1
|
Thomson CA, Aragaki AK, Prentice RL, Stefanick ML, Manson JE, Wactawski-Wende J, Watts NB, Van Horn L, Shikany JM, Rohan TE, Lane DS, Wild RA, Robles-Morales R, Shadyab AH, Saquib N, Cauley J. Long-Term Effect of Randomization to Calcium and Vitamin D Supplementation on Health in Older Women : Postintervention Follow-up of a Randomized Clinical Trial. Ann Intern Med 2024; 177:428-438. [PMID: 38467003 DOI: 10.7326/m23-2598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Although calcium and vitamin D (CaD) supplementation may affect chronic disease in older women, evidence of long-term effects on health outcomes is limited. OBJECTIVE To evaluate long-term health outcomes among postmenopausal women in the Women's Health Initiative CaD trial. DESIGN Post hoc analysis of long-term postintervention follow-up of the 7-year randomized intervention trial of CaD. (ClinicalTrials.gov: NCT00000611). SETTING A multicenter (n = 40) trial across the United States. PARTICIPANTS 36 282 postmenopausal women with no history of breast or colorectal cancer. INTERVENTION Random 1:1 assignment to 1000 mg of calcium carbonate (400 mg of elemental calcium) with 400 IU of vitamin D3 daily or placebo. MEASUREMENTS Incidence of colorectal, invasive breast, and total cancer; disease-specific and all-cause mortality; total cardiovascular disease (CVD); and hip fracture by randomization assignment (through December 2020). Analyses were stratified on personal supplement use. RESULTS For women randomly assigned to CaD versus placebo, a 7% reduction in cancer mortality was observed after a median cumulative follow-up of 22.3 years (1817 vs. 1943 deaths; hazard ratio [HR], 0.93 [95% CI, 0.87 to 0.99]), along with a 6% increase in CVD mortality (2621 vs. 2420 deaths; HR, 1.06 [CI, 1.01 to 1.12]). There was no overall effect on other measures, including all-cause mortality (7834 vs. 7748 deaths; HR, 1.00 [CI, 0.97 to 1.03]). Estimates for cancer incidence varied widely when stratified by whether participants reported supplement use before randomization, whereas estimates on mortality did not vary, except for CVD mortality. LIMITATION Hip fracture and CVD outcomes were available on only a subset of participants, and effects of calcium versus vitamin D versus joint supplementation could not be disentangled. CONCLUSION Calcium and vitamin D supplements seemed to reduce cancer mortality and increase CVD mortality after more than 20 years of follow-up among postmenopausal women, with no effect on all-cause mortality. PRIMARY FUNDING SOURCE National Heart, Lung, and Blood Institute of the National Institutes of Health.
Collapse
Affiliation(s)
- Cynthia A Thomson
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona (C.A.T.)
| | - Aaron K Aragaki
- Fred Hutchinson Cancer Center, Seattle, Washington (A.K.A., R.L.P.)
| | - Ross L Prentice
- Fred Hutchinson Cancer Center, Seattle, Washington (A.K.A., R.L.P.)
| | - Marcia L Stefanick
- Department of Medicine, Stanford School of Medicine, Stanford University, Palo Alto, California (M.L.S.)
| | - JoAnn E Manson
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts (J.E.M.)
| | - Jean Wactawski-Wende
- School of Public Health and Health Professions, University at Buffalo, Buffalo, New York (J.W.)
| | | | - Linda Van Horn
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois (L.V.H.)
| | - James M Shikany
- Division of Preventive Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama (J.M.S.)
| | - Thomas E Rohan
- Albert Einstein College of Medicine, Bronx, New York (T.E.R.)
| | - Dorothy S Lane
- Renaissance School of Medicine, Stony Brook, New York (D.S.L.)
| | - Robert A Wild
- Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma (R.A.W.)
| | - Rogelio Robles-Morales
- Department of Clinical Translational Sciences, College of Medicine, University of Arizona, Tucson, Arizona (R.R.)
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health, University of California, San Diego, San Diego, California (A.H.S.)
| | - Nazmus Saquib
- Clinical Sciences Department, College of Medicine, Sulaiman Alrajhi University, Al Bukayriyah, Saudi Arabia (N.S.)
| | - Jane Cauley
- University of Pittsburgh, Pittsburgh, Pennsylvania (J.C.)
| |
Collapse
|
2
|
Yeung LK, Alschuler DM, Wall M, Luttmann-Gibson H, Copeland T, Hale C, Sloan RP, Sesso HD, Manson JE, Brickman AM. Multivitamin Supplementation Improves Memory in Older Adults: A Randomized Clinical Trial. Am J Clin Nutr 2023; 118:273-282. [PMID: 37244291 PMCID: PMC10375458 DOI: 10.1016/j.ajcnut.2023.05.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/18/2023] [Accepted: 05/02/2023] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND Maintenance of cognitive abilities is of critical importance to older adults, yet few effective strategies to slow cognitive decline currently exist. Multivitamin supplementation is used to promote general health; it is unclear whether it favorably affects cognition in older age. OBJECTIVES To examine the effect of daily multivitamin/multimineral supplementation on memory in older adults. METHODS The COcoa Supplement and Multivitamin Outcomes Study Web (COSMOS-Web) ancillary study (NCT04582617) included 3562 older adults. Participants were randomly assigned to a daily multivitamin supplement (Centrum Silver) or placebo and evaluated annually with an Internet-based battery of neuropsychological tests for 3 y. The prespecified primary outcome measure was change in episodic memory, operationally defined as immediate recall performance on the ModRey test, after 1 y of intervention. Secondary outcome measures included changes in episodic memory over 3 y of follow-up and changes in performance on neuropsychological tasks of novel object recognition and executive function over 3 y. RESULTS Compared with placebo, participants randomly assigned to multivitamin supplementation had significantly better ModRey immediate recall at 1 y, the primary endpoint (t(5889) = 2.25, P = 0.025), as well as across the 3 y of follow-up on average (t(5889) = 2.54, P = 0.011). Multivitamin supplementation had no significant effects on secondary outcomes. Based on cross-sectional analysis of the association between age and performance on the ModRey, we estimated that the effect of the multivitamin intervention improved memory performance above placebo by the equivalent of 3.1 y of age-related memory change. CONCLUSIONS Daily multivitamin supplementation, compared with placebo, improves memory in older adults. Multivitamin supplementation holds promise as a safe and accessible approach to maintaining cognitive health in older age. This trial was registered at clinicaltrials.gov as NCT04582617.
Collapse
Affiliation(s)
- Lok-Kin Yeung
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States
| | - Daniel M Alschuler
- Area Mental Health Data Science, New York State Psychiatric Institute, New York, NY, United States
| | - Melanie Wall
- Area Mental Health Data Science, New York State Psychiatric Institute, New York, NY, United States; Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States
| | - Heike Luttmann-Gibson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Trisha Copeland
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Christiane Hale
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States
| | - Richard P Sloan
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States; Division of Behavioral Medicine, New York State Psychiatric Institute, New York, NY, United States
| | - Howard D Sesso
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Division of Aging, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - JoAnn E Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Adam M Brickman
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States; Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States; Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, United States.
| |
Collapse
|
3
|
Kurek M, Benaida-Debbache N, Elez Garofulić I, Galić K, Avallone S, Voilley A, Waché Y. Antioxidants and Bioactive Compounds in Food: Critical Review of Issues and Prospects. Antioxidants (Basel) 2022; 11:antiox11040742. [PMID: 35453425 PMCID: PMC9029822 DOI: 10.3390/antiox11040742] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/04/2022] [Accepted: 04/06/2022] [Indexed: 12/14/2022] Open
Abstract
This review paper gives an insight into the effective delivery mechanisms for health-promoting substances and highlights the challenges of using antioxidants and bioactives in foods. The selection criteria for choosing bioactives and their extraction in bioavailable form with their adequate incorporation techniques and delivery mechanisms are covered. Moreover, an overview of existing methods for determination of bioactivity is given. The importance of scientifically evaluating the effects of foods or food components on consumer health before making claims about the healthiness is aligned. Finally, a scientific perspective on how to respond to the booming demand for health-promoting products is given, and we acknowledge that despite the work done, there are still many challenges that need to be overcome.
Collapse
Affiliation(s)
- Mia Kurek
- Department of Food Engineering, Faculty of Food Technology and Biotechnology, Pierottijeva 6, 10000 Zagreb, Croatia; (I.E.G.); (K.G.)
- Correspondence: ; Tel.: +385-1460-5003
| | - Nadjet Benaida-Debbache
- Laboratoire de Biochimie Appliquée, Faculté des Sciences de la Nature et de la Vie, Université de Bejaia, Bejaia 06000, Algeria;
| | - Ivona Elez Garofulić
- Department of Food Engineering, Faculty of Food Technology and Biotechnology, Pierottijeva 6, 10000 Zagreb, Croatia; (I.E.G.); (K.G.)
| | - Kata Galić
- Department of Food Engineering, Faculty of Food Technology and Biotechnology, Pierottijeva 6, 10000 Zagreb, Croatia; (I.E.G.); (K.G.)
| | - Sylvie Avallone
- QualiSud, University of Montpellier, 34000 Montpellier, France;
- CIRAD, Institut Universitaire de Technologie d’Avignon, 84029 Avignon, France
| | - Andrée Voilley
- International Joint Research Laboratory “Tropical Bioresources & Biotechnology” UMR PAM, Institut Agro Dijon, Université de Bourgogne, 1 Esplanade Erasme, 21078 Dijon, France; (A.V.); (Y.W.)
- The School of Biotechnology and Food Technology, Hanoi University of Science and Technology, Hanoi 100000, Vietnam
| | - Yves Waché
- International Joint Research Laboratory “Tropical Bioresources & Biotechnology” UMR PAM, Institut Agro Dijon, Université de Bourgogne, 1 Esplanade Erasme, 21078 Dijon, France; (A.V.); (Y.W.)
- The School of Biotechnology and Food Technology, Hanoi University of Science and Technology, Hanoi 100000, Vietnam
| |
Collapse
|
4
|
Bussy U, You H, Kwik-Uribe C. OUP accepted manuscript. J AOAC Int 2022; 105:1060-1068. [PMID: 35080238 PMCID: PMC9247699 DOI: 10.1093/jaoacint/qsac007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 12/08/2021] [Accepted: 12/17/2021] [Indexed: 11/14/2022]
Abstract
Background Objective Method Results Conclusions Highlights
Collapse
Affiliation(s)
| | - Hong You
- Corresponding author’s e-mail: ;
| | | |
Collapse
|
5
|
Liu S, Sesso HD. Flavonoid consumption and cardiometabolic health: Potential benefits due to foods, supplements, or biomarkers? Am J Clin Nutr 2021; 114:9-11. [PMID: 33963738 PMCID: PMC8246617 DOI: 10.1093/ajcn/nqab147] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Simin Liu
- Departments of Epidemiology, Medicine, and Surgery and Center for Global Cardiometabolic Health, Brown University, Providence, RI, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Howard D Sesso
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| |
Collapse
|
6
|
Roy G, Boucher A, Couture P, Drouin-Chartier JP. Impact of Diet on Plasma Lipids in Individuals with Heterozygous Familial Hypercholesterolemia: A Systematic Review of Randomized Controlled Nutritional Studies. Nutrients 2021; 13:nu13010235. [PMID: 33561083 PMCID: PMC7829745 DOI: 10.3390/nu13010235] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/11/2021] [Accepted: 01/13/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Conclusive data on the effectiveness of dietary interventions in heterozygous familial hypercholesterolemia (HeFH) management are unavailable. Whether this is due to a true lack of effects or biases in intervention designs remains unsettled. We systematically assessed the impact on LDL-C of published dietary randomized controlled trials (RCTs) conducted among individuals with HeFH in relation to their design and risk of bias. METHODS We systematically searched PubMed, Web of Science, and Embase in November 2020 to identify RCTs that assessed the impact of: (1) food-based interventions; (2) dietary counseling interventions; or (3) dietary supplements on LDL-C in individuals with HeFH. We evaluated the risk of bias of each study using the Cochrane Risk of Bias 2 method. RESULTS A total of 19 RCTs comprising 837 individuals with HeFH were included. Of those, five were food-based interventions, three were dietary counseling interventions and 12 were dietary supplement-based interventions (omega-3, n = 3; phytosterols, n = 7; guar gum, n = 1; policosanol, n = 1). One study qualified both as a food-based intervention and as a dietary supplement intervention due to its factorial design. A significant reduction in LDL-C levels was reported in 10 RCTs, including eight dietary supplement interventions (phytosterols, n = 6, omega-3, n = 1; guar gum, n = 1), one food-based intervention and one dietary counseling intervention. A total of 13 studies were judged to have some methodological biases in a way that substantially lowers confidence in the results. Studies at low risk of biases were more likely to report significant reductions in LDL-C concentrations, compared with studies at risk of bias (chi-square statistic: 5.49; p = 0.02). CONCLUSION This systemic review shows that the apparent lack of effectiveness of diet manipulation in modulating plasma levels of LDL-C among individuals with HeFH is likely due to biases in study designs, rather than a true lack of effects. The likelihood of reporting significant reductions in LDL-C was associated with the concurrent risk of bias.
Collapse
Affiliation(s)
- Gabrielle Roy
- Centre Nutrition, Santé et Société (NUTRISS), Institut Sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada; (G.R.); (A.B.); (P.C.)
| | - Anykim Boucher
- Centre Nutrition, Santé et Société (NUTRISS), Institut Sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada; (G.R.); (A.B.); (P.C.)
| | - Patrick Couture
- Centre Nutrition, Santé et Société (NUTRISS), Institut Sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada; (G.R.); (A.B.); (P.C.)
- Centre de Recherche du CHU de Québec-Université Laval, Québec, QC G1V 4G2, Canada
| | - Jean-Philippe Drouin-Chartier
- Centre Nutrition, Santé et Société (NUTRISS), Institut Sur la Nutrition et les Aliments Fonctionnels (INAF), Université Laval, Québec, QC G1V 0A6, Canada; (G.R.); (A.B.); (P.C.)
- Faculté de Pharmacie, Université Laval, Québec, QC G1V 0A6, Canada
- Correspondence: ; Tel.: +418-656-2131
| |
Collapse
|
7
|
Rist PM, Sesso HD, Manson JE. Innovation in the design of large-scale hybrid randomized clinical trials. Contemp Clin Trials 2020; 99:106178. [PMID: 33086158 PMCID: PMC7568770 DOI: 10.1016/j.cct.2020.106178] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 10/11/2020] [Accepted: 10/15/2020] [Indexed: 02/07/2023]
Affiliation(s)
- Pamela M Rist
- Division of Preventive 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.
| | - Howard D Sesso
- Division of Preventive 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
| | - JoAnn E Manson
- Division of Preventive 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
| |
Collapse
|
8
|
Ottaviani JI, Britten A, Lucarelli D, Luben R, Mulligan AA, Lentjes MA, Fong R, Gray N, Grace PB, Mawson DH, Tym A, Wierzbicki A, Forouhi NG, Khaw KT, Schroeter H, Kuhnle GGC. Biomarker-estimated flavan-3-ol intake is associated with lower blood pressure in cross-sectional analysis in EPIC Norfolk. Sci Rep 2020; 10:17964. [PMID: 33087825 PMCID: PMC7578063 DOI: 10.1038/s41598-020-74863-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 10/06/2020] [Indexed: 12/18/2022] Open
Abstract
Flavan-3-ols are a group of bioactive compounds that have been shown to improve vascular function in intervention studies. They are therefore of great interest for the development of dietary recommendation for the prevention of cardio-vascular diseases. However, there are currently no reliable data from observational studies, as the high variability in the flavan-3-ol content of food makes it difficult to estimate actual intake without nutritional biomarkers. In this study, we investigated cross-sectional associations between biomarker-estimated flavan-3-ol intake and blood pressure and other CVD risk markers, as well as longitudinal associations with CVD risk in 25,618 participants of the European Prospective Investigation into Cancer (EPIC) Norfolk cohort. High flavan-3-ol intake, achievable as part of an habitual diet, was associated with a significantly lower systolic blood pressure (- 1.9 (- 2.7; - 1.1) mmHg in men and - 2.5 (- 3.3; - 1.8) mmHg in women; lowest vs highest decile of biomarker), comparable to adherence to a Mediterranean Diet or moderate salt reduction. Subgroup analyses showed that hypertensive participants had stronger inverse association between flavan-3-ol biomarker and systolic blood pressure when compared to normotensive participants. Flavanol intake could therefore have a role in the maintenance of cardiovascular health on a population scale.
Collapse
Affiliation(s)
| | - Abigail Britten
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | | | - Robert Luben
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | | | | | | | - Nicola Gray
- Department of Food and Nutritional Sciences, University of Reading, Reading, UK
| | | | | | - Amy Tym
- LGC, Newmarket Road, Fordham, UK
| | | | - Nita G Forouhi
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Kay-Tee Khaw
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | | | - Gunter G C Kuhnle
- Department of Food and Nutritional Sciences, University of Reading, Reading, UK.
| |
Collapse
|
9
|
Manson JE. Editorial from the new editor-in-chief. Contemp Clin Trials 2020; 96:106127. [PMID: 32912819 PMCID: PMC7472069 DOI: 10.1016/j.cct.2020.106127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- JoAnn E Manson
- Brigham and Women's Hospital, Medicine, Harvard Medical School, United States of America
| |
Collapse
|
10
|
Matsui R, Hamburg NM. Eating Chocolate to Improve Muscle Health and Walking Ability in Patients With Peripheral Artery Disease. Circ Res 2020; 126:600-602. [DOI: 10.1161/circresaha.120.316614] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Reiko Matsui
- From the Evans Department of Medicine, Whitaker Cardiovascular Institute, Boston University School of Medicine, MA
| | - Naomi M. Hamburg
- From the Evans Department of Medicine, Whitaker Cardiovascular Institute, Boston University School of Medicine, MA
| |
Collapse
|
11
|
Baker LD, Rapp SR, Shumaker SA, Manson JE, Sesso HD, Gaussoin SA, Harris D, Caudle B, Pleasants D, Espeland MA. Design and baseline characteristics of the cocoa supplement and multivitamin outcomes study for the Mind: COSMOS-Mind. Contemp Clin Trials 2019; 83:57-63. [PMID: 31271875 PMCID: PMC6642834 DOI: 10.1016/j.cct.2019.06.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 06/16/2019] [Accepted: 06/27/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Large simple trials are potentially efficient and cost-effective approaches to assess interventions to preserve cognitive function in older adults. High-dose cocoa flavanols supplementation is a promising intervention that warrants additional testing. We describe the design, recruitment success, and baseline characteristics of the Cocoa Supplement and Multivitamin Outcomes Study for the Mind (COSMOS-Mind) trial. METHODS COSMOS-Mind is an ancillary study to the large-scale and predominantly mail-based COSMOS randomized controlled clinical trial. COSMOS is assessing whether cocoa extract (including 600 mg/d cocoa flavanols) and a multivitamin reduce risks for major cardiovascular events and total invasive cancer. COSMOS-Mind uses telephone-based interviews to assess cognitive function and impairment to determine whether cocoa flavanols benefit cognitive function in adults aged 65 years or older, targeting the enrollment of 2000 participants to provide >90% statistical power across 3 years of annual follow-up. RESULTS Of the 3224 COSMOS screenees who expressed interest in COSMOS-Mind, 2350 (76%) successfully completed baseline cognitive assessments and 2262 (96%) geographically diverse, eligible individuals were ultimately enrolled over one year. At baseline, the primary outcome, a composite of cognitive test scores, was inversely associated with age in a manner consistent with assumptions used in projections of statistical power. CONCLUSIONS Older adults are willing to enroll in large simple trials that include telephone-based cognitive assessments. Embedding these trials in large studies of other health outcomes is efficient and expands the scientific knowledge gained from the research. ClinicalTrials.gov Identifiers: NCT03035201 (COSMOS-Mind); NCT102422745 (parent COSMOS).
Collapse
Affiliation(s)
- Laura D Baker
- Department of Internal Medicine, Wake Forest School of Medicine, One Medical Center Boulevard, Winston-Salem, NC, 27157, United States of America; Department of Social Sciences and Health Policy, Wake Forest School of Medicine, One Medical Center Boulevard, Winston-Salem, NC, 27157, United States of America.
| | - Stephen R Rapp
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, One Medical Center Boulevard, Winston-Salem, NC, 27157, United States of America; Department of Psychiatry and Prevention, Wake Forest School of Medicine, One Medical Center Boulevard, Winston-Salem, NC, 27157, United States of America.
| | - Sally A Shumaker
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, One Medical Center Boulevard, Winston-Salem, NC, 27157, United States of America.
| | - JoAnn E Manson
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, and the Department of Epidemiology, Harvard T.H. Chan School of Public Health, 900 Commonwealth Avenue, Boston, MA 02115, United States of America.
| | - Howard D Sesso
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, and the Department of Epidemiology, Harvard T.H. Chan School of Public Health, 900 Commonwealth Avenue, Boston, MA 02115, United States of America.
| | - Sarah A Gaussoin
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, One Medical Center Boulevard, Winston-Salem, NC, 27157, United States of America.
| | - Darrin Harris
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, One Medical Center Boulevard, Winston-Salem, NC, 27157, United States of America.
| | - Brad Caudle
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, One Medical Center Boulevard, Winston-Salem, NC, 27157, United States of America.
| | - Debbie Pleasants
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, One Medical Center Boulevard, Winston-Salem, NC, 27157, United States of America.
| | - Mark A Espeland
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, One Medical Center Boulevard, Winston-Salem, NC, 27157, United States of America.
| |
Collapse
|