Dietary intake and the development of the metabolic syndrome: the Atherosclerosis Risk in Communities study

Metabolic Syndrome and Associated Components Among Police Officers: A 7 and 12-Year Longitudinal Analysis

OBJECTIVE

This study estimated risk of metabolic syndrome (MetSyn) and its components among police officers including differences by sex.

METHODS

Police officers were examined at baseline and two follow-up examinations after 7 and 12 years. MetSyn was defined using the 2005 guidelines from the American Heart Association/National Heart, Lung, and Blood Institute. Risk for incident MetSyn and its components at follow-up exams and risk ratios in males compared to females were estimated using modified Poisson regression.

RESULTS

The 7- ( n = 276) and 12- ( n = 191) year incidence of MetSyn was 20.4% and 22.2%, respectively. MetSyn components with lowest and highest incidence were reduced HDL cholesterol and abdominal obesity. The 7-year risk of developing glucose intolerance was two-fold higher in males compared to females.

CONCLUSIONS

Longitudinal analysis of incidence of MetSyn and its components is important for understanding future cardiovascular disease morbidity and mortality.

Nonnutritive sweetener consumption, metabolic risk factors, and inflammatory biomarkers among Adults in the Cancer Prevention Study-3 Diet Assessment Sub-Study

BACKGROUND

Nonnutritive sweeteners (NNSs) are widely used to replace added sugars, yet their role in metabolic health and chronic disease prevention is debated.

OBJECTIVE

The objective of this study was to examine associations between NNS consumption, metabolic risk factors, and inflammatory biomarkers.

METHODS

This cross-sectional analysis included 624 adults in the American Cancer Society's Cancer Prevention Study-3 Diet Assessment Substudy (DAS). Consumption of NNS, including aspartame, saccharin, sucralose, and acesulfame-potassium, was estimated using the mean quantities reported in 6 24-h dietary recalls over 1 y. Fasting insulin, C-peptide, hemoglobin A1c (HbA1c), leptin, adiponectin, C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and interleukin-10 (IL-10) were measured in fasting blood samples collected twice, 6 mo apart. Multivariable linear regression was used to examine associations between NNS consumption and the mean levels of each metabolic or inflammatory biomarker. Base models were adjusted for age, sex, race, education, smoking, and physical activity; full models were further adjusted for body mass index (BMI), diet quality (Healthy Eating Index 2020), and energy intake.

RESULTS

More than half (55%) of participants reported consuming NNS (mean daily NNS consumption 7, 38, and 221 mg across tertiles). NNS consumption was positively associated with leptin (P-trend = 0.0006) and CRP (P-trend = 0.02), but associations were attenuated after adjustment for BMI, diet quality, and energy intake. NNS consumption was not associated with insulin, C-peptide, HbA1c, adiponectin, TNF-α, or IL-10. In analyses stratified by BMI, NNS consumption was positively associated with IL-6 among participants with BMI ≥25kg/m2 but not BMI <25kg/m2.

CONCLUSIONS

Findings in the full sample were null after adjustment for energy intake and BMI, but NNS consumption was positively associated with IL-6 among participants with overweight or obesity. Investigation of mechanisms through which NNS consumption may impact inflammatory pathways is warranted.

Socioeconomic Status and Lifestyle Factors Differences in the Association Between Dietary Patterns and Metabolic Syndrome: Tehran Lipid and Glucose Study

Background: Socioeconomic status and lifestyle factors could potentially modify the association between diet and chronic diseases such as metabolic syndrome (MetS). Objective: This study aimed to investigate the combined effect of socioeconomic status, lifestyle factors, and dietary patterns on the MetS risk. Methods: During 8.9 years of follow-up, dietary information of 1915 individuals was collected by a validated Food Frequency Questionnaire (FFQ). Dietary patterns were derived using principal component analysis. Results: Two major dietary patterns including healthy dietary and Western dietary patterns were identified. In the crude and fully adjusted models, an association was not found between Western and healthy dietary patterns and the risk of MetS. There was a significant decrease in the risk of MetS among participants with higher levels of education who adhered to a healthy dietary pattern (hazard ratio: 0.71, 95% confidence interval: 0.34-0.89). Furthermore, the risk of MetS decreased in the fourth quartile of healthy dietary pattern among nonemployed (0.78, 0.51-0.94). According to the stratification of physical activity levels, it was shown that the healthy dietary pattern had a negative association with the risk of MetS only among participants who engaged in a high level of physical activity (0.70, 0.40-0.91). About the smoking status, it was shown that among non-smoker participants, higher adherence to a healthy dietary pattern was associated with a reduction in the risk of MetS. The risk of MetS reduced by 36% (0.64, 0.51-0.97) in the third quartile and by 39% (0.61, 0.54-0.95) in the fourth quartile of the healthy dietary pattern. No association was found between Western dietary pattern with MetS in different status of socioeconomic and lifestyle factors. Conclusions: Adhering to a healthy dietary pattern, engaging in regular physical activity, and abstaining from smoking could reduce incidents of MetS. Moreover, socioeconomic status modified the association between healthy dietary pattern and MetS.

Association between the dietary inflammatory index and depressive symptoms in adults with metabolic syndrome: a cross-sectional study from the NHANES database

Objective

The comorbidity of metabolic syndrome (MS) and depressive symptoms has emerged as a growing public health concern, contributing to a substantial global economic burden. The pathogenesis of this comorbidity is thought to be closely linked to inflammation. However, research examining the impact of the Dietary Inflammatory Index (DII) on depressive symptoms in adults with MS remains limited. This study aims to investigate the association between the DII and depressive symptoms in adults with MS, utilizing data from the National Health and Nutrition Examination Survey (NHANES).

Methods

This cross-sectional study included 7,553 participants aged 20 and older MS from six cycles of the NHANES (2007-2018). Depressive symptoms were assessed using the Patient Health Questionnaire scores, and dietary information was gathered to calculate the Dietary Inflammatory Index (DII). The association between DII scores and depressive symptoms in individuals with MS was evaluated through multivariable logistic regression analysis, adjusting for relevant covariates. Subgroup analyses and restricted cubic splines (RCS) were performed to explore this relationship further.

Results

Among the participants, 907 individuals (12.0%) were identified as having depressive symptoms. After adjusting for all covariates, a positive correlation was observed (OR = 1.09, 95% CI: 1.04-1.14). After adjusting for all covariates, a positive association was observed between DII scores and depressive symptoms (OR = 1.09, 95% CI: 1.04-1.14). Individuals in the highest tertile of DII scores had significantly higher odds of depressive symptoms compared to those in the lowest tertile (OR = 1.36, 95% CI: 1.13-1.65). Subgroup analyses revealed that men were more likely to experience depressive symptoms among adults with MS. The RCS model revealed a nonlinear positive association between DII scores and depressive symptoms in these participants.

Conclusion

Our study indicates that the DII is positively correlated with an increased likelihood of depressive symptoms among adults with MS in the United States. These findings align with existing research and necessitate further validation through prospective cohort studies.

Association between Mediterranean diet and metabolic health status among adults was not mediated through serum adropin levels

BACKGROUND

Prevalence of metabolic disorders has been increased in recent years around the world. The relationship between Mediterranean diet (MD) with metabolic health status and serum adropin levels has been less examined in Iranian adults. We investigated the association between MD compliance with metabolic health status and adropin hormone in Iranian adults.

METHODS

This observational study was conducted on 527 men and women. Food intakes were evaluated by a validated food frequency questionnaire. Blood pressure and anthropometric parameters were measured. Fasting blood samples were drawn to measure serum adropin concentrations, blood glucose, triglycerides, high-density lipoprotein cholesterol, high sensitive C-reactive protein and insulin. Metabolic unhealthy (MU) status was defined as having ≥ 2 cardio-metabolic risk factors.

RESULTS

After adjustments for potential confounders, subjects in highest versus lowest tertile of MD had 52% lower odds of MU status (OR = 0.48, 95%CI: 0.23-0.97). Stratified analysis revealed a significant association in normal-weight participants (OR = 0.12; 95%CI: 0.02-0.64), but not in those with overweight/obesity (OR = 0.66, 95%CI: 0.27-1.57). By excluding each component of MD, the association disappeared, except for three components (vegetables, nuts and grains). MD adherence was not significantly related to serum adropin levels in multivariable-adjusted model (unstandardized B= -0.19, 95%CI: -4.97, 4.59; P = 0.94). Serum adropin hormone levels were also not substantially different among metabolic healthy versus unhealthy subjects (P = 0.66).

CONCLUSIONS

This cross-sectional study showed an inverse association between adherence to MD and odds of MU status, especially in subjects with normal-weight. Serum adropin concentrations were not associated with MD adherence or metabolic health status.

High-risk drug use among Palestinian adolescent refugees in the North West Bank Palestine

Palestinian adolescent refugees are at increased risk for behaviors that can lead to poor health outcomes, such as high-risk substance use. This research focuses on the prevalence of substance use and its relationship with depression among adolescent male refugees in Palestine's North-West Bank. A cross-sectional study was conducted in five of seven refugee camps to gather data using a proportional stratified sampling technique. A structured questionnaire-based interview was conducted to gather sociodemographic data, self-reported substance use, and depression scale information. Additionally, urine screening tests were used to detect the presence of different drugs in participants' urine samples. The final sample size was 386 refugee males; 24.0% were workers, and 13.7% worked previously. For self-reported substance use, 26.9%;12.4%; 28.0%; 37.0%; and 60.4%, 2.6% of adolescents reported current users of cigarettes, e-cigarettes, waterpipe, coffee, energy drinks (ED), and alcohol, respectively. Moreover, 3.4% tested positive for at least one drug. The drugs that tested positive were as follows: PCP (5%), MDMA (1.8%), THC (1.6%), BZO (0.5%), and MET (0.5%). The adjusted logistic regression showed an increased risk of depression among workers (OR = 3.777; p-value = 0.008), cigarette smokers (OR = 2.948; p-value = 0.04), waterpipe smokers (OR = 4.458; p-value = 0.041), and coffee users (OR = 2.883, p-value = 0.046). In conclusion, Palestinian adolescent refugees are at increased risk for behaviors that can lead to poor health outcomes, such as high-risk substance use, including illicit drugs, alcohol use, tobacco smoking, and ED intake. The results of this study reveal alarming figures on drug use associated with depression in refugee camps which demand controlling interventions.

Short-term high-fat diet alters behavior, peripheral metabolism, and brain mitochondrial function in Swiss mice

Understanding the temporal dynamics of high-fat diets (HFD) effects on behavior and metabolism is crucial for comprehending their negative impact on organisms. This study investigated the short-term effects (15, 25, and 35 days) of HFD in Swiss mice. Our findings revealed distinct behavioral and metabolic changes throughout the treatment. After 15 days of HFD, mice exhibited impaired exploratory habituation and significant increases in visceral adipose mass, fasting glucose levels, and glucose intolerance. Extending the diet to 25 days intensified the metabolic effects, resulting in compromised acquisition of recognition memory, increased body mass gain, and elevated plasma total cholesterol and triglyceride levels. After 35 days of HFD, these effects were further intensified and accompanied by anxiogenic-like responses in the open field test. Additionally, we observed a positive correlation between metabolic changes and behavioral impairments alongside prefrontal cortex mitochondrial dysfunction. In conclusion, our study reveals the temporal dynamics of behavioral and metabolic changes induced by short-term HFD in Swiss mice, highlighting the relationship between metabolic dysfunction and behavioral impairments. These findings pave the way for future research to unravel the underlying mechanisms and develop strategies to counteract the detrimental effects of HFD on behavior and metabolism.

Trends in nonsugar sweetener use among United States adults by chronic diseases presence: 1999 to March 2020

BACKGROUND

Although long-term health effects of nonsugar sweeteners (NSSs) are uncertain, they are widely used as a common alternative to added sugar, especially among people with chronic diseases. It is essential to evaluate trends in NSS use to inform policy makers.

OBJECTIVES

This study aimed to investigate trends in NSS use overall and by chronic diseases presence in United States adults.

METHODS

The analysis used data of United States adults (≥20 y) collected in National Health and Nutrition Examination Survey [NHANES (1999 to March 2020)]. Age-adjusted percentage of individuals consuming NSS beverages, NSS foods, tabletop NSS, or any of them during the first 24-h dietary recall period was calculated in each NHANES survey cycle. Weighted multivariable logistic or linear regression models were used to examine trends in NSS use over time.

RESULTS

A total of 51,703 United States adults were included in the analysis. In total population, age-adjusted percentage of individuals consuming NSS in the past day increased from 29.3% in 1999-2000 to 37.5% in 2005-2006 and decreased to 24.1% in 2017 to March 2020 (P < 0.001 for nonlinear trend). Similar trends were observed for different subcategories of NSS-containing product consumption (NSS beverages, foods, and tabletop sweeteners). Similar trends were found among individuals with or without chronic disease. Among individuals with ≥1 chronic disease (cancer, cardiovascular disease, diabetes, hypertension, obesity, hyperlipemia), age-adjusted percentage of individuals consuming NSS in the past day increased from 34.5% in 1999-2000 to 41.1% in 2005-2008 and decreased to 28.1% in 2017 to March 2020, while NSS consumption increased from 20.0% in 1999-2000 to 27.4% in 2005-2008 and decreased to 14.3% in 2017 to March 2020 among individuals without chronic diseases (all P < 0.001 for nonlinear trend).

CONCLUSIONS

NSS use increased from 1999 to 2006 and decreased until March 2020 among entire United States adults and individuals with or without chronic diseases. Moreover, NSS use is generally higher among individuals with chronic diseases during study periods.

The association between dietary patterns and cardiovascular disease risk factors in Iranian adults: a cross-sectional study

BACKGROUND

Dietary patterns are important factors associated with cardiovascular diseases (CVDs). We examined the association between dietary patterns derived from factor analysis and CVD risk factors.

METHODS

In the present cross-sectional study, a total of 3,687 adults (aged 40 to 70 years) with one or more types of CVDs were enrolled as participants. A validated semi-quantitative food-frequency questionnaire was utilized to assess food intakes, and then dietary patterns were extracted by factor analysis. Fasting blood sugar (FBS), lipid profile, anthropometric indices, and blood pressure (BP) were measured. Multivariable-adjusted logistic regression analysis was employed to ascertain the odds ratio (OR) of CVD risk factors associated with posteriori dietary patterns. In this study, healthy and unhealthy dietary patterns were identified.

RESULTS

Adherence to a healthy dietary pattern was associated with a decrease in systolic BP (SBP) (OR = 0.78; 95% confidence interval (CI): 0.62-0.99) and high-density lipoprotein cholesterol (HDL-C) levels (OR = 1.32; 95% CI: 1.06-1.64). Additionally, greater adherence to the unhealthy dietary pattern was positively associated with SBP (OR = 1.43; 95% CI: 1.13-1.80) and diastolic BP (DBP) (OR = 1.33; 95% CI: 1.01-1.76).

CONCLUSIONS

We concluded that greater adherence to an unhealthy dietary pattern was associated with an increase in SBP and DBP. On the other hand, greater adherence to a healthy dietary pattern could be effective in reducing SBP. Further investigation is recommended to validate these findings.

Association of a dietary pattern related to serum vitamin D levels with metabolic syndrome risk among Korean adults: based on the Korean national health and nutrition examination survey

PURPOSE

Vitamin D has a crucial role in our metabolic health. We aimed to examine associations of vitamin D status and its related dietary pattern (DP) with prevalent risk of metabolic syndrome (MetS) in 9,237 Korean adults aged 19-64 years based on the National Health and Nutrition Examination Survey.

METHODS

Vitamin D status was examined by serum 25-hydroxyvitamin D (25(OH)D). A vitamin D-related DP associated with 25(OH)D levels was derived using reduced rank regression (RRR). Associations of vitamin D status and its related DP with MetS prevalence were examined using multivariable logistic regression models adjusted for potential confounders.

RESULTS

Men with sufficient vitamin D status had a 44% lower risk of MetS prevalence (OR: 0.56; 95%CI: 0.36-0.87) compared to those with deficiency. A vitamin D-related DP derived using RRR was characterized by high intakes of vegetables, fish, fruits, and nuts and low intakes of eggs, oils, and mushrooms in this study population. Among men, the DP was significantly associated with a lower risk of MetS prevalence, showing a 12% (95%CI: 4-20%) reduction in risk for a one-unit increase in the DP score. However, there was no significant association among women.

CONCLUSION

The study's findings suggest that a sufficient vitamin D status and a related DP with high intakes of vegetables, fish, fruit, and nuts were associated with the risk of MetS, particularly in Korean male adults.

Associations between dietary diversity and dyslipidemia among Japanese workers: cross-sectional study and longitudinal study findings

OBJECTIVE

The aim of this study was to determine the associations between dietary diversity and risk of dyslipidemia in Japanese workers.

METHODS

The cross-sectional study included 1399 participants aged 20-63 years and the longitudinal study included 751 participants aged 20-60 years in 2012-2013 (baseline) who participated at least once from 2013 to 2017 with cumulative participation times of 4.9 times. Dietary intake was assessed using a food frequency questionnaire, and dietary diversity score (DDS) was determined using the Quantitative Index for Dietary Diversity. Dyslipidemia was diagnosed when at least one of the following conditions was met: hypertriglyceridemia, high LDL-cholesterol, low HDL-cholesterol, high non-HDL-cholesterol, and a history of dyslipidemia. Multivariable logistic regression was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for dyslipidemia with control of confounding factors in cross-sectional analysis. Generalized estimating equations were used for calculating the ORs (95% CI) for dyslipidemia in the follow-up period according to the DDS at baseline with control of confounding factors in longitudinal analysis.

RESULTS

Cross-sectional analysis showed that the highest DDS reduced the odds of dyslipidemia in men (OR [95% CI] in Tertile 3: 0.67 [0.48-0.95], p value = 0.023). In longitudinal analysis, a moderate DDS reduced the risk of dyslipidemia (OR [95% CI] in Tertile 2: 0.21 [0.07-0.60], p value = 0.003) in women.

CONCLUSIONS

The results of cross-sectional analysis in this study suggest that the higher diversity of diet might reduce the presence of dyslipidemia in men and the results of longitudinal analysis suggest that a moderate DDS might reduce the risk of dyslipidemia in women. Further studies are needed since the results of cross-sectional and longitudinal analyses in this study were inconsistent.

Carbonated Beverage, Fruit Drink, and Water Consumption and Risk of Acute Stroke: the INTERSTROKE Case-Control Study

BACKGROUND AND PURPOSE

Cold beverage intake (carbonated drinks, fruit juice/drinks, and water) may be important population-level exposures relevant to stroke risk and prevention. We sought to explore the association between intake of these beverages and stroke.

METHODS

INTERSTROKE is an international matched case-control study of first stroke. Participants reported beverage intake using food frequency questionnaires or were asked "How many cups do you drink each day of water?" Multivariable conditional logistic regression estimated odds ratios (OR) and 95% confidence intervals (CI) for associations with stroke.

RESULTS

We include 13,462 cases and 13,488 controls; mean age was 61.7±13.4 years and 59.6% (n=16,010) were male. After multivariable adjustment, carbonated beverages were linearly associated with ischemic stroke (OR 2.39 [95% CI 1.64-3.49]); only consumption once/day was associated with intracerebral hemorrhage (ICH) (OR 1.58 [95% CI 1.23-2.03]). There was no association between fruit juice/drinks and ischemic stroke, but increased odds of ICH for once/day (OR 1.37 [95% CI 1.08-1.75)] or twice/day (OR 3.18 [95% CI 1.69-5.97]). High water intake (>7 cups/day) was associated ischemic stroke (OR 0.82 [95% CI 0.68-0.99]) but not ICH. Associations differed by Eugeographical region-increased odds for carbonated beverages in some regions only; opposing directions of association of fruit juices/drinks with stroke in selected regions.

CONCLUSION

Carbonated beverages were associated with increased odds of ischemic stroke and ICH, fruit juice/drinks were associated with increased odds of ICH, and high water consumption was associated with reduced odds of ischemic stroke, with important regional differences. Our findings suggest optimizing water intake, minimizing fruit juice/drinks, and avoiding carbonated beverages.

Coffee consumption might be associated with lower potential risk and severity of metabolic syndrome: national health and nutrition examination survey 2003-2018

BACKGROUND

Metabolic syndrome (MetS) is a clinical syndrome characterized by multiple metabolic disorders and is a serious global health problem. The coffee effect, acting as one of the most prevalent beverages on metabolic syndrome, is debatable.

METHODS

We included patients from the National Health and Nutrition Examination Survey 2003-2018 and used a comprehensive evaluation called the MetS z-score to assess the severity of metabolic syndrome. The relationship between coffee, decaffeinated coffee, tea, and MetS z-scores was explored using a weighted linear regression. We also divided the participants into metabolic and non-metabolic syndrome groups according to the NCEP/ATP III criteria for the subgroup analysis.

RESULTS

A total of 14,504 participants were included in this study. The results demonstrated that drinking more than three cups of coffee daily was significantly linked to lower MetS z-scores (p < 0.001). Daily coffee consumption was also associated with lower BMI (p = 0.02), systolic blood pressure (p < 0.001), Homeostatic Model Assessment for Insulin Resistance (p < 0.001), and triglycerides (p < 0.001), while it was positively correlated with HDL-C (p = 0.001). Participants who consumed more than three cups of coffee daily had a lower MetS z-score in the MetS (p < 0.001) and non-MetS (p = 0.04) groups.

CONCLUSION

This research indicates that coffee consumption is linked to MetS severity. However, decaffeinated coffee and tea intake were unrelated to MetS severity.

Could Insulin Be a Better Regulator of Appetite/Satiety Balance and Body Weight Maintenance in Response to Glucose Exposure Compared to Sucrose Substitutes? Unraveling Current Knowledge and Searching for More Appropriate Choices

BACKGROUND

Insulin exerts a crucial impact on glucose control, cellular growing, function, and metabolism. It is partially modulated by nutrients, especially as a response to the intake of foods, including carbohydrates. Moreover, insulin can exert an anorexigenic effect when inserted into the hypothalamus of the brain, in which a complex network of an appetite/hunger control system occurs. The current literature review aims at thoroughly summarizing and scrutinizing whether insulin release in response to glucose exposure may be a better choice to control body weight gain and related diseases compared to the use of sucrose substitutes (SSs) in combination with a long-term, well-balanced diet.

METHODS

This is a comprehensive literature review, which was performed through searching in-depth for the most accurate scientific databases and applying effective and relevant keywords.

RESULTS

The insulin action can be inserted into the hypothalamic orexigenic/anorexigenic complex system, activating several anorexigenic peptides, increasing the hedonic aspect of food intake, and effectively controlling the human body weight. In contrast, SSs appear not to affect the orexigenic/anorexigenic complex system, resulting in more cases of uncontrolled body weight maintenance while also increasing the risk of developing related diseases.

CONCLUSIONS

Most evidence, mainly derived from in vitro and in vivo animal studies, has reinforced the insulin anorexigenic action in the hypothalamus of the brain. Simultaneously, most available clinical studies showed that SSs during a well-balanced diet either maintain or even increase body weight, which may indirectly be ascribed to the fact that they cannot cover the hedonic aspect of food intake. However, there is a strong demand for long-term longitudinal surveys to effectively specify the impact of SSs on human metabolic health.

Consumption of foods and beverages rich in added sugar associated with incident metabolic syndrome: the Coronary Artery Risk Development in Young Adults (CARDIA) study

AIMS

Numerous studies report positive associations between total carbohydrate (CHO) intake and incident metabolic syndrome (MetS), but few differentiate quality or type of CHO relative to MetS. We examined source of CHO intake, including added sugar (AS), AS-rich CHO foods, and sugar-sweetened beverages (SSBs) associated with incident MetS in adults enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study.

METHODS AND RESULTS

Among 3154 Black American and White American women and men aged 18-30 years at baseline, dietary intake was assessed by diet history three times over 20 years. Sources of AS-rich CHO foods and beverages include sugar-rich refined grain products, candy, sugar products, and SSBs. Incident MetS was created according to standard criteria. Time-dependent Cox proportional hazards regression analysis evaluated the associations of incident MetS across quintiles of cumulative intakes of AS-rich CHO foods and beverages, AS, and SSBs adjusted for potential confounding factors over 30 years of follow-up. The associations of AS-rich CHO foods and beverages, AS, and SSB intakes with incident MetS were consistent. Compared with the lowest intake, the greatest intakes of AS-rich CHOs, AS, and SSBs were associated with 59% (Ptrend < 0.001), 44% (Ptrend = 0.01), and 34% (Ptrend = 0.03) higher risk of developing MetS, respectively. As expected, diet quality was lower across increasing quintiles of AS-rich CHO foods and beverages, AS, and SSBs (all Ptrend < 0.001).

CONCLUSION

Our study findings are consistent with an elevated risk of developing MetS with greater consumption of AS, AS-rich CHO foods, and SSBs, which support consuming fewer AS-rich CHO foods and SSBs.

The Relationship between Dietary Patterns and Metabolic Phenotypes: A Cross-Sectional Study in a Representative Sample of Iranian Industrial Employees

Background and Aim: There is limited evidence to support the relationship between dietary patterns and metabolic phenotypes. Therefore, this study aimed to assess the association of dietary patterns with metabolic phenotypes among a large sample of Iranian industrial employees. Methods: This cross-sectional study was conducted among 3,063 employees of Esfahan Steel Company, Iran. Using exploratory factor analysis, major dietary patterns were obtained from a validated short form of food frequency questionnaire. The metabolic phenotypes were defined according to Adult Treatment Panel III guidelines. The independent-sample t-test, one-way analysis of variance, χ2 test, and multivariable logistic regression were applied to analyze data. Results: Three major dietary patterns were identified by factor analysis: the Western dietary pattern, the healthy dietary pattern, and the traditional dietary pattern. After controlling for potential confounders, subjects in the highest tertile of Western dietary pattern score had a higher odds ratio (OR) for metabolically healthy obese (MHO; OR 1.58, 95% confidence interval [CI]: 1.29-1.94), metabolically unhealthy normal weight (OR 1.93, 95% CI 1.08-3.45), and metabolically unhealthy obese (MUHO) phenotypes (OR 2.87, 95% CI 2.05-4.03) than those in the lowest tertile. Also, higher adherence to traditional dietary pattern was positively associated with a higher risk of MHO (OR 1.91, 95% CI 1.56-2.34) and MUHO phenotypes (OR 2.33, 95% CI 1.69-3.22) in the final model. Conclusion: There were significant associations between dietary patterns and metabolic phenotypes, suggesting the necessity of nutritional interventions in industrial employees to improve metabolic phenotype, health outcomes, and, therefore, job productivity in the workforce population.

Associations Between Metabolic Syndrome and Long-Term Mortality in Patients who underwent Percutaneous Coronary Intervention: An Australian Cohort Analysis

Metabolic syndrome (MetS) provides significant risk for coronary disease, however long-term prognosis after percutaneous coronary intervention (PCI) has been understudied. We assessed the prevalence and outcomes of patients with MetS from an Australian PCI cohort. We retrospectively examined data from the Melbourne Interventional Group multicenter PCI registry using a modified definition for MetS including ≥3 of the following: hypertension, diabetes mellitus, dyslipidemia, and body mass index ≥30 kg/m2. Thirty-day outcomes and long-term mortality were compared with patients without MetS. Cox regression methods were used to assess the multivariable effect of MetS on long-term mortality. Of 41,146 patients, 12,228 (34%) had MetS. Patients with MetS experienced greater 30-day myocardial infarction (2.2% vs 1.8%, p = 0.013), whereas patients without MetS had a trend for greater 30-day mortality (3.0% vs 3.4%, p = 0.051) and greater in-hospital major bleeding (1.7% vs 2.4%, p <0.001). After a median follow-up of 5.62 years (Q1 2.03, Q3 8.89), patients with MetS experienced greater mortality (24% vs 19%, p <0.001). After adjustment, MetS was not an independent predictor of long-term mortality (hazard ratio 0.95 confidence interval 0.86 to 1.05, p = 0.35). In sensitivity analyses, MetS-Diabetic patients had the highest, and MetS-NonDiabetic obese patients had the lowest long-term mortality. One in 3 patients who underwent all-comer PCI presented with MetS and experienced greater long-term mortality compared with others. However, this association was lost after adjustment for baseline confounders, highlighting that MetS is a marker of risk after PCI. Our findings support the obesity paradox and confirm robust associations between diabetes mellitus and long-term mortality.

The association between dietary patterns and metabolic syndrome among Iranian adults, a cross-sectional population-based study (findings from Bandare-Kong non-communicable disease cohort study)

BACKGROUND

Metabolic syndrome is a cluster of metabolic disorders increasing the risk of cardiovascular disease and diabetes. Dietary patterns are supposed to be important and controllable factors in developing metabolic syndrome. The purpose of this study was to investigate the association of dietary patterns with metabolic syndrome and its components.

SUBJECTS/METHODS

Cross-sectional data were extracted from the Bandare-Kong cohort study conducted on 4063 people aged 35 to 70. Dietary patterns were extracted using principal component analysis based on thirty-eight pre-defined food groups. Multivariable logistic regression was conducted to investigate the association between metabolic syndrome and its components with quintiles of dietary patterns in crude and adjusted models.

RESULTS

Three major dietary patterns were identified (healthy, western, and traditional) in the final analysis of 2823 eligible individuals. After adjusting for covariates, the odds of metabolic syndrome were significantly decreased by 46% in subjects with the highest adherence to the healthy dietary pattern compared to those with the lowest adherence quintile. Results from fully adjusted models on individual metabolic syndrome components showed an inverse association between higher adherence to the healthy dietary pattern and the odds of increased blood glucose, high waist circumference, and elevated blood pressure. However, in fully adjusted models, no significant association was observed between the western and traditional dietary patterns with odds of metabolic syndrome and its components.

CONCLUSIONS

Adherence to a healthy dietary pattern containing high amounts of fruits, vegetables, nuts, low-fat dairy products, and legumes, could be recommended to prevent and control metabolic syndrome.

Investigation of the interaction between genetic risk score (GRS) and fatty acid quality indices on metabolic syndrome among overweight and obese women

BACKGROUND AND AIM

Metabolic syndrome is one of the major public-health challenges, affecting one-quarter of the world population. Fatty acid quality indices are novel determinants of this disease and their interactions with genetic factors may have an impact on metabolic syndrome risk. Therefore, we aimed to investigate the interaction between genetic risk score (GRS) and fatty acid quality indices with metabolic syndrome (MetS) among overweight and obese women.

METHODS

In the present cross-sectional study, 279 overweight and obese women (18-48 years old) were included. Several anthropometric measurements such as weight, height, body mass index (BMI), waist circumference (WC), and body fat percent (BF%) were measured. Also, systolic and diastolic blood pressure (SBP and DBP) were measured. Biochemical determination was performed for fasting blood glucose (FBS), triglyceride (TG), and high-density lipoprotein (HDL). MetS was determined according to National Cholesterol Education Program (NCEP ATP III) criteria. Dietary intake was evaluated by a validated and reliable 147-item semi-quantitative food frequency questionnaire. Cholesterol-saturated fat index (CSI) and the ratio of omega-6/omega-3 (ω-6/ω-3) essential fatty acids were considered as fat quality indices. The salting-out method was used to extract the total DNA. The unweighted GRS was calculated using the risk alleles of the three single nucleotide polymorphisms. The total average GRS value was 2 and the sum of the risk alleles of the 3 polymorphisms was 6.

RESULT

The results of our analysis showed that after controlling for age, energy intake, BMI, and physical activity, there was a positive interaction between T2 of GRS and T2 of N6/N3 ratio on WC (β = 7.95, 95%CI = 0.83,15.08, P = 0.029), T3 of GRS and T2 of N6/N3 ratio on DBP (β = 5.93, 95%CI= -0.76,12.63, P = 0.083), and FBS (β = 6.47, 95%CI = 0.59,13.53, P = 0.073), T3 of GRS and T3 of N6/N3 ratio on TG (β = 54.42, 95%CI = 1.76,107.08, P = 0.043), and T3 of GRS and T3 of CSI on BF% (β = 3.55, 95%CI= -0.35,7.45, P = 0.075). Also T2 of GRS in the interaction with T3 of CSI leads to an decrease - 8.35 mg/dl in HDL level after adjustment in (β= -8.35, 95%CI= -17.34,0.62, P = 0.068).

CONCLUSION

It seems the interaction of GRS and fatty acid quality indices is positively associated with several components of metabolic syndrome such as WC, TG and BF%. Our findings are of importance to public health, considering the high consumption of foods that are high on fatty acids. Conflicting evidence of many previous studies regarding the effect of fat intake and obesity and cardiovascular diseases could be because of the gene-diet interactions and genetic heterogeneity across various ethnic groups. Hence, the synergism effect of genetic and dietay intakes should be considered in future studies.

Chronic sucralose consumption inhibits farnesoid X receptor signaling and perturbs lipid and cholesterol homeostasis in the mouse livers, potentially by altering gut microbiota functions

Sucralose has raised concerns regarding its safety and recent studies have demonstrated that sucralose consumption can disrupt the normal gut microbiome and alter metabolic profiles in mice. However, the extent to which this perturbation affects the functional interaction between the microbiota and the host, as well as its potential impact on host health, remains largely unexplored. Here, we aimed to investigate whether chronic sucralose consumption, at levels within the Acceptable Daily Intake (ADI), could disturb key gut microbial functions and lead to adverse health effects in mice. Following six-month sucralose consumption, several bacterial genera associated with bile acid metabolism were decreased, including Lactobacillus and Ruminococcus. Consequently, the richness of secondary bile acid biosynthetic pathway and bacterial bile salt hydrolase gene were decreased in the sucralose-treated gut microbiome. Compared to controls, sucralose-consuming mice exhibited significantly lower ratios of free bile acids and taurine-conjugated bile acids in their livers. Additionally, several farnesoid X receptor (FXR) agonists were decreased in sucralose-treated mice. This reduction in hepatic FXR activation was associated with altered expression of down-stream genes, in the liver. Moreover, the expression of key lipogenic genes was up-regulated in the livers of sucralose-treated mice. Changes in hepatic lipid profiles were also observed, characterized by lower ceramide levels, a decreased PC/PE ratio, and a mildly increase in lipid accumulation. Additionally, sucralose-consumed mice exhibited higher hepatic cholesterol level compared to control mice, with up-regulation of cholesterol efflux genes and down-regulation of genes associated with reverse cholesterol transport. In conclusion, chronic sucralose consumption disrupts FXR signaling activation and perturbs hepatic lipid and cholesterol homeostasis, potentially by diminishing the bile acid metabolic capacity of the gut microbiome. These findings shed light on the complex interplay between sucralose, the gut microbiota, and host metabolism, raising important questions about the safety of its long-term consumption.

Prevalence of metabolic syndrome in patients with inflammatory bowel disease: a systematic review and meta-analysis

OBJECTIVES

Patients with inflammatory bowel disease (IBD) may experience comorbidities involving metabolic syndrome (MetS). However, this association remains controversial. Our objective was to estimate the prevalence of MetS in patients with IBD and assess whether MetS is more strongly associated with ulcerative colitis (UC) or Crohn's disease (CD).

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

PubMed, Cochrane Library, Web of Science, EMBASE and MEDLINE were searched from their inception to July 2022.

ELIGIBILITY CRITERIA

Observational studies reporting data regarding the rate of comorbid MetS among patients with IBD and published in English.

DATA EXTRACTION AND SYNTHESIS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Meta-analysis of Observational Studies in Epidemiology reporting guidelines were followed. Pooled prevalence, ORs and 95% CIs were calculated using random-effects models. The Newcastle-Ottawa Scale and the Agency for Healthcare Research and Quality checklist were used. Heterogeneity, sensitivity and stratified analyses were performed using R (V.4.2.1).

RESULTS

11 eligible studies involving 2501 patients were included. Of these studies, four reported MetS prevalence separately by IBD phenotype, and only one contained a non-IBD comparison group. Overall, the methodological quality of the included studies was moderate. The pooled prevalence of MetS in IBD was 19.4% (95% CI 15.1% to 23.8%), with a moderate heterogeneity (I2=51.8%, Cochrane Q statistic=12.4, p=0.053). Stratified analyses demonstrated that the aggregate estimate of comorbid MetS was significantly higher in UC than in CD (38.2% vs 13.6%, χ2=4.88, p=0.03). We found a positive association between MetS and UC compared with CD (OR=2.11, 95% CI 1.19 to 3.74, p=0.01). Additionally, four studies identified that higher age was a risk factor associated with the development of MetS.

CONCLUSIONS

MetS is not rare in IBD, especially in UC. However, longitudinal studies are needed to further clarify the relationship between IBD and MetS.

PROSPERO REGISTRATION NUMBER

CRD42022346340.

2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association

BACKGROUND

The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood pressure, glucose control, and metabolic syndrome) that contribute to cardiovascular health. The AHA Heart Disease and Stroke Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, brain health, complications of pregnancy, kidney disease, congenital heart disease, rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary heart disease, cardiomyopathy, heart failure, valvular disease, venous thromboembolism, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs).

METHODS

The AHA, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2024 AHA Statistical Update is the product of a full year's worth of effort in 2023 by dedicated volunteer clinicians and scientists, committed government professionals, and AHA staff members. The AHA strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional global data, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains.

RESULTS

Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics.

CONCLUSIONS

The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

Adherence to the healthy eating index-2010 and alternative healthy eating index-2010 in relation to metabolic syndrome among African Americans in the Jackson heart study

OBJECTIVE

The primary objective of this study was to determine whether Healthy Eating Index (HEI) and Alternative Healthy Eating Index (AHEI) scores were associated with incident metabolic syndrome.

DESIGN

This study is a secondary analysis of data from the Jackson Heart Study. HEI and AHEI scores were divided into quintiles and Cox proportional hazards regression models were analysed for 1864 African American adults free from metabolic syndrome at Exam 1 to examine the incidence of metabolic syndrome by quintile of dietary quality score.

SETTING

Hinds, Madison and Rankin counties, Mississippi, USA.

PARTICIPANTS

African American adults, ages 21-94 years, 60·9 % female.

RESULTS

Over a mean follow-up time of 6·7 years, we observed 932 incident cases of metabolic syndrome. After adjusting for multiple covariates, a higher HEI score at Exam 1 was not associated with the risk of incident metabolic syndrome, except when looking at the trend analysis for the subgroup of adults with two metabolic syndrome components at Exam 1 (P-trend = 0·03). A higher AHEI score at Exam 1 was associated with the risk of incident metabolic syndrome (hazard ratio for those in the highest quintile compared to the lowest: 0·80 (95 % CI: 0·65, 0·99), P-trend = 0·03).

CONCLUSION

These findings suggest that a dietary pattern that scores higher on the AHEI may help reduce the risk of metabolic syndrome, even for adults who already have two of the minimum of three components required for a diagnosis of metabolic syndrome.

Association of gestational metabolic syndrome with the Chinese Healthy Eating Index in mid-pregnancy: a cross-sectional study

BACKGROUND

This study aims to investigate the relationship between gestational metabolic syndrome (GMS) and the Chinese Healthy Eating Index (CHEI) in mid-pregnancy, and to identify potentially beneficial or high-risk dietary habits. We have developed a mid-pregnancy version of CHEI-2022, adapting the Chinese Healthy Eating Index to align with the food quantity recommendations outlined in the 2022 Dietary Guidelines for Chinese Residents for mid-pregnancy.

METHODS

Using the inclusion and exclusion criteria, data from 2411 mid-pregnant individuals were collected through interviews. The Total CHEI score and its component scores were determined through analysis of responses from the food frequency questionnaire. GMS diagnosis involved conducting physical examinations and performing blood biochemical tests. A logistic regression model was employed to analyze the relationship between GMS or related indices and both the total CHEI score and its component scores.

RESULTS

The study identified an overall GMS prevalence of 21.65% (522 out of 2411 participants). During mid-pregnancy, participants diagnosed with GMS exhibited higher BMI, FBG, 1hPBG, 2hPBG, TC, TG, HDL, SBP, as well as higher educational levels and daily activity, compared to those without GMS (P < 0.001). After adjusting for potential confounders, participants with higher total CHEI scores (≥ 80) were found to have lower odds of GMS or related indices (P < 0.05). Increasing dietary intake of potatoes, whole grains, beans, dark green vegetables, and fruits, as per the CHEI recommendations, was associated with reduced odds of GMS or related indices (P < 0.05).

CONCLUSION

A high-quality diet, as indicated by a total CHEI score of 80 or higher, and increased consumption of specific dietary components, namely potatoes, beans, dark green vegetables, and fruits, were found to effectively reduce the odds of GMS or related indices during mid-pregnancy.

Nut Consumption and Fertility: a Systematic Review and Meta-Analysis

The high concentration of omega-3 polyunsaturated fats, dietary fibers, vitamins, minerals, and polyphenols found in nuts suggest their regular consumption may be a simple strategy for improving reproductive health. This systematic review and meta-analysis aimed to present up-to-date evidence regarding the association between nut intake and fertility outcomes in males and females. Ovid MEDLINE, Embase, CINAHL, and Scopus were searched from inception to 30 June 2023. Eligible articles were interventional or observational studies in human subjects of reproductive age (18-49 y) that assessed the effects (or association) of dietary nut consumption (for a minimum of 3 mo) on fertility-related outcomes. Random-effects meta-analyses were completed to produce a pooled effect estimate of nut consumption on sperm total motility, vitality, morphology, and concentration in healthy males. Four studies involving 875 participants (646 males, 229 females) were included in this review. Meta-analysis of 2 RCTs involving 223 healthy males indicated consumption of ≥ 60g nuts/d increased sperm motility, vitality, and morphology in comparison to controls but had no effect on sperm concentration. Nonrandomized studies reported no association between dietary nut intake and conventional sperm parameters in males, embryo implantation, clinical pregnancy or live birth in males and females undergoing ART. Our meta-analysis shows that including at least 2 servings of nuts daily as part of a Western-style diet in healthy males improves sperm parameters, which are predictors of male fertility. Due to their nutritional profile, nuts were found to have potential to promote successful reproductive outcomes. This trial was registered at PROSPERO (CRD42020204586).

Exploring a novel therapeutic strategy: the interplay between gut microbiota and high-fat diet in the pathogenesis of metabolic disorders

In the past two decades, the rapid increase in the incidence of metabolic diseases, including obesity, diabetes, dyslipidemia, non-alcoholic fatty liver disease, hypertension, and hyperuricemia, has been attributed to high-fat diets (HFD) and decreased physical activity levels. Although the phenotypes and pathologies of these metabolic diseases vary, patients with these diseases exhibit disease-specific alterations in the composition and function of their gut microbiota. Studies in germ-free mice have shown that both HFD and gut microbiota can promote the development of metabolic diseases, and HFD can disrupt the balance of gut microbiota. Therefore, investigating the interaction between gut microbiota and HFD in the pathogenesis of metabolic diseases is crucial for identifying novel therapeutic strategies for these diseases. This review takes HFD as the starting point, providing a detailed analysis of the pivotal role of HFD in the development of metabolic disorders. It comprehensively elucidates the impact of HFD on the balance of intestinal microbiota, analyzes the mechanisms underlying gut microbiota dysbiosis leading to metabolic disruptions, and explores the associated genetic factors. Finally, the potential of targeting the gut microbiota as a means to address metabolic disturbances induced by HFD is discussed. In summary, this review offers theoretical support and proposes new research avenues for investigating the role of nutrition-related factors in the pathogenesis of metabolic disorders in the organism.

Moderate or greater daily coffee consumption is associated with lower incidence of metabolic syndrome in Taiwanese militaries: results from the CHIEF cohort study

BACKGROUND

Daily moderate coffee intake was found with a lower risk of specific metabolic abnormalities, e.g., hypertension and hyperglycemia, while the association of coffee intake and incident metabolic syndrome (MetS) has not been clarified in prior studies, particularly in young adults.

METHODS

A total of 2,890 military personnel, aged 18-39 years, free of MetS were followed for incident MetS from baseline (2014) until the end of 2020 in Taiwan. Daily coffee amount consumed was grouped to those ≥3 cups or 600 mL (moderate or more amount) and those without. Incidence of MetS was identified in annual health examinations. MetS was diagnosed on the basis of the guideline of the International Diabetes Federation. Multivariable Cox regression model with adjustments for sex, age, body mass index, physical activity and substance use status at baseline was performed to determine the association.

RESULTS

At baseline, there were 145 subjects with daily coffee intake ≥3 cups or 600 mL (5.0%) in the overall cohort. During a mean follow-up of 6.0 years, 673 incident MetS (23.3%) were found. As compared to those consuming less coffee or none, those consuming daily coffee ≥3 cups had a lower risk of MetS [hazard ratio (HR): 0.69 (95% confidence interval: 0.48, 0.99)].

CONCLUSION

This study suggests that adhering to the guideline recommended moderate or greater daily coffee consumption for promoting health, may confer advantages in preventing the development of MetS among young adults.

Metabolic Syndrome: An Overview on Its Genetic Associations and Gene-Diet Interactions

Metabolic syndrome (MetS) is a cluster of cardiometabolic risk factors that includes central obesity, hyperglycemia, hypertension, and dyslipidemias and whose inter-related occurrence may increase the odds of developing type 2 diabetes and cardiovascular diseases. MetS has become one of the most studied conditions, nevertheless, due to its complex etiology, this has not been fully elucidated. Recent evidence describes that both genetic and environmental factors play an important role on its development. With the advent of genomic-wide association studies, single nucleotide polymorphisms (SNPs) have gained special importance. In this review, we present an update of the genetics surrounding MetS as a single entity as well as its corresponding risk factors, considering SNPs and gene-diet interactions related to cardiometabolic markers. In this study, we focus on the conceptual aspects, diagnostic criteria, as well as the role of genetics, particularly on SNPs and polygenic risk scores (PRS) for interindividual analysis. In addition, this review highlights future perspectives of personalized nutrition with regard to the approach of MetS and how individualized multiomics approaches could improve the current outlook.

Thermogenic Modulation of Adipose Depots: A Perspective on Possible Therapeutic Intervention with Early Cardiorenal Complications of Metabolic Impairment

Cardiovascular complications of diabetes and obesity remain a major cause for morbidity and mortality worldwide. Despite significant advances in the pharmacotherapy of metabolic disease, the available approaches do not prevent or slow the progression of complications. Moreover, a majority of patients present with significant vascular involvement at early stages of dysfunction prior to overt metabolic changes. The lack of disease-modifying therapies affects millions of patients globally, causing a massive economic burden due to these complications. Significantly, adipose tissue inflammation was implicated in the pathogenesis of metabolic syndrome, diabetes, and obesity. Specifically, perivascular adipose tissue (PVAT) and perirenal adipose tissue (PRAT) depots influence cardiovascular and renal structure and function. Accumulating evidence implicates localized PVAT/PRAT inflammation as the earliest response to metabolic impairment leading to cardiorenal dysfunction. Increased mitochondrial uncoupling protein 1 (UCP1) expression and function lead to PVAT/PRAT hypoxia and inflammation as well as vascular, cardiac, and renal dysfunction. As UCP1 function remains an undruggable target so far, modulation of the augmented UCP1-mediated PVAT/PRAT thermogenesis constitutes a lucrative target for drug development to mitigate early cardiorenal involvement. This can be achieved either by subtle targeted reduction in UCP-1 expression using innovative proteolysis activating chimeric molecules (PROTACs) or by supplementation with cyclocreatine phosphate, which augments the mitochondrial futile creatine cycling and thus decreases UCP1 activity, enhances the efficiency of oxygen use, and reduces hypoxia. Once developed, these molecules will be first-in-class therapeutic tools to directly interfere with and reverse the earliest pathology underlying cardiac, vascular, and renal dysfunction accompanying the early metabolic deterioration. SIGNIFICANCE STATEMENT: Adipose tissue dysfunction plays a major role in the pathogenesis of metabolic diseases and their complications. Although mitochondrial alterations are common in metabolic impairment, it was only recently shown that the early stages of metabolic challenge involve inflammatory changes in select adipose depots associated with increased uncoupling protein 1 thermogenesis and hypoxia. Manipulating this mode of thermogenesis can help mitigate the early inflammation and the consequent cardiorenal complications.

Genetic and dietary modulators of the inflammatory response in the gastrointestinal tract of the BXD mouse genetic reference population

Inflammatory gut disorders, including inflammatory bowel disease (IBD), can be impacted by dietary, environmental, and genetic factors. While the incidence of IBD is increasing worldwide, we still lack a complete understanding of the gene-by-environment interactions underlying inflammation and IBD. Here, we profiled the colon transcriptome of 52 BXD mouse strains fed with a chow or high-fat diet (HFD) and identified a subset of BXD strains that exhibit an IBD-like transcriptome signature on HFD, indicating that an interplay of genetics and diet can significantly affect intestinal inflammation. Using gene co-expression analyses, we identified modules that are enriched for IBD-dysregulated genes and found that these IBD-related modules share cis-regulatory elements that are responsive to the STAT2, SMAD3, and REL transcription factors. We used module quantitative trait locus analyses to identify genetic loci associated with the expression of these modules. Through a prioritization scheme involving systems genetics in the mouse and integration with external human datasets, we identified Muc4 and Epha6 as the top candidates mediating differences in HFD-driven intestinal inflammation. This work provides insights into the contribution of genetics and diet to IBD risk and identifies two candidate genes, MUC4 and EPHA6, that may mediate IBD susceptibility in humans.

A new metabolic syndrome prediction model for self-evaluation as a primary screening tool in an apparently MetS-free population

BACKGROUND

Metabolic syndrome (MetS) is a growing global public health concern associated with increased morbidity and mortality. The study aimed to establish a simple self-evaluated prediction model to identify MetS.

METHODS

A cross-sectional study based on the American National Health and Nutrition Examination Survey database was performed. Participants aged ≥20 in the 2009-2018 surveys, with no current pregnancy or major morbidities, were included. The model was built with data from 2009 to 2016 and validated using 2017-2018 data. MetS was defined according to AHA/NHLBI guidelines. Multivariable logistic regression was applied to build a prediction model. The area under the receiver operating characteristic curve (AUC) was used to assess the discrimination ability and the maximal Youden's index was used to identify the optimal cut-off value.

RESULTS

The study included 4245 individuals (median age 37, IQR 28-49, 51.8% females) in the training group and 911 individuals (median age 37, IQR 28-52, 52.5% females) in the validation group. Older age, male gender, non-Black race, no postsecondary education, and higher BMI were significantly associated with increased risk of MetS. The final model included age, gender, race, education, and BMI, and showed good discrimination ability (AUC = 0.810, 95% CI 0.793-0.827, sensitivity 80.4%, specificity 66.2%, positive likelihood ratio 2.379, negative likelihood ratio 0.296, PPV 59.6% and NPV 84.5%).

CONCLUSION

A new model for self-evaluation may serve as a primary, easy-to-use screening tool to identify MetS in an apparently MetS-free population. A simple application may serve for primary and secondary prevention, thus enabling risk reduction in the development of cardiovascular morbidity and health expenditure.

Role of Dietary Fibre in Managing Periodontal Diseases-A Systematic Review and Meta-Analysis of Human Intervention Studies

BACKGROUND

Periodontitis is a chronic multifactorial inflammatory disease, that leads to tooth loss and is associated with other systemic diseases. The role of dietary fibre in the prevention and management of periodontal diseases is not well understood. The objective of this systematic review and meta-analysis was to assess how an intake of dietary fibre affects periodontal diseases in humans and any concomitant effects on systemic inflammation.

METHODOLOGY

Human interventional studies investigating the effects of oral fibre intake on various clinical parameters of periodontal diseases were included. Search strategy with MeSH and free-text search terms was performed on the following database: CINAHL Complete, EMBASE, MEDLINE, SciVerse Scopus®, and Web of Science Core Collection on 21 October 2021 and updated on 19 February 2023 to identify relevant studies. Articles were filtered using the Covidence© web-based platform software. Data were pooled using random effects meta-analysis.

RESULTS

From all databases, a total of 19,971 studies were obtained. Upon title and abstract screening, 101 studies were included for full-text screening. Upon full-text screening, six studies were included for analysis. Of these, five were randomised controlled trials, and one was a sequential feeding trial involving fibre-rich daily diet for a 4-8 weeks period. Fibre-rich dietary intervention significantly reduced Clinical Attachment Loss/Level by 0.48 mm/tooth (95% CI, -0.63 to -0.33, p < 0.001), Bleeding On Probing by 27.57% sites/tooth (95% CI -50.40 to -4.74, p = 0.02), Periodontal Inflamed Surface Area by 173.88 mm2 (95% CI -288.06 to -59.69, p = 0.003), Plaque Index by 0.02 (95% CI -0.04 to -0.00, p = 0.04), and Gingival Index by 0.41 (95% -0.67 to -0.16, p= 0.002). A non-significant reduction was observed for Probing Depth (-0.17 mm/tooth; 95% CI, -0.37 to 0.02, p = 0.09).

CONCLUSIONS

Fibre-rich dietary interventions are associated with a reduction of clinical and particularly inflammatory markers of periodontal diseases. This shows a promising effect of dietary fibre as an intervention for inflammatory conditions like periodontal diseases.

Effect of weight change on the association between overall and source of carbohydrate intake and risk of metabolic syndrome: Tehran lipid and glucose study

BACKGROUND

In this prospective cohort study, we aimed to evaluate the association between dietary carbohydrates, whole grains, refined grains, and simple sugar with the risk of metabolic syndrome (MetS) and assess the effect of weight change on these associations.

METHODS

This study was conducted within the framework of the Tehran Lipid and Glucose Study (TLGS). We included 1915 healthy participants with complete demographic, anthropometric and dietary measurements, among whom 591 developed MetS during 8.9 years of follow-up. Intake of dietary carbohydrates, whole grains, refined grains, and simple sugar was assessed with a validated semi-quantitative food frequency questionnaire. Multivariable adjusted Cox regression was used to estimate hazard ratios (HRs) for MetS events across tertiles of dietary variables. Using joint classification, the effect of weight change on the association between dietary variables and risk of MetS was assessed by Cox regression.

RESULTS

Carbohydrate intake was not associated with the risk of MetS in multivariable-adjusted models. Whole grains intake was inversely associated with the risk of MetS (HR: 0.78, CI: 0.63-0.98), while this association disappeared after adjustment for weight change. The risk of MetS increased by 11% (1.11, 1.09-1.14) for each 3% energy increment from simple sugar, and by 5% (1.05, 1.03-1.08) for each 1 serving/day increment in refined grains. Consumption of refined grains increased the risk of MetS; an effect modification of this association was found by weight change. Among subjects with weight loss, intake of refined grains < median intake decreased the risk of MetS (0.59, 0.41-0.87). However, consumption of refined grains ≥ median intake increased the risk of MetS in individuals with weight gain (1.47, 1.08-2.01). Simple sugar was positively associated with an increased risk of MetS, after adjustment for weight change (3.00, 2.37-3.82). In joint classification, intake of simple sugar greater than median intake increased the risk of MetS, independent of weight change.

CONCLUSION

Our findings suggest an effect modification by weight change on the association between carbohydrates, and refined grains intake and the risk of MetS. Weight loss along with lower consumption of carbohydrates, and refined grains reduced the risk of MetS. However, simple sugar intake, regardless of weight change, was associated with an increased risk of MetS.

The combined association of dietary inflammatory index and resting metabolic rate on cardiorespiratory fitness in adults

BACKGROUND

No study has examined the combined association of dietary inflammatory index (DII) of the diet and resting metabolic rate (RMR) on cardiorespiratory fitness (CRF). Therefore, we investigated the combined association between DII and RMR on CRF.

METHODS

This cross-sectional study was conducted on 270 adult subjects. The DII was calculated using a validated semi-quantified food frequency questionnaire. RMR was measured using an indirect calorimetric method. Socioeconomic status, anthropometric measures, body composition and blood pressure were documented by a trained interviewer. CRF was assessed by using Bruce protocol. Binary logistic regression was performed to find the association of CRF with DII/RMR categories in various models.

RESULTS

The participants categorized into four groups including: (1) low DII/high RMR, (2) low DII/low RMR, (3) high DII/low RMR, (4) high DII/high RMR. The mean of VO2Max (mL/kg/min), VO2max (L/min) and VO2max relative to lean body mass (LBM) was lower in participants that were classified as high DII/low RMR compared to those in low DII/high RMR. After controlling for age, sex, education status, smoking status, and physical activity those who were in the high DII/low RMR group, compared to the low DII/high RMR group were 28% less likely to have higher VO2max (ml/kg/min) (OR 0.72; 95% CI 0.18, 0.82, p = 0.04). Moreover, had 25% lower odds of VO2max (L/min) which was significant (OR 0.75, 95% CI 0.11, 0.89, p = 0.03). In addition, were 21% less likely to have higher VO2max (LBM) (OR 0.79; 95% CI 0.30, 0.92, p = 0.02).

CONCLUSIONS

Overall, consumption of a pro-inflammatory diet in combination with low RMR status is associated with lower odds of CRF compared to those who had anti-inflammatory diet in combination with high RMR status among Iranian healthy adults. This study suggests that researchers should focus on combined relationships rather than single pair-wise associations for having a better judgment.

The Prospect of Non-Alcoholic Fatty Liver Disease in Adult Patients with Metabolic Syndrome: A Systematic Review

In recent years, there has been an increasing trend in the development of non-alcoholic fatty liver disease (NAFLD) due to lifestyle changes. The limited treatment option for the disease makes it challenging to manage. This study aims to summarize the relationship between NAFLD and metabolic syndrome (MetS) and to give a clear idea of the risk factors in this systematic research. The five databases screened were PubMed, Google Scholar, Science Direct, and BMC using keywords and Medical Subject Heading (Mesh) combinations. The keywords used are "Metabolic Syndrome," "Syndrome X," "Insulin Resistance," "Obesity," "Type 2 Diabetes," and "Dyslipidemia." Articles underwent a detailed process of screening and quality appraisal. Using the English language as a primary filtering parameter, papers over the last 13 years, dating from 2010 to 2023, are the basis of this review. We reviewed all possible human studies documenting NAFLD with a component of MetS. A total of 1106 papers were identified. After duplicate removal, 995 articles underwent a rigorous review, and 35 articles were chosen for quality appraisal. A total of 15 articles are part of this systematic review. This systematic review strongly concludes that NAFLD predominates in MetS patients. The pathophysiology and insulin resistance that is shared by the two conditions as well as the fact that obesity is at the center of both is the connecting factor in this. Besides various demographic and risk factors, physical activity and diet also play a role in the development of NAFLD. Consequently, more studies on this relevant topic are needed.

Dietary Advanced Glycation End Products: Their Role in the Insulin Resistance of Aging

Insulin resistance (IR) is commonly observed during aging and is at the root of many of the chronic nontransmissible diseases experienced as people grow older. Many factors may play a role in causing IR, but diet is undoubtedly an important one. Whether it is total caloric intake or specific components of the diet, the factors responsible remain to be confirmed. Of the many dietary influences that may play a role in aging-related decreased insulin sensitivity, advanced glycation end products (AGEs) appear particularly important. Herein, we have reviewed in detail in vitro, animal, and human evidence linking dietary AGEs contributing to the bodily burden of AGEs with the development of IR. We conclude that numerous small clinical trials assessing the effect of dietary AGE intake in combination with strong evidence in many animal studies strongly suggest that reducing dietary AGE intake is associated with improved IR in a variety of disease conditions. Reducing AGE content of common foods by simple changes in culinary techniques is a feasible, safe, and easily applicable intervention in both health and disease. Large-scale clinical trials are still needed to provide broader evidence for the deleterious role of dietary AGEs in chronic disease.

Diet and metabolic syndrome: a narrative review

Metabolic syndrome (MetS) is a highly prevalent condition defined by the presence of at least three out of five risk factors including central obesity, increased fasting glucose, high blood pressure, and dyslipidaemia. Metabolic syndrome is associated with a 2-fold increase in cardiovascular outcomes and a 1.5-fold increase in all-cause mortality. Excess energy intake and Western dietary pattern may influence the development of metabolic syndrome. By contrast, both Mediterranean diet (Med-diet) and Dietary Approaches to Stop Hypertension (DASH) diet, with or without calorie restriction, have positive effects. For the prevention and management of MetS, it is recommended to increase the daily intake of fiber-rich and low-glycaemic-index foods and the consumption of fish and dairy products, especially yogurt and nuts. Moreover, it is advisable to consume a large variety of unprocessed cereals, legumes, and fruit. Finally, it is suggested to replace saturated fatty acids with monounsaturated and polyunsaturated fatty acids and to limit the consumption of free sugars to less than 10% of the total energy intake. The aim of this narrative review is to analyze current evidence on the different dietary patterns and nutrients that may affect prevention and treatment of MetS and to discuss the underlying pathophysiological mechanisms.

Association between plant-based diets and metabolic syndrome in obese adults from Iran: a cross-sectional study

BACKGROUND

Metabolic syndrome (MetS) is a common chronic disease with several complications. Given that, studies on the association of plant-based diet indices (PDIs) with risk of MetS among adults with obesity, are limited, we aimed to examine the association between PDIs (including overall PDI, healthy PDI (hPDI), unhealthy PDI (uPDI)) and MetS in Iranian adults with obesity.

METHODS

In Tabriz, Iran, a total of 347 adults between the ages of 20 and 50 participated in this cross-sectional research study. We created an overall PDI, hPDI, and uPDI from validated semi-quantitative food-frequency questionnaire (FFQ) data. To investigate the association between hPDI, overall PDI, uPDI, and MetS and its components, a binary logistic regression analysis was performed.

RESULTS

The average age was 40.78 ± 9.23 years, and the average body mass index was 32.62 ± 4.80 kg/m². There was no significant association between overall PDI (OR: 0.87; 95% CI: 0.54-1.47), hPDI (OR: 0.82; 95% CI: 0.48-1.40), and uPDI (OR: 0.83; 95% CI: 0.87-2.46) with MetS, even after adjustment for confounders. Moreover, our findings showed that participants with the highest adherence to uPDI had a higher chance of hyperglycemia (OR: 2.50; 95% CI: 1.13-5.52). Also, this association was significant in the first (OR: 2.51; 95% CI: 1.04-6.04) and second (OR: 2.58; 95% CI: 1.05-6.33) models, after controlling for covariates. However, in both adjusted and crude models, we did not find a significant association between hPDI and PDI scores and MetS components such as high triglyceride, high waist circumference, low High-density lipoprotein cholesterol, raised blood pressure, and hyperglycemia. Moreover, those in the top tertile of uPDI had higher fasting blood sugar and insulin levels when compared with those in the first tertile, and subjects in the last tertile of hPDI compared with participants in the first tertile had lower weight, waist-to-hip ratio, and fat-free mass.

CONCLUSION

We found a direct significant association between uPDI and odds of hyperglycemia in the whole population of study. Future large-scale, prospective studies on PDIs and the MetS are necessary to confirm these findings.

Western Diet Causes Heart Failure With Reduced Ejection Fraction and Metabolic Shifts After Diastolic Dysfunction and Novel Cardiac Lipid Derangements

Western diet (WD) impairs glucose tolerance and cardiac lipid dynamics, preceding heart failure with reduced ejection fraction (HFrEF) in mice. Unlike diabetic db/db mice with high cardiac triglyceride (TG) and rapid TG turnover, WD mice had high TG but slowed turnover, reducing lipolytic PPAR⍺ activation. WD deranged cardiac TG dynamics by imbalancing synthesis and lipolysis, with low cardiac TG lipase (ATGL), low ATGL co-activator, and high ATGL inhibitory peptide. By 24 weeks of WD, hearts shifted from diastolic dysfunction to diastolic dysfunction with HFrEF with decreases in GLUT4 and exogenous glucose oxidation and elevated β-hydroxybutyrate dehydrogenase 1 without increasing ketone oxidation.

Resveratrol and Dulaglutide ameliorate adiposity and liver dysfunction in rats with diet-induced metabolic syndrome: Role of SIRT-1 / adipokines / PPARγ and IGF-1

BACKGROUND

Adiposity and non-alcoholic fatty liver disease (NAFLD) are common characteristics of metabolic syndrome (MS). Understanding the underlying pathogenesis is crucial for the development of new remedies. Resveratrol controls obesity and glycemic disorders in patients with MS.

OBJECTIVES

This study aimed to evaluate the effect of resveratrol and dulaglutide on adipose tissues and liver in rats with MS, declaring their possible mechanisms.

METHODS

Rats allocated as Control, MS (induced by a high fat/ high sucrose diet for eight weeks), MS + Resveratrol (30 mg/kg/day orally), and MS + Dulaglutide (0.6 mg/kg twice weekly SC); drugs administration was in the last four weeks. Serum biochemical measurements were done. Liver and visceral fat were processed for biochemistry, histopathology, and immunohistochemistry.

RESULTS

MS results demonstrated significantly increased systolic and diastolic blood pressure, anthropometric measurements, serum levels of alanine aminotransferase (ALT), glycemic indices, and lipids with decreased HDL-C. Tissue levels of leptin, malondialdehyde (MDA), and TNF-α reactivity significantly increased. Expression of adiponectin, PPARγ, and insulin growth factor-1 (IGF-1) decreased. Also, Western blotting mRNA gene expression of liver SIRT-1 was down-regulated. Resveratrol and dulaglutide significantly and effectively reversed MS complexity, ameliorating all findings, particularly NAFLD and adiposity-induced inflammation. Resveratrol significantly appears superior to dulaglutide regarding the effects on hemodynamics, lipids, adipokines, IGF-1 levels, and adipocyte size. Parallel, dulaglutide has more influence on glycemic control.

CONCLUSION

Protective effects of the drugs may be through correlations between SIRT-1/adipokines/IGF-1 and PPARγ, improving the cross-talk between insulin resistance, obesity markers, liver dysfunction, and TNF-α. Promising multi-beneficial therapies of resveratrol or dulaglutide in MS are recommended clinically for this purpose. Showing the Experimental Design.

Coffee Consumption and the Risk of Metabolic Syndrome in the ‘Seguimiento Universidad de Navarra’ Project

(1) Background: Metabolic Syndrome (MetS) affects over a third of the United States population, and has similar prevalence in Europe. Dietary approaches to prevention are important. Coffee consumption has been inversely associated with mortality and chronic disease; however, its relation to the risk of MetS is unclear. We aimed to investigate the association between coffee consumption and incident MetS in the ‘Seguimiento Universidad de Navarra’ cohort. (2) Methods: From the SUN project, we included 10,253 participants initially free of MetS. Coffee consumption was assessed at baseline, and the development of MetS was assessed after 6 years of follow-up. All data were self-reported by participants. MetS was defined according to the Harmonizing Definition. We used multivariable logistic regression models to estimate odds ratios and 95% confidence intervals for incident MetS according to four categories of coffee consumption: <1 cup/month; ≥1 cup/month to <1 cup/day; ≥1 cup/day to <4 cups/day; ≥4 cups/day. (3) Results: 398 participants developed MetS. Coffee consumption of ≥1 to <4 cups/day was associated with significantly lower odds of developing MetS (multivariable adjusted OR = 0.71, 95% CI (0.50–0.99)) as compared to consumption of <1 cup/month. (4) Conclusions: In a Mediterranean cohort, moderate coffee consumption may be associated with a lower risk of MetS.

The Association between Plant-Based Diet Indices and Metabolic Syndrome in Chinese Adults: Longitudinal Analyses from the China Health and Nutrition Survey

Objectives: To investigate the association between a plant-based diet and metabolic syndrome (MetS) among Chinese adults. Methods: Based on the data from the 2004–2015 China Health and Nutrition Survey and the corresponding edition of China Food Composition, we calculated the healthy plant-based diet indices (hPDI) and unhealthy plant-based diet indices (uPDI). The Cox proportional hazards regression model was used to estimate the hazard ratios (HRs) with 95% confidence intervals (CIs) for MetS. Mediation analysis was further conducted to explore the mediator role of Body Mass Index (BMI) in the association between hPDI and MetS. Results: We included 10,013 participants, and over a median follow-up of 5 years, 961 patients (9.60%) developed MetS. Compared to those in the lowest quintile of hPDI score, we found that those in the highest quintile of hPDI score had a 28% lower ([HR]: 0.72, 95% CI 0.56–0.93, Ptrend = 0.021) risk of developing MetS and had a 20% lower (hazard ratio [HR]: 0.80, 95% CI 0.70–0.92, Ptrend = 0.004) risk of developing abdominal obesity. No significant associations were observed between uPDI and the MetS, but those in the highest quintile of uPDI score had a 36% higher (hazard ratio [HR]: 1.36, 95% CI 1.20–1.64, Ptrend < 0.001) risk of developing abdominal obesity, compared to those in the lowest quintile of uPDI score. In exploratory analysis, we observed that BMI at baseline mediated 27.8% of the association between hPDI and incident MetS, and BMI at baseline mediated 29.7% of the association between hPDI and abdominal obesity. Conclusion: The current findings reveal a possible causal relationship between a healthy plant-based diet and a reduced risk of MetS, especially abdominal obesity. It is observed that BMI may mediate the relationship between hPDI score and MetS. Controlling early dietary patterns and BMI may help reduce the risk of MetS.

The potential harms of sedentary behaviour on cardiometabolic health are mitigated in highly active adults: a compositional data analysis

BACKGROUND

Insufficient physical activity and sedentary behaviour (SB) are important factors that determine cardiometabolic health and the development of non-communicable diseases. The aim of this study was to investigate the modifying effects of moderate-to-vigorous physical activity (MVPA) on the association between SB and cardiometabolic health within highly active adults.

METHODS

In a cross-sectional design, 61 (male/female: 41/20) highly trained adults (age: 33.6 ± 10.7 years; BMI: 22.4 ± 2.3 kg/m2) performed a maximal cardiopulmonary exercise test from which indicators for peak performance were determined. Physical activity and SB were assessed using the activPAL3™ accelerometer. In addition, anthropometrics, blood pressure, plasma lipids and insulin sensitivity were assessed. These cross-sectional associations between a daily movement behaviour composition and cardiometabolic health parameters were investigated using a compositional data analysis approach.

RESULTS

Participants spent 600 ± 86 min/day in SB and engaged in almost 1.5 h per day of MVPA. No association was found between SB and cardiometabolic health related variables, whereas MVPA (β = 8.07 ± 2.18; r2 = 0.544; p < 0.001) was only significantly associated with oxygen uptake, relative to all other remaining behaviours.

CONCLUSION

No associations were found between the time spent in SB and cardiometabolic health related outcomes, possibly due to the high amount of time spent in MVPA within highly active adults.

TRIAL REGISTRATION

The present study was registered on the 14th of January 2022 at clinicaltrials.gov (NCT04711928).

Sex differences in the association between sugar-sweetened beverages consumption and metabolic risks among the working-age population in Taiwan

OBJECTIVE

Sugar-sweetened beverages (SSB) are linked to increased metabolic risk. However, the sex differences in the relationship between SSB intake and adverse health effects remain unclear. Therefore, the present study examined the association between SSB consumption and metabolic risks among working-age males and females from Taiwanese communities.

DESIGN

A community-based study utilised data from a comprehensive health screening project conducted by the Public Health Bureau in Changhua County, Taiwan. Metabolic risks included waist circumference, systolic blood pressure, diastolic blood pressure, total cholesterol, TAG, LDL cholesterol and fasting glucose level using serum tests.

SETTING

Participants were recruited in Changhua County, Taiwan.

PARTICIPANTS

Between 2005 and 2014, 92 724 citizens participated in the health screening; our data analysis included 75 278 respondents between 30 and 64.

RESULTS

The results showed that the frequency of SSB consumption was associated with abnormal waist circumference and elevated total cholesterol, TAG, LDL and glucose in both men and women. Increased SSB consumption frequency was associated with elevated glucose and hypertension in women. Even a slight increase in SSB intake frequency was related to raising the metabolic risks. Similar patterns were evident when models included BMI; however, the associations were attenuated. In the BMI-stratified subgroup analysis, the relationship between SSB consumption and metabolic risks was more pronounced in participants without obesity.

CONCLUSION

The present study suggests that SSB consumption carries metabolic risk among working-age Taiwanese, particularly women and those without obesity. Health promotion programmes should raise awareness of the health hazards associated with SSB.

Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association

BACKGROUND

The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs).

METHODS

The American Heart Association, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2023 Statistical Update is the product of a full year's worth of effort in 2022 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. The American Heart Association strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional COVID-19 (coronavirus disease 2019) publications, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains.

RESULTS

Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics.

CONCLUSIONS

The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

Six weeks effect of different nanocellulose on blood lipid level and small intestinal morphology in mice

AIMS

Cellulose nanofibrils (CNF, or NFC), cellulose nanocrystals (CNC, or NCC), and Tempo (2,2,6,6-tetramethylpiperidine-1-oxyl radical) oxidized CNF (Tempo-CNF) were compared for the short-term effect on mice fed with a high-fat and high-sugar (Western diet, WD) to investigate their effect when combined with a sub-optimal diet.

SCOPE

Thirty C57B/C female mice (10 weeks old; 5-6 mice/group) were given water, cellulose, or three types of nanocellulose once daily in a dose of 30 mg/kg body weight by oral gavage. After six weeks, weight changes, fecal output, glucose homeostasis, and gut permeability showed no significant among groups. Serum analysis including triglycerides, cholesterol and total bile acids and small intestinal morphology including villus length, villus width, crypt depth, goblet cell count and goblet cell density were no difference for all groups. Only CNC group had higher excretion of bile acids in the feces.

CONCLUSIONS

These results suggest that current treated dose using three types of nanocellulose had no detrimental effects on blood lipid level and small intestinal morphology.

Impact of dietary sucralose and sucrose-sweetened water intake on lipid and glucose metabolism in male mice

AIMS

Overconsumption of sugar-sweetened beverages (SSBs) is associated with an increased risk of metabolic disorders, including obesity and diabetes. However, accumulating evidence also suggests the potential negative impact of consuming nonnutritive sweeteners (NNSs) on weight and glycaemic control. The metabolic effects of sucralose, the most widely used NNS, remain controversial. This study aimed to compare the impact of intake of dietary sucralose (acceptable daily intake dose, ADI dose) and sucrose-sweetened water (at the same sweetness level) on lipid and glucose metabolism in male mice.

MATERIALS AND METHODS

Sucralose (0.1 mg/mL) or sucrose (60 mg/mL) was added to the drinking water of 8-week-old male C57BL/6 mice for 16 weeks, followed by oral glucose and intraperitoneal insulin tolerance tests, and measurements of bone mineral density, plasma lipids, and hormones. After the mice were sacrificed, the duodenum and ileum were used for examination of sweet taste receptors (STRs) and glucose transporters.

RESULTS

A significant increase in fat mass was observed in the sucrose group of mice after 16 weeks of sweetened water drinking. Sucrose consumption also led to increased levels of plasma LDL, insulin, lipid deposition in the liver, and increased glucose intolerance in mice. Compared with the sucrose group, mice consuming sucralose showed much lower fat accumulation, hyperlipidaemia, liver steatosis, and glucose intolerance. In addition, the daily dose of sucralose only had a moderate effect on T1R2/3 in the intestine, without affecting glucose transporters and plasma insulin levels.

CONCLUSION

Compared with mice consuming sucrose-sweetened water, daily drinking of sucralose within the ADI dose had a much lower impact on glucose and lipid homeostasis.

Role of advanced glycation end products and insulin resistance in diabetic nephropathy

Metabolic syndrome (MetS), i.e. a cluster of physiological and biochemical abnormalities can lead to diabetic nephropathy (DN). Insulin resistance, impaired fasting glucose are the main signs and symptoms of MetS. Excess sugar can induce various substantial structural changes like formation of advanced glycation end products (AGEs). AGEs are formed due to reaction of reducing sugars with amino groups of proteins, lipids and nucleic acids. AGEs when bound to the receptor for advanced glycation end products (RAGE) activate increased production of pro-inflammatory markers like interleukin-6 (IL-6), tumour necrosis factor alpha (TNF-α) along with induction of endoplasmic reticulum (ER) stress. Accumulation of AGEs, enhanced reactive oxygen species (ROS) generation and activation of protein kinase C (PKC), are considered to induce glomerular hypertrophy, podocyte apoptosis, therefore contributing to the development and progression of DN. In this review, we decipher different biochemical and physiological factors that link AGEs and DN.

The association between carbon and nitrogen stable isotope ratios of human hair and hypertension

BACKGROUND

The relationship between stable isotope ratios and dietary protein sources has been reported. However, few studies have examined the effect of stable isotope ratios on metabolic risk in humans. We investigated whether the stable isotope ratios of carbon and nitrogen in human hair are associated with blood pressure and hypertension.

METHODS

We conducted a cross-sectional study of 392 subjects (228 men and 164 women). Hair samples of the subjects were used for the measurement of stable isotope ratios of carbon (δ¹³C) and nitrogen (δ¹⁵N).

RESULTS

The δ¹³C and δ¹⁵N values showed positive correlations with diastolic blood pressure in the subjects without antihypertensive medication. In the subjects without antihypertensive medication, the multivariable-adjusted odds ratio (95% confidence interval) for hypertension was 1.55 (1.04-2.30) per 1‰ increase in δ¹⁵N and 1.22 (0.86-1.73) per 1‰ increase in δ¹³C, respectively. However, in the subjects with antihypertensive medication, neither δ¹³C nor δ¹⁵N values showed a significant association with hypertension.

CONCLUSIONS

The stable isotopic ratio of nitrogen in scalp hair is independently associated with hypertension in subjects without antihypertensive medication. The hair δ¹⁵N value might be used as a surrogate marker to screen a high-risk population for hypertension.

Association between Sugar-Sweetened Beverage Consumption and the Risk of the Metabolic Syndrome: A Systematic Review and Meta-Analysis

(1) Background: The increasing occurrence of the metabolic syndrome (MetS) is largely related to harmful food habits. Among them, the consumption of sugar-sweetened beverages (SSBs) is noteworthy. However, to our knowledge, there are not enough high-quality methodological studies summarizing the association between the intake of SSBs and the MetS. Therefore, the aim of this study is to examine the existing published results on this association among adults by synthesizing the existing evidence. (2) Methods: Systematic review and meta-analysis of observational studies following the PRISMA guidelines. Relevant information was extracted and presented following the PRISMA recommendations. PubMed and SCOPUS databases were searched for studies published until June 2022 that assessed the association between SSB consumption (including soft drinks, bottled fruit juices, energy drinks, and milkshakes) and the occurrence of MetS. Random effect models were used to estimate pooled odds ratios (ORs) with their 95% coefficient interval, and I² was used to assess heterogeneity. (3) Results: A total of 14 publications from 6 different countries were included in this meta-analysis (9 cross-sectional and 5 cohort studies). For the cross-sectional studies, which included 62,693 adults, the pooled OR for the risk of MetS was 1.35 (95% CI 1.15, 1.58; I² 57%) when the highest versus the lowest categories of SSB consumption were compared. For the cohort studies, which included 28,932 adults, the pooled OR was 1.18 (95% CI 1.06, 1.32; I² 70%). (4) Conclusions: The consumption of SSBs was positively associated with an increased risk of MetS. The published literature supports public health strategies and the need to reduce the consumption of SSBs to prevent MetS.