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Baughman C, Gong Y, Wu Y, Hanlon E, Juraschek S. Nonpharmacologic Management of Hypertension in Older Adults. Clin Geriatr Med 2024; 40:615-628. [PMID: 39349035 PMCID: PMC11443068 DOI: 10.1016/j.cger.2024.04.013] [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] [Indexed: 10/02/2024]
Abstract
Hypertension is ubiquitous among older adults and leads to major adverse cardiovascular events. Nonpharmacologic lifestyle interventions represent important preventive and adjunct strategies in the treatment of hypertension and have benefits beyond cardiovascular disease in this population characterized by a high prevalence of frailty and comorbid conditions. In this review, the authors examine nonpharmacologic interventions with the strongest evidence to prevent cardiovascular disease with an emphasis on the older adults.
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Affiliation(s)
- Carter Baughman
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Deaconess Building, Suite 306, One Deaconess Road, Boston, MA 02215, USA
| | - Yusi Gong
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Deaconess Building, Suite 306, One Deaconess Road, Boston, MA 02215, USA
| | - Yingfei Wu
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Emma Hanlon
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Deaconess Building, Suite 306, One Deaconess Road, Boston, MA 02215, USA
| | - Stephen Juraschek
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Deaconess Building, Suite 306, One Deaconess Road, Boston, MA 02215, USA.
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2
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Lyas C. The Beneficial Effects of Fruits and Vegetables on Kidney Disease Progression and Cardiovascular Disease Risk. Am J Med 2024; 137:1025-1026. [PMID: 39098626 DOI: 10.1016/j.amjmed.2024.07.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Accepted: 07/31/2024] [Indexed: 08/06/2024]
Affiliation(s)
- Claretha Lyas
- The University of Alabama at Birmingham, Division of Nephrology.
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3
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Reynolds LM, Houston DK, Skiba MB, Whitsel EA, Stewart JD, Li Y, Zannas AS, Assimes TL, Horvath S, Bhatti P, Baccarelli AA, Tooze JA, Vitolins MZ. Diet Quality and Epigenetic Aging in the Women's Health Initiative. J Acad Nutr Diet 2024; 124:1419-1430.e3. [PMID: 38215906 PMCID: PMC11236955 DOI: 10.1016/j.jand.2024.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 12/05/2023] [Accepted: 01/08/2024] [Indexed: 01/14/2024]
Abstract
BACKGROUND Higher diet quality scores are associated with a lower risk for many chronic diseases and all-cause mortality; however, it is unclear if diet quality is associated with aging biology. OBJECTIVE This study aimed to examine the association between diet quality and a measure of biological aging known as epigenetic aging. DESIGN A cross-sectional data analysis was used to examine the association between three diet quality scores based on self-reported food frequency questionnaire data and five measures of epigenetic aging based on DNA methylation (DNAm) data from peripheral blood. PARTICIPANTS/SETTING This study included 4,500 postmenopausal women recruited from multiple sites across the United States (1993-98), aged 50 to 79 years, with food frequency questionnaire and DNAm data available from the Women's Health Initiative baseline visit. MAIN OUTCOME MEASURES Five established epigenetic aging measures were generated from HumanMethylation450 Beadchip DNAm data, including AgeAccelHannum, AgeAccelHorvath, AgeAccelPheno, AgeAccelGrim, and DunedinPACE. STATISTICAL ANALYSES PERFORMED Linear mixed models were used to test for associations between three diet quality scores (Healthy Eating Index, Dietary Approaches to Stop Hypertension, and alternate Mediterranean diet scores) and epigenetic aging measures, adjusted for age, race and ethnicity, education, tobacco smoking, physical activity, Women's Health Initiative substudy from which DNAm data were obtained, and DNAm-based estimates of leukocyte proportions. RESULTS Healthy Eating Index, Dietary Approaches to Stop Hypertension, and alternate Mediterranean diet scores were all inversely associated with AgeAccelPheno, AgeAccelGrim, and DunedinPACE (P < 0.05), with the largest effects with DunedinPACE. A one standard deviation increment in diet quality scores was associated with a decrement (β ± SE) in DunedinPACE z score of -0.097 ± 0.014 (P = 9.70 x 10-13) for Healthy Eating Index, -0.107 ± 0.014 (P = 1.53 x 10-14) for Dietary Approaches to Stop Hypertension, and -0.068 ± 0.013 (P = 2.31 x 10-07) for the alternate Mediterranean diet. CONCLUSIONS In postmenopausal women, diet quality scores were inversely associated with DNAm-based measures of biological aging, particularly DunedinPACE.
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Affiliation(s)
- Lindsay M Reynolds
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
| | - Denise K Houston
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Meghan B Skiba
- Division of Biobehavioral Health Science, University of Arizona Cancer Center, University of Arizona, Tucson, Arizona
| | - Eric A Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - James D Stewart
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina; Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Yun Li
- Department of Genetics, School of Medicine, University of North Carolina, Chapel Hill, North Carolina; Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Anthony S Zannas
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina
| | - Themistocles L Assimes
- Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Steve Horvath
- Department of Human Genetics, University of California Los Angeles, Los Angeles, California; Altos Labs, San Diego, California
| | - Parveen Bhatti
- Cancer Control Research, BC Cancer Research Institute, Vancouver, British Columbia, Canada; School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrea A Baccarelli
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York
| | - Janet A Tooze
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Mara Z Vitolins
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina
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Almulla AA, Augustin H, Ahmed LA, Bärebring L. Dietary patterns during pregnancy in relation to maternal dietary intake: The Mutaba'ah Study. PLoS One 2024; 19:e0312442. [PMID: 39436896 PMCID: PMC11495628 DOI: 10.1371/journal.pone.0312442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 10/07/2024] [Indexed: 10/25/2024] Open
Abstract
AIM To relate adherence to healthy dietary patterns, evaluated by different dietary indices, to the intake of nutrients and food groups among pregnant women in the United Arab Emirates. METHODS The analyses included 1122 pregnant women from the Mutaba'ah Study. Dietary intake was assessed using a semi-quantitative Food Frequency Questionnaire. Adherence to three dietary pattern indices was assessed; Alternate Healthy Eating Index for Pregnancy (AHEI-P), Alternate Mediterranean Diet (aMED) and Dietary Approaches to Stop Hypertension (DASH). Associations between adherence (score >median) to the three dietary indices and intake of nutrients and food groups were analyzed using logistic regression analysis. RESULTS Women with higher intake of polyunsaturated fatty acids, fiber, vegetables, fruits, legumes, and nuts and lower intake of saturated fatty acids, red meat, and sweetened beverages had significantly higher odds of adherence to all three dietary patterns (p<0.05). Associations between intakes of nutrients and food groups with odds of adherence to the dietary patterns differed for total fat (only with AHEI-P, [odds ratio [OR]: 0.96; 95% confidence interval [CI]: 0.94-0.98]) and monounsaturated fatty acids (only with aMED, [OR: 1.06; 95% CI: 1.02-1.10]), dairy (with AHEI-P [OR: 0.89; 95% CI: 0.84-0.95] and aMED [OR: 0.86; 95% CI: 0.81-0.91], and with DASH [OR: 1.10; 95% CI: 1.04-1.17]), whole grain (only with aMED [OR: 2.19; 95% CI: 1.61-2.99] and DASH [OR: 4.27; 95% CI: 3.04-5.99]) and fish (with AHEI-P [OR: 1.36; 95% CI: 1.02-1.80] and aMED [OR: 1.79; 95% CI: 1.35-2.38], and with DASH [OR: 0.67; 95% CI: 0.52-0.86]). CONCLUSION Adherence to the three dietary pattern indices was generally associated with a favorable intake of nutrients and food groups. However, the indices captured slightly different aspects of dietary intake. These results show that dietary indices that assess adherence to healthy dietary patterns cannot be used interchangeably.
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Affiliation(s)
- Aisha A. Almulla
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Dietary Services, Tawam Hospital, Abu Dhabi Health Services Company (SEHA), Abu Dhabi, United Arab Emirates
| | - Hanna Augustin
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Luai A. Ahmed
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Zayed Centre for Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Linnea Bärebring
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Adachi K, Azegami T, Sei N, Yamada-Goto N, Uchida K, Murai-Takeda A, Inokuchi M, Hayashi K, Mori M, Hirose H. Secular trends in blood pressure among university students in Japan over the last two decades. Hypertens Res 2024:10.1038/s41440-024-01955-6. [PMID: 39433969 DOI: 10.1038/s41440-024-01955-6] [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: 06/17/2024] [Revised: 09/16/2024] [Accepted: 10/05/2024] [Indexed: 10/23/2024]
Abstract
High blood pressure (BP) increases the risk of cardiovascular disease, not only among middle-aged and older adults, but also in young adults. Early interventions for high BP may prevent future organ damage. Therefore, it is essential to monitor BP trends in young adults to support this approach. During the COVID-19 pandemic, a trend of increasing BP was observed worldwide. However, young adults have not been fully evaluated. Therefore, this study examined BP trends among university students (n = 106,691) over two decades, every 5 years from 2003 to 2023, including the period before and after the COVID-19 pandemic. From 2003 to 2018, there were no notable changes in BP. However, following the COVID-19 pandemic, increased BP was observed in both men and women, with systolic BP increasing from 118.1 (SD, 14.2) mmHg in 2018 to 120.6 (SD, 12.5) mmHg in 2023 among men, and from 104.6 (SD, 11.8) mmHg to 105.1 (SD, 11.7) mmHg among women. These trends were particularly pronounced among students with normal and underweight somatotypes and among first- and second-year students. The results of the lifestyle survey showed a decrease in smoking and drinking habits, insufficient sleep, mental stress, consumption of fast food and snacks, and an increase in exercise habits. Although contributing factors to the recent increase in BP were not identified, there was an upward trend in BP among Japanese university students. It is important to carefully observe how BP trends change over the long term following the end of the COVID-19 pandemic.
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Affiliation(s)
- Keika Adachi
- Keio University Health Center, Yokohama-shi, Japan
- Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Tatsuhiko Azegami
- Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
| | - Nahomi Sei
- Keio University Health Center, Yokohama-shi, Japan
| | | | - Keiko Uchida
- Keio University Health Center, Yokohama-shi, Japan
| | | | | | - Kaori Hayashi
- Division of Nephrology, Endocrinology and Metabolism, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Masaaki Mori
- Keio University Health Center, Yokohama-shi, Japan
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Beck LC, Woo JG. The contribution of dietary composition over 25 years to cardiovascular risk factors in childhood and adulthood: the Princeton Lipid Research Study. Br J Nutr 2024:1-12. [PMID: 39381972 DOI: 10.1017/s0007114524001521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2024]
Abstract
Diet is a contributing factor to CVD risk, but how diet quality changes over the long term and contributes to CVD risk is less well studied. Diet data were analysed from parents and offspring from the Princeton Lipid Research Study (24-h recall in the 1970s; Block FFQ in 1998). Diet quality was assessed using an 8-point Dietary Approaches to Stop Hypertension nutrient-based scoring index, including a new method for scoring in children, as well as examining twelve key macro/micronutrients. Outcomes included blood glucose, blood pressure, serum lipids and BMI. The analysis included 221 parents (39 % male, mean age 38·9 ± 6·5 at baseline and 66·6 ± 6·6 at follow-up) and 606 offspring (45 % male, 11·9 ± 3·2 at baseline and 38·5 ± 3·6 at follow-up). Parents' Dietary Approaches to Stop Hypertension score increased slightly from baseline to follow-up (1·4 ± 1·0 and 2·1 ± 1·3, respectively, P < 0·001), while offspring remained consistent (1·6 ± 0·9 and 1·6 ± 1·1, respectively, P = 0·58). Overall, the Dietary Approaches to Stop Hypertension score, adjusted for age, race, sex and BMI, was not significantly associated with any examined outcomes. Of the macro/micronutrients at follow-up, saturated and total fat were associated with increased diabetes and dyslipidaemia in parents, while the inverse was seen with niacin. Among offspring, niacin was associated with lower rates of hypertension and dyslipidaemia. In conclusion, no relationship was detected between Dietary Approaches to Stop Hypertension adherence and disease outcomes. However, both saturated fat and niacin were associated with components of CVD risk, highlighting the need for improved diet quality overall.
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Affiliation(s)
- Leah C Beck
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jessica G Woo
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
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McEvoy JW, McCarthy CP, Bruno RM, Brouwers S, Canavan MD, Ceconi C, Christodorescu RM, Daskalopoulou SS, Ferro CJ, Gerdts E, Hanssen H, Harris J, Lauder L, McManus RJ, Molloy GJ, Rahimi K, Regitz-Zagrosek V, Rossi GP, Sandset EC, Scheenaerts B, Staessen JA, Uchmanowicz I, Volterrani M, Touyz RM. 2024 ESC Guidelines for the management of elevated blood pressure and hypertension. Eur Heart J 2024; 45:3912-4018. [PMID: 39210715 DOI: 10.1093/eurheartj/ehae178] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/04/2024] Open
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Golmohammadi M, Attari VE, Salimi Y, Nachvak SM, Samadi M. The effect of MIND diet on sleep status, anxiety, depression, and cardiometabolic indices in obese diabetic women with insomnia: study protocol for a randomized controlled clinical trial {1}. Trials 2024; 25:660. [PMID: 39370509 PMCID: PMC11457347 DOI: 10.1186/s13063-024-08486-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Accepted: 09/19/2024] [Indexed: 10/08/2024] Open
Abstract
BACKGROUND The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet is a plant-based and anti-inflammatory diet that has the ability to protect and manage cardiovascular and nervous system diseases. Regarding that insomnia and cardiovascular problems are x`common in type 2 diabetes mellitus (T2DM), the present study will assess the effectiveness of the MIND dietary pattern on sleep quality, cardiometabolic indicators, and other psychological indicators. METHODS Forty-four overweight/obese T2DM women with insomnia, aged 30-65 years, will voluntarily participate in this randomized controlled trial and will be randomized to receive either a MIND low-calorie diet (MLCD) or a low-calorie diet (LCD) over a 3-month period. Before and after the study, sleep quality, some biochemical and cardiometabolic indices, cortisol, brain-derived neurotrophic factor (BDNF), high-sensitivity C-reactive protein (hs-CRP), and oxidative stress indicators will be assessed. DISCUSSION The use of dietary interventions in the management of T2DM complications is practical and safe. This research seeks to investigate the capacity of the MIND diet in the management of insomnia and cardiovascular problems of DM. It is expected that the results of this research will provide new perspectives on using an ideal dietary regimen to treat these health conditions. TRIAL REGISTRATION IRCT20181111041611N8. Registered on August 7, 2023. https://www.irct.ir/trial/71772.
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Affiliation(s)
- Mona Golmohammadi
- Student Research Committee, Department of Nutritional Sciences, School of Nutrition Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Vahideh Ebrahimzadeh Attari
- Department of Biochemistry and Nutrition, School of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Yahya Salimi
- Social Development & Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyed Mostafa Nachvak
- Department of Nutritional Sciences, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Mehnoosh Samadi
- Department of Nutritional Sciences, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Nohara J, Muraki I, Sobue T, Tamakoshi A, Iso H. Development of a Concise Healthy Diet Score for Cardiovascular Disease among Japanese; The Japan Collaborative Cohort Study. J Atheroscler Thromb 2024; 31:1443-1459. [PMID: 38735755 PMCID: PMC11456349 DOI: 10.5551/jat.64629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 03/10/2024] [Indexed: 05/14/2024] Open
Abstract
AIMS Several diet quality indicators have been developed primarily for cardiovascular disease (CVD) prevention in Western countries. However, those previous indicators are complicated and less feasible in clinical and health-promoting settings. Therefore, we aimed to develop a concise dietary risk score for CVD prevention in Japanese. METHODS Using the self-administered food frequency questionnaire with 35 food items, we developed a concise healthy diet score (cHDS) ranging from 0 to 5 points. We examined the association of cHDS with risks of all-cause and cause-specific mortality among 23,115 men and 35,557 women who were free of CVD and cancer. RESULTS During 19.2 years of median follow-up, 6,291 men and 5,365 women died. In men, the multivariable hazard ratios (95% confidence intervals) for the highest cHDS (5 points) compared to the lowest (0-1 points) were 0.74 (0.60-0.91, P-trend=0.008) for CVD and 0.86 (0.77-0.95, P-trend=0.05) for all causes. No significant associations were found for stroke, coronary heart disease, and other causes in men. The corresponding hazard ratio in women was 0.65 (0.52-0.81, P-trend<0.001) for CVD, 0.63 (0.45-0.88, P-trend<0.001) for stroke, 0.48 (0.30-0.78, P-trend=0.008) for coronary heart disease, 0.67 (0.54-0.84, P-trend<0.001) for other causes, and 0.75 (0.66-0.85, P-trend<0.001) for all causes. CONCLUSION We developed a concise diet quality score named cHDS in the Japanese population and found the inverse association of cHDS with mortality from CVD and all causes for both men and women.
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Affiliation(s)
- Junko Nohara
- Environmental Medicine, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
- Department of Nutrition, Faculty of Health Sciences, Kio University, Nara, Japan
| | - Isao Muraki
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tomotaka Sobue
- Environmental Medicine, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Hokkaido University Graduate School of Medicine, Hokkaido, Japan
| | - Hiroyasu Iso
- Institute for Global Health Medicine, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
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Øvretveit K, Ingeström EML, Spitieris M, Tragante V, Thomas LF, Steinsland I, Brumpton BM, Gudbjartsson DF, Holm H, Stefansson K, Wisløff U, Hveem K. Polygenic Interactions With Environmental Exposures in Blood Pressure Regulation: The HUNT Study. J Am Heart Assoc 2024; 13:e034612. [PMID: 39291479 DOI: 10.1161/jaha.123.034612] [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: 04/23/2024] [Accepted: 07/10/2024] [Indexed: 09/19/2024]
Abstract
BACKGROUND The essential hypertension phenotype results from an interplay between genetic and environmental factors. The influence of lifestyle exposures such as excess adiposity, alcohol consumption, tobacco use, diet, and activity patterns on blood pressure (BP) is well established. Additionally, polygenic risk scores for BP traits are associated with clinically significant phenotypic variation. However, interactions between genetic and environmental risk factors in hypertension morbidity and mortality are poorly characterized. METHODS AND RESULTS We used genotype and phenotype data from up to 49 234 participants from the HUNT (Trøndelag Health Study) to model gene-environment interactions between genome-wide polygenic risk scores for systolic BP and diastolic BP and 125 environmental exposures. Among the 125 environmental exposures assessed, 108 and 100 were independently associated with SBP and DBP, respectively. Of these, 12 interactions were identified for genome-wide PRSs for systolic BP and 4 for genome-wide polygenic risk scores for diastolic BP, 2 of which were overlapping (P < 2 × 10-4). We found evidence for gene-dependent influence of lifestyle factors such as cardiorespiratory fitness, dietary patterns, and tobacco exposure, as well as biomarkers such as serum cholesterol, creatinine, and alkaline phosphatase on BP. CONCLUSIONS Individuals that are genetically susceptible to high BP may be more vulnerable to common acquired risk factors for hypertension, but these effects appear to be modifiable. The gene-dependent influence of several common acquired risk factors indicates the potential of genetic data combined with lifestyle assessments in risk stratification, and gene-environment-informed risk modeling in the prevention and management of hypertension.
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Affiliation(s)
- Karsten Øvretveit
- HUNT Center for Molecular and Clinical Epidemiology (MCE), Department of Public Health and Nursing Norwegian University of Science and Technology (NTNU) Trondheim Norway
| | - Emma M L Ingeström
- Cardiac Exercise Research Group (CERG), Department of Circulation and Medical Imaging Norwegian University of Science and Technology (NTNU) Trondheim Norway
| | - Michail Spitieris
- HUNT Center for Molecular and Clinical Epidemiology (MCE), Department of Public Health and Nursing Norwegian University of Science and Technology (NTNU) Trondheim Norway
- Department of Mathematical Sciences Norwegian University of Science and Technology (NTNU) Trondheim Norway
| | | | - Laurent F Thomas
- HUNT Center for Molecular and Clinical Epidemiology (MCE), Department of Public Health and Nursing Norwegian University of Science and Technology (NTNU) Trondheim Norway
- Department of Clinical and Molecular Medicine Norwegian University of Science and Technology (NTNU) Trondheim Norway
| | - Ingelin Steinsland
- Department of Mathematical Sciences Norwegian University of Science and Technology (NTNU) Trondheim Norway
| | - Ben M Brumpton
- HUNT Center for Molecular and Clinical Epidemiology (MCE), Department of Public Health and Nursing Norwegian University of Science and Technology (NTNU) Trondheim Norway
- HUNT Research Centre, Department of Public Health and Nursing Norwegian University of Science and Technology (NTNU) Levanger Norway
| | - Daniel F Gudbjartsson
- deCODE Genetics/Amgen Inc. Reykjavik Iceland
- School of Engineering and Natural Sciences University of Iceland Reykjavik Iceland
| | - Hilma Holm
- deCODE Genetics/Amgen Inc. Reykjavik Iceland
| | - Kari Stefansson
- deCODE Genetics/Amgen Inc. Reykjavik Iceland
- Faculty of Medicine University of Iceland Reykjavik Iceland
| | - Ulrik Wisløff
- Cardiac Exercise Research Group (CERG), Department of Circulation and Medical Imaging Norwegian University of Science and Technology (NTNU) Trondheim Norway
| | - Kristian Hveem
- HUNT Center for Molecular and Clinical Epidemiology (MCE), Department of Public Health and Nursing Norwegian University of Science and Technology (NTNU) Trondheim Norway
- Department of Innovation and Research, St. Olav's Hospital Trondheim Norway
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11
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Tien DS, Hockey M, So D, Stanford J, Clarke ED, Collins CE, Staudacher HM. Recommendations for Designing, Conducting, and Reporting Feeding Trials in Nutrition Research. Adv Nutr 2024; 15:100283. [PMID: 39134209 PMCID: PMC11480951 DOI: 10.1016/j.advnut.2024.100283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 07/05/2024] [Accepted: 08/07/2024] [Indexed: 09/01/2024] Open
Abstract
Double-blind, placebo-controlled, randomized controlled trials are the gold standard for clinical trials in nutrition science. For trials of whole diets, dietary counseling is advantageous as they offer clinical translatability although can vary in the fidelity of the intended intervention from participant to participant and across studies. Feeding trials, in which most or all food is provided, offer high precision and can provide proof-of-concept evidence that a dietary intervention is efficacious and can also better evaluate the effect of known quantities of foods and nutrients on physiology. However, they come with additional methodological complexities. Feeding trials also call for a variety of unique methodological considerations, not least of which relate to the design and delivery of diets to participants. This review aims to provide a comprehensive summary of recommendations for design and conduct of feeding trials, encompassing domiciled and nondomiciled feeding trials. Several pertinent aspects of trial design and methodology are discussed, including defining the study population to maximize retention, safety, and generalizability of findings, recommendations for design of control interventions and optimizing blinding, and specific considerations for clinical populations. A detailed stepwise process for menu design, development, validation, and delivery are also presented. These recommendations aim to facilitate methodologic consistency and execution of high-quality feeding trials, ultimately facilitating improved understanding of the role of diet in treating disease and the underpinning mechanisms.
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Affiliation(s)
- Delyse Sy Tien
- Food & Mood Centre, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, Victoria, Australia
| | - Meghan Hockey
- Food & Mood Centre, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, Victoria, Australia
| | - Daniel So
- Department of Gastroenterology, Monash University and Alfred Health, Melbourne, Victoria, Australia
| | - Jordan Stanford
- School of Health Sciences, College of Health Medicine and Wellbeing, the University of Newcastle, New South Wales, Australia; Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Erin D Clarke
- School of Health Sciences, College of Health Medicine and Wellbeing, the University of Newcastle, New South Wales, Australia; Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Clare E Collins
- School of Health Sciences, College of Health Medicine and Wellbeing, the University of Newcastle, New South Wales, Australia; Food and Nutrition Research Program, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Heidi M Staudacher
- Food & Mood Centre, Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, Victoria, Australia.
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Trumbo PR, Glass KA, Lee SY, Moshfegh A, Welling PA, Zecca P. North American considerations, strategies, and practices in reducing the sodium content in processed foods. J Food Sci 2024; 89:6086-6097. [PMID: 39289814 DOI: 10.1111/1750-3841.17361] [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: 05/29/2024] [Revised: 08/08/2024] [Accepted: 08/17/2024] [Indexed: 09/19/2024]
Abstract
Most Americans exceed the recommended limit for sodium in their diet, a risk factor for hypertension and cardiovascular disease. Efforts have been made by the food industry and government agencies to reduce the sodium content in foods and encourage the consumption of lower sodium diets. Such efforts, however, are not successful in improving public health when consumers do not accept and consume lower sodium foods. This review article provides an overview of the strategies that have been used by the US food industry to reduce and replace sodium in consumer packaged goods, as well as future sodium reduction strategies and approaches for replacing sodium with potassium salts. Challenges in consumer acceptance regarding the reduction of sodium in foods are also discussed. Because of the widespread consumption of numerous sodium-containing consumer packaged goods, implementing future strategies in various aspects of salt reduction and potassium replacement in foods should have a profound impact on the health of Americans. PRACTICAL APPLICATION: New information is provided herein as it discusses the most current and collective perspectives of major food industry successes and challenges, as well as government strategies to decrease sodium intake. The information provided also addresses future strategies for reducing sodium content in foods, increasing potassium intake, and consumer acceptance of lower sodium foods.
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Affiliation(s)
- Paula R Trumbo
- School of Health Sciences, Paula R. Trumbo Consulting and Liberty University, Mount Pleasant, South Carolina, USA
| | - Kathleen A Glass
- Food Research Institute, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Soo-Yeun Lee
- School of Food Science, Washington State University, Pullman, Washington, USA
| | - Alanna Moshfegh
- Food Surveys Research Group, Beltsville Human Nutrition Research Center, U.S. Department of Agriculture, Agricultural Research Center, Beltsville, Maryland, USA
| | - Paul A Welling
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Patricia Zecca
- Department of Medicine, Institute for the Advancement of Food and Nutrition Sciences, Washington, DC, USA
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13
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Tolonen U, Lankinen M, Laakso M, Schwab U. Healthy dietary pattern is associated with lower glycemia independently of the genetic risk of type 2 diabetes: a cross-sectional study in Finnish men. Eur J Nutr 2024; 63:2521-2531. [PMID: 38864868 PMCID: PMC11490453 DOI: 10.1007/s00394-024-03444-5] [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: 12/18/2023] [Accepted: 05/30/2024] [Indexed: 06/13/2024]
Abstract
PURPOSE Hyperglycemia is affected by lifestyle and genetic factors. We investigated if dietary patterns associate with glycemia in individuals with high or low genetic risk for type 2 diabetes (T2D). METHODS Men (n = 1577, 51-81 years) without T2D from the Metabolic Syndrome in Men (METSIM) cohort filled a food-frequency questionnaire and participated in a 2-hour oral glucose tolerance test. Polygenetic risk score (PRS) including 76 genetic variants was used to stratify participants into low or high T2D risk groups. We established two data-driven dietary patterns, termed healthy and unhealthy, and investigated their association with plasma glucose concentrations and hyperglycemia risk. RESULTS Healthy dietary pattern was associated with lower fasting and 2-hour plasma glucose, glucose area under the curve, and better insulin sensitivity (Matsuda insulin sensitivity index) and insulin secretion (disposition index) in unadjusted and adjusted models, whereas the unhealthy pattern was not. No interaction was observed between the patterns and PRS on glycemic measures. Healthy dietary pattern was negatively associated with the risk for hyperglycemia in an adjusted model (OR 0.69, 95% CI 0.51-0.95, in the highest tertile), whereas unhealthy pattern was not (OR 1.08, 95% CI 0.79-1.47, in the highest tertile). No interaction was found between diet and PRS on the risk for hyperglycemia (p = 0.69 for healthy diet, p = 0.54 for unhealthy diet). CONCLUSION Our findings suggest that healthy diet is associated with lower glucose concentrations and lower risk for hyperglycemia in men with no interaction with the genetic risk.
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Affiliation(s)
- Ulla Tolonen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, PO Box 1627, Kuopio, 70211, Finland.
| | - Maria Lankinen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, PO Box 1627, Kuopio, 70211, Finland
| | - Markku Laakso
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, PO Box 1627, Kuopio, 70211, Finland
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland
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14
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Trabado-Fernández A, García-Colomo A, Cuadrado-Soto E, Peral-Suárez Á, Salas-González MD, Lorenzo-Mora AM, Aparicio A, Delgado-Losada ML, Maestú-Unturbe F, López-Sobaler AM. Association of a DASH diet and magnetoencephalography in dementia-free adults with different risk levels of Alzheimer's disease. GeroScience 2024:10.1007/s11357-024-01361-3. [PMID: 39354239 DOI: 10.1007/s11357-024-01361-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Accepted: 09/18/2024] [Indexed: 10/03/2024] Open
Abstract
This study explored how adherence to the DASH diet relates to electrophysiological measures in individuals at varying Alzheimer's disease (AD) risk due to family history (FH). There were 179 dementia-free subjects. DASH index was calculated, and participants were classified into different DASH adherence groups. Tertiles of relative alpha power in default mode network (DMN) regions were calculated. Multivariate logistic regression models were used to examine the association. Lower DASH adherence was associated with decreased odds of higher relative alpha power in the DMN, observed across the entire sample and specifically among those without a FH of AD. Logistic regression models indicated that participants with poorer DASH adherence had a reduced likelihood of elevated DMN alpha power, potentially influenced by vascular and amyloid-beta mechanisms. These findings underscore the dietary pattern's potential role in neural activity modulation, particularly in individuals not genetically predisposed to AD.
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Affiliation(s)
- Alfredo Trabado-Fernández
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Pl. de Ramón y Cajal S/N, 28040, Madrid, Spain
| | - Alejandra García-Colomo
- Department of Experimental Psychology, Cognitive Processes and Speech Therapy, Faculty of Psychology, Complutense University of Madrid, 28223, Madrid, Spain
- Center for Cognitive and Computational Neuroscience, Complutense University of Madrid, 28223, Madrid, Spain
| | - Esther Cuadrado-Soto
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Pl. de Ramón y Cajal S/N, 28040, Madrid, Spain.
- VALORNUT Research Group, Department of Nutrition and Food Science, Complutense University of Madrid, 28040, Madrid, Spain.
| | - África Peral-Suárez
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Pl. de Ramón y Cajal S/N, 28040, Madrid, Spain
- VALORNUT Research Group, Department of Nutrition and Food Science, Complutense University of Madrid, 28040, Madrid, Spain
| | - María Dolores Salas-González
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Pl. de Ramón y Cajal S/N, 28040, Madrid, Spain
- VALORNUT Research Group, Department of Nutrition and Food Science, Complutense University of Madrid, 28040, Madrid, Spain
| | - Ana María Lorenzo-Mora
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Pl. de Ramón y Cajal S/N, 28040, Madrid, Spain
- Department of Nursing and Nutrition, Faculty of Biomedical Sciences, Universidad Europea de Madrid, 28670, Villaviciosa de Odón, Madrid, Spain
| | - Aránzazu Aparicio
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Pl. de Ramón y Cajal S/N, 28040, Madrid, Spain
- VALORNUT Research Group, Department of Nutrition and Food Science, Complutense University of Madrid, 28040, Madrid, Spain
- Health Research Institute of the Hospital Clínico San Carlos (IdISSC), 28040, Madrid, Spain
| | - María Luisa Delgado-Losada
- Department of Experimental Psychology, Cognitive Processes and Speech Therapy, Faculty of Psychology, Complutense University of Madrid, 28223, Madrid, Spain
- VALORNUT Research Group, Department of Nutrition and Food Science, Complutense University of Madrid, 28040, Madrid, Spain
- Health Research Institute of the Hospital Clínico San Carlos (IdISSC), 28040, Madrid, Spain
| | - Fernando Maestú-Unturbe
- Department of Experimental Psychology, Cognitive Processes and Speech Therapy, Faculty of Psychology, Complutense University of Madrid, 28223, Madrid, Spain
- Center for Cognitive and Computational Neuroscience, Complutense University of Madrid, 28223, Madrid, Spain
- Health Research Institute of the Hospital Clínico San Carlos (IdISSC), 28040, Madrid, Spain
| | - Ana M López-Sobaler
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, Pl. de Ramón y Cajal S/N, 28040, Madrid, Spain
- VALORNUT Research Group, Department of Nutrition and Food Science, Complutense University of Madrid, 28040, Madrid, Spain
- Health Research Institute of the Hospital Clínico San Carlos (IdISSC), 28040, Madrid, Spain
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Kim H, Lichtenstein AH, Coresh J, Appel LJ, Rebholz CM. Serum protein responses to Dietary Approaches to Stop Hypertension (DASH) and DASH-Sodium trials and associations with blood pressure changes. J Hypertens 2024; 42:1823-1830. [PMID: 39196693 DOI: 10.1097/hjh.0000000000003828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2024]
Abstract
OBJECTIVES The Dietary Approaches to Stop Hypertension (DASH) diet reduces blood pressure, but the mechanisms underlying DASH diet-blood pressure relations are not well understood. Proteomic measures may provide insights into the pathophysiological mechanisms through which the DASH diet reduces blood pressure. METHODS The DASH (1994-1996) and DASH-Sodium (1997-1999) trials were multicenter, randomized-controlled feeding trials. Proteomic profiling was conducted in serum collected at the end of the feeding period (DASH, N = 215; DASH-Sodium, N = 390). Multivariable linear regression models were used to identify interactions between 71 DASH diet-related proteins and changes in systolic and diastolic blood pressure. Estimates were meta-analyzed across both trials. Elastic net models were used to identify proteins that predict changes in blood pressure. RESULTS Ten significant interactions were identified [systolic blood pressure: seven proteins; diastolic blood pressure: three proteins], which represented nine unique proteins. A high level of renin at the end of the feeding period was associated with greater reductions in diastolic blood pressure in individuals consuming the control than DASH diets. A high level of procollagen c-endopeptidase enhancer 1 (PCOLCE) and collagen triple helix repeat-containing protein 1 (CTHRC1) were associated with greater reductions in systolic blood pressure in individuals consuming the DASH than control diets, and with elevations in systolic blood pressure in individuals consuming the control diets (P for interaction for all tests < 0.05). Elastic net models identified six additional proteins that predicted change in blood pressure. CONCLUSIONS Several novel proteins were identified that may provide some insight into the relationship between the DASH diet and blood pressure.
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Affiliation(s)
- Hyunju Kim
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland
- Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington
| | - Alice H Lichtenstein
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts
| | - Josef Coresh
- New York University Grossman School of Medicine, New York, New York
| | - Lawrence J Appel
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Casey M Rebholz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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16
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Shin HR, Kim J, Song S. Association between nut consumption and mortality risk: a 20-year cohort study in Korea with a stratified analysis by health-related variables. Nutr J 2024; 23:113. [PMID: 39342232 PMCID: PMC11439287 DOI: 10.1186/s12937-024-01019-y] [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: 06/03/2024] [Accepted: 09/17/2024] [Indexed: 10/01/2024] Open
Abstract
BACKGROUND Although nuts are a well-known healthy food group, the relationship between nut consumption and mortality remains unclear, particularly among Asians. This prospective cohort study examined the association between nut consumption and the risk of all-cause, cardiovascular disease (CVD), and cancer mortality in Korean adults. METHODS Data from two cohorts (the Ansan-Ansung and Health-Examinees) from the Korean Genome and Epidemiology Study were used. A total of 114,140 individuals aged 40-79 years were included in the data analyses. Nut consumption was assessed using a validated semi-quantitative food frequency questionnaire and categorized into four groups: non-consumers, less than 1 serving/week, 1-2 servings/week, and 2 or more servings/week (one serving was 15 g of nuts). Mortality outcomes were determined based on the 2001-2021 death records from Statistics Korea. Cox proportional hazard regression analysis was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality across nut consumption categories. A stratified subgroup analysis by health-related variables was also performed. RESULTS During a mean follow-up of 12.3 years, 4,559 deaths were recorded. After adjusting for covariates, the HR for all-cause mortality was 0.877 (95% CI = 0.772-0.996, p for trend = 0.006) in individuals with a nut consumption of 2 or more servings/week compared with that in non-consumers. Multivariable HRs for CVD mortality were 0.800 (95% CI = 0.681-0.939) in individuals consuming less than 1 serving/week, 0.656 (95% CI = 0.469-0.918) in those consuming 1-2 servings/week, and 1.009 (95% CI = 0.756-1.347) in those consuming 2 or more servings/week compared with that in non-consumers (p for trend = 0.080). No association was observed between nut consumption and cancer mortality. Stratified analysis identified significant interactions in the association between nut consumption and all-cause mortality by age, body mass index, and physical activity. CONCLUSIONS Nut consumption was linearly associated with the reduced risk of all-cause mortality and showed a non-linear dose-response relationship with CVD mortality in Koreans, but had no association with cancer mortality. The effects of nut consumption, which have been inadequately investigated in this population, varied across different subgroups. These findings suggest that incorporating nuts into the diet should be encouraged for long-term health of Korean adults.
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Affiliation(s)
- Hye Ran Shin
- Department of Food and Nutrition, College of Life Science and Nano-technology, Hannam University, Daejeon, 34054, Korea
| | - Jihye Kim
- Department of Genetics and Biotechnology, College of Life Sciences, Kyung Hee University, Yongin, 17104, Korea
| | - SuJin Song
- Department of Food and Nutrition, College of Life Science and Nano-technology, Hannam University, Daejeon, 34054, Korea.
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Meernik C, Eilat-Adar S, Leonard D, Barlow CE, Gerber Y, Tesler R, Byker Shanks C, Pettee Gabriel K, Pavlovic A, DeFina LF, Shuval K. Dietary patterns and cardiorespiratory fitness in midlife and subsequent all-cause dementia: findings from the cooper center longitudinal study. Int J Behav Nutr Phys Act 2024; 21:109. [PMID: 39334147 PMCID: PMC11428374 DOI: 10.1186/s12966-024-01663-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 09/18/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND Identifying lifestyle factors that independently or jointly lower dementia risk is a public health priority given the limited treatment options available to patients. In this cohort study, we examined the associations between Mediterranean or Dietary Approaches to Stop Hypertension (DASH) diet adherence and cardiorespiratory fitness (CRF) with later-life dementia, and assessed whether the associations between dietary pattern and dementia are modified by CRF. METHODS Data are from 9,095 adults seeking preventive care at the Cooper Clinic (1987-1999) who completed a 3-day dietary record and a maximal exercise test. Alzheimer's disease and related disorders or senile dementia (i.e., all-cause dementia) was identified from Medicare administrative claims (1999-2019). Illness-death models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations between Mediterranean or DASH diet adherence (primary exposure), CRF (secondary exposure), and all-cause dementia, adjusted for demographic and clinical factors. An interaction term was included between diet score and CRF to assess effect modification by CRF. RESULTS The mean age at baseline was 50.6 (standard deviation [SD]: 8.4) years, and a majority of the study sample were men (77.5%) and White (96.4%). 1449 cases of all-cause dementia were identified over a mean follow-up of 9.2 (SD: 5.8) years. Neither Mediterranean nor DASH diet adherence was associated with dementia risk in fully adjusted models (HR per SD of Mediterranean diet score: 1.00, 95% CI: 0.94, 1.05; HR per SD of DASH diet score: 1.02, 95% CI: 0.96, 1.08). However, participants with higher CRF had a decreased hazard of dementia (HR, per metabolic equivalent of task [MET] increase, Mediterranean model: 0.95, 95% CI: 0.92, 0.98; HR, per MET increase, DASH model: 0.96, 95% CI: 0.92, 0.97). No effect modification by CRF was observed in the association between diet and dementia. CONCLUSIONS In this sample of apparently healthy middle-aged adults seeking preventive care, higher CRF at midlife was associated with a lower risk of all-cause dementia, though adherence to a Mediterranean or DASH diet was not, and CRF did not modify the diet-dementia association. CRF should be emphasized in multimodal interventions for dementia prevention and investigated among diverse samples.
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Affiliation(s)
- Clare Meernik
- The Cooper Institute, 12330 Preston Rd, Dallas, TX, 75230, USA.
| | - Sigal Eilat-Adar
- Levinsky-Wingate Academic College, Netanya, Israel
- School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - David Leonard
- The Cooper Institute, 12330 Preston Rd, Dallas, TX, 75230, USA
| | | | - Yariv Gerber
- School of Public Health, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Riki Tesler
- Department of Health Systems Management, Ariel University, Ariel, Israel
| | | | - Kelley Pettee Gabriel
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Laura F DeFina
- The Cooper Institute, 12330 Preston Rd, Dallas, TX, 75230, USA
| | - Kerem Shuval
- The Cooper Institute, 12330 Preston Rd, Dallas, TX, 75230, USA
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18
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Heredia NI, Garza ER, Velasco-Huerta F, Swoboda TL, Fwelo P, Mathews PD, Fernandez ME. implementation of healthy heart ambassador to improve blood pressure control at community health centers in Texas. BMC Health Serv Res 2024; 24:1105. [PMID: 39304836 PMCID: PMC11414079 DOI: 10.1186/s12913-024-11485-z] [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: 02/16/2024] [Accepted: 08/23/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND Hypertension is one of the most prevalent chronic diseases in the United States and can increase a person's risk of stroke and other cardiovascular complications. Yet only 1 in 4 people with high blood pressure in the United States have their blood pressure managed. To improve hypertension control, we supported 9 health centers in Texas with the implementation of the Healthy Heart Ambassador Blood Pressure Self-Monitoring (HHA) Program. METHODS We provided health center training using the HHA Program Facilitation Training Guide, recorded barriers to implementing the HHA program, and employed strategies to overcome those barriers. RESULTS There were 68 staff members from the health centers trained to deliver the HHA program. Three health centers successfully implemented all three major components of HHA, three were able to implement two components, two adopted two components, and one withdrew due to insufficient capacity. Capability, technology infrastructure, and motivation were among the barriers most referenced. CONCLUSION Clinic non-physician team members delivering the HHA program will need training and ongoing technical assistance to overcome implementation barriers.
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Affiliation(s)
- Natalia I Heredia
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, 7000 Fannin, Suite 2558, Houston, TX, 77030, USA.
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA.
| | - Ella R Garza
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Fernanda Velasco-Huerta
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Tracy L Swoboda
- Center for Quality Health IT Improvement (CQHII), McWilliams School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Pierre Fwelo
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Patenne D Mathews
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Maria E Fernandez
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center at Houston, 7000 Fannin, Suite 2558, Houston, TX, 77030, USA
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
- Institute for Implementation Science, University of Texas Health Science Center at Houston, Houston, TX, USA
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Soroń-Lisik M, Więch P, Dąbrowski M. Beneficial Effect of Dietary Approaches to Stop Hypertension Diet Combined with Regular Physical Activity on Fat Mass and Anthropometric and Metabolic Parameters in People with Overweight and Obesity. Nutrients 2024; 16:3187. [PMID: 39339786 PMCID: PMC11435128 DOI: 10.3390/nu16183187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Revised: 09/15/2024] [Accepted: 09/18/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND/OBJECTIVE Obesity and overweight have become growing health-related issues worldwide, which also applies to Poland. Excess fat mass is associated with an increased risk of metabolic and non-metabolic complications. The aim of our pre-post-designed study was to assess the effect of behavioral intervention on body weight, fat mass and anthropometric and metabolic parameters in obese and overweight individuals. METHODS The study included one hundred people (85 women) with excess fat mass who voluntarily declared their willingness to participate in the weight-loss program consisted of 12 weeks of the DASH diet combined with regular, supervised physical activity. Anthropometric measurements and laboratory tests were performed in all study participants, and anthropometric and metabolic indices were calculated at baseline and after three months of treatment. RESULTS Body weight decreased significantly by 5.63 ± 4.03 kg, BMI by 2.06 ± 1.44 kg/m2, waist circumference by 5.6 ± 3.7 cm, fat mass from 40.04 ± 6.90 to 36.56 ± 7.07% and uric acid level by 16.0 ± 41.6 μmol/L (p < 0.001 in all cases). We also found an improvement in lipid profile and anthropometric and metabolic indices, except for HDL cholesterol and plasma glucose levels. CONCLUSIONS The effect of the DASH diet and supervised physical activity was beneficial regardless of age, sex and the presence of hypertension or dysglycemia at baseline. The implementation of a healthy lifestyle was associated with a significant improvement in anthropometric and metabolic parameters, which, if continued, may reduce the risk of unfavorable health-related outcomes in the future.
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Affiliation(s)
- Małgorzata Soroń-Lisik
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, 35-310 Rzeszów, Poland
| | - Paweł Więch
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, 35-310 Rzeszów, Poland
| | - Mariusz Dąbrowski
- Institute of Medical Sciences, College of Medical Sciences, University of Rzeszów, 35-310 Rzeszów, Poland
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Verzelloni P, Giuliano V, Wise LA, Urbano T, Baraldi C, Vinceti M, Filippini T. Cadmium exposure and risk of hypertension: a systematic review and dose-response meta-analysis. ENVIRONMENTAL RESEARCH 2024; 263:120014. [PMID: 39304018 DOI: 10.1016/j.envres.2024.120014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Revised: 09/07/2024] [Accepted: 09/13/2024] [Indexed: 09/22/2024]
Abstract
BACKGROUND Exposure to environmental toxic metals represents a significant global public health concern. Many studies have reported that cadmium (Cd) exposure increases the risk of hypertension. Since the shape of such relation has not been well characterized, we assessed it by performing a systematic review and dose-response meta-analysis of human studies. METHODS We searched the literature through September 5, 2024 to identify papers related to Cd, hypertension, and blood pressure. Inclusion criteria were: observational design, adult population, assessment of exposure using Cd biomarkers, and availability of exposure category-specific risk estimates for hypertension. We performed a dose-response meta-analysis of the results from included studies. RESULTS Of the 18 studies published between 2006-2024, most had a cross-sectional design. Cd was measured in whole blood and/or urine in almost all studies, whereas only two studies measured Cd in serum. The dose-response meta-analysis indicated an almost linear relation between urinary Cd concentrations and hypertension risk with RR=1.18, 95% CI 1.02-1.37 at 2.0 μg/g creatinine compared with no exposure. In contrast, the association between blood Cd concentrations and hypertension risk was non-linear: there was a steep monotonic increase in risk for Cd concentrations below 2 μg/L, reaching a RR of 1.48 (95% CI 1.17-1.86) at 2.0 μg/L, after which a plateau seemed reached. We found similar trends when restricting to studies of Asian population, while when considering North American studies, hypertension risk increased above 1.0 μg/g creatinine. CONCLUSIONS In this dose-response meta-analysis, risk of hypertension showed a non-linear positive association with blood Cd concentrations and a linear positive association with urinary Cd concentrations. Inconsistency in the shape of associations could relate to the different timing of exposure assessed by the biomarkers or the alteration Cd excretion at increasing exposure levels. Mitigation of Cd exposure is confirmed as a public health priority for chronic disease prevention.
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Affiliation(s)
- Pietro Verzelloni
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Vincenzo Giuliano
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Teresa Urbano
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Claudia Baraldi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Marco Vinceti
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Tommaso Filippini
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; School of Public Health, University of California Berkeley, Berkeley, CA, USA.
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21
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Ataran A, Pompian A, Hajirezaei H, Lodhi R, Javaheri A. Fueling the Heart: What Are the Optimal Dietary Strategies in Heart Failure? Nutrients 2024; 16:3157. [PMID: 39339757 PMCID: PMC11434961 DOI: 10.3390/nu16183157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Revised: 09/10/2024] [Accepted: 09/15/2024] [Indexed: 09/30/2024] Open
Abstract
OBJECTIVES Heart failure (HF) is a global health concern with rising incidence and poor prognosis. While the essential role of nutritional and dietary strategies in HF patients is acknowledged in the existing scientific guidelines and clinical practice, there are no comprehensive nutritional recommendations for optimal dietary management of HF. METHODS In this review, we discuss results from recent studies on the obesity paradox and the effects of calorie restriction and weight loss, intermittent fasting, the Western diet, the Mediterranean diet, the ketogenic diet, and the DASH diet on HF progression. RESULTS Many of these strategies remain under clinical and basic investigation for their safety and efficacy, and there is considerable heterogeneity in the observed response, presumably because of heterogeneity in the pathogenesis of different types of HF. In addition, while specific aspects of cardiac metabolism, such as changes in ketone body utilization, might underlie the effects of certain dietary strategies on the heart, there is a critical divide between supplement strategies (i.e., with ketones) and dietary strategies that impact ketogenesis. CONCLUSION This review aims to highlight this gap by exploring emerging evidence supporting the importance of personalized dietary strategies in preventing progression and improving outcomes in the context of HF.
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Affiliation(s)
- Anahita Ataran
- Center for Cardiovascular Research, Washington University School of Medicine, St. Louis, MO 63110, USA; (A.A.); (A.P.); (H.H.); (R.L.)
| | - Alexander Pompian
- Center for Cardiovascular Research, Washington University School of Medicine, St. Louis, MO 63110, USA; (A.A.); (A.P.); (H.H.); (R.L.)
| | - Hamidreza Hajirezaei
- Center for Cardiovascular Research, Washington University School of Medicine, St. Louis, MO 63110, USA; (A.A.); (A.P.); (H.H.); (R.L.)
| | - Rehman Lodhi
- Center for Cardiovascular Research, Washington University School of Medicine, St. Louis, MO 63110, USA; (A.A.); (A.P.); (H.H.); (R.L.)
| | - Ali Javaheri
- Center for Cardiovascular Research, Washington University School of Medicine, St. Louis, MO 63110, USA; (A.A.); (A.P.); (H.H.); (R.L.)
- John Cochran VA Hospital, St. Louis, MO 63110, USA
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22
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Sun J, Chen Y, Zhao X, Niu Z, Gu Z, Yan Z, Wang W. Effect and interaction of PINK1 genetic polymorphisms and environmental factors on blood pressure in COEs-exposed workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024:1-12. [PMID: 39295235 DOI: 10.1080/09603123.2024.2403685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 09/09/2024] [Indexed: 09/21/2024]
Abstract
Coke oven emissions (COEs) contain a variety of polycyclic aromatic hydrocarbons (PAHs), which can cause damage to the human cardiovascular system. In addition, myocardial mitochondria are susceptible to damage in hypertensive patients. However, it is not clear whether genetic variation, in single nucleotide polymorphisms (SNPs) in PINK1 affects COEs exposure-induced abnormal blood pressure. We surveyed and tested 518 workers exposed to COEs and statistically analyzed them with SPSS 21.0 software. SBP was greater in the high-exposure group than in the low-exposure group. Generalized linear model analysis showed that the interaction of PINK1 rs3738136 (GA+AA) and COEs had an effect on SBP [β(95%CI) = -6.537(-12.072, -1.002), p = 0.021] and DBP [β(95%CI) = -4.811(-8.567, -1.056), p = 0.012]. This study is the first to identify the role of PINK1 rs3738136 in COE- induced abnormal blood pressure, and to prove that the abnormal blood pressure of workers is the result of environmental and genetic factors.
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Affiliation(s)
- Jing Sun
- Department of Occupational Health and Occupational Diseases, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- The Key Laboratory of Nanomedicine and Health Inspection of Zhengzhou, Zhengzhou, Henan, China
| | - Yang Chen
- Department of Occupational Health and Occupational Diseases, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- The Key Laboratory of Nanomedicine and Health Inspection of Zhengzhou, Zhengzhou, Henan, China
| | - Xiangkai Zhao
- Department of Occupational Health and Occupational Diseases, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- The Key Laboratory of Nanomedicine and Health Inspection of Zhengzhou, Zhengzhou, Henan, China
| | - Zeming Niu
- Department of Occupational Health and Occupational Diseases, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- The Key Laboratory of Nanomedicine and Health Inspection of Zhengzhou, Zhengzhou, Henan, China
| | - Zhiguang Gu
- Department of Occupational Health and Occupational Diseases, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- The Key Laboratory of Nanomedicine and Health Inspection of Zhengzhou, Zhengzhou, Henan, China
| | - Zhaofan Yan
- Department of Occupational Health and Occupational Diseases, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- The Key Laboratory of Nanomedicine and Health Inspection of Zhengzhou, Zhengzhou, Henan, China
| | - Wei Wang
- Department of Occupational Health and Occupational Diseases, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
- The Key Laboratory of Nanomedicine and Health Inspection of Zhengzhou, Zhengzhou, Henan, China
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23
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Okubo H, Nakayama SF, Mito A, Arata N. Association Between Periconceptional Diet Quality and Hypertensive Disorders of Pregnancy: The Japan Environment and Children's Study. J Am Heart Assoc 2024; 13:e033702. [PMID: 39258529 DOI: 10.1161/jaha.123.033702] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 04/17/2024] [Indexed: 09/12/2024]
Abstract
BACKGROUND Little is known about the relationship of healthy diets, which are widely recommended to prevent diseases in general populations, with the risk of hypertensive disorders of pregnancy (HDP), particular among non-Western populations with different dietary habits. We aimed to investigate the association between periconceptional diet quality and the risk of HDP among pregnant Japanese women. METHODS AND RESULTS Dietary intake over 1 year before the first trimester of pregnancy was assessed using a validated, self-administered food frequency questionnaire among 81 113 pregnant Japanese women who participated in a prospective cohort of the Japan Environment and Children's Study. Overall diet quality was assessed by the Balanced Diet Score (BDS) based on adherence to the country-specific dietary guidelines and the Dietary Approaches to Stop Hypertension (DASH) score. Cases of HDP were identified by medical record transcription. The association between diet quality and HDP risk was examined using Bayesian logistic regression models with monotonic effects. We identified 2383 (2.9%) cases of HDP. A higher BDS was associated with a lower risk of HDP. When comparing the highest with the lowest quintile of the BDS, the adjusted odds ratio (aOR) of HDP was 0.83 (95% credible interval [CrI], 0.73-0.94). The DASH score and HDP risk were inversely associated in a monotonic dose-response manner (aOR per 1-quintile increase in the DASH score, 0.92 [95% CrI, 0.89-0.95]). CONCLUSIONS A high-quality diet, which is recommended for disease prevention in general populations, before conception may also reduce the risk of HDP among pregnant Japanese women.
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Affiliation(s)
- Hitomi Okubo
- Japan Environment and Children's Study Programme Office National Institute for Environmental Studies Ibaraki Japan
- Japan Society for the Promotion of Science Tokyo Japan
| | - Shoji F Nakayama
- Japan Environment and Children's Study Programme Office National Institute for Environmental Studies Ibaraki Japan
| | - Asako Mito
- Division of Maternal Medicine, Center for Maternal-Fetal, Neonatal and Reproductive Medicine National Center for Child Health and Development Tokyo Japan
| | - Naoko Arata
- Division of Maternal Medicine, Center for Maternal-Fetal, Neonatal and Reproductive Medicine National Center for Child Health and Development Tokyo Japan
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24
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Braune T, Kudlek L, Xiao C, Tang H, Demers-Potvin É, Harris HA, Fitzsimons-West E, Adams J, Winpenny EM. Interpersonal determinants of diet quality and eating behaviors in people aged 13-30 years: A systematic scoping review. Obes Rev 2024:e13835. [PMID: 39275893 DOI: 10.1111/obr.13835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 08/29/2024] [Accepted: 08/29/2024] [Indexed: 09/16/2024]
Abstract
Adolescence is an important period of increasing independence, when adolescents experience changing influences of family and friends on their diets as they transition into adulthood. We conducted a scoping review to map the literature on interpersonal determinants of diet quality and eating behaviors among individuals aged 13-30 years. We searched seven literature databases, and following screening, 329 papers were included. Determinants were grouped according to sub-categories of the Determinants of Nutrition and Eating framework: family structure (n = 122), social influences (n = 121), parental behaviors (n = 90), family food culture (n = 83), social support (n = 69), parental feeding styles (n = 24), parental attitudes/beliefs (n = 8), and parental resources/risk factors (n = 6), and we added two new sub-categories: parenting style (n = 74) and partner behaviors (n = 6). Fruit/vegetable (n = 143) and sugar-sweetened beverage (n = 102) intake were the most commonly measured diet outcomes, and breakfast consumption (n = 41) and fast food/takeaway intake (n = 39) the most commonly examined eating behaviors. This review highlights the gaps in the literature, both across the determinant sub-categories and also the relative paucity of longitudinal evidence and lack of evidence in emerging adults, particularly outside of university settings. Future research should focus on these areas to provide stronger evidence to support better design of interventions for this age group.
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Affiliation(s)
- Tanya Braune
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Laura Kudlek
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Christina Xiao
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Hao Tang
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Élisabeth Demers-Potvin
- Centre NUTRISS-Nutrition, Santé et Société, Institut sur la Nutrition et les Aliments Fonctionnels, Université Laval, Québec, Canada
| | - Holly A Harris
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | | | - Jean Adams
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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25
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Taniguchi T, Williams-Nguyen J, Muller CS, Fyfe-Johnson A, Henderson A, Umans JG, Standridge J, Shackleford T, Rosenman R, Buchwald D, Jernigan VB. Pilot study of a heart-healthy food box intervention for Native Americans with uncontrolled hypertension: methods and results from the Chickasaw Healthy Eating Environments Research Study. HEALTH EDUCATION RESEARCH 2024; 39:454-465. [PMID: 38965030 PMCID: PMC11398897 DOI: 10.1093/her/cyae023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/30/2024] [Accepted: 06/21/2024] [Indexed: 07/06/2024]
Abstract
We sought to evaluate the acceptability and feasibility of a culturally tailored food box intervention for improving blood pressure (BP), food security and Body Mass Index (BMI) among Chickasaw Nation adults with uncontrolled hypertension. As part of the Chickasaw Healthy Eating Environments Research Study (CHEERS), we administered a group randomized pilot study in four tribal communities (two intervention, two control). Participants in the intervention communities received six heart-healthy food boxes, culturally tailored to traditional Chickasaw diet and current food context. Outcomes were measured over 6 months. We enrolled 262 participants, and 204 with complete data on key variables were included in the analysis. The food boxes were very popular, and we achieved high retention for follow-up data collection. Intervention community participants had 2.6 mmHg lower mean systolic BP and improved diet quality and BMI compared with control participants, although, as expected for a pilot study, the differences were not statistically significant. The culturally tailored diet intervention and randomized trial study design were acceptable and feasible for Chickasaw Nation adults with uncontrolled hypertension. Our findings support the value of tribal-food bank partnerships as a potential approach for reducing food insecurity and hypertension-related disparities in Native American communities.
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Affiliation(s)
- Tori Taniguchi
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Jessica Williams-Nguyen
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USA
| | - Clemma S Muller
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USA
| | - Amber Fyfe-Johnson
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USA
| | - Austin Henderson
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USA
| | - Jason G Umans
- MedStar Health Research Institute, Hyattsville, MD, USA
- Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC, USA
| | | | | | - Robert Rosenman
- Institute for Research and Education to Advance Community Health, Washington State University, Seattle, WA, USA
| | | | - Valarie Bluebird Jernigan
- Center for Indigenous Health Research and Policy, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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26
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Zeng XF, Varady KA, Wang XD, Targher G, Byrne CD, Tayyem R, Latella G, Bergheim I, Valenzuela R, George J, Newberry C, Zheng JS, George ES, Spearman CW, Kontogianni MD, Ristic-Medic D, Peres WAF, Depboylu GY, Yang W, Chen X, Rosqvist F, Mantzoros CS, Valenti L, Yki-Järvinen H, Mosca A, Sookoian S, Misra A, Yilmaz Y, Kim W, Fouad Y, Sebastiani G, Wong VWS, Åberg F, Wong YJ, Zhang P, Bermúdez-Silva FJ, Ni Y, Lupsor-Platon M, Chan WK, Méndez-Sánchez N, de Knegt RJ, Alam S, Treeprasertsuk S, Wang L, Du M, Zhang T, Yu ML, Zhang H, Qi X, Liu X, Pinyopornpanish K, Fan YC, Niu K, Jimenez-Chillaron JC, Zheng MH. The role of dietary modification in the prevention and management of metabolic dysfunction-associated fatty liver disease: An international multidisciplinary expert consensus. Metabolism 2024; 161:156028. [PMID: 39270816 DOI: 10.1016/j.metabol.2024.156028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 08/25/2024] [Accepted: 09/08/2024] [Indexed: 09/15/2024]
Abstract
Metabolic dysfunction-associated fatty liver disease (MAFLD) or metabolic dysfunction-associated steatotic liver disease (MASLD), has become the leading cause of chronic liver disease worldwide. Optimal dietary intervention strategies for MAFLD are not standardized. This study aimed to achieve consensus on prevention of MAFLD through dietary modification. A multidisciplinary panel of 55 international experts, including specialists in hepatology, gastroenterology, dietetics, endocrinology and other medical specialties from six continents collaborated in a Delphi-based consensus development process. The consensus statements covered aspects ranging from epidemiology to mechanisms, management, and dietary recommendations for MAFLD. The recommended dietary strategies emphasize adherence to a balanced diet with controlled energy intake and personalized nutritional interventions, such as calorie restriction, high-protein, or low-carbohydrate diets. Specific dietary advice encouraged increasing the consumption of whole grains, plant-based proteins, fish, seafood, low-fat or fat-free dairy products, liquid plant oils, and deeply colored fruits and vegetables. Concurrently, it advised reducing the intake of red and processed meats, saturated and trans fats, ultra-processed foods, added sugars, and alcohol. Additionally, maintaining the Mediterranean or DASH diet, minimizing sedentary behavior, and engaging in regular physical activity are recommended. These consensus statements lay the foundation for customized dietary guidelines and proposing avenues for further research on nutrition and MAFLD.
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Affiliation(s)
- Xu-Fen Zeng
- Department of Clinical Nutrition, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Krista A Varady
- Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL, USA
| | - Xiang-Dong Wang
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Giovanni Targher
- Department of Medicine, University of Verona, Verona, Italy; Metabolic Diseases Research Unit, IRCCS Sacro Cuore-Don Calabria Hospital, Negrar di Valpolicella, Italy
| | - Christopher D Byrne
- Southampton National Institute for Health and Care Research Biomedical Research Centre, University Hospital Southampton, and University of Southampton, Southampton General Hospital, Southampton, UK
| | - Reema Tayyem
- Department of Human Nutrition, College of Health Science, Qatar University, Doha, Qatar
| | - Giovanni Latella
- Gastroenterology, Hepatology and Nutrition Division, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Ina Bergheim
- Department of Nutritional Sciences, Molecular Nutritional Science, University of Vienna, Vienna, Austria
| | - Rodrigo Valenzuela
- Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Jacob George
- Storr Liver Centre, The Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Sydney, NSW, Australia
| | - Carolyn Newberry
- Division of Gastroenterology, Weill Cornell Medical Center, New York, NY, USA
| | - Ju-Sheng Zheng
- Westlake Center for Intelligent Proteomics, Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, China; School of Medicine, School of Life Sciences, Westlake University, Hangzhou, China
| | - Elena S George
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - C Wendy Spearman
- Division of Hepatology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Meropi D Kontogianni
- Department of Nutrition and Dietetics, School of Health Sciences & Education, Harokopio University of Athens, Athens, Greece
| | - Danijela Ristic-Medic
- Group for Nutritional Biochemistry and Dietology, Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of the Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Wilza Arantes Ferreira Peres
- Department of Nutrition and Dietetics, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Gamze Yurtdaş Depboylu
- Izmir Katip Celebi University, Faculty of Health Sciences, Department of Nutrition and Dietetics, İzmir, Türkiye
| | - Wanshui Yang
- Department of Nutrition, School of Public Health, Anhui Medical University, Hefei, China
| | - Xu Chen
- Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Fredrik Rosqvist
- Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden, and Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Christos S Mantzoros
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Luca Valenti
- Precision Medicine-Biological Resource Center, Transfusion Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milano, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Hannele Yki-Järvinen
- Department of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Antonella Mosca
- Hepatology and Liver Transplant Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Silvia Sookoian
- Clinical and Molecular Hepatology, Translational Health Research Center (CENITRES), Maimónides University, Buenos Aires, Argentina; Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina; Faculty of Health Science, Maimónides University, Buenos Aires, Argentina
| | - Anoop Misra
- Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, New Delhi, India; National Diabetes, Obesity and Cholesterol Foundation (N-DOC), Diabetes Foundation (India) (DFI), New Delhi, India
| | - Yusuf Yilmaz
- Department of Gastroenterology, School of Medicine, Recep Tayyip Erdogan University, Rize, Türkiye
| | - Won Kim
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Republic of Korea
| | - Yasser Fouad
- Department of Gastroenterology, Hepatology and Endemic Medicine, Faculty of Medicine, Minia University, Minia, Egypt
| | - Giada Sebastiani
- Division of Gastroenterology and Hepatology and Chronic Viral Illness Service, McGill University Health Centre, Montreal, Canada; Division of Experimental Medicine, McGill University, Montreal, Canada
| | - Vincent Wai-Sun Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Fredrik Åberg
- Transplantation and Liver Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Yu Jun Wong
- Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore; Duke-NUS Medical School, SingHealth, Singapore
| | - Pianhong Zhang
- Department of Clinical Nutrition, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Francisco-Javier Bermúdez-Silva
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, Spain; Clinical Unit of Endocrinology and Nutrition, University Regional Hospital of Málaga, Málaga, Spain; The Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain
| | - Yan Ni
- Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, China
| | - Monica Lupsor-Platon
- Department of Medical Imaging, Prof. Dr. Octavian Fodor Regional Institute of Gastroenterology and Hepathology, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Wah Kheong Chan
- Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nahum Méndez-Sánchez
- Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico; Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico
| | - Robert J de Knegt
- Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, Rotterdam, the Netherlands
| | - Shahinul Alam
- Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Sombat Treeprasertsuk
- Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Li Wang
- School of Basic Medical Sciences, Beijing Key Laboratory of Neural Regeneration and Repair, Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Mulong Du
- Department of Biostatistics, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Tiejun Zhang
- School of Public Health, the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Ming-Lung Yu
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; College of Medicine and Center for Liquid Biopsy and Cohort Research, Kaohsiung Medical University, Kaohsiung, Taiwan; School of Medicine and Doctoral Program of Clinical and Experimental Medicine, College of Medicine and Center of Excellence for Metabolic Associated Fatty Liver, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Huijie Zhang
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xingshun Qi
- Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China
| | - Xin Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Global Health Institute, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Kanokwan Pinyopornpanish
- Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Yu-Chen Fan
- Department of Hepatology, Qilu Hospital, Shandong University, Jinan, China
| | - Kaijun Niu
- School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin, China; Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Josep C Jimenez-Chillaron
- Institut de Recerca Sant Joan de Déu, SJD-Barcelona Children's Hospital, Endocrine Division, Esplugues, Barcelona, Spain; Department of Physiological Sciences, School of Medicine, University of Barcelona, L'Hospitalet, Barcelona, Spain
| | - Ming-Hua Zheng
- MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China; Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, China.
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27
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Li D, Jovanovski E, Zurbau A, Sievenpiper J, Milicic D, El-Sohemy A, Vuksan V. No Difference between the Efficacy of High-Nitrate and Low-Nitrate Vegetable Supplementation on Blood Pressure after 16 Weeks in Individuals with Early-Stage Hypertension: An Exploratory, Double-Blinded, Randomized, Controlled Trial. Nutrients 2024; 16:3018. [PMID: 39275333 PMCID: PMC11397180 DOI: 10.3390/nu16173018] [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: 08/13/2024] [Revised: 08/31/2024] [Accepted: 09/02/2024] [Indexed: 09/16/2024] Open
Abstract
Dietary inorganic nitrate lowers blood pressure (BP) in healthy individuals through improved nitric oxide (NO) bioavailability. However, there is limited evidence examining the long-term effects of dietary nitrate for managing hypertension. We aimed to determine whether the sustained intake of dietary nitrate improved BP and cardiovascular disease (CVD) risk factors in individuals with early-stage hypertension. The Dietary Nitrate (NO3) on BP and CVD Risk Factors (DINO3) Trial was a multi-center, double-blinded, parallel, randomized, controlled trial in participants with elevated BP. Participants were supplemented with high-nitrate (HN) (~400 mg nitrate) or low-nitrate (LN) vegetable powder (~50 mg nitrate) on top of their usual diets for 16 weeks. The primary outcome was office systolic BP at 16 weeks. The secondary outcomes were 24 h ambulatory BP, central BP, heart-rate-corrected augmentation index (AIx75), carotid-femoral pulse wave velocity (cf-PWV), lipids, and high-sensitivity C-reactive protein (hs-CRP). Sixty-six participants were randomized at baseline (39M:27F, age: 51.5 ± 10.8 years, BMI:27.9 ± 3.2 kg/m2). In an intention-to-treat analysis, no differences were observed between HN and LN groups in terms of office systolic BP at 16 weeks (3.91 ± 3.52 mmHg, p = 0.27) or secondary outcomes. In this exploratory study, sustained HN vegetable supplementation did not exhibit more favorable vascular effects than LN vegetable supplementation in individuals with elevated BP.
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Affiliation(s)
- Dandan Li
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON M5B 1X1, Canada
| | - Elena Jovanovski
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON M5B 1X1, Canada
| | - Andreea Zurbau
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON M5B 1X1, Canada
| | - John Sievenpiper
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON M5B 1X1, Canada
| | - Davor Milicic
- Department of Cardiovascular Diseases, School of Medicine, University of Zagreb, University Hospital Center Zagreb, Kispaticeva 12, 10000 Zagreb, Croatia
| | - Ahmed El-Sohemy
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Vladimir Vuksan
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
- Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON M5B 1X1, Canada
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Abate V, Vergatti A, Altavilla N, Garofano F, Salcuni AS, Rendina D, De Filippo G, Vescini F, D'Elia L. Potassium Intake and Bone Health: A Narrative Review. Nutrients 2024; 16:3016. [PMID: 39275337 PMCID: PMC11397259 DOI: 10.3390/nu16173016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Revised: 08/28/2024] [Accepted: 09/03/2024] [Indexed: 09/16/2024] Open
Abstract
Potassium is a cation involved in the resting phase of membrane potential. Diets rich in fresh fruit and vegetables, whole grains, dairy products, and coffee have high potassium content. The shift from a pre-agriculture diet to today's consumption has led to reduced potassium intake. Indeed, the Western diet pattern is characterized by a high daily intake of saturated fats, sugars, sodium, proteins from red meat, and refined carbohydrates with a low potassium intake. These reductions are also mirrored by high sodium intakes and a high consumption of acid-generating food, which promote a chronic state of low-grade metabolic acidosis. The low-grade metabolic acidosis is a cause of the bone-wasting effect. Therefore, a long-standing acidotic state brings into play the bone that contributes to the buffering process through an increase in osteoclastic resorption. In consideration of this background, we carried out a review that focused on the pathophysiological mechanisms of the relationship between dietary potassium intake and bone health, underlining the detrimental effects of the Western dietary patterns characterized by low potassium consumption.
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Affiliation(s)
- Veronica Abate
- Department of Clinical Medicine and Surgery, University Federico II, 80131 Naples, Italy
| | - Anita Vergatti
- Department of Clinical Medicine and Surgery, University Federico II, 80131 Naples, Italy
| | - Nadia Altavilla
- Department of Clinical Medicine and Surgery, University Federico II, 80131 Naples, Italy
| | - Francesca Garofano
- Department of Clinical Medicine and Surgery, University Federico II, 80131 Naples, Italy
| | - Antonio Stefano Salcuni
- Unit of Endocrinology and Metabolism, University-Hospital S. M. Misericordia, 33100 Udine, Italy
| | - Domenico Rendina
- Department of Clinical Medicine and Surgery, University Federico II, 80131 Naples, Italy
| | - Gianpaolo De Filippo
- Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Service d'Endocrinologie et Diabétologie, 75019 Paris, France
| | - Fabio Vescini
- Unit of Endocrinology and Metabolism, University-Hospital S. M. Misericordia, 33100 Udine, Italy
| | - Lanfranco D'Elia
- Department of Clinical Medicine and Surgery, University Federico II, 80131 Naples, Italy
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29
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Ke TM, Lophatananon A, Muir KR. Exploring the Relationships between Lifestyle Patterns and Epigenetic Biological Age Measures in Men. Biomedicines 2024; 12:1985. [PMID: 39335499 PMCID: PMC11428654 DOI: 10.3390/biomedicines12091985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Revised: 08/16/2024] [Accepted: 08/21/2024] [Indexed: 09/30/2024] Open
Abstract
DNA methylation, validated as a surrogate for biological age, is a potential tool for predicting future morbidity and mortality outcomes. This study aims to explore how lifestyle patterns are associated with epigenetic changes in British men. Five biological age clocks were utilised to investigate the relationship between these epigenetic markers and lifestyle-related factors in a prospective study involving 221 participants. Spearman's correlation test, Pearson's correlation test, and univariate linear regression were employed for analysis. The results indicate that higher consumption of saturated fat and total daily calories, and a higher body mass index (BMI) are associated with accelerated biological aging. Conversely, higher vitamin D intake and a higher healthy lifestyle index (HLI) are linked to decelerated biological aging. These findings highlight the potential impact of specific lifestyle-related factors on biological aging and can serve as a reference for applying healthy lifestyle improvements in future disease prevention studies.
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Affiliation(s)
- Te-Min Ke
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PT, UK
| | - Artitaya Lophatananon
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PT, UK
| | - Kenneth R Muir
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M13 9PT, UK
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30
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Ross FC, Mayer DE, Horn J, Cryan JF, Del Rio D, Randolph E, Gill CIR, Gupta A, Ross RP, Stanton C, Mayer EA. Potential of dietary polyphenols for protection from age-related decline and neurodegeneration: a role for gut microbiota? Nutr Neurosci 2024; 27:1058-1076. [PMID: 38287652 DOI: 10.1080/1028415x.2023.2298098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
Many epidemiological studies have shown the beneficial effects of a largely plant-based diet, and the strong association between the consumption of a Mediterranean-type diet with healthy aging including a lower risk of cognitive decline. The Mediterranean diet is characterized by a high intake of olive oil, fruits and vegetables and is rich in dietary fiber and polyphenols - both of which have been postulated to act as important mediators of these benefits. Polyphenols are large molecules produced by plants to protect them from environmental threats and injury. When ingested by humans, as little as 5% of these molecules are absorbed in the small intestine with the majority metabolized by the gut microbiota into absorbable simple phenolic compounds. Flavan-3-ols, a type of flavonoid, contained in grapes, berries, pome fruits, tea, and cocoa have been associated with many beneficial effects on several risk factors for cardiovascular disease, cognitive function and brain regions involved in memory formation. Both preclinical and clinical studies suggest that these brain and heart benefits can be attributed to endothelial vascular effects and anti-inflammatory properties among others. More recently the gut microbiota has emerged as a potential modulator of the aging brain and intriguingly polyphenols have been shown to alter microbiota composition and be metabolized by different microbial species. However, there is a need for well controlled studies in large populations to identify predictors of response, particularly given the vast inter-individual variation of human gut microbiota.
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Affiliation(s)
- F C Ross
- APC Microbiome Ireland, University College Cork, Co. Cork, Ireland
| | - D E Mayer
- Institute of Human Nutrition, Columbia University, New York, USA
| | - J Horn
- Oppenheimer Centre for Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, UCLA, Los Angeles, USA
| | - J F Cryan
- APC Microbiome Ireland, University College Cork, Co. Cork, Ireland
- Department Anatomy & Neuroscience, University College Cork, Co. Cork, Ireland
| | - D Del Rio
- Department of Food and Drugs, University of Parma, Parma, Italy
| | - E Randolph
- Oppenheimer Centre for Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, UCLA, Los Angeles, USA
| | - C I R Gill
- Nutrition Innovation Centre for Food and Health, Northern Ireland, UK
| | - A Gupta
- Division of Digestive Diseases, UCLA, Los Angeles, USA
- Goodman Luskin Microbiome Center at UCLA, Los Angeles, CA, USA
| | - R P Ross
- APC Microbiome Ireland, University College Cork, Co. Cork, Ireland
| | - C Stanton
- Teagasc Food Research Centre, Moorepark, Fermoy, Co. Cork, Ireland
| | - E A Mayer
- Oppenheimer Centre for Neurobiology of Stress and Resilience, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine, UCLA, Los Angeles, USA
- Goodman Luskin Microbiome Center at UCLA, Los Angeles, CA, USA
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31
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Jeong S, Linder BA, Barnett AM, Tharpe MA, Hutchison ZJ, Culver MN, Sanchez SO, Nichols OI, Grosicki GJ, Bunsawat K, Nasci VL, Gohar EY, Fuller-Rowell TE, Robinson AT. Interplay of race and neighborhood deprivation on resting and ambulatory blood pressure in young adults. Am J Physiol Heart Circ Physiol 2024; 327:H601-H613. [PMID: 38995211 PMCID: PMC11442101 DOI: 10.1152/ajpheart.00726.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 07/02/2024] [Accepted: 07/02/2024] [Indexed: 07/13/2024]
Abstract
Nighttime blood pressure (BP) and BP dipping (daytime-nighttime BP) are prognostic for cardiovascular disease. When compared with other racial/ethnic groups, Black Americans exhibit elevated nighttime BP and attenuated BP dipping. Neighborhood deprivation may contribute to disparities in cardiovascular health, but its effects on resting and ambulatory BP patterns in young adults are unclear. Therefore, we examined associations between neighborhood deprivation with resting and nighttime BP and BP dipping in young Black and White adults. We recruited 19 Black and 28 White participants (23 males/24 females, 21 ± 1 yr, body mass index: 26 ± 4 kg/m2) for 24-h ambulatory BP monitoring. We assessed resting BP, nighttime BP, and BP dipping (absolute dip and nighttime:daytime BP ratio). We used the area deprivation index (ADI) to assess average neighborhood deprivation during early and mid-childhood and adolescence. When compared with White participants, Black participants exhibited higher resting systolic and diastolic BP (Ps ≤ 0.029), nighttime systolic BP (114 ± 9 vs. 108 ± 9 mmHg, P = 0.049), diastolic BP (63 ± 8 vs. 57 ± 7 mmHg, P = 0.010), and attenuated absolute systolic BP dipping (12 ± 5 vs. 9 ± 7 mmHg, P = 0.050). Black participants experienced greater average ADI scores compared with White participants [110 (10) vs. 97 (22), P = 0.002], and select ADI scores correlated with resting BP and some ambulatory BP measures. Within each race, select ADI scores correlated with some BP measures for Black participants, but there were no ADI and BP correlations for White participants. In conclusion, our findings suggest that neighborhood deprivation may contribute to higher resting BP and impaired ambulatory BP patterns in young adults warranting further investigation in larger cohorts.NEW & NOTEWORTHY We demonstrate that young Black adults exhibit higher resting blood pressure, nighttime blood pressure, and attenuated systolic blood pressure dipping compared with young White adults. Black adults were exposed to greater neighborhood deprivation, which demonstrated some associations with resting and ambulatory blood pressure. Our findings add to a growing body of literature indicating that neighborhood deprivation may contribute to increased blood pressure.
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Affiliation(s)
- Soolim Jeong
- School of Kinesiology, Auburn University, Auburn, Alabama, United States
| | - Braxton A Linder
- School of Kinesiology, Auburn University, Auburn, Alabama, United States
| | - Alex M Barnett
- School of Kinesiology, Auburn University, Auburn, Alabama, United States
| | - McKenna A Tharpe
- School of Kinesiology, Auburn University, Auburn, Alabama, United States
| | - Zach J Hutchison
- School of Kinesiology, Auburn University, Auburn, Alabama, United States
| | - Meral N Culver
- School of Kinesiology, Auburn University, Auburn, Alabama, United States
| | - Sofia O Sanchez
- School of Kinesiology, Auburn University, Auburn, Alabama, United States
| | - Olivia I Nichols
- Department of Human Development and Family Studies, Auburn University, Auburn, Alabama, United States
| | - Gregory J Grosicki
- Department of Health Sciences and Kinesiology, Biodynamics and Human Performance Center, Georgia Southern University (Armstrong Campus), Savannah, Georgia, United States
| | - Kanokwan Bunsawat
- Division of Geriatrics, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, United States
- George E. Wahlen Department of Veterans Affairs Medical Center, Geriatric Research, Education, and Clinical Center, Salt Lake City, Utah, United States
| | - Victoria L Nasci
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Eman Y Gohar
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Thomas E Fuller-Rowell
- Department of Human Development and Family Studies, Auburn University, Auburn, Alabama, United States
| | - Austin T Robinson
- School of Kinesiology, Auburn University, Auburn, Alabama, United States
- Department of Kinesiology, School of Public Health, Indiana University, Bloomington, Indiana, United States
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32
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Reis A, Rocha BS, Laranjinha J, de Freitas V. Dietary (poly)phenols as modulators of the biophysical properties in endothelial cell membranes: its impact on nitric oxide bioavailability in hypertension. FEBS Lett 2024; 598:2190-2210. [PMID: 38281810 DOI: 10.1002/1873-3468.14812] [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: 10/13/2023] [Revised: 12/18/2023] [Accepted: 12/27/2023] [Indexed: 01/30/2024]
Abstract
Hypertension is a major contributor to premature death, owing to the associated increased risk of damage to the heart, brain and kidneys. Although hypertension is manageable by medication and lifestyle changes, the risk increases with age. In an increasingly aged society, the incidence of hypertension is escalating, and is expected to increase the prevalence of (cerebro)vascular events and their associated mortality. Adherence to plant-based diets improves blood pressure and vascular markers in individuals with hypertension. Food flavonoids have an inhibitory effect towards angiotensin-converting enzyme (ACE1) and although this effect is greatly diminished upon metabolization, their microbial metabolites have been found to improve endothelial nitric oxide synthase (eNOS) activity. Considering the transmembrane location of ACE1 and eNOS, the ability of (poly)phenols to interact with membrane lipids modulate the cell membrane's biophysical properties and impact on nitric oxide (·NO) synthesis and bioavailability, remain poorly studied. Herein, we provide an overview of the current knowledge on the lipid remodeling of endothelial membranes with age, its impact on the cell membrane's biophysical properties and ·NO permeability across the endothelial barrier. We also discuss the potential of (poly)phenols and other plant-based compounds as key players in hypertension management, and address the caveats and challenges in adopted methodologies.
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Affiliation(s)
- Ana Reis
- REQUIMTE/LAQV, Departamento de Química e Bioquímica, Faculdade de Ciências, Universidade do Porto, Portugal
| | - Barbara S Rocha
- Faculty of Pharmacy and Center for Neuroscience and Cell Biology, University of Coimbra, Polo das Ciências da Saúde, Portugal
| | - João Laranjinha
- Faculty of Pharmacy and Center for Neuroscience and Cell Biology, University of Coimbra, Polo das Ciências da Saúde, Portugal
| | - Victor de Freitas
- REQUIMTE/LAQV, Departamento de Química e Bioquímica, Faculdade de Ciências, Universidade do Porto, Portugal
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33
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Oude Griep LM, Frost G, Holmes E, Wareham NJ, Elliott P. Systems Approach to Investigate the Role of Fruit and Vegetable Types on Vascular Function in Pre-Hypertensive Participants: Protocol and Baseline Characteristics of a Randomised Crossover Dietary Intervention. Nutrients 2024; 16:2923. [PMID: 39275238 PMCID: PMC11397325 DOI: 10.3390/nu16172923] [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: 07/18/2024] [Revised: 08/16/2024] [Accepted: 08/26/2024] [Indexed: 09/16/2024] Open
Abstract
The evidence on the impact of fruits and vegetable types on cardiovascular risk factors remains limited. Specifically, the utilisation of biomarkers to objectively measure dietary compliance and metabolic responses is emerging. This protocol and baseline characteristics of a pilot randomised controlled, crossover, dietary intervention study aimed to examine the effects of citrus fruits, cruciferous vegetables, or common fruits and vegetables on cardiovascular risk factors. A total of 39 volunteers with untreated prehypertension was recruited and consumed a standardised, provided diet with eight daily portions of citrus fruits and cruciferous vegetables, common fruits and vegetables, or a low fruit and vegetable diet (two portions/d, control diet) in a random order for 2 weeks each, separated by a wash-out week. A targeted cohort-based recruitment strategy was utilised and resulted in 74% of participants recruited by re-contacting preselected individuals from two cohort studies with a 15% average enrolment rate. Participants had an average age of 54.4 years (±6.1 years), BMI of 27.9 kg/m2, and BP of 135/81 mmHg and were mainly male (67%). The primary outcome was office blood pressure; secondary outcomes included arterial stiffness, lipid profiles, inflammation, cognitive function, and subjective mood. Biofluids, i.e., 24 h urine, stool, and blood samples, were collected for biomarker measurements with multiple metabolomic platforms and the gut microbial composition, together with traditional dietary biomarkers.
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Affiliation(s)
- Linda M Oude Griep
- Medical Research Council (MRC) Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge CB2 0QQ, UK
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, UK
| | - Gary Frost
- Section of Nutrition, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London SW7 2AZ, UK
| | - Elaine Holmes
- Section of Nutrition, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London SW7 2AZ, UK
- Centre for Computational and Systems Medicine, Health Futures Institute, Murdoch University, Perth 6150, Australia
| | - Nicholas J Wareham
- Medical Research Council (MRC) Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge CB2 0QQ, UK
| | - Paul Elliott
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, UK
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34
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Mazur M, Przytuła A, Szymańska M, Popiołek-Kalisz J. Dietary strategies for cardiovascular disease risk factors prevention. Curr Probl Cardiol 2024; 49:102746. [PMID: 39002618 DOI: 10.1016/j.cpcardiol.2024.102746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Accepted: 07/10/2024] [Indexed: 07/15/2024]
Abstract
Nutrition can play a key role in cardiovascular disease risk reduction, and its risk factors modification. This paper aims to present, compare, and summarize the main dietary concepts for preventing the main cardiovascular disease risk factors - obesity, hypertension, and dyslipidemia. The dietary models and macronutrient intakes were compared between main cardiovascular risk factors prevention recommendations. Dietary recommendations related to selected cardiovascular risk factors share the points, that can be suggested as crucial for overall cardiovascular risk factors reduction. Recommendations suggest limiting saturated fatty acids intake to <10% of total caloric intake in obesity, and <7 % in hypercholesterolemia, along with an increased intake of mono- and polyunsaturated fatty acids. In addition, daily dietary fiber intake should reach a level of 25-40 g. The vegetables and fruits should be consumed at a daily minimum level of 200g (or 4-5 portions) each. Salt intake should not exceed 5g/day. Alcohol should be generally avoided, and moderate intake levels (sex-specific) should not be exceeded. It is also worth noting, that proteins are essential for tissue formation and regeneration. Carbohydrates are the main source of energy, but it is necessary to choose products with a low glycemic index. Dietary antioxidants help combat free radicals and prevent cell damage.
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Affiliation(s)
- Michał Mazur
- Lifestyle Medicine Students' Club, Medical University of Lublin, Poland, ul. Chodzki 7, Lublin 20-093, Poland
| | - Agata Przytuła
- Clinical Dietetics Unit, Medical University of Lublin, Poland, ul. Chodzki 7, Lublin 20-093, Poland
| | - Magdalena Szymańska
- Clinical Dietetics Unit, Medical University of Lublin, Poland, ul. Chodzki 7, Lublin 20-093, Poland
| | - Joanna Popiołek-Kalisz
- Clinical Dietetics Unit, Medical University of Lublin, Poland, ul. Chodzki 7, Lublin 20-093, Poland; Department of Cardiology, Cardinal Wyszynski Hospital in Lublin, Poland, al. Krasnicka 100, Lublin 20-718, Poland.
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35
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Qin Y, Lu M, Liu L, Li M, Mi B, Zhou J, Xiao Y. The effects of diet quality, eating behavior, and sleep on the academic performance among elementary school students. Ecol Food Nutr 2024; 63:472-488. [PMID: 38909380 DOI: 10.1080/03670244.2024.2371154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2024]
Abstract
The academic success of children contributes to their income, social status, and public health. This study was conducted with 217 elementary school students from western China. Scores on the Chinese Children Dietary Index (CCDI), Dietary Approaches to Stop Hypertension (DASH), adjusted DASH, and KIDMED index were calculated to evaluate diet quality. Eating behavior and sleep quality were assessed using the Children's Eating Behavior Questionnaire (CEBQ) and Children's Sleep Habits Questionnaire (CHSQ), respectively. Academic achievement was measured using school-provided average grades. Higher CCDI scores, longer sleep time, lower total CHSQ scores, and lower subscores on "satiety responsiveness," "slowness in eating," "emotional undereating," and "food fussiness" dimensions of the CEBQ were associated with high academic achievement. In conclusion, good diet quality, sleep quality, healthy eating behaviors, and adequate sleep duration were associated with better academic performance. Interventions are recommended to be developed in education system to improve healthy diets and lifestyles, enhancing academic achievement.
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Affiliation(s)
- Yujie Qin
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Mengnan Lu
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Lujie Liu
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Meng Li
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Baibing Mi
- Department of Epidemiology and Biostatistics, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Jing Zhou
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yanfeng Xiao
- Department of Pediatrics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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36
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Narasaki Y, Siu MK, Nguyen M, Kalantar-Zadeh K, Rhee CM. Personalized nutritional management in the transition from non-dialysis dependent chronic kidney disease to dialysis. Kidney Res Clin Pract 2024; 43:575-585. [PMID: 38738275 PMCID: PMC11467355 DOI: 10.23876/j.krcp.23.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 08/14/2023] [Accepted: 11/10/2023] [Indexed: 05/14/2024] Open
Abstract
Dialysis has been the dominant treatment regimen in end-stage kidney disease as a means to remove uremic waste products and to maintain electrolyte, acid base, and fluid balance. However, given that dialysis may not always provide a survival benefit nor improved quality of life in certain subpopulations, there is growing recognition of the need for conservative and preservative management as an alternative treatment strategy for advanced chronic kidney disease (CKD). Personalized nutritional management tailored to patient's sociodemographics, social needs, psychological status, health literacy level, and preferences is a key component of conservative and preservative care, as well as in the management of patients transitioning from non-dialysis dependent CKD to dialysis. In this review, we discuss the nutritional and metabolic alterations that ensue in CKD; the rationale for low-protein diets in the conservative and preservative management of advanced CKD; the role of plant-based diets in kidney health; emerging data on dietary potassium and sodium intake on CKD outcomes; and the practical implementation of dietary interventions in advanced kidney disease.
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Affiliation(s)
- Yoko Narasaki
- Division of Nephrology, Hypertension, and Kidney Transplantation, Department of Medicine, University of California Irvine, Orange, CA, USA
- Tibor Rubin Veterans Affairs Long Beach Healthcare System, Long Beach, CA, USA
| | - Man Kit Siu
- Division of Nephrology, Hypertension, and Kidney Transplantation, Department of Medicine, University of California Irvine, Orange, CA, USA
- Tibor Rubin Veterans Affairs Long Beach Healthcare System, Long Beach, CA, USA
| | - Matthew Nguyen
- Division of Nephrology, Hypertension, and Kidney Transplantation, Department of Medicine, University of California Irvine, Orange, CA, USA
| | - Kamyar Kalantar-Zadeh
- Division of Nephrology, Hypertension, and Kidney Transplantation, Department of Medicine, University of California Irvine, Orange, CA, USA
- Tibor Rubin Veterans Affairs Long Beach Healthcare System, Long Beach, CA, USA
- The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Connie M. Rhee
- Division of Nephrology, Hypertension, and Kidney Transplantation, Department of Medicine, University of California Irvine, Orange, CA, USA
- Tibor Rubin Veterans Affairs Long Beach Healthcare System, Long Beach, CA, USA
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37
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Harper Z, Alvarado AV, Katz SE, Rovner AJ, Steeves EA, Raynor HA, Robson SM. Examining Food Security, Fruit and Vegetable Intake, and Cardiovascular Disease Risk Outcomes of Produce Prescription (PPR) Programs: A Systematic Review. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024:S1499-4046(24)00387-7. [PMID: 39217534 DOI: 10.1016/j.jneb.2024.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 06/28/2024] [Accepted: 06/28/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVE Outcomes from produce prescription (PPR) programs, an exemplar of a Food is Medicine intervention, have not been synthesized. The objective of this study was to conduct a systematic review to examine the impact of PPR programs on food security, fruit and vegetable (FV) intake, and/or cardiovascular risk factors (HbA1c, blood pressure, and blood lipids). DESIGN Searches were conducted across three databases (PubMed, CINAHL, and Web of Science). Eligible studies were published between August 2012 and April 2023, conducted in the US in child/family, or adult populations, written in English and had a PPR program as an exposure. OUTCOMES VARIABLES MEASURED Food security, FV intake, and/or cardiovascular risk factors. RESULTS Twenty studies ranging from a duration of between 6 weeks to 24 months were included. Of the 5 studies (3 in child/family and 4 in adult populations) that analyzed changes in food security status, all reported significant (P < 0.05) improvements after the PPR program. Approximately half of the included studies found significant (P < 0.05) increases in fruit, vegetable, and/or FV intake. Only studies in adult populations included cardiovascular risk factor outcomes. In these studies, mixed findings were reported; however, there were significant (P < 0.05) improvements in HbA1c when PPR programs enrolled individuals with type 2 diabetes. CONCLUSIONS AND IMPLICATIONS PPR programs provide an opportunity to improve food security in child/family, and adult populations. Evidence to support whether PPR programs increase FV intake and improve cardiovascular disease risk factors outside of HbA1c in adult populations with high HbA1c upon enrollment is less known.
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Affiliation(s)
- Zoe Harper
- Department of Health Behavior and Nutrition Sciences, University of Delaware, Newark, DE
| | | | - Sarah E Katz
- Library, Museums and Press, University of Delaware, Newark, DE
| | - Alisha J Rovner
- Department of Health Behavior and Nutrition Sciences, University of Delaware, Newark, DE
| | | | - Hollie A Raynor
- Department of Nutrition, University of Tennessee, Knoxville, TN
| | - Shannon M Robson
- Department of Health Behavior and Nutrition Sciences, University of Delaware, Newark, DE.
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38
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Lv Y, Aihemaiti G, Guo H. Effect of Dietary Approaches to Stop Hypertension (DASH) on Patients with Metabolic Syndrome and Its Potential Mechanisms. Diabetes Metab Syndr Obes 2024; 17:3103-3110. [PMID: 39206416 PMCID: PMC11350064 DOI: 10.2147/dmso.s477739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 08/02/2024] [Indexed: 09/04/2024] Open
Abstract
Metabolic syndrome (MS) is more prevalent in chronic diseases and, if left untreated, can lead to serious consequences, such as cardiovascular disease (CVD), cerebrovascular disease and type 2 diabetes, which have become significant public health issues globally. Metabolic syndrome is significantly influenced by the daily diet of patients. The dietary approaches to stop hypertension (DASH) diet, originally designed to prevent or control hypertension, offers additional metabolic benefits due to its nutrient composition. The DASH diet recommends the intake of potassium, magnesium, calcium and fibre while limiting total fat, saturated fat and sodium, which is beneficial for patients with MS. Due to its limited fat content and high levels of fibre and calcium, individuals following the DASH diet are less prone to being overweight and obese and have lower concentrations of total and low-density lipoprotein cholesterol. Moreover, the DASH diet can reduce blood pressure and is effective in correcting glucose and insulin abnormalities. This review comprehensively summarises the health benefits of the DASH diet on the risk factors of MS and describes the potential mechanisms based on available evidence.
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Affiliation(s)
- Yangting Lv
- Department of Neurology, the Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou City, Zhejiang Province, 311500, People’s Republic of China
| | - Guliziba Aihemaiti
- Department of Medicine, Changji Branch of the First Affiliated Hospital of Xinjiang Medical University, Changji City, Xinjiang Province, 831100, People’s Republic of China
| | - Huirong Guo
- Department of Scientific Research and Teaching, Changji Branch of the First Affiliated Hospital of Xinjiang Medical University, Changji City, Xinjiang Province, 831100, People’s Republic of China
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Zhan JJ, Hodge RA, Dunlop AL, Lee MM, Bui L, Liang D, Ferranti EP. Dietaryindex: a user-friendly and versatile R package for standardizing dietary pattern analysis in epidemiological and clinical studies. Am J Clin Nutr 2024:S0002-9165(24)00672-5. [PMID: 39182618 DOI: 10.1016/j.ajcnut.2024.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 07/26/2024] [Accepted: 08/09/2024] [Indexed: 08/27/2024] Open
Abstract
BACKGROUND Few standardized and open-source tools exist for calculating multiple dietary pattern indexes from dietary intake data in epidemiological and clinical studies. OBJECTIVES The primary aim is to develop and validate dietaryindex, a user-friendly and versatile R package that standardizes the calculation of dietary indexes. METHODS Dietaryindex can calculate multiple dietary indexes of high interest in research, including the Healthy Eating Index (HEI)-2020, the Alternative HEI 2010, the Dietary Approaches to Stop Hypertension Index, the Alternate Mediterranean Diet Score, the Dietary Inflammatory Index, the American Cancer Society 2020 dietary index, and the Planetary Health Diet Index from the EAT-Lancet Commission. The package includes generic dietary index calculation functions that accept any dietary assessment with preprocessed serving sizes of food groups and nutrients as defined by the research group that developed each index. For ease of use and to eliminate any need for data preprocessing, dietaryindex also offers 1-step functions that directly reference common datasets and tools, including the National Health and Nutrition Examination Survey (NHANES), the Automated Self-Administered 24-h Dietary Assessment Tool (ASA24), the Diet History Questionnaire III (DHQ3), and the Block Food Frequency Questionnaire. At least 2 independent researchers validated the serving size definitions and scoring algorithms of dietaryindex. RESULTS In our validation process, dietaryindex demonstrated full accuracy (100%) in all generic functions with 2-decimal rounding precision when compared with hand-calculated results. Similarly, using NHANES 2017-2018 data and ASA24 and DHQ3 example data, the HEI-2015 outputs from dietaryindex aligned (99.95%-100%) with results using the Statistical Analysis System codes from the National Cancer Institute. CONCLUSIONS Dietaryindex is a user-friendly, versatile, and validated informatics tool for standardized dietary index calculations. We have open-sourced all validation files and codes with detailed tutorials on GitHub (https://github.com/jamesjiadazhan/dietaryindex).
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Affiliation(s)
- Jiada J Zhan
- Nutrition & Health Sciences Doctoral Program, Laney Graduate School, Emory University, Atlanta, GA, United States.
| | - Rebecca A Hodge
- Department of Population Science, American Cancer Society, Kennesaw, GA, United States.
| | - Anne L Dunlop
- Department of Gynecology & Obstetrics, Department of Family & Preventive Medicine, School of Medicine, Emory University, Atlanta, GA, United States
| | - Matthew M Lee
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Linh Bui
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Research Advancement Consortium in Health, Hanoi, Vietnam
| | - Donghai Liang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Erin P Ferranti
- Department of Gynecology & Obstetrics, Nell Hodgson Woodruff School of Nursing, School of Medicine, Emory University, Atlanta, GA, United States
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Sekome K, Gómez-Olivé FX, Sherar LB, Esliger DW, Myezwa H. Sociocultural perceptions of physical activity and dietary habits for hypertension control: voices from adults in a rural sub-district of South Africa. BMC Public Health 2024; 24:2194. [PMID: 39138450 PMCID: PMC11320885 DOI: 10.1186/s12889-024-19320-0] [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: 08/14/2023] [Accepted: 07/01/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Over half of adults from rural South Africa are hypertensive. Apart from pharmaceutical treatment, lifestyle changes such as increasing physical activity and reducing dietary salt have been strongly advocated for the control of hypertension. However, the control rates of hypertension for adults in rural South Africa are low. In this paper we explore whether this is due to the recommended lifestyle intervention not aligning with the individual's socio-cultural determinants of behaviour change. AIM To explore the social and cultural beliefs, perceptions and practices regarding physical activity and diet as a hypertension control intervention on hypertensive adults living in a rural sub-district in South Africa. METHODS Nine focus group discussions were conducted with hypertensive adults aged 40 years and above from Bushbuckridge sub-district in Mpumalanga Province of South Africa using a semi-structured interview guide. Each session began with introductions of the discussion theme followed by a short discussion on what the participants know about hypertension and the normal blood pressure readings. Physical activity and dietary habits were then introduced as the main subject of discussion. Probing questions were used to get more insight on a specific topic. A thematic analysis approach was used to generate codes, categories, and themes. A manual approach to data analysis was chosen and data obtained through transcripts were analysed inductively. FINDINGS Participants had a lack of knowledge about blood pressure normal values. Perceived causes of hypertension were alluded to psychosocial factors such as family and emotional-related issues. Physical activity practices were influenced by family and community members' attitudes and gender roles. Factors which influenced dietary practices mainly involved affordability and availability of food. To control their hypertension, participants recommend eating certain foods, emotional control, taking medication, exercising, praying, correct food preparation, and performing house chores. CONCLUSION Lifestyle interventions to control hypertension for adults in a rural South African setting using physical activity promotion and dietary control must consider the beliefs related to hypertension control of this population.
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Affiliation(s)
- Kganetso Sekome
- Department of physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Johannesburg, 2193, South Africa.
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, South Africa.
| | - Francesc Xavier Gómez-Olivé
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Lauren B Sherar
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, South Africa
| | - Dale W Esliger
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, South Africa
| | - Hellen Myezwa
- School of Therapeutic Science, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Clair L, Kashton J, Pierce GN. Estimating the Potential Health Care Cost-Savings from a Flax-Based Treatment for Hypertension. Nutrients 2024; 16:2638. [PMID: 39203775 PMCID: PMC11356921 DOI: 10.3390/nu16162638] [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: 07/03/2024] [Revised: 08/04/2024] [Accepted: 08/07/2024] [Indexed: 09/03/2024] Open
Abstract
Hypertension contributes to the increase in health care spending in Canada through two primary mechanisms. First, it directly increases costs, as individuals with hypertension require medical care to manage the condition. Second, it indirectly raises expenses by serving as a risk factor for numerous chronic diseases, leading to increased health care utilization among those affected. Therefore, reducing hypertension prevalence could alleviate its resulting strain on the Canadian health care system. Clinical trials have demonstrated that daily flaxseed consumption effectively lowers both systolic and diastolic blood pressure. This study employs a four-step cost-of-illness analysis to estimate the potential health care cost-savings from a flaxseed-based treatment for hypertension. The analysis begins by assessing the proportion of individuals with hypertension likely to adopt the flaxseed regimen. It then evaluates the impact of flaxseed consumption on systolic and diastolic blood pressure. Next, data from the Canadian Health Measures Survey, Cycles 5 and 6, are used to estimate the prevalence of hypertension and the expected reduction in prevalence due to the flaxseed treatment. Finally, the potential reduction in health care spending is calculated. To incorporate uncertainty, partial sensitivity analysis and Monte Carlo simulations were utilized, varying the intake success rate and other model parameters, respectively. The most conservative estimate suggests a potential health care cost-savings of CAD 96,284,344 in Canada for the year 2020.
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Affiliation(s)
- Luc Clair
- Canadian Centre for Agri-Food Research in Health and Medicine, Albrechtsen Research Centre, St. Boniface Hospital, Winnipeg, MB R2H 2A6, Canada; (J.K.); (G.N.P.)
- Department of Economics, Faculty of Business and Economics, University of Winnipeg, Winnipeg, MB R3B 2E9, Canada
| | - Jared Kashton
- Canadian Centre for Agri-Food Research in Health and Medicine, Albrechtsen Research Centre, St. Boniface Hospital, Winnipeg, MB R2H 2A6, Canada; (J.K.); (G.N.P.)
| | - Grant N. Pierce
- Canadian Centre for Agri-Food Research in Health and Medicine, Albrechtsen Research Centre, St. Boniface Hospital, Winnipeg, MB R2H 2A6, Canada; (J.K.); (G.N.P.)
- Institute of Cardiovascular Sciences, Albrechtsen Research Centre, St. Boniface Hospital, Winnipeg, MB R2H 2A6, Canada
- Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W3, Canada
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Wang Q, Xie T, Huo X, Snieder H, Corpeleijn E. Diet Quality at 3 Years of Age Relates to Lower Body Mass Index but Not Lower Blood Pressure at 10 Years of Age. Nutrients 2024; 16:2634. [PMID: 39203771 PMCID: PMC11356893 DOI: 10.3390/nu16162634] [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: 07/04/2024] [Revised: 07/26/2024] [Accepted: 07/31/2024] [Indexed: 09/03/2024] Open
Abstract
A healthy diet prevents overweight problems and hypertension. We investigated the associations of a healthy diet with the body mass index (BMI) and blood pressure (BP) in early childhood. In the GECKO birth cohort, height, weight, and BP were measured at 5 and 10 years of age. Diet was evaluated at 3 years using three diet scores: the Dietary Approaches to Stop Hypertension (DASH), the Mediterranean Diet Score (MDS), and the Lifelines Diet Score (LLDS). Linear and logistic regression models assessed the associations of diet scores with the BMI and BP. Of the 1077 children included, 10.8% were overweight or obese at 5 years. That number was 16.5% at 10 years. In addition, 34.5% had elevated BP at 5 years. That number was 23.9% at 10 years. Higher DASH, MDS, and LLDS, which indicate healthier diets, were all associated with lower BMI z-scores at 10 years of age. Higher DASH is related to lower overweight risk at 10 years. None of the diet scores were associated with BP or elevated BP at either 5 or 10 years. Also, in an overweight subset, diet was not related to BP. A healthy diet in early childhood is related to children being less overweight but not having lower BP at 10 years of age.
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Affiliation(s)
- Qihua Wang
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (Q.W.); (H.S.)
- Laboratory of Environmental Medicine and Developmental Toxicology, Guangdong Key Laboratory of Environmental Pollution and Health, College of Environment and Climate, Jinan University, Guangzhou 511443, China;
| | - Tian Xie
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (Q.W.); (H.S.)
| | - Xia Huo
- Laboratory of Environmental Medicine and Developmental Toxicology, Guangdong Key Laboratory of Environmental Pollution and Health, College of Environment and Climate, Jinan University, Guangzhou 511443, China;
| | - Harold Snieder
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (Q.W.); (H.S.)
| | - Eva Corpeleijn
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (Q.W.); (H.S.)
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Crowthers R, Thi Mong Nguyen T, Martinez D. Circadian disruptions and their role in the development of hypertension. Front Neurosci 2024; 18:1433512. [PMID: 39170672 PMCID: PMC11335678 DOI: 10.3389/fnins.2024.1433512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Accepted: 07/22/2024] [Indexed: 08/23/2024] Open
Abstract
Circadian fluctuations in physiological setpoints are determined by the suprachiasmatic nucleus (SCN) which exerts control over many target structures within and beyond the hypothalamus via projections. The SCN, or central pacemaker, orchestrates synchrony between the external environment and the internal circadian mechanism. The resulting cycles in hormone levels and autonomic nervous system (ANS) activity provide precise messages to specific organs, adjusting, for example, their sensitivity to approaching hormones or metabolites. The SCN responds to both photic (light) and non-photic input. Circadian patterns are found in both heart rate and blood pressure, which are linked to daily variations in activity and autonomic nervous system activity. Variations in blood pressure are of great interest as several cardiovascular diseases such as stroke, arrhythmias, and hypertension are linked to circadian rhythm dysregulation. The disruption of normal day-night cycles, such as in shift work, social jetlag, or eating outside of normal hours leads to desynchronization of the central and peripheral clocks. This desynchronization leads to disorganization of the cellular processes that are normally driven by the interactions of the SCN and photic input. Here, we review autonomic system function and dysfunction due to regulation and interaction between different cardiorespiratory brain centers and the SCN, as well as social, lifestyle, and external factors that may impact the circadian control of blood pressure.
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Ham JY, Jang YK, Jeon BY, Shon YH. Magnesium from Deep Seawater as a Potentially Effective Natural Product against Insulin Resistance: A Randomized Trial. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1265. [PMID: 39202546 PMCID: PMC11355969 DOI: 10.3390/medicina60081265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 07/31/2024] [Accepted: 08/02/2024] [Indexed: 09/03/2024]
Abstract
Background and Objectives: Deep seawater has been shown to restore pancreatic function in obese diabetic mice and considerably improve the homeostatic model assessment for insulin resistance, total cholesterol, and low-density lipoprotein cholesterol concentrations in patients with impaired fasting glucose or glucose tolerance. In this study, the effect of 12-week daily consumption of magnesium (Mg2+)-containing deep seawater mineral extracts on blood glucose concentration and insulin metabolism-associated indicators was investigated in patients with impaired glucose tolerance. Materials and methods: In this 12-week randomized, double-blind trial, patients (n = 37) with impaired glucose tolerance consumed deep seawater mineral extracts. Changes in blood glucose concentration and related indicators were compared between the treatment group and placebo group (n = 38). Results: The fasting insulin, C-peptide, homeostatic model assessment for insulin resistance, quantitative insulin sensitivity check index, homeostatic model assessment of beta-cell function, and Stumvoll insulin sensitivity index values in the deep seawater mineral extract group showed improvements compared with the placebo group. However, no significant differences between groups were observed in fasting blood glucose, postprandial blood glucose, glycated hemoglobin, or incremental area under the curve values. Conclusions: Oral supplementation with deep seawater mineral extracts enriched in Mg2+ markedly improves insulin sensitivity in patients with pre-diabetes. This study illustrates the potential clinical application of natural Mg2+ from deep seawater to alleviate insulin resistance in patients with pre-diabetes. Trial registration: This trial was retrospectively registered with Clinical Research information Service (CRIS), No. KCT0008695, on 8 August 2023.
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Affiliation(s)
- Ji Yeon Ham
- Department of Laboratory Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, 807 Hogukro Buk-gu, Daegu 41404, Republic of Korea
| | - You Kyung Jang
- QBM Research Institute, QBM Co., Ltd., 7-25 Gangnam-daero 27-gil, Seocho-gu, Seoul 06752, Republic of Korea
| | - Byong Yeob Jeon
- QBM Research Institute, QBM Co., Ltd., 7-25 Gangnam-daero 27-gil, Seocho-gu, Seoul 06752, Republic of Korea
| | - Yun Hee Shon
- Bio-Medical Research Institute, Kyungpook National University Hospital, 135 Dongdukro Jung-gu, Daegu 41940, Republic of Korea
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Nabil MA, Rychlik L, Nicholson A, Cheung P, Olsovsky GD, Molden J, Tripuraneni A, Hajivandi SS, Banchs JE. Dietary interventions in the management of atrial fibrillation. Front Cardiovasc Med 2024; 11:1418059. [PMID: 39149585 PMCID: PMC11324562 DOI: 10.3389/fcvm.2024.1418059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 07/22/2024] [Indexed: 08/17/2024] Open
Abstract
Atrial fibrillation (AF) represents the most common cardiac arrhythmia with significant morbidity and mortality implications. It is a common cause of hospital admissions, significantly impacts quality of life, increases morbidity and decreases life expectancy. Despite advancements in treatment options, prevalence of AF remains exceptionally high. AF is a challenging disease to manage, not just clinically but also financially. Evidence suggests lifestyle modification, including dietary changes, plays a significant role in the treatment of AF. This review aims to analyze the existing literature on the effects of dietary modifications on the incidence, progression, and outcomes of atrial fibrillation. It examines various dietary components, including alcohol, caffeine, omega-3 polyunsaturated fatty acids and minerals, and their impact on AF incidence, progression, and outcomes. The evidence surrounding the effects of dietary patterns, such as the Mediterranean and low carbohydrate diets, on AF is also evaluated. Overall, this review underscores the importance of dietary interventions as part of a comprehensive approach to AF management and highlights the need for further research in this emerging field.
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Affiliation(s)
- Muhammad Ahad Nabil
- Department of Medicine, Division of Cardiology, Baylor Scott & White Health, Round Rock, TX, United States
| | - Leanne Rychlik
- Department of Medicine, Division of Cardiology, Baylor Scott & White Health, Temple, TX, United States
| | - Audrey Nicholson
- Department of Medicine, Division of Cardiology, Baylor Scott & White Health, Round Rock, TX, United States
| | - Peter Cheung
- Department of Medicine, Division of Cardiology, Baylor Scott & White Health, Round Rock, TX, United States
| | - Gregory D Olsovsky
- Department of Medicine, Division of Cardiology, Baylor Scott & White Health, Temple, TX, United States
| | - Jaime Molden
- Department of Medicine, Division of Cardiology, Baylor Scott & White Health, Temple, TX, United States
| | - Ajay Tripuraneni
- Department of Medicine, Division of Cardiology, Baylor Scott & White Health, Temple, TX, United States
| | - Shayan-Salehi Hajivandi
- Department of Medicine, Division of Cardiology, Baylor Scott & White Health, Round Rock, TX, United States
| | - Javier E Banchs
- Department of Medicine, Division of Cardiology, Baylor Scott & White Health, Temple, TX, United States
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Herforth AW, Ballard T, Rzepa A. Development of the Diet Quality Questionnaire for Measurement of Dietary Diversity and Other Diet Quality Indicators. Curr Dev Nutr 2024; 8:103798. [PMID: 39161595 PMCID: PMC11331720 DOI: 10.1016/j.cdnut.2024.103798] [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: 02/01/2024] [Revised: 05/15/2024] [Accepted: 06/13/2024] [Indexed: 08/21/2024] Open
Abstract
Background To monitor trends toward healthy and sustainable diets, there is a need for feasible survey tools, with cross-cultural validity, low-cost, and low-expertise requirements. Objectives The objective of this research was to develop a method to gather data suitable for monitoring diet quality in the general population (women and men of all ages) that is feasible within multitopic surveys, low burden for both enumerators and respondents, valid at population level, and that captures the information necessary for understanding diet quality at global and local levels. Methods A literature review was conducted to identify constructs of diet quality with existing consensus, indicators with existing global demand, and methods that may be feasible and valid. Results were presented to a technical advisory group for debate, resulting in consensus on a set of constructs to be measured, desired indicators, viable data collection platforms, and an approach for testing and piloting. Results Food group-based indicators and 24-h recall period were selected as the most feasible and valid approach for population-level monitoring. A 29-item Diet Quality Questionnaire (DQQ) was developed, where each yes/no question asks about the consumption of a distinct food group on the previous day or night. The food groups were selected for the purpose of deriving indicators to capture the constructs for which there was consensus: nutrient adequacy, and protection against noncommunicable diseases, including both positive and negative risk factors. Conclusions The DQQ is low cost and feasible to administer in existing large-scale surveys, overcoming barriers to diet data collection that have precluded the routine monitoring of diet quality in the past. This novel approach has now been used across >85 countries in the Gallup World Poll and other surveys, generating the first nationally representative available datasets on Minimum Dietary Diversity for Women and complementary diet quality indicators.
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Affiliation(s)
- Anna W Herforth
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Terri Ballard
- Independent Scholar, Rome, Italy
- Gallup, Inc., Dubai, United Arab Emirates
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Sathyanarayanan A. First, a seat; then, an upgrade. J Hum Hypertens 2024; 38:620-623. [PMID: 38987380 DOI: 10.1038/s41371-024-00933-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 06/26/2024] [Accepted: 07/04/2024] [Indexed: 07/12/2024]
Abstract
The Sir Stanley Peart Essay Competition is an annual event run by the British and Irish Hypertension Society to encourage Early Career Researchers to continue the ethos of Sir Stanley Peart. Sir Stanley Peart was a clinician and clinical researcher who made a major contribution to our understanding of blood pressure regulation. He was the first to demonstrate the release of noradrenaline in response to sympathetic nerve stimulation. He was also the first to purify, and determine the structure of, angiotensin and he later isolated the enzyme, renin, and carried out many important investigations of the factors controlling its release in the body. This year, the essay topic was "Do we need new classes of antihypertensive drugs?". In his prize-winning essay, "First, a seat; then, an upgrade", Dr Sathyanarayanan argues that we do not need new classes of antihypertensive drugs, instead we should focus our attention on addressing the factors that lead to high blood pressure in the first place and use our existing drug classes more effectively.
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Jin Q, Chen Y. Risk of heart disease and stroke among individuals with prehypertension or blood pressure progression: a national population-based cohort study. Blood Press Monit 2024; 29:173-179. [PMID: 38465651 PMCID: PMC11198946 DOI: 10.1097/mbp.0000000000000698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 10/13/2023] [Indexed: 03/12/2024]
Abstract
OBJECTIVE The purpose of our study was to analyze the association of blood pressure and blood pressure progression with heart disease and stroke among Chinese population. METHOD We included a total of 10 122 adults aged 45 years and above free of heart disease or stroke at baseline from the China Health and Retirement Longitudinal Study cohort. We used Cox proportional hazards models to analyze the relationship between cardiovascular risk and prehypertension in subjects with or without progression to hypertension. RESULT During a mean follow-up of 6.5 years, 1972 subjects were either diagnosed with heart disease or had a stroke (composite outcome). Compared with individuals with normotension at baseline, the fully adjusted hazard ratio (HR) [95% confidence interval (CI)] was 1.25 (1.10-1.42) and 1.52 (1.34-1.74) for composite outcome in individuals with prehypertension and hypertension at baseline, respectively. The subjects who progressed to hypertension had higher risk of cardiovascular outcomes than those who remained at normal blood pressure or prehypertension in a fully adjusted model. The subjects who progressed from prehypertension to hypertension had 1.72 times higher risk [HR (95% CI): 1.72 (1.37-2.16)] of cardiovascular outcomes than those who remained at normal blood pressure or prehypertension in a fully adjusted model. CONCLUSION The cardiovascular risk of subjects with prehypertension is higher than that of subjects with normal blood pressure. After a diagnosis of hypertension, subjects who progressed from normal blood pressure to hypertension had an increased risk of heart disease and stroke.
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Affiliation(s)
- Qingdong Jin
- The Third Clinical Medical College, Fujian Medical University, Fuzhou
- Department of Neurosurgery, the First Hospital of Putian, Putain
| | - Yanqing Chen
- Scientific Research and Education, the First Hospital of Putian, Putain, Fujian, China
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Sims KD, Wei PC, Penko JM, Hennessy S, Coxson PG, Mukand NH, Bellows BK, Kazi DS, Zhang Y, Boylan R, Moran AE, Bibbins-Domingo K. Projected Impact of Nonpharmacologic Management of Stage 1 Hypertension Among Lower-Risk US Adults. Hypertension 2024; 81:1758-1765. [PMID: 38881463 PMCID: PMC11254541 DOI: 10.1161/hypertensionaha.124.22704] [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: 01/07/2024] [Accepted: 05/28/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND The 2017 American College of Cardiology/American Heart Association blood pressure guideline classified 31 million US adults as having stage 1 hypertension and recommended clinicians provide counseling on behavioral change to the low-risk portion of this group. However, nationwide reductions in cardiovascular disease (CVD) and associated health care expenditures achievable by nonpharmacologic therapy remain unquantified. METHODS We simulated interventions on a target population of US adults aged 35 to 64 years, identified from the 2015-2018 National Health and Nutrition Examination Survey, with low-risk stage 1 systolic hypertension: that is, untreated systolic blood pressure 130 to 139 mm Hg with diastolic BP <90 mm Hg; no history of CVD, diabetes, or chronic kidney disease; and a low 10-year risk of CVD. We used meta-analyses and trials to estimate the effects of population-level behavior modification on systolic blood pressure. We assessed the extent to which restricting intervention to those in regular contact with clinicians might prevent the delivery of nonpharmacologic therapy. RESULTS Controlling systolic blood pressure to <130 mm Hg among the 8.8 million low-risk US adults with stage 1 hypertension could prevent 26 100 CVD events, avoid 2900 deaths, and save $1.7 billion in total direct health care costs over 10 years. Adoption of the Dietary Approaches to Stop Hypertension diet could prevent 28 000 CVD events. Other nonpharmacologic interventions could avert between 3800 and 19 500 CVD events. However, only 51% of men and 75% of women regularly interacted with clinicians for counseling opportunities. CONCLUSIONS Among low-risk adults with stage 1 hypertension, substantial benefits to cardiovascular health could be achieved through public policy that promotes the adoption of nonpharmacologic therapy.
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Affiliation(s)
- Kendra D. Sims
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California
- Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Pengxiao Carol Wei
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California
| | - Joanne M. Penko
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California
| | - Susan Hennessy
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California
| | - Pamela G. Coxson
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California
| | - Nita H. Mukand
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California
| | - Brandon K. Bellows
- Department of Medicine, Division of General Medicine, Columbia University Irving Medical Center, New York, New York
| | - Dhruv S. Kazi
- Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Division of Cardiology, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, Massachusetts
| | - Yiyi Zhang
- Department of Medicine, Division of General Medicine, Columbia University Irving Medical Center, New York, New York
| | - Ross Boylan
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California
| | - Andrew E. Moran
- Department of Medicine, Division of General Medicine, Columbia University Irving Medical Center, New York, New York
| | - Kirsten Bibbins-Domingo
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California
- Division of General Internal Medicine, Zuckerberg San Francisco General Hospital, San Francisco, California
- UCSF Center for Vulnerable Populations at Zuckerberg San Francisco General Hospital, San Francisco, California
- Editorial Board, Journal of the American Medical Association, Chicago, Illinois
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Genovesi S, Vania A, Caroli M, Orlando A, Lieti G, Parati G, Giussani M. Non-Pharmacological Treatment for Cardiovascular Risk Prevention in Children and Adolescents with Obesity. Nutrients 2024; 16:2497. [PMID: 39125377 PMCID: PMC11314452 DOI: 10.3390/nu16152497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Revised: 07/28/2024] [Accepted: 07/29/2024] [Indexed: 08/12/2024] Open
Abstract
In younger generations, excess weight has reached very alarming levels. Excess weight in adults is associated with increased mortality and morbidity from cardiovascular disease. However, it is not easy to distinguish to what extent these effects are the result of obesity itself or how much is due to the various cardiovascular risk factors that often accompany excess weight. Several risk factors, such as hypertension, dyslipidemia, hyperuricemia, glucose intolerance, and type 2 diabetes mellitus, are already present in pediatric age. Therefore, early intervention with the goal of correcting and/or eliminating them is particularly important. In the child and adolescent with obesity, the first approach to achieve weight reduction and correct the risk factors associated with severe excess weight should always be non-pharmacologic and based on changing poor eating habits and unhealthy lifestyles. The purpose of this review is to give an update on non-pharmacological interventions to be implemented for cardiovascular prevention in children and adolescents with obesity, and their effectiveness. In particular, interventions targeting each individual cardiovascular risk factor will be discussed.
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Affiliation(s)
- Simonetta Genovesi
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milano, Italy;
- Istituto Auxologico Italiano, IRCCS, 20145 Milano, Italy; (A.O.); (M.G.)
| | | | | | - Antonina Orlando
- Istituto Auxologico Italiano, IRCCS, 20145 Milano, Italy; (A.O.); (M.G.)
| | - Giulia Lieti
- UO Nefrologia e Dialisi, ASST-Rhodense, 20024 Garbagnate Milanese, Italy;
| | - Gianfranco Parati
- School of Medicine and Surgery, University of Milano-Bicocca, 20126 Milano, Italy;
- Istituto Auxologico Italiano, IRCCS, 20145 Milano, Italy; (A.O.); (M.G.)
| | - Marco Giussani
- Istituto Auxologico Italiano, IRCCS, 20145 Milano, Italy; (A.O.); (M.G.)
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