1
|
Hosseini F, Jayedi A, Khan TA, Shab-Bidar S. Dietary carbohydrate and the risk of type 2 diabetes: an updated systematic review and dose-response meta-analysis of prospective cohort studies. Sci Rep 2022; 12:2491. [PMID: 35169172 PMCID: PMC8847553 DOI: 10.1038/s41598-022-06212-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 01/05/2022] [Indexed: 12/12/2022] Open
Abstract
We did this study to clarify the association between carbohydrate intake and the risk of type 2 diabetes (T2D) and potential effect modification by geographical location. PubMed, Scopus and Web of Science were searched to find prospective cohort studies of dietary carbohydrate intake and T2D risk. A random-effects dose-response meta-analysis was performed to calculate the summary hazard ratios (HRs) and 95%CIs. The quality of cohort studies and the certainty of evidence was rated using the Newcastle-Ottawa Scale and GRADE tool, respectively. Eighteen prospective cohort studies with 29,229 cases among 607,882 participants were included. Thirteen studies were rated to have high quality, and five as moderate quality. The HR for the highest compared with the lowest category of carbohydrate intake was 1.02 (95%CI: 0.91, 1.15; I2 = 67%, GRADE = low certainty). The HRs were 0.93 (95%CI: 0.82, 1.05; I2 = 58%, n = 7) and 1.26 (95%CI: 1.11, 1.44; I2 = 6%, n = 6) in Western and Asian countries, respectively. Dose-response analysis indicated a J shaped association, with the lowest risk at 50% carbohydrate intake (HR50%: 0.95, 95%CI: 0.90, 0.99) and with risk increasing significantly at 70% carbohydrate intake (HR70%: 1.18, 95%CI: 1.03, 1.35). There was no association between low carbohydrate diet score and the risk of T2D (HR: 1.14, 95%CI: 0.89, 1.47; I2 = 90%, n = 5). Carbohydrate intake within the recommended 45-65% of calorie intake was not associated with an increased risk of T2D. Carbohydrate intake more than 70% calorie intake might be associated with a higher risk.
Collapse
Affiliation(s)
- Fatemeh Hosseini
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Ahmad Jayedi
- Social Determinant of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Tauseef Ahmad Khan
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON, Canada
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), No 44, Hojjat-dost Alley, Naderi St., Keshavarz Blvd, P. O. Box 14155/6117, Tehran, Iran.
| |
Collapse
|
2
|
Sakurai M, Ishizaki M, Morikawa Y, Kido T, Naruse Y, Nakashima Y, Okamoto C, Nogawa K, Watanabe Y, Suwazono Y, Hozawa A, Yoshita K, Nakagawa H. Frequency of consumption of balanced meals, bodyweight gain and incident risk of glucose intolerance in Japanese men and women: A cohort study. J Diabetes Investig 2021; 12:763-770. [PMID: 32869545 PMCID: PMC8089009 DOI: 10.1111/jdi.13392] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 08/17/2020] [Accepted: 08/20/2020] [Indexed: 12/14/2022] Open
Abstract
AIMS/INTRODUCTION This cohort study assessed the risk for bodyweight gain and development of glucose intolerance based on the frequency of consumption of balanced meals including grain, fish or meat and vegetables. MATERIALS AND METHODS The participants (8,573 men, 3,327 women) were employees of a company in Japan. A self-administered questionnaire was used to evaluate the frequency of balanced meal consumption. Bodyweight changes and the incidence of glucose intolerance (glycated hemoglobin >6.0%) during the 3-year follow-up period were determined through annual health examinations. RESULTS The mean bodyweight change over a period of 3 years was 0.78 kg for men and 0.84 kg for women. A lower frequency of balanced meals was associated with a higher bodyweight gain for men (P for trend = 0.004), but not for women. During the study, 464 men and 115 women developed glucose intolerance. Overall, the frequency of balanced meals was not associated with the risk of glucose intolerance in either sex. However, the interaction between the frequency of balanced meals and degree of obesity had a significant effect on the incidence of glucose intolerance in men (P = 0.005), with less frequent consumption of balanced meals being associated with a higher risk for glucose intolerance among men with a BMI ≥25.0 kg/m2 (P for trend = 0.007). CONCLUSIONS A higher frequency of balanced meals, including grain, fish or meat and vegetable dishes - important components of healthy Japanese food - was associated with a lower risk of glucose intolerance in obese men, but not in non-obese men and women.
Collapse
Affiliation(s)
- Masaru Sakurai
- Department of Social and Environmental MedicineKanazawa Medical UniversityUchinadaJapan
- Health Evaluation CenterKanazawa Medical UniversityUchinadaJapan
| | - Masao Ishizaki
- Department of Social and Environmental MedicineKanazawa Medical UniversityUchinadaJapan
- Health Evaluation CenterKanazawa Medical UniversityUchinadaJapan
| | - Yuko Morikawa
- School of NursingKanazawa Medical UniversityUchinadaJapan
| | - Teruhiko Kido
- School of Health SciencesCollege of Medical, Pharmaceutical and Health SciencesKanazawa UniversityKanazawaJapan
| | | | | | | | - Kazuhiro Nogawa
- Department of Occupation and Environmental MedicineGraduate School of MedicineChiba UniversityChibaJapan
| | - Yuuka Watanabe
- Department of Occupation and Environmental MedicineGraduate School of MedicineChiba UniversityChibaJapan
| | - Yasushi Suwazono
- Department of Occupation and Environmental MedicineGraduate School of MedicineChiba UniversityChibaJapan
| | - Atsushi Hozawa
- Department of Preventive Medicine and EpidemiologyTohoku Medical Megabank OrganizationTohoku UniversitySendaiJapan
| | - Katsushi Yoshita
- Department of Food Science and NutritionGraduate School of Human Life ScienceOsaka City UniversityOsakaJapan
| | - Hideaki Nakagawa
- Department of Social and Environmental MedicineKanazawa Medical UniversityUchinadaJapan
| |
Collapse
|
3
|
|
4
|
The Effectiveness of a Smartphone Application on Modifying the Intakes of Macro and Micronutrients in Primary Care: A Randomized Controlled Trial. The EVIDENT II Study. Nutrients 2018; 10:nu10101473. [PMID: 30309008 PMCID: PMC6212958 DOI: 10.3390/nu10101473] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 10/04/2018] [Accepted: 10/08/2018] [Indexed: 02/07/2023] Open
Abstract
Background: This study evaluates the effectiveness of adding a diet smartphone application to standard counseling to modify dietary composition over the long term (12 months). Methods: A randomized, controlled, multicenter clinical trial was conducted involving the participation of 833 subjects from primary care clinics (415 to the intervention (counseling + application) group (IG) and 418 to the control (counseling) group (CG)). Both groups were counseled about a healthy diet and physical activity. For the 3-month intervention period, the IG was also trained to use a diet smartphone application that involved dietary self-monitoring and tailored feedback. Nutritional composition was estimated using a self-reported food frequency questionnaire. Results: An analysis of repeated measures revealed an interaction between the group and the percentages of carbohydrates (p = 0.031), fats (p = 0.015) and saturated fats (p = 0.035) consumed. Both groups decreased their energy intake (Kcal) at 12 months (IG: −114 (95% CI: −191 to −36); CG: −108 (95% CI: −184 to −31)). The IG reported a higher percentage intake of carbohydrates (1.1%; 95% CI: 0.1 to 2.0), and lower percentage intakes of fats (−1.0%; 95% CI: −1.9 to −0.1) and saturated fats (−0.4%; 95%CI: −0.8 to −0.1) when compared to the CG. Conclusions: Better results were achieved in terms of modifying usual diet composition from counseling and the diet smartphone application compared to counseling alone. This was evaluated by a self-reported questionnaire, which indicated an increased percentage intake of carbohydrates, and decreased percentage intakes of fats and saturated fats.
Collapse
|
5
|
Oral magnesium supplementation improves endothelial function and attenuates subclinical atherosclerosis in thiazide-treated hypertensive women. J Hypertens 2017; 35:89-97. [PMID: 27759579 DOI: 10.1097/hjh.0000000000001129] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Epidemiological studies demonstrate an inverse association between serum magnesium and incidence of cardiovascular disease. Diuretics commonly cause hypomagneseamia. METHOD We evaluated effects of magnesium supplementation on blood pressure (BP) and vascular function in thiazide-treated hypertensive women in a randomized, double-blind, clinical trial. Hypertensive women (40-65 years) on hydrochlorothiazide and mean 24-h BP at least 130/80 mmHg were divided into placebo and supplementation (magnesium chelate 600 mg/day) groups. Patients were evaluated for nutritional and biochemical parameters, office and ambulatory blood pressure monitoring, brachial flow-mediated dilatation (FMD), peripheral arterial tonometry, assessment of carotid intima-media thickness, central hemodynamic parameters and pulse wave velocity at inclusion and after 6-month follow-up. RESULTS The magnesium group had a significant reduction in SBP (144 ± 17 vs. 134 ± 14 mmHg, P = 0.036) and DBP (88 ± 9 vs. 81 ± 8 mmHg, P = 0.005) at 6 months, without effect on plasma glucose, lipids, or arterial stiffness parameters. The placebo group showed a significant increase in carotid intima-media thickness (0.78 ± 0.13 vs. 0.89 ± 0.14 mm, P = 0.033) without change in the magnesium group (0.79 ± 0.16 vs. 0.79 ± 0.19 mm, P = 0.716) after 6 months. The magnesium group demonstrated a significant increase in variation of FMD vs. the placebo group (+3.7 ± 2.1 vs. 2.4 ± 1.2%, P = 0.015). There was a significant correlation between the intracellular magnesium variation and FMD (r = 0.44, P = 0.011). CONCLUSION Magnesium supplementation was associated with better BP control, improved endothelial function and amelioration of subclinical atherosclerosis in these thiazide-treated hypertensive women.
Collapse
|
6
|
Metabolic phenotyping for discovery of urinary biomarkers of diet, xenobiotics and blood pressure in the INTERMAP Study: an overview. Hypertens Res 2016; 40:336-345. [PMID: 28003647 DOI: 10.1038/hr.2016.164] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 10/03/2016] [Accepted: 10/07/2016] [Indexed: 12/27/2022]
Abstract
The etiopathogenesis of cardiovascular diseases (CVDs) is multifactorial. Adverse blood pressure (BP) is a major independent risk factor for epidemic CVD affecting ~40% of the adult population worldwide and resulting in significant morbidity and mortality. Metabolic phenotyping of biological fluids has proven its application in characterizing low-molecular-weight metabolites providing novel insights into gene-environmental-gut microbiome interaction in relation to a disease state. In this review, we synthesize key results from the INTERnational study of MAcro/micronutrients and blood Pressure (INTERMAP) Study, a cross-sectional epidemiologic study of 4680 men and women aged 40-59 years from Japan, the People's Republic of China, the United Kingdom and the United States. We describe the advancements we have made regarding the following: (1) analytical techniques for high-throughput metabolic phenotyping; (2) statistical analyses for biomarker identification; (3) discovery of unique food-specific biomarkers; and (4) application of metabolome-wide association studies to gain a better understanding into the molecular mechanisms of cross-cultural and regional BP differences.
Collapse
|
7
|
The Effect of the Sodium to Potassium Ratio on Hypertension Prevalence: A Propensity Score Matching Approach. Nutrients 2016; 8:nu8080482. [PMID: 27509520 PMCID: PMC4997395 DOI: 10.3390/nu8080482] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Revised: 07/20/2016] [Accepted: 08/02/2016] [Indexed: 11/17/2022] Open
Abstract
This study investigated the effect of the sodium to potassium ratio on hypertension prevalence and blood pressure. The study population was constructed by pooling the Korean National Health and Nutrition Examination Surveys between 2010 and 2014. The study population was divided into quartiles based on the sodium to potassium ratio, and the effect was inferred by the difference in hypertension prevalence across quartiles by six pairwise comparisons using a propensity score matching technique. The quartiles with the higher sodium to potassium ratio had higher hypertension prevalence rates based on the following pairwise comparisons: the first vs. third quartile, the first vs. fourth quartile, the second vs. third quartile, and the second vs. fourth quartile. The prevalence differences were 2.74% point (p < 0.05), 3.44% point (p < 0.01), 2.47% point (p < 0.05), and 2.95% point (p < 0.01), respectively. In addition, statistically significant higher systolic (p < 0.05) and diastolic blood pressure (p < 0.01) was observed in the second quartiles compared to the first quartiles. Because a strong association was also detected between the sodium to potassium ratio and blood pressure even at a low level of sodium to potassium ratio, a lower sodium to potassium ratio diet than a usual diet is recommended to control high blood pressure in Korea.
Collapse
|
8
|
Chan Q, Stamler J, Oude Griep LM, Daviglus ML, Van Horn L, Elliott P. An Update on Nutrients and Blood Pressure. J Atheroscler Thromb 2015; 23:276-89. [PMID: 26686565 PMCID: PMC6323301 DOI: 10.5551/jat.30000] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Adverse blood pressure (BP) is a major independent risk factor for epidemic cardiovascular diseases affecting almost one-quarter of the adult population worldwide. Dietary intake is a major determinant in the development and progression of high BP. Lifestyle modifications, including recommended dietary guidelines, are advocated by the American Society of Hypertension, the International Society of Hypertension, the Japanese Society of Hypertension, and many other organisations for treating all hypertensive people, prior to initiating drug therapy and as an adjunct to medication in persons already on drug therapy. Lifestyle modification can also reduce high BP and prevent development of hypertension. This review synthesizes results from the International Study of Macro/Micronutrients and Blood Pressure (INTERMAP), a cross-sectional epidemiological study of 4,680 men and women aged 40-59 years from Japan, the People's Republic of China, the United Kingdom, and the United States, published over the past few years on cross cultural BP differences. INTERMAP has previously reported that intakes of vegetable protein, glutamic acid, total and insoluble fibre, total polyunsaturated fatty acid and linoleic acid, total n-3 fatty acid and linolenic acid, phosphorus, calcium, magnesium, and non-heme iron were inversely related to BP. Direct associations of sugars (fructose, glucose, and sucrose) and sugar-sweetened beverages (especially combined with high sodium intake), cholesterol, glycine, alanine, and oleic acid from animal sources with BP were also reported by the INTERMAP Study.
Collapse
Affiliation(s)
- Queenie Chan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Jeremiah Stamler
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Linda M. Oude Griep
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Martha L. Daviglus
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Institute for Minority Health Research, University of Chicago, IL, USA
| | - Linda Van Horn
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Paul Elliott
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| |
Collapse
|
9
|
Sakurai M, Nakamura K, Miura K, Takamura T, Yoshita K, Nagasawa SY, Morikawa Y, Ishizaki M, Kido T, Naruse Y, Nakashima M, Nogawa K, Suwazono Y, Sasaki S, Nakagawa H. Dietary carbohydrate intake, presence of obesity and the incident risk of type 2 diabetes in Japanese men. J Diabetes Investig 2015; 7:343-51. [PMID: 27330720 PMCID: PMC4847888 DOI: 10.1111/jdi.12433] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 08/18/2015] [Accepted: 09/10/2015] [Indexed: 12/11/2022] Open
Abstract
Aims/Introduction The present cohort study assessed the risk among Japanese men for developing type 2 diabetes, based on the percentage of energy intake from carbohydrates and degree of obesity. Participants and Methods The participants were 2,006 male factory employees, and the macronutrient intake of each patient was measured using a self‐administered diet history questionnaire. The incidence of diabetes was determined in annual blood examinations over a 10‐year period. Results During the study, 232 participants developed diabetes. The crude incidence rates (/1,000 person‐years) for different levels of carbohydrate intake as a percentage of calories consumed (<50.0, 50.0–57.4, 57.5–65.0, >65.0% of energy intake) were 16.5, 14.4, 12.7 and 17.6. Overall, carbohydrate intake was not associated with the risk of diabetes. However, there was significant interaction between carbohydrate intake and degree of obesity on the incidence of diabetes (P for interaction = 0.024). Higher carbohydrate intake was associated with elevated risk for diabetes among participants with a body mass index ≥25.0 kg/m2 (P for trend = 0.034). For obese participants, the multivariate‐adjusted hazard ratio for those with carbohydrate intakes >65% energy was 2.01 (95% confidence interval 1.08–3.71), which was significantly higher than that of participants with carbohydrate intakes 50.0–57.4% energy. Conclusions Higher carbohydrate intake was associated with higher risk of diabetes in obese participants, but not in non‐obese participants. Obese participants with carbohydrate intakes >65% energy should reduce their intakes to levels within the desirable carbohydrate energy proportion for Japanese (50–65% energy) to prevent development of type 2 diabetes.
Collapse
Affiliation(s)
- Masaru Sakurai
- Department of Epidemiology and Public Health Kanazawa Medical University Ishikawa Japan
| | - Koshi Nakamura
- Department of Public Health Hokkaido University Graduate School of Medicine Sapporo Japan
| | - Katsuyuki Miura
- Department of Health Science Shiga University of Medical Science Otsu Japan
| | - Toshinari Takamura
- Department of Disease Control and Homeostasis Kanazawa University Graduate School of Medical Science Kanazawa Japan
| | - Katsushi Yoshita
- Department of Food Science and Nutrition Graduate School of Human Life Science Osaka City University Osaka Japan
| | - Shin-Ya Nagasawa
- Department of Epidemiology and Public Health Kanazawa Medical University Ishikawa Japan
| | - Yuko Morikawa
- Department of Epidemiology and Public Health Kanazawa Medical University Ishikawa Japan
| | - Masao Ishizaki
- Department of Social and Environmental Medicine Kanazawa Medical University Ishikawa Japan
| | - Teruhiko Kido
- School of Health Sciences College of Medical Pharmaceutical and Health Sciences Kanazawa University Kanazawa Japan
| | - Yuchi Naruse
- Department of Human Science and Fundamental Nursing Toyama University Toyama Japan
| | - Motoko Nakashima
- Department of Community Health Nursing Kanazawa Medical University Ishikawa Japan
| | - Kazuhiro Nogawa
- Department of Occupation and Environmental Medicine Graduate School of Medicine Chiba University Chiba Japan
| | - Yasushi Suwazono
- Department of Occupation and Environmental Medicine Graduate School of Medicine Chiba University Chiba Japan
| | - Satoshi Sasaki
- Department of Social and Preventive Epidemiology School of Public Health The University of Tokyo Tokyo Japan
| | - Hideaki Nakagawa
- Department of Epidemiology and Public Health Kanazawa Medical University Ishikawa Japan
| |
Collapse
|
10
|
Kulthinee S, Wyss JM, Roysommuti S. Taurine supplementation prevents the adverse effect of high sugar intake on arterial pressure control after cardiac ischemia/reperfusion in female rats. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2015; 803:597-611. [PMID: 25833530 DOI: 10.1007/978-3-319-15126-7_48] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Supaporn Kulthinee
- Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | | | | |
Collapse
|
11
|
Molitor J, Brown IJ, Chan Q, Papathomas M, Liverani S, Molitor N, Richardson S, Van Horn L, Daviglus ML, Dyer A, Stamler J, Elliott P. Blood pressure differences associated with Optimal Macronutrient Intake Trial for Heart Health (OMNIHEART)-like diet compared with a typical American Diet. Hypertension 2014; 64:1198-204. [PMID: 25201893 PMCID: PMC4230995 DOI: 10.1161/hypertensionaha.114.03799] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The Dietary Approaches to Stop Hypertension-Sodium (DASH-Sodium) trial demonstrated beneficial effects on blood pressure (BP) of the DASH diet with lower sodium intake when compared with typical American diet. The subsequent Optimal Macronutrient Intake Trial for Heart Health (OMNIHEART) trial reported additional BP benefits from replacing carbohydrate in the DASH diet with either protein or monounsaturated fats. The primary aim of this study is to assess possible BP benefits of an OMNIHEART-like diet in free-living Americans using cross-sectional US population data of the International Study of Macronutrients, Micronutrients and Blood Pressure (INTERMAP) study. The INTERMAP data include four 24-hour dietary recalls, 2 timed 24-hour urine collections, 8 BP readings for 2195 individuals aged 40 to 59 years from 8 US INTERMAP population samples. Analyses are conducted using 2 approaches: (1) regression of BP on a linear OMNIHEART nutrient score calculated for each individual and (2) a Bayesian approach comparing estimated BP levels of an OMNIHEART-like nutrient profile with a typical American nutrient profile. After adjustment for potential confounders, an OMNIHEART score higher by 1 point was associated with systolic/diastolic BP differences of -1.0/-0.5 mm Hg (both P<0.001). Mean systolic/diastolic BPs were 111.3/68.4 and 115.2/70.6 mm Hg for Bayesian OMNIHEART and Control profiles, respectively, after controlling for possible confounders, with BP differences of -3.9/-2.2 mm Hg, P(difference≤0)=0.98/0.96. Findings were comparable for men and women, for nonhypertensive participants, and with adjustment for antihypertensive treatment. Our findings from data on US population samples indicate broad generalizability of OMNIHEART results beyond the trial setting and support recommendations for an OMNIHEART-style diet for prevention/control of population-wide adverse BP levels.
Collapse
Affiliation(s)
- John Molitor
- From the Department of Epidemiology and Biostatistics, School of Public Health (J.M., I.J.B., Q.C., S.L., N.M., P.E.), MRC-HPA Centre for Environment and Health (Q.C., P.E.), Imperial College London, London, United Kingdom; College of Public Health and Human Sciences, Oregon State University, Corvallis (J.M.); School of Mathematics and Statistics, University of St Andrews, St Andrews, United Kingdom (M.P.); MRC Biostatistics Unit, Cambridge, United Kingdom (S.L., S.R.); and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (L.V.H., M.L.D., A.D., J.S.).
| | - Ian J Brown
- From the Department of Epidemiology and Biostatistics, School of Public Health (J.M., I.J.B., Q.C., S.L., N.M., P.E.), MRC-HPA Centre for Environment and Health (Q.C., P.E.), Imperial College London, London, United Kingdom; College of Public Health and Human Sciences, Oregon State University, Corvallis (J.M.); School of Mathematics and Statistics, University of St Andrews, St Andrews, United Kingdom (M.P.); MRC Biostatistics Unit, Cambridge, United Kingdom (S.L., S.R.); and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (L.V.H., M.L.D., A.D., J.S.)
| | - Queenie Chan
- From the Department of Epidemiology and Biostatistics, School of Public Health (J.M., I.J.B., Q.C., S.L., N.M., P.E.), MRC-HPA Centre for Environment and Health (Q.C., P.E.), Imperial College London, London, United Kingdom; College of Public Health and Human Sciences, Oregon State University, Corvallis (J.M.); School of Mathematics and Statistics, University of St Andrews, St Andrews, United Kingdom (M.P.); MRC Biostatistics Unit, Cambridge, United Kingdom (S.L., S.R.); and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (L.V.H., M.L.D., A.D., J.S.)
| | - Michail Papathomas
- From the Department of Epidemiology and Biostatistics, School of Public Health (J.M., I.J.B., Q.C., S.L., N.M., P.E.), MRC-HPA Centre for Environment and Health (Q.C., P.E.), Imperial College London, London, United Kingdom; College of Public Health and Human Sciences, Oregon State University, Corvallis (J.M.); School of Mathematics and Statistics, University of St Andrews, St Andrews, United Kingdom (M.P.); MRC Biostatistics Unit, Cambridge, United Kingdom (S.L., S.R.); and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (L.V.H., M.L.D., A.D., J.S.)
| | - Silvia Liverani
- From the Department of Epidemiology and Biostatistics, School of Public Health (J.M., I.J.B., Q.C., S.L., N.M., P.E.), MRC-HPA Centre for Environment and Health (Q.C., P.E.), Imperial College London, London, United Kingdom; College of Public Health and Human Sciences, Oregon State University, Corvallis (J.M.); School of Mathematics and Statistics, University of St Andrews, St Andrews, United Kingdom (M.P.); MRC Biostatistics Unit, Cambridge, United Kingdom (S.L., S.R.); and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (L.V.H., M.L.D., A.D., J.S.)
| | - NuooTing Molitor
- From the Department of Epidemiology and Biostatistics, School of Public Health (J.M., I.J.B., Q.C., S.L., N.M., P.E.), MRC-HPA Centre for Environment and Health (Q.C., P.E.), Imperial College London, London, United Kingdom; College of Public Health and Human Sciences, Oregon State University, Corvallis (J.M.); School of Mathematics and Statistics, University of St Andrews, St Andrews, United Kingdom (M.P.); MRC Biostatistics Unit, Cambridge, United Kingdom (S.L., S.R.); and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (L.V.H., M.L.D., A.D., J.S.)
| | - Sylvia Richardson
- From the Department of Epidemiology and Biostatistics, School of Public Health (J.M., I.J.B., Q.C., S.L., N.M., P.E.), MRC-HPA Centre for Environment and Health (Q.C., P.E.), Imperial College London, London, United Kingdom; College of Public Health and Human Sciences, Oregon State University, Corvallis (J.M.); School of Mathematics and Statistics, University of St Andrews, St Andrews, United Kingdom (M.P.); MRC Biostatistics Unit, Cambridge, United Kingdom (S.L., S.R.); and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (L.V.H., M.L.D., A.D., J.S.)
| | - Linda Van Horn
- From the Department of Epidemiology and Biostatistics, School of Public Health (J.M., I.J.B., Q.C., S.L., N.M., P.E.), MRC-HPA Centre for Environment and Health (Q.C., P.E.), Imperial College London, London, United Kingdom; College of Public Health and Human Sciences, Oregon State University, Corvallis (J.M.); School of Mathematics and Statistics, University of St Andrews, St Andrews, United Kingdom (M.P.); MRC Biostatistics Unit, Cambridge, United Kingdom (S.L., S.R.); and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (L.V.H., M.L.D., A.D., J.S.)
| | - Martha L Daviglus
- From the Department of Epidemiology and Biostatistics, School of Public Health (J.M., I.J.B., Q.C., S.L., N.M., P.E.), MRC-HPA Centre for Environment and Health (Q.C., P.E.), Imperial College London, London, United Kingdom; College of Public Health and Human Sciences, Oregon State University, Corvallis (J.M.); School of Mathematics and Statistics, University of St Andrews, St Andrews, United Kingdom (M.P.); MRC Biostatistics Unit, Cambridge, United Kingdom (S.L., S.R.); and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (L.V.H., M.L.D., A.D., J.S.)
| | - Alan Dyer
- From the Department of Epidemiology and Biostatistics, School of Public Health (J.M., I.J.B., Q.C., S.L., N.M., P.E.), MRC-HPA Centre for Environment and Health (Q.C., P.E.), Imperial College London, London, United Kingdom; College of Public Health and Human Sciences, Oregon State University, Corvallis (J.M.); School of Mathematics and Statistics, University of St Andrews, St Andrews, United Kingdom (M.P.); MRC Biostatistics Unit, Cambridge, United Kingdom (S.L., S.R.); and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (L.V.H., M.L.D., A.D., J.S.)
| | - Jeremiah Stamler
- From the Department of Epidemiology and Biostatistics, School of Public Health (J.M., I.J.B., Q.C., S.L., N.M., P.E.), MRC-HPA Centre for Environment and Health (Q.C., P.E.), Imperial College London, London, United Kingdom; College of Public Health and Human Sciences, Oregon State University, Corvallis (J.M.); School of Mathematics and Statistics, University of St Andrews, St Andrews, United Kingdom (M.P.); MRC Biostatistics Unit, Cambridge, United Kingdom (S.L., S.R.); and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (L.V.H., M.L.D., A.D., J.S.)
| | - Paul Elliott
- From the Department of Epidemiology and Biostatistics, School of Public Health (J.M., I.J.B., Q.C., S.L., N.M., P.E.), MRC-HPA Centre for Environment and Health (Q.C., P.E.), Imperial College London, London, United Kingdom; College of Public Health and Human Sciences, Oregon State University, Corvallis (J.M.); School of Mathematics and Statistics, University of St Andrews, St Andrews, United Kingdom (M.P.); MRC Biostatistics Unit, Cambridge, United Kingdom (S.L., S.R.); and Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (L.V.H., M.L.D., A.D., J.S.).
| |
Collapse
|
12
|
Zhu X, Lin J, Song Y, Liu H, Zhang R, Fan M, Li Y, Tian R, Fang D. A high-carbohydrate diet lowered blood pressure in healthy Chinese male adolescents. Biosci Trends 2014; 8:132-7. [DOI: 10.5582/bst.8.132] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
13
|
Stamler J, Brown IJ, Yap IKS, Chan Q, Wijeyesekera A, Garcia-Perez I, Chadeau-Hyam M, Ebbels TMD, De Iorio M, Posma J, Daviglus ML, Carnethon M, Holmes E, Nicholson JK, Elliott P. Dietary and urinary metabonomic factors possibly accounting for higher blood pressure of black compared with white Americans: results of International Collaborative Study on macro-/micronutrients and blood pressure. Hypertension 2013; 62:1074-80. [PMID: 24101663 PMCID: PMC3912568 DOI: 10.1161/hypertensionaha.113.01810] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Black compared with non-Hispanic white Americans have higher systolic and diastolic blood pressure and rates of prehypertension/hypertension. Reasons for these adverse findings remain obscure. Analyses here focused on relations of foods/nutrients/urinary metabolites and higher black blood pressure for 369 black compared with 1190 non-Hispanic white Americans aged 40 to 59 years from 8 population samples. Multiple linear regression, standardized data from four 24-hour dietary recalls per person, two 24-hour urine collections, and 8 blood pressure measurements were used to quantitate the role of foods, nutrients, and metabolites in higher black blood pressure. Compared with non-Hispanic white Americans, blacks' average systolic/diastolic pressure was higher by 4.7/3.4 mm Hg (men) and 9.0/4.8 mm Hg (women). Control for higher body mass index of black women reduced excess black systolic/diastolic pressure to 6.8/3.8 mm Hg. Lesser intake of vegetables, fruits, grains, vegetable protein, glutamic acid, starch, fiber, minerals, and potassium, and higher intake of processed meats, pork, eggs, and sugar-sweetened beverages, along with higher cholesterol and higher Na/K ratio, related to in higher black blood pressure. Control for 11 nutrient and 10 non-nutrient correlates reduced higher black systolic/diastolic pressure to 2.3/2.3 mm Hg (52% and 33% reduction in men) and to 5.3/2.8 mm Hg (21% and 27% reduction in women). Control for foods/urinary metabolites had little further influence on higher black blood pressure. Less favorable multiple nutrient intake by blacks than non-Hispanic white Americans accounted, at least in part, for higher black blood pressure. Improved dietary patterns can contribute to prevention/control of more adverse black blood pressure levels.
Collapse
Affiliation(s)
- Jeremiah Stamler
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, 680 N Lake Shore Dr, Suite 1400, Chicago, IL 60611.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Ismail NA, Posma JM, Frost G, Holmes E, Garcia-Perez I. The role of metabonomics as a tool for augmenting nutritional information in epidemiological studies. Electrophoresis 2013; 34:2776-86. [PMID: 23893902 DOI: 10.1002/elps.201300066] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 07/04/2013] [Accepted: 07/12/2013] [Indexed: 11/07/2022]
Abstract
Most chronic diseases have been demonstrated to have a link to nutrition. Within food and nutritional research there is a major driver to understand the relationship between diet and disease in order to improve health of individuals. However, the lack of accurate dietary intake assessment in free-living populations, makes accurate estimation of how diet is associated with disease risk difficulty. Thus, there is a pressing need to find solutions to the inaccuracy of dietary reporting. Metabolic profiling of urine or plasma can provide an unbiased approach to characterizing dietary intake and various high-throughput analytical platforms have been used in order to implement targeted and nontargeted assays in nutritional clinical trials and nutritional epidemiology studies. This review describes first the challenges presented in interpreting the relationship between diet and health within individual and epidemiological frameworks. Second, we aim to explore how metabonomics can benefit different types of nutritional studies and discuss the critical importance of selecting appropriate analytical techniques in these studies. Third, we propose a strategy capable of providing accurate assessment of food intake within an epidemiological framework in order establish accurate associations between diet and health.
Collapse
Affiliation(s)
- Nurhafzan A Ismail
- Division of Endocrinology and Metabolism, Nutrition and Dietetic Research Group, Imperial College London, London, United Kingdom
| | | | | | | | | |
Collapse
|
15
|
Stamler J, Brown IJ, Daviglus ML, Chan Q, Miura K, Okuda N, Ueshima H, Zhao L, Elliott P. Dietary glycine and blood pressure: the International Study on Macro/Micronutrients and Blood Pressure. Am J Clin Nutr 2013; 98:136-45. [PMID: 23656904 PMCID: PMC3683815 DOI: 10.3945/ajcn.112.043000] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 03/29/2013] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Available data have indicated independent direct relations of dietary animal protein and meat to the blood pressure (BP) of individuals. OBJECTIVE In this study, we aimed to assess whether BP is associated with the intake of dietary amino acids higher relatively in animal than in vegetable protein (alanine, arginine, aspartic acid, glycine, histidine, lysine, methionine, and threonine). DESIGN The study was a cross-sectional epidemiologic study that involved 4680 persons aged 40-59 y from 17 random population samples in the People's Republic of China, Japan, the United Kingdom, and the United States. BP was measured 8 times at 4 visits; dietary data (83 nutrients and 18 amino acids) were from four 24-h dietary recalls and two 24-h urine collections. RESULTS Dietary glycine and alanine (the percentage of total protein intake) were considered singly related directly to BP; with these 2 amino acids together in regression models (from model 1, which was controlled for age, sex, and sample, to model 5, which was controlled for 16 possible confounders), glycine, but not alanine, was significantly related to BP. Estimated average BP differences associated with a 2-SD higher glycine intake (0.71 g/24 h) were 2.0-3.0-mm Hg systolic BP (z = 2.97-4.32) stronger in Western than in East Asian participants. In Westerners, meat was the main dietary source of glycine but not in East Asians (Chinese: grains/flour and rice/noodles; Japanese: fish/shellfish and rice/noodles). CONCLUSION Dietary glycine may have an independent adverse effect on BP, which possibly contributes to direct relations of animal protein and meat to BP.
Collapse
Affiliation(s)
- Jeremiah Stamler
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Miura K, Stamler J, Brown IJ, Ueshima H, Nakagawa H, Sakurai M, Chan Q, Appel LJ, Okayama A, Okuda N, Curb JD, Rodriguez BL, Robertson C, Zhao L, Elliott P. Relationship of dietary monounsaturated fatty acids to blood pressure: the International Study of Macro/Micronutrients and Blood Pressure. J Hypertens 2013; 31:1144-50. [PMID: 23572200 PMCID: PMC4109685 DOI: 10.1097/hjh.0b013e3283604016] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE In short-term feeding trials, replacement of other macronutrients with monounsaturated fatty acid reduces blood pressure. However, observational studies have not clearly demonstrated a relationship between monounsaturated fatty acid intake and blood pressure. We report associations of monounsaturated fatty acid intake of individuals with blood pressure in a cross-sectional study. METHODS The International Study of Macro/Micronutrients and Blood Pressure is a cross-sectional epidemiologic study of 4680 men and women ages 40-59 years from 17 population samples in China, Japan, UK and USA. Nutrient intake data were based on four in-depth multipass 24-h dietary recalls/person and two-timed 24-h urine collections/person. Blood pressure was measured eight times at four visits. RESULTS Mean monounsaturated fatty acid intake ranged from 8.1%kcal (China) to 12.2%kcal (USA). With sequential models to control for possible confounders (dietary, other), linear regression analyses showed significant inverse relationship of total monounsaturated fatty acid intake with DBP for all participants; for 2238 'nonintervened' individuals, the relationship was stronger. Estimated DBP differences with 2-SD higher monounsaturated fatty acids (5.35%kcal) were -0.82 mmHg (P < 0.05) for all participants and -1.70 mmHg (P < 0.01) for nonintervened individuals. Inverse associations of dietary total oleic acid (main monounsaturated) with blood pressure in nonintervened individuals were not significant, but those of oleic acid from vegetable sources were stronger and significant (P < 0.05). CONCLUSION Dietary monounsaturated fatty acid intake, especially oleic acid from vegetable sources, may contribute to prevention and control of adverse blood pressure levels in general populations.
Collapse
Affiliation(s)
- Katsuyuki Miura
- Department of Health Science, Shiga University of Medical Science, Otsu, Japan.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
|
18
|
Direct association between dietary cholesterol intake and blood pressure: too good to be 'entirely' true. J Hypertens 2011; 29:194-7. [PMID: 21191277 DOI: 10.1097/hjh.0b013e3283424d3b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
19
|
Brown IJ, Stamler J, Van Horn L, Robertson CE, Chan Q, Dyer AR, Huang CC, Rodriguez BL, Zhao L, Daviglus ML, Ueshima H, Elliott P. Sugar-sweetened beverage, sugar intake of individuals, and their blood pressure: international study of macro/micronutrients and blood pressure. Hypertension 2011; 57:695-701. [PMID: 21357284 PMCID: PMC3086758 DOI: 10.1161/hypertensionaha.110.165456] [Citation(s) in RCA: 150] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The obesity epidemic has focused attention on relationships of sugars and sugar-sweetened beverages (SSBs) to cardiovascular risk factors. Here we report cross-sectional associations of SSBs, diet beverages, and sugars with blood pressure (BP) for United Kingdom and US participants of the International Study of Macro/Micronutrients and Blood Pressure. Data collected include four 24-hour dietary recalls, two 24-hour urine collections, 8 BP readings, and questionnaire data for 2696 people ages 40 to 59 years of age from 10 US/United Kingdom population samples. Associations of SSBs, diet beverages, and sugars (fructose, glucose, and sucrose) with BP were assessed by multiple linear regression. SSB intake related directly to BP, with P values of 0.005 to <0.001 (systolic BP) and 0.14 to <0.001 (diastolic BP). SSB intake higher by 1 serving per day (355 mL/24 hours) was associated with systolic/diastolic BP differences of +1.6/+0.8 mm Hg (both P<0.001) and +1.1/+0.4 mm Hg (P<0.001/<0.05) with adjustment for weight and height. Diet beverage intake was inversely associated with BP (P 0.41 to 0.003). Fructose- and glucose-BP associations were direct, with significant sugar-sodium interactions: for individuals with above-median 24-hour urinary sodium excretion, fructose intake higher by 2 SD (5.6% kcal) was associated with systolic/diastolic BP differences of +3.4/+2.2 mm Hg (both P<0.001) and +2.5/+1.7 mm Hg (both P=0.002) with adjustment for weight and height. Observed independent, direct associations of SSB intake and BP are consistent with recent trial data. These findings, plus adverse nutrient intakes among SSB consumers, and greater sugar-BP differences for persons with higher sodium excretion lend support to recommendations that intake of SSBs, sugars, and salt be substantially reduced.
Collapse
Affiliation(s)
- Ian J. Brown
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Jeremiah Stamler
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Linda Van Horn
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Claire E. Robertson
- Department of Human and Health Sciences, School of Biosciences, University of Westminster, London, UK
| | - Queenie Chan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Alan R. Dyer
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Chiang-Ching Huang
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | | | - Liancheng Zhao
- Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Martha L. Daviglus
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Hirotsugu Ueshima
- Department of Health Science, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Paul Elliott
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- MRC-HPA Centre for Environment and Health, Imperial College London, London, UK
| | | |
Collapse
|
20
|
Sakurai M, Stamler J, Miura K, Brown IJ, Nakagawa H, Elliott P, Ueshima H, Chan Q, Tzoulaki I, Dyer AR, Okayama A, Zhao L. Relationship of dietary cholesterol to blood pressure: the INTERMAP study. J Hypertens 2011; 29:222-8. [PMID: 21045731 PMCID: PMC3075799 DOI: 10.1097/hjh.0b013e32834069a5] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE A direct relationship of dietary cholesterol to blood pressure of men has been reported in a few observational studies from the USA. It is not clear whether this association prevails consistently, for example, in populations with varied dietary habits, across ethnic groups, and sexes. Cross-sectional data from the International Study of Macro/Micro-nutrients and Blood Pressure (INTERMAP) were used to assess relations of dietary cholesterol intake to blood pressure in men and women from four countries. METHODS Data include 83 nutrients from four multipass 24-h dietary recalls and two-timed 24-h urine collections; eight blood pressure readings, and questionnaire data, for 4680 participants ages 40-59 years from 17 population samples in Japan, People's Republic of China, UK, and USA. RESULTS With sequential models to control for multiple possible confounders (dietary, other), linear regression analyses showed that dietary cholesterol was directly related to SBP for all participants and for nonhypertensive individuals, but not to DBP. With adjustment for 12 variables, estimated SBP differences with 2SD for higher cholesterol intake (131.0 mg/1000 kcal) were 0.9 mmHg (P < 0.05) for all participants and 1.1 mmHg (P < 0.01) for nonhypertensive individuals, findings attenuated with addition of height and weight to the model. CONCLUSION INTERMAP found a low-order, positive relationship of dietary cholesterol intake to SBP with control for multiple possible confounders. Reduction of dietary cholesterol intake may contribute to prevention and control of adverse blood pressure levels in general populations.
Collapse
Affiliation(s)
- Masaru Sakurai
- Department of Epidemiology and Public Health, Kanazawa Medical University, Ishikawa, Japan
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Does dietary starch raise blood pressure? J Hypertens 2009; 27:212-3. [DOI: 10.1097/hjh.0b013e32831dde9b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|