Nutritional recommendations for cardiovascular disease prevention

Associations between cardiac rehabilitation structure and processes and dietary habits after myocardial infarction: a nationwide registry study

AIMS

Improved dietary habits are important for successful secondary prevention after myocardial infarction (MI), with counselling and support on healthy dietary habits constituting a cornerstone of cardiac rehabilitation (CR). However, there is limited knowledge on how to optimize CR organization to motivate patients to adopt healthy dietary habits. We aimed to explore associations between CR programme structure, processes, and self-reported dietary habits 1 year post-MI.

METHODS AND RESULTS

Organizational data from 73 Swedish CR centres and patient-level data from 5248 CR patients were analysed using orthogonal partial least squares discriminant analysis to identify predictors for healthy dietary habits. Variables of importance for the projection (VIP) values exceeding 0.80 were considered meaningful. Key predictors included the CR centre having a medical director [VIP (95% confidence interval)] [1.86 (1.1-2.62)], high self-reported team spirit [1.63 (1.29-1.97)], nurses have formal training in counselling methods [1.20 (0.75-1.65)], providing discharge information on risk factors [2.23 (1.82-2.64)] and lifestyle [1.81 (1.31-2.31)], time dedicated to patient interaction during follow-up [1.60 (0.80-2.40)], and centres aiming for patients to have the same nurse throughout follow-up [1.54 (1.17-1.91)]. The more positive predictors a CR centre reported to follow, the further improvement in patient-level dietary habits, were analysed by multivariable regression analysis [odds ratio for each additional positive predictor reported 1.03 (1.02-1.05), P < 0.001].

CONCLUSION

Several variables related to CR structure and processes were identified as predictors for patients reporting healthier dietary habits. These findings offer guidance for CR centres in resource allocation and optimizing patient benefits of CR attendance.

Pulse wave analysis as a tool to assess endothelial function following lipid lowering intervention in hypercholesterolemia

BACKGROUND

Pulse wave analysis (PWA) assesses endothelial dependent vasodilation (EDV) via the change in augmentation index (AIx) and has been used as a tool to assess endothelial function. However, its effectiveness in assessing the response to lipid lowering treatment has not been evaluated. The study aimed to describe and correlate the change in EDV following lipid lowering intervention in patients with hypercholesterolemia.

METHODS

48 newly diagnosed patients with hypercholesterolemia underwent 6 months intervention with statin and/or therapeutic lifestyle changes (TLC) in clinical setting. Lipid profile measurement and endothelial function assessment using PWA were performed pre- and post-intervention.

RESULTS

Significant reductions in low density lipoprotein cholesterol (LDL-C), non-high density lipoprotein cholesterol (non-HDL-C) and total cholesterol (TC) with corresponding significant improvement in EDV (2.94 ± 3.69 % to 7.50 ± 3.79 %, p < 0.001) were observed following intervention. Sub-analyses revealed greater LDL-C reductions and EDV improvements in the statin group compared to TLC. There was a significant inverse correlation between the change in EDV and the change in LDL-C after intervention (r = -0.298, p = 0.040).

CONCLUSION

Endothelial function assessed by PWA showed a parallel change with lipid profile pattern following lipid lowering intervention. The simple and non-invasive method may provide a potential tool for evaluating endothelial function and treatment outcomes in patients with hypercholesterolemia.

Time-Restricted Feeding Reduces Atherosclerosis in LDLR KO Mice but Not in ApoE Knockout Mice

BACKGROUND

Dyslipidemia increases cardiovascular disease risk, the leading cause of death worldwide. Under time-restricted feeding (TRF), wherein food intake is restricted to a consistent window of <12 hours, weight gain, glucose intolerance, inflammation, dyslipidemia, and hypercholesterolemia are all reduced in mice fed an obesogenic diet. LDLR (low-density lipoprotein receptor) mutations are a major cause of familial hypercholesterolemia and early-onset cardiovascular disease.

METHODS

We subjected benchmark preclinical models, mice lacking LDLR-knockout or ApoE knockout to ad libitum feeding of an isocaloric atherogenic diet either ad libitum or 9 hours TRF for up to 13 weeks and assessed disease development, mechanism, and global changes in hepatic gene expression and plasma lipids. In a regression model, a subset of LDLR-knockout mice were ad libitum fed and then subject to TRF.

RESULTS

TRF could significantly attenuate weight gain, hypercholesterolemia, and atherosclerosis in mice lacking the LDLR-knockout mice under experimental conditions of both prevention and regression. In LDLR-knockout mice, increased hepatic expression of genes mediating β-oxidation during fasting is associated with reduced VLDL (very-low-density lipoprotein) secretion and lipid accumulation. Additionally, increased sterol catabolism coupled with fecal loss of cholesterol and bile acids contributes to the atheroprotective effect of TRF. Finally, TRF alone or combined with a cholesterol-free diet can reduce atherosclerosis in LDLR-knockout mice. However, mice lacking ApoE, which is an important protein for hepatic lipoprotein reuptake do not respond to TRF.

CONCLUSIONS

In a preclinical animal model, TRF is effective in both the prevention and regression of atherosclerosis in LDLR knockout mice. The results suggest TRF alone or in combination with a low-cholesterol diet can be a lifestyle intervention for reducing cardiovascular disease risk in humans.

Does hazelnut consumption affect brain health and function against neurodegenerative diseases?

INTRODUCTION

A healthy daily diet and consuming certain nutrients, such as polyphenols, vitamins, and unsaturated fatty acids, may help neuronal health maintenance. Polyphenolic chemicals, which have antioxidant and anti-inflammatory properties, are involved in the neuroprotective pathway. Because of their nutritional value, nuts have been shown in recent research to be helpful in neuroprotection.

OBJECTIVE

Hazelnut is often consumed worldwide in various items, including processed foods, particularly in bakery, chocolate, and confectionery products. This nut is an excellent source of vitamins, amino acids, tocopherols, phytosterols, polyphenols, minerals, and unsaturated fatty acids. Consuming hazelnut may attenuate the risk of neurodegenerative disorders including Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, multiple sclerosis, and Huntington's disease due to its anti-inflammatory and anti-oxidant qualities.

RESULTS

Many documents introduce hazelnut as an excellent choice to provide neuroprotection against neurodegenerative disorders and there is some direct proof of its neuroprotective effects.

DISCUSSION

So hazelnut consumption in daily diet may reduce neurodegenerative disease risk and be advantageous in reducing the imposed costs of dealing with neurodegenerative diseases.

Strategies for Cardiovascular Disease Prevention in Type 1 Diabetes: A Comprehensive Review

Cardiovascular disease (CVD) is a leading cause of morbidity and mortality among individuals with type 1 diabetes (T1D), necessitating effective prevention strategies. This comprehensive review consolidates current knowledge and evidence on preventing CVD in T1D patients. It begins by exploring the pathophysiological mechanisms that link T1D to an increased risk of CVD, highlighting factors such as chronic hyperglycemia, hypertension, dyslipidemia, and inflammation. The review also examines the epidemiology and specific risk factors for CVD in this population, emphasizing the need for rigorous risk assessment and screening. Lifestyle modifications, including dietary interventions, regular physical activity, and smoking cessation, are evaluated for their effectiveness in reducing CVD risk. Additionally, the review discusses pharmacological interventions, such as insulin therapy for glycemic control, antihypertensive medications, lipid-lowering agents, and antiplatelet therapy, underscoring their critical role in CVD prevention. Emerging therapies and future research directions are explored, focusing on novel pharmacological agents, advances in insulin delivery systems, and personalized medicine approaches. The importance of integrated care models involving multidisciplinary teams and the use of technology is highlighted as essential for comprehensive management. Challenges and barriers to implementing these strategies, including healthcare system limitations, patient adherence, and socioeconomic factors, are also addressed. This review provides a detailed synthesis of current strategies and future directions for preventing CVD in individuals with T1D, serving as a valuable resource for clinicians, researchers, and policymakers dedicated to improving cardiovascular outcomes in this high-risk population.

Profiles of volatile sulfur compounds in various vegetables consumed in Korea using HS-SPME-GC/MS technique

Volatile sulfur compounds (VSCs) are not only important for their therapeutic potential but also significantly influence the flavor profiles of agricultural products. VSCs exhibit various chemical structures due to their stability and volatility, and they may form or be altered as a result of enzymatic and chemical reactions during storage and cooking. This study has focused on profiles of VSCs in 58 different vegetable samples by using HS-SPME-GC/MS technique and chemometric analyses. The validation was carried out using cabbage juice as a vegetable matrix for VSCs analysis, showing satisfactory repeatability (RSD 8.07% ~ 9.45%), reproducibility (RSD 4.22% ~ 7.71%), accuracy and specificity. The established method was utilized on various vegetables, revealing that 21 VSCs such as sulfides, disulfides, trisulfides, isothiocyanates, sulfhydryls, and thiophenes were successfully identified and quantified. These compounds were found in a range of vegetables including Allium species, Cruciferae, Capsicum species, green leafy vegetables, and mushrooms. In particular, isocyanate and allyl groups were abundant in Cruciferae and Allium vegetables, respectively. Cooking conditions were shown to reduce the levels of certain sulfur compounds such as dimethyl sulfide and dimethyl trisulfide in vegetables like broccoli and cabbage, suggesting that heat treatment can lead to the volatilization and reduction of these compounds. The present study provides reliable insights into the compositions of VSCs in various vegetables and examines the changes induced by different cooking methods.

Nailfold Capillaroscopy: A Comprehensive Review on Its Usefulness in Both Clinical Diagnosis and Improving Unhealthy Dietary Lifestyles

Since the 1970s, the utility of nailfold capillaroscopy (NFC) in diagnosing rheumatological disorders such as systemic sclerosis has been well established. Further studies have also shown that NFC can detect non-rheumatic diseases such as diabetes, glaucoma, dermatitis, and Alzheimer disease. In the past decade, nailfold capillary morphological changes have also been reported as symptoms of unhealthy lifestyle habits such as poor diet, smoking, sleep deprivation, and even psychological stress, all of which contribute to slow blood flow. Therefore, studying the relationships between the morphology of nailfold capillaries and lifestyle habits has a high potential to indicate unhealthy states or even pre-disease conditions. Simple, inexpensive, and non-invasive methods such as NFC are important and useful for routine medical examinations. The present study began with a systematic literature search of the PubMed database followed by a summary of studies reporting the assessment of morphological changes detected by NFC, and a comprehensive review of NFC's utility in clinical diagnosis and improving unhealthy dietary lifestyles. It culminates in a summary of dietary and lifestyle health promotion strategy, assessed based on NFC and other related measurements that indicate healthy microvascular blood flow and endothelial function.

Selected Psychosocial Factors, Nutritional Behavior, and the Analysis of Concentrations of Selected Vitamins in Patients with Cardiovascular Diseases

Cardiovascular diseases (CVD) are the leading cause of death worldwide, influenced by the interaction of factors, including age, sex, genetic conditions, overweight/obesity, hypertension, an abnormal lipid profile, vitamin deficiencies, diabetes, and psychological factors. This study aimed to assess the relationships between psychosocial and nutritional factors in a group of 61 patients with CVD (i.e., atherosclerosis, hypertension, ischemic heart disease, and myocardial infarction) and their possible impact on the course of the disease. The plasma concentrations of vitamins A, E, D, and β-carotene were determined using validated HPLC-MS/MS, while the lipid profile was analyzed enzymatically. Psychosocial factors and nutritional behaviors were assessed using author-designed questionnaires. Over 50% of patients had 25-OH-D3 and retinol deficiencies, while >85% of patients exhibited significant deficiencies in α-tocopherol and β-carotene. The lipid profile showed no specific relationship with any particular CVD. Dietary behavior minimally impacted biochemical parameters except for higher β-carotene concentrations in the group with higher fruit and vegetable intake. The negative impact of the CVD on selected parameters of quality of life was noticed. To increase the effectiveness of the prevention and treatment of CVD, the need for interdisciplinary cooperation observed between doctors, psychologists, and specialists in human nutrition seems to be justified.

Standard and New Echocardio Techniques, Such as Global Longitudinal Strain, to Monitor the Impact of Diets on Cardiovascular Diseases and Heart Function

"The Seven Countries Study", published in 1984, was the first study to find a correlation between diet and mortality related to cardiovascular diseases (CVDs). Since then, many investigations have addressed the relationship between type of diet, or specific nutrients, and CVDs. Based on these findings, some traditional dietary models, such as the Mediterranean or Nordic diet, are recommended to prevent CVDs. Meanwhile, new diets have been proposed for optimal nutrition therapy, for example, the Dietary Approaches to Stop Hypertension (DASH) and the Mediterranean-DASH Intervention Diet for Neurodegenerative Delay (MIND). The main outcomes evaluated after implementing these dietary models are as follows: CVD-related death; the development of specific CVDs, such as myocardial infarction and hypertension; or biochemical parameters related to CVDs, i.e., non-HDL cholesterol, C-reactive protein (CPR) and homocysteine. However, the early impact of diet on heart functionality is less evaluated. Recently, the echographic measurement of left ventricle (LV) deformation by global longitudinal strain (GLS) has been introduced as a novel marker of clinical and subclinical cardiac dysfunction. This technology allows a subclinical evaluation of heart functionality since, differently from the traditional evaluation of left ventricle ejection fraction (LVEF), it is capable of detecting early myocardial dysfunction. In this review, we analyzed the available studies that correlate dietetic regimens to cardiovascular diseases, focusing on the relevance of LV strain to detect subclinical myocardial alteration related to diet. Evidence is presented that DASH and MIND can have a positive impact on heart functionality and that myocardial strain is useful for early detection of diet-related changes in cardiac function.

Long-term exposure to particulate matter is associated with elevated blood pressure: Evidence from the Chinese plateau area

Background

Ambient air pollution could increase the risk of hypertension; however, evidence regarding the relationship between long-term exposure to particulate matter and elevated blood pressure in plateau areas with lower pollution levels is limited.

Methods

We assessed the associations of long-term exposure to particulate matter (PM, PM1, PM2.5, and PM10) with hypertension, diastolic blood pressure (DBP), systolic blood pressure (SBP) and pulse pressure (PP) in 4.235 Tibet adults, based on the baseline of the China multi-ethnic cohort study (CMEC) in Lhasa city, Tibet from 2018-19. We used logistic regression and linear regression models to evaluate the associations of ambient PM with hypertension and blood pressure, respectively.

Results

Long-term exposure to PM1, PM2.5, and PM10 is positively associated with hypertension, DBP, and SBP, while negatively associated with PP. Among these air pollutants, PM10 had the strongest effect on hypertension, DBP, and SBP, while PM2.5 had the strongest effect on PP. The results showed for hypertension odds ratio (OR) = 1.99; 95% confidence interval (CI) = 1.58, 2.51 per interquartile range (IQR) μg/m3 increase in PM1, OR = 1.93; 95% CI = 1.55, 2.40 per IQR μg/m3 increase in PM2.5, and OR = 2.12; 95% CI = 1.67, 2.68 per IQR μg/m3 increase in PM10.

Conclusions

Long-term exposure to ambient air pollution was associated with an increased risk of hypertension, elevated SBP and DBP levels, and decreased PP levels. To reduce the risk of hypertension and PP reduction, attention should be paid to air quality interventions in plateau areas with low pollution levels.

Associations of long-term exposure to air pollution and physical activity with the risk of systemic inflammation-induced multimorbidity in Chinese adults: results from the China multi-ethnic cohort study (CMEC)

OBJECTIVE

Previous studies proved the effect of long-term exposure to air pollution or physical activity (PA) on the risk of systemic inflammation-induced multimorbidity (SIIM), while the evidence regarding their joint effects was rare, especially in low- and middle-income countries. Therefore, we aimed to examine the extent of interaction or joint relations of PA and air pollution with SIIM.

METHODS

This study included 72,172 participants from China Multi-Ethnic Cohort.The average concentrations of ambient particulate matter pollutants (PM1, PM2.5, and PM10) were estimated using satellite-based random forest models. Self-reported information on a range of physical activities related to occupation, housework, commuting, and leisure activities was collected by an interviewer-administered questionnaire. A total of 11 chronic inflammatory systemic diseases were assessed based on self-reported lifetime diagnosis or medical examinations. SIIM was defined as having ≥ 2 chronic diseases related to systemic inflammation. Logistic regression models were used to assess the complex associations of air pollution particulate matter and PA with SIIM.

RESULTS

We found positive associations between long-term air pollution particulates exposure and SIIM, with odds ratios (95%CI) of 1.07 (1.03 to 1.11), 1.18 (1.13 to 1.24), and 1.08 (1.05 to 1.12) per 10 µg/m3 increase in PM1, PM2.5, and PM10. No significant multiplicative interaction was found between ambient air pollutant exposure and PA on SIIM, whereas negative additive interaction was observed between long-term exposure to PM2.5 and PA on SIIM. The positive associations between low volume PA and SIIM were stronger among those exposed to high-level air pollution particulates. Compared with individuals engaged in high volume PA and exposed to low-level ambient air pollutants, those engaged in low volume PA and exposed to high-level ambient air pollutants had a higher risk of SIIM (OR = 1.49 in PM1 exposure, OR = 1.84 in PM2.5 exposure, OR = 1.19 in PM10 exposure).

CONCLUSIONS

Long-term (3 years average) exposure to PM1, PM2.5, and PM10 was associated with an increased risk of SIIM. The associations were modified by PA, highlighting PA's importance in reducing SIIM for all people, especially those living in high-level air pollution regions.

Promotion of nutritional behaviors in the prevention of cardiovascular diseases: application of the health belief model in primary health care centers

BACKGROUND

Cardiovascular diseases (CVD) are the most important cause of death in many countries of the world, including Iran. This study aimed to investigate the effect of educational intervention based on the Health Belief Model (HBM) on the promotion of nutritional behaviors to prevent CVD among the all people (aged 30-59 years).

METHODS

This semi-experimental study was conducted on all people (aged 30-59 years) referring to the primary healthcare centers of Jahorm city, southern Iran, from September 2021 to July 2022. In this study, 100 participants (50 participants for the intervention group and 50 for the control group) were selected using a multistage cluster random sampling method. The data collection tool was a questionnaire with confirmed validity and reliability. Also, the food consumption frequency checklist was used. The educational intervention included holding four sessions, each lasting for 60 min. The methods used for training included lectures, questions and answers, and group discussions. Before the intervention and three months after, the intervention and control groups completed the questionnaire. The obtained data were analyzed by SPSS 17.

RESULTS

after the educational intervention, the mean score of knowledge (4.84 ± 0.84; 2.76 ± 1.41; p < 0.001), perceived susceptibility (9.52 ± 1.81; 8.76 ± 1.9; p = 0.004), perceived severity (14.78 ± 1.66; 13.80 ± 2.23; p = 0.015), perceived benefits (10.66 ± 1.79; 7.52 ± 1.99; p < 0.001), perceived barriers (5.92 ± 2.81; 12.68 ± 10.24; p < 0.001) and practice (178.78 ± 14.35; 147.36 ± 13.19; p < 0.001) showed a significant difference between the intervention and control groups.

CONCLUSION

The results showed that the educational intervention effectively improved people (aged 30-59 years) knowledge and HBM constructs to prevent CVD. Also, improving people's performance regarding CVD prevention behaviors will be successful by implementing an educational intervention based on the HBM.

Empowerment-based nutrition interventions on blood pressure: a randomized comparative effectiveness trial

Introduction

Empowerment lifestyle programs are needed to reduce the risk of hypertension. Our study compared the effectiveness of two empowerment-based approaches toward blood pressure (BP) reduction: salt reduction-specific program vs. healthy lifestyle general program.

Methods

Three hundred and eleven adults (median age of 44 years, IQR 34-54 years) were randomly assigned to a salt reduction (n = 147) or a healthy lifestyle program (n = 164). The outcome measures were urinary sodium (Na+) and potassium (K+) excretion, systolic (SBP) and diastolic (DBP) blood pressure, weight, and waist circumference.

Results

There were no significant differences in primary and secondary outcomes between the two program groups. When comparing each program to baseline, the program focused on salt reduction was effective in lowering BP following a 12-week intervention with a mean change of -2.5 mm Hg in SBP (95% CI, -4.1 to -0.8) and - 2.7 mm Hg in DBP (95% CI, -3.8 to -1.5) in the intention-to-treat (ITT) analysis. In the complete-case (CC) analysis, the mean change was -2.1 mm Hg in SBP (95% CI, -3.7 to -0.5) and - 2.3 mm Hg in DBP (95% CI, -3.4 to -1.1). This effect increases in subjects with high-normal BP or hypertension [SBP - 7.9 mm Hg (95% CI, -12.5 to -3.3); DBP - 7.3 mm Hg (95% CI, -10.2 to -4.4)]. The healthy lifestyle group also exhibited BP improvements after 12 weeks; however, the changes were less pronounced compared to the salt reduction group and were observed only for DBP [mean change of -1.5 mm Hg (95% CI, -2.6 to -0.4) in ITT analysis and - 1.4 mm Hg (95% CI, -2.4 to -0.3) in CC analysis, relative to baseline]. Overall, improvements in Na+/K+ ratio, weight, and Mediterranean diet adherence resulted in clinically significant SBP decreases. Importantly, BP reduction is attributed to improved dietary quality, rather than being solely linked to changes in the Na+/K+ ratio.

Conclusion

Salt-focused programs are effective public health tools mainly in managing individuals at high risk of hypertension. Nevertheless, in general, empowerment-based approaches are important strategies for lowering BP, by promoting health literacy that culminates in adherence to the Mediterranean diet and weight reduction.

Nutrition and Lifestyle Coaching: An Interprofessional Course for Pharmacy, Medical, and Dietetic Students

Background Poor nutrition and lifestyle choices are major contributors to the development and progression of various chronic diseases. Enhancing patients' awareness of healthy nutrition and lifestyle habits by interprofessional healthcare teams can play a significant role in tackling many chronic diseases, particularly in underserved communities with inequitable access to healthcare and educational opportunities. However, healthcare professionals are not adequately prepared to provide effective, culturally competent nutrition and lifestyle coaching due to a lack of emphasis on these topics in the curricula of many healthcare professional programs. Objective This study introduces a virtual, interprofessional, team-based elective course to address the curricular gap in nutrition education among healthcare professional programs. Methods Quantitative and qualitative pre-/post-surveys were utilized to evaluate course impact on student's knowledge, confidence in coaching families, and interprofessional competencies. Quantitative pre-/post-training scores were analyzed by a two-tailed, Mann-Whitney test, where P < 0.05 indicated a significant difference. Additionally, student learning outcomes were assessed using readiness assurance tests and application exercises, along with end-of-course presentations and mock interviews. Results Pre-/post-course assessments (n = 16) demonstrated significant improvement in students' confidence in coaching families (20%; P = 0.01) and knowledge of coaching curriculum (87%; P < 0.001). Improvement in different interprofessional competencies ranged between 15% (P = 0.002) and 46% (P < 0.001). Course material/activities, facilitation, impact on learning new knowledge/skills/mindset, and application in future practice were applauded by 81-94% of students. Conclusion Positive outcomes of this course encourage future offerings and systematic incorporation of similar training in healthcare professional programs to prepare clinicians capable of transforming lives through interprofessional, patient-centered nutrition and lifestyle coaching.

Associations of socioeconomic status and obesity with hypertension in tibetan adults in a Chinese plateau area

BACKGROUND

Previous studies have identified that socioeconomic status (SES) and obesity are associated with hypertension. However, their interaction on hypertension risk has not yet been assessed.

METHODS

The study used data from 6,069 Tibetan residents in Chengguan District in Lhasa, the Chinese Tibetan autonomous region's capital, based on a cohort study conducted from May 2018 to September 2019 in five provinces in southwest China. We used logistic regression models to assess the complex relations of SES and obesity with hypertension.

RESULTS

Compared with individuals of high SES, low and moderate SES were positively associated with high risk of hypertension. SES and obesity have significant additive interaction on hypertension (general obesity by BMI: RERI = 1.33, P < 0.001; abdominal obesity by WC: RERI = 0.76, P < 0.001; abdominal obesity by WHtR: RERI = 0.96, P < 0.001). In people from the low and moderate SES segments, obesity was linked to an increased risk of hypertension, but the correlations were stronger in people from the moderate SES category. Compared with people of high SES and non obese, those with moderate SES and obesity had a higher risk of hypertension, and ORs were 4.38 (2.80, 6.84) for general obesity by BMI, 3.38 (2.05, 5.57) for abdominal obesity by WC, and 3.18 (1.57, 6.42) for abdominal obesity by WHtR.

CONCLUSION

There is an independent and additive interaction effect of obesity and SES on the risk of hypertension. People with obesity, especially those of moderate and low SES, should reduce weight and waist circumference, and pay more attention to blood pressure. Moreover, the government, health administration departments, and society should prioritize improving the socioeconomic status of the Tibetan population and addressing risk factors like obesity.

In Vitro Assessment of The Bioactive Compounds and Anticancer Potential of Citrus medica Leaf Extract

Citrus medica is a horticultural crop grown in different parts of the world. The plant leaves have medicinal importance in traditional medicine for the treatment of various diseases. The leaves are an underutilised part of the plant, despite having various bioactive compounds with health benefits, with phytochemical analysis having revealed the presence of flavonoids, fatty acids, alkaloids, terpenoids, glycosides, carbohydrates and phytosterols. The biochemical constituents were identified using Fourier-transform infrared spectroscopy (FTIR) and gas chromatography-mass spectrometry (GC-MS), which confirmed the presence of terpenoids, alcohols, alkanes, phytosterols and fatty acids. Among these, methyl 8, 11, 14-heptadecatrienoate is a linolenic acid, and α-linolenic acid, trimethylsilyl ester and levulinic acid are the predominant compounds belonging to the omega-3 fatty acid group, which has known health benefits. Further, the antimicrobial activity of C. medica plant leaves were tested against certain food-borne pathogens and showed significant results. The minimum inhibitory concentrations ranged from 6.09 mg/mL to 390 mg/mL for bacterial organisms and 48.75 mg/mL to 390 mg/mL for fungal organisms. The antioxidant activity values were 300 μg/mL and 450 μg/mL by 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 3-ethylbenzothiazoline-6-sulfonic acid (ABTS) assay, respectively. The methanolic extract from the C. medica leaves also showed anticancer activity against MCF7 breast cancer cell lines, with an IC50 value of material for developing a healthy processed food such as nutraceuticals and functional foods.

Cariogenic diet consumption during lockdown

BACKGROUND

During stressful situations such as pandemic-associated lockdowns, individuals' diets may change towards (cariogenic) 'comfort food'. This study assessed the dietary patterns during the lockdown in the Colombian population.

METHODS

A cross-sectional online survey was designed. A convenience sample of 489 adults was drawn, with 50% of them being in COVID-19 lockdown and the other being not or only partially in lockdown. The questionnaire collected data about the type and frequency of food consumed, with a special focus on cariogenic (i.e., rich in free sugars and starches) food. Descriptive analyses were performed, and a generalised linear model was estimated to predict the frequency of cariogenic diet consumption in this period of time.

RESULTS

Sweet whole wheat bread (38.2%, p = 0.005), flavoured milk (26.4%, p = 0.002), sugar-sweetened bubble gums (39.8%, p = 0.001), toffees (35.4%, p = 0.004), soft candies (e.g., gums) (35.4%, p = 0.018), chocolates (55.3%, p = 0.017), filled doughnuts (28.5%, p = 0.013) or grapes (51.2%, p = 0.002) were significantly consumed more during the lockdown. Multivariable generalised linear modelling showed being single, having children and being in lockdown were significantly associated with higher frequency of cariogenic food consumption.

CONCLUSIONS

Lockdown was found to be associated with detrimentally altered food consumption patterns and, specifically, a more cariogenic diet. Healthcare professionals should consider this when reopening services, and political decision-makers may want to reflect on the unwarranted side effect of lockdown.

Effect of diet on cardiovascular health-related circulating parameters in men and women athletes participating in a marathon race: A cross-sectional study

OBJECTIVES

The main objective of this study is to understand how diet affects performance and cardiovascular health in a group of women participating in a demanding aerobic race such as marathon, compared to men.

METHODS

Fifteen women participating in the Barcelona Marathon-2016 were recruited to participate in the study. A group of men (n = 15) that performed the same marathon race was selected. Anthropometric parameters and diet records were collected before the race. Circulating parameters were analyzed 24 h-pre-race, immediately after the race and 48 h-post-race. These included certain minerals, lipid profile, muscle damage, inflammatory and cardiovascular health markers.

RESULTS

Diets were very similar in the men and women, with inadequate amounts of carbohydrates and proteins for endurance events. Creatine kinase (CK; a muscle damage marker) and C-reactive protein (CRP; a marker of inflammation) remained elevated 48 h post-race in all participants, but was significant in women (641 vs. 143 U/L for CK and 5.8 vs. 0.7 mg/dL for CRP). Cardiac markers (high sensitivity troponin T (Hs-TnT), suppression of tumorigenicity and N-terminal pro B-type natriuretic peptide) increased post-race and returned to pre-race values after 48 h in men and women. In particular, Hs-TnT (marker of myocyte stress) increased from 2.2 to 62.5 ng/L post-race in women and from 3.1 to 52.9 ng/L in men. Finally, circulating lipid parameters were at borderline unhealthy levels in both sexes.

CONCLUSION

Structural and functional cardiac advantages that women display compared to men in aerobic efforts are not manifested when diet is not adequately designed.

Can Bioactive Food Substances Contribute to Cystic Fibrosis-Related Cardiovascular Disease Prevention?

Advances in cystic fibrosis (CF) care have significantly improved the quality of life and life expectancy of patients. Nutritional therapy based on a high-calorie, high-fat diet, antibiotics, as well as new therapies focused on CFTR modulators change the natural course of the disease. They do so by improving pulmonary function and growing BMI. However, the increased weight of such patients can lead to unwanted long-term cardiovascular effects. People with CF (pwCF) experience several cardiovascular risk factors. Such factors include a high-fat diet and increased dietary intake, altered lipid metabolism, a decrease in the level of fat-soluble antioxidants, heightened systemic inflammation, therapeutic interventions, and diabetes mellitus. PwCF must pay special attention to food and eating habits in order to maintain a nutritional status that is as close as possible to the proper physiological one. They also have to benefit from appropriate nutritional counseling, which is essential in the evolution and prognosis of the disease. Growing evidence collected in the last years shows that many bioactive food components, such as phytochemicals, polyunsaturated fatty acids, and antioxidants have favorable effects in the management of CF. An important positive effect is cardiovascular prevention. The possibility of preventing/reducing cardiovascular risk in CF patients enhances both quality of life and life expectancy in the long run.

The Association between DASH Diet Adherence and Cardiovascular Risk Factors

Background

The dietary approaches to stop hypertension (DASH) encourages high fruit, vegetable, and lean protein consumption and low salt, red meat, and fat intake to prevent or treat hypertension. However, besides hypertension, adherence to this diet has been shown to decrease other cardiovascular risk factors.

Methods

This study assessed the relationship between the DASH diet and cardiovascular risk factors in a cross-sectional study of 2,831 adults chosen by multistage cluster sampling from 27 counties of Khuzestan province, Iran. DASH scores were calculated using data obtained from a qualitative food frequency questionnaire. Regression models were used to evaluate the association of DASH scores and common cardiovascular risk factors.

Results

Significant trends were observed across quintiles of DASH scores for systolic blood pressure, fasting blood sugar, triglyceride, total cholesterol, and its components (p < 0·05). After adjusting for potential confounders such as sex, age, ethnicity, residence, wealth score, physical activity, energy intake, and family history of heart disease, the multiple regression analysis for each cardiovascular risk factor revealed that being in the highest quintile of total DASH score (OR = 0.72, 95% CI 0.52-0.99) was negatively associated with hyperglycemia.

Conclusions

This study showed a positive relationship between DASH diet adherence and lower serum levels of glucose, triglycerides, and cholesterol. Prospective studies are needed to confirm these findings.

Chia seeds (Salvia hispanica L.): A therapeutic weapon in metabolic disorders

The growth of functional components containing agricultural foods is enhancing because these components aid the human body against different chronic diseases. Currently, chia seeds basically belong to the mint family and are edible seeds of Salvia hispanica. These seeds are composed of different functional components including fiber, polyphenols, antioxidants, omega-3 fatty acid vitamins, minerals, and peptides. Besides, these seeds are also a good source of vegetable protein, unsaturated fat, carbohydrates, and ash. Chia seed components are helpful in cardiovascular disease (CVD) by reducing blood pressure, platelet aggregation, cholesterol, and oxidation. In GI-tract-related diseases like diabetes and constipation, chia fiber reduces the blood glucose level and provides bulk to stool. However, antioxidants and polyphenols are protected beta cells of the pancreas from inflammation. These components are protected from the cell damage of the different body parts, which can provide help in different types of cancer including breast, colorectal, liver, and pancreatic. Conclusively, some pervious studies approved that chia seed components are played important role in chronic diseases.

Impact of mulberry consumption on cardiometabolic risk factors: A systematic review and meta-analysis of randomized-controlled trials

OBJECTIVE

The current study aimed to comprehensively evaluate the potential effects of mulberry consumption on cardiometabolic risk factors in adults.

METHODS

Relevant articles published up to January 2021 were systematically retrieved from SCOPUS, PubMed/MEDLINE, EMBASE, and Web of Science databases. We included all randomized controlled trials (RCTs) investigating the impact of mulberry consumption on various cardiometabolic risk factors.

RESULTS

The quantitative meta-analysis of 12 eligible RCTs demonstrated a significant reducing effect of mulberry consumption on haemoglobin A1c (HbA1c) (weighted mean difference [WMD]: -0. 55, 95% CI: -1.08, -0.02, p = 0.044), serum total cholesterol (TC) (WMD: -13.13 mg/dl, 95% CI: -19.06, -7.20, p < 0.001), low-density lipoprotein levels (LDL-C) (WMD: -8.84 mg/dl, 95% CI: -13.26, -4.42, p < 0.001), triglycerides (TG) (WMD: -19.67 mg/dl, 95% CI: -30.13, -9.22, p < 0.001) and C-reactive protein (CRP) (WMD: -1.60, mg/L, 95% CI: -3.07, -0.12, p = 0.034). Also, >300 mg daily intake of mulberry exhibited a favourable effect on serum high-density lipoprotein levels (HDL-C). However, there were no significant differences between mulberry intervention and control groups for other factors.

CONCLUSION

The current systematic review and meta-analysis revealed that incorporating mulberry into the diet may favourably affect several cardiometabolic risk factors.

The effect of telemedicine on secondary prevention of atherosclerotic cardiovascular disease: A systematic review and meta-analysis

Aim

The purpose of this systematic review was to evaluate the efficiency of telemedicine on the secondary level of prevention of patients with arteriosclerotic cardiovascular disease (ASCVD), provide evidence for the application of telemedicine in secondary prevention and promote the development of telemedicine in secondary prevention.

Methods

A computer-based search was conducted in MEDLINE, Embase, Pubmed, EBSCO, CINAHL, the Cochrane Library, and Web of Science. Randomized controlled trials regarding the effect of telemedicine on secondary prevention of ASCVD were included from inception to May, 2022. Meta-analysis was used to compare the results of the included studies by RevMan5.4 software. The Cochrane Collaboration bias risk tool was used to perform risk of bias assessment in this study. Outcomes included risk factors, physical activity and exercise, muscle function, exercise compliance, medication adherence, healthy diet, depression and anxiety, self-efficacy, knowledge score, economy, and safety endpoints. Subgroup analysis was carried out for different main intervention measures included in the literature.

Results

A total of 32 randomized clinical studies (n = 10 997 participants) were included in the meta-analysis. Compared with usual secondary prevention (USP) group, participants in telemedicine of secondary prevention (TOSP) group showed significant improvement in some risk factors including BMI (MD -0.87, p = 0.002), SBP (MD -4.09, p = 0.007) and DBP (MD -2.91, p = 0.0002) when they use the telephone as the intervention. In physical activity and exercise, Patients in TOSP showed an improvement in VO2 Peak (mL⋅kg-1⋅min-1) (OR 1.58, p = 0.02), 6MWT (MD 21.41, p = 0.001), GSLTPA score (MD 2.89, p = 0.005). Effects on medication adherence, exercise compliance, muscle function, healthy diet, economy and self-efficacy were synthesized narratively. Patients in TOSP did not show a reduction in knowledge score, depression, anxiety and safety endpoints.

Conclusion

There is a net benefit of secondary prevention supported by telemedicine (especially when using the telephone as an intervention) in patients with ASCVD in the terms of some risk factors, physical activity and exercise. There are still controversies in the improvement of medication adherence, exercise compliance, muscle function, healthy diet, knowledge score, self-efficacy and economy via telemedicine, which is worth exploring. Larger samples size and longer-term follow-ups are needed in future studies.

Systematic review registration

[https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=330478], identifier [CRD42022330478].

Therapeutic role of traditionally used Indian medicinal plants and spices in combating COVID-19 pandemic situation

The coronavirus disease (COVID-19) caused by SARS-CoV-2 is a big challenge and burning issue to the scientific community and doctors worldwide. Globally, COVID-19 has created a health disaster and adversely affects the economic growth. Although some vaccines have already emerged, no therapeutic medication has yet been approved by FDA for the treatment of COVID-19 patients. Traditionally, we have been using different medicinal plants like neem, tulsi, tea, and many spices like garlic, ginger, turmeric, black seed, onion, etc. for the treatment of flu-like diseases. In this paper, we are highlighting the recent research progress in the identification of natural products from the Indian medicinal plants and spices that have potential inhibition properties against SARS-CoV-2. This study will provide an initiative to stimulate further research by providing useful guidance to the medicinal chemists for designing new protease inhibitors effective against SARS-CoV-2 in future.

Ten things to know about ten cardiovascular disease risk factors - 2022

The American Society for Preventive Cardiology (ASPC) "Ten things to know about ten cardiovascular disease risk factors - 2022" is a summary document regarding cardiovascular disease (CVD) risk factors. This 2022 update provides summary tables of ten things to know about 10 CVD risk factors and builds upon the foundation of prior annual versions of "Ten things to know about ten cardiovascular disease risk factors" published since 2020. This 2022 version provides the perspective of ASPC members and includes updated sentinel references (i.e., applicable guidelines and select reviews) for each CVD risk factor section. The ten CVD risk factors include unhealthful dietary intake, physical inactivity, dyslipidemia, pre-diabetes/diabetes, high blood pressure, obesity, considerations of select populations (older age, race/ethnicity, and sex differences), thrombosis (with smoking as a potential contributor to thrombosis), kidney dysfunction and genetics/familial hypercholesterolemia. Other CVD risk factors may be relevant, beyond the CVD risk factors discussed here. However, it is the intent of the ASPC "Ten things to know about ten cardiovascular disease risk factors - 2022" to provide a tabular overview of things to know about ten of the most common CVD risk factors applicable to preventive cardiology and provide ready access to applicable guidelines and sentinel reviews.

Valorization and Potential Antimicrobial Use of Olive Mill Wastewater (OMW) from Italian Olive Oil Production

The production of olive oil generates olive mill wastewater (OMW) which essentially derives from the processing, treatment and pressing of olives in mills. Traditional milling processes require a quantity of water varying between 40 and 120 L per quintal of pressed olives, generating a considerable amount of wastewater. It is thus necessary to reduce process water and enhance its use to implement the concept of a circular economy. To this end, our preliminary work was dedicated to water purification by means of suitable and efficient filtration systems. The microfiltered OMW was firstly concentrated through reverse osmosis. Then, an additional concentration step was carried out via vacuum membrane distillation using hydrophobic hollow fiber membranes. The application of the membrane-based processes allowed the recovery of a purified water and the concentration of valuable polyphenols in a smaller volume. The different fractions obtained from the purification have been tested for the determination of the antioxidant power (DPPH assay) and dosage of polyphenols (Folin–Ciocalteu assay) and were characterized using IR spectroscopy. All samples showed relevant antioxidant activity (percentage range: 10–80%) and total phenolic content in the 1.5–15 g GAE/L range. The obtained fractions were tested for their antimicrobial effect on numerous clinical isolates of Gram-positive and Gram-negative species, resistant and multi-resistant to current antibiotic drugs. OMW samples showed widespread activity against the considered (phyto)pathogens (MIC range 8–16 mg/mL) thus supporting the value of this waste material in the (phyto)pharmaceutical field.

2022 Prevention of chronic non-communicable diseases in Of the Russian Federation. National guidelines

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Chrononutrition in Cardiometabolic Health

In recent years, a healthy balanced diet together with weight reduction has risen to the forefront of minimizing the impact of cardiovascular disease. There is evidence that metabolic processes present circadian rhythmicity. Moreover, the timing of food consumption exerts a powerful influence on circadian rhythms. In this context, the subject of chrononutrition, described as the alignment of timing of food intake to the rhythms imposed by the circadian clock, has attracted considerable interest for possible beneficial effects on cardiovascular health. Current human studies suggest that chrononutrition-based dietary interventions could reduce the risk for cardiovascular disease by improving weight control, hypertension, dyslipidemia, and diabetes. However, meta-analysis of randomized control trials in this topic present varying and somehow conflicting results. Even the traditional association of breakfast skipping with adverse cardiovascular outcomes is nowadays controversial. Therefore, long-term and fairly consistent studies on the effect of chrononutrition on cardiovascular outcomes are needed. The purpose of this review is to provide concise evidence of the most recent literature involving the effects of chrononutrition and the specific chrononutrition-based dietary interventions, in particular time-restricted eating, on body weight and other cardiovascular disease risk factors.

Adherence to lifestyle modification in patients with nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease (NAFLD) makes a major impact on morbidity and mortality among the workingage population in developed countries. In the lack of effective pharmacological methods, the leading role in treatment of NAFLD belongs to lifestyle modification, consistent and gradual weight loss, and its maintenance. The qualitative and quantitative structure of the diet, intensity of physical activity, and most importantly, regularity and consistency of implementation of lifestyle modification activities are the key to successful management of patients with NAFLD.

To date, there are very few studies on adherence to lifestyle modification activities in this group of patients, which is mainly due to a deficiency of methodological tools. The questionnaire “QAA-25” recommended by the Russian Scientific Medical Society of Therapists for quantitative assessment of adherence to treatment allows to assess both adherence to therapy in general and adherence to its individual components (adherence to drug therapy, adherence to medical counseling, and adherence to lifestyle modification), which requires further study taking into account features of therapeutic strategies in treating NAFLD. 

Healthy Eating as a New Way of Life: A Qualitative Study of Successful Long-Term Diet Change

Background

Improving diet quality has been shown to be an effective way to improve health and well-being. Yet information on how to assist those wanting to transition to and maintain a healthier diet is still limited. The aim of this study was to explore what motivated people to initiate and maintain a healthy diet.

Methods

Semi-structured interviews were conducted with 20 participants (all Australian residents) who had made significant improvements to their diets and had maintained these changes for a minimum of two years (n_female = 15, n_male = 5, M_age = 37.7, SD = 12.4). The transcripts were analysed using thematic analysis which identified five overarching themes: A desire to feel better, investigation and learning, helpful habits, benefits, and values.

Results

Participants reported a strong wish to feel better and investigated the role of diet as a possible way to improve well-being. Through daily habits and continuous engagement with the topic, healthy eating became a way of life for many participants. Experiencing the benefits of a healthier diet and having developed strong values regarding diet and health supported long-term maintenance.

Conclusions

Findings from the present study contribute to the literature in highlighting the importance of internal motivation and autonomy for health behaviours. Findings may inform the development of healthy eating interventions. Encouraging autonomy, fostering values aligned with a healthier diet, and helping individuals establish daily habits is likely to support change.

Recent advances in nanocarriers for nutrient delivery

For the past few years, there has been a surge in the use of nutraceuticals. The global nutraceuticals market in 2020 was USD 417.66 billion, and the market value is expected to increase by 8.9% compound annual growth rate from 2020 to 2028. This is because nutraceuticals are used to treat and prevent various diseases such as cancer, skin disorders, gastrointestinal, ophthalmic, diabetes, obesity, and central nervous system-related diseases. Nutritious food provides the required amount of nutrition to the human body through diet, whereas most of the bioactive agents present in the nutrients are highly lipophilic, with low aqueous solubility leading to poor dissolution and oral bioavailability. Also, the nutraceuticals like curcumin, carotenoids, anthocyanins, omega-3 fatty acids, vitamins C, vitamin B12, and quercetin have limitations such as poor solubility, chemical instability, bitter taste, and an unpleasant odor. Additionally, the presence of gastrointestinal (GIT) membrane barriers, varied pH, and reaction with GIT enzymes cause the degradation of some of the nutraceuticals. Nanotechnology-based nutrient delivery systems can be used to improve oral bioavailability by increasing nutraceutical stability in foods and GIT, increasing nutraceutical solubility in intestinal fluids, and decreasing first-pass metabolism in the gut and liver. This article has compiled the properties and applications of various nanocarriers such as polymeric nanoparticles, micelles, liposomes, niosomes, solid lipid nanocarriers, nanostructured lipid carrier, microemulsion, nanoemulsion, dendrimers in organic nanoparticles, and nanocomposites for effective delivery of bioactive molecules.

Associations between dietary intake of B vitamins and cardiovascular risk factors in elderly men: A cross-sectional study

OBJECTIVE

Low intake of B vitamins can lead to hyperhomocysteinaemia, which is reported as a risk factor for cardiovascular disease (CVD). However, little is known about this relationship. Therefore, we decided to examine the association between dietary intake of B vitamins and cardiovascular risk factors in elderly men.

METHODS

The present cross-sectional study consisted of 357 elderly men. Dietary intake was assessed using a validated and reliable food frequency questionnaire. All biochemical factors [fasting blood sugar (FBS), triglyceride (TG), high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6) and tumour necrosis factor-α (TNF-α)], waist circumference (WC) and blood pressure (BP) were assessed using standard methods.

RESULTS

A significant inverse association was observed between high dietary intake of total B vitamins (OR_{Total B vitamins} : 0.30; 95% CI: 0.10, 0.86; P = .01) and vitamin B9 (OR_{vitamin B9} : 0.20; 95% CI: 0.02, 0.52; P = .002) with high WC. Furthermore, an inverse association was observed between high dietary intake of vitamin B6 (OR_{vitamin B6} : 0.28; 95% CI: 0.08, 1.00; P = .05) and vitamin B9 (OR_{vitamin B9} : 0.20; 95% CI: 0.06, 0.70; P = .01) with hs-CRP level.

CONCLUSIONS

In elderly men, a high dietary intake of total B vitamins and vitamin B9 was associated with lower odds of having a high WC. Similarly, high dietary intake of vitamin B6 and B9 was associated with lower odds of having a high hs-CRP level.

Maternal polyphenol intake impairs cerebellar redox homeostasis in newborn rats

INTRODUCTION

Polyphenols are compounds found in plants that have been extensively studied due to the health benefits of its consumption in adulthood. Meanwhile, recent evidence suggests that polyphenol consumption during pregnancy may not be safe for the fetus.

OBJECTIVE

The goal of this study was to evaluate the effect of naringenin supplementation during pregnancy on brain redox homeostasis and mitochondrial activity of the newborn rat.

METHODS

Adult female Wistar rats were divided into two groups: (1) vehicle (1 mL/Kg p.o.) or (2) naringenin (50 mg/Kg p.o.). Naringenin was administered once a day during pregnancy. The offspring were euthanized on postnatal day 7, as well the dams, and brain regions were dissected.

RESULTS

The offspring cerebellum was the most affected region, presenting increased activity of the mitochondrial electron transport system, allied to increased reactive species levels, lipid peroxidation, and glutathione concentration. The nitric oxide levels suffered structure-dependent alteration, with decreased levels in the pups' cerebellum and increased in the hippocampus. The offspring parietal cortex was not affected, as well as the parameters evaluated in the dams' brains.

CONCLUSION

Maternal consumption of naringenin alters offspring cerebellar redox homeostasis, which could be related to adverse effects on the motor and cognitive development in the descendants.

Primary Barriers of Adherence to a Structured Nutritional Intervention in Patients with Dyslipidemia

PURPOSE

To describe the primary barriers to adequately adhering to a structured nutritional intervention.

PATIENTS AND METHODS

A total of 106 participants diagnosed with dyslipidemia and without a medical nutrition therapeutic plan were included in this two-year study conducted at the INCMNSZ dyslipidemia clinic in Mexico City. All patients were treated with the same structured strategies, including three face-to-face visits and two telephone follow-up visits. Diet plan adherence was evaluated at each site visit through a 3-day or 24-h food recall.

RESULTS

Barriers to adhere to the nutritional intervention were: lack of time to prepare their meals (23%), eating outside the home (19%), unwillingness to change dietary patterns (14%), and lack of information about a correct diet for dyslipidemias (14%). All barriers decreased significantly at the end of the intervention. Female gender, current smoking, and following a plan of more than 1500 kcal (R² = 0.18 and p-value = 0.004) were associated with good diet adherence. Participants showed good levels of adherence to total caloric intake at visit 2 and 3, reporting 104.7% and 95.4%, respectively. Adherence to macronutrient intake varied from 65.1% to 126%, with difficulties in adhering to recommended carbohydrate and fat consumption being more notable.

CONCLUSION

The study findings confirm that a structured nutritional intervention is effective in reducing barriers and improving dietary adherence and metabolic control in patients with dyslipidemias. Health providers must identify barriers to adherence early on to design interventions that reduce these barriers and improve adherence.

Dietary Pattern and Long-Term Effects of Particulate Matter on Blood Pressure: A Large Cross-Sectional Study in Chinese Adults

[Figure: see text].

Impact of nutritional index on contrast-associated acute kidney injury and mortality after percutaneous coronary intervention

The risk of malnutrition in acute kidney injury and mortality in coronary artery disease patients has not been studied. This study aimed to evaluate whether nutritional status assessed by Onodera's prognostic nutritional index (PNI) was related to percutaneous coronary intervention (PCI) outcomes. A total of 3731 patients who received PCI between January 2010 and December 2018 were included. The relationship between PNI at the time of PCI and the occurrence of contrast-associated acute kidney injury (AKI) and all-cause death was evaluated using logistic regression and Cox proportional hazards models, respectively. AKI occurred in 271 patients (7.3%). A low PNI was independently associated with an increased risk of AKI on multivariate logistic regression analysis (OR 0.96, 95% CI 0.94-0.98, P = 0.001). During the median follow-up of 4.3 years, Kaplan-Meier analysis showed that patients with AKI/low PNI < 47.8 had a higher death rate. After adjusting for various risk factors, a low PNI was a significant risk factor for mortality (HR 0.98, CI 0.96-0.99, P = 0.003). A low level of PNI was associated with increased mortality, especially in the group aged over 70 years and female sex. PNI was closely associated with acute kidney outcomes and patient mortality after PCI.

Farmed Mussels: A Nutritive Protein Source, Rich in Omega-3 Fatty Acids, with a Low Environmental Footprint

The world’s ever-growing population presents a major challenge in providing sustainable food options and in reducing pressures on the Earth’s agricultural land and freshwater resources. Current estimates suggest that agriculture contributes ~30% of global greenhouse gas (GHG) emissions. Additionally, there is an increased demand for animal protein, the production of which is particularly polluting. Therefore, the climate-disrupting potential of feeding the planet is likely to substantially worsen in the future. Due to the nutritional value of animal-based protein, it is not a simple solution to recommend a wholesale reduction in production/consumption of animal proteins. Rather, employing strategies which result in the production of low carbon animal protein may be part of the solution to reduce the GHGs associated with our diets without compromising diet quality. We suggest that farmed mussels may present a partial solution to this dilemma. Mussel production has a relatively low GHG production and does not put undue pressure on land or fresh water supplies. By drawing comparisons to other protein sources using the Australian Food and Nutrient Database and other published data, we demonstrate that they are a sustainable source of high-quality protein, long-chain omega-3 fatty acids, phytosterols, and other key micronutrients such as B-12 and iron. The aim of this review is to summarise the current knowledge on the health benefits and potential risks of increasing the consumption of farmed mussels.

Ten things to know about ten cardiovascular disease risk factors

Given rapid advancements in medical science, it is often challenging for the busy clinician to remain up-to-date on the fundamental and multifaceted aspects of preventive cardiology and maintain awareness of the latest guidelines applicable to cardiovascular disease (CVD) risk factors. The "American Society for Preventive Cardiology (ASPC) Top Ten CVD Risk Factors 2021 Update" is a summary document (updated yearly) regarding CVD risk factors. This "ASPC Top Ten CVD Risk Factors 2021 Update" summary document reflects the perspective of the section authors regarding ten things to know about ten sentinel CVD risk factors. It also includes quick access to sentinel references (applicable guidelines and select reviews) for each CVD risk factor section. The ten CVD risk factors include unhealthful nutrition, physical inactivity, dyslipidemia, hyperglycemia, high blood pressure, obesity, considerations of select populations (older age, race/ethnicity, and sex differences), thrombosis/smoking, kidney dysfunction and genetics/familial hypercholesterolemia. For the individual patient, other CVD risk factors may be relevant, beyond the CVD risk factors discussed here. However, it is the intent of the "ASPC Top Ten CVD Risk Factors 2021 Update" to provide a succinct overview of things to know about ten common CVD risk factors applicable to preventive cardiology.

Assessing Overall Diet Quality: Development and Evaluation of the Performance of a Short Self-Administrated Questionnaire SCASA

Several tools assessing diet quality have been developed over the last decades, but their use in public health and clinical practice is limited because they necessitate detailed quantitative assessment of food intake. Our goal was to develop and validate a score (Score d’Alimentation Saine, SCASA) based on a short self-administrated online questionnaire to assess overall diet quality. SCASA targets the adult population in French-speaking Switzerland, but it was designed in a way enabling its adaptation for other regions. The choice of the items involved experts and lay volunteers. Construct validation and inter-method reliability were assessed by screening meal plans and by comparing the self-rated scores with food-record derived scores (kappa and Bland–Altman). SCASA (17 components) discriminated adequately balanced from imbalanced meal plans (93–95% and 44–46% of maximal score). Agreement between self-assessed and food record-based scores ranged between >90% (3 items), 80–89% (3 items), 70–79% (4 items), and <70% (5 items). The Bland–Altman plot showed a mean difference of −1.60 (95% CI −2.36 to −0.84), indicating a slight overestimation of the self-assessed diet quality compared to the food record. SCASA offers a reliable way to assess overall diet quality without requiring burdensome data collection or nutrient calculations.

Plasma lipocalin-2/NGAL is stable over 12 weeks and is not modulated by exercise or dieting

Amongst other immune cells, neutrophils play a key role in systemic inflammation leading to cardiovascular disease and can release inflammatory factors, including lipocalin-2 (LCN2). LCN2 drives cardiac hypertrophy and plays a role in maladaptive remodelling of the heart and has been associated with renal injury. While lifestyle factors such as diet and exercise are known to attenuate low-grade inflammation, their ability to modulate plasma LCN2 levels is unknown. Forty-eight endurance athletes and 52 controls (18–55 years) underwent measurement for various cardiovascular health indicators, along with plasma LCN2 concentration. No significant difference in LCN2 concentration was seen between the two groups. LCN2 was a very weak predictor or absent from models describing blood pressures or predicting athlete status. In another cohort, 57 non-diabetic overweight or obese men and post-menopausal women who fulfilled Adult Treatment Panel III metabolic syndrome criteria were randomly allocated into either a control, modified Dietary Approaches to Stop Hypertension (DASH) diet, or DASH and exercise group. Pre- and post-intervention demographic, cardiovascular health indicators, and plasma LCN2 expression were measured in each individual. While BMI fell in intervention groups, LCN2 levels remained unchanged within and between all groups, as illustrated by strong correlations between LCN2 concentrations pre- and 12 weeks post-intervention (r = 0.743, P < 0.0001). This suggests that circulating LCN2 expression are stable over a period of at least 12 weeks and is not modifiable by diet and exercise.

Assessment of Dietary Habits Using the Diet Quality Index-International in Cerebrovascular and Cardiovascular Disease Patients

Improvement of dietary habits is recommended for the management of cerebrovascular and cardiovascular diseases (CCVD). This study aimed to evaluate the dietary habits of CCVD patients and compare them with the general population by using the Diet Quality Index—International (DQI-I). Data from the Korean National Health and Nutrition Examination Surveys (2013–2016) were used. Cardiovascular diseases included myocardial infarction, angina pectoris, and heart failure; and cerebrovascular diseases included stroke, cerebral infarction, and hemorrhage. In total, 12,683 subjects over 20 years old were included, comprising 718 CCVD patients and 11,965 non-CCVD subjects. Survey-weighted multiple linear regression analyses with adjustment for covariates were used to compare DQI-I scores. The mean total DQI-I scores for the CCVD and non-CCVD groups were 66.7 ± 9.2 and 67.8 ± 9.2, respectively. After adjusting for covariates, the CCVD group had DQI-I scores significantly lower than the non-CCVD group (coefficient −1.13, p-value = 0.011). In the analysis of each DQI-I component, the CCVD group had lower scores for variety (coefficient −0.54, p-value = 0.004) and adequacy (coefficient −0.86, p-value = 0.001). In this study, using nationally representative data, dietary habits of CCVD patients were shown to be lower in quality than non-CCVD subjects. Therefore, evaluation and education of adequate dietary habits are needed in the management of CCVD patients.

Intrinsic atomic interaction at molecular proximal vicinity infer cellular biocompatibility of antibacterial nanopepper

Aim: Fabrication of nanopepper (NP) for antibacterial application and elucidation of its molecular and cellular biocompatibility. Materials & methods: Synthesis of NP was achieved using a high-energy ball milling method. Following characterization, its antibacterial activity and cellular and molecular biocompatibility were evaluated in vitro by experimental and computational approaches. Results: A total of 15 h of milling pepper produced NP with a size of 44 ± 12 nm and zeta potential of -22 ± 12 mV. Bulk pepper and NP showed antibacterial activity and an LC50 of 1.9 μM and 2.1 μM in HCT116 colon cells. Components of pepper, piperine and β-caryophyllene were found to interact with superoxide dismutase [Cu-Zn] and apoptotic protease-activating factor-1-caspase-9 through different amino acids via H-bonds. Conclusion: NP exhibits significant antibacterial activity with cellular biocompatibility due to intrinsic atomic interaction.

Aim: Fabrication of nanopepper (NP) for antibacterial application and elucidation of its molecular and cellular biocompatibility. Materials & methods: Synthesis of NP was achieved using a high-energy ball milling method. Following characterization, its antibacterial activity and cellular and molecular biocompatibility were evaluated in vitro by experimental and computational approaches. Results: A total of 15 h of milling pepper produced NP with a size of 44 ± 12 nm and zeta potential of -22 ± 12 mV. Bulk pepper and NP showed antibacterial activity and an LC50 of 1.9 μM and 2.1 μM in HCT116 colon cells. Components of pepper, piperine and β-caryophyllene were found to interact with superoxide dismutase [Cu-Zn] and apoptotic protease-activating factor-1-caspase-9 through different amino acids via H-bonds. Conclusion: NP exhibits significant antibacterial activity with cellular biocompatibility due to intrinsic atomic interaction.

Predictors of change in cardiovascular disease risk and events following gastric bypass: a 7-year prospective multicenter study

BACKGROUND

Change in short-term (i.e., 10-year) and lifetime risk of cardiovascular disease (CVD) following Roux-en-Y gastric bypass (RYGB) has significant heterogeneity.

OBJECTIVE

To identify predictors of change in CVD risk and cardiovascular events following RYGB.

METHODS

Between 2006-2009, 1625 adults without a history of CVD enrolled in a prospective cohort study and underwent RYGB at 1 of 10 U.S. hospitals. Participants were followed annually for a maximum of 7 years. Associations between presurgery characteristics (anthropometric, sociodemographic, physical and mental health, alcohol/drug use, eating behaviors) and 1) pre to postsurgery change in 10 year and lifetime atherosclerotic CVD (ASCVD) risk scores, respectively, and 2) having a CVD event (nonfatal myocardial infarction, stroke, ischemic heart disease, congestive heart failure, angina, percutaneous coronary intervention, coronary artery bypass grafting, or CVD-attributed death) as repeated measures (yr 1-7) were evaluated.

SETTING

Observational cohort study at ten hospitals throughout the United States.

RESULTS

Presurgery factors independently associated with decreases in both 10-year and lifetime risk scores 1-7 years post-RYGB were higher CVD risk score, female sex, higher household income, and normal kidney function. Additionally, Black race and having diabetes were independently associated with decreases in 10-year risk, while not having diabetes and a higher (better) composite mental health score were independently related to decreases in lifetime risk. A lower (worse) presurgery composite physical health score was associated with a higher CVD event risk (RR = 1.68, per 10 points).

CONCLUSION

This study identified multiple presurgery factors that characterize patients who may have more cardiovascular benefit from RYGB, and patients who might require additional support to improve their cardiovascular health.