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Butler JL, Gordon-Larsen P, Steffen LM, Shikany JM, Jacobs DR, Popkin BM, Poti JM. Associations of 5-year changes in alcoholic beverage intake with 5-year changes in waist circumference and BMI in the Coronary Artery Risk Development in Young Adults (CARDIA) study. PLoS One 2023; 18:e0281722. [PMID: 36888592 PMCID: PMC9994756 DOI: 10.1371/journal.pone.0281722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 01/30/2023] [Indexed: 03/09/2023] Open
Abstract
OBJECTIVE This study aimed to shed light on contradictory associations of alcohol intake with waist circumference (WC) and body mass index (BMI) by examining 5-yr changes in alcohol intake in relation to 5-yr WC and BMI changes. METHODS This prospective study included 4,355 participants (1,974 men and 2,381 women) enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study at baseline (1985-1986) and followed over 25 years (2010-2011). Longitudinal random effects linear regression models were used to test whether changes in drinking (defined categorically) as starting to drink, increasing, decreasing, stable drinking or stopping drinking (versus stable non-drinking) over a series of 5-yr periods were associated with corresponding 5-yr WC and BMI changes. Associations with 5-yr changes (defined categorically as starting, stable or stopping) in drinking level (i.e., light/moderate and excessive) and 5-yr changes (defined categorically as increasing, no change, or decreasing) by beverage type (i.e., beer, wine and liquor/mixed drinks) were also examined. RESULTS In men, compared to stable non-drinking, decreasing total alcohol intake was associated with lower 5-yr WC (β:-0.62 cm; 95% CI: -1.09, -0.14 cm) and BMI gains (β:-0.20 kg/m2; 95% CI: -0.30, -0.03 kg/m2) and stopping excessive drinking was associated with lower 5-yr WC gains (β:-0.77 cm; 95% CI: -1.51, -0.03 cm). In women, compared to those with stable non-drinking habits, starting light/moderate drinking was associated with lower 5-yr WC (β: -0.78 cm; 95% CI: -1.29, -0.26 cm) and BMI gains (β:-0.42 kg/m2; 95% CI: -0.64, -0.20 kg/m2). Increasing wine intake was associated with a lower 5-yr BMI gain (β:-0.27 kg/m2; 95% CI: -0.51, -0.03 kg/m2). Decreasing liquor/mixed drink (β:-0.33 kg/m2; 95% CI: -0.56, -0.09 kg/m2) intake was associated with lower 5-yr WC (β:-0.88 cm; 95% CI: -1.43, -0.34 cm) and BMI (β:-0.33 kg/m2; 95% CI: -0.56, -0.09 kg/m2) gains. CONCLUSIONS Associations of alcohol intake with obesity measures are complex. In women, wine and liquor/mixed drink intakes had contrasting associations with WC and BMI change. In men, decreasing weekly alcoholic beverage intake with an emphasis on stopping excessive consumption may be beneficial in managing WC and BMI gains.
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Grants
- HHSN268201800005I NHLBI NIH HHS
- HHSN268201800007I NHLBI NIH HHS
- HHSN268201800003I NHLBI NIH HHS
- HHSN268201800006I NHLBI NIH HHS
- HHSN268201800004I NHLBI NIH HHS
- R01 HL104580 NHLBI NIH HHS
- R01 DK098072 NIDDK NIH HHS
- T32 DK007686 NIDDK NIH HHS
- P2C HD050924 NICHD NIH HHS
- National Heart, Lung, and Blood Institute in collaboration with the University of Alabama at Birmingham
- National Heart, Lung, and Blood Institute in collaboration with Northwestern University
- National Heart, Lung, and Blood Institute in collaboration with the University of Minnesota
- National Heart, Lung, and Blood Institute in collaboration with the Kaiser Foundation Research Institute
- National Institutes of Health, NIH,
- National Institutes of Health
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
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Affiliation(s)
- J. Lauren Butler
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Nutrition and Foods Program, School of Family and Consumer Sciences, Texas State University, San Marcos, Texas, United States of America
- * E-mail:
| | - Penny Gordon-Larsen
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Lyn M. Steffen
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - James M. Shikany
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States of America
| | - David R. Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Barry M. Popkin
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Jennifer M. Poti
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
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Navas-Carretero S, San-Cristobal R, Alvarez-Alvarez I, Celis-Morales C, Livingstone KM, O'Donovan CB, Mavrogianni C, Lambrinou CP, Manios Y, Traczyck I, Drevon CA, Marsaux CFM, Saris WHM, Fallaize R, Macready AL, Lovegrove JA, Gundersen TE, Walsh M, Brennan L, Gibney ER, Gibney M, Mathers JC, Martinez JA. Interactions of Carbohydrate Intake and Physical Activity with Regulatory Genes Affecting Glycaemia: A Food4Me Study Analysis. Lifestyle Genom 2021; 14:63-72. [PMID: 34186541 DOI: 10.1159/000515068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 02/04/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Carbohydrate intake and physical activity are related to glucose homeostasis, both being influenced by individual genetic makeup. However, the interactions between these 2 factors, as affected by genetics, on glycaemia have been scarcely reported. OBJECTIVE We focused on analysing the interplay between carbohydrate intake and physical activity levels on blood glucose, taking into account a genetic risk score (GRS), based on SNPs related to glucose/energy metabolism. METHODS A total of 1,271 individuals from the Food4Me cohort, who completed the nutritional intervention, were evaluated at baseline. We collected dietary information by using an online-validated food frequency questionnaire, a questionnaire on physical activity, blood biochemistry by analysis of dried blood spots, and by analysis of selected SNPs. Fifteen out of 31 SNPs, with recognized participation in carbohydrate/energy metabolism, were included in the component analyses. The GRS included risk alleles involved in the control of glycaemia or energy-yielding processes. RESULTS Data concerning anthropometric, clinical, metabolic, dietary intake, physical activity, and genetics related to blood glucose levels showed expected trends in European individuals of comparable sex and age, being categorized by lifestyle, BMI, and energy/carbohydrate intakes, in this Food4Me population. Blood glucose was inversely associated with physical activity level (β = -0.041, p = 0.013) and positively correlated with the GRS values (β = 0.015, p = 0.047). Interestingly, an interaction affecting glycaemia, concerning physical activity level with carbohydrate intake, was found (β = -0.060, p = 0.033), which also significantly depended on the genetic background (GRS). CONCLUSIONS The relationships of carbohydrate intake and physical activity are important in understanding glucose homeostasis, where a role for the genetic background should be ascribed.
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Affiliation(s)
- Santiago Navas-Carretero
- Centre for Nutrition Research, School of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain.,CIBEROBN, Instituto de Salud Carlos III, Madrid, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Rodrigo San-Cristobal
- Centre for Nutrition Research, School of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain
| | - Ismael Alvarez-Alvarez
- Centre for Nutrition Research, School of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain
| | - Carlos Celis-Morales
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom.,BHF Glasgow cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Katherine M Livingstone
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom.,Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
| | - Claire B O'Donovan
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland
| | | | | | - Yannis Manios
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Iwona Traczyck
- Department of Human Nutrition, Faculty of Health Sciences, Medical University of Warsaw, Warsaw, Poland
| | - Christian A Drevon
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Cyril F M Marsaux
- Department of Human Biology, NUTRIM, School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Wim H M Saris
- Department of Human Biology, NUTRIM, School for Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Rosalind Fallaize
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom.,Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom
| | - Anna L Macready
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom
| | - Julie A Lovegrove
- Hugh Sinclair Unit of Human Nutrition and Institute for Cardiovascular and Metabolic Research, University of Reading, Reading, United Kingdom
| | | | - Marianne Walsh
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland
| | - Lorraine Brennan
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland
| | - Eileen R Gibney
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland
| | - Mike Gibney
- UCD Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland
| | - John C Mathers
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - J Alfredo Martinez
- Centre for Nutrition Research, School of Pharmacy and Nutrition, University of Navarra, Pamplona, Spain.,CIBEROBN, Instituto de Salud Carlos III, Madrid, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
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Effect of a Shock Micro-Cycle on Biochemical Markers in University Soccer Players. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073581. [PMID: 33808309 PMCID: PMC8036591 DOI: 10.3390/ijerph18073581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/24/2021] [Accepted: 03/25/2021] [Indexed: 01/04/2023]
Abstract
This study aimed to examine various biochemical biomarkers changes during a shock micro-cycle in soccer players from a university team. The study had 22 players (age: 22 ± 3 years; body mass: 68.6 ± 7.1 kg; height: 1.73 ± 0.07 m). The study measured total cholesterol (TC), triglycerides (TG), cholesterol linked to high-density lipoproteins (HDL), low-density lipoproteins (LDL), very low density lipoproteins (VLDL), arterial index (AI), creatine kinase (CK), glutamate-oxalacetate-transaminase (GOT), glutamate-pyruvate-transaminase (GPT), creatinine (Cr), catalase (CAT), superoxide dismutase (SOD), cytokines IL6 and TNFα, total antioxidant capacity (Cap antiox tot), hemolysis percentage and glomerular filtration rate (GFR); measurements were conducted during a shock micro-cycle. The lipid profile variables had no statistical significance when compared on day 1 with day 14. Except for TNFα, the other biomarkers compared with day one had progressive increments until day seven, with a subsequent reduction on day 14; however, none of the biomarkers returned to baseline values despite this decrease. The data shown herein suggest the need to research these biomarkers in distinct types of mesocycles, exercise, intensity, load, and duration to diminish fatigue and improve athlete performance.
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Semlitsch T, Krenn C, Jeitler K, Berghold A, Horvath K, Siebenhofer A. Long-term effects of weight-reducing diets in people with hypertension. Cochrane Database Syst Rev 2021; 2:CD008274. [PMID: 33555049 PMCID: PMC8093137 DOI: 10.1002/14651858.cd008274.pub4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND All major guidelines for antihypertensive therapy recommend weight loss. Dietary interventions that aim to reduce body weight might therefore be a useful intervention to reduce blood pressure and adverse cardiovascular events associated with hypertension. OBJECTIVES Primary objectives To assess the long-term effects of weight-reducing diets in people with hypertension on all-cause mortality, cardiovascular morbidity, and adverse events (including total serious adverse events, withdrawal due to adverse events, and total non-serious adverse events). Secondary objectives To assess the long-term effects of weight-reducing diets in people with hypertension on change from baseline in systolic blood pressure, change from baseline in diastolic blood pressure, and body weight reduction. SEARCH METHODS For this updated review, the Cochrane Hypertension Information Specialist searched the following databases for randomised controlled trials up to April 2020: the Cochrane Hypertension Specialised Register, CENTRAL (2020, Issue 3), Ovid MEDLINE, Ovid Embase, and ClinicalTrials.gov. We also contacted authors of relevant papers about further published and unpublished work. The searches had no language restrictions. SELECTION CRITERIA We included randomised controlled trials (RCTs) of at least 24 weeks' duration that compared weight-reducing dietary interventions to no dietary intervention in adults with primary hypertension. DATA COLLECTION AND ANALYSIS Two review authors independently assessed risks of bias and extracted data. Where appropriate and in the absence of significant heterogeneity between studies (P > 0.1), we pooled studies using a fixed-effect meta-analysis. In case of moderate or larger heterogeneity as measured by Higgins I2, we used a random-effects model. MAIN RESULTS This second review update did not reveal any new trials, so the number of included trials remains the same: eight RCTs involving a total of 2100 participants with high blood pressure and a mean age of 45 to 66 years. Mean treatment duration was 6 to 36 months. We judged the risks of bias as unclear or high for all but two trials. No study included mortality as a predefined outcome. One RCT evaluated the effects of dietary weight loss on a combined endpoint consisting of the necessity of reinstating antihypertensive therapy and severe cardiovascular complications. In this RCT, weight-reducing diet lowered the endpoint compared to no diet: hazard ratio 0.70 (95% confidence interval (CI) 0.57 to 0.87). None of the trials evaluated adverse events as designated in our protocol. The certainty of the evidence was low for a blood pressure reduction in participants assigned to weight-loss diets as compared to controls: systolic blood pressure: mean difference (MD) -4.5 mm Hg (95% CI -7.2 to -1.8 mm Hg) (3 studies, 731 participants), and diastolic blood pressure: MD -3.2 mm Hg (95% CI -4.8 to -1.5 mm Hg) (3 studies, 731 participants). We judged the certainty of the evidence to be high for weight reduction in dietary weight loss groups as compared to controls: MD -4.0 kg (95% CI -4.8 to -3.2) (5 trials, 880 participants). Two trials used withdrawal of antihypertensive medication as their primary outcome. Even though we did not consider this a relevant outcome for our review, the results of these RCTs strengthen the finding of a reduction of blood pressure by dietary weight-loss interventions. AUTHORS' CONCLUSIONS In this second update, the conclusions remain unchanged, as we found no new trials. In people with primary hypertension, weight-loss diets reduced body weight and blood pressure, but the magnitude of the effects are uncertain due to the small number of participants and studies included in the analyses. Whether weight loss reduces mortality and morbidity is unknown. No useful information on adverse effects was reported in the relevant trials.
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Affiliation(s)
- Thomas Semlitsch
- Institute of General Practice and Evidence-Based Health Services Research, Medical University of Graz, Graz, Austria
| | - Cornelia Krenn
- Institute of General Practice and Evidence-Based Health Services Research, Medical University of Graz, Graz, Austria
| | - Klaus Jeitler
- Institute of General Practice and Evidence-Based Health Services Research, Medical University of Graz, Graz, Austria
| | - Andrea Berghold
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Karl Horvath
- Institute of General Practice and Evidence-Based Health Services Research, Medical University of Graz, Graz, Austria
| | - Andrea Siebenhofer
- Institute of General Practice and Evidence-Based Health Services Research, Medical University of Graz, Graz, Austria
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O'Connor EA, Evans CV, Rushkin MC, Redmond N, Lin JS. Behavioral Counseling to Promote a Healthy Diet and Physical Activity for Cardiovascular Disease Prevention in Adults With Cardiovascular Risk Factors: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 2020; 324:2076-2094. [PMID: 33231669 DOI: 10.1001/jama.2020.17108] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
IMPORTANCE Cardiovascular disease is the leading cause of death in the US, and poor diet and lack of physical activity are major factors contributing to cardiovascular morbidity and mortality. OBJECTIVE To review the benefits and harms of behavioral counseling interventions to improve diet and physical activity in adults with cardiovascular risk factors. DATA SOURCES MEDLINE, PubMed, PsycINFO, and the Cochrane Central Register of Controlled Trials through September 2019; literature surveillance through July 24, 2020. STUDY SELECTION English-language randomized clinical trials (RCTs) of behavioral counseling interventions to help people with elevated blood pressure or lipid levels improve their diet and increase physical activity. DATA EXTRACTION AND SYNTHESIS Data were extracted from studies by one reviewer and checked by a second. Random-effects meta-analysis and qualitative synthesis were used. MAIN OUTCOMES AND MEASURES Cardiovascular events, mortality, subjective well-being, cardiovascular risk factors, diet and physical activity measures (eg, minutes of physical activity, meeting physical activity recommendations), and harms. Interventions were categorized according to estimated contact time as low (≤30 minutes), medium (31-360 minutes), and high (>360 minutes). RESULTS Ninety-four RCTs were included (N = 52 174). Behavioral counseling interventions involved a median of 6 contact hours and 12 sessions over the course of 12 months and varied in format and dietary recommendations; only 5% addressed physical activity alone. Interventions were associated with a lower risk of cardiovascular events (pooled relative risk, 0.80 [95% CI, 0.73-0.87]; 9 RCTs [n = 12 551]; I2 = 0%). Event rates were variable; in the largest trial (Prevención con Dieta Mediterránea [PREDIMED]), 3.6% in the intervention groups experienced a cardiovascular event, compared with 4.4% in the control group. Behavioral counseling interventions were associated with small, statistically significant reductions in continuous measures of blood pressure, low-density lipoprotein cholesterol levels, fasting glucose levels, and adiposity at 12 to 24 months' follow-up. Measurement of diet and physical activity was heterogeneous, and evidence suggested small improvements in diet consistent with the intervention recommendation targets but mixed findings and a more limited evidence base for physical activity. Adverse events were rare, with generally no group differences in serious adverse events, any adverse events, hospitalizations, musculoskeletal injuries, or withdrawals due to adverse events. CONCLUSIONS AND RELEVANCE Medium- and high-contact multisession behavioral counseling interventions to improve diet and increase physical activity for people with elevated blood pressure and lipid levels were effective in reducing cardiovascular events, blood pressure, low-density lipoproteins, and adiposity-related outcomes, with little to no risk of serious harm.
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Affiliation(s)
- Elizabeth A O'Connor
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Corinne V Evans
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Megan C Rushkin
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Nadia Redmond
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
| | - Jennifer S Lin
- Kaiser Permanente Evidence-based Practice Center, Center for Health Research, Kaiser Permanente, Portland, Oregon
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Parmenter BH, Croft KD, Hodgson JM, Dalgaard F, Bondonno CP, Lewis JR, Cassidy A, Scalbert A, Bondonno NP. An overview and update on the epidemiology of flavonoid intake and cardiovascular disease risk. Food Funct 2020; 11:6777-6806. [PMID: 32725042 DOI: 10.1039/d0fo01118e] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
There is an accumulating body of literature reporting on dietary flavonoid intake and the risk of cardiovascular disease (CVD) in prospective cohort studies. This makes apparent the need for an overview and update on the current state of the science. To date, at least 27 prospective cohorts (in 44 publications) have evaluated the association between estimated habitual flavonoid intake and CVD risk. At this time, the totality of evidence suggests long-term consumption of flavonoid-rich foods may be associated with a lower risk of fatal and non-fatal ischemic heart disease (IHD), cerebrovascular disease, and total CVD; disease outcomes which are principally, though not exclusively, composed of cases of atherosclerotic CVD (ASCVD). To date, few studies have investigated outcome specific ASCVD, such as peripheral artery disease (PAD) or ischemic stroke. Of the flavonoid subclasses investigated, evidence more often implicates diets rich in anthocyanins, flavan-3-ols, and flavonols in lowering the risk of CVD. Although inferences are restricted by confounding and other inherent limitations of observational studies, causality appears possible based on biological plausibility, temporality, and the relative consistency of the reported associations. However, whether the associations observed represent a benefit of the isolated bioactives per se, or are a signal of the bioactives acting in concert with the co-occurring nutrient matrix within flavonoid-bearing foods, are issues of consideration. Thus, the simple interpretation, and the one most relevant for dietary advice, is that consumption of flavonoid-rich foods or diets higher in flavonoids, appear nutritionally beneficial in the prevention of CVD.
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Affiliation(s)
- Benjamin H Parmenter
- School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital Research Foundation, Perth, Australia.
| | - Kevin D Croft
- School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital Research Foundation, Perth, Australia.
| | - Jonathan M Hodgson
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia and Medical School, University of Western Australia, Perth, Australia
| | - Frederik Dalgaard
- Department of Cardiology, Herlev & Gentofte University Hospital, Copenhagen, Denmark
| | - Catherine P Bondonno
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia and Medical School, University of Western Australia, Perth, Australia
| | - Joshua R Lewis
- School of Medical and Health Sciences, Edith Cowan University, Perth, Australia and Medical School, University of Western Australia, Perth, Australia and Centre for Kidney Research, School of Public Health, The University of Sydney, Sydney, Australia
| | - Aedín Cassidy
- Institute for Global Food Security, Queen's University, Belfast, Northern Ireland
| | - Augustin Scalbert
- Biomarkers Group, International Agency for Research on Cancer, Lyon, France
| | - Nicola P Bondonno
- School of Biomedical Sciences, University of Western Australia, Royal Perth Hospital Research Foundation, Perth, Australia. and School of Medical and Health Sciences, Edith Cowan University, Perth, Australia and Institute for Global Food Security, Queen's University, Belfast, Northern Ireland
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Hirahatake KM, Jacobs DR, Shikany JM, Jiang L, Wong ND, Odegaard AO. Cumulative average dietary pattern scores in young adulthood and risk of incident type 2 diabetes: the CARDIA study. Diabetologia 2019; 62:2233-2244. [PMID: 31478081 DOI: 10.1007/s00125-019-04989-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 07/25/2019] [Indexed: 01/04/2023]
Abstract
AIMS/HYPOTHESIS The evidence for the role of contemporary dietary patterns, trends and predominant aspects of energy intake in a typical American diet and in type 2 diabetes risk is limited. Therefore, we examined the association between dietary pattern scores created to reflect the 2015 Dietary Guidelines for Americans (DGA) Scientific Report, a Palaeolithic (Palaeo) diet, a diet high in 'empty calories', and the A Priori Diet Quality Score (APDQS) (cohort reference) and type 2 diabetes risk over time. METHODS We carried out a prospective analysis of 4719 young adult black and white men and women from the Coronary Artery Risk Development in Young Adults (CARDIA) study with repeated dietary histories collected at study years 0, 7 and 20. Using multivariable Cox proportional hazards regression models, we examined the association between time-dependent cumulative average dietary pattern scores and incident type 2 diabetes. RESULTS During the 30 year follow-up period, 680 (14.4%) incident cases of type 2 diabetes occurred. There was no association between the 2015 DGA, Palaeo or empty calorie scores and type 2 diabetes risk in the overall population. Participants in the fourth quartile of the APDQS, reflecting a more healthful dietary pattern, had a 45% lower risk of type 2 diabetes compared with those in the lowest quartile (HR 0.55 [95% CI 0.41, 0.74]). In stratified analyses there was an inverse association for the 2015 DGA in non-smokers per SD (HR 0.86 [95% CI 0.74, 0.99]) and an inverse association for the empty calorie score in white women (HR 0.76 [95% CI 0.60, 0.96]) as well as in a subgroup analysis of the Palaeo index of participants who maintained a high score over 20 years (per SD, HR 0.59 [95% CI 0.39, 0.88]). CONCLUSIONS/INTERPRETATION Higher levels of the APDQS, which largely aligns with the 2015 DGA, were strongly inversely associated with 30 year type 2 diabetes risk in the CARDIA cohort; the results from the other patterns were nuanced and need to be considered in the context of the study and potential biases.
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Affiliation(s)
- Kristin M Hirahatake
- Department of Epidemiology, School of Medicine, University of California, Irvine, CA, 92697-7550, USA
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - James M Shikany
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Luohua Jiang
- Department of Epidemiology, School of Medicine, University of California, Irvine, CA, 92697-7550, USA
| | - Nathan D Wong
- Department of Epidemiology, School of Medicine, University of California, Irvine, CA, 92697-7550, USA
| | - Andrew O Odegaard
- Department of Epidemiology, School of Medicine, University of California, Irvine, CA, 92697-7550, USA.
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Hirahatake KM, Jacobs DR, Shikany JM, Jiang L, Wong ND, Steffen LM, Odegaard AO. Cumulative intake of artificially sweetened and sugar-sweetened beverages and risk of incident type 2 diabetes in young adults: the Coronary Artery Risk Development In Young Adults (CARDIA) Study. Am J Clin Nutr 2019; 110:733-741. [PMID: 31374564 PMCID: PMC6736196 DOI: 10.1093/ajcn/nqz154] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 06/24/2019] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Epidemiological evidence has demonstrated a positive association between artificially sweetened beverage (ASB) and sugar-sweetened beverage (SSB) consumption and type 2 diabetes (T2D) risk. However, research informing this topic in young adults is limited. OBJECTIVE This study examined the association between ASB, SSB, and total sweetened beverage (TSB; combined ASB and SSB) consumption and T2D risk in young adults. METHODS A prospective analysis of 4719 Black and White men and women aged 18-30 y at baseline was conducted from the Coronary Artery Risk Development in Young Adults (CARDIA) study. Each participant's beverage intake was assessed using the CARDIA Diet History at baseline and at study Years 7 and 20. Multivariable Cox proportional hazards regression models were used to examine cumulative average ASB, SSB, and TSB intakes and risk of T2D. RESULTS During the 30-y follow-up period, 680 participants developed T2D. ASB consumption was associated with a 12% greater risk of T2D per serving/day (HR 1.12, 95% CI 1.04-1.20) in a model adjusted for lifestyle factors, diet quality, and dieting behavior. Further adjustments for baseline BMI (HR 1.07, 95% CI 0.99-1.14) and weight change during follow-up (HR 1.04, 95% CI 0.97-1.12) attenuated the association. SSB and TSB consumption as continuous variables per 1 serving/day of intake were associated with 6% and 5% increased risks of T2D, respectively (HRSSB 1.06, 95% CI 1.01-1.10; HRTSB 1.05, 95% CI 1.01-1.09), in the model accounting for lifestyle factors, dieting behavior, baseline BMI, and weight change. Results were consistent when the exposures were modeled in categories of consumption and quintiles. CONCLUSIONS In young adults, long-term ASB, SSB, and TSB consumption were associated with increased risks of T2D. However, the estimates for ASB were attenuated when accounting for weight changes.
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Affiliation(s)
- Kristin M Hirahatake
- Department of Epidemiology, School of Medicine, University of California, Irvine, CA, USA
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, MN, USA
| | - James M Shikany
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, MN, USA,Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, AL, USA
| | - Luohua Jiang
- Department of Epidemiology, School of Medicine, University of California, Irvine, CA, USA
| | - Nathan D Wong
- Department of Epidemiology, School of Medicine, University of California, Irvine, CA, USA,Heart Disease Prevention Program, Department of Medicine, University of California, Irvine, CA, USA
| | - Lyn M Steffen
- Department of Epidemiology, School of Medicine, University of California, Irvine, CA, USA
| | - Andrew O Odegaard
- Department of Epidemiology, School of Medicine, University of California, Irvine, CA, USA,Address correspondence to AOO (E-mail: )
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9
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Jacobs DR, Hu T. Childhood nutrition and cardiovascular disease risk: People in training for a plant-centered diet. J Diabetes 2018; 10:796-798. [PMID: 29962054 PMCID: PMC6160320 DOI: 10.1111/1753-0407.12790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Grants
- R01 HL084064 NHLBI NIH HHS
- R01HL084064 National Heart, Lung, and Blood Institute, National Institutes of Health
- R01HL127077 National Heart, Lung, and Blood Institute, National Institutes of Health
- R40 MC 00319 Maternal and Child Health Bureau (Title V, Social Security Act) Health Resources and Services Administration, Department of Health and Human Services
- R01 HL116892 NHLBI NIH HHS
- R01HL116892 National Heart, Lung, and Blood Institute, National Institutes of Health
- R01 HL127077 NHLBI NIH HHS
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Affiliation(s)
- David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Tian Hu
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
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10
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Ekun OA, Emiabata AF, Abiodun OC, Ogidi NO, Adefolaju FO, Ekun OO. Effects of football sporting activity on renal and liver functions among young undergraduate students of a Nigerian tertiary institution. BMJ Open Sport Exerc Med 2017; 3:e000223. [PMID: 28761709 PMCID: PMC5530113 DOI: 10.1136/bmjsem-2017-000223] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 04/11/2017] [Accepted: 05/03/2017] [Indexed: 12/31/2022] Open
Abstract
Background Football sporting exercise is one of the most popular events in the world. While there are well-documented reports on the effects of different athletic sporting activities on the biochemical markers of renal and liver functions, there are paucity of well-documented reports on the effects of football activity on Nigerian sportsmen, hence the need for this study. Method Biochemical markers of renal and liver functions (urea, creatinine, aspartate aminotransaminase (AST), alanine aminotransaminase (ALT), alkaline phosphatase (ALP)) were determined using Cobas c 111 auto-analyser by Roche. Results The mean urea (mmol/L)±SEM, creatinine (μmol/L)±SEM, AST (U/L)±SEM, ALT (U/L)±SEM and ALP (U/L)±SEM values before and after soccer exercise were 3.56±0.12, 3.76±0.13, p=0.000; 79.36±1.53, 95.90±2.03, p=0.000; 32.54±1.15, 35.81±1.32, p=0.000; 15.68±1.02, 13.97±0.81, p=0.000; and 82.21±3.67, 86.08±3.86, p=0.046, respectively. Pearson’s degree of association for AST and ALT before and after exercise were r=0.678, p=0.000 and r=0.770, p=0.000, respectively; ALT and ALP before exercise showed a positive and significant association (r=0.317, p=0.028). On the other hand, there was a negative but insignificant correlation between urea before exercise and ALP after exercise (r=−0.003, p=0.982) and urea before exercise versus AST after exercise (r=−0.120, p=0.418). A positive but insignificant association was observed between urea and creatinine before exercise (r=0.093, p=0.530). Conclusion Football sporting event is associated with an increase in urea, creatinine, AST and ALP plasma values, and such interpretation of these parameters among sportsmen should be done with caution.
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Affiliation(s)
- Oloruntoba Ayodele Ekun
- Department of Medical Laboratory Science, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Adijat Folake Emiabata
- Department of Medical Laboratory Science, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Olalekan Clement Abiodun
- Department of Medical Laboratory Science, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Nkeiruka Ogochukwu Ogidi
- Department of Medical Laboratory Science, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Florence O Adefolaju
- Department of Haematology and Blood Transfusion, College of Medicine, University of Lagos, Lagos, Nigeria
| | - Oyeronke Olufemi Ekun
- Laboratory Department, General Hospital Ijede, Lagos State Health Service Commission, Lagos, Nigeria
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11
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Zhang X, Devlin HM, Smith B, Imperatore G, Thomas W, Lobelo F, Ali MK, Norris K, Gruss S, Bardenheier B, Cho P, Garcia de Quevedo I, Mudaliar U, Jones CD, Durthaler JM, Saaddine J, Geiss LS, Gregg EW. Effect of lifestyle interventions on cardiovascular risk factors among adults without impaired glucose tolerance or diabetes: A systematic review and meta-analysis. PLoS One 2017; 12:e0176436. [PMID: 28493887 PMCID: PMC5426619 DOI: 10.1371/journal.pone.0176436] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 04/10/2017] [Indexed: 02/07/2023] Open
Abstract
Structured lifestyle interventions can reduce diabetes incidence and cardiovascular disease (CVD) risk among persons with impaired glucose tolerance (IGT), but it is unclear whether they should be implemented among persons without IGT. We conducted a systematic review and meta-analyses to assess the effectiveness of lifestyle interventions on CVD risk among adults without IGT or diabetes. We systematically searched MEDLINE, EMBASE, CINAHL, Web of Science, the Cochrane Library, and PsychInfo databases, from inception to May 4, 2016. We selected randomized controlled trials of lifestyle interventions, involving physical activity (PA), dietary (D), or combined strategies (PA+D) with follow-up duration ≥12 months. We excluded all studies that included individuals with IGT, confirmed by 2-hours oral glucose tolerance test (75g), but included all other studies recruiting populations with different glycemic levels. We stratified studies by baseline glycemic levels: (1) low-range group with mean fasting plasma glucose (FPG) <5.5mmol/L or glycated hemoglobin (A1C) <5.5%, and (2) high-range group with FPG ≥5.5mmol/L or A1C ≥5.5%, and synthesized data using random-effects models. Primary outcomes in this review included systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and triglycerides (TG). Totally 79 studies met inclusion criteria. Compared to usual care (UC), lifestyle interventions achieved significant improvements in SBP (-2.16mmHg[95%CI, -2.93, -1.39]), DBP (-1.83mmHg[-2.34, -1.31]), TC (-0.10mmol/L[-0.15, -0.05]), LDL-C (-0.09mmol/L[-0.13, -0.04]), HDL-C (0.03mmol/L[0.01, 0.04]), and TG (-0.08mmol/L[-0.14, -0.03]). Similar effects were observed among both low-and high-range study groups except for TC and TG. Similar effects also appeared in SBP and DBP categories regardless of follow-up duration. PA+D interventions had larger improvement effects on CVD risk factors than PA alone interventions. In adults without IGT or diabetes, lifestyle interventions resulted in significant improvements in SBP, DBP, TC, LDL-C, HDL-C, and TG, and might further reduce CVD risk.
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Affiliation(s)
- Xuanping Zhang
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- * E-mail:
| | - Heather M. Devlin
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Bryce Smith
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Giuseppina Imperatore
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - William Thomas
- Office of Public Health Scientific Services, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Felipe Lobelo
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Mohammed K. Ali
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Keri Norris
- Health Policy and Administration, Fulton-DeKalb Hospital Authority, Atlanta, Georgia, United States of America
| | - Stephanie Gruss
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Barbara Bardenheier
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Pyone Cho
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Isabel Garcia de Quevedo
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Uma Mudaliar
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Christopher D. Jones
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jeffrey M. Durthaler
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jinan Saaddine
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Linda S. Geiss
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Edward W. Gregg
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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12
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Wibisono C, Probst Y, Neale E, Tapsell L. Changes in diet quality during a 12 month weight loss randomised controlled trial. BMC Nutr 2017; 3:38. [PMID: 32153818 PMCID: PMC7050806 DOI: 10.1186/s40795-017-0157-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 04/08/2017] [Indexed: 11/25/2022] Open
Abstract
Background Reductions in energy intake are seen in weight loss trials, but whether this occurs with improvements to diet quality (DQ) is less established. The aim of this study was to evaluate changes in diet quality in a sample of volunteers in a weight loss trial. Methods This was a secondary analysis of dietary data from a lifestyle intervention trial (the HealthTrack study) which advised on dietary guidelines. The trial ran for 12 months with three treatment groups: control (general advice C), intervention (individualised advice, I), and intervention plus a supplement of walnuts (IW). Both the published a priori diet quality score (APDQS, maximum score 164) and a study specific Diet Quality Tracker (DQT, maximum score 44) indicated compliance to dietary advice. DQ scores calculated at 0, 3months and 12months were evaluated using two-way RMANOVA, one-way ANOVA and one-way RMANOVA. Changes in intakes of food groups and nutrients were analysed using Kruskal-Wallis and Friedman’s tests. Results There were no differences between groups at baseline, but at 3months IW recorded higher DQ scores (APDQS:96 ± 10; DQT:22 ± 5, P < 1 × 10−3 for both) compared to I (APDQS:91 ± 13, P < 1 × 10−3; DQT:21 ± 4, P < 1 × 10−2) and C (APDQS:87 ± 12, P < 5 × 10−2; DQT:19 ± 4, P > 5 × 10−2), and a higher consumption of nuts at 3 months (P < 1 × 10−3), and 12months (P < 1 × 10−2). All groups reported decreased intakes of discretionary foods/beverages assessed by the DQT (P < 1 × 10−3 for IW and I; P < 1 × 10−2 for C). The APDQS showed this as reduced intakes of grain based desserts (P < 1 × 10−3 at 3 and 12months), and salty snacks at 12months (P < 1 × 10−3 for IW and I; P < 5 × 10−2 for C). Intakes of monounsaturated and saturated fatty acids were lowest, and polyunsaturated fatty acids highest for IW (P < 1 × 10−3), resulting in a higher dietary polyunsaturated:saturated fat ratio (P < 1 × 10−3). Conclusions Lifestyle intervention addressing dietary guidelines can lead to significant reductions in consumption of discretionary foods and saturated fat, but individualised advice may have a greater impact on improving overall DQ regardless of DQI used. Providing a healthy food supplement may help assure higher DQ and where the food is walnuts, produce commensurate differences in dietary fatty acid profiles. Trial registration ANZCTRN 12614000581662. Date of registration: 30th May 2014. Electronic supplementary material The online version of this article (doi:10.1186/s40795-017-0157-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Cinthya Wibisono
- 1School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales 2522 Australia
| | - Yasmine Probst
- 1School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales 2522 Australia.,2Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales 2522 Australia
| | - Elizabeth Neale
- 1School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales 2522 Australia.,2Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales 2522 Australia
| | - Linda Tapsell
- 1School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales 2522 Australia.,2Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales 2522 Australia
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13
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Zhang X, Imperatore G, Thomas W, Cheng YJ, Lobelo F, Norris K, Devlin HM, Ali MK, Gruss S, Bardenheier B, Cho P, Garcia de Quevedo I, Mudaliar U, Saaddine J, Geiss LS, Gregg EW. Effect of lifestyle interventions on glucose regulation among adults without impaired glucose tolerance or diabetes: A systematic review and meta-analysis. Diabetes Res Clin Pract 2017; 123:149-164. [PMID: 28024276 PMCID: PMC6625761 DOI: 10.1016/j.diabres.2016.11.020] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 11/16/2016] [Accepted: 11/26/2016] [Indexed: 12/31/2022]
Abstract
This study systematically assessed the effectiveness of lifestyle interventions on glycemic indicators among adults (⩾18years) without IGT or diabetes. Randomized controlled trials using physical activity (PA), diet (D), or their combined strategies (PA+D) with follow-up ⩾12months were systematically searched from multiple electronic-databases between inception and May 4, 2016. Outcome measures included fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), fasting insulin (FI), homeostasis model assessment-estimated insulin resistance (HOMA-IR), and bodyweight. Included studies were divided into low-range (FPG <5.5mmol/L or HbA1c <5.5%) and high-range (FPG ⩾5.5mmol/L or HbA1c ⩾5.5%) groups according to baseline glycemic levels. Seventy-nine studies met inclusion criteria. Random-effect models demonstrated that compared with usual care, lifestyle interventions achieved significant reductions in FPG (-0.14mmol/L [95%CI, -0.19, -0.10]), HbA1c (-0.06% [-0.09, -0.03]), FI (%change: -15.18% [-20.01, -10.35]), HOMA-IR (%change: -22.82% [-29.14, -16.51]), and bodyweight (%change: -3.99% [-4.69, -3.29]). The same effect sizes in FPG reduction (0.07) appeared among both low-range and high-range groups. Similar effects were observed among all groups regardless of lengths of follow-up. D and PA+D interventions had larger effects on glucose reduction than PA alone. Lifestyle interventions significantly improved FPG, HbA1c, FI, HOMA-IR, and bodyweight among adults without IGT or diabetes, and might reduce progression of hyperglycemia to type 2 diabetes mellitus.
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Affiliation(s)
- Xuanping Zhang
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Giuseppina Imperatore
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - William Thomas
- Office of Public Health Scientific Services, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Yiling J Cheng
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Felipe Lobelo
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Keri Norris
- Health Policy and Administration, Fulton-DeKalb Hospital Authority, Atlanta, GA, USA.
| | - Heather M Devlin
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Mohammed K Ali
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Stephanie Gruss
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Barbara Bardenheier
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Pyone Cho
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Isabel Garcia de Quevedo
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Uma Mudaliar
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Jinan Saaddine
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Linda S Geiss
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Edward W Gregg
- Division of Diabetes Translation, National Centers for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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14
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Hu T, Jacobs DR, Larson NI, Cutler GJ, Laska MN, Neumark-Sztainer D. Higher Diet Quality in Adolescence and Dietary Improvements Are Related to Less Weight Gain During the Transition From Adolescence to Adulthood. J Pediatr 2016; 178:188-193.e3. [PMID: 27640354 PMCID: PMC5085861 DOI: 10.1016/j.jpeds.2016.08.026] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 07/19/2016] [Accepted: 08/08/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVES To examine the previously validated A Priori Diet Quality Score (APDQS), and weight change among adolescents transitioning into young adulthood. STUDY DESIGN Young people were recruited in middle/high schools and followed for 10 years. Participants reported diet and weight in 1999 (mean age, 15 years), 2004 (20 years), and 2009 (25 years). The analytic sample (n = 2656) had dietary intake assessments in 1999 and at least one other assessment. The APDQS (without alcoholic items) was based on 13 beneficial food groups, 12 adverse food groups, and 9 neutral food groups to capture aspects of Mediterranean/prudent diets, focusing on foods that are varied, based on nutritionally rich plants, and less processed. RESULTS From mean age 15 to 25 years, mean (SD) weight increased from 61.0 (14.7) kg to 76.1 (18.8) kg, and APDQS increased from 43.1 (11.1) points to 45.6 (10.7) points. Within-person tracking correlation of the APDQS was 0.35 at mean age 15-20 years, increasing to 0.49 at 20-25 years. Independent of lifestyle factors and energy intake, a 15-point (IQR) higher APDQS in 1999 was associated with 1.5 kg (95% CI, 0.7-2.3 kg) less weight gain over 10 years, The increase in APDQS over time was similarly associated with less concurrent weight gain. Findings were stronger for models of excess weight gain. CONCLUSION Higher diet quality, based on an assessment of dietary patterns in and after adolescence, was associated with reduced weight gain during the next 10 years. Establishment of high-quality dietary patterns in adolescence may help mitigate excess weight gain by young adulthood.
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Affiliation(s)
- Tian Hu
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN
| | - David R Jacobs
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN.
| | - Nicole I Larson
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN
| | - Gretchen J Cutler
- Department of Pediatric Emergency Medicine, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN
| | - Melissa N Laska
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN
| | - Dianne Neumark-Sztainer
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN
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15
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Clustering of adherence to personalised dietary recommendations and changes in healthy eating index within the Food4Me study. Public Health Nutr 2016; 19:3296-3305. [PMID: 27499187 DOI: 10.1017/s1368980016001932] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To characterise clusters of individuals based on adherence to dietary recommendations and to determine whether changes in Healthy Eating Index (HEI) scores in response to a personalised nutrition (PN) intervention varied between clusters. DESIGN Food4Me study participants were clustered according to whether their baseline dietary intakes met European dietary recommendations. Changes in HEI scores between baseline and month 6 were compared between clusters and stratified by whether individuals received generalised or PN advice. SETTING Pan-European, Internet-based, 6-month randomised controlled trial. SUBJECTS Adults aged 18-79 years (n 1480). RESULTS Individuals in cluster 1 (C1) met all recommended intakes except for red meat, those in cluster 2 (C2) met two recommendations, and those in cluster 3 (C3) and cluster 4 (C4) met one recommendation each. C1 had higher intakes of white fish, beans and lentils and low-fat dairy products and lower percentage energy intake from SFA (P<0·05). C2 consumed less chips and pizza and fried foods than C3 and C4 (P<0·05). C1 were lighter, had lower BMI and waist circumference than C3 and were more physically active than C4 (P<0·05). More individuals in C4 were smokers and wanted to lose weight than in C1 (P<0·05). Individuals who received PN advice in C4 reported greater improvements in HEI compared with C3 and C1 (P<0·05). CONCLUSIONS The cluster where the fewest recommendations were met (C4) reported greater improvements in HEI following a 6-month trial of PN whereas there was no difference between clusters for those randomised to the Control, non-personalised dietary intervention.
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16
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Vassallo P, Driver SL, Stone NJ. Metabolic Syndrome: An Evolving Clinical Construct. Prog Cardiovasc Dis 2016; 59:172-177. [PMID: 27497505 DOI: 10.1016/j.pcad.2016.07.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 07/31/2016] [Indexed: 01/19/2023]
Abstract
Metabolic syndrome (MetS), a clustering of metabolic risk factors, identifies individuals at increased risk of diabetes and cardiovascular disease (CVD). Measurement of waist circumference, high-density lipoprotein-cholesterol, triglycerides, blood pressure and fasting blood glucose are easily obtained in the clinic. At any level of low-density lipoprotein-cholesterol, presence of MetS increases the risk of adverse CVD outcomes including bothatherosclerotic CVD and atrial fibrillation. The MetS construct should focus the clinician on recommending behavioral lifestyle modification as this improves all of its components. The challenge, however, has been the lack of a standardized approach to achieve effective and sustained lifestyle modification in clinical practice. We briefly review various approaches useful to the clinician in counseling such patients. These include group lifestyle programs and emerging mobile technology. Technology alone may not be sufficient, but as an adjunct has the promise to improve low rates of behavioral change currently seen with traditional programs.
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Affiliation(s)
- Patricia Vassallo
- McGaw Medical Center, Northwestern University, Division of Cardiology.
| | - Steven L Driver
- McGaw Medical Center, Northwestern University, Division of Cardiology
| | - Neil J Stone
- McGaw Medical Center, Northwestern University, Division of Cardiology
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17
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Semlitsch T, Jeitler K, Berghold A, Horvath K, Posch N, Poggenburg S, Siebenhofer A. Long-term effects of weight-reducing diets in people with hypertension. Cochrane Database Syst Rev 2016; 3:CD008274. [PMID: 26934541 PMCID: PMC7154764 DOI: 10.1002/14651858.cd008274.pub3] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND All major guidelines for antihypertensive therapy recommend weight loss. Thus dietary interventions that aim to reduce body weight might be a useful intervention to reduce blood pressure and adverse cardiovascular events associated with hypertension. OBJECTIVES Primary objectivesTo assess the long-term effects of weight-reducing diets in people with hypertension on all-cause mortality, cardiovascular morbidity, and adverse events (including total serious adverse events, withdrawal due to adverse events, and total non-serious adverse events). Secondary objectivesTo assess the long-term effects of weight-reducing diets in people with hypertension on change from baseline in systolic blood pressure, change from baseline in diastolic blood pressure, and body weight reduction. SEARCH METHODS We obtained studies from computerised searches of the Cochrane Central Register of Controlled Trials (CENTRAL), the Cochrane Hypertension Specialised Register, Ovid MEDLINE, and Ovid EMBASE, and from searches in reference lists, systematic reviews, and the clinical trials registry ClinicalTrials.gov (status as of 2 February 2015). SELECTION CRITERIA We included randomised controlled trials (RCTs) of at least 24 weeks' duration that compared weight-reducing dietary interventions to no dietary intervention in adults with primary hypertension. DATA COLLECTION AND ANALYSIS Two review authors independently assessed risk of bias and extracted data. We pooled studies using fixed-effect meta-analysis. In case of moderate or larger heterogeneity as measured by Higgins I(2), we used a random-effects model. MAIN RESULTS This review update did not reveal any new studies, so the number of included studies remained the same: 8 studies involving a total of 2100 participants with high blood pressure and a mean age of 45 to 66 years. Mean treatment duration was 6 to 36 months. We judged the risk of bias as unclear or high for all but two trials. No study included mortality as a predefined outcome. One RCT evaluated the effects of dietary weight loss on a combined endpoint consisting of the necessity of reinstating antihypertensive therapy and severe cardiovascular complications. In this RCT, weight-reducing diet lowered the endpoint compared to no diet: hazard ratio 0.70 (95% confidence interval (CI), 0.57 to 0.87). None of the studies evaluated adverse events as designated in our protocol. There was low-quality evidence for a blood pressure reduction in participants assigned to weight loss diets as compared to controls: systolic blood pressure: mean difference (MD) -4.5 mm Hg (95% CI -7.2 to -1.8 mm Hg) (3 of 8 studies included in analysis), and diastolic blood pressure: MD -3.2 mm Hg (95% CI -4.8 to -1.5 mm Hg) (3 of 8 studies included in analysis). There was moderate-quality evidence for weight reduction in dietary weight loss groups as compared to controls: MD -4.0 kg (95% CI -4.8 to -3.2) (5 of 8 studies included in analysis). Two studies used withdrawal of antihypertensive medication as their primary outcome. Even though we did not consider this a relevant outcome for our review, the results of these studies strengthen the finding of reduction of blood pressure by dietary weight loss interventions. AUTHORS' CONCLUSIONS In this update, the conclusions remain the same, as we found no new trials. In people with primary hypertension, weight loss diets reduced body weight and blood pressure, however the magnitude of the effects are uncertain due to the small number of participants and studies included in the analyses. Whether weight loss reduces mortality and morbidity is unknown. No useful information on adverse effects was reported in the relevant trials.
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Affiliation(s)
- Thomas Semlitsch
- Medical University of GrazInstitute of General Practice and Evidence‐Based Health Services ResearchAuenbruggerplatz 2/9GrazAustria8036
| | - Klaus Jeitler
- Medical University of GrazInstitute of General Practice and Evidence‐Based Health Services Research / Institute of Medical Informatics, Statistics and DocumentationAuenbruggerplatz 2/9GrazAustria8036
| | - Andrea Berghold
- Medical University of GrazInstitute of General Practice and Evidence‐Based Health Services Research / Institute of Medical Informatics, Statistics and DocumentationAuenbruggerplatz 2/9GrazAustria8036
| | - Karl Horvath
- Medical University of GrazInstitute of General Practice and Evidence‐Based Health Services Research / Department of Internal Medicine, Division of Endocrinology and MetabolismAuenbruggerplatz 2/9GrazAustria8036
| | - Nicole Posch
- Medical University of GrazInstitute of General Practice and Evidence‐Based Health Services ResearchAuenbruggerplatz 2/9GrazAustria8036
| | - Stephanie Poggenburg
- Medical University of GrazInstitute of General Practice and Evidence‐Based Health Services ResearchAuenbruggerplatz 2/9GrazAustria8036
| | - Andrea Siebenhofer
- Graz, Austria / Institute of General Practice, Goethe UniversityInstitute of General Practice and Evidence‐Based Health Services Research, Medical University of GrazFrankfurt am MainGermany
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Abstract
PURPOSE OF REVIEW Given scientific and public debate about optimal diet to prevent cardiovascular disease, and interest in diet and other chronic diseases, we propose that following a few simple dietary principles would reduce chronic disease incidence. RECENT FINDINGS Nutrition research has been criticized for focusing on individual nutrients and foods, treated like drug therapy. With a few important exceptions, clinical trials of supplemental nutrients have not shown benefit. Although highly specific nutrition information is elusive, diet patterns have provided consistent answers, important for public health. Observational cohort studies have found that some dietary patterns are reported with high reliability over long periods and predict future cardiovascular and other inflammatory-related diseases. Two randomized clinical trials confirmed this finding. There are many common features of Mediterranean and prudent diets, particularly the plant-centered aspect, coupled with variety of foods eaten. A dietary pattern characterized by high fruit, vegetable, legume, whole grain, nut, berry, seed, and fish intakes, and possibly by intakes of dairy, coffee, tea, chocolate, and alcohol (not in excess), but low meat and detrimentally processed foods is associated with reduced incidence of cardiovascular disease and rates of noncardiovascular, noncancer chronic inflammatory-related mortality. SUMMARY A plant-centered diet may be broadly recommended.
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Affiliation(s)
- David R Jacobs
- aDivision of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA bSchool of Health Sciences, University of Wollongong, Wollongong, NSW, Australia
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Thompson HJ, Sedlacek SM, Wolfe P, Paul D, Lakoski SG, Playdon MC, McGinley JN, Matthews SB. Impact of Weight Loss on Plasma Leptin and Adiponectin in Overweight-to-Obese Post Menopausal Breast Cancer Survivors. Nutrients 2015; 7:5156-76. [PMID: 26132992 PMCID: PMC4516992 DOI: 10.3390/nu7075156] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 06/10/2015] [Accepted: 06/18/2015] [Indexed: 12/13/2022] Open
Abstract
Women who are obese at the time of breast cancer diagnosis have higher overall mortality than normal weight women and some evidence implicates adiponectin and leptin as contributing to prognostic disadvantage. While intentional weight loss is thought to improve prognosis, its impact on these adipokines is unclear. This study compared the pattern of change in plasma leptin and adiponectin in overweight-to-obese post-menopausal breast cancer survivors during weight loss. Given the controversies about what dietary pattern is most appropriate for breast cancer control and regulation of adipokine metabolism, the effect of a low fat versus a low carbohydrate pattern was evaluated using a non-randomized, controlled study design. Anthropometric data and fasted plasma were obtained monthly during the six-month weight loss intervention. While leptin was associated with fat mass, adiponectin was not, and the lack of correlation between leptin and adiponectin concentrations throughout weight loss implies independent mechanisms of regulation. The temporal pattern of change in leptin but not adiponectin was affected by magnitude of weight loss. Dietary pattern was without effect on either adipokine. Mechanisms not directly related to dietary pattern, weight loss, or fat mass appear to play dominant roles in the regulation of circulating levels of these adipokines.
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Affiliation(s)
- Henry J Thompson
- Cancer Prevention Laboratory, Colorado State University, Fort Collins, CO 80523-1173, USA.
| | - Scot M Sedlacek
- Cancer Prevention Laboratory, Colorado State University, Fort Collins, CO 80523-1173, USA.
- Rocky Mountain Cancer Centers, Denver, CO 80220, USA.
| | - Pamela Wolfe
- Colorado Biostatistics Consortium, University of Colorado, Denver, CO 80045, USA.
| | - Devchand Paul
- Rocky Mountain Cancer Centers, Denver, CO 80220, USA.
| | - Susan G Lakoski
- Department of Internal Medicine, University of Vermont, Burlington, VT 05405, USA.
| | - Mary C Playdon
- Cancer Prevention Laboratory, Colorado State University, Fort Collins, CO 80523-1173, USA.
- Department of Chronic Disease Epidemiology, Yale University, New Haven, CT 06520, USA.
| | - John N McGinley
- Cancer Prevention Laboratory, Colorado State University, Fort Collins, CO 80523-1173, USA.
| | - Shawna B Matthews
- Cancer Prevention Laboratory, Colorado State University, Fort Collins, CO 80523-1173, USA.
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Lifestyle modification for metabolic syndrome: a systematic review. Am J Med 2014; 127:1242.e1-10. [PMID: 25004456 DOI: 10.1016/j.amjmed.2014.06.035] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 06/07/2014] [Accepted: 06/09/2014] [Indexed: 01/07/2023]
Abstract
BACKGROUND All 5 components of metabolic syndrome have been shown to improve with lifestyle and diet modification. New strategies for achieving adherence to meaningful lifestyle change are needed to optimize atherosclerotic cardiovascular risk reduction. We performed a systematic literature review, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework (PRISMA), investigating optimal methods for achieving lifestyle change in metabolic syndrome. METHODS We submitted standardized search terms to the PubMed Central, CINAHL, Web of Science, and Ovid databases. Within those results, we selected randomized controlled trials (RCTs) presenting unique methods of achieving lifestyle change in patients with one or more components of the metabolic syndrome. Data extraction using the population, intervention, comparator, outcome, and risk of bias framework (PICO) was used to compare the following endpoints: prevalence of metabolic syndrome, prevalence of individual metabolic syndrome components, mean number of metabolic syndrome components, and amount of weight loss achieved. RESULTS Twenty-eight RCTs (6372 patients) were included. Eight RCTs demonstrated improvement in metabolic syndrome risk factors after 1 year. Team-based, interactive approaches with high-frequency contact with patients who are motivated made the largest and most lasting impact. Technology was found to be a useful tool in achieving lifestyle change, but ineffective when compared with personal contact. CONCLUSION Patient motivation leading to improved lifestyle adherence is a key factor in achieving reduction in metabolic syndrome components. These elements can be enhanced via frequent encounters with the health care system. Use of technologies such as mobile and Internet-based communication can increase the effectiveness of lifestyle change in metabolic syndrome, but should not replace personal contact as the cornerstone of therapy. Our ability to derive quantitative conclusions is limited by inconsistent outcome measures across studies, low power and homogeneity of individual studies, largely motivated study populations, short follow-up periods, loss to follow-up, and lack of or incomplete blinding.
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Jacobs DR, Orlich MJ. Diet pattern and longevity: do simple rules suffice? A commentary. Am J Clin Nutr 2014; 100 Suppl 1:313S-9S. [PMID: 24871470 PMCID: PMC4144105 DOI: 10.3945/ajcn.113.071340] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Nutritionism reduces dietary advice to statements about a few nutrients, with sometimes unintended implications for science, industry, and the public. Although reductionist questions about nutrition are legitimate scientifically, a nutrient focus in the public arena forces the food industry to compete with the use of nutrient statements. Consumers must interpret information that may not be correct or relevant. The theory of food synergy, which postulates that the many constituents of individual foods and dietary patterns act together on health, leads to the idea that dietary policy would be clearer if it focused on foods. To illustrate this method, the food-based A Priori Diet Quality Score was described in the Iowa Women's Health Study; a substantial total mortality reduction for increasing quartiles of the score was found. The simple food-based rules implied in this a priori score support minimizing meat, salt, added sugar, and heavily processed foods while emphasizing phytochemical-rich foods. These principles could help improve nutrition policy, help industry to supply better food, and help to focus future scientific research. Although an understanding of what foods are best for health is a step forward in nutrition, other major challenges remain, including getting high-quality food to the masses and food sustainability.
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Affiliation(s)
- David R Jacobs
- From the Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN (DRJ), and the Department of Preventive Medicine, School of Medicine, Loma Linda University, Loma Linda, CA (MJO)
| | - Michael J Orlich
- From the Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN (DRJ), and the Department of Preventive Medicine, School of Medicine, Loma Linda University, Loma Linda, CA (MJO)
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Sijtsma FPC, Meyer KA, Steffen LM, Van Horn L, Shikany JM, Odegaard AO, Gross MD, Kromhout D, Jacobs DR. Diet quality and markers of endothelial function: the CARDIA study. Nutr Metab Cardiovasc Dis 2014; 24:632-8. [PMID: 24534074 PMCID: PMC4037360 DOI: 10.1016/j.numecd.2013.12.010] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 12/18/2013] [Accepted: 12/18/2013] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND AIM Dietary patterns are associated cross-sectionally with cellular adhesion molecules (CAMs). We studied prospective associations of three dietary patterns with CAMs. METHODS AND RESULTS In the Coronary Artery Risk Development in Young Adults (CARDIA) study, diet was assessed at years 0 (1985-86) and 7 (1992-93) examinations. Four circulating CAMs (E-selectin, P-selectin, soluble intercellular adhesion molecule 1 (sICAM-1), and vascular cellular adhesion molecule (VCAM)) were assayed at years 7 and 15 (2000-01). We created one index score "A Priori Diet Quality Score" and derived dietary patterns using principal components analysis (PCA). Multivariable linear regression models predicted year 15 CAMs from averaged (year 0/7) dietary patterns. The A Priori Diet Quality Score rated 46 food groups beneficial, neutral or adverse based on hypothesized health effects. We derived two PCA dietary patterns: "fruit and vegetables (FV)" (high intakes of fruit, vegetables, and whole grains) and "meat" (high intakes of red meat, refined grain, and butter). All dietary patterns were related to E-selectin and sICAM-1. P-selectin was not related to the FV dietary pattern. VCAM was only related to the A Priori Diet Quality Score. Strongest associations were for the meat dietary pattern with E-selectin (effect size 28% of an SD (+3.9/13.7 ng/mL)) and P-selectin (effect size 37% of an SD (+4.1/11.2 ng/mL)) and the A Priori Diet Quality Score with sICAM-1 (effect size 34% of an SD (-15.1/44.7 ng/mL)) and VCAM (effect size of 26% of an SD (-45.1/170.3 ng/mL)). CONCLUSION This prospective analysis suggests that dietary patterns are associated with CAMs.
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Affiliation(s)
- F P C Sijtsma
- The Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA; The Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
| | - K A Meyer
- Department of Nutrition, University of North Carolina, Chapel Hill, NC, USA
| | - L M Steffen
- The Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - L Van Horn
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - J M Shikany
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - A O Odegaard
- The Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - M D Gross
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - D Kromhout
- The Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - D R Jacobs
- The Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA; The Department of Nutrition, University of Oslo, Oslo, Norway
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Shikany JM, Jacobs DR, Lewis CE, Steffen LM, Sternfeld B, Carnethon MR, Richman JS. Associations between food groups, dietary patterns, and cardiorespiratory fitness in the Coronary Artery Risk Development in Young Adults study. Am J Clin Nutr 2013; 98:1402-9. [PMID: 24088719 PMCID: PMC3831533 DOI: 10.3945/ajcn.113.058826] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Few studies have investigated the association between overall diet and cardiorespiratory fitness (CRF). OBJECTIVE We aimed to investigate associations of food groups, a diet-quality score, and dietary patterns with CRF in black and white adults. DESIGN We included 2632 participants aged 38-50 y who attended the year 20 exam of the Coronary Artery Risk Development in Young Adults (CARDIA) study and Coronary Artery Risk Development in Young Adults Fitness Study (CFS) conducted in 2005-2006. Diet was assessed by using a validated diet history. A dietary score and 2 types of patterns were included as follows: the a priori diet-quality score and meat and fruit-vegetable dietary patterns derived from principal components analysis. CRF was assessed by using a graded exercise treadmill test. Linear regression models regressed the treadmill duration on food groups and dietary scores and patterns overall and in race-sex subgroups. RESULTS Grains (whole and refined), processed meats, and beverages (coffee, meal-replacement drinks, beer, and wine) were positively associated with the treadmill duration overall; whole fruit (not juices), organ meats, fried meats and fish, and soy and nondairy products were negatively associated. The a priori diet-quality score was positively associated with the duration overall and in all race-sex subgroups (P <0.05) except black men. The meat pattern was negatively associated with the duration in white men and white women only. The fruit-vegetable pattern was positively associated with duration in white women only. CONCLUSIONS Overall, the a priori diet-quality score was positively associated with CRF in this cohort of black and white adults, whereas the meat dietary pattern was negatively associated only in whites. The CARDIA study and CFS were registered at clinicaltrials.gov as NCT00005130 and NCT00106457, respectively.
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Affiliation(s)
- James M Shikany
- Division of Preventive Medicine (JMS and CEL) and the Department of Surgery (JSR), School of Medicine, University of Alabama at Birmingham, Birmingham, AL; the Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN (DRJ and LMS); the Kaiser Permanente Division of Research, Oakland, CA (BS); and the Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (MRC)
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Odegaard AO, Jacobs DR, Steffen LM, Van Horn L, Ludwig DS, Pereira MA. Breakfast frequency and development of metabolic risk. Diabetes Care 2013; 36:3100-6. [PMID: 23775814 PMCID: PMC3781522 DOI: 10.2337/dc13-0316] [Citation(s) in RCA: 131] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The relation of breakfast intake frequency to metabolic health is not well studied. The aim of this study was to examine breakfast intake frequency with incidence of metabolic conditions. RESEARCH DESIGN AND METHODS We performed an analysis of 3,598 participants from the community-based Coronary Artery Risk Development in Young Adults (CARDIA) study who were free of diabetes in the year 7 examination when breakfast and dietary habits were assessed (1992-1993) and participated in at least one of the five subsequent follow-up examinations over 18 years. RESULTS Relative to those with infrequent breakfast consumption (0-3 days/week), participants who reported eating breakfast daily gained 1.9 kg less weight over 18 years (P=0.001). In a Cox regression analysis, there was a stepwise decrease in risk across conditions in frequent breakfast consumers (4-6 days/week) and daily consumers. The results for incidence of abdominal obesity, obesity, metabolic syndrome, and hypertension remained significant after adjustment for baseline measures of adiposity (waist circumference or BMI) in daily breakfast consumers. Hazard ratios (HRs) and 95% CIs for daily breakfast consumption were as follows: abdominal obesity HR 0.78 (95% CI 0.66-0.91), obesity 0.80 (0.67-0.96), metabolic syndrome 0.82 (0.69-0.98), and hypertension 0.84 (0.72-0.99). For type 2 diabetes, the corresponding estimate was 0.81 (0.63-1.05), with a significant stepwise inverse association in black men and white men and women but no association in black women. There was no evidence of differential results for high versus low overall dietary quality. CONCLUSIONS Daily breakfast intake is strongly associated with reduced risk of a spectrum of metabolic conditions.
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Mursu J, Steffen LM, Meyer KA, Duprez D, Jacobs DR. Diet quality indexes and mortality in postmenopausal women: the Iowa Women's Health Study. Am J Clin Nutr 2013; 98:444-53. [PMID: 23783291 PMCID: PMC3712553 DOI: 10.3945/ajcn.112.055681] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND A priori diet scores such as the Alternative Healthy Eating Index (AHEI) and the food-based a priori diet quality score predict chronic disease risk. OBJECTIVE We compared the AHEI and a priori diet quality score relative to mortality. DESIGN Postmenopausal women who were free of diabetes, cardiovascular disease (CVD), and cancer in the Iowa Women's Health Study (in 1986, n = 29,634 with a mean 6 SD age of 61.4 6 4.2 y; in 2004, n = 15,076 with a mean 6 SD age of 79.7 6 4.0 y). A food-frequency questionnaire was used. Through 31 December 2008, 10,343 total, 3646 CVD, 3207 cancer, and 2888 inflammatory-related deaths were identified through record linkage. HRs were computed for quartiles of each diet score at baseline and 2004. To compare scores, the residual of each score given the other score was computed by using linear regression. RESULTS At baseline, indexes had a correlation of 0.65. For the AHEI, the multivariable-adjusted HRs (95% CIs) for total, CVD, cancer, and inflammatory-related mortality were 0.82 (0.77, 0.87), 0.79 (0.72, 0.88), 0.88 (0.79, 0.98), and 0.76 (0.68, 0.84), respectively. The a priori score had corresponding HRs of 0.80 (0.76, 0.85), 0.79 (0.72, 0.88), 0.86 (0.77, 0.95), and 0.75 (0.67, 0.84), respectively. Each score added information to the other score for total, CVD mortality, and inflammatory-related mortality. In 2004, both scores predicted total, CVD, and inflammatory-related mortality, and the a priori score also predicted cancer mortality. The a priori score added independent information for all outcomes except cancer, whereas the AHEI added information only for total mortality. CONCLUSION Two correlated diet quality scores predicted total and disease-specific mortality, but their residuals also predicted complementarily.
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Affiliation(s)
- Jaakko Mursu
- Divisions of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN 55454, USA
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Nazare JA, Smith J, Borel AL, Alméras N, Tremblay A, Bergeron J, Poirier P, Després JP. Changes in both global diet quality and physical activity level synergistically reduce visceral adiposity in men with features of metabolic syndrome. J Nutr 2013; 143:1074-83. [PMID: 23719226 DOI: 10.3945/jn.113.175273] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
With regard to the beneficial impact of lifestyle interventions on weight and abdominal obesity management, our objective was to identify which components of a lifestyle-intervention program [physical activity (PA), energy and macronutrient intake, diet quality] had an influence on visceral adipose tissue (VAT) loss. The present lifestyle intervention targeted a daily energy deficit (500 kcal), coupled with a PA program (160 min/wk). From the 144 participants initially recruited, 93 viscerally obese men (age: 49 ± 1 y; waist circumference: 108 ± 9 cm; plasma triglyceride concentration: 2.46 ± 0.09 mmol/L) who completed a 3-d dietary journal both at baseline and after 1 y of intervention and a daily PA journal for 1 y were considered in the present analyses. Body composition and fat distribution were assessed by using dual-energy X-ray absorptiometry and computed tomography. After 1 y, abdominally obese men significantly improved their diet quality, as assessed by the Dietary Approaches to Stop Hypertension (DASH)-derived diet quality (DQ) score (P < 0.0001). Improved DQ and higher levels of PA were both independently and significantly associated with reductions in body weight, fat mass, VAT, and thigh muscle fat content, beyond reported energy intake or diet macronutrient composition. When stratified according to the level of PA and DQ [PA- (low PA), DQ- (low DQ), PA+ (high PA), DQ+ (high DQ)], the PA+/DQ+ group showed reductions in VAT that were 20% greater than in the PA-/DQ+ group, 28% greater than in the PA+/DQ- group, and 50% (P < 0.05) greater than in the PA-/DQ- group. Our results highlight the strong contribution of DQ beyond macronutrient and energy content to changes in body composition and suggest that synergistic changes in both DQ and PA levels optimally reduce VAT in men with features of metabolic syndrome.
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Affiliation(s)
- Julie-Anne Nazare
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, Quebec, Canada
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Abstract
Food synergy is the concept that the non-random mixture of food constituents operates in concert for the life of the organism eaten and presumably for the life of the eater. Isolated nutrients have been extensively studied in well-designed, long-term, large randomised clinical trials, typically with null and sometimes with harmful effects. Therefore, although nutrient deficiency is a known phenomenon, serious for the sufferer, and curable by taking the isolated nutrient, the effect of isolated nutrients or other chemicals derived from food on chronic disease, when that chemical is not deficient, may not have the same beneficial effect. It appears that the focus on nutrients rather than foods is in many ways counterproductive. This observation is the basis for the argument that nutrition research should focus more strongly on foods and on dietary patterns. Unlike many dietary phenomena in nutritional epidemiology, diet pattern appears to be highly correlated over time within person. A consistent and robust conclusion is that certain types of beneficial diet patterns, notably described with words such as 'Mediterranean' and 'prudent', or adverse patterns, often described by the word 'Western', predict chronic disease. Food is much more complex than drugs, but essentially uninvestigated as food or pattern. The concept of food synergy leads to new thinking in nutrition science and can help to forge rational nutrition policy-making and to determine future nutrition research strategies.
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Dietary patterns, inflammation and the metabolic syndrome. DIABETES & METABOLISM 2012; 39:99-110. [PMID: 23062863 DOI: 10.1016/j.diabet.2012.08.007] [Citation(s) in RCA: 191] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2011] [Revised: 06/10/2012] [Accepted: 08/16/2012] [Indexed: 11/21/2022]
Abstract
AIM The study of dietary patterns offers a comprehensive, real-life approach towards examining the complex diet and disease relationship. The simultaneous association of dietary patterns with inflammation and the metabolic syndrome (MetS) has not been extensively reviewed. This report reviews the association of dietary patterns with inflammation in the context of the MetS. METHODS Original English-language research studies with humans were identified via MEDLINE, using inflammation, MetS, whole diets and dietary patterns as keywords. The findings were carefully examined and synthesized along consistent axes. RESULTS Many observational and a few prospective studies, as well as some randomized controlled trials (RCTs), support an inverse association between a Mediterranean dietary pattern and markers of inflammation. The link is generally independent of traditional cardiovascular disease (CVD) risk factors and weight loss. The few studies that have examined the association between following a healthy dietary pattern, evaluated using various diet quality scores, and inflammation report an inverse association; however, this association was attenuated upon adjusting for CVD risk factors. A Mediterranean dietary pattern has also been associated with a reduced risk of the MetS in several cross-sectional studies and a few prospective studies conducted with healthy people. Few RCTs (lasting 1-2years) have confirmed the benefits of following a Mediterranean diet on MetS risk in obese individuals, in those with the MetS or in those at CVD risk. The evidence, albeit limited, for a link between healthy diets based on other diet quality scores and the MetS supports a similar inverse association for the primary and secondary prevention of the MetS. CONCLUSION Adhering to healthy diets such as the Mediterranean diet and/or national dietary guidelines can reduce inflammation and the MetS.
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Jenkins NT, Martin JS, Laughlin MH, Padilla J. Exercise-induced Signals for Vascular Endothelial Adaptations: Implications for Cardiovascular Disease. CURRENT CARDIOVASCULAR RISK REPORTS 2012; 6:331-346. [PMID: 22844545 PMCID: PMC3404842 DOI: 10.1007/s12170-012-0241-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This article reviews recent advances in our understanding of hemodynamic signals, external/compressive forces, and circulating factors that mediate exercise training-induced vascular adaptations, with particular attention to the roles of these signals in prevention and treatment of endothelial dysfunction and cardiovascular (CV) diseases.
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Affiliation(s)
| | | | - M. Harold Laughlin
- Biomedical Sciences, University of Missouri, Columbia, MO
- Dalton Cardiovascular Research Center, University of Missouri, Columbia, MO
- Medical Pharmacology and Physiology, University of Missouri, Columbia, MO
| | - Jaume Padilla
- Biomedical Sciences, University of Missouri, Columbia, MO
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Jacobs DR, Sijtsma FPC, Meyer KA, Steffen LM, Harnack L, Shikany JM, Van Horn L, Kromhout D. Reply to V Miller, J Cantwell Wood, and A Wang. Am J Clin Nutr 2012. [DOI: 10.3945/ajcn.112.039180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Sijtsma FPC, Meyer KA, Steffen LM, Shikany JM, Van Horn L, Harnack L, Kromhout D, Jacobs DR. Longitudinal trends in diet and effects of sex, race, and education on dietary quality score change: the Coronary Artery Risk Development in Young Adults study. Am J Clin Nutr 2012; 95:580-6. [PMID: 22301926 PMCID: PMC3278239 DOI: 10.3945/ajcn.111.020719] [Citation(s) in RCA: 125] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The food supply and dietary preferences have changed in recent decades. OBJECTIVE We studied time- and age-related individual and population-wide changes in a dietary quality score and food groups during 1985-2006. DESIGN The Coronary Artery Risk Development in Young Adults (CARDIA) study of 5115 black and white men and women [aged 18-30 y at year 0 (1985-1986)] assessed diet at examinations at study years 0, 7 (1992-1993), and 20 (2005-2006). The dietary quality score, which was validated by its inverse association with cardiovascular disease risk, summed 46 food groups rated by investigators as positive or negative on the basis of hypothesized health effects. We used repeated-measures regression to estimate time-specific mean diet scores and servings per day of food groups. RESULTS In 2652 participants with all 3 diet assessments, the mean (±SD) dietary quality score increased from 64.1 ± 13.0 at year 0 to 71.1 ± 12.6 at year 20, which was mostly attributable to increased age. However, the secular trend, which was estimated from differences of dietary quality scores across time at a fixed age (age-matched time trend) decreased. The diet score was higher in whites than in blacks and in women than in men and increased with education, but demographic gaps in the score narrowed over 20 y. There tended to be increases in positively rated food groups and decreases in negatively rated food groups, which were generally similar in direction across demographic groups. CONCLUSIONS The CARDIA study showed many age-related, desirable changes in food intake over 20 y of observation, despite a secular trend toward a lower diet quality. Nevertheless, demographic disparities in diet persist.
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Affiliation(s)
- Femke P C Sijtsma
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN 55454, USA
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Siebenhofer A, Jeitler K, Berghold A, Waltering A, Hemkens LG, Semlitsch T, Pachler C, Strametz R, Horvath K. Long-term effects of weight-reducing diets in hypertensive patients. Cochrane Database Syst Rev 2011:CD008274. [PMID: 21901719 DOI: 10.1002/14651858.cd008274.pub2] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND All major guidelines for antihypertensive therapy recommend weight loss. Thus dietary interventions that aim to reduce body weight might be a useful intervention to reduce blood pressure and adverse cardiovascular events associated with hypertension. OBJECTIVES Primary objectivesTo assess the long-term effects of weight-reducing diets in hypertensive patients on- all cause mortality - cardiovascular morbidity - adverse events (including total serious adverse events, withdrawal due to adverse events and total non-serious adverse events)Secondary objectivesTo assess the long-term effects of weight-reducing diets in hypertensive patients on- change from baseline in systolic blood pressure - change from baseline in diastolic blood pressure - body weight reduction SEARCH STRATEGY Studies were obtained from computerised searches of Ovid MEDLINE, EMBASE, CENTRAL and from searches in reference lists and systematic reviews. SELECTION CRITERIA Randomised controlled trials (RCT) in adult hypertensive patients were included if they had a study duration of at least 24 weeks and compared weight reducing dietary interventions to no dietary intervention in adult patients with primary hypertension. DATA COLLECTION AND ANALYSIS Two authors independently assessed risk of bias and extracted data. Studies were pooled using fixed-effect meta-analysis. In case of moderate or larger heterogeneity as measured by Higgins I(2), a random effects model was used. MAIN RESULTS Eight studies involving a total of 2100 participants with high blood pressure and a mean age of 45 to 66 years met our inclusion criteria. Mean treatment duration was 6 to 36 months. No study included mortality as a pre-defined outcome. One RCT evaluated the effects of dietary weight loss on a combined endpoint, consisting of the necessity of reinstating antihypertensive therapy and severe cardiovascular complications. In this RCT weight reducing diet lowered the endpoint, hazard ratio 0.70 (95% confidence interval [CI], 0.57 to 0.87) compared to no diet. None of the studies evaluated adverse events as designated in our protocol. Blood pressure was reduced in patients assigned to weight loss diets as compared to controls: systolic blood pressure (SBP): weighted mean difference (WMD): -4.5 mm Hg; 95% CI, -7.2 to -1.8 mm Hg (3 of 8 studies included in analysis), and diastolic blood pressure (DBP): WMD -3.2 mm Hg; 95% CI, -4.8 to -1.5 mm Hg (3 of 8 studies included in analysis). Patients' body weight was also reduced in dietary weight loss groups as compared to controls, WMD of -4.0 kg (95% CI: -4.8 to -3.2) (5 of 8 studies included in analysis). Two studies used withdrawal of antihypertensive medication as their primary outcome. Even though this was not considered a relevant outcome for this review, the results of these studies strengthen the finding of reduction of blood pressure by dietary weight loss interventions. AUTHORS' CONCLUSIONS In patients with primary hypertension, weight loss diets reduced body weight and blood pressure, however the magnitude of the effects are uncertain as a result of the small number of patients and studies that could be included in the analyses. It is not known whether weight loss reduces mortality and morbidity. No useful information on adverse effects was reported in the relevant trials.
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Affiliation(s)
- Andrea Siebenhofer
- Institute for General Practice, Goethe University, Theodor-Stern-Kai 7, Frankfurt am Main, Germany, 60590
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Polyzos SA, Kountouras J, Zavos C, Tsiaousi E. The role of adiponectin in the pathogenesis and treatment of non-alcoholic fatty liver disease. Diabetes Obes Metab 2010; 12:365-83. [PMID: 20415685 DOI: 10.1111/j.1463-1326.2009.01176.x] [Citation(s) in RCA: 177] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Non-alcoholic fatty liver disease (NAFLD) is recognized as the most common type of chronic liver disease in Western countries and the leading cause of cryptogenic cirrhosis. Insulin resistance (IR) is a key factor in the pathogenesis of NAFLD, the latter being considered as the hepatic component of IR or metabolic syndrome (MetS). Although the pathogenesis of NAFLD is not fully elucidated, a complex interaction between adipokines and cytokines produced by adipocytes and/or inflammatory cells infiltrating adipose tissue appears to play a crucial role in MetS and NAFLD. Adiponectin is the most abundant and adipose-specific adipokine. In the liver, adiponectin acts through the activation of 5-AMP-activated protein kinase and peroxisome proliferator-activated receptor-alpha pathways and inhibition of toll-like receptor-4 mediated signalling. There is an evidence that adiponectin decreases hepatic and systematic IR and attenuates liver inflammation and fibrosis. Adiponectin generally predicts steatosis grade and severity of NAFLD, but it remains to be addressed to what extent this is a direct effect or related to the presence of more severe IR. Although there is no proven pharmacotherapy for the treatment of NAFLD, recent therapeutic strategies have focused on the indirect upregulation of adiponectin through the administration of various therapeutic agents and/or lifestyle modifications. Weight loss, through diet, lifestyle changes and/or medications including orlistat, sibutramine, rimonabant or bariatric surgery, increase adiponectin and may improve liver histology. Insulin sensitizers, including pioglitazone and rosiglitazone, and lipid-lowering agents, including statins and fibrates, also upregulate adiponectin and ameliorate liver histology. The wider use of new treatment approaches appears to signal the dawn of a new era in the management of NAFLD. In this adiponectin-focused review, the pathogenetic role and the potential therapeutic benefits of adiponectin in NAFLD are systematically analysed.
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Affiliation(s)
- Stergios A Polyzos
- Second Medical Clinic, Medical School, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Greece.
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Vieira VJ, Valentine RJ, Wilund KR, Antao N, Baynard T, Woods JA. Effects of exercise and low-fat diet on adipose tissue inflammation and metabolic complications in obese mice. Am J Physiol Endocrinol Metab 2009; 296:E1164-71. [PMID: 19276393 PMCID: PMC2681303 DOI: 10.1152/ajpendo.00054.2009] [Citation(s) in RCA: 147] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Adipose tissue inflammation causes metabolic disturbances, including insulin resistance and hepatic steatosis. Exercise training (EX) may decrease adipose tissue inflammation, thereby ameliorating such disturbances, even in the absence of fat loss. The purpose of this study was to 1) compare the effects of low-fat diet (LFD), EX, and their combination on inflammation, insulin resistance, and hepatic steatosis in high-fat diet-induced obese mice and 2) determine the effect of intervention duration (i.e., 6 vs. 12 wk). C57BL/6 mice (n = 109) fed a 45% fat diet (HFD) for 6 wk were randomly assigned to an EX (treadmill: 5 days/wk, 6 or 12 wk, 40 min/day, 65-70% Vo(2max)) or sedentary (SED) group. Mice remained on HFD or were placed on a 10% fat diet (LFD) for 6 or 12 wk. Following interventions, fat pads were weighed and expressed relative to body weight; hepatic steatosis was assessed by total liver triglyceride and insulin resistance by HOMA-IR and glucose AUC. RT-PCR was used to determine adipose gene expression of MCP-1, F4/80, TNF-alpha, and leptin. By 12 wk, MCP-1, F4/80, and TNF-alpha mRNA were reduced by EX and LFD. Exercise (P = 0.02), adiposity (P = 0.03), and adipose F4/80 (P = 0.02) predicted reductions in HOMA-IR (r(2) = 0.75, P < 0.001); only adiposity (P = 0.04) predicted improvements in hepatic steatosis (r(2) = 0.51, P < 0.001). Compared with LFD, EX attenuated increases in adiposity, hepatic steatosis, and adipose MCP-1 expression from 6 to 12 wk. There are unique metabolic consequences of a sedentary lifestyle and HFD that are most evident long term, highlighting the importance of both EX and LFD in preventing obesity-related metabolic disturbances.
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