Physiological risk factors for cardiovascular disease in middle-aged (40-60 year) adults and their association with dietary intake, Northern Iran

The Mediterranean diet and dietary approach to stop hypertension (DASH)-style diet are differently associated with lipid profile in a large sample of Iranian adults: a cross-sectional study of Shahedieh cohort

BACKGROUND

The association between the Mediterranean diet (MED) or dietary approach to stop hypertension (DASH) and cardiovascular disease (CVD) risk factors is well-documented. Nevertheless, a consistent relationship with the Middle East population has yet to be known. Thus, we aimed to investigate the association between DASH/MED and blood lipids in Iranian adults.

METHODS

Four thousand seven hundred forty participants, aged 35-70 years (mean: 50.0) participated in the Shahedieh cohort study in Yazd, Iran, were followed from 2016 until now. Participants provided dietary and blood lipid data through a validated semi-quantitative food frequency questionnaire, and blood samples were taken after a fasted state. We used binary logistic regression to examine the association between DASH/MED scores and blood lipids.

RESULTS

In the participants who ingested a DASH-like diet the third vs. the first tertile of total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL) levels, and LDL/HDL (high-density lipoprotein) ratio reduced significantly (P < 0.01). While in the participants who ingested the MED-like diet the HDL level increased significantly( 52.8 ± 12. 3 vs. 51.6 ± 11.6, P < 0.01). In Binary logistic regression, higher adherence to the DASH diet showed 19 % lower odds of high TC level (OR: 0.81; 95 %CI: 0.69-0.95) and 18 % lower odds of high LDL/HDL ratio (OR: 0.82; 95 %CI: 0.70-0.96). Besides, high adherence to the MED diet was associated with lower odds of LDL/HDL ratio (OR: 0.85; 95 %CI: 0.72-0.99).

CONCLUSIONS

Our findings suggest that TC, TG, LDL, LDL/HDL ratio, and HDL improved in participants who ingested a DASH-like diet and the LDL/HDL ratio improved in participants who ingested MED-like diet and, subsequently they might have a protective effect on CVDs risk. Further epidemiological studies are needed to confirm our findings.

Long-term incidence of cardiovascular outcomes in the middle-aged and elderly with different patterns of physical activity: Tehran lipid and glucose study

Background

Following the global upward trend of cardiovascular diseases (CVD/CHD), much attention has been paid to lifestyle behaviors such as physical activity (PA). However, most of previous studies were conducted in developed countries and with just one measurement of physical activity. The aim of the current study is to assess the effect of changes in the PA on the incidence of CVD/CHD in middle-aged and older men and women in an Eastern-Mediterranean population, over a decade follow-up.

Methods

This study has been conducted within the framework of the Tehran Lipid and Glucose Study (TLGS) including 4073 (57% women) participants without CVD/CHD at baseline. The participants were followed up for an average period of 12 years. The Iranian version of Modified Activity Questionnaire (MAQ) was used to measure PA at baseline and at the closest follow-up to the outcome. Subsequently, participants were categorized as “compliers”, “non-compliers”, “adopters” and “relapsers”, based on their adherence to the PA guideline recommendations. All analysis has been conducted in two separate age groups including middle-aged and elderly in both men and women. The effect of PA patterns on incidence of CVD/CHD was investigated using Cox proportional hazard model. Variables including marital status, job status, education, smoking, and family history of CVD/CHD were adjusted in the models.

Results

Adherence to guideline recommendation increased from 63.5 to 66.6% between the two measurements. At the second measurement of PA, the percentages of compliers, non-compliers, adopters and relapsers were 48.4, 18.3, 18.2, and 15.1%, respectively. In fully adjusted models, HRs of CVD and CHD for men aged 40–60 years in the complier group were 0.58 (95% CI: 0.38–0.87, P = 0.008) and 0.58 (95% CI: 0.38–0.89, P = 0.01), respectively. HRs of CVD and CHD for men aged 40–60 years in adopter group were 0.61 (95% CI: 0.38–0.96, P = 0.03) and 0.60 (95% CI: 0.37–0.97, P = 0.04) respectively. The corresponding values were not significant in women.

Conclusions

Adhering to established PA recommendations have a protective effect on the incidence of CVD/CHD among middle-aged men; findings which need to be considered in reducing cardiovascular outcomes in this population.

Lifestyle Interventions to Promote Healthy Nutrition and Physical Activity in Middle-Age (40-60 Years) Adults: A Randomized Controlled Trial in the North of Iran

BACKGROUND

This study was conducted to evaluate the effectiveness of short-term structured interventions on healthy lifestyle behaviors, dietary intake, anthropometric measures, blood pressure, fasting blood glucose, and serum lipid profile of middle-aged adults.

STUDY DESIGN

Randomized controlled trial study.

METHODS

Overall, 300 individuals out of apparently healthy (non-patient) adults aged 40-60 yr living in Amirkola, Babol the north of Iran were enrolled in 2016-2017. The Persian translation of the Health Promoting Lifestyle Profile II (HPLP-II) and two days 24-h food recall questionnaires were used for data collection. Eligible participants were allocated randomly in three groups (high-intensive, low-intensive and the control). The follow-up examination has been conducted after 16 wk of intervention.

RESULTS

The three study groups had no significant difference in age (P=0.888), sex (P=0.395), BMI (P=0.969), healthy lifestyle score (P=0.675) and total daily energy intake (P=0.612). After intervention, the mean scores of all the six subdomains of HPLP-II questionnaire had significant improvement (P<0.001). Mean weight loss was 1.5, 1.0 and 0.3 kg, in high-intensive, low-intensive and control groups, respectively. BMI although reduced, was still in the overweight range in two sexes. Mean of neck, arm, waist and buttock size, diastolic blood pressure, serum triglyceride, total cholesterol, and HDL levels have been changed to a better condition in comparison with the baseline values (P<0.001). Dietary intake had good changes in total daily energy (P<0.001), daily intake of carbohydrate, protein, and fat (P<0.001), and proportion of energy from carbohydrate (P=0.007) and fat (P=0.022) after the intervention.

CONCLUSION

Our intervention program could have positive impact on healthy lifestyle behaviors, dietary intake and weight in addition to some other anthropometric variables and serum lipid profile of middle-aged adults.