Childhood serum cholesterol ester fatty acids are associated with blood pressure 27 y later in the Cardiovascular Risk in Young Finns Study

Quantitative determination of plasma cholesteryl ester levels in Japanese preadolescents from the Hokkaido study using liquid chromatography/tandem mass spectrometry

Cholesteryl esters (CE) are sterols comprising various fatty acyl chains attached to a cholesterol hydroxyl moiety. CEs are often considered plasma biomarkers of liver function; however, their absolute concentrations in the plasma of Japanese preadolescents have not been well explored. This study aimed to determine the plasma CE levels in Japanese preadolescents of different sexes, ages, and body weights living in Hokkaido, Japan using targeted liquid chromatography/tandem mass spectrometry. The analysis was performed on the non-fasting plasma of preadolescents aged 9-12 years (n = 339 healthy volunteers; 178 boys and 161 girls) from Sapporo, Hokkaido, Japan. The analysis results showed that the total CE levels in boys and girls were 871 ± 153 and 862 ± 96 pmol/μL, respectively. CE 18:2 (41 ± 2.9 %) was found to be the most abundant species followed by CE 18:1 (16 ± 1.5 %) and CE 16:0 (13 ± 1.1 %). The ω-3 fatty acid-containing CEs such as CE 18:3 and CE 20:5 were significantly lower in girls than in boys. Despite the different ages, CEs were tightly regulated in the plasma of children's, and the total CEs ranged between 844 and 906 pmol/μL in boys and 824 and 875 pmol/μL in girls. The participants were further classified into three groups based on their body mass index underweight (n = 237), normal weight (n = 94), and overweight (n = 8). Most of the quantified CEs were accumulated in the overweight group. Interestingly, CE 18:3 was significantly upregulated in the overweight group compared to that in the normal range, and the area under the receiver operating characteristic curve was 0.73, suggesting that it could be a possible marker for obesity. This study marks the initial investigation of absolute CE levels in the plasma of children and can help elucidate the relationship between CEs and childhood obesity.

Association of omega-6 polyunsaturated fatty acids with blood pressure: A systematic review and meta-analysis of observational studies

OBJECTIVES

This systematic review and meta-analysis aimed at summarizing earlier findings on the association of n-6 PUFAs levels in diets or blood with blood pressure.

METHODS

PubMed/Medline, Scopus, and Web of Science were searched for observational studies. Publications with data on the risk of hypertension, or the correlation between n-6 PUFAs or mean values of serum n-6 PUFAs levels in normotensive and hypertensive were included.

RESULTS

Twenty-two studies (16 cross-sectional studies, 5 cohorts and one case-control) were eligible. Combining 14 extracted effect sizes showed that higher circulatory/dietary n-6 PUFAs tended to be associated with 10% lower risk of HTN (95% CI: 0.81, 1.00), whereas combining 23 effect sizes illustrated no difference in circulatory/dietary n-6 PUFAs mean levels between normotensive and hypertensive subjects. According to subgroup analysis based on fatty acid types, total n-6 PUFAs (OR = 0.82, 95% CI: 0.70, 0.97) and linoleic acid (OR = 0.56, 95% CI: 0.39, 0.82) were inversely related to the risk of HTN. Circulatory/dietary n-6 PUFAs were correlated neither with systolic nor with diastolic blood pressure.

CONCLUSIONS

Higher circulatory/dietary n-6 PUFAs tend to be associated with lower odds of HTN. Particularly, total n-6 PUFAs and linoleic acid were associated with lower risk of HTN.

Plasma metabolites mediate the association of coarse grain intake with blood pressure in hypertension-free adults

BACKGROUND AND AIMS

Increased intake of whole/coarse grains was associated with improved blood pressure control, but concurrent metabolism alterations are less clear. We sought to identify metabolomic profiles of blood pressure, and to explore their mediation effects on the coarse grain intake-blood pressure association among young adults free of hypertension.

METHODS AND RESULTS

Plasma metabolome of 86 participants from the Carbohydrate Alternatives and Metabolic Phenotypes study was characterized by untargeted lipidomics and metabolomics using liquid chromatography-high-resolution mass spectrometry. We identified 24 and 117 metabolites associated with systolic blood pressure (SBP) and diastolic blood pressure (DBP), respectively, using random forest modeling and partial correlation analysis. Moreover, metabolite panels for highly specific prediction of blood pressure (8 metabolites for SBP and 11 metabolites for DBP) were determined using ten-fold cross-validated ridge regression (R² ≥ 0.70). We also observed an inverse association between metabolite panel of SBP (β ± SE = -0.02 ± 0.01, P = 0.04) or DBP (β ± SE = -0.03 ± 0.01, P = 0.02) and coarse grain intake. Furthermore, we observed significant mediating effects of metabolites, in particular, sphingolipid ceramides, on the association between coarse grain exposure and blood pressure using both bias-corrected bootstrap tests and high-dimensional mediation analysis adapted for large-scale and high-throughput omics data.

CONCLUSIONS

We identified metabolomic profiles specifically associated with blood pressure in young Chinese adults without diagnosed hypertension. The inverse association between coarse grain intake and blood pressure may be mediated by sphingolipid metabolites.

Consumption Patterns of Grain-Based Foods among Children and Adolescents in Canada: Evidence from Canadian Community Health Survey-Nutrition 2015

The current analyses used data from the Canadian Community Health Survey-Nutrition 2015 to investigate grain-based food (GBF) dietary patterns of consumptions among 6,400,000 Canadian children and adolescents 2 to 18 years old. Nutrient intakes, socioeconomic differences, body mass index (BMI) z-scores, and intakes of several food groups were examined across the identified grain patterns of consumption. We employed k-mean cluster analysis to identify the consumption patterns of grain products. Based on the contributions of 21 grain food groups to the total energy intake of each individual, seven GBF consumption patterns were identified including other bread; salty snacks; pasta; rice; cakes and cookies; white bread; and mixed grains. Individuals having less than one serving of grain products were also separately categorized as no-grain consumers. Mean energy intake (kcal/day) was lowest for the "no-grain" consumers and greatest in children/adolescents consuming a "salty snacks" pattern when all GBF patterns were compared. Children and adolescents with "no-grain" and "rice" GBF consumption patterns had significantly lower intakes of several nutrients including dietary fiber, folate, magnesium, calcium, iron, zinc, thiamin, niacin, and riboflavin. No associations were observed with any of the identified GBF patterns and BMI z-scores. In addition, the socioeconomic status (SES) indicators such as household incomes and immigration status of participants were shown to be significantly different across the identified clusters.

Associations of Whole Blood n-3 and n-6 Polyunsaturated Fatty Acids with Blood Pressure in Children and Adolescents - Results from the IDEFICS/I.Family Cohort

Background

Polyunsaturated n-3 and n-6 polyunsaturated fatty acids (PUFA) are precursors of biologically active metabolites that affect blood pressure (BP) regulation. This study investigated the association of n-3 and n-6 PUFA and BP in children and adolescents.

Methods

In a subsample of 1267 children aged 2–9 years at baseline of the European IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) cohort whole blood fatty acids were measured by a validated gas chromatographic method. Systolic and diastolic BP was measured at baseline and after two and six years. Mixed-effects models were used to assess the associations between fatty acids at baseline and BP z-scores over time adjusting for relevant covariables. Models were further estimated stratified by sex and weight status.

Results

The baseline level of arachidonic acid was positively associated with subsequent systolic BP (β = 0.08, P = 0.002) and diastolic BP (β = 0.07, P<0.001). In thin/normal weight children, baseline alpha-linolenic (β = -1.13, P = 0.003) and eicosapentaenoic acid (β = -0.85, P = 0.003) levels were inversely related to baseline and also to subsequent systolic BP and alpha-linolenic acid to subsequent diastolic BP. In overweight/obese children, baseline eicosapentaenoic acid level was positively associated with baseline diastolic BP (β = 0.54, P = 0.005).

Conclusions

Low blood arachidonic acid levels in the whole sample and high n-3 PUFA levels in thin/normal weight children are associated with lower and therefore healthier BP. The beneficial effects of high n-3 PUFA on BP were not observed in overweight/obese children, suggesting that they may have been overlaid by the unfavorable effects of excess weight.

Longitudinal study of circulating oxidized LDL and HDL and fatty liver: the Cardiovascular Risk in Young Finns Study

Oxidative reactions are thought to play a role in the inflammatory condition called fatty liver. It is unclear whether oxidized lipoprotein lipids or proteins are associated with future fatty liver. In the Cardiovascular Risk in Young Finns Study, we determined the circulating levels of LDL and HDL oxidized lipids and studied their associations with fatty liver assessed by ultrasonography. There were 1286 middle-aged subjects with normal liver and 288 subjects with fatty liver. Analysis of oxidized lipids consisted of conjugated dienes in isolated HDL (oxHDLlipids) and LDL (oxLDLlipids). Oxidized LDL was also measured with a method based on antibodies against oxidized apolipoprotein B (oxLDLprot). After adjustment for age, sex, leisure-time physical activity, body mass index, alcohol intake, smoking, serum LDL and HDL cholesterol as well as particle concentrations, participants with elevated oxLDLlipids (odds ratio for 1-SD change in oxLDLlipids = 1.27, p =0.011) had an increased risk for fatty liver. Similarly, a high oxidation score (oxLDLlipids + oxLDLprot) was directly associated with fatty liver (odds ratio=1.34, p = 0.012). The strongest direct association was seen with a high oxLDLlipids/oxHDLlipids ratio (odds ratio=1.49, p = 0.001). These data suggest that oxidized lipoprotein lipids are linked with the risk of fatty liver in middle-aged adults.

Reference values of whole-blood fatty acids by age and sex from European children aged 3-8 years

OBJECTIVES

To establish reference values for fatty acids (FA) especially for n-3 and n-6 long-chain polyunsaturated FAs (LC PUFA) in whole-blood samples from apparently healthy 3-8-year-old European children. The whole-blood FA composition was analysed and the age- and sex-specific distribution of FA was determined.

DESIGN AND SUBJECTS

Blood samples for FA analysis were taken from 2661 children of the IDEFICS (identification and prevention of dietary- and lifestyle-induced health effects in children and infants) study cohort. Children with obesity (n=454) and other diseases that are known to alter the FA composition (n=450) were excluded leaving 1653 participants in the reference population.

MEASUREMENTS

The FA composition of whole blood was analysed from blood drops by a rapid, validated gas chromatographic method.

RESULTS

Pearson correlation coefficients showed an age-dependent increase of C18:2n-6 and a decrease of C18:1n-9 in a subsample of normal weight boys and girls. Other significant correlations with age were weak and only seen either in boys or in girls, whereas most of the FA did not show any age dependence. For age-dependent n-3 and n-6 PUFA as well as for other FA that are correlated with age (16:0, C18:0 and C18:1n-9) percentiles analysed with the general additive model for location scale and shape are presented. A higher median in boys than in girls was observed for C20:3n-6, C20:4n-6 and C22:4n-6.

CONCLUSIONS

Given the reported associations between FA status and health-related outcome, the provision of FA reference ranges may be useful for the interpretation of the FA status of children in epidemiological and clinical studies.

Serum long-chain omega-3 polyunsaturated Fatty acids and future blood pressure in an ageing population

OBJECTIVES

To investigate the associations of serum long-chain omega-3 polyunsaturated fatty acids (PUFA) and hair mercury with future blood pressure in an ageing population.

DESIGN

Prospective study with baseline measurements in 1998-2001 and follow-up measurements in 2005-2008. The linear relationships (β) of baseline serum fatty acids and hair mercury with future systolic and diastolic blood pressure and pulse pressure were analyzed with multiple linear regression models, using log-transformed values.

PARTICIPANTS

181 men and 200 women aged 53-73 y from the Kuopio Ischemic Heart Disease Risk Factor Study (KIHD) population in Eastern Finland, who were free of cardiovascular disease, diabetes or hypertension at baseline.

MEASUREMENTS

Total serum esterified and nonesterified fatty acids and pubic hair mercury were used as markers for exposure. Anthropometric and other lifestyle and health-related data were collected.

RESULTS

The mean serum concentrations were 1.67% (SD 0.92) for eicosapentaenoic acid (EPA), 0.79% (SD 0.16) for docosapentaenoic acid (DPA) and 2.78 (SD 0.92) for docosahexaenoic acid (DHA), of all serum fatty acids. The mean hair mercury concentration was 1.5 µg/g (SD 1.6). We did not find statistically significant associations between the baseline serum long-chain omega-3 PUFA concentrations or hair mercury content and future blood pressure. Hair mercury did not modify the associations with the long-chain omega-3 PUFAs, either.

CONCLUSIONS

Higher serum long-chain omega-3 PUFA concentration, a biomarker of fish or fish oil consumption, may not have an impact on future blood pressure in an ageing population.

The development of a diet quality score for preschool children and its validation and determinants in the Generation R Study

BACKGROUND

Although many studies have examined health effects of infant feeding, studies on diet quality shortly after the weaning and lactation period are scarce.

OBJECTIVES

Our aims were to develop and evaluate a diet score that measures overall diet quality in preschool children and to examine the sociodemographic and lifestyle determinants of this score.

METHODS

On the basis of national and international dietary guidelines for young children, we developed a diet score containing 10 components: intake of vegetables; fruit; bread and cereals; rice, pasta, potatoes, and legumes; dairy; meat and eggs; fish; oils and fats; candy and snacks; and sugar-sweetened beverages. The total score ranged from 0 to 10 on a continuous scale and was standardized to an energy intake of 1200 kcal/d with the residual method. The score was evaluated in 3629 children participating in the Generation R Study, a population-based prospective cohort study. Food consumption was assessed with a food-frequency questionnaire (FFQ) at a median age of 13 mo.

RESULTS

The mean ± SD diet score was 4.1 ± 1.3. The food-based diet score was positively associated with intakes of many nutrients, including n-3 (ω-3) fatty acids [FAs; 0.25 SD increase (95% CI: 0.22, 0.27) per 1 point increase in the diet score], dietary fiber [0.32 (95% CI: 0.30, 0.34)], and calcium [0.13 (95% CI: 0.11, 0.16)], and was inversely associated with intakes of sugars [-0.28 (95% CI: -0.31, -0.26)] and saturated fat [-0.03 (95% CI: -0.05, -0.01)]. A higher diet score was associated with several health-conscious behaviors, such as maternal folic acid supplement use during pregnancy, no smoking during pregnancy, and children watching less television.

CONCLUSION

We developed a novel food-based diet score for preschool children that could be applied in future studies to compare diet quality in early childhood and to investigate associations between diet in early childhood and growth, health, and development.

[Accuracy of body fat and waist circumference in predicting metabolic abnormalities indicating cardiovascular risk in adolescents]

OBJECTIVE

To evaluate the performance of percent body fat (%BF) and waist circumference (WC) in predicting metabolic abnormalities indicating cardiovascular risk in adolescents.

SUBJECTS AND METHODS

Cross-sectional study with a probabilistic sample of 573 adolescents aged 12 to 19 years from state public schools in Niterói, RJ. The Receiver Operating Characteristic Curve was used to evaluate the accuracy of WC and %BF in predicting alterations in blood pressure, lipid profile, and blood glucose.

RESULTS

The best %BF cutoff points were 21% for boys, and 23% for girls, with sensitivity (SE) and specificity (SP) of approximately 60%. The best WC cutoff points were 71 cm for boys, and 66 cm for girls (SE: 55% to 70%; SP: 55% to 78%).

CONCLUSION

Even the best cutoff points misidentified high proportions of adolescents with metabolic abnormalities. Caution is recommended in the use of these indicators for cardiovascular risk screening in this age group.

When to prevent cardiovascular disease? As early as possible: lessons from prospective cohorts beginning in childhood

PURPOSE OF REVIEW

To detail recent developments linking modifiable youth risk factors with preclinical markers of cardiovascular disease such as carotid artery intima-media thickness, pulse-wave velocity (PVW) and large artery stiffness, brachial artery flow-mediated dilatation, left ventricular geometry, and coronary artery calcification in adulthood.

RECENT FINDINGS

Population-based data from prospective cohort studies beginning in youth with follow-up into adulthood have shown that the modifiable youth risk factors of elevated blood lipids, blood pressure, and adiposity, smoking (active and passive), metabolic disorders, physical inactivity, low cardiorespiratory fitness, and diet associate with preclinical markers of cardiovascular disease in adulthood. The data suggest that, in some instances, those who amend their trajectory by not maintaining these risk factors into adulthood experience reductions in preclinical markers to levels associated with never having had the risk factor.

SUMMARY

Though avoidance of risk factors in youth is ideal, there is still a window for intervention where long-lasting cardiovascular effects might be avoided. Health-enhancing changes in the rates of active and passive smoking, adiposity, increased physical activity, accentuated fitness, modified diet, and socioeconomic position in the transition from youth to adulthood might be important in modifying an individual's trajectory from high risk in youth to low risk in adulthood.

Maternal dietary counseling during pregnancy and infant fatty acid profiles

We aimed to explore whether maternal dietary counseling to increase the intake of unsaturated fatty acids (FA) is reflected in infant FA status. Serum cholesteryl ester (CE) and triacylglycerol (TAG) FA were analyzed from infants of 45 women randomized to receive dietary counseling from the first trimester of pregnancy and 45 control women. Counseling resulted in a higher intake of polyunsaturated FA and a lower intake of saturated FA. The dietary intake was reflected in cord blood TAGs: the n-6 to n-3 FA ratio was lower [mean difference -0.50 (95%CI -0.95 to -0.06)] and the sum of n-3 FA was higher in the intervention than in the control group [1.46 (0.44 to 2.48)% of total FA]. Reasons for the lack of changes in the cord blood CE fraction and FA fractions at 1-month remain unclear, but may indicate that the changes achieved in the maternal diet through counseling were too modest.

Main findings from the prospective Cardiovascular Risk in Young Finns Study

PURPOSE OF REVIEW

To provide a comprehensive overview on the main findings from the Cardiovascular Risk in Young Finns Study. This prospective multicenter study initiated in 1980 (N = 3596, baseline age 3-18 years) has followed up study participants over 30 years to investigate childhood risk factors for cardiometabolic outcomes in adulthood.

RECENT FINDINGS

Childhood BMI, socioeconomic status, parental risk factor status, as well as genetic polymorphisms are independent predictors of adult obesity, hypertension, and dyslipidemia. Results from the Young Finns Study and other follow-up studies have shown that conventional childhood risk factors, such as dyslipidemia, obesity, elevated blood pressure and smoking, are predictive of subclinical atherosclerosis in young adults. Recent findings suggest that childhood lifestyle (diet, physical activity) is associated with subclinical atherosclerosis and its progression in adulthood. Concerning the timing of risk factor measurements, they seem to be predictive of adult atherosclerosis from the age of 9 onwards. From a clinical point of view, a recent observation suggesting that the adverse cardiometabolic effects of childhood overweight/obesity are reversed among those who become nonobese adults, provides optimism during the days of obesity epidemic.

SUMMARY

Current data suggest that childhood risk factors are associated with higher risk of subclinical atherosclerosis in adulthood. Future studies among aging cohorts followed since childhood will provide data on their influence on clinical cardiovascular outcomes.

Impact of nutrition since early life on cardiovascular prevention

The cardiovascular disease represents the leading cause of morbidity and mortality in Western countries and it is related to the atherosclerotic process. Cardiovascular disease risk factors, such as dyslipidemia, hypertension, insulin resistance, obesity, accelerate the atherosclerotic process which begins in childhood and progresses throughout the life span. The cardiovascular disease risk factor detection and management through prevention delays the atherosclerotic progression towards clinical cardiovascular disease. Dietary habits, from prenatal nutrition, breastfeeding, complementary feeding to childhood and adolescence nutrition play a basic role for this topic.

The metabolic and neuroendocrine environment of the fetus is fundamental in the body’s “metabolic programming”. Further several studies have demonstrated the beneficial effects of breastfeeding on cardiovascular risk factors reduction. Moreover the introduction of complementary foods represents another important step, with particular regard to protein intake. An adequate distribution between macronutrients (lipids, proteins and carbohydrates) is required for correct growth development from infancy throughout adolescence and for prevention of several cardiovascular disease risk determinants in adulthood.

The purpose of this review is to examine the impact of nutrition since early life on disease.

La malattia cardiovascolare rappresenta la principale causa di morbilità e mortalità dei paesi occidentali ed è correlata a degenerazione vascolare aterosclerotica. I fattori di rischio cardiovascolari quali dislipidemia, ipertensione, insulino resistenza e obesità accelerano tale processo il cui esordio è noto sin dell’età pediatrica ed evolve nel corso della vita. L’individuazione e la cura dei fattori di rischio cardiovascolari mediante la prevenzione dei fattori causali ritardano la progressione dell’aterosclerosi e l’insorgenza dei sintomi cardiovascolari. La nutrizione svolge un ruolo preventivo fondamentale sin dall’epoca prenatale e nelle diverse età della crescita.

La condizione metabolica e neuro-endocrino cui è sottoposto il feto è rilevante per la “programmazione metabolica”. E’ dimostrata inoltre l’importanza delle modalità di allattamento e divezzamento con particolare interesse per l’assunzione di proteine nel controllo dei fattori di rischio cardiovascolari. La corretta distribuzione di macronutrienti (lipidi, proteine e carboidrati) dall’infanzia all’adolescenza favorisce una crescita corretta e risulta utile a prevenire l’insorgenza dei determinanti di rischio di malattia cardiovascolare in età adulta.

Nella presente review verrà esaminato l’impatto della nutrizione dalle più precoci fasi delle vita sul rischio cardiovascolare.