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Zheng W, Zhou H, Li Y, Fan Z, Wang B, Wang Y, Zhang L, Wu X, Qin J, Wang X. High-resolution MR vessel wall imaging and cardiovascular health for evaluating the occurrence of ischemic stroke. Eur J Radiol 2024; 178:111646. [PMID: 39094467 DOI: 10.1016/j.ejrad.2024.111646] [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: 03/04/2024] [Revised: 06/13/2024] [Accepted: 07/22/2024] [Indexed: 08/04/2024]
Abstract
OBJECTIVES To explore the value of high-resolution MR vessel wall imaging (HR-VWI) based plaque characteristics combined with cardiovascular health (CVH) metrics in the risk evaluation of ischemic stroke attributed to middle cerebral artery (MCA) atherosclerotic stenosis. METHODS Retrospective analysis of 209 participants with middle cerebral atherosclerosis, 146 patients with high signal in the MCA area on DWI were included in the symptomatic group, and 63 patients were included in the asymptomatic group. The degree of stenosis, enhancement ratio, plaque burden, remodeling index, and intraplaque hemorrhage were measured and compared between groups. Seven CVH metrics and other clinical data were obtained. The association between these factors and ischemic stroke was investigated by univariate and multivariate analysis. RESULTS The degree of stenosis [OR, 1.036 (95 % CI, 1.014-1.058); P = 0.001], plaque burden [OR, 0.958 (95 % CI, 0.928-0.989); P = 0.009], intraplaque hemorrhage [OR, 3.530 (95 % CI, 1.233-10.110); P = 0.019], physical activity [OR, 4.321 (95 % CI, 1.526-12.231); P = 0.006], and diet [OR, 8.986 (95 % CI, 2.747-29.401); P < 0.001] were the independent characteristics associated with the occurrence of ischemic stroke. ROC curve showed that the combination of plaque characteristics, diet, and physical activity achieved the highest AUC of 0.828 (95 % CI 0.770-0.877; P < 0.001), with sensitivity and specificity being 86.30 % and 66.67 %, respectively. CONCLUSION Plaque characteristics combined with CVH metrics may identify high-risk populations for ischemic stroke and offer novel insights into risk evaluation and stratification.
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Affiliation(s)
- Wenqiao Zheng
- Department of Radiology, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, PR China; Department of Medical Imaging, Shanxi Medical University, Taiyuan, Shanxi 030001, PR China
| | - Hui Zhou
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, Shanxi 030001, PR China
| | - Yan Li
- Department of Radiology, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, PR China
| | - Zhichang Fan
- Department of Medical Imaging, Shanxi Medical University, Taiyuan, Shanxi 030001, PR China
| | - Bin Wang
- Department of Radiology, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, PR China
| | - Yongfang Wang
- Department of Radiology, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, PR China
| | - Lei Zhang
- Department of Radiology, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, PR China
| | - Xiaofeng Wu
- Department of Radiology, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, PR China
| | - Jiangbo Qin
- Department of Radiology, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, PR China
| | - Xiaochun Wang
- Department of Radiology, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, PR China; Shanxi Key Laboratory of Intelligent Imaging, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, PR China.
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Loreaux F, Jéhannin P, Le Pabic E, Paillard F, Le Faucheur A, Mahe G. An unfavorable dietary pattern is associated with symptomatic peripheral artery disease. Nutr Metab Cardiovasc Dis 2024; 34:2173-2181. [PMID: 39003132 DOI: 10.1016/j.numecd.2024.05.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 04/11/2024] [Accepted: 05/29/2024] [Indexed: 07/15/2024]
Abstract
BACKGROUND AND AIMS Diet has an essential role in primary and secondary cardiovascular prevention by modulating various cardiovascular risk factors. The need to have easily useable tools seems essential to facilitate the daily practice of clinicians in order to propose the most optimal management of their patients' diet. The aim of this study was to compare the diet assessed with a simple food frequency questionnaire (FFQ) between patients with symptomatic peripheral artery disease (PAD) and healthy subjects. MATERIALS AND RESULTS In this ancillary study (ELECTRO-PAD study), we included symptomatic PAD patients and healthy participants. All participants filled a FFQ previously validated called Cardiovascular-Dietary-Questionnaire 2 (CDQ-2). CDQ-2 allows the calculation of different scores: global food score, saturated fatty acids score (SFA), unsaturated fatty acids score (UFA), fruit and vegetable score. The higher the score, the better the diet. We compared the different scores between PAD patients and healthy participants. We included 37 PAD patients and 40 healthy subjects. Mean global score was significantly lower in PAD patients compared to the healthy participants (5.35 ± 7.65 vs 10.60 ± 5.81; p = 0.0011). Similarly, the sub-scores concerning unsaturated fatty acids and fruits-vegetables were significantly lower in PAD patients (p < 0.010). Only the sub-score concerning saturated fatty acids was not significantly different (p = 0.8803) between PAD patients and healthy participants. CONCLUSION CDQ-2 highlights that PAD patients have an unfavorable diet compared with healthy participants. CDQ-2 is a tool of interest to help the clinicians for dietary advice of PAD patients.
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Affiliation(s)
| | | | - Estelle Le Pabic
- CHU Rennes, Inserm, CIC 1414 (Clinical Investigation Center), F-35000 Rennes, France
| | | | | | - Guillaume Mahe
- Vascular Medicine Unit, CHU Rennes, France; CHU Rennes, Inserm, CIC 1414 (Clinical Investigation Center), F-35000 Rennes, France; Centre de Cardio-prévention, CHU Rennes, France; Univ Rennes 1, Rennes, France.
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Besseau S, Sartori E, Larnier P, Paillard F, Laviolle B, Mahé G. Impact of dietary intervention on eating behavior after ischemic stroke. Front Nutr 2023; 10:1067755. [PMID: 37426187 PMCID: PMC10325571 DOI: 10.3389/fnut.2023.1067755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 05/16/2023] [Indexed: 07/11/2023] Open
Abstract
Objective Ischemic stroke is a major health issue. Currently, the relationship between dietary patterns and the occurrence of cardiovascular diseases including stroke is established, but the effect of systematic dietary intervention on dietary changes in ischemic stroke patients is unknown. Our objective was to compare changes in the dietary pattern of ischemic stroke patients who received a systematic diet intervention with changes in the dietary pattern of ischemic stroke patients who did not receive a systematic dietary intervention during their hospitalization. Methods In this before-and-after study, two groups of patients with ischemic stroke were compared: Group 1 included 34 patients admitted with an ischemic stroke without a systematic dietray intervention; Group 2 included 34 patients admitted with an ischemic stroke with a systematic dietary intervention. Dietary patterns were assessed by a validated food frequency questionnaire of 19 questions (from a previously validated questionnaire of 14 questions), at the onset of stroke and at 6 months after stroke. This questionnaire allows the calculation of different scores as follows: global food score, saturated fatty acids score (SFA), unsaturated fatty acids score (UFA), fruit and vegetable score, and alcohol score. Results Score changes were more important in group 2 than in group 1 for the global food score (7.4 ± 7 vs. 1.9 ± 6.7, p = 0.0013), the fruit and vegetable score (2 ± 2.6 vs. 0.6 ± 2.2, p = 0.0047), and the UFA score (1.8 ± 2.7 vs. 0.1 ± 3.3, p = 0.0238), whereas no significant differences were observed for the SFA score (-3.9 ± 4.9 vs. -1.6 ± 6, p = 0.1779) and the alcohol score (-0.4 ± 1.5 vs. -0.3 ± 1.1, p = 0.6960). Conclusion This study showed that systematic dietary intervention during hospitalization improves the dietary patterns of ischemic stroke patients. The impact on the recurrence of ischemic stroke or cardiovascular events after dietary pattern changes needs to be studied.
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Affiliation(s)
- Samuel Besseau
- Department of Family Medicine, Faculty of Medicine of Rennes, Rennes, France
| | - Eric Sartori
- Department of Neurology, Hospital of Lorient, Lorient, France
| | - Pauline Larnier
- Vascular Medicine Unit, CHU Rennes, University Hospital, Rennes, France
| | - François Paillard
- Cardiovascular Prevention Centre, University Hospital, Rennes, France
| | | | - Guillaume Mahé
- Vascular Medicine Unit, CHU Rennes, University Hospital, Rennes, France
- Univ Rennes, Rennes, France
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Chhabra JS, Juneja A, Etkin Y, Landis G, Gardener H, Garuthara M, Hoffstaetter T, Oropallo A. The effect of nutrition on stroke risk: A systematic review. Nutr Health 2022; 29:255-267. [PMID: 36040714 DOI: 10.1177/02601060221122218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: An estimated 33% reduction in cardiovascular events can be achieved when incorporating whole grains, fruits, vegetables, poultry, nuts, and vegetable oils in the diet along with reduced consumption of refined carbohydrates, processed meats, and sugar sweetened beverages. We performed a systematic review to analyze the impact of nutritional intervention on stroke risk, as there is no current consensus concerning dietary recommendation for primary and secondary stroke prevention. Methods: A literature search of the PubMed database from January 2010 to June 2020 was performed using combinations of the following search terms: carotid disease, carotid artery disease, carotid stenosis, carotid intima-media thickness (CIMT), diet, nutrition, micronutrition, embolic stroke, and stroke. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 checklist. Results: 28 studies met our inclusion criteria. Multiple studies showed an inverse relationship between consumption of vegetables and fruits and stroke risk. Vitamin B12 or a combination of B Vitamins was the most common supplement studied in stroke prevention. Only one RCT showed the use of B12 (500 micrograms/day) correlated with lower CIMT at follow up in healthy vegetarians. Discussion: The key findings from this systematic review indicate that adopting a diet rich in fruits and vegetables earlier in life may lower stroke risk compared with meats and fat intake. B vitamins also appear to confer some protection against stroke. However, not enough data exists to support the use of multivitamins, calcium, soy products and other supplements for primary or secondary stroke prevention.
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Affiliation(s)
| | | | - Yana Etkin
- Northwell Health, New Hyde Park, NY, USA
| | | | - Hannah Gardener
- University of Miami Miller School of Medicine, Miami, FL, USA
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Validation and reproducibility of a short food frequency questionnaire for cardiovascular prevention. Arch Cardiovasc Dis 2021; 114:570-576. [PMID: 33933403 DOI: 10.1016/j.acvd.2020.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/03/2020] [Accepted: 12/23/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Diet strongly influences cardiovascular risk. Dietary evaluation is a major issue in cardiovascular prevention, but few simple tools are available. Our team previously validated a short food frequency questionnaire; a new version of this questionnaire (Cardiovascular Dietary Questionnaire 2 [CDQ-2]) is easier to complete and more reliable. AIMS To validate CDQ-2 in comparison with the original version, and to test its reproducibility. METHODS CDQ-2 has 17 closed-ended questions; it provides a global dietary score that is a combination of specific scores for saturated, monounsaturated and omega-3 fatty acids, and fruit and vegetables. CDQ-2 was validated against the original version in two groups, who completed both questionnaires: 99 patients with cardiovascular risk factors and 50 healthy subjects. Reproducibility was assessed with 27 health professionals who completed the questionnaire twice, with a 1-month interval. RESULTS The correlation coefficients of the scores between the two questionnaires ranged from 0.65 (monounsaturated fatty acids) to 0.93 (fruit and vegetables) (all P<0.001). The percentage of subjects classified in the same quartile by both questionnaires ranged from 56% (omega-3 fatty acids) to 78% (fruit and vegetables). The percentage of subjects classified in the same or adjacent quartile ranged from 91% to 99%. The intraclass correlation coefficients, which assessed reproducibility, ranged from 0.61 (fruit and vegetables) to 0.88 (saturated fatty acids) (P<0.001). CONCLUSIONS This new version of the short dietary questionnaire shows good reproducibility and correlations with the original version; use and reliability are improved, which makes CDQ-2 a valuable tool for cardiovascular prevention.
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Brouwer-Goossensen D, Scheele M, van Genugten L, Lingsma HF, Dippel DWJ, Koudstaal PJ, den Hertog HM. Motivational interviewing in a nurse-led outpatient clinic to support lifestyle behaviour change after admission to a stroke unit: a randomized controlled trial. Eur J Cardiovasc Nurs 2021; 21:36-45. [PMID: 33824973 DOI: 10.1093/eurjcn/zvab001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 09/23/2020] [Accepted: 01/12/2021] [Indexed: 11/13/2022]
Abstract
AIMS Modification of health behaviour is an important part of stroke risk management. However, the majority of people with cardiovascular disease fail to sustain lifestyle modification in the long term. We aimed to evaluate the effectiveness of motivational interviewing to encourage lifestyle behaviour changes after transient ischaemic attack (TIA) or minor ischaemic stroke. METHODS AND RESULTS We performed a randomized controlled open-label phase II trial with blinded endpoint assessment. The intervention consisted of three 15-minute visits in 3 months by a motivational interviewing trained nurse practitioner. Patients in the control group received standard consultation after 1 and 3 months by a nurse practitioner. Primary outcome was lifestyle behaviour change, defined as smoking cessation and/or increased physical activity (30 min/day) and/or healthy diet improvement (5 points at the Food Frequency Questionnaire) at 6 months. We adjusted for age and sex with multivariable logistic regression. Between January 2014 and February 2016, we included 136 patients (of whom 68 were assigned to the intervention group). Twenty-five of 55 patients in the intervention group (45%) and 27 of 61 patients in the control group (44%) had changed their lifestyle at 6 months. We found no effect of motivational interviewing on lifestyle behaviour change after 6 months (aOR 0.99; 95% confidence interval: 0.44-2.26). CONCLUSION Our results do not support the effectiveness of motivational interviewing in supporting lifestyle behaviour change after TIA or ischaemic stroke. However, the overall lifestyle behaviour change was high and might be explained by the role of specialized nurses in both groups.
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Affiliation(s)
- Dorien Brouwer-Goossensen
- Department of Neurology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Maaike Scheele
- Department of Neurology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Lenneke van Genugten
- Department of Neurology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Hester F Lingsma
- Department of Neurology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Diederik W J Dippel
- Department of Neurology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Peter J Koudstaal
- Department of Neurology, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
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Brouwer-Goossensen D, Lingsma HF, Koudstaal PJ, den Hertog HM. The optimal timing of supporting patients in health-related behavior change after TIA or ischemic stroke: a prospective cohort study to determinants of health-related intention to change over time. Int J Rehabil Res 2021; 44:32-37. [PMID: 33208689 PMCID: PMC7884245 DOI: 10.1097/mrr.0000000000000443] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 10/10/2020] [Indexed: 11/25/2022]
Abstract
The optimal timing of an intervention to support health-related behavior after transient ischemic attack (TIA) or ischemic stroke is unknown. We aimed to assess determinants of patients' health-related intention to change over time. We prospectively studied 100 patients with TIA or minor ischemic stroke. Patients completed questionnaires on fear, response-efficacy (belief that lifestyle change reduces risk of recurrent stroke), and self-efficacy (patients' confidence to carry out lifestyle behavior) for behavior change, at baseline, 6 weeks and at 3 months after their TIA or ischemic stroke. We studied differences between these determinants at each visit by means of Wilcoxon signed-rank tests. Median self-efficacy score at baseline was 4.3 [interquartile range (IQ) 3.9-4.7], median fear 16 (IQ 7-21), and response-efficacy 10 (9-12). Fear was significantly higher at baseline than at 3 months (mean difference 2.0; 95% confidence interval: 0.78-3.9) and started to decrease after 6 weeks. No change in self-efficacy or response-efficacy was found. Since fear significantly decreased over time after TIA or ischemic stroke and self-efficacy and response-efficacy scores remained high, the optimal moment to start an intervention to support patients in health-related behavior change after TIA or ischemic stroke seems directly after the stroke or TIA.
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Zhang W, Zhou F, Huang H, Mao Y, Ye D. Biomarker of dietary linoleic acid and risk for stroke: A systematic review and meta-analysis. Nutrition 2020; 79-80:110953. [PMID: 32862121 DOI: 10.1016/j.nut.2020.110953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/11/2020] [Accepted: 07/07/2020] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Previous observational studiíes provided conflicting findings on the relationship between linoleic acid (LA) and the risk for stroke. The aim of this study was to evaluate the association of LA levels in blood or adipose tissue samples with risk for stroke. METHODS PubMed, Web of Science, and Embase databases were searched until February 29, 2020 to identify eligible observational studies, including cohort studies, nested case-control studies, case-cohort studies, and case-control studies, reporting the association of LA with the risk for stroke and its subtypes. We pooled hazard ratio (HR) estimates with 95% confidence intervals (CIs) and conducted heterogeneity test. Sensitivity analysis and publication bias test were also carried out. RESULTS Twelve studies from 11 observational articles involving 47 836 individuals were included in the meta-analysis. We observed an inverse association between biomarkers of dietary LA and risk for total stroke (HR, 0.88; 95% CI, 0.83-0.94; P < 0.001). Meta-regression analysis suggested that ethnicity (P = 0.029) and study design (P = 0.049) contributed to between-study heterogeneity. Subgroup analysis showed that the association was statistically significant among studies conducted in white (P < 0.001) and Asian (P = 0.032) populations, and those with cohort (P = 0.001) and case-cohort design (P = 0.007). Moreover, we found that higher LA levels were associated with a reduced risk for ischemic stroke (HR, 0.87; 95% CI, 0.80-0.95; P = 0.001), although no statistically significant association was found between LA levels and the risk for hemorrhagic stroke. CONCLUSIONS The present study supported an inverse association of LA levels with the risk for stroke, particularly ischemic stroke. Racial disparity exists in the association between LA and the risk for stroke, which deserves further studies.
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Affiliation(s)
- Wanting Zhang
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Feixiang Zhou
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Huijun Huang
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yingying Mao
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Ding Ye
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
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Herath J, Liu O. Sudden Natural Deaths in Ontario, Canada: A Retrospective Autopsy Analysis (2012–2016). JOURNAL OF FORENSIC SCIENCE AND MEDICINE 2020. [DOI: 10.4103/jfsm.jfsm_50_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Brouwer-Goossensen D, van Genugten L, Lingsma HF, Dippel DWJ, Koudstaal PJ, den Hertog HM. Self-efficacy for health-related behaviour change in patients with TIA or minor ischemic stroke. Psychol Health 2018; 33:1490-1501. [DOI: 10.1080/08870446.2018.1508686] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Dorien Brouwer-Goossensen
- Department Neurology and Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Lenneke van Genugten
- Department Neurology and Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Hester F. Lingsma
- Department Neurology and Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Diederik W. J. Dippel
- Department Neurology and Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
| | - Peter J. Koudstaal
- Department Neurology and Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
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Noury-Desvaux B, Congnard F, Quertier B, Paillard F, Mahé G. Evaluation of short food-frequency questionnaires to assess the dietary pattern associated with atherosclerotic cardiovascular diseases. JOURNAL DE MÉDECINE VASCULAIRE 2018; 43:283-287. [PMID: 30217341 DOI: 10.1016/j.jdmv.2018.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 05/25/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Cardiovascular diseases are strongly related to dietary habits. Diet can be assessed using dedicated questionnaires that can be self-completed by subjects but with the risk of errors. AIM To compare the completion error rate of two questionnaires designed to assess dietary pattern linked to cardiovascular diseases and to study the correlation between the two questionnaires. MATERIALS AND METHODS Two questionnaires were used to assess dietary patterns of students: the 14-item Food-Frequency-Questionnaire (FFQ) that was validated against biomarkers, and the Cardiovascular-Dietary-Questionnaire 2 (CDQ2), which is a 19-item-FFQ derived from the previous 14-item FFQ. Both questionnaires assessed the intake of various food groups associated with either favourable or unfavourable effects on cardiovascular risk. A global dietary score was calculated for each questionnaire. RESULTS FFQ and CDQ2 were completed by 150 sport degree students. In the case of FFQ, 111 questionnaires out of 150 (74.0%) were incomplete compared to only 1 CDQ2 out of 150 (0.7%) (P<0.001). The correlation coefficient between the overall CDQ2 score and the FFQ dietary score was 0.53 (P<0.01). CONCLUSION The self-completion of CDQ2 compared to FFQ was associated with far less errors. There was a significant correlation between CDQ2 and FFQ. Preference should be given to CDQ2 in clinical practice and in studies where dietary pattern are evaluated without any interviewer.
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Affiliation(s)
- B Noury-Desvaux
- IFEPSA, Institute of physical education and sports sciences, UCO Angers, 49130 Les Ponts-de-Cé, France
| | - F Congnard
- IFEPSA, Institute of physical education and sports sciences, UCO Angers, 49130 Les Ponts-de-Cé, France
| | - B Quertier
- IFEPSA, Institute of physical education and sports sciences, UCO Angers, 49130 Les Ponts-de-Cé, France
| | - F Paillard
- Centre de prévention cardiovasculaire, CHU de Rennes, 35033 Rennes, France
| | - G Mahé
- Unité de médecine vasculaire, CHU de Rennes, 35033 Rennes, France; Inserm, CIC 1414, université de Rennes, CHU de Rennes, 35000 Rennes, France.
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Shen J, Rastogi R, Guan L, Li F, Du H, Geng X, Ding Y. Omega-3 fatty acid supplement reduces activation of NADPH oxidase in intracranial atherosclerosis stenosis. Neurol Res 2018; 40:499-507. [PMID: 29576013 DOI: 10.1080/01616412.2018.1451290] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Jiamei Shen
- China-America Institute of Neuroscience, Beijing Luhe Hospital, Capital Medical University, Beijing, China
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Radhika Rastogi
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Longfei Guan
- China-America Institute of Neuroscience, Beijing Luhe Hospital, Capital Medical University, Beijing, China
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Fengwu Li
- China-America Institute of Neuroscience, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Huishan Du
- China-America Institute of Neuroscience, Beijing Luhe Hospital, Capital Medical University, Beijing, China
- Department of Neurology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Xiaokun Geng
- China-America Institute of Neuroscience, Beijing Luhe Hospital, Capital Medical University, Beijing, China
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
- Department of Neurology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Yuchuan Ding
- China-America Institute of Neuroscience, Beijing Luhe Hospital, Capital Medical University, Beijing, China
- Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
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A Systematic Review and Meta-Analysis on Self-Management for Improving Risk Factor Control in Stroke Patients. Int J Behav Med 2017; 24:42-53. [PMID: 27469998 DOI: 10.1007/s12529-016-9582-7] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE The aims of this review were to describe the self-management interventions used to improve risk factor control in stroke patients and quantitatively assess their effects on the following: 1) overall risk factor control from lifestyle behaviour (i.e. physical activity, diet and nutrition, stress management, smoking, alcohol, and medication adherence), and medical risk factors (i.e. blood pressure, cholesterol, blood glucose) and (2) individual risk factors. METHOD We systematically searched the PubMed, PsycINFO, CINAHL and Cochrane Database of Systematic Reviews databases to September 2015 to identify relevant randomized controlled trials investigating self-management to improve stroke risk factors. The self-management interventions were qualitatively described, and the data included in meta-analyses. RESULTS Fourteen studies were included for review. The model estimating an effect averaged across all stroke risk factors was not significant, but became significant when four low-quality studies were removed (SMD = 0.10 [95 % CI = 0.02 to 0.17], I 2 = 0 %, p = 0.01). Subgroup analyses revealed a significant effect of self-management interventions on lifestyle behaviour risk factors (SMD = 0.15 [95 % CI = 0.04 to 0.25], I 2 = 0 %, p = 0.007) but not medical risk factors. Medication adherence was the only individual risk factor that self-management interventions significantly improved (SMD = 0.31 [95 % CI = 0.07 to 0.56], I 2 = 0 %, p = 0.01). CONCLUSION Self-management interventions appear to be effective at improving overall risk factor control; however, more high-quality research is needed to corroborate this observation. Self-management has a greater effect on lifestyle behaviour risk factors than medical risk factors, with the largest effect at improving medication adherence.
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Adriouch S, Lelong H, Kesse-Guyot E, Baudry J, Lampuré A, Galan P, Hercberg S, Touvier M, Fezeu LK. Compliance with Nutritional and Lifestyle Recommendations in 13,000 Patients with a Cardiometabolic Disease from the Nutrinet-Santé Study. Nutrients 2017; 9:nu9060546. [PMID: 28587108 PMCID: PMC5490525 DOI: 10.3390/nu9060546] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Revised: 05/02/2017] [Accepted: 05/22/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND A healthy diet has been shown to prevent cardiovascular diseases complications. The objective of this study was to assess dietary intakes and compliance with nutritional and lifestyle recommendations in French adults diagnosed with hypertension, diabetes, dyslipidaemia or cardiovascular disease compared with healthy individuals. METHODS Data was collected from 26,570 subjects aged 35 to 70 years (13,285 patients and 13,285 controls matched by sex and age) of the French cohort NutriNet-Santé. Dietary intakes were assessed using three 24-h records. Mean food and nutrient intakes of patients were compared to those of healthy subjects using multivariable mixed logistic and linear regressions. RESULTS Compared to healthy controls, adults reporting cardiometabolic diseases had lower intakes of sweetened products, higher intakes of fish and seafood and a better compliance with dairy products. However, overall, they reported unhealthier lifestyles and dietary habits. Indeed, they were less often physically active and had similar habits regarding alcohol and tobacco consumption. They also had lower intakes of fruit, higher intakes of meat, processed meat and added fats. It is noteworthy that diabetic subjects tended to show the highest compliance with certain dietary recommendations (vegetables, pulses and whole grain products). CONCLUSION Our study brings into focus the fact that some nutritional aspects still need to be improved among individuals with a cardiometabolic disease. We should encourage higher intakes of fruits and vegetables, whole grain products, and lower intakes of meat and sodium, as well as healthy lifestyle (physical activity, no-smoking and limited intake of alcohol) in order to encourage a healthier management after being diagnosed.
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Affiliation(s)
- Solia Adriouch
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France.
| | - Hélène Lelong
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France.
| | - Emmanuelle Kesse-Guyot
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France.
| | - Julia Baudry
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France.
| | - Aurélie Lampuré
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France.
| | - Pilar Galan
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France.
- Département de Santé Publique, Hôpital Avicenne, F-93017 Bobigny, France.
| | - Serge Hercberg
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France.
- Département de Santé Publique, Hôpital Avicenne, F-93017 Bobigny, France.
| | - Mathilde Touvier
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France.
| | - Léopold K Fezeu
- Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre de Recherche en Epidémiologie et Statistiques, Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, F-93017 Bobigny, France.
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Shen J, Hafeez A, Stevenson J, Yang J, Yin C, Li F, Wang S, Du H, Ji X, Rafols JA, Geng X, Ding Y. Omega-3 fatty acid supplement prevents development of intracranial atherosclerosis. Neuroscience 2016; 334:226-235. [DOI: 10.1016/j.neuroscience.2016.08.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Revised: 07/15/2016] [Accepted: 08/07/2016] [Indexed: 11/26/2022]
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Choe H, Hwang JY, Yun JA, Kim JM, Song TJ, Chang N, Kim YJ, Kim Y. Intake of antioxidants and B vitamins is inversely associated with ischemic stroke and cerebral atherosclerosis. Nutr Res Pract 2016; 10:516-523. [PMID: 27698959 PMCID: PMC5037069 DOI: 10.4162/nrp.2016.10.5.516] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 12/11/2015] [Accepted: 05/17/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND/OBJECTIVES This study was conducted to examine relationships between dietary habits and intakes of antioxidants and B vitamins and the risk of ischemic stroke, and to compare dietary factors according to the presence of cerebral artery atherosclerosis and stroke subtypes. SUBJECTS/METHODS A total of 147 patients and 144 control subjects were recruited consecutively in the metropolitan area of Seoul, Korea. Sixty participants each in the case and control groups were included in analyses after 1:1 frequency matching. In addition, 117 acute ischemic stroke patients were classified into subtypes according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) guidelines. Dietary intake was measured using a semi-quantitative food frequency questionnaire composed of 111 food items and plasma lipid and homocysteine levels were analyzed. RESULTS When compared with control subjects, stroke patients had unfavorable dietary behaviors and lower intakes of fruits (73.1 ± 83.2 g vs. 230.9 ± 202.1 g, P < 0.001), vegetables (221.1 ± 209.0 g vs. 561.7 ± 306.6 g, P < 0.001), and antioxidants, including vitamins C, E, B6, β-carotene, and folate. The intakes of fruits, vegetables, vitamin C, and folate were inversely associated with the risk of ischemic stroke after adjusting for confounding factors. Intakes of vegetables, vitamins C, B6, B12, and folate per 1,000 kcal were lower in ischemic stroke with cerebral atherosclerosis than in those without. Overall vitamin B12 intake per 1,000 kcal differed according to the TOAST classification (P = 0.004), but no differences among groups existed based on the post-hoc test. CONCLUSIONS When compared with control subjects, ischemic stroke patients, particularly those with cerebral atherosclerosis, had unfavorable dietary intake, which may have contributed to the development of ischemic stroke. These results indicate that proper dietary recommendations are important for the prevention of ischemic stroke.
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Affiliation(s)
- Hansaem Choe
- Department of Nutritional Science and Food Management, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea
| | - Ji-Yun Hwang
- Department of Foodservice Management and Nutrition, Sangmyung University, Seoul 03016, Korea
| | - Jin A Yun
- Department of Nutritional Science and Food Management, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea
| | - Ji-Myung Kim
- Food and Nutrition Major, Division of Food Science and Culinary Arts, Shinhan University, Gyeonggi 11644, Korea
| | - Tae-Jin Song
- Department of Neurology, Ewha Womans University, School of Medicine, Seoul 03760, Korea
| | - Namsoo Chang
- Department of Nutritional Science and Food Management, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea
| | - Yong-Jae Kim
- Department of Neurology, Ewha Womans University, School of Medicine, Seoul 03760, Korea
| | - Yuri Kim
- Department of Nutritional Science and Food Management, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 03760, Korea
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Brouwer-Goossensen D, Genugten LV, Lingsma H, Dippel D, Koudstaal P, Hertog HD. Determinants of intention to change health-related behavior and actual change in patients with TIA or minor ischemic stroke. PATIENT EDUCATION AND COUNSELING 2016; 99:644-650. [PMID: 26561311 DOI: 10.1016/j.pec.2015.10.028] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 10/07/2015] [Accepted: 10/29/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To assess determinants of intention to change health-related behavior and actual change in patients with TIA or ischemic stroke. METHODS In this prospective cohort study, 100 patients with TIA or minor ischemic stroke completed questionnaires on behavioral intention and sociocognitive factors including perception of severity, susceptibility, fear, response-efficacy and self-efficacy at baseline. Questionnaires on physical activity, diet and smoking were completed at baseline and at 3 months. Associations between sociocognitive factors and behavioral intention and actual change were studied with multivariable linear and logistic regression. RESULTS Self-efficacy, response efficacy, and fear were independently associated with behavioral intention, with self-efficacy as the strongest determinant of intention to increase physical activity (aBeta 0.40; 95% CI 0.12-0.71), adapt a healthy diet (aBeta 0.49; 95% CI 0.23-0.75), and quit smoking (aBeta 0.51; 95% CI 0.13-0.88). Intention to change tended to be associated with actual health-related behavior change. CONCLUSION Self-efficacy, fear, and response-efficacy were determinants of intention to change health-related behavior after TIA or ischemic stroke. PRACTICE IMPLICATIONS These determinants of intention to change health-related behavior after TIA or ischemic stroke should be taken into account in the development of future interventions promoting health-related behavior change in these group of patients.
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Affiliation(s)
| | - Lenneke van Genugten
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Hester Lingsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Diederik Dippel
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Peter Koudstaal
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Heleen den Hertog
- Department of Neurology, Medisch Spectrum Twente, Enschede, The Netherlands
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Afshari L, Amani R, Soltani F, Haghighizadeh MH, Afsharmanesh MR. The relation between serum Vitamin D levels and body antioxidant status in ischemic stroke patients: A case-control study. Adv Biomed Res 2015; 4:213. [PMID: 26605242 PMCID: PMC4627183 DOI: 10.4103/2277-9175.166150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Accepted: 04/23/2015] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Stroke is the second cause of death among elderly people. Oxidative stress plays an important role in brain damage after stroke. Currently, Vitamin D has been shown as an antioxidant. The aim of this study was to evaluate the status of Vitamin D, antioxidant enzymes, and the relation between them in ischemic stroke patients. MATERIALS AND METHODS This case-control study was carried out on 36 patients with ischemic stroke patients and 36 matched subjects as controls. Intake of fruits and vegetables, exposure of sunlight, serum lipid profile, concentrations of serum 25-dihydroxy Vitamin D (25(OH) D), activities of serum superoxide dismutase, and glutathione peroxidase enzymes were determined. RESULTS Severe Vitamin D deficiency was seen in 30% of the patients versus 11% of the controls (P < 0.05). Consumption of fruits and vegetables was lower in patients than that of controls (P < 0.05). Activities of antioxidant enzymes and intake of fruits were positively correlated in stroke patients (P = 0.02). The most potent predictors of stroke risk were hypertension, high levels of low-density lipoprotein cholesterol (LDL-C) and history of cardiovascular disease (CVD) (odds ratios: 3.33, 3.15, and 3.14, respectively, P < 0.05 for all). There was no association between 25(OH) D levels with activities of serum antioxidant enzymes and lipid profile in the two groups. CONCLUSION Ischemic stroke patients have higher prevalence of severe Vitamin D deficiency and lower intakes of fruits and vegetables. Intake of fruits was positive correlated to higher antioxidant enzymes levels. High levels of blood pressure, history of CVD, and high LDL-C levels are the strongest predictors of ischemic stroke.
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Affiliation(s)
- Laleh Afshari
- Department of Nutrition, Arvand International Division, Faculty of Paramedicine, Health Research Institute, Diabetes Research Center, Ahvaz, Iran
| | - Reza Amani
- Department of Nutrition, Faculty of Paramedicine, Health Research Institute, Diabetes Research Center, Ahvaz, Iran
| | - Farhad Soltani
- Department of Aneshtesiology, ICU, Golestan Medical Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Hossein Haghighizadeh
- Department of Statistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Balquet L, Noury-Desvaux B, Jaquinandi V, Mahé G. [Good reproducibility of a 14-item food frequency questionnaire for cardiovascular prevention in students]. ACTA ACUST UNITED AC 2015; 40:18-23. [PMID: 25576436 DOI: 10.1016/j.jmv.2014.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 11/17/2014] [Indexed: 10/24/2022]
Abstract
UNLABELLED Diet is a modifiable risk factor of atherosclerosis. A 14-item food frequency questionnaire (FFQ) has been developed. The reproducibility of this FFQ is unknown in a student population whereas its use could be of interest. METHODS This FFQ allows calculating different scores for different food groups involved in cardiovascular disease. The vascular dietary score (VDS) can be calculated. The VSD ranges from -17 to +19. The higher the VSD, the better diet. Reproducibility was assessed in sports faculty students using mean tests comparing measurement 1 and 2 (minimum time interval ≥ 7 days) and intra-class correlation (ICC) tests. RESULTS Thirty students (50% men) were included in a French Sports Faculty. Time between two FFQ assessments was 19 ± 9 days. Mean VSD was 0.50 ± 3.70 for the first assessment and 0.30 ± 3.14 for the second one (non significant). Any score for each food group was statistically significant between the first and the second measurement. ICC of VSD was 0.68 [95% confidence interval: 0.43-0.83]. CONCLUSION This FFQ that assesses a risky vascular diet has good reproducibility. This tool could be useful for large studies involving students.
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Affiliation(s)
- L Balquet
- APCoSS, institut de formation en éducation physique et en sport d'Angers (IFEPSA), université catholique de l'Ouest (UCO), 49, rue des Perrins, 49136 Les Ponts de Cé, France
| | - B Noury-Desvaux
- APCoSS, institut de formation en éducation physique et en sport d'Angers (IFEPSA), université catholique de l'Ouest (UCO), 49, rue des Perrins, 49136 Les Ponts de Cé, France
| | - V Jaquinandi
- Cabinet de médecine vasculaire, 6, rue de Bellinière, 49800 Trélazé, France
| | - G Mahé
- Inserm centre d'investigation clinique CIC 1414, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France; Université de Rennes, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France.
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Saadatnia M, Shakeri F, Hassanzadeh Keshteli A, Saneei P, Esmaillzadeh A. Dietary Patterns in Relation to Stroke among Iranians: A Case-Control Study. J Am Coll Nutr 2015; 34:32-41. [DOI: 10.1080/07315724.2014.890553] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Rodríguez-Campello A, Jiménez-Conde J, Ois Á, Cuadrado-Godia E, Giralt-Steinhauer E, Schroeder H, Romeral G, Llop M, Soriano-Tárraga C, Garralda-Anaya M, Roquer J. Dietary habits in patients with ischemic stroke: a case-control study. PLoS One 2014; 9:e114716. [PMID: 25506934 PMCID: PMC4266513 DOI: 10.1371/journal.pone.0114716] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 11/12/2014] [Indexed: 12/23/2022] Open
Abstract
Background and Aims Diet appears to have some role in stroke development. The objective of our study was to describe the dietary habits in patients admitted with acute ischemic stroke and compare selected dietary components with healthy controls. Adherence to healthy diet behaviors was also assessed. Methods A case-control study of consecutive patients with acute ischemic stroke admitted to the Neurology Department of Hospital del Mar from 2007 to 2010. Patients were matched by age and sex with control subjects. A previously validated nutritional survey was administered to patients and controls. Demographic data, vascular risk factors, caloric intake and dietary nutrients were evaluated. Intention to follow a healthy diet was also assessed in both groups. Results A total of 300 acute ischemic stroke patients and 300 controls with evaluation of dietary habits. No differences were observed in vascular risk factors, except smoking habit, diabetes and ischemic heart disease. Stroke patients reported a higher caloric intake: 2444.8(1736.8–3244.5) vs 2208.7(1753.1–2860.7) Kcal, p = 0.001. After adjusting for energy intake, patients had higher intake of proteins (p<0.001; OR 1.02), total cholesterol (p = 0.001; OR 1.04), and breaded foods (p = 0.001; OR 1.94) and lower consumption of probiotic yogurt (p = 0.002; OR 0.88). Compared to patients, control participants indicated greater intention to eat vegetables (p = 0.002; OR 1.5) and whole foods (p = 0.000; OR 2.4) and reduce their intake of salt (p = 0.002; OR 1.7), fat (p = 0.000; OR 3.7) and sweets (p = 0.004; OR 1.7) than patients. Conclusion We observed different dietary patterns between stroke patients and controls. Stroke patients have a higher caloric intake and are less concerned about maintaining healthy nutritional habits.
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Affiliation(s)
- Ana Rodríguez-Campello
- Stroke Unit, Department of Neurology, Neurovascular Research Group, IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
- * E-mail:
| | - Jordi Jiménez-Conde
- Stroke Unit, Department of Neurology, Neurovascular Research Group, IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ángel Ois
- Stroke Unit, Department of Neurology, Neurovascular Research Group, IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Elisa Cuadrado-Godia
- Stroke Unit, Department of Neurology, Neurovascular Research Group, IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
- DCEXS, Universitat Pompeu Fabra, Barcelona, Spain
| | - Eva Giralt-Steinhauer
- Stroke Unit, Department of Neurology, Neurovascular Research Group, IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Helmut Schroeder
- Stroke Unit, Department of Neurology, Neurovascular Research Group, IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain
- Cardiovascular Risk and Nutrition Research Group (CARIN-ULEC), Program of Research in Inflammatory and Cardiovascular Disorders (RICAD), IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain, CIBER Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Gemma Romeral
- Stroke Unit, Department of Neurology, Neurovascular Research Group, IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mireia Llop
- Stroke Unit, Department of Neurology, Neurovascular Research Group, IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Carolina Soriano-Tárraga
- Stroke Unit, Department of Neurology, Neurovascular Research Group, IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Montserrat Garralda-Anaya
- Stroke Unit, Department of Neurology, Neurovascular Research Group, IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain
- Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jaume Roquer
- Stroke Unit, Department of Neurology, Neurovascular Research Group, IMIM-Hospital del Mar (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain
- DCEXS, Universitat Pompeu Fabra, Barcelona, Spain
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Purine receptors are required for DHA-mediated neuroprotection against oxygen and glucose deprivation in hippocampal slices. Purinergic Signal 2014; 11:117-26. [PMID: 25504554 DOI: 10.1007/s11302-014-9438-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 12/04/2014] [Indexed: 12/20/2022] Open
Abstract
Docosahexaenoic acid (DHA) is important for central nervous system function during pathological states such as ischemia. DHA reduces neuronal injury in experimental brain ischemia; however, the underlying mechanisms are not well understood. In the present study, we investigated the effects of DHA on acute hippocampal slices subjected to experimental ischemia by transient oxygen and glucose deprivation (OGD) and re-oxygenation and the possible involvement of purinergic receptors as the mechanism underlying DHA-mediated neuroprotection. We observed that cellular viability reduction induced by experimental ischemia as well as cell damage and thiobarbituric acid reactive substances (TBARS) production induced by glutamate (10 mM) were prevented by hippocampal slices pretreated with DHA (5 μM). However, glutamate uptake reduction induced by OGD and re-oxygenation was not prevented by DHA. The beneficial effect of DHA against cellular viability reduction induced by OGD and re-oxygenation was blocked with PPADS (3 μM), a nonselective P2X1-5 receptor antagonist as well as with a combination of TNP-APT (100 nM) plus brilliant blue (100 nM), which blocked P2X1, P2X3, P2X2/3, and P2X7 receptors, respectively. Moreover, adenosine receptors blockade with A1 receptor antagonist DPCPX (100 nM) or with A2B receptor antagonist alloxazine (100 nM) inhibited DHA-mediated neuroprotection. The addition of an A2A receptor antagonist ZM241385 (50 nM), or A3 receptor antagonist VUF5574 (1 μM) was ineffective. Taken together, our results indicated that neuroprotective actions of DHA may depend on P2X, A1, and A2B purinergic receptors activation. Our results reinforce the notion that dietary DHA may act as a local purinergic modulator in order to prevent neurodegenerative diseases.
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Dietary and circulating lycopene and stroke risk: a meta-analysis of prospective studies. Sci Rep 2014; 4:5031. [PMID: 24848940 PMCID: PMC5381376 DOI: 10.1038/srep05031] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 05/02/2014] [Indexed: 11/16/2022] Open
Abstract
Epidemiological studies support a protective role of lycopene against stroke occurrence or mortality, but the results have been conflicting. We conducted a meta-analysis to assess the relationship between dietary or circulating lycopene and stroke risk (including stroke occurrence or mortality). Relevant papers were collected by screening the PubMed database through October 2013. Only prospective studies providing relative risk estimates with 95% confidence intervals for the association between lycopene and stroke were included. A random-effects model was used to calculate the pooled estimate. Subgroup analysis was conducted to investigate the effects of various factors on the final results. The pooled analysis of seven prospective studies, with 116,127 participants and 1,989 cases, demonstrated that lycopene decreased stroke risk by 19.3% (RR = 0.807, 95% CI = 0.680–0.957) after adjusting for confounding factors. No heterogeneity was observed (p = 0.234, I2 = 25.5%). Circulating lycopene, not dietary lycopene, was associated with a statistically significant decrease in stroke risk (RR = 0.693, 95% CI = 0.503–0.954). Lycopene could protect European, or males against stroke risk. Duration of follow-up had no effect on the final results. There was no evidence of publication bias. Lycopene, especially circulating lycopene, is negatively associated with stroke risk.
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Mangat A, Grewal D, Kaur P, Jyotsna R, Singh R, Pandian JD. Dietary patterns in stroke patients in Northwest India. Nutr Neurosci 2013; 16:288-92. [PMID: 23433119 DOI: 10.1179/1476830513y.0000000058] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Little is known about the dietary patterns among stroke patients in India. We explored the dietary patterns in stroke patients and attempted to correlate the dietary patterns with stroke characteristics. METHODS This hospital-based study was carried out in a tertiary referral centre in Northwest India from March 2008 to September 2009. All first ever stroke (ischaemic and hemorrhagic) patients were interviewed by the dietician using an oral diet questionnaire. The demographic information and risk factors were noted and outcome was assessed after 30 days using modified Rankin scale (≤2 = good outcome). RESULTS A total of 210 stroke patients were enrolled. The mean age was 60 ± 14 years and 126 (60%) patients were men. Hypertension (167 (79.5%)) was the major risk factor. All patients consumed cereals and beverages. Consumption of other food items in the diet were as follows: milk and milk products (203 (96.7%)), saturated fats (butter, butter oil, cream) (133 (63.3%)), bakery items (139 (66.2%)), fried snacks (116 (55.2%)), fruits (96 (45.7%)), and juices (20 (9.5%)). Large proportion of the patients (112 (53.6%)) consumed more food calories than recommended. Use of fried snacks was significant in patients who consumed alcohol (P = 0.03) and patients who had diabetes mellitus were more likely to use saturated fats (P = 0.01). DISCUSSION Majority of the patients consumed milk and milk products. Fruits and juices were consumed by a small proportion of patients. Our results provide opportunities for stroke prevention by diet modification.
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Affiliation(s)
- Arshi Mangat
- Christian Medical College, Ludhiana, Punjab, India
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Chan R, Chan D, Woo J. The association of a priori and a posterior dietary patterns with the risk of incident stroke in Chinese older people in Hong Kong. J Nutr Health Aging 2013; 17:866-74. [PMID: 24257570 DOI: 10.1007/s12603-013-0334-y] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Dietary patterns can be identified by a priori and a posterior approaches. Limited data have related dietary patterns with stroke risk in Chinese population. This study examined stroke risk associated with patterns identified by both approaches. METHODS Data on 1,338 Chinese men and 1,397 Chinese women aged >= 65 years participating in a cohort study examining the risk factors for osteoporosis in Hong Kong were analyzed. Baseline dietary data were collected between 2001 and 2003 using a validated food frequency questionnaire. Adherence to a priori dietary patterns including the Mediterranean Diet Score (MDS) and the Dietary Approaches to Stop Hypertension (DASH) was assessed. Factor analysis (FA) identified three a posterior dietary patterns: "vegetables-fruits", "snacks-drinks-milk products", and "meat-fish". Data on incidence of stroke were retrieved from an official database in 2008. Cox regression was used to estimate hazard ratios (HRs) for stroke risk adjusted for potential confounders. RESULTS There were 156 incident stroke events during a median follow up of 5.7 years. A posterior dietary patterns derived by FA were not associated with risk of incident stroke in either men or women. MDS was inversely associated with risk of incident stroke [Adjusted HR=0.55 (95% CI: 0.31-0.99) of the highest level of MDS compared with the lowest level, ptrend=0.008] in men but not in women. Similar non-significant inverse association was observed between DASH accordance and stroke risk in men [Multivariate HR (95% CI) of the DASH score of >=4.5 = 0.62 (0.38-1.04) compared with the DASH score of <=4, ptrend = 0.068] but not in women. CONCLUSION Our findings suggest that higher MDS and possibly higher DASH scores were associated with lower stroke risk in Chinese older people in Hong Kong.
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Affiliation(s)
- R Chan
- Dr Ruth Chan, Research assistant professor, Rm 124021, 10/F Clinical Sciences Building, Prince of Wales Hospital, Shatin, New Territories, Hong Kong SAR, Telephone number: (852) 2632 2190, Fax number: (852) 2637 9215,
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Lin YH, Loewke JD, Hyun DY, Leazer J, Hibbeln JR. Fast transmethylation of serum lipids using microwave irradiation. Lipids 2012; 47:1109-17. [PMID: 23015312 DOI: 10.1007/s11745-012-3714-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Accepted: 08/22/2012] [Indexed: 12/19/2022]
Abstract
Microwave irradiation as the energy source for one-step direct transesterification of fatty acids in human serum lipids was examined in a solvent system of methanol: hexane: acetyl chloride based on a Lepage & Roy assay. Innovative and explosion proof single-mode or multimode microwave accelerated reaction system was employed. Recoveries were calculated as the percentage of fatty acid concentrations measured by microwave assay to those by the reference method of the Lepage & Roy assay that utilized conductive heating at 100 °C for 60 min. Under conditions of 100 °C for 1 min in Single-mode (S4-100 × 1), or 125 °C for 5 min in Multimode (M5-125 × 5), the recoveries were 100-103 % for the total fatty acids and 96-106 % for each categorized fatty acid, including saturates, monounsaturates, n-6 PUFA, and n-3 PUFA. For individual PUFA, the mean recoveries were 102-105 % for 18:2n-6 and 18:3n-3; 99, 109, and 95 % for 20:4n-6, 20:5n-3, and 22:6n-3, respectively. Thus, fatty acid concentrations determined by microwave fatty acid assay were accurate to those results by the reference method, when the microwave conditions were optimal. In summary, the microwave irradiation could replace conductive heating in one-step direct transesterification, and reduce the duration from 60 min to 5 min or less. This methodology may be applied in both the absolute and relative quantification of serum total fatty acids.
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Affiliation(s)
- Yu Hong Lin
- Laboratory of Membrane Biochemistry and Biophysics, Section of Nutritional Neuroscience, National Institute on Alcohol Abuse & Alcoholism, National Institutes of Health, Bethesda, MD 20892, USA.
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Carsin-Mahé M, Abraham P, Le Faucheur A, Leftheriotis G, Mahé G. Simple routine assessment of dietary pattern in patients with peripheral artery disease. J Vasc Surg 2012; 56:281-2. [DOI: 10.1016/j.jvs.2012.02.059] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Revised: 02/09/2012] [Accepted: 02/12/2012] [Indexed: 10/28/2022]
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Dietary supplementation of herring roe and milt enhances hepatic fatty acid catabolism in female mice transgenic for hTNFα. Eur J Nutr 2011; 51:741-53. [DOI: 10.1007/s00394-011-0254-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Accepted: 09/26/2011] [Indexed: 12/22/2022]
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Best Medical Therapy or Wishful Thinking in Carotid Disease? A Single-centre Audit in Germany. Eur J Vasc Endovasc Surg 2011; 41:501-6. [DOI: 10.1016/j.ejvs.2010.12.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Accepted: 12/13/2010] [Indexed: 11/20/2022]
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Dietary pattern, a modifiable risk factor that can be easily assessed for atherosclerosis vascular disease prevention in clinical practice. Public Health Nutr 2010; 14:319-26. [PMID: 20602867 DOI: 10.1017/s1368980010001862] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Nutrition is one of the modifiable risk factors of atherosclerosis vascular diseases (VD). We aimed to (i) evaluate the dietary patterns associated with VD in clinical practice using a validated FFQ; and (ii) determine potential independent sociodemographic and behavioural factors that are involved in such dietary patterns. The FFQ determined the vascular dietary score (VDS; ranges from -17 to 19) for each subject. DESIGN Cross-sectional study. SETTING A general practitioner's (GP) office in 2009. SUBJECTS A total of 250 French subjects (18-84 years old). RESULTS A total of 21 % had a favourable vascular diet (VDS ≥ 8), 79 % needed to improve their diet (VDS < 8) and 21 % had a risky vascular diet (VDS ≤ -1). A step-by-step multivariate linear regression analysis with stepwise selection was performed using the VDS as a dependent variable. Significant variables were: age (β = 0·495, P < 0·0001), men (β = -0·282, P < 0·0001), 'sport ≥ 1 h/week' (β = 0·253, P = 0·001), 'walking 20 min/d' (β = 0·161, P = 0·012), 'former smoker' (β = 0·118, P = 0·029), previous nutritional advice (β = 0·105, P = 0·049), 'alcohol ≥ 20 g/d' (β = -0·216, P < 0·0001) and 'primary school' (β = -0·156, P = 0·010). The R2 coefficient of this model was 0·347 (P < 0·0001). In all, 88·7 % of the subjects found the evaluation very interesting and 89·6 % believed that the GP should perform it. CONCLUSIONS Simple dietary assessment for VD prevention can be easily performed in clinical practice to allow physicians to give objective and rapid advice for each patient. Age, educational status, alcohol consumption, gender and physical activity are associated with the VDS. Compliance with such evaluation was found to be very high, which should encourage larger dietary screening in the population in order to reduce the impact of VD.
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