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Couch CA, Ament Z, Patki A, Kijpaisalratana N, Bhave V, Jones AC, Armstrong ND, Cheung KL, Kimberly WT, Tiwari HK, Irvin MR. The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) Diet and Metabolites in Chronic Kidney Disease. Nutrients 2024; 16:2458. [PMID: 39125339 PMCID: PMC11314466 DOI: 10.3390/nu16152458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Revised: 07/24/2024] [Accepted: 07/25/2024] [Indexed: 08/12/2024] Open
Abstract
The Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) is a hybrid of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets, and its association with renal outcomes remains unclear. In the REasons for Geographic and Racial Disparities in Stroke (REGARDS) cohort, diet data were collected at baseline using food frequency questionnaires. Modified Poisson regression was used to examine the association of MIND diet with incident chronic kidney disease (CKD). In the REGARDS stroke case-cohort, 357 metabolites were measured in baseline plasma. Weighted linear regression was used to test associations between MIND diet and metabolites. Weighted logistic regression was used to test associations between MIND-associated metabolites and incident CKD. Mediation analyses were conducted to determine whether metabolites mediated the relationship between MIND diet and CKD. A higher MIND diet score was associated with a decreased risk of incident CKD (risk ratio 0.90, 95% CI (0.86-0.94); p = 2.03 × 10-7). Fifty-seven metabolites were associated with MIND diet (p < 3 × 10-4). Guanosine was found to mediate the relationship between MIND diet and incident CKD (odds ratio for indirect effects 0.93, 95% CI (0.88-0.97); p < 0.05). These findings suggest a role of the MIND diet in renal outcomes.
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Affiliation(s)
- Catharine A. Couch
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (A.C.J.); (N.D.A.); (M.R.I.)
| | - Zsuzsanna Ament
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; (Z.A.); (N.K.); (W.T.K.)
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Amit Patki
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35233, USA; (A.P.); (H.K.T.)
| | - Naruchorn Kijpaisalratana
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; (Z.A.); (N.K.); (W.T.K.)
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
- Division of Neurology, Department of Medicine and Division of Academic Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand
| | - Varun Bhave
- Harvard Medical School, Boston, MA 02115, USA;
| | - Alana C. Jones
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (A.C.J.); (N.D.A.); (M.R.I.)
| | - Nicole D. Armstrong
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (A.C.J.); (N.D.A.); (M.R.I.)
| | - Katharine L. Cheung
- Division of Nephrology, Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, VT 05405-0068, USA;
| | - W. Taylor Kimberly
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA; (Z.A.); (N.K.); (W.T.K.)
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
- Harvard Medical School, Boston, MA 02115, USA;
| | - Hemant K. Tiwari
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35233, USA; (A.P.); (H.K.T.)
| | - Marguerite Ryan Irvin
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA; (A.C.J.); (N.D.A.); (M.R.I.)
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Georgoulis M, Damigou E, Derdelakou E, Kosti RI, Chrysohoou C, Barkas F, Kravvariti E, Tsioufis C, Pitsavos C, Liberopoulos E, Sfikakis PP, Panagiotakos DB. Adherence to the Mediterranean diet and 20-year incidence of hypertension: the ATTICA prospective epidemiological study (2002-2022). Eur J Clin Nutr 2024; 78:630-638. [PMID: 38605190 DOI: 10.1038/s41430-024-01440-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 04/03/2024] [Accepted: 04/05/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND/OBJECTIVES Dietary habits are a significant predictor of hypertension (HTN). We aimed to evaluate the long-term association between adherence to the Mediterranean diet and HTN incidence. SUBJECTS/METHODS This was a prospective study among 1415 non-hypertensive adults (44% men, age: 41 ± 13 years) followed up for 20 years. Anthropometric, lifestyle, and clinical parameters were evaluated at baseline. Adherence to the Mediterranean diet was evaluated both at baseline and 10 years through the MedDietScore (range: 0-55, higher values indicate greater adherence). RESULTS At the 20-year follow-up, 314 new HTN cases were recorded. HTN incidence was 35.5%, 22.5%, and 8.7% in the lowest, middle, and upper tertile of baseline MedDietScore, respectively (p < 0.001). For each 1-point increase in baseline MedDietScore, the 20-year HTN risk decreased by 7% [relative risk (RR): 0.925, 95% confidence interval (CI): 0.906, 0.943], and this effect remained significant after adjustment for age, sex, and baseline lifestyle and clinical confounders, i.e., body mass index, physical activity, smoking, systolic and diastolic blood pressure, family history of HTN, and presence of hypercholesterolemia and diabetes mellitus (RR: 0.973, 95%CI: 0.949, 0.997). In a similar multiadjusted model, compared to subjects who were consistently away from the Mediterranean diet (in the lowest MedDietScore tertile both at baseline and 10 years), only those who were consistently close (in the middle and upper MedDietScore tertiles both at baseline and 10 years) exhibited a 47% lower 20-year HTN risk. CONCLUSION A high adherence to the Mediterranean diet, particularly when longitudinally sustained, is associated with lower incidence of HTN.
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Affiliation(s)
- Michael Georgoulis
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17676, Athens, Greece
| | - Evangelia Damigou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17676, Athens, Greece
| | - Evgenia Derdelakou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17676, Athens, Greece
| | - Rena I Kosti
- Department of Nutrition and Dietetics, School of Physical Education, Sports and Dietetics, University of Thessaly, 38221, Trikala, Greece
| | - Christina Chrysohoou
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527, Athens, Greece
| | - Fotios Barkas
- Department of Internal Medicine, Medical School, University of Ioannina, 45500, Ioannina, Greece
| | - Evrydiki Kravvariti
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772, Athens, Greece
| | - Costas Tsioufis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527, Athens, Greece
| | - Christos Pitsavos
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, 11527, Athens, Greece
| | - Evangelos Liberopoulos
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772, Athens, Greece
| | - Petros P Sfikakis
- First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, 15772, Athens, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University of Athens, 17676, Athens, Greece.
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Rahmani F, Asgari S, Azizi F, Hadaegh F. The association of ideal cardiovascular health metrics and incident hypertension among an urban population of Iran: a decade follow-up in Tehran Lipid and Glucose Study. J Hum Hypertens 2024; 38:267-276. [PMID: 38110597 DOI: 10.1038/s41371-023-00881-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 11/28/2023] [Accepted: 11/30/2023] [Indexed: 12/20/2023]
Abstract
We aimed to determine the association between ideal cardiovascular health metrics (ICVHM) and the incidence of hypertension among Iranian adults. The study population included 5409 Iranian adults aged ≥20 years (2088 men) without hypertension (applying the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guideline) at baseline. The ICVHM was defined according to the AHA's 2020 impact goals, excluding total cholesterol was replaced by non-HDL cholesterol (non-HDL-C). Multivariable Cox proportional hazards regression analysis was done to estimate the hazard ratios (HRs) for ICVHM both as continuous and categorical variables. During a median 8.5-year follow-up, 2972 new cases of hypertension were identified (men: 1,287). Non-HDL-C < 130 mg/dL in men [HR (95% CI): 0.75(0.65-0.86)] and fasting plasma glucose(FPG) < 100 mg/dL in women[HR (95% CI): 0.79(0.64-0.97)], and among both genders, being normal/overweigth status (compared to obese) and blood pressure <120/80 mmHg were associated with a lower risk for hypertension. Additionally, in both gender, a 1-point increase in the number of global ICVHM decreased the risk of hypertension by more than 10%, and having ≥5 vs. <2 ICVHM, were associated with a lower risk of hypertension by 30% (all p values < 0.05). Applying the JNC 7 guideline, the association between ICVHM, with incident hypertension, were generally similar. Having a higher number of ICVHM was associated with a lower risk of incident hypertension, using both 2017 ACC/AHA and JNC 7 guidelines, mostly attributable to keeping the ideal status of body mass index, non-HDL-C, and FPG.
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Affiliation(s)
- Fatemeh Rahmani
- Clinical Research and Development Center, Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samaneh Asgari
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Tirani SA, Poursalehi D, Lotfi K, Shahdadian F, Hajhashemy Z, Rouhani P, Saneei P. Adherence to Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay Diet in Relation to Serum Brain-Derived Neurotrophic Factor Concentrations and Metabolic Health Status in Adults. Curr Dev Nutr 2024; 8:102082. [PMID: 38351976 PMCID: PMC10862409 DOI: 10.1016/j.cdnut.2024.102082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/20/2023] [Accepted: 01/10/2024] [Indexed: 02/16/2024] Open
Abstract
Background There is a lack of data regarding the Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) diet and metabolic health. Objectives This study assessed the relation between MIND diet and metabolic health status relative to serum brain-derived neurotrophic factor (BDNF) concentrations. Methods This was a cross-sectional study of 527 adults (286 males and 241 females) recruited from 20 schools in 6 different educational districts of Isfahan, Iran. Dietary intakes of participants were collected by a validated 168-item food frequency questionnaire, and MIND diet score was estimated. Anthropometric indices, blood pressure, biochemical parameters, and BDNF concentrations were assessed for all participants. The metabolically unhealthy (MU) phenotype was determined based on blood pressure, glycemic and lipid profiles, chronic inflammation, and insulin resistance. Results The frequency of MU phenotype among obese/overweight and normal-weight individuals was 79.5 % and 20.5 %, respectively. After adjustment for confounders, individuals in the top tertile of the MIND diet scores had 58 % lower odds of having the MU phenotype than individuals in the bottom tertile (odds ratios [ORs]: 0.42; 95 % confidence interval [CI]: 0.20, 0.90). In the fully adjusted model, females and normal-weight individuals had 81 % (OR: 0.19; 95 % CI: 0.04, 0.83) and 89 % (OR: 0.11; 95 % CI: 0.02, 0.69) lower chance of developing the MU phenotype, respectively. In addition, significant inverse associations between adherence to the MIND diet and high-blood pressure and hypertriglyceridemia were found. No significant association was found between adherence to MIND diet and odds of low BDNF concentrations. Conclusions Adherence to MIND diet is inversely associated with odds of MU phenotype, especially among women and normal-weight individuals. BDNF concentration is not associated with MIND diet and MU status.
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Affiliation(s)
- Shahnaz Amani Tirani
- Students’ Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Donya Poursalehi
- Students’ Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Keyhan Lotfi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnaz Shahdadian
- Students’ Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Clinical Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Hajhashemy
- Students’ Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parisa Rouhani
- Students’ Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Parvane Saneei
- Department of Community Nutrition, School of Nutrition and Food Science, Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Akbar Z, Fituri S, Ouagueni A, Alalwani J, Sukik A, Al-Jayyousi GF, Bassil M, Tayyem R. Associations of the MIND Diet with Cardiometabolic Diseases and Their Risk Factors: A Systematic Review. Diabetes Metab Syndr Obes 2023; 16:3353-3371. [PMID: 37908631 PMCID: PMC10614652 DOI: 10.2147/dmso.s427412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/14/2023] [Indexed: 11/02/2023] Open
Abstract
Purpose Recent studies have expanded the scope of research on the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet beyond its impact on cognitive performance. These investigations have specifically explored its potential to provide protection against cardiometabolic diseases and associated risk factors, including obesity and dyslipidemia. Methods We systematically summarized and evaluated all existing observational and trial evidence for the MIND diet in relation to cardiometabolic diseases and their risk factors in adults. PubMed, Embase, CINAHL and Cochrane Library databases were systematically searched to extract original studies on humans published until September 2023, without date restrictions. A total of 491 studies were initially retrieved, out of which 23 met the eligibility criteria and were included in the final review. Duplicated and irrelevant studies were screened out by five independent reviewers using the Rayyan platform. Quality assessment was ascertained using the Newcastle-Ottawa scale for observational studies and the Cochrane risk-of-bias tool (RoB 2) for randomized trials. Results Across the different study designs, the MIND diet was generally associated with an improvement in anthropometric measures and other cardiometabolic outcomes, such as blood pressure, glycemic control, lipid profile, inflammation and stroke. The effects of the MIND eating pattern on some cardiovascular diseases are less conclusive. Conclusion The findings of this systematic review support the recommendation of the MIND diet as a strategy to reduce cardiometabolic risk in adults. Further well-designed and long-term studies are warranted.
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Affiliation(s)
- Zoha Akbar
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Sundus Fituri
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Asma Ouagueni
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Joud Alalwani
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Ayah Sukik
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | | | - Maya Bassil
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Reema Tayyem
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
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Golzarand M, Moslehi N, Mirmiran P, Azizi F. Adherence to the DASH, MeDi, and MIND diet scores and the incidence of metabolically unhealthy phenotypes. Obes Res Clin Pract 2023:S1871-403X(23)00025-X. [PMID: 37037714 DOI: 10.1016/j.orcp.2023.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 04/03/2023] [Accepted: 04/07/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND A metabolically unhealthy phenotype is associated with the risk of cardiometabolic events and can be prevented by adherence to healthy dietary patterns. The present study was designed to investigate the association between high adherence to the Dietary Approaches to Stop Hypertension (DASH), Mediterranean (MeDi), and Mediterranean-DASH intervention for neurodegenerative delay (MIND) diet scores and the incidence of metabolically unhealthy phenotypes in adults across body mass index (BMI) categories. METHODS In this cohort study, 512 subjects with metabolically healthy normal weight (MHNW) at baseline and 787 subjects with metabolically healthy overweight/obesity (MHOW/MHO) at baseline were included. Dietary intake was collected by a validated food frequency questionnaire, and DASH, MeDi, and MIND scores were calculated. The Joint Interim Statement (JIS) criteria were used to define a metabolically unhealthy status. RESULTS A total of 137 and 388 subjects with metabolically unhealthy normal weight (MUNW) and metabolically unhealthy overweight/obesity (MUOW/MUO) phenotypes, respectively, were observed, over a mean of 5.91 years of follow-up. The Cox proportional hazard regression indicated participants in the third tertile of the DASH score had a lower risk of the MUNW phenotype (HR: 0.59; 95% CI: 0.37-0.92) than those in the lowest tertile. Similarly, the highest adherence to the MeDi and MIND scores was also linked to a 46% (HR: 0.54; 95% CI: 0.36-0.81) and 47% (HR: 0.53; 95% CI: 0.34-0.83) lower risk of the MUNW phenotype, respectively. As well, there was an inverse relationship between the highest adherence to the DASH (HR: 0.66; 95% CI: 0.50-0.86), MeDi (HR: 0.74; 95% CI: 0.58-0.93), and MIND (HR: 0.57; 95% CI: 0.43-0.74) scores and the risk of MUOW/MUO. There was no interaction between age and the three dietary patterns in relation to a metabolically unhealthy phenotype. CONCLUSION High compliance with the DASH, MeDi, and MIND scores was associated with a lower risk of MUNW. An inverse relationship between these three dietary patterns and the incidence of the metabolically unhealthy phenotype was also observed in individuals who had MHOW/MHO at baseline.
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Affiliation(s)
- Mahdieh Golzarand
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Nazanin Moslehi
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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