1
|
Sucato V, Sausa G, Gambino G, D'Agostino A, Evola S, Novo G, Corrado E, Galassi AR. The impact of coronavirus disease 2019 on acute coronary syndrome: Differences between epidemic waves. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2024; 44:100422. [PMID: 39092075 PMCID: PMC11292252 DOI: 10.1016/j.ahjo.2024.100422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 06/23/2024] [Accepted: 06/29/2024] [Indexed: 08/04/2024]
Abstract
Introduction Since the beginning of the COronaVIrus Disease 2019 (COVID-19) pandemic, poor attention has been paid to the indirect effects of the pandemia on cardiovascular health system, in particular in patients with Acute Coronary Syndrome (ACS). The aims of this study is to compare possible epidemiological, clinical and management differences between the four epidemic waves in groups of patients hospitalized for ACS with a view to highlighting the burden of the pandemic on the management of this syndrome. Materials and methods In this retrospective observational study we included 98 patients admitted to Coronary Intensive Care Unit (CICU) for ACS between March 2020 and March 2022, who underwent revascularization procedure using percutaneous coronary angioplasty (PCI). The patients examined were divided into four groups representative of the four epidemic waves that affected our country. Results The rate of hospitalization for ACS increased progressively to a 178 % increase in the third wave compared to the first (p = 0.003), with an increase of 900 % if we consider only Non-ST-Elevation Myocardial Infarction (NSTEMI) (representing 54 % of the ACS diagnoses of the third group against 14.3 % in the first). Longer door-to-balloon times were recorded in the third wave for the increased presence of NSTEMI. The average hospital stay was lower in the third wave with 5 ± 2 days (p = 0.007) as well as mortality (5.1 % in the third wave; the highest in the fourth wave with 9.5 %). Conclusions The study show that the management of ACS suffered most from the indirect effects of the pandemic during the first wave, both because of the unpreparedness of hospital facilities and because of the fear of infection that has dissuaded people from asking for help.
Collapse
Affiliation(s)
- Vincenzo Sucato
- Division of Cardiology, University Hospital Paolo Giaccone, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo, Italy
| | - Giusy Sausa
- Division of Cardiology, University Hospital Paolo Giaccone, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo, Italy
| | - Grazia Gambino
- Division of Cardiology, University Hospital Paolo Giaccone, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo, Italy
| | - Alessandro D'Agostino
- Division of Cardiology, University Hospital Paolo Giaccone, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo, Italy
| | - Salvatore Evola
- Division of Cardiology, University Hospital Paolo Giaccone, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo, Italy
| | - Giuseppina Novo
- Division of Cardiology, University Hospital Paolo Giaccone, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo, Italy
| | - Egle Corrado
- Division of Cardiology, University Hospital Paolo Giaccone, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo, Italy
| | - Alfredo Ruggero Galassi
- Division of Cardiology, University Hospital Paolo Giaccone, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (ProMISE), University of Palermo, Italy
| |
Collapse
|
2
|
Zeenny RM, Haddad C, Hajj A, Zeidan RK, Salameh P, Ferrières J. Adherence to the Mediterranean Diet and Cardiovascular Risk Factors among the Lebanese Population: A Nationwide Cross-Sectional Post Hoc Study. Nutrients 2024; 16:2426. [PMID: 39125308 PMCID: PMC11313688 DOI: 10.3390/nu16152426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Revised: 07/16/2024] [Accepted: 07/17/2024] [Indexed: 08/12/2024] Open
Abstract
OBJECTIVE This study aims to identify the association between adherence to healthy eating, using the Lebanese Mediterranean Diet Scale (LMDS), and cardiovascular risk factors in the Lebanese population. MATERIALS AND METHODS A cross-sectional study using a multistage cluster sample was conducted in Lebanon. Sociodemographic characteristics were collected through structured interviews and self-administered questionnaires. The LMDS assessed dietary habits. The associations between diabetes, dyslipidemia, and cardiovascular disease were investigated using stratification analysis. RESULTS The study included 2048 people (mean age: 41.54 ± 17.09 years). Higher adherence to the Mediterranean diet was associated with older age (Beta = 0.175, p < 0.001), being female (Beta = 0.085, p = 0.001), being married (Beta = 0.054, p = 0.047), participating in regular physical activity (Beta = 0.142, p < 0.001), and having cardiovascular disease (Beta = 0.115, p < 0.001) and diabetes (Beta = 0.055, p = 0.043). Adherence was, however, negatively associated with being a smoker (Beta = -0.083, p = 0.002), a previous smoker (Beta = -0.059, p = 0.026), and having higher distress levels (Beta = -0.079, p = 0.002). Stratification analysis by diabetes, dyslipidemia, and cardiovascular disease (CVD) consistently demonstrated these associations. CONCLUSIONS These findings suggest that demographic and health factors influence the Lebanese population's adherence to the Mediterranean diet. Older age, female gender, married status, physical activity, CVD, and diabetes were all found to be associated with adherence to the Mediterranean diet in the Lebanese population. In contrast, smoking and distress were inversely associated with it.
Collapse
Affiliation(s)
- Rony M. Zeenny
- Department of Mathématiques Informatique et Télécommunications, Université Toulouse III, Paul Sabatier, INSERM, UMR 1295, F-31000 Toulouse, France
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut 1103, Lebanon; (C.H.); (A.H.); (R.K.Z.); (P.S.)
- Department of Pharmacy, American University of Beirut Medical Center, Beirut 1107, Lebanon
| | - Chadia Haddad
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut 1103, Lebanon; (C.H.); (A.H.); (R.K.Z.); (P.S.)
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos 4504, Lebanon
- School of Health Sciences, Modern University of Business and Science, Beirut 7501, Lebanon
- Research Department, Psychiatric Hospital of the Cross, Jal El Dib 1525, Lebanon
| | - Aline Hajj
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut 1103, Lebanon; (C.H.); (A.H.); (R.K.Z.); (P.S.)
- Faculté de Pharmacie, Université Laval, Québec, QC G1V 0A6, Canada
- Oncology Division, CHU de Québec-Université Laval Research Center, Québec, QC G1R 3S3, Canada
| | - Rouba K. Zeidan
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut 1103, Lebanon; (C.H.); (A.H.); (R.K.Z.); (P.S.)
- Sharjah Institute of Medical Research, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Pascale Salameh
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut 1103, Lebanon; (C.H.); (A.H.); (R.K.Z.); (P.S.)
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos 4504, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat 1103, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, 2417 Nicosia, Cyprus
| | - Jean Ferrières
- Department of Cardiology and INSERM UMR 1295, Rangueil University Hospital, F-31059 Toulouse, France;
| |
Collapse
|
3
|
Zulianello dos Santos R, Scheafer Korbes A, Batista Bonin CD, Marques Vieira A, Karsten M, Benetti M, Oh P, Ghisi GLDM. Preliminary Effects of a Structured Educational Program in Cardiac Patients at Different Stages of Enrollment in Cardiovascular Rehabilitation. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2024; 44:365-376. [PMID: 38817096 PMCID: PMC11143761 DOI: 10.1177/0272684x221080119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
This quasi-experimental study investigated the preliminary effects of a structured education intervention in a pooled sample of cardiovascular rehabilitation (CR) patients in Brazil. Recently enrolled (RE) and long-term enrolled (LTE) patients attended 12 weekly education sessions in addition to three weekly exercise sessions. Patients completed surveys assessing disease-related knowledge, physical activity, food intake, self-efficacy, and health literacy. Functional capacity was assessed by the 6-minutes walking test. All outcomes were assessed at pre-,post-CR, and 6-months follow-up. Bonferroni correction was applied. In total, 69 (69.7%) patients completed all three assessments. There were significant improvements in knowledge pre-to post-test in both subgroups (p < 0.001), and in functional capacity (p ≤ 0.001) and food intake (p ≤ 0.001) pre-to post-test in the RE subgroup. Post-test knowledge was correlated to physical activity, functional capacity and health literacy. This preliminary study suggests the importance of structured education for CR patients. A larger study using a randomized controlled design is needed to determine efficacy.
Collapse
Affiliation(s)
| | - Andrea Scheafer Korbes
- Cardio Oncology and Exercise Medicine Nucleus (NCME), University of Santa Catarina State, Santa Catarina, Brazil
| | - Christiani D. Batista Bonin
- Cardio Oncology and Exercise Medicine Nucleus (NCME), University of Santa Catarina State, Santa Catarina, Brazil
| | - Ariany Marques Vieira
- Montreal Behavioural Medicine Centre, Hôpital Sacré-Cœur de Montréal, Montreal, QC, Canada
| | - Marlus Karsten
- Cardio Oncology and Exercise Medicine Nucleus (NCME), University of Santa Catarina State, Santa Catarina, Brazil
| | - Magnus Benetti
- Cardio Oncology and Exercise Medicine Nucleus (NCME), University of Santa Catarina State, Santa Catarina, Brazil
| | - Paul Oh
- Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | | |
Collapse
|
4
|
Abrignani V, Salvo A, Pacinella G, Tuttolomondo A. The Mediterranean Diet, Its Microbiome Connections, and Cardiovascular Health: A Narrative Review. Int J Mol Sci 2024; 25:4942. [PMID: 38732161 PMCID: PMC11084172 DOI: 10.3390/ijms25094942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 04/25/2024] [Accepted: 04/28/2024] [Indexed: 05/13/2024] Open
Abstract
The Mediterranean diet (MD), rich in minimally processed plant foods and in monounsaturated fats but low in saturated fats, meat, and dairy products, represents one of the most studied diets for cardiovascular health. It has been shown, from both observational and randomized controlled trials, that MD reduces body weight, improves cardiovascular disease surrogates such as waist-to-hip ratios, lipids, and inflammation markers, and even prevents the development of fatal and nonfatal cardiovascular disease, diabetes, obesity, and other diseases. However, it is unclear whether it offers cardiovascular benefits from its individual components or as a whole. Furthermore, limitations in the methodology of studies and meta-analyses have raised some concerns over its potential cardiovascular benefits. MD is also associated with characteristic changes in the intestinal microbiota, mediated through its constituents. These include increased growth of species producing short-chain fatty acids, such as Clostridium leptum and Eubacterium rectale, increased growth of Bifidobacteria, Bacteroides, and Faecalibacterium prausnitzii species, and reduced growth of Firmicutes and Blautia species. Such changes are known to be favorably associated with inflammation, oxidative status, and overall metabolic health. This review will focus on the effects of MD on cardiovascular health through its action on gut microbiota.
Collapse
Affiliation(s)
- Vincenzo Abrignani
- Internal Medicine and Stroke Care Ward, University of Palermo, 90127 Palermo, Italy; (V.A.); (A.S.); (G.P.)
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy
| | - Andrea Salvo
- Internal Medicine and Stroke Care Ward, University of Palermo, 90127 Palermo, Italy; (V.A.); (A.S.); (G.P.)
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy
| | - Gaetano Pacinella
- Internal Medicine and Stroke Care Ward, University of Palermo, 90127 Palermo, Italy; (V.A.); (A.S.); (G.P.)
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy
| | - Antonino Tuttolomondo
- Internal Medicine and Stroke Care Ward, University of Palermo, 90127 Palermo, Italy; (V.A.); (A.S.); (G.P.)
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy
| |
Collapse
|
5
|
Sucato V, Ortello A, Comparato F, Novo G, Galassi AR. Cholesterol-Lowering Strategies for Cardiovascular Disease Prevention: The Importance of Intensive Treatment and the Simplification of Medical Therapy. J Clin Med 2024; 13:1882. [PMID: 38610647 PMCID: PMC11012834 DOI: 10.3390/jcm13071882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 03/09/2024] [Accepted: 03/12/2024] [Indexed: 04/14/2024] Open
Abstract
Cardiovascular diseases (CVDs) are a leading global cause of mortality and are primarily driven by atherosclerotic coronary artery disease. Their pathogenesis involves multi-factorial mechanisms, among which low-density lipoprotein (LDL) plays a causative role. Recent ESC/EAS guidelines advocate for a shift toward new risk estimation algorithms that better emphasize non-fatal cardiovascular events, lifetime risk prediction, and tailored pharmacological approaches, including statin + ezetimibe and triple therapy, in specific cases. Intensive lipid-lowering therapy has been shown to be pivotal, especially in post-acute coronary events. Intracoronary imaging has revealed insights into the composition of plaque and demonstrated the significant regression that can be achieved through the use of statins such as rosuvastatin and atorvastatin. The positive effects of Proprotein Convertase Subtilisin/Kexin type 9 (PCSK9) inhibitors, particularly alirocumab and evolocumab, on plaque regression, have been demonstrated. Inclisiran, which targets PCSK9 gene expression, significantly reduces LDL cholesterol. The associated challenges include hesitancy to prescribe intensive regimens and limited treatment adherence, highlighting the need for pharmacological combinations to improve therapeutic outcomes.
Collapse
Affiliation(s)
- Vincenzo Sucato
- Division of Cardiology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE) “G. D’Alessandro”, University Hospital Paolo Giaccone, University of Palermo, 90133 Palermo, Italy; (A.O.); (G.N.)
| | | | | | | | | |
Collapse
|
6
|
Bekele TH, Trijsburg L, Brouwer ID, de Vries JH, Covic N, Kennedy G, Alemayehu D, Feskens EJ. Dietary Recommendations for Ethiopians on the Basis of Priority Diet-Related Diseases and Causes of Death in Ethiopia: An Umbrella Review. Adv Nutr 2023; 14:895-913. [PMID: 37182739 PMCID: PMC10334157 DOI: 10.1016/j.advnut.2023.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 05/02/2023] [Accepted: 05/04/2023] [Indexed: 05/16/2023] Open
Abstract
Food-based dietary guidelines (FBDG) need to be evidence-based. As part of the development of Ethiopian FBDG, we conducted an umbrella review to develop dietary recommendations. Protein-energy malnutrition (PEM), deficiencies of vitamin A, zinc, calcium, or folate, cardiovascular diseases (CVD), and type 2 diabetes mellitus (T2DM) were selected as a priority. Systematic reviews were eligible if they investigated the impact of foods, food groups, diet, or dietary patterns on priority diseases. After a search, 1513 articles were identified in PubMed, Scopus, and Google Scholar published from January 2014 to December 2021. The results showed that 19 out of 164 systematic reviews reported the impact of diet on PEM or micronutrient deficiencies. Daily 30-90 g whole-grain consumption reduces risk of CVD and T2DM. Pulses improve protein status, and consuming 50-150 g/d is associated with a reduced incidence of CVD and T2DM. Nuts are a good source of minerals, and consuming 15-35 g/d improves antioxidant status and is inversely associated with CVD risk. A daily intake of 200-300 mL of milk and dairy foods is a good source of calcium and contributes to bone mineral density. Limiting processed meat intake to <50 g/d reduces CVD risk. Fruits and vegetables are good sources of vitamins A and C. CVD and T2DM risks are reduced by consuming 200-300 g of vegetables plus fruits daily. Daily sugar consumption should be below 10% of total energy to lower risk of obesity, CVD, and T2DM. Plant-based fat has favorable nutrient profiles and modest saturated fat content. The association of saturated fatty acids with CVD and T2DM is inconclusive, but intake should be limited because of the low-density lipoprotein cholesterol-raising effect. Plant-based diets lower risk of CVD and T2DM but reduce micronutrient bioavailability. The review concludes with 9 key dietary recommendations proposed to be implemented in the Ethiopian FBDG. This review was registered at PROSPERO (CRD42019125490).
Collapse
Affiliation(s)
- Tesfaye Hailu Bekele
- Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia; Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands.
| | - Laura Trijsburg
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Inge D Brouwer
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Jeanne Hm de Vries
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Namukolo Covic
- Poverty, Health and Nutrition Division, International Food Policy Research Institute, Addis Ababa, Ethiopia
| | - Gina Kennedy
- Knowledge Leadership, Global Alliance for Improved Nutrition, Washington, DC, United States
| | - Dawit Alemayehu
- Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Edith Jm Feskens
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| |
Collapse
|
7
|
Tousoulis D, Guzik T, Padro T, Duncker DJ, De Luca G, Eringa E, Vavlukis M, Antonopoulos AS, Katsimichas T, Cenko E, Djordjevic-Dikic A, Fleming I, Manfrini O, Trifunovic D, Antoniades C, Crea F. Mechanisms, therapeutic implications, and methodological challenges of gut microbiota and cardiovascular diseases: a position paper by the ESC Working Group on Coronary Pathophysiology and Microcirculation. Cardiovasc Res 2022; 118:3171-3182. [PMID: 35420126 PMCID: PMC11023489 DOI: 10.1093/cvr/cvac057] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 01/27/2022] [Accepted: 02/03/2022] [Indexed: 01/25/2023] Open
Abstract
The human gut microbiota is the microbial ecosystem in the small and large intestines of humans. It has been naturally preserved and evolved to play an important role in the function of the gastrointestinal tract and the physiology of its host, protecting from pathogen colonization, and participating in vitamin synthesis, the functions of the immune system, as well as glucose homeostasis and lipid metabolism, among others. Mounting evidence from animal and human studies indicates that the composition and metabolic profiles of the gut microbiota are linked to the pathogenesis of cardiovascular disease, particularly arterial hypertension, atherosclerosis, and heart failure. In this review article, we provide an overview of the function of the human gut microbiota, summarize, and critically address the evidence linking compositional and functional alterations of the gut microbiota with atherosclerosis and coronary artery disease and discuss the potential of strategies for therapeutically targeting the gut microbiota through various interventions.
Collapse
Affiliation(s)
- Dimitris Tousoulis
- 1st Cardiology Department, National and Kapodistrian University of Athens, Vas. Sofias Avenue 114, 11527 Athens, Greece
| | - Tomasz Guzik
- Institute of Cardiovascular Medical Sciences, BHF Glasgow Cardiovascular Research Centre, UK
| | - Teresa Padro
- Sant Pau Institute for Biomedical Research, Barcelona, Spain
| | - Dirk J Duncker
- Department of Cardiology, Thorax Center, Erasmus MC, Rotterdam, the Netherlands
| | - Giuseppe De Luca
- Division of Cardiology, Eastern Piedmont University, Novara, Italy
| | - Etto Eringa
- Institute of Cardiovascular Research, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | | | - Alexios S Antonopoulos
- 1st Cardiology Department, National and Kapodistrian University of Athens, Vas. Sofias Avenue 114, 11527 Athens, Greece
| | - Themistoklis Katsimichas
- 1st Cardiology Department, National and Kapodistrian University of Athens, Vas. Sofias Avenue 114, 11527 Athens, Greece
| | - Edina Cenko
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | | | - Ingrid Fleming
- Centre of Molecular Medicine, Goethe University, Frankfurt, Germany
| | - Olivia Manfrini
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | | | | | - Filippo Crea
- Department of Cardiology and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy
| |
Collapse
|
8
|
Halabi Z, Osman M, Hoteit R. Primary care physicians' awareness and perceptions on adherence to primary cardiovascular disease prevention guidelines in Lebanon: A cross-sectional study. Chronic Illn 2022; 18:719-728. [PMID: 33375844 DOI: 10.1177/1742395320983879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To assess the awareness and have an insight on practice patterns of primary care physicians (PCPs) with respect to several professional primary cardiovascular diseases (CVDs) preventive guidelines. METHODS This is a cross-sectional study, questionnaire-based using a non-probability convenience sampling. Data collection occurred at the annual conferences of the Lebanese Societies of General Practice, Family Medicine, and Internal Medicine in Lebanon. 104 PCPs were recruited. MAIN OUTCOME MEASURES Awareness and practices of CVDs preventive guidelines. RESULTS The response rate was 37%. Awareness of the various CVD preventive guidelines was high among PCPs (>81%). Around 69% of PCPs reported that they always calculate the total cardiovascular risk assessment score. Gaps in managing patients according to guidelines' recommendations were higher in statin initiation compared to antihypertensive initiation. There is over prescription of statin in low risk patients and underutilization in high risk patients. Around 20% of PCPs would initiate aspirin for a low risk patient. Around 17% of physicians do not perform abdominal aortic aneurysm screening. DISCUSSION Although PCPs demonstrated high level of awareness regarding CVD preventive guidelines, gaps remain present in managing patients according to guidelines' recommendations. Less adherence to guidelines will increase mortality and affect patient care.
Collapse
Affiliation(s)
- Zeina Halabi
- Department of Family Medicine, American University of Beirut, Beirut, Lebanon
| | - Mona Osman
- Department of Family Medicine, American University of Beirut, Beirut, Lebanon
| | - Reem Hoteit
- Department of Family Medicine, American University of Beirut, Beirut, Lebanon
| |
Collapse
|
9
|
Deka P, Blesa J, Pathak D, Sempere-Rubio N, Iglesias P, Micó L, Soriano JM, Klompstra L, Marques-Sule E. Combined Dietary Education and High-Intensity Interval Resistance Training Improve Health Outcomes in Patients with Coronary Artery Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811402. [PMID: 36141673 PMCID: PMC9517078 DOI: 10.3390/ijerph191811402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/05/2022] [Accepted: 09/07/2022] [Indexed: 05/13/2023]
Abstract
BACKGROUND Reducing cardiovascular risk through lifestyle changes that include a heart-healthy diet and regular exercise is recommended in the rehabilitation of patients with coronary artery disease (CAD). We pilot-tested the effectiveness of a dietary-education and high-intensity interval resistance training (DE-HIIRT) program on healthy food choices and associated anthropometric variables in patients with established CAD. METHODS A total of 22 participants, aged 60.0 ± 7.2 years, were enrolled in the study. Over 3 months, under the guidance and supervision of a physiotherapist, participants performed the resistance exercises 2×/week in a group setting (cohort of 11). Participants additionally attended three sessions of dietary education led by a dietician. Participants demonstrated their knowledge and understanding of dietary education by picking heart-healthy foods by reading food labels. Outcomes included change in diet (measured using the tricipital skinfold thickness Mediterranean Diet Adherence questionnaire (MEDAS-14) and the Food Consumption Frequency Questionnaire (FCFQ)) and anthropometric measurements (body composition, body circumference, and tricipital skinfold thickness). A paired t-test was performed to analyze the differences between the baseline and post-intervention results. RESULTS Participants significantly increased their consumption of vegetables (p = 0.04) and lowered their consumption of sweet snacks (p = 0.007), pastries (p = 0.02), and processed food (p = 0.05). Significant improvements in body mass index (p = 0.001), waist circumference (p = 0.0001), hip circumference (p = 0.04), and body fat (p = 0.0001) were also achieved. CONCLUSION Making lifestyle changes that include both diet and exercise is essential in the management of CAD. The HIIRT program combined with dietary changes shows promise in achieving weight-loss goals in this population and needs to be further investigated with appropriate study designs.
Collapse
Affiliation(s)
- Pallav Deka
- College of Nursing, Michigan State University, East Lansing, MI 48824, USA
- Correspondence: ; Tel.: +1-517-432-8309
| | - Jesús Blesa
- Department of Preventive Medicine, Public Health, Food Sciences, Toxicology and Legal Medicine, University of Valencia, 46010 Valencia, Spain
- Joint Research Unit on Endocrinology, Nutrition and Clinical Dietetics, University of Valencia-Health Research Institute La Fe, 46026 Valencia, Spain
| | - Dola Pathak
- Department of Statistics and Probability, Michigan State University, East Lansing, MI 48824, USA
| | - Nuria Sempere-Rubio
- Research Unit in Clinical Biomechanics (UBIC), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | - Paula Iglesias
- University Clinic of Nutrition, Physical Activity and Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | - Lydia Micó
- University Clinic of Nutrition, Physical Activity and Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | - José Miguel Soriano
- Joint Research Unit on Endocrinology, Nutrition and Clinical Dietetics, University of Valencia-Health Research Institute La Fe, 46026 Valencia, Spain
- Food & Health Lab, Institute of Materials Science, University of Valencia, 46980 Valencia, Spain
| | - Leonie Klompstra
- Department of Health, Medicine and Caring Sciences, Linkoping University, 58185 Linkoping, Sweden
| | - Elena Marques-Sule
- Physiotherapy in Motion, Multispeciality Research Group (PTinMOTION), Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| |
Collapse
|
10
|
Zhang Y, Lu C, Li X, Fan Y, Li J, Liu Y, Yu Y, Zhou L. Healthy Eating Index-2015 and Predicted 10-Year Cardiovascular Disease Risk, as Well as Heart Age. Front Nutr 2022; 9:888966. [PMID: 35903444 PMCID: PMC9315384 DOI: 10.3389/fnut.2022.888966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 06/22/2022] [Indexed: 11/30/2022] Open
Abstract
Background and Aims Dietary factor plays an important role in the prevention of cardiovascular disease (CVD). The healthy eating index-2015 (HEI-2015), an indicator of the overall dietary quality, has been introduced to reflect adherence to the 2015–2020 Dietary Guidelines for Americans (DGA). This study aims to explore the associations of the HEI-2015 with predicted 10-year CVD risk and heart age among United States adults aged 30–74 years old using data from the National Health and Nutrition Examination Survey (NHANES) 2011–2014. Methods and Results We conducted a cross-sectional analysis among 6,614 participants aged 30–74 years old. The HEI-2015 scores were calculated from 2-days 24-h dietary recall interviews. The 10-year CVD risk and heart age were derived from the sex-specific Framingham general cardiovascular disease risk score. We defined high cardiovascular disease risk as a predicted 10-year cardiovascular disease risk of > 20%. Multiple linear regression and binary logistic regression models were used to investigate the associations of the HEI-2015 with predicted 10-year CVD risk and heart age. Compared with participants in the lowest HEI-2015 quartile, those in the highest quartile had lower predicted 10-year CVD risk (β = −2.37, 95% CI: −3.09 to –1.65, P < 0.0001), lower heart age (β = −2.63, 95% CI: −3.29 to –1.96, P < 0.0001) and lower odds for high risk of CVD (OR = 0.62, 95% CI: 0.49 to 0.80, P-trend < 0.0001) after adjusting for multiple covariates. Conclusion Higher adherence to the 2015–2020 Dietary Guidelines for Americans is associated with lower predicted 10-year cardiovascular disease risk and lower heart age among United States adults.
Collapse
Affiliation(s)
- Yinyin Zhang
- School of Public Health, Xi’an Jiaotong University, Xi’an, China
| | - Cong Lu
- Department of Cardiology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Xinyu Li
- School of Public Health, Xi’an Jiaotong University, Xi’an, China
| | - Yameng Fan
- School of Public Health, Xi’an Jiaotong University, Xi’an, China
| | - Jiaqiao Li
- School of Public Health, Xi’an Jiaotong University, Xi’an, China
| | - Yamei Liu
- School of Public Health, Xi’an Jiaotong University, Xi’an, China
| | - Yan Yu
- School of Public Health, Xi’an Jiaotong University, Xi’an, China
- *Correspondence: Yan Yu,
| | - Long Zhou
- Department of Cardiology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Long Zhou,
| |
Collapse
|
11
|
Parental Traits Associated with Adherence to the Mediterranean Diet in Children and Adolescents in Croatia: A Cross-Sectional Study. Nutrients 2022; 14:nu14132598. [PMID: 35807779 PMCID: PMC9268300 DOI: 10.3390/nu14132598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/17/2022] [Accepted: 06/20/2022] [Indexed: 12/05/2022] Open
Abstract
The Mediterranean diet (MD) is known to be one of the healthiest dietary patterns. Despite the significance of a healthful diet during the early stage of life, data for young individuals indicate that nutrition problems are common. This cross-sectional study aimed to determine parental factors associated with MD adherence in children and adolescents living in the Mediterranean region in Croatia. In total, 2623 children aged 2 to 18 years and their parents participated in this study. Data were collected during the period from September 2021 to February 2022 by using an anonymous questionnaire. We used KIDMED and MEDAS questionnaires for assessing MD adherence in young individuals and their parents, respectively. To assess the association of children’s MD adherence categories with the parental predictors, we performed multivariate multinomial logistic regression. Results showed that the children of parents with a low MD adherence are much more likely to have poor MD adherence than good (OR = 47.54 (95% C.I 18.24, 123.87), p < 0.001) or average (OR = 5.64 (95% C.I 3.70, 8.6), p < 0.001) MD adherence. Further, children of fathers with higher BMI (OR = 1.035 (95% C.I 1.0, 1.071)) and those who do not live with both parents (OR = 1.703 (95% C.I 0.994, 2.916), p = 0.053) are more likely to have poor MD adherence than good MD adherence. These results indicate that interventions focusing on enhancing the quality of both parents’ diets could effectively improve their children’s eating habits.
Collapse
|
12
|
Ghaddar F, Zeidan RK, Salameh P, Tatari S, Achkouty G, Maupas-Schwalm F. Risk Factors for Coronary Heart Disease Among Lebanese Women: A Case–Control Study. Vasc Health Risk Manag 2022; 18:297-311. [PMID: 35464735 PMCID: PMC9021001 DOI: 10.2147/vhrm.s350108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 03/30/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Women are increasingly concerned by coronary heart disease (CHD), with peculiarities of their own, particularly concerning risk factors. The aim of the study was to assess the risk factors for CHD in Lebanese women over forty. Patients and Methods A case–control study was carried out in 6 hospitals in Beirut and Mount-Lebanon, from December 2018 to December 2019 including 1500 patients (1200 controls and 300 cases). Women were stratified into pre- and post-menopausal groups. Personal and medical data were collected from hospital records and during an interview where validated questionnaires were used. Binary logistic regressions were performed to investigate potential predictors of CHD in the 2 groups. Results In post-menopausal women, dyslipidemia (adjusted odds ratio [aOR], 3.018; 95% confidence interval, 2.102–4.332), hypertension (aOR: 2.449, [1.386–4.327]), a family history of CHD (aOR: 2.724, [1.949–3.808]), cigarette smoking (aOR: 2.317, [1.574–3.410]) and common non-rheumatic joint pain (aOR: 1.457, [1.053–2.016]) were strongly associated with CHD. Conversely, living in Mount Lebanon seemed protective, compared to Beirut (aOR: 0.589, [0.406–0.854]), as well as having a moderate monthly income (aOR: 0.450, [0.220–0.923]), adhering to a Mediterranean diet (aOR: 0.965, [0.936–0.994]), and practicing physical activity [PA] (aOR: 0.396, [0.206–0.759] and 0.725, [0.529–0.992], respectively for high and moderate vs low PA). In pre-menopausal women, dyslipidemia (aOR: 6.938, [1.835–26.224]), hypertension (aOR: 6.195, [1.318–29.119]), family histories of dyslipidemia (aOR: 6.143, [1.560–24.191]) and CHD (aOR: 4.739, [1.336–16.805]) reached statistical significance. Conclusion The identification of factors associated with CHD in women, some of which are frequent and trivialized in post-menopause, underlines the need to put in place specific and dedicated CHD prevention strategies in women.
Collapse
Affiliation(s)
- Fatima Ghaddar
- Doctoral School of Biology Health and Biotechnologies, Toulouse University, Toulouse, France
- Correspondence: Fatima Ghaddar, Doctoral school of Biology Health and Biotechnologies, Toulouse University, Toulouse, France, Tel +32 470 53 71 52, Email
| | - Rouba K Zeidan
- Sharjah Institute of Medical Research, University of Sharjah, Sharjah, United Arab Emirates
- Faculty of Public Health II, Lebanese University, Mount-Lebanon, Lebanon
- INSPECT-LB, National Institute of Public Health, Clinical Epidemiology and Toxicology, Beirut, Lebanon
- CERIPH, Center for Research in Public Health, Faculty of Public Health, Lebanese University, Mount-Lebanon, Lebanon
| | - Pascale Salameh
- INSPECT-LB, National Institute of Public Health, Clinical Epidemiology and Toxicology, Beirut, Lebanon
- Department of Research, Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
- School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Souzan Tatari
- Cardiology department, Rafik Hariri University Hospital, Beirut, Lebanon
| | - Guy Achkouty
- Cardiology Department, Mount Lebanon University Hospital, Mount-Lebanon, Lebanon
| | | |
Collapse
|
13
|
Coronary artery disease in South Asian patients: cardiovascular risk factors, pathogenesis and treatments. Curr Probl Cardiol 2022:101228. [DOI: 10.1016/j.cpcardiol.2022.101228] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 04/24/2022] [Indexed: 12/22/2022]
|
14
|
Amrouche TA, Yang X, Güven EÇ, Huang W, Chen Q, Wu L, Zhu Y, Liu Y, Wang Y, Lu B. Contribution of edible flowers to the Mediterranean diet: Phytonutrients, bioactivity evaluation and applications. FOOD FRONTIERS 2022. [DOI: 10.1002/fft2.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Thanina Amel Amrouche
- College of Biosystems Engineering and Food Science National‐Local Joint Engineering Laboratory of Intelligent Food Technology and Equipment Key Laboratory for Agro‐Products Nutritional Evaluation of Ministry of Agriculture and Rural Affairs Key Laboratory of Agro‐Products Postharvest Handling of Ministry of Agriculture and Rural Affairs Zhejiang Key Laboratory for Agro‐Food Processing Zhejiang International Scientific and Technological Cooperation Base of Health Food Manufacturing and Quality
- Fuli Institute of Food Science Zhejiang University Hangzhou China
- Ningbo Research Institute Zhejiang University Ningbo China
| | - Xuan Yang
- College of Biosystems Engineering and Food Science National‐Local Joint Engineering Laboratory of Intelligent Food Technology and Equipment Key Laboratory for Agro‐Products Nutritional Evaluation of Ministry of Agriculture and Rural Affairs Key Laboratory of Agro‐Products Postharvest Handling of Ministry of Agriculture and Rural Affairs Zhejiang Key Laboratory for Agro‐Food Processing Zhejiang International Scientific and Technological Cooperation Base of Health Food Manufacturing and Quality
- Fuli Institute of Food Science Zhejiang University Hangzhou China
- Ningbo Research Institute Zhejiang University Ningbo China
| | - Esra Çapanoğlu Güven
- Faculty of Chemical and Metallurgical Engineering Food Engineering Department Istanbul Technical University Maslak Istanbul Turkey
| | - Weisu Huang
- Zhejiang Economic & Trade Polytechnic Department of Applied Technology Hangzhou China
| | - Qi Chen
- College of Biosystems Engineering and Food Science National‐Local Joint Engineering Laboratory of Intelligent Food Technology and Equipment Key Laboratory for Agro‐Products Nutritional Evaluation of Ministry of Agriculture and Rural Affairs Key Laboratory of Agro‐Products Postharvest Handling of Ministry of Agriculture and Rural Affairs Zhejiang Key Laboratory for Agro‐Food Processing Zhejiang International Scientific and Technological Cooperation Base of Health Food Manufacturing and Quality
- Fuli Institute of Food Science Zhejiang University Hangzhou China
- Ningbo Research Institute Zhejiang University Ningbo China
| | - Lipeng Wu
- College of Biosystems Engineering and Food Science National‐Local Joint Engineering Laboratory of Intelligent Food Technology and Equipment Key Laboratory for Agro‐Products Nutritional Evaluation of Ministry of Agriculture and Rural Affairs Key Laboratory of Agro‐Products Postharvest Handling of Ministry of Agriculture and Rural Affairs Zhejiang Key Laboratory for Agro‐Food Processing Zhejiang International Scientific and Technological Cooperation Base of Health Food Manufacturing and Quality
- Fuli Institute of Food Science Zhejiang University Hangzhou China
- Ningbo Research Institute Zhejiang University Ningbo China
| | - Yuhang Zhu
- College of Biosystems Engineering and Food Science National‐Local Joint Engineering Laboratory of Intelligent Food Technology and Equipment Key Laboratory for Agro‐Products Nutritional Evaluation of Ministry of Agriculture and Rural Affairs Key Laboratory of Agro‐Products Postharvest Handling of Ministry of Agriculture and Rural Affairs Zhejiang Key Laboratory for Agro‐Food Processing Zhejiang International Scientific and Technological Cooperation Base of Health Food Manufacturing and Quality
- Fuli Institute of Food Science Zhejiang University Hangzhou China
- Ningbo Research Institute Zhejiang University Ningbo China
| | - Yuqi Liu
- College of Biosystems Engineering and Food Science National‐Local Joint Engineering Laboratory of Intelligent Food Technology and Equipment Key Laboratory for Agro‐Products Nutritional Evaluation of Ministry of Agriculture and Rural Affairs Key Laboratory of Agro‐Products Postharvest Handling of Ministry of Agriculture and Rural Affairs Zhejiang Key Laboratory for Agro‐Food Processing Zhejiang International Scientific and Technological Cooperation Base of Health Food Manufacturing and Quality
- Fuli Institute of Food Science Zhejiang University Hangzhou China
- Ningbo Research Institute Zhejiang University Ningbo China
| | - Yixuan Wang
- College of Biosystems Engineering and Food Science National‐Local Joint Engineering Laboratory of Intelligent Food Technology and Equipment Key Laboratory for Agro‐Products Nutritional Evaluation of Ministry of Agriculture and Rural Affairs Key Laboratory of Agro‐Products Postharvest Handling of Ministry of Agriculture and Rural Affairs Zhejiang Key Laboratory for Agro‐Food Processing Zhejiang International Scientific and Technological Cooperation Base of Health Food Manufacturing and Quality
- Fuli Institute of Food Science Zhejiang University Hangzhou China
- Ningbo Research Institute Zhejiang University Ningbo China
| | - Baiyi Lu
- College of Biosystems Engineering and Food Science National‐Local Joint Engineering Laboratory of Intelligent Food Technology and Equipment Key Laboratory for Agro‐Products Nutritional Evaluation of Ministry of Agriculture and Rural Affairs Key Laboratory of Agro‐Products Postharvest Handling of Ministry of Agriculture and Rural Affairs Zhejiang Key Laboratory for Agro‐Food Processing Zhejiang International Scientific and Technological Cooperation Base of Health Food Manufacturing and Quality
- Fuli Institute of Food Science Zhejiang University Hangzhou China
- Ningbo Research Institute Zhejiang University Ningbo China
| |
Collapse
|
15
|
Yeh JJ, Lai MC, Yang YC, Hsu CY, Kao CH. Relationships Between Bronchodilators, Steroids, Antiarrhythmic Drugs, Antidepressants, and Benzodiazepines and Heart Disease and Ischemic Stroke in Patients With Predominant Bronchiectasis and Asthma. Front Cardiovasc Med 2022; 9:797623. [PMID: 35252385 PMCID: PMC8893278 DOI: 10.3389/fcvm.2022.797623] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 01/17/2022] [Indexed: 01/09/2023] Open
Abstract
ObjectiveWe investigated the effects of medication on heart disease and ischemic stroke (HDS) risk in patients with predominant bronchiectasis-asthma combination (BCAS).MethodsBCAS and non-BCAS cohorts (N = 588 and 1,118, respectively) were retrospectively enrolled. The cumulative incidence of HDS was analyzed using Cox proportional regression; propensity scores were estimated using non-parsimonious multivariable logistic regression. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for HDS were calculated, adjusting for sex, age, comorbidities, and medication {long- and short-acting β2 agonists and muscarinic antagonists (LABAs/SABAs and LAMAs/SAMAs), steroids [inhaled corticosteroid steroids (ICSs), oral steroids (OSs)], antiarrhythmics, antidepressants (fluoxetine), benzodiazepines (alprazolam, fludiazepam), statins and antihypertensive drugs (diuretics, cardioselective beta blockers, calcium channel blockers (CCBs) and angiotensin converting enzyme inhibitors (ACEi), angiotensin II blockers)}.ResultsCompared with the non-BCAS cohort, the BCAS cohort taking LABAs, SABAs, SAMAs, ICSs, OSs, antiarrhythmics, and alprazolam had an elevated HDS risk [aHRs (95% CIs): 2.36 (1.25–4.33), 2.65 (1.87–3.75), 2.66 (1.74–4.05), 2.53 (1.61–3.99), 1.76 (1.43–2.18), 9.88 (3.27–30.5), and 1.73 (1.15–2.58), respectively except fludiazepam 1.33 (0.73–2.40)]. The aHRs (95% CIs) for LABAs ≤ 30 days, DDDs <415, ICSs ≤ 30 days were 1.10 (0.38–3.15), 2.95 (0.22–38.8), 1.45 (0.76–2.77). The aHRs (95% CIs) for current and recent alprazolam were 1.78 (1.09–2.93) and 777.8 (1.34–451590.0); for current and past fludiazepam were 1.39 (0.75–2.59) and 1.29 (0.42–4.01) and for past alprazolam was 1.57 (0.55–4.46); respectively. The aHRs (95% CIs) for alprazolam >30 DDDs, fludiazepam >20 DDDs, ICSs ≦415 DDDs, and OSs DDDs ≦15 were 1.60 (0.78–3.29), 2.43 (0.90–6.55), 5.02 (1.76–14.3), and 2.28 (1.43–3.62), respectively.ConclusionThe bronchodilators, steroids, and antiarrhythmics were associated with higher risk of HDS, even low dose use of steroids. However, the current use of LABAs/ICSs were not associated with HDS. Benzodiazepines were relatively safe, except for current or recent alprazolam use. Notably, taking confounders into account is crucial in observational studies.
Collapse
Affiliation(s)
- Jun-Jun Yeh
- Department of Family Medicine, Chest Medicine, Geriatric Medicine and Medical Research, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Mei-Chu Lai
- Department of Laboratory Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan
| | - Yu-Cih Yang
- College of Medicine, China Medical University, Taichung, Taiwan
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Chung-Y. Hsu
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, Taiwan
- Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung, Taiwan
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
- *Correspondence: Chia-Hung Kao ;
| |
Collapse
|
16
|
Effects of Olive Oil and Its Components on Intestinal Inflammation and Inflammatory Bowel Disease. Nutrients 2022; 14:nu14040757. [PMID: 35215407 PMCID: PMC8875923 DOI: 10.3390/nu14040757] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/07/2022] [Accepted: 02/09/2022] [Indexed: 12/14/2022] Open
Abstract
With the rising global burden of inflammatory bowel disease (IBD) and the rising costs of novel biological drugs, there is an increasing need for dietary approaches and functional foods that could modulate the course of IBD. The Mediterranean diet has proven to be efficacious in managing chronic inflammatory diseases, and recent studies have also shown its benefits in the setting of IBD. Since olive oil and its compounds have been shown to provide a considerable anti-inflammatory effect, in this review, we aim to discuss the latest evidence concerning the impact of olive oil and its bioactive compounds on IBD. Numerous preclinical studies have exhibited solid evidence on the mechanisms by which polyphenol-rich extra-virgin olive oil (EVOO) or specific polyphenols like hydroxytyrosol (HT) provide their anti-inflammatory, antioxidative, antitumour, and microbiota-modulation effects. Accordingly, several human studies that explored the effects of olive oil on patients with IBD further confirmed the evidence brought forward by preclinical studies. Nevertheless, there is a need for larger-scale, multicentric, randomized control trials that would finally elucidate olive oil’s level of efficacy in modulating the course of IBD.
Collapse
|
17
|
Matana A, Franić I, Radić Hozo E, Burger A, Boljat P. Adherence to the Mediterranean Diet among Children and Youth in the Mediterranean Region in Croatia: A Comparative Study. Nutrients 2022; 14:nu14020302. [PMID: 35057484 PMCID: PMC8780278 DOI: 10.3390/nu14020302] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/07/2022] [Accepted: 01/09/2022] [Indexed: 02/06/2023] Open
Abstract
The Mediterranean diet (MD) is considered one of the healthiest dietary patterns. The aim of this study was to assess MD adherence in children and youth living in the Mediterranean region in Croatia and evaluate the differences in adherence to the MD among different educational stages. In total, 2722 individuals aged 2 to 24 years were enrolled in this study. Subjects were divided into different groups according to the Croatian educational system. Mediterranean Diet Quality Index (KIDMED) was used to assess adherence to the MD. In the total sample, the adherence to the MD was poor in 19.2%, average in 60.8%, and good in 20.1% of the study participants. The prevalence rate of poor adherence to the MD increased with higher educational stage, i.e., the highest prevalence rate of poor MD adherence was observed for college students (39.3%). Children having a higher number of snacks on days-off, those with lower physical activity, and not having breakfast together with a family are more likely to have poor MD adherence, while children having a higher number of snacks on working days are less likely to have a poor MD. The results of this study showed low adherence to the principles of the MD, confirming the need for improvement of adherence to the MD pattern in the studied population.
Collapse
Affiliation(s)
- Antonela Matana
- The University Department of Health Studies, University of Split, Ruđera Boškovića 35, 21000 Split, Croatia; (I.F.); (E.R.H.); (A.B.)
- Correspondence:
| | - Ivana Franić
- The University Department of Health Studies, University of Split, Ruđera Boškovića 35, 21000 Split, Croatia; (I.F.); (E.R.H.); (A.B.)
| | - Endica Radić Hozo
- The University Department of Health Studies, University of Split, Ruđera Boškovića 35, 21000 Split, Croatia; (I.F.); (E.R.H.); (A.B.)
| | - Ante Burger
- The University Department of Health Studies, University of Split, Ruđera Boškovića 35, 21000 Split, Croatia; (I.F.); (E.R.H.); (A.B.)
| | - Petra Boljat
- Elementary School Žnjan-Pazdigrad, Pazdigradska 1, 21000 Split, Croatia;
| |
Collapse
|
18
|
Acosta S, Johansson A, Drake I. Diet and Lifestyle Factors and Risk of Atherosclerotic Cardiovascular Disease-A Prospective Cohort Study. Nutrients 2021; 13:nu13113822. [PMID: 34836078 PMCID: PMC8622601 DOI: 10.3390/nu13113822] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 10/20/2021] [Accepted: 10/25/2021] [Indexed: 12/23/2022] Open
Abstract
Atherosclerotic cardiovascular disease (ACVD) is the leading cause of death worldwide. This study aimed to investigate the association between diet and lifestyle factors, beyond traditional risk factors, and the risk of incident ACVD. The Malmö Diet and Cancer study included 30,446 middle-aged individuals. Baseline examinations including a dietary assessment, questionnaire and interviews, were performed between 1991–1996. After excluding individuals with prevalent cardiovascular disease and atrial fibrillation or flutter, 26,990 participants remained. In a previously developed diet quality index, adherence to recommended intake of saturated fat (SFA), polyunsaturated fat (PUFA), fish and shellfish, fiber, vegetables and fruit, and sucrose results in one point per dietary component, with a maximum diet score of six points. Diagnosis of incident ACVD was based on validated diagnoses of coronary artery disease, atherothrombotic ischemic stroke, carotid artery disease or peripheral artery disease. Multivariable Cox regression analysis adjusting for established risk factors was performed to assess hazard ratios (HR) with 95% confidence intervals (CI). After a median follow-up of 21.1 years, 5858 (21.7%) individuals diagnosed with ACVD unrelated to atrial fibrillation or flutter were identified. Higher diet score (HR 0.94/point increase; 95% CI 0.91–0.97; p < 0.001), intake of fish and shellfish (HR 0.95/standard deviation (SD) increment, 95% CI 0.93–0.98), fiber (HR 0.93/SD increment, 95% CI 0.89–0.98) and SFA (HR 0.96/SD increment, 95% CI 0.92–0.99) consumption were associated with decreased risk for incident ACVD. High leisure-time physical activity (HR 0.82, 95% CI 0.74–0.91) was associated with reduced risk and obesity (HR 1.17, 95% CI 1.08–1.27) with increased risk of incident ACVD. The present study strengthens current recommendations of improving diet quality and increasing physical activity in preventing ACVD.
Collapse
Affiliation(s)
- Stefan Acosta
- Department of Clinical Sciences, Lund University, 214 21 Malmö, Sweden; (A.J.); (I.D.)
- Vascular Center, Department of Cardiothoracic and Vascular Surgery, Skåne University Hospital, 205 01 Malmö, Sweden
- Correspondence: ; Tel.: +46-040-331000
| | - Anna Johansson
- Department of Clinical Sciences, Lund University, 214 21 Malmö, Sweden; (A.J.); (I.D.)
- Örestadskliniken, 217 67 Malmö, Sweden
| | - Isabel Drake
- Department of Clinical Sciences, Lund University, 214 21 Malmö, Sweden; (A.J.); (I.D.)
| |
Collapse
|
19
|
McKay GJ, Lyner N, Linden GJ, Kee F, Moitry M, Biasch K, Amouyel P, Dallongeville J, Bongard V, Ferrières J, Gey KF, Patterson CC, Woodside JV. Association of low plasma antioxidant levels with all-cause mortality and coronary events in healthy middle-aged men from France and Northern Ireland in the PRIME study. Eur J Nutr 2021; 60:2631-2641. [PMID: 33355688 PMCID: PMC8275518 DOI: 10.1007/s00394-020-02455-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 12/03/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND The main underlying risk factors associated with coronary heart disease (CHD) are modifiable and oxidative injury and systemic inflammatory damage represent key aetiological factors associated with the development and progression of CHD and premature mortality. OBJECTIVE To examine associations of plasma antioxidant status with all-cause mortality and fatal or non-fatal cardiovascular events. DESIGN The PRIME study prospectively evaluated 9709 men aged 50-59 years between 1991 and 1993 in Northern Ireland and France who were free of CHD at recruitment and followed annually for deaths and cardiovascular events for 10 years. Serum concentrations of vitamin C, retinol, two forms of vitamin E (α- and γ-tocopherol) and six carotenoids were quantified by high-performance liquid chromatography. Baseline conventional risk factors were considered, as well as socioeconomic differences and lifestyle behaviours including diet, smoking habit, physical activity, and alcohol consumption through Cox regression analyses. RESULTS At 10 years, there were 538 deaths from any cause and 440 fatal or non-fatal cardiovascular events. After adjustment for country, age, systolic blood pressure, diabetes, body mass index, cholesterol, high density lipoprotein cholesterol, triglycerides, height, total physical activity, alcohol consumption and smoking habit, higher levels of all antioxidants were associated with significantly lower risk of all-cause mortality, with the exception of γ-tocopherol. Only retinol was significantly associated with decreased risk of cardiovascular events in a fully adjusted model. CONCLUSIONS Low antioxidant levels contribute to the gradient of all-cause mortality and cardiovascular incidence independent of lifestyle behaviours and traditional cardiovascular and socioeconomic risk factors.
Collapse
Affiliation(s)
- Gareth J McKay
- Centre for Public Health, Royal Victoria Hospital, Queen's University Belfast, Belfast, BT12 6BA, UK.
| | - Natalie Lyner
- Centre for Public Health, Royal Victoria Hospital, Queen's University Belfast, Belfast, BT12 6BA, UK
| | - Gerry J Linden
- Centre for Public Health, Royal Victoria Hospital, Queen's University Belfast, Belfast, BT12 6BA, UK
| | - Frank Kee
- Centre for Public Health, Royal Victoria Hospital, Queen's University Belfast, Belfast, BT12 6BA, UK
| | | | | | | | | | | | | | - K Fred Gey
- The MONICA Reference Centre for Vitamins, Department of Biochemistry and Molecular Biology, University of Bern, Bern, Switzerland
| | - Chris C Patterson
- Centre for Public Health, Royal Victoria Hospital, Queen's University Belfast, Belfast, BT12 6BA, UK
| | - Jayne V Woodside
- Centre for Public Health, Royal Victoria Hospital, Queen's University Belfast, Belfast, BT12 6BA, UK
| |
Collapse
|
20
|
Nutritional status and high adherence to the Mediterranean diet in Colombian school children and teenagers during the COVID-19 pandemic according to sex. J Nutr Sci 2021. [PMCID: PMC8314198 DOI: 10.1017/jns.2021.48] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
The current COVID-19 pandemic has generated a series of changes in the daily routines of people, including children and teenagers, in an unprecedented way, which constitutes a global challenge in public health. Social isolation has been a prophylactic measure to prevent the spread of the virus; however, it has generated negative impacts on the physical and emotional health of parents, caregivers, children and teenagers around the world. The objective of the present study was to evaluate the effects of confinement caused by the COVID-19 pandemic at the level of nutritional status, dietary and behavioural patterns of elementary school children and teenagers in a small town of Colombia. Anthropometric parameters such as BMI Z-score, waist circumference and waist/height ratio were evaluated in 266 school children and teenagers. A questionnaire with socio-demographic, clinical and lifestyle characteristics and the KIDMED were applied to learn about nutritional aspects. A total of 102 students (38⋅3 %) were classified as having altered nutritional status, being 39 (14⋅7 %) classified as overweight and 36 (13⋅5 %) with obesity. The prevalence of high adherence to the Mediterranean diet was 12 %, 95 % CI (0⋅08, 0⋅16). Overweight was more prevalent in women (26/39, 66⋅7 %; P = 0⋅0439), and obesity was discreetly more frequent in men (19/36, 52⋅7 %; P = 0⋅7193). We observed a worrying nutritional, dietary and behavioural situation in the children and teenagers studied during the confinement associated with the COVID-19 pandemic. This unveils the need to establish strategies and/or public policies in our town that help to promote an adequate biopsychosocial development of the paediatric patient and their family group.
Collapse
|
21
|
Mediterranean diet adherence amongst adolescents in North Lebanon: the role of skipping meals, meals with the family, physical activity and physical well-being. Br J Nutr 2021; 128:1349-1356. [PMID: 34266518 DOI: 10.1017/s0007114521002269] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The Mediterranean diet (MD) is a model of a healthy diet and healthy lifestyle. Adherence to the MD has been correlated with a reduction in many metabolic disorders including cancers. The factors associated with adolescents' adherence to the MD in North Lebanon using the KIDMED index have never been explored. Therefore, we thought to examine these factors amongst a sample of them. A cross-sectional survey was conducted in the city of Tripoli, North Lebanon. A total of 798 adolescents aged 11-18 years were randomly selected to participate in this study. All participants completed a questionnaire assessing adherence to the MD (KIDMED index), physical activity (physical activity questionnaires for older children and adolescents), health-related quality of life (KIDSCREEN-27 index) and sociodemographic characteristics (age, sex, grade level and parents' educational status). Anthropometric measurements, including weight, height and waist circumference, were also collected. Adherence to the MD was good amongst only 13·3 % of the adolescents. The prevalence rate of overweight and obesity was elevated, affecting 36·9 % of the students. Lower adherence to the MD was significantly correlated with skipping meals (P = 0·001). Meanwhile, adolescents who were engaged in a high level of physical activity, those who consumed more meals with their families and those who benefited from better physical well-being had a better diet quality (P < 0·001). Nutrition intervention programmes, as well as public health policies, would be of interest in order to improve diet quality amongst Lebanese adolescents.
Collapse
|
22
|
Derosa G, Colletti A, Maffioli P, D'Angelo A, Lupi A, Zito GB, Mureddu GF, Raddino R, Fedele F, Cicero AFG. Lipid-lowering nutraceuticals update on scientific evidence. J Cardiovasc Med (Hagerstown) 2021; 21:845-859. [PMID: 32639326 DOI: 10.2459/jcm.0000000000000970] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
: Cardiovascular diseases (CVDs) are the main cause of mortality worldwide. Risk factors of CVD can be classified into modifiable (smoking, hypertension, diabetes, hypercholesterolemia) through lifestyle changes or taking drug therapy and not modifiable (age, ethnicity, sex and family history). Elevated total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C) levels have a lead role in the development of coronary heart disease (CHD), while high levels of high-density lipoprotein-cholesterol (HDL-C) seem to have a protective role.The current treatment for dyslipidemia consists of lifestyle modification or drug therapy even if not pharmacological treatment should be always considered in addition to lipid-lowering medications.The use of lipid-lowering nutraceuticals alone or in association with drug therapy may be considered when the atherogenic cholesterol goal was not achieved.These substances can be classified according to their mechanisms of action into natural inhibitors of intestinal cholesterol absorption, inhibitors of hepatic cholesterol synthesis and enhancers of the excretion of LDL-C. Nevertheless, many of them are characterized by mixed or unclear mechanisms of action.The use of these nutraceuticals is suggested in individuals with borderline lipid profile levels or with drug intolerance, but cannot replace standard lipid-lowering treatment in patients at high, or very high CVD risk.Nutraceuticals can also have vascular effects, including improvement in endothelial dysfunction and arterial stiffness, as well as antioxidative properties. Moreover, epidemiological and clinical studies reported that in patients intolerant of statins, many nutraceuticals with demonstrated hypolipidemic effect are well tolerated.
Collapse
Affiliation(s)
- Giuseppe Derosa
- Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico San Matteo, PAVIA; SINut (Italian Society of Nutraceuticals)
| | - Alessandro Colletti
- Department of Medical and Surgical Sciences, University of Bologna, BOLOGNA; SINut (Italian Society of Nutraceuticals)
| | - Pamela Maffioli
- Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico San Matteo, PAVIA; SINut (Italian Society of Nutraceuticals)
| | - Angela D'Angelo
- Department of Internal Medicine and Therapeutics, University of Pavia, Fondazione IRCCS Policlinico San Matteo, PAVIA; SINut (Italian Society of Nutraceuticals)
| | - Alessandro Lupi
- Cardiology Unit, Ospedali Riuniti di Domodossola e Verbania, OMEGNA; CFC (Federative College of Cardiology)
| | - Giovanni B Zito
- ASL Naples 3 SOUTH, NAPLES; ARCA (Regional Association of Ambulatorial Cardiologists)
| | - Gian Francesco Mureddu
- Cardiology Unit - San Giovanni Addolorata Hospital, ROME; AICPR (Italian Association of Clinical, Preventive and Rehabilitative Cardiology)
| | - Riccardo Raddino
- Cardiology Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University, Cardiothoracic Department, Spedali Civili of Brescia, BRESCIA; SIRC (Italian Society of Cardiovascular Research)
| | - Francesco Fedele
- Department of Cardiovascular, Respiratory, Anesthesiology, Nephrology and Geriatric Sciences, Sapienza University of Rome, ROME; INCRC (Cardiovascular Research Consortium)
| | - Arrigo F G Cicero
- Department of Medical and Surgical Sciences, University of Bologna, BOLOGNA; SINut (Italian Society of Nutraceuticals)
| |
Collapse
|
23
|
Effects of a Mediterranean Diet, Dairy, and Meat Products on Different Phenotypes of Dyslipidemia: A Preliminary Retrospective Analysis. Nutrients 2021; 13:nu13041161. [PMID: 33915861 PMCID: PMC8065939 DOI: 10.3390/nu13041161] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 12/11/2022] Open
Abstract
Background: Dyslipidemia is one of the major causes of atherosclerotic cardiovascular disease (ASCVD) and a Mediterranean Diet (MD) is recommended for its prevention. The objectives of this study were to evaluate adherence to an MD at baseline and follow-up, in a cohort of dyslipidemic patients, and to evaluate how different food intakes can influence lipid profile, especially how different sources of saturated fatty acids impact lipid phenotype. Methods: A retrospective analysis was conducted on 106 dyslipidemic patients. Clinical characteristics, lipid profile, and food habits data were collected at baseline and after three months of follow-up with counseling. Adherence to an MD was evaluated with a validated food-frequency questionnaire (MEDI-LITE score). Results: The cross-sectional analysis showed that higher consumption of dairy products correlated independently with higher levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) and with lower triglycerides (TG) levels. Instead, lower HDL-C and TG levels and higher TC levels were independently associated with higher consumption of meat products. Adherence to an MD significantly improved after the follow-up period, from a mean value of 10 ± 3 (median 10, IQR 8–12) to 13 ± 2 (median 14, IQR 12–15), p < 0.0001. Conclusions: Dyslipidemic patients benefit from counseling for improving their adherence to an MD. The high intake of dairy products was associated with less atherogenic hyperlipidemia, which was characterized by higher levels of TC and HDL-C as compared withs the intake of an excessive amount of meat products, which was associated with higher levels of TC and TG and lower levels of HDL-C.
Collapse
|
24
|
Lasalvia P, Gianfagna F, Veronesi G, Franchin M, Tozzi M, Castelli P, Grandi AM, Zambon A, Iacoviello L, Ferrario MM. Identification of dietary patterns in a general population of North Italian adults and their association with arterial stiffness. The RoCAV study. Nutr Metab Cardiovasc Dis 2021; 31:44-51. [PMID: 32981800 DOI: 10.1016/j.numecd.2020.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 07/17/2020] [Accepted: 08/03/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIMS The aims of this study were to identify dietary patterns in a general population of North Italian adults and to investigate the cross-sectional association between prevalent dietary patterns and arterial stiffness. METHODS AND RESULTS Participants to the RoCAV study without chronic diseases at recruitment and with reliable dietary data were included. The food-frequency EPIC questionnaire was used to evaluate dietary habits. Dietary patterns were estimated using principal components analysis and Mediterranean diet adherence score (MedS). Carotid-femoral pulse wave velocity (cfPWV) was used as proxy of arterial stiffness. Basing on data from 2640 subjects (1608 men and 1032 women, mean ± SD 65.5 ± 6.7 years), four principal components (PC) were retained, explaining 24% of the overall variance. Considering 1284 subjects with cfPWV (mean ± SD 10.7 ± 2.5 m/s) data available, adherence to PC1 (Western-like dietary pattern) was associated with higher stiffness values (+0.29 m/s cfPWV for 1 SD increase of PC1, 95% CI:0.08,0.50; p = 0.007) in a multivariate model. Conversely, adherence to PC2 (Mediterranean-like) was not related to cfPWV values (-0.18, 95% CI: -0.36, 0.004; p = 0.06). Likewise, MedS and other PC patterns did not show any significant association with cfPWV. Mediation analysis showed that the association between Western-like dietary pattern and cfPWV is mediated by higher levels of leucocytes (9.2% of the effect, p = 0.047). CONCLUSIONS Our study in a Southern European population identified a Western-like dietary pattern associated with an increased cfPWV, a proxy of arterial stiffness. The association with cfPWV was in part mediated by inflammatory status.
Collapse
Affiliation(s)
- Paolo Lasalvia
- EPIMED Research Center, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Francesco Gianfagna
- EPIMED Research Center, Department of Medicine and Surgery, University of Insubria, Varese, Italy; Mediterranea Cardiocentro, Napoli, Italy.
| | - Giovanni Veronesi
- EPIMED Research Center, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Marco Franchin
- Vascular Surgery, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Matteo Tozzi
- Vascular Surgery, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Patrizio Castelli
- Vascular Surgery, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Anna M Grandi
- Internal Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Antonella Zambon
- Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy; Istituto Auxologico Italiano, IRCCS, Biostatistic Unit, Milan, Italy
| | - Licia Iacoviello
- EPIMED Research Center, Department of Medicine and Surgery, University of Insubria, Varese, Italy; Department of Epidemiology and Prevention, IRCCS Neuromed, Pozzilli, Italy
| | - Marco M Ferrario
- EPIMED Research Center, Department of Medicine and Surgery, University of Insubria, Varese, Italy; Occupational, Preventive Medicine and Toxicology Unit, Varese University Hospital, Varese, Italy
| |
Collapse
|
25
|
Silveira BKS, da Silva A, Hermsdorff HHM, Bressan J. Effect of chronic consumption of nuts on oxidative stress: a systematic review of clinical trials. Crit Rev Food Sci Nutr 2020; 62:726-737. [DOI: 10.1080/10408398.2020.1828262] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
| | - Alessandra da Silva
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Brazil
| | | | - Josefina Bressan
- Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Brazil
| |
Collapse
|
26
|
Jalilpiran Y, Darooghegi Mofrad M, Mozaffari H, Bellissimo N, Azadbakht L. Adherence to dietary approaches to stop hypertension (DASH) and Mediterranean dietary patterns in relation to cardiovascular risk factors in older adults. Clin Nutr ESPEN 2020; 39:87-95. [DOI: 10.1016/j.clnesp.2020.07.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/21/2020] [Accepted: 07/24/2020] [Indexed: 01/28/2023]
|
27
|
Han A, Sun T, Ming J, Chai L, Liao X. Are the Chinese Moving toward a Healthy Diet? Evidence from Macro Data from 1961 to 2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5294. [PMID: 32717812 PMCID: PMC7432933 DOI: 10.3390/ijerph17155294] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/18/2020] [Accepted: 07/21/2020] [Indexed: 01/21/2023]
Abstract
The change in diet structure is one of the critical features of social transformation, and diet structure is directly related to human health. In China, with rapid economic development, changes in the diet structure of the population have begun and are proceeding at a fairly rapid rate. In order to reveal how the Chinese diet is approaching or deviating from the nutritional goal, a novel index, NDBI (National Dietary Balance Index), is developed in this study to investigate the Chinese diet from 1961 to 2017 at a national level. The results show that the Chinese diet has transitioned from the under-intake stage to the over-intake stage. Before the 1980s, Chinese people ate all foods inadequately except staple foods; after the 1980s, the issue of under-intake began to fade, and the intake of meats even became excessive. The intake of staple foods is always excessive during this period. Currently, the Chinese diet is still unhealthy because of the inadequate intake of dairy products and the excessive intake of staple foods and meats. By evaluating diet structure on a national level, this study can help people to better understand how the Chinese diet deviated from the nutritional goal and provides information for policymakers intervening in China's food consumption.
Collapse
Affiliation(s)
- Aixi Han
- International College Beijing, China Agricultural University, Beijing 100083, China; (A.H.); (T.S.)
| | - Tianhao Sun
- International College Beijing, China Agricultural University, Beijing 100083, China; (A.H.); (T.S.)
| | - Jing Ming
- School of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu 610225, China;
| | - Li Chai
- International College Beijing, China Agricultural University, Beijing 100083, China; (A.H.); (T.S.)
- Chinese-Israeli International Center for Research and Training in Agriculture, China Agricultural University, Beijing 100083, China
| | - Xiawei Liao
- School of Environment and Energy, Peking University Shenzhen Graduate School, University Town, Shenzhen 518055, China;
- College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| |
Collapse
|
28
|
Dietary influence on central nervous system myelin production, injury, and regeneration. Biochim Biophys Acta Mol Basis Dis 2020; 1866:165779. [DOI: 10.1016/j.bbadis.2020.165779] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 03/19/2020] [Accepted: 03/22/2020] [Indexed: 02/07/2023]
|
29
|
Patnaik A, Tran J, McWhorter JW, Burks H, Ngo A, Nguyen TD, Mody A, Moore L, Hoelscher DM, Dyer A, Sarris L, Harlan T, Chassay CM, Monlezun D. Regional variations in medical trainee diet and nutrition counseling competencies: Machine learning-augmented propensity score analysis of a prospective multi-site cohort study. MEDICAL SCIENCE EDUCATOR 2020; 30:911-915. [PMID: 34457749 PMCID: PMC8368255 DOI: 10.1007/s40670-020-00973-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Medical professionals and students are inadequately trained to respond to rising global obesity and nutrition-related chronic disease epidemics, primarily focusing on cardiovascular disease. Yet, there are no multi-site studies testing evidence-based nutrition education for medical students in preventive cardiology, let alone establishing student dietary and competency patterns. METHODS Cooking for Health Optimization with Patients (CHOP; NIH NCT03443635) was the first multi-national cohort study using hands-on cooking and nutrition education as preventive cardiology, monitoring and improving student diets and competencies in patient nutrition education. Propensity-score adjusted multivariable regression was augmented by 43 supervised machine learning algorithms to assess students outcomes from UT Health versus the remaining study sites. RESULTS 3,248 medical trainees from 20 medical centers and colleges met study criteria from 1 August 2012 to 31 December 2017 with 60 (1.49%) being from UTHealth. Compared to the other study sites, trainees from UTHealth were more likely to consume vegetables daily (OR 1.82, 95%CI 1.04-3.17, p=0.035), strongly agree that nutrition assessment should be routine clinical practice (OR 2.43, 95%CI 1.45-4.05, p=0.001), and that providers can improve patients' health with nutrition education (OR 1.73, 95%CI 1.03-2.91, p=0.038). UTHealth trainees were more likely to have mastered 12 of the 25 competency topics, with the top three being moderate alcohol intake (OR 1.74, 95%CI 0.97-3.11, p=0.062), dietary fats (OR 1.26, 95%CI 0.57-2.80, p=0.568), and calories (OR 1.26, 95%CI 0.70-2.28, p=0.446). CONCLUSION This machine learning-augmented causal inference analysis provides the first results that compare medical students nationally in their diets and competencies in nutrition education, highlighting the results from UTHealth. Additional studies are required to determine which factors in the hands-on cooking and nutrition curriculum for UTHealth and other sites produce optimal student - and, eventually, preventive cardiology - outcomes when they educate patients in those classes.
Collapse
Affiliation(s)
- Anish Patnaik
- McGovern Medical School, University of Texas Health Sciences Center at Houston (UTHealth), Houston, TX USA
| | - Justin Tran
- McGovern Medical School, University of Texas Health Sciences Center at Houston (UTHealth), Houston, TX USA
| | - John W. McWhorter
- School of Public Health, University of Texas Health Sciences Center at Houston (UTHealth), Houston, TX USA
- Michael & Susan Dell Center for Healthy Living, Austin, TX USA
| | - Helen Burks
- McGovern Medical School, University of Texas Health Sciences Center at Houston (UTHealth), Houston, TX USA
| | - Alexandra Ngo
- McGovern Medical School, University of Texas Health Sciences Center at Houston (UTHealth), Houston, TX USA
| | - Tu Dan Nguyen
- McGovern Medical School, University of Texas Health Sciences Center at Houston (UTHealth), Houston, TX USA
| | - Avni Mody
- McGovern Medical School, University of Texas Health Sciences Center at Houston (UTHealth), Houston, TX USA
| | - Laura Moore
- School of Public Health, University of Texas Health Sciences Center at Houston (UTHealth), Houston, TX USA
- Michael & Susan Dell Center for Healthy Living, Austin, TX USA
| | - Deanna M. Hoelscher
- School of Public Health, University of Texas Health Sciences Center at Houston (UTHealth), Houston, TX USA
- Michael & Susan Dell Center for Healthy Living, Austin, TX USA
| | - Amber Dyer
- The Goldring Center for Culinary Medicine, Tulane University School of Medicine, New Orleans, LA USA
| | - Leah Sarris
- The Goldring Center for Culinary Medicine, Tulane University School of Medicine, New Orleans, LA USA
| | - Timothy Harlan
- The Goldring Center for Culinary Medicine, Tulane University School of Medicine, New Orleans, LA USA
| | - C Mark Chassay
- McGovern Medical School, University of Texas Health Sciences Center at Houston (UTHealth), Houston, TX USA
| | - Dominique Monlezun
- McGovern Medical School, University of Texas Health Sciences Center at Houston (UTHealth), Houston, TX USA
- The Goldring Center for Culinary Medicine, Tulane University School of Medicine, New Orleans, LA USA
| |
Collapse
|
30
|
Mattioli AV, Sciomer S, Moscucci F, Maiello M, Cugusi L, Gallina S, Dei Cas A, Lombardi C, Pengo M, Parati G, Barilla F, Ciccone MM, Palmiero P, Mercuro G, Maffei S. Cardiovascular prevention in women: a narrative review from the Italian Society of Cardiology working groups on 'Cardiovascular Prevention, Hypertension and peripheral circulation' and on 'Women Disease'. J Cardiovasc Med (Hagerstown) 2020; 20:575-583. [PMID: 31246698 DOI: 10.2459/jcm.0000000000000831] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
: Cardiovascular disease (CVD) is the leading cause of mortality and morbidity in women.Some authors highlighted that the female risk profile consists of traditional and emerging risk factors. Despite the lower prevalence of type 2 diabetes, years of life lost owing to the disease for women are substantially higher compared with men. In addition, pregnancy complicated by gestational diabetes represents a risk factor for CVD. Women with gestational diabetes have a higher prevalence of coronary artery disease that occur at a younger age and are independent of T2DM.Hypertension is an important cardiovascular risk factor in women. Estrogens and progesterone, known to have an impact on blood pressure levels, have also been proposed to be protective against sleep-disordered breathing. It is very difficult to understand whereas obstructive sleep apnea in women is independently associated with hypertension or if many confounders acting at different stages of the woman lifespan mediate this relation.The cardioprotective effect of physical activity in women of all ages is well known. Women are generally more physically inactive than men. During and after menopause, most women tend to reduce their physical activity levels and together with the reduction in basal metabolic rate, women experience loss of skeletal muscle mass with a negative change in the ratio of fat-to-lean mass.In conclusion, sex differences in the cardiovascular system are because of dissimilarities in gene expression and sex hormones; these result in variations in prevalence and presentation of CVD and associated conditions, such as diabetes, hypertension and vascular and cardiac remodeling.Changes in lifestyle and increase in physical activity could help in prevention of cardiovascular disease in women.
Collapse
Affiliation(s)
- Anna Vittoria Mattioli
- Department of Surgical, Medical and Dental Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia
| | - Susanna Sciomer
- Department of Cardiovascular, Respiratory Nephrological, Anesthesiological and Geriatric Sciences, Sapienza University
| | - Federica Moscucci
- Department of Cardiovascular, Respiratory Nephrological, Anesthesiological and Geriatric Sciences, Sapienza University
| | - Maria Maiello
- ASL Brindisi, Cardiology Equipe, District of Brindisi
| | - Lucia Cugusi
- Department of Medical Sciences and Public Health, University of Cagliari
| | - Sabina Gallina
- Department of Neuroscience, Imaging and Clinical Sciences, University of Chieti-Pescara, Chieti
| | - Alessandra Dei Cas
- Endocrinology and Metabolism, Department of Clinical and Experimental Medicine, University of Parma
| | - Carolina Lombardi
- Department of Cardiovascular, Neural and Metabolic Sciences, S.Luca Hospital, Istituto Auxologico Italiano, IRCCS, Milan
| | - Martino Pengo
- Department of Cardiovascular, Neural and Metabolic Sciences, S.Luca Hospital, Istituto Auxologico Italiano, IRCCS, Milan
| | - Gianfranco Parati
- Department of Cardiovascular, Neural and Metabolic Sciences, S.Luca Hospital, Istituto Auxologico Italiano, IRCCS, Milan
| | - Francesco Barilla
- Department of Cardiovascular, Respiratory Nephrological, Anesthesiological and Geriatric Sciences, Sapienza University
| | - Marco Matteo Ciccone
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation (DETO), University 'A. Moro' of Bari
| | - Pasquale Palmiero
- Department of Cardiovascular, Respiratory Nephrological, Anesthesiological and Geriatric Sciences, Sapienza University
| | - Giuseppe Mercuro
- Department of Medical Sciences and Public Health, University of Cagliari
| | - Silvia Maffei
- Cardiovascular and Gynaecological Endocrinology Unit, Fondazione G. Monasterio CNR-Regione Toscana, Pisa, Italy
| |
Collapse
|
31
|
Nasi M, Patrizi G, Pizzi C, Landolfo M, Boriani G, Dei Cas A, Cicero AFG, Fogacci F, Rapezzi C, Sisca G, Capucci A, Vitolo M, Galiè N, Borghi C, Berrettini U, Piepoli M, Mattioli AV. The role of physical activity in individuals with cardiovascular risk factors: an opinion paper from Italian Society of Cardiology-Emilia Romagna-Marche and SIC-Sport. J Cardiovasc Med (Hagerstown) 2020; 20:631-639. [PMID: 31436678 DOI: 10.2459/jcm.0000000000000855] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
: Regular physical activity is a cornerstone in the prevention and treatment of atherosclerotic cardiovascular disease (CVD) due to its positive effects in reducing several cardiovascular risk factors. Current guidelines on CVD suggest for healthy adults to perform at least 150 min/week of moderate intensity or 75 min/week of vigorous intensity aerobic physical activity. The current review explores the effects of physical activity on some risk factors, specifically: diabetes, dyslipidemia, hypertension and hyperuricemia. Physical activity induces an improvement in insulin sensitivity and in glucose control independently of weight loss, which may further contribute to ameliorate both diabetes-associated defects. The benefits of adherence to physical activity have recently proven to extend beyond surrogate markers of metabolic syndrome and diabetes by reducing hard endpoints such as mortality. In recent years, obesity has greatly increased in all countries. Weight losses in these patients have been associated with improvements in many cardiometabolic risk factors. Strategies against obesity included caloric restriction, however greater results have been obtained with association of diet and physical activity. Similarly, the beneficial effect of training on blood pressure via its action on sympathetic activity and on other factors such as improvement of endothelial function and reduction of oxidative stress can have played a role in preventing hypertension development in active subjects. The main international guidelines on prevention of CVD suggest to encourage and to increase physical activity to improve lipid pattern, hypertension and others cardiovascular risk factor. An active action is required to the National Society of Cardiology together with the Italian Society of Sports Cardiology to improve the prescription of organized physical activity in patients with CVD and/or cardiovascular risk factors.
Collapse
Affiliation(s)
- Milena Nasi
- Department of Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena
| | | | - Carmine Pizzi
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, Alma Mater Studiorum
| | - Matteo Landolfo
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna
| | - Giuseppe Boriani
- Division of Cardiology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena
| | - Alessandra Dei Cas
- Endocrinology and Metabolism, Department of Clinical and Experimental Medicine, University of Parma, Parma
| | - Arrigo F G Cicero
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna
| | - Federica Fogacci
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna
| | - Claudio Rapezzi
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, Alma Mater Studiorum
| | - Giovanbattista Sisca
- Bologna F.C.,FIFA Medical Centre of Excellence, Isokinetic Medical Group, Bologna
| | | | - Marco Vitolo
- Division of Cardiology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena
| | - Nazzareno Galiè
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, Alma Mater Studiorum
| | - Claudio Borghi
- Department of Medicine and Surgery Sciences, University of Bologna, Bologna
| | | | - Massimo Piepoli
- Heart Failure Unit, Cardiology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Anna V Mattioli
- Department of Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena
| |
Collapse
|
32
|
Ma E, Ohira T, Sakai A, Yasumura S, Takahashi A, Kazama J, Shimabukuro M, Nakano H, Okazaki K, Maeda M, Yabe H, Suzuki Y, Kamiya K. Associations between Dietary Patterns and Cardiometabolic Risks in Japan: A Cross-Sectional Study from the Fukushima Health Management Survey, 2011-2015. Nutrients 2020; 12:nu12010129. [PMID: 31906499 PMCID: PMC7019971 DOI: 10.3390/nu12010129] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 12/27/2019] [Accepted: 12/30/2019] [Indexed: 12/17/2022] Open
Abstract
Cardiometabolic risks were increasing in Fukushima residents after the Great East Japan Earthquake. We examined the association between dietary patterns and cardiometabolic risks in those aged ≥16 years. Dietary patterns were derived by principal component analysis for participants who underwent at least one diet assessment using a short-form food frequency questionnaire during 2011–2013 and a health checkup in 2014 and 2015 (n = 15,409 and 14,999, respectively). In 2014, the adjusted prevalence ratio (PR) and 95% confidence interval (CI) in the highest versus lowest quartile of accumulative mean scores were 0.97 (0.96–0.99) for overweight/obesity, 0.96 (0.95–0.97) for total cholesterol (TC) ≥ 220 mg/dL, 0.96 (0.95–0.98) for low-density lipoprotein cholesterol (LDL-C) ≥ 140 mg/dL, and 0.97 (0.96–0.99) for triglycerides ≥ 150 mg/dL for a vegetable diet and 1.03 (1.01–1.04) for TC ≥ 220 mg/dL and 1.02 (1.01–1.04) for LDL-C ≥ 140 mg/dL for a juice/milk diet. In 2015, we found consistently significant associations for the vegetable and juice/milk diets, and the PR and 95% CI were 0.99 (0.98–1.00) for HDL-C < 40 mg/dL for a meat diet. The continuous promotion of the vegetable pattern diet is necessary to reduce cardiometabolic risks, particularly dyslipidemia, in Japan.
Collapse
Affiliation(s)
- Enbo Ma
- Health Promotion Center, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan;
- Department of Epidemiology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan; (H.N.); (K.O.)
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
- Correspondence: ; Tel.: +81-24-547-1788
| | - Tetsuya Ohira
- Health Promotion Center, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan;
- Department of Epidemiology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan; (H.N.); (K.O.)
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
| | - Akira Sakai
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
- Department of Radiation Life Sciences, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
- Department of Public Health, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Atsushi Takahashi
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
- Department of Gastroenterology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Junichiro Kazama
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
- Department of Nephrology and Hypertension, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Michio Shimabukuro
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
- Department of Diabetes, Endocrinology and Metabolism School of Medicine, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Hironori Nakano
- Department of Epidemiology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan; (H.N.); (K.O.)
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
| | - Kanako Okazaki
- Department of Epidemiology, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan; (H.N.); (K.O.)
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
| | - Masaharu Maeda
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
- Department of Disaster Psychiatry, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan
| | - Hirooki Yabe
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima 960-1295, Japan;
| | - Yuriko Suzuki
- Department of Adult Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8553, Japan;
| | - Kenji Kamiya
- Radiation Medical Science Center for Fukushima Health Management Survey, Fukushima Medical University, 1 Hikariga-oka, Fukushima 960-1295, Japan; (A.S.); (S.Y.); (A.T.); (J.K.); (M.S.); (M.M.); (K.K.)
| |
Collapse
|
33
|
Correale M, Paolillo S, Mercurio V, Limongelli G, Barillà F, Ruocco G, Palazzuoli A, Scrutinio D, Lagioia R, Lombardi C, Lupi L, Magrì D, Masarone D, Pacileo G, Scicchitano P, Matteo Ciccone M, Parati G, Tocchetti CG, Nodari S. Comorbidities in chronic heart failure: An update from Italian Society of Cardiology (SIC) Working Group on Heart Failure. Eur J Intern Med 2020; 71:23-31. [PMID: 31708358 DOI: 10.1016/j.ejim.2019.10.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 07/27/2019] [Accepted: 10/05/2019] [Indexed: 12/25/2022]
Abstract
The increasing number of patients with heart failure HF and comorbidities is due to aging population and increase of life expectancy of patients with cardiovascular disease. Encouraging results derived by recent trials may suggest some comorbidities as new targets for new drugs, highlighting the need for a better understanding of the comorbidities' effects in HF patients and the need of a multidisciplinary approach for the management of chronic HF with comorbidities. We report a brief review about main cardiovascular and non-cardiovascular comorbidities in HF patients in order to update physicians and researchers engaged in the HF research or in "fight against heart failure."
Collapse
Affiliation(s)
| | - Stefania Paolillo
- Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy
| | - Valentina Mercurio
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Giuseppe Limongelli
- Heart Failure Unit, AORN dei Colli, Monaldi Hospital, Naples, Italy; Department of Translational Medical Sciences, Luigi Vanvitelli University, Naples, Italy; Institute of Cardiovascular Sciences, University College of London, London, United Kingdom
| | - Francesco Barillà
- Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, Sapienza" University of Rome, Italy
| | - Gaetano Ruocco
- Cardiovascular Diseases Unit Department of Internal Medicine, University of Siena, Siena, Italy
| | - Alberto Palazzuoli
- Cardiovascular Diseases Unit Department of Internal Medicine, University of Siena, Siena, Italy
| | | | - Rocco Lagioia
- Cardiology Department, IRCCS "S. Maugeri" Cassano (BA), Bari, Italy
| | - Carolina Lombardi
- Istituto Auxologico Italiano, IRCCS, Sleep Disorders Center & Department of Cardiovascular, Neural and Metabolic Sciences. San Luca Hospital, Milan, Italy
| | - Laura Lupi
- Section of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Italy
| | - Damiano Magrì
- Department of Clinical and Molecular Medicine, University "La Sapienza", Rome, Italy
| | - Daniele Masarone
- Heart Failure Unit, AORN dei Colli, Monaldi Hospital, Naples, Italy
| | - Giuseppe Pacileo
- Heart Failure Unit, AORN dei Colli, Monaldi Hospital, Naples, Italy
| | - Pietro Scicchitano
- Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, University of Bari "A. Moro", Bari, Italy
| | - Marco Matteo Ciccone
- Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, University of Bari "A. Moro", Bari, Italy
| | - Gianfranco Parati
- Istituto Auxologico Italiano, IRCCS, Sleep Disorders Center & Department of Cardiovascular, Neural and Metabolic Sciences. San Luca Hospital, Milan, Italy
| | - Carlo G Tocchetti
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Savina Nodari
- Section of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Italy
| |
Collapse
|
34
|
Perrone MA, Gualtieri P, Gratteri S, Ali W, Sergi D, Muscoli S, Cammarano A, Bernardini S, Di Renzo L, Romeo F. Effects of postprandial hydroxytyrosol and derivates on oxidation of LDL, cardiometabolic state and gene expression: a nutrigenomic approach for cardiovascular prevention. J Cardiovasc Med (Hagerstown) 2019; 20:419-426. [PMID: 31593559 DOI: 10.2459/jcm.0000000000000816] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND AND AIM Cardiovascular diseases (CVDs) are the most frequent causes of death in the world. Inflammation and oxidative damage contribute significantly to the development of atherosclerosis and CVDs. European Food Safety Authority scientific opinion has acknowledged that hydroxytyrosol (3,4-dihydroxyphenylethanol) and derivatives, contained in extra virgin olive oil (EVOO), typically used in Mediterranean diet may play a crucial role in the reduction of the inflammatory pathway and in the prevention of CVDs. The aim of the study was to determine the effect in healthy volunteers of 25 g of phenols-rich EVOO (p-EVOO). METHODS The clinical study was a randomized, controlled trial to determine the acute effect in the postprandial time of 25 g of p-EVOO. We evaluated nutritional status using anthropometric parameters, body composition, serum metabolites, oxidative stress biomarkers and gene expression of eight genes related to oxidative stress and human inflammasome pathways, lasting 2 h after p-EVOO administration. Twenty-two participants resulted as eligible for the study. RESULTS A significant reduction of oxidized LDL, malondialdehyde, triglycerides and visceral adiposity index was highlighted (P < 0.05). Significant upregulation of catalase, superoxide dismutase 1 and upstream transcription factor 1 were observed (P < 0.05). CONCLUSION The current study shows that intake of 25 g of p-EVOO has been able to be modulated, in the postprandial time, the antioxidant profile and the expression of inflammation and oxidative stress-related genes, as superoxide dismutase 1, upstream transcription factor 1 and catalase. We also observed a significant reduction of oxidized LDL, malondialdehyde, triglycerides and visceral adiposity index. We have demonstrated that a daily intake of phenols and antioxidants can reduce the inflammatory pathway and oxidative stress and therefore the risk of atherosclerosis and CVDs. More studies on a larger population are necessary before definitive conclusions can be drawn.Trial registration ClinicalTrials.gov NCT01890070.
Collapse
Affiliation(s)
- Marco A Perrone
- Division of Cardiology.,Division of Clinical Biochemistry and Clinical Molecular Biology.,University Sports Centre
| | - Paola Gualtieri
- Division of Clinical Nutrition and Nutrigenomics, University of Rome Tor Vergata, Rome
| | - Santo Gratteri
- Department of Surgery and Medical Science, Magna Græcia University, Catanzaro, Germaneto, Italy
| | - Wahid Ali
- Department of Pathology, King George S. Medical University, Lucknow, Uttar Pradesh, India
| | | | | | - Andrea Cammarano
- Division of Clinical Nutrition and Nutrigenomics, University of Rome Tor Vergata, Rome
| | - Sergio Bernardini
- Division of Clinical Biochemistry and Clinical Molecular Biology.,University Sports Centre
| | - Laura Di Renzo
- Division of Clinical Nutrition and Nutrigenomics, University of Rome Tor Vergata, Rome
| | | |
Collapse
|
35
|
Matsuzono K, Mieno M, Fujimoto S. Ramen restaurant prevalence is associated with stroke mortality in Japan: an ecological study. Nutr J 2019; 18:53. [PMID: 31484549 PMCID: PMC6727387 DOI: 10.1186/s12937-019-0482-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Accepted: 08/30/2019] [Indexed: 11/23/2022] Open
Abstract
Background The association between stroke and nutrition has recently been investigated. However, the association between diet and stroke in Japan has not been clarified. We hypothesized that there may be an association between consumption of ramen and stroke mortality. Therefore, we investigated the association between the prevalence of ramen restaurants and stroke mortality in Japanese prefectures. Methods We used Pearson’s correlation coefficients to evaluate associations between the prevalence of each of four restaurant types (ramen, fast food, French or Italian, and udon or soba) and age- and sex-adjusted stroke mortality rates in each prefecture. We also investigated correlations between acute myocardial infarction and the prevalence of each type of restaurant as a control. We obtained age- and sex-adjusted stroke mortality rates and the acute myocardial infarction mortality rate in each prefecture from the 2017 Trends in National Health published in Japan. Data on the number of restaurants of each type in each prefecture were obtained from the database of the Nippon Telegraph and Telephone Corporation. Results The prevalence of ramen restaurants, but not of other restaurant types, positively correlated with stroke mortality in both men and women (r > 0.5). We found no correlation between ramen restaurant prevalence and mortality from acute myocardial infarction. Conclusion The prevalence of ramen restaurants in Japanese prefectures has a significant correlation with the stroke mortality rate. Electronic supplementary material The online version of this article (10.1186/s12937-019-0482-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Kosuke Matsuzono
- Division of Neurology, Department of Medicine, Jichi Medical University School of Medicine, Yakushiji 3311-1, Shimotsuke, Tochigi, 329-0498, Japan.
| | - Makiko Mieno
- Department of Medical Informatics, Center for Information, Jichi Medical University School of Medicine, Yakushiji 3311-1, Shimotsuke, Tochigi, 329-0498, Japan
| | - Shigeru Fujimoto
- Division of Neurology, Department of Medicine, Jichi Medical University School of Medicine, Yakushiji 3311-1, Shimotsuke, Tochigi, 329-0498, Japan
| |
Collapse
|
36
|
Abstract
OBJECTIVE To summarize the recent scientific evidence regarding the wellness-promoting capacity of the Mediterranean lifestyle (ML), with a special focus on physical, social and environmental wellness. DESIGN Narrative review of English-language publications in PubMed, Scopus and Embase, from 1 January 2010 to 31 October 2018. SETTING Prospective cohort studies, interventional studies, meta-analyses and reviews of those investigating the effect of at least one component of the ML on wellness parameters. PARTICIPANTS General population. RESULTS Although an explicit definition of ML is missing, compliance with various combinations of its components improves metabolic health and protects against or ameliorates disease state. However, there is heterogeneity in the healthy behaviours that the ML-focused studies include in their design and the way these are assessed. Also, despite that features of the ML could contribute to other wellness dimensions, there are no studies exploring the effect this healthy lifestyle could confer to them. CONCLUSIONS Chronic lifestyle diseases are of multifactorial aetiology and they warrant multifaceted approaches targeting the general way of living. ML, if thoroughly evaluated, can provide a valuable tool to holistically promote health and wellness.
Collapse
|
37
|
Di Francesco S, Robuffo I, Caruso M, Giambuzzi G, Ferri D, Militello A, Toniato E. Metabolic Alterations, Aggressive Hormone-Naïve Prostate Cancer and Cardiovascular Disease: A Complex Relationship. ACTA ACUST UNITED AC 2019; 55:medicina55030062. [PMID: 30866568 PMCID: PMC6473682 DOI: 10.3390/medicina55030062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 01/30/2019] [Accepted: 02/27/2019] [Indexed: 02/06/2023]
Abstract
Background: Epidemiological studies suggest a possible relationship between metabolic alterations, cardiovascular disease and aggressive prostate cancer, however, no clear consensus has been reached. Objective: The aim of the study was to analyze the recent literature and summarize our experience on the association between metabolic disorders, aggressive hormone-naïve prostate cancer and cardiovascular disease. Method: We identified relevant papers by searching in electronic databases such as Scopus, Life Science Journals, and Index Medicus/Medline. Moreover, we showed our experience on the reciprocal relationship between metabolic alterations and aggressive prostate cancer, without the influence of hormone therapy, as well the role of coronary and carotid vasculopathy in advanced prostate carcinoma. Results: Prostate cancer cells have an altered metabolic homeostatic control linked to an increased aggressivity and cancer mortality. The absence of discrimination of risk factors as obesity, systemic arterial hypertension, diabetes mellitus, dyslipidemia and inaccurate selection of vascular diseases as coronary and carotid damage at initial diagnosis of prostate cancer could explain the opposite results in the literature. Systemic inflammation and oxidative stress associated with metabolic alterations and cardiovascular disease can also contribute to prostate cancer progression and increased tumor aggressivity. Conclusions: Metabolic alterations and cardiovascular disease influence aggressive and metastatic prostate cancer. Therefore, a careful evaluation of obesity, diabetes mellitus, dyslipidemia, systemic arterial hypertension, together with a careful evaluation of cardiovascular status, in particular coronary and carotid vascular disease, should be carried out after an initial diagnosis of prostatic carcinoma.
Collapse
Affiliation(s)
- Simona Di Francesco
- Department of Medical and Oral Sciences and Biotechnologies, G. D'Annunzio University of Chieti-Pescara, 66100 Chieti, Italy.
- Department of Urological, Biomedical and Translational Sciences, Federiciana University, 87100 Cosenza, Italy.
| | - Iole Robuffo
- Institute of Molecular Genetics, National Research Council, Section of Chieti, 66100 Chieti, Italy.
| | - Marika Caruso
- Department of Medical and Oral Sciences and Biotechnologies, G. D'Annunzio University of Chieti-Pescara, 66100 Chieti, Italy.
- Department of Urological, Biomedical and Translational Sciences, Federiciana University, 87100 Cosenza, Italy.
| | - Giulia Giambuzzi
- Department of Medical and Oral Sciences and Biotechnologies, G. D'Annunzio University of Chieti-Pescara, 66100 Chieti, Italy.
| | - Deborah Ferri
- Department of Medical and Oral Sciences and Biotechnologies, G. D'Annunzio University of Chieti-Pescara, 66100 Chieti, Italy.
| | - Andrea Militello
- Department of Urological, Biomedical and Translational Sciences, Federiciana University, 87100 Cosenza, Italy.
- Urology and Andrology Section, Villa Immacolata Hospital, 01100 Viterbo, Italy.
| | - Elena Toniato
- Department of Medical and Oral Sciences and Biotechnologies, G. D'Annunzio University of Chieti-Pescara, 66100 Chieti, Italy.
| |
Collapse
|
38
|
Mattioli AV, Migaldi M, Farinetti A. Coffee in hypertensive women with asymptomatic peripheral arterial disease: a potential nutraceutical effect. J Cardiovasc Med (Hagerstown) 2018; 19:183-185. [PMID: 29489740 DOI: 10.2459/jcm.0000000000000626] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Anna V Mattioli
- Department of Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | | | | |
Collapse
|
39
|
Affiliation(s)
- Anna Vittoria Mattioli
- Department of Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| |
Collapse
|
40
|
Mattioli AV, Coppi F, Migaldi M, Farinetti A. Physical activity in premenopausal women with asymptomatic peripheral arterial disease. J Cardiovasc Med (Hagerstown) 2018; 19:677-680. [DOI: 10.2459/jcm.0000000000000714] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
|
41
|
Sciomer S, Moscucci F, Maffei S, Gallina S, Mattioli AV. Prevention of cardiovascular risk factors in women: The lifestyle paradox and stereotypes we need to defeat. Eur J Prev Cardiol 2018; 26:609-610. [PMID: 30373379 DOI: 10.1177/2047487318810560] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- S Sciomer
- 1 Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, University of Rome "Sapienza", Italy
| | - F Moscucci
- 1 Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, University of Rome "Sapienza", Italy
| | - S Maffei
- 2 Cardiovascular and Gynaecological Endocrinology, Fondazione Toscana 'G. Monasterio' for Clinical Research and Public Health, Italy
| | - S Gallina
- 3 Department of Neuroscience and Imaging, "G. d'Annunzio", University of Chieti-Pescara, Italy
| | - A V Mattioli
- 4 Department of Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Italy
| |
Collapse
|
42
|
Archero F, Ricotti R, Solito A, Carrera D, Civello F, Di Bella R, Bellone S, Prodam F. Adherence to the Mediterranean Diet among School Children and Adolescents Living in Northern Italy and Unhealthy Food Behaviors Associated to Overweight. Nutrients 2018; 10:E1322. [PMID: 30231531 PMCID: PMC6165180 DOI: 10.3390/nu10091322] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 09/11/2018] [Accepted: 09/12/2018] [Indexed: 02/06/2023] Open
Abstract
The purposes of this study were to evaluate the differences in Mediterranean diet and its components among primary and secondary school children and adolescents living in northern Italy, and the associations with the weight status. Adherence was assessed by the KIDMED (Mediterranean Diet Quality Index) questionnaire on 669 subjects (6⁻16 years) attending five schools of Novara. The adherence was poor in 16.7%, average in 63.7%, and high in 19.6% of the students. Poor adherence was more frequent in primary than in secondary schools (20.7% vs. 13.7%, p < 0.04). Some unhealthy behaviors were more prevalent in younger children. Children of other ethnic origins had a mixed behavior, choosing both traditional healthy and unhealthy foods. Besides male gender and primary school, in Italian children, the risk of overweight was directly associated with eating at fast-food restaurants (OR: 1.890, CI 95% 1.002⁻3.563), and inversely with consumption of vegetables more than once a day (OR: 0.588, CI 95% 0.349⁻0.991), and olive oil at home (OR: 0.382, CI 95% 0.176⁻0.826). In children of other ethnic origins, this risk was associated with skipping breakfast (OR: 16.046, CI 95% 1.933⁻133.266), or consuming commercial baked good or pastries for breakfast (OR: 10.255, CI 95% 1.052⁻99.927). The overall KIDMED score correlated with height (β: 0.108; p < 0.005). Poor food quality is replacing the Mediterranean dietary pattern in children and adolescents, in particular among younger children. Because the risk of overweight was associated with different components of the Mediterranean diet depending on ethnic origins, tailored nutritional programs remain a need.
Collapse
Affiliation(s)
- Francesca Archero
- SCDU of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy.
| | - Roberta Ricotti
- SCDU of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy.
| | - Arianna Solito
- SCDU of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy.
| | - Deborah Carrera
- SCDO of Clinical Nutrition and Dietetics, Maggiore della Carità Hospital, 28100 Novara, Italy.
| | - Federica Civello
- SCDU of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy.
| | - Rosina Di Bella
- SCDU of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy.
| | - Simonetta Bellone
- SCDU of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy.
- Interdisciplinary Research Center of Autoimmune Diseases, University of Piemonte Orientale, 28100 Novara, Italy.
| | - Flavia Prodam
- SCDU of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy.
- Interdisciplinary Research Center of Autoimmune Diseases, University of Piemonte Orientale, 28100 Novara, Italy.
- Endocrinology, Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy.
| |
Collapse
|
43
|
Puaschitz NG, Assmus J, Strand E, Karlsson T, Vinknes KJ, Lysne V, Drevon CA, Tell GS, Dierkes J, Nygård O. Adherence to the Healthy Nordic Food Index and the incidence of acute myocardial infarction and mortality among patients with stable angina pectoris. J Hum Nutr Diet 2018; 32:86-97. [PMID: 30091209 DOI: 10.1111/jhn.12592] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND The Healthy Nordic Food Index (HNFI) has been associated with beneficial effects on markers of cardiovascular disease (CVD). Whether such effects are present among patients with established coronary heart disease is unknown. In the present study, we investigated the association between adherence to the HNFI and the risk of acute myocardial infarction (AMI) (fatal or nonfatal) and death among patients with stable angina pectoris. METHODS In the Western Norway B-vitamin Intervention Trial, participants completed a 169-item semi-quantitative food frequency questionnaire. The HNFI was calculated from six food groups (fish, cabbage, apples/pears, root vegetables, whole grain bread and oatmeal), scoring 0-6. Three adherence groups were defined: 0-1 points (low), 2-3 points (medium) or 4-6 points (high). Cox regression analyses investigated associations between adherence to the HNFI and outcomes. RESULTS Among 2019 men (79.7%) and women with mean age of 61.7 years, 307 patients experienced an AMI event during a median (25th and 75th percentiles) follow-up of 7.5 (6.3 and 8.7) years. Median follow-up for total mortality was 10.5 (9.3 and 11.7) years; 171 patients died from CVD and 380 from any cause. No association between HNFI and the risk of AMI was detected. However, the HNFI was associated with a reduced risk of all-cause death, both by linear estimates [hazard ratio (95% confidence interval = 0.91 (0.84-0.98)] and by comparison of the highest with the lowest adherence group [hazard ratio (95% confidence interval = 0.70 (0.52-0.95)]. CONCLUSIONS The results of the present study suggest that a Healthy Nordic diet may reduce mortality in patients with established CVD.
Collapse
Affiliation(s)
- N G Puaschitz
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - J Assmus
- Department of Research and Development, Haukeland University Hospital, Bergen, Norway
| | - E Strand
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - T Karlsson
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - K J Vinknes
- Department of Nutrition, Faculty of Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - V Lysne
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - C A Drevon
- Department of Nutrition, Faculty of Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - G S Tell
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Division of Mental and Physical Health, Department of Non-Communicable Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - J Dierkes
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - O Nygård
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.,KG Jebsen Centre for Diabetes Research, Department of Clinical Science, University of Bergen, Bergen, Norway
| |
Collapse
|
44
|
Ghisi GLDM, Mahajan A, da Silva Chaves GS, Rouse V, Brum M, Ajwani F, Aultman C, Ricupero M, Oh P, Colella TJF. Validation of a self-administered version of the Mediterranean diet scale (MDS) for cardiac rehabilitation patients in Canada. Int J Food Sci Nutr 2018; 70:202-211. [DOI: 10.1080/09637486.2018.1486392] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Gabriela Lima de Melo Ghisi
- Cardiovascular Prevention and Rehabilitation Program University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada
| | - Anisha Mahajan
- Brain and Spinal Cord Rehabilitation Program Toronto Rehabilitation Institute University Health Network, Toronto, ON, Canada
- South Asian Adolescents Diabetes Awareness Program (SAADAP), University of Toronto, Toronto, ON, Canada
| | | | - Veronica Rouse
- Cardiovascular Prevention and Rehabilitation Program University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada
| | - Margaret Brum
- Toronto Western Hospital Ambulatory Cardiac Clinic and University Health Network Cardiovascular Prevention and Rehabilitation Clinic, Toronto, ON, Canada
| | - Fatim Ajwani
- Cardiovascular Prevention and Rehabilitation Program University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada
| | - Crystal Aultman
- Cardiovascular Prevention and Rehabilitation Program University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada
| | - Maria Ricupero
- Endocrine & Mental Health Clinics, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Paul Oh
- Cardiovascular Prevention and Rehabilitation Program University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada
| | - Tracey J. F. Colella
- Cardiovascular Prevention and Rehabilitation Program University Health Network Toronto Rehabilitation Institute, Toronto, ON, Canada
| |
Collapse
|
45
|
Machine Learning-Augmented Propensity Score-Adjusted Multilevel Mixed Effects Panel Analysis of Hands-On Cooking and Nutrition Education versus Traditional Curriculum for Medical Students as Preventive Cardiology: Multisite Cohort Study of 3,248 Trainees over 5 Years. BIOMED RESEARCH INTERNATIONAL 2018; 2018:5051289. [PMID: 29850526 PMCID: PMC5925138 DOI: 10.1155/2018/5051289] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 02/28/2018] [Indexed: 01/01/2023]
Abstract
Background Cardiovascular disease (CVD) annually claims more lives and costs more dollars than any other disease globally amid widening health disparities, despite the known significant reductions in this burden by low cost dietary changes. The world's first medical school-based teaching kitchen therefore launched CHOP-Medical Students as the largest known multisite cohort study of hands-on cooking and nutrition education versus traditional curriculum for medical students. Methods This analysis provides a novel integration of artificial intelligence-based machine learning (ML) with causal inference statistics. 43 ML automated algorithms were tested, with the top performer compared to triply robust propensity score-adjusted multilevel mixed effects regression panel analysis of longitudinal data. Inverse-variance weighted fixed effects meta-analysis pooled the individual estimates for competencies. Results 3,248 unique medical trainees met study criteria from 20 medical schools nationally from August 1, 2012, to June 26, 2017, generating 4,026 completed validated surveys. ML analysis produced similar results to the causal inference statistics based on root mean squared error and accuracy. Hands-on cooking and nutrition education compared to traditional medical school curriculum significantly improved student competencies (OR 2.14, 95% CI 2.00–2.28, p < 0.001) and MedDiet adherence (OR 1.40, 95% CI 1.07–1.84, p = 0.015), while reducing trainees' soft drink consumption (OR 0.56, 95% CI 0.37–0.85, p = 0.007). Overall improved competencies were demonstrated from the initial study site through the scale-up of the intervention to 10 sites nationally (p < 0.001). Discussion This study provides the first machine learning-augmented causal inference analysis of a multisite cohort showing hands-on cooking and nutrition education for medical trainees improves their competencies counseling patients on nutrition, while improving students' own diets. This study suggests that the public health and medical sectors can unite population health management and precision medicine for a sustainable model of next-generation health systems providing effective, equitable, accessible care beginning with reversing the CVD epidemic.
Collapse
|
46
|
Mische LJ, Mowry EM. The Evidence for Dietary Interventions and Nutritional Supplements as Treatment Options in Multiple Sclerosis: a Review. Curr Treat Options Neurol 2018; 20:8. [PMID: 29549521 DOI: 10.1007/s11940-018-0494-5] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
PURPOSE OF REVIEW This review aims to critically evaluate published studies examining diets and nutritional supplements (excepting vitamin D) for the impact on prevention and prognosis of multiple sclerosis (MS). RECENT FINDINGS There is a negative relationship between the Mediterranean diet and vascular disease, and vascular co-morbidities are associated with a worse MS prognosis. Low-fat, fish-based diets, sodium-restricted diets, calorie restriction, the paleo diet, and gluten-free diets have been examined, mostly in observational studies; results are inconclusive. With regard to nutritional supplements, pilot data show a possible benefit of biotin with respect to disability worsening in people with progressive MS (PMS). The best designed randomized controlled trials (RCTs) for PUFA supplementation have not shown significant impact, but several weaker RCTs have. Many other nutritional supplements have been tested, including several anti-oxidants. While some early studies show positive results, no result has been definitive. Unfortunately, there is no strong evidence for a direct benefit of any given dietary intervention on MS risk or prognosis. However, due to its relationship with vascular co-morbidities, the Mediterranean diet has the strongest rationale for employment in PwMS. Higher-quality clinical trials are needed to ascertain the possible benefits of nutritional supplements.
Collapse
Affiliation(s)
- Leah J Mische
- Johns Hopkins School of Medicine, 733 North Broadway, Baltimore, MD, 21205, USA.
| | - Ellen M Mowry
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, 21218, USA
| |
Collapse
|
47
|
Affiliation(s)
- Sharon A Watts
- Sharon A. Watts is an NP in endocrinology at the Louis Stokes Cleveland VA Medical Center in Cleveland, Ohio, and is the Metabolic Syndrome and Diabetes Advisor for the Office of Nursing Services Veterans Affairs in Washington, D.C. Carl Stevenson is a staff RN at the Boise VA Medical Center in Boise, Idaho. Julianne Patterson is an RN certified diabetes educator at the VA Central Iowa Health Care System in Des Moines, Iowa
| | | | | |
Collapse
|
48
|
Affiliation(s)
- Anna Vittoria Mattioli
- Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Italy.
| | - Alberto Farinetti
- Surgical, Medical and Dental Department of Morphological Sciences Related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Italy
| |
Collapse
|
49
|
Fanelli Kuczmarski M, Bodt BA, Stave Shupe E, Zonderman AB, Evans MK. Dietary Patterns Associated with Lower 10-Year Atherosclerotic Cardiovascular Disease Risk among Urban African-American and White Adults Consuming Western Diets. Nutrients 2018; 10:E158. [PMID: 29385036 PMCID: PMC5852734 DOI: 10.3390/nu10020158] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 01/09/2018] [Accepted: 01/28/2018] [Indexed: 02/07/2023] Open
Abstract
The study's objective was to determine whether variations in the 2013 American College of Cardiology/American Heart Association 10-year risk for atherosclerotic cardiovascular disease (ASCVD) were associated with differences in food consumption and diet quality. Findings from the baseline wave of Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study 2004-2009, revealed participants consumed a Western diet. Diet quality measures, specifically the Healthy Eating Index (HEI)-2010, Dietary Approaches to Stop Hypertension (DASH) diet and the Mean Adequacy Ratio (MAR), based on two 24-h recalls collected during follow-up HANDLS studies from 2009-2013, were used. Reported foods were assigned to 27 groups. In this cross-sectional analysis, the participants (n = 2140) were categorized into tertiles based on their 10-year ASCVD risk. Lower and upper tertiles were used to determine significantly different consumption rates among the food groups. Ten groups were used in hierarchical case clustering to generate four dietary patterns (DPs) based on group energy contribution. The DP with the highest HEI-2010 score included sandwiches along with vegetables and cheese/yogurt. This DP, along with the pizza/sandwiches DP, had significantly higher DASH and MAR scores and a lower 10-year ASCVD risk, compared to the remaining two DPs-meats/sandwiches and sandwiches/bakery products; thus, Western dietary patterns were associated with different levels of ASCVD 10-year risk.
Collapse
Affiliation(s)
| | - Barry A Bodt
- College of Health Sciences, STAR, University of Delaware, Newark, DE 19716, USA.
| | - Emily Stave Shupe
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, DE 19716, USA.
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institute of Health, Baltimore, MD 21224, USA.
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institute of Health, Baltimore, MD 21224, USA.
| |
Collapse
|
50
|
Cacabelos R, Lombardi V, Fernández-Novoa L, Carrera I, Cacabelos P, Corzo L, Carril JC, Teijido O. Basic and Clinical Studies With Marine LipoFishins and Vegetal Favalins in Neurodegeneration and Age-Related Disorders. STUDIES IN NATURAL PRODUCTS CHEMISTRY 2018. [DOI: 10.1016/b978-0-444-64179-3.00006-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|