1
|
Liu L, Gracely EJ, Zhao X, Gliebus GP, May NS, Volpe SL, Shi J, DiMaria-Ghalili RA, Eisen HJ. Association of multiple metabolic and cardiovascular markers with the risk of cognitive decline and mortality in adults with Alzheimer's disease and AD-related dementia or cognitive decline: a prospective cohort study. Front Aging Neurosci 2024; 16:1361772. [PMID: 38628973 PMCID: PMC11020085 DOI: 10.3389/fnagi.2024.1361772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 02/26/2024] [Indexed: 04/19/2024] Open
Abstract
Background and objectives There is a scarcity of data stemming from large-scale epidemiological longitudinal studies focusing on potentially preventable and controllable risk factors for Alzheimer's disease (AD) and AD-related dementia (ADRD). This study aimed to examine the effect of multiple metabolic factors and cardiovascular disorders on the risk of cognitive decline and AD/ADRD. Methods We analyzed a cohort of 6,440 participants aged 45-84 years at baseline. Multiple metabolic and cardiovascular disorder factors included the five components of the metabolic syndrome [waist circumference, high blood pressure (HBP), elevated glucose and triglyceride (TG) concentrations, and reduced high-density lipoprotein cholesterol (HDL-C) concentrations], C-reactive protein (CRP), fibrinogen, interleukin-6 (IL-6), factor VIII, D-dimer, and homocysteine concentrations, carotid intimal-medial thickness (CIMT), and urine albumin-to-creatinine ratio (ACR). Cognitive decline was defined using the Cognitive Abilities Screening Instrument (CASI) score, and AD/ADRD cases were classified using clinical diagnoses. Results Over an average follow-up period of 13 years, HBP and elevated glucose, CRP, homocysteine, IL-6, and ACR concentrations were significantly associated with the risk of mortality in the individuals with incident AD/ADRD or cognitive decline. Elevated D-dimer and homocysteine concentrations, as well as elevated ACR were significantly associated with incident AD/ADRD. Elevated homocysteine and ACR were significantly associated with cognitive decline. A dose-response association was observed, indicating that an increased number of exposures to multiple risk factors corresponded to a higher risk of mortality in individuals with cognitive decline or with AD/ADRD. Conclusion Findings from our study reaffirm the significance of preventable and controllable factors, including HBP, hyperglycemia, elevated CRP, D-dimer, and homocysteine concentrations, as well as, ACR, as potential risk factors for cognitive decline and AD/ADRD.
Collapse
Affiliation(s)
- Longjian Liu
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
| | - Edward J. Gracely
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
- Department of Family, Community & Preventive Medicine, College of Medicine, Drexel University, Philadelphia, PA, United States
| | - Xiaopeng Zhao
- Department of Mechanical, Aerospace, and Biomedical Engineering, University of Tennessee, Knoxville, Knoxville, TN, United States
| | - Gediminas P. Gliebus
- Department of Neurology, College of Medicine, Drexel University Philadelphia, Philadelphia, PA, United States
| | - Nathalie S. May
- Department of Medicine, College of Medicine, Drexel University, Philadelphia, PA, United States
| | - Stella L. Volpe
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States
| | - Jingyi Shi
- Department of Mathematics and Statistics, Mississippi State University, Starkville, MS, United States
| | - Rose Ann DiMaria-Ghalili
- Doctoral Nursing Department, Nutrition Science Department, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, United States
| | - Howard J. Eisen
- Clinical Research for the Advanced Cardiac and Pulmonary Vascular Disease Program, Thomas Jefferson University Hospital, Philadelphia, PA, United States
| |
Collapse
|
2
|
Vafaei S, Alkhrait S, Yang Q, Ali M, Al-Hendy A. Empowering Strategies for Lifestyle Interventions, Diet Modifications, and Environmental Practices for Uterine Fibroid Prevention; Unveiling the LIFE UP Awareness. Nutrients 2024; 16:807. [PMID: 38542717 PMCID: PMC10975324 DOI: 10.3390/nu16060807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 02/28/2024] [Accepted: 03/07/2024] [Indexed: 04/01/2024] Open
Abstract
Uterine fibroids (UFs) are the most common prevalent benign tumor among women of reproductive age, disproportionately affecting women of color. This paper introduces an innovative management strategy for UFs, emphasizing the curbing of disease prevention and progression. Traditionally, medical intervention is deferred until advanced stages, necessitating invasive surgeries such as hysterectomy or myomectomy, leading to high recurrence rates and increased healthcare costs. The strategy, outlined in this review, emphasizes UF disease management and is named LIFE UP awareness-standing for Lifestyle Interventions, Food Modifications, and Environmental Practices for UF Prevention. These cost-effective, safe, and accessible measures hold the potential to prevent UFs, improve overall reproductive health, reduce the need for invasive procedures, and generate substantial cost savings for both individuals and healthcare systems. This review underscores the importance of a proactive UF management method, paving the way for future research and policy initiatives in this domain.
Collapse
Affiliation(s)
| | | | | | - Mohamed Ali
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL 60637, USA; (S.V.); (S.A.); (Q.Y.)
| | - Ayman Al-Hendy
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL 60637, USA; (S.V.); (S.A.); (Q.Y.)
| |
Collapse
|
3
|
Moslehi N, Mohammadpour S, Mirmiran P, Mehran L, Azizi F. Cardiometabolic-related dietary patterns and thyroid function: a population-based cross-sectional study. Eur J Med Res 2023; 28:602. [PMID: 38111080 PMCID: PMC10726591 DOI: 10.1186/s40001-023-01553-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 11/27/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND Little is known about the association of dietary patterns with thyroid function. Since thyroid function and cardiometabolic variables are inter-related, we investigated whether cardiometabolic-related dietary patterns are associated with thyroid function. METHODS This cross-sectional study included 3520 Tehran Lipid and Glucose Study participants. Reduced rank regression was used to find dietary patterns with body mass index, serum fasting glucose, triglycerides, HDL-C, and systolic and diastolic blood pressures as response variables. Two patterns were retained, one based on 35 food groups (native-based pattern) and the other based on the European Prospective Investigation into Cancer and Nutrition Germany (EPIC) food grouping (n = 33). A confirmatory cardio-metabolic dietary pattern was also created according to the weight of food groups proposed by the Framingham Offspring Study (FOS). The association of each pattern with thyroid-stimulating hormone (TSH), free thyroxine, and thyroid peroxidase antibody (TPOAb) and the odds of thyroid dysfunction was examined by linear and logistic regression, respectively. RESULTS The two exploratory dietary patterns were highly correlated and associated with greater TSH levels in euthyroid participants. The adjusted odds ratio (95% CI) of subclinical hypothyroidism per one standard deviation was 1.14 (1.01, 1.28) for the native-based pattern and 1.16 (1.03, 1.31) for the EPIC-based pattern. The odds of subclinical hypothyroidism was significantly greater in the second and third tertiles of the native-based pattern compared to the first tertile in the adjusted model (p-trend = 0.005). The odds of subclinical hypothyroidism increased across the tertiles of the EPIC-based pattern, but the odds was significantly higher only in tertile 3 compared to tertile 1, with an OR (95% CI) of 1.44 (1.07, 1.94) in the adjusted model. The adjusted odds of clinical hypothyroidism were greater in tertile 3 of the native-based pattern compared with tertile 1 (OR = 1.65, 95% CI 1.04, 2.62). The patterns were unrelated to hyperthyroidism or TPOAb positivity. The FOS-based confirmatory score was unrelated to thyroid function. CONCLUSIONS A diet high in fast foods, soft drinks, and legumes and low in confectionery, potatoes, butter, and jam and honey was associated with higher TSH levels in euthyroidism and higher odds of subclinical hypothyroidism.
Collapse
Affiliation(s)
- Nazanin Moslehi
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No. 24, Shahid Arabi St, Yemen Blvd, Chamran Exp, Tehran, 1985717413, Iran.
| | - Saba Mohammadpour
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No. 7, Shahid Hafezi St., Farahzadi Blvd., Shahrak-e-qods, Tehran, 1981619573, Iran
| | - Parvin Mirmiran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No. 7, Shahid Hafezi St., Farahzadi Blvd., Shahrak-e-qods, Tehran, 1981619573, Iran.
| | - Ladan Mehran
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
4
|
Brayner B, Perez-Cornago A, Kaur G, Keske MA, Piernas C, Livingstone KM. Cross-sectional associations of dietary patterns characterized by fat type with markers of cardiometabolic health. Nutr Metab Cardiovasc Dis 2023; 33:797-808. [PMID: 36890071 DOI: 10.1016/j.numecd.2023.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 02/16/2023]
Abstract
BACKGROUND AND AIMS Individual dietary fats can differentially impact on cardiometabolic health. However, their impact within a dietary pattern is not well understood, and warrants comparison with diet quality scores with a dietary fat focus. The aim of this study was to investigate cross-sectional associations between a posteriori dietary patterns characterized by fat type and cardiometabolic health markers, and compare these with two diet quality scores. METHODS AND RESULTS UK Biobank adults with ≥two 24-h dietary assessments and data on cardiometabolic health were included (n = 24 553; mean age: 55.9 y). A posteriori dietary patterns (DP1; DP2) were generated through reduced rank regression (response variables: SFA, MUFA, PUFA). Mediterranean Diet Score (MDS) and Dietary Approaches to Stop Hypertension (DASH) dietary patterns were created. Multiple linear regression analyses were used to investigate associations between standardized dietary patterns and cardiometabolic health (total cholesterol, HDL-C, LDL-C and VLDL-C cholesterol, triglycerides, C-reactive protein [CRP], glycated hemoglobin [HbA1c]). DP1, positively correlated with SFAs, MUFAs and PUFAs, characterized by higher nuts, seeds and vegetables intake and lower fruits and low-fat yoghurt intake, was associated with lower HDL-C (β: -0.07; 95% CI: -0.10, -0.03) and triglycerides (-0.17; -0.23, -0.10) and higher LDL-C (0.07; 0.01,0.12), CRP (0.01; 0.01, 0.03) and HbA1c (0.16; 0.11,0.21). DP2, positively correlated with SFAs, negatively correlated with PUFAs, characterized by higher butter and high-fat cheese intake and lower nuts, seeds and vegetable intake, was associated with higher total cholesterol (0.10; 0.01, 0.21), VLDL-C (0.05; 0.02, 0.07), triglycerides (0.07; 0.01, 0.13), CRP (0.03; 0.02, 0,04) and HbA1c (0.06; 0.01, 0.11). Higher adherence to MDS and DASH was associated with favorable cardiometabolic health markers concentration. CONCLUSIONS Irrespective of the method used, dietary patterns that encourage healthy fat consumption were associated with favorable cardiometabolic health biomarkers. This study strengthens the evidence for incorporation of dietary fat type into policy and practice guidelines for CVD prevention.
Collapse
Affiliation(s)
- Barbara Brayner
- Deakin University, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Geelong, Victoria 3220, Australia.
| | - Aurora Perez-Cornago
- University of Oxford, Nuffield Department of Population Health, Medical Sciences Division, Old Road Campus, Headington, Oxford OX3 7LF, United Kingdom.
| | - Gunveen Kaur
- Deakin University, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Geelong, Victoria 3220, Australia.
| | - Michelle A Keske
- Deakin University, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Geelong, Victoria 3220, Australia.
| | - Carmen Piernas
- University of Oxford, Nuffield Department of Primary Care Health Sciences, Medical Sciences Division, Old Road Campus, Headington, Oxford OX3 7LF, United Kingdom; Department of Biochemistry and Molecular Biology II, Center for Biomedical Research (CIBM), University of Granada, Spain.
| | - Katherine M Livingstone
- Deakin University, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Geelong, Victoria 3220, Australia.
| |
Collapse
|
5
|
Jang HH, Noh H, Kim G, Cho SY, Kim HJ, Choe JS, Kim J, Scalbert A, Gunter MJ, Kwon O, Kim H. Differences in dietary patterns related to metabolic health by gut microbial enterotypes of Korean adults. Front Nutr 2023; 9:1045397. [PMID: 36687725 PMCID: PMC9853283 DOI: 10.3389/fnut.2022.1045397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 12/13/2022] [Indexed: 01/07/2023] Open
Abstract
Diet has a profound impact on the progression of metabolic syndrome (MetS) into various diseases. The gut microbiota could modulate the effect of diet on metabolic health. We examined whether dietary patterns related to MetS differed according to gut microbial enterotypes among 348 Korean adults aged 18-60 years recruited between 2018∼2021 in a cross-sectional study. The enterotype of each participant was identified based on 16S rRNA gut microbiota data. The main dietary pattern predicting MetS (MetS-DP) of each enterotype was derived using reduced-rank regression (RRR) models. In the RRR models, 27 food group intakes assessed by a semi-quantitative food frequency questionnaire and MetS prediction markers including triglyceride to high-density lipoprotein cholesterol (TG/HDL) ratio and homeostatic model assessment for insulin resistance (HOMA-IR) were used as predictor and response variables, respectively. The MetS-DP extracted in Bacteroides enterotype (B-type) was characterized by high consumption of refined white rice and low consumption of eggs, vegetables, and mushrooms. The MetS-DP derived among Prevotella enterotype (P-type) was characterized by a high intake of sugary food and low intakes of bread, fermented legumes, and fermented vegetables. The MetS-DP of B-type was positively associated with metabolic unhealthy status (OR T3 vs. T1 = 3.5; 95% CI = 1.5-8.2), comparing the highest tertile to the lowest tertile. Although it was not significantly associated with overall metabolic unhealthy status, the MetS-DP of P-type was positively associated with hyperglycemia risk (OR T3 vs. T1 = 6.2; 95% CI = 1.6-24.3). These results suggest that MetS-DP may differ according to the gut microbial enterotype of each individual. If such associations are found to be causal, personalized nutrition guidelines based on the enterotypes could be recommended to prevent MetS.
Collapse
Affiliation(s)
- Hwan-Hee Jang
- National Institute of Agricultural Sciences, Rural Development Administration (NAS-RDA), Wanju, Jeollabuk-do, Republic of Korea
| | - Hwayoung Noh
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France
- Department of Cancer Prevention and Environment, Léon Bérard Cancer Center, L’Institut National de la Santé et de la Recherche Médicale (INSERM) U1296, Lyon, France
| | - Gichang Kim
- National Institute of Agricultural Sciences, Rural Development Administration (NAS-RDA), Wanju, Jeollabuk-do, Republic of Korea
| | - Su-Yeon Cho
- National Institute of Agricultural Sciences, Rural Development Administration (NAS-RDA), Wanju, Jeollabuk-do, Republic of Korea
| | - Hyeon-Jeong Kim
- National Institute of Agricultural Sciences, Rural Development Administration (NAS-RDA), Wanju, Jeollabuk-do, Republic of Korea
| | - Jeong-Sook Choe
- National Institute of Agricultural Sciences, Rural Development Administration (NAS-RDA), Wanju, Jeollabuk-do, Republic of Korea
| | - Jeongseon Kim
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
| | - Augustin Scalbert
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Marc J. Gunter
- Nutrition and Metabolism Branch, International Agency for Research on Cancer (IARC-WHO), Lyon, France
| | - Oran Kwon
- Graduate Program in System Health Science and Engineering, Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, Republic of Korea
| | - Hyesook Kim
- Graduate Program in System Health Science and Engineering, Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, Republic of Korea
| |
Collapse
|
6
|
Brayner B, Keske MA, Kaur G, Islam SMS, Perez-Cornago A, Piernas C, Livingstone KM. Longitudinal Associations Between Fat-Derived Dietary Patterns and Early Markers of Cardiovascular Disease Risk in the UK Biobank Study. J Am Heart Assoc 2022; 11:e024069. [PMID: 35621194 PMCID: PMC9238710 DOI: 10.1161/jaha.121.024069] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Although the impact of dietary fats on cardiovascular disease (CVD) risk is widely researched, longitudinal associations between dietary patterns (DPs) based on fat type and early markers of CVD risk remain unclear. Methods and Results UK Biobank participants (46.9% men, mean age 55 years) with data on early markers of CVD risk (n=12 706) were followed longitudinally (2014-2020; mean 8.4 years). Two DPs (DP1, DP2) were derived using reduced rank regression (response variables: monounsaturated fat, polyunsaturated fat, and saturated fat based on two 24-hour dietary assessments. Multivariable logistic and linear regression were used to investigate associations between DPs and odds of elevated CVD risk (using the nonlaboratory Framingham Risk Score) and changes in early CVD markers, respectively. DP1 (characterized by higher nuts and seeds and lower fruit and legumes intake) was positively correlated with saturated fat, monounsaturated fat, and polyunsaturated fat; DP2 (characterized by higher butter and high-fat cheese, lower nuts and seeds intake) was positively correlated with saturated fat and negatively with polyunsaturated fat and monounsaturated fat. DP2 was associated with slightly higher odds of elevated CVD risk (odds ratio, 1.04 [95% CI, 1.00-1.07]). DP1 was associated with higher diastolic blood pressure (β, 0.20 [95% CI, 0.01-0.37]) and lower cardiac index (β, -0.02 [95% CI, -0.04 to -0.01]); DP2 was associated with higher carotid intima medial thickness (β, 1.80 [95% CI, 0.01-3.59]) and lower left ventricular ejection fraction (β, -0.15 [95% CI, -0.24 to -0.07]) and cardiac index (β, -0.01 [95% CI, -0.02 to -0.01]). Conclusions This study suggests small but statistically significant associations between DPs based on fat type and some early markers of CVD risk. Further research is needed to confirm these associations.
Collapse
Affiliation(s)
- Barbara Brayner
- School of Exercise and Nutrition Sciences Institute for Physical Activity and Nutrition Deakin University Geelong Victoria Australia
| | - Michelle A Keske
- School of Exercise and Nutrition Sciences Institute for Physical Activity and Nutrition Deakin University Geelong Victoria Australia
| | - Gunveen Kaur
- School of Exercise and Nutrition Sciences Institute for Physical Activity and Nutrition Deakin University Geelong Victoria Australia
| | - Sheikh Mohammed Shariful Islam
- School of Exercise and Nutrition Sciences Institute for Physical Activity and Nutrition Deakin University Geelong Victoria Australia
| | - Aurora Perez-Cornago
- Cancer Epidemiology Unit Nuffield Department of Population Health University of Oxford, Old Road Campus Headington, Oxford United Kingdom
| | - Carmen Piernas
- Nuffield Department of Primary Care Health Sciences Medical Sciences Division Radcliffe Primary Care Building Radcliffe Observatory QuarterUniversity of Oxford United Kingdom
| | - Katherine M Livingstone
- School of Exercise and Nutrition Sciences Institute for Physical Activity and Nutrition Deakin University Geelong Victoria Australia
| |
Collapse
|
7
|
Shams-Rad S, Bidaki R, Nadjarzadeh A, Salehi-Abargouei A, de Courten B, Mirzaei M. The association between major dietary patterns and severe mental disorders symptoms among a large sample of adults living in central Iran: Baseline data of YaHS-TAMYZ cohort study. BMC Public Health 2022; 22:1121. [PMID: 35659205 PMCID: PMC9167504 DOI: 10.1186/s12889-022-13518-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 05/25/2022] [Indexed: 11/16/2022] Open
Abstract
Background The diet’s role in developing psychological disorders has been considered by researchers in recent years. Objective To examine the association between major dietary patterns and severe mental disorders symptoms in a large sample of adults living in Yazd city, central Iran. Methods This cross-sectional study used the baseline data of a population-based cohort study (Yazd Health study: YaHS). Dietary intakes were assessed by a multiple-choice semi-quantitative food frequency questionnaire (FFQ, Yazd nutrition survey called TAMYZ). Psychological assessments were also done by using the depression, anxiety, and stress scale-21 (DASS-21) questionnaire. Major dietary patterns were identified using principal component analysis (PCA). Analysis of covariance (ANCOVA) and logistic regression analyses were used to evaluate the relationship between dietary patterns and mental disorders symptoms. Results A total of 7574 adults were included in the current analysis. Four major dietary patterns were identified: "Sugar and Fats”, “Processed Meats and Fish”, "Fruits" and “Vegetables and Red Meat”. After adjustment for all confounding variables, participants in the fifth quintile of “Fruits” dietary pattern which was highly correlated with dried fruits, canned fruits, fruit juice, olive, hydrogenated fats and fruits intake, had a lower odds of severe depression (OR=0.61, 95% CI: 0.45–0.81, p for trend=0.057), anxiety (OR=0.64, 95% CI: 0.50–0.80, p for trend=0.007), and stress, (OR=0.45, 95% CI: 0.30–0.68, p for trend=0.081). Conclusions The intake of a dietary pattern high in dried fruits, canned fruits, fruit juice, olive, hydrogenated fats, and fruits might be inversely associated with depression, anxiety, and stress symptoms. Future prospective studies are needed to warrant this finding. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13518-w.
Collapse
|
8
|
Yi SY, Steffen LM, Haring B, Rebholz CM, Mosley TH, Shah AM. Associations of the Dietary Approaches to Stop Hypertension dietary pattern with cardiac structure and function. Nutr Metab Cardiovasc Dis 2021; 31:3345-3351. [PMID: 34635365 PMCID: PMC8605993 DOI: 10.1016/j.numecd.2021.08.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND AIMS Various food groups have been associated with measures of left ventricular geometry and function. Whether the Dietary Approaches to Stop Hypertension (DASH) dietary pattern in mid-life is associated with a favorable cardiac structure and function later in life is unknown. METHODS AND RESULTS The study population consisted of the Atherosclerosis Risk in Communities study participants free of cardiovascular disease at study visit 3 in 1993-1995. Dietary intake was assessed by food frequency questionnaire at study visits 1 (1987-1989) and 3 (1993-1995). Participants who underwent transthoracic echocardiograms at the Jackson field center at visit 3 (n = 1974) and at all field centers at study visit 5 (2011-2013; n = 4651) were included in this study. General linear regression was used to evaluate associations between dietary intake and markers of cardiac structure and function adjusting for potential confounders. Higher DASH score was associated with lower left ventricle mean wall thickness and higher absolute value of longitudinal strain at visit 5 (ptrend = 0.004 and < 0.001, respectively). CONCLUSION The DASH dietary pattern in midlife was favorably associated with left ventricle structure and systolic function later in life. These results emphasize the importance of adhering to a healthy eating plan as one lifestyle measure to preserve cardiac structure and function.
Collapse
Affiliation(s)
- So-Yun Yi
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Lyn M Steffen
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA.
| | - Bernhard Haring
- Department of Cardiology, Medical University of Graz, Graz, Austria
| | - Casey M Rebholz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Thomas H Mosley
- MIND Center, University of Mississippi Medical Center, Jackson, MS, USA
| | - Amil M Shah
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, USA
| |
Collapse
|
9
|
Liu L, Volpe SL, Ross JA, Grimm JA, Van Bockstaele EJ, Eisen HJ. Dietary sugar intake and risk of Alzheimer's disease in older women. Nutr Neurosci 2021; 25:2302-2313. [PMID: 34328409 DOI: 10.1080/1028415x.2021.1959099] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Despite some reports of cardiometabolic disorders associated with the risk of Alzheimer's disease (AD), limited studies have been conducted to examine the association between excessive sugar intake (a risk factor for cardiometabolic disorders) and AD risk. AIM The purpose of our study was to evaluate if excessive sugar intake has a significant long-term effect on the risk of AD. METHODS A population sample of 37,689 participants, who enrolled in the United States (US) Women's Health Initiative - Dietary Modification Trial (WHI-DM) in 1993-2005 and its extended observational follow-up study through 1 March 2019, were analyzed. Dietary sugar intake was measured using food frequency questionnaires. AD was classified by reports using a standard questionnaire. A dietary pattern that explained the maxima variations in sugar intake was constructed using reduced rank regression (RRR) technique. Associations of RRR dietary pattern scores and sugar intake (g/day) by quartiles (Q1 through Q4) with AD risk were examined using Cox proportional hazards regression analysis with adjusting for key covariates. RESULTS During a mean follow-up of 18.7 years, 4586 participants reported having incident AD. The total incidence rate (95% confidence interval [CI]) of AD was 6.5 (6.3-6.7) per 1000 person-years (PYs). The incidence rates (95% CI) of AD by total sugar intake were 6.2 (5.8-6.6), 6.4 (6.0-6.8), 6.6 (6.3-7.0), and 6.9 (6.5-7.3) per 1000 PYs among those in quartiles (Q) 1 to Q4 (toward higher sugar consumption) of total sugar intake, respectively (test for trend of AD incident rates, p < 0.001). Individuals in Q4 of total sugar intake had a 1.19 higher risk of incident AD than those in Q1 (hazard ratio [HR] = 1.19, 95% CI: 1.05-1.34, p = 0.01). An estimated increase of 10 g/day in total sugar intake (about 2.4 teaspoons) was associated with an increased AD risk by 1.3-1.4%. Of six subtypes of sugar intake, lactose was significantly associated with AD risk. CONCLUSIONS Our study indicates that excessive total sugar intake was significantly associated with AD risk in women. Of six subtypes of sugar intake, lactose had a stronger impact on AD risk.
Collapse
Affiliation(s)
- Longjian Liu
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, USA
| | - Stella L Volpe
- Department of Human Nutrition, Foods, and Exercise, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
| | - Jennifer A Ross
- Department of Pharmacology and Physiology, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Jessica A Grimm
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, USA
| | | | - Howard J Eisen
- Division of Cardiology, Heart and Vascular Institute, Pennsylvania State University, Hershey, PA, USA
| |
Collapse
|
10
|
Placental insufficiency induces a sexually dimorphic response in the expression of cardiac growth and metabolic signalling molecules upon exposure to a postnatal western diet in guinea pigs. J Dev Orig Health Dis 2021; 13:345-357. [PMID: 34308829 DOI: 10.1017/s204017442100043x] [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] [Indexed: 01/22/2023]
Abstract
There is a strong relationship between low birth weight (LBW) and an increased risk of developing cardiovascular disease (CVD). In postnatal life, LBW offspring are becoming more commonly exposed to the additional independent CVD risk factors, such as an obesogenic diet. However, how an already detrimentally programmed LBW myocardium responds to a secondary insult, such as an obesogenic diet (western diet; WD), during postnatal life is ill defined. Herein, we aimed to determine in a pre-clinical guinea pig model of CVD, both the independent and interactive effects of LBW and a postnatal WD on the molecular pathways that regulate cardiac growth and metabolism. Uterine artery ablation was used to induce placental insufficiency (PI) in pregnant guinea pigs to generate LBW offspring. Normal birth weight (NBW) and LBW offspring were weaned onto either a Control diet or WD. At ˜145 days after birth (young adulthood), male and female offspring were humanely killed, the heart weighed and left ventricle tissue collected. The mRNA expression of signalling molecules involved in a pathological hypertrophic and fibrotic response was increased in the myocardium of LBW male, but not female offspring, fed a WD as was the mRNA expression of transcription factors involved in fatty acid oxidation. The mRNA expression of glucose transporters was downregulated by LBW and WD in male, but not female hearts. This study has highlighted a sexually dimorphic cardiac pathological hypertrophic and fibrotic response to the secondary insult of postnatal WD consumption in LBW offspring.
Collapse
|
11
|
Abstract
Nutrition is the primary source of energy production for myocardial contractility and to maintaining cardiac efficiency. Although many studies provided evidence of the benefits of nutritional intervention in chronic heart failure patients (CHF), these effects are not still completely understood. We searched in PubMed and Embase articles related to the following keywords: "chronic heart failure" with "diet," "nutrition," "insulin resistance," and "caloric restriction." Of the 975 retrieved articles, 20 have been selected. The primary endpoint was the left ventricular (LV) function and the secondary mortality rate in HF patients. Some studies showed that the Mediterranean diet (MedDiet) had a beneficial effect on cardiac function, while others did not find any positive impact. Nutritional supplements and hypercaloric intake had positive effects on underweight HF patients, while hypocaloric diet was beneficial in obese HF patients improving glucose control and cardiac function. The effect of MedDiet in HF patients showed conflicting results. Changes in the dietary pattern can reduce the evolution of HF, considering not only the quality of food but also the caloric intake. The discriminant factor to prescribe a diet regime in HF patients is represented by body mass index (BMI). A well-balanced caloric diet represents an effective therapy in overweight HF patients to reduce the mortality rate. Long-term studies evaluating cause-effect of energy and macronutrients intake on cardiac function in HF patients are necessary.
Collapse
Affiliation(s)
- Vittorio Emanuele Bianchi
- Endocrinology and Metabolism, Clinical Center Stella Maris, Strada Rovereta, 42-47891 Falciano, Falciano, San Marino.
| |
Collapse
|
12
|
Liu L, Lima JAC, Post WS, Szklo M. Associations of time-varying obesity and metabolic syndrome with risk of incident heart failure and its subtypes: Findings from the Multi-Ethnic Study of Atherosclerosis. Int J Cardiol 2021; 338:127-135. [PMID: 34089770 DOI: 10.1016/j.ijcard.2021.05.051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/10/2021] [Accepted: 05/27/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Most previous studies have examined associations between metabolic disorders measured at a single point in time and risk of heart failure (HF). However, there are many situations where the values of exposures vary over time before HF occurs. We aimed to examine the associations of time-varying obesity and metabolic syndrome (MetSyn) measured at multiple points in time with HF. METHODS A total of 6750 participants in the Multi-Ethnic Study of Atherosclerosis from 2000 were included in the study. Follow-up was completed through December 2015. MetSyn was defined using the American Heart Association criteria. Incident HF was diagnosed by clinical criteria. Subtypes HF (reduced ejection fraction (HFrEF) and preserved (HFpEF) were classified by left ventricular EF. RESULTS A total of 331 HF cases were identified during 82,609 person-years of observation. The incidence (95%CI) of total HF was 4.0 (3.4-4.4) per 1000 person-years. Of the total HF cases, 45.6% were HFrEF (n = 151), 40.8% HFpEF (n = 135), and 13.6% were unclassified HF subtypes (n = 45). After adjusting for key covariates, time-varying obesity (BMI ≥ 30 kg/m2) and MetSyn were significantly associated with HF, with a stronger association for HFpEF than for HFrEF. The corresponding hazards ratios (HR, 95%CI) were 1.97 (1.43-2.72) and 1.86 (1.43-2.42) for HFpEF, and 1.46 (1.07-1.98), and 1.39 (1.06-1.82) for HFrEF respectively. Time-varying large waist circumference was significantly associated with for HFpEF, but not with HFrEF. CONCLUSION Time-varying obesity and MetSyn were significantly associated with HF risk, with a stronger association with HFpEF than with HFrEF. Continued effort to control these risk factors is recommended.
Collapse
Affiliation(s)
- Longjian Liu
- Department of Epidemiology and Biostatistics, Drexel University, Dornsife School of Public Health, Philadelphia, PA, United States of America.
| | - Joao A C Lima
- Division of Cardiology of the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Wendy S Post
- Division of Cardiology of the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Moyses Szklo
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States of America
| |
Collapse
|
13
|
Cai Q, Osté MCJ, Gomes-Neto AW, Dekker LH, Borgonjen-van den Berg KJ, Geleijnse JM, Bakker SJL, de Borst MH, Navis GJ. Metabolic syndrome-related dietary pattern and risk of mortality in kidney transplant recipients. Nutr Metab Cardiovasc Dis 2021; 31:1129-1136. [PMID: 33618925 DOI: 10.1016/j.numecd.2021.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 12/14/2020] [Accepted: 01/07/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Presence of the metabolic syndrome (MetS) importantly contributes to excess mortality in kidney transplant recipients (KTRs). However, it is unclear which dietary factors drive the adverse role of MetS in KTRs. We aimed to define a dietary pattern that maximally explained the variation in MetS components, and to investigate the association between this MetS-related dietary pattern (MetS-DP) and all-cause mortality in KTRs. METHODS AND RESULTS We included 429 adult KTRs who had a functioning graft ⩾1 year. A MetS-DP was constructed using habitual dietary intake derived from a 177-item food frequency questionnaire. We used reduced rank regression (RRR), and defined the six components of MetS (waist circumference, systolic blood pressure, diastolic blood pressure, serum triglycerides, HbA1c, and HDL cholesterol) as response variables and 48 food groups as predictor variables. We evaluated the association between the MetS-DP and all-cause mortality using multivariable Cox regression analysis. The MetS-DP was characterized by high intakes of processed meat and desserts, and low intakes of vegetables, tea, rice, fruits, milk, and meat substitutes. During a mean follow-up of 5.3 ± 1.2 years, 63 KTRs (14.7%) died. Compared to the lowest tertile of the Mets-DP score, those with the greatest adherence had a more than 3-fold higher risk of all-cause mortality (hazard ratio [HR] = 3.63; 95% confidence interval [CI], 1.70-7.74, P < 0.001), independent of potential confounders. CONCLUSIONS We identified a MetS-related dietary pattern which was independently associated with all-cause mortality in KTRs. The association between this dietary pattern and all-cause mortality was mediated by MetS. Clinical trial reg. no. NCT02811835.
Collapse
Affiliation(s)
- Qingqing Cai
- Department of Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
| | - Maryse C J Osté
- Department of Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - António W Gomes-Neto
- Department of Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Louise H Dekker
- Department of Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Aletta Jacobs School of Public Health, Groningen, the Netherlands
| | | | - Johanna M Geleijnse
- Division of Human Nutrition and Health, Wageningen University, Wageningen, the Netherlands
| | - Stephan J L Bakker
- Department of Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Martin H de Borst
- Department of Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Gerjan J Navis
- Department of Medicine, Division of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| |
Collapse
|
14
|
Associations of the Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay diet with cardiac remodelling in the community: the Framingham Heart Study. Br J Nutr 2021; 126:1888-1896. [PMID: 33618785 DOI: 10.1017/s0007114521000660] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Normal cardiac function is directly associated with the maintenance of cerebrovascular health. Whether the Mediterranean-Dietary Approaches to Stop Hypertension Intervention for Neurodegenerative Delay (MIND) diet, designed for the maintenance of neurocognitive health, is associated with cardiac remodelling is unknown. We evaluated 2512 Framingham Offspring Cohort participants who attended the eighth examination cycle and had available dietary and echocardiographic data (mean age 66 years; 55 % women). Using multivariable regression, we related the cumulative MIND diet score (independent variable) to left ventricular (LV) ejection fraction, left atrial emptying fraction, LV mass (LVM), E/e' ratio (dependent variables; primary), global longitudinal strain, global circumferential strain (GCS), mitral annular plane systolic excursion, longitudinal segmental synchrony, LV hypertrophy and aortic root diameter (secondary). Adjusting for age, sex and energy intake, higher cumulative MIND diet scores were associated with lower values of indices of LV diastolic (E/e' ratio: logβ = -0·03) and systolic function (GCS: β = -0·04) and with higher values of LVM (logβ = 0·02), all P ≤ 0·01. We observed effect modification by age in the association between the cumulative MIND diet score and GCS. When we further adjusted for clinical risk factors, the associations of the cumulative MIND diet score with GCS in participants ≥66 years (β = -0·06, P = 0·005) and LVM remained significant. In our community-based sample, relations between the cumulative MIND diet score and cardiac remodelling differ among indices of LV structure and function. Our results suggest that favourable associations between a higher cumulative MIND diet score and indices of LV function may be influenced by cardiometabolic and lifestyle risk factors.
Collapse
|
15
|
Abstract
Acculturation may influence diet pattern, a risk factor for cardiometabolic disease. We assessed whether strength of traditional cultural beliefs and practices, a robust measure of acculturation, affects diet pattern among South Asians in America. With data from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) cohort, we used ordinal logistic regression to assess the association between strength of traditional cultural beliefs, 6 cultural practices and diet pattern. Of 892 participants, 47% were women. Weaker traditional cultural beliefs [OR(95%CI) 1.07(1.04,1.10)] and cultural practices (p < 0.05) were associated with consuming more of the Animal Protein dietary pattern and less [0.95(0.93,0.97)] of the Fried snacks, Sweets, High-fat dairy (FSHD) pattern (P < 0.05). South Asians in America with stronger traditional cultural beliefs and practices were more likely to consume the FSHD pattern. Prevention programs may consider dietary pattern modification as part of comprehensive risk reduction in South Asians.
Collapse
|
16
|
Dietary patterns and their associations with the metabolic syndrome and predicted 10-year risk of CVD in northwest Chinese adults. Br J Nutr 2020; 126:913-922. [PMID: 33256885 DOI: 10.1017/s000711452000478x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The impact of diet on the metabolic syndrome (MetS) and CVD has been investigated widely, but few studies have investigated the association between dietary patterns (DP) and the predicted CVD, derived from reduced rank regression (RRR). The objectives of this study were to derive DP using RRR and principal component analysis (PCA) and investigate their associations with the MetS and estimated 10-year atherosclerotic CVD (ASCVD). We used the baseline dataset from the Xinjiang multi-ethnic cohort study in China, collected from June 2018 to May 2019. A total of 14 982 subjects aged 35-74 years from Urumqi, Huo Cheng and Mo Yu were included in the analysis. The 10-year ASCVD risk was estimated using the Chinese ASCVD risk equations. The associations of DP with the MetS and 10-year ASCVD were determined using multivariable logistic regression models. In Urumqi and Mo Yu, the increased RRR DP score was associated with a higher OR of having the MetS and with a higher OR of elevated 10-year ASCVD risk. However, only the first DP determined by PCA in Urumqi was inversely associated with the MetS and elevated 10-year ASCVD risk. The prevalence of the MetS and elevated ASCVD risk in urban population is higher than that in rural areas. Our results may help nutritionists develop more targeted dietary strategies to prevent the MetS and ASCVD in different regions in China.
Collapse
|
17
|
Wagner S, Lioret S, Girerd N, Duarte K, Lamiral Z, Bozec E, Van den Berghe L, Hoge A, Donneau AF, Boivin JM, Mercklé L, Zannad F, Laville M, Rossignol P, Nazare JA. Association of Dietary Patterns Derived Using Reduced-Rank Regression With Subclinical Cardiovascular Damage According to Generation and Sex in the STANISLAS Cohort. J Am Heart Assoc 2020; 9:e013836. [PMID: 32200718 PMCID: PMC7428593 DOI: 10.1161/jaha.119.013836] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background The diet impact on cardiovascular diseases has been investigated widely, but the association between dietary patterns (DPs) and subclinical cardiovascular damage remains unclear. More informative DPs could be provided by considering metabolic syndrome components as intermediate markers. This study aimed to identify DPs according to generation and sex using reduced‐rank regression (RRR) with metabolic syndrome components as intermediate markers and assess their associations with intima‐media thickness, left ventricular mass, and carotid‐femoral pulse‐wave velocity in an initially healthy population‐based family study. Methods and Results This study included 1527 participants from the STANISLAS (Suivi Temporaire Annuel Non‐Invasif de la Santé des Lorrains Assurés Sociaux) cohort fourth examination. DPs were derived using reduced‐rank regression according to generation (G1: age ≥50 years; G2: age <50 years) and sex. Associations between DPs and cardiovascular damage were analyzed using multivariable linear regression models. Although identified DPs were correlated between generations and sex, qualitative differences were observed: whereas only unhealthy DPs were found for both men generations, healthy DPs were identified in G2 (“fruity desserts”) and G1 (“fiber and w3 oil”) women. The “alcohol,” “fast food and alcohol,” “fried, processed, and dairy products,” and “meat, starch, sodas, and fat” DPs in G1 and G2 men and in G1 and G2 women, respectively, were associated with high left ventricular mass (β [95% CI], 0.23 [0.10–0.36], 0.76 [0.00–1.52], 1.71 [0.16–3.26], and 1.80 [0.45–3.14]). The “alcohol” DP in G1 men was positively associated with carotid‐femoral pulse‐wave velocity (0.22 [0.09–0.34]). Conclusions The DPs that explain the maximum variation in metabolic syndrome components had different associations with subclinical cardiovascular damage across generation and sex. Our results indicate that dietary recommendations should be tailored according to age and sex. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT01391442.
Collapse
Affiliation(s)
- Sandra Wagner
- INSERM CIC 1433 Nancy CHRU Inserm U1116 FCRIN INI-CRCT University of Lorraine Nancy France
| | - Sandrine Lioret
- Paris University Paris France.,UMR1153 Center for Research in Epidemiology and StatisticS (CRESS) Research Team on Early Life Origins of Health Inserm Paris France
| | - Nicolas Girerd
- INSERM CIC 1433 Nancy CHRU Inserm U1116 FCRIN INI-CRCT University of Lorraine Nancy France
| | - Kevin Duarte
- INSERM CIC 1433 Nancy CHRU Inserm U1116 FCRIN INI-CRCT University of Lorraine Nancy France
| | - Zohra Lamiral
- INSERM CIC 1433 Nancy CHRU Inserm U1116 FCRIN INI-CRCT University of Lorraine Nancy France
| | - Erwan Bozec
- INSERM CIC 1433 Nancy CHRU Inserm U1116 FCRIN INI-CRCT University of Lorraine Nancy France
| | - Laurie Van den Berghe
- CarMeN Laboratory Centre de Recherche en Nutrition Humaine Rhône-Alpes Univ-Lyon Université Claude Bernard Lyon1 Hospices Civils de Lyon F-CRIN/FORCE Network Pierre Bénite, Lyon France
| | - Axelle Hoge
- Département des Sciences de la Santé Publique Université de Liège Belgium
| | | | - Jean-Marc Boivin
- INSERM CIC 1433 Nancy CHRU Inserm U1116 FCRIN INI-CRCT University of Lorraine Nancy France
| | - Ludovic Mercklé
- INSERM CIC 1433 Nancy CHRU Inserm U1116 FCRIN INI-CRCT University of Lorraine Nancy France
| | - Faiez Zannad
- INSERM CIC 1433 Nancy CHRU Inserm U1116 FCRIN INI-CRCT University of Lorraine Nancy France
| | - Martine Laville
- CarMeN Laboratory Centre de Recherche en Nutrition Humaine Rhône-Alpes Univ-Lyon Université Claude Bernard Lyon1 Hospices Civils de Lyon F-CRIN/FORCE Network Pierre Bénite, Lyon France
| | - Patrick Rossignol
- INSERM CIC 1433 Nancy CHRU Inserm U1116 FCRIN INI-CRCT University of Lorraine Nancy France
| | - Julie-Anne Nazare
- CarMeN Laboratory Centre de Recherche en Nutrition Humaine Rhône-Alpes Univ-Lyon Université Claude Bernard Lyon1 Hospices Civils de Lyon F-CRIN/FORCE Network Pierre Bénite, Lyon France
| |
Collapse
|
18
|
Maugeri A, Hruskova J, Jakubik J, Hlinomaz O, Medina-Inojosa JR, Barchitta M, Agodi A, Vinciguerra M. How dietary patterns affect left ventricular structure, function and remodelling: evidence from the Kardiovize Brno 2030 study. Sci Rep 2019; 9:19154. [PMID: 31844105 PMCID: PMC6915714 DOI: 10.1038/s41598-019-55529-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 11/30/2019] [Indexed: 01/19/2023] Open
Abstract
Little is still known about the effect of dietary patterns on left ventricular hypertrophy (LVH). Here, we derived dietary patterns by principal component analysis (PCA) and evaluated their association with LV structure, function, and remodelling. Our cross-sectional study included 438 members (aged 25–65 years; 59.1% women) of the Kardiovize Brno 2030 with no history of cardiovascular disease. Two dietary patterns were derived using PCA, namely prudent and western. Primary outcomes were echocardiographic parameters and LV geometric patterns, such as concentric LV remodelling (cLVR), concentric LVH (cLVH), and eccentric LVH (eLVH). Interestingly, participants with high adherence to the prudent dietary pattern had decreased odds of cLVH after adjustment for socio-demographic, clinical and behavioral covariates (OR = 0.24, 95% CI = 0.08–0.88; p = 0.031). By contrast, several echocardiographic parameters increased with increasing adherence to the western dietary pattern, which resulted in higher odds of cLVH among participants with high adherence (OR = 5.38, 95% CI = 1.17–23.58; p = 0.035). Although our findings may have an immediate relevance for public-health strategies, further large-size prospective studies should be encouraged to better understand the observed association and their causality.
Collapse
Affiliation(s)
- Andrea Maugeri
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy.,International Clinical Research Center, St'Anne University Hospital, Brno, Czech Republic
| | - Jana Hruskova
- International Clinical Research Center, St'Anne University Hospital, Brno, Czech Republic
| | - Juraj Jakubik
- International Clinical Research Center, St'Anne University Hospital, Brno, Czech Republic
| | - Ota Hlinomaz
- International Clinical Research Center, St'Anne University Hospital, Brno, Czech Republic
| | - Jose R Medina-Inojosa
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Martina Barchitta
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - Antonella Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy.
| | - Manlio Vinciguerra
- International Clinical Research Center, St'Anne University Hospital, Brno, Czech Republic.
| |
Collapse
|
19
|
Liu L, Miura K, Kadota A, Fujiyoshi A, Gracely EJ, Xue F, Liu Z, Takashima N, Miyagawa N, Ohkubo T, Arima H, Okayama A, Okamura T, Ueshima H. The impact of sex on risk of cardiovascular disease and all-cause mortality in adults with or without diabetes mellitus: A comparison between the U.S. and Japan. J Diabetes Complications 2019; 33:417-423. [PMID: 31003923 DOI: 10.1016/j.jdiacomp.2019.03.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 03/28/2019] [Accepted: 03/28/2019] [Indexed: 01/02/2023]
Abstract
AIMS To test a hypothesis that women with diabetes mellitus (DM) versus those without DM had a significantly higher risk of heart disease (HD), stroke and all-cause mortality than their male counterparts in the U.S. as well as in Japan. METHODS We analyzed two nationally representative datasets, one from the U.S. NHANES III cohort (n = 13,169), and the other from the Japan NIPPON DATA90 cohort (n = 7445). Hazard ratios (HRs) of DM for risk of mortality and sex-DM interaction effect on mortality were analyzed prospectively using Cox's proportional hazards regression models. RESULTS Patients with DM had significantly higher mortality from HD, stroke and all-cause mortality in the U.S. and in Japan. However, the HRs of DM versus non-DM for HD and all-cause mortality were significantly higher in women compared to men in the U.S. (sex-DM interaction: HR = 1.59, p = 0.01, and 1.24, p = 0.045 for HD and all-cause mortality), but the sex-DM interaction effect was not statistically significant in the Japanese cohort. DISCUSSION Patients with DM had a significantly higher risk of mortality than those without DM in the U.S. and Japan. However, women with DM versus those without DM had a higher relative risk of HD and all-cause mortality than their counterparts in men in the U.S, but this sex difference by DM status was not observed in the Japanese cohort. Whether the sex-difference effect of DM on HD and all-cause mortality is due to a difference in metabolic disorders between the two populations warrants consideration and further studies.
Collapse
Affiliation(s)
- Longjian Liu
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA.
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science, Otsu, Shiga, Japan; Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Aya Kadota
- Department of Public Health, Shiga University of Medical Science, Otsu, Shiga, Japan; Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Akira Fujiyoshi
- Department of Public Health, Shiga University of Medical Science, Otsu, Shiga, Japan; Department of Hygiene, Wakayama Medical School, Wakayama, Japan
| | - Edward J Gracely
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA; Department of Family, Community, & Prevention Medicine, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Fuzhong Xue
- Department of Biostatistics, Shandong University School of Public Health, Jinan, Shandong, China
| | - Zuolu Liu
- Department of Neurology, University of California at Los Angeles, Los Angeles, CA, USA
| | - Naoyuki Takashima
- Department of Public Health, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Naoko Miyagawa
- Department of Public Health, Shiga University of Medical Science, Otsu, Shiga, Japan; International Center for Nutrition and Information, National Institute of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
| | - Hisatomi Arima
- Department of Preventive Medicine and Public Health, Fukuoka University, Fukuoka, Japan
| | - Akira Okayama
- Research Institute of Strategy for Prevention, Tokyo, Japan
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University, Tokyo, Japan
| | - Hirotsugu Ueshima
- Department of Public Health, Shiga University of Medical Science, Otsu, Shiga, Japan; Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Shiga, Japan
| |
Collapse
|
20
|
Abstract
OBJECTIVE An index of biomarkers derived from dietary factors (diet-biomarker-related index) identifies foods and nutrients that encompass physiological potentials and provides scientific evidence for dietary patterns that increase the risk of disease associated with specific biomarkers. Although men and women have different dietary patterns and physiological characteristics, sex is not often considered when investigators develop a diet-biomarker-related index. We aimed to review whether epidemiological studies developed diet-biomarker-related indices in a sex-specific way. DESIGN We systematically searched for epidemiological studies that developed diet-biomarker-related indices, including (i) biomarker prediction indices that include dietary factors as explanatory variables and (ii) dietary patterns to explain biomarker variations, in the PubMed and EMBASE databases. We qualitatively reviewed the sex consideration in index development. RESULTS We identified seventy-nine studies that developed a diet-biomarker-related index. We found that fifty-four studies included both men and women. Of these fifty-four studies, twenty-nine (53·7 %) did not consider sex, eleven (20·3 %) included sex in the development model, seven (13·0 %) considered sex but did not include sex in the development model, and seven (13·0 %) derived a diet-biomarker-related index for men and women separately. A list of selected dietary factors that explained levels of biomarkers generally differed by sex in the studies that developed a diet-biomarker-related index in a sex-specific way. CONCLUSIONS Most studies that included both men and women did not develop the diet-biomarker-related index in a sex-specific way. Further research is needed to identify whether a sex-specific diet-biomarker-related index is more predictive of the disease of interest than an index without sex consideration.
Collapse
|
21
|
Akintoye E, Mahmoud K, Shokr M, Sandio A, Mallikethi-Reddy S, Sheikh M, Adegbala O, Egbe A, Briasoulis A, Afonso L. Racial/ethnic differences in the prognostic utility of left ventricular mass index for incident cardiovascular disease. Clin Cardiol 2018; 41:502-509. [PMID: 29663526 DOI: 10.1002/clc.22914] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 01/07/2018] [Accepted: 01/30/2018] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Evidence exists for racial/ethnic differences in left ventricular mass index (LVMI). How this translates to future cardiovascular disease (CVD) events is unknown. HYPOTHESIS The impact of racial/ethnic differences in LVMI on incident cardiovascular outcomes could have potential implications for the optimization of risk stratification strategies. METHODS Using the prospectively collected database of the Multi-Ethnic Study of Atherosclerosis (MESA) involving 4 racial/ethnic groups (non-Hispanic Whites, Chinese, Blacks, and Hispanics) free of CVD at baseline, we assessed for racial/ethnic differences in the relationship between LVMI and incident CVD using a Cox model. RESULTS 5004 participants (mean age, 62 ± 10 years; 48% male) were included in this study. After an average follow-up of 10.2 years, 369 (7.4%) CVD events occurred. Significant racial/ethnic differences existed in the relationship between LVMI and incident CVD (P for interaction = 0.04). Notably, the relationship was strongest for Chinese (HR per 10-unit increase in LVMI: 1.7, 95% CI: 1.1-2.8) and Hispanics (HR per 10-unit increase in LVMI: 1.9, 95% CI: 1.5-2.2). Non-Hispanic Whites demonstrated the lowest relationship (HR: 1.3, 95% CI: 1.1-1.5). LVMI values of 36.9 g/m2.7 , 31.8 g/m2.7 , 39.9 g/m2.7 , and 41.7 g/m2.7 were identified as optimal cutpoints for defining left ventricular hypertrophy (LVH) for non-Hispanic Whites, Chinese, Blacks, and Hispanics, respectively. In secondary analysis of LVH (vs no LVH) using these optimal cutpoints, we found a similar pattern of association as above (P for interaction = 0.04). For example, compared with those without LVH, Chinese with LVH had HR: 5.3, 95% CI: 1.6-17, whereas non-Hispanic Whites with LVH had HR: 1.6, 95% CI: 1.2-2.1 for CVD events. CONCLUSIONS Among 4 races/ethnicities studied, LVMI has more prognostic utility predicting future CVD events for Chinese and Hispanics and is least significant for non-Hispanic Whites.
Collapse
Affiliation(s)
- Emmanuel Akintoye
- Department of Internal Medicine, Wayne State University/Detroit Medical Center, Detroit, Michigan
| | - Karim Mahmoud
- Department of Internal Medicine, Wayne State University/Detroit Medical Center, Detroit, Michigan
| | - Mohamed Shokr
- Department of Internal Medicine, Wayne State University/Detroit Medical Center, Detroit, Michigan
| | - Aubin Sandio
- Wayne State University School of Medicine, Detroit, Michigan
| | | | - Muhammad Sheikh
- Department of Internal Medicine, Wayne State University/Detroit Medical Center, Detroit, Michigan
| | - Oluwole Adegbala
- Englewood Hospital and Medical Center/Seton Hall University, Englewood, New Jersey
| | - Alexander Egbe
- Division of Cardiology, Mayo Clinic, Rochester, Minnesota
| | - Alexandros Briasoulis
- Division of Cardiovascular Medicine, Section of Heart Failure and Transplant, University of Iowa, Iowa City, Iowa
| | - Luis Afonso
- Division of Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York
| |
Collapse
|
22
|
Current evidence on the association of the metabolic syndrome and dietary patterns in a global perspective. Nutr Res Rev 2018; 29:152-162. [PMID: 27955720 DOI: 10.1017/s095442241600007x] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The metabolic syndrome (MetS) is a key indicator of two main causes of death worldwide: CVD and diabetes. The present paper aimed to perform a review of the population-based research on the association of dietary patterns and the MetS in terms of methodology and findings. For the purpose of the present study, a scoping literature review was conducted using MEDLINE and EMBASE databases and hand searching in Google Scholar. Thirty-nine population-based studies were selected. Most of these studies used the factor analysis method and the a priori dietary approach, which had been initially extracted via a posteriori methods such as using the Mediterranean dietary pattern. The main finding was that following the Mediterranean or similar 'healthy' pattern reduced risk of the MetS, while following a 'Western' pattern increased risk of the MetS. The methodological approach in determining the dietary pattern of a population, whether a priori or a posteriori, should be chosen based on the purpose of the research. Overall, evidence suggests a diet based on the components of the Mediterranean diet and the avoidance of the 'Western' diet can aid in preventing the MetS.
Collapse
|
23
|
Borges CA, Rinaldi AE, Conde WL, Mainardi GM, Behar D, Slater B. Dietary patterns: a literature review of the methodological characteristics of the main step of the multivariate analyzes. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2017; 18:837-57. [PMID: 26982299 DOI: 10.1590/1980-5497201500040013] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 05/14/2015] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE To describe the solutions adopted in the multiple steps of the use of multivariate techniques to obtain a dietary pattern (DP) concerning: the objective of the studies, the selection of the method for measuring food intake, the criteria for grouping the foods, the number of food groups used, the number of DP obtained, and the nomenclature criteria. METHODS The articles were selected from MEDLINE and Lilacs scientific databases using the following keywords: "dietary patterns" versus "factor analysis"; "principal components analysis"; "cluster analysis" and "reduced regression rank." The initial search resulted in 1,752 articles. After inclusion and exclusion criteria, 189 publications were selected. RESULTS The following aspects were relevant among the studies: the prevalence of the principal component analysis (PCA); the prevalence of the use of 4 to 5 DPs in the studies of association with health outcomes; the use of 30 or more food groups from the food frequency questionnaire (FFQ); the prevalence of studies that associated DPs with health outcomes and socioeconomic factors; and the heterogeneity of criteria used throughout the analytical stages of the multivariate techniques. CONCLUSION The heterogeneity between the publications concentrates on the criteria for food grouping, the nomenclature, and the number of dietary patterns calculated, which varied depending on the number of food groups present in these analyses. To understand, apply, and explore in full, the multivariate techniques has become necessary in order to improve the reliability of the results and, consequently, to improve the relationships with health outcomes and socioeconomic factors.
Collapse
Affiliation(s)
| | - Ana Elisa Rinaldi
- Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Wolney Lisboa Conde
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | - Dora Behar
- Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Betzabeth Slater
- Departamento de Nutrição, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil
| |
Collapse
|
24
|
Thimóteo NSB, Scavuzzi BM, Simão ANC, Dichi I. The impact of cranberry (Vaccinium macrocarpon) and cranberry products on each component of the metabolic syndrome: a review. ACTA ACUST UNITED AC 2017. [DOI: 10.1186/s41110-017-0048-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
25
|
Drehmer M, Odegaard AO, Schmidt MI, Duncan BB, Cardoso LDO, Matos SMA, Molina MDCB, Barreto SM, Pereira MA. Brazilian dietary patterns and the dietary approaches to stop hypertension (DASH) diet-relationship with metabolic syndrome and newly diagnosed diabetes in the ELSA-Brasil study. Diabetol Metab Syndr 2017; 9:13. [PMID: 28228848 PMCID: PMC5307839 DOI: 10.1186/s13098-017-0211-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 02/03/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Studies evaluating dietary patterns, including the DASH diet, and their relationship with the metabolic syndrome and diabetes may help to understand the role of dairy products (low fat or full fat) in these conditions. Our aim is to identify dietary patterns in Brazilian adults and compare them with the (DASH) diet quality score in terms of their associations with metabolic syndrome and newly diagnosed diabetes in the Brazilian Longitudinal Study of Adult Health-the ELSA-Brasil study. METHODS The ELSA-Brasil is a multicenter cohort study comprising 15,105 civil servants, aged 35-74 years at baseline (2008-2010). Standardized interviews and exams were carried out, including an OGTT. We analyzed baseline data for 10,010 subjects. Dietary patterns were derived by principal component analysis. Multivariable logistic regression investigated associations of dietary patterns with metabolic syndrome and newly diagnosed diabetes and multivariable linear regression with components of metabolic syndrome. RESULTS After controlling for potential confounders, we observed that greater adherence to the Common Brazilian meal pattern (white rice, beans, beer, processed and fresh meats), was associated with higher frequencies of newly diagnosed diabetes, metabolic syndrome and all of its components, except HDL-C. Participants with greater intake of a Common Brazilian fast foods/full fat dairy/milk based desserts pattern presented less newly diagnosed diabetes. An inverse association was also seen between the DASH Diet pattern and the metabolic syndrome, blood pressure and waist circumference. Diet, light foods and beverages/low fat dairy pattern was associated with more prevalence of both outcomes, and higher fasting glucose, HDL-C, waist circumference (among men) and lower blood pressure. Vegetables/fruit dietary pattern did not protect against metabolic syndrome and newly diagnosed diabetes but was associated with lower waist circumference. CONCLUSIONS The inverse associations found for the dietary pattern characterizing Brazilian fast foods and desserts, typically containing dairy products, with newly diagnosed diabetes, and for the DASH diet with metabolic syndrome, support previously demonstrated beneficial effects of dairy products in metabolism. The positive association with metabolic syndrome and newly diagnosed diabetes found for the pattern characterizing a typical Brazilian meal deserves further investigation, particularly since it is frequently accompanied by processed meat. Trial registration NCT02320461. Registered 18 December 2014.
Collapse
Affiliation(s)
- Michele Drehmer
- Department of Nutrition, School of Medicine, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2400, 4o andar, Porto Alegre, RS Brazil
- Postgraduate Program in Epidemiology and Hospital de Clínicas de Porto Alegre, School of Medicine, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos 2600, sala 419, Porto Alegre, RS Brazil
| | - Andrew O. Odegaard
- Department of Epidemiology, School of Medicine, University of California, Irvine, USA
| | - Maria Inês Schmidt
- Postgraduate Program in Epidemiology and Hospital de Clínicas de Porto Alegre, School of Medicine, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos 2600, sala 419, Porto Alegre, RS Brazil
- Department of Social Medicine, School of Medicine, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2600, sala 419, Porto Alegre, RS Brazil
| | - Bruce B. Duncan
- Postgraduate Program in Epidemiology and Hospital de Clínicas de Porto Alegre, School of Medicine, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos 2600, sala 419, Porto Alegre, RS Brazil
- Department of Social Medicine, School of Medicine, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, 2600, sala 419, Porto Alegre, RS Brazil
| | | | - Sheila M. Alvim Matos
- Institute of Collective Health, Federal University of Bahia, 513 Araújo Pinho Ave., Salvador, Brazil
| | | | - Sandhi M. Barreto
- Research Group on Epidemiology on Chronic and Occupational Diseases (GERMINAL), School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais 30130-100 Brazil
| | - Mark A. Pereira
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, 1300 S. 2nd Street, Suite 300, Minneapolis, MN USA
| |
Collapse
|
26
|
Liu L, Simon B, Shi J, Mallhi AK, Eisen HJ. Impact of diabetes mellitus on risk of cardiovascular disease and all-cause mortality: Evidence on health outcomes and antidiabetic treatment in United States adults. World J Diabetes 2016; 7:449-461. [PMID: 27795819 PMCID: PMC5065665 DOI: 10.4239/wjd.v7.i18.449] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 06/22/2016] [Accepted: 08/18/2016] [Indexed: 02/05/2023] Open
Abstract
AIM To examine the epidemic of diabetes mellitus (DM) and its impact on mortality from all-cause and cardiovascular disease (CVD), and to test the effect of antidiabetic therapy on the mortality in United States adults.
METHODS The analysis included a randomized population sample of 272149 subjects ages ≥ 18 years who participated in the National Health Interview Surveys (NHIS) in 2000-2009. Chronic conditions (hypertension, DM and CVD) were classified by participants’ self-reports of physician diagnosis. NHIS-Mortality Linked Files, and NHIS-Medical Expenditure Panel Survey Linkage Files on prescribed medicines for patients with DM were used to test the research questions. χ2, Poisson and Cox’s regression models were applied in data analysis.
RESULTS Of all participants, 22305 (8.2%) had DM. The prevalence of DM significantly increased from 2000 to 2009 in all age groups (P < 0.001). Within an average 7.39 (SD = 3) years of follow-up, male DM patients had 1.56 times higher risk of death from all-cause (HR = 1.56, 95%CI: 1.49-1.64), 1.72 times higher from heart disease [1.72 (1.53-1.93)], 1.48 times higher from cerebrovascular disease [1.48 (1.18-1.85)], and 1.67 times higher from CVD [1.67 (1.51-1.86)] than subjects without DM, respectively. Similar results were observed in females. In males, 10% of DM patients did not use any antidiabetic medications, 38.1% used antidiabetic monotherapy, and 51.9% used ≥ 2 antidiabetic medications. These corresponding values were 10.3%, 40.4% and 49.4% in females. A significant protective effect of metformin monotherapy or combination therapy (except for insulin) on all-cause mortality and a protective but non-significant effect on CVD mortality were observed.
CONCLUSION This is the first study using data from multiple linkage files to confirm a significant increased prevalence of DM in the last decade in the United States. Patients with DM have significantly higher risk of death from all-cause and CVD than those without DM. Antidiabetic mediations, specifically for metformin use, show a protective effect against all-cause and CVD mortalities.
Collapse
|
27
|
Levitan EB, Ahmed A, Arnett DK, Polak JF, Hundley WG, Bluemke DA, Heckbert SR, Jacobs DR, Nettleton JA. Mediterranean diet score and left ventricular structure and function: the Multi-Ethnic Study of Atherosclerosis. Am J Clin Nutr 2016; 104:595-602. [PMID: 27488238 PMCID: PMC4997295 DOI: 10.3945/ajcn.115.128579] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 06/27/2016] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Data are limited on the relation between dietary patterns and left ventricular (LV) structure and function. OBJECTIVE We examined cross-sectional associations of a diet-score assessment of a Mediterranean dietary pattern with LV mass, volume, mass-to-volume ratio, stroke volume, and ejection fraction. DESIGN We measured LV variables with the use of cardiac MRI in 4497 participants in the Multi-Ethnic Study of Atherosclerosis study who were aged 45-84 y and without clinical cardiovascular disease. We calculated a Mediterranean diet score from intakes of fruit, vegetables, nuts, legumes, whole grains, fish, red meat, the monounsaturated fat:saturated fat ratio, and alcohol that were self-reported with the use of a food-frequency questionnaire. We used linear regression with adjustment for body size, physical activity, and cardiovascular disease risk factors to model associations and assess the shape of these associations (linear or quadratic). RESULTS The Mediterranean diet score had a slight U-shaped association with LV mass (adjusted means: 146, 145, 146, and 147 g across quartiles of diet score, respectively; P-quadratic trend = 0.04). The score was linearly associated with LV volume, stroke volume, and ejection fraction: for each +1-U difference in score, LV volume was 0.4 mL higher (95% CI: 0.0, 0.8 mL higher), the stroke volume was 0.5 mL higher (95% CI: 0.2, 0.8 mL higher), and the ejection fraction was 0.2 percentage points higher (95% CI: 0.1, 0.3 percentage points higher). The score was not associated with the mass-to-volume ratio. CONCLUSIONS A higher Mediterranean diet score is cross-sectionally associated with a higher LV mass, which is balanced by a higher LV volume as well as a higher ejection fraction and stroke volume. Participants in this healthy, multiethnic sample whose dietary patterns most closely conformed to a Mediterranean-type pattern had a modestly better LV structure and function than did participants with less-Mediterranean-like dietary patterns. This trial was registered at clinicaltrials.gov as NCT00005487.
Collapse
Affiliation(s)
- Emily B Levitan
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL;
| | - Ali Ahmed
- Center for Health and Aging, Washington DC VA Medical Center, Washington, DC
| | - Donna K Arnett
- College of Public Health, University of Kentucky, Lexington, KY
| | - Joseph F Polak
- Department of Radiology, Tufts University School of Medicine, Boston, MA
| | - W Gregory Hundley
- Departments of Internal Medicine (Cardiology) and Radiology, Wake Forest University School of Medicine, Winston-Salem, NC
| | | | - Susan R Heckbert
- Department of Epidemiology, University of Washington, Seattle, WA
| | - David R Jacobs
- Department of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN; and
| | - Jennifer A Nettleton
- Division of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center-Houston, Houston, TX
| |
Collapse
|
28
|
Hahn M, Baierle M, Charão MF, Bubols GB, Gravina FS, Zielinsky P, Arbo MD, Cristina Garcia S. Polyphenol-rich food general and on pregnancy effects: a review. Drug Chem Toxicol 2016; 40:368-374. [DOI: 10.1080/01480545.2016.1212365] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Marla Hahn
- Laboratory of Toxicology (LATOX), Department of Analysis, Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil,
| | - Marília Baierle
- Laboratory of Toxicology (LATOX), Department of Analysis, Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil,
- Post-Graduate Program in Pharmaceutical Sciences (PPGCF), Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil,
| | - Mariele F. Charão
- Laboratory of Toxicology (LATOX), Department of Analysis, Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil,
- Toxicological Analysis Laboratory, Institute of Health Sciences, Feevale University, Novo Hamburgo, RS, Brazil,
| | - Guilherme B. Bubols
- Laboratory of Toxicology (LATOX), Department of Analysis, Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil,
- Post-Graduate Program in Pharmaceutical Sciences (PPGCF), Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil,
| | - Fernanda S. Gravina
- Laboratory of Toxicology (LATOX), Department of Analysis, Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil,
| | - Paulo Zielinsky
- Cardiology Institute, University Foundation of Cardiology, Porto Alegre, RS, Brazil, and
| | - Marcelo D. Arbo
- Laboratory of Toxicology (LATOX), Department of Analysis, Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil,
- Post-Graduate Program in Pharmaceutical Sciences (PPGCF), Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil,
- Department of Veterinary Clinical Pathology, Faculty of Veterinary, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Solange Cristina Garcia
- Laboratory of Toxicology (LATOX), Department of Analysis, Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil,
- Post-Graduate Program in Pharmaceutical Sciences (PPGCF), Faculty of Pharmacy, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil,
- Cardiology Institute, University Foundation of Cardiology, Porto Alegre, RS, Brazil, and
| |
Collapse
|
29
|
Johns DJ, Lindroos AK, Jebb SA, Sjöström L, Carlsson LMS, Ambrosini GL. Dietary patterns, cardiometabolic risk factors, and the incidence of cardiovascular disease in severe obesity. Obesity (Silver Spring) 2015; 23:1063-70. [PMID: 25865622 PMCID: PMC6680188 DOI: 10.1002/oby.20920] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 09/16/2014] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The longitudinal associations between a dietary pattern (DP) and cardiometabolic risk factors and cardiovascular disease (CVD) incidence were investigated in a cohort of adults with severe obesity. METHODS The analysis included 2,037 individuals with severe obesity (>34 and >38 kg/m(2) for men and women, respectively) from the Swedish Obese Subjects study repeatedly followed up for 10 years. Reduced rank regression was used to identify a DP characterized by dietary energy density, saturated fat intake, and fiber density. Mixed models examined relationships between repeated measures of DP z-scores and cardiometabolic risk factors. Cox proportional hazards models assessed relationships between DP scores and CVD incidence. RESULTS An energy-dense, high-saturated-fat, and low-fiber DP was derived. A one-unit increase in the DP z-score between follow-ups was associated with an increase in weight [β (SE)] (1.71 ± 0.10 kg), waist circumference (1.49 ± 0.07 cm), BMI (0.60 ± 0.34 kg/m2), serum cholesterol (0.06 ± 0.01 mmol/l), and serum insulin (1.22 ± 0.17 mmol/l; all P < 0.0001), as well as in serum triglycerides (0.05 ± 0.02 mmol/l; P < 0.05), systolic blood pressure (1.05 ± 0.27 mmHg; P < 0.001), and diastolic blood pressure (0.55 ± 0.16 mmHg; P < 0.05). No significant association was observed between repeated measures of the DP z-scores and CVD incidence (HR = 0.96; 95% CI = 0.83-1.12). CONCLUSIONS An energy-dense, high-saturated-fat, and low-fiber DP was longitudinally associated with increases in cardiometabolic risk factors in severe obesity but not with CVD incidence.
Collapse
Affiliation(s)
- David J Johns
- Diet and Obesity Research, Medical Research Council, Human Nutrition Research, Elsie Widdowson Laboratory, Cambridge, UK
| | | | | | | | | | | |
Collapse
|
30
|
Gardener H, Rundek T, Wright CB, Gu Y, Scarmeas N, Homma S, Russo C, Elkind MS, Sacco RL, Di Tullio MR. A Mediterranean-style diet and left ventricular mass (from the Northern Manhattan Study). Am J Cardiol 2015; 115:510-4. [PMID: 25542392 DOI: 10.1016/j.amjcard.2014.11.038] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 11/25/2014] [Accepted: 11/25/2014] [Indexed: 02/07/2023]
Abstract
One mechanism linking diet, specifically the Mediterranean-style diet (DT), with cardiovascular disease prevention may be an association between a DT and left ventricular (LV) mass. However, there are little data on this relation. We hypothesized that adherence to a DT would be inversely associated with LV mass in the multiethnic population-based Northern Manhattan Study. The study included 1,937 participants with diet assessments and LV mass measured using echocardiography (mean age 67 ± 9 years, 39% male, 58% Hispanic, 20% white, 20% black). A DT adherence score (range 0 to 9, 9 representing maximal adherence) was examined continuously and categorically (score 6 to 9 representing the top quartile vs 0 to 5). Multivariable-adjusted linear regression models were constructed to examine the cross-sectional association between a DT and LV mass. An inverse association was observed between the DT score and LV mass. In a model controlling for demographics, behavioral risk factors, diabetes, and blood pressure variables, LV mass was 1.98 g lesser for each 1-point greater DT score, and those with scores of 6 to 9 had an average LV mass that was 7.30 g less than those with scores of 0 to 5. The association was attenuated but remained statistically significant after additionally adjusting for body mass index. Results were similar when LV mass was corrected for height (LV mass). In conclusion, greater adherence to a DT is associated with decreased LV mass, an important risk factor for cardiovascular disease, and this association may be partly mediated by obesity. The association with LV mass may be involved in the protective effect of a DT on clinical vascular outcomes.
Collapse
|
31
|
Comparison of two exploratory dietary patterns in association with the metabolic syndrome in a Northern German population. Br J Nutr 2014; 112:1364-72. [DOI: 10.1017/s0007114514002098] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Diet is related to many chronic disease conditions such as the metabolic syndrome (MetS). We set out to compare behaviour-related with disease-related patterns and their association with the MetS in a German cross-sectional study. A total of 905 participants of a Northern German cohort (aged 25–82 years) completed a FFQ, underwent anthropometric assessments and provided a blood sample. Dietary patterns were derived by principal component analysis (PCA) and reduced-rank regression (RRR) from forty-two food groups. Components of the MetS were used as response variables for the RRR analysis. Simplified patterns comprising ten food groups were generated. Logistic regression analysis was performed to evaluate the likelihood of having the MetS across the quartiles of simplified pattern scores. We identified two similar dietary patterns derived by PCA and RRR characterised by high intakes of potatoes, various vegetables, red and processed meat, fats, sauce and bouillon. Comparing simplified patterns, an increased RRR pattern score was associated with a higher OR (2·18, 95 % CI 1·25, 3·81) of having the MetS than an increased PCA pattern score (OR 1·92, 95 % CI 1·21, 3·03). Comparing concordant food groups by both dietary pattern methods, a diet high in legumes, beef, processed meat and bouillon was also positively associated with the prevalence of the MetS after adjustment for potential confounders (OR 1·71, 95 % CI 1·04, 2·79). We identified a behaviour-related pattern that was positively associated with the MetS. The application of both dietary pattern methods may be advantageous to obtain information for designing and realising dietary guidelines. Prospective studies are needed to confirm the results.
Collapse
|
32
|
Park YI, Joo N. Structural relations of late night snacking choice attributes and health promotion behaviors according to dietary style of industrial workers. Nutr Res Pract 2014; 8:432-8. [PMID: 25110564 PMCID: PMC4122716 DOI: 10.4162/nrp.2014.8.4.432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 04/25/2014] [Accepted: 04/28/2014] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND/OBJECTIVES This research was conducted to develop a construct model regarding the dietary style, late night snacking choice attributes and health promotion behaviors of industrial workers. SUBJECTS/METHODS The surveys were collected during the period between January and February 2013. A statistical analysis of 888 industrial workers was conducted using SPSS 12.0 for Windows and SEM (Structural Equation Model) using AMOS (Analysis of Moment Structure) 5.0 statistics package. RESULTS The results of the correlations between all variables showed significant positive correlations (P < 0.05). Results of factors analysis on dietary styles were categorized into five factors and health promotion behaviors were categorized into four. The reliability of these findings was supported by a Cronbach's alpha coefficient of 0.6 and higher for all other factors. After obtaining the factors from processing an exploratory factor analysis and the end results supported the validity. In an attempt to study the late night snacking choice attributes in accordance to dietary styles and the health promotion behaviors of industrial workers, a structural equation model was constructed and analyzed. CONCLUSIONS All tests proved the model satisfied the recommended levels of the goodness on fit index, and thus, the overall research model was proved to be appropriate.
Collapse
Affiliation(s)
- Young Il Park
- Department of Food and Nutrition, Sookmyung Women's University, 100 Cheongpa-ro 47-gil, Yongsan-gu, Seoul 140-742, Korea
| | - Nami Joo
- Department of Food and Nutrition, Sookmyung Women's University, 100 Cheongpa-ro 47-gil, Yongsan-gu, Seoul 140-742, Korea
| |
Collapse
|
33
|
Abstract
Heart failure (HF) is typically a chronic disease, with progressive deterioration occurring over a period of years or even decades. HF poses an especially large public health burden. It represents a new epidemic of cardiovascular disease, affecting nearly 5.8 million people in the United States, and over 23 million worldwide. In the present article, our goal is to describe the most up-to-date epidemiology of HF in the United States and worldwide, and challenges facing HF prevention and treatment.
Collapse
Affiliation(s)
- Longjian Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, 1505 Race Street, Philadelphia, PA 19102, USA.
| | | |
Collapse
|
34
|
Impact of metabolic syndrome on the risk of cardiovascular disease mortality in the United States and in Japan. Am J Cardiol 2014; 113:84-9. [PMID: 24169008 DOI: 10.1016/j.amjcard.2013.08.042] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 08/20/2013] [Accepted: 08/20/2013] [Indexed: 11/23/2022]
Abstract
The United States has a higher prevalence of metabolic syndrome (MS) and cardiovascular disease (CVD) mortality than Japan, but it is unknown how much of the difference in MS accounts for the mortality difference. The aim of this study was to examine the impact of MS on the excess CVD mortality in the United States compared with that in Japan. Data from the United States Third National Health and Nutrition Examination Survey (NHANES III; n = 12,561) and the Japanese National Integrated Project for Prospective Observation of Noncommunicable Disease and Its Trends in Aged (NIPPON DATA; n = 7,453) were analyzed. MS was defined as ≥3 of 5 risk factors (obesity, high blood pressure, decreased high-density lipoprotein cholesterol, elevated glycosylated hemoglobin, and elevated triglycerides). The results show that after a median of 13.8 years of follow-up in the United States, 1,683 patients died from CVD (11.75 per 1,000 person-years), and after a median of 15 years of follow-up in Japan, 369 patients died from CVD (3.56 per 1,000 person-years). The age-adjusted prevalence of MS was 26.7% in the United States and 19.3% in Japan. Of 5 MS factors, obesity, high blood pressure, elevated triglycerides, and glycosylated hemoglobin in the United States, and high blood pressure and elevated glycosylated hemoglobin in Japan were significant risk factors for CVD mortality. Estimates of 13.3% and 44% of the excess CVD mortality for the United States could be explained by the higher prevalence of MS and MS plus baseline CVD history than in Japan. In conclusion, the present study is the first to quantitatively demonstrate that MS and MS plus baseline CVD history may significantly contribute to the explanation of excess CVD mortality in the United States compared with Japan.
Collapse
|
35
|
van den Hooven EH, de Jonge LL, Kiefte-de Jong JC, Raat H, Villamor E, Hofman A, Felix JF, Jaddoe VWV, Moll HA, Franco OH. Infant macronutrient composition is associated with differences in cardiovascular structures and function in childhood. J Nutr 2013; 143:1989-98. [PMID: 24068791 DOI: 10.3945/jn.113.179440] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Early-life nutrition may influence cardiovascular development. Not much is known about the associations between dietary composition and cardiovascular risk factors in childhood. We examined the associations of infant macronutrient intake with cardiovascular structures and function in 2882 children participating in a prospective, population-based cohort study. Information on macronutrient intake at the age of 14 mo was obtained from food-frequency questionnaires completed by a parent. Systolic and diastolic blood pressure, carotid-femoral pulse wave velocity (PWV), fractional shortening, and left cardiac structures (left atrial diameter, aortic root diameter, and left ventricular mass) were measured at the age of 6 y. Linear regression analyses were performed by using energy-adjusted macronutrient intakes, adjusted for maternal, child, and other dietary factors. Higher total fat intake was associated with higher carotid-femoral PWV (P-trend = 0.03), whereas higher intakes of total carbohydrate and mono- and disaccharides were associated with lower carotid-femoral PWV. No consistent associations were observed for macronutrient intake with systolic blood pressure, diastolic blood pressure, fractional shortening, and aortic root diameter. Higher intakes of total, saturated, monounsaturated, and polyunsaturated fat were associated with lower left atrial diameter (all P-trend ≤ 0.01), and higher total carbohydrate and mono- and disaccharide intakes were associated with higher left atrial diameter (P-trend < 0.01 and 0.02, respectively). Furthermore, the third tertile of mono- and disaccharide intake was associated with a higher left ventricular mass (difference: 1.01 g; 95% CI: 0.18, 1.85 g; P = 0.02). Dietary macronutrient composition in infancy may lead to developmental differences in cardiovascular structures and function in childhood. Further studies are needed to investigate whether these differences have consequences for the risk of future cardiovascular disease.
Collapse
|
36
|
Abstract
BACKGROUND Evidence from observational studies to date suggests that healthy dietary patterns are associated with better cognitive performance in later life. We examined the extent to which childhood intelligence quotient (IQ) and socioeconomic status account for this association. METHODS Analyses were carried out on 882 participants in the Lothian Birth Cohort 1936 Study. Four dietary patterns were extracted using principal components analysis of a food frequency questionnaire, namely "Mediterranean-style," "health aware," "traditional," and "sweet foods." Cognitive function was assessed at the age of 70 years, including general (g) cognitive ability, processing speed, memory, and verbal ability. RESULTS Before adjustment for childhood IQ and socioeconomic status, the "Mediterranean-style" dietary pattern was associated with significantly better cognitive performance (effect size as partial eta-square (ηp(2)) range = 0.005 to 0.055), and the "traditional" dietary pattern was associated with poorer performance on all cognitive domains measured in old age (ηp(2) = 0.009 to 0.103). After adjustment for childhood IQ (measured at the age of 11 years) and socioeconomic status, statistical significance was lost for most associations, with the exception of verbal ability and the "Mediterranean-style" pattern (National Adult Reading Test (NART) ηp(2) = 0.006 and Wechsler Test of Adult Reading (WTAR) ηp(2) = 0.013), and the "traditional" pattern (NART ηp(2) = 0.035 and WTAR ηp(2) = 0.027). CONCLUSIONS Our results suggest a pattern of reverse causation or confounding; a higher childhood cognitive ability (and adult socioeconomic status) predicts adherence to a "healthy" diet and better cognitive performance in old age. Our models show no direct link between diet and cognitive performance in old age; instead they are related via the lifelong-stable trait of intelligence.
Collapse
|
37
|
Liu J, Hickson DA, Musani SK, Talegawkar SA, Carithers TC, Tucker KL, Fox CS, Taylor HA. Dietary patterns, abdominal visceral adipose tissue, and cardiometabolic risk factors in African Americans: the Jackson heart study. Obesity (Silver Spring) 2013; 21:644-51. [PMID: 23592674 PMCID: PMC3478414 DOI: 10.1002/oby.20265] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2011] [Accepted: 05/11/2012] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To examine the relative association of abdominal visceral adipose tissue (VAT) with cardiometabolic risk factors between African and European Americans. DESIGN AND METHODS We conducted a cross-sectional study of 2035 African Americans from Jackson Heart Study (JHS) and 3170 European Americans from Framingham Heart Study (FHS) who underwent computed tomography assessment of VAT and subcutaneous adipose tissue (SAT). The FHS participants were weighted to match the age distribution of the JHS participants and the metabolic risk factors were examined by study groups in relation to VAT. RESULTS JHS participants had higher rates of obesity, hypertension, diabetes and metabolic syndrome than FHS participants (all p = 0.001). The associations were weaker in JHS women for VAT with blood pressure, triglycerides, HDL-C, and total cholesterol (pinteraction = 0.03 to 0.001) than FHS women. In contrast, JHS men had stronger associations for VAT with high triglycerides, low HDL, and metabolic syndrome (all pinteraction = 0.001) compared to FHS men. Similar associations and gender patterns existed for SAT with most metabolic risk factors. CONCLUSIONS The relative association between VAT and cardiometabolic risk factors is weaker in JHS women compared to FHS women, whereas stronger association with triglycerides and HDL were observed in JHS men.
Collapse
Affiliation(s)
- Jiankang Liu
- Jackson Heart Study, University of Mississippi Medical Center, Jackson State University, Jackson, Mississippi, USA.
| | | | | | | | | | | | | | | |
Collapse
|
38
|
Russo SB, Baicu CF, Van Laer A, Geng T, Kasiganesan H, Zile MR, Cowart LA. Ceramide synthase 5 mediates lipid-induced autophagy and hypertrophy in cardiomyocytes. J Clin Invest 2013; 122:3919-30. [PMID: 23023704 DOI: 10.1172/jci63888] [Citation(s) in RCA: 167] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Accepted: 08/02/2012] [Indexed: 12/18/2022] Open
Abstract
Diabetic cardiomyopathy (DbCM), which consists of cardiac hypertrophy and failure in the absence of traditional risk factors, is a major contributor to increased heart failure risk in type 2 diabetes patients. In rodent models of DbCM, cardiac hypertrophy and dysfunction have been shown to depend upon saturated fatty acid (SFA) oversupply and de novo sphingolipid synthesis. However, it is not known whether these effects are mediated by bulk SFAs and sphingolipids or by individual lipid species. In this report, we demonstrate that a diet high in SFA induced cardiac hypertrophy, left ventricular systolic and diastolic dysfunction, and autophagy in mice. Furthermore, treatment with the SFA myristate, but not palmitate, induced hypertrophy and autophagy in adult primary cardiomyocytes. De novo sphingolipid synthesis was required for induction of all pathological features observed both in vitro and in vivo, and autophagy was required for induction of hypertrophy in vitro. Finally, we implicated a specific ceramide N-acyl chain length in this process and demonstrated a requirement for (dihydro)ceramide synthase 5 in cardiomyocyte autophagy and myristate-mediated hypertrophy. Thus, this report reveals a requirement for a specific sphingolipid metabolic route and dietary SFAs in the molecular pathogenesis of lipotoxic cardiomyopathy and hypertrophy.
Collapse
Affiliation(s)
- Sarah Brice Russo
- Department of Biochemistry and Molecular Biology, Medical University of South Carolina, Charleston, South Carolina 29403, USA
| | | | | | | | | | | | | |
Collapse
|
39
|
Long Y, Gracely EJ, Newschaffer CJ, Liu L. Analysis of the prevalence of cardiovascular disease and associated risk factors for European-American and African-American populations in the state of Pennsylvania 2005-2009. Am J Cardiol 2013; 111:68-72. [PMID: 23040600 DOI: 10.1016/j.amjcard.2012.08.045] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Revised: 08/21/2012] [Accepted: 08/21/2012] [Indexed: 11/30/2022]
Abstract
We examined the burden of cardiovascular disease (CVD) and its associated risk factors using statewide representative data from the Pennsylvania Behavior Risk Factors Surveillance System. The data from 35,576 subjects aged ≥ 18 years participating in the Pennsylvania Behavior Risk Factors Surveillance System in 2005, 2007, and 2009 were analyzed. The age-adjusted prevalence rates of CVD were computed. Logistic regression analysis was applied to examine associations between the risk factors and CVD prevalence, with adjustment for confounding variables. The results showed that no significant changes in the prevalence of CVD, coronary heart disease, and stroke were observed in either European Americans or African Americans from 2005 to 2009 (p >0.05). African Americans had significantly greater CVD rates than European Americans. Although smoking rates significantly decreased, several other CVD risk factors (i.e., obesity, hypertension, and hypercholesterolemia) significantly increased from 2005 to 2009 in European Americans. Similar changes were observed in African Americans, although these changes did not reach statistical significance. Logistic regression analysis indicated that African Americans had a 35% greater risk of CVD. Education level less than high school, smoking, obesity, hypertension, and diabetes were significantly and positively associated with CVD. In conclusion, no significant achievements in CVD control and risk factor reduction were observed from 2005 to 2009 in Pennsylvania. Additional aggressive control of hypertension, obesity, and diabetes for both European and African Americans must be made to reduce the burden of CVD.
Collapse
Affiliation(s)
- Yong Long
- Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA, USA
| | | | | | | |
Collapse
|
40
|
Liu L, Chen M, Hankins SR, Nùñez AE, Watson RA, Weinstock PJ, Newschaffer CJ, Eisen HJ. Serum 25-hydroxyvitamin D concentration and mortality from heart failure and cardiovascular disease, and premature mortality from all-cause in United States adults. Am J Cardiol 2012; 110:834-9. [PMID: 22658246 DOI: 10.1016/j.amjcard.2012.05.013] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Revised: 05/08/2012] [Accepted: 05/08/2012] [Indexed: 02/07/2023]
Abstract
We aimed to examine associations between serum 25-hydroxyvitamin D (25[OH]D) concentration and mortality from heart failure (HF) and cardiovascular disease (CVD) and premature death from all causes using data from the Third National Health and Nutrition Examination Survey, which included 13,131 participants (6,130 men, 7,001 women) ≥35 years old at baseline (1988 to 1994) and followed through December 2000. Premature death was defined all-cause death at <75 years of age. Results indicated that during an average 8-year follow-up, there were 3,266 deaths (24.9%) including 101 deaths from HF, 1,451 from CVD, and 1,066 premature all-cause deaths. Among HF deaths, 37% of decedents had serum 25(OH)D levels <20 ng/ml, whereas only 26% of those with non-HF deaths had such levels (p <0.001). Multivariate-adjusted Cox model indicated that subjects with serum 25(OH)D levels <20 ng/ml had 2.06 times higher risk (95% confidence interval 1.01 to 4.25) of HF death than those with serum 25(OH)D levels ≥30 ng/ml (p <0.001). In addition, hazard ratios (95% confidence intervals) for premature death from all causes were 1.40 (1.17 to 1.68) in subjects with serum 25(OH)D levels <20 ng/ml and 1.11 (0.93 to 1.33) in those with serum 25(OH)D levels of 20 to 29 ng/ml compared to those with serum 25(OH)D levels ≥30 ng/ml (p <0.001, test for trend). In conclusion, adults with inadequate serum 25(OH)D levels have significantly higher risk of death from HF and all CVDs and all-cause premature death.
Collapse
|
41
|
Dietary patterns: a novel approach to examine the link between nutrition and cognitive function in older individuals. Nutr Res Rev 2012; 25:207-22. [PMID: 22874455 DOI: 10.1017/s0954422412000133] [Citation(s) in RCA: 124] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Cognitive decline may lead to dementia whose most frequent cause is Alzheimer's disease (AD). Among the many potential risk factors of cognitive decline and AD, diet raises increasing interest. Most studies considered diet in the frame of a single nutrient approach with inconsistent results. A novel approach to examine the link between nutrition and cognitive function is the use of dietary patterns. The aim of the present review was to update and complete the body of knowledge about dietary patterns in relationship with various cognitive outcomes in the elderly. Two approaches can be used: a priori and a posteriori patterns. A priori patterns are defined by the adhesion to a pre-defined healthy diet using a score such as the Mediterranean diet (MeDi) score, the Healthy Eating Index, the Canadian Healthy Eating Index, the French National Nutrition and Health Programme (Programme National Nutrition Santé) Guideline Score (PNNS-GS), the Recommended Food Score (RFS) and Dietary Approaches to Stop Hypertension (DASH). MeDi score, RFS, PNNS-GS and DASH have been associated with lower risks of cognitive impairment, cognitive decline, and dementia or AD. Principal components analysis, reduced rank regression and clustering methods allow the identification of 'healthy' patterns associated with lower risk of cognitive decline. However, some studies did not report any associations with cognitive outcomes and results are discordant especially regarding MeDi and the risk of dementia. Several methodological challenges should be overcome to provide a higher level of evidence supporting the development of nutritional policies to prevent cognitive decline and AD.
Collapse
|
42
|
Song Y, Joung H. A traditional Korean dietary pattern and metabolic syndrome abnormalities. Nutr Metab Cardiovasc Dis 2012; 22:456-462. [PMID: 21215606 DOI: 10.1016/j.numecd.2010.09.002] [Citation(s) in RCA: 127] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2010] [Revised: 08/30/2010] [Accepted: 09/06/2010] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND AIMS Using national data, we explored the relationship between dietary patterns and metabolic abnormalities to address how the traditional Korean diet, high in carbohydrate and low in animal fat with plenty of plant foods, has influenced metabolic abnormalities in the adult population. METHODS AND RESULTS We examined cross-sectional associations between dietary patterns and the risk of metabolic abnormalities in 4,730 subjects aged 20 years or more using both health and dietary data from the 2005 Korean National Health and Nutrition Examination survey. Three evident dietary patterns were derived by cluster analysis: 'Traditional' (50.3% of total population), 'Meat and Alcohol, (15.8%) and 'Korean Healthy' (33.9%). The 'Traditional' group was characterised by high consumptions of rice and kimchi, while the 'Korean healthy' group ate a modified Korean-style diet with various foods such as noodles, bread, eggs and milk, and the 'Meat and Alcohol' group had high consumptions of processed meat and alcohol. Compared with the 'Traditional' pattern, the 'Meat and Alcohol' pattern was associated with a 33% increased risk of having elevated blood glucose, a 21% increased risk of having elevated serum triglycerides and a 21% increased risk of having elevated blood pressure. However, the 'Traditional' pattern showed a 23% increased risk of having low high density lipoprotein (HDL)-cholesterol compared with the other two patterns by logistics analysis. CONCLUSIONS Fifty percent of the Korean adult population continues to follow a traditional dietary pattern, having beneficial effects with respect to some metabolic abnormalities. However, the high prevalence of low HDL-cholesterol, attributable to a high-carbohydrate diet, should be considered.
Collapse
Affiliation(s)
- Y Song
- School of Human Ecology, The Catholic University of Korea, 43-1 Yeokgok2-dong, Wonmi-gu, Bucheon-si, Gyeonggi-do 420-743, Republic of Korea.
| | | |
Collapse
|
43
|
A dietary pattern derived to correlate with estrogens and risk of postmenopausal breast cancer. Breast Cancer Res Treat 2012; 132:1157-62. [PMID: 22218885 DOI: 10.1007/s10549-011-1942-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Accepted: 12/22/2011] [Indexed: 10/14/2022]
Abstract
Circulating estrogens are an established risk factor for breast cancer and some data suggest that diet may influence estrogen levels. Therefore, using a subsample (n = 550) of women from a large cohort, we applied reduced rank regression to identify a dietary pattern that was correlated with estradiol and estrone sulfate. We then adapted the pattern to be used with the full cohort (n = 67,802) and prospectively assessed its association with postmenopausal breast cancer. The estrogen food pattern, characterized by higher intakes of red meat, legumes, and pizza, but lower intakes of coffee and whole grains, was modestly but significantly correlated with estradiol (r = 0.14) and estrone sulfate (r = 0.20). During 22 years of follow-up, we ascertained 4,596 incident breast cancer, with 2,938 estrogen receptor-positive tumors and 689 estrogen receptor-negative tumors. However, after adjusting for potential confounders, we did not observe any association with overall estrogen receptor-positive or estrogen receptor-negative breast cancer. In conclusion, diet pattern appeared to only have modest association with estrogens, and was not associated with postmenopausal breast cancer risk. Although these results were null, it should be repeated in other populations as differences in food intake may yield a dietary pattern with stronger association with estrogens.
Collapse
|
44
|
Haufe S, Utz W, Engeli S, Kast P, Böhnke J, Pofahl M, Traber J, Haas V, Hermsdorf M, Mähler A, Busjahn A, Wiesner S, Otto C, Mehling H, Luft FC, Boschmann M, Schulz-Menger J, Jordan J. Left ventricular mass and function with reduced-fat or reduced-carbohydrate hypocaloric diets in overweight and obese subjects. Hypertension 2011; 59:70-5. [PMID: 22068866 DOI: 10.1161/hypertensionaha.111.178616] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
In animals, carbohydrate and fat composition during dietary interventions influenced cardiac metabolism, structure, and function. Because reduced-carbohydrate and reduced-fat hypocaloric diets are commonly used in the treatment of obesity, we investigated whether these interventions differentially affect left ventricular mass, cardiac function, and blood pressure. We randomized 170 overweight and obese subjects (body mass index, 32.9±4.4; range, 26.5-45.4 kg/m(2)) to 6-month hypocaloric diets with either reduced carbohydrate intake or reduced fat intake. We obtained cardiac MRI and ambulatory blood pressure recordings over 24 hours before and after 6 months. Ninety subjects completing the intervention period had a full cardiac MRI data set. Subjects lost 7.3±4.0 kg (7.9±3.8%) with reduced-carbohydrate diet and 6.2±4.2 kg (6.7±4.4%) with reduced-fat diet (P<0.001 within each group; P=not significant between interventions). Caloric restriction led to similar significant decreases in left ventricular mass with low-carbohydrate diets (5.4±5.4 g) or low-fat diets (5.2±4.8 g; P<0.001 within each group; P=not significant between interventions). Systolic and diastolic left ventricular function did not change with either diet. The 24-hour systolic blood pressure decreased similarly with both interventions. Body weight change (β=0.33; P=0.02) and percentage of ingested n-3 polyunsaturated fatty acids (β=-0.27; P=0.03) predicted changes in left ventricular mass. In conclusion, weight loss induced by reduced-fat diets or reduced-carbohydrate diets similarly improved left ventricular mass in overweight and obese subjects over a 6-month period. However, n-3 polyunsaturated fatty acid ingestion may have an independent beneficial effect on left ventricular mass.
Collapse
Affiliation(s)
- Sven Haufe
- Franz Volhard Clinical Research Center at the Experimental and Clinical Research Center, Charité University Medical Faculty and Max-Delbrück Center for Molecular Medicine, Berlin, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Fumeron F, Lamri A, Abi Khalil C, Jaziri R, Porchay-Baldérelli I, Lantieri O, Vol S, Balkau B, Marre M. Dairy consumption and the incidence of hyperglycemia and the metabolic syndrome: results from a french prospective study, Data from the Epidemiological Study on the Insulin Resistance Syndrome (DESIR). Diabetes Care 2011; 34:813-7. [PMID: 21447660 PMCID: PMC3064033 DOI: 10.2337/dc10-1772] [Citation(s) in RCA: 132] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE In the French Data from the Epidemiological Study on the Insulin Resistance Syndrome (DESIR) cohort, cross-sectional analyses have shown that a higher consumption of dairy products and calcium are associated with a lower prevalence of the metabolic syndrome (MetS). We assess the influence of dairy products on 9-year incident MetS and on impaired fasting glycemia and/or type 2 diabetes (IFG/T2D). RESEARCH DESIGN AND METHODS Men and women who completed a food frequency questionnaire at baseline and after 3 years were studied (n = 3,435). Logistic regression models were used to study associations between the average year 0 and year 3 consumption of milk and dairy products, cheese, dietary calcium density, and incident MetS and IFG/T2D after adjusting for 1) sex, age, alcohol, smoking, physical activity, fat intake and 2) additionally for BMI. Associations between dairy products and continuous variables were studied by repeated-measures ANCOVA, using the same covariates. RESULTS Dairy products other than cheese, and dietary calcium density, were inversely associated with incident MetS and IFG/T2D; cheese was negatively associated with incident MetS. All three parameters were associated with lower diastolic blood pressure, and with a lower BMI gain. Higher cheese intake and calcium density were associated with a lower increase in waist circumference and lower triglyceride levels. Calcium density was also associated with a lower systolic blood pressure and a lower 9-year increase in plasma triglyceride levels. CONCLUSIONS A higher consumption of dairy products and calcium was associated with a lower 9-year incidence of MetS and IFG/T2D in a large cohort drawn from the general population.
Collapse
|
46
|
Liu L. Social Connections, Diabetes Mellitus, and Risk of Mortality among White and African-American Adults Aged 70 and Older: An Eight-Year Follow-up Study. Ann Epidemiol 2011; 21:26-33. [DOI: 10.1016/j.annepidem.2010.10.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2010] [Revised: 09/24/2010] [Accepted: 10/05/2010] [Indexed: 11/29/2022]
|
47
|
Altmaier E, Kastenmüller G, Römisch-Margl W, Thorand B, Weinberger KM, Illig T, Adamski J, Döring A, Suhre K. Questionnaire-based self-reported nutrition habits associate with serum metabolism as revealed by quantitative targeted metabolomics. Eur J Epidemiol 2010; 26:145-56. [DOI: 10.1007/s10654-010-9524-7] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Accepted: 11/18/2010] [Indexed: 11/30/2022]
|
48
|
Basu A, Du M, Leyva MJ, Sanchez K, Betts NM, Wu M, Aston CE, Lyons TJ. Blueberries decrease cardiovascular risk factors in obese men and women with metabolic syndrome. J Nutr 2010; 140:1582-7. [PMID: 20660279 PMCID: PMC2924596 DOI: 10.3945/jn.110.124701] [Citation(s) in RCA: 300] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Among all fruits, berries have shown substantial cardio-protective benefits due to their high polyphenol content. However, investigation of their efficacy in improving features of metabolic syndrome and related cardiovascular risk factors in obesity is limited. We examined the effects of blueberry supplementation on features of metabolic syndrome, lipid peroxidation, and inflammation in obese men and women. Forty-eight participants with metabolic syndrome [4 males and 44 females; BMI: 37.8 +/- 2.3 kg/m(2); age: 50.0 +/- 3.0 y (mean +/- SE)] consumed freeze-dried blueberry beverage (50 g freeze-dried blueberries, approximately 350 g fresh blueberries) or equivalent amounts of fluids (controls, 960 mL water) daily for 8 wk in a randomized controlled trial. Anthropometric and blood pressure measurements, assessment of dietary intakes, and fasting blood draws were conducted at screening and at wk 4 and 8 of the study. The decreases in systolic and diastolic blood pressures were greater in the blueberry-supplemented group (- 6 and - 4%, respectively) than in controls (- 1.5 and - 1.2%) (P lt 0.05), whereas the serum glucose concentration and lipid profiles were not affected. The decreases in plasma oxidized LDL and serum malondialdehyde and hydroxynonenal concentrations were greater in the blueberry group (- 28 and - 17%, respectively) than in the control group (- 9 and - 9%) (P lt 0.01). Our study shows blueberries may improve selected features of metabolic syndrome and related cardiovascular risk factors at dietary achievable doses.
Collapse
Affiliation(s)
- Arpita Basu
- Nutritional Sciences, Oklahoma State University, Stillwater, OK 74078, USA.
| | - Mei Du
- Harold Hamm Oklahoma Diabetes Center and Section of Endocrinology and Diabetes, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104
| | - Misti J. Leyva
- General Clinical Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117
| | - Karah Sanchez
- Nutritional Sciences, Oklahoma State University, Stillwater, OK 74078
| | - Nancy M. Betts
- Nutritional Sciences, Oklahoma State University, Stillwater, OK 74078
| | - Mingyuan Wu
- Harold Hamm Oklahoma Diabetes Center and Section of Endocrinology and Diabetes, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104
| | - Christopher E. Aston
- General Clinical Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117
| | - Timothy J. Lyons
- General Clinical Research Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73117,Harold Hamm Oklahoma Diabetes Center and Section of Endocrinology and Diabetes, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104
| |
Collapse
|
49
|
Liu L, Núñez AE. Cardiometabolic syndrome and its association with education, smoking, diet, physical activity, and social support: findings from the Pennsylvania 2007 BRFSS Survey. J Clin Hypertens (Greenwich) 2010; 12:556-64. [PMID: 20629821 PMCID: PMC8673169 DOI: 10.1111/j.1751-7176.2010.00317.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2009] [Revised: 02/28/2010] [Accepted: 03/08/2010] [Indexed: 12/28/2022]
Abstract
The authors aimed to examine the prevalence of cardiometabolic syndrome (CMS) and its association with education, smoking, diet, physical activity, and social support among white, black, and Hispanic adults using data from the 2007 Pennsylvania Behavior Risk Factor Surveillance System (BRFSS) survey, the largest population-based survey in the state. The authors examined associations between CMS and associated factors cross-sectionally using univariate and multivariate methods. The study included a representative sample of 12,629 noninstitutionalized Pennsylvanians aged > or =18. Components of CMS included obesity, hypercholesterolemia, angina (as a surrogate for decreased high-density lipoprotein), prehypertension or hypertension, and prediabetes or diabetes. CMS was identified as the presence of > or =3 CMS components. The results show that the prevalence of CMS was 20.48% in blacks, followed by Hispanics (19.14%) and whites (12.26%), (P<.01). Multivariate logistic regression analyses indicated that physical inactivity, lower educational levels, smoking, daily consumption of vegetables and/or fruits <3 servings, and lack of social support were significantly associated with the odds of having CMS. In conclusion, black and Hispanic adults have a significantly higher prevalence of CMS than whites. The significant association between CMS and risk factors provides new insights in the direction of health promotion to prevent and control CMS in those who are at high risk.
Collapse
Affiliation(s)
- Longjian Liu
- Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA, USA.
| | | |
Collapse
|
50
|
Gu Y, Nieves JW, Stern Y, Luchsinger JA, Scarmeas N. Food combination and Alzheimer disease risk: a protective diet. ACTA ACUST UNITED AC 2010; 67:699-706. [PMID: 20385883 DOI: 10.1001/archneurol.2010.84] [Citation(s) in RCA: 269] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To assess the association between food combination and Alzheimer disease (AD) risk. Because foods are not consumed in isolation, dietary pattern (DP) analysis of food combination, taking into account the interactions among food components, may offer methodological advantages. DESIGN Prospective cohort study. SETTING Northern Manhattan, New York, New York. PATIENTS OR OTHER PARTICIPANTS Two thousand one hundred forty-eight community-based elderly subjects (aged > or = 65 years) without dementia in New York provided dietary information and were prospectively evaluated with the same standardized neurological and neuropsychological measures approximately every 1.5 years. Using reduced rank regression, we calculated DPs based on their ability to explain variation in 7 potentially AD-related nutrients: saturated fatty acids, monounsaturated fatty acids, omega-3 polyunsaturated fatty acids, omega-6 polyunsaturated fatty acids, vitamin E, vitamin B(12), and folate. The associations of reduced rank regression-derived DPs with AD risk were then examined using a Cox proportional hazards model. Main Outcome Measure Incident AD risk. RESULTS Two hundred fifty-three subjects developed AD during a follow-up of 3.9 years. We identified a DP strongly associated with lower AD risk: compared with subjects in the lowest tertile of adherence to this pattern, the AD hazard ratio (95% confidence interval) for subjects in the highest DP tertile was 0.62 (0.43-0.89) after multivariable adjustment (P for trend = .01). This DP was characterized by higher intakes of salad dressing, nuts, fish, tomatoes, poultry, cruciferous vegetables, fruits, and dark and green leafy vegetables and a lower intake of high-fat dairy products, red meat, organ meat, and butter. CONCLUSION Simultaneous consideration of previous knowledge regarding potentially AD-related nutrients and multiple food groups can aid in identifying food combinations that are associated with AD risk.
Collapse
Affiliation(s)
- Yian Gu
- The Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA
| | | | | | | | | |
Collapse
|