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Sebastian SA, Shah Y, Arsene C. Intermittent fasting and cardiovascular disease: A scoping review of the evidence. Dis Mon 2024:101778. [PMID: 38910053 DOI: 10.1016/j.disamonth.2024.101778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
Intermittent fasting (IF), characterized by alternating periods of fasting and unrestricted eating, typically within an 8-hour window or less each day, has gained significant attention as a possible dietary approach. While it is recognized for its metabolic advantages, like weight loss and enhanced glucose and insulin sensitivity, its effect on cardiovascular health remains a topic of mixed opinions. Recent findings suggest a potential downside, with reports indicating a concerning association: a 91 % higher risk of cardiovascular disease (CVD) mortality compared to eating spread across a 12- to 16-hour period. Despite this alarming statistic, the evidence cannot establish a causal link. The impact of IF on CVD is still insufficiently understood, with benefits sometimes exaggerated and risks downplayed in popular discourse. This scoping review aims to consolidate the current evidence, addressing unresolved questions about the benefits and risks of IF, particularly its association with CVD risks and mortality. The goal is to provide a balanced perspective on the potential health implications of IF, emphasizing the need for further research to clarify its long-term effects on cardiovascular health.
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Affiliation(s)
| | - Yash Shah
- Department of Internal Medicine, Trinity Health Oakland/Wayne State University, Pontiac, Michigan, USA
| | - Camelia Arsene
- Department of Internal Medicine, Trinity Health Oakland/Wayne State University, Pontiac, Michigan, USA
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Chmielewski PP, Data K, Strzelec B, Farzaneh M, Anbiyaiee A, Zaheer U, Uddin S, Sheykhi-Sabzehpoush M, Mozdziak P, Zabel M, Dzięgiel P, Kempisty B. Human Aging and Age-Related Diseases: From Underlying Mechanisms to Pro-Longevity Interventions. Aging Dis 2024:AD.2024.0280. [PMID: 38913049 DOI: 10.14336/ad.2024.0280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 06/02/2024] [Indexed: 06/25/2024] Open
Abstract
As human life expectancy continues to rise, becoming a pressing global concern, it brings into focus the underlying mechanisms of aging. The increasing lifespan has led to a growing elderly population grappling with age-related diseases (ARDs), which strains healthcare systems and economies worldwide. While human senescence was once regarded as an immutable and inexorable phenomenon, impervious to interventions, the emerging field of geroscience now offers innovative approaches to aging, holding the promise of extending the period of healthspan in humans. Understanding the intricate links between aging and pathologies is essential in addressing the challenges presented by aging populations. A substantial body of evidence indicates shared mechanisms and pathways contributing to the development and progression of various ARDs. Consequently, novel interventions targeting the intrinsic mechanisms of aging have the potential to delay the onset of diverse pathological conditions, thereby extending healthspan. In this narrative review, we discuss the most promising methods and interventions aimed at modulating aging, which harbor the potential to mitigate ARDs in the future. We also outline the complexity of senescence and review recent empirical evidence to identify rational strategies for promoting healthy aging.
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Affiliation(s)
- Piotr Pawel Chmielewski
- Division of Anatomy, Department of Human Morphology and Embryology, Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Krzysztof Data
- Division of Anatomy, Department of Human Morphology and Embryology, Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Bartłomiej Strzelec
- 2nd Department of General Surgery and Surgical Oncology, Medical University Hospital, Wroclaw, Poland
| | - Maryam Farzaneh
- Fertility, Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Amir Anbiyaiee
- Department of Surgery, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Uzma Zaheer
- School of Biosciences, Faculty of Health Sciences and Medicine, The University of Surrey, United Kingdom
| | - Shahab Uddin
- Translational Institute and Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar
- Department of Biosciences, Integral University, Lucknow, Uttar Pradesh, India
| | | | - Paul Mozdziak
- Graduate Physiology Program, North Carolina State University, Raleigh, NC 27695, USA
| | - Maciej Zabel
- Division of Histology and Embryology, Department of Human Morphology and Embryology, Wroclaw Medical University, Wroclaw, Poland
- Division of Anatomy and Histology, The University of Zielona Góra, Poland
| | - Piotr Dzięgiel
- Division of Histology and Embryology, Department of Human Morphology and Embryology, Wroclaw Medical University, Wroclaw, Poland
| | - Bartosz Kempisty
- Division of Anatomy, Department of Human Morphology and Embryology, Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland
- Department of Veterinary Surgery, Institute of Veterinary Medicine, Nicolaus Copernicus University in Torun, Torun, Poland
- Physiology Graduate Faculty, North Carolina State University, Raleigh, NC 27695, USA
- Center of Assisted Reproduction, Department of Obstetrics and Gynecology, University Hospital and Masaryk University, Brno, Czech Republic
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Wang Y, Li F, Li X, Wu J, Chen X, Su Y, Qin T, Liu X, Liang L, Ma J, Qin P. Breakfast skipping and risk of all-cause, cardiovascular and cancer mortality among adults: a systematic review and meta-analysis of prospective cohort studies. Food Funct 2024; 15:5703-5713. [PMID: 38738978 DOI: 10.1039/d3fo05705d] [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: 05/14/2024]
Abstract
Background: Numerous studies reported inconsistent association between breakfast skipping and all-cause, cardiovascular disease (CVD) and cancer mortality. Therefore, we conducted a systematic review and meta-analysis to elucidate these associations. Methods: PubMed, Embase, and Web of Science databases were searched up to July 2023 for prospective cohort studies that assessed the association between breakfast skipping and all-cause, CVD and cancer mortality in general adults. A random effect model was used to estimate the pooled hazard ratio (HR) and 95% confidence intervals (CIs), with subgroup analysis and sensitivity analysis performed. The Newcastle-Ottawa Scale (NOS) was used to assess the study and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool was used to assess the risk of bias. Results: The final analysis included 9 cohort studies including 242 095 participants, with 6 studies for all-cause mortality, 4 studies for CVD mortality, and 2 studies for cancer mortality. Compared to regular breakfast consumption, skipping breakfast was associated with a higher risk of all-cause (HR: 1.27, 95% CI, 1.07-1.51, I2 = 77%), CVD (HR 1.28, 95% CI 1.10-1.50, I2 = 0), and cancer (HR: 1.34, 95% CI: 1.11-1.61, I2 = 0%) mortality. Sensitivity analysis revealed inconsistent results in all-cause and CVD mortality. Subgroup analysis showed significant association in studies with larger participants, longer follow-up, adjustments for energy intake, and high-quality articles. GRADE showed very low evidence for all-cause mortality and low evidence for CVD and cancer mortality. Conclusion: The findings underscore the importance of regular breakfast habits for health and longevity. However, these results require careful interpretation due to geographic limitations, potential heterogeneity, and instability.
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Affiliation(s)
- Yanqi Wang
- Center for Clinical Epidemiology and Evidence-based Medicine, Shenzhen Qianhai Shekou Free Trade Zone Hospital, No. 128, Gongye 7th Road, Shekou Street, Shenzhen, 518037, Guangdong, China.
- School of Public Health, Shantou University, Shantou, Guangdong, China
| | - Fengjuan Li
- Center for Clinical Epidemiology and Evidence-based Medicine, Shenzhen Qianhai Shekou Free Trade Zone Hospital, No. 128, Gongye 7th Road, Shekou Street, Shenzhen, 518037, Guangdong, China.
- School of Public Health, Shantou University, Shantou, Guangdong, China
| | - Xinying Li
- Center for Clinical Epidemiology and Evidence-based Medicine, Shenzhen Qianhai Shekou Free Trade Zone Hospital, No. 128, Gongye 7th Road, Shekou Street, Shenzhen, 518037, Guangdong, China.
- School of Public Health, Shantou University, Shantou, Guangdong, China
| | - Jun Wu
- Center for Clinical Epidemiology and Evidence-based Medicine, Shenzhen Qianhai Shekou Free Trade Zone Hospital, No. 128, Gongye 7th Road, Shekou Street, Shenzhen, 518037, Guangdong, China.
| | - Xiaojuan Chen
- Center for Clinical Epidemiology and Evidence-based Medicine, Shenzhen Qianhai Shekou Free Trade Zone Hospital, No. 128, Gongye 7th Road, Shekou Street, Shenzhen, 518037, Guangdong, China.
- School of Public Health, Shantou University, Shantou, Guangdong, China
| | - Yuhao Su
- Center for Clinical Epidemiology and Evidence-based Medicine, Shenzhen Qianhai Shekou Free Trade Zone Hospital, No. 128, Gongye 7th Road, Shekou Street, Shenzhen, 518037, Guangdong, China.
- School of Public Health, Shantou University, Shantou, Guangdong, China
| | - Tianhang Qin
- Institute of Software, Chinese Academy of Sciences, Beijing, Guangdong, China
| | - Xiaoning Liu
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Lei Liang
- Department of Gynecology and Obstetrics, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, China
| | - Jianping Ma
- Center for Clinical Epidemiology and Evidence-based Medicine, Shenzhen Qianhai Shekou Free Trade Zone Hospital, No. 128, Gongye 7th Road, Shekou Street, Shenzhen, 518037, Guangdong, China.
| | - Pei Qin
- Center for Clinical Epidemiology and Evidence-based Medicine, Shenzhen Qianhai Shekou Free Trade Zone Hospital, No. 128, Gongye 7th Road, Shekou Street, Shenzhen, 518037, Guangdong, China.
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Lu CF, Cang XM, Liu WS, Wang LH, Huang HY, Wang XQ, Zhao LH, Xu F. A late eating midpoint is associated with increased risk of diabetic kidney disease: a cross-sectional study based on NHANES 2013-2020. Nutr J 2024; 23:39. [PMID: 38520010 PMCID: PMC10960429 DOI: 10.1186/s12937-024-00939-z] [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: 11/15/2023] [Accepted: 03/11/2024] [Indexed: 03/25/2024] Open
Abstract
BACKGROUND Modifying diet is crucial for diabetes and complication management. Numerous studies have shown that adjusting eating habits to align with the circadian rhythm may positively affect metabolic health. However, eating midpoint, eating duration, and their associations with diabetic kidney disease (DKD) are poorly understood. METHODS The National Health and Nutrition Examination Survey (2013-2020) was examined for information on diabetes and dietary habits. From the beginning and ending times of each meal, we calculated the eating midpoint and eating duration. Urinary albumin-to-creatinine ratio (UACR) ≥ 30 mg/g and/or estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2 were the specific diagnostic criteria for DKD. RESULTS In total, details of 2194 subjects with diabetes were collected for analysis. The overall population were divided into four subgroups based on the eating midpoint quartiles. The prevalence of DKD varied noticeably (P = 0.037) across the four categories. When comparing subjects in the second and fourth quartiles of eating midpoint to those in the first one, the odds ratios (ORs) of DKD were 1.31 (95% CI, 1.03 to 1.67) and 1.33 (95% CI, 1.05 to 1.70), respectively. And after controlling for potential confounders, the corresponding ORs of DKD in the second and fourth quartiles were 1.42 (95% CI, 1.07 to 1.90) and 1.39 (95% CI, 1.04 to 1.85), respectively. CONCLUSIONS A strong correlation was found between an earlier eating midpoint and a reduced incidence of DKD. Eating early in the day may potentially improve renal outcomes in patients with diabetes.
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Affiliation(s)
- Chun-Feng Lu
- Department of Endocrinology, Affiliated Hospital 2 of Nantong University and First People's Hospital of Nantong City, No. 666 Shengli Road, Nantong, 226001, China
| | - Xiao-Min Cang
- Department of Endocrinology, Affiliated Hospital 2 of Nantong University and First People's Hospital of Nantong City, No. 666 Shengli Road, Nantong, 226001, China
| | - Wang-Shu Liu
- Department of Endocrinology, Affiliated Hospital 2 of Nantong University and First People's Hospital of Nantong City, No. 666 Shengli Road, Nantong, 226001, China
| | - Li-Hua Wang
- Department of Nursing, Affiliated Hospital 2 of Nantong University and First People's Hospital of Nantong City, No. 666 Shengli Road, Nantong, 226001, China
| | - Hai-Yan Huang
- Department of Endocrinology, Affiliated Hospital 2 of Nantong University and First People's Hospital of Nantong City, No. 666 Shengli Road, Nantong, 226001, China
| | - Xue-Qin Wang
- Department of Endocrinology, Affiliated Hospital 2 of Nantong University and First People's Hospital of Nantong City, No. 666 Shengli Road, Nantong, 226001, China.
| | - Li-Hua Zhao
- Department of Nursing, Affiliated Hospital 2 of Nantong University and First People's Hospital of Nantong City, No. 666 Shengli Road, Nantong, 226001, China.
| | - Feng Xu
- Department of Endocrinology, Affiliated Hospital 2 of Nantong University and First People's Hospital of Nantong City, No. 666 Shengli Road, Nantong, 226001, China.
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Wu Z, Li J, Xu Y, Guo R, Wang F, Liu Y, Wang S, Dong Y, Li B. Association of Physical Activity with Phenotypic Age among Populations with Different Breakfast Habits. Nutrients 2024; 16:575. [PMID: 38474704 DOI: 10.3390/nu16050575] [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: 01/17/2024] [Revised: 02/13/2024] [Accepted: 02/16/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND The global aging situation has reached a serious stage, and healthy lifestyles, like regular physical activity and eating breakfast, could slow the process. Phenotypic age (PhenoAge) is regarded as a novel measure of aging. Therefore, our study aimed to quantify the impact of physical activity and eating breakfast on aging via PhenoAge and phenotypic age acceleration (PhenoAgeAccel). METHODS A total of 3719 adults who participated in the National Health and Nutrition Examination Survey were involved in this study. Physical activity was divided into an active group and an inactive group. According to the number of reported breakfast recalls, eating breakfast was divided into the no recalls group, one recall group, and both recalls group. Sensitivity analysis was performed by stratified analysis. RESULTS Active physical activity was a protective factor for PhenoAge and PhenoAgeAccel. Compared to the inactive group, the β values of the active group were -8.36 (-10.09, -6.62) for PhenoAge and -1.67 (-2.21, -1.14) for PhenoAgeAccel. The stratified analysis results showed that in the groups reporting breakfast in both recalls, one recall, and no recalls, the β values of the active group were -8.84 (-10.70, -6.98), -8.17 (-12.34, -4.00), and -3.46 (-7.74, 0.82), respectively, compared to the inactive group. CONCLUSIONS Active physical activity was strongly correlated with lower values of PhenoAge and PhenoAgeAccel, but the association was no longer statistically significant when combined with not regularly eating breakfast.
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Affiliation(s)
- Zibo Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun 130021, China
| | - Jing Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun 130021, China
| | - Yang Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun 130021, China
| | - Ruirui Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun 130021, China
| | - Fengdan Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun 130021, China
| | - Yan Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun 130021, China
| | - Sizhe Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun 130021, China
| | - Yibo Dong
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun 130021, China
| | - Bo Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Xinmin Street No.1163, Changchun 130021, China
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Ye W, Wang J, Little PJ, Zou J, Zheng Z, Lu J, Yin Y, Liu H, Zhang D, Liu P, Xu S, Ye W, Liu Z. Anti-atherosclerotic effects and molecular targets of ginkgolide B from Ginkgo biloba. Acta Pharm Sin B 2024; 14:1-19. [PMID: 38239238 PMCID: PMC10792990 DOI: 10.1016/j.apsb.2023.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 09/03/2023] [Accepted: 09/13/2023] [Indexed: 01/22/2024] Open
Abstract
Bioactive compounds derived from herbal medicinal plants modulate various therapeutic targets and signaling pathways associated with cardiovascular diseases (CVDs), the world's primary cause of death. Ginkgo biloba , a well-known traditional Chinese medicine with notable cardiovascular actions, has been used as a cardio- and cerebrovascular therapeutic drug and nutraceutical in Asian countries for centuries. Preclinical studies have shown that ginkgolide B, a bioactive component in Ginkgo biloba , can ameliorate atherosclerosis in cultured vascular cells and disease models. Of clinical relevance, several clinical trials are ongoing or being completed to examine the efficacy and safety of ginkgolide B-related drug preparations in the prevention of cerebrovascular diseases, such as ischemia stroke. Here, we present a comprehensive review of the pharmacological activities, pharmacokinetic characteristics, and mechanisms of action of ginkgolide B in atherosclerosis prevention and therapy. We highlight new molecular targets of ginkgolide B, including nicotinamide adenine dinucleotide phosphate oxidases (NADPH oxidase), lectin-like oxidized LDL receptor-1 (LOX-1), sirtuin 1 (SIRT1), platelet-activating factor (PAF), proprotein convertase subtilisin/kexin type 9 (PCSK9) and others. Finally, we provide an overview and discussion of the therapeutic potential of ginkgolide B and highlight the future perspective of developing ginkgolide B as an effective therapeutic agent for treating atherosclerosis.
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Affiliation(s)
- Weile Ye
- International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Ministry of Education (MOE) of China, Jinan University, Guangzhou 510632, China
- Guangdong Province Key Laboratory of Pharmacodynamic Constituents of Traditional Chinese Medicine and New Drugs Research, College of Pharmacy, Jinan University, Guangzhou 510632, China
- State Key Laboratory of Bioactive Molecules and Druggability Assessment, Jinan University, Guangzhou 510632, China
| | - Jiaojiao Wang
- International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Ministry of Education (MOE) of China, Jinan University, Guangzhou 510632, China
- Guangdong Province Key Laboratory of Pharmacodynamic Constituents of Traditional Chinese Medicine and New Drugs Research, College of Pharmacy, Jinan University, Guangzhou 510632, China
- State Key Laboratory of Bioactive Molecules and Druggability Assessment, Jinan University, Guangzhou 510632, China
| | - Peter J. Little
- Pharmacy Australia Centre of Excellence, School of Pharmacy, University of Queensland, Woolloongabba QLD 4102, Australia
- Sunshine Coast Health Institute and School of Health and Behavioural Sciences, University of the Sunshine Coast, Birtinya QLD 4575, Australia
| | - Jiami Zou
- International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Ministry of Education (MOE) of China, Jinan University, Guangzhou 510632, China
- Guangdong Province Key Laboratory of Pharmacodynamic Constituents of Traditional Chinese Medicine and New Drugs Research, College of Pharmacy, Jinan University, Guangzhou 510632, China
- State Key Laboratory of Bioactive Molecules and Druggability Assessment, Jinan University, Guangzhou 510632, China
| | - Zhihua Zheng
- International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Ministry of Education (MOE) of China, Jinan University, Guangzhou 510632, China
- Guangdong Province Key Laboratory of Pharmacodynamic Constituents of Traditional Chinese Medicine and New Drugs Research, College of Pharmacy, Jinan University, Guangzhou 510632, China
- State Key Laboratory of Bioactive Molecules and Druggability Assessment, Jinan University, Guangzhou 510632, China
| | - Jing Lu
- National-Local Joint Engineering Lab of Druggability and New Drugs Evaluation, Guangdong Provincial Key Laboratory of New Drug Design and Evaluation, Sun Yat-sen University, Guangzhou 510006, China
| | - Yanjun Yin
- School of Pharmacy, Bengbu Medical College, Bengbu 233030, China
| | - Hao Liu
- School of Pharmacy, Bengbu Medical College, Bengbu 233030, China
| | - Dongmei Zhang
- Guangdong Province Key Laboratory of Pharmacodynamic Constituents of Traditional Chinese Medicine and New Drugs Research, College of Pharmacy, Jinan University, Guangzhou 510632, China
- State Key Laboratory of Bioactive Molecules and Druggability Assessment, Jinan University, Guangzhou 510632, China
| | - Peiqing Liu
- National-Local Joint Engineering Lab of Druggability and New Drugs Evaluation, Guangdong Provincial Key Laboratory of New Drug Design and Evaluation, Sun Yat-sen University, Guangzhou 510006, China
| | - Suowen Xu
- School of Pharmacy, Bengbu Medical College, Bengbu 233030, China
- Institute of Endocrine and Metabolic Diseases, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China
| | - Wencai Ye
- Guangdong Province Key Laboratory of Pharmacodynamic Constituents of Traditional Chinese Medicine and New Drugs Research, College of Pharmacy, Jinan University, Guangzhou 510632, China
- State Key Laboratory of Bioactive Molecules and Druggability Assessment, Jinan University, Guangzhou 510632, China
| | - Zhiping Liu
- International Cooperative Laboratory of Traditional Chinese Medicine Modernization and Innovative Drug Development of Ministry of Education (MOE) of China, Jinan University, Guangzhou 510632, China
- Guangdong Province Key Laboratory of Pharmacodynamic Constituents of Traditional Chinese Medicine and New Drugs Research, College of Pharmacy, Jinan University, Guangzhou 510632, China
- State Key Laboratory of Bioactive Molecules and Druggability Assessment, Jinan University, Guangzhou 510632, China
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Gahm C, Park S. The association between skipping breakfast and chronic kidney disease. Int Urol Nephrol 2023; 55:3209-3215. [PMID: 37093440 DOI: 10.1007/s11255-023-03590-5] [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: 05/31/2022] [Accepted: 04/04/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND/OBJECTIVES There are few reports on the relationship between skipping breakfast and chronic kidney disease (CKD). We examined the skipping breakfast-CKD relationship and the mediation effects of metabolic diseases (obesity, hypertension, and diabetes) on this relationship. SUBJECTS/METHODS We analyzed the data of 21,138 participants aged ≥ 40 years from the Korea National Health and Nutrition Examination Survey 2013-2018. Skipping breakfast was defined as rarely eating breakfast over the past year. CKD was defined as decreased kidney function expressed by an estimated glomerular filtration rate of < 60 mL/min/1.73 m2. We used a complex sample logistic regression model to examine the relationship between skipping breakfast and CKD. We used Baron and Kenny's approach to examine whether metabolic diseases work as a mediator within the skipping breakfast-CKD relationships. RESULTS About 7.6% of participants skipped breakfast, and 5.5% had CKD. After adjusting for confounders, participants who skipped breakfast were at higher odds of having CKD (odds ratio 1.61; 95% confidence interval 1.07-2.42; p value 0.021) compared to those who did not skip breakfast. With full adjustments for confounders, skipping breakfast was not significantly associated with any metabolic diseases, while CKD was significantly associated with diabetes and hypertension. CONCLUSION We found that middle-aged or older people who skipped breakfast had a significantly higher odds of having CKD compared to those who did not skip breakfast. However, metabolic diseases did not mediate the relationship between skipping breakfast and CKD.
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Affiliation(s)
- Chulmin Gahm
- Graduate School of Urban Public Health, University of Seoul, 163 Seoulsiripdae-ro, Dongdaemun-gu, Seoul, 02504, Republic of Korea
| | - Sangshin Park
- Graduate School of Urban Public Health, University of Seoul, 163 Seoulsiripdae-ro, Dongdaemun-gu, Seoul, 02504, Republic of Korea.
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Yu J, Zhuang C, Guo W, Zhou X, Chen Y, Wang L, Li W, Zhu Y, Zhuang R, Tian K. Causal relationship between breakfast skipping and bone mineral density: a two-sample Mendelian randomized study. Front Endocrinol (Lausanne) 2023; 14:1200892. [PMID: 38027166 PMCID: PMC10660815 DOI: 10.3389/fendo.2023.1200892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 10/11/2023] [Indexed: 12/01/2023] Open
Abstract
Objective To explore the causal association between breakfast skipping and bone mineral density (BMD) through two-sample Mendelian randomisation (MR) analysis. Methods A two-sample MR approach was adopted to explore the causal relationship of breakfast skipping with BMDs (across three skeletal sites and five age groups). Publicly available genome-wide association study summary data were used for MR analysis. We used five methods to estimate the causal associations between breakfast skipping and BMDs: inverse-variance weighting (IVW), MR-Egger, weighted median, simple mode, and weighted mode. IVW was used for the main analysis and the remaining four methods were used as supplementary analyses. The heterogeneity of the MR results was determined using IVW and MR-Egger methods. The pleiotropy of the MR results was determined using MR-Egger intercept. Furthermore, a leave-one-out test was performed to determine whether the MR results were affected by a single nucleotide polymorphism. Results With the IVW method, we did not find any causal relationship between breakfast skipping and forearm, femoral neck, and lumbar spine BMD. Subsequently, when we included BMD data stratified by five different age groups in the analysis, the results showed that there was no apparent causal effect between breakfast skipping and age-stratified BMD. This finding was supported by all four supplementary methods (P > 0.05 for all methods). No heterogeneity or horizontal pleiotropy was detected in any of the analyses (P > 0.05). The leave-one-out tests conducted in the analyses did not identify any single nucleotide polymorphism that could have influenced the MR results, indicating the reliability of our findings. Conclusion No causal effect was found between breakfast skipping and BMD (across three skeletal sites and five age groups).
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Affiliation(s)
- Jinsheng Yu
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Chen Zhuang
- Alberta Institute, Wenzhou Medical University, Wenzhou, China
| | - Wenxuan Guo
- Orthopedic Department, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China
| | - Xing Zhou
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yixuan Chen
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Likang Wang
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Wenkai Li
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yiwen Zhu
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Rujie Zhuang
- Orthopedic Department, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China
| | - Kun Tian
- Orthopedic Department, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China
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Behbahani HB, Shokuhi M, Clark CCT, Javid AZ, Aghamohammadi V, Bazyar H, Samadani M, Haybar H. Glycemic index, glycemic load, dietary insulin index, and dietary insulin load in relation to cardiometabolic risk factors among participants with atherosclerosis: a cross-sectional study. BMC Nutr 2023; 9:98. [PMID: 37582773 PMCID: PMC10426217 DOI: 10.1186/s40795-023-00755-4] [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: 01/25/2023] [Accepted: 08/08/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND We examined the cross-sectional associations of dietary Glycemic Index (GI), Glycemic Load (GL), Dietary Insulin Index (DII), and Dietary Insulin Load (DIL) with cardiovascular disease (CVD) factors in subjects with atherosclerosis. METHODS The present cross-sectional study was conducted on subjects with atherosclerosis. Regular dietary intake was assessed using a 168-item semi-quantitative food frequency questionnaire (FFQ) and GI, GL, DIL, and DII were also calculated. Odds Ratio (OR) and 95% Confidence Intervals (CIs) were estimated for general and central obesity according to the GI, GL, DII, and DIL. RESULTS According to the continuous score of GL, there was a significant positive association between GL and central obesity for women in all models. Regarding the association between DIL score and biochemical variables, there was a significant positive association between Na and Aspartate transaminase (AST) with DII. Moreover, there was a significant positive association between LDL-c(p = 0.03) and AST (p = 0.04)with DIL score in all 3 models. CONCLUSION In this study, GL was associated with greater odds of central obesity in women, but not in men. Neither dietary DII nor DIL was associated with BMI and central obesity. GI, GL, DII, and DIL were significantly associated with some CVD risk biomarkers in subjects with atherosclerosis.
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Affiliation(s)
- Hossein Bavi Behbahani
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahshad Shokuhi
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Cain C T Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, CV1 5FB, UK
| | - Ahmad Zare Javid
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Hadi Bazyar
- Department of Public Health, Sirjan School of Medical Sciences, Sirjan, Iran.
- Student Research Committee, Sirjan School of Medical Sciences, Sirjan, Iran.
| | - Mahsa Samadani
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Habib Haybar
- Cardiovascular Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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10
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Liu T, Wang Y, Wang X, Liu C, Zhang Q, Song M, Song C, Zhang Q, Shi H. Habitually Skipping Breakfast Is Associated with the Risk of Gastrointestinal Cancers: Evidence from the Kailuan Cohort Study. J Gen Intern Med 2023; 38:2527-2536. [PMID: 36869181 PMCID: PMC10465444 DOI: 10.1007/s11606-023-08094-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 02/08/2023] [Indexed: 03/05/2023]
Abstract
BACKGROUND Habitually skipping breakfast may promote the initiation and progression of gastrointestinal (GI) cancers, which have never been systematically explored in large-scale prospective studies. METHODS We prospectively examined the effects of breakfast frequency on the occurrence of GI cancers among 62,746 participants. The hazard ratios (HRs) and 95% confidence intervals (95% CIs) of GI cancers were calculated by Cox regression. The CAUSALMED procedure was used to perform the mediation analyses. RESULTS During a median follow-up of 5.61 (5.18 ~ 6.08) years, 369 incident GI cancer cases were identified. Participants who consumed 1-2 times breakfasts per week exhibited an increased risk of stomach (HR = 3.45, 95% CI: 1.06-11.20) and liver cancer (HR = 3.42, 95% CI: 1.22-9.53). Participants who did not eat breakfast had an elevated risk of esophageal (HR = 2.72, 95% CI: 1.05-7.03), colorectal (HR = 2.32, 95% CI: 1.34-4.01), liver (HR = 2.41, 95% CI: 1.23-4.71), gallbladder, and extrahepatic bile duct cancer (HR = 5.43, 95% CI: 1.34-21.93). In the mediation effect analyses, BMI, CRP, and TyG (fasting triglyceride-glucose) index did not mediate the association between breakfast frequency and the risk of GI cancer incidence (all P for mediation effect > 0.05). CONCLUSIONS Habitually skipping breakfast was associated with a greater risk of GI cancers including esophageal, gastric, colorectal, liver, gallbladder, and extrahepatic bile duct cancer. TRIAL REGISTRATION Kailuan study, ChiCTR-TNRC-11001489. Registered 24 August, 2011-Retrospectively registered, http://www.chictr.org.cn/showprojen.aspx?proj=8050.
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Affiliation(s)
- Tong Liu
- Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038 China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038 China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038 China
| | - Yiming Wang
- Department of Hepatobiliary Surgery, Kailuan General Hospital, Tangshan, 063000 China
| | - Xiaomeng Wang
- Department of Education, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038 China
- Department of Education, Peking University Ninth School of Clinical Medicine, Beijing, 100038 China
| | - Chenan Liu
- Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038 China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038 China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038 China
| | - Qi Zhang
- Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038 China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038 China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038 China
| | - Mengmeng Song
- Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038 China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038 China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038 China
| | - Chunhua Song
- Department of Epidemiology and Statistics, College of Public Health, Zhengzhou University, ZhengzhouHenan, 450001 China
| | - Qingsong Zhang
- Department of General Surgery, Kailuan General Hospital, Tangshan, 063000 China
| | - Hanping Shi
- Department of Gastrointestinal Surgery/Clinical Nutrition, Capital Medical University Affiliated Beijing Shijitan Hospital, Beijing, 100038 China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038 China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038 China
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11
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Marjot T, Tomlinson JW, Hodson L, Ray DW. Timing of energy intake and the therapeutic potential of intermittent fasting and time-restricted eating in NAFLD. Gut 2023; 72:1607-1619. [PMID: 37286229 PMCID: PMC10359613 DOI: 10.1136/gutjnl-2023-329998] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 05/14/2023] [Indexed: 06/09/2023]
Abstract
Non-alcoholic fatty liver disease (NAFLD) represents a major public health concern and is associated with a substantial global burden of liver-related and cardiovascular-related morbidity and mortality. High total energy intake coupled with unhealthy consumption of ultra-processed foods and saturated fats have long been regarded as major dietary drivers of NAFLD. However, there is an accumulating body of evidence demonstrating that the timing of energy intake across a the day is also an important determinant of individual risk for NAFLD and associated metabolic conditions. This review summarises the available observational and epidemiological data describing associations between eating patterns and metabolic disease, including the negative effects of irregular meal patterns, skipping breakfast and night-time eating on liver health. We suggest that that these harmful behaviours deserve greater consideration in the risk stratification and management of patients with NAFLD particularly in a 24-hour society with continuous availability of food and with up to 20% of the population now engaged in shiftwork with mistimed eating patterns. We also draw on studies reporting the liver-specific impact of Ramadan, which represents a unique real-world opportunity to explore the physiological impact of fasting. By highlighting data from preclinical and pilot human studies, we present a further biological rationale for manipulating timing of energy intake to improve metabolic health and discuss how this may be mediated through restoration of natural circadian rhythms. Lastly, we comprehensively review the landscape of human trials of intermittent fasting and time-restricted eating in metabolic disease and offer a look to the future about how these dietary strategies may benefit patients with NAFLD and non-alcoholic steatohepatitis.
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Affiliation(s)
- Thomas Marjot
- Oxford Centre for Diabetes Endocrinology and Metabolism, NIHR Oxford Biomedical Research Centre, Churchill Hospital, University of Oxford, Oxford, UK
- Oxford Liver Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Jeremy W Tomlinson
- Oxford Centre for Diabetes Endocrinology and Metabolism, NIHR Oxford Biomedical Research Centre, Churchill Hospital, University of Oxford, Oxford, UK
| | - Leanne Hodson
- Oxford Centre for Diabetes Endocrinology and Metabolism, NIHR Oxford Biomedical Research Centre, Churchill Hospital, University of Oxford, Oxford, UK
| | - David W Ray
- Oxford Centre for Diabetes Endocrinology and Metabolism, NIHR Oxford Biomedical Research Centre, Churchill Hospital, University of Oxford, Oxford, UK
- Sir Jules Thorn Sleep and Circadian Neuroscience Institute, University of Oxford, Oxford, UK
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12
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Sakai K, Okada H, Hamaguchi M, Nishioka N, Tateyama Y, Shimamoto T, Kurogi K, Murata H, Ito M, Iwami T, Fukui M. Eating behaviors and incident cardiovascular disease in Japanese people: The population-based Panasonic cohort study 14. Curr Probl Cardiol 2023:101818. [PMID: 37211300 DOI: 10.1016/j.cpcardiol.2023.101818] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 05/23/2023]
Abstract
Evidence on common eating behaviors to support the prevention of cardiovascular disease (CVD) in Japanese people is insufficient. This retrospective cohort study aimed to investigate the association of diet behaviors (e.g., skipping breakfast, eating speed, snack after dinner, and alcohol consumption) with incident CVD in Japanese individuals. Employees of Panasonic Corporation who underwent the annual health checkups and without a history of CVD at baseline were enrolled. The main outcome was incident 3-point major adverse cardiovascular events (MACE). The secondary outcomes were incident coronary artery disease (CAD) and stroke. To assess the effect of BMI, the subgroup analysis was conducted. In total, 132,795 participants were included. Overall, 3,115, 1,982, and 1,165 participants developed 3-point MACE, CAD, and stroke, respectively. Skipping breakfast (HR: 1.13, 95% CI: 1.03-1.23) and fast eating (HR: 1.23, 95% CI: 1.04-1.47) were associated with 3-point MACE in the participants overall. Skipping breakfast (HR: 1.23, 95% CI: 1.10-1.37) and fast eating (HR: 1.38, 95% CI: 1.12-1.71) were also associated with 3-point MACE in participants with BMI < 25 kg/m2. In contrast, in participants with BMI ≥ 25 kg/m2, these associations were not detectable (P value for the interaction between subgroups = 0.09 [skipping breakfast] and 0.03 [fast eating], respectively). The diet behavior is a potential risk factor of incident CVD in Japanese people, particularly in those with BMI < 25 kg/m2.
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Affiliation(s)
- Kimiko Sakai
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Hiroshi Okada
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan; Department of Diabetes and Endocrinology, Matsushita Memorial Hospital, Moriguchi, Japan.
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - Norihiro Nishioka
- Department of Preventive Services, Kyoto University School of Public Health, Kyoto, Japan
| | - Yukiko Tateyama
- Department of Preventive Services, Kyoto University School of Public Health, Kyoto, Japan
| | - Tomonari Shimamoto
- Department of Preventive Services, Kyoto University School of Public Health, Kyoto, Japan
| | - Kazushiro Kurogi
- Department of Health Care Center, Panasonic Health Insurance Organization, Moriguchi, Japan
| | - Hiroaki Murata
- Department of Orthopaedic Surgery, Matsushita Memorial Hospital, Moriguchi, Japan
| | - Masato Ito
- Department of Health Care Center, Panasonic Health Insurance Organization, Moriguchi, Japan
| | - Taku Iwami
- Department of Preventive Services, Kyoto University School of Public Health, Kyoto, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
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13
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Alashmali S, Aljaaly E. Investigating the quality of breakfast for female adolescents using a multi-method approach in Saudi Arabia: A cross-sectional study. Medicine (Baltimore) 2023; 102:e33248. [PMID: 36961177 PMCID: PMC10035993 DOI: 10.1097/md.0000000000033248] [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: 10/17/2022] [Accepted: 02/20/2023] [Indexed: 03/25/2023] Open
Abstract
Breakfast has been shown to provide nutritional adequacy and improve the healthy lifestyle status of adolescents. However, limited information is available on the quality of breakfast among adolescents. Thus, this study aimed to evaluate the quality of breakfast among adolescents using a multiple-method approach in Saudi Arabia. This cross-sectional, school-based study was conducted in 3 public high schools in Al-Jumum, Saudi Arabia. High school females (n = 174) aged 15 to 18 years old were selected considering the regularity of consuming breakfast (≥ 4 d/wk and not after 10:00 a.m.). The quality of breakfast was assessed using 3 approaches: the modified Saudi food frequency questionnaire, the adapted method of breakfast quality, and the nutrient profile model. Sweet food items were consumed most frequently (64.9%, n = 113), followed by drinks (57.4%, n = 100), while the least frequently consumed items were sandwiches and burgers (43.52%, n = 76), snacks (41.9%, n = 72), and dairy and fats (41.8%, n = 71). The majority of breakfast eaters were classified as eating breakfasts of poor quality (50.6%), while the rest ate breakfasts of either good quality (38.1%) or very poor breakfast quality (10.8%). Based on the nutrient profile model of breakfast, high fat salt sugar (HFSS) food/drink items and non-HFSS items were consumed by 44.4% and 55.5% of the participants, respectively. This study showed that the majority of female adolescents consume poor-quality breakfast, mostly sweets and sweetened beverages. The nutrient content analysis emphasized these results by presenting a similar consumption of non-HFSS and HFSS breakfast foods. Future education programs on healthy breakfast options should be implemented among this population.
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Affiliation(s)
- Shoug Alashmali
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdul Aziz University, Jeddah, Saudi Arabia
| | - Elham Aljaaly
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdul Aziz University, Jeddah, Saudi Arabia
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14
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Tang D, Tang Q, Huang W, Zhang Y, Tian Y, Fu X. Fasting: From Physiology to Pathology. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2023; 10:e2204487. [PMID: 36737846 PMCID: PMC10037992 DOI: 10.1002/advs.202204487] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 01/06/2023] [Indexed: 06/18/2023]
Abstract
Overnutrition is a risk factor for various human diseases, including neurodegenerative diseases, metabolic disorders, and cancers. Therefore, targeting overnutrition represents a simple but attractive strategy for the treatment of these increasing public health threats. Fasting as a dietary intervention for combating overnutrition has been extensively studied. Fasting has been practiced for millennia, but only recently have its roles in the molecular clock, gut microbiome, and tissue homeostasis and function emerged. Fasting can slow aging in most species and protect against various human diseases, including neurodegenerative diseases, metabolic disorders, and cancers. These centuried and unfading adventures and explorations suggest that fasting has the potential to delay aging and help prevent and treat diseases while minimizing side effects caused by chronic dietary interventions. In this review, recent animal and human studies concerning the role and underlying mechanism of fasting in physiology and pathology are summarized, the therapeutic potential of fasting is highlighted, and the combination of pharmacological intervention and fasting is discussed as a new treatment regimen for human diseases.
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Affiliation(s)
- Dongmei Tang
- Division of Endocrinology and Metabolism, National Clinical Research Center for Geriatrics, State Key Laboratory of Biotherapy, West China HospitalSichuan University and Collaborative Innovation Center of BiotherapyChengduSichuan610041China
| | - Qiuyan Tang
- Neurology Department of Integrated Traditional Chinese and Western Medicine, School of Clinical MedicineChengdu University of Traditional Chinese MedicineChengduSichuan610075China
| | - Wei Huang
- West China Centre of Excellence for PancreatitisInstitute of Integrated Traditional Chinese and Western MedicineWest China‐Liverpool Biomedical Research CentreWest China HospitalSichuan UniversityChengduSichuan610041China
| | - Yuwei Zhang
- Division of Endocrinology and MetabolismWest China HospitalSichuan UniversityChengduSichuan610041China
| | - Yan Tian
- Division of Endocrinology and Metabolism, National Clinical Research Center for Geriatrics, State Key Laboratory of Biotherapy and Cancer Center, West China HospitalSichuan University and Collaborative Innovation Center of BiotherapyChengduSichuan610041China
| | - Xianghui Fu
- Division of Endocrinology and Metabolism, National Clinical Research Center for Geriatrics, State Key Laboratory of Biotherapy and Cancer Center, West China HospitalSichuan University and Collaborative Innovation Center of BiotherapyChengduSichuan610041China
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15
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Basdeki ED, Argyris AA, Efthymiou O, Athanasopoulou E, Sfikakis PP, Protogerou AD, Karatzi K. Systematic Breakfast Consumption of Medium-Quantity and High-Quality Food Choices Is Associated with Better Vascular Health in Individuals with Cardiovascular Disease Risk Factors. Nutrients 2023; 15:nu15041025. [PMID: 36839387 PMCID: PMC9967081 DOI: 10.3390/nu15041025] [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: 01/23/2023] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Breakfast consumption has been associated with the improvement of many cardiovascular disease (CVD) risk factors, yet data regarding its association with subclinical vascular damage, which precedes the onset of CVD, are scarce. The aim of this study is to investigate this association in a large sample of adults with CVD risk factors. METHODS Anthropometric measurements, vascular biomarkers and dietary intake with two 24-h dietary recalls, focusing on breakfast frequency and its quantity and content, were assessed in 902 adults (45.2% males). Breakfast quality was assessed by identifying a posteriori breakfast dietary pattern (DP) by using principal component analysis (PCA). RESULTS Systematic breakfast consumption (SBC) was inversely associated with central systolic blood pressure (b: -3.28, 95% C.I.: -5.7 to -0.86), diastolic blood pressure (b: -1.85, 95% C.I.: -3.34 to -0.36), augmentation index (b: -3.17, 95% C.I.:-4.98 to 1.35) and left carotid intima media thickness (b: -0.03, 95% C.I.:-0.06 to -0.01) compared to breakfast skipping independently of age, sex, hypertension, diabetes, dyslipidemia, smoking, and BMI. SBC of 10-20% of daily total energy intake (dTEI) was inversely associated with Aix (b: -2.31, 95% C.I.:-4.05 to -0.57) compared to <10% dTEI after adjustment for the aforementioned confounders. DP1 (high coffee and sugar consumption, low consumption of low- and full-fat dairy products, fruits, and fresh juices) was positively associated with Aix (b: 1.19, 95% C.I.: 0.48 to 1.90). CONCLUSION SBC comprised of medium-energy density and high-nutrient content food items may be a simple daily habit associated with better vascular health.
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Affiliation(s)
- Eirini D. Basdeki
- Cardiovascular Prevention & Research Unit, Clinic & Laboratory of Pathophysiology, Department of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Antonios A. Argyris
- Cardiovascular Prevention & Research Unit, Clinic & Laboratory of Pathophysiology, Department of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Olga Efthymiou
- Department of Life Sciences, School of Sciences, European University of Cyprus, Nicosia 22006, Cyprus
| | - Elpida Athanasopoulou
- Cardiovascular Prevention & Research Unit, Clinic & Laboratory of Pathophysiology, Department of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Petros P. Sfikakis
- 1st Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Athanase D. Protogerou
- Cardiovascular Prevention & Research Unit, Clinic & Laboratory of Pathophysiology, Department of Medicine, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Kalliopi Karatzi
- Laboratory of Dietetics and Quality of Life, Department of Food Science & Human Nutrition, Agricultural University of Athens, 75 Iera Odos, 11855 Athens, Greece
- Correspondence:
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16
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Du X, Yang R, Ma M, Ke S, Zheng J, Tan X. The association of energy and macronutrient intake at breakfast and cardiovascular disease in Chinese adults: From a 14-year follow-up cohort study. Front Nutr 2023; 10:1093561. [PMID: 37020811 PMCID: PMC10069285 DOI: 10.3389/fnut.2023.1093561] [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: 11/09/2022] [Accepted: 02/13/2023] [Indexed: 04/07/2023] Open
Abstract
Background We aimed to examine the associations between energy and macronutrient intakes at breakfast and the incidence of cardiovascular events among Chinese adults. Methods There were 12,937 participants from the China Health and Nutrition Survey who met the study criteria and completed six rounds of questionnaires in 1997, 2000, 2004, 2006, 2009, and 2011. Combined weighing methods with 24-h dietary recall were used to measure dietary intake throughout the day. Intakes of macronutrients at breakfast were calculated using energy provided by nutrients as a percentage of breakfast energy. We calculated hazard ratios using a multivariable Cox frailty model with random intercepts to account for household clustering. Results During follow-up, we documented 453 (3.6 per 1,000 person-years) major cardiovascular events, 195 (1.5 per 1,000 person-years) myocardial infarctions, and 293 (2.3 per 1,000 person-years) strokes. In Chinese adults, more breakfast carbohydrates or less proteins intake was associated with the reduced risk of cardiovascular diseases. Especially for women, higher intake of breakfast carbohydrates was associated with a lower risk of major cardiovascular events (quintile 5 vs. quintile 1, HR 0.47 [95%CI 0.30-0.74]; p trend = 0.0008) and stroke (quintile 5 vs. quintile 1, HR 0.48 [95%CI 0.26-0.88]; p trend = 0.0006). Higher intake of breakfast proteins was associated with a higher risk of major cardiovascular events (quintile 5 vs. quintile 1, HR 1.77 [95%CI 1.12-2.79]; p trend = 0.1162), myocardial infarction (quintile 5 vs. quintile 1, HR 2.49 [95%CI 1.21-5.11]; p trend = 0.2641). There was a significant association between breakfast fat intake and cardiovascular diseases in the adult population, but less significant correlation was found in Chinese men or women. Breakfast fat intake was positively associated with the risk of major cardiovascular events (quintile 5 vs. quintile 1, HR 1.74 [95%CI 1.27-2.36]; p trend = 0.0070), myocardial infarction (quintile 5 vs. quintile 1, HR 2.03 [95%CI 1.23-3.37]; p trend = 0.0168), and stroke (quintile 5 vs. quintile 1, HR 1.64 [95%CI 1.12-2.41]; p trend = 0.0732). There was a significant reduction in major cardiovascular events and stroke when breakfast energy intake was moderated, even if the independence of skipping breakfast. Conclusion High carbohydrate intake and low protein and fat intake at breakfast may contribute to cardiovascular health while maintaining a moderate energy intake.
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Affiliation(s)
- Xiaoan Du
- Wuhan Blood Center, Institute of Blood Transfusion of Hubei Province, Wuhan, China
| | - Ru Yang
- Wuhan Blood Center, Institute of Blood Transfusion of Hubei Province, Wuhan, China
| | - Mengdi Ma
- Wuhan Blood Center, Institute of Blood Transfusion of Hubei Province, Wuhan, China
| | - Songqing Ke
- Wuhan Blood Center, Institute of Blood Transfusion of Hubei Province, Wuhan, China
| | - Jie Zheng
- Wuhan Blood Center, Institute of Blood Transfusion of Hubei Province, Wuhan, China
- *Correspondence: Jie Zheng,
| | - Xiaodong Tan
- School of Public Health, Wuhan University, Wuhan, China
- School of Health and Nursing, Wuchang University of Technology, Wuhan, China
- Xiaodong Tan,
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Niki A, Baden MY, Kato S, Mitsushio K, Horii T, Ozawa H, Ishibashi C, Fujita S, Kimura T, Fujita Y, Tokunaga A, Nammo T, Fukui K, Kozawa J, Shimomura I. Consumption of two meals per day is associated with increased intrapancreatic fat deposition in patients with type 2 diabetes: a retrospective study. BMJ Open Diabetes Res Care 2022; 10:10/5/e002926. [PMID: 36126992 PMCID: PMC9490586 DOI: 10.1136/bmjdrc-2022-002926] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 08/28/2022] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION This study aimed to identify the associations between lifestyle factors and intrapancreatic fat deposition in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS The participants were 185 patients with type 2 diabetes who were hospitalized at Osaka University Hospital between 2008 and 2020 and underwent abdominal CT during hospitalization. Information regarding lifestyle factors, including the number of meals consumed per day, snacking habits, exercise habits, exercise at work, smoking habits, alcohol intake, insomnia, sleep apnea syndrome, and night-shift working, was acquired from self-administered questionnaires or medical records. We measured the mean CT values for the pancreas (P), liver (L), and spleen (S), and the visceral fat area (VFA), and quantified intrapancreatic and liver ectopic fat accumulation as P-S and L-S, respectively. RESULTS After adjustment for age, sex, hemoglobin A1c, and body mass index (BMI), participants who consumed two meals per day had significantly lower P-S (higher intrapancreatic fat deposition, p=0.02) than those who consumed three meals per day. There were no significant associations between the number of meals consumed and liver ectopic fat accumulation and VFA (p=0.73 and p=0.67, respectively). CONCLUSIONS Patients with diabetes who consumed two meals per day showed greater intrapancreatic fat deposition than those who consumed three meals per day, even after adjustment for BMI. These findings support the current guideline for diabetes treatment that skipping meals should be avoided.
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Affiliation(s)
- Akiko Niki
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Megu Y Baden
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Lifestyle Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Sarasa Kato
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kento Mitsushio
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Tomomi Horii
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Harutoshi Ozawa
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Lifestyle Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Chisaki Ishibashi
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Shingo Fujita
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Takekazu Kimura
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Yukari Fujita
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Community Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Ayumi Tokunaga
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Takao Nammo
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kenji Fukui
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Junji Kozawa
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan
- Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan
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18
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Abstract
Dietary habits play an important role in the development of obesity and type 2 diabetes. However, evidence on association between diet frequency and type 2 diabetes was limited and inconclusive. We aimed to examine the association between meal frequency and risk of type 2 diabetes. The cohort study used data from China Health and Retirement Longitudinal Study of 8874 community-dwelling people aged over 45 years. Participants were classified as eating two meals per day, three meals per day and four meals per day. Multiple Poisson regression models were used to examine risk of 4-year incident type 2 diabetes among people who ate more or less than three meals per day compared with people who ate three meals per day. We documented 706 type 2 diabetes cases during follow-up. After adjustment for known risk factors for type 2 diabetes, except for BMI, participants who ate four meals per day were at a lower risk of type 2 diabetes than those who ate three meals per day (relative risk(RR) = 0·73 (0·58, 0·92)). After further adjustment for baseline BMI, the association was slightly attenuated but remained statistically significant (RR = 0·76 (0·60, 0·97)). Subgroup analysis showed that the fully adjusted RR of type 2 diabetes for people eating four meals per day were 0·66 (0·48, 0·91) and 0·93 (0·65, 1·34) among those had a BMI < 25 and ≥ 25 kg/m2, respectively. Eating four meals per day, compared with eating three meals per day was associated with lower risk of developing type 2 diabetes in a Chinese population, particularly in those with a BMI < 25 kg/m2.
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19
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Askari S, Salimi N, Bakhshi E. Predictors Of Breakfast Consumption Among Iranian Students: Applying Social Cognitive Theory. RUSSIAN OPEN MEDICAL JOURNAL 2022. [DOI: 10.15275/rusomj.2022.0208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background — Despite the known significance of regular breakfast consumption, skipping or inadequate consumption of breakfast is common among students. Social cognitive theory (SCT) is one of the most effective theories in predicting nutritional behaviors, especially breakfast-related behaviors Objective — This study aimed to determine the factors related to breakfast consumption based on SCT among students of Islamic Azad University Kermanshah Branch. Methods — In this cross-sectional study, 206 students of Islamic Azad University Kermanshah Branch were selected based on availability sampling. An online questionnaire consisting of demographic information scales, SCT variables and breakfast consumption behavior was sent to student groups. Data were analyzed using descriptive statistical tests, chi-square test, linear regression and correlation analysis in SPSS software version 16. Results — On average, students consume breakfast 4.39 times a week. Overall, 17.6% of students had completely ignored breakfast and 42.4% of them ate breakfast irregularly between one and six times a week. Among the components of social cognitive theory, self-efficacy and observational learning predicted 55.7% of changes in breakfast consumption among students (P<0.001). Conclusions — It seems that social cognitive theory is a useful framework for predicting breakfast consumption behavior among young people, and it is possible to improve breakfast consumption behavior by designing and implementing appropriate educational interventions based on this theory.
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Affiliation(s)
| | | | - Ehsan Bakhshi
- Kermanshah University of Medical Science, Kermanshah, Iran
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20
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Duan H, Pan J, Guo M, Li J, Yu L, Fan L. Dietary strategies with anti-aging potential: dietary patterns and supplements. Food Res Int 2022; 158:111501. [DOI: 10.1016/j.foodres.2022.111501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 06/05/2022] [Accepted: 06/09/2022] [Indexed: 11/04/2022]
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21
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Yu L, Zhu Q, Li Y, Song P, Zhang J. Dietary Branched-Chain Amino Acids (BCAAs) and Risk of Dyslipidemia in a Chinese Population. Nutrients 2022; 14:nu14091824. [PMID: 35565798 PMCID: PMC9103899 DOI: 10.3390/nu14091824] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/24/2022] [Accepted: 04/25/2022] [Indexed: 12/10/2022] Open
Abstract
This study aimed to explore the association between dietary BCAAs, blood lipid levels and risk of dyslipidemia. In this case−control study, a total of 9541 subjects with normal blood lipids were included as a control group, and 9792 patients with dyslipidemia were included as a case group. Dietary BCAA intake data were measured using 3-day 24 h meal recalls and household condiment weighing. All samples were from China Nutrition and Health Surveillance (2015). Generalized linear model, logistic regression, and restricted cubic spline (RCS) were used to evaluate the relationship between dietary BCAAs, blood lipids and dyslipidemia. After adjusting for confounding factors, dietary BCAAs were positively correlated with TC and LDL-C (p < 0.05). Higher dietary BCAAs were associated with higher OR for Hypercholesteremia (Q4 vs. Q1, OR = 1.29, 95% CI: 1.05−1.58, p-trend = 0.034). The ORs of Hyper-LDL-cholesterolemia showed inverted U-shaped with increasing dietary BCAAs (Q3 vs. Q1, OR = 1.20, 95% CI: 1.03−1.39; Q2 vs. Q1, OR = 1.05, 95% CI: 1.01−1.31). The relationship between dietary BCAAs and the risk of Hypercholesteremia and Hyper-LDL-cholesterolemia were both nonlinear (p nonlinearity = 0.0059, 0.0198). Our study reveals that dietary BCAAs are associated with specific types of lipids and risk of dyslipidemia, some of which may be non-linear.
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Affiliation(s)
- Lianlong Yu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China; (L.Y.); (Q.Z.); (Y.L.); (P.S.)
| | - Qianrang Zhu
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China; (L.Y.); (Q.Z.); (Y.L.); (P.S.)
| | - Yuqian Li
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China; (L.Y.); (Q.Z.); (Y.L.); (P.S.)
- NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Pengkun Song
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China; (L.Y.); (Q.Z.); (Y.L.); (P.S.)
| | - Jian Zhang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China; (L.Y.); (Q.Z.); (Y.L.); (P.S.)
- Correspondence: ; Tel.: +86-010-6623-7174
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22
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Nizami H, Su L, Jain R, Jain R. Effects of chronically skipping meals on atrial fibrillation risk. Future Cardiol 2022; 18:497-506. [PMID: 35360935 DOI: 10.2217/fca-2021-0086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Atrial fibrillation is the most common form of arrhythmia and can result in significant morbidity and mortality. While there are many potential causes of atrial fibrillation that have been well studied, this work considers the potential effect of chronically skipping meals on the development of atrial fibrillation. The authors discuss the various processes that skipping meals initiates in the body that may ultimately result in atrial fibrillation. Through a better understanding of the various disease pathophysiologies that can contribute to the development of atrial fibrillation, this narrative review may help lead to more advanced therapeutic and preventive approaches.
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Affiliation(s)
- Hamasah Nizami
- School of Medicine, American University of Integrative Sciences, #9 5th Avenue Belleville, St. Michael, Barbados
| | - Lilly Su
- School of Medicine, Pennsylvania State College of Medicine, 700 HMC Crescent Road, Hershey, PA 17033, USA
| | - Rahul Jain
- University Hospital, 1 Hospital drive, Columbia, MO 65212, USA
| | - Rohit Jain
- Penn State Milton S. Hershey Medical Center, 500 University Drive, Hershey, PA 17033, USA
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23
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Li QM, Wu CK, Ma PC, Cui H, Li RN, Hong C, Zeng L, Liao SW, Xiao LS, Liu L, Li WY. Breakfast consumption frequency is associated with dyslipidemia: a retrospective cohort study of a working population. Lipids Health Dis 2022; 21:33. [PMID: 35351127 PMCID: PMC8966363 DOI: 10.1186/s12944-022-01641-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/02/2022] [Indexed: 01/03/2023] Open
Abstract
Background Dyslipidemia is a significant contributor to cardiovascular and cerebrovascular diseases. Research on the relationship between breakfast consumption frequency and dyslipidemia in the working population is lacking. Therefore, we aimed to investigate this relationship based on a retrospective cohort study of a large working population in China. Methods This retrospective cohort study used data from the physical examinations and questionnaire survey of working participants at Nanfang Hospital from January 20, 2015 to October 16, 2020. Univariate and multivariate analyses were conducted to explore the relationship between breakfast consumption frequency and dyslipidemia in this working population (n = 7644). Results The prevalence of dyslipidemia among the participants was 26.4%. The univariate logistic regression test showed that the breakfast consumption frequency was inversely correlated with dyslipidemia. After adjusting for multiple factors, such as sex, age, body mass index, hypertension, hyperuricaemia, diabetes, smoking status, alcohol consumption, education level, marital status, long-term exposure to kitchen oil fumes, attending business dinners, and sleep time, it was found that breakfast consumption remained inversely associated with dyslipidaemia. The odds ratio for daily breakfast consumption was 0.466 (95% confidence interval 0.283–0.770, P = 0.003). After adjusting for confounding factors, we found that the higher the frequency of breakfast consumption, the lower the odds ratios for hypertriglyceridaemia. Conclusions This study demonstrated that breakfast consumption frequency was inversely correlated with dyslipidemia. The higher the frequency of breakfast, the lower the risk of hypertriglyceridaemia. This study provides a basis on which dietary suggestions for the working population and lifestyle guidance for patients with a clinical need to prevent dyslipidemia can be made. Supplementary Information The online version contains supplementary material available at 10.1186/s12944-022-01641-x.
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24
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Xie J, Huang H, Chen Y, Xu L, Xu C. Skipping breakfast is associated with an increased long-term cardiovascular mortality in metabolic dysfunction-associated fatty liver disease (MAFLD) but not MAFLD-free individuals. Aliment Pharmacol Ther 2022; 55:212-224. [PMID: 34877669 DOI: 10.1111/apt.16727] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/03/2021] [Accepted: 11/23/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Balancing calorie control to prevent cardiovascular diseases (CVDs) by skipping breakfast while guarding against its potential risks is a challenge. AIMS To explore the association between skipping breakfast and cardiovascular mortality in individuals with metabolic dysfunction-associated fatty liver disease (MAFLD). METHODS A total of 9926 individuals (including 3004 MAFLD participants) aged 20 years or older were enrolled in the Third National Health and Nutrition Examination Survey and followed for up to 27 years. All participants were classified according to the frequency of breakfast consumption (every day, some days, rarely and never). Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for cardiovascular mortality. RESULTS During the 212 239 person-years of follow-up, we documented a total of 2595 deaths including 603 deaths from CVDs. Of these, 1039 deaths including 253 deaths from CVDs were recorded in MAFLD individuals. MAFLD individuals showed higher cardiovascular mortality than MAFLD-free controls (P < 0.001). Furthermore, skipping breakfast was independently associated with high cardiovascular mortality risk (adjusted HR: 2.850, 95% CI: 1.490-5.452; P = 0.002), and a high cerebrovascular disease mortality risk (adjusted HR: 5.570, 95% CI: 1.814-17.099; P = 0.003) in participants with MAFLD. However, skipping breakfast was not associated with cardiovascular mortality in MAFLD-free individuals (adjusted HR: 1.526, 95% CI: 0.701-3.326; P = 0.280). CONCLUSIONS In this US population-based study, skipping breakfast was associated with a high risk of cardiovascular mortality in MAFLD but not MAFLD-free individuals.
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Affiliation(s)
- Jiarong Xie
- Department of Gastroenterology, Ningbo First Hospital, Ningbo, China.,Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Hangkai Huang
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yishu Chen
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lei Xu
- Department of Gastroenterology, Ningbo First Hospital, Ningbo, China.,Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chengfu Xu
- Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
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25
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Mähler A, Jahn C, Klug L, Klatte C, Michalsen A, Koppold-Liebscher D, Boschmann M. Metabolic Response to Daytime Dry Fasting in Bahá'í Volunteers-Results of a Preliminary Study. Nutrients 2021; 14:nu14010148. [PMID: 35011024 PMCID: PMC8746620 DOI: 10.3390/nu14010148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 12/26/2021] [Accepted: 12/28/2021] [Indexed: 12/26/2022] Open
Abstract
Each year in March, adherents of the Bahá’í faith abstain from eating and drinking from sunrise to sunset for 19 days. Thus, Bahá’í fasting (BF) can be considered as a form of daytime dry fasting. We investigated whether BF decreased energy expenditure after a meal and whether it improved anthropometric measures and systemic and tissue-level metabolic parameters. This was a self-controlled cohort study with 11 healthy men. We measured anthropometric parameters, metabolic markers in venous blood and pre- and postprandial energy metabolism at systemic (indirect calorimetry) and tissue (adipose tissue and skeletal muscle microdialysis) level, both before and during BF. During BF, we found reduced body weight, body mass index, body fat and blood glucose. Postprandial increase in energy expenditure was lower and diet-induced thermogenesis tended to be lower as well. In adipose tissue, perfusion, glucose supply and lipolysis were increased. In skeletal muscle, tissue perfusion did not change. Glucose supply and lipolysis were decreased. Glucose oxidation was increased, indicating improved insulin sensitivity. BF may be a promising approach to losing weight and improving metabolism and health. However, outside the context of religiously motivated fasting, skipping a meal in the evening (dinner cancelling) might be recommended, as metabolism appeared to be reduced in the evening.
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Affiliation(s)
- Anja Mähler
- Experimental and Clinical Research Center (ECRC), a Cooperation between Charité—Universitätsmedizin Berlin and Max-Delbrück-Center for Molecular Medicine, 13125 Berlin, Germany; (C.J.); (L.K.); (M.B.)
- Berlin Institute of Health, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany
- Max-Delbrück-Center for Molecular Medicine (MDC) in the Helmholtz Association, 13125 Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), 10785 Berlin, Germany
- Correspondence: ; Tel.: +49-30-450-540-323
| | - Carmen Jahn
- Experimental and Clinical Research Center (ECRC), a Cooperation between Charité—Universitätsmedizin Berlin and Max-Delbrück-Center for Molecular Medicine, 13125 Berlin, Germany; (C.J.); (L.K.); (M.B.)
| | - Lars Klug
- Experimental and Clinical Research Center (ECRC), a Cooperation between Charité—Universitätsmedizin Berlin and Max-Delbrück-Center for Molecular Medicine, 13125 Berlin, Germany; (C.J.); (L.K.); (M.B.)
| | - Caroline Klatte
- Institute of Social Medicine, Epidemiology & Health Economics, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany; (C.K.); (A.M.); (D.K.-L.)
| | - Andreas Michalsen
- Institute of Social Medicine, Epidemiology & Health Economics, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany; (C.K.); (A.M.); (D.K.-L.)
- Department of Internal and Integrative Medicine, Immanuel Krankenhaus Berlin, 14109 Berlin, Germany
| | - Daniela Koppold-Liebscher
- Institute of Social Medicine, Epidemiology & Health Economics, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany; (C.K.); (A.M.); (D.K.-L.)
| | - Michael Boschmann
- Experimental and Clinical Research Center (ECRC), a Cooperation between Charité—Universitätsmedizin Berlin and Max-Delbrück-Center for Molecular Medicine, 13125 Berlin, Germany; (C.J.); (L.K.); (M.B.)
- Berlin Institute of Health, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany
- Max-Delbrück-Center for Molecular Medicine (MDC) in the Helmholtz Association, 13125 Berlin, Germany
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26
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Katsuura-Kamano S, Arisawa K, Uemura H, Van Nguyen T, Takezaki T, Ibusuki R, Suzuki S, Otani T, Okada R, Kubo Y, Tamura T, Hishida A, Koyama T, Matsui D, Kuriki K, Takashima N, Miyagawa N, Ikezaki H, Matsumoto Y, Nishida Y, Shimanoe C, Oze I, Matsuo K, Mikami H, Kusakabe M, Takeuchi K, Wakai K. Association of skipping breakfast and short sleep duration with the prevalence of metabolic syndrome in the general Japanese population: Baseline data from the Japan Multi-Institutional Collaborative cohort study. Prev Med Rep 2021; 24:101613. [PMID: 34976669 PMCID: PMC8683995 DOI: 10.1016/j.pmedr.2021.101613] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 10/14/2021] [Accepted: 10/22/2021] [Indexed: 11/26/2022] Open
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27
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Li ZH, Xu L, Dai R, Li LJ, Wang HJ. Effects of regular breakfast habits on metabolic and cardiovascular diseases: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e27629. [PMID: 34871228 PMCID: PMC8568444 DOI: 10.1097/md.0000000000027629] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 08/06/2021] [Accepted: 10/12/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Breakfast, which is considered as an important meal of the day, is being ignored by an increasing number of people as the pace of modern life accelerates. Although a large number of previous studies have reported the relationship between skipping breakfast and type 2 diabetes mellitus, most of them were cross-sectional studies. It remains unclear how skipping breakfast affects such specific cardio-metabolic diseases as hypertension, strokes and hypercholesterolemia. METHODS The protocols and reports of this meta-analysis are based on a meta-analysis of observational studies in epidemiological guidelines (MOOSE). Relevant studies were systematically retrieved from PubMed, Embase, Web of Science and the Cochrane Library, and were restricted to English from the inception to May 10, 2019. All the results were obtained by RRs, and outcomes of interests should include the occurrence of cardiovascular and metabolic diseases. RESULTS Fourteen cohort studies in total were eventually included. Compared with people having breakfast frequency≦3times/week, those with a frequency>3 times/week have reduced the risk of type 2 diabetes mellitus, obesity, Metabolic Syndrome, Low high-density lipoprotein cholesterolemia, Cardiovascular Diseases, cardiovascular Mortality, hypertension and strokes, with (RR = 0.8 [95% CI: 0.7-0.91], P = .142, I2 = 37.6%), (RR = 0.74 [95% CI: 0.59-0.94], P < .001, I2 = 89%), (RR = 0.86 [95% CI:0.75-0.99], P = .512, I2 = 0%), (RR = 0.75 [95% CI:0.61-0.93], P = .643, I2 = 0%), (RR = 0.87 [95% CI:0.81-0.93], P = .479, I2 = 0%), (RR = 0.63 [95% CI:0.51-0.78], P = .396, I2 = 0%), (RR = 0.92 [95% CI:0.86-0.98], P = .419, I2 = 0.7%), and (RR = 0.89 [95% CI:0.79-0.99], P = .238, I2 = 29%), respectively. CONCLUSIONS A regular daily breakfast habit benefits the cardio-metabolism to a great extent, reducing the risk of Cardiovascular Diseases, type 2 diabetes mellitus, obesity, hypertension, strokes, Metabolic Syndrome, cardiovascular Mortality, Low high-density lipoprotein cholesterolemia, and Abdominal obesity, while it is not significantly related to hypercholesterolemia and coronary heart disease regardless of gender. Nevertheless, skipping breakfast once a week may greatly reduce the benefits of cardio-metabolism. Therefore, public institutions should promote and encourage citizens to cultivate regular daily breakfast habits.
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Affiliation(s)
- Zhi-hui Li
- Department of Orthopedics, Huaihe Hospital of Henan University, Kaifeng,China
| | - Lei Xu
- Department of Gastroenterology, Affiliated Hospital of Qinghai University, Xining, China
| | - Rao Dai
- Department of Interventional Therapy, Affiliated Hospital of Qinghai University, Xining, China
| | - Li-jie Li
- Department of Cardiology, Tong Xu County Hospital, Tongxu, China
| | - Hao-jie Wang
- Department of Interventional Therapy, Affiliated Hospital of Qinghai University, Xining, China
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28
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Pak HH, Haws SA, Green CL, Koller M, Lavarias MT, Richardson NE, Yang SE, Dumas SN, Sonsalla M, Bray L, Johnson M, Barnes S, Darley-Usmar V, Zhang J, Yen CLE, Denu JM, Lamming DW. Fasting drives the metabolic, molecular and geroprotective effects of a calorie-restricted diet in mice. Nat Metab 2021; 3:1327-1341. [PMID: 34663973 PMCID: PMC8544824 DOI: 10.1038/s42255-021-00466-9] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 08/30/2021] [Indexed: 02/07/2023]
Abstract
Calorie restriction (CR) promotes healthy ageing in diverse species. Recently, it has been shown that fasting for a portion of each day has metabolic benefits and promotes lifespan. These findings complicate the interpretation of rodent CR studies, in which animals typically eat only once per day and rapidly consume their food, which collaterally imposes fasting. Here we show that a prolonged fast is necessary for key metabolic, molecular and geroprotective effects of a CR diet. Using a series of feeding regimens, we dissect the effects of calories and fasting, and proceed to demonstrate that fasting alone recapitulates many of the physiological and molecular effects of CR. Our results shed new light on how both when and how much we eat regulate metabolic health and longevity, and demonstrate that daily prolonged fasting, and not solely reduced caloric intake, is likely responsible for the metabolic and geroprotective benefits of a CR diet.
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Affiliation(s)
- Heidi H Pak
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
- Interdisciplinary Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Spencer A Haws
- Interdisciplinary Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
- Department of Biomolecular Chemistry, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Institute for Discovery, Madison, WI, USA
| | - Cara L Green
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Mikaela Koller
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Mitchell T Lavarias
- Interdisciplinary Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - Nicole E Richardson
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
- Endocrinology and Reproductive Physiology Graduate Training Program, University of Wisconsin-Madison, Madison, WI, USA
| | - Shany E Yang
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Sabrina N Dumas
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Michelle Sonsalla
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Lindsey Bray
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Michelle Johnson
- Nathan Shock Center of Excellence in the Basic Biology of Aging, Department of Pathology, University of Alabama, Birmingham, Birmingham, AL, USA
| | - Stephen Barnes
- Department of Pharmacology, University of Alabama, Birmingham, Birmingham, AL, USA
| | - Victor Darley-Usmar
- Nathan Shock Center of Excellence in the Basic Biology of Aging, Department of Pathology, University of Alabama, Birmingham, Birmingham, AL, USA
| | - Jianhua Zhang
- Nathan Shock Center of Excellence in the Basic Biology of Aging, Department of Pathology, University of Alabama, Birmingham, Birmingham, AL, USA
| | - Chi-Liang Eric Yen
- Interdisciplinary Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
- Department of Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
| | - John M Denu
- Interdisciplinary Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA
- Department of Biomolecular Chemistry, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Institute for Discovery, Madison, WI, USA
| | - Dudley W Lamming
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA.
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA.
- Interdisciplinary Graduate Program in Nutritional Sciences, University of Wisconsin-Madison, Madison, WI, USA.
- Endocrinology and Reproductive Physiology Graduate Training Program, University of Wisconsin-Madison, Madison, WI, USA.
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29
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Meal patterns and incident hypertension in community-dwelling middle-aged adults: an 11-year follow-up cohort study. J Hypertens 2021; 39:1393-1401. [PMID: 33470737 DOI: 10.1097/hjh.0000000000002794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE We aimed to examine whether meal patterns, as well as energy intake from three main meals and snacks, were associated with incident hypertension. METHODS We included 12 995 participants aged 18-59 years from the China Health and Nutrition Survey in the final analysis. Dietary intake was assessed using weighing methods in combination with 24-h food records. Cox proportional hazards regression models were used to examine the association of meal patterns, and energy intake from different meals with incident hypertension. RESULTS During a mean follow-up of 11.2 years, 4766 new hypertension cases were documented. Four meal patterns were derived according to energy intake: balanced, breakfast dominant, lunch dominant, and dinner dominant patterns. Dinner dominant meal pattern was associated with a lower risk of incident hypertension [hazard ratio (95% confidence interval): 0.90 (0.84-0.98)] compared with the balanced meal pattern. Breakfast energy intake was positively, but dinner energy intake was inversely associated with incident hypertension. The positive association between breakfast energy intake and incident hypertension was observed in rural residents only [1.22 (1.07-1.41) for rural residents, 0.98 (0.82-1.18) for urban residents; P interaction = 0.0348]. A positive association between energy intake from lunch and incident hypertension was observed in the urban residents only. CONCLUSION Dinner dominant meal pattern was associated with a lower risk of hypertension compared with the balanced meal pattern in Chinese adults. A relatively small breakfast and large dinner may help to prevent or delay the development of hypertension, especially in urban residents.
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Ibanez B, Fernández-Ortiz A, Fernández-Friera L, García-Lunar I, Andrés V, Fuster V. Progression of Early Subclinical Atherosclerosis (PESA) Study: JACC Focus Seminar 7/8. J Am Coll Cardiol 2021; 78:156-179. [PMID: 34238438 DOI: 10.1016/j.jacc.2021.05.011] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 03/24/2021] [Accepted: 05/14/2021] [Indexed: 12/23/2022]
Abstract
Atherosclerosis starts early in life and progresses silently for decades. Considering atherosclerosis as a "systemic disease" invites the use of noninvasive methodologies to detect disease in various regions before symptoms appear. The PESA-(Progression of Early Subclinical Atherosclerosis) CNIC-SANTANDER study is an ongoing prospective cohort study examining imaging, biological, and behavioral parameters associated with the presence and progression of early subclinical atherosclerosis. Between 2010 and 2014, PESA enrolled 4,184 asymptomatic middle-aged participants who undergo serial 3-yearly follow-up examinations including clinical interviews, lifestyle questionnaires, sampling, and noninvasive imaging assessment of multiterritorial subclinical atherosclerosis (carotids, iliofemorals, aorta, and coronaries). PESA tracks the trajectories of atherosclerosis and associated disorders from early stages to the transition to symptomatic phases. A joint venture between the CNIC and the Santander Bank, PESA is expected to run until at least 2029, and its significant contributions to date are presented in this review paper.
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Affiliation(s)
- Borja Ibanez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Cardiology Department, IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain; CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Antonio Fernández-Ortiz
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Hospital Clínico San Carlos, IdISSC, Universidad Complutense, Madrid, Spain
| | - Leticia Fernández-Friera
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Hospital Universitario HM Montepríncipe-CIEC, Universidad San Pablo CEU, Madrid, Spain
| | - Inés García-Lunar
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Cardiology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Vicente Andrés
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; CIBER de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Valentín Fuster
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Icahn School of Medicine at Mount Sinai, New York, New York, USA.
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Mostafavi F, Zamani-Alavijeh F, Mansourian M, Bastami F. The promotion of healthy breakfast and snacks based on the social marketing model: a mixed-methods study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2021; 40:22. [PMID: 33962686 PMCID: PMC8106147 DOI: 10.1186/s41043-021-00245-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 04/22/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Skipping breakfast and replacing it with non-nutritious snacks are progressively increasing among adolescents. This study aimed to develop an educational intervention based on the Social Marketing Model and evaluate its effects on healthy breakfast and snack consumption among female adolescent students. METHODS This mixed-methods study was conducted in 2016-2019 in two phases. In the first phase, a qualitative study was conducted through directed content analysis in guidance schools in Khorramabad, Isfahan, and Tehran, Iran, to explore factors affecting breakfast consumption. The results of this phase were set in the benchmarks of the Social Marketing Model. In the second phase, a randomized controlled trial was conducted based on the benchmarks of the Social Marketing Model on 94 students randomly recruited from guidance schools in Khorramabad, Iran. RESULTS The findings of the qualitative phase were categorized into the benchmarks of the Social Marketing Model, namely the social marketing mix, the intended behavior, internal and external competing factors for behavior modification, theoretical concepts related to the behavior, and the role of supporters. In the quantitative phase, the univariate analysis showed significant between-group differences concerning the product, price, promotion, and behavior (p < 0.05). CONCLUSION Healthy breakfast and snack consumption can be promoted through making acceptable the tastes, costs, preparations, and consumption places of breakfast and snack. TRIAL REGISTRATION The trial was registered in the Iranian Registry of Clinical Trials (code: IRCT20170201032347N1 ). The trial was registered in 11/07/2018 and is accessible on the Iranian Clinical Trial Registration website.
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Affiliation(s)
- Firoozeh Mostafavi
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fereshteh Zamani-Alavijeh
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marjan Mansourian
- Department of Epidemiology and Biostatistic, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Bastami
- Department of Public Health, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
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Muscente F, De Caterina R. Challenges in ischaemic heart disease: not sleeping enough, not brushing your teeth, and skipping breakfast-three ways of increasing your risk of myocardial infarction? Eur Heart J Suppl 2021; 22:L57-L60. [PMID: 33654468 PMCID: PMC7904058 DOI: 10.1093/eurheartj/suaa136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Despite optimal medical therapies, there is currently a persistent residual cardiovascular risk. The most likely pathway responsible for this residual risk has been identified in the inflammatory state. Recent studies have confirmed that inflammation increases cardiovascular risk independently from LDL cholesterol levels. Addressing traditional risk factors, such as obesity, cigarette smoking, diabetes, arterial hypertension, and dyslipidaemia, also provides an important reduction of the levels of inflammation. Nonetheless, inflammation is also a target for specific and focused therapeutic interventions. Recent studies have outlined an association between oral hygiene, sleep deprivation, and nutritional patterns on the one hand, with the development of multi-districts atherosclerosis and/or adverse cardiovascular events on the other. These lifestyle patterns appear to be involved in fostering inflammation associated with atherosclerosis. There is, however, a persistent need for further studies to clarify whether such associations with cardiovascular disease are direct and causal, and if they are all channelled through vascular inflammation.
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Affiliation(s)
- Francesca Muscente
- Department Heart and Vessels, Division of Cardiology, Ospedale Civile Maria SS. dello Splendore, Giulianova (Teramo)
| | - Raffaele De Caterina
- Chair of Cardiology, University of Pisa, Pisa, Italy.,University Cardiology Division, Pisa University Hospital, Pisa, Italy
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Shang X, Hill E, Li Y, He M. Energy and macronutrient intakes at breakfast and cognitive declines in community-dwelling older adults: a 9-year follow-up cohort study. Am J Clin Nutr 2021; 113:1093-1103. [PMID: 33675345 PMCID: PMC8106757 DOI: 10.1093/ajcn/nqaa403] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 12/01/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND It is unclear whether breakfast consumption and breakfast composition are independently associated with changes in cognition over a long-term period in older adults. OBJECTIVES We aimed to examine the associations between energy and macronutrient intakes at breakfast and cognitive declines. METHODS We included 2935 participants aged 55-93 y at baseline from the China Health and Nutrition Survey in our analysis. Cognition was assessed in 1997, 2000, 2004, 2006, and 2015. Dietary intake was assessed using weighing methods in combination with 24-h food records. RESULTS Breakfast contributed to 25.9% of total energy intake of the day and percentages of breakfast energy intake from protein, fat, and carbohydrates were 12.8%, 11.5%, and 75.7%, respectively. During a median follow-up of 9 y, the β values for changes in global cognitive z-scores for Quintile 5 of protein and fat intakes at breakfast, with Quintile 1 as the reference, were 0.13 (95% CI: 0.01-0.25) and 0.17 (95% CI: 0.04-0.30), respectively. Substitution of 5% energy from carbohydrates with equivalent energy from protein (β, 0.06; 95% CI: 0.01-0.11) or fat (β, 0.05; 95% CI: 0.02-0.08) at breakfast was positively associated with the change in the global cognitive z-score. Energy intake at breakfast was not significantly associated with the global cognitive z-score. Similar results were found for the verbal memory z-score. The positive association of breakfast fat intake and the inverse association of breakfast carbohydrate intake with cognitive declines were stronger in urban residents. CONCLUSIONS Higher intakes of protein and fat and lower intake of carbohydrates at breakfast were associated with a lower rate of cognitive decline in older adults. Substitution of carbohydrates with protein or fat intake at breakfast may help to delay or prevent cognitive declines.
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Affiliation(s)
- Xianwen Shang
- Department of Ophthalmology, Guandong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - Edward Hill
- Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia
- Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Australia
| | - Yanping Li
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
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Santos HO, Genario R, Macedo RCO, Pareek M, Tinsley GM. Association of breakfast skipping with cardiovascular outcomes and cardiometabolic risk factors: an updated review of clinical evidence. Crit Rev Food Sci Nutr 2020; 62:466-474. [PMID: 32935557 DOI: 10.1080/10408398.2020.1819768] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
"Eat breakfast like a king, lunch like a prince and dinner like a pauper" (Adelle Davis, 1904-1974) is a concept that appears to align with some contemporary evidence concerning the appropriate proportioning of daily meals. At the same time, with the popular and scientific dissemination of the concepts of intermittent fasting and time-restricted feeding, well-controlled clinical trials have emerged showing the safety or even possible benefits of skipping breakfast. In this comprehensive literature review, we discuss recent evidence regarding breakfast intake, cardiovascular outcomes and cardiovascular risk markers. Overall, breakfast omission appears to be associated with a higher risk for atherosclerotic and adverse cardiovascular outcomes. However, caution should be employed when deciphering these data as many complex, unmeasured confounders may have contributed. Unfortunately, long-term randomized, clinical trials with detailed dietary control that have assessed clinical outcomes are sparse. Notwithstanding the observational findings, current trials conducted so far-albeit apparently smaller number-have shown that breakfast addition in subjects who do not habitually consume this meal may increase body weight, particularly fat mass, through caloric excess, whereas skipping breakfast may be a feasible strategy for some people aiming for calorie restriction. To date, definitive benefits of breakfast omission or consumption are not supported by the best evidence-based research, and the question of whether skipping breakfast per se is causally associated with cardiovascular outcomes remains unresolved.
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Affiliation(s)
- Heitor O Santos
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | | | | | - Manan Pareek
- Department of Cardiology, North Zealand Hospital, Hilleroed, Denmark.,Department of Internal Medicine, Yale New Haven Hospital, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Grant M Tinsley
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, Texas, USA
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Guevara RM, Urchaga JD, Cabaco AS, Moral-García JE. The Quality of Breakfast and Healthy Diet in School-aged Adolescents and Their Association with BMI, Weight Loss Diets and the Practice of Physical Activity. Nutrients 2020; 12:E2294. [PMID: 32751733 PMCID: PMC7469001 DOI: 10.3390/nu12082294] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/22/2020] [Accepted: 07/27/2020] [Indexed: 12/18/2022] Open
Abstract
Dietary habits are an important factor in the protection of adolescent health. The quality and frequency of breakfast and the various food groups can affect the wellbeing of this population group in both the short and long term. Research indicates that there is a range of relevant variables in the study of diet at this stage: following a weight loss diet, body mass index and the practice of physical exercise, amongst others. In this paper, all three variables are analysed, together with others of a demographic nature (sex and age). This is a descriptive cross-sectional survey that was carried out on 1318 adolescents aged 11 to 18. The Health Behaviour in School-Aged Children (HBSC) international study questionnaire, sponsored by the World Health Organisation, was used. In general terms, the data revealed that the majority of adolescents do not have adequate eating patterns. The quality and frequency of breakfast and the consumption of food types are associated with almost all the variables under study; additionally, there are significant differences by sex and school year. Finally, proposals are made to prevent eating disorders, which are appearing at an increasingly young age.
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Affiliation(s)
| | - José D. Urchaga
- Faculty of Education, C/ Henry Collet, Pontifical University of Salamanca, 37007 Salamanca, Spain; (R.M.G.); (A.S.C.); (J.E.M.-G.)
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Breakfast skipping, nutritional status, and physical activity in a middle-aged Latin American population: a population-based study from Ecuador. NUTR HOSP 2020; 36:1123-1132. [PMID: 31545071 DOI: 10.20960/nh.02393] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Introduction: the failure to eat breakfast has been associated with weight gain, a lower level of physical activity, and poor diet quality. Objective: to examine the frequency of skipping breakfast in an Ecuadorian population and its association with nutritional status and level of physical activity. Methods: a cross-sectional study of individuals who reported breakfast omission in a national survey. Nutritional status and physical activity were evaluated through anthropometric measures and the International Physical Activity Questionnaire, respectively. Results: the mean age of the study sample was 34.2 ± 14 years, 40% were aged 20 to 34 years, one half were women, 55% were living in the coastal region, and one half were classified as low socioeconomic status. Overall, 6.6% of participants did not mention breakfast in both recalls. Individuals who skipped breakfast were more likely to be aged 20 to 34 years (42.6% vs. 37.4%) and from the coastal region (61.1% vs. 51.8%) than those who ate breakfast. We did not find an association between skipping breakfast and being overweight or obese (35.2% vs. 36.1%), nor achieving a low level of physical activity (28.6% vs. 29.8%). In addition, breakfast consumers (vs. non-consumers) had higher intake of total energy, macronutrients (protein, carbohydrate, fat, and sugar), and micronutrients (fiber and calcium). Conclusions: in Ecuador, ~ 7% of the population skips breakfast. The nutritional status and level of physical activity did not differ between those who ate breakfast and those who did not. However, the long-term health consequences should be avoided by changing this eating habit.
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Wang W, Grech A, Gemming L, Rangan A. Breakfast size is associated with daily energy intake and diet quality. Nutrition 2020; 75-76:110764. [PMID: 32248055 DOI: 10.1016/j.nut.2020.110764] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 01/27/2020] [Accepted: 01/29/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the role of breakfast consumption and breakfast size on daily energy, nutrient intakes, and diet quality. METHODS One-day 24-h recall data from the 2011 to 2012 National Nutrition and Physical Activity Survey (n = 9341, adults ≥ 19 y) were analyzed, and respondents were classified into breakfast consumers or skippers. Breakfast consumers were further classified into quartile of breakfast size (energy intake [EI] from breakfast × 100%/daily EI). Diet quality was assessed using the Healthy Eating Index for Australian Adults. General linear modeling was undertaken to compare groups, adjusting for potential confounders. RESULTS Overall, 85.9% of adults consumed breakfast, contributing a mean of 19.9 ± 10.9% of daily EI for consumers. Among breakfast consumers, obtaining a higher proportion of daily EI from breakfast was associated with lower daily intakes of energy, added sugars, saturated fat, and alcohol (%E); higher intakes of dietary fiber (%E) and most micronutrients (per 1000 kJ); and better Healthy Eating Index for Australian Adults scores (Ptrend < 0.0001). Additionally, those in the highest quartile of breakfast size (>25.5% EI) had higher diet quality scores (P < 0.001) but similar daily EI (P = 0.751) compared with breakfast skippers. CONCLUSIONS These findings indicate that obtaining a higher proportion of daily EI from breakfast may result in more favorable dietary profiles and lower daily EI. Further research is needed to confirm this.
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Affiliation(s)
- Wenjie Wang
- The University of Sydney, Nutrition and Dietetics Group, Charles Perkins Centre, Faculty of Science, Sydney, Australia
| | - Amanda Grech
- The University of Sydney, Nutrition and Dietetics Group, Charles Perkins Centre, Faculty of Science, Sydney, Australia
| | - Luke Gemming
- The University of Sydney, Nutrition and Dietetics Group, Charles Perkins Centre, Faculty of Science, Sydney, Australia
| | - Anna Rangan
- The University of Sydney, Nutrition and Dietetics Group, Charles Perkins Centre, Faculty of Science, Sydney, Australia.
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Al-Hazzaa HM, Alhowikan AM, Alhussain MH, Obeid OA. Breakfast consumption among Saudi primary-school children relative to sex and socio-demographic factors. BMC Public Health 2020; 20:448. [PMID: 32252722 PMCID: PMC7132954 DOI: 10.1186/s12889-020-8418-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 02/26/2020] [Indexed: 11/10/2022] Open
Abstract
Background Breakfast is an important meal that provides essential nutrients and energy. However, few comprehensive studies have reported breakfast habits and related behaviors among Saudi children. This study investigated breakfast consumption patterns and the associations of socio-demographic variables with daily breakfast intake among Saudi children. Methods A multistage stratified cluster random sampling technique was used to select 1051 elementary school boys and girls in Riyadh. Body weight and height were measured and body mass index (BMI) was computed. The breakfast eating habits and behaviors were assessed using a specifically designed self-reported questionnaire that was completed by the children’s parents. Results More than 79% of children skipped daily breakfast, with no significant sex difference. Children in private schools consumed breakfast more frequently than those attending public schools. Multivariate analyses showed that boys in private schools had a significantly higher intake of breakfast than that in boys in public schools, yet, boys in public schools had significantly higher BMI than boys in private schools. Using logistic regression while adjusting for confounders showed insignificant effect for parent education. Among breakfast eaters, spread cheese sandwiches were consumed most frequently, followed by fried egg sandwiches and breakfast cereals. Full-fat milk, tea with milk, water, and fruit juice were the most consumed drinks. Girls consumed significantly more fresh fruits during breakfast than did boys. Mothers prepared breakfast at home most of the time (84.5%). Parents appeared mostly satisfied with the breakfast consumed by their child at home and placed high importance on breakfast compared to lunch or dinner. Conclusions The proportion of school children who ate daily breakfast at home was low, which may have implications for children’s school performance. Effort is needed to promote daily breakfast consumption among Saudi school children and to introduce appropriate interventions aimed at promoting daily breakfast consumption among Saudi children.
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Affiliation(s)
- Hazzaa M Al-Hazzaa
- Lifestyle and Health Research Center, Health Science Research Center, Princess Nourah bint Abdulrahman University, P. O. Box: 93216, Riyadh, 11673, Saudi Arabia.
| | | | - Maha H Alhussain
- Department of Food Science & Nutrition, College of Food & Agricultural Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Omar A Obeid
- Department of Human Nutrition and Food Sciences, American University of Beirut, Beirut, Lebanon
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Dong JY, Ikehara S, Kimura T, Cui M, Kawanishi Y, Kimura T, Ueda K, Iso H. Skipping breakfast before and during early pregnancy and incidence of gestational diabetes mellitus: the Japan Environment and Children's Study. Am J Clin Nutr 2020; 111:829-834. [PMID: 32020171 DOI: 10.1093/ajcn/nqaa014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 01/22/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND There is little evidence linking breakfast skipping to the incidence of gestational diabetes mellitus (GDM). OBJECTIVES We aimed to evaluate the prospective association of breakfast consumption with the incidence of GDM. METHODS A total of 103,099 pregnancies were registered during study enrollment (January 2011 to March 2014), involving 97,454 pregnant women from 15 areas across Japan. Singleton pregnant women free of GDM, stroke, heart disease, cancer, and type 1 or type 2 diabetes at the study enrollment were eligible for analysis. We used a self-administered questionnaire to obtain data on demographic information, socioeconomic status, self-rated health status, disease history, lifestyle, and dietary habits of each woman at study enrollment. A semiquantitative FFQ was used for dietary assessment. We used logistic regression to obtain the OR of GDM in relation to breakfast consumption. RESULTS Among 84,669 pregnant women for analysis, 1935 cases of GDM were documented. After adjustment for potential confounding factors including prepregnancy BMI, the multivariable-adjusted ORs of GDM for women who consumed breakfast 5-6 times/wk, 3-4 times/wk, and 0-2 times/wk were 1.09 (95% CI: 0.93, 1.27), 1.14 (95% CI: 0.96, 1.34), and 1.21 (95% CI: 1.05, 1.41), respectively, compared with daily breakfast eaters. The association appeared to be dose dependent (P-trend = 0.006) and was not significantly modified by prepregnancy BMI. CONCLUSIONS Breakfast consumption <3 times/wk before and during early pregnancy, compared with daily consumption, was associated with an increased odds of developing GDM.
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Affiliation(s)
- Jia-Yi Dong
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Satoyo Ikehara
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takashi Kimura
- Department of Public Health, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Meishan Cui
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yoko Kawanishi
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kimiko Ueda
- Maternal and Child Health Information Center, Osaka Women's and Children's Hospital, Osaka, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.,Department of Public Health Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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Nutritional Content, Labelling and Marketing of Breakfast Cereals on the Belgian Market and Their Reformulation in Anticipation of the Implementation of the Nutri-Score Front-Of-Pack Labelling System. Nutrients 2020; 12:nu12040884. [PMID: 32218115 PMCID: PMC7230794 DOI: 10.3390/nu12040884] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 03/20/2020] [Accepted: 03/23/2020] [Indexed: 12/27/2022] Open
Abstract
Objective: Breakfast cereals are frequently consumed in Belgium, especially among children. We investigated the nutritional content, labelling and marketing of breakfast cereals and the changes in nutrient content and reformulation in anticipation of the implementation of the Nutri-Score front-of-pack label. Design: Pictures were taken of cereal packages. The WHO-Europe nutrient profiling tool was used to classify cereals into ‘permitted’/‘not-permitted’ to be marketed to children, while the nutritional quality was assessed using Nutri-Score. The proportion of cereals with nutrition and health claims and/or promotional characters on the front-of-pack was compared between permitted and not-permitted cereals and between different Nutriscore categories using Chi-squared tests. The average nutrient contents per 100g were compared between 2017 and 2018 using paired t-tests. Setting: Belgium. Participants: All breakfast cereals in the major supermarkets (n = 7) in 2017 and 2018. Results: Overall, 330 cereals were included. About 77.2% of cereals were not permitted to be marketed to children but, of those, 22.0% displayed promotional characters. More claims (68.9% of all claims) were found on ‘not-permitted’ compared with ‘permitted’ cereals, particularly nutrition claims. Most claims were displayed on cereals with the allocated Nutri-Score A (42.0%) and C (37.0%). A significant reformulation of cereals was found between 2017 and 2018, with reductions in total sugar (−5%) (p < 0.001) and sodium (−20%) (p = 0.002) and increases in fibre (+3%) (p = 0.012) and proteins (+2%) (p = 0.002). Conclusion: Breakfast cereals on the Belgian market are predominantly unhealthy and frequently carry claims and promotional characters. Minimal reformulation occurred over one year. Policy recommendations include restrictions on claims and marketing for not-permitted cereals.
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Association of Skipping Breakfast With Cardiovascular and All-Cause Mortality. J Am Coll Cardiol 2020; 73:2025-2032. [PMID: 31023424 DOI: 10.1016/j.jacc.2019.01.065] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 12/08/2018] [Accepted: 01/08/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND Skipping breakfast is common among U.S. adults. Limited evidence suggests that skipping breakfast is associated with atherosclerosis and cardiovascular disease. OBJECTIVES The authors sought to examine the association of skipping breakfast with cardiovascular and all-cause mortality. METHODS This is a prospective cohort study of a nationally representative sample of 6,550 adults 40 to 75 years of age who participated in the National Health and Nutrition Examination Survey III 1988 to 1994. Frequency of breakfast eating was reported during an in-house interview. Death and underlying causes of death were ascertained by linkage to death records through December 31, 2011. The associations between breakfast consumption frequency and cardiovascular and all-cause mortality were investigated by using weighted Cox proportional hazards regression models. RESULTS Among the 6,550 participants (mean age 53.2 years; 48.0% male) in this study, 5.1% never consumed breakfast, 10.9% rarely consumed breakfast, 25.0% consumed breakfast some days, and 59.0% consumed breakfast every day. During 112,148 person-years of follow-up, 2,318 deaths occurred including 619 deaths from cardiovascular disease. After adjustment for age, sex, race/ethnicity, socioeconomic status, dietary and lifestyle factors, body mass index, and cardiovascular risk factors, participants who never consumed breakfast compared with those consuming breakfast everyday had hazard ratios of 1.87 (95% confidence interval: 1.14 to 3.04) for cardiovascular mortality and 1.19 (95% confidence interval: 0.99 to 1.42) for all-cause mortality. CONCLUSIONS In a nationally representative cohort with 17 to 23 years of follow-up, skipping breakfast was associated with a significantly increased risk of mortality from cardiovascular disease. Our study supports the benefits of eating breakfast in promoting cardiovascular health.
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Chen H, Zhang B, Ge Y, Shi H, Song S, Xue W, Li J, Fu K, Chen X, Teng W, Tian L. Association between skipping breakfast and risk of cardiovascular disease and all cause mortality: A meta-analysis. Clin Nutr 2020; 39:2982-2988. [PMID: 32085933 DOI: 10.1016/j.clnu.2020.02.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 01/13/2020] [Accepted: 02/07/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND & AIMS Previous studies on the association between skipping breakfast and risk of cardiovascular disease and all cause mortality have drawn controversial conclusions. Therefore, we carried out a meta-analysis to illuminate this association. METHODS Studies about the association between skipping breakfast and risk of cardiovascular disease and all cause mortality were identified by searching Pubmed, Embase, Cochrane, and Web of Science databases until June 2019. Then we screened articles for eligibility, extracted data, and pooled the results using a random-effects model. RESULTS Seven cohort studies concerning a total of 221,732 participants were included in this meta-analysis. Skipping breakfast was associated with elevated risk of cardiovascular disease (relative risk 1.22 95% confidence interval 1.10-1.35) and all cause mortality (relative risk 1.25 95% confidence interval 1.11-1.40) compared with eating breakfast regularly. CONCLUSION Skipping breakfast increases the risk of cardiovascular disease and all cause mortality. Eating breakfast regularly may promote cardiovascular health and decrease all cause mortality.
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Affiliation(s)
- Hanze Chen
- Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Beidi Zhang
- Department of Endodontics, School of Stomatology, China Medical University, Shenyang, China
| | - Yusong Ge
- Department of Neurology, The Second Hospital of Dalian Medical University, Dalian, China
| | - Han Shi
- Clinical Department One, China Medical University, Shenyang, China
| | - Siqi Song
- Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Weishuang Xue
- Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Jinwei Li
- Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Kailei Fu
- Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Xinxin Chen
- Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Weiyu Teng
- Department of Neurology, The First Affiliated Hospital, China Medical University, Shenyang, China.
| | - Li Tian
- Department of Geriatrics, Shengjing Hospital, China Medical University, Shenyang, China.
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Mita T, Osonoi Y, Osonoi T, Saito M, Nakayama S, Someya Y, Ishida H, Gosho M, Watada H. Breakfast skipping is associated with persistently increased arterial stiffness in patients with type 2 diabetes. BMJ Open Diabetes Res Care 2020; 8:8/1/e001162. [PMID: 32098899 PMCID: PMC7206922 DOI: 10.1136/bmjdrc-2019-001162] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 01/11/2020] [Accepted: 01/28/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE While certain lifestyle habits may be associated with arterial stiffness, there is limited literature investigating the relationship between lifestyle habits and longitudinal changes in arterial stiffness in patients with type 2 diabetes mellitus (T2DM). This is an exploratory study to determine whether lifestyle habits, in addition to conventional atherosclerotic risk factors, are associated with increased arterial stiffness. RESEARCH DESIGN AND METHODS The study participants comprised 734 Japanese outpatients with T2DM and no history of apparent cardiovascular diseases. Lifestyle habits were analyzed using self-reported questionnaires, and brachial-ankle pulse wave velocity (baPWV) was measured at baseline, and at years 2 and 5. A multivariable linear mixed-effects model was used to determine the predictive value of lifestyle habits and possible atherosclerotic risk factors for longitudinal change in baPWV. RESULTS Over 5 years of follow-up, baPWV values significantly increased. In a multivariable linear mixed-effects model that adjusted for age and gender, a low frequency of breakfast intake was significantly associated with persistently high baPWV, independently of other lifestyle habits. Furthermore, in a multivariable linear mixed-effects model that included both lifestyle habits and possible atherosclerotic risk factors, a low frequency of breakfast intake remained the only independent predictive factor for persistently high baPWV. Subjects who ate breakfast less frequently tended to have additional unhealthy lifestyle habits and atherosclerotic risk factors. CONCLUSIONS Our analyses suggest that breakfast skipping is an independent lifestyle habit that is associated with persistently increased arterial stiffness in patients with T2DM. TRIAL REGISTRATION NUMBER UMIN000010932.
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Affiliation(s)
- Tomoya Mita
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Japan
- Center for Molecular Diabetology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yusuke Osonoi
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Japan
| | | | | | - Shiho Nakayama
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Japan
| | - Yuki Someya
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Japan
| | | | - Masahiko Gosho
- Department of Biostatistics, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hirotaka Watada
- Department of Metabolism & Endocrinology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Japan
- Center for Molecular Diabetology, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Center for Therapeutic Innovations in Diabetes, Juntendo University Graduate School of Medicine, Tokyo, Japan
- Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Chen X, Chen H, Gong L, Fang Y, Luo X, Zhu D. Relationship between Breakfast and Academic Performance of Primary and Middle School Students in Mianyang City. Health (London) 2020. [DOI: 10.4236/health.2020.1210100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Impacts of lifestyle behavior and shift work on visceral fat accumulation and the presence of atherosclerosis in middle-aged male workers. Hypertens Res 2019; 43:235-245. [DOI: 10.1038/s41440-019-0362-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 10/16/2019] [Accepted: 10/31/2019] [Indexed: 12/17/2022]
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Trends in Guideline-Driven Revascularization in Diabetic Patients with Multivessel Coronary Heart Disease. J Cardiovasc Dev Dis 2019; 6:jcdd6040041. [PMID: 31752091 PMCID: PMC6956319 DOI: 10.3390/jcdd6040041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 11/10/2019] [Accepted: 11/16/2019] [Indexed: 02/07/2023] Open
Abstract
In diabetes patients with chronic ≥3 vessel disease, coronary artery bypass grafting (CABG) holds a class I recommendation in the American College of Cardiology and American Heart Association (ACC/AHA) 2011 guidelines, and this classification has not changed to date. Much of the literature has focused upon whether CABG or percutaneous coronary intervention (PCI) produces better outcomes; there is a paucity of data comparing the odds of receiving these procedures. A secondary analysis was conducted in a de-identified database comprised of 30,482 patients satisfying the entry criteria. Odds of occurrence (CABG, PCI) were determined as the binary dependent variable in period 1, (17 October 2009 through 31 December 2011), and period 2 (1 January 2013 through 16 March 2015), before and after the 2011 guidelines, while controlling for gender, ethnicity/race, and ischemic heart disease as covariates. The odds of performing CABG rather than PCI in period 2 were not statistically significantly different than in period 1 (p = 0.400). The logistic regression model chi-square statistic was statistically significant, with χ2 (7) = 308.850, p < 0.0001. The Wald statistic showed that ethnicity/race (African American, Caucasian, Hispanic and Other), gender, and heart disease contributed significantly to the prediction model with p < 0.05, but ethnicity ‘Unknown’ did not. The odds of CABG versus PCI in period 2 were 0.98 times those in period 1 95% confidence interval (CI) = (0.925, 1.032), statistically controlling for covariates. There was no significant rise in the odds of undergoing a CABG among this dataset of high-risk patients with diabetes and multivessel coronary heart disease. Modern practice has evolved regarding patient choice and additional variables that impact the final revascularization method employed. The degree to which odds of occurrence of procedures are a reliable surrogate for provider compliance with guidelines remains uncertain.
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Lopez-Minguez J, Gómez-Abellán P, Garaulet M. Timing of Breakfast, Lunch, and Dinner. Effects on Obesity and Metabolic Risk. Nutrients 2019; 11:E2624. [PMID: 31684003 PMCID: PMC6893547 DOI: 10.3390/nu11112624] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 10/22/2019] [Accepted: 10/28/2019] [Indexed: 02/06/2023] Open
Abstract
(1) Background: Eating is fundamental to survival. Animals choose when to eat depending on food availability. The timing of eating can synchronize different organs and tissues that are related to food digestion, absorption, or metabolism, such as the stomach, gut, liver, pancreas, or adipose tissue. Studies performed in experimental animal models suggest that food intake is a major external synchronizer of peripheral clocks. Therefore, the timing of eating may be decisive in fat accumulation and mobilization and affect the effectiveness of weight loss treatments. (2) Results: We will review multiple studies about the timing of the three main meals of the day, breakfast, lunch and dinner, and its potential impact on metabolism, glucose tolerance, and obesity-related factors. We will also delve into several mechanisms that may be implicated in the obesogenic effect of eating late. Conclusion: Unusual eating time can produce a disruption in the circadian system that might lead to unhealthy consequences.
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Affiliation(s)
- Jesus Lopez-Minguez
- Department of Physiology, University of Murcia, 30100 Murcia; Spain.
- IMIB-Arrixaca, 30120 Murcia, Spain.
| | | | - Marta Garaulet
- Department of Physiology, University of Murcia, 30100 Murcia; Spain.
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Meta-Analysis of Relation of Skipping Breakfast With Heart Disease. Am J Cardiol 2019; 124:978-986. [PMID: 31326073 DOI: 10.1016/j.amjcard.2019.06.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 06/07/2019] [Accepted: 06/12/2019] [Indexed: 12/15/2022]
Abstract
To determine whether skipping breakfast is associated with heart disease, the first meta-analysis of currently available epidemiological studies was performed. To identify case-control, cross-sectional, longitudinal, or cohort studies investigating the association of skipping breakfast with prevalence, incidence, or mortality of heart disease in adults, PubMed, and Web of Science were searched through April 2019. Adjusted (if unavailable, unadjusted) hazard ratios (HRs) or odds ratios (ORs) with their confidence interval (CIs) of prevalence, incidence, or mortality for skipping breakfast were extracted from each study. Study-specific estimates were combined using inverse variance-weighted averages of logarithmic HRs/ORs in the random-effects model. Eight eligible studies with a total of 284,484 participants were identified and included in the present meta-analysis. The primary meta-analysis combining HRs for Q1 (first quartile, most skipping breakfast) versus Q4 (fourth quartile, least skipping breakfast) from 3 studies together with other HRs/ORs demonstrated that skipping breakfast was associated with the significantly increased risk of heart disease (pooled HR/OR 1.24; 95% CI 1.09 to 1.40; p = 0.001). In sensitivity analyses combining HRs for Q2 (second quartile, second most skipping breakfast) versus Q4 or HRs for Q3 (third quartile, second least skipping breakfast) versus Q4 from 3 studies together with other HRs/ORs, the association of skipping breakfast with the increased risk of heart disease in the primary meta-analysis was confirmed. In conclusion, skipping breakfast is associated with the increased risk of heart disease.
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Ofori-Asenso R, Owen AJ, Liew D. Skipping Breakfast and the Risk of Cardiovascular Disease and Death: A Systematic Review of Prospective Cohort Studies in Primary Prevention Settings. J Cardiovasc Dev Dis 2019; 6:E30. [PMID: 31443394 PMCID: PMC6787634 DOI: 10.3390/jcdd6030030] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 08/07/2019] [Accepted: 08/19/2019] [Indexed: 12/13/2022] Open
Abstract
Several studies have associated skipping (not having) breakfast with cardiometabolic risk factors such as obesity, high blood pressure, unfavorable lipid profiles, diabetes, and metabolic syndrome. We examined the available evidence regarding the effect of skipping breakfast on cardiovascular morbidity and mortality, as well as all-cause mortality. Medline, Embase, and Web of Science were searched from inception until May 2019 to identify prospective cohort studies that examined the association between skipping breakfast and the risk of cardiovascular morbidity and mortality and all-cause death. Electronic searches were supplemented by manual screening of the references of retrieved studies. Out of 456 citations identified, four studies (from Japan and the US) were included. The included studies involved a total of 199,634 adults (aged ≥40 years; 48.5% female) without known cardiovascular disease (CVD) at baseline followed over a median duration of 17.4 years. The pooled data suggested that people who regularly skipped breakfast were about 21% more likely (hazard ratio (HR) 1.21, 95% confidence interval (CI) 1.08-1.35; I2 = 17.3%, p = 0.304) to experience incident CVD or die from it than people who regularly consumed breakfast. Also, the risk of all-cause death was 32% higher (HR 1.32, 95% CI 1.17-1.48; I2 = 7.6%, p = 0.339) in people who regularly skipped breakfast than in people who regularly consumed breakfast. However, the definition of skipping breakfast was heterogenous and adjustment for confounders varied significantly. Therefore, residual confounding could not be ruled out and caution is required in the interpretation of the findings. Hence, large prospective studies with a consistent definition of skipping breakfast, and conducted across different populations, are needed to provide more robust evidence of the health effects of skipping breakfast.
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Affiliation(s)
- Richard Ofori-Asenso
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, VIC 3004, Australia.
| | - Alice J Owen
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, VIC 3004, Australia
| | - Danny Liew
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, VIC 3004, Australia
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50
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Dashti HS, Merino J, Lane JM, Song Y, Smith CE, Tanaka T, McKeown NM, Tucker C, Sun D, Bartz TM, Li-Gao R, Nisa H, Reutrakul S, Lemaitre RN, Alshehri TM, de Mutsert R, Bazzano L, Qi L, Knutson KL, Psaty BM, Mook-Kanamori DO, Perica VB, Neuhouser ML, Scheer FAJL, Rutter MK, Garaulet M, Saxena R. Genome-wide association study of breakfast skipping links clock regulation with food timing. Am J Clin Nutr 2019; 110:473-484. [PMID: 31190057 PMCID: PMC6669061 DOI: 10.1093/ajcn/nqz076] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 04/08/2019] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Little is known about the contribution of genetic variation to food timing, and breakfast has been determined to exhibit the most heritable meal timing. As breakfast timing and skipping are not routinely measured in large cohort studies, alternative approaches include analyses of correlated traits. OBJECTIVES The aim of this study was to elucidate breakfast skipping genetic variants through a proxy-phenotype genome-wide association study (GWAS) for breakfast cereal skipping, a commonly assessed correlated trait. METHODS We leveraged the statistical power of the UK Biobank (n = 193,860) to identify genetic variants related to breakfast cereal skipping as a proxy-phenotype for breakfast skipping and applied several in silico approaches to investigate mechanistic functions and links to traits/diseases. Next, we attempted validation of our approach in smaller breakfast skipping GWAS from the TwinUK (n = 2,006) and the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium (n = 11,963). RESULTS In the UK Biobank, we identified 6 independent GWAS variants, including those implicated for caffeine (ARID3B/CYP1A1), carbohydrate metabolism (FGF21), schizophrenia (ZNF804A), and encoding enzymes important for N6-methyladenosine RNA transmethylation (METTL4, YWHAB, and YTHDF3), which regulates the pace of the circadian clock. Expression of identified genes was enriched in the cerebellum. Genome-wide correlation analyses indicated positive correlations with anthropometric traits. Through Mendelian randomization (MR), we observed causal links between genetically determined breakfast skipping and higher body mass index, more depressive symptoms, and smoking. In bidirectional MR, we demonstrated a causal link between being an evening person and skipping breakfast, but not vice versa. We observed association of our signals in an independent breakfast skipping GWAS in another British cohort (P = 0.032), TwinUK, but not in a meta-analysis of non-British cohorts from the CHARGE consortium (P = 0.095). CONCLUSIONS Our proxy-phenotype GWAS identified 6 genetic variants for breakfast skipping, linking clock regulation with food timing and suggesting a possible beneficial role of regular breakfast intake as part of a healthy lifestyle.
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Affiliation(s)
- Hassan S Dashti
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA,Program in Medical and Population Genetics, Broad Institute, Cambridge, MA,Department of Anesthesia, Critical Care, and Pain Medicine,Address correspondence to HSD (e-mail:
| | - Jordi Merino
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA,Program in Medical and Population Genetics, Broad Institute, Cambridge, MA,Diabetes Unit, Massachusetts General Hospital, and Department of Medicine, Harvard Medical School, Boston, MA
| | - Jacqueline M Lane
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA,Program in Medical and Population Genetics, Broad Institute, Cambridge, MA,Department of Anesthesia, Critical Care, and Pain Medicine
| | - Yanwei Song
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA,Program in Medical and Population Genetics, Broad Institute, Cambridge, MA
| | | | - Toshiko Tanaka
- Translational Gerontology Branch, National Institute on Aging, Baltimore, MD
| | - Nicola M McKeown
- Nutritional Epidemiology Program, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA
| | - Chandler Tucker
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA
| | - Dianjianyi Sun
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Traci M Bartz
- Cardiovascular Health Research Unit, Departments of Biostatistics and Medicine, University of Washington, Seattle, WA
| | - Ruifang Li-Gao
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
| | - Hoirun Nisa
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Sirimon Reutrakul
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Illinois at Chicago, Chicago, IL
| | - Rozenn N Lemaitre
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA
| | - Tahani M Alshehri
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
| | - Renée de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
| | - Lydia Bazzano
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA,Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Kristen L Knutson
- Center for Circadian and Sleep Medicine, Department of Neurology, Northwestern University, Chicago, IL
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Departments of Epidemiology, Medicine, and Health Services, University of Washington, Seattle, WA,Kaiser Permanente Washington Health Research Institute, Seattle, WA
| | - Dennis O Mook-Kanamori
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands,Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
| | - Vesna Boraska Perica
- Department for Medical Biology, University of Split School of Medicine, Split, Croatia
| | - Marian L Neuhouser
- Cancer Prevention Program, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Frank A J L Scheer
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA,Division of Sleep Medicine, Harvard Medical School, Boston, MA,Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA
| | - Martin K Rutter
- Division of Endocrinology, Diabetes, and Gastroenterology, School of Medical Sciences, Faculty of Biology, Medicine, and Health, University of Manchester, Manchester, United Kingdom,Manchester Diabetes Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Marta Garaulet
- Department of Physiology, University of Murcia, Murcia, Spain,IMIB-Arrixaca, Murcia, Spain
| | - Richa Saxena
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA,Program in Medical and Population Genetics, Broad Institute, Cambridge, MA,Department of Anesthesia, Critical Care, and Pain Medicine,E-mail: )
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