Increased Waist-to-height Ratio May Contribute to Age-related Increase in Cardiovascular Risk Factors

Cardiovascular disease risk among male workers of a regional electricity distribution company in Brazil

BACKGROUND

At energy distribution companies, office and operational employees work in different occupational environments. Cardiovascular diseases (CVD) can develop due to occupational factors and can often lead to morbidity and disability.

OBJECTIVE

To evaluate the risk of CVD in workers with different occupations in an energy distribution company, using cardiometabolic indices.

METHODS

Workers (men), aged between 20 and 70 years, were divided into two groups: operational (n = 78) and office (n = 106) workers. Their metabolic profiles were analyzed using anthropometric and laboratory data to obtain the atherogenic plasma index (AIP) and insulin resistance index (TyG), and to identify the hypertriglyceridemic waist (HTGW) phenotype as cardiometabolic indicators.

RESULTS

There was no difference in CVD risk between the two groups. However, 82% of the test subjects presented a high risk for the development of atherosclerosis based on the AIP, and 11.4% presented the HTGW phenotype, along with the presence of dyslipidemia, insulin resistance, and being overweight as risk factors for CVD.

CONCLUSIONS

Although the identified risk factors are not related to the type of occupation at work, companies in the electricity sector can invest in the implementation of measures for health promotion to protect and prevent diseases and improve labor productivity and quality.

Dietary Intakes of Zinc, Copper, Magnesium, Calcium, Phosphorus, and Sodium by the General Adult Population Aged 20-50 Years in Shiraz, Iran: A Total Diet Study Approach

In the present total diet study, the dietary intake of zinc (Zn), copper (Cu), magnesium (Mg), calcium (Ca), phosphorus (P), and sodium (Na) by healthy adults in Shiraz, Iran, was estimated from the foods as consumed. A total of 580 individual food items were collected, prepared, and pooled into 129 composite samples. The metal concentration was then evaluated using inductively coupled plasma-optical emission spectrometry. The mean intakes of Zn (12.92 mg/d), Cu (3.80 mg/d), and Mg (412.68 mg/d) exceeded the estimated average requirements (EARs), but they were well below the upper limits. A high prevalence of inadequate intake was observed for Ca (91.6%) and P (89.7%), which was mainly due to nutritionally imbalanced diets. Sodium intake for average and high consumers (97.5th percentile) was 123.6% and 237.8% of the tolerable upper intake level of 2300 mg/d, respectively, with 70% of the participants having intakes higher than this threshold value. Nutrition education, nutritional rehabilitation, Ca supplementation, food fortification, mandatory reduction of salt content in processed foods, and discretionary salt use (in home cooking or at the table) are among the possible strategies that can be adopted to combat the health problems.

Flaxseed oil in the context of a weight loss programme ameliorates fatty liver grade in patients with non-alcoholic fatty liver disease: a randomised double-blind controlled trial

Long-chain n-3 fatty acids have been shown to regulate lipid metabolism and reduce fat accumulation in the liver. This trial investigated the effect of flaxseed oil, as a rich source of α-linolenic acid, on fatty liver and cardiometabolic risk factors in patients with non-alcoholic fatty liver disease (NAFLD). The randomised, double-blind, controlled trial was performed on sixty-eight NAFLD patients who were divided into flaxseed (n 34) and sunflower (n 34) oil groups. Patients were given a hypoenergetic diet (−2092 kJ/d) and 20 g/d of the corresponding oil for 12 weeks. Fatty liver grade, liver enzymes and cardiometabolic parameters were determined. The intention-to-treat approach was used for data analysis. Fatty liver grade significantly decreased in both groups (−0·68 in flaxseed v. −0·29 in sunflower, P = 0·002). Alanine aminotransferase and aspartate aminotransferase decreased in both groups (P < 0·01). Also, significant reduction was observed in blood glucose (P = 0·005) and fat mass (P = 0·01) in the flaxseed and muscle mass (P = 0·01) in the sunflower group. However, none of these alterations was significantly different between the groups. Weight, waist circumference and blood pressure were significantly decreased in both groups but only weight change was significantly different between the groups (P = 0·01). IL-6 did not significantly change in either group but showed a significant between-group difference (P = 0·03). Overall, the results showed that in the context of a low-energy diet and moderate physical activity, flaxseed oil may benefit NAFLD patients to improve fatty liver grade, weight and IL-6 compared with sunflower oil.

Cardiovascular risk factors in adults with coarctation of the aorta

BACKGROUND

The aging patient with adult congenital heart disease (ACHD) faces the risk of developing atherosclerotic disease. Patients with coarctation of the aorta (CoA) are especially vulnerable because of an inherent high risk of developing hypertension. However, data on the prevalence of other cardiovascular risk factors are scarce. Therefore, this study aimed to describe the prevalence of traditional cardiovascular risk factors (diabetes, hypertension, hyperlipidemia, smoking, obesity, and sedentary lifestyle) in adult patients with CoA.

METHODS

Patients with CoA who were registered at the ACHD clinic in Gothenburg were asked to participate in a comprehensive cardiovascular risk assessment. This assessment included a glucose tolerance test, cholesterol profile, ambulatory blood pressure measurements, and a lifestyle questionnaire.

RESULTS

A total of 72 patients participated. The median age was 43.5 years and 58.3% were men. Sixty-six (91.7%) patients had ≥one cardiovascular risk factor and 40.3% had ≥three risk factors. Three (4.2%) patients were newly diagnosed with diabetes or impaired glucose tolerance. More than half of the patients had hyperlipidemia (n = 42, 58.3%) and 35 patients (48.6%) were overweight or obese. Only three (4.2%) patients smoked regularly. Of the 60 patients who underwent 24-hour ambulatory blood pressure measurement, 33 (55.0%) were hypertensive. Of the 30 patients with known hypertension only 9 (30.0%) had well-controlled blood pressure on ambulatory blood pressure measurement.

CONCLUSIONS

Cardiovascular risk factors among patients with CoA are prevalent. This may indicate a need for more aggressive screening strategies of traditional risk factors to minimize the risk of these patients also developing atherosclerotic disease.

Effect of Natural Honey on Glycemic Control and Anthropometric Measures of Patients with Type 2 Diabetes: A Randomized Controlled Crossover Trial

Background

Due to high content of fructose, honey has been introduced as a suitable natural sweetener for patients with type 2 diabetes. We investigated the effect of honey consumption on glycemic control and anthropometric measures of patients with type 2 diabetes.

Methods

This randomized controlled crossover clinical trial was conducted on 53 patients with type 2 diabetes. The participants were randomly divided into groups of control (weight maintenance diet) or treatment (weight maintenance diet +50 g/day honey) for 8 weeks. After a 4-week washout, the second phase began, in which the role of the groups was interchanged. Blood glycated hemoglobin (HbA1c), glucose, insulin, and anthropometric characteristics were measured. Statistical analysis was performed with SPSS. Repeated measures of ANOVA were used to test differences within- and between the two conditions.

Results

Forty-two patients completed the study. HbA1c significantly decreased in control (-0.22%, P = 0.03) and nonsignificantly increased in honey condition (+0.17%, P = 0.22). There was a significant difference between the two conditions (P = 0.02). Fasting glucose did not significantly change in either honey or control condition but insulin concentrations (-0.85 μU/ml, P = 0.01) and insulin secretion (-10.7%, P = 0.01) decreased significantly in the control condition. There was no significant difference in any of these parameters between the two conditions. Waist circumference decreased by honey treatment with a significant difference between the two conditions (P = 0.02).

Conclusions

Eight weeks consumption of 50 g/day honey increased HbA1c and decreased waist circumference of patients with type 2 diabetes.

Effects of fat-to-sugar ratio in excess dietary energy on lipid abnormalities: a 7-month prospective feeding study in adult cynomolgus monkeys

BACKGROUND

Excess energy intake contributes to metabolic disorders. However, the relationship between excess sugar and fat in their contributions to metabolic abnormalities remains to be further elucidated. Here we conducted a prospective feeding experiment to evaluate effects of dietary fat-to-sugar ratio on diet-induced metabolic abnormalities in adult cynomolgus monkeys.

METHODS

Four groups of adult cynomolgus monkeys were fed regular chow plus emulsion with combinations of high sugar (HS) or low sugar (HS) and low fat (LF) or high fat (HF) for 7 months. Plasma levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG) and blood glucose were measured for all the four groups of animals during the experiment.

RESULTS

Plasma levels of TC and LDL-C gradually increased in all 4 diets groups, with the highest increase found in the LSHF group compared to the other three groups (P = 0.0018 and P = 0.0005 respectively). HF induced increased fasting glucose (P = 0.0077) and HS induced higher TG (P = 0.0227) respectively. Intriguingly, HSHF led to dramatically smaller magnitude of increase in LDL-C and TC levels compared to LSHF, while such difference was absent between the LSLF and LSHF groups. Our findings thus indicate interactive effects of HS and HF on TC and LDL-C. In addition, HF exhibited stronger effects on lipid abnormalities than HS.

CONCLUSIONS

In the current study, our prospective feeding experiment in adult cynomolgus monkeys revealed effects of different fat-to-sugar ratios on diet-induced metabolic abnormalities. Furthermore, our findings suggest that not only excess dietary energy but also the balance of dietary fat-to-sugar ratio matters in diet-induced lipid abnormalities.

Waist circumference and waist:height ratio percentiles using LMS method in Chilean population

BACKGROUND AND AIMS

The concern over the weight gain problem continues to grow among both the international scientific community and public health authorities, since overweight and obesity prevalence rates continue to increase worldwide. In Chile, two out of three people are overweight, whereas 25% of the adult population is obese. Abdominal fat, has been linked to the development of a number of metabolic disorders. Waist circumference (WC) and the waist:height ratio (WHtR) have recently been evidenced as good predictors of metabolic risk for both adults and children. Thus, the present work aims at establishing smoothed centile charts and LMS tables for WC and WHtR for Chilean adults based on data from the National Health Survey-ENS, in order to have reliable information for identifying groups at risk.

METHODS AND RESULTS

A sample of 4788 subjects aged 15-75 years old (mean age 46 ± 18 years old) was considered. Body weight, height, and WC were measured and Body Mass Index (BMI) and WHtR were also determined. Percentiles were calculated using the L (curve Box-Cox), M (curve median), S (curve coefficient of variation) method. In the obese group the WC cutoff values were 99.75 cm and 92.35 cm for men and women, respectively. The cutoff point for WHtR was 0.59 for both obese men and women.

CONCLUSION

The study shows, for the first time, reference values for WC and WHtR for Chilean adults.