Dietary prevention of cardiovascular diseases

Intakes of folate, vitamin B6, and vitamin B12 and cardiovascular disease risk: a national population-based cross-sectional study

Background

Only a few studies that investigated dietary intakes of folate, vitamin B6, and vitamin B12 in relation to cariovascular disease (CVD). This study aimed to assess the association of dietary folate, vitamin B6, and vitamin B12 with CVD in the United States population.

Methods

A cross-sectional analysis of 65,322 adults aged ≥ 20 years who participated in the Third National Health and Nutrition Examination Survey (NHANES III) and NHANES 1999-2018. Before 2003, dietary intake data were assessed using a 24-hour dietary call, and two 24-hour dietary calls were used during 2003 and 2018. Odds ratios and 95% confidence intervals (CIs) for CVD associated with dietary folate, vitamin B6, and vitamin B12 were estimated using multivariate logistic regression models.

Results

Dietary vitamin B6 intake were inversely associated with the odds of CVD. In males, the multivariable OR for the highest vs. lowest quartiles of vitamin B6 was 0.77 (95%CI: 0.61-0.97, Ptrend = 0.013) for the odds of CVD. In females, the adjusted OR for the highest quartile of vitamin B6 compared with the lowest quartile was 0.73 (95%CI: 0.56-0.95, Ptrend = 0.038) for the odds of CVD. No significant association was observed between dietary folate and vitamin B12 intakes and the odds of CVD.

Conclusions

Our findings indicate that higher intake of dietary vitamin B6 may be associated with lower prevalence of CVD, suggesting that dietary vitamin B6 has major public health implications in the prevention of CVD in the United States population.

Association between adherence to the EAT-Lancet diet and risk of cancer and cardiovascular outcomes in the prospective NutriNet-Santé cohort

BACKGROUND

The EAT-Lancet commission proposed, in 2019, a planetary, healthy, and universal dietary pattern. However, this diet has rarely been studied in relation to various health outcomes.

OBJECTIVES

We aimed to prospectively estimate the association between the EAT-Lancet diet and cancer and cardiovascular disease (CVD) risk.

METHODS

The study was conducted in participants of the NutriNet-Santé cohort (2009-2021). The endpoints were the incident outcomes (cancer and CVDs and mortality from these diseases), combined and separately. Adherence to the EAT-Lancet diet was estimated using the EAT-Lancet Diet Index (ELD-I) modeled as quintiles (Qs). Multivariable Cox proportional hazard models were used to estimate HRs and 95% CIs, adjusted for potential confounders and moderators.

RESULTS

A total of 62,382 subjects were included; 2475 cases of cancer and 786 cases of cardiovascular events occurred during a median follow-up of 8.1 y. The sample was 76% female, the mean ± SD age at inclusion was 51.0 ± 10.2 y. The ELD-I ranged from -162 to 332 points with a mean ± SD score of 45.4 ± 25.6 points. In multivariable models, no significant association between the EAT-Lancet diet and the risk of cancer and CVD combined, and separately, was observed. Alcohol consumption was an effect modifier of the association. A significant association was observed among low drinkers (HRQ5vs.Q1: 0.86; 95% CI: 0.73, 1.02; P-trend = 0.02). A higher ELD-I was significantly associated with a lower risk of overall cancer only among females (HRQ5vs.Q1: 0.89; 95% CI: 0.75, 1.05; P-trend = 0.03). Both associations were largely attenuated by BMI.

CONCLUSIONS

Contrary to our hypothesis, our results documented significant associations between adherence to the EAT-Lancet diet and incidence of cancer only in some subgroups, and no association with CVD.This trial was registered at clinicaltrials.gov as NCT03335644.

Prospective association between several dietary scores and risk of cardiovascular diseases: Is the Mediterranean diet equally associated to cardiovascular diseases compared to National Nutritional Scores?

BACKGROUND

Mediterranean diet has been consistently negatively associated with cardiovascular diseases (CVD) but the superiority compared to official nutritional guidelines has not been tested yet. Our objective was to prospectively investigate the association between several nutritional scores and incidence of cardiovascular diseases.

METHODS AND FINDINGS

A total of 94,113 participants from the NutriNet-Santé cohort were followed between 2009 and 2018. The participants have completed at least three 24 h dietary records during the first two-years of follow-up to compute nutritional scores reflecting adherence to the Mediterranean diet (MEDI-LITE), American dietary guidelines (AHEI-2010) and French dietary guidelines (mPNNS-GS). Sex-specific quartiles (Q) of scores were computed. Multivariable Cox proportional hazards models were used to estimate the associations between scores and incidence of CVD, documented using Hazard Ratio (HR) and 95% confidence intervals (95%CI). Thus, 1399 incident CVD events occurred during the follow-up (mean follow-up = 5.4 years). Comparing Q4 versus Q1 quartile, HR for the MEDI-LITE and AHEI-2010 were 0.79 (95% CI: 0.67-0.93, P-trend = .004) and 0.75 (95% CI: 0.63-0.89, P-trend = .002) respectively. These associations remained similar when removing early cases of CVD, when analyses were restricted to participants with >6 dietary records and when considering transient ischemic attacks. In this last case, association between CVD' risk and mPNNS-GS become significant.

CONCLUSIONS

A better nutritional quality of diet is overall associated with lower risk of CVD. The future version of the PNNS-GS, based on the updated version of the French dietary guidelines, should strengthen the CVD protective effect of French recommendations.

The Importance of School-based Healthy Living Initiatives: Introducing the Health and Wellness Academy Concept

Over the last 15 years, the number of school and community based health-intervention programs in the United States has grown. Many of these programs aim to prevent non-communicable chronic disease diagnoses (e.g., obesity, cardiovascular disease and type-2 diabetes). The Department of Physical Therapy in the College of Applied Health Sciences (CAHS) at the University of Illinois at Chicago (UIC) created a school-based wellness program (SBWP) that focuses on nutrition and physical activity, providing tailored experiences that motivate adolescents to make healthier lifestyle choices. The SBWP began as a camp for children in the surrounding neighborhoods and implemented healthy living practices utilizing students from Departments in the CAHS. From this camp, the Health and Wellness Academy (HWA) evolved. This paper provides a review of school-based initiatives and introduces the UIC HWA, an innovative and reproducible approach that can bring positive environmental change by improving health outcomes for children and their families.