Interaction of smoking and dietary habits modifying the risk of coronary heart disease in women: results from a case–control study

Nutritional status, feeding behavior, and oral conditions in preschool children exposed to secondhand smoke

This study evaluated whether the nutritional status of preschoolers is influenced by secondhand smoke. Pairs of mothers-children (N = 201) were allocated in "children exposed to secondhand smoke (ESHS)" or "not exposed (N_ESHS)." Mothers answered, "The Parental Feeding Style Questionnaire (PFSQ)." The nutritional status and oral conditions were evaluated using WHO criteria. ESHS was 3.5 more likely to have a high BMI and their mothers had 10 kg more than N_ESHS. The probability of having dental caries was 2.28 and 3.68 times greater when the mother's BMI increases and when family/mothers were smokers, independently whether they smoke in the child's presence.

Editor's Choice - Prevalence of Peripheral Arterial Disease, Abdominal Aortic Aneurysm, and Risk Factors in the Hamburg City Health Study: A Cross Sectional Analysis

OBJECTIVE

There is a paucity of current figures on the prevalence of carotid and lower extremity peripheral arterial disease (PAD) and abdominal aortic aneurysm (AAA) as well as the associated cardiovascular risk factors to support considerations on screening programmes.

METHODS

In the population based Hamburg City Health Study, participants between 45 and 74 years were randomly recruited. In the current cross sectional analysis of the first 10 000 participants enrolled between February 2016 and November 2018, the prevalence of carotid artery disease (intima-media thickness ≥ 1 mm), lower extremity PAD (ankle brachial index ≤ 0.9), and AAA (aortic diameter ≥ 30 mm) was determined. Multivariable logistic regression models were applied to determine the association between vascular diseases and risk factors. To account for missing values, multiple imputation was performed.

RESULTS

A total of 10 000 participants were analysed (51.1% females, median age 63 years, median body mass index 26.1 kg/m2). In medians, the intima media thickness was 0.74 mm (interquartile range [IQR] 0.65 - 0.84), the ankle brachial index 1.04 (IQR 0.95 - 1.13), and the aortic diameter 17.8 mm (IQR 16.1 - 19.6). Concerning risk factors, 64% self reported any smoking, 39% hypertension, 5% coronary artery disease, 3% congestive heart failure, 5% atrial fibrillation, and 3% history of stroke or myocardial infarction, respectively. In males, the prevalence of carotid artery disease, lower extremity PAD, and AAA were 35.3%, 22.7%, and 1.3%, respectively, and in females, 23.4%, 24.8%, and 0.2%, respectively. Higher age and current smoking were likewise associated with higher prevalence while the impact of variables varied widely.

CONCLUSION

In this large population based cohort study of 10 000 subjects from Hamburg, Germany, a strikingly high prevalence of PAD was revealed. Almost 45% suffered from any index disease, while AAA was only diagnosed in 1.3% of males and 0.2% of females. The high prevalence of atherosclerotic disease and associated cardiovascular risk factors underline that it is essential to increase awareness and fuel efforts for secondary prevention.

Dietary patterns are associated with arterial stiffness and carotid atherosclerosis in postmenopausal women

PURPOSE

The increase in cardiovascular risk after the menopausal transition remains partly explained until today. Further research is needed to identify risk factors potentially modifiable by primary prevention practices. This cross-sectional study, part of a larger prospective project, aims to investigate possible associations between dietary patterns and indices of vascular structure and function among healthy postmenopausal women.

METHODS

Postmenopausal women (n = 310) without clinically overt cardiovascular disease were recruited consecutively from a University Menopause Clinic over three years. Dietary intake was assessed by a validated food frequency questionnaire and the MedDietScore. In addition, we assessed anthropometric/biochemical parameters, including the Triglyceride-glucose index (TyG-Index), body fat distribution [triceps skinfold (TSF), mid-upper arm circumference (MUAC)] and physical activity. The vascular assessment included carotid-femoral pulse wave velocity (PWV), carotid and femoral-artery intima-media thickness (IMT) and atheromatous plaques presence.

RESULTS

Consumption of non-refined cereals was associated with carotid-bulb IMT (R² = 5.5% b-coefficient = -0.142; p = 0.011), adjusting for age, physical activity, lipids, systolic blood pressure, smoking, body mass index, insulin resistance, and daily energy intake. PWV was associated with the intake of total dairy products (R² = 27.3%, b-coefficient = -0.117; p = 0.017). Higher red meat consumption was related to a greater TyG-index (Model 1, R² = 14.3%, b-coefficient=0.121; p = 0.048), an association mediated by total daily energy intake. Higher consumption of alcohol, as well as the MedDietScore, were inversely associated with TSF measurements, significant after Bonferroni correction.

CONCLUSION

Dietary patterns are associated with metabolic indices and subclinical atherosclerosis in postmenopausal women independently of traditional cardiovascular risk factors, total energy intake or physical activity.

NPAS4 Polymorphisms Contribute to Coronary Heart Disease (CHD) Risk

As genetic inheritance is an inevitable risk factor in the development of coronary heart disease (CHD), it is critical to identify the polymorphisms of CHD risk. This study explored whether the NPAS4 polymorphisms are related to the CHD risk in the Chinese Han population. Five SNPs in NPAS4 were genotyped using Agena Mass ARRAY from 499 CHD and 500 controls. RT-PCR detected the NPAS4 expression levels in peripheral blood mononuclear cells from 50 CHD and 50 controls. χ² test compared the distributions of gender, allele and genotypes frequencies between cases and controls. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs). MDR analyzed the SNP-SNP interactions on risk of CHD. U test compared the differences in gene expression between different groups. The results showed that rs4466842 was correlated with an increased CHD risk in overall, males and age ≤ 60; rs117186164 and rs12785321 were significantly related to an increased CHD risk in male and age ≤ 60, respectively; haplotype A_rs117186164C_rs4466842 was significantly correlated with an increased CHD risk. SNP-SNP interactions results showed that the best model was the four-locus model was the combination of rs117770654, rs117957381, rs12785321, and rs4466842 (CVC = 10/10, Testing Sensitivity = 0.647). The expression levels of NPAS4 in the case group (0.365 ± 0.139) were significantly lower than that in the control group (0.782 ± 0.224) (P < 0.001). The results revealed that SNPs in NPAS4 may play an important role in the occurrence and development of CHD.

[Nutritional problems in smokers and passive smokers]

OBJECTIVE

active or passive tobacco use affects a high percentage of individuals and is associated with various health risks. The aim of this review was to look more closely at the nutritional problems that are specific of smokers, which may harm their health.

METHODS

a bibliographic search related to the topic.

RESULTS

smokers consume lower amounts of various foods, especially fruits, vegetables, cereals and dairy. As a result, their intake of vitamins, minerals, and phytochemicals is lower than that observed in non-smokers. Their consumption of meat, caffeine and alcohol is usually higher, and their activity lower than those of non-smokers, coexisting in smokers unhealthy behaviors that contribute to harming their health and quality of life. Oxidative stress and metabolic changes render the needs for some nutrients higher in smokers to achieve the same biochemical situation as in non-smokers. Recommended intakes of vitamin C have increased, but it will probably be necessary to also increase the intakes of other nutrients. In general, smokers suffer from deficiencies more frequently (vitamins C, E, β-carotene, B1, B2, B12, folic acid, calcium, magnesium, iron, iodine, etc.) than non-smokers. Passive smokers are also affected in their eating habits and nutritional status.

CONCLUSIONS

the worse nutritional status of smokers can contribute to the appearance/worsening of various diseases associated with smoking (cardiovascular, cancer, cataracts, osteoporosis, etc.); therefore, nutritional surveillance and correction of nutritional deficiencies could represents health benefits for smokers and passive smokers, which should be considered in the future.

Interaction between eNOS gene polymorphism and current smoking on susceptibility to coronary heart disease in Chinese people

OBJECTIVE

This study aims to explore the relation between endothelial nitric oxide synthase (eNOS) single-nucleotide polymorphisms (SNPs) and the risk of coronary heart disease (CHD).

METHODS

SNPstats (online software: http://bioinfo.iconcologia.net/SNPstats) was performed to test Hardy-Weinberg equilibrium in controls. Generalized multifactor dimensionality reduction (GMDR) was adopted to screen the preferable interaction between eNOS SNPs and smoking.

RESULTS

The frequency for the rs1799983-T allele was 31.1% in CHD patients, which was significantly higher than that of 19.8% in controls (P < 0.05). The frequency for the rs891512-A allele was 28.8% in cases, which was also significantly higher than that of 20.1% in controls (P < 0.05). Logistic regression analysis showed that both rs1799983-T and rs891512-A alleles were related with increased risk of CHD, and the odds ratios (ORs) [95% confidence interval (CI)] were 1.71 (1.31-2.15) and 1.57 (1.14-2.07), respectively. High-order interactions were investigated among SNPs and environmental factors using the GMDR method. The data showed that a two-locus model (rs1799983 × smoking) had a testing accuracy of 0.60 (P = 0.001). We found that current smokers with rs1799983-GT or TT within eNOS gene have the highest CHD risk, compared to never smokers with rs1799983-GG genotype, OR (95% CI) = 2.74 (1.78-3.85), after covariates adjustment for age, gender, BMI, and alcohol drinking.

CONCLUSION

The rs1799983-T and rs891512-A alleles and interaction between rs1799983 and smoking were all risk factors of CHD.

Poor Adherence to International Cancer Prevention Recommendations Among Patients With Prostate Cancer: First Results From the MARTINI-Lifestyle Cohort

BACKGROUND

Promotion of a healthy lifestyle in patients with prostate cancer (PCa) has gained traction to increase patient investment in his/her health care practices, improve patient quality of life, and improve survival outcomes.

OBJECTIVE

To investigate adherence of patients with PCa to healthy lifestyle recommendations from the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR).

DESIGN, SETTING, AND PARTICIPANTS

A total of 2227 men with PCa scheduled for radical prostatectomy in the Martini-Klinik at the University Hospital Hamburg-Eppendorf, Hamburg, Germany between January 2016 and December 2017.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS

Age and clinical characteristics were collected at the time of the diagnosis. Assessment of diet and physical activity data were obtained via e-mail surveys using validated questionnaires developed for the European Prospective Investigation into Cancer and Nutrition (EPIC) study [food frequency questionnaire, version 2 (FFQ2), EPIC-Physical Activity Questionnaire (EPIC-PAQ)]. Baseline characteristics were calculated as means and standard deviations for continuous data or counts and percentages for categorical data.

RESULTS AND LIMITATIONS

Patients followed 3.3 (±1.5) of the 10 WCRF/AICR recommendations. None of the participants reached all goals; 67.3% of the patients did not fulfill the criteria of a healthy normal weight, 33.5% reported no exercise at all, and 49.6% were characterized as current or ex-smokers. As to nutritional goals, 75.4% did not meet the recommended intake of meat, 88.8% reported a low consumption of fruit and vegetables, and 86% did not achieve the recommended fiber intake. Because these analyses are based on self-reported data of diet and lifestyle, a bias toward underreporting cannot be excluded.

CONCLUSIONS

First results of the MARTINI-Lifestyle cohort show that adherence to the AICR/WCRF recommendations for cancer prevention is poor.

PATIENT SUMMARY

Patients with prostate cancer scheduled for surgery do not adhere to cancer prevention guidelines. Thus, improving lifestyle habits may provide significant impact on patient health and quality of life.