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Huang Y, Ao Y, Wan X, Liu X, Yao J, Ye H, Wang A, Zhuang P, Jiao J, Zhang Y. Assessing the Hypertension Risk: A Deep Dive into Cereal Consumption and Cooking Methods-Insights from China. Nutrients 2024; 16:3027. [PMID: 39275342 PMCID: PMC11397540 DOI: 10.3390/nu16173027] [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: 07/17/2024] [Revised: 08/16/2024] [Accepted: 08/17/2024] [Indexed: 09/16/2024] Open
Abstract
BACKGROUND Cereal grains are rich in carbohydrates and could trigger a hyperglycemic response which is closely linked to blood pressure status. We aim to examine the associations between the consumption of cereals with different cooking methods and hypertension risk. METHODS We conducted a prospective analysis utilizing the nationwide data of 11,080 adult participants who were free of hypertension at baseline. Cereal intake was assessed using 3-day 24 h dietary recalls with a weighing technique. Hypertension incidence was identified in adherence with the Seventh Joint National Commission guidelines during the follow-up. Cox proportional hazards regression models were used to extrapolate hazard ratios associated with hypertension risk. RESULTS Over an average follow-up span of 7 years (77,560 person-years), we identified 3643 new hypertension cases. The intake of total, fried, and baked cereals was associated with 15%, 20%, and 20% higher risk of hypertension, respectively. Whole grain consumers had an 8% lower risk of hypertension compared with non-consumers, while total refined grain consumers showed no significant association. Replacing one daily serving of fried or baked cereals with an equivalent serving of boiled cereals was related to a 28% or 14% lower risk, respectively. CONCLUSIONS Total, fried, and baked cereal consumption was positively associated with hypertension risk, while consuming whole grains was related to a lower risk. Modifying cooking methods from frying or baking to boiling for cereals may be beneficial to lower risk. The current study underscores the significance of considering both the degree of processing and cooking methods applied to cereals in addressing hypertension prevention and management.
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Affiliation(s)
- Yingyu Huang
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
- Department of Food Science and Nutrition, College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310058, China
| | - Yang Ao
- Department of Endocrinology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
- Department of Nutrition, School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Xuzhi Wan
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
- Department of Food Science and Nutrition, College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310058, China
| | - Xiaohui Liu
- Department of Endocrinology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
- Department of Nutrition, School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Jianxin Yao
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
- Department of Food Science and Nutrition, College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310058, China
| | - Hao Ye
- Department of Endocrinology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
- Department of Nutrition, School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Anli Wang
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
- Department of Food Science and Nutrition, College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310058, China
| | - Pan Zhuang
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Jingjing Jiao
- Department of Endocrinology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
- Department of Nutrition, School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Yu Zhang
- Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
- Department of Food Science and Nutrition, College of Biosystems Engineering and Food Science, Zhejiang University, Hangzhou 310058, China
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Keshani M, Sadeghi N, Tehrani SD, Ahmadi AR, Sharma M. Mediterranean diet enriched with olive oil shows no consistent benefits on cardiometabolic and anthropometric parameters: a systematic review with meta-analysis of randomized controlled trials. Eur J Nutr 2024:10.1007/s00394-024-03478-9. [PMID: 39153124 DOI: 10.1007/s00394-024-03478-9] [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: 10/23/2023] [Accepted: 07/31/2024] [Indexed: 08/19/2024]
Abstract
PURPOSE Cardiovascular disease (CVD) is the primary cause of death worldwide but there is a variation in its burden across some nations that seems to be related to dietary habits. Mediterranean populations have lower rates of morbidity and mortality from CVD. Thus, this systematic review and meta-analysis aimed to assess the impacts of the Mediterranean diet (MedDiet) enriched with olive oil on blood lipids, glycemic indices, blood pressure, and anthropometric indices. METHODS A comprehensive search of the Web of Science, PubMed (MEDLINE), Scopus, Cochrane Library, Google Scholar, Embase, and CINAHL databases until March 2024 was conducted to identify clinical trials studying the effects of MedDiet enriched with olive oil on the aforementioned parameters. RESULTS In total, 3303 records were retrieved. A total of 18 clinical trials met the inclusion criteria after records were screened for eligibility. According to the pooled analysis from the random-effects model, the MedDiet enriched with olive oil significantly reduced triglycerides (TG) compared with the control group (WMD = -2.40 mg/dl; 95%CI, -4.533 to -0.262; P = 0.027). Strong heterogeneity was observed. Sensitivity analysis did not change our results and no significant effect of any trial on the overall effect sizes of all variables were found. There was a concern about the reporting bias for some studies which reported some main outcomes. CONCLUSION MedDiet enriched with olive oil showed no consistent effects on any of the reported markers of cardiovascular health except on TG. SYSTEMATIC REVIEW REGISTRATION CRD42023424641.
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Affiliation(s)
- Mahdi Keshani
- Nutrition and Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Narges Sadeghi
- Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Nutrition, School of Allied Medical Science, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sahar Dadkhah Tehrani
- Nutrition and Food Security Research Center and Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Manoj Sharma
- Department of Social & Behavioral Health, School of Public Health, University of Nevada, Las Vegas (UNLV), Las Vegas, NV, USA
- Department of Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV, USA
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Hareer LW, Lau YY, Mole F, Reidlinger DP, O'Neill HM, Mayr HL, Greenwood H, Albarqouni L. The effectiveness of the Mediterranean Diet for primary and secondary prevention of cardiovascular disease: An umbrella review. Nutr Diet 2024. [PMID: 39143663 DOI: 10.1111/1747-0080.12891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 05/15/2024] [Accepted: 05/19/2024] [Indexed: 08/16/2024]
Abstract
AIMS This study aimed to review meta-analyses of randomised controlled trials that evaluated the effectiveness of the Mediterranean Diet for the primary and secondary prevention of cardiovascular disease. METHODS Five databases (Medline, Embase, Cochrane, CINAHL and ProQuest) were searched from inception to November 2022. Inclusion criteria were: (i) systematic review of randomised controlled studies with metanalysis; (ii) adults ≥18 years from the general population with (secondary prevention) and without (primary prevention) established cardiovascular disease; (iii) Mediterranean Diet compared with another dietary intervention or usual care. Review selection and quality assessment using AMSTAR-2 were completed in duplicate. GRADE was extracted from each review, and results were synthesised narratively. RESULTS Eighteen meta-analyses of 238 randomised controlled trials were included, with an 8% overlap of primary studies. Compared to usual care, the Mediterranean Diet was associated with reduced cardiovascular disease mortality (n = 4 reviews, GRADE low certainty; risk ratio range: 0.35 [95% confidence interval: 0.15-0.82] to 0.90 [95% confidence interval: 0.72-1.11]). Non-fatal myocardial infarctions were reduced (n = 4 reviews, risk ratio range: 0.47 [95% confidence interval: 0.28-0.79] to 0.60 [95% confidence interval: 0.44-0.82]) when compared with another active intervention. The methodological quality of most reviews (n = 16/18; 84%) was low or critically low and strength of evidence was generally weak. CONCLUSIONS This review showed that the Mediterranean Diet can reduce fatal cardiovascular disease outcome risk by 10%-67% and non-fatal cardiovascular disease outcome risk by 21%-70%. This preventive effect was more significant in studies that included populations with established cardiovascular disease. Better quality reviews are needed.
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Affiliation(s)
- Laima W Hareer
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Yan Ying Lau
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Frances Mole
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Dianne P Reidlinger
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Hayley M O'Neill
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Hannah L Mayr
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Centre for Functioning and Health Research, Metro South Health, Brisbane, Queensland, Australia
| | - Hannah Greenwood
- Faculty of Health Sciences and Medicine, Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Queensland, Australia
| | - Loai Albarqouni
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
- Faculty of Health Sciences and Medicine, Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Queensland, Australia
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Bakrim S, Aboulaghras S, Aanniz T, Benali T, El Omari N, El-Shazly M, Lee LH, Mustafa SK, Sahib N, Rebezov M, Ali Shariati M, Lorenzo JM, Bouyahya A. Effects of Mediterranean diets and nutrigenomics on cardiovascular health. Crit Rev Food Sci Nutr 2024; 64:7589-7608. [PMID: 36908235 DOI: 10.1080/10408398.2023.2187622] [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] [Indexed: 03/14/2023]
Abstract
The field of nutrigenomics studies the interaction between nutrition and genetics, and how certain dietary patterns can impact gene expression and overall health. The Mediterranean diet (MedDiet), characterized by a high intake of fruits, vegetables, whole grains, and healthy fats, has been linked to better cardiovascular health (CVH) outcomes. This review summarizes the current state of research on the effects of nutrigenomics and MedDiet on cardiovascular health. Results suggest that MedDiet, through its impact on gene expression, can positively influence CVH markers such as blood pressure, lipid profile, and inflammation. However, more research is needed to fully understand the complex interactions between genetics, nutrition, and CVH, and to determine the optimal dietary patterns for individualized care. The aim of this scientific review is to evaluate the current evidence on the effects of nutrigenomics and MedDiet on cardiovascular health. The review summarizes the available studies that have investigated the relationship between nutrition, genetics, and cardiovascular health, and explores the mechanisms by which certain dietary patterns can impact CVH outcomes. The review focuses on the effects of MedDiet, a dietary pattern that is rich in whole foods and healthy fats, and its potential to positively influence CVH through its impact on gene expression. The review highlights the limitations of current research and the need for further studies to fully understand the complex interplay between nutrition, genetics, and cardiovascular health.
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Affiliation(s)
- Saad Bakrim
- Geo-Bio-Environment Engineering and Innovation Laboratory, Molecular Engineering, Biotechnology and Innovation Team, Polydisciplinary Faculty of Taroudant, Ibn Zohr University, Agadir, Morocco
| | - Sara Aboulaghras
- Physiology and Physiopathology Team, Faculty of Sciences, Genomic of Human Pathologies Research, Mohammed V University, Rabat, Morocco
| | - Tarik Aanniz
- Medical Biotechnology Laboratory, Rabat Medical & Pharmacy School, Mohammed V University in Rabat, Rabat, Morocco
| | - Taoufiq Benali
- Environment and Health Team, Polydisciplinary Faculty of Safi, Cadi Ayyad University, Marrakesh-Safi, Morocco
| | - Nasreddine El Omari
- Laboratory of Histology, Embryology, and Cytogenetic, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Mohamed El-Shazly
- Department of Pharmacognosy, Faculty of Pharmacy, Ain-Shams University, Cairo, Egypt
- Pharmaceutical Biology Department, Faculty of Pharmacy and Biotechnology, The German University in Cairo, Cairo, Egypt
| | - Learn-Han Lee
- Novel Bacteria and Drug Discovery Research Group (NBDD), Microbiome and Bioresource Research Strength (MBRS), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
| | - Syed Khalid Mustafa
- Department of Chemistry, Faculty of Science, University of Tabuk, Tabuk, Saudi Arabia
| | - Nargis Sahib
- Laboratoire d'Amélioration des Productions Agricoles, Biotechnologie et Environnement (LAPABE), Faculté des Sciences, Mohammed Premier University, Oujda, Morocco
| | - Maksim Rebezov
- V. M. Gorbatov Federal Research Center for Food Systems of Russian Academy of Sciences, Moscow, Russian Federation
| | - Mohammad Ali Shariati
- Kazakh Research Institute of Processing and Food Industry, Semey Branch of the Institute, Almaty, Republic of Kazakhstan
| | - Jose M Lorenzo
- Centro Tecnológico de la Carne de Galicia, Parque Tecnológico de Galicia, Ourense, Spain
- Área de Tecnología de los Alimentos, Facultad de Ciencias de Ourense, Universidade de Vigo, Ourense, Spain
| | - Abdelhakim Bouyahya
- Laboratory of Human Pathologies Biology, Department of Biology, Faculty of Sciences, Mohammed V University in Rabat, Rabat, Morocco
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Georgoulis M, Damigou E, Derdelakou E, Kosti RI, Chrysohoou C, Barkas F, Kravvariti E, Tsioufis C, Pitsavos C, Liberopoulos E, Sfikakis PP, Panagiotakos DB. Adherence to the Mediterranean diet and 20-year incidence of hypertension: the ATTICA prospective epidemiological study (2002-2022). Eur J Clin Nutr 2024; 78:630-638. [PMID: 38605190 DOI: 10.1038/s41430-024-01440-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 04/03/2024] [Accepted: 04/05/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND/OBJECTIVES Dietary habits are a significant predictor of hypertension (HTN). We aimed to evaluate the long-term association between adherence to the Mediterranean diet and HTN incidence. SUBJECTS/METHODS This was a prospective study among 1415 non-hypertensive adults (44% men, age: 41 ± 13 years) followed up for 20 years. Anthropometric, lifestyle, and clinical parameters were evaluated at baseline. Adherence to the Mediterranean diet was evaluated both at baseline and 10 years through the MedDietScore (range: 0-55, higher values indicate greater adherence). RESULTS At the 20-year follow-up, 314 new HTN cases were recorded. HTN incidence was 35.5%, 22.5%, and 8.7% in the lowest, middle, and upper tertile of baseline MedDietScore, respectively (p < 0.001). For each 1-point increase in baseline MedDietScore, the 20-year HTN risk decreased by 7% [relative risk (RR): 0.925, 95% confidence interval (CI): 0.906, 0.943], and this effect remained significant after adjustment for age, sex, and baseline lifestyle and clinical confounders, i.e., body mass index, physical activity, smoking, systolic and diastolic blood pressure, family history of HTN, and presence of hypercholesterolemia and diabetes mellitus (RR: 0.973, 95%CI: 0.949, 0.997). In a similar multiadjusted model, compared to subjects who were consistently away from the Mediterranean diet (in the lowest MedDietScore tertile both at baseline and 10 years), only those who were consistently close (in the middle and upper MedDietScore tertiles both at baseline and 10 years) exhibited a 47% lower 20-year HTN risk. CONCLUSION A high adherence to the Mediterranean diet, particularly when longitudinally sustained, is associated with lower incidence of HTN.
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Affiliation(s)
- Michael Georgoulis
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17676, Athens, Greece
| | - Evangelia Damigou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17676, Athens, Greece
| | - Evgenia Derdelakou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17676, Athens, Greece
| | - Rena I Kosti
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, 38221, Trikala, Greece
| | - Christina Chrysohoou
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527, Athens, Greece
| | - Fotios Barkas
- Department of Internal Medicine, Medical School, University of Ioannina, 45500, Ioannina, Greece
| | - Evrydiki Kravvariti
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772, Athens, Greece
| | - Costas Tsioufis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527, Athens, Greece
| | - Christos Pitsavos
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527, Athens, Greece
| | - Evangelos Liberopoulos
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772, Athens, Greece
| | - Petros P Sfikakis
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772, Athens, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17676, Athens, Greece.
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Li L, Momma H, Chen H, Nawrin SS, Xu Y, Inada H, Nagatomi R. Dietary patterns associated with the incidence of hypertension among adult Japanese males: application of machine learning to a cohort study. Eur J Nutr 2024; 63:1293-1314. [PMID: 38403812 PMCID: PMC11139695 DOI: 10.1007/s00394-024-03342-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 01/30/2024] [Indexed: 02/27/2024]
Abstract
PURPOSE The previous studies that examined the effectiveness of unsupervised machine learning methods versus traditional methods in assessing dietary patterns and their association with incident hypertension showed contradictory results. Consequently, our aim is to explore the correlation between the incidence of hypertension and overall dietary patterns that were extracted using unsupervised machine learning techniques. METHODS Data were obtained from Japanese male participants enrolled in a prospective cohort study between August 2008 and August 2010. A final dataset of 447 male participants was used for analysis. Dimension reduction using uniform manifold approximation and projection (UMAP) and subsequent K-means clustering was used to derive dietary patterns. In addition, multivariable logistic regression was used to evaluate the association between dietary patterns and the incidence of hypertension. RESULTS We identified four dietary patterns: 'Low-protein/fiber High-sugar,' 'Dairy/vegetable-based,' 'Meat-based,' and 'Seafood and Alcohol.' Compared with 'Seafood and Alcohol' as a reference, the protective dietary patterns for hypertension were 'Dairy/vegetable-based' (OR 0.39, 95% CI 0.19-0.80, P = 0.013) and the 'Meat-based' (OR 0.37, 95% CI 0.16-0.86, P = 0.022) after adjusting for potential confounding factors, including age, body mass index, smoking, education, physical activity, dyslipidemia, and diabetes. An age-matched sensitivity analysis confirmed this finding. CONCLUSION This study finds that relative to the 'Seafood and Alcohol' pattern, the 'Dairy/vegetable-based' and 'Meat-based' dietary patterns are associated with a lower risk of hypertension among men.
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Affiliation(s)
- Longfei Li
- School of Physical Education and Health, Heze University, 2269 University Road, Mudan District, Heze, 274-015, Shandong, China
- Department of Medicine and Science in Sports and Exercise, Tohoku University Graduate School of Medicine, 2-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Haruki Momma
- Department of Medicine and Science in Sports and Exercise, Tohoku University Graduate School of Medicine, 2-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Haili Chen
- Department of Medicine and Science in Sports and Exercise, Tohoku University Graduate School of Medicine, 2-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Saida Salima Nawrin
- Division of Biomedical Engineering for Health & Welfare, Tohoku University Graduate School of Biomedical Engineering, 6-6-12, Aramaki Aza Aoba Aoba-ku, Sendai, Miyagi, 980-8579, Japan
| | - Yidan Xu
- Department of Medicine and Science in Sports and Exercise, Tohoku University Graduate School of Medicine, 2-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan
| | - Hitoshi Inada
- Department of Developmental Neuroscience, Tohoku University Graduate School of Medicine, 2-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
- Department of Biochemistry and Cellular Biology, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8502, Japan.
| | - Ryoichi Nagatomi
- Department of Medicine and Science in Sports and Exercise, Tohoku University Graduate School of Medicine, 2-1 Seiryo-Machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan.
- Division of Biomedical Engineering for Health & Welfare, Tohoku University Graduate School of Biomedical Engineering, 6-6-12, Aramaki Aza Aoba Aoba-ku, Sendai, Miyagi, 980-8579, Japan.
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Xiao Y, Xiao X, Zhang X, Yi D, Li T, Hao Q, Zhang F, Li X, Wang N. Mediterranean diet in the targeted prevention and personalized treatment of chronic diseases: evidence, potential mechanisms, and prospects. EPMA J 2024; 15:207-220. [PMID: 38841625 PMCID: PMC11147989 DOI: 10.1007/s13167-024-00360-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 04/08/2024] [Indexed: 06/07/2024]
Abstract
The prevalence of chronic diseases is currently a major public health issue worldwide and is exploding with the population growth and aging. Dietary patterns are well known to play a important role in our overall health and well-being, and therefore, poor diet and malnutrition are among the most critical risk factors for chronic disease. Thus, dietary recommendation and nutritional supplementation have significant clinical implications for the targeted treatment of some of these diseases. Multiple dietary patterns have been proposed to prevent chronic disease incidence, like Dietary Approaches to Stop Hypertension (DASH) and Diabetes Risk Reduction Diet (DRRD). Among them, the MedDiet, which is one of the most well-known and studied dietary patterns in the world, has been related to a wide extent of health benefits. Substantial evidence has supported an important reverse association between higher compliance to MedDiet and the risk of chronic disease. Innovative strategies within the healthcare framework of predictive, preventive, and personalized medicine (PPPM/3PM) view personalized dietary customization as a predictive medical approach, cost-effective preventive measures, and the optimal dietary treatment tailored to the characteristics of patients with chronic diseases in primary and secondary care. Through a comprehensive collection and review of available evidence, this review summarizes health benefits of MedDiet in the context of PPPM/3PM for chronic diseases, including cardiovascular disease, hypertension, type 2 diabetes, obesity, metabolic syndrome, osteoporosis, and cancer, thereby a working hypothesis that MedDiet can personalize the prevention and treatment of chronic diseases was derived.
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Affiliation(s)
- Yuji Xiao
- School of Public Health, Dalian Medical University, Dalian, Liaoning People’s Republic of China
- Bishan Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Xuefei Xiao
- Bishan Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Xue Zhang
- School of Public Health, Dalian Medical University, Dalian, Liaoning People’s Republic of China
- The Second People’s Hospital of Dalian, Dalian, Liaoning People’s Republic of China
| | - Dongxin Yi
- School of Public Health, Dalian Medical University, Dalian, Liaoning People’s Republic of China
| | - Tao Li
- Department of Cardiology, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning People’s Republic of China
| | - Qiangqiang Hao
- School of Public Health, Dalian Medical University, Dalian, Liaoning People’s Republic of China
| | - Feng Zhang
- School of Public Health, Dalian Medical University, Dalian, Liaoning People’s Republic of China
| | - Xu Li
- Department of Clinical Nutrition, the Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning People’s Republic of China
| | - Ningning Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Global Health Research Center, Dalian Medical University, Dalian, Liaoning People’s Republic of China
- Global Health Research Center, Dalian Medical University, Dalian, Liaoning People’s Republic of China
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Elsahoryi NA, Neville CE, Patterson CC, McKinley MC, Baldrick FR, Mulligan C, McCall DO, Noad RL, Rooney C, Wallace I, McEvoy CT, Hunter S, McCance DR, Edgar DJ, Elborn SJ, McKeown PP, Young IS, Moore RE, Nugent AP, Woodside JV. The effect of increased fruit and vegetable consumption on blood pressure and lipids: a pooled analysis of six randomised controlled fruit and vegetable intervention trials. Age Ageing 2024; 53:ii80-ii89. [PMID: 38748910 DOI: 10.1093/ageing/afae043] [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: 12/12/2023] [Indexed: 07/02/2024] Open
Abstract
BACKGROUND Increasing fruit and vegetable (FV) consumption is associated with reduced cardiovascular disease risk in observational studies but with little evidence from randomised controlled trials (RCTs). The impact of concurrent pharmacological therapy is unknown. OBJECTIVE To pool data from six RCTs to examine the effect of increasing FV intake on blood pressure (BP) and lipid profile, also exploring whether effects differed by medication use. DESIGN Across trials, dietary intake was assessed by diet diaries or histories, lipids by routine biochemical methods and BP by automated monitors. Linear regression provided an estimate of the change in lipid profile or BP associated with a one portion increase in self-reported daily FV intake, with interaction terms fitted for medication use. RESULTS The pooled sample included a total of 554 participants (308 males and 246 females). Meta-analysis of regression coefficients revealed no significant change in either systolic or diastolic BP per portion FV increase, although there was significant heterogeneity across trials for systolic BP (I2 = 73%). Neither adjusting for change in body mass index, nor analysis according to use of anti-hypertensive medication altered the relationship. There was no significant change in lipid profile per portion FV increase, although there was a significant reduction in total cholesterol among those not on lipid-lowering therapy (P < 0.05 after Bonferroni correction). CONCLUSION Pooled analysis of six individual FV trials showed no impact of increasing intake on BP or lipids, but there was a total cholesterol-lowering effect in those not on lipid-lowering therapy.
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Affiliation(s)
- Nour A Elsahoryi
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT12 6BJ, UK
| | - Charlotte E Neville
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT12 6BJ, UK
| | - Chris C Patterson
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT12 6BJ, UK
| | - Michelle C McKinley
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT12 6BJ, UK
| | - Francina R Baldrick
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT12 6BJ, UK
| | - Ciara Mulligan
- Diabetes Department, Ulster Hospital, South Eastern Trust, Belfast, UK
| | | | - Rebecca L Noad
- Belfast Health and Social Care Trust, Belfast BT12 6BA, UK
| | - Ciara Rooney
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT12 6BJ, UK
| | - Ian Wallace
- Regional Centre for Endocrinology, Belfast Health and Social Care Trust, Belfast BT12 6BA, UK
| | - Claire T McEvoy
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT12 6BJ, UK
| | - Steven Hunter
- Regional Centre for Endocrinology, Belfast Health and Social Care Trust, Belfast BT12 6BA, UK
| | - David R McCance
- Regional Centre for Endocrinology, Belfast Health and Social Care Trust, Belfast BT12 6BA, UK
| | | | - Stuart J Elborn
- School of Medicine, Dentistry & Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Pascal P McKeown
- Belfast Health and Social Care Trust, Belfast BT12 6BA, UK
- School of Medicine, Dentistry & Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Ian S Young
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT12 6BJ, UK
| | - Rachel E Moore
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT12 6BJ, UK
| | - Anne P Nugent
- School of Biological Sciences, Queen's University Belfast, Belfast BT9 5DL, UK
| | - Jayne V Woodside
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast BT12 6BJ, UK
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9
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Cai ZL, Wang LY, Zhang BY, Zhu AS. Mediterranean diet for cardiovascular disease: an evidence mapping study. Public Health Nutr 2024; 27:e118. [PMID: 38600858 PMCID: PMC11075113 DOI: 10.1017/s1368980024000776] [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: 08/21/2023] [Revised: 01/11/2024] [Accepted: 03/18/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVE This study aimed to evaluate the methodological quality of existing meta-analyses (MA) and the quality of evidence for outcome indicators to provide an updated overview of the evidence concerning the therapeutic efficacy of the Mediterranean diet (MD) for various types of CVD. DESIGN We conducted comprehensive searches of PubMed, Cochrane Library, and Embase databases. The quality of the MA was assessed using the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) checklist, while the Grading of Recommendations Assessment, Development and Evaluation (GRADE) evidence evaluation system was employed to evaluate the quality of evidence for significant outcomes. SETTING The CVD remains a significant contributor to global mortality. Multiple MA have consistently demonstrated the efficacy of medical interventions in managing CVD. However, due to variations in the scope, quality and outcomes of these reviews, definitive conclusions are yet to be established. PARTICIPANTS This study included five randomized trials and twelve non-randomized studies, with a combined participant population of 716 318. RESULTS The AMSTAR 2 checklist revealed that 54·55 % of the studies demonstrated high quality, while 9·09 % exhibited low quality, and 36·36 % were deemed critically low quality. Additionally, there was moderate evidence supporting a positive correlation between MD and CHD/acute myocardial infarction, stroke, heart failure, cardiovascular events, coronary events and major adverse cardiovascular events. CONCLUSIONS This study indicates that although recognizing the potential efficacy of MD in managing CVD, the quality of the methodology and the evidence for the outcome indicators remain unsatisfactory.
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Affiliation(s)
- Zi-ling Cai
- Basic Medical College, Zhejiang Chinese Medical University, Hangzhou310053, People’s Republic of China
| | - Liao-yao Wang
- Basic Medical College, Zhejiang Chinese Medical University, Hangzhou310053, People’s Republic of China
| | - Bing-yue Zhang
- Section of Integrative Medicine, Zhejiang Provincial People’s Hospital, Hangzhou310053, People’s Republic of China
| | - Ai-song Zhu
- Basic Medical College, Zhejiang Chinese Medical University, Hangzhou310053, People’s Republic of China
- Key Laboratory of Blood-stasis-toxin syndrome of Zhejiang Province, Hangzhou310053, People’s Republic of China
- Zhejiang Engineering Research Center for ‘Preventive Treatment’ Smart Health of Traditional Chinese Medicine, Hangzhou310053, People’s Republic of China
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10
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Barcellos PAM, Dall'Agnol A, Sandi GM, Remonti LR, Silveiro SP. Dietary approach for the treatment of arterial hypertension in patients with diabetes mellitus. J Hypertens 2024; 42:583-593. [PMID: 38441180 DOI: 10.1097/hjh.0000000000003674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
The association of hypertension and diabetes mellitus is extremely common, increasing the mortality risk of patients, mainly by cardiovascular causes. Regarding the blood pressure (BP) targets to be achieved, most guidelines suggest levels of 130 mmHg for SBP and of 80 mmHg for DBP. Dietary modifications are quite effective, and many studies suggest that decreasing sodium intake and increasing potassium ingestion are both valuable practices for reducing BP. This can be achieved by stimulating the ingestion of lacteous products, vegetables, and nuts. As for the ideal pharmacologic treatment for hypertension, either calcium channel blockers, diuretics or angiotensin-system blockers can be the first class of drug to be used. In this review, we summarize the evaluation of patients with diabetes mellitus and hypertension, and discuss the available therapeutic approaches, with emphasis on evidence-based dietary recommendations.
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Affiliation(s)
| | - Angélica Dall'Agnol
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul
| | - Giovanna M Sandi
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul
| | | | - Sandra P Silveiro
- Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul
- Endocrine Unit, Hospital de Clínicas de Porto Alegre, RS, Brazil
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11
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Jelaska J, Vučković M, Gugić Ordulj I, Kolak E, Šolić Šegvić L, Đapić Kolak Z, Keser I, Radić J. Unlocking Cognitive Potential: Association of Sarcopenia and Mediterranean Diet on Cognitive Function in Community-Dwelling Elderly of the Dalmatian Region. Nutrients 2024; 16:991. [PMID: 38613024 PMCID: PMC11013823 DOI: 10.3390/nu16070991] [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: 03/07/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
The aim of this study was to determine the association between muscle strength, adherence to the Mediterranean diet (MeDi) and cognitive function in community-dwelling elderly. General data, data of body composition and anthropometric parameters, clinical and laboratory findings, cognitive test questionnaires (Mini-Mental State Examination-MMSE, Trail Making Test-TMT, Symbol Digit Modalities Test-SDMT), and nutritional assessments (Mini Nutritional Assessment-MNA, Mediterranean Diet Serving Score-MDSS) were obtained for each study participant. Handgrip strength (HS) was used as one of the key parameters for defining probable sarcopenia, among the Short Physical Performance Battery test (SPPB) (for defining physical activity) and the strength, assistance with walking, rising from a chair, climbing stairs, and falls questionnaire (SARC-F). Our cross-sectional study involved 114 participants aged ≥ 60 years, and two-thirds of the participants were female (76.3% vs. 23.7%). Probable sarcopenia was found in 34.7% of them. Using bivariate regression analysis, cognitive deficit among the sarcopenic population was associated with the following groups of collected data: (a) sociodemographic-associated factors-advanced age (OR: 1.07; p = 0.004), single marital status (OR: 3.25; p = 0.03), and low level of education (OR: 0.22; p < 0.003); (b) behavioral-associated factors-duration of institutionalization (OR: 1.05; p = 0.007), performance of heavy physical work (OR: 6.26; p = 0.001), low physical activity (OR: 0.08; p = 0.002), and risk of malnutrition (OR: 3.87; p = 0.005); (c) disease-related factors-loss of appetite (OR: 2.24; p = 0.04), information processing speed (OR: 0.88; p < 0.001), blood pressure systolic/diastolic variables (OR: 0.96/0.96; p = 0.002/0.02), medications (OR: 1.19; p = 0.005), predictive sarcopenia score ≥ 4 (OR: 3.1; p = 0.003), and low muscle strength (OR: 0.92; p = 0.002). Cognitive preservation among the sarcopenic population was associated with married status (OR: 0.23; p = 0.20), a high level of education (OR: 0.18; p = 0.002), smoking (OR: 0.33; p = 0.02), high physical activity (OR: 0.07; p < 0.001), and dietary habits using poultry (OR: 0.12; p = 0.004). The results suggest a significant association between sarcopenia and cognitive function in community-dwelling elderly, highlighting the need for regular nutritional interventions in this special population.
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Affiliation(s)
- Julija Jelaska
- Faculty of Food Technology and Biotechnology, University of Zagreb, 10000 Zagreb, Croatia; (J.J.); (I.G.O.)
| | - Marijana Vučković
- Internal Medicine Department, Nephrology and Haemodialysis Division, University Hospital of Split, 21000 Split, Croatia; (M.V.); (L.Š.Š.)
| | - Ivana Gugić Ordulj
- Faculty of Food Technology and Biotechnology, University of Zagreb, 10000 Zagreb, Croatia; (J.J.); (I.G.O.)
| | - Ela Kolak
- Nutrition and Dietetics Department, University Hospital of Split, 21000 Split, Croatia;
| | - Lucija Šolić Šegvić
- Internal Medicine Department, Nephrology and Haemodialysis Division, University Hospital of Split, 21000 Split, Croatia; (M.V.); (L.Š.Š.)
| | | | - Irena Keser
- Laboratory for Nutrition Science, Faculty of Food Technology and Biotechnology, University of Zagreb, 10000 Zagreb, Croatia;
| | - Josipa Radić
- Internal Medicine Department, Nephrology and Haemodialysis Division, University Hospital of Split, 21000 Split, Croatia; (M.V.); (L.Š.Š.)
- Department of Internal Medicine, School of Medicine, University of Split, 21000 Split, Croatia
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12
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Charles JA, Habibullah NK, Bautista S, Davis B, Joshi S, Hull SC. Planting the Seed for Blood Pressure Control: The Role of Plant-Based Nutrition in the Management of Hypertension. Curr Cardiol Rep 2024; 26:121-134. [PMID: 38526748 PMCID: PMC10990999 DOI: 10.1007/s11886-023-02008-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/26/2023] [Indexed: 03/27/2024]
Abstract
PURPOSE OF REVIEW Hypertension results in significant morbidity, mortality, and healthcare expenditures. Fortunately, it is largely preventable and treatable by implementing dietary interventions, though these remain underutilized. Here, we aim to explore the role of healthy dietary patterns in hypertension management and describe approaches for busy clinicians to address nutrition effectively and efficiently with patients. RECENT FINDINGS DASH, Mediterranean, vegetarian, and vegan diets that include minimally processed, plant-based foods as core elements have consistently shown positive effects on hypertension. Recommendations that distill the most healthful components of these diets can significantly impact patient outcomes. Clinicians can harness evidence-based dietary assessment and counseling tools to implement and support behavioral changes, even during brief office visits. Healthful plant-based dietary patterns can often effectively prevent and treat hypertension. Clinicians may help improve patient outcomes by discussing evidence-based nutrition with their patients. Future work to promote infrastructural change that supports incorporating evidence-based nutrition into medical education, clinical care, and society at large can support these efforts.
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Affiliation(s)
- Justin A Charles
- Department of Family Medicine and Public Health, UC San Diego Health, San Diego, CA, USA.
| | | | - Saul Bautista
- Ethos Farm to Health/Ethos Primary Care, Long Valley, NJ, USA
| | - Brenda Davis
- Brenda Davis, Nutrition Consultations, Calgary, AB, Canada
| | - Shivam Joshi
- Department of Veterans Affairs, Orlando, FL, USA
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, USA
| | - Sarah C Hull
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA
- Program for Biomedical Ethics, Yale School of Medicine, New Haven, CT, USA
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13
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Pant A, Chew DP, Mamas MA, Zaman S. Cardiovascular Disease and the Mediterranean Diet: Insights into Sex-Specific Responses. Nutrients 2024; 16:570. [PMID: 38398894 PMCID: PMC10893368 DOI: 10.3390/nu16040570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 02/25/2024] Open
Abstract
Cardiovascular disease (CVD) is a leading cause of mortality and disease burden in women globally. A healthy diet is important for the prevention of CVD. Research has consistently favoured the Mediterranean diet as a cardio-protective diet. Several studies have evaluated associations between the Mediterranean diet and cardiovascular outcomes, including traditional risk factors like hypertension, type 2 diabetes mellitus, and obesity. In addition, consistent evidence suggests that the components of the Mediterranean diet have a synergistic effect on cardiovascular risk due to its anti-inflammatory profile and microbiome effects. While the benefits of the Mediterranean diet are well-established, health advice and dietary guidelines have been built on largely male-dominant studies. Few studies have investigated the beneficial associations of the Mediterranean diet in sex-specific populations, including those with non-traditional risk factors that are specific to women, for instance polycystic ovarian syndrome and high-risk pregnancies, or more prevalent in women, such as chronic inflammatory diseases. Therefore, this review aims to provide a comprehensive overview of the current evidence regarding the Mediterranean diet in women in relation to cardiovascular health outcomes.
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Affiliation(s)
- Anushriya Pant
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2145, Australia;
| | - Derek P. Chew
- Victorian Heart Hospital, Victorian Heart Institute, Monash University, Melbourne, VIC 3800, Australia
| | - Mamas A. Mamas
- Keele Cardiovascular Research Group, Keele University, Newcastle ST5 5BG, UK
| | - Sarah Zaman
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2145, Australia;
- Department of Cardiology, Westmead Hospital, Sydney, NSW 2145, Australia
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14
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Lee SY. Vegetarian Diets and Cardiovascular Risk Reduction: Pros. J Lipid Atheroscler 2023; 12:315-322. [PMID: 37800106 PMCID: PMC10548187 DOI: 10.12997/jla.2023.12.3.315] [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: 07/24/2023] [Revised: 09/03/2023] [Accepted: 09/05/2023] [Indexed: 10/07/2023] Open
Abstract
There is an ongoing need for public health interventions aimed at further mitigating the risk of cardiovascular disease (CVD) through changes in dietary patterns and other lifestyle habits. Plant-based diets (PBDs) are effective in reducing CVD risk factors, a benefit evidenced by the favorable cardio-metabolic profiles observed in vegetarians who abstain from consuming meat, fish, and poultry compared to omnivores. Numerous studies have demonstrated that PBDs, particularly when rich in high-quality plant foods such as whole grains, fruits, vegetables, and nuts, are associated with a lower risk of adverse cardiovascular outcomes. Herein, we briefly review the current evidence regarding the relationship between CVD and PBDs, as well as the potential underlying biological mechanisms.
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Affiliation(s)
- Soo Yong Lee
- Division of Cardiology, Department of Internal Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
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15
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Lin P, Hillstrom K, Gottesman K, Jia Y, Kuo T, Robles B. Financial and Other Life Stressors, Psychological Distress, and Food and Beverage Consumption among Students Attending a Large California State University during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3668. [PMID: 36834363 PMCID: PMC9965632 DOI: 10.3390/ijerph20043668] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
The novel coronavirus disease 2019 (COVID-19) pandemic abruptly disrupted the daily lives and health of college students across the United States. This study investigated several stressors (e.g., financial strain/uncertainty), psychological distress, and dietary behaviors among college students attending a large state university during the pandemic. A cross-sectional online survey was administered to students from the California State University, Los Angeles between April and May 2021 (final analytic sample n = 736). Differences in gender and race/ethnicity were examined using chi-square, t-test, and one-way ANOVA tests. Paired t-tests were performed to compare variables before and during the pandemic. Negative binomial regression models examined the associations between various stressors, psychological distress, and three key dietary outcomes. Descriptive results showed that the consumption of fruits and vegetables, fast food, and sugary beverages, along with psychological distress, all increased during the pandemic. Significant differences in fruit and vegetable and fast food consumption by gender and race/ethnicity were also observed. In the regression models, several stressors, including financial strain and psychological distress, were associated with unfavorable food and beverage consumption, thereby suggesting that college students may need more support in mitigating these stressors so they do not manifest as poor dietary behaviors. Poor diet quality is associated with poor physical health outcomes such as premature development of type 2 diabetes or hypertension.
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Affiliation(s)
- Paulina Lin
- Department of Epidemiology, UCLA Fielding School of Public Health, P.O. Box 951722, Los Angeles, CA 90095, USA
| | - Kathryn Hillstrom
- Department of Nutrition and Food Science, California State University, Los Angeles, 5151 State University Drive, Los Angeles, CA 90032, USA
| | - Kimberly Gottesman
- Department of Nutrition and Food Science, California State University, Los Angeles, 5151 State University Drive, Los Angeles, CA 90032, USA
| | - Yuane Jia
- School of Health Professions, Rutgers Biomedical and Health Sciences, 65 Bergen St., Newark, NJ 07101, USA
| | - Tony Kuo
- Department of Epidemiology, UCLA Fielding School of Public Health, P.O. Box 951722, Los Angeles, CA 90095, USA
- Department of Family Medicine, David Geffen School of Medicine at UCLA, 10880 Wilshire Blvd, Suite 1800, Los Angeles, CA 90024, USA
- Population Health Program, UCLA Clinical and Translational Science Institute, 10833 Le Conte Ave., BE-144 CHS, Los Angeles, CA 90095, USA
| | - Brenda Robles
- Research Group on Statistics, Econometrics, and Health (GRECS), University of Girona, Carrer de la Universitat de Girona 10, Campus de Montilivi, 17003 Girona, Spain
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16
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Gajda R, Raczkowska E, Sobieszczańska M, Noculak Ł, Szymala-Pędzik M, Godyla-Jabłoński M. Diet Quality Variation among Polish Older Adults: Association with Selected Metabolic Diseases, Demographic Characteristics and Socioeconomic Status. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2878. [PMID: 36833574 PMCID: PMC9957466 DOI: 10.3390/ijerph20042878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/01/2023] [Accepted: 02/04/2023] [Indexed: 06/18/2023]
Abstract
A lot of civilization diseases are related to a low-quality diet, which is often determined by environmental factors. The aim of the present study was to assess the relationship between the quality of diet and the selected metabolic diseases, as well as demographic characteristics and socioeconomic status among Polish seniors. The study was conducted on the basis of the KomPAN questionnaire (Questionnaire for Dietary Views and Habits). The research sample was chosen arbitrarily. In addition, in order to diversify the research sample, the use of the snowball method was used. The study was conducted from June to September 2019 in a group of 437 people aged 60 or more years in two regions of Poland. Two diet quality indices with a potentially beneficial (pHDI-10) and adverse impact on health (pHDI-14) were selected based on data on the frequency of consumption of 24 food groups using the KomPAN questionnaire data development procedure. Based on the intensities (low, moderate, high) and combinations of these indices, three diet quality index profiles were developed with potentially different influences on health: lower (lowest), middle (intermediate) and upper (highest). Logistic regression was used to evaluate the relationship between diet quality indices, some metabolic diseases (obesity, arterial hypertension, diabetes type 2), demographic characteristics (gender, age, place of residence), and socioeconomic status (low, moderate, high). It was shown that in the examined seniors with selected metabolic diseases, the higher quality diet was more common among women, urban inhabitants and subjects with higher socioeconomic status. In turn, among the elderly with obesity, a high-quality diet was observed more often in people aged 60-74 years and those with type II diabetes at ages 75 years or more. The relationships between diet quality, demographic characteristics and socioeconomic status were demonstrated, but it was not possible to obtain unambiguous results on the relationship of these variables with the occurrence of metabolic diseases. Further extended studies should assess the importance of diet quality in reducing the risk of metabolic diseases in the elderly, taking into account the variability resulting from the environmental characteristics of the study population.
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Affiliation(s)
- Robert Gajda
- Department of Human Nutrition, Faculty of Biotechnology and Food Sciences, Wrocław University of Environmental and Life Sciences, Chełmońskiego 37, 51-630 Wroclaw, Poland
| | - Ewa Raczkowska
- Department of Human Nutrition, Faculty of Biotechnology and Food Sciences, Wrocław University of Environmental and Life Sciences, Chełmońskiego 37, 51-630 Wroclaw, Poland
| | - Małgorzata Sobieszczańska
- Clinic Department of Geriatrics, Faculty of Medicines, Wrocław Medical University, M. Curie-Skłodowskiej 66, 50-369 Wroclaw, Poland
| | - Łukasz Noculak
- Clinic Department of Geriatrics, Faculty of Medicines, Wrocław Medical University, M. Curie-Skłodowskiej 66, 50-369 Wroclaw, Poland
| | - Małgorzata Szymala-Pędzik
- Clinic Department of Geriatrics, Faculty of Medicines, Wrocław Medical University, M. Curie-Skłodowskiej 66, 50-369 Wroclaw, Poland
| | - Michaela Godyla-Jabłoński
- Department of Human Nutrition, Faculty of Biotechnology and Food Sciences, Wrocław University of Environmental and Life Sciences, Chełmońskiego 37, 51-630 Wroclaw, Poland
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17
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Olive Oil in the Mediterranean Diet and Its Biochemical and Molecular Effects on Cardiovascular Health through an Analysis of Genetics and Epigenetics. Int J Mol Sci 2022; 23:ijms232416002. [PMID: 36555645 PMCID: PMC9782563 DOI: 10.3390/ijms232416002] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 11/27/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
Human nutrition is a relatively new science based on biochemistry and the effects of food constituents. Ancient medicine considered many foods as remedies for physical performance or the treatment of diseases and, since ancient times, especially Greek, Asian and pre-Christian cultures similarly thought that they had beneficial effects on health, while others believed some foods were capable of causing illness. Hippocrates described the food as a form of medicine and stated that a balanced diet could help individuals stay healthy. Understanding molecular nutrition, the interaction between nutrients and DNA, and obtaining specific biomarkers could help formulate a diet in which food is not only a food but also a drug. Therefore, this study aims to analyze the role of the Mediterranean diet and olive oil on cardiovascular risk and to identify their influence from the genetic and epigenetic point of view to understand their possible protective effects.
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18
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Suriyawong W, Kao TSA, Robbins LB, Ling J, Malete L. Psychosocial Determinants of Recommended Lifestyle Behaviors among Hypertensive Patients: An Integrative Literature Review. West J Nurs Res 2022; 45:455-468. [PMID: 36515369 DOI: 10.1177/01939459221144177] [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: 12/15/2022]
Abstract
Healthy lifestyle levels are low among adults with hypertension (HTN). Unfortunately, psychosocial factors contributing to patients' inability to meet healthy lifestyle recommendations are not well-understood. This integrative review examined the relationships of three psychosocial factors (self-efficacy, outcome expectancy, and social support) with dietary adherence (DA) and physical activity (PA) among adults with HTN. In total, 24 peer-reviewed studies were assessed. Results showed self-efficacy had small-to-large relationships with PA (r = 0.02-0.46) and DA (r = 0.06-0.79), with the strength of the associations varying by the assessed domain and country of origin. However, few studies reported a small relationship between the remaining factors (outcome expectancy and social support) and PA and DA. Thus, more efforts are needed to delineate the contributions of social support and outcome expectancies on DA or PA. When designing an intervention that focuses on improving PA or DA among adults with HTN, these psychosocial factors should be targeted.
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Affiliation(s)
- Wachira Suriyawong
- Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand.,College of Nursing, Michigan State University, East Lansing, MI, USA
| | | | | | - Jiying Ling
- College of Nursing, Michigan State University, East Lansing, MI, USA
| | - Leapetswe Malete
- Department of Kinesiology, Michigan State University, East Lansing, MI, USA
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19
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Pieczyńska K, Rzymski P. Health Benefits of Vegetarian and Mediterranean Diets: Narrative Review. POL J FOOD NUTR SCI 2022. [DOI: 10.31883/pjfns/156067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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20
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Shobako N, Goto C, Nakagawa T, Yamato T, Kondo S, Nakamura F, Nakazeko T, Hirano Y, Honda K. Hypotensive and HbA1c reducing effect of novel dietary intervention program “COMB meal program”: Two randomized clinical trials. J Funct Foods 2022. [DOI: 10.1016/j.jff.2022.105279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Abstract
PURPOSE OF REVIEW To discuss the interplay behind how a high-fibre diet leads to lower blood pressure (BP) via the gut microbiome. RECENT FINDINGS Compelling evidence from meta-analyses support dietary fibre prevents the development of cardiovascular disease and reduces BP. This relation is due to gut microbial metabolites, called short-chain fatty acids (SCFAs), derived from fibre fermentation. The SCFAs acetate, propionate and butyrate lower BP in independent hypertensive models. Mechanisms are diverse but still not fully understood-for example, they include G protein-coupled receptors, epigenetics, immune cells, the renin-angiotensin system and vasculature changes. Lack of dietary fibre leads to changes to the gut microbiota that drive an increase in BP. The mechanisms involved are unknown. The intricate interplay between fibre, the gut microbiota and SCFAs may represent novel therapeutic approaches for high BP. Other gut microbiota-derived metabolites, produced when fibre intake is low, may hold potential therapeutic applications. Further translational evidence is needed.
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Affiliation(s)
- Chudan Xu
- Hypertension Research Laboratory, School of Biological Sciences, Faculty of Science, Monash University, Melbourne, Australia
| | - Francine Z Marques
- Hypertension Research Laboratory, School of Biological Sciences, Faculty of Science, Monash University, Melbourne, Australia.
- Heart Failure Research Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia.
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22
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Noori S, Mirzababaei A, Abaj F, Ghaffarian-Ensaf R, Mirzaei K. Does the Mediterranean diet reduce the odds of diabetic nephropathy in women? A case–control study. Front Nutr 2022; 9:984622. [PMID: 36118745 PMCID: PMC9481419 DOI: 10.3389/fnut.2022.984622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 08/12/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundIn recent decades, the prevalence of chronic diseases such as diabetes is increasing. One of the major complications of diabetes is diabetic nephropathy (DN), so it is important to find a way that can delay or control the onset of DN. Therefore, in this study, we investigated the relationship between the Mediterranean diet (MED) and the odds of DN.MethodsThis case–control study was performed among 210 women (30–65 years) who were referred to the Kowsar Diabetes Clinic in Semnan, Iran. Biochemical variables and anthropometric measurements were assessed. The food frequency questionnaire (FFQ) was used to calculate dietary intakes. Data from dietary intakes based on the FFQ were used to evaluate the MED score. Logistic regression was used to examine the associations.ResultsOur results showed that in the crude model with higher adherence to the MED (OR: 0.272; 95% CI: 0.154, 0.481; P = 0.001), the odds of DN has reduced by 73%, and in model 1, after controlling for potential confounders, with higher adherence to the MED (OR: 0.239; 95% CI: 0.128, 0.447; P = 0.001), the odds of DN has reduced by 76% compared to low adherence. Also, in model 1, significant associations were observed between high consumption of grains (OR: 0.360; 95% CI: 0.191, 0.676; P = 0.001), legumes (OR: 0.156; 95% CI: 0.083, 0.292; P = 0.001), vegetables (OR: 0.273; 95% CI: 0.149, 0.501; P = 0.001), fruits (OR: 0.179; 95% CI: 0.093, 0.347; P = 0.001), fish (OR: 0.459; 95% CI: 0.254, 0.827; P = 0.01), and reduced odds of DN (P < 0.05).ConclusionWe observed that with higher adherence to the MED, the odds of DN had reduced through mechanisms. However, additional studies are needed to confirm these findings.
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Affiliation(s)
- Sahar Noori
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Atieh Mirzababaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Faezeh Abaj
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- *Correspondence: Khadijeh Mirzaei
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Martin ZT, Olvera G, Villegas CA, Campbell JC, Akins JD, Brown KK, Brothers RM. The Impact of a Plant-Based Diet on Indices of Cardiovascular Health in African Americans: A Cross-Sectional Study. Appl Physiol Nutr Metab 2022; 47:903-914. [PMID: 35512369 DOI: 10.1139/apnm-2022-0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
African American (AA) individuals are disproportionately affected by cardiovascular diseases. Plant-based diets (PBD) may be cardioprotective in part through their high antioxidant capacity and low inflammatory load. We tested the hypothesis that AA individuals adhering to a 100% PBD would have better vascular health than AA individuals following a typical American diet (TAD). Eighteen AA individuals participated; 9 (24±4 years; 6 females) were following a PBD for 2.4±0.8 years and 9 (21±2 years; 5 females) were following a TAD. Blood lipids and C-reactive protein (CRP) were assessed. Peripheral and central blood pressure (BP) were measured, and vascular function tests included cerebrovascular reactivity to hypercapnia, brachial artery flow-mediated dilation & reactive hyperemia, and local heating-induced cutaneous hyperemia. Total (TC) and low-density lipoprotein (LDL-C) serum cholesterol were lower (TC: 142±30 vs. 174±36 mg/dl; LDL-C: 76±17 vs. 106±33 mg/dl; p<0.05 and d>0.80 for both) and serum CRP tended to be lower (0.38±0.18 mg/l vs. 0.96±0.89 mg/l; p=0.05, d=0.91) in the PBD cohort. Brachial (b) and central (c) mean arterial BP (MAP) were lower in the PBD cohort (bMAP: 86±5 vs. 91±7 mmHg; cMAP: 81±5 vs. 87±7 mmHg; p<0.05 and d>0.80 for both). All indices of vascular function were similar between groups (p>0.05 for all). A PBD was associated with more optimal blood lipid concentrations and decreased peripheral and central BP in AA individuals, but this association was not present in the various indices of vascular function. Registered at ClinicalTrials.gov: NCT05344287.
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Affiliation(s)
- Zachary T Martin
- The University of Texas at Arlington, 12329, Department of Kinesiology, Arlington, United States;
| | - Guillermo Olvera
- The University of Texas at Arlington, 12329, Department of Kinesiology, Arlington, United States;
| | - Christian A Villegas
- The University of Texas at Arlington, 12329, Department of Kinesiology, Arlington, United States;
| | - Jeremiah C Campbell
- The University of Texas at Arlington, 12329, Department of Kinesiology, Arlington, United States;
| | - John D Akins
- The University of Texas at Arlington, 12329, Department of Kinesiology, Arlington, United States;
| | - Kyrah K Brown
- The University of Texas at Arlington, 12329, Department of Kinesiology, Arlington, United States;
| | - R Matthew Brothers
- The University of Texas at Arlington, 12329, Department of Kinesiology, Arlington, United States;
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Acevedo-León D, Gómez-Abril SÁ, Monzó-Beltrán L, Estañ-Capell N, Arroyo-Montañés R, Bañuls C, Salas-Salvadó J, Sáez G. Adherence to the Mediterranean Diet Has a Protective Role against Metabolic and DNA Damage Markers in Colorectal Cancer Patients. Antioxidants (Basel) 2022; 11:499. [PMID: 35326149 PMCID: PMC8944597 DOI: 10.3390/antiox11030499] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 02/28/2022] [Accepted: 03/02/2022] [Indexed: 12/12/2022] Open
Abstract
Oxidative stress (OS) and inflammation have been related to colorectal cancer (CRC), but the influence of the Mediterranean diet (MD) on these parameters is unknown. Therefore, the aim of this study was to determine the association between adherence to the MD and markers of OS and DNA damage in CRC patients and to study the influence of adherence to the MD on metabolic and tumor-related factors. This prospective observational study included a total of 80 patients diagnosed with CRC. Adherence to the MD was estimated by the 14-item Mediterranean Diet Adherence Screener (MEDAS) questionnaire. The levels of OS markers (catalase, glutathione peroxidase, and glutathione system in serum; 8-oxo-7'8-dihydro-2'-deoxyguanosine and F2-isoprotanes in urine) and tumor and metabolic factors were determined. A total of 51.2% of our CRC patients showed a high adherence to the MD. These patients presented decreased levels of 8-oxodG, increased GPX and HDL-cholesterol levels, and a downward trend in the GSSG/GSH ratio with respect to patients with low adherence to the MD. In addition, a high adherence to the MD was associated with a lower histological grade of the tumor and a lower presence of synchronous adenomas. We conclude that a high adherence to the MD has a protective role against metabolic and oxidative DNA damage and improves antioxidant systems in CRC patients.
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Affiliation(s)
- Delia Acevedo-León
- Service of Clinical Analysis, University Hospital Dr. Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46017 Valencia, Spain; (D.A.-L.); (N.E.-C.); (R.A.-M.)
| | - Segundo Ángel Gómez-Abril
- Department of General Surgery and Digestive System, University Hospital Dr. Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46017 Valencia, Spain;
| | - Lidia Monzó-Beltrán
- Department of Biochemistry and Molecular Biology, Faculty of Medicine and Odontology, Health Research Institute, Clinical Hospital of Valencia, University of Valencia, 46010 Valencia, Spain;
| | - Nuria Estañ-Capell
- Service of Clinical Analysis, University Hospital Dr. Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46017 Valencia, Spain; (D.A.-L.); (N.E.-C.); (R.A.-M.)
| | - Rafael Arroyo-Montañés
- Service of Clinical Analysis, University Hospital Dr. Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46017 Valencia, Spain; (D.A.-L.); (N.E.-C.); (R.A.-M.)
| | - Celia Bañuls
- Department of Endocrinology and Nutrition, University Hospital Doctor Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46017 Valencia, Spain
| | - Jordi Salas-Salvadó
- Unitat de Nutrició Humana, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, 43201 Reus, Spain;
- Institut d’Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari San Joan de Reus, 43204 Reus, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Guillermo Sáez
- Service of Clinical Analysis, University Hospital Dr. Peset, Foundation for the Promotion of Health and Biomedical Research in the Valencian Region (FISABIO), 46017 Valencia, Spain; (D.A.-L.); (N.E.-C.); (R.A.-M.)
- Department of Biochemistry and Molecular Biology, Faculty of Medicine and Odontology, Health Research Institute, Clinical Hospital of Valencia, University of Valencia, 46010 Valencia, Spain;
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Rahimlou M, Grau N, Banaie-Jahromi N, Taheri M, Khosravi A, Mavrommatis Y, Mohammadifard N. Association of adherence to the dietary approach to stop hypertension and Mediterranean diets with blood pressure in a non-hypertensive population: Results from Isfahan Salt Study (ISS). Nutr Metab Cardiovasc Dis 2022; 32:109-116. [PMID: 34893410 DOI: 10.1016/j.numecd.2021.09.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Hypertension is among the major risk factors for cardiovascular events in the Iranian population. This cross-sectional study was designed to examine the association of adherence to the dietary approaches to stop hypertension (DASH) and Mediterranean (MED) dietary patterns with the distribution of blood pressure and pre-hypertension prevalence. METHODS AND RESULTS This cross-sectional study was carried out in 1363 non-hypertensive adults. Adherence to the DASH and MED diets was calculated using a semi-quantitative food frequency questionnaire (FFQ). Hypertension was measured by the standard method. Multiple logistic regression was applied to obtain the odds ratio of pre-hypertension in the tertiles of MED and DASH dietary patterns. Compared to the lowest, participants with the highest adherence to the DASH dietary pattern had significantly lower systolic blood pressure (SBP) (111.3 ± 11.8 vs. 112.8 ± 12.5; P = 0.010) and diastolic blood pressure (DBP) (70.7 ± 9.2 vs. 71.8 ± 9.8; 0.042). There was no significant difference in the mean SBP and DBP among the participants across tertiles of MED or diet adherence. Higher scores of the DASH and MED diets were inversely associated with lower SBP after adjustment for all potential confounders (OR = -0.04, 95% CI = -0.29, -0.01, P = 0.039) and (OR = -0.04, 95% CI = -0.72, -0.02, P = 0.044), respectively. Also, DASH and MED dietary patterns was associated with reduced OR of pre-hypertension occurrence by 13% (OR: 0.87; 95% CI: 0.70-0.98; P for trend = 0.042) and 16% ([OR: 0.84; 95% CI: 0.69-0.97; P trend = 0.035), respectively. CONCLUSION Adherence to the DASH and MED diets was inversely associated with the odds for pre-hypertension and SBP.
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Affiliation(s)
- Mehran Rahimlou
- Department of Nutrition, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Narges Grau
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nasrin Banaie-Jahromi
- Department of Nutrition, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Marzieh Taheri
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Khosravi
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Yiannis Mavrommatis
- Faculty of Sport Health and Applied Science, St Mary's University Twickenham, TW14SX, UK
| | - Noushin Mohammadifard
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
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The Effect of Behavioral Changes on the Treatment of Hypertension. Curr Hypertens Rep 2021; 23:43. [PMID: 34820738 DOI: 10.1007/s11906-021-01164-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE OF REVIEW Hypertension is one of the leading causes of preventable premature death. RECENT FINDINGS Strongly advocating for lifestyle changes to improve blood pressure control is of paramount importance in the successful management of hypertension. In this review, we will discuss the effect of various behavioral and lifestyle changes and review the evidence to support these changes to improve blood pressure control. These include dietary modifications, alcohol consumption, weight loss, various types of exercise, device-guided breathing, relaxation, and biofeedback techniques.
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Bakaloudi DR, Chrysoula L, Leonida I, Kotzakioulafi E, Theodoridis X, Chourdakis M. Impact of the level of adherence to the Mediterranean Diet on blood pressure: A systematic review and meta-analysis of observational studies. Clin Nutr 2021; 40:5771-5780. [PMID: 34773865 DOI: 10.1016/j.clnu.2021.10.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/28/2021] [Accepted: 10/02/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND High blood pressure (BP) constitutes a common and serious medical condition which is rising globally, and is among preventable factors for cardiovascular, renal, brain and other diseases. Modifiable risk factors of high BP include unhealthy dietary patterns, presence of obesity, excess alcohol consumption and lack of physical activity. Data in regard to the different types of diets show that Mediterranean diet (MD) is associated with healthy levels of BP. In this study we aimed to investigate the impact of the level of adherence to MD in BP. AIMS-METHODS A systematic literature search (up to 08.2021) in PubMed, Scopus, Embase, Web of Science, Cochrane and Google Scholar databases was conducted, and 54 observational studies were included. RESULTS Systolic blood pressure (SBP) was found to be lower in the high adherence to MD group SMD: -0.08, (95%CI: -0.15, -0.02) whereas no differences regarding diastolic blood pressure (DBP) were observed between the high and low adherence to MD groups [SMD: -0.07, (95%CI: -0.13, 0.00)]. Mean DBP of all included studies for both high and low adherence groups were in healthy levels (<90 mmHg). CONCLUSIONS Higher adherence to MD could positively influence SBP, but further research is needed in this field due to the heterogeneous definitions of low/high adherence and the type of studies used (observational).
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Affiliation(s)
- Dimitra Rafailia Bakaloudi
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Lydia Chrysoula
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Ioannis Leonida
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Evangelia Kotzakioulafi
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Xenophon Theodoridis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece
| | - Michail Chourdakis
- Laboratory of Hygiene, Social & Preventive Medicine and Medical Statistics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece.
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Effects of a Mediterranean diet on the development of diabetic complications: A longitudinal study from the nationwide diabetes report of the National Program for Prevention and Control of Diabetes (NPPCD 2016-2020). Maturitas 2021; 153:61-67. [PMID: 34654529 DOI: 10.1016/j.maturitas.2021.08.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 08/10/2021] [Accepted: 08/18/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of a Mediterranean dietary pattern on the incidence of macrovascular and microvascular complications of diabetes, namely cardiovascular disease (CVD), diabetic foot disorders, diabetic retinopathy, nephropathy, and neuropathy. METHODS This longitudinal study was conducted among 71392 adults with diabetes who attended academic tertiary-care outpatient clinics from February 2016 to March 2020 across Iran using the National Program for Prevention and Control of Diabetes database. Among them, 22187 patients with diabetes (type 1 and type 2) completed 2-11 follow-up visits after baseline registration. The association between adherence to a Mediterranean diet and diabetic complications was assessed using pooled logistic regression models. This association was adjusted for potential confounders. The effect of time was assessed using fractional polynomials. RESULTS A total of 22187 participants were included in the analysis (30.22% men and 69.78% women) with either type 1 (mean age 50.7 years) or type 2 (mean age 59.9 years) diabetes. After adjustment for confounding variables, there was a negative correlation between adherence to a Mediterranean diet and the incidence of CVD among patients with type 1 diabetes (T1D) and 2 diabetes (T2D) (OR= 0.53, 95% CI: 0.37 - 0.75, p-value <0.001 and OR= 0.61, 95% CI: 0.57 - 0.89, p-value <0.001, respectively). Also, the diet had a statistically significant protective effect against incident symptomatic neuropathy (OR= 0.32, 95% CI: 0.23 - 0.43, p-value <0.001, and OR= 0.68, 95% CI: 0.64 - 0.72, p-value <0.001, respectively), nephropathy (OR= 0.42, 95% CI: 0.30 - 0.58, p-value <0.001, and OR= 0.88, 95% CI: 0.80 - 0.96, p-value= 0.007, respectively), and retinopathy (OR= 0.32, 95% CI: 0.24 - 0.44, p-value <0.001, and OR= 0.68, 95% CI: 0.61 - 0.71, p-value <0.001, respectively) in T1D and T2D. CONCLUSION The Mediterranean dietary pattern is associated with a lower incidence of CVD and microvascular complications (i.e. diabetic retinopathy, nephropathy, and neuropathy) among a cohort of patients with T1D and T2D in Iran.
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Amiot MJ, Latgé C, Plumey L, Raynal S. Intake Estimation of Phytochemicals in a French Well-Balanced Diet. Nutrients 2021; 13:nu13103628. [PMID: 34684628 PMCID: PMC8539512 DOI: 10.3390/nu13103628] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 10/13/2021] [Accepted: 10/14/2021] [Indexed: 12/26/2022] Open
Abstract
Phytochemicals contribute to the health benefits of plant-rich diets, notably through their antioxidant and anti-inflammatory effects. However, recommended daily amounts of the main dietary phytochemicals remain undetermined. We aimed to estimate the amounts of phytochemicals in a well-balanced diet. A modelled diet was created, containing dietary reference intakes for adults in France. Two one-week menus (summer and winter) were devised to reflect typical intakes of plant-based foods. Existing databases were used to estimate daily phytochemical content for seven phytochemical families: phenolic acids, flavonoids (except anthocyanins), anthocyanins, tannins, organosulfur compounds, carotenoids, and caffeine. The summer and winter menus provided 1607 and 1441 mg/day, respectively, of total polyphenols (phenolic acids, flavonoids, anthocyanins, and tannins), the difference being driven by reduced anthocyanin intake in winter. Phenolic acids, flavonoids (including anthocyanins), and tannins accounted for approximately 50%, 25%, and 25% of total polyphenols, respectively. Dietary carotenoid and organosulfur compound content was estimated to be approximately 17 and 70 mg/day, respectively, in both seasons. Finally, both menus provided approximately 110 mg/day of caffeine, exclusively from tea and coffee. Our work supports ongoing efforts to define phytochemical insufficiency states that may occur in individuals with unbalanced diets and related disease risk factors.
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Affiliation(s)
- Marie-Josèphe Amiot
- INRAE, MoISA, University of Montpellier, CIHEAM-IAMM, CIRAD, Institut Agro-Montpellier SupAgro, IRD, Campus La Gaillarde, 2 Place Pierre Viala, 34000 Montpellier, France
- Correspondence: ; Tel.: +33-(0)4-99-61-22-16
| | - Christian Latgé
- Pierre Fabre Laboratories, Langlade-3 Avenue Hubert Curien-BP 13 562, CEDEX 1, 31035 Toulouse, France;
| | - Laurence Plumey
- NUTRITION CO&CO, 11 Avenue des Vignes, 92210 St Cloud, France;
| | - Sylvie Raynal
- Naturactive, Pierre Fabre Laboratories, 29 Avenue du Sidobre, 81106 Castres, France;
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Mediterranean Diet and Physical Activity for Successful Aging: An Update for Nutritionists and Endocrinologists. ENDOCRINES 2021. [DOI: 10.3390/endocrines2040034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The constant advancement in the medical field has allowed for the diagnosis and treatment of several health conditions. It has also contributed to increasing the average human lifespan, which is considered an outstanding achievement in history. Nevertheless, the impact of this in an ever-increasing aged population with chronic diseases and, most of the time, with limited and poor quality of life was not considered. Thus, it is imperative to establish strategies to age successfully. In order to do have a better understanding of this crucial issue, this review will analyze the endocrine changes in the elderly. It will present common conditions found in this population, chronic inflammation, and oxidative stress. Additionally, we will explain aging-related metabolic and physical performance decline related to hormone changes and lifestyle modifications. We will propose the Mediterranean diet and some specific guidelines about physical activity as part of the plan to have an active and successful aging process.
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Mediterranean Diet Adherence and Nutritional Status in Dalmatian Kidney Transplant Recipients-Are They Related? Nutrients 2021; 13:nu13093246. [PMID: 34579123 PMCID: PMC8471203 DOI: 10.3390/nu13093246] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 09/16/2021] [Accepted: 09/16/2021] [Indexed: 01/29/2023] Open
Abstract
The aim of this study was to evaluate adherence to Mediterranean diet (MeDi) and possible correlation of MeDi adherence and nutritional status parameters in Dalmatian kidney transplant recipients (KTRs). One hundred and sixteen KTRs were included in this study. Data about Mediterranean Diet Serving Score (MDSS), body mass composition, anthropometric parameters, clinical and laboratory parameters were collected for each study participant. The results showed 25% adherence to the MeDi in Dalmatian KTRs. MDSS showed association with higher serum albumin and phosphorus level and higher skeletal muscle mass. Also, significant association between diabetic status and MDSS was found. Adherence to olive oil intake suggested by the MeDi showed significant association with lower level of triglycerides and adherence to nuts suggestions was associated with lower level of fat mass. Following MeDi recommendations for consumption of other foods (cereals, potato, eggs, vegetables, fruits and dairy) were also associated with body mass composition parameters and laboratory findings. In conclusion, low adherence to the MeDi in Dalmatian KTRs raises high concerns. The results showed that MeDi can have favorable effects on nutritional status in KTRs. A structured nutritional approach is needed to enhance adherence to the MeDi and prevent possible adverse effects in this patient population.
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Xiao X, Qin Z, Lv X, Dai Y, Ciren Z, Yangla Y, Zeng P, Ma Y, Li X, Wang L, Hu Y, Yang F, Fan C, Tang D, Dai S, Zhang N, Xie X, Yin J, Zhao X. Dietary patterns and cardiometabolic risks in diverse less-developed ethnic minority regions: results from the China Multi-Ethnic Cohort (CMEC) Study. LANCET REGIONAL HEALTH-WESTERN PACIFIC 2021; 15:100252. [PMID: 34528018 PMCID: PMC8383007 DOI: 10.1016/j.lanwpc.2021.100252] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/01/2021] [Accepted: 08/03/2021] [Indexed: 01/09/2023]
Abstract
Background In Western developed countries, food-based dietary patterns have been associated with the risk of cardiometabolic diseases, but little is known about such associations in less developed ethnic minority regions (LEMRs), where the cardiometabolic disease burden is growing rapidly and food patterns differ substantially. Methods Between May 2018 and September 2019, we recruited 99556 participants aged 30-79 years from the China Multi-Ethnic Cohort (CMEC) Study. We measured habitual dietary intake with validated food frequency questionnaire (FFQ) and then calculated dietary pattern scores for two of the most studied a priori dietary patterns, i.e., Dietary Approaches to Stop Hypertension (DASH) and alternative Mediterranean (aMED) style diets, and three a posteriori dietary patterns. Four cardiometabolic risks, including hypertension, diabetes, dyslipidaemia and metabolic syndrome (MetS), were newly diagnosed by medical examination and blood tests. We estimated adjusted odds ratios (OR) relating various dietary pattern scores to cardiometabolic risks using marginal structural models under the guidance of directed acyclic graphs. For the above associations, we further calculated the proportion mediated by overweight (PM) using regression-based mediation analysis for better public health implications. Findings The final study sample consisted of 68834 participants. Among them, we newly diagnosed 12803 hypertension, 3527 diabetes, 16342 hyperlipidaemia, and 8198 MetS cases. Overall, all 5 dietary patterns showed considerable associations with risks of hypertension and MetS. Comparing the highest with the lowest quintiles, the DASH score showed the strongest inverse associations with risks of hypertension (OR=0.74, 95% CI:0.70-0.79; PM=10%) and MetS (OR=0.79, 95% CI:0.74-0.85; PM=35%); conversely, scores of the localized a posteriori Yunnan-Guizhou plateau dietary pattern in LEMRs showed the strongest positive associations with risks of hypertension (OR=1.44, 95% CI:1.35-1.52; PM=10%) and MetS (OR=1.35, 95% CI:1.26-1.46; PM=33%), with all P values for trend <0.001. These associations were consistent in various subgroups defined by sex, age, smoking and physical activity, but with magnitudes that differed substantially across different ethnic regions and urbanicity. By investigating the single-component effects of dietary patterns, the dairy intake component contributed a major proportion to the beneficial effects of DASH (41.9% for hypertension and 100.5% for MetS). Interpretation Substantial socioeconomic status and ethnic disparities in diet quality and related cardiometabolic risks were seen in LEMRs, with hypertension being the top diet-related cardiometabolic risk. Our findings support that DASH provides superior dietary guidance compared to aMED for reducing cardiometabolic risks in LEMRs. In particular, the dairy intake encouraged by DASH may produce considerable beneficial effects. Funding This study was funded by the National Key R&D Program of China; full funding sources listed in the acknowledgements.
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Affiliation(s)
- Xiong Xiao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Zixiu Qin
- the key Laboratory of Environmental Pollution Monitoring and Disease Control, School of Public Health, Guizhou Medical University, Guiyang, China
| | - Xiaoyan Lv
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Yingxue Dai
- Chengdu Center for Disease Control and Prevention, Chengdu, China
| | - Zhuoga Ciren
- Tibet Center for Disease Control and Prevention, Lhasa, China
| | | | | | - Yue Ma
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xiang Li
- Institute of Surveying and Mapping, Information Engineering University, Zhengzhou, China
| | - Lina Wang
- School of Computer and Communication Engineering, Zhengzhou University of Light Industry, Zhengzhou, China
| | - Yifan Hu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Fan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Chaonan Fan
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Dan Tang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Suyao Dai
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Ning Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xiaofen Xie
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jianzhong Yin
- School of Public Health, Kunming Medical University; Baoshan College of Traditional Chinese Medicine, Kunming, China
- Prof Jianzhong Yin, School of Public Health, Kunming Medical University; Baoshan College of Traditional Chinese Medicine, Kunming, China
| | - Xing Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Correspondence to: Prof Xing Zhao, Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
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Rezende-Alves K, Hermsdorff HHM, Miranda AEDS, Lopes ACS, Bressan J, Pimenta AM. Food processing and risk of hypertension: Cohort of Universities of Minas Gerais, Brazil (CUME Project). Public Health Nutr 2021; 24:4071-4079. [PMID: 32758322 PMCID: PMC10195226 DOI: 10.1017/s1368980020002074] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 05/22/2020] [Accepted: 06/02/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To analyse the association between food consumption according to the degree of processing and incidence of hypertension in CUME project participants. DESIGN Longitudinal study in which food consumption was evaluated according to the percentage contribution of daily energetic intake (%/d) of each NOVA classification group (unprocessed/minimally processed foods and culinary preparations (U/MPF&CP); processed foods and ultra-processed foods (UPF)). Hypertension was defined according to American College of Cardiology/American Heart Association (ACC/AHA) criteria. Adjusted relative risks (RR) and their 95% confidence intervals (95 % CI) were estimated by Poisson regression models with robust variances. SETTING Brazil. PARTICIPANTS 1221 graduates classified as non-hypertensive at baseline and monitored for 2 years. RESULTS Daily energetic percentage from each group according to degree of processing was 64·3 (sd 12) % for U/MPF&CP; 9·9 (sd 5·8) % for processed foods and 25·8 (sd 11) % for UPF. Incidence of hypertension was high (152/1000 person-years; n 113, 193/1000 person-years in males and n 257, 138/1000 person-years in females). After adjusting for potential confounders, participants in the upper quintile of daily energetic intake of U/MPF&CP presented a reduced risk of hypertension (RR: 0·72; 95 % CI 0·52, 0·98), while those in the upper quintile of daily energetic intake of UPF presented an increased risk of the outcome (RR: 1·35; 95 % CI 1·01, 1·81). CONCLUSIONS In this prospective cohort of Brazilian middle-aged adult university graduates, the highest consumptions of U/MPF&CP and UPF were associated with, respectively, reduced and increased risk of hypertension. Additional longitudinal studies are needed to confirm our results.
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Affiliation(s)
| | | | - Aline Elizabeth da Silva Miranda
- Department of Maternal-Child Nursing and Public Health, School of Nursing, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Aline Cristine Souza Lopes
- Department of Nutrition, School of Nursing, Federal University of Minas Gerais,Belo Horizonte, MG, Brazil
| | - Josefina Bressan
- Department of Nutrition and Health, Federal University of Viçosa, Viçosa, MG, Brazil
| | - Adriano Marçal Pimenta
- Department of Maternal-Child Nursing and Public Health, School of Nursing, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
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Guasch-Ferré M, Willett WC. The Mediterranean diet and health: a comprehensive overview. J Intern Med 2021; 290:549-566. [PMID: 34423871 DOI: 10.1111/joim.13333] [Citation(s) in RCA: 256] [Impact Index Per Article: 85.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 03/22/2021] [Indexed: 12/18/2022]
Abstract
The Mediterranean diet (MedDiet), one of the most studied and well-known dietary patterns worldwide, has been associated with a wide range of benefits for health. In the present narrative review, we aimed to provide a comprehensive overview of the current knowledge on the relation of the MedDiet to important health outcomes, considering both observational and intervention studies with both risk factors and clinical diseases as outcomes. In addition, we considered the clinical and public health impacts of the MedDiet on both human and planetary health. Earlier research confirmed by recent studies has provided strong evidence for the benefits of the MedDiet on cardiovascular health, including reduction in the incidence of cardiovascular outcomes as well as risk factors including obesity, hypertension, metabolic syndrome, and dyslipidaemia. There is also evidence that MedDiet is associated with lower rates of incident diabetes, and better glycaemic control in diabetic patients compared to control diets. In prospective studies, adherence to the MedDiet reduced mortality, especially cardiovascular mortality, hence increased longevity. In addition, it has been associated with less age-related cognitive dysfunction and lower incidence of neurodegenerative disorders, particularly Alzheimer's disease. Furthermore, the relatively low environmental impacts (water, nitrogen and carbon footprint) of the MedDiet is an additional positive aspect of the Mediterranean dietary model. It is likely that the combination of a healthy diet with social behaviours and the way of life of Mediterranean regions makes the MedDiet a sustainable lifestyle model that could likely be followed in other regions with country-specific and culturally appropriate variations.
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Affiliation(s)
- M Guasch-Ferré
- From the, Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - W C Willett
- From the, Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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35
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Plante TB, Long DL, Guo B, Howard G, Carson AP, Howard VJ, Judd SE, Jenny NS, Zakai NA, Cushman M. C-Reactive Protein and Incident Hypertension in Black and White Americans in the REasons for Geographic And Racial Differences in Stroke (REGARDS) Cohort Study. Am J Hypertens 2021; 34:698-706. [PMID: 33326556 PMCID: PMC8351501 DOI: 10.1093/ajh/hpaa215] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 11/16/2020] [Accepted: 12/14/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND More inflammation is associated with greater risk incident hypertension, and Black United States (US) adults have excess burden of hypertension. We investigated whether increased inflammation as quantified by higher C-reactive protein (CRP) explains the excess incidence in hypertension experienced by Black US adults. METHODS We included 6,548 Black and White REasons for Geographic and Racial Differences in Stroke (REGARDS) participants without hypertension at baseline (2003-2007) who attended a second visit (2013-2016). Sex-stratified risk ratios (RRs) for incident hypertension at the second exam in Black compared to White individuals were estimated using Poisson regression adjusted for groups of factors known to partially explain the Black-White differences in incident hypertension. We calculated the percent mediation by CRP of the racial difference in hypertension. RESULTS Baseline CRP was higher in Black participants. The Black-White RR for incident hypertension in the minimally adjusted model was 1.33 (95% confidence interval 1.22, 1.44) for males and 1.15 (1.04, 1.27) for females. CRP mediated 6.6% (95% confidence interval 2.7, 11.3%) of this association in females and 19.7% (9.8, 33.2%) in males. In females, CRP no longer mediated the Black-White RR in a model including waist circumference and body mass index, while in males the Black-White difference was fully attenuated in models including income, education and dietary patterns. CONCLUSIONS Elevated CRP attenuated a portion of the unadjusted excess risk of hypertension in Black adults, but this excess risk was attenuated when controlling for measures of obesity in females and diet and socioeconomic factors in males. Inflammation related to these risk factors might explain part of the Black-White disparity in hypertension.
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Affiliation(s)
- Timothy B Plante
- Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vermont, USA
| | - D Leann Long
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Boyi Guo
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - George Howard
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - April P Carson
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Virginia J Howard
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Suzanne E Judd
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Nancy Swords Jenny
- Department of Pathology and Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vermont, USA
| | - Neil A Zakai
- Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vermont, USA
- Department of Pathology and Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vermont, USA
| | - Mary Cushman
- Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vermont, USA
- Department of Pathology and Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vermont, USA
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36
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Motamedi A, Ekramzadeh M, Bahramali E, Farjam M, Homayounfar R. Diet quality in relation to the risk of hypertension among Iranian adults: cross-sectional analysis of Fasa PERSIAN cohort study. Nutr J 2021; 20:57. [PMID: 34174902 PMCID: PMC8236133 DOI: 10.1186/s12937-021-00717-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 06/12/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Hypertension is a common chronic disease with various complications and is a main contributing factor to cardiovascular disease (CVD). This study aimed to assess the association of diet quality, assessed by dietary diversity score (DDS), Mediterranean dietary score (MDS), diet quality index-international (DQI-I), and healthy eating index-2015 (HEI-2015) with the risk of hypertension. METHODS This study recruited a total of 10,111 individuals (45.14% male) with mean age of 48.63 ± 9.57 years from the Fasa Cohort Study, Iran. Indices of diet quality, including MDS, HEI-2015, DQI-I, and DDS were computed by a 125-item Food Frequency Questionnaire. Participants were diagnosed as hypertensive if they had a diastolic blood pressure (DBP) ≥90 mmHg, systolic blood pressure (SBP) ≥140 mmHg,, or used antihypertensive drugs. RESULTS Hypertension was prevalent in 28.3% of the population (21.59% in males and 33.74% in females). In the whole population, after adjustment for potential covariates, including daily energy intake, age, gender, physical activity, smoking, family history of hypertension, body mass index, and the level of education, higher adherence to the MDS (OR: 0.86, 95%CI = 0.75-0.99) and HEI-2015 (OR: 0.79, 95%CI = 0.68-0.90) was significantly associated with decreased risk of hypertension. The protective effect of HEI-2015 against hypertension remained significant for both males (OR: 0.80, 95%CI = 0.64-0.99) and females (OR: 0.78, 95%CI = 0.66-0.94), while, for MDS, this relationship disappeared in the subgroup analysis by gender. DQI-I and DDS were not related to the odds of hypertension. CONCLUSIONS Adhering to MDS and HEI-2015 diets could contribute to the prevention of hypertension.
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Affiliation(s)
- Amir Motamedi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Ekramzadeh
- Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Ehsan Bahramali
- Noncommunicable diseases research center, Fasa university of medical sciences, Fasa, Iran
| | - Mojtaba Farjam
- Noncommunicable diseases research center, Fasa university of medical sciences, Fasa, Iran
| | - Reza Homayounfar
- Noncommunicable diseases research center, Fasa university of medical sciences, Fasa, Iran. .,Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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37
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Dietary interventions and blood pressure in overweight or obese individuals: A systematic review and meta-analysis. Clin Nutr 2021; 41:1001-1012. [PMID: 35031150 DOI: 10.1016/j.clnu.2021.06.003] [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: 01/22/2021] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND & AIMS Increased fruit and vegetable consumption (FVC) beneficially impacts hypertension, yet researchers have not synthesized the effects of FVC interventions on blood pressure (BP) among overweight or obese individuals. Therefore, we aimed to examine if diets with increased FVC decrease BP in overweight and obese persons and explore effects of moderators, study methods, participants, intervention, and source characteristics. METHODS A thorough literature search was conducted in CINAHL, ProQuest Dissertation & Theses, Scopus, PubMed, The Cochrane Library, and Web of Science. Last search was conducted on February 28, 2020. Inclusion criteria consisted of randomized controlled trials, an increased FVC intervention, and a body mass index (BMI) ≥25. Studies were independently coded and evaluated for bias using Cochrane Collaboration's tool for assessing study bias. The Grading of Recommendations Assessment, Development and Evaluation tool was used to evaluate the body of evidence, which was found to be moderate. Data was analyzed using Stata 16SE Software. We used a random effects model, comparing mean differences. Moderator analysis was conducted using meta-regression for continuous variables and meta-analytic ANOVA analog for categorical variables. Publication bias was assessed using funnel plot symmetry, Begg and Mazumdar's rank and correlation, Egger's test of the intercept, and Duval and Tweedie's trim and fill. RESULTS Ten studies met criteria, which included 6862 participants. Overall, effects of FVC interventions on systolic blood pressure (SBP) was 2.16 mmHg (p < 0.001) and -0.55 mmHg (p = 0.39) for diastolic blood pressure (DBP). Moderator analyses showed greater drops in SBP from samples recruited from the community and medical schools (vs. health care/programs), interventions that used the DASH diet, and measured intake with food diaries. When concealed allocation was used and fidelity checked, there were less decreases in SBP than when it was not used. The amount of FVC significantly moderated the effects of SBP and DBP with greater increased FVC leading to greater decreases in SBP and DBP. DISCUSSION Our findings are encouraging in that FVC improves blood pressure. However, outcomes are limited by the small number of studies that met inclusion criteria, significant heterogeneity, possible publication bias, and several studies had quality concerns. Tests for publication bias indicated none and most heterogeneity among studies was explained with moderator analysis our findings should be interpreted with caution. CONCLUSIONS Increased FVC decreased SBP and DBP in obese and overweight individuals which may lower the risk of cardiovascular events. In the future, researchers might conduct higher quality studies and report quality indicators. Researchers might examine the effects of interventions for specific subgroups (overweight vs obese, younger vs older) and explore the impacts of diet-assisted technologies.
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Ribó-Coll M, Lassale C, Sacanella E, Ros E, Toledo E, Sorlí JV, Babio N, Lapetra J, Gómez-Gracia E, Alonso-Gómez ÁM, Fiol M, Serra-Majem L, Pinto X, Castañer O, Díez-Espino J, González JI, Becerra-Tomás N, Cofán M, Díaz-López A, Estruch R, Hernáez Á. Mediterranean diet and antihypertensive drug use: a randomized controlled trial. J Hypertens 2021; 39:1230-1237. [PMID: 33496530 DOI: 10.1097/hjh.0000000000002765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine in older individuals at high cardiovascular risk whether following a Mediterranean diet decreased the necessity of antihypertensive drugs and modulated their associated cardiovascular risk. METHODS In the PREvención con DIeta MEDiterránea study, we assessed whether volunteers randomly allocated to an intervention with a Mediterranean diet enriched with extra-virgin olive oil or nuts (relative to a low-fat control diet) disclosed differences in the risk of: initiating antihypertensive medication in nonusers at baseline (n = 2188); and escalating therapy in participants using one, two, or three drugs at baseline (n = 2361, n = 1579, and n = 554, respectively). We also assessed whether allocation to Mediterranean diet modified the association between antihypertensive drug use and incident cardiovascular events. RESULTS Participants allocated to Mediterranean diet interventions were associated with lower risk of initiating antihypertensive therapy [5-year incidence rates: 47.1% in the control diet, 43.0% in MedDiets; hazard ratio = 0.84, 95% CI (0.74--0.97), in a model adjusted for age, sex, and recruitment site]. Volunteers using two drugs at baseline in the Mediterranean diet intervention enriched with extra-virgin olive oil decreased their risk of therapy escalation [5-year incidence rates: 22.9% in the control diet, 20.1% in the MedDiet; hazard ratio = 0.77, 95% CI (0.60--0.99)]. Allocation to Mediterranean diet interventions attenuated the association between antihypertensive therapy at baseline and incidence of major adverse cardiovascular events (P interaction = 0.003). CONCLUSION In an older population at high cardiovascular risk, following a Mediterranean diet reduced the risk of initiating or escalating antihypertensive medication and attenuated cardiovascular risk in antihypertensive drug users.
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Affiliation(s)
- Margarita Ribó-Coll
- Cardiovascular Risk, Nutrition, and Aging Research Group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS)
- PhD program in Food Science and Nutrition, Faculty of Pharmacy and Food Science, Universitat de Barcelona, Barcelona
| | - Camille Lassale
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM)
| | - Emilio Sacanella
- Cardiovascular Risk, Nutrition, and Aging Research Group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Internal Medicine Service, Hospital Clínic
| | - Emilio Ros
- Cardiovascular Risk, Nutrition, and Aging Research Group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, Barcelona
| | - Estefanía Toledo
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona
| | - José V Sorlí
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Department of Preventive Medicine and Public Health, Universidad de Valencia, Valencia
| | - Nancy Babio
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Unitat de Nutrició Humana, Departament de Bioquimica i Biotecnologia, Universitat Rovira i Virgili
- Institut d'Investigació Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, Reus
| | - José Lapetra
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla
| | - Enrique Gómez-Gracia
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Department of Preventive Medicine and Public Health, Universidad de Málaga, Málaga
| | - Ángel M Alonso-Gómez
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz
| | - Miquel Fiol
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Health Research Institute of the Balearic Islands (IdISBa). Hospital Son Espases. Palma de Mallorca
| | - Lluis Serra-Majem
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Instituto de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria
- Centro Hospitalario Universitario Insular Materno Infantil, Servicio Canario de Salud, Las Palmas
| | - Xavier Pinto
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat
| | - Olga Castañer
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM)
| | - Javier Díez-Espino
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Department of Preventive Medicine and Public Health, Universidad de Navarra, Pamplona
- Centro de Salud de Tafalla, Gerencia de Atención Primaria, Servicio Navarro de Salud-Osasunbidea, Tafalla
- Instituto de Investigación Sanitaria de Navarra (IDISNA), Pamplona
| | - José I González
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Department of Preventive Medicine and Public Health, Universidad de Valencia, Valencia
| | - Nerea Becerra-Tomás
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Department of Preventive Medicine and Public Health, Universidad de Valencia, Valencia
- Unitat de Nutrició Humana, Departament de Bioquimica i Biotecnologia, Universitat Rovira i Virgili
- Institut d'Investigació Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, Reus
| | - Montserrat Cofán
- Cardiovascular Risk, Nutrition, and Aging Research Group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, Barcelona
| | - Andrés Díaz-López
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Unitat de Nutrició Humana, Departament de Bioquimica i Biotecnologia, Universitat Rovira i Virgili
- Institut d'Investigació Pere Virgili (IISPV), Hospital Universitari Sant Joan de Reus, Reus
| | - Ramón Estruch
- Cardiovascular Risk, Nutrition, and Aging Research Group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Internal Medicine Service, Hospital Clínic
| | - Álvaro Hernáez
- Cardiovascular Risk, Nutrition, and Aging Research Group, August Pi i Sunyer Biomedical Research Institute (IDIBAPS)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid
- Blanquerna School of Health Sciences, Universitat Ramon Llull, Barcelona, Spain
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Cowell OR, Mistry N, Deighton K, Matu J, Griffiths A, Minihane AM, Mathers JC, Shannon OM, Siervo M. Effects of a Mediterranean diet on blood pressure: a systematic review and meta-analysis of randomized controlled trials and observational studies. J Hypertens 2021; 39:729-739. [PMID: 33060448 DOI: 10.1097/hjh.0000000000002667] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To conduct a systematic review and meta-analysis investigating effects of MedDiet on blood pressure in randomized controlled trials (RCTs) and associations of MedDiet with risk of hypertension in observational studies. METHODS PubMed, The Cochrane Library and EBSCOhost were searched from inception until January 2020 for studies that met the following criteria: participants aged at least 18 years, RCTs investigating effects of a MedDiet versus control on BP, observational studies exploring associations between MedDiet adherence and risk of hypertension. Random-effects meta-analyses were conducted. Meta-regression and subgroup analyses were performed for RCTs to identify potential effect moderators. RESULTS Nineteen RCTs reporting data on 4137 participants and 16 observational studies reporting data on 59 001 participants were included in the meta-analysis. MedDiet interventions reduced SBP and DBP by a mean -1.4 mmHg (95% CI: -2.40 to -0.39 mmHg, P = 0.007, I2 = 53.5%, Q = 44.7, τ2 = 1.65, df = 19) and -1.5 mmHg (95% CI: -2.74 to -0.32 mmHg, P = 0.013, I2 = 71.5%, Q = 51.6, τ2 = 4.72, df = 19) versus control, respectively. Meta-regression revealed that longer study duration and higher baseline SBP was associated with a greater decrease in BP, in response to a MedDiet (P < 0.05). In observational studies, odds of developing hypertension were 13% lower with higher versus lower MedDiet adherence (95% CI: 0.78--0.98, P = 0.017, I2 = 69.6%, Q = 41.1, τ2 = 0.03, df = 17). CONCLUSION Data suggest that MedDiet is an effective dietary strategy to aid BP control, which may contribute towards the lower risk of CVD reported with this dietary pattern. This study was registered with PROSPERO: CRD42019125073.
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Affiliation(s)
- Owen R Cowell
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne
| | - Nathan Mistry
- Institute for Sport, Physical Activity & Leisure, Leeds Beckett University, Leeds
- Department of Clinical and Pharmaceutical Sciences, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Hertfordshire
| | | | - Jamie Matu
- School of Clinical Applied Sciences, Leeds Beckett University, Leeds
| | - Alex Griffiths
- Institute for Sport, Physical Activity & Leisure, Leeds Beckett University, Leeds
| | - Anne Marie Minihane
- Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia (UEA), Norwich
| | - John C Mathers
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne
| | - Oliver M Shannon
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne
| | - Mario Siervo
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
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Ribó-Coll M, Castro-Barquero S, Lassale C, Sacanella E, Ros E, Toledo E, Sorlí JV, Díaz-López A, Lapetra J, Muñoz-Bravo C, Arós F, Fiol M, Serra-Majem L, Pinto X, Castañer O, Fernández-Lázaro CI, Portolés O, Babio N, Estruch R, Hernáez Á. Mediterranean Diet and Physical Activity Decrease the Initiation of Cardiovascular Drug Use in High Cardiovascular Risk Individuals: A Cohort Study. Antioxidants (Basel) 2021; 10:397. [PMID: 33808041 PMCID: PMC7999777 DOI: 10.3390/antiox10030397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/27/2021] [Accepted: 03/02/2021] [Indexed: 11/29/2022] Open
Abstract
Our aim was to assess whether long-term adherence to a Mediterranean diet (MedDiet) and leisure-time physical activity (LTPA) were associated with a lower initiation of cardiovascular drug use. We studied the association between cumulative average of MedDiet adherence and LTPA and the risk of cardiovascular drug initiation in older adults at high cardiovascular risk (PREvención con DIeta MEDiterránea trial participants) non-medicated at baseline: glucose-lowering drugs (n = 4437), antihypertensives (n = 2145), statins (n = 3977), fibrates (n = 6391), antiplatelets (n = 5760), vitamin K antagonists (n = 6877), antianginal drugs (n = 6837), and cardiac glycosides (n = 6954). One-point increases in MedDiet adherence were linearly associated with a decreased initiation of glucose-lowering (HR: 0.76 [0.71-0.80]), antihypertensive (HR: 0.79 [0.75-0.82]), statin (HR: 0.82 [0.78-0.85]), fibrate (HR: 0.78 [0.68-0.89]), antiplatelet (HR: 0.79 [0.75-0.83]), vitamin K antagonist (HR: 0.83 [0.74; 0.93]), antianginal (HR: 0.84 [0.74-0.96]), and cardiac glycoside therapy (HR: 0.69 [0.56-0.84]). LTPA was non-linearly related to a delayed initiation of glucose-lowering, antihypertensive, statin, fibrate, antiplatelet, antianginal, and cardiac glycoside therapy (minimum risk: 180-360 metabolic equivalents of task-min/day). Both combined were synergistically associated with a decreased onset of glucose-lowering drugs (p-interaction = 0.04), antihypertensive drugs (p-interaction < 0.001), vitamin K antagonists (p-interaction = 0.04), and cardiac glycosides (p-interaction = 0.01). Summarizing, sustained adherence to a MedDiet and LTPA were associated with lower risk of initiating cardiovascular-related medications.
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Affiliation(s)
- Margarita Ribó-Coll
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (M.R.-C.); (S.C.-B.); (E.S.); (E.R.); (R.E.)
- PhD Program in Food Science and Nutrition, Faculty of Pharmacy and Food Science, Universitat de Barcelona, 08028 Barcelona, Spain
| | - Sara Castro-Barquero
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (M.R.-C.); (S.C.-B.); (E.S.); (E.R.); (R.E.)
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (E.T.); (J.V.S.); (A.D.-L.); (J.L.); (F.A.); (M.F.); (L.S.-M.); (X.P.); (O.C.); (C.I.F.-L.); (O.P.); (N.B.)
| | - Camille Lassale
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (E.T.); (J.V.S.); (A.D.-L.); (J.L.); (F.A.); (M.F.); (L.S.-M.); (X.P.); (O.C.); (C.I.F.-L.); (O.P.); (N.B.)
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
| | - Emilio Sacanella
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (M.R.-C.); (S.C.-B.); (E.S.); (E.R.); (R.E.)
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (E.T.); (J.V.S.); (A.D.-L.); (J.L.); (F.A.); (M.F.); (L.S.-M.); (X.P.); (O.C.); (C.I.F.-L.); (O.P.); (N.B.)
- Internal Medicine Service, Hospital Clínic, 08036 Barcelona, Spain
| | - Emilio Ros
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (M.R.-C.); (S.C.-B.); (E.S.); (E.R.); (R.E.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (E.T.); (J.V.S.); (A.D.-L.); (J.L.); (F.A.); (M.F.); (L.S.-M.); (X.P.); (O.C.); (C.I.F.-L.); (O.P.); (N.B.)
- Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, 08036 Barcelona, Spain
| | - Estefanía Toledo
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (E.T.); (J.V.S.); (A.D.-L.); (J.L.); (F.A.); (M.F.); (L.S.-M.); (X.P.); (O.C.); (C.I.F.-L.); (O.P.); (N.B.)
- Department of Preventive Medicine and Public Health, Universidad de Navarra, 31008 Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
| | - José V. Sorlí
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (E.T.); (J.V.S.); (A.D.-L.); (J.L.); (F.A.); (M.F.); (L.S.-M.); (X.P.); (O.C.); (C.I.F.-L.); (O.P.); (N.B.)
- Department of Preventive Medicine and Public Health, Universidad de Valencia, 46010 Valencia, Spain
| | - Andrés Díaz-López
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (E.T.); (J.V.S.); (A.D.-L.); (J.L.); (F.A.); (M.F.); (L.S.-M.); (X.P.); (O.C.); (C.I.F.-L.); (O.P.); (N.B.)
- Unitat de Nutrició i Salut Pública, Departament de Ciències Mèdiques Bàsiques, Universitat Rovira i Virgili, 43201 Reus, Spain
- Institut d’Investigació Sanitaria Pere Virgili (IISPV), 43204 Reus, Spain
| | - José Lapetra
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (E.T.); (J.V.S.); (A.D.-L.); (J.L.); (F.A.); (M.F.); (L.S.-M.); (X.P.); (O.C.); (C.I.F.-L.); (O.P.); (N.B.)
- Department of Family Medicine-Research Unit, Distrito Sanitario Atención Primaria Sevilla, 41013 Sevilla, Spain
| | - Carlos Muñoz-Bravo
- Department of Public Health and Psychiatry, Universidad de Málaga, 29071 Málaga, Spain;
| | - Fernando Arós
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (E.T.); (J.V.S.); (A.D.-L.); (J.L.); (F.A.); (M.F.); (L.S.-M.); (X.P.); (O.C.); (C.I.F.-L.); (O.P.); (N.B.)
- Department of Cardiology, Hospital Universitario de Álava, 01009 Vitoria, Spain
| | - Miquel Fiol
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (E.T.); (J.V.S.); (A.D.-L.); (J.L.); (F.A.); (M.F.); (L.S.-M.); (X.P.); (O.C.); (C.I.F.-L.); (O.P.); (N.B.)
- Health Research Institute of the Balearic Islands (IdISBa), Hospital Son Espases, 07120 Palma de Mallorca, Spain
| | - Lluis Serra-Majem
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (E.T.); (J.V.S.); (A.D.-L.); (J.L.); (F.A.); (M.F.); (L.S.-M.); (X.P.); (O.C.); (C.I.F.-L.); (O.P.); (N.B.)
- Instituto de Investigaciones Biomédicas y Sanitarias, Universidad de Las Palmas de Gran Canaria, 35016 Las Palmas, Spain
- Centro Hospitalario Universitario Insular Materno Infantil, Servicio Canario de Salud, 35016 Las Palmas, Spain
| | - Xavier Pinto
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (E.T.); (J.V.S.); (A.D.-L.); (J.L.); (F.A.); (M.F.); (L.S.-M.); (X.P.); (O.C.); (C.I.F.-L.); (O.P.); (N.B.)
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, 08907 L’Hospitalet de Llobregat, Spain
| | - Olga Castañer
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (E.T.); (J.V.S.); (A.D.-L.); (J.L.); (F.A.); (M.F.); (L.S.-M.); (X.P.); (O.C.); (C.I.F.-L.); (O.P.); (N.B.)
- Cardiovascular Risk and Nutrition Research Group, Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
| | - César I. Fernández-Lázaro
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (E.T.); (J.V.S.); (A.D.-L.); (J.L.); (F.A.); (M.F.); (L.S.-M.); (X.P.); (O.C.); (C.I.F.-L.); (O.P.); (N.B.)
- Navarra Institute for Health Research (IdiSNA), 31008 Pamplona, Spain
| | - Olga Portolés
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (E.T.); (J.V.S.); (A.D.-L.); (J.L.); (F.A.); (M.F.); (L.S.-M.); (X.P.); (O.C.); (C.I.F.-L.); (O.P.); (N.B.)
- Department of Preventive Medicine and Public Health, Universidad de Valencia, 46010 Valencia, Spain
| | - Nancy Babio
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (E.T.); (J.V.S.); (A.D.-L.); (J.L.); (F.A.); (M.F.); (L.S.-M.); (X.P.); (O.C.); (C.I.F.-L.); (O.P.); (N.B.)
- Institut d’Investigació Sanitaria Pere Virgili (IISPV), 43204 Reus, Spain
- Unitat de Nutrició Humana, Departament de Bioquimica i Biotecnologia, Universitat Rovira i Virgili, 43201 Reus, Spain
| | - Ramón Estruch
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (M.R.-C.); (S.C.-B.); (E.S.); (E.R.); (R.E.)
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, 08036 Barcelona, Spain
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (E.T.); (J.V.S.); (A.D.-L.); (J.L.); (F.A.); (M.F.); (L.S.-M.); (X.P.); (O.C.); (C.I.F.-L.); (O.P.); (N.B.)
- Internal Medicine Service, Hospital Clínic, 08036 Barcelona, Spain
| | - Álvaro Hernáez
- August Pi i Sunyer Biomedical Research Institute (IDIBAPS), 08036 Barcelona, Spain; (M.R.-C.); (S.C.-B.); (E.S.); (E.R.); (R.E.)
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; (C.L.); (E.T.); (J.V.S.); (A.D.-L.); (J.L.); (F.A.); (M.F.); (L.S.-M.); (X.P.); (O.C.); (C.I.F.-L.); (O.P.); (N.B.)
- Blanquerna School of Health Sciences, Universitat Ramon Llull, 08025 Barcelona, Spain
- Centre for Fertility and Health, Norwegian Institute of Public Health, 0473 Oslo, Norway
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Guiné RP, Florença SG, Barroca MJ, Anjos O. The duality of innovation and food development versus purely traditional foods. Trends Food Sci Technol 2021. [DOI: 10.1016/j.tifs.2021.01.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Filippou CD, Thomopoulos CG, Kouremeti MM, Sotiropoulou LI, Nihoyannopoulos PI, Tousoulis DM, Tsioufis CP. Mediterranean diet and blood pressure reduction in adults with and without hypertension: A systematic review and meta-analysis of randomized controlled trials. Clin Nutr 2021; 40:3191-3200. [PMID: 33581952 DOI: 10.1016/j.clnu.2021.01.030] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 12/14/2020] [Accepted: 01/22/2021] [Indexed: 01/13/2023]
Abstract
BACKGROUND & AIMS It is unclear whether the Mediterranean diet (MedDiet) has a favorable effect on blood pressure (BP) levels because among randomized controlled trials (RCTs) investigating the MedDiet-mediated BP reduction significant methodological and clinical differences are observed. The purpose of this study was to comprehensively assess the MedDiet BP-effect compared to the usual diet or another dietary intervention (e.g. low-fat diet) in adults with and without hypertension, accounting for methodological and clinical confounders. METHODS We systematically searched Medline and the Cochrane Collaboration Library databases and identified 35 RCTs (13,943 participants). Random-effects model was used to calculate the mean attained systolic BP (SBP) and diastolic BP (DBP) differences during follow-up. Subgroup and meta-regression analyses were also conducted. RESULTS Compared to the usual diet and all other active intervention diets the MedDiet reduced SBP and DBP (difference in means: -1.5 mm Hg; 95% CI: -2.8, -0.1; P = 0.035, and -0.9 mm Hg; 95% CI: -1.5, -0.3; P = 0.002, respectively). Compared only to the usual diet the MedDiet reduced SBP and DBP, while compared to all other active intervention diets or only to the low-fat diet the MedDiet did not reduce SBP and DBP. The MedDiet reduced DBP levels to a higher extent in trials with mean baseline SBP ≥130 mm Hg, while both SBP and DBP were reduced more in trials with a mean follow-up period ≥16 weeks. The quality of evidence was rated as moderate for both outcomes according to the grading of recommendations, assessment, development and evaluation (GRADE) approach. CONCLUSIONS The adoption of the MedDiet was accompanied by a relatively small, but yet significant BP reduction, while higher baseline SBP levels and longer follow-up duration enhanced the BP-lowering effect of the intervention. This meta-analysis was registered in the International Prospective Register of Systematic Reviews (PROSPERO) as CRD42020167308. REGISTRY NUMBER CRD42020167308.
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Affiliation(s)
- Christina D Filippou
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | | | - Maria M Kouremeti
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Lida I Sotiropoulou
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Petros I Nihoyannopoulos
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Dimitrios M Tousoulis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Costas P Tsioufis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece.
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The Beneficial Health Effects of Vegetables and Wild Edible Greens: The Case of the Mediterranean Diet and Its Sustainability. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10249144] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The Mediterranean diet (MD) concept as currently known describes the dietary patterns that were followed in specific regions of the area in the 1950s and 1960s. The broad recognition of its positive effects on the longevity of Mediterranean populations also led to the adoption of this diet in other regions of the world, and scientific interest focused on revealing its health effects. MD is not only linked with eating specific nutritional food products but also with social, religious, environmental, and cultural aspects, thus representing a healthy lifestyle in general. However, modern lifestyles adhere to less healthy diets, alienating people from their heritage. Therefore, considering the increasing evidence of the beneficial health effects of adherence to the MD and the ongoing transitions in consumers’ behavior, the present review focuses on updating the scientific knowledge regarding this diet and its relevance to agrobiodiversity. In addition, it also considers a sustainable approach for new marketing opportunities and consumer trends of the MD.
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Liu X, Lai H, Mi B, Qi X, Gan W, Du H. Associations of Coarse Grain Intake with Undiagnosed Hypertension among Chinese Adults: Results from the China Kadoorie Biobank. Nutrients 2020; 12:nu12123814. [PMID: 33322167 PMCID: PMC7764616 DOI: 10.3390/nu12123814] [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] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/09/2020] [Accepted: 12/09/2020] [Indexed: 01/15/2023] Open
Abstract
Whole grain intake was associated with better blood pressure control, but evidence is lacking in non-Western populations with different grain intake patterns. We aimed to determine the associations between coarse grain intake, usually considered as the best proxy of whole grain intake for Chinese diets, with blood pressure and undiagnosed hypertension using baseline data from the China Kadoorie Biobank study. After excluding participants with clinically diagnosed hypertension or use of antihypertensive dugs, 435,907 participants were included in our analysis. A self-reported questionnaire was used to measure coarse grain intake frequency. Overall, 12.8% and 29.2% of the participants reported daily consumption and never consumption, respectively. With multivariable adjustments including BMI, outdoor temperature, and physical activity, higher frequency of coarse grain intake was associated with lower systolic and diastolic blood pressure in those older than 40 years, p trend < 0.05. Compared to never consumers, the odds ratio (95% CI) of hypertension was 0.78 (0.73–0.84), 0.84 (0.77–0.91), 0.91 (0.88–0.94), and 0.97 (0.95–0.99) for daily, 4–6 days/week, 1–3 days/week, and monthly groups, P trend < 0.001. Our cross-sectional study in a nationwide sample of Chinese adults suggests that higher coarse grain intake was associated with lower blood pressure and lower hypertension risk.
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Affiliation(s)
- Xin Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi’an Jiaotong University Health Science Center, 76 West Yanta Road, Xi’an 710061, China; (H.L.); (B.M.); (X.Q.)
- Correspondence: ; Tel.: +86-29-82655108
| | - Hao Lai
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi’an Jiaotong University Health Science Center, 76 West Yanta Road, Xi’an 710061, China; (H.L.); (B.M.); (X.Q.)
| | - Baibing Mi
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi’an Jiaotong University Health Science Center, 76 West Yanta Road, Xi’an 710061, China; (H.L.); (B.M.); (X.Q.)
| | - Xin Qi
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi’an Jiaotong University Health Science Center, 76 West Yanta Road, Xi’an 710061, China; (H.L.); (B.M.); (X.Q.)
| | - Wei Gan
- Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK; (W.G.); (H.D.)
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Huaidong Du
- Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK; (W.G.); (H.D.)
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
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Sukhato K, Akksilp K, Dellow A, Vathesatogkit P, Anothaisintawee T. Efficacy of different dietary patterns on lowering of blood pressure level: an umbrella review. Am J Clin Nutr 2020; 112:1584-1598. [PMID: 33022695 DOI: 10.1093/ajcn/nqaa252] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 08/11/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Many systematic reviews and meta-analyses have assessed the efficacy of dietary patterns on blood pressure (BP) lowering but their findings are largely conflicting. OBJECTIVE This umbrella review aims to provide an update on the available evidence for the efficacy of different dietary patterns on BP lowering. METHODS PubMed and Scopus databases were searched to identify relevant studies through to June 2020. Systematic reviews with meta-analyses of randomized controlled trials (RCTs) were eligible if they measured the effect of dietary patterns on systolic (SBP) and/or diastolic blood pressure (DBP) levels. The methodological quality of included systematic reviews was assessed by A Measurement Tool to Assess Systematic Review version 2. The efficacy of each dietary pattern was summarized qualitatively. The confidence of the effect estimates for each dietary pattern was graded using the NutriGrade scoring system. RESULTS Fifty systematic reviews and meta-analyses of RCTs were eligible for review. Twelve dietary patterns namely the Dietary Approaches to Stop Hypertension (DASH), Mediterranean, Nordic, vegetarian, low-salt, low-carbohydrate, low-fat, high-protein, low glycemic index, portfolio, pulse, and Paleolithic diets were included in this umbrella review. Among these dietary patterns, the DASH diet was associated with the greatest overall reduction in BP with unstandardized mean differences ranging from -3.20 to -7.62 mmHg for SBP and from -2.50 to -4.22 mmHg for DBP. Adherence to Nordic, portfolio, and low-salt diets also significantly decreased SBP and DBP levels. In contrast, evidence for the efficacy of BP lowering using the Mediterranean, vegetarian, Paleolithic, low-carbohydrate, low glycemic index, high-protein, and low-fat diets was inconsistent. CONCLUSION Adherence to the DASH, Nordic, and portfolio diets effectively reduced BP. Low-salt diets significantly decreased BP levels in normotensive Afro-Caribbean people and in hypertensive patients of all ethnic origins. This review was registered at PROSPERO as CRD42018104733.
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Affiliation(s)
- Kanokporn Sukhato
- Department of Family Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Katika Akksilp
- Health Intervention and Technology Assessment Program, Department of Health, Ministry of Public Health, Bangkok, Thailand
| | - Alan Dellow
- Former Postgraduate Tutor, Oxford Deanery, United Kingdom
| | - Prin Vathesatogkit
- Cardiology Unit, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Thunyarat Anothaisintawee
- Department of Family Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.,Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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COSTA GLA, BUCCINI DF, ARRUDA ALA, FAVARO SP, MORENO SE. Phytochemical profile, anti-inflammatory, antimutagenic and antioxidant properties of Acrocomia aculeata (Jacq.) Lodd. pulp oil. FOOD SCIENCE AND TECHNOLOGY 2020. [DOI: 10.1590/fst.25319] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
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Romanidou M, Tripsianis G, Hershey MS, Sotos-Prieto M, Christophi C, Moffatt S, Constantinidis TC, Kales SN. Association of the Modified Mediterranean Diet Score (mMDS) with Anthropometric and Biochemical Indices in US Career Firefighters. Nutrients 2020; 12:E3693. [PMID: 33265967 PMCID: PMC7759922 DOI: 10.3390/nu12123693] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 11/24/2020] [Accepted: 11/27/2020] [Indexed: 12/26/2022] Open
Abstract
The Mediterranean diet is associated with multiple health benefits, and the modified Mediterranean Diet Score (mMDS) has been previously validated as a measure of Mediterranean diet adherence. The aim of this study was to examine associations between the mMDS and anthropometric indices, blood pressure, and biochemical parameters in a sample of career firefighters. The participants were from Indiana Fire Departments, taking part in the "Feeding America's Bravest" study, a cluster-randomized controlled trial that aimed to assess the efficacy of a Mediterranean diet intervention. We measured Mediterranean diet adherence using the mMDS. Anthropometric, blood pressure, and biochemical measurements were also collected. Univariate and multivariate linear regression models were used. In unadjusted analyses, many expected favorable associations between the mMDS and cardiovascular disease risk factors were found among the 460 firefighters. After adjustment for age, gender, ethnicity, physical activity, and smoking, a unitary increase in the mMDS remained associated with a decrease of the total cholesterol/HDL ratio (β-coefficient -0.028, p = 0.002) and an increase of HDL-cholesterol (β-coefficient 0.254, p = 0.004). In conclusion, greater adherence to the Mediterranean diet was associated with markers of decreased cardiometabolic risk. The mMDS score is a valid instrument for measuring adherence to the Mediterranean diet and may have additional utility in research and clinical practice.
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Affiliation(s)
- Maria Romanidou
- Department of Medical Statistics, Medical Faculty, Democritus University of Thrace, 68100 Alexandroupolis, Greece;
| | - Grigorios Tripsianis
- Department of Medical Statistics, Medical Faculty, Democritus University of Thrace, 68100 Alexandroupolis, Greece;
| | - Maria Soledad Hershey
- Department of Preventive Medicine and Public Health, Navarra Institute for Health Research, University of Navarra, 31008 Pamplona, Spain;
| | - Mercedes Sotos-Prieto
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02215, USA or (M.S.-P.); (C.C.); (S.N.K.)
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Calle del Arzobispo Morcillo 4, 28029 Madrid, Spain
- Biomedical Research Network Centre of Epidemiology and Public Health (CIBERESP), Carlos III Health Institute, 28029 Madrid, Spain
| | - Costas Christophi
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02215, USA or (M.S.-P.); (C.C.); (S.N.K.)
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, 30 Archbishop Kyprianou Str., Lemesos 3036, Cyprus
| | - Steven Moffatt
- National Institute for Public Safety Health, IN 324 E New York Street, Indianapolis, IN 46204, USA;
| | - Theodoros C. Constantinidis
- Laboratory of Hygiene and Environmental Protection, Medical School, Democritus University of Thrace, 68100 Alexandroupolis, Greece;
| | - Stefanos N. Kales
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02215, USA or (M.S.-P.); (C.C.); (S.N.K.)
- Occupational Medicine, Cambridge Health Alliance/Harvard Medical School, Cambridge, MA 02319, USA
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48
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Interplay between dietary phenolic compound intake and the human gut microbiome in hypertension: A cross-sectional study. Food Chem 2020; 344:128567. [PMID: 33203597 DOI: 10.1016/j.foodchem.2020.128567] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/23/2020] [Accepted: 11/02/2020] [Indexed: 12/18/2022]
Abstract
In the present study, potential associations between dietary phenolic compounds (PCs), gut microbiota composition and targeted faecal metabolites were identified in a cross-sectional study including grade 1 hypertensive (HT) and normotensive (NT) subjects. We performed comprehensive quantification of PC intake, together with 16S rRNA gene sequencing of the gut microbiota, and faecal and plasma short-chain fatty acids (SCFAs) determination. The results showed multiple-way relationships between PCs from several plant-based foods and 25 bacterial taxa previously defined as discriminant biomarkers among groups. Remarkably, coffee PCs were positively associated with systolic and diastolic blood pressure, faecal SCFAs, Bacteroides plebeius and Bacteroides coprocola in HT and negatively associated with Faecalibacterium prausnitzii and Christensenellaceae R-7 in NT. Olive fruit PCs were positively associated with Ruminococcaceae UCG-010, Christensenellaceae R-7 and plasma SCFAs in NT. These interplays with discriminant bacterial taxa in HT and NT subjects highlight the potential role of specific PCs as gut microbiome modulators in either the pathogenesis or prevention of hypertension.
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49
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How to protect both health and food system sustainability? A holistic 'global health'-based approach via the 3V rule proposal. Public Health Nutr 2020; 23:3028-3044. [PMID: 32758320 DOI: 10.1017/s136898002000227x] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To define a generic diet to protect human health and food system sustainability based on three dimensions: animal:plant ratio, degree of food processing and food diversity. DESIGN/SETTING The percentages of maximum animal and ultra-processed energy content were evaluated from scientific papers (Web of Science database) and reports from international scientific institutions. Then, a weekly French standard diet, including these percentages and food diversity (≥42 different foods), was designed to calculate adequacy to nutritional needs. RESULTS Based on traditional and scientifically based healthy diets, and on foresight scenarios for sustainable diets at horizon 2050, a median daily animal energy content intake of 15 % was found to be protective towards both human health and environment. Based on epidemiological studies associating ultra-processed energy consumption with increased overweight/obesity risk, a precautionary threshold of approximately 15 % ultra-processed energy content was observed. The French diet allows addressing all nutritional needs and other nutritional indicators such as maximum salt and simple sugar consumption, α-linolenic acid:linoleic acid ratio and essential amino acids. This diet was named the '3V rule' for Végétal (plant), Vrai (real) and Varié (varied, if possible organic, local and seasonal). This generic diet can be adapted according to regional traditions and environmental characteristics. Excluding only one dimension of it would threaten both health and food system sustainability. CONCLUSIONS Tending towards a 3V-based diet, while respecting local constraints, should allow preserving human health, environment (greenhouse gas emissions, pollution, deforestation, etc.), small farmers, animal welfare and biodiversity, culinary traditions and socioeconomics (including an alleviation of public health cost).
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50
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R Muralitharan R, Marques FZ. Diet-related gut microbial metabolites and sensing in hypertension. J Hum Hypertens 2020; 35:162-169. [PMID: 32733062 DOI: 10.1038/s41371-020-0388-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 07/08/2020] [Accepted: 07/21/2020] [Indexed: 02/07/2023]
Abstract
Advances in sequencing technology have increased our understanding of the composition of the gut microbiota and their contribution to health and disease states, including in cardiovascular diseases such as hypertension. The gut microbiota is heavily influenced by diet and produce metabolites such as short-chain fatty acids (SCFAs) and trimethylamine-N-oxide (TMAO) from various food sources. SCFAs, such as acetate, propionate, and butyrate, have been shown to have blood pressure, cardiac hypertrophy, and fibrosis lowering properties, while TMAO has been associated with increased risk of major cardiovascular adverse events and mortality. Some of these metabolites have known ligands (for example, SCFA receptors such as GPR41, GPR43, GPR109a, and Olf78 in mice/OR51E2 in humans) which could potentially be manipulated as therapeutic targets for hypertension. In this review, we discuss several types of diet-related gut microbial metabolites and their sensing mechanisms that are relevant for hypertension, and the future directions for the field.
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Affiliation(s)
- Rikeish R Muralitharan
- Hypertension Research Laboratory, School of Biological Sciences, Faculty of Science, Monash University, Melbourne, VIC, Australia.,Institute for Medical Research, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Francine Z Marques
- Hypertension Research Laboratory, School of Biological Sciences, Faculty of Science, Monash University, Melbourne, VIC, Australia. .,Heart Failure Research Group, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia.
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