Department of Family Medicine, Distrito Sanitario Atención Primaria Sevilla, 41013 Sevilla, Spain
| | - Enrique Gómez-Gracia
- Department of Preventive Medicine and Public Health, Universidad de Málaga, 29071 Málaga, Spain;
| | - Ángel M. Alonso-Gómez
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 01009 Vitoria-Gasteiz, Spain
| | - Miquel Fiol
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Health Research Institute of the Balearic Islands (IdISBa), Hospital Son Espases, 07120 Palma de Mallorca, Spain
| | - Lluis Serra-Majem
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Instituto de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, 35016 Las Palmas, Spain
- Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Servicio Canario de Salud, 35016 Las Palmas, Spain
| | - Emilio Sacanella
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (S.C.-B.); (E.R.); (E.S.); (M.C.); (R.E.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain
- Internal Medicine Service, Hospital Clínic, 08036 Barcelona, Spain
| | - Cristina Razquin
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Department of Preventive Medicine and Public Health, Universidad de Navarra, 31008 Pamplona, Spain
- Department of Endocrinology and Nutrition, Complejo Hospitalario de Navarra, 31008 Pamplona, Spain
| | - Dolores Corella
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Department of Preventive Medicine, Universidad de Valencia, 46010 Valencia, Spain
| | - Marta Guasch-Ferré
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Institut d’Investigació Pere Virgili (IISPV), 43204 Reus, Spain
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
| | - Montserrat Cofán
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (S.C.-B.); (E.R.); (E.S.); (M.C.); (R.E.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, 08036 Barcelona, Spain
| | - Ramón Estruch
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (S.C.-B.); (E.R.); (E.S.); (M.C.); (R.E.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (A.T.-R.); (O.C.); (X.P.); (Z.V.-R.); (J.V.S.); (J.S.-S.); (J.L.); (Á.M.A.-G.); (M.F.); (L.S.-M.); (C.R.); (D.C.); (M.G.-F.)
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain
- Internal Medicine Service, Hospital Clínic, 08036 Barcelona, Spain
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Mediterranean Diet Decreases the Initiation of Use of Vitamin K Epoxide Reductase Inhibitors and Their Associated Cardiovascular Risk: A Randomized Controlled Trial. Nutrients 2020; 12:nu12123895. [PMID: 33352771 PMCID: PMC7766197 DOI: 10.3390/nu12123895] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 12/12/2020] [Accepted: 12/16/2020] [Indexed: 12/29/2022] Open
Abstract
Our aim is to assess whether following a Mediterranean Diet (MedDiet) decreases the risk of initiating antithrombotic therapies and the cardiovascular risk associated with its use in older individuals at high cardiovascular risk. We evaluate whether participants of the PREvención con DIeta MEDiterránea (PREDIMED) study allocated to a MedDiet enriched in extra-virgin olive oil or nuts (versus a low-fat control intervention) disclose differences in the risk of initiation of: (1) vitamin K epoxide reductase inhibitors (acenocumarol/warfarin; n = 6772); (2) acetylsalicylic acid as antiplatelet agent (n = 5662); and (3) other antiplatelet drugs (cilostazol/clopidogrel/dipyridamole/ditazol/ticlopidine/triflusal; n = 6768). We also assess whether MedDiet modifies the association between the antithrombotic drug baseline use and incident cardiovascular events. The MedDiet intervention enriched with extra-virgin olive oil decreased the risk of initiating the use of vitamin K epoxide reductase inhibitors relative to control diet (HR: 0.68 [0.46-0.998]). Their use was also more strongly associated with an increased risk of cardiovascular disease in participants not allocated to MedDiet interventions (HRcontrol diet: 4.22 [1.92-9.30], HRMedDiets: 1.71 [0.83-3.52], p-interaction = 0.052). In conclusion, in an older population at high cardiovascular risk, following a MedDiet decreases the initiation of antithrombotic therapies and the risk of suffering major cardiovascular events among users of vitamin K epoxide reductase inhibitors.
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Abstract
The beneficial effects of a Mediterranean diet on human health and, in particular, on lowering risk of cardiovascular disease, has been mainly attributed to its high content to extra virgin olive oil (EVOO). While its main fatty acid, oleic acid, is considered important to these effects, EVOO has other biological properties that depend on, or are potentiated by other minor components of this oil. Initially, the mechanisms considered as possible causes of this cardioprotective effect of EVOO were based on the incidence on the so-called traditional risk factors (especially lipids and blood pressure). However, the high relative reduction in the prevalence of cardiovascular morbidity and mortality were not proportional to the limited findings about regulation of those traditional risk factors. In addition to several studies confirming the above effects, current research on beneficial effect of EVOO, and in particular in conjunction with Mediterranean style diets, is being focused on defining its effects on newer cardiovascular risk factors, such as inflammation, oxidative stress, coagulation, platelet aggregation, fibrinolysis, endothelial function or lipids or on the modulation of the conditions which predispose people to cardiovascular events, such as obesity, metabolic syndrome or type 2 diabetes mellitus. In the current review, we will mainly focus on reviewing the current evidence about the effects that EVOO exerts on alternative factors, including postprandial lipemia or coagulation, among others, discussing the underlying mechanism by which it exerts its effect, as well as providing a short review on future directions.
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Abstract
Previous studies reported an inverse association between healthy dietary patterns (such as Mediterranean diet) and the incidence of cardiovascular events. As the mechanism accounting for cardiovascular disease is prevalently due to the atherothrombosis, where a pivotal role is played by platelet activation, it would be arguable that diets with protective effects against cardiovascular disease exert an anti-atherothrombotic effect via inhibition of platelet activation. There are several and sparse typologies of studies, which investigated if single nutrients by diets recognized as having cardiovascular protection may exert an antithrombotic effect. The most investigated nutrients are key components of the Mediterranean diets such as fruits and vegetables, fish, olive oil, and wine; other diets with protective effects include nuts and cocoa. Here we summarize experimental and human interventional studies which investigated the antithrombotic effects of such nutrients in experimental models of thrombosis or analyzed biomarkers of clotting, platelet, and fibrinolysis activation in human; furthermore in vitro studies explored the underlying mechanism at level of several cell lines such as platelets or endothelial cells. In this context, we analyzed if nutrients affect simultaneously or separately clotting, platelet, and fibrinolysis pathways giving special attention to the relationship between oxidative stress and thrombosis as most nutrients are believed to possess antioxidant properties.
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Affiliation(s)
- Francesco Violi
- From the Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Italy (F.V., D.P., P.P.).,Mediterranea Cardiocentro, Napoli, Italy (F.V., P.P., R.C.)
| | - Daniele Pastori
- From the Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Italy (F.V., D.P., P.P.)
| | - Pasquale Pignatelli
- From the Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Italy (F.V., D.P., P.P.).,Mediterranea Cardiocentro, Napoli, Italy (F.V., P.P., R.C.)
| | - Roberto Carnevale
- Mediterranea Cardiocentro, Napoli, Italy (F.V., P.P., R.C.).,Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Italy (R.C.)
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The Fluid Aspect of the Mediterranean Diet in the Prevention and Management of Cardiovascular Disease and Diabetes: The Role of Polyphenol Content in Moderate Consumption of Wine and Olive Oil. Nutrients 2019; 11:nu11112833. [PMID: 31752333 PMCID: PMC6893438 DOI: 10.3390/nu11112833] [Citation(s) in RCA: 103] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 11/10/2019] [Accepted: 11/13/2019] [Indexed: 12/20/2022] Open
Abstract
A growing interest has emerged in the beneficial effects of plant-based diets for the prevention of cardiovascular disease, diabetes and obesity. The Mediterranean diet, one of the most widely evaluated dietary patterns in scientific literature, includes in its nutrients two fluid foods: olive oil, as the main source of fats, and a low-to-moderate consumption of wine, mainly red, particularly during meals. Current mechanisms underlying the beneficial effects of the Mediterranean diet include a reduction in inflammatory and oxidative stress markers, improvement in lipid profile, insulin sensitivity and endothelial function, as well as antithrombotic properties. Most of these effects are attributable to bioactive ingredients including polyphenols, mono- and poly-unsaturated fatty acids. Polyphenols are a heterogeneous group of phytochemicals containing phenol rings. The principal classes of red wine polyphenols include flavonols (quercetin and myricetin), flavanols (catechin and epicatechin), anthocyanin and stilbenes (resveratrol). Olive oil has at least 30 phenolic compounds. Among them, the main are simple phenols (tyrosol and hydroxytyrosol), secoroids and lignans. The present narrative review focuses on phenols, part of red wine and virgin olive oil, discussing the evidence of their effects on lipids, blood pressure, atheromatous plaque and glucose metabolism.
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Olas B. Biochemistry of blood platelet activation and the beneficial role of plant oils in cardiovascular diseases. Adv Clin Chem 2019; 95:219-243. [PMID: 32122524 DOI: 10.1016/bs.acc.2019.08.006] [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: 12/28/2022]
Abstract
The main function of blood platelets is to form hemostatic plugs and enable thrombosis. These properties, however, can be greatly influenced by dietary components which may inhibit certain steps of platelet activation, including platelet aggregation. Such inhibition can play a role in the prophylaxis and treatment of cardiovascular diseases associated with blood platelet hyperactivation. In fact, plant and fish oils have been identified and specifically used for this purpose. Numerous in vivo and in vitro experiments have explored the potential use of these oils to inhibit platelet activation as well as their role in reducing oxidative stress and blood pressure, and lowering triglyceride and cholesterol. This chapter presents and compares the anti-platelet effects of fish and plant oils and their constituents, especially fatty acids. Studies on healthy subjects and patients with various cardiovascular diseases are also examined. Findings indicate that both fish and plant oils contain protective components with anti-platelet activity having clearly defined mechanisms of action. Although both are excellent sources of omega fatty acids and vitamins, plant oils contain components with cardioprotective benefit in hypercholesterolemics, i.e., phytosterols. Plant oils may hence play a key role in strategies for preventing and treating cardiovascular diseases associated with platelet hyperactivation. Further studies are clearly needed to determine the precise dose of these components needed for effective prophylaxis and treatment.
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Affiliation(s)
- Beata Olas
- Department of General Biochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Lodz, Poland.
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Schwingshackl L, Morze J, Hoffmann G. Mediterranean diet and health status: Active ingredients and pharmacological mechanisms. Br J Pharmacol 2019; 177:1241-1257. [PMID: 31243760 DOI: 10.1111/bph.14778] [Citation(s) in RCA: 140] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 06/08/2019] [Accepted: 06/17/2019] [Indexed: 12/28/2022] Open
Abstract
The Mediterranean diet (MedDiet) is one of the most widely described and evaluated dietary patterns in scientific literature. It is characterized by high intakes of vegetables, legumes, fruits, nuts, grains, fish, seafood, extra virgin olive oil, and a moderate intake of red wine. A large body of observational and experimental evidence suggests that higher adherence to the MedDiet is associated with lower risk of mortality, cardiovascular disease, metabolic disease, and cancer. Current mechanisms underlying the beneficial effects of the MedDiet include reduction of blood lipids, inflammatory and oxidative stress markers, improvement of insulin sensitivity, enhancement of endothelial function, and antithrombotic function. Most likely, these effects are attributable to bioactive ingredients such as polyphenols, monounsaturated and polyunsaturated fatty acids, or fibre. This review will focus on both established and less established mechanisms of action of biochemical compounds contained in a MedDiet. LINKED ARTICLES: This article is part of a themed section on The Pharmacology of Nutraceuticals. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v177.6/issuetoc.
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Affiliation(s)
- Lukas Schwingshackl
- Institute for Evidence in Medicine, Faculty of Medicine and Medical Centre, University of Freiburg, Freiburg, Germany
| | - Jakub Morze
- Department of Human Nutrition, Faculty of Food Sciences, University of Warmia and Mazury, Olsztyn, Poland
| | - Georg Hoffmann
- Department of Nutritional Sciences, University of Vienna, Vienna, Austria
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Becerra-Tomás N, Blanco Mejía S, Viguiliouk E, Khan T, Kendall CW, Kahleova H, Rahelić D, Sievenpiper JL, Salas-Salvadó J. Mediterranean diet, cardiovascular disease and mortality in diabetes: A systematic review and meta-analysis of prospective cohort studies and randomized clinical trials. Crit Rev Food Sci Nutr 2019; 60:1207-1227. [PMID: 30676058 DOI: 10.1080/10408398.2019.1565281] [Citation(s) in RCA: 147] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Nerea Becerra-Tomás
- Unitat de Nutrició, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Nutrition Unit, University Hospital of Sant Joan de Reus, Reus, Spain
| | - Sonia Blanco Mejía
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Effie Viguiliouk
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Tauseef Khan
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Cyril W.C. Kendall
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Hana Kahleova
- Institute for Clinical and Experimental Medicine, Prague, Czech Republic
- Physicians Committee for Responsible Medicine, Washington, DC, USA
| | - Dario Rahelić
- Department of Endocrinology, Diabetes and Clinical Pharmacology, Dubrava University Hospital, Zagreb, Croatia
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - John L. Sievenpiper
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Jordi Salas-Salvadó
- Unitat de Nutrició, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Nutrition Unit, University Hospital of Sant Joan de Reus, Reus, Spain
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Simeone P, Boccatonda A, Liani R, Santilli F. Significance of urinary 11-dehydro-thromboxane B 2 in age-related diseases: Focus on atherothrombosis. Ageing Res Rev 2018; 48:51-78. [PMID: 30273676 DOI: 10.1016/j.arr.2018.09.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 09/13/2018] [Accepted: 09/23/2018] [Indexed: 12/13/2022]
Abstract
Platelet activation plays a key role in atherogenesis and atherothrombosis. Biochemical evidence of increased platelet activation in vivo can be reliably obtained through non-invasive measurement of thromboxane metabolite (TXM) excretion. Persistent biosynthesis of TXA2 has been associated with several ageing-related diseases, including acute and chronic cardio-cerebrovascular diseases and cardiovascular risk factors, such as cigarette smoking, type 1 and type 2 diabetes mellitus, obesity, hypercholesterolemia, hyperhomocysteinemia, hypertension, chronic kidney disease, chronic inflammatory diseases. Given the systemic nature of TX excretion, involving predominantly platelet but also extraplatelet sources, urinary TXM may reflect either platelet cyclooxygenase-1 (COX-1)-dependent TX generation or COX-2-dependent biosynthesis by inflammatory cells and/or platelets, or a combination of the two, especially in clinical settings characterized by low-grade inflammation or enhanced platelet turnover. Although urinary 11-dehydro-TXB2 levels are largely suppressed with low-dose aspirin, incomplete TXM suppression by aspirin predicts the future risk of vascular events and death in high-risk patients and may identify individuals who might benefit from treatments that more effectively block in vivo TX production or activity. Several disease-modifying agents, including lifestyle intervention, antidiabetic drugs and antiplatelet agents besides aspirin have been shown to reduce TX biosynthesis. Taken together, these aspects may contribute to the development of promising mechanism-based therapeutic strategies to reduce the progression of atherothrombosis. We intended to critically review current knowledge on both the pathophysiological significance of urinary TXM excretion in clinical settings related to ageing and atherothrombosis, as well as its prognostic value as a biomarker of vascular events.
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Affiliation(s)
- Paola Simeone
- Department of Medicine and Aging, and Center of Aging Science and Translational Medicine (CESI-Met), Via Luigi Polacchi, Chieti, Italy
| | - Andrea Boccatonda
- Department of Medicine and Aging, and Center of Aging Science and Translational Medicine (CESI-Met), Via Luigi Polacchi, Chieti, Italy
| | - Rossella Liani
- Department of Medicine and Aging, and Center of Aging Science and Translational Medicine (CESI-Met), Via Luigi Polacchi, Chieti, Italy
| | - Francesca Santilli
- Department of Medicine and Aging, and Center of Aging Science and Translational Medicine (CESI-Met), Via Luigi Polacchi, Chieti, Italy.
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Changing to a Low-Polyphenol Diet Alters Vascular Biomarkers in Healthy Men after Only Two Weeks. Nutrients 2018; 10:nu10111766. [PMID: 30441880 PMCID: PMC6267476 DOI: 10.3390/nu10111766] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 11/10/2018] [Accepted: 11/12/2018] [Indexed: 12/11/2022] Open
Abstract
Bioactive dietary compounds play a critical role in health maintenance. The relation between bioactive compound intake and cardiovascular health-related biomarkers has been demonstrated in several studies, although mainly with participants who have altered biochemical parameters (high blood pressure, high cholesterol, metabolic syndrome, etc.). The aim of this study was to evaluate if adopting a diet low in polyphenol-rich food for two weeks would affect vascular biomarkers in healthy men. In a crossover study, 22 healthy men were randomly assigned to their usual diet (UD), consuming healthy food rich in polyphenols, or to a low antioxidant diet (LAD), with less than two servings of fruit and vegetables per day and avoiding the intake of cocoa products, coffee and tea. As a marker of compliance, total polyphenols in urine were significantly lower after the LAD than after the UD (79 ± 43 vs. 123 ± 58 mg GAE/g creatinine). Nitric oxide levels were also reduced (52 ± 28 in LAD vs. 80 ± 34 µM in UD), although no significant changes in cellular adhesion molecules and eicosanoids were observed; however, an increasing ratio between thromboxane A2 (TXA2) and prostaglandin I2 (PGI2) was reached (p = 0.048). Thus, a slight dietary modification, reducing the consumption of polyphenol-rich food, may affect vascular biomarkers even in healthy individuals.
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Gnagnarella P, Dragà D, Misotti AM, Sieri S, Spaggiari L, Cassano E, Baldini F, Soldati L, Maisonneuve P. Validation of a short questionnaire to record adherence to the Mediterranean diet: An Italian experience. Nutr Metab Cardiovasc Dis 2018; 28:1140-1147. [PMID: 30077491 DOI: 10.1016/j.numecd.2018.06.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 06/11/2018] [Accepted: 06/11/2018] [Indexed: 01/23/2023]
Abstract
BACKGROUND AND AIMS A greater adherence to the Mediterranean diet has been associated with a reduced risk of major chronic diseases and cancer. The aim of the study was to assess the validity of a new short self-administered 15-item questionnaire (QueMD) to measure adherence to the Mediterranean diet in Italy. METHODS AND RESULTS Four-hundred and eighty three participants to cancer-screening programmes at the European Institute of Oncology, Milan (Italy) were invited to join this study. Those interested compiled the QueMD and a validated Food Frequency Questionnaire (FFQ) reporting their usual food consumption during the previous six months. We derived the alternate Mediterranean score (aMED) from both questionnaires with values ranging from 0 (minimal adherence) to 9 (maximal adherence). Complete dietary data were available for 343 individuals (participation rates 71.0%). Spearman correlation coefficient between the responses to the 15 questions of the QueMD and corresponding food intake derived from the FFQ ranged from 0.15 to 0.84. A moderate correlation was found between the aMED scores calculated from the QueMD and the FFQ (intraclass correlation coefficient 0.50; 95% CI, 0.42-0.58), while agreement between the two instruments was only poor to fair for 7 of the 9 single items composing the aMED score, with values ranging from 53.0% for wholegrain products to 79.5% for fruits. CONCLUSION This new self-administered 15-item questionnaire could be a useful tool to assess adherence to the Mediterranean diet in the Italian population.
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Affiliation(s)
- P Gnagnarella
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
| | - D Dragà
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
| | - A M Misotti
- UOSD Dietologia e Nutrizione Clinica, ASST Melegnano e Martesana, Italy
| | - S Sieri
- Department of Research, Epidemiology and Prevention Unit, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan, Italy
| | - L Spaggiari
- Department of Thoracic Surgery, European Institute of Oncology, Milan, Italy; Department of Oncology and Emato-Oncology, University of Milan, Milan, Italy
| | - E Cassano
- Breast Imaging Division, European Institute of Oncology, Milan, Italy
| | - F Baldini
- Division of Melanoma, Sarcoma and Rare Cancer, European Institute of Oncology, Milan, Italy
| | - L Soldati
- Department of Health Sciences, University of Milan, Milan, Italy
| | - P Maisonneuve
- Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy
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Voskoboinik A, Prabhu S, Sugumar H, Kistler PM. Effect of Dietary Factors on Cardiac Rhythm. Am J Cardiol 2018; 122:1265-1271. [PMID: 30075892 DOI: 10.1016/j.amjcard.2018.06.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 06/15/2018] [Accepted: 06/25/2018] [Indexed: 11/19/2022]
Abstract
The interaction between arrhythmias and certain lifestyle factors such as obesity and alcohol consumption is well-established. There is significant public and professional interest in the role of various diets, vitamins, and minerals in cardiovascular health. However, many widely held beliefs are not supported by the literature. There is limited evidence for routine magnesium and omega-3 poly-unsaturated fatty acids supplementation, while coffee, tea, nuts, antioxidant vitamins, and even chocolate may have some antiarrhythmic properties. Saturated fat, added salt, and excessive energy drink consumption appear to be harmful for patients with rhythm disorders. However most recommendations are based on observation studies, and this remains a fertile area for further research.
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Affiliation(s)
- Aleksandr Voskoboinik
- Alfred Heart Centre, Alfred Hospital, Melbourne, Victoria, Australia; Baker Heart and Diabetes Research Institute, Melbourne, Victoria, Australia
| | - Sandeep Prabhu
- Alfred Heart Centre, Alfred Hospital, Melbourne, Victoria, Australia; Baker Heart and Diabetes Research Institute, Melbourne, Victoria, Australia
| | - Hariharan Sugumar
- Alfred Heart Centre, Alfred Hospital, Melbourne, Victoria, Australia; Baker Heart and Diabetes Research Institute, Melbourne, Victoria, Australia
| | - Peter M Kistler
- Alfred Heart Centre, Alfred Hospital, Melbourne, Victoria, Australia; Baker Heart and Diabetes Research Institute, Melbourne, Victoria, Australia; University of Melbourne, Parkville, Victoria, Australia.
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Vicinanza R, Troisi G, Cangemi R, De Martino MU, Pastori D, Bernardini S, Crisciotti F, Di Violante F, Frizza A, Cacciafesta M, Pignatelli P, Marigliano V. Aging and Adherence to the Mediterranean Diet: Relationship with Cardiometabolic Disorders and Polypharmacy. J Nutr Health Aging 2018; 22:73-81. [PMID: 29300425 DOI: 10.1007/s12603-017-0922-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To investigate the association between adherence to the Mediterranean Diet (Med-Diet), cardiometabolic disorders and polypharmacy. DESIGN Cross-sectional study. SETTING Geriatrics outpatient clinic, Policlinico Umberto I, Sapienza University of Rome. PARTICIPANTS 508 patients (219 male, 289 female) aged 50 to 89 who were evaluated for cardiovascular and metabolic disorders. METHODS AND MEASUREMENTS Patients underwent a comprehensive medical assessment including medical history and the use of medications. Adherence to Med-Diet was assessed using the validated Med-Diet 14-item questionnaire; for the analysis, patients were divided in high (≥8) and medium-low (<8) adherence. Polypharmacy was defined as taking ≥5 medications. RESULTS 476 patients completed the study. Mean age was 70.4 years; 58% female. Median Med-Diet score was 8 (interquartile range, 6-9). Patients with medium-low adherence had higher body mass index (p=0.029) and higher prevalence of arterial hypertension (p<0.001), previous coronary (p=0.002) and cerebrovascular events (p=0.011), diabetes, (p<0.001) and dyslipidemia (p=0.001) compared to those at high adherence. Med-Diet score decreased with the number of cardiometabolic disorders (p<0.001). The prevalence of polypharmacy was 39%. Consumption of olive oil (p=0.005), vegetables, (p<0.001), wine (p=0.017), legumes (p=0.028), fish (p=0.046) and nuts (p=0.045) were all inversely associated with the overall number of medications. In a multivariable regression model, medium-low adherence to Med-Diet was independently associated to polypharmacy (O.R.:1.859; 95% CI 1.142 to 3.025; p=0.013), after adjusting for possible confounding factors. CONCLUSION Med-Diet was inversely associated with cardiometabolic disorders and with polypharmacy, suggesting that improved Med-Diet adherence might potentially delay the onset of age-related health deterioration and reduce the need of multiple medications.
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Affiliation(s)
- R Vicinanza
- Roberto Vicinanza, M.D., Ph.D. Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, «Sapienza» University of Rome, Rome, Italy. Phone: +39.328.2710244
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Mattioli AV, Palmiero P, Manfrini O, Puddu PE, Nodari S, Dei Cas A, Mercuro G, Scrutinio D, Palermo P, Sciomer S, Di Francesco S, Novo G, Novo S, Pedretti RF, Zito A, Parati G, Pedrinelli R, Farinetti A, Maiello M, Moscucci F, Tenaglia RL, Sucato V, Triggiani M, Cugusi L, Scicchitano P, Saba PS, Ciccone MM. Mediterranean diet impact on cardiovascular diseases. J Cardiovasc Med (Hagerstown) 2017; 18:925-935. [PMID: 28914660 DOI: 10.2459/jcm.0000000000000573] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Violi F, Loffredo L, Carnevale R, Pignatelli P, Pastori D. Atherothrombosis and Oxidative Stress: Mechanisms and Management in Elderly. Antioxid Redox Signal 2017; 27:1083-1124. [PMID: 28816059 DOI: 10.1089/ars.2016.6963] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
SIGNIFICANCE The incidence of cardiovascular events (CVEs) increases with age, representing the main cause of death in an elderly population. Aging is associated with overproduction of reactive oxygen species (ROS), which may affect clotting and platelet activation, and impair endothelial function, thus predisposing elderly patients to thrombotic complications. Recent Advances: There is increasing evidence to suggest that aging is associated with an imbalance between oxidative stress and antioxidant status. Thus, upregulation of ROS-producing enzymes such as nicotinamide adenine dinucleotide phosphate (NADPH) oxidase and myeloperoxidase, along with downregulation of antioxidant enzymes, such as superoxide dismutase and glutathione peroxidase, occurs during aging. This imbalance may predispose to thrombosis by enhancing platelet and clotting activation and eliciting endothelial dysfunction. Recently, gut-derived products, such as trimethylamine N-oxide (TMAO) and lipopolysaccharide, are emerging as novel atherosclerotic risk factors, and gut microbiota composition has been shown to change by aging, and may concur with the increased cardiovascular risk in the elderly. CRITICAL ISSUES Antioxidant treatment is ineffective in patients at risk or with cardiovascular disease. Further, anti-thrombotic treatment seems to work less in the elderly population. FUTURE DIRECTIONS Interventional trials with antioxidants targeting enzymes implicated in aging-related atherothrombosis are warranted to explore whether modulation of redox status is effective in lowering CVEs in the elderly. Antioxid. Redox Signal. 27, 1083-1124.
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Affiliation(s)
- Francesco Violi
- 1 I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome , Roma, Italy
| | - Lorenzo Loffredo
- 1 I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome , Roma, Italy
| | - Roberto Carnevale
- 1 I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome , Roma, Italy .,2 Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome , Latina, Italy
| | - Pasquale Pignatelli
- 1 I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome , Roma, Italy
| | - Daniele Pastori
- 1 I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome , Roma, Italy
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Pastori D, Carnevale R, Nocella C, Novo M, Santulli M, Cammisotto V, Menichelli D, Pignatelli P, Violi F. Gut-Derived Serum Lipopolysaccharide is Associated With Enhanced Risk of Major Adverse Cardiovascular Events in Atrial Fibrillation: Effect of Adherence to Mediterranean Diet. J Am Heart Assoc 2017; 6:e005784. [PMID: 28584074 PMCID: PMC5669181 DOI: 10.1161/jaha.117.005784] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 04/12/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Gut microbiota is emerging as a novel risk factor for atherothrombosis, but the predictive role of gut-derived lipopolysaccharide (LPS) is unknown. We analyzed (1) the association between LPS and major adverse cardiovascular events (MACE) in atrial fibrillation (AF) and (2) its relationship with adherence to a Mediterranean diet (Med-diet). METHODS AND RESULTS This was a prospective single-center study including 912 AF patients treated with vitamin K antagonists (3716 patient-years). The primary end point was a composite of MACE. Baseline serum LPS, adherence to Med-diet (n=704), and urinary excretion of 11-dehydro-thromboxane B2 (TxB2, n=852) were investigated. Mean age was 73.5 years; 42.9% were women. A total of 187 MACE (5.0% per year) occurred: 54, 59, and 74 in the first, second, and third tertile of LPS, respectively (log-rank test P=0.004). Log-LPS (hazard ratio 1.194, P=0.009), age (hazard ratio 1.083, P<0.001), and previous cerebrovascular (hazard ratio 1.634, P=0.004) and cardiac events (hazard ratio 1.822, P<0.001) were predictors of MACE. In the whole cohort, AF (versus sinus rhythm) (β 0.087, P=0.014) and low-density lipoprotein cholesterol (β 0.069, P=0.049) were associated with circulating LPS. Furthermore, Med-diet score (β -0.137, P<0.001) was predictive of log-LPS, with fruits (β -0.083, P=0.030) and legumes (β -0.120, P=0.002) negatively associated with log-LPS levels. Log-LPS and log-TxB2 were highly correlated (r=0.598, P<0.001). Log-LPS (β 0.574, P<0.001) and Med-diet score (β -0.218, P<0.001) were significantly associated with baseline urinary excretion of TxB2. CONCLUSIONS In this cohort of AF patients, LPS levels were predictive of MACE and negatively affected by high adherence to Med-diet. LPS may contribute to MACE incidence in AF by increasing platelet activation.
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Affiliation(s)
- Daniele Pastori
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy
- Department of Anatomical, Histological, Forensic Medicine and Orthopedics Sciences, Sapienza University of Rome, Italy
| | - Roberto Carnevale
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
| | - Cristina Nocella
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy
| | - Marta Novo
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy
| | - Maria Santulli
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy
- Department of Experimental Medicine, Sapienza University of Rome, Italy
| | - Vittoria Cammisotto
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy
| | - Danilo Menichelli
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy
| | - Pasquale Pignatelli
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy
| | - Francesco Violi
- I Clinica Medica, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy
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Loffredo L, Perri L, Nocella C, Violi F. Antioxidant and antiplatelet activity by polyphenol-rich nutrients: focus on extra virgin olive oil and cocoa. Br J Clin Pharmacol 2017; 83:96-102. [PMID: 26922974 PMCID: PMC5338167 DOI: 10.1111/bcp.12923] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 02/24/2016] [Accepted: 02/25/2016] [Indexed: 12/25/2022] Open
Abstract
Cardiovascular disease is the most common cause of death in the Western world. In the last decades nutraceutical approaches have been proposed to counteract atherosclerotic complications. In particular, polyphenols, a class of bio-active molecules prevalently contained in foods such as cocoa, fruits, vegetables, wine and tea, have been widely studied for their beneficial properties. Several epidemiological and interventional studies have shown that polyphenol-rich nutrients, as in extra virgin olive oil (EVOO) and cocoa, are associated with a risk reduction of cardiovascular events and/or modulation of cardiovascular risk factors. Definition of the mechanisms accounting for this putative cardio-protective effect is still elusive. This review focuses on the mechanisms that may be implicated in the beneficial effects of EVOO and cocoa, including down-regulation of oxidative stress and platelet aggregation, improvement of endothelial function and cardiovascular risk factor such as blood pressure, serum cholesterol and insulin sensitivity.
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Affiliation(s)
- Lorenzo Loffredo
- I Clinica Medica, Department of Internal Medicine and Medical SpecialtiesSapienza University of RomeItaly
| | - Ludovica Perri
- I Clinica Medica, Department of Internal Medicine and Medical SpecialtiesSapienza University of RomeItaly
| | - Cristina Nocella
- I Clinica Medica, Department of Internal Medicine and Medical SpecialtiesSapienza University of RomeItaly
| | - Francesco Violi
- I Clinica Medica, Department of Internal Medicine and Medical SpecialtiesSapienza University of RomeItaly
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Cerletti C, De Curtis A, Bracone F, Digesù C, Morganti AG, Iacoviello L, de Gaetano G, Donati MB. Dietary anthocyanins and health: data from FLORA and ATHENA EU projects. Br J Clin Pharmacol 2016; 83:103-106. [PMID: 27016122 DOI: 10.1111/bcp.12943] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 03/11/2016] [Accepted: 03/20/2016] [Indexed: 11/29/2022] Open
Abstract
Adherence to a 'Mediterranean diet' has been shown to be beneficial to human health. Fruit and vegetables represent some of the main components of the Mediterranean diet and their role has been increasingly considered in the process of preventing or reducing the risk of chronic degenerative diseases, such as cerebrovascular or coronary heart disorders, cancer and neurodegenerative diseases. To investigate the beneficial effect of these dietary compounds, two EU-funded projects were conducted during the last 10 years. Their results from experimental models suggest that dietary anthocyanin enrichment is beneficial against a number of ischemic and degenerative conditions. On the other hand, human studies demonstrated that anthocyanin supplementation can counteract the inflammatory response to stress conditions, such as a fatty meal. Moreover, an intervention trial in patients with breast cancer undergoing radiotherapy is presently testing the possible beneficial effect of the administration of a product enriched in anthocyanins on the inflammatory response to radiation and on its consequent skin toxicity, as well as on systemic low-grade inflammation reaction.
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Affiliation(s)
- Chiara Cerletti
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, IS, Italy
| | - Amalia De Curtis
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, IS, Italy
| | | | - Cinzia Digesù
- Radiotherapy Department, Fondazione Giovanni Paolo II, Catholic University, Campobasso, Italy
| | - Alessio G Morganti
- Radiotherapy Department, Fondazione Giovanni Paolo II, Catholic University, Campobasso, Italy
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, IS, Italy
| | - Giovanni de Gaetano
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, IS, Italy
| | - Maria Benedetta Donati
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, IS, Italy
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Maluf CB, Barreto SM, dos Reis RC, Vidigal PG. Platelet volume is associated with the Framingham risk score for cardiovascular disease in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). ACTA ACUST UNITED AC 2016; 54:879-87. [DOI: 10.1515/cclm-2015-0686] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 10/06/2015] [Indexed: 11/15/2022]
Abstract
AbstractBackground:Platelet volume indices (PVI), an easy and inexpensive surrogate measure of platelet function, have been associated with cardiovascular diseases (CVD) and their risk factors. However, results are conflicting because of the lack of standardized procedures. The purpose of this study is to investigate the relationship of PVI with the Framingham risk score (FRS).Methods:Baseline data (2008–2010) of 3115 participants enrolled in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) were used. PVI measurements were strictly controlled. The cohort was distributed according to risk factors and the general FRS was estimated. Multiple linear regression analysis was used to estimate the association between PVI and FRS.Results:Mean platelet volume (MPV), platelet distribution width (PDW) and platelet large cell ratio (P-LCR) independently correlated (p≤0.01) with FRS after adjustment for confounding variables. One unit increase in MPV, PDW, or P-LCR increased the FRS by 0.59%, 0.40%, and 0.08%, respectively. Diabetics had higher (p≤0.004) MPV, PDW, and P-LCR, and hypertensive individuals had higher (p≤0.045) PDW and P-LCR.Conclusions:Increased PVI was independently correlated with higher CVD risk based on the FRS, diabetes, and systolic hypertension. Prospective follow up of this cohort is warranted to confirm that PVI is associated with the development of CVD.
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Pignatelli P, Pastori D, Vicario T, Bucci T, Del Ben M, Russo R, Tanzilli A, Nardoni ML, Bartimoccia S, Nocella C, Ferro D, Saliola M, Cangemi R, Lip GYH, Violi F. Relationship between Mediterranean diet and time in therapeutic range in atrial fibrillation patients taking vitamin K antagonists. Europace 2015; 17:1223-8. [PMID: 25995397 DOI: 10.1093/europace/euv127] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 04/07/2015] [Indexed: 12/31/2022] Open
Abstract
AIMS It is unclear if atrial fibrillation (AF) patients treated with oral vitamin K antagonists (VKAs) must follow a specific diet to avoid interference with anticoagulation. The aim of this study was to assess if Mediterranean diet (Med-Diet) may affect quality of anticoagulation, as expressed by the time in therapeutic range (TTR). METHODS AND RESULTS A prospective observational study including 553 non-valvular AF patients. Time in therapeutic range was calculated for all patients treated with VKAs, and adherence to Med-Diet was evaluated with a validated nine-item dietary questionnaire. Cardiovascular events (CVEs), such as cardiovascular death and fatal/non-fatal stroke or myocardial infarction, and bleedings were recorded. The median follow-up was 31.6 months. The median number of international normalized ratios for each patient was 63.0 (35.0-98.0) and 38 730 blood samples were analysed. In the whole cohort, the mean TTR was 65.5 ± 17.8%. The mean Med-Diet score was 5.19 ± 1.6, with frequent use of olive oil (90.1%), fruits (88.4%), and vegetables (69.3%) and low meat intake (71.2%). There were no differences among tertiles of Med-Diet score regarding TTR. A multivariable linear regression analysis showed that diabetes (β: -0.105, P = 0.015) and the use of angiotensin converting enzyme inhibitor/angiotensin receptor blockers (β: 0.153, P < 0.001) were associated with TTR. Compared with those without, AF patients with a CVE had significantly lower TTR (65.9 ± 17.9 vs. 59.6 ± 15.9, P = 0.029) and Med-Diet score (5.2 ± 1.5 vs. 4.4 ± 1.9, P = 0.004). A reduction of CVE was observed for each point of the Med-Diet score (hazard ratio 0.790, P = 0.017). CONCLUSION In our cohort of AF patients, Med-Diet is not associated with changes in TTR, and thus can be recommended for AF patients who are taking VKAs.
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Affiliation(s)
- Pasquale Pignatelli
- Center of Atherothrombosis, I Medical Clinic, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Umberto I Policlinic of Rome, I Clinica Medica, Viale del Policlinico 155, Rome 00161, Italy
| | - Daniele Pastori
- Center of Atherothrombosis, I Medical Clinic, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Umberto I Policlinic of Rome, I Clinica Medica, Viale del Policlinico 155, Rome 00161, Italy
| | - Tommasa Vicario
- Center of Atherothrombosis, I Medical Clinic, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Umberto I Policlinic of Rome, I Clinica Medica, Viale del Policlinico 155, Rome 00161, Italy
| | - Tommaso Bucci
- Center of Atherothrombosis, I Medical Clinic, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Umberto I Policlinic of Rome, I Clinica Medica, Viale del Policlinico 155, Rome 00161, Italy
| | - Maria Del Ben
- Center of Atherothrombosis, I Medical Clinic, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Umberto I Policlinic of Rome, I Clinica Medica, Viale del Policlinico 155, Rome 00161, Italy
| | - Roberta Russo
- Center of Atherothrombosis, I Medical Clinic, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Umberto I Policlinic of Rome, I Clinica Medica, Viale del Policlinico 155, Rome 00161, Italy
| | - Alessandra Tanzilli
- Center of Atherothrombosis, I Medical Clinic, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Umberto I Policlinic of Rome, I Clinica Medica, Viale del Policlinico 155, Rome 00161, Italy
| | - Maria Lavinia Nardoni
- Center of Atherothrombosis, I Medical Clinic, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Umberto I Policlinic of Rome, I Clinica Medica, Viale del Policlinico 155, Rome 00161, Italy
| | - Simona Bartimoccia
- Center of Atherothrombosis, I Medical Clinic, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Umberto I Policlinic of Rome, I Clinica Medica, Viale del Policlinico 155, Rome 00161, Italy
| | - Cristina Nocella
- Center of Atherothrombosis, I Medical Clinic, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Umberto I Policlinic of Rome, I Clinica Medica, Viale del Policlinico 155, Rome 00161, Italy
| | - Domenico Ferro
- Center of Atherothrombosis, I Medical Clinic, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Umberto I Policlinic of Rome, I Clinica Medica, Viale del Policlinico 155, Rome 00161, Italy
| | - Mirella Saliola
- Center of Atherothrombosis, I Medical Clinic, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Umberto I Policlinic of Rome, I Clinica Medica, Viale del Policlinico 155, Rome 00161, Italy
| | - Roberto Cangemi
- Center of Atherothrombosis, I Medical Clinic, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Umberto I Policlinic of Rome, I Clinica Medica, Viale del Policlinico 155, Rome 00161, Italy
| | - Gregory Y H Lip
- University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, UK
| | - Francesco Violi
- Center of Atherothrombosis, I Medical Clinic, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Umberto I Policlinic of Rome, I Clinica Medica, Viale del Policlinico 155, Rome 00161, Italy
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