Cardiovascular risk factors in young, overweight, and obese European adults and associations with physical activity and omega-3 index

Early-Adulthood Weight Change and Later Physical Activity in Relation to Cardiovascular and All-Cause Mortality: NHANES 1999-2014

Limited evidence investigated the combined influence of early-adulthood weight change and later physical activity on the risk of cardiovascular (CVD) and all-cause mortality. The aim of this study is to explore the associations of early-adulthood weight change and later physical activity with CVD and all-cause mortality. This is a cohort study of 23,193 US adults aged 40 to 85 years from the National Health and Nutrition Examination Survey (NHANES) 1999 to 2014. Cox proportional hazards regression was used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) of CVD and all-cause mortality associated with early-adulthood weight change and later physical activity. During a median follow-up of 9.2 years, there were 533 and 2734 cases of CVD and all-cause deaths. Compared with being physically inactive, the HRs of the CVD mortality of being physically active were 0.44 (0.26 to 0.73), 0.58 (0.19 to 1.82), 0.38 (0.17 to 0.86) and 0.46 (0.21 to 1.02) among individuals with stable normal, stable obese, non-obese to obese and maximum overweight early-adulthood weight change patterns. Using stable normal patterns that were physically active later as the reference, other early-adulthood weight change patterns did not show a significantly higher risk of CVD mortality when participants were physically active in later life; later physically inactive participants had a significantly increased risk of CVD mortality, with HRs of 2.17 (1.30 to 3.63), 5.32 (2.51 to 11.28), 2.59 (1.29 to 5.18) and 2.63 (1.32 to 5.26) in the stable normal, stable obese, non-obese to obese and maximum overweight groups, respectively. Similar results can be seen in the analyses for all-cause mortality. Our findings suggest that inadequate physical activity worsens the negative impact of unhealthy early-adulthood weight change patterns, which is worthy of being noted in the improvement of public health.

Developmental trajectories of body mass index from childhood into late adolescence and subsequent late adolescence-young adulthood cardiometabolic risk markers

Background

Reports on body mass index (BMI) trajectories from childhood into late adolescence, their determinants, and subsequent cardiometabolic risk markers, particularly among European populations have been few. Moreover, sex-specific investigation is necessary considering the sex difference in BMI, and the sex-specific association between BMI and some cardiometabolic risk markers.

Methods

Using a sample from the DOrtmund Nutritional and Anthropometric Longitudinally Designed study, we explored sex-specific trajectories of the BMI standard deviation score (SDS) from 4 to 18 years of age in 354 males and 335 females by latent (class) growth models. The determinants of trajectory were assessed by logistic regression. We identified cardiometabolic risk markers that were highly associated with BMI SDS trajectory by random forest regression, and finally we used generalized linear models to investigate differences in the identified cardiometabolic risk markers between pairs of trajectories.

Results

We observed four: ‘low-normal weight’, ‘mid-normal weight’, ‘high-normal weight’, and ‘overweight’, and three: ‘‘low-normal weight’, ‘mid-normal weight’, and ‘high-normal weight’ trajectories in males and females, respectively. Higher maternal prepregnancy BMI was associated with the ‘overweight’ trajectory, and with ‘high-normal weight’ trajectory in both sexes. In addition, employed mothers and first-born status were associated with ‘high-normal weight’ trajectory in females. BMI SDS trajectory was associated with high-density lipoprotein-cholesterol and interleukin-18 (IL-18) in males, and diastolic blood pressure and interleukin-6 (IL-6) in females. However, only males following the ‘overweight’ trajectory had significantly higher IL-18 when compared to their ‘low-normal weight’ counterpart.

Conclusions

We identified sex-specific distinct trajectories of BMI SDS from childhood into late adolescence, higher maternal prepregnancy BMI as a common determinant of the ‘high-normal weight’ and ‘overweight’ trajectories, and ‘overweight’ trajectory being associated with elevated IL-18 in late adolescence–young adulthood. This study emphasizes the role of maternal prepregnancy BMI in overweight, and highlights IL-18 as a cardiometabolic signature of overweight across life.

Electronic supplementary material

The online version of this article (10.1186/s12933-019-0813-5) contains supplementary material, which is available to authorized users.

Dietary Intake and Cardiovascular Risk Factors in Icelanders Following Voluntarily a Low Carbohydrate Diet

Background/Aim

Most studies regarding low-carbohydrate diets (LCDs) have been intervention studies. The aim of the current study was to investigate dietary intake and cardiovascular risk factors among individuals who voluntarily follow a LCD.

Methods

A cross-sectional study was conducted (N = 54, 20–66yrs) in Reykjavik, Iceland. Participants recorded food intake for three days. Blood samples were analyzed for cardiovascular risk factors.

Results

Nearly half of the participants were obese and around 60% had been on a LCD for ≥ 6 months. Fifty percent claimed they had lost weight during the past month. The median intake of carbohydrate, protein and fat were 8%, 22% and 68% E (hereof 25% saturated fatty acids), respectively. The consumption of bread and wholegrain cereals was very low (<5g/day), including the intake of dietary fiber (11g/day). Median fruit intake was 12 g/day. Intake of red meat and meat products was double that of the general population or ~900 g/week. Median intake of vitamins and minerals were mostly higher than the estimated average requirements. Cardiovascular risk factors were mostly within normal range. Mean blood lipids were slightly elevated although the high density lipoprotein/total cholesterol ratio was normal.

Conclusion

Despite poor diet quality and high prevalence of obesity, individuals who voluntarily follow a LCD have cardiovascular risk factors mostly within reference range. These individuals consume very low amounts of carbohydrates and high amounts of fat and saturated fat acids. Intake of red meat and processed meat exceeds recommended intake. Very low intake of whole grain cereals and fruits results in low intake of fiber. Long term health implications need to be examined further in longitudinal studies.

Association between omega-3 index and blood lipids in older Australians

Management of hyperlipidaemia remains a cornerstone therapy for the prevention of cardiovascular disease (CVD). Dietary supplementation with n-3 polyunsaturated fatty acid (PUFA) has been shown to modulate blood lipid profiles and reduce the risk of developing CVD. However, studies relating objective measures of long-term dietary n-3 PUFA intake and circulating lipid levels in older adults are limited. Thus, we aimed to determine whether there is an association between erythrocyte n-3 PUFA status (omega-3 index, O3I) and blood lipid profiles in older adults. A sample of adults aged 65-95 years who participated in the Retirement Health and Lifestyle Study was evaluated. Outcome measures included O3I (% eicosapentaenoic acid+% docosahexaenoic acid) and fasting blood lipid profiles [total cholesterol (TC), low-density lipoprotein (LDL)-cholesterol, high-density lipoprotein (HDL)-cholesterol and triglyceride (TG)]. Two hundred and seventy-six subjects were included in the analyses. The mean±SD age was 77.6±7.4 years, and 40.9% were males. O3I was significantly higher in females compared to males. O3I was inversely associated with plasma TG (P<.001) and TC/HDL-cholesterol ratio (P<.05), and positively associated with HDL-cholesterol (P<.05), in all subjects. Associations between O3I and TG were evident in both females (r=-0.250, P<.01) and males (r=-0.225, P<.05). In females only, the odds of being hypertriglyceridaemic were highest in those with lowest O3I (P=.006). Trends for hypercholesterolaemia and elevated LDL risk were converse between males and females. Long-term n-3 PUFA status is associated with blood lipid profiles in older Australians. Our findings support the development and implementation of age-specific dietary strategies to reduce the risk of CVD via improving the O3I.

Omega-3 fatty acids' effect on leptin and adiponectin concentrations in patients with spinal cord injury: A double-blinded randomized clinical trial

CONTEXT

Omega-3 fatty acids have been recently proposed to induce neural improvement in patients with spinal cord injury (SCI) while affecting some hormones including leptin and adiponectin.

OBJECTIVES

We tried to evaluate the effect of omega-3 fatty acids on circulatory concentrations of leptin and adiponectin among these patients.

DESIGN

This study is a double-blinded randomized clinical trial with intervention duration of 14 months.

SETTING

A tertiary rehabilitation center.

PARTICIPANTS

Total of 104 patients with SCI who did not meet our exclusion criteria entered the study. Those with history of diabetes, cancer, endocrinology disease, acute infection, and use of special medications were excluded. Patients were divided randomly into the treatment and control group by using permuted balanced block randomization.

INTERVENTION

The treatment group received two MorDHA® capsules per day (each capsule contain 465 mg of docosahexaenoic acid (DHA) and 63 mg of eicosapentaenoic acid (EPA)) for 14 months while the control group received placebo capsules with similar color, shape, and taste.

MAIN OUTCOMES MEASURES

Leptin and adiponectin concentrations in plasma were measured at the beginning of trial and then after 6 and 14 months.

RESULTS

Fourteen months of treatment with DHA and EPA did not influence concentrations of leptin but adiponectin level was significantly decreased (P: 0.03). Weight was positively correlated with leptin level at stage 0 of trial (P: 0.008, r=0.41) while this association was attenuated through stages of trial after intervention.

CONCLUSION

Our data show that omega-3 fatty acids may not affect plasma concentrations of leptin but adiponectin level is decreased in patients with SCI. Moreover, this intervention influences the linear relationship between weight and leptin after 14 months administration of DHA and EPA.

Development and validation of an electronic FFQ to assess food intake in the Slovene population

OBJECTIVE

To develop and validate an electronic FFQ that estimates the food and nutrient intakes, especially fat intake, in a healthy, adult population from the coastal (Mediterranean) part of Slovenia.

DESIGN

A new electronic FFQ was developed for a survey entitled 'A multidisciplinary approach in the treatment of obesity', conducted at the University of Primorska, and validated against a 3 d weighed food record (FR).

SETTING

Coastal region of Slovenia.

SUBJECTS

Our study population included eighty-five healthy adults aged 25-49 years, recruited from the local coastal region of Slovenia. Intakes of food groups, macronutrients and energy, estimated by the FR and the FFQ, were compared using correlation coefficients, cross-classification and Bland-Altman plots.

RESULTS

The mean value of most nutrient intakes tended to be higher in the FFQ compared with the FR, except for carbohydrate, fibre and energy. Regression analysis demonstrated an acceptable agreement between the FFQ and FR. The FFQ was moderately correlated with the FR (0·30-0·54), and most of the correlations increased after energy adjustment and after de-attenuation. Relatively high (more than 70 %) proportions of participants were correctly classified into the same or an adjacent quartile. Bland-Altman analysis confirmed an acceptable level of agreement between the two methods.

CONCLUSIONS

The electronic FFQ, developed for a healthy adult Slovene population from the coastal region, was shown to be a valid tool to assess food group and nutrient intakes, especially fat intakes, and to rank individuals by their intakes within gene-nutrient studies.

Fish meal supplementation and ambulatory blood pressure in patients with hypertension: relevance of baseline membrane fatty acid composition

BACKGROUND

Studies on fish oil effects on ambulatory blood pressure (ABP) are inconclusive. We evaluated fish effects on fatty acid composition of red blood cell (RBC) membrane and ABP values and tested the hypothesis that the starting membrane fatty acid composition affects the ability to incorporate additional polyunsaturated fatty acids (PUFA) and decrease blood pressure.

METHODS

In 55 hypertensive patients, we measured RBC membrane fatty acid by gas chromatography and performed ABP monitoring. Patients received nutritional counseling and 3 weekly meals of trout rich in PUFA. In 42 patients, RBC membrane fatty acid and ABP were reassessed after 6 months.

RESULTS

At baseline, the PUFA/saturated fatty acid (SFA) ratio of RBC membrane (PUFA/SFA) was inversely related to 24-hour, daytime, and nighttime systolic and pulse pressure, a relationship that was independent of covariables. At follow-up, the PUFA/SFA ratio increased in 20 (48%) of 42 patients. Patients with increased PUFA/SFA ratio at follow-up had lower baseline PUFA/SFA ratio than patients without such increase. Fish meal supplementation decreased 24-hour systolic and diastolic pressure only in patients who had increased PUFA/SFA ratio, a change that was more prominent during the nighttime. The change in PUFA/SFA was inversely and independently related to the change in 24-hour systolic and pulse pressure, and a logistic regression analysis indicated low baseline PUFA/SFA ratio as the only independent predictor of PUFA/SFA increase and blood pressure decrease.

CONCLUSIONS

The ability of fish meals to increase membrane PUFA content and decrease blood pressure in hypertensive patients depends upon the starting membrane fatty acid composition.

Omega-3 fatty acids and blood pressure

Epidemiological and clinical studies suggest that consumption of omega (ω-3) polyunsaturated fatty acids (PUFA) contributes to the reduction of cardiovascular mortality through different mechanisms including modulation of cellular metabolic functions, gene expression and beneficial effects on lipid profile or blood pressure. The aim of the study is to review the effects of ω-3 PUFA supplemented as fish oil or blue fish in blood pressure. The analysis of different studies suggests that high doses ω-3 PUFA ( ≥ 3 g/day) produces a small but significant decrease in blood pressure, especially systolic blood pressure, in older and hypertensive subjects; however, the evidence is not consistent among different studies. ω-3 polyunsaturated fatty acids consumption might have a place in the control of patients with mild hypertension before starting drug treatment and of those who prefer changes of lifestyles like diet.

Omega-3 Index correlates with healthier food consumption in adolescents and with reduced cardiovascular disease risk factors in adolescent boys

The Omega-3 Index, a measure of long-chain omega-3 fats in red blood cell membranes, predicts heart disease mortality in adults, but its association with cardiovascular risk factors in younger populations is unknown. We determined the Omega-3 Index in adolescents participating in the Western Australian Pregnancy (Raine) Cohort, assessed associations with diet, lifestyle and socioeconomic factors, and investigated independent associations with cardiovascular and metabolic risk factors. Red blood cell fatty acid analysis was determined for 1,301 adolescents aged 13-15 years. Risk factors examined were blood pressure, fasting blood insulin and glucose concentrations, and fasting blood lipids including ratios. The mean Omega-3 Index was 4.90 ± 1.04% (range 1.41-8.42%). When compared with categories identified in adults, 15.6% of adolescents were in the high risk category (Index < 4%). Age (P < 0.01), maternal education (P < 0.01) and BMI (P = 0.05) were positively associated with the Omega-3 Index. The Index was positively associated with dietary intakes of eicosapentaenoic and docosahexaenoic acid (P < 0.01), protein (P < 0.01), omega-3 fats (P < 0.04), and food groups of fish and wholegrains (both P < 0.01), and negatively associated with intakes of soft drinks and crisps (both P < 0.01). In boys, the Omega-3 Index was independently associated with total (β = 0.06, P = 0.01) and HDL-cholesterol (β = 0.03, P = 0.01), and diastolic blood pressure (β = -0.68, P = 0.04). The predictability of the Index for the risk of cardiovascular disease later in life warrants further investigation in the adolescent population.