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Abe C, Imai T, Sezaki A, Miyamoto K, Kawase F, Shirai Y, Sanada M, Inden A, Sugihara N, Honda T, Sumikama Y, Nosaka S, Shimokata H. Global Associations of the Traditional Japanese Diet Score with Hypertension Prevalence and Systolic Blood Pressure from 2009 to 2019: A Cross-Sectional and Longitudinal Ecological Study. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2024:1-8. [PMID: 38975987 DOI: 10.1080/27697061.2024.2374408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Accepted: 06/25/2024] [Indexed: 07/09/2024]
Abstract
OBJECTIVE Prevention and improvement of hypertension is one of the most important health issues worldwide. The traditional Japanese diet contributes to the prevention of some non-communicable diseases associated with hypertension. However, whether traditional Japanese dietary patterns are associated with hypertension prevalence and systolic blood pressure (SBP) worldwide remains unknown. In this study, we aimed to investigate whether the traditional Japanese diet score (TJDS) is associated with hypertension prevalence and SBP. METHODS This cross-sectional and longitudinal ecological study from 2009 to 2019 included 141 countries with a population of at least 1 million. All data used for analysis were obtained from internationally available databases. The TJDS was calculated using country-specific supplies of five foods commonly eaten in the traditional Japanese diet (rice, fish, soybean, vegetables, and egg) and three less commonly eaten foods (wheat, milk, and red meat). Hypertension was defined by SBP ≥140 mmHg, diastolic blood pressure ≥90 mmHg, or use of antihypertensive medications. The mean SBP was >25 age-standardized data. A general linear model was used for the cross-sectional model in 2009, and a linear mixed model was used for the longitudinal analysis from 2009 to 2019. The covariates included gross domestic product, percentage of population aged >65 years, years of education, smoking rate, average body mass index, physical activity, and energy supply. RESULTS The TJDS was negatively associated with hypertension prevalence (β ± standard error: -0.861 ± 0.202, p < 0.001) and SBP (β ± standard error: -0.364 ± 0.154, p < 0.05) in the cross-sectional analysis. The TJDS was significantly negatively associated with hypertension prevalence (β ± standard error: -0.845 ± 0.200, p < 0.001) and SBP (β ± standard error: -0.312 ± 0.149, p < 0.05) in the 10-year longitudinal analysis controlled for full covariables. CONCLUSIONS Traditional Japanese dietary patterns are associated with lower hypertension prevalence and SBP worldwide.
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Affiliation(s)
- Chisato Abe
- Department of Food and Nutrition, Tsu City College, Mie, Japan
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Aichi, Japan
| | - Tomoko Imai
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Aichi, Japan
- Department of Food Science and Nutrition, Doshisha Women's College of Liberal Arts, Kyoto, Japan
| | - Ayako Sezaki
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Aichi, Japan
- National Cancer Center Japan, Tokyo, Japan
| | - Keiko Miyamoto
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Aichi, Japan
- Department of Nursing, Nagoya University of Arts and Sciences, Aichi, Japan
| | - Fumiya Kawase
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Aichi, Japan
- Department of Nutrition, Asuke Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Aichi, Japan
| | - Yoshiro Shirai
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Aichi, Japan
- Persuasive Technology Group, Life Science Laboratories, KDDI Research, Inc, Saitama, Japan
| | - Masayo Sanada
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Aichi, Japan
- Department of Nursing, Heisei College of Health Sciences, Gifu, Japan
| | - Ayaka Inden
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Aichi, Japan
- Hamamatsu University Hospital, Shizuoka, Japan
| | - Norie Sugihara
- Faculty of Health and Social Services, Kanagawa University of Human Services, Kanagawa, Japan
| | - Toshie Honda
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Aichi, Japan
- Department of Nursing, Nagoya University of Arts and Sciences, Aichi, Japan
| | - Yuta Sumikama
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Aichi, Japan
- Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Aichi, Japan
| | - Saya Nosaka
- Department of Food Science and Nutrition, Doshisha Women's College of Liberal Arts, Kyoto, Japan
- Graduate School of Nutritional Science, Nagoya University of Arts and Sciences, Aichi, Japan
| | - Hiroshi Shimokata
- Institute of Health and Nutrition, Nagoya University of Arts and Sciences, Aichi, Japan
- Graduate School of Nutritional Science, Nagoya University of Arts and Sciences, Aichi, Japan
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Georgoulis M, Damigou E, Derdelakou E, Kosti RI, Chrysohoou C, Barkas F, Kravvariti E, Tsioufis C, Pitsavos C, Liberopoulos E, Sfikakis PP, Panagiotakos DB. Adherence to the Mediterranean diet and 20-year incidence of hypertension: the ATTICA prospective epidemiological study (2002-2022). Eur J Clin Nutr 2024; 78:630-638. [PMID: 38605190 DOI: 10.1038/s41430-024-01440-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 04/03/2024] [Accepted: 04/05/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND/OBJECTIVES Dietary habits are a significant predictor of hypertension (HTN). We aimed to evaluate the long-term association between adherence to the Mediterranean diet and HTN incidence. SUBJECTS/METHODS This was a prospective study among 1415 non-hypertensive adults (44% men, age: 41 ± 13 years) followed up for 20 years. Anthropometric, lifestyle, and clinical parameters were evaluated at baseline. Adherence to the Mediterranean diet was evaluated both at baseline and 10 years through the MedDietScore (range: 0-55, higher values indicate greater adherence). RESULTS At the 20-year follow-up, 314 new HTN cases were recorded. HTN incidence was 35.5%, 22.5%, and 8.7% in the lowest, middle, and upper tertile of baseline MedDietScore, respectively (p < 0.001). For each 1-point increase in baseline MedDietScore, the 20-year HTN risk decreased by 7% [relative risk (RR): 0.925, 95% confidence interval (CI): 0.906, 0.943], and this effect remained significant after adjustment for age, sex, and baseline lifestyle and clinical confounders, i.e., body mass index, physical activity, smoking, systolic and diastolic blood pressure, family history of HTN, and presence of hypercholesterolemia and diabetes mellitus (RR: 0.973, 95%CI: 0.949, 0.997). In a similar multiadjusted model, compared to subjects who were consistently away from the Mediterranean diet (in the lowest MedDietScore tertile both at baseline and 10 years), only those who were consistently close (in the middle and upper MedDietScore tertiles both at baseline and 10 years) exhibited a 47% lower 20-year HTN risk. CONCLUSION A high adherence to the Mediterranean diet, particularly when longitudinally sustained, is associated with lower incidence of HTN.
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Affiliation(s)
- Michael Georgoulis
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17676, Athens, Greece
| | - Evangelia Damigou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17676, Athens, Greece
| | - Evgenia Derdelakou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17676, Athens, Greece
| | - Rena I Kosti
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, 38221, Trikala, Greece
| | - Christina Chrysohoou
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527, Athens, Greece
| | - Fotios Barkas
- Department of Internal Medicine, Medical School, University of Ioannina, 45500, Ioannina, Greece
| | - Evrydiki Kravvariti
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772, Athens, Greece
| | - Costas Tsioufis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527, Athens, Greece
| | - Christos Pitsavos
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527, Athens, Greece
| | - Evangelos Liberopoulos
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772, Athens, Greece
| | - Petros P Sfikakis
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772, Athens, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17676, Athens, Greece.
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Mu YF, Gao ZX, Mao ZH, Pan SK, Liu DW, Liu ZS, Wu P. Perspectives on the involvement of the gut microbiota in salt-sensitive hypertension. Hypertens Res 2024:10.1038/s41440-024-01747-y. [PMID: 38877311 DOI: 10.1038/s41440-024-01747-y] [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: 11/13/2023] [Revised: 03/13/2024] [Accepted: 05/28/2024] [Indexed: 06/16/2024]
Abstract
Salt-sensitivity hypertension (SSH) is an independent predictor of cardiovascular event-related death. Despite the extensiveness of research on hypertension, which covers areas such as the sympathetic nervous system, the renin-angiotensin system, the vascular system, and the immune system, its pathogenesis remains elusive, with sub-optimal blood pressure control in patients. The gut microbiota is an important component of nutritional support and constitutes a barrier in the host. Long-term high salt intake can lead to gut microbiota dysbiosis and cause significant changes in the expression of gut microbiota-related metabolites. Of these metabolites, short chain fatty acids (SCFAs), trimethylamine oxide, amino acids, bile acids, and lipopolysaccharide are essential mediators of microbe-host crosstalk. These metabolites may contribute to the incidence and development of SSH via inflammatory, immune, vascular, and nervous pathways, among others. In addition, recent studies, including those on the histone deacetylase inhibitory mechanism of SCFAs and the blood pressure-decreasing effects of H2S via vascular activation, suggest that several proteins and factors in the classical pathway elicit their effects through multiple non-classical pathways. This review summarizes changes in the gut microbiota and its related metabolites in high-salt environments, as well as corresponding treatment methods for SSH, such as diet management, probiotic and prebiotic use, antibiotic use, and fecal transplantation, to provide new insights and perspectives for understanding SSH pathogenesis and the development of strategies for its treatment.
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Affiliation(s)
- Ya-Fan Mu
- Traditional Chinese Medicine Integrated Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Institute of Nephrology, Zhengzhou University, Zhengzhou, China
- Henan Province Research Center for Kidney Disease, Zhengzhou, China
- Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou, China
| | - Zhong-Xiuzi Gao
- Traditional Chinese Medicine Integrated Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Institute of Nephrology, Zhengzhou University, Zhengzhou, China
- Henan Province Research Center for Kidney Disease, Zhengzhou, China
- Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou, China
| | - Zi-Hui Mao
- Traditional Chinese Medicine Integrated Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Institute of Nephrology, Zhengzhou University, Zhengzhou, China
- Henan Province Research Center for Kidney Disease, Zhengzhou, China
- Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou, China
| | - Shao-Kang Pan
- Traditional Chinese Medicine Integrated Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Institute of Nephrology, Zhengzhou University, Zhengzhou, China
- Henan Province Research Center for Kidney Disease, Zhengzhou, China
- Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou, China
| | - Dong-Wei Liu
- Traditional Chinese Medicine Integrated Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Institute of Nephrology, Zhengzhou University, Zhengzhou, China
- Henan Province Research Center for Kidney Disease, Zhengzhou, China
- Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou, China
| | - Zhang-Suo Liu
- Traditional Chinese Medicine Integrated Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
- Institute of Nephrology, Zhengzhou University, Zhengzhou, China.
- Henan Province Research Center for Kidney Disease, Zhengzhou, China.
- Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou, China.
| | - Peng Wu
- Traditional Chinese Medicine Integrated Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
- Institute of Nephrology, Zhengzhou University, Zhengzhou, China.
- Henan Province Research Center for Kidney Disease, Zhengzhou, China.
- Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou, China.
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Filippou CD, Thomopoulos CG, Konstantinidis DG, Dimitriadis KS, Chrysochoou CA, Tatakis FA, Siafi EP, Tousoulis DM, Nihoyannopoulos PI, Panagiotakos DB, Tsioufis KP. Effect of DASH vs. mediterranean diet accompanied by a salt restriction on metabolic syndrome and cardiometabolic risk factors in adults with high normal blood pressure or grade 1 hypertension: secondary analyses of a randomized controlled trial. Hellenic J Cardiol 2024:S1109-9666(24)00110-6. [PMID: 38777087 DOI: 10.1016/j.hjc.2024.05.006] [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: 02/02/2024] [Revised: 03/29/2024] [Accepted: 05/03/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE Lifestyle interventions are recommended as the first-line treatment to control metabolic syndrome components and improve cardiometabolic risk factors. However, studies directly comparing the cardiometabolic effects of the Dietary Approaches to Stop Hypertension (DASH) vs. the Mediterranean diet (MedDiet) accompanied by salt restriction are currently lacking. Thus, with the present secondary analyses of a randomized trial, we aimed to assess the cardiometabolic effects of a 3-month intensive dietary intervention implementing salt restriction alone or on top of the DASH and MedDiet compared to no/minimal intervention in never drug-treated adults with high normal blood pressure (BP) or grade 1 hypertension. METHODS We randomly assigned individuals to the control group (CG, n = 60), salt restriction group (SRG, n = 60), DASH diet with salt restriction group (DDG, n = 60), or MedDiet with salt restriction group (MDG, n = 60). RESULTS According to the intention-to-treat analysis, the DDG and the MDG had lower odds ratio (OR) (95% CI) of metabolic syndrome [0.29 (0.12, 0.72), and 0.15 (0.06, 0.41), respectively] compared to the CG. Moreover, the MDG had lower odds of metabolic syndrome compared to the SRG and lower odds of elevated BP levels than the DDG and the SRG. Moreover, total and LDL-cholesterol, fasting glucose, HbA1c, and systolic/diastolic BP were reduced in all three intervention groups compared to the CG. CONCLUSION On a background of salt restriction, the MedDiet was superior in BP reduction, but the DASH and MedDiet reduced the prevalence of metabolic syndrome to the same extent.
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Affiliation(s)
- Christina D Filippou
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | | | - Dimitrios G Konstantinidis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Kyriakos S Dimitriadis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Christina A Chrysochoou
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Fotis A Tatakis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Eirini P Siafi
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Dimitrios M Tousoulis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Petros I Nihoyannopoulos
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Konstantinos P Tsioufis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
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Barcellos PAM, Dall'Agnol A, Sandi GM, Remonti LR, Silveiro SP. Dietary approach for the treatment of arterial hypertension in patients with diabetes mellitus. J Hypertens 2024; 42:583-593. [PMID: 38441180 DOI: 10.1097/hjh.0000000000003674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
The association of hypertension and diabetes mellitus is extremely common, increasing the mortality risk of patients, mainly by cardiovascular causes. Regarding the blood pressure (BP) targets to be achieved, most guidelines suggest levels of 130 mmHg for SBP and of 80 mmHg for DBP. Dietary modifications are quite effective, and many studies suggest that decreasing sodium intake and increasing potassium ingestion are both valuable practices for reducing BP. This can be achieved by stimulating the ingestion of lacteous products, vegetables, and nuts. As for the ideal pharmacologic treatment for hypertension, either calcium channel blockers, diuretics or angiotensin-system blockers can be the first class of drug to be used. In this review, we summarize the evaluation of patients with diabetes mellitus and hypertension, and discuss the available therapeutic approaches, with emphasis on evidence-based dietary recommendations.
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Affiliation(s)
| | - Angélica Dall'Agnol
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul
| | - Giovanna M Sandi
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul
| | | | - Sandra P Silveiro
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul
- Endocrine Unit, Hospital de Clínicas de Porto Alegre, RS, Brazil
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Sun C, Li J, Zhao Z, Ren S, Guan Y, Zhang M, Li T, Tan L, Yao Q, Chen L. The correlation between fruit intake and all-cause mortality in hypertensive patients: a 10-year follow-up study. Front Nutr 2024; 11:1363574. [PMID: 38585613 PMCID: PMC10995410 DOI: 10.3389/fnut.2024.1363574] [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: 12/31/2023] [Accepted: 03/06/2024] [Indexed: 04/09/2024] Open
Abstract
Objective Extensive research has consistently shown the beneficial impact of fruit consumption on overall health. While some studies have proposed a potential association between fruit consumption and hypertension management, the influence of fruit consumption on mortality rates among hypertensive individuals remains uncertain. Consequently, aim of this study is to evaluate whether fruit consumption is associated with all-cause mortality among hypertensive patients. Methods Data were obtained from the National Health and Nutrition Examination Survey (NHANES), conducted between 2003 and 2006. Ten-year follow-up data from the National Death Index (NDI) were used to assess all-cause mortality. Cox proportional hazard model was utilized to explore the impact of fruit intake on all-cause mortality among hypertensive individuals. Results The study included a cohort of 2,480 patients diagnosed with hypertension, and during the follow-up period, a total of 658 deaths from various causes were recorded. The COX regression analysis demonstrated that hypertensive patients who consumed apples three to six times per week exhibited a significantly reduced risk of all-cause mortality (HR = 0.60, 95%CI: 0.45-0.78, p < 0.001) in comparison to those who consumed apples less than once per month. Likewise, consuming bananas three to six times per week also led to a comparable outcome (HR = 0.76, 95%CI: 0.59-0.97, p = 0.027). Moreover, Combined consumption of bananas and apples three to six times per week exhibited a noteworthy decrease in all-cause mortality (HR = 0.57, 95%CI: 0.39-0.84, p = 0.005) when compared to individuals who consumed these fruits less frequently. Conversely, no significant association was found between the consumption of other fruits, including pears, pineapples, and grapes, and all-cause mortality. Conclusion The study discovered that moderate consumption of apples and bananas was associated with a reduced risk of all-cause mortality in patients with hypertension.
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Affiliation(s)
- Chuang Sun
- Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Jie Li
- General Practice Department, The First Affiliated Hospital of Yangtze University, Jingzhou, China
| | - Zeyuan Zhao
- Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Shupeng Ren
- Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yue Guan
- Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Miaoan Zhang
- Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Tianfeng Li
- Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Linglin Tan
- Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Qiying Yao
- Department of Physiology, Dalian Medical University, Dalian, China
| | - Liang Chen
- Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
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Galekop MMJ, Del Bas JM, Calder PC, Uyl-De Groot CA, Redekop WK. A health technology assessment of personalized nutrition interventions using the EUnetHTA HTA Core Model. Int J Technol Assess Health Care 2024; 40:e15. [PMID: 38444327 DOI: 10.1017/s0266462324000060] [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: 03/07/2024]
Abstract
OBJECTIVES Poor nutrition links to chronic diseases, emphasizing the need for optimized diets. The EU-funded project PREVENTOMICS, introduced personalized nutrition to address this. This study aims to perform a health technology assessment (HTA) comparing personalized nutrition interventions developed through this project, with non-personalized nutrition interventions (control) for people with normal weight, overweight, or obesity. The goal is to support decisions about further development and implementation of personalized nutrition. METHODS The PREVENTOMICS interventions were evaluated using the European Network for HTA Core Model, which includes a methodological framework that encompasses different domains for value assessment. Information was gathered via [1] different statistical analyses and modeling studies, [2] questions asked of project partners and, [3] other (un)published materials. RESULTS Clinical trials of PREVENTOMICS interventions demonstrated different body mass index changes compared to control; differences ranged from -0.80 to 0.20 kg/m2. Long-term outcome predictions showed generally improved health outcomes for the interventions; some appeared cost-effective (e.g., interventions in UK). Ethical concerns around health inequality and the lack of specific legal regulations for personalized nutrition interventions were identified. Choice modeling studies indicated openness to personalized nutrition interventions; decisions were primarily affected by intervention's price. CONCLUSIONS PREVENTOMICS clinical trials have shown promising effectiveness with no major safety concerns, although uncertainties about effectiveness exist due to small samples (n=60-264) and short follow-ups (10-16 weeks). Larger, longer trials are needed for robust evidence before implementation could be considered. Among other considerations, developers should explore financing options and collaborate with policymakers to prevent exclusion of specific groups due to information shortages.
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Affiliation(s)
| | | | - Philip C Calder
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK
| | - Carin A Uyl-De Groot
- Erasmus School of Health, Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - William Ken Redekop
- Erasmus School of Health, Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
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Charles JA, Habibullah NK, Bautista S, Davis B, Joshi S, Hull SC. Planting the Seed for Blood Pressure Control: The Role of Plant-Based Nutrition in the Management of Hypertension. Curr Cardiol Rep 2024; 26:121-134. [PMID: 38526748 PMCID: PMC10990999 DOI: 10.1007/s11886-023-02008-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/26/2023] [Indexed: 03/27/2024]
Abstract
PURPOSE OF REVIEW Hypertension results in significant morbidity, mortality, and healthcare expenditures. Fortunately, it is largely preventable and treatable by implementing dietary interventions, though these remain underutilized. Here, we aim to explore the role of healthy dietary patterns in hypertension management and describe approaches for busy clinicians to address nutrition effectively and efficiently with patients. RECENT FINDINGS DASH, Mediterranean, vegetarian, and vegan diets that include minimally processed, plant-based foods as core elements have consistently shown positive effects on hypertension. Recommendations that distill the most healthful components of these diets can significantly impact patient outcomes. Clinicians can harness evidence-based dietary assessment and counseling tools to implement and support behavioral changes, even during brief office visits. Healthful plant-based dietary patterns can often effectively prevent and treat hypertension. Clinicians may help improve patient outcomes by discussing evidence-based nutrition with their patients. Future work to promote infrastructural change that supports incorporating evidence-based nutrition into medical education, clinical care, and society at large can support these efforts.
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Affiliation(s)
- Justin A Charles
- Department of Family Medicine and Public Health, UC San Diego Health, San Diego, CA, USA.
| | | | - Saul Bautista
- Ethos Farm to Health/Ethos Primary Care, Long Valley, NJ, USA
| | - Brenda Davis
- Brenda Davis, Nutrition Consultations, Calgary, AB, Canada
| | - Shivam Joshi
- Department of Veterans Affairs, Orlando, FL, USA
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Sarah C Hull
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA
- Program for Biomedical Ethics, Yale School of Medicine, New Haven, CT, USA
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Greenwood H, Barnes K, Ball L, Glasziou P. Comparing dietary strategies to manage cardiovascular risk in primary care: a narrative review of systematic reviews. Br J Gen Pract 2024:BJGP.2022.0564. [PMID: 38373850 PMCID: PMC10904132 DOI: 10.3399/bjgp.2022.0564] [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: 11/16/2022] [Accepted: 09/19/2023] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Nutrition care in general practice is crucial for cardiovascular disease (CVD) prevention and management, although comparison between dietary strategies is lacking. AIM To compare the best available (most recent, relevant, and high-quality) evidence for six dietary strategies that are effective for primary prevention/absolute risk reduction of CVD. DESIGN AND SETTING A pragmatic narrative review of systematic reviews of randomised trials focused on primary prevention of cardiovascular events. METHOD Studies about: 1) adults without a history of cardiovascular events; 2) target dietary strategies postulated to reduce CVD risk; and 3) direct cardiovascular or all-cause mortality outcomes were included. Six dietary strategies were examined: energy deficit, Mediterranean-like diet, sodium reduction (salt reduction and substitution), the Dietary Approaches to Stop Hypertension (DASH) diet, alcohol reduction, and fish/fish oil consumption. Reviews were selected based on quality, recency, and relevance. Quality and certainty of evidence was assessed using GRADE. RESULTS Twenty-five reviews met inclusion criteria; eight were selected as the highest quality, recent, and relevant. Three dietary strategies showed modest, significant reductions in cardiovascular events: energy deficit (relative risk reduction [RRR] 30%, 95% confidence interval [CI] = 13 to 43), Mediterranean-like diet (RRR 40%, 95% CI = 20 to 55), and salt substitution (RRR 30%, 95% CI = 7 to 48). Still, some caveats remain on the effectiveness of these dietary strategies. Salt reduction, DASH diet, and alcohol reduction showed small, significant reductions in blood pressure, but no reduction in cardiovascular events. Fish/fish oil consumption showed little or no effect; supplementation of fish oil alone showed small reductions in CVD events. CONCLUSION For primary prevention, energy deficit, Mediterranean-like diets, and sodium substitution have modest evidence for risk reduction of CVD events. Strategies incorporated into clinical nutrition care should ensure guidance is person centred and tailored to clinical circumstances.
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Affiliation(s)
- Hannah Greenwood
- Institute for Evidence-Based Healthcare, Faculty of Health Science & Medicine, Bond University, Gold Coast
| | - Katelyn Barnes
- Centre for Community Health and Wellbeing, University of Queensland, Brisbane; senior research officer, Academic Unit of General Practice, ACT Health Directorate; School of Medicine and Psychology, The Australian National University, Canberra
| | - Lauren Ball
- Centre for Community Health and Wellbeing, University of Queensland, Brisbane
| | - Paul Glasziou
- Institute for Evidence-Based Healthcare, Faculty of Health Science & Medicine, Bond University, Gold Coast
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10
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Pant A, Chew DP, Mamas MA, Zaman S. Cardiovascular Disease and the Mediterranean Diet: Insights into Sex-Specific Responses. Nutrients 2024; 16:570. [PMID: 38398894 PMCID: PMC10893368 DOI: 10.3390/nu16040570] [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] [Received: 01/10/2024] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 02/25/2024] Open
Abstract
Cardiovascular disease (CVD) is a leading cause of mortality and disease burden in women globally. A healthy diet is important for the prevention of CVD. Research has consistently favoured the Mediterranean diet as a cardio-protective diet. Several studies have evaluated associations between the Mediterranean diet and cardiovascular outcomes, including traditional risk factors like hypertension, type 2 diabetes mellitus, and obesity. In addition, consistent evidence suggests that the components of the Mediterranean diet have a synergistic effect on cardiovascular risk due to its anti-inflammatory profile and microbiome effects. While the benefits of the Mediterranean diet are well-established, health advice and dietary guidelines have been built on largely male-dominant studies. Few studies have investigated the beneficial associations of the Mediterranean diet in sex-specific populations, including those with non-traditional risk factors that are specific to women, for instance polycystic ovarian syndrome and high-risk pregnancies, or more prevalent in women, such as chronic inflammatory diseases. Therefore, this review aims to provide a comprehensive overview of the current evidence regarding the Mediterranean diet in women in relation to cardiovascular health outcomes.
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Affiliation(s)
- Anushriya Pant
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2145, Australia;
| | - Derek P. Chew
- Victorian Heart Hospital, Victorian Heart Institute, Monash University, Melbourne, VIC 3800, Australia
| | - Mamas A. Mamas
- Keele Cardiovascular Research Group, Keele University, Newcastle ST5 5BG, UK
| | - Sarah Zaman
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2145, Australia;
- Department of Cardiology, Westmead Hospital, Sydney, NSW 2145, Australia
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11
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D’Elia L, Strazzullo P. Dietary Salt Restriction and Adherence to the Mediterranean Diet: A Single Way to Reduce Cardiovascular Risk? J Clin Med 2024; 13:486. [PMID: 38256620 PMCID: PMC10816989 DOI: 10.3390/jcm13020486] [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: 12/04/2023] [Revised: 01/08/2024] [Accepted: 01/13/2024] [Indexed: 01/24/2024] Open
Abstract
The dietary restriction of salt intake and the adhesion to Mediterranean dietary patterns are among the most recommended lifestyle modifications for the prevention of cardiovascular diseases. A large amount of evidence supports these recommendations; indeed, several studies show that a higher adherence to Mediterranean dietary patterns is associated with a reduced risk of cardiovascular disease. Likewise, findings from observational and clinical studies suggest a causal role of excess salt intake in blood pressure increase, cardiovascular organ damage, and the incidence of cardiovascular diseases. In this context, it is also conceivable that the beneficial effects of these two dietary patterns overlap because Mediterranean dietary patterns are typically characterized by a large consumption of plant-based foods with low sodium content. However, there is little data on this issue, and heterogeneous results are available on the relationship between adherence to salt restriction and to Mediterranean dietary patterns. Thus, this short review focuses on the epidemiological and clinical evidence of the relationship between the adherence to Mediterranean dietary patterns and dietary salt restriction in the context of cardiovascular risk.
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Affiliation(s)
| | - Pasquale Strazzullo
- Department of Clinical Medicine and Surgery, “Federico II” University of Naples Medical School, 80131 Naples, Italy;
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12
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Georgoulis M, Damigou E, Chrysohoou C, Barkas F, Anastasiou G, Kravvariti E, Tsioufis C, Liberopoulos E, Sfikakis PP, Pitsavos C, Panagiotakos DB. Mediterranean diet trajectories and 20-year incidence of cardiovascular disease: The ATTICA cohort study (2002-2022). Nutr Metab Cardiovasc Dis 2024; 34:153-166. [PMID: 38007352 DOI: 10.1016/j.numecd.2023.09.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 09/19/2023] [Accepted: 09/20/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND AND AIMS Only few studies have assessed longitudinal dietary trends in relation to cardiovascular disease (CVD) risk. We aimed to evaluate the association between adherence to the Mediterranean diet, both baseline and longitudinal, and 20-year CVD incidence. METHODS AND RESULTS This was a prospective study among 1988 Greek adults (50% men, age: 45 ± 14years). Adherence to the Mediterranean diet was evaluated at baseline and 10 years through the MedDietScore, based on which longitudinal Mediterranean diet trajectories were identified. CVD incidence was recorded at 20 years. Each one-unit increase in baseline MedDietScore was associated with an 8% reduction in 20-year CVD incidence. Compared to subjects in the lowest tertile of baseline MedDietScore, those in the highest exhibited a 44% lower 20-year CVD risk (relative risk: 0.56, 95% confidence interval: 0.32, 0.97) adjusted for age, sex, baseline body mass index, smoking, physical activity, presence of hypercholesterolemia, hypertension and diabetes mellitus, and family history of CVD; further adjustment for high-sensitivity C-reactive protein, uric acid and estimated glomerular filtration rate attenuated this association. Results were similar in models adjusted for longitudinal changes in body weight, physical activity and smoking, and 10-year medical status. Mediterranean diet trajectory analysis revealed that 24.7%, 8.6%, 45.8% and 20.9% of participants longitudinally sustained a low adherence, moved closer, moved away or sustained a high adherence, respectively; among those, the corresponding CVD incidence was 63.3%, 65.5%, 28.1% and 9.4% (p-value<0.001). CONCLUSION The Mediterranean diet offers long-term protection against CVD, part of which is mediated by inflammation, uricemia and renal function.
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Affiliation(s)
- Michael Georgoulis
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17676 Athens, Greece
| | - Evangelia Damigou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17676 Athens, Greece
| | - Christina Chrysohoou
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece
| | - Fotios Barkas
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772 Athens, Greece
| | - Georgia Anastasiou
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772 Athens, Greece
| | - Evridiki Kravvariti
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772 Athens, Greece
| | - Costas Tsioufis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece
| | - Evangelos Liberopoulos
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772 Athens, Greece
| | - Petros P Sfikakis
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772 Athens, Greece
| | - Christos Pitsavos
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527 Athens, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17676 Athens, Greece.
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13
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Aljuraiban GS, Gibson R, Chan DS, Van Horn L, Chan Q. The Role of Diet in the Prevention of Hypertension and Management of Blood Pressure: An Umbrella Review of Meta-Analyses of Interventional and Observational Studies. Adv Nutr 2024; 15:100123. [PMID: 37783307 PMCID: PMC10831905 DOI: 10.1016/j.advnut.2023.09.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 09/12/2023] [Accepted: 09/26/2023] [Indexed: 10/04/2023] Open
Abstract
High blood pressure (BP) is a major pathological risk factor for the development of several cardiovascular diseases. Diet is a key modifier of BP, but the underlying relationships are not clearly demonstrated. This is an umbrella review of published meta-analyses to critically evaluate the wide range of dietary evidence from bioactive compounds to dietary patterns on BP and risk of hypertension. PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials were searched from inception until October 31, 2021, for relevant meta-analyses of randomized controlled trials or meta-analyses of observational studies. A total of 175 publications reporting 341 meta-analyses of randomized controlled trials (145 publications) and 70 meta-analyses of observational studies (30 publications) were included in the review. The methodological quality of the included publications was assessed using Assessment of Multiple Systematic Reviews 2 and the evidence quality of each selected meta-analysis was assessed using NutriGrade. This umbrella review supports recommended public health guidelines for prevention and control of hypertension. Dietary patterns including the Dietary Approaches to Stop Hypertension and the Mediterranean-type diets that further restrict sodium, and moderate alcohol intake are advised. To produce high-quality evidence and substantiate strong recommendations, future research should address areas where the low quality of evidence was observed (for example, intake of dietary fiber, fish, egg, meat, dairy products, fruit juice, and nuts) and emphasize focus on dietary factors not yet conclusively investigated.
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Affiliation(s)
- Ghadeer S Aljuraiban
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia.
| | - Rachel Gibson
- Department of Nutritional Sciences, King's College London, London, United Kingdom; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
| | - Doris Sm Chan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
| | - Linda Van Horn
- Department of Preventive Medicine, Northwestern University, Chicago, IL, United States.
| | - Queenie Chan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.
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14
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Landolfo M, Spannella F, Poliseno C, Massacesi A, Giulietti F, Festa R, Cavazzin E, Sasso G, Mazza A, Sarzani R. The Effects of ESC/ESH-Based Written Generic Lifestyle Advice and a Nutraceutical on 24-Hour Blood Pressure in Patients with High-Normal Office Blood Pressure and Low-Moderate Cardiovascular Risk. Nutrients 2023; 15:5099. [PMID: 38140359 PMCID: PMC10745575 DOI: 10.3390/nu15245099] [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: 11/19/2023] [Revised: 12/09/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
(1) Background: Lifestyle changes, eventually coupled with a nutraceutical, are recommended strategies for managing high-normal blood pressure (BP) patients with low-moderate cardiovascular (CV) risk. In a real-life clinical setting, we evaluated the effects of generic written lifestyle advice, extrapolated from the 2018 ESC/ESH guidelines, and a beetroot-based nutraceutical on 24 h BP in a population with a high-normal office BP and low-moderate CV risk. (2) Methods: A longitudinal observational study was conducted in two ESH Hypertension Excellence Centres on 43 consecutive subjects with high-normal BP according to repeated office BP (OBP) measurements and a low-moderate CV risk based on SCORE2/SCORE2-OP. Additionally, 24 h ambulatory BP monitoring (ABPM) was carried out at baseline and three months after lifestyle changes, according to generic written advice from the 2018 ESC/ESH guidelines, coupled with a nutraceutical containing 500 mg of dry beetroot extract. (3) Results: The mean age was 50 ± 11 years, with male prevalence (54%). The prevalence of overweight/obesity was 58%. The mean OBP was 135 ± 3/85 ± 3 mmHg. At baseline, the mean 24 h BP, daytime BP, and night-time BP were 127 ± 7/80 ± 6 mmHg, 131 ± 8/83 ± 6 mmHg, and 118 ± 8/70 ± 5 mmHg, respectively, BP profiles compatible with hypertension status in some subjects. After a median follow-up of 98 (92-121) days, all BPs, except night-time diastolic BP, were significantly decreased: -3 ± 6/-2 ± 4 mmHg for 24 h BP, -3.9 ± 6.0/-3.0 ± 4.0 mmHg for daytime BP, and -3.3 ± 7.4/-1.3 ± 4.7 mmHg for night-time BP, respectively. No significant clinical changes in body weight were detected. BP decreased independently of baseline BP levels, sex, smoking status, and body mass index, while a more substantial BP decrease was observed in older patients. (4) Conclusions: Our exploratory study shows, for the first time, that written generic lifestyle advice taken from the ESC/ESH hypertension guidelines coupled with a beetroot-based nutraceutical may represent a valid initial non-pharmacological approach in subjects with a high-normal office BP and low-moderate CV risk, even without personalized diet interventions.
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Affiliation(s)
- Matteo Landolfo
- Internal Medicine and Geriatrics, ESH Excellence Hypertension Centre, IRCCS INRCA, 60127 Ancona, Italy; (M.L.); (R.S.)
- Department of Clinical and Molecular Sciences, Centre for Obesity, University “Politecnica delle Marche”, 60126 Ancona, Italy
| | - Francesco Spannella
- Internal Medicine and Geriatrics, ESH Excellence Hypertension Centre, IRCCS INRCA, 60127 Ancona, Italy; (M.L.); (R.S.)
- Department of Clinical and Molecular Sciences, Centre for Obesity, University “Politecnica delle Marche”, 60126 Ancona, Italy
| | - Chiara Poliseno
- Internal Medicine and Geriatrics, ESH Excellence Hypertension Centre, IRCCS INRCA, 60127 Ancona, Italy; (M.L.); (R.S.)
- Department of Clinical and Molecular Sciences, Centre for Obesity, University “Politecnica delle Marche”, 60126 Ancona, Italy
| | - Adriano Massacesi
- Internal Medicine and Geriatrics, ESH Excellence Hypertension Centre, IRCCS INRCA, 60127 Ancona, Italy; (M.L.); (R.S.)
- Department of Clinical and Molecular Sciences, Centre for Obesity, University “Politecnica delle Marche”, 60126 Ancona, Italy
| | - Federico Giulietti
- Internal Medicine and Geriatrics, ESH Excellence Hypertension Centre, IRCCS INRCA, 60127 Ancona, Italy; (M.L.); (R.S.)
| | | | - Enrico Cavazzin
- ESH Excellence Hypertension Unit, Department of Internal Medicine, Rovigo General Hospital, 45100 Rovigo, Italy (A.M.)
| | - Giulio Sasso
- ESH Excellence Hypertension Unit, Department of Internal Medicine, Rovigo General Hospital, 45100 Rovigo, Italy (A.M.)
| | - Alberto Mazza
- ESH Excellence Hypertension Unit, Department of Internal Medicine, Rovigo General Hospital, 45100 Rovigo, Italy (A.M.)
| | - Riccardo Sarzani
- Internal Medicine and Geriatrics, ESH Excellence Hypertension Centre, IRCCS INRCA, 60127 Ancona, Italy; (M.L.); (R.S.)
- Department of Clinical and Molecular Sciences, Centre for Obesity, University “Politecnica delle Marche”, 60126 Ancona, Italy
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15
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Young HA, Geurts L, Scarmeas N, Benton D, Brennan L, Farrimond J, Kiliaan AJ, Pooler A, Trovò L, Sijben J, Vauzour D. Multi-nutrient interventions and cognitive ageing: are we barking up the right tree? Nutr Res Rev 2023; 36:471-483. [PMID: 36156184 DOI: 10.1017/s095442242200018x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
As we continue to elucidate the mechanisms underlying age-related brain diseases, the reductionist strategy in nutrition–brain function research has focused on establishing the impact of individual foods. However, the biological processes connecting diet and cognition are complex. Therefore, consideration of a combination of nutritional compounds may be most efficacious. One barrier to establishing the efficacy of multi-nutrient interventions is that the area lacks an established set of evidence-based guidelines for studying their effect on brain health. This review is an output of the International Life Sciences Institute (ILSI) Europe. A multi-disciplinary expert group was assembled with the aim of developing a set of considerations to guide research into the effects of multi-nutrient combinations on brain functions. Consensus recommendations converged on six key issues that should be considered to advance research in this area: (1) establish working mechanisms of the combination and contributions of each individual compound; (2) validate the relevance of the mechanisms for the targeted human condition; (3) include current nutrient status, intake or dietary pattern as inclusion/exclusion criteria in the study design; (4) select a participant population that is clinically and biologically appropriate for all nutritional components of the combination; (5) consider a range of cognitive outcomes; (6) consider the limits of reductionism and the ‘gold standard’ randomised controlled trial. These guiding principles will enhance our understanding of the interactive/complementary activities of dietary components, thereby strengthening the evidence base for recommendations aimed at delaying cognitive decline.
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Affiliation(s)
| | - Lucie Geurts
- International Life Sciences Institute Europe, Brussels, Belgium
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
- Department of Neurology, Columbia University, New York, USA
| | - David Benton
- Department of Psychology, Swansea University, Wales, UK
| | - Lorraine Brennan
- UCD Conway Institute of Biomolecular and Biomedical Research, UCD Institute of Food and Health, UCD School of Agriculture and Food Science, Dublin, Republic of Ireland
| | | | - Amanda J Kiliaan
- Department of Medical Imaging, Anatomy, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Amy Pooler
- Formerly at Nestlé Institute of Health Sciences, Lausanne, Switzerland. Currently at Sangamo Therapeutics, Inc, San Francisco, USA
| | - Laura Trovò
- Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé S.A., Vers-chez-les-Blanc, 1000 Lausanne 26, Switzerland
| | - John Sijben
- Danone Nutricia Research, Utrecht, The Netherlands
| | - David Vauzour
- Norwich Medical School, University of East Anglia, Norwich, UK
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16
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Wang L, Liu T, Zhang Q, Wang L, Zhou Q, Wang J, Miao H, Hao J, Qi C. Correlation between dietary inflammation and mortality among hyperlipidemics. Lipids Health Dis 2023; 22:206. [PMID: 38017484 PMCID: PMC10683303 DOI: 10.1186/s12944-023-01975-0] [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] [Received: 10/10/2023] [Accepted: 11/19/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Although the the Dietary Inflammatory Index (DII) serves to be one of the reliable indicator for hyperlipidaemia, there is still uncertainty about its relationship to prognosis in the hyperlipidaemic population. In current study, the DII levels were analyzed in relation to the mortality risk among among the hyperlipidaemic individuals with the aim of determining any prospective correlation. METHODS 14,460 subjects with hyperlipidaemia from the 10-year (2001-2010) National Health and Nutrition Examination Survey (NHANES) were chosen for this study. The endpoint event for follow-up was all-cause mortality, and subjects were tracked for up to December 31, 2019, or death, whichever occurred first. The tertiles of the DII levels were utilized for categorizing the study population into three groups. Survival curves, Cox proportional hazards regression models, restricted cubic spline (RCS), subgroup and interaction analyses, and sensitivity analyses were employed sequentially for the purpose of evaluating the association of the DII with mortality. RESULTS 3170 (21.92%) all-cause deaths were recorded during an average 148-month follow-up period. Kaplan-Meier survival curves indicated that the survival rate of participants divided into the low DII group was substantially improved compared to that of those in the higher DII group (log-rank P < 0.001). After controlling for confounders, higher levels of DII were observed to be meaningfully linked to an elevated risk of death, no matter whether DII was specified for the continuous (hazard ratio (HR): 1.06; 95% confidence interval (CI): 1.04-1.08) or the categorical variable (HR: 1.22; 95% CI: 1.11-1.33). The DII and mortality displayed a linear association, according to the RCS. Stratified and sensitivity analyses reinforced the proof that these findings were reliable. CONCLUSION Among patients with hyperlipidaemia, the risk of death was positively and linearly linked with DII levels.
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Affiliation(s)
- Lili Wang
- Department of Cardiology, The Second Affiliated Hospital of Xuzhou Medical University, 221000, Xuzhou, China
| | - Tao Liu
- Department of Cardiology, Jinshan Branch of Shanghai Sixth People's Hospital, 201500, Shanghai, China
| | - Qingdui Zhang
- Department of Cardiology, The Second Affiliated Hospital of Xuzhou Medical University, 221000, Xuzhou, China
| | - Lele Wang
- Department of Cardiology, The Second Affiliated Hospital of Xuzhou Medical University, 221000, Xuzhou, China
| | - Qiang Zhou
- Department of Cardiology, The Second Affiliated Hospital of Xuzhou Medical University, 221000, Xuzhou, China
| | - Jing Wang
- Department of Cardiology, The Second Affiliated Hospital of Xuzhou Medical University, 221000, Xuzhou, China
| | - Hao Miao
- Department of Cardiology, The Second Affiliated Hospital of Xuzhou Medical University, 221000, Xuzhou, China
| | - Ji Hao
- Department of Cardiology, The Second Affiliated Hospital of Xuzhou Medical University, 221000, Xuzhou, China.
| | - Chunmei Qi
- Department of Cardiology, The Second Affiliated Hospital of Xuzhou Medical University, 221000, Xuzhou, China.
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17
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Moreira-Rosário A, Ismael S, Barreiros-Mota I, Morais J, Rodrigues C, Castela I, Mendes IC, Soares MI, da Costa LS, Oliveira CB, Henriques T, Pinto P, Pita D, de Oliveira CM, Maciel J, Serafim T, Araújo J, Rocha JC, Pestana D, Silvestre MP, Marques C, Faria A, Polonia J, Calhau C. Empowerment-based nutrition interventions on blood pressure: a randomized comparative effectiveness trial. Front Public Health 2023; 11:1277355. [PMID: 38026295 PMCID: PMC10679749 DOI: 10.3389/fpubh.2023.1277355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Empowerment lifestyle programs are needed to reduce the risk of hypertension. Our study compared the effectiveness of two empowerment-based approaches toward blood pressure (BP) reduction: salt reduction-specific program vs. healthy lifestyle general program. Methods Three hundred and eleven adults (median age of 44 years, IQR 34-54 years) were randomly assigned to a salt reduction (n = 147) or a healthy lifestyle program (n = 164). The outcome measures were urinary sodium (Na+) and potassium (K+) excretion, systolic (SBP) and diastolic (DBP) blood pressure, weight, and waist circumference. Results There were no significant differences in primary and secondary outcomes between the two program groups. When comparing each program to baseline, the program focused on salt reduction was effective in lowering BP following a 12-week intervention with a mean change of -2.5 mm Hg in SBP (95% CI, -4.1 to -0.8) and - 2.7 mm Hg in DBP (95% CI, -3.8 to -1.5) in the intention-to-treat (ITT) analysis. In the complete-case (CC) analysis, the mean change was -2.1 mm Hg in SBP (95% CI, -3.7 to -0.5) and - 2.3 mm Hg in DBP (95% CI, -3.4 to -1.1). This effect increases in subjects with high-normal BP or hypertension [SBP - 7.9 mm Hg (95% CI, -12.5 to -3.3); DBP - 7.3 mm Hg (95% CI, -10.2 to -4.4)]. The healthy lifestyle group also exhibited BP improvements after 12 weeks; however, the changes were less pronounced compared to the salt reduction group and were observed only for DBP [mean change of -1.5 mm Hg (95% CI, -2.6 to -0.4) in ITT analysis and - 1.4 mm Hg (95% CI, -2.4 to -0.3) in CC analysis, relative to baseline]. Overall, improvements in Na+/K+ ratio, weight, and Mediterranean diet adherence resulted in clinically significant SBP decreases. Importantly, BP reduction is attributed to improved dietary quality, rather than being solely linked to changes in the Na+/K+ ratio. Conclusion Salt-focused programs are effective public health tools mainly in managing individuals at high risk of hypertension. Nevertheless, in general, empowerment-based approaches are important strategies for lowering BP, by promoting health literacy that culminates in adherence to the Mediterranean diet and weight reduction.
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Affiliation(s)
- André Moreira-Rosário
- NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
- CINTESIS@RISE, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Shámila Ismael
- NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
- CINTESIS@RISE, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
- CHRC, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Inês Barreiros-Mota
- NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
- CHRC, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Juliana Morais
- NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
- CINTESIS@RISE, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Catarina Rodrigues
- NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
- CHRC, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Inês Castela
- NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
- CINTESIS@RISE, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
- CHRC, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
| | | | | | | | | | | | - Patrícia Pinto
- CUF Academic and Research Medical Center, Lisbon, Portugal
| | - Débora Pita
- CUF Academic and Research Medical Center, Lisbon, Portugal
| | | | - Janaína Maciel
- CUF Academic and Research Medical Center, Lisbon, Portugal
| | - Thaina Serafim
- CUF Academic and Research Medical Center, Lisbon, Portugal
| | - João Araújo
- NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
- CINTESIS@RISE, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Júlio César Rocha
- NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
- CINTESIS@RISE, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Diogo Pestana
- NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
- CINTESIS@RISE, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Marta P. Silvestre
- NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
- CINTESIS@RISE, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Cláudia Marques
- NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
- CINTESIS@RISE, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Ana Faria
- NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
- CINTESIS@RISE, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
- CHRC, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Jorge Polonia
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS@RISE, Faculty of Medicine, University of Porto, Porto, Portugal
- Hypertension and Cardiovascular Risk Unit, Unidade Local de Saúde Matosinhos, Matosinhos, Portugal
| | - Conceição Calhau
- NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
- CINTESIS@RISE, NOVA Medical School, Faculdade de Ciências Médicas, NMS, FCM, Universidade Nova de Lisboa, Lisbon, Portugal
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18
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Zhang S, Chen S, He K, Liu J, Su X, Li W, Ma J, Cheng C, Ouyang R, Mu Y, Zheng L, Cai J, Feng Y, Zeng F, Peng L, Ye Y. The Interaction of Dietary Patterns and Genetic Variants on the Risk of Cardiovascular Diseases in Chinese Patients with Type 2 Diabetes. Mol Nutr Food Res 2023; 67:e2300332. [PMID: 37712112 DOI: 10.1002/mnfr.202300332] [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] [Received: 05/23/2023] [Revised: 08/09/2023] [Indexed: 09/16/2023]
Abstract
SCOPE Diabetes is an important risk factor for cardiovascular disease (CVD), which in turn is the most common and serious complication of diabetes. This study analyzes dietary patterns and single nucleotide polymorphisms (SNPs) in 543 diabetes patients with new-onset cardiovascular events and 461 diabetic patients without. METHODS AND RESULTS SNPs are determined and analyzed using real time PCR and gene chip method. Factor analysis and logistic regression are used to determine dietary patterns and evaluate the level of associations and interaction effects, respectively. The legumes and edible fungi pattern and vegetable pattern show a significant negative correlation with complication risk. ADIPOQ rs37563 and legumes and edible fungi pattern have a significant interactive effect on disease, and patients with a high score of C polymorphism genotype (GC + CC) have a lower risk of disease. 5-10-Methylenetetrahydrofolate reductase (MTHFR) rs1801131 and vegetable pattern have a borderline interaction effect on disease, and those patients with TT genotype have a lower risk of disease. CONCLUSION These findings provide new insights into the role of the interactive protection of dietary patterns and SNPs. And participants with specific alleles show a lower risk of cardiovascular complications.
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Affiliation(s)
- Shiwen Zhang
- Department of Clinical Nutrition, The First Affiliated Hospital of Jinan University, No. 613 Huangpu Road West, Guangzhou, 510630, China
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou, 510632, China
| | - Shiyun Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou, 510632, China
| | - Kaiyin He
- Department of Clinical Nutrition, The First Affiliated Hospital of Jinan University, No. 613 Huangpu Road West, Guangzhou, 510630, China
| | - Jiazi Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou, 510632, China
| | - Xin Su
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou, 510632, China
| | - Wanlin Li
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou, 510632, China
| | - Junrong Ma
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou, 510632, China
| | - Chen Cheng
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou, 510632, China
| | - RuiQing Ouyang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou, 510632, China
| | - Yingjun Mu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou, 510632, China
| | - Lu Zheng
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou, 510632, China
| | - Jun Cai
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou, 510632, China
| | - Yonghui Feng
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou, 510632, China
| | - Fangfang Zeng
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, No.601 Huangpu Road West, Guangzhou, 510632, China
| | - Longyun Peng
- Department of Cardiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China
| | - Yanbin Ye
- Department of Clinical Nutrition, The First Affiliated Hospital of Jinan University, No. 613 Huangpu Road West, Guangzhou, 510630, China
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19
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Li F, Zhang Y, Pan L, Chen H. Effects of dietary patterns on the all-cause mortality and cardiovascular disease mortality in patients with hypertension: A cohort study based on the NHANES database. Clin Cardiol 2023; 46:1353-1370. [PMID: 37587785 PMCID: PMC10642326 DOI: 10.1002/clc.24118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/27/2023] [Accepted: 08/01/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Hypertension (HTN) patients have higher risk of all-cause and cardiovascular disease (CVD)-specific mortality. Dietary patterns have been reported related to the risk of mortality, but their roles in HTN patients is unclear. HYPOTHESIS To explore the relationships between different dietary patterns and all-cause/CVD-specific mortality and provide dietary guidance for HTN patients' prognosis improvement. METHODS Data of 27 618 HTN patients were extracted from the National Health and Nutrition Examination Survey (NHANES) database in this retrospective cohort study. The associations between Healthy Eating Index (HEI)-2015, Alternate Healthy Eating Index (AHEI)-2010, Dietary Approaches to Stop Hypertension (DASH), and Mediterranean (MED) diet and all-cause and CVD-specific mortality were explored using univariate and multivariate Cox regression analyses with hazard ratios (HRs) and 95% confidence intervals (CIs). Subgroup analyses of age, gender, body mass index, and comorbidity were also performed. RESULTS The median follow-up time was 83 months. A total of 3462 patients died for all-cause and 1064 died due to CVD. After adjusting for covariates, we found that high adherence to AHEI-2010 (HR = 0.84 for all-cause; HR = 0.72 for CVD), and MED (HR = 0.84 for all-cause; HR = 0.77 for CVD) diet were associated with decreased risks of both all-cause and CVD-specific mortality. In patients who aged ≥65 years old, were normal/overweight, without complications, the relationships between different dietary patterns and risk of mortality were different. CONCLUSION High scores of AHEI-2010 and MED may be associated with decreased risks of all-cause and CVD-specific mortality in patients with HTN.
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Affiliation(s)
- Fang Li
- Department of CardiologyThe Second Hospital of Hebei Medical UniversityShijiazhuangHebeiPeople's Republic of China
| | - Yanping Zhang
- Department of Urological SurgeryThe Second Hospital of Hebei Medical UniversityShijiazhuangHebeiPeople's Republic of China
| | - Lina Pan
- Department of Internal MedicineWuji County People's HospitalShijiazhuangHebeiPeople's Republic of China
| | - Hui Chen
- Department of CardiologyThe Second Hospital of Hebei Medical UniversityShijiazhuangHebeiPeople's Republic of China
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20
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Ribeiro F, Teixeira M, Alves AJ, Sherwood A, Blumenthal JA. Lifestyle Medicine as a Treatment for Resistant Hypertension. Curr Hypertens Rep 2023; 25:313-328. [PMID: 37470944 DOI: 10.1007/s11906-023-01253-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 07/21/2023]
Abstract
PURPOSE OF REVIEW Approximately 10% of the adults with hypertension fail to achieve the recommended blood pressure treatment targets on 3 antihypertensive medications or require ≥ 4 medications to achieve goal. These patients with 'resistant hypertension' have an increased risk of target organ damage, adverse clinical events, and all-cause mortality. Although lifestyle modification is widely recommended as a first-line approach for the management of high blood pressure, the effects of lifestyle modifications in patients with resistant hypertension has not been widely studied. This review aims to provide an overview of the emerging evidence on the benefits of lifestyle modifications in patients with resistant hypertension, reviews potential mechanisms by which lifestyles may reduce blood pressure, and discusses the clinical implications of the recent findings in this field. RECENT FINDINGS Evidence from single-component randomized clinical trials demonstrated that aerobic exercise, weight loss and dietary modification can reduce clinic and ambulatory blood pressure in patients with resistant hypertension. Moreover, evidence from multi-component trials involving exercise and dietary modification and weight management can facilitate lifestyle change, reduce clinic and ambulatory blood pressure, and improve biomarkers of cardiovascular risk. This new evidence supports the efficacy of lifestyle modifications added to optimized medical therapy in reducing blood pressure and improving cardiovascular risk biomarkers in patients with resistant hypertension. These findings need to be confirmed in larger studies, and the persistence of benefit over extended follow-up needs further study.
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Affiliation(s)
- Fernando Ribeiro
- Institute of Biomedicine (iBiMED), School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Manuel Teixeira
- Institute of Biomedicine (iBiMED), School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Alberto J Alves
- University of Maia, Research Center in Sports Sciences, Health Sciences and Human Development, Castêlo da Maia, Portugal
| | - Andrew Sherwood
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, 27710, USA
| | - James A Blumenthal
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, 27710, USA.
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21
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Zhang J, Du W, Huang F, Li L, Bai J, Wei Y, Wang Z, Zhang B, Wang H. Longitudinal study of dietary patterns and hypertension in adults: China Health and Nutrition Survey 1991-2018. Hypertens Res 2023; 46:2264-2271. [PMID: 37337099 PMCID: PMC10550817 DOI: 10.1038/s41440-023-01322-x] [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: 11/04/2022] [Revised: 05/08/2023] [Accepted: 05/10/2023] [Indexed: 06/21/2023]
Abstract
China is undergoing the nutrition transition that may explain partly the high prevalence of hypertension. We aimed to investigate the longitudinal association between dietary patterns and hypertension in Chinese adults over 28 years of follow-up. We used data collected in the China Health and Nutrition Survey from 1991 to 2018. Adults aged 18 years and above (n = 15,929) were included in the analysis, for whom questionnaires and anthropometric data were collected during at least two waves. Factor analysis was conducted to derive food patterns based on 18 foods or food groups. We constructed three-level mixed-effect linear regression models to estimate systolic blood pressure (SBP) and diastolic blood pressure (DBP) in relation to quartiles of dietary pattern score and performed three-level mixed-effect logistic regression models to assess the risk of hypertension. Participants in the top quartile of the modern pattern had a decrease in SBP (β = - 0.51; 95% CI -0.86, -0.16; P < 0.01) when adjusted for all potential confounders, whereas participants in the top quartile of the meat pattern had an increase in DBP (β = 0.31; 95% CI 0.08, 0.53; P < 0.01). Participants in the highest quartile of the meat pattern were more likely to have hypertension (OR = 1.14; 95% CI 1.03, 1.24; P < 0.01). Adherence to the modern pattern characterized by high intake of fruits and dairy products was inversely associated with SBP, whereas the meat pattern was positively associated with DBP and the risk of hypertension. These findings may well have important public health implications.
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Affiliation(s)
- Jiguo Zhang
- Key Laboratory of Trace Element Nutrition of National Health Commission, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29, Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Wenwen Du
- Key Laboratory of Trace Element Nutrition of National Health Commission, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29, Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Feifei Huang
- Key Laboratory of Trace Element Nutrition of National Health Commission, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29, Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Li Li
- Key Laboratory of Trace Element Nutrition of National Health Commission, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29, Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Jing Bai
- Key Laboratory of Trace Element Nutrition of National Health Commission, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29, Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Yanli Wei
- Key Laboratory of Trace Element Nutrition of National Health Commission, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29, Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Zhihong Wang
- Key Laboratory of Trace Element Nutrition of National Health Commission, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29, Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Bing Zhang
- Key Laboratory of Trace Element Nutrition of National Health Commission, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29, Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Huijun Wang
- Key Laboratory of Trace Element Nutrition of National Health Commission, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 29, Nanwei Road, Xicheng District, Beijing, 100050, China.
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22
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Filippou C, Thomopoulos C, Konstantinidis D, Siafi E, Tatakis F, Manta E, Drogkaris S, Polyzos D, Kyriazopoulos K, Grigoriou K, Tousoulis D, Tsioufis K. DASH vs. Mediterranean diet on a salt restriction background in adults with high normal blood pressure or grade 1 hypertension: A randomized controlled trial. Clin Nutr 2023; 42:1807-1816. [PMID: 37625311 DOI: 10.1016/j.clnu.2023.08.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 08/11/2023] [Accepted: 08/13/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND & AIMS Non-pharmacological measures are recommended as the first-line treatment for individuals with high-normal blood pressure (BP) or mild hypertension. Studies directly comparing the BP effects of the Dietary Approaches to Stop Hypertension (DASH) vs. the Mediterranean diet (MedDiet) on a salt restriction background are currently lacking. Thus, our purpose was to assess the BP effects of a 3-month intensive dietary intervention implementing salt restriction either alone or in the context of the DASH, and the MedDiet compared to no/minimal intervention in adults with high normal BP or grade 1 hypertension. METHODS We randomly assigned never drug-treated individuals to a control group (CG, n = 60), a salt restriction group (SRG, n = 60), a DASH diet with salt restriction group (DDG, n = 60), or a MedDiet with salt restriction group (MDG, n = 60). The primary outcome was the attained office systolic BP difference among the randomized arms during follow-up. RESULTS A total of 240 patients were enrolled, while 204 (85%) completed the study. According to the intention-to-treat analysis, compared to the CG, office and 24 h ambulatory systolic and diastolic BP were reduced in all intervention groups. A greater reduction in the mean office systolic BP was observed in the MDG compared to all other study groups (MDG vs. CG: mean difference = -15.1 mmHg; MDG vs. SRG: mean difference = -7.5 mmHg, and MDG vs. DDG: mean difference = -3.2 mmHg, all P-values <0.001). The DDG and the MDG did not differ concerning the office diastolic BP and the 24 h ambulatory systolic and diastolic BP; however, both diets were more efficient in BP-lowering compared to the SRG. CONCLUSIONS On a background of salt restriction, the MedDiet was superior in office systolic BP-lowering, but the DASH and MedDiet reduced BP to an extent higher than salt restriction alone.
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Affiliation(s)
- Christina Filippou
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece.
| | | | - Dimitrios Konstantinidis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Eirini Siafi
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Fotis Tatakis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Eleni Manta
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Sotiris Drogkaris
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Dimitrios Polyzos
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Konstantinos Kyriazopoulos
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Kalliopi Grigoriou
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Dimitrios Tousoulis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Konstantinos Tsioufis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
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23
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Różańska D, Kujawa K, Szuba A, Zatońska K, Regulska-Ilow B. Dietary Patterns and the Prevalence of Noncommunicable Diseases in the PURE Poland Study Participants. Nutrients 2023; 15:3524. [PMID: 37630715 PMCID: PMC10459498 DOI: 10.3390/nu15163524] [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] [Received: 06/23/2023] [Revised: 07/19/2023] [Accepted: 08/01/2023] [Indexed: 08/27/2023] Open
Abstract
The aim of the study was to analyze the association between dietary patterns (DP) identified in the group of Lower Silesia (Poland) inhabitants and the prevalence of selected noncommunicable diseases, such as total cardiovascular diseases (CVD), hypertension, diabetes, impaired fasting glucose (IFG), visceral obesity, and excessive body weight. This study involved 2023 subjects aged 35-70 years, from Wroclaw and surrounding villages. The assessment of food intake in the study group was assessed using the standardized Food Frequency Questionnaire. Dietary patterns were identified using the principal components analysis (PCA) with varimax rotation. Three dietary patterns were identified in the study group: unhealthy, healthy, and traditional. The prevalence of hypertension, diabetes, IFG, and visceral obesity decreased across the quartiles of healthy DP. Prevalence of IFG increased across the quartiles of unhealthy DP, but the prevalence of hypertension decreased. When the diet was more adherent to the traditional DP the prevalence of CVD, diabetes, IFG, visceral obesity, obesity, and being overweight was higher. DP abundant in fruits, vegetables, seeds, nuts, raisins, and unrefined grains, named "healthy dietary pattern", had a beneficial association with lower prevalence of selected noncommunicable diseases. DP abundant in meat products, but poor in fruits and vegetables were positively associated with higher prevalence of total CVD, diabetes, IFG, excessive body weight, and visceral obesity.
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Affiliation(s)
- Dorota Różańska
- Department of Dietetics and Bromatology, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Krzysztof Kujawa
- Statistical Analysis Center, Wroclaw Medical University, 50-368 Wroclaw, Poland
| | - Andrzej Szuba
- Department of Angiology, Hypertension and Diabetology, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Katarzyna Zatońska
- Division of Population Studies and Prevention of Non-Communicable Diseases, Department of Population Health, Wroclaw Medical University, 50-372 Wroclaw, Poland
| | - Bożena Regulska-Ilow
- Department of Dietetics and Bromatology, Wroclaw Medical University, 50-556 Wroclaw, Poland
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24
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Vitale M, Giosuè A, Sieri S, Krogh V, Massimino E, Rivellese AA, Riccardi G, Vaccaro O, Masulli M. Legume Consumption and Blood Pressure Control in Individuals with Type 2 Diabetes and Hypertension: Cross-Sectional Findings from the TOSCA.IT Study. Nutrients 2023; 15:2895. [PMID: 37447221 DOI: 10.3390/nu15132895] [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: 06/01/2023] [Revised: 06/19/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Our aims were to evaluate the relationship of habitual legume consumption with blood pressure (BP) control in a large cohort of people with T2D and hypertension, and to investigate whether specific nutritional components of legumes or other foods may contribute to regulate BP levels. METHODS We studied 1897 participants with T2D and hypertension. Dietary habits were assessed through a validated food frequency questionnaire. Sex-specific quartiles of legume consumption were created. RESULTS Higher legume consumption was associated with a lower intake of energy, carbohydrates, glycaemic load, alcohol, and sodium, and a significantly greater intake of proteins, fat, monounsaturated, polyunsaturated, fibre, potassium, and polyphenols. Significantly lower systolic and diastolic BP values were observed in the highest vs. lowest quartile of legume consumption (132.9 ± 6.7 vs. 137.3 ± 7.0 mmHg, p < 0.001; 78.9 ± 4.1 vs. 81.0 ± 4.2 mmHg, p = 0.002; respectively), as well as the proportion of people meeting the treatment targets (61.3% vs. 37.4% and 71.3% vs. 52.4%, respectively, p < 0.01). This association was independent from other foods whose consumption is associated with the high legume intake. CONCLUSIONS In people with T2D and hypertension, three servings of legumes per week are associated with significantly better BP control. This gives further support to current dietary guidelines in recommending the frequent consumption of legumes, as a "ready-to-use" dietary strategy to achieve optimal BP control.
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Affiliation(s)
- Marilena Vitale
- Department of Clinical Medicine and Surgery, Federico II University of Naples, 80131 Naples, Italy
| | - Annalisa Giosuè
- Department of Clinical Medicine and Surgery, Federico II University of Naples, 80131 Naples, Italy
| | - Sabina Sieri
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20121 Milan, Italy
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, 20121 Milan, Italy
| | - Elena Massimino
- Department of Clinical Medicine and Surgery, Federico II University of Naples, 80131 Naples, Italy
| | | | - Gabriele Riccardi
- Department of Clinical Medicine and Surgery, Federico II University of Naples, 80131 Naples, Italy
| | - Olga Vaccaro
- Department of Clinical Medicine and Surgery, Federico II University of Naples, 80131 Naples, Italy
| | - Maria Masulli
- Department of Clinical Medicine and Surgery, Federico II University of Naples, 80131 Naples, Italy
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25
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Ismail A, Ravipati S, Gonzalez-Hernandez D, Mahmood H, Imran A, Munoz EJ, Naeem S, Abdin ZU, Siddiqui HF. Carotid Artery Stenosis: A Look Into the Diagnostic and Management Strategies, and Related Complications. Cureus 2023; 15:e38794. [PMID: 37303351 PMCID: PMC10250083 DOI: 10.7759/cureus.38794] [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] [Accepted: 05/09/2023] [Indexed: 06/13/2023] Open
Abstract
Carotid stenosis (CS) is a buildup of atherosclerotic plaque within the artery leading to a wide range of symptoms, from mild symptoms, including blurred vision and confusion, to much more life-threatening presentations, including paralysis due to stroke. The presentation is insidious, with symptoms exhibiting predominantly at severe stenosis; hence the emphasis is placed on the importance of early diagnosis, treatment, and lifestyle modifications. CS is seen undergoing almost the same pathogenesis of any atherosclerotic plaque formation, from endothelial damage of the artery lumen to the formation of a fibrous cap with a foam cell, lipid-filled core. The findings of our review article were consistent with the recent literature, depicting that comorbid hypertension, diabetes, and chronic kidney disease (CKD), and lifestyle aspects, including smoking and diet, played the most salient role in plaque development. Among several imaging modalities, duplex ultrasound (DUS) imaging is the widely preferred method in clinical practice. Carotid endarterectomy (CEA) and carotid stenting are the primarily advocated procedures for symptomatic severe stenosis, with similar long-term outcomes. Although, earlier clinical trials showed promising results in mitigating the risk of stroke among asymptomatic severe CS with surgical intervention. However, recent advancements have shifted the focus to medical management alone due to comparable results among the asymptomatic population. Both surgical and medical regimens are beneficial in treating patients, but it is still an ongoing debate as to which is predominantly superior. The currently advancing trials and research will help elucidate definitive guidelines. However, the massive impact of lifestyle modifications advocates some degree of individualized multidisciplinary management strategies.
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Affiliation(s)
- Aqsa Ismail
- Department of Medicine, United Medical and Dental College, Karachi, PAK
| | - Shivani Ravipati
- Department of Medicine, Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Vijayawada, IND
| | | | - Hashim Mahmood
- Department of Medicine, University College of Medicine and Dentistry, University of Lahore, Lahore, PAK
| | - Alizay Imran
- Department of Surgery, Windsor University School of Medicine, Chicago, USA
| | - Eduardo J Munoz
- Department of General Medicine, Montemorelos University, Montemorelos, MEX
| | - Saad Naeem
- Department of Internal Medicine, Faisalabad Medical University, Faisalabad, PAK
- Department of Internal Medicine, Punjab Social Security Hospital, Faisalabad, PAK
| | - Zain U Abdin
- Department of Medicine, District Head Quarters Hospital, Faisalabad, PAK
| | - Humza F Siddiqui
- Department of Medicine, Jinnah Sindh Medical University, Karachi, PAK
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26
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Chiriacò M, Tubili C, Bo S, Parillo M, Vetrani C, Mazzotti A, Pistis D, Marelli G, Grandone I, Natali A. Critical evaluation of the questionnaires assessing adherence to the Mediterranean diet that are based on servings. Nutr Metab Cardiovasc Dis 2023; 33:724-736. [PMID: 36842958 DOI: 10.1016/j.numecd.2023.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 01/25/2023] [Accepted: 01/30/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND AND AIMS The Mediterranean Diet (MD) is characterized by a high intake of vegetables, fruit, legumes, nuts, and olive oil, and moderate fish, dairy, and wine intake. A high adherence to MD has been associated with numerous health benefits, including reduced risk of chronic diseases such as cardiovascular disease, cancer, and type 2 diabetes. The clinical assessment of MD adherence is complicated by the absence of a univocally accepted tool and by the abundance of questionnaires developed to determine adherence, whose reliability and validity is uncertain. In this inter-associative document, we critically evaluated servings-based questionnaires for the assessment of MD adherence, aiming to identify the most valuable tool for the use in clinical practice. METHODS AND RESULTS For each questionnaire, we analyzed the structure, evidence on health-related outcomes and agreement with the recommendations of MD. We found that most questionnaires do not accurately reflect the principles of MD in terms of the food groups and their optimal consumption frequency. Additionally, the comparison of questionnaires revealed low agreement and some concerns with regard to the scoring assumptions. CONCLUSIONS Among the available questionnaires, we suggest the use of the 15-Items Pyramid based Mediterranean Diet Score (PyrMDS), which is the one with fewer flaws and a strong supporting body of theoretical and scientific evidence. The use of the PyrMDS may facilitate the assessment of MD adherence in clinical practice, which is instrumental in reducing the risk of non-communicable chronic diseases.
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Affiliation(s)
- Martina Chiriacò
- Dipartimento di Medicina Clinica e Sperimentale - Università di Pisa, Italy.
| | - Claudio Tubili
- UOSD Diabetologia, Azienda Ospedaliera "S. Camillo - Forlanini", Roma, Italy
| | - Simona Bo
- Dipartimento di Scienze Mediche, Università di Torino, Italy
| | - Mario Parillo
- UOSD Endocrinologia e Malattie dismetaboliche, Azienda Ospedaliera di Caserta, Italy
| | - Claudia Vetrani
- UO Endocrinologia, Dipartimento di Medicina Clinica, Università di Napoli "Federico II", Italy
| | - Arianna Mazzotti
- UO Diabetologia, Ospedale Santa Maria delle Croci, Ravenna, Italy
| | - Danila Pistis
- UO Diabetologia- Poliambulatorio Quartu S.Elena Asl Cagliari, Italy
| | - Giuseppe Marelli
- Servizio di Diabetologia/Endocrinologia, Ospedale Sacra Famiglia Fatebenefratelli - Erba (CO), Italy
| | - Ilenia Grandone
- Sc Diabetologia, Dietologia e Nutrizione Clinica - AOSP Terni, Italy
| | - Andrea Natali
- Dipartimento di Medicina Clinica e Sperimentale - Università di Pisa, Italy; Centro di Ricerca Nutraceutica e Alimentazione per la Salute NUTRAFOOD
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Song Y, Chang Z, Cui K, Song C, Cai Z, Shi B, Dong Q, Dou K. The value of the MIND diet in the primary and secondary prevention of hypertension: A cross-sectional and longitudinal cohort study from NHANES analysis. Front Nutr 2023; 10:1129667. [PMID: 36998902 PMCID: PMC10043250 DOI: 10.3389/fnut.2023.1129667] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 02/24/2023] [Indexed: 03/17/2023] Open
Abstract
BackgroundThe Mediterranean-Dietary Approaches to Stop Hypertension for neurodegenerative delay (MIND) has been regarded as a novel healthy dietary pattern with huge benefits. However, its value in preventing and treating hypertension has not been investigated. The objective of this study is to investigate the impact of adhering to the MIND diet on the prevalence of hypertension in the entire population and long-term mortality in hypertensive patients.MethodsIn this cross-sectional and longitudinal study, 6,887 participants consisting of 2,984 hypertensive patients in the National Health and Nutritional Examination Surveys were analyzed and divided into 3 groups according to the MIND diet scores (MDS; groups of MDS-low [<7.5], MDS-medium [7.5–8.0] and MDS-high [≥8.5]). In the longitudinal analysis, the primary outcome was all-cause death and the secondary outcome was cardiovascular (CV) death. Hypertensive patients received a follow-up with a mean time of 9.25 years (median time: 111.1 months, range 2 to 120 months). Multivariate logistics regression models and Cox proportional hazards models were applicated to estimate the association between MDS and outcomes. Restricted cubic spline (RCS) was used to estimate the dose–response relationship.ResultsCompared with the MDS-low group, participants in the MDS-high group presented a significantly lower prevalence of hypertension (odds ratio [OR] 0.76, 95% confidence interval [CI] 0.58, 0.97, p = 0.040) and decreased levels of systolic blood pressure (β = −0.41, p = 0.033). Among hypertensive patients, 787 (26.4%) all-cause death consisting of 293 (9.8%) CV deaths were recorded during a 10-year follow-up. Hypertensive patients in the MDS-high group presented a significantly lower prevalence of ASCVD (OR = 0.71, 95% CI, 0.51, 0.97, p = 0.043), and lower risk of all-cause death (hazard ratio [HR] = 0.69, 95% CI, 0.58, 0.81, p < 0.001) and CV death (HR = 0.62, 95% CI, 0.46, 0.85, p for trend = 0.001) when compared with those in the MDS-low group.ConclusionFor the first time, this study revealed the values of the MIND diet in the primary and secondary prevention of hypertension, suggesting the MIND diet as a novel anti-hypertensive dietary pattern.
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Affiliation(s)
- Yanjun Song
- Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Cardiometabolic Medicine Center, State Key Laboratory of Cardiovascular Disease, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases, Beijing, China
| | - Zhen'ge Chang
- Department of Respiratory Medicine, Civil Aviation General Hospital, Beijing, China
| | - Kongyong Cui
- Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Cardiometabolic Medicine Center, State Key Laboratory of Cardiovascular Disease, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases, Beijing, China
| | - Chenxi Song
- Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Cardiometabolic Medicine Center, State Key Laboratory of Cardiovascular Disease, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases, Beijing, China
| | - Zhongxing Cai
- Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Cardiometabolic Medicine Center, State Key Laboratory of Cardiovascular Disease, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases, Beijing, China
| | - Boqun Shi
- Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Cardiometabolic Medicine Center, State Key Laboratory of Cardiovascular Disease, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases, Beijing, China
| | - Qiuting Dong
- Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Cardiometabolic Medicine Center, State Key Laboratory of Cardiovascular Disease, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases, Beijing, China
- Qiuting Dong,
| | - Kefei Dou
- Cardiometabolic Medicine Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Cardiometabolic Medicine Center, State Key Laboratory of Cardiovascular Disease, Beijing, China
- National Clinical Research Center for Cardiovascular Diseases, Beijing, China
- *Correspondence: Kefei Dou,
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Mattas K, Raptou E, Alayidi A, Yener G, Baourakis G. Assessing the interlinkage between biodiversity and diet through the Mediterranean diet case. Adv Nutr 2023; 14:570-582. [PMID: 36997093 DOI: 10.1016/j.advnut.2023.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 03/02/2023] [Accepted: 03/24/2023] [Indexed: 03/30/2023] Open
Abstract
The adoption of healthy and sustainable diets, and the transition to sustainable food systems is of principal importance in order to counteract the double burden of climate change and non-communicable diseases. The Mediterranean diet (MD) has been widely recognized as a biodiversity and healthy nutrition resource to support sustainable development and food security. This study explored biodiversity in terms of food plants species, subspecies, varieties and races, and also addressed food-plant diversity differences between the MD and western-type consumption patterns. It was funded by the EU BioValue Project, aiming to promote the integration of underutilized crops into the food value chains. Using a two-stage scheme, data were selected from MEDUSA and Euro+Med databases (including 449 species, 2,366 subspecies, varieties, and races). Furthermore, 12 countries from North Africa and Europe were classified in two groups according to their sub-regional attributes and their traditionally most prevalent dietary pattern (MD or western-type diets). Statistical analysis showed that the mean of the majorly cultivated food plants in the MD was significantly higher than its counterpart in the Western-diet. Furthermore, no statistical difference was detected in the averages of native food plants between the MD group and the Western diet group, implying that the higher diversity in food plants observed in the MD seems to be attributed to crop utilization rather than crop availability. Our findings indicated the interlinkage between biodiversity and prevailing dietary patterns, and further underlined that biodiversity could constitute a prerequisite for dietary diversity, and hence nutrition security. In addition, this study demonstrated that diets and nutrition should be approached in a broader way within the context of both agro-food and ecological systems.
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Affiliation(s)
- Konstadinos Mattas
- Department of Agricultural Economics, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Elena Raptou
- Department of Agricultural Development, Democritus University of Thrace, Orestiada, Greece
| | - Ahmed Alayidi
- Department of Business Economics and Management, CIHEAM Mediterranean Agronomic Institute of Chania, Chania, Greece
| | - Gizem Yener
- Department of Business Economics and Management, CIHEAM Mediterranean Agronomic Institute of Chania, Chania, Greece
| | - George Baourakis
- CIHEAM Mediterranean Agronomic Institute of Chania, Chania, Greece
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Turner-McGrievy GM, Wilson MJ, Carswell J, Okpara N, Aydin H, Bailey S, Davey M, Hutto B, Wilcox S, Friedman DB, Sarzynski MA, Liese AD. A 12-Week Randomized Intervention Comparing the Healthy US, Mediterranean, and Vegetarian Dietary Patterns of the US Dietary Guidelines for Changes in Body Weight, Hemoglobin A1c, Blood Pressure, and Dietary Quality among African American Adults. J Nutr 2023; 153:579-587. [PMID: 36894249 PMCID: PMC10196600 DOI: 10.1016/j.tjnut.2022.11.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 11/10/2022] [Accepted: 11/17/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The US Dietary Guidelines (USDG) form the basis of nutrition guidelines, but the research informing the 3 USDG dietary patterns (Healthy US-Style [H-US], Mediterranean [Med], and vegetarian [Veg]) has been drawn largely from observational studies among White populations. OBJECTIVES The Dietary Guidelines 3 Diets study was a 3-arm, 12-wk randomly assigned intervention among African American (AA) adults at risk of type 2 diabetes mellitus that tested the 3 USDG dietary patterns. METHODS The AAs (ages 18-65 y, BMI 25-49.9 kg/m2, and BMI was measured in kg/m2) with ≥3 type 2 diabetes mellitus risk factors were recruited. Weight, HbA1c, blood pressure, and dietary quality (healthy eating index [HEI]) were collected at baseline and 12 wk. In addition, participants attended weekly online classes that were designed using material from the USDG/MyPlate. Repeated measures, mixed models with maximum likelihood estimation, and robust computation of standard errors were tested. RESULTS Of the 227 participants screened, 63 were eligible (83% female; age 48.0 ± 10.6 y, BMI 35.9 ± 0.8 kg/m2) and randomly assigned to the Healthy US-Style Eating Pattern (H-US) (n = 21, 81% completion), healthy Mediterranean-style eating pattern (Med) (n = 22, 86% completion), or healthy vegetarian eating pattern (Veg) (n = 20, 70% completion) groups. Within-group, but not between groups, weight loss was significant (-2.4 ± 0.7 kg H-US, -2.6 ± 0.7 kg Med, -2.4 ± 0.8 kg Veg; P = 0.97 between group). There was also no significant difference between groups for changes in HbA1c (0.03 ± 0.05% H-US, -0.10 ± 0.05% Med, 0.07 ± 0.06% Veg; P = 0.10), systolic BP (-5.5 ± 2.7 mmHg H-US, -3.2 ± 2.5 mmHg Med, -2.4 ± 2.9 mmHg Veg; P = 0.70), diastolic blood pressure (-5.2 ± 1.8 mmHg H-US, -2.0 ± 1.7 mmHg Med, -3.4 ± 1.9 mmHg Veg; P = 0.41), or HEI (7.1 ± 3.2 H-US, 15.2 ± 3.1 Med, 4.6 ± 3.4 Veg; P = 0.06). Post hoc analyses showed that the Med group had significantly greater improvements in HEI compared to the Veg group (difference = -10.6 ± 4.6; 95% CI: -19.7, -1.4; P = 0.02). CONCLUSIONS The present study demonstrates that all 3 USDG dietary patterns lead to significant weight loss among AA adults. However, none of the outcomes were significantly different between groups. This trial was registered at clinicaltrials.gov as NCT04981847.
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Affiliation(s)
- Gabrielle M Turner-McGrievy
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
| | - Mary J Wilson
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Jessica Carswell
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Nkechi Okpara
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Halide Aydin
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Shiba Bailey
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Marty Davey
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Brent Hutto
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Sara Wilcox
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA; Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Daniela B Friedman
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Mark A Sarzynski
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Angela D Liese
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Cao Y, Li P, Zhang Y, Qiu M, Li J, Ma S, Yan Y, Li Y, Han Y. Dietary Inflammatory Index and All-Cause Mortality in Older Adults with Hypertension: Results from NHANES. J Clin Med 2023; 12:jcm12020506. [PMID: 36675436 PMCID: PMC9864621 DOI: 10.3390/jcm12020506] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/27/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023] Open
Abstract
Both diet and inflammation are strongly associated with hypertension. However, the relationship between the dietary inflammatory index (DII) and the prognosis of hypertensive patients over 65 years of age is unclear. The objective of this study is to investigate the correlation between DII and all-cause mortality in older adults with hypertension. Data were obtained from the 2011−2018 National Health and Nutrition Examination Survey (NHANES) and followed for survival through December 31, 2019. DII was calculated by the 24 h dietary history interview. Cox proportional hazards models were used to investigate the associations. A total of 2531 participants were finally included. During a median follow-up of 4.33 years, 471 participants were determined as all-cause mortality. After adjusting for confounding factors, DII was positively correlated with the risk of all-cause mortality (HR = 1.08, 95% CI = 1.01−1.16). Compared with the anti-inflammatory diet group (DII < 0), the pro-inflammatory diet group (DII > 0) had a 54% increased risk of all-cause death (HR = 1.54, 95% CI = 1.13−2.10). The results were robust in subgroup and sensitivity analyses. DII was positively correlated with the all-cause mortality of elderly hypertensive patients. The results provided an aid to dietary evaluation in the nonpharmacologic management of hypertension.
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Affiliation(s)
- Yang Cao
- The Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110000, China
- The Department of Cardiology, Xijing Hospital, Air Force Medical University, Xi’an 710000, China
| | - Pengxiao Li
- The Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110000, China
- The Department of Cardiology, Xijing Hospital, Air Force Medical University, Xi’an 710000, China
| | - Yan Zhang
- The Department of Cardiology, Xijing Hospital, Air Force Medical University, Xi’an 710000, China
| | - Miaohan Qiu
- The Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110000, China
| | - Jing Li
- The Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110000, China
| | - Sicong Ma
- The Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110000, China
| | - Yudong Yan
- The Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110000, China
- The Department of Cardiology, Xijing Hospital, Air Force Medical University, Xi’an 710000, China
| | - Yi Li
- The Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110000, China
- Correspondence: (Y.L.); (Y.H.)
| | - Yaling Han
- The Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 110000, China
- Correspondence: (Y.L.); (Y.H.)
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Singh RB, Nabavizadeh F, Fedacko J, Pella D, Vanova N, Jakabcin P, Fatima G, Horuichi R, Takahashi T, Mojto V, Juneja L, Watanabe S, Jakabcinova A. Dietary Approaches to Stop Hypertension via Indo-Mediterranean Foods, May Be Superior to DASH Diet Intervention. Nutrients 2022; 15:nu15010046. [PMID: 36615704 PMCID: PMC9824062 DOI: 10.3390/nu15010046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 11/24/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Abstract
Western-type diet with high salt and sugar, sedentary behavior, obesity, tobacco and alcoholism are important risk factors for hypertension. This review aims to highlight the role of western diet-induced oxidative stress and inflammation in the pathogenesis of hypertension and the role of various types of diets in its prevention with reference to dietary approaches to stop hypertension (DASH) diet. It seems that it is crucial to alter the western type of diet because such diets can also predispose all CVDs. Western diet-induced oxidative stress is characterized by excessive production of reactive oxygen species (ROS) with an altered oxidation-reduction (redox) state, leading to a marked increase in inflammation and vascular dysfunction. Apart from genetic and environmental factors, one important cause for differences in the prevalence of hypertension in various countries may be diet quality, deficiency in functional foods, and salt consumption. The role of the DASH diet has been established. However, there are gaps in knowledge about the role of some Indo-Mediterranean foods and Japanese foods, which have been found to decrease blood pressure (BP) by improving vascular function. The notable Indo-Mediterranean foods are pulses, porridge, spices, and millets; fruits such as guava and blackberry and vegetables, which may also decrease BPs. The Japanese diet consists of soya tofu, whole rice, in particular medical rice, vegetables and plenty of fish rich in fish oil, fish peptides and taurine that are known to decrease BPs. Epidemiological studies and randomized, controlled trials have demonstrated the role of these diets in the prevention of hypertension and metabolic diseases. Such evidence is still meager from Japan, although the prevalence of hypertension is lower (15-21%) compared to other developed countries, which may be due to the high quality of the Japanese diet. Interestingly, some foods, such as berries, guava, pumpkin seeds, carrots, soya beans, and spices, have been found to cause a decrease in BPs. Omega-3 fatty acids, fish peptide, taurine, dietary vitamin D, vitamin C, potassium, magnesium, flavonoids, nitrate and l-arginine are potential nutrients that can also decrease BPs. Larger cohort studies and controlled trials are necessary to confirm our views.
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Affiliation(s)
- Ram B. Singh
- Halberg Hospital and Research Institute, Moradabad 244001, India
| | - Fatemeh Nabavizadeh
- Department of Cardiology, Emirates Hospital, Dubai 999041, United Arab Emirates
| | - Jan Fedacko
- Department of Gerontology and Geriatric, PJ Safarik University and MEDIPARK—University Research Park, PJ Safarik University, 1, 041-90 Kosice, Slovakia
- Correspondence:
| | - Dominik Pella
- 1st Department of Cardiology, PJ Safarik University Faculty of Medicine and East Slovak Institute for Cardiovascular Disease, 040-11 Kosice, Slovakia
| | - Natalia Vanova
- Department of Internal Medicine, PJ Safarik University and Agel Hospital Kosice-Saca, 040-11 Kosice, Slovakia
| | - Patrik Jakabcin
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University, 10000 Prague, Czech Republic
| | - Ghizal Fatima
- Era Medical College, Era University, Lucknow 226001, India
| | - Rie Horuichi
- Department of Food Sciences and Nutrition, Faculty of Human Environmental Sciences, Mukogawa Women’s University, Nishinomiya City 663-8558, Japan
| | - Toru Takahashi
- Department of Nutrition, Faculty of Nutrition, Kanazawa Gakuin University, Kanazawa City 920-1392, Japan
| | - Viliam Mojto
- Department of Internal Medicine, Comenius University, 813-72 Bratislava, Slovakia
| | - Lekh Juneja
- Executive Vice President, Kameda Seika Co., Ltd., Tokyo 160-0005, Japan
| | | | - Andrea Jakabcinova
- Department of Gerontology and Geriatric, Faculty of Medicine, PJ Safarik University and MEDIPARK—University Research Park, PJ Safarik University, 040-11 Kosice, Slovakia
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Razmpoosh E, Moslehi N, Abdollahi S, Soltani S, Mirmiran P, Azizi F. The Mediterranean, DASH, and MIND diets and the incident of hypertension over a median follow-up of 7.4 years in the Tehran Lipid and Glucose Study. BMC Public Health 2022; 22:2374. [PMID: 36528561 PMCID: PMC9759907 DOI: 10.1186/s12889-022-14843-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 12/08/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Despite the favorable effects of well-known dietary patterns in the treatment of hypertension (HTN), such as the Mediterranean (MED) and Dietary Approach to Stop Hypertension (DASH) diets, it is uncertain if adherence to these diets can reduce the risk of HTN, especially in non-Mediterranean populations. Moreover, none of the previous studies evaluated the association between the MED-DASH Intervention for Neurodegenerative Delay (MIND) diet adherence and the incidence of HTN. Therefore, we aimed to assess the association of adherence to these diets with the development of HTN in adults. METHODS This prospective study included 2706 adults free of HTN who were selected from the Tehran Lipid and Glucose Study. The MED, DASH, and MIND diet scores were computed at baseline using dietary information collected with the food frequency questionnaire. Associations between the dietary indices and risk of HTN over a median follow-up of 7.4 years were examined using Cox proportional hazards regression analysis. RESULTS The baseline mean age of participants was 37.9 ± 12.5 years (age range: 20-79 years), and 52.4% were women. During the 18262 person-years follow-up, 599 incidents of HTN were identified. There was no significant relationship between the dietary scores and the risk of HTN, either as continuous or categorical variables, even after excluding individuals with early/late HTN diagnosis, prehypertension, diabetes, or chronic kidney disease at baseline. A significant interaction was found between body mass index (BMI) and DASH (P-interaction < 0.001). Stratified analyses based on baseline BMI status revealed an inverse association between DASH and HTN risk in individuals with normal-weight (HR = 0.84, 95% CI = 0.71-0.98, P = 0.031), although this association did not reach statistical significance across the tertiles of DASH. CONCLUSIONS In this study, MED, DASH, and MIND showed no significant association with the occurrence of HTN in adults. Further prospective studies on diverse populations are required to assess whether adherence to the MED, DASH, and MIND diets is an effective strategy for reducing the occurrence HTN.
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Affiliation(s)
- Elham Razmpoosh
- grid.411600.2Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nazanin Moslehi
- grid.411600.2Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shima Abdollahi
- grid.464653.60000 0004 0459 3173Department of Nutrition, School of Public Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Sepideh Soltani
- grid.412505.70000 0004 0612 5912Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Parvin Mirmiran
- grid.411600.2Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- grid.411600.2Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Al Kudsee K, Vahid F, Bohn T. High adherence to the Mediterranean diet and Alternative Healthy Eating Index are associated with reduced odds of metabolic syndrome and its components in participants of the ORISCAV-LUX2 study. Front Nutr 2022; 9:1087985. [PMID: 36583217 PMCID: PMC9793091 DOI: 10.3389/fnut.2022.1087985] [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: 11/04/2022] [Accepted: 11/23/2022] [Indexed: 12/14/2022] Open
Abstract
Background Metabolic syndrome (MetS) is a major risk factor for cardiometabolic complications. Certain dietary patterns play a pivotal role in improving MetS components. The aim of this investigation was to study associations between the Mediterranean Diet Score (MDS) and the Alternative Healthy Eating Index (AHEI) and the odds of MetS and its components in adults living in Luxembourg. Methods Data from 1,404 adults participating in the cross-sectional ORISCAV-LUX2 study were analyzed by a self-reported questionnaire, anthropometric measures, a food frequency questionnaire (174 items), and blood/urine samples. Results A significant association of dietary indices and MetS was not found except when expressing MetS as a score (continuous variable, log-transformed), based on the weighting of compounds using exploratory factor analysis with the MDS (β = -0.118, 95% CI: -0.346, -0.120) and AHEI (β = -0.133, 95% CI: -0.059, -0.019). Fully adjusted linear regression models further showed significant inverse associations between components of MetS and MDS (all as log-transformed variables), including body mass index (BMI) (β = -0.0067, 95% CI: -0.0099, -0.0036), waist-circumference (WC) (β = -0.0048, 95% CI: -0.0072, -0.0024), systolic blood pressure (SBP) (β = -0.0038, 95% CI: -0.0061, -0.0016), and diastolic blood pressure (DBP) (β = -0.0035, 95% CI: -0.0060, -0.0009). Similarly, significant inverse associations between AHEI and components of MetS (log-transformed) included BMI (β = -0.0001, 95% CI: -0.0016, -0.0002), WC (β = -0.0007, 95% CI: -0.0011, -0.0002), SBP (β = -0.0006, 95% CI: -0.0010, -0.0002), and DBP (β = -0.0006, 95% CI: -0.0011, -0.0001). Conclusion Higher adherence to a Mediterranean diet and following healthy eating guidelines were associated with reduced odds of MetS and several of its components in Luxembourgish residents, highlighting that balanced and healthy eating patterns are a crucial cornerstone in the fight against MetS.
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Pieczyńska K, Rzymski P. Health Benefits of Vegetarian and Mediterranean Diets: Narrative Review. POL J FOOD NUTR SCI 2022. [DOI: 10.31883/pjfns/156067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Yau KY, Law PS, Wong CN. Cardiac and Mental Benefits of Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) Diet plus Forest Bathing (FB) versus MIND Diet among Older Chinese Adults: A Randomized Controlled Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192214665. [PMID: 36429384 PMCID: PMC9690744 DOI: 10.3390/ijerph192214665] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 11/05/2022] [Indexed: 05/26/2023]
Abstract
(1) Background: The Mediterranean-DASH intervention for neurodegenerative delay (MIND) diet and forest bathing (FB) are first-line therapies for controlling hypertension. This study aimed to investigate the combined effects of a MIND diet and FB and MIND diet alone among older Chinese patients with hypertension. (2) Methods: Seventy-two participants aged >50 with stages 1 or 2 hypertension were randomly assigned to the MIND group (n = 23), MIND-FB group (n = 25), or control group (n = 24). Systolic blood pressure (SBP) (primary outcome), point-of-care tests for blood lipid panel and glucose (Glu), anxiety levels, mood states, body mass index (BMI), waist-to-hip ratio (WHR), and body fat percentage (BFP) were measured. (3) Results: After a four-week intervention, the change in SBP revealed no significant differences between the intervention groups, and SBP tended to decrease in the MIND and MIND-FB groups. Total cholesterol, and low-density lipoprotein (LDL-C) were significantly decreased (p < 0.01), Triglycerides (TG) and Glu levels were significantly lower (p < 0.05) in the MIND-FB and MIND groups, and the mean differences for anxiety level and negative mood states were significantly lower (p < 0.00) in MIND-FB group. (4) Conclusions: The results provide preliminary evidence that the MIND diet and FB are good for promoting cardiac and mental health well-being in the Chinese population.
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Affiliation(s)
- Ka-Yin Yau
- School of Nursing, Tung Wah College, Ho Man Tin, Hong Kong
| | - Pui-Sze Law
- School of Nursing, and Health Studies, Hong Kong Metropolitan University, Ho Man Tin, Hong Kong
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Tussing-Humphreys L, Lamar M, McLeod A, Schiffer L, Blumstein L, Dakers R, Karstens A, Hemphill NON, Strahan D, Siegel L, Flack JS, Antonic M, Restrepo L, Berbaum M, Fitzgibbon M. Effect of Mediterranean diet and Mediterranean diet plus calorie restriction on cognition, lifestyle, and cardiometabolic health: A randomized clinical trial. Prev Med Rep 2022; 29:101955. [PMID: 36161108 PMCID: PMC9502289 DOI: 10.1016/j.pmedr.2022.101955] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 08/06/2022] [Accepted: 08/14/2022] [Indexed: 11/30/2022] Open
Abstract
A Mediterranean diet and intentional weight loss each positively affect cognitive functioning. Combining both could produce synergistic effects on cognition. The purpose of this study is to compare a Mediterranean diet lifestyle intervention with and without caloric restriction versus control on cognition, lifestyle, and cardiometabolic disease. In a three-arm trial conducted between 2017 and 2020 in Chicago, one hundred and eight-five, 55–85-year-old, predominately non-Hispanic black females with obesity were randomized (2:2:1) to an 8-month Mediterranean diet plus caloric restriction intervention, Mediterranean diet alone, or control. The primary outcome was change from baseline to post-intervention in cognitive composite scores: attention, information & processing; executive function; and learning, memory, & recognition. Secondary outcomes were weight, lifestyle and cardiometabolic markers. The 8-month Mediterranean diet interventions did not significantly affect cognition. Adherence to a Mediterranean diet improved more in the Mediterranean diet plus caloric restriction arm (mean [SE] score change, +6.3 [0.7] points) and Mediterranean diet alone arm (+4.8 [0.7] points) relative to controls (+0.6 [0.9] points). Mean weight loss was greater among the Mediterranean diet plus caloric restriction arm (−4.6 [0.6] kg) compared to the Mediterranean diet alone (−2.6 [0.6] kg) and control arms (−0.6 [0.7] kg). The interventions did not affect activity or cardiometabolic risk markers; although, fasting insulin did decline in the Mediterranean diet plus caloric restriction arm relative to the Mediterranean diet alone and control arms. A Mediterranean diet lifestyle intervention with and without caloric restriction did not significantly affect cognitive function compared to controls. The Mediterranean diet interventions, however, significantly affected diet quality and body weight.
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Affiliation(s)
- Lisa Tussing-Humphreys
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
- University of Illinois Cancer Center, University of Illinois Chicago, Chicago, IL, USA
| | - Melissa Lamar
- Department of Psychiatry and Behavioral Sciences, Division of Behavioral Sciences, Rush Medical College, Chicago, IL, USA
| | - Andrew McLeod
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Linda Schiffer
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Lara Blumstein
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Roxanne Dakers
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Aimee Karstens
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
- Mayo Clinic, Rochester, MN, USA
| | - Nefertiti Oji Njideka Hemphill
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Desmona Strahan
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
- Department of Pediatrics, University of Illinois at Chicago, Chicago, IL, USA
| | - Leilah Siegel
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
- University of Illinois Extension, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Jennifer Sanchez Flack
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
- University of Illinois Cancer Center, University of Illinois Chicago, Chicago, IL, USA
- Department of Pediatrics, University of Illinois at Chicago, Chicago, IL, USA
| | - Mirjana Antonic
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
- University of Illinois Cancer Center, University of Illinois Chicago, Chicago, IL, USA
- Department of Pediatrics, University of Illinois at Chicago, Chicago, IL, USA
| | - Leo Restrepo
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Michael Berbaum
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
- School of Public Health, University of Illinois at Chicago, Chicago, IL, USA
- Center for Clinical and Translational Science, University of Illinois at Chicago, Chicago, IL, USA
| | - Marian Fitzgibbon
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
- University of Illinois Cancer Center, University of Illinois Chicago, Chicago, IL, USA
- Department of Pediatrics, University of Illinois at Chicago, Chicago, IL, USA
- Corresponding author at: University of Illinois at Chicago, 1747 W. Roosevelt Rd. MC 558, Chicago, IL 60608, USA.
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Hartley M, Fyfe CL, Wareham NJ, Khaw KT, Johnstone AM, Myint PK. Association between Legume Consumption and Risk of Hypertension in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk Cohort. Nutrients 2022; 14:nu14163363. [PMID: 36014869 PMCID: PMC9415844 DOI: 10.3390/nu14163363] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/07/2022] [Accepted: 08/12/2022] [Indexed: 02/02/2023] Open
Abstract
Hypertension is a significant and preventable cardiovascular disease risk factor. Growing evidence suggests legumes have blood-pressure (BP) lowering properties. However, there is little population-based research on legume intake and hypertension risk in Western populations. The objective was to investigate the relationship between legume intake and blood pressure by using data from the European Prospective Investigation into Cancer and Nutrition (EPIC) Norfolk cohort. Further, to identify any potential legume intake that confers benefits in relation to blood pressure. We included participants who completed both 7-day food diaries to assess legume intake and undertook a first (1993−1997) and second (1998−2000) health check from the EPIC-Norfolk prospective study. Legume consumption was categorized using percentile cut off values. We used multivariate logistic regression models to calculate the odds ratio of hypertension (defined as >140 mmHg systolic and/or >90 mmHg diastolic blood pressure) at the second health check, stratified by legume intake, adjusting for antihypertensive medication use and demographic, socioeconomic and lifestyle covariates. A total of 7522 participants were included with mean age (± SD) of 58.0 ± 8.9 years. The follow-up time was 3.7 years (range: 2.1−6.6 years). Mean legume consumption was 17.3 ± 16.3 g/day. Participants in the 97th percentile of legume intake had the lowest odds of subsequent hypertension (OR: 0.71; 95% CI: 0.52, 0.96). Legume consumption between 55−70 g/day was associated with reduced odds of hypertension (OR: 0.57; 95% CI: 0.37, 0.88); sex-specific values for men and women were 0.64 (0.38, 1.03) and 0.32 (0.12, 0.88), respectively. In this UK population, legume intake of 55−70 g/day was associated with a lower subsequent risk of hypertension. Given the low legume intake in the UK and Western countries, dietary guidance to increase intake above 55 g/day may lower the burden of hypertension and associated diseases.
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Affiliation(s)
- Michael Hartley
- Institute of Applied Health Sciences, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen AB25 2ZD, UK
| | - Claire L. Fyfe
- The Rowett Institute, University of Aberdeen, Ashgrove Road West, Aberdeen AB25 2ZD, UK
| | | | - Kay-Tee Khaw
- Clinical Gerontology Unit, Department of Public Health and Primary Care, Gonville and Caius College, Cambridge CB2 1TA, UK
| | | | - Phyo K. Myint
- Institute of Applied Health Sciences, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen AB25 2ZD, UK
- Aberdeen Cardiovascular & Diabetes Centre, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen AB25 2ZD, UK
- Correspondence: ; Tel.: +44-(0)-1224-437841
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Gomez-Delgado F, Romero-Cabrera JL, Perez-Martinez P. Diet and vascular risk. Curr Opin Cardiol 2022; 37:343-349. [PMID: 35731680 DOI: 10.1097/hco.0000000000000960] [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
PURPOSE OF REVIEW The basis for the prevention and treatment of cardiovascular disease (CVD) inevitably involves lifestyle modification, including dietary pattern (DP). The aim of this review is to address the different models of healthy DP with their peculiarities and nutritional components as well as their importance in the management of CVD. RECENT FINDINGS Classical cardiovascular risk factors such as hypertension, dyslipidaemia and diabetes are strongly influenced by diet and physical activity. However, current evidence supports the role of emerging risk factors such as inflammatory status, oxidative stress and endothelial function in the development of CVD. Likewise, recent evidence explores how healthy DP can modulate CVD risk through these risk factors. SUMMARY Although the Mediterranean diet (MedDiet) is the paradigm of the healthy DP in the light of current scientific evidence, there are other DP that we should be aware of due to their results in epidemiological studies, randomized clinical trials (RCTs) and meta-analyses on CVD risk modulation. The best-analysed DP are the MedDiet, Dietary Approaches to Stop Hypertension (DASH), the Nordic DP, the Vegetarian DP, the Portfolio DP, the Low-carbohydrate DP and the Planetary Health diet initiative.
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Affiliation(s)
- Francisco Gomez-Delgado
- Internal Medicine Unit/Jaen University Hospital, Jaen
- CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Luis Romero-Cabrera
- Lipids and Atherosclerosis Unit, IMIBIC/Reina Sofia University Hospital/University of Cordoba, Cordoba
- CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Pablo Perez-Martinez
- Lipids and Atherosclerosis Unit, IMIBIC/Reina Sofia University Hospital/University of Cordoba, Cordoba
- CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
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Ideas to further understand similarities and differences in blood pressure effects among various diets. J Hypertens 2022; 40:408. [PMID: 34992198 DOI: 10.1097/hjh.0000000000002979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Metabolic Syndrome, Cognitive Impairment and the Role of Diet: A Narrative Review. Nutrients 2022; 14:nu14020333. [PMID: 35057514 PMCID: PMC8780484 DOI: 10.3390/nu14020333] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/04/2022] [Accepted: 01/10/2022] [Indexed: 01/27/2023] Open
Abstract
Background: This narrative review presents the association between metabolic syndrome (MetS), along with its components, and cognition-related disorders, as well as the potential reversal role of diet against cognitive impairment by modulating MetS. Methods: An electronic research in Medline (Pubmed) and Scopus was conducted. Results: MetS and cognitive decline share common cardiometabolic pathways as MetS components can trigger cognitive impairment. On the other side, the risk factors for both MetS and cognitive impairment can be reduced by optimizing the nutritional intake. Clinical manifestations such as dyslipidemia, hypertension, diabetes and increased central body adiposity are nutrition-related risk factors present during the prodromal period before cognitive impairment. The Mediterranean dietary pattern stands among the most discussed predominantly plant-based diets in relation to cardiometabolic disorders that may prevent dementia, Alzheimer’s disease and other cognition-related disorders. In addition, accumulating evidence suggests that the consumption of specific dietary food groups as a part of the overall diet can improve cognitive outcomes, maybe due to their involvement in cardiometabolic paths. Conclusions: Early MetS detection may be helpful to prevent or delay cognitive decline. Moreover, this review highlights the importance of healthy nutritional habits to reverse such conditions and the urgency of early lifestyle interventions.
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Seifu CN, Fahey PP, Ahmed KY, Atlantis E. Is the Mediterranean Diet Pattern Associated with Weight Related Health Complications in Adults? A Cross-Sectional Study of Australian Health Survey. Nutrients 2021; 13:nu13113905. [PMID: 34836161 PMCID: PMC8624026 DOI: 10.3390/nu13113905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 12/02/2022] Open
Abstract
We hypothesized that unhealthy dietary pattern would be associated with weight related complications among overweight. We analysed data from the Australian Health Survey conducted from 2011 to 2013. A total of 5055 adults with at least overweight (body mass index ≥25 kg/m2) were analysed. We used logistic regression to assess the association between unhealthy dietary pattern, defined by low adherence to Mediterranean Diet Score (MDS), and weight related complications, defined by the Edmonton Obesity Staging System (EOSS). We repeated the logistic regression models by age and socio-economic disadvantage strata in sensitivity analyses. We also repeated the main analysis on a propensity score matched dataset (n = 3364). Complications by EOSS ≥2 was present in 3036 (60.1%) participants. There was no statistically significant association between unhealthy dietary pattern and weight related complication (odds ratio 0.98 (95%confidence interval: 0.85, 1.12)). The null association remained the same after repeating the analysis on three age and five socio-economic indexes for areas strata. The finding persisted after the analysis was repeated on a propensity score matched dataset. We found no evidence to support the hypothesis that unhealthy dietary pattern was associated with weight related complications in this cross-sectional study of the Australian population with overweight or obesity.
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Affiliation(s)
- Canaan Negash Seifu
- School of Health Sciences, Western Sydney University, Penrith, NSW 2751, Australia
| | - Paul Patrick Fahey
- School of Health Sciences, Western Sydney University, Penrith, NSW 2751, Australia
- Translational Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia
| | - Kedir Yimam Ahmed
- Translational Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia
| | - Evan Atlantis
- School of Health Sciences, Western Sydney University, Penrith, NSW 2751, Australia
- Translational Health Research Institute, Western Sydney University, Penrith, NSW 2751, Australia
- Discipline of Medicine, Faculty of Medicine and Health, Nepean Clinical School, The University of Sydney, Sydney, NSW 2006, Australia
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Cicero AFG, Veronesi M, Fogacci F. Dietary Intervention to Improve Blood Pressure Control: Beyond Salt Restriction. High Blood Press Cardiovasc Prev 2021; 28:547-553. [PMID: 34533781 PMCID: PMC8590666 DOI: 10.1007/s40292-021-00474-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 09/03/2021] [Indexed: 01/25/2023] Open
Abstract
Lifestyle improvement is a cornerstone of cardiovascular disease prevention and has a relevant effect on blood pressure control. During the last decades the attention of the researcher has focused on low-salt diets as the lifestyle modification most effective in blood pressure reduction. Current international guidelines thus suggest to stress the importance of the implementation of the dietary approach to stop hypertension (DASH) diet and of a low-salt Mediterranean diet to achieve the best results in term of blood pressure decrease. However, salt reduction in diet could be not the only nor the main determinant of blood pressure reduction under dietary treatment. DASH and low-salt Mediterranean diet are also characterized by a high intake of vegetables (NO and polyphenol sources), whole grains, some low-fat dairy products, and low intake of red meat, sugar, and trans-hydrogenated fats. Lacto-ovo vegetarian diet are also per se associated to a significant improvement in blood pressure levels. Moreover, these diets are particularly effective when associated with a significant weight loss. Furthermore, blood pressure can also be lowered by some nutraceuticals (beetroot, magnesium, vitamin C, catechin-rich beverages, lycopene, etc). The aim of this narrative review is to critically resume the most recent evidence supporting a complete approach to dietary counseling for hypertension prevention and management.
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Affiliation(s)
- Arrigo F G Cicero
- Hypertension and Cardiovascular Risk Research Center, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, Bologna, Italy. .,IRCCS AOU S. Orsola-Malpighi, Bologna, Italy. .,Hypertension and Cardiovascular Risk Research Group, Medical and Surgical Sciences Department, Sant'Orsola-Malpighi University Hospital, U.O. Medicina Interna Borghi, Via Albertoni, 15, 40138, Bologna, Italy.
| | - Maddalena Veronesi
- Hypertension and Cardiovascular Risk Research Center, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, Bologna, Italy.,IRCCS AOU S. Orsola-Malpighi, Bologna, Italy
| | - Federica Fogacci
- Hypertension and Cardiovascular Risk Research Center, Medical and Surgical Sciences Department, Alma Mater Studiorum University of Bologna, Bologna, Italy
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Impact of the Level of Adherence to Mediterranean Diet on the Parameters of Metabolic Syndrome: A Systematic Review and Meta-Analysis of Observational Studies. Nutrients 2021; 13:nu13051514. [PMID: 33946280 PMCID: PMC8146502 DOI: 10.3390/nu13051514] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/24/2021] [Accepted: 04/28/2021] [Indexed: 12/18/2022] Open
Abstract
High adherence to the Mediterranean diet (MD) has been associated with a lower prevalence of Metabolic Syndrome (MetS). The present study aimed to investigate the impact of MD adherence on parameters of MetS. A systematic literature search was performed in PubMed, Cochrane Central Registry of Clinical Trials (CENTRAL), Scopus, EMBASE, Web of Science and Google Scholar databases. Observational studies that recorded adherence to MD and components/measures of the MetS, such as waist circumference (WC), blood pressure (BP), fasting blood glucose (FBG), high-density lipoprotein (HDL) cholesterol and triglycerides (TG), were included in this study. A total of 58 studies were included in our study. WC and TG were significantly lower in the high adherence MD group (SMD: −0.20, (95%CI: −0.40, −0.01), SMD: −0.27 (95%CI: −0.27, −0.11), respectively), while HDL cholesterol was significantly higher in the same group (SMD: −0.28 (95%CI: 0.07, 0.50). There was no difference in FBG and SBP among the two groups (SMD: −0.21 (95%CI: −0.54, 0.12) & SMD: −0.15 (95%CI: −0.38, 0.07), respectively). MD may have a positive impact on all parameters of MetS. However, further research is needed in this field.
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Gardiner P, McGonigal L, Villa A, Kovell LC, Rohela P, Cauley A, Rinker D, Olendzki B. Our Whole Lives for Hypertension and Cardiac Risk Factors (OWL-H)—Combining a Teaching Kitchen Group Visit with an Online Platform: A Feasibility Trial (Preprint). JMIR Form Res 2021; 6:e29227. [PMID: 35576575 PMCID: PMC9152723 DOI: 10.2196/29227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 02/22/2022] [Accepted: 03/01/2022] [Indexed: 11/13/2022] Open
Abstract
Background Hypertension (HTN) affects millions of Americans. Our Whole Lives: an eHealth toolkit for Hypertension and Cardiac Risk Factors (OWL-H) is an eHealth platform that teaches evidence-based lifestyle strategies, such mindfulness and cooking skills, to improve self-management of HTN. Objective The primary goal of this pilot study was to evaluate the feasibility of OWL-H combined with teaching kitchen medical group visits (TKMGVs) in a low-income population of participants with HTN. Methods We conducted a pre-post 8-week study to assess the feasibility of a hybrid program (a web-based 9-module self-management program, which includes mindfulness and Mediterranean and Dietary Approaches to Stop Hypertension diet) accompanied by 3 in-person TKMGVs among patients with HTN. Data including demographics, platform use, and satisfaction after using OWL-H were examined. Outcome data collected at baseline and 8 weeks included the Mediterranean Diet Questionnaire, Hypertension Self-Care Profile Self-Efficacy Instrument, Blood Pressure Knowledge Questionnaire, and the number of self-reported blood pressure readings. For the statistical analysis, we used descriptive statistics, paired sample t tests (1-tailed), and qualitative methods. Results Of the 25 enrolled participants, 22 (88%) participants completed the study. Participants’ average age was 57 (SD 12.1) years, and 46% (11/24) of them reported a household income <US $30,000 per year. Among the 22 participants who logged in to OWL-H, the average number of mindfulness practices completed was 7 and the average number of module sessions accessed was 4. In all, 73% (16/22) of participants reported that they were “very satisfied” with using OWL-H to help manage their HTN. Participants’ blood pressure knowledge significantly increased from baseline (mean 5.58, SD 1.44) to follow-up (mean 6.13, SD 1.23; P=.03). Participants significantly increased their adherence to a Mediterranean diet from baseline (mean 7.65, SD 2.19) to follow-up (mean 9, SD 1.68; P=.004). Participants’ self-efficacy in applying heart-healthy habits, as measured by the Hypertension Self-Care Profile Self-Efficacy Instrument, increased from baseline (mean 63.67, SD 9.06) to follow-up (mean 65.54, SD 7.56; P=.14). At the 8-week follow-up, 82% (18/22) of the participants had self-reported their blood pressure on the OWL-H platform at least once during the 8 weeks. Conclusions The eHealth platform for HTN self-management, OWL-H, and accompanying in-person TKMGVs have the potential to effectively improve lifestyle management of HTN. Trial Registration ClinicalTrials.gov NCT03974334; https://clinicaltrials.gov/ct2/show/NCT03974334
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Affiliation(s)
- Paula Gardiner
- Department of Family Medicine and Community Health, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Lisa McGonigal
- Department of Family Medicine and Community Health, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Ariel Villa
- Department of Family Medicine and Community Health, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Lara C Kovell
- Division of Cardiovascular Medicine, Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Pallavi Rohela
- Department of Family Medicine and Community Health, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Andrew Cauley
- Department of Family Medicine and Community Health, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Diana Rinker
- Department of Family Medicine and Community Health, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Barbara Olendzki
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, United States
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