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Kodeboina M, Piayda K, Jenniskens I, Vyas P, Chen S, Pesigan RJ, Ferko N, Patel BP, Dobrin A, Habib J, Franke J. Challenges and Burdens in the Coronary Artery Disease Care Pathway for Patients Undergoing Percutaneous Coronary Intervention: A Contemporary Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095633. [PMID: 37174152 PMCID: PMC10177939 DOI: 10.3390/ijerph20095633] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/24/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023]
Abstract
Clinical and economic burdens exist within the coronary artery disease (CAD) care pathway despite advances in diagnosis and treatment and the increasing utilization of percutaneous coronary intervention (PCI). However, research presenting a comprehensive assessment of the challenges across this pathway is scarce. This contemporary review identifies relevant studies related to inefficiencies in the diagnosis, treatment, and management of CAD, including clinician, patient, and economic burdens. Studies demonstrating the benefits of integration and automation within the catheterization laboratory and across the CAD care pathway were also included. Most studies were published in the last 5-10 years and focused on North America and Europe. The review demonstrated multiple potentially avoidable inefficiencies, with a focus on access, appropriate use, conduct, and follow-up related to PCI. Inefficiencies included misdiagnosis, delays in emergency care, suboptimal testing, longer procedure times, risk of recurrent cardiac events, incomplete treatment, and challenges accessing and adhering to post-acute care. Across the CAD pathway, this review revealed that high clinician burnout, complex technologies, radiation, and contrast media exposure, amongst others, negatively impact workflow and patient care. Potential solutions include greater integration and interoperability between technologies and systems, improved standardization, and increased automation to reduce burdens in CAD and improve patient outcomes.
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Affiliation(s)
- Monika Kodeboina
- Cardiovascular Center Aalst, OLV Clinic, 9300 Aalst, Belgium
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80138 Naples, Italy
- Clinic for Internal Medicine and Cardiology, Marien Hospital, 52066 Aachen, Germany
| | - Kerstin Piayda
- Cardiovascular Center Frankfurt, 60389 Frankfurt, Germany
- Department of Cardiology and Vascular Medicine, Medical Faculty, Justus-Liebig-University Giessen, 35392 Giessen, Germany
| | | | | | | | | | | | | | | | | | - Jennifer Franke
- Cardiovascular Center Frankfurt, 60389 Frankfurt, Germany
- Philips Chief Medical Office, 22335 Hamburg, Germany
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Serés-Noriega T, Giménez M, Perea V, Boswell L, Viñals C, Blanco J, Vinagre I, Pané A, Esmatjes E, Conget I, Amor AJ. Use of the Steno T1 Risk Engine Identifies Preclinical Atherosclerosis Better Than Use of ESC/EASD-2019 in Adult Subjects With Type 1 Diabetes at High Risk. Diabetes Care 2022; 45:2412-2421. [PMID: 35944257 DOI: 10.2337/dc22-0118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 06/27/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To evaluate the concordance between the 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD (ESC/EASD-2019) and the Steno T1 Risk Engine (Steno-Risk) cardiovascular risk scales for individuals with type 1 diabetes (T1D) without cardiovascular disease (CVD) and to analyze the relationships of their use with identification of preclinical atherosclerosis. RESEARCH DESIGN AND METHODS We consecutively selected patients with T1D, without CVD, age ≥40 years, with nephropathy, and/or with ≥10 years of T1D evolution with another risk factor. The presence of plaque at different carotid segments was determined by ultrasonography. Cardiovascular risk was estimated in accord with ESC/EASD-2019 risk groups (moderate/high/very high) and the Steno-Risk (<10%, low; 10-20%, moderate; ≥20%, high), as T1D-specific scores. In an exploratory analysis, we also evaluated the non-T1D-specific 2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk (ACC/AHA-2013) pooled cohort equation for individuals between 40 and 79 years of age. RESULTS We included 501 patients (53% men, mean age 48.8 years, median T1D duration 26.5 years, 41.3% harboring plaques). Concordance between T1D-specific scales was poor (κ = 0.19). A stepped increase in the presence of plaques according to Steno-Risk category was seen (18.4%, 38.2%, and 64.1%, for low, moderate, and high risk, respectively; P for trend <0.001), with no differences according to ESC/EASD-2019 (P = 0.130). Steno-Risk identified individuals with plaques, unlike ESC/EASD-2019 (area under the curve [AUC] 0.691, P < 0.001, vs. AUC 0.538, P = 0.149). Finally, in polynomial regression models (with adjustment for lipid parameters and cardioprotective treatment), irrespective of the ESC/EASD-2019 category, high risk by Steno-Risk was directly associated with atherosclerosis (in moderate/high-risk by ESC/EASD-2019 odds ratio 2.91 [95% CI 1.27-6.72] and 4.94 [2.35-10.40] for the presence of plaque and two or more plaques). Similar results were obtained with discordant higher Steno-Risk versus ACC/AHA-2013 (P < 0.001). CONCLUSIONS Among T1D patients undergoing primary prevention, use of Steno-Risk seems to result in better recognition of individuals with atherosclerosis in comparison with ESC/EASD-2019. Notwithstanding, carotid ultrasound could improve the categorization of cardiovascular risk.
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Affiliation(s)
- Tonet Serés-Noriega
- Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain
| | - Marga Giménez
- Diabetes Unit, Endocrinology and Nutrition Department, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Verónica Perea
- Endocrinology and Nutrition Department, Hospital Universitari Mútua de Terrassa, Terrassa, Spain
| | - Laura Boswell
- Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain
- Endocrinology and Nutrition Department, Althaia University Health Network, Manresa, Spain
| | - Clara Viñals
- Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain
| | - Jesús Blanco
- Diabetes Unit, Endocrinology and Nutrition Department, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Irene Vinagre
- Diabetes Unit, Endocrinology and Nutrition Department, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Adriana Pané
- Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain
| | - Enric Esmatjes
- Diabetes Unit, Endocrinology and Nutrition Department, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Ignacio Conget
- Diabetes Unit, Endocrinology and Nutrition Department, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Antonio J Amor
- Diabetes Unit, Endocrinology and Nutrition Department, Hospital Clínic, Barcelona, Spain
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Martín-Peláez S, Serra-Majem L, Cano-Ibáñez N, Martínez-González MÁ, Salas-Salvadó J, Corella D, Lassale C, Martínez JA, Alonso-Gómez ÁM, Wärnberg J, Vioque J, Romaguera D, López-Miranda J, Estruch R, Tinahones FJ, Lapetra J, Fernández-Aranda F, Bueno-Cavanillas A, Tur JA, Martín V, Pintó X, Delgado-Rodríguez M, Matía P, Vidal J, Vázquez C, Daimiel L, Ros E, Toledo E, Nishi SK, Sorli JV, Malcampo M, Zulet MÁ, Moreno-Rodríguez A, Cueto-Galán R, Vivancos-Aparicio D, Colom A, García-Ríos A, Casas R, Bernal-López MR, Santos-Lozano JM, Vázquez Z, Gómez-Martínez C, Ortega-Azorín C, del Val JL, Abete I, Goikoetxea-Bahon A, Pascual E, Becerra-Tomás N, Chillarón JJ, Sánchez-Villegas A. Contribution of cardio-vascular risk factors to depressive status in the PREDIMED-PLUS Trial. A cross-sectional and a 2-year longitudinal study. PLoS One 2022; 17:e0265079. [PMID: 35417452 PMCID: PMC9007355 DOI: 10.1371/journal.pone.0265079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 02/13/2022] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Cardio-vascular disease and depression are thought to be closely related, due to shared risk factors. The aim of the study was to determine the association between cardio-vascular risk (CVR) factors and depressive status in a population (55-75 years) with metabolic syndrome (MetS) from the PREDIMED-Plus trial. METHODS AND FINDINGS Participants were classified into three groups of CVR according to the Framingham-based REGICOR function: (1) low (LR), (2) medium (MR) or (3) high/very high (HR). The Beck Depression Inventory-II (BDI-II) was used to assess depressive symptoms at baseline and after 2 years. The association between CVR and depressive status at baseline (n = 6545), and their changes after 2 years (n = 4566) were evaluated through multivariable regression models (logistic and linear models). HR women showed higher odds of depressive status than LR [OR (95% CI) = 1.78 (1.26, 2.50)]. MR and HR participants with total cholesterol <160 mg/mL showed higher odds of depression than LR [OR (95% CI) = 1.77 (1.13, 2.77) and 2.83 (1.25, 6.42) respectively)] but those with total cholesterol ≥280 mg/mL showed lower odds of depression than LR [OR (95% CI) = 0.26 (0.07, 0.98) and 0.23 (0.05, 0.95), respectively]. All participants decreased their BDI-II score after 2 years, being the decrease smaller in MR and HR diabetic compared to LR [adjusted mean±SE = -0.52±0.20, -0.41±0.27 and -1.25±0.31 respectively). MR and HR participants with total cholesterol between 240-279 mg/mL showed greater decreases in the BDI-II score compared to LR (adjusted mean±SE = -0.83±0.37, -0.77±0.64 and 0.97±0.52 respectively). CONCLUSIONS Improving cardiovascular health could prevent the onset of depression in the elderly. Diabetes and total cholesterol in individuals at high CVR, may play a specific role in the precise response. International Standard Randomized Controlled Trial (ISRCTN89898870).
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Affiliation(s)
- Sandra Martín-Peláez
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
- * E-mail:
| | - Lluis Serra-Majem
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Naomi Cano-Ibáñez
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
- Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Miguel Ángel Martínez-González
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, IdiSNA, University of Navarre, Pamplona, Spain
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Jordi Salas-Salvadó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana. Reus, Spain
- University Hospital of Sant Joan de Reus, Nutrition Unit, Reus, Spain
- Institut d’Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Dolores Corella
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Camille Lassale
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del mar de Investigaciones Médicas Municipal d’Investigació Médica (IMIM), Barcelona, Spain
| | - Jose Alfredo Martínez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Nutrition, Food Sciences and Physiology, University of Navarra, Pamplona, Spain
- Precision Nutrition Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Ángel M. Alonso-Gómez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area; Osakidetza Basque Health Service, Araba University Hospital; University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Julia Wärnberg
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Nursing, School of Health Sciences. University of Malaga- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Jesús Vioque
- Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante, ISABIAL-UMH. Alicante, Spain
| | - Dora Romaguera
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - José López-Miranda
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain
| | - Ramón Estruch
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Internal Medicine, Institut dÌnvestigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Francisco J. Tinahones
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Virgen de la Victoria Hospital, Department of Endocrinology, Instituto de Investigación Biomédica de Málaga (IBIMA). University of Málaga, Málaga, Spain
| | - José Lapetra
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - Fernando Fernández-Aranda
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Aurora Bueno-Cavanillas
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
- Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
| | - Josep A. Tur
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
- Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
| | - Vicente Martín
- Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III, Madrid, Spain
- Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - Xavier Pintó
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Miguel Delgado-Rodríguez
- Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Granada, Spain
- Center for Advanced Studies in Olive Grove and Olive Oils, University of Jaén, Jaén, Spain
| | - Pilar Matía
- Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Josep Vidal
- CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- Department of Endocrinology, Institut dÌnvestigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Clotilde Vázquez
- Department of Endocrinology and Nutrition, Hospital Fundación Jiménez-Díaz, Instituto de Investigaciones Biomédicas IISFJD. University Autónoma, Madrid, Spain
| | - Lidia Daimiel
- Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Emili Ros
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Lipid Clinic, Department of Endocrinology and Nutrition, Institut d’Investigació Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, Barcelona, Spain
| | - Estefanía Toledo
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, IdiSNA, University of Navarre, Pamplona, Spain
| | - Stephanie K. Nishi
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana. Reus, Spain
- University Hospital of Sant Joan de Reus, Nutrition Unit, Reus, Spain
- Institut d’Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Jose V. Sorli
- Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Mireia Malcampo
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del mar de Investigaciones Médicas Municipal d’Investigació Médica (IMIM), Barcelona, Spain
| | - M. Ángeles Zulet
- Department of Nutrition, Food Sciences and Physiology, University of Navarra, Pamplona, Spain
| | - Anaí Moreno-Rodríguez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area; Osakidetza Basque Health Service, Araba University Hospital; University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Raquel Cueto-Galán
- Department of Nursing, School of Health Sciences. University of Malaga- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | | | - Antoni Colom
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Antonio García-Ríos
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain
| | - Rosa Casas
- Department of Internal Medicine, Institut dÌnvestigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - M Rosa Bernal-López
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Virgen de la Victoria Hospital, Department of Endocrinology, Instituto de Investigación Biomédica de Málaga (IBIMA). University of Málaga, Málaga, Spain
| | - Jose Manuel Santos-Lozano
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - Zenaida Vázquez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, IdiSNA, University of Navarre, Pamplona, Spain
| | - Carlos Gómez-Martínez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana. Reus, Spain
- University Hospital of Sant Joan de Reus, Nutrition Unit, Reus, Spain
- Institut d’Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | | | - Jose Luís del Val
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del mar de Investigaciones Médicas Municipal d’Investigació Médica (IMIM), Barcelona, Spain
| | - Itziar Abete
- Department of Nutrition, Food Sciences and Physiology, University of Navarra, Pamplona, Spain
| | - Amaia Goikoetxea-Bahon
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area; Osakidetza Basque Health Service, Araba University Hospital; University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain
| | - Elena Pascual
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, IdiSNA, University of Navarre, Pamplona, Spain
| | - Nerea Becerra-Tomás
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana. Reus, Spain
- University Hospital of Sant Joan de Reus, Nutrition Unit, Reus, Spain
- Institut d’Investigació Sanitària Pere Virgili (IISPV), Reus, Spain
| | - Juan J. Chillarón
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Unit of Cardiovascular Risk and Nutrition, Institut Hospital del mar de Investigaciones Médicas Municipal d’Investigació Médica (IMIM), Barcelona, Spain
| | - Almudena Sánchez-Villegas
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
- Institute for Innovation & Sustainable Development in Food Chain. Universidad Pública de Navarra (UPNA), IdisNA, Pamplona, Spain
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Prevalence of Peripheral Arterial Disease and Associated Vascular Risk Factors in 65-Years-Old People of Northern Barcelona. J Clin Med 2021; 10:jcm10194467. [PMID: 34640483 PMCID: PMC8509737 DOI: 10.3390/jcm10194467] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 01/14/2023] Open
Abstract
Objective: To determine the prevalence and risk factors associated with peripheral arterial disease (PAD) in Northern Barcelona at 65 years of age. Methods: A single-center, cross-sectional study, including males and females 65 years of age, health care cardholders of Barcelona Nord. PAD was defined as an ankle–brachial index (ABI) < 0.9. Attending subjects were evaluated for a history of common cardiovascular risk factors. A REGICOR score was obtained, as well as a physical examination and anthropometric measurements. Results: From November 2017 to December 2018, 1174 subjects were included: 479 (40.8%) female and 695 (59.2%) male. Overall prevalence of PAD was 6.2% (95% CI: 4.8–7.6%), being 7.9% (95% CI: 5.9–9.9%) in males and 3.8% (95% CI: 2.1–5.5%) in females. An independent strong association was seen in male smokers and diabetes, with ORs pf 7.2 (95% CI: 2.8–18.6) and 1.8 (95% CI: 1.0–3.3), respectively, and in female smokers and hypertension, with ORs of 5.2 (95% CI: 1.6–17.3) and 3.3 (95% CI: 1.2–9.0). Male subjects presented with higher REGICOR scores (p < 0.001). Conclusion: Higher-risk groups are seen in male subjects with a history of smoking and diabetes and female smokers and arterial hypertension, becoming important subgroups for our primary healthcare centers and should be considered for ABI screening programs.
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Effect of a chronotype-adjusted diet on weight loss effectiveness: A randomized clinical trial. Clin Nutr 2020; 39:1041-1048. [DOI: 10.1016/j.clnu.2019.05.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 04/10/2019] [Accepted: 05/10/2019] [Indexed: 11/22/2022]
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6
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Paulo F, Santos L. Encapsulation of the Antioxidant Tyrosol and Characterization of Loaded Microparticles: an Integrative Approach on the Study of the Polymer-Carriers and Loading Contents. FOOD BIOPROCESS TECH 2020. [DOI: 10.1007/s11947-020-02407-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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7
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Alcubierre N, Granado-Casas M, Real J, Perpiñán H, Rubinat E, Falguera M, Castelblanco E, Franch-Nadal J, Mauricio D. Spanish People with Type 2 Diabetes Show an Improved Adherence to the Mediterranean Diet. Nutrients 2020; 12:nu12020560. [PMID: 32093385 PMCID: PMC7071466 DOI: 10.3390/nu12020560] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 02/15/2020] [Accepted: 02/17/2020] [Indexed: 12/11/2022] Open
Abstract
The aim of this study was to assess the dietary pattern (i.e., Mediterranean Diet (MedDiet) and healthy eating) in people with type 2 diabetes (T2D) compared with those without diabetes. In addition, we explored clinical factors associated with the dietary pattern. This cross-sectional study was performed with a sample of 476 participants (238 with T2D and 238 participants without diabetes, matched for age and sex). The alternate Mediterranean Diet (aMED) score and the alternate Healthy Eating Index (aHEI) were calculated. Statistical analysis included comparison between groups and multivariable models. Participants with T2D showed higher aMED and aHEI scores (mean (SD): 4.3 (1.5) and 43.9 (6.5), respectively) in comparison with the control group (3.5 (1.8) and 39.4 (7.4), respectively; p < 0.001). In addition, a higher proportion of participants with T2D in higher tertiles of aMED (21.8%) and aHEI (39.9%) was observed compared with participants without diabetes (11.3% for the aMED, and 19.3% for the aHEI; p < 0.001). The adjusted multivariable analysis revealed that T2D (p < 0.001), increasing age (p = 0.006 and p = 0.030, respectively), and physical activity (p = 0.009) were positively associated with higher aMED and aHEI scores. Dyslipidemia and female gender were positively associated with aMED and aHEI (p = 0.031 and p < 0.001, respectively). The specific multivariable analysis for the group with T2D yielded a positive association of age (p < 0.001) and dyslipidemia (p = 0.021) with aMED. Regarding the aHEI, only female gender was positively related with this score in diabetes participants (p = 0.025). Participants with T2D showed a higher adherence to the MedDiet and a healthier eating pattern.
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Affiliation(s)
- Nuria Alcubierre
- Department of Nutrition and Dietetics, Avantmedic, 25008 Lleida, Spain;
| | - Minerva Granado-Casas
- Department of Endocrinology and Nutrition, Health Sciences Research Institute & University Hospital Germans Trias i Pujol, 08916 Badalona, Spain;
- Lleida Institute for Biomedical Research Dr. Pifarré Foundation IRB Lleida, University of Lleida, 25198 Lleida, Spain;
| | - Jordi Real
- DAP-Cat Group, Unitat de Suport a la Recerca de Barcelona, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 08007 Barcelona, Spain;
- Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, 08907 Barcelona, Spain;
| | - Hèctor Perpiñán
- Conselleria de Sanitat Universal i Salut Pública, Generalitat Valenciana, 46010 Valencia, Spain;
| | - Esther Rubinat
- Lleida Institute for Biomedical Research Dr. Pifarré Foundation IRB Lleida, University of Lleida, 25198 Lleida, Spain;
- Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, 08907 Barcelona, Spain;
- Department of Nursing and Physiotherapy, Serra Hunter Lecture, University of Lleida, 25198 Lleida, Spain
| | - Mireia Falguera
- Primary Health Care Center Igualada Nord, 08700 Igualada, Spain;
| | - Esmeralda Castelblanco
- Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, 08907 Barcelona, Spain;
- Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau & Sant Pau Biomedical Research Institute (IIB Sant Pau), 08041 Barcelona, Spain
| | - Josep Franch-Nadal
- DAP-Cat Group, Unitat de Suport a la Recerca de Barcelona, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 08007 Barcelona, Spain;
- Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, 08907 Barcelona, Spain;
- Correspondence: (J.F.-N.); (D.M.); Tel.: +34-933-293-912 (J.F.-N.); +34-935-565-602 (D.M.)
| | - Didac Mauricio
- Lleida Institute for Biomedical Research Dr. Pifarré Foundation IRB Lleida, University of Lleida, 25198 Lleida, Spain;
- Center for Biomedical Research on Diabetes and Associated Metabolic Diseases (CIBERDEM), Instituto de Salud Carlos III, 08907 Barcelona, Spain;
- Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau & Sant Pau Biomedical Research Institute (IIB Sant Pau), 08041 Barcelona, Spain
- Department of Medicine, Barcelona Autonomous University (UAB), 08035 Barcelona, Spain
- Correspondence: (J.F.-N.); (D.M.); Tel.: +34-933-293-912 (J.F.-N.); +34-935-565-602 (D.M.)
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Serra-Majem L, Román-Viñas B, Sanchez-Villegas A, Guasch-Ferré M, Corella D, La Vecchia C. Benefits of the Mediterranean diet: Epidemiological and molecular aspects. Mol Aspects Med 2019; 67:1-55. [PMID: 31254553 DOI: 10.1016/j.mam.2019.06.001] [Citation(s) in RCA: 106] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/03/2019] [Accepted: 06/04/2019] [Indexed: 01/16/2023]
Abstract
More than 50 years after the Seven Countries Study, a large number of epidemiological studies have explored the relationship between the Mediterranean diet (MD) and health, through observational, case-control, some longitudinal and a few experimental studies. The overall results show strong evidence suggesting a protective effect of the MD mainly on the risk of cardiovascular disease (CVD) and certain types of cancer. The beneficial effects have been attributed to the types of food consumed, total dietary pattern, components in the food, cooking techniques, eating behaviors and lifestyle behaviors, among others. The aim of this article is to review and summarize the knowledge derived from the literature focusing on the benefits of the MD on health, including those that have been extensively investigated (CVD, cancer) along with more recent issues such as mental health, immunity, quality of life, etc. The review begins with a brief description of the MD and its components. Then we present a review of studies evaluating metabolic biomarkers and genotypes in relation to the MD. Other sections are dedicated to observation and intervention studies for various pathologies. Finally, some insights into the relationship between the MD and sustainability are explored. In conclusion, the research undertaken on metabolomics approaches has identified potential markers for certain MD components and patterns, but more investigation is needed to obtain valid measures. Further evaluation of gene-MD interactions are also required to better understand the mechanisms by which the MD diet exerts its beneficial effects on health. Observation and intervention studies, particularly PREDIMED, have provided invaluable data on the benefits of the MD for a wide range of chronic diseases. However further research is needed to explore the effects of other lifestyle components associated with Mediterranean populations, its environmental impact, as well as the MD extrapolation to non-Mediterranean contexts.
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Affiliation(s)
- Lluis Serra-Majem
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas, Spain; Preventive Medicine Service, Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Nutrition Research Foundation, University of Barcelona Science Park, Barcelona, Spain.
| | - Blanca Román-Viñas
- Nutrition Research Foundation, University of Barcelona Science Park, Barcelona, Spain; School of Health and Sport Sciences (EUSES), Universitat de Girona, Salt, Spain; Department of Physical Activity and Sport Sciences, Blanquerna, Universitat Ramon Llull, Barcelona, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Almudena Sanchez-Villegas
- Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria, Las Palmas, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Marta Guasch-Ferré
- Department of Nutrition, Harvard T.H.Chan School of Public Health, Boston, MA, USA; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Dolores Corella
- Genetic and Molecular Epidemiology Unit. Department of Preventive Medicine. University of Valencia, Valencia, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20133, Milan, Italy
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Corbatón Anchuelo A, Martínez-Larrad MT, Serrano-García I, Fernández Pérez C, Serrano-Ríos M. Body fat anthropometric indexes: Which of those identify better high cardiovascular risk subjects? A comparative study in Spanish population. PLoS One 2019; 14:e0216877. [PMID: 31120940 PMCID: PMC6532872 DOI: 10.1371/journal.pone.0216877] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 04/30/2019] [Indexed: 01/20/2023] Open
Abstract
Aim To determine the association of body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR), waist to height ratio (WHtr) and Body Shape Index (ABSI) with high cardiovascular risk (CVR), as well as to determine whether how strong are these relationships. Material and methods A cross-sectional study was carried out in Spanish Caucasian adults. 3,456 subjects completed the study, 45.78% males, aged < 65 years and non-diabetic subjects. Anthropometric/biochemical variables were measured. We determined ABSI based on WC adjusted for height and weight. High CVR was defined as ≥ 20% according to the Framingham chart, ≥ 5% with the SCORE chart, and ≥ 7.5% with the ACC/AHA guide. Areas under the receiver operating characteristic curves (AUCs) were estimated for each anthropometric measure. Results Most significant AUCs in males were: WHtr and ABSI for Framingham ≥ 20% and SCORE ≥ 5%. Also significant were WHtr, WC and ABSI for ACCA/AHA ≥ 7.5%. On the other hand, most significant AUCs in females were: WHtr and WC for Framingham ≥ 20%; and WHtr and WHR for SCORE ≥ 5%, WHtr, and WC for ACC/AHA guide ≥ 7.5%. Conclusions Overall, the best anthropometric index identifying Spanish males and females who are at high risk for CV events is WHtr. ABSI was also found to be a good anthropometric index to predict high CVR in Spanish males according to FR, SCORE and ACC/AHA charts. For Spanish females, WC is a good anthropometric index according to FR and ACC/AHA guide, while WHR is better according to SCORE.
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Affiliation(s)
- Arturo Corbatón Anchuelo
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- * E-mail:
| | - María Teresa Martínez-Larrad
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - Irene Serrano-García
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- UGC de Medicina Preventiva, Hospital Clínico San Carlos, Madrid, Spain
| | - Cristina Fernández Pérez
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
- UGC de Medicina Preventiva, Hospital Clínico San Carlos, Madrid, Spain
- Facultad de Enfermería, Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - Manuel Serrano-Ríos
- Spanish Biomedical Research Centre in Diabetes and Associated Metabolic Disorders (CIBERDEM), Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain
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10
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Gonzalez-Sanchez J, Recio-Rodriguez JI, Fernandez-delRio A, Sanchez-Perez A, Magdalena-Belio JF, Gomez-Marcos MA, Garcia-Ortiz L. Using a smartphone app in changing cardiovascular risk factors: A randomized controlled trial (EVIDENT II study). Int J Med Inform 2019; 125:13-21. [DOI: 10.1016/j.ijmedinf.2019.02.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 01/11/2019] [Accepted: 02/11/2019] [Indexed: 01/01/2023]
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11
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Maximizing the Functional Performance Outcomes of Patients Undergoing Rehabilitation by Maximizing Their Overall Health and Wellbeing. J Hum Kinet 2019; 65:57-68. [PMID: 30687419 PMCID: PMC6341960 DOI: 10.2478/hukin-2018-0039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
To maximize the performance of an athlete, a team of experts work together to ensure each athlete achieves the maximal benefit from their prescribed exercise conditioning programs. In addition to the exercise specialists, the athlete’s team frequently includes psychologists (who address performance anxiety, stress, and depression), counselors (who address smoking cessation, reduction or elimination of alcohol consumption if necessary, weight optimization, and optimal sleep), and nutritionists (who address optimal nutrition and body mass attributes). Such a collaborative approach has become standard practice for athletes aiming to excel in their sports. Despite unequivocal and compelling evidence, this paradigm has only weakly been transferred to the needs of patients participating in rehabilitation programs. These individuals, like the athlete, also need to achieve their highest level of functional performance and recovery for carrying out their activities of daily living, managing the needs of their families, and often returning to work. This article reviews the evidence-based literature and the implications of this multifaceted approach in rehabilitation programs. The augmented benefits to exercise training and conditioning (prescriptive activity/exercise and less sitting) along with their ‘effect sizes’ are described in the rehabilitation context, in conjunction with smoking cessation, reduced harmful alcohol consumption, optimal nutrition, optimal body mass, manageable stress, and optimal sleep. These factors can be viewed as physical performance enhancers both in individuals participating in rehabilitation whose aim is maximal performance and recovery and in athletes aiming for maximal performance in their sports. Thus, without targeted attention to these lifestyle factors, rehabilitation outcomes cannot be maximized. The evidence presented in this article has implications for health professionals including physical therapists and others who are practicing in rehabilitation settings and those working with individuals in need in the community.
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12
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Silveira BKS, de Novaes JF, Reis NDA, Lourenço LP, Capobiango AHM, Vieira SA, Hermsdorff HHM. "Traditional" and "Healthy" Dietary Patterns Are Associated with Low Cardiometabolic Risk in Brazilian Subjects. Cardiol Res Pract 2018; 2018:4585412. [PMID: 30581607 PMCID: PMC6276399 DOI: 10.1155/2018/4585412] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 09/28/2018] [Accepted: 10/23/2018] [Indexed: 12/18/2022] Open
Abstract
This study aimed at determining the dietary patterns and investigating their association with cardiometabolic risk markers in a brazilian population at risk. This transversal study was carried out with data of 265 patients (n = 123 M/172 W, age 42 ± 16 years) of the Cardiovascular Health Care Program-PROCARDIO-UFV, Brazil-who had their first appointment between 2012 and 2017. A 24-hour recall was applied. The dietary patterns were determined by Principal Component Analysis. Anthropometric, clinical-metabolic, sociodemographic, and lifestyle data were collected through medical record analysis. Five patterns were identified: "Traditional", "Caloric", "Unhealthy", "Healthy," and "Healthy Snacks". In bivariate analysis, the "Healthy" pattern was negatively associated with WC (waist circunference), BMI (body mass index), WHR (waist-to-hip ratio), SBP (systolic blood pressure), fasting glucose, TG/HDL, LDL/HDL, and TG/HDL values and positively to HDL. The "Traditional" pattern was positively associated with adiposity indicators (WC, BMI, and WHR) and negatively associated with body fat, TyG (triglyceride-glucose index), HDL, and LDL (P < 0.05). However, in adjusted models of Poisson regression, individuals with positive factor score (higher adherence) in the "Traditional" and "Healthy" patterns had less occurrence of abdominal obesity (PR 0.85; 95% CI 0.74-0.99/PR 0.88; 95% CI 0.02-0.76), as well as dyslipidemia (PR 0.06; 95% CI 0.02-0.51/PR 0.03; 95% CI 0.01-0.27), diabetes (PR 0.05; 95% CI 0.01-0.45/PR 0.02; 95% CI 0.01-021), and hypertension (PR 0.06; 95% CI 0.02-0.50/PR 0.02; 95% CI 0.01-0.21). A greater adherence to the "Healthy" pattern was associated with lower values to cardiometabolic risk markers and less occurrence of chronic diseases, while the "Traditional" pattern presented contradictory results.
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Affiliation(s)
| | - Juliana Farias de Novaes
- PhD, Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - Nínive de Almeida Reis
- MSc, Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - Larissa Pereira Lourenço
- Undergraduate Student, Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - Ana Helena Moretto Capobiango
- Undergraduate Student, Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - Sarah Aparecida Vieira
- PhD, Department of Integrated Education in Health, Universidade Federal do Espírito Santo, Espírito Santo, Brazil
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Oikonomou E, Psaltopoulou T, Georgiopoulos G, Siasos G, Kokkou E, Antonopoulos A, Vogiatzi G, Tsalamandris S, Gennimata V, Papanikolaou A, Tousoulis D. Western Dietary Pattern Is Associated With Severe Coronary Artery Disease. Angiology 2017; 69:339-346. [DOI: 10.1177/0003319717721603] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The independent predictive value of an unhealthy diet on the severity of coronary artery disease (CAD) requires further investigation. We assessed the impact of dietary pattern on CAD severity. In this cohort study, we included 188 symptomatic stable patients with CAD. Patients were categorized as having severe CAD or nonsevere CAD by coronary angiography. Among several demographics and clinical characteristics, all patients were tested using a semiquantitative food frequency questionnaire. Concerning baseline demographic characteristics, there was no difference between patients with severe CAD and nonsevere CAD. Principal component analysis revealed 8 distinct dietary patterns. The first component Western dietary pattern (increased intake of fat, red meat, and carbohydrates and minimal consumption of fruits and green leafy vegetables) was predictive of severe CAD (area under the curve: 0.73, 95% confidence intervals: 0.64-0.83, P < .001). In conclusion, an unhealthy Western type of diet is associated with the severity of coronary artery lesions in patients with stable CAD. These findings highlight the role of dietary patterns when estimating cardiovascular risk for the management of patients with CAD.
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Affiliation(s)
- Evangelos Oikonomou
- First Department of Cardiology, “Hippokration” Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodora Psaltopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Georgiopoulos
- First Department of Cardiology, “Hippokration” Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Gerasimos Siasos
- First Department of Cardiology, “Hippokration” Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Eleni Kokkou
- First Department of Cardiology, “Hippokration” Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexios Antonopoulos
- First Department of Cardiology, “Hippokration” Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgia Vogiatzi
- First Department of Cardiology, “Hippokration” Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Sotirios Tsalamandris
- First Department of Cardiology, “Hippokration” Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Vassiliki Gennimata
- First Department of Cardiology, “Hippokration” Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Aggelos Papanikolaou
- First Department of Cardiology, “Hippokration” Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitris Tousoulis
- First Department of Cardiology, “Hippokration” Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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14
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Vidal-Peracho C, Tricás-Moreno JM, Lucha-López AC, Lucha-López MO, Camuñas-Pescador AC, Caverni-Muñoz A, Fanlo-Mazas P. Adherence to Mediterranean Diet Pattern among Spanish Adults Attending a Medical Centre: Nondiabetic Subjects and Type 1 and 2 Diabetic Patients. J Diabetes Res 2017; 2017:5957821. [PMID: 29527536 PMCID: PMC5733177 DOI: 10.1155/2017/5957821] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To identify adherence to Mediterranean diet among two groups of Spanish adults: diabetic patients and nondiabetic subjects. METHODS Adherence to Mediterranean diet was measured by a 14-item screener (scale: 0-14; ≤5: low, 6-9: moderate, and ≥10: high) in 351 volunteers. RESULTS Mean age was 50.97 ± 12.58 in nondiabetics (n = 154) and 59.50 ± 13.34 in diabetics (n = 197). The whole sample scored 8.77 ± 1.82. Score was 9.19 ± 1.84 in nondiabetic females (n = 58) and 8.15 ± 1.79 in diabetic females (n = 85) (p = 0.003), due to lower consumption of olive oil (p = 0.005) and nuts (p = 0.000). Type 2 diabetic males (n = 79; 8.76 ± 1.88) consumed less olive oil than healthy males (n = 28; 9.36 ± 1.59) (p = 0.046). Up to 30-year-old nondiabetics scored lower than more than 60-year-old nondiabetics (8.40 ± 1.5 versus 9.74 ± 2.03; p = 0.047). The youngest ate less olive oil (p = 0.002) and more pastries (p = 0.007). CONCLUSIONS The sample presented moderate adherence to Mediterranean diet in all subgroups. Scientific evidence about the benefits of Mediterranean diet, olive oil, and nuts supports the recommendation to increase consumption of olive oil and nuts in diabetic women and of daily olive oil in type 2 diabetic men, reducing consumption of red meat, butter, and pastries, and to promote Mediterranean diet among the youngest of the sample studied.
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Affiliation(s)
- Concepción Vidal-Peracho
- Department of Endocrinology and Nutrition, Hospital Royo Villanova SALUD, Barrio San Gregorio, s/n, 50015 Zaragoza, Spain
- Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral, s/n, 50009 Zaragoza, Spain
| | - José Miguel Tricás-Moreno
- Faculty of Health Sciences, Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral, s/n, 50009 Zaragoza, Spain
| | - Ana Carmen Lucha-López
- Faculty of Health Sciences, Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral, s/n, 50009 Zaragoza, Spain
| | - Maria Orosia Lucha-López
- Faculty of Health Sciences, Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral, s/n, 50009 Zaragoza, Spain
| | - Ana Cristina Camuñas-Pescador
- Department of Endocrinology and Nutrition, Hospital Royo Villanova SALUD, Barrio San Gregorio, s/n, 50015 Zaragoza, Spain
| | - Alberto Caverni-Muñoz
- ALCER EBRO (Aragonese Association of Patients with Chronic Renal Insufficiency), Santa Teresa de Jesús, No. 29-35 Bajos, 50006 Zaragoza, Spain
| | - Pablo Fanlo-Mazas
- Faculty of Health Sciences, Physiotherapy Research Unit, University of Zaragoza, C/Domingo Miral, s/n, 50009 Zaragoza, Spain
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