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Norwitz NG, Czeisler MÉ, Delichatsios HK, Hoenig MP, Cywes R. Metabolic Health Immersion for Medical Education: A Pilot Program with Continuous Glucose Monitors in Medical and Dental Students. Am J Lifestyle Med 2023; 17:782-790. [PMID: 38511113 PMCID: PMC10948922 DOI: 10.1177/15598276221119989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024] Open
Abstract
Diet-related chronic diseases are increasing in prevalence and poised to dominate the future careers of current medical students. While the value of nutritionally-informed care and nutrition-based health interventions is increasingly recognized, nutrition education is inconsistently and often inadequately included in medical school curricula. One obstacle to incorporating nutrition into medical and dental school curricula is the density of existing coursework, with incorporation of new material necessitating removal of other material. One solution is to engage students outside the classroom in immersive education in nutrition and metabolism using health-wearables. We report the Metabolic Health Immersion for Medical Education pilot program, spearheaded and designed by Harvard Medical students centering on use of continuous glucose monitors (CGM). Students reported enjoyment with the study, felt encouraged to improve health behaviors, and shared that the experience enhanced their understanding of nutrition and metabolism, was valuable to their medical education, and would influence their future patient care. This study demonstrates proof-of-principle that metabolic health immersion opportunities for health care trainees provide a means of helping to address the current deficit in medical school nutrition education.
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Affiliation(s)
- Nicholas G. Norwitz
- Harvard Medical School, Boston, MA, USA (NGN, MEC, HKD, MPH); Massachusetts General Hospital, Boston, MA, USA (HKD); Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA (MPH); JSAPA, Metabolic and Surgery Center, Jupiter, FL, USA (RC)
| | - Mark É. Czeisler
- Harvard Medical School, Boston, MA, USA (NGN, MEC, HKD, MPH); Massachusetts General Hospital, Boston, MA, USA (HKD); Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA (MPH); JSAPA, Metabolic and Surgery Center, Jupiter, FL, USA (RC)
| | - Helen K. Delichatsios
- Harvard Medical School, Boston, MA, USA (NGN, MEC, HKD, MPH); Massachusetts General Hospital, Boston, MA, USA (HKD); Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA (MPH); JSAPA, Metabolic and Surgery Center, Jupiter, FL, USA (RC)
| | - Melanie P. Hoenig
- Harvard Medical School, Boston, MA, USA (NGN, MEC, HKD, MPH); Massachusetts General Hospital, Boston, MA, USA (HKD); Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA (MPH); JSAPA, Metabolic and Surgery Center, Jupiter, FL, USA (RC)
| | - Robert Cywes
- Harvard Medical School, Boston, MA, USA (NGN, MEC, HKD, MPH); Massachusetts General Hospital, Boston, MA, USA (HKD); Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA (MPH); JSAPA, Metabolic and Surgery Center, Jupiter, FL, USA (RC)
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Barungi S, Hernández-Camarero P, Moreno-Terribas G, Villalba-Montoro R, Marchal JA, López-Ruiz E, Perán M. Clinical implications of inflammation in atheroma formation and novel therapies in cardiovascular diseases. Front Cell Dev Biol 2023; 11:1148768. [PMID: 37009489 PMCID: PMC10061140 DOI: 10.3389/fcell.2023.1148768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/06/2023] [Indexed: 03/18/2023] Open
Abstract
Cardiovascular diseases (CVD) are the leading causes of death and disability in the world. Among all CVD, the most common is coronary artery disease (CAD). CAD results from the complications promoted by atherosclerosis, which is characterized by the accumulation of atherosclerotic plaques that limit and block the blood flow of the arteries involved in heart oxygenation. Atherosclerotic disease is usually treated by stents implantation and angioplasty, but these surgical interventions also favour thrombosis and restenosis which often lead to device failure. Hence, efficient and long-lasting therapeutic options that are easily accessible to patients are in high demand. Advanced technologies including nanotechnology or vascular tissue engineering may provide promising solutions for CVD. Moreover, advances in the understanding of the biological processes underlying atherosclerosis can lead to a significant improvement in the management of CVD and even to the development of novel efficient drugs. To note, over the last years, the observation that inflammation leads to atherosclerosis has gained interest providing a link between atheroma formation and oncogenesis. Here, we have focused on the description of the available therapy for atherosclerosis, including surgical treatment and experimental treatment, the mechanisms of atheroma formation, and possible novel therapeutic candidates such as the use of anti-inflammatory treatments to reduce CVD.
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Affiliation(s)
- Shivan Barungi
- Department of Health Sciences, University of Jaén, Jaén, Spain
| | | | | | | | - Juan Antonio Marchal
- Centre for Biomedical Research (CIBM), Biopathology and Regenerative Medicine Institute (IBIMER), University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Department of Human Anatomy and Embryology, Faculty of Medicine, University of Granada, Granada, Spain
- Excellence Research Unit “Modeling Nature” (MNat), University of Granada, Granada, Spain
| | - Elena López-Ruiz
- Department of Health Sciences, University of Jaén, Jaén, Spain
- Excellence Research Unit “Modeling Nature” (MNat), University of Granada, Granada, Spain
- *Correspondence: Elena López-Ruiz, ; Macarena Perán,
| | - Macarena Perán
- Department of Health Sciences, University of Jaén, Jaén, Spain
- Centre for Biomedical Research (CIBM), Biopathology and Regenerative Medicine Institute (IBIMER), University of Granada, Granada, Spain
- Excellence Research Unit “Modeling Nature” (MNat), University of Granada, Granada, Spain
- *Correspondence: Elena López-Ruiz, ; Macarena Perán,
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Linking Heart Health and Mental Wellbeing: Centering Indigenous Perspectives from across Canada. J Clin Med 2022; 11:jcm11216485. [PMID: 36362713 PMCID: PMC9657304 DOI: 10.3390/jcm11216485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/20/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022] Open
Abstract
Indigenous peoples have thrived since time immemorial across North America; however, over the past three to four generations there has been a marked increase in health disparities amongst Indigenous peoples versus the general population. Heart disease and mental health issues have been well documented and appear to be interrelated within Indigenous peoples across Canada. However, Western medicine has yet to clearly identify the reasons for the increased prevalence of heart disease and mental health issues and their relationship. In this narrative review, we discuss how Indigenous perspectives of health and wholistic wellness may provide greater insight into the connection between heart disease and mental wellbeing within Indigenous peoples and communities across Canada. We argue that colonization (and its institutions, such as the Indian Residential School system) and a failure to include or acknowledge traditional Indigenous health and wellness practices and beliefs within Western medicine have accelerated these health disparities within Indigenous peoples. We summarize some of the many Indigenous cultural perspectives and wholistic approaches to heart health and mental wellbeing. Lastly, we provide recommendations that support and wholistic perspective and Indigenous peoples on their journey of heart health and mental wellbeing.
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Mounika A, Ilangovan B, Mandal S, Shraddha Yashwant W, Priya Gali S, Shanmugam A. Prospects of ultrasonically extracted food bioactives in the field of non-invasive biomedical applications - A review. ULTRASONICS SONOCHEMISTRY 2022; 89:106121. [PMID: 35987106 PMCID: PMC9403563 DOI: 10.1016/j.ultsonch.2022.106121] [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: 04/28/2022] [Revised: 07/27/2022] [Accepted: 08/10/2022] [Indexed: 05/15/2023]
Abstract
Foods incorporated with bioactive compounds, called nutraceuticals, can fight or prevent or alleviate diseases. The contribution of nutraceuticals or phytochemicals to non-invasive biomedical applications is increasing. Although there are many traditional methods for extracting bioactive compounds or secondary metabolites, these processes come with many disadvantages like lower yield, longer process time, high energy consumption, more usage of solvent, yielding low active principles with low efficacy against diseases, poor quality, poor mass transfer, higher extraction temperature, etc. However, nullifying all these disadvantages of a non-thermal technology, ultrasound has played a significant role in delivering them with higher yield and improved bio-efficacy. The physical and chemical effects of acoustic cavitation are the crux of the output. This review paper primarily discusses the ultrasound-assisted extraction (USAE) of bioactives in providing non-invasive prevention and cure to diseases and bodily dysfunctions in human and animal models. The outputs of non-invasive bioactive components in terms of yield and the clinical efficacy in either in vitro or in vitro conditions are discussed in detail. The non-invasive biomedical applications of USAE bioactives providing anticancer, antioxidant, cardiovascular health, antidiabetic, and antimicrobial benefits are analyzed in-depth and appraised. This review additionally highlights the improved performance of USAE compounds against conventionally extracted compounds. In addition, an exhaustive analysis is performed on the role and application of the food bioactives in vivo and in vitro systems, mainly for promoting these efficient USAE bioactives in non-invasive biomedical applications. Also, the review explores the recovery of bioactives from the less explored food sources like cactus pear fruit, ash gourd, sweet granadilla, basil, kokum, baobab, and the food processing industrial wastes like peel, pomace, propolis, wine residues, bran, etc., which is rare in literature.
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Affiliation(s)
- Addanki Mounika
- Food Processing Business Incubation Centre, National Institute of Food Technology, Entrepreneurship and Management - Thanjavur, India
| | - Bhaargavi Ilangovan
- Food Processing Business Incubation Centre, National Institute of Food Technology, Entrepreneurship and Management - Thanjavur, India
| | - Sushmita Mandal
- Food Processing Business Incubation Centre, National Institute of Food Technology, Entrepreneurship and Management - Thanjavur, India
| | - Waghaye Shraddha Yashwant
- Food Processing Business Incubation Centre, National Institute of Food Technology, Entrepreneurship and Management - Thanjavur, India
| | - Swetha Priya Gali
- Food Processing Business Incubation Centre, National Institute of Food Technology, Entrepreneurship and Management - Thanjavur, India
| | - Akalya Shanmugam
- Food Processing Business Incubation Centre, National Institute of Food Technology, Entrepreneurship and Management - Thanjavur, India; Centre of Excellence in Non-Thermal Processing, National Institute of Food Technology, Entrepreneurship and Management - Thanjavur, India.
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Vanegas P, Zazpe I, Santiago S, Fernandez-Lazaro CI, de la O V, Martínez-González MÁ. Macronutrient quality index and cardiovascular disease risk in the Seguimiento Universidad de Navarra (SUN) cohort. Eur J Nutr 2022; 61:3517-3530. [PMID: 35597843 PMCID: PMC9464119 DOI: 10.1007/s00394-022-02901-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 04/27/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE To assess the association between a multi-dimensional Macronutrient Quality Index (MQI) and the risk of cardiovascular disease (CVD) in a Mediterranean cohort. METHODS Prospective analyses among 18,418 participants (mean age 36 years, 60.8% women) of the Seguimiento Universidad de Navarra (SUN) cohort. Dietary intake information was obtained through a validated semi-quantitative food-frequency questionnaire (FFQ). The MQI (expressing high-quality macronutrient intake) was calculated based on three previously reported quality indices: the Carbohydrate Quality Index (CQI), the Fat Quality Index (FQI), and the Healthy Plate Protein source Quality Index (HPPQI). Adherence to the Mediterranean diet (MedDiet) and Provegetarian Diet was evaluated using the Trichopoulou index and the score proposed by Martínez-González, respectively. CVD was defined as new-onset stroke, myocardial infarction, or CVD death. RESULTS After a median follow-up time of 14 years (211,744 person-years), 171 cases of CVD were identified. A significant inverse association was found between the MQI and CVD risk with multivariable-adjusted HR for the highest vs. the lowest quartile of 0.60 (95% IC, 0.38-0.96; Ptrend = 0.024). CONCLUSION In this Mediterranean cohort, we found a significant inverse relationship between a multidimensional MQI (expressing high-quality macronutrient intake) and a lower risk of CVD.
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Affiliation(s)
- Paola Vanegas
- School of Pharmacy and Nutrition, Department of Nutrition and Food Sciences and Physiology, University of Navarra, Campus Universitario, 31080 Pamplona, Spain
| | - Itziar Zazpe
- School of Pharmacy and Nutrition, Department of Nutrition and Food Sciences and Physiology, University of Navarra, Campus Universitario, 31080 Pamplona, Spain ,School of Medicine, Department of Preventive Medicine and Public Health, University of Navarra, Campus Universitario, 31080 Pamplona, Spain ,IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Navarra Spain ,CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Susana Santiago
- School of Pharmacy and Nutrition, Department of Nutrition and Food Sciences and Physiology, University of Navarra, Campus Universitario, 31080 Pamplona, Spain ,IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Navarra Spain
| | - Cesar I. Fernandez-Lazaro
- School of Medicine, Department of Preventive Medicine and Public Health, University of Navarra, Campus Universitario, 31080 Pamplona, Spain ,IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Navarra Spain
| | - Víctor de la O
- School of Medicine, Department of Preventive Medicine and Public Health, University of Navarra, Campus Universitario, 31080 Pamplona, Spain ,IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Navarra Spain ,CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Miguel Ángel Martínez-González
- School of Medicine, Department of Preventive Medicine and Public Health, University of Navarra, Campus Universitario, 31080, Pamplona, Spain. .,IdiSNA, Instituto de Investigación Sanitaria de Navarra, Pamplona, Navarra, Spain. .,CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. .,Department of Nutrition, Harvard T.H Chan School of Public Health, Boston, MA, USA.
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Effects of Calorie Restriction on Health Span and Insulin Resistance: Classic Calorie Restriction Diet vs. Ketosis-Inducing Diet. Nutrients 2021; 13:nu13041302. [PMID: 33920973 PMCID: PMC8071299 DOI: 10.3390/nu13041302] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/09/2021] [Accepted: 04/13/2021] [Indexed: 12/31/2022] Open
Abstract
As the incidence of Chronic Non-Communicable Diseases (CNCDs) increases, preventive approaches become more crucial. In this review, calorie restriction (CR) effects on human beings were evaluated, comparing the benefits and risks of different CR diets: classic CR vs. ketosis-inducing diets, including intermittent fasting (IF), classic ketogenic diet (CKD), fasting mimicking diet (FMD), very-low-calorie ketogenic Diet (VLCKD) and Spanish ketogenic Mediterranean diet (SKMD). Special emphasis on insulin resistance (IR) was placed, as it mediates metabolic syndrome (MS), a known risk factor for CNCD, and is predictive of MS diagnosis. CR is the most robust intervention known to increase lifespan and health span, with high evidence and known biochemical mechanisms. CR improves cardiometabolic risk parameters, boosts exercise insulin sensitivity response, and there may be benefits of implementing moderate CR on healthy young and middle-aged individuals. However, there is insufficient evidence to support long-term CR. CKD is effective for weight and MS management, and may have additional benefits such as prevention of muscle loss and appetite control. SKMD has extreme significance benefits for all the metabolic parameters studied. Studies show inconsistent benefits of IF compared to classic CR. More studies are required to study biochemical parameters, reinforce evidence, identify risks, and seek effective and safe nutritional CR approaches.
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Micek A, Raźny U, Paweł K. Association between health risk factors and dietary flavonoid intake in cohort studies. Int J Food Sci Nutr 2021; 72:1019-1034. [PMID: 33827357 DOI: 10.1080/09637486.2021.1908965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The aim of this study was to identify the health risk factors associated with flavonoid intake in cohort studies investigating the association between dietary polyphenols and the risk of cardiovascular disease (CVD). A systematic search of the PubMed and EMBASE databases was performed. Prospective studies with the background characteristics given for categories of flavonoid intake were eligible to inclusion. A bivariate meta-analysis summarising the intercepts and slopes of the linear regression and a dose-response meta-analysis of differences in means were used to analyse the relationships. The intake of total flavonoids was inversely associated with BMI, alcohol consumption, saturated fat intake, and current smoking, and positively associated with vitamin E, folate, fibre, beta-carotene intake, multivitamin supplement use, and high physical activity. The results of this study underline the importance of considering the association between dietary flavonoid consumption and CVD risk in the context of a healthy lifestyle.
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Affiliation(s)
- Agnieszka Micek
- Faculty of Health Sciences, Institute of Nursing and Midwifery, Department of Nursing Management and Epidemiology Nursing, Jagiellonian University Medical College, Krakow, Poland
| | - Urszula Raźny
- Faculty of Medicine, Department of Clinical Biochemistry, Jagiellonian University Medical College, Krakow, Poland
| | - Kawalec Paweł
- Faculty of Health Sciences, Institute of Public Health, Department of Nutrition and Drug Research, Jagiellonian University Medical College, Krakow, Poland
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