Development and Validation of a Short Food Frequency Questionnaire to Measure Dietary Intake of a Selection of Immune-Modulating Nutrients in Patients with Established Peripheral Arterial Disease.

Bianca J Collins,Christopher L Delaney,Michelle D Miller,Jade E Boffo

doi:10.3390/nu13103316

Bianca J Collins, Christopher L Delaney + Show 2 more

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https://doi.org/10.3390/nu13103316

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Journal: Nutrients	Publication Date: Sep 23, 2021
Citations: 1	License type: CC BY 4.0

Affiliation: Flinders University, Flinders Medical Centre

Abstract

Nutrients with the ability to modulate the immune system (immune-modulating nutrients; IMN) may help prevent the development and progression of atherosclerosis, the main disease process underlying peripheral artery disease (PAD). Currently, no screening tool exists to measure IMN intake; therefore, the aim of this project is to develop and validate a short food frequency questionnaire (FFQ) that measures dietary intake of 14 nutrients with proposed immune-modulating effects, identified by the literature (copper, iron and zinc, vitamins A, C, D and E, alpha linolenic acid, total long-chain omega-3 fatty acids, arginine, glutamic acid, isoleucine, leucine and valine) in patients with established PAD. A 21-item FFQ was developed to measure average daily intake of IMNs over the past 12 months. Participants (n = 106) were recruited from Flinders Medical Centre, where they completed the FFQ followed by the reference method, a diet history reflecting usual intake over the past week. The mean age of participants was 72 years, with 83% being male (n = 88). Bland–Altman analysis resulted in a statistically non-significant p-value (p-value > 0.05) for 12 out of 14 nutrients, demonstrating good agreement between the two methods. Additionally, over 50% of nutrients had a sensitivity or specificity >70%. Consequently, the novel 21-item FFQ was determined to be a promising measure of dietary intake of 14 IMNs in patients with PAD when compared to the reference method of a diet history, and it is recommended that further investigations of the utility against biomarkers be explored in the future.

Highlights

Peripheral artery disease (PAD) is a local manifestation of the systemic disease state atherosclerosis, affecting over 200 million people globally [1,2,3,4,5]
The endothelial cells (EC) lining the cardiovascular system contribute to vascular homeostasis through the production of nitric oxide (NO), which acts as a vasodilator, decreases platelet aggregation and blocks the expression of pro-inflammatory and adhesion molecules [2,3,8,9]
Risk factors such as hyperlipidaemia, smoking, hypertension and diabetes mellitus result in abnormalities in the production or bioavailability of NO, termed EC dysfunction [3,4]. These changes result in the adhesion and infiltration of monocytes and low-density lipoproteins (LDL) to the subendothelial space, initiating a complex pathological sequence resulting in the formation of an atherosclerotic plaque and a state of systemic pro-inflammation and oxidation [4,10]

Summary

Introduction

Peripheral artery disease (PAD) is a local manifestation of the systemic disease state atherosclerosis, affecting over 200 million people globally [1,2,3,4,5]. The endothelial cells (EC) lining the cardiovascular system contribute to vascular homeostasis through the production of nitric oxide (NO), which acts as a vasodilator, decreases platelet aggregation and blocks the expression of pro-inflammatory and adhesion molecules [2,3,8,9]. Risk factors such as hyperlipidaemia, smoking, hypertension and diabetes mellitus result in abnormalities in the production or bioavailability of NO, termed EC dysfunction [3,4]. These changes result in the adhesion and infiltration of monocytes and low-density lipoproteins (LDL) to the subendothelial space, initiating a complex pathological sequence resulting in the formation of an atherosclerotic plaque and a state of systemic pro-inflammation and oxidation [4,10]

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