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Abris GP, Shavlik DJ, Mathew RO, Butler FM, Oh J, Sirirat R, Sveen LE, Fraser GE. Cause-specific and all-cause mortalities in vegetarian compared to non-vegetarian participants from the Adventist Health Study-2 cohort. Am J Clin Nutr 2024:S0002-9165(24)00652-X. [PMID: 39098708 DOI: 10.1016/j.ajcnut.2024.07.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 05/15/2024] [Accepted: 07/30/2024] [Indexed: 08/06/2024] Open
Abstract
BACKGROUND There have been mixed results reported internationally when associating vegetarian dietary patterns with all-cause and cause-specific mortalities. OBJECTIVE To extend our previous results by evaluating, with a larger number of deaths (N=12515), cause-specific mortalities comparing different vegetarian types to non-vegetarians. METHODS This prospective study used data from the Adventist Health Study-2 cohort. Mortality was ascertained between study baseline, 2002-2007 and follow-up through 2015. Dietary data were collected at baseline using a validated quantitative food frequency questionnaire and then categorized into five dietary patterns: non-vegetarian, semi-vegetarian, pesco-vegetarian, lacto-ovo-vegetarian, and vegan. Main outcomes and measures include all-cause and cause-specific mortalities using Cox proportional hazards regression models and competing risk methods. RESULTS The analytic sample included 88400 participants who provided 971424 person-years of follow-up. We report results as estimated at ages 65 and 85 years due to age-dependence of many hazard ratios (HR's). Compared to non-vegetarians, vegetarians had lower risks of mortality (HR's and 95% confidence interval - 95% CI at age 65; followed by same at age 85 years in parentheses), overall (0.89[0.83,0.95];0.98[0.91,1.04]), from renal failure (0.52[0.38,0.70]; 0.65[0.55,0.76]), infectious disease (0.57[0.40,0.82];0.90[0.70,1.17]), diabetes (0.51[0.33,0.78]; 0.69[0.53,0.88]), select cardiac (0.75[0.65,0.87]; 0.89[0.83,0.95]), and ischemic heart disease causes (0.730.59,0.90]; 0.84[0.75,0.94]). Vegans, lacto-ovo-vegetarians and pesco-vegetarians were also observed to have lower risks of total mortality and several similar cause-specific mortalities. However, higher cause-specified neurological mortalities were observed among older vegetarians (estimated at age 85 years), specifically stroke (HR=1.17[1.02,1.33]), dementia (HR=1.13[1.00,1.27]), and Parkinson's Disease (HR=1.37[0.98,1.91]). Results in Black subjects for vegetarian/nonvegetarian comparisons largely followed the same trends, but HR's were less precise due to smaller numbers. CONCLUSIONS Vegetarian diets are associated with lower risk for all-cause and many cause-specific mortalities, especially among males and in younger subjects. However, higher risks were observed among older vegetarians for stroke and dementia. These results need further support and investigation.
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Affiliation(s)
- Grace P Abris
- Adventist Health Study, Research Affairs, Loma Linda University, Loma Linda, CA, 92350, USA; Center for Nutrition, Healthy Lifestyles and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA, 92350, USA
| | - David J Shavlik
- School of Public Health, Loma Linda University, Loma Linda, CA, 92350, USA
| | - Roy O Mathew
- Division of Nephrology, Department of Medicine, Loma Linda VA Healthcare System, Loma Linda, CA, 92357, USA; Division of Nephrology, Department of Medicine, Loma Linda University School of Medicine & Loma Linda University Health, Loma Linda, CA, 92357, USA
| | - Fayth M Butler
- Adventist Health Study, Research Affairs, Loma Linda University, Loma Linda, CA, 92350, USA; Center for Nutrition, Healthy Lifestyles and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA, 92350, USA; Division of Biochemistry, Department of Basic Sciences, School of Medicine, Loma Linda University, Loma Linda, CA, 92350, USA
| | - Jisoo Oh
- Center for Nutrition, Healthy Lifestyles and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA, 92350, USA; School of Public Health, Loma Linda University, Loma Linda, CA, 92350, USA
| | - Rawiwan Sirirat
- Adventist Health Study, Research Affairs, Loma Linda University, Loma Linda, CA, 92350, USA; Center for Nutrition, Healthy Lifestyles and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA, 92350, USA
| | - Lars E Sveen
- Adventist Health Study, Research Affairs, Loma Linda University, Loma Linda, CA, 92350, USA
| | - Gary E Fraser
- Adventist Health Study, Research Affairs, Loma Linda University, Loma Linda, CA, 92350, USA; Center for Nutrition, Healthy Lifestyles and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA, 92350, USA; Department of Medicine, School of Medicine, Loma Linda University, Loma Linda, CA, 92350, USA.
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Li T, Yan S, Sun D, Wu Y, Liang H, Zheng Q, Zhong P. The value of lipid accumulation products in predicting type 2 diabetes mellitus: a cross-sectional study on elderlies over 65 in Shanghai. J Diabetes Metab Disord 2024; 23:1223-1231. [PMID: 38932880 PMCID: PMC11196563 DOI: 10.1007/s40200-024-01414-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 02/26/2024] [Indexed: 06/28/2024]
Abstract
Purpose As lifestyle changes, there is an increasing number of type 2 diabetes mellitus (T2DM) patients in China. The present study aimed to investigate the predictive value of the lipid accumulation product (LAP) for T2DM in Chinese elderlies over 65 years. Methods The present cross-sectional study recruited 2,092 adults from communities of Pudong New Area of Shanghai. Questionnaires were filled and anthropometric and laboratory examinations were completed by all participants. The predictive value of different risk factors for T2DM was analyzed using the receiver operating characteristics curve (ROC). Results LAP was found to be closely related to T2DM (adjusted OR: 0.613, 95% CI: 0.581-0.645). Fasting plasma glucose (FPG), LAP, and urea nigrogen (UN) were associated with T2DM in females, whereas FPG, LAP, neck circumference (NC) were associated with T2DM in males. When the cut-off value was 33.8, LAP displayed the optimal predictive performance. A gender difference was observed with an LAP of 37.95 demonstrating the best predictive value in males (AUC = 0.604, 95% CI: 0.577-0.652) and 60.2 in females (AUC = 0.617, 95% CI: 0.574-0.660), respectively. Conclusion LAP is more significantly associated with the risk of T2DM in elderlies than FPG, UN or NC, and it serves as a strong predictor of T2DM. However, this is impacted by FPG and neck circumference to a certain extent. Future large-scale studies are needed to confirm its efficacy in predicting diabetes.
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Affiliation(s)
- Tuming Li
- Department of Neurology, Shidong Hospital, 999 Shiguang Road, Yangpu District, Shanghai, 200438 China
| | - Shuo Yan
- Shanghai Medical College of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Henan University of Traditional Chinese Medicine, Henan, China
| | - Dongmei Sun
- Community Health Service Center, Pudong New Area, Shanghai, China
| | - Ying Wu
- Department of Neurology, Shidong Hospital, 999 Shiguang Road, Yangpu District, Shanghai, 200438 China
| | - Huazheng Liang
- Clinical Research Center for Anesthesiology and Perioperative Medicine, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, China
- Monash Suzhou Research Institute, Suzhou Industrial Park, Suzhou, Jiangsu Province China
| | - Qinghu Zheng
- Community Health Service Center, Pudong New Area, Shanghai, China
| | - Ping Zhong
- Department of Neurology, Shidong Hospital, 999 Shiguang Road, Yangpu District, Shanghai, 200438 China
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3
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Okamura T, Tsukamoto K, Arai H, Fujioka Y, Ishigaki Y, Koba S, Ohmura H, Shoji T, Yokote K, Yoshida H, Yoshida M, Deguchi J, Dobashi K, Fujiyoshi A, Hamaguchi H, Hara M, Harada-Shiba M, Hirata T, Iida M, Ikeda Y, Ishibashi S, Kanda H, Kihara S, Kitagawa K, Kodama S, Koseki M, Maezawa Y, Masuda D, Miida T, Miyamoto Y, Nishimura R, Node K, Noguchi M, Ohishi M, Saito I, Sawada S, Sone H, Takemoto M, Wakatsuki A, Yanai H. Japan Atherosclerosis Society (JAS) Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2022. J Atheroscler Thromb 2024; 31:641-853. [PMID: 38123343 DOI: 10.5551/jat.gl2022] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Affiliation(s)
- Tomonori Okamura
- Preventive Medicine and Public Health, Keio University School of Medicine
| | | | | | - Yoshio Fujioka
- Faculty of Nutrition, Division of Clinical Nutrition, Kobe Gakuin University
| | - Yasushi Ishigaki
- Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine, Iwate Medical University
| | - Shinji Koba
- Division of Cardiology, Department of Medicine, Showa University School of Medicine
| | - Hirotoshi Ohmura
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine
| | - Tetsuo Shoji
- Department of Vascular Medicine, Osaka Metropolitan University Graduate school of Medicine
| | - Koutaro Yokote
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine
| | - Hiroshi Yoshida
- Department of Laboratory Medicine, The Jikei University Kashiwa Hospital
| | | | - Juno Deguchi
- Department of Vascular Surgery, Saitama Medical Center, Saitama Medical University
| | - Kazushige Dobashi
- Department of Pediatrics, School of Medicine, University of Yamanashi
| | | | | | - Masumi Hara
- Department of Internal Medicine, Mizonokuchi Hospital, Teikyo University School of Medicine
| | - Mariko Harada-Shiba
- Cardiovascular Center, Osaka Medical and Pharmaceutical University
- Department of Molecular Pathogenesis, National Cerebral and Cardiovascular Center Research Institute
| | - Takumi Hirata
- Institute for Clinical and Translational Science, Nara Medical University
| | - Mami Iida
- Department of Internal Medicine and Cardiology, Gifu Prefectural General Medical Center
| | - Yoshiyuki Ikeda
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Shun Ishibashi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Jichi Medical University, School of Medicine
- Current affiliation: Ishibashi Diabetes and Endocrine Clinic
| | - Hideyuki Kanda
- Department of Public Health, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University
| | - Shinji Kihara
- Medical Laboratory Science and Technology, Division of Health Sciences, Osaka University graduate School of medicine
| | - Kazuo Kitagawa
- Department of Neurology, Tokyo Women's Medical University Hospital
| | - Satoru Kodama
- Department of Prevention of Noncommunicable Diseases and Promotion of Health Checkup, Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine
| | - Masahiro Koseki
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine
| | - Yoshiro Maezawa
- Department of Endocrinology, Hematology and Gerontology, Chiba University Graduate School of Medicine
| | - Daisaku Masuda
- Department of Cardiology, Center for Innovative Medicine and Therapeutics, Dementia Care Center, Doctor's Support Center, Health Care Center, Rinku General Medical Center
| | - Takashi Miida
- Department of Clinical Laboratory Medicine, Juntendo University Graduate School of Medicine
| | | | - Rimei Nishimura
- Department of Diabetes, Metabolism and Endocrinology, The Jikei University School of Medicine
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
| | - Midori Noguchi
- Division of Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University
| | - Mitsuru Ohishi
- Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University
| | - Isao Saito
- Department of Public Health and Epidemiology, Faculty of Medicine, Oita University
| | - Shojiro Sawada
- Division of Metabolism and Diabetes, Faculty of Medicine, Tohoku Medical and Pharmaceutical University
| | - Hirohito Sone
- Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine
| | - Minoru Takemoto
- Department of Diabetes, Metabolism and Endocrinology, International University of Health and Welfare
| | | | - Hidekatsu Yanai
- Department of Diabetes, Endocrinology and Metabolism, National Center for Global Health and Medicine Kohnodai Hospital
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Fujiyoshi A, Kohsaka S, Hata J, Hara M, Kai H, Masuda D, Miyamatsu N, Nishio Y, Ogura M, Sata M, Sekiguchi K, Takeya Y, Tamura K, Wakatsuki A, Yoshida H, Fujioka Y, Fukazawa R, Hamada O, Higashiyama A, Kabayama M, Kanaoka K, Kawaguchi K, Kosaka S, Kunimura A, Miyazaki A, Nii M, Sawano M, Terauchi M, Yagi S, Akasaka T, Minamino T, Miura K, Node K. JCS 2023 Guideline on the Primary Prevention of Coronary Artery Disease. Circ J 2024; 88:763-842. [PMID: 38479862 DOI: 10.1253/circj.cj-23-0285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Affiliation(s)
| | - Shun Kohsaka
- Department of Cardiology, Keio University School of Medicine
| | - Jun Hata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University
| | - Mitsuhiko Hara
- Department of Health and Nutrition, Wayo Women's University
| | - Hisashi Kai
- Department of Cardiology, Kurume Univeristy Medical Center
| | | | - Naomi Miyamatsu
- Department of Clinical Nursing, Shiga University of Medical Science
| | - Yoshihiko Nishio
- Department of Diabetes and Endocrine Medicine, Kagoshima University Graduate School of Medical and Dental Sciences
| | - Masatsune Ogura
- Department of General Medical Science, Chiba University School of Medicine
- Department of Metabolism and Endocrinology, Eastern Chiba Medical Center
| | - Masataka Sata
- Department of Cardiovascular Medicine, Tokushima University Graduate School of Biomedical Sciences
| | | | - Yasushi Takeya
- Division of Helath Science, Osaka University Gradiate School of Medicine
| | - Kouichi Tamura
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine
| | | | - Hiroshi Yoshida
- Department of Laboratory Medicine, The Jikei University Kashiwa Hospital
| | - Yoshio Fujioka
- Division of Clinical Nutrition, Faculty of Nutrition, Kobe Gakuin University
| | | | - Osamu Hamada
- Department of General Internal Medicine, Takatsuki General Hospital
| | | | - Mai Kabayama
- Division of Health Sciences, Osaka University Graduate School of Medicine
| | - Koshiro Kanaoka
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center
| | - Kenjiro Kawaguchi
- Division of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University
| | | | | | | | - Masaki Nii
- Department of Cardiology, Shizuoka Children's Hospital
| | - Mitsuaki Sawano
- Department of Cardiology, Keio University School of Medicine
- Yale New Haven Hospital Center for Outcomes Research and Evaluation
| | | | - Shusuke Yagi
- Department of Cardiovascular Medicine, Tokushima University Hospital
| | - Takashi Akasaka
- Department of Cardiovascular Medicine, Nishinomiya Watanabe Cardiovascular Cerebral Center
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Meidicine
| | - Katsuyuki Miura
- Department of Preventive Medicine, NCD Epidemiology Research Center, Shiga University of Medical Science
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
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5
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Wen J, Satyanarayanan SK, Li A, Yan L, Zhao Z, Yuan Q, Su KP, Su H. Unraveling the impact of Omega-3 polyunsaturated fatty acids on blood-brain barrier (BBB) integrity and glymphatic function. Brain Behav Immun 2024; 115:335-355. [PMID: 37914102 DOI: 10.1016/j.bbi.2023.10.018] [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: 08/01/2023] [Revised: 10/05/2023] [Accepted: 10/22/2023] [Indexed: 11/03/2023] Open
Abstract
Alzheimer's disease (AD) and other forms of dementia represent major public health challenges but effective therapeutic options are limited. Pathological brain aging is associated with microvascular changes and impaired clearance systems. The application of omega-3 polyunsaturated fatty acids (n-3 or omega-3 PUFAs) is one of the most promising nutritional interventions in neurodegenerative disorders from epidemiological data, clinical and pre-clinical studies. As essential components of neuronal membranes, n-3 PUFAs have shown neuroprotection and anti-inflammatory effects, as well as modulatory effects through microvascular pathophysiology, amyloid-beta (Aβ) clearance and glymphatic pathways. This review meticulously explores these underlying mechanisms that contribute to the beneficial effects of n-3 PUFAs against AD and dementia, synthesizing evidence from both animal and interventional studies.
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Affiliation(s)
- Jing Wen
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau
| | - Senthil Kumaran Satyanarayanan
- Centre for Regenerative Medicine and Health, Hong Kong Institute of Science & Innovation, Chinese Academy of Sciences, Hong Kong Science Park, Hong Kong
| | - Ang Li
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau
| | - Lingli Yan
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau
| | - Ziai Zhao
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau
| | - Qiuju Yuan
- Centre for Regenerative Medicine and Health, Hong Kong Institute of Science & Innovation, Chinese Academy of Sciences, Hong Kong Science Park, Hong Kong
| | - Kuan-Pin Su
- An-Nan Hospital, China Medical University, Tainan, Taiwan; Department of Psychiatry, China Medical University Hospital, Taichung, Taiwan; Mind-Body Interface Research Center (MBI-Lab), China Medical University Hospital, Taichung, Taiwan.
| | - Huanxing Su
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau.
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6
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O’Keefe JH, Tintle NL, Harris WS, O’Keefe EL, Sala-Vila A, Attia J, Garg GM, Hure A, Bork CS, Schmidt EB, Venø SK, Chien KL, Chen YY(A, Egert S, Feldreich TR, Ärnlöv J, Lind L, Forouhi NG, Geleijnse JM, Pertiwi K, Imamura F, de Mello Laaksonen V, Uusitupa WM, Tuomilehto J, Laakso M, Lankinen MA, Laurin D, Carmichael PH, Lindsay J, Leander K, Laguzzi F, Swenson BR, Longstreth WT, Manson JE, Mora S, Cook NR, Marklund M, van Lent DM, Murphy R, Gudnason V, Ninomiya T, Hirakawa Y, Qian F, Sun Q, Hu F, Ardisson Korat AV, Risérus U, Lázaro I, Samieri C, Le Goff M, Helmer C, Steur M, Voortman T, Ikram MK, Tanaka T, Das JK, Ferrucci L, Bandinelli S, Tsai M, Guan W, Garg P, Verschuren WMM, Boer JMA, Biokstra A, Virtanen J, Wagner M, Westra J, Albuisson L, Yamagishi K, Siscovick DS, Lemaitre RN, Mozaffarian D. Omega-3 Blood Levels and Stroke Risk: A Pooled and Harmonized Analysis of 183 291 Participants From 29 Prospective Studies. Stroke 2024; 55:50-58. [PMID: 38134264 PMCID: PMC10840378 DOI: 10.1161/strokeaha.123.044281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/30/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND The effect of marine omega-3 PUFAs on risk of stroke remains unclear. METHODS We investigated the associations between circulating and tissue omega-3 PUFA levels and incident stroke (total, ischemic, and hemorrhagic) in 29 international prospective cohorts. Each site conducted a de novo individual-level analysis using a prespecified analytical protocol with defined exposures, covariates, analytical methods, and outcomes; the harmonized data from the studies were then centrally pooled. Multivariable-adjusted HRs and 95% CIs across omega-3 PUFA quintiles were computed for each stroke outcome. RESULTS Among 183 291 study participants, there were 10 561 total strokes, 8220 ischemic strokes, and 1142 hemorrhagic strokes recorded over a median of 14.3 years follow-up. For eicosapentaenoic acid, comparing quintile 5 (Q5, highest) with quintile 1 (Q1, lowest), total stroke incidence was 17% lower (HR, 0.83 [CI, 0.76-0.91]; P<0.0001), and ischemic stroke was 18% lower (HR, 0.82 [CI, 0.74-0.91]; P<0.0001). For docosahexaenoic acid, comparing Q5 with Q1, there was a 12% lower incidence of total stroke (HR, 0.88 [CI, 0.81-0.96]; P=0.0001) and a 14% lower incidence of ischemic stroke (HR, 0.86 [CI, 0.78-0.95]; P=0.0001). Neither eicosapentaenoic acid nor docosahexaenoic acid was associated with a risk for hemorrhagic stroke. These associations were not modified by either baseline history of AF or prevalent CVD. CONCLUSIONS Higher omega-3 PUFA levels are associated with lower risks of total and ischemic stroke but have no association with hemorrhagic stroke.
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Affiliation(s)
- James H O’Keefe
- Saint Luke’s Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, MO
| | | | - William S Harris
- Fatty Acid Research Institute, Sioux Falls, SD
- University of South Dakota, Sioux Falls, SD
| | - Evan L O’Keefe
- Saint Luke’s Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, MO
| | - Aleix Sala-Vila
- Fatty Acid Research Institute, Sioux Falls, SD
- Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - John Attia
- The University of Newcastle, School of Biomedical Sciences and Pharmacy, Callaghan, Australia
| | - G Manohar Garg
- The University of Newcastle, School of Biomedical Sciences and Pharmacy, Callaghan, Australia
| | - Alexis Hure
- The University of Newcastle, School of Biomedical Sciences and Pharmacy, Callaghan, Australia
| | | | - Erik Berg Schmidt
- Aalborg University Hospital, Department of Clinical Medicine, Aalborg, Denmark
| | - Stine Krogh Venø
- Aalborg University Hospital, Department of Clinical Biochemistry, Aalborg, Denmark
| | - Kuo-Liong Chien
- National Taiwan University, Institute of Epidemiology and Preventive Medicine, Taipei Taiwan
| | - Yun-Yu (Amelia) Chen
- Taichung Veterans General Hospital, Department of Medical Research, Taichung, Taiwan
| | - Sarah Egert
- University of Bonn, Institute of Nutrition and Food Sciences and Nutritional Physiology, Bonn, Germany
| | | | - Johan Ärnlöv
- Karolinska Institutet, Division of Family Medicine and Primary Care, Department of Neurobiology Care Sciences & Society, Solna, Sweden
| | - Lars Lind
- Uppsala University, Department of Medical Sciences Cardiovascular Epidemiology, Uppsala, Sweden
| | - Nita G Forouhi
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Johanna M Geleijnse
- Wageningen University & Research, Division of Human Nutrition and Health, Wageningen, Netherlands
| | - Kamalita Pertiwi
- Wageningen University & Research, Division of Human Nutrition and Health, Wageningen, Netherlands
| | - Fumiaki Imamura
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Vanessa de Mello Laaksonen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - W Matti Uusitupa
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Jaakko Tuomilehto
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Markku Laakso
- University of Eastern Finland, School of Medicine, Department of Internal Medicine, Kuopio, Finland
| | - Maria Anneli Lankinen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Danielle Laurin
- CHU de Québec-Université Laval and VITAM Research Centers, Centre d’Excellence sur le Vieillissement de Québec, Québec, Canada
| | - Pierre-Hugues Carmichael
- CHU de Québec-Université Laval and VITAM Research Centers, Centre d’Excellence sur le Vieillissement de Québec, Québec, Canada
| | - Joan Lindsay
- University of Ottawa, School of Epidemiology and Public Health, Ottawa, Canada
| | - Karin Leander
- Karolinska Institutet, Institute of Environmental Medicine, Unit of Cardiovascular and Nutritional Epidemiology, Stockholm, Sweden
| | - Federica Laguzzi
- Karolinska Institutet, Institute of Environmental Medicine, Unit of Cardiovascular and Nutritional Epidemiology, Stockholm, Sweden
| | - Brenton R Swenson
- University of Washington, Cardiovascular Health Research Unit, Seattle, WA
| | - William T Longstreth
- University of Washington, Departments of Neurology and Epidemiology, Seattle, WA
| | - JoAnn E Manson
- Harvard Medical School, Department of Medicine, Brigham & Women’s Hospital, Boston, MA
| | - Samia Mora
- Harvard Medical School, Department of Medicine, Brigham & Women’s Hospital, Boston, MA
| | - Nancy R Cook
- Harvard Medical School, Department of Medicine, Brigham & Women’s Hospital, Boston, MA
| | - Matti Marklund
- The George Institute for Global Health, University of New South Wales, Newtown, NSW Australia; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland: and Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Debora Melo van Lent
- University of Texas, Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, San Antonio, TX
| | - Rachel Murphy
- University of British Columbia, Cancer Control Research, British Columbia Cancer, School of Population and Public Health, Vancouver, Canada
| | | | - Toshihara Ninomiya
- Kyushu University, Department of Epidemiology and Public Health and Center for Cohort Studies, Fukouka, Japan
| | - Yoichiro Hirakawa
- Kyushu University, Department of Epidemiology and Public Health and Center for Cohort Studies, Fukouka, Japan
| | - Frank Qian
- Harvard Medical School, T.H. Chan School of Public Health and Beth Deaconess Medical Center, Boston, MA
| | - Qi Sun
- Harvard Medical School, T.H. Chan School of Public Health and Channing Division of Network Medicine Brigham and Women’s Hospital, Boston, MA
| | - Frank Hu
- Harvard Medical School, T.H. Chan School of Public Health and Channing Division of Network Medicine Brigham and Women’s Hospital, Boston, MA
| | | | - Ulf Risérus
- Uppsala University, Department of Public Health and Caring Sciences Clinical Nutrition and Metabolism Unit, Uppsala, Sweden
| | - Iolanda Lázaro
- Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Cecilia Samieri
- University of Bordeaux, Bordeaux Population Health Research Centre, Bordeaux, France
| | - Mélanie Le Goff
- University of Bordeaux, Bordeaux Population Health Research Centre, Bordeaux, France
| | - Catherine Helmer
- University of Bordeaux, Bordeaux Population Health Research Centre, Bordeaux, France
| | - Marinka Steur
- University Medical Center Rotterdam, Department of Epidemiology, Rotterdam, The Netherlands
| | - Trudy Voortman
- University Medical Center Rotterdam, Department of Epidemiology, Rotterdam, The Netherlands
| | - M Kamran Ikram
- University Medical Center Rotterdam, Department of Epidemiology, Rotterdam, The Netherlands
| | - Toshiko Tanaka
- National Institute of Health, National Institute on Aging, Longitudinal Studies Section, Baltimore, MD
| | | | - Luigi Ferrucci
- National Institute of Health, National Institute on Aging, Longitudinal Studies Section, Baltimore, MD
| | | | - Michael Tsai
- University of Minnesota, Department of Laboratory Medicine and Pathology, Minneapolis, MN
| | - Weihua Guan
- University of Minnesota, Division of Biostatistics, Minneapolis, MN
| | - Parveen Garg
- University of Southern California, Department of Medicine, Cardiology, Los Angeles, CA
| | - WM Monique Verschuren
- National Institute for Public Health and the Environment Bilthoven, The Netherlands, Julius Center for Health Sciences and Primary Care and Centre for Nutrition, Prevention and Health Services, Utrecht, The Netherlands
| | - Jolanda MA Boer
- National Institute for Public Health and the Environment Bilthoven, The Netherlands
| | - Anneke Biokstra
- National Institute for Public Health and the Environment Bilthoven, The Netherlands
| | - Jyrki Virtanen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Michael Wagner
- University Hospital, Depts of Neurodegenerative Diseases and Geriatric Psychiatry and German Center for Neurodegenerative Diseases, Bonn, Germany
| | | | | | - Kazumasa Yamagishi
- University of Tsukubu, Department of Public Health Medicine, Tsukuba, Japan
| | - David S Siscovick
- New York Academy of Medicine, Department of Epidemiology, New York, New York
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7
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Relationships between growth-related traits with carcass and meat quality traits in Spanish Assaf suckling lambs. Livest Sci 2023. [DOI: 10.1016/j.livsci.2023.105173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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8
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Reprint of: Dietary fat and fatty foods in the prevention of non-communicable diseases: A review of the evidence. Trends Food Sci Technol 2022. [DOI: 10.1016/j.tifs.2022.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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9
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Dietary fat and fatty foods in the prevention of non-communicable diseases: A review of the evidence. Trends Food Sci Technol 2022. [DOI: 10.1016/j.tifs.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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10
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Cupino A, Fraser G, Knutsen S, Knutsen R, Heskey C, Sabaté J, Shavlik D. Are total omega-3 and omega-6 polyunsaturated fatty acids predictors of fatal stroke in the Adventist Health Study 2 prospective cohort? PLoS One 2022; 17:e0274109. [PMID: 36084005 PMCID: PMC9462555 DOI: 10.1371/journal.pone.0274109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 08/22/2022] [Indexed: 11/27/2022] Open
Abstract
Introduction The effects of omega-3 (n-3) and omega-6 (n-6) polyunsaturated fatty acids (PUFA) on cerebrovascular disease remain unsettled. However, most studies have focused on marine sourced n-3 PUFA rather than total n-3 PUFA, of which the majority in the American diet is plant derived. This study therefore intended to investigate these effects in a cohort for which the vegetarian diet was more prevalent than the general public. Methods Cox proportional hazards with fatal stroke as the outcome was performed on the approximately 96,000 subject Adventist Health Study 2 prospective cohort. Stratification by race and sex was performed on models with a priori covariables, comparing 90th to 10th percentile daily intakes of energy-adjusted total n-3 PUFA, total n-6 PUFA, and the n-6 / n-3 PUFA ratio as variables of interest. Results For the main analytical group (78,335 subjects), the hazard ratio (95% confidence interval) for total n-3 PUFA was 0.65 (0.51–0.83), and for total n-6 PUFA was 1.37 (1.02–1.82), while adjusting for both fatty acids in the model. The n-6 / n-3 PUFA ratio was harmful with a HR of 1.40 (1.16–1.69), whereas the inclusion of total n-3 PUFA slightly attenuated the HR to 1.33(1.02–1.74). Effects were similar for the non-black sex-combined and sex-specific analyses. Conclusion In most analytic groups, subjects with greater total n-3 PUFA intakes have lower risk of fatal stroke, and those with a higher n-6 / n-3 PUFA ratio had higher risk. However, the n-6 / n-3 PUFA ratio remains statistically significant even after adjusting for total n-3 PUFA or total n-6 PUFA, suggesting that the ratio is of epidemiologic interest for cerebrovascular disease research.
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Affiliation(s)
- Alan Cupino
- School of Public Health, Loma Linda University, Loma Linda, CA, United States of America
- * E-mail:
| | - Gary Fraser
- School of Public Health, Loma Linda University, Loma Linda, CA, United States of America
| | - Synnøve Knutsen
- School of Public Health, Loma Linda University, Loma Linda, CA, United States of America
| | - Raymond Knutsen
- School of Public Health, Loma Linda University, Loma Linda, CA, United States of America
| | - Celine Heskey
- School of Public Health, Loma Linda University, Loma Linda, CA, United States of America
| | - Joan Sabaté
- School of Public Health, Loma Linda University, Loma Linda, CA, United States of America
| | - David Shavlik
- School of Public Health, Loma Linda University, Loma Linda, CA, United States of America
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11
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Guo N, Zhu Y, Tian D, Zhao Y, Zhang C, Mu C, Han C, Zhu R, Liu X. Role of diet in stroke incidence: an umbrella review of meta-analyses of prospective observational studies. BMC Med 2022; 20:194. [PMID: 35606791 PMCID: PMC9128224 DOI: 10.1186/s12916-022-02381-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 04/22/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Stroke is one of the major challenges for the global healthcare system, which makes it necessary to explore the relationship between various modifiable factors and stroke risk. Recently, numerous meta-analyses of prospective observational studies have reported that dietary factors played a key role in the occurrence of stroke. However, the conclusions of previous studies have remained controversial and unclear. Accordingly, we conducted an umbrella review synthesizing and recalculating available evidence to assess the certainty of the associations between dietary factors and stroke. METHODS Relevant meta-analyses examining the associations between dietary factors and stroke were searched in PubMed and Embase databases up to September 1, 2021. For each eligible meta-analysis, two independent reviewers appraised the methodologic quality using the AMSTAR 2 criteria and estimated the summary effect size, 95% confidence intervals, 95% prediction intervals, heterogeneity between studies, and small-study effects. Moreover, we further assessed the associations between dietary factors and ischemic stroke as well as hemorrhagic stroke. Lastly, a set of pre-specified criteria was applied to qualitatively evaluate the epidemiological credibility of each dietary factor. RESULTS Overall, our umbrella review included 122 qualified meta-analyses for qualitative synthesis, involving 71 dietary factors related to food groups, foods, macronutrients, and micronutrients. Using the AMSTAR 2 criteria, 5 studies were assessed as high quality, 4 studies as moderate quality, and 113 studies as low or critically low quality. We identified 34 dietary factors associated with stroke occurrence, 25 dietary factors related to ischemic stroke, and 11 factors related to hemorrhagic stroke. Among them, high/moderate certainty epidemiological evidence demonstrated an inverse association between intake of fruits (RR: 0.90) and vegetables (RR: 0.92) and stroke incidence, but a detrimental association between red meat (RR: 1.12), especially processed red meat consumption (RR:1.17), and stroke incidence. Besides, the evidence of high/moderate certainty suggested that the intake of processed meat, fruits, coffee, tea, magnesium, and dietary fiber was associated with ischemic stroke risk, while consumption of tea, fruits, and vegetables was relevant to hemorrhagic stroke susceptibility. CONCLUSIONS Our study has reported that several dietary factors have a significant impact on stroke risk and offered a new insight into the relationship between dietary modification and stroke occurrence. Our results may provide an effective strategy for stroke prevention.
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Affiliation(s)
- Na Guo
- Department of Neurology, First Affiliated Hospital of China Medical University, No. 155 North Nanjing Street, Shenyang, 110001, Liaoning, China
| | - Ying Zhu
- Department of Neurology, First Affiliated Hospital of China Medical University, No. 155 North Nanjing Street, Shenyang, 110001, Liaoning, China
| | - Dandan Tian
- Department of Neurology, First Affiliated Hospital of China Medical University, No. 155 North Nanjing Street, Shenyang, 110001, Liaoning, China
| | - Yating Zhao
- Department of Neurology, First Affiliated Hospital of China Medical University, No. 155 North Nanjing Street, Shenyang, 110001, Liaoning, China
| | - Chenguang Zhang
- Department of Neurology, First Affiliated Hospital of China Medical University, No. 155 North Nanjing Street, Shenyang, 110001, Liaoning, China
| | - Changqing Mu
- Department of Neurology, First Affiliated Hospital of China Medical University, No. 155 North Nanjing Street, Shenyang, 110001, Liaoning, China
| | - Chen Han
- Department of Neurology, First Affiliated Hospital of China Medical University, No. 155 North Nanjing Street, Shenyang, 110001, Liaoning, China
| | - Ruixia Zhu
- Department of Neurology, First Affiliated Hospital of China Medical University, No. 155 North Nanjing Street, Shenyang, 110001, Liaoning, China
| | - Xu Liu
- Department of Neurology, First Affiliated Hospital of China Medical University, No. 155 North Nanjing Street, Shenyang, 110001, Liaoning, China.
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12
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Zhang Y, Guo H, Liang J, Xiao W, Li Y. Relationship Between Dietary Omega-3 and Omega-6 Polyunsaturated Fatty Acids Level and Sarcopenia. A Meta-Analysis of Observational Studies. Front Nutr 2022; 8:738083. [PMID: 35096921 PMCID: PMC8789889 DOI: 10.3389/fnut.2021.738083] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 12/08/2021] [Indexed: 12/25/2022] Open
Abstract
Objective: This study investigates the relationship between dietary omega-3 and omega-6 polyunsaturated fatty acids (PUFAs) levels and sarcopenia. Methods: A comprehensive literature search in the databases of PubMed, Web of Science, and Embase (up to July 2021) were conducted to identify the observational studies on the relationship between dietary omega-3 and omega-6 PUFAs level and sarcopenia. The pooled odds ratio (OR) of sarcopenia for the highest vs. lowest dietary omega-3 and omega-6 PUFAs level and the standard mean difference (SMD) of dietary omega-3 and omega-6 PUFAs levels for sarcopenia vs. control subjects were calculated. Results: A total of six studies were identified in this meta-analysis. The overall multi-variable adjusted OR showed that dietary omega-3 PUFAs level was inversely associated with sarcopenia (OR = 0.41, 95% CI: 0.26–0.65; P = 0.0001). Moreover, the overall combined SMD showed that the dietary omega-3 PUFAs level in sarcopenia was lower than that in control subjects (SMD = −0.19, 95% CI: −0.32 to −0.07; P = 0.002). With regard to dietary omega-6 PUFAs level, the overall multi-variable adjusted OR suggested no significant relationship between dietary omega-6 PUFAs level and sarcopenia (OR = 0.64, 95% CI: 0.33–1.24; P = 0.19). However, the overall combined SMD showed that the dietary omega-6 PUFAs level in sarcopenia was slightly lower than that in control subjects (SMD = −0.15, 95% CI: −0.27 to −0.02; P = 0.02). Conclusion: Our results suggested that the dietary omega-3 PUFAs level was inversely associated with sarcopenia. However, current evidence is still insufficient to demonstrate the definite relationship between dietary omega-6 PUFAs levels and sarcopenia. More well-designed prospective cohort studies with the dietary omega-3/omega-6 PUFAs ratio are still needed.
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Affiliation(s)
- Yi Zhang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Hongbin Guo
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Jieyu Liang
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Wenfeng Xiao
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Yusheng Li
- Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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13
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Schwingshackl L, Zähringer J, Beyerbach J, Werner SS, Heseker H, Koletzko B, Meerpohl JJ. Total Dietary Fat Intake, Fat Quality, and Health Outcomes: A Scoping Review of Systematic Reviews of Prospective Studies. ANNALS OF NUTRITION AND METABOLISM 2021; 77:4-15. [PMID: 33789278 DOI: 10.1159/000515058] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 02/03/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION We conducted a scoping review of systematic reviews (SRs) on dietary fat intake and health outcomes in human adults within the context of a position paper by the "International Union of Nutritional Sciences Task force on Dietary Fat Quality" tasked to summarize the available evidence and provide dietary recommendations. METHODS We systematically searched several databases for relevant SRs of randomized controlled trials (RCTs) and/or prospective cohort studies published between 2015 and 2019 assessing the association between dietary fat and health outcomes. RESULTS Fifty-nine SRs were included. The findings from SRs of prospective cohort studies, which frequently compare the highest versus lowest intake categories, found mainly no association of total fat, monounsaturated fatty acid (MUFA), polyunsaturated fatty acid (PUFA), and saturated fatty acid (SFA) with risk of chronic diseases. SRs of RCTs applying substitution analyses indicate that SFA replacement with PUFA and/or MUFA improves blood lipids and glycemic control, with the effect of PUFA being more pronounced. A higher intake of total trans-fatty acid (TFA), but not ruminant TFA, was probably associated with an increased risk of mortality and cardiovascular disease based on existing SRs. CONCLUSION Overall, the available published evidence deems it reasonable to recommend replacement of SFA with MUFA and PUFA and avoidance of consumption of industrial TFA.
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Affiliation(s)
- Lukas Schwingshackl
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jasmin Zähringer
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Jessica Beyerbach
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sarah S Werner
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Helmut Heseker
- Department of Sports and Health, Paderborn University, Paderborn, Germany
| | - Berthold Koletzko
- Division of Metabolic and Nutritional Medicine, Department Paediatrics, Dr. von Hauner Children's Hospital, University of Munich Medical Center, LMU - Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Joerg J Meerpohl
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Cochrane Germany, Cochrane Germany Foundation, Freiburg, Germany
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14
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Role of polyunsaturated fatty acids in ischemic stroke - A perspective of specialized pro-resolving mediators. Clin Nutr 2021; 40:2974-2987. [PMID: 33509668 DOI: 10.1016/j.clnu.2020.12.037] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 12/14/2020] [Accepted: 12/26/2020] [Indexed: 12/17/2022]
Abstract
Polyunsaturated fatty acids (PUFAs) have been proposed as beneficial for cardiovascular health. However, results from both epidemiological studies and clinical trials have been inconsistent, whereas most of the animal studies showed promising benefits of PUFAs in the prevention and treatment of ischemic stroke. In recent years, it has become clear that PUFAs are metabolized into various types of bioactive derivatives, including the specialized pro-resolving mediators (SPMs). SPMs exert multiple biofunctions, such as to limit excessive inflammatory responses, regulate lipid metabolism and immune cell functions, decrease production of pro-inflammatory factors, increase anti-inflammatory mediators, as well as to promote tissue repair and homeostasis. Inflammation has been recognised as a key contributor to the pathophysiology of acute ischemic stroke. Owing to their potent pro-resolving actions, SPMs are potential for development of novel anti-stroke therapy. In this review, we will summarize current knowledge of epidemiological studies, basic research and clinical trials concerning PUFAs in stroke prevention and treatment, with special attention to SPMs as the unsung heroes behind PUFAs.
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15
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Yamagishi SI, Matsui T. Effects of Dietary Intake and Supplementation of Fatty Acids on Cardiometabolic Disorders in Humans: a Lesson from a Large Number of Meta-Analyses. LETT DRUG DES DISCOV 2019. [DOI: 10.2174/1570180816666181107113148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Dietary fatty acids have exerted numerous pathophysiological effects in humans. Indeed,
monounsaturated fatty acids and ω-3 polyunsaturated fatty acids are generally thought to have favorable
cardiometabolic actions via their anti-inflammatory and anti-thrombotic properties, while saturated
fatty acids and trans fatty acids are supposed to contribute to the development and progression
of atherosclerotic cardiovascular diseases by inducing dyslipidemia and obesity. However, there is
much controversy about the effects of dietary intake and supplementation of fatty acids on cardiometabolic
disorders. Therefore, in the present study, we limited the scope of this review to metaanalyses
(1) of observational studies of dietary intake of fatty acids and (2) of interventional trials
with fatty acid supplements to scrutinize the role of fatty acids in various cardiometabolic disorders.
We discuss here the clinical effects of fatty acids from dietary intake or supplements on incidence of
diabetes, metabolic syndrome, obesity and body weight, cardiovascular diseases and total mortality,
and also review the association of fatty acid biomarkers with these cardiometabolic disorders.
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Affiliation(s)
- Sho-ichi Yamagishi
- Department of Pathophysiology and Therapeutics of Diabetic Vascular Complications, Kurume University School of Medicine, Kurume, Japan
| | - Takanori Matsui
- Department of Pathophysiology and Therapeutics of Diabetic Vascular Complications, Kurume University School of Medicine, Kurume, Japan
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16
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Abstract
AbstractFindings from observational studies on the associations between vitamin E intake and stroke risk remain controversial, and the dose–response relationship between vitamin E intake and risk of stroke remains to be determined. We conducted a meta-analysis of prospective studies aiming to clarify the relationships between vitamin E intake and risk of stroke. Relevant studies were identified by searching online databases through to June 2018. We computed summary relative risks (RR) with corresponding 95 % CI. Among 3156 articles retrieved from online databases and relevant bibliographies, nine studies involving 3284 events and 220 371 participants were included in the final analyses. High dietary vitamin E intake was inversely associated with the risk of overall stroke (RR=0·83, 95 % CI 0·73, 0·94), and with the risk of stroke for individuals who were followed-up for <10 (RR=0·84, 95 % CI 0·72, 0·91). There was a non-linear association between dietary vitamin E intake and stroke risk (P=0·0249). Omission of any single study did not alter the summary result. In conclusion, this meta-analysis suggests that there is a significant inverse relationship between dietary vitamin E intake and stroke risk. This meta-analysis provides evidence that a higher dietary vitamin E intake is associated with a lower stroke risk.
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17
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The Role of n-3 Long Chain Polyunsaturated Fatty Acids in Cardiovascular Disease Prevention, and Interactions with Statins. Nutrients 2018; 10:nu10060775. [PMID: 29914111 PMCID: PMC6024670 DOI: 10.3390/nu10060775] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 06/09/2018] [Accepted: 06/13/2018] [Indexed: 01/08/2023] Open
Abstract
Decreases in global cardiovascular disease (CVD) mortality and morbidity in recent decades can be partly attributed to cholesterol reduction through statin use. n-3 long chain polyunsaturated fatty acids are recommended by some authorities for primary and secondary CVD prevention, and for triglyceride reduction. The residual risk of CVD that remains after statin therapy may potentially be reduced by n-3 long chain polyunsaturated fatty acids. However, the effects of concomitant use of statins and n-3 long chain polyunsaturated fatty acids are not well understood. Pleiotropic effects of statins and n-3 long chain polyunsaturated fatty acids overlap. For example, cytochrome P450 enzymes that metabolize statins may affect n-3 long chain polyunsaturated fatty acid metabolism and vice versa. Clinical and mechanistic study results show both synergistic and antagonistic effects of statins and n-3 long chain polyunsaturated fatty acids when used in combination.
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18
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de Rezende LFM, Rey-López JP, de Sá TH, Chartres N, Fabbri A, Powell L, Stamatakis E, Bero L. Reporting bias in the literature on the associations of health-related behaviors and statins with cardiovascular disease and all-cause mortality. PLoS Biol 2018; 16:e2005761. [PMID: 29912869 PMCID: PMC6023226 DOI: 10.1371/journal.pbio.2005761] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 06/28/2018] [Accepted: 06/07/2018] [Indexed: 12/16/2022] Open
Abstract
Reporting bias in the literature occurs when there is selective revealing or suppression of results, influenced by the direction of findings. We assessed the risk of reporting bias in the epidemiological literature on health-related behavior (tobacco, alcohol, diet, physical activity, and sedentary behavior) and cardiovascular disease mortality and all-cause mortality and provided a comparative assessment of reporting bias between health-related behavior and statin (in primary prevention) meta-analyses. We searched Medline, Embase, Cochrane Methodology Register Database, and Web of Science for systematic reviews synthesizing the associations of health-related behavior and statins with cardiovascular disease mortality and all-cause mortality published between 2010 and 2016. Risk of bias in systematic reviews was assessed using the ROBIS tool. Reporting bias in the literature was evaluated via small-study effect and excess significance tests. We included 49 systematic reviews in our study. The majority of these reviews exhibited a high overall risk of bias, with a higher extent in health-related behavior reviews, relative to statins. We reperformed 111 meta-analyses conducted across these reviews, of which 65% had statistically significant results (P < 0.05). Around 22% of health-related behavior meta-analyses showed small-study effect, as compared to none of statin meta-analyses. Physical activity and the smoking research areas had more than 40% of meta-analyses with small-study effect. We found evidence of excess significance in 26% of health-related behavior meta-analyses, as compared to none of statin meta-analyses. Half of the meta-analyses from physical activity, 26% from diet, 18% from sedentary behavior, 14% for smoking, and 12% from alcohol showed evidence of excess significance bias. These biases may be distorting the body of evidence available by providing inaccurate estimates of preventive effects on cardiovascular and all-cause mortality.
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Affiliation(s)
| | - Juan Pablo Rey-López
- Prevention Research Collaboration, School of Public Health, The University of Sydney, Sydney, Australia
| | - Thiago Hérick de Sá
- Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Universidade de São Paulo, São Paulo, São Paulo, Brasil
| | - Nicholas Chartres
- Charles Perkins Centre, Faculty of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia
| | - Alice Fabbri
- Charles Perkins Centre, Faculty of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia
| | - Lauren Powell
- Prevention Research Collaboration, School of Public Health, The University of Sydney, Sydney, Australia
| | - Emmanuel Stamatakis
- Prevention Research Collaboration, School of Public Health, The University of Sydney, Sydney, Australia
- Charles Perkins Centre, Epidemiology Unit, The University of Sydney, Sydney, Australia
| | - Lisa Bero
- Charles Perkins Centre, Faculty of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia
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19
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Cheng P, Pan J, Xia J, Huang W, Bai S, Zhu X, Shao W, Wang H, Xie P, Deng F. Dietary cholesterol intake and stroke risk: a meta-analysis. Oncotarget 2018; 9:25698-25707. [PMID: 29876017 PMCID: PMC5986647 DOI: 10.18632/oncotarget.23933] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Accepted: 11/03/2017] [Indexed: 01/11/2023] Open
Abstract
Background/Objectives The association between dietary cholesterol and stroke risk has remained controversial over the past two decades. The aim of this meta-analysis was to assess the relationship between dietary cholesterol and stroke risk. Results Seven prospective studies including 269,777 non-overlapping individuals (4,604 strokes) were included. The combined RR of stroke for higher cholesterol intake (> 300 mg/day) was 0.98 (95% CI, 0.90–1.07), and the combined RR of stroke for higher cholesterol intake (> 300 mg/day) in females (age of ≥ 60 years or body mass index of ≥ 24 kg/m2) was 1.18 (95% CI, 1.02–1.36). Materials and Methods The PubMed, Medline, Embase, Web of Knowledge, and Google Scholar databases were searched. Relevant studies were identified by searching these online databases through September 2017. The relative risk (RR) and 95% confidence interval (CI) were used to investigate the strength of the association. Conclusions Higher cholesterol intake has no association with the overall stroke risk. Age and body mass index affect the relationship between dietary cholesterol intake and stroke risk. However, the association between higher dietary cholesterol and stroke risk in males remains unclear.
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Affiliation(s)
- Pengfei Cheng
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.,Chongqing Key Laboratory of Neurobiology, Chongqing, 400016, China.,Institute of Neuroscience and The Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, 400016, China.,Department of Neurology, The First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang Province, 154002, China
| | - Junxi Pan
- Chongqing Key Laboratory of Neurobiology, Chongqing, 400016, China.,Institute of Neuroscience and The Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, 400016, China.,The M.O.E. Key Laboratory of Laboratory Medical Diagnostics, The College of Laboratory Medicine, Chongqing Medical University, Chongqing, 400016, China
| | - Jinjun Xia
- Chongqing Key Laboratory of Neurobiology, Chongqing, 400016, China.,Institute of Neuroscience and The Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, 400016, China.,The M.O.E. Key Laboratory of Laboratory Medical Diagnostics, The College of Laboratory Medicine, Chongqing Medical University, Chongqing, 400016, China
| | - Wen Huang
- Department of Neurology, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China
| | - Shunjie Bai
- Chongqing Key Laboratory of Neurobiology, Chongqing, 400016, China.,Institute of Neuroscience and The Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, 400016, China.,The M.O.E. Key Laboratory of Laboratory Medical Diagnostics, The College of Laboratory Medicine, Chongqing Medical University, Chongqing, 400016, China
| | - Xiaofeng Zhu
- Institute of Neuroscience, Jiamusi University, Jiamusi, Heilongjiang Province, 154002, China
| | - Weihua Shao
- Department of Respiratory Medicine, The First Affiliated Hospital, Chongqing Medical University, Chongqing, 400016, China
| | - Haiyang Wang
- Chongqing Key Laboratory of Neurobiology, Chongqing, 400016, China.,Institute of Neuroscience and The Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, 400016, China
| | - Peng Xie
- Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.,Chongqing Key Laboratory of Neurobiology, Chongqing, 400016, China.,Institute of Neuroscience and The Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, 400016, China
| | - Fengli Deng
- Chongqing Key Laboratory of Neurobiology, Chongqing, 400016, China.,Institute of Neuroscience and The Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, 400016, China
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Zhang XQ, Jin YM, Badgery WB, Tana. Diet selection and n-3 polyunsaturated fatty acid deposition in lambs as affected by restricted time at pasture. Sci Rep 2017; 7:15641. [PMID: 29142278 PMCID: PMC5688176 DOI: 10.1038/s41598-017-15875-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 11/01/2017] [Indexed: 02/05/2023] Open
Abstract
This study investigates the effects of restricted grazing time on forage selectivity and meat fatty acid deposition of lambs compared to a traditional grazing system. Results showed that the animals preferred to graze pasture species that were more palatable and lower in fibre, while demonstrating a partial preference for species with high protein levels. Leymus chinensis was more preferentially selected by lambs grazing pasture for shorter periods than longer periods. Lambs that grazed for 4 h per day had a high LNA (α-linolenic acid) intake. The accumulation of LNA and its elongation products in tissue was closely related to the LNA level in diet. Therefore, allowing lambs to graze for at least 4 h per day resulted in a meat fatty acid profile that is richer in health-promoting fatty acids. In particular, the highest DHA (docosahexaenoic acid) was observed in meat from lambs which grazed pasture for 4-h versus 8- and 12-h. It can be concluded that, in grassland systems, a healthier meat fatty acid profile for humans and the potential for better pasture management is achieved by limiting the grazing of lambs to 4 h per day rather than grazing over longer time periods.
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Affiliation(s)
- X Q Zhang
- Institute of Grassland Research, CAAS, Hohhot, 010010, China.
| | - Y M Jin
- Marine college, Shandong University at Weihai, Weihai, 264209, China
| | - W B Badgery
- New South Wales Department of Primary Industries, Orange Agricultural Institute, Orange, NSW 2800, Australia
| | - Tana
- Institute of Grassland Research, CAAS, Hohhot, 010010, China
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21
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Hu W, Chao Y, Geng X. Neuroprotective strategies for patients with acute myocardial infarction combined with hypoxic ischemic encephalopathy in the ICU. Hellenic J Cardiol 2017; 58:427-431. [DOI: 10.1016/j.hjc.2016.12.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Revised: 12/30/2016] [Accepted: 12/30/2016] [Indexed: 01/17/2023] Open
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22
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Hankey GJ. The Role of Nutrition in the Risk and Burden of Stroke. Stroke 2017; 48:3168-3174. [DOI: 10.1161/strokeaha.117.016993] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 08/17/2017] [Accepted: 08/23/2017] [Indexed: 12/27/2022]
Affiliation(s)
- Graeme J. Hankey
- From the Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, Perth; Sir Charles Gairdner Hospital, Perth, Australia; and Perron Institute for Neurological and Translational Science, Perth, Australia
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23
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Visceral adiposity index, lipid accumulation product and intracranial atherosclerotic stenosis in middle-aged and elderly Chinese. Sci Rep 2017; 7:7951. [PMID: 28801558 PMCID: PMC5554161 DOI: 10.1038/s41598-017-07811-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 06/30/2017] [Indexed: 01/25/2023] Open
Abstract
We investigated the association of the newly established lipid accumulation product (LAP) and visceral adiposity index (VAI) with intracranial atherosclerotic stenosis (ICAS) in middle-aged and elderly Chinese. From June 2012 to January 2013, consecutive patients ≥40 years of age who underwent cerebral vascular imaging for various medical reasons were enrolled in this study. Multivariate logistic regression models were used to evaluate the correlation of VAI and LAP with the risk of ICAS. In total, 845 patients were included in the study. The prevalence of ICAS gradually increased in females and in all patients with advancing tertiles of VAI or LAP. After adjusting for potential risks, both the VAI and LAP were related to ICAS in females [VAI: odds ratio (OR) = 3.25, 95% confidence interval (95%CI) = 1.17–9.03, P = 0.024; LAP: OR = 4.11, 95%CI = 1.39–12.12, P = 0.011; tertiles 3 vs. 1]. The sensitivity, specificity, and positive predictive value (PPV) were 74.7%, 45.5%, and 84.4% for VAI (cut-off: 1.71) and 79.3%, 40.5%, and 84.1% for LAP (cut-off: 23.99). The same relationships in males were not significant. Both VAI and LAP were closely associated with an increased risk of ICAS in middle-aged and elderly Chinese females.
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24
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Yang B, Ren XL, Huang H, Guo XJ, Ma AG, Li D. Circulating long-chain n-3 polyunsaturated fatty acid and incidence of stroke: a meta-analysis of prospective cohort studies. Oncotarget 2017; 8:83781-83791. [PMID: 29137382 PMCID: PMC5663554 DOI: 10.18632/oncotarget.19530] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 07/12/2017] [Indexed: 01/29/2023] Open
Abstract
Background Circulating long-chain (LC) n-3 polyunsaturated fatty acid (PUFA) can provide objective measures that reflect both dietary consumption and relevant biological processes. Nevertheless, prospective cohort studies on circulating LC n-3 PUFA in relation to incidence of stroke have yielded inconsistent results. We therefore conducted a meta-analysis to quantitatively evaluate the association. Results A total of 2,836 stroke events occurred among 20,460 individuals aged 35–79 yr from 10 prospective cohort studies. Circulating LC n-3 PUFA was significantly associated with reduced risk of stroke (RR: 0.86; 95% CI: 0.76, 0.98; I2 = 0.00%), especially 22:5n-3 (RR: 0.74; 95% CI: 0.60, 0.92) and 22:6n-3 (RR: 0.78; 95% CI: 0.65, 0.94). The associations were more pronounced with ischemic stroke (RR: 0.81; 95% CI: 0.68, 0.96), but not with hemorrhagic stroke (RR: 0.95; 95% CI: 0.60, 1.49). A 1% increment of 22:5n-3 and 22:6n-3 proportions in circulating blood was associated with 25% (RR: 0.75; 95% CI: 0.64, 0.87) and 11% (RR: 0.89; 95% CI: 0.83, 0.95) reduced risk of stroke, respectively. Materials and Methods Pertinent studies were identified from Cochrane Library, PubMed and EMBASE database through June 2017. Multivariate-adjusted risk ratios (RRs) with 95% confidence interval (CI) for incident stroke when comparing the top with the bottom tertiles of baseline LC n-3 PUFA proportions in blood were pooled using a random-effect model. Conclusions Circulating LC n-3 PUFAs were linearly associated with reduced risk of stroke, especially 22:5n-3 and 22:6n-3. Such findings highlight the importance of circulating LC n-3 PUFA in the development of ischemic stroke.
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Affiliation(s)
- Bo Yang
- School of Public Health, Qingdao University, Qingdao, China.,Key Laboratory of Watershed Science and Health of Zhejiang Province, School of Public Health, Wenzhou Medical University, Wenzhou, China
| | - Xiao-Li Ren
- The Laboratory of Animal Center, Wenzhou Medical University, Wenzhou, China
| | - Hong Huang
- Key Laboratory of Watershed Science and Health of Zhejiang Province, School of Public Health, Wenzhou Medical University, Wenzhou, China
| | - Xiao-Juan Guo
- Key Laboratory of Watershed Science and Health of Zhejiang Province, School of Public Health, Wenzhou Medical University, Wenzhou, China
| | - Ai-Guo Ma
- School of Public Health, Qingdao University, Qingdao, China
| | - Duo Li
- School of Public Health, Qingdao University, Qingdao, China
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25
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Dong MX, Hu QC, Shen P, Pan JX, Wei YD, Liu YY, Ren YF, Liang ZH, Wang HY, Zhao LB, Xie P. Recombinant Tissue Plasminogen Activator Induces Neurological Side Effects Independent on Thrombolysis in Mechanical Animal Models of Focal Cerebral Infarction: A Systematic Review and Meta-Analysis. PLoS One 2016; 11:e0158848. [PMID: 27387385 PMCID: PMC4936748 DOI: 10.1371/journal.pone.0158848] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Accepted: 06/22/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND AND PURPOSE Recombinant tissue plasminogen activator (rtPA) is the only effective drug approved by US FDA to treat ischemic stroke, and it contains pleiotropic effects besides thrombolysis. We performed a meta-analysis to clarify effect of tissue plasminogen activator (tPA) on cerebral infarction besides its thrombolysis property in mechanical animal stroke. METHODS Relevant studies were identified by two reviewers after searching online databases, including Pubmed, Embase, and ScienceDirect, from 1979 to 2016. We identified 6, 65, 17, 12, 16, 12 and 13 comparisons reporting effect of endogenous tPA on infarction volume and effects of rtPA on infarction volume, blood-brain barrier, brain edema, intracerebral hemorrhage, neurological function and mortality rate in all 47 included studies. Standardized mean differences for continuous measures and risk ratio for dichotomous measures were calculated to assess the effects of endogenous tPA and rtPA on cerebral infarction in animals. The quality of included studies was assessed using the Stroke Therapy Academic Industry Roundtable score. Subgroup analysis, meta-regression and sensitivity analysis were performed to explore sources of heterogeneity. Funnel plot, Trim and Fill method and Egger's test were obtained to detect publication bias. RESULTS We found that both endogenous tPA and rtPA had not enlarged infarction volume, or deteriorated neurological function. However, rtPA would disrupt blood-brain barrier, aggravate brain edema, induce intracerebral hemorrhage and increase mortality rate. CONCLUSIONS This meta-analysis reveals rtPA can lead to neurological side effects besides thrombolysis in mechanical animal stroke, which may account for clinical exacerbation for stroke patients that do not achieve vascular recanalization with rtPA.
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Affiliation(s)
- Mei-Xue Dong
- Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Neurobiology, Chongqing, China
| | - Qing-Chuan Hu
- Chongqing Key Laboratory of Neurobiology, Chongqing, China
| | - Peng Shen
- Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jun-Xi Pan
- Chongqing Key Laboratory of Neurobiology, Chongqing, China
| | - You-Dong Wei
- Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yi-Yun Liu
- Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yi-Fei Ren
- Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zi-Hong Liang
- Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hai-Yang Wang
- Chongqing Key Laboratory of Neurobiology, Chongqing, China
| | - Li-Bo Zhao
- Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Peng Xie
- Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Institute of Neuroscience and the Collaborative Innovation Center for Brain Science, Chongqing Medical University, Chongqing, China
- Chongqing Key Laboratory of Neurobiology, Chongqing, China
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Cheng P, Wang J, Shao W. Monounsaturated Fatty Acid Intake and Stroke Risk: A Meta-analysis of Prospective Cohort Studies. J Stroke Cerebrovasc Dis 2016; 25:1326-34. [DOI: 10.1016/j.jstrokecerebrovasdis.2016.02.017] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 01/25/2016] [Accepted: 02/11/2016] [Indexed: 11/28/2022] Open
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