Prevention Of Chronic Diseases Research Articles

Ultra-Microporous Fe-MOF with Prolonged NO Delivery in Biological Media for Therapeutic Application.

Nitric oxide (NO), a key element in the regulation of essential biological mechanisms, presents huge potential as therapeutic agent in the treatment and prevention of chronic diseases. Metal-organic frameworks (MOFs) with open metal sites are promising carriers for NO therapies but delivering it over an extended period in biological media remains a great challenge due to i) a fast degradation of the material in body fluids and/or ii) a rapid replacement of NO by water molecules onto the Lewis acid sites. Here, a new ultra-narrow pores Fe bisphosphonate MOF, denoted MIP-210(Fe) or Fe(H2O)(Hmbpa) (H4mbpa = p-xylenediphosphonic acid) is described that adsorbs NO due to an unprecedented sorption mechanism: coordination of NO through the Fe(III) sites is unusually preferred, replacing bound water, and creating a stable interaction with the free H2O and P-OH groups delimiting the ultra-narrow pores. This, associated with the high chemical stability of the MOF in body fluids, enables an unprecedented slow replacement of NO by water molecules in biological media, achieving an extraordinarily extended NO delivery time over at least 70h, exceeding by far the NO kinetics release reported with others porous materials, paving the way for the development of safe and successful gas therapies.

Effect of hearing intervention on communicative function: A secondary analysis of the ACHIEVE randomized controlled trial.

The Aging and Cognitive Health Evaluation in Elders (ACHIEVE) Study was designed to determine the effects of a best-practice hearing intervention on cognitive decline among community-dwelling older adults. Here, we conducted a secondary analysis of the ACHIEVE Study to investigate the effect of hearing intervention on self-reported communicative function. The ACHIEVE Study is a parallel-group, unmasked, randomized controlled trial of adults aged 70-84 years with untreated mild-to-moderate hearing loss and without substantial cognitive impairment. Participants were randomly assigned (1:1) to a hearing intervention (audiological counseling and provision of hearing aids) or a control intervention of health education (individual sessions with a health educator covering topics on chronic disease prevention) and followed semiannually for 3 years. Self-reported communicative function was measured with the Hearing Handicap Inventory-Elderly Screening version (HHIE-S, range 0-40, higher scores indicate greater impairment). Effect of hearing intervention versus control on HHIE-S was analyzed through an intention-to-treat model controlling for known covariates. HHIE-S improved after 6-months with hearing intervention compared to control, and continued to be better through 3-year follow-up. We estimated a difference of -8.9 (95% CI: -10.4, -7.5) points between intervention and control groups in change in HHIE-S score from baseline to 6 months, -9.3 (95% CI: -10.8, -7.9) to Year 1, -8.4 (95% CI: -9.8, -6.9) to Year 2, and - 9.5 (95% CI: -11.0, -8.0) to Year 3. Other prespecified sensitivity analyses that varied analytical parameters did not change the observed results. Hearing intervention improved self-reported communicative function compared to a control intervention within 6 months and with effects sustained through 3 years. These findings suggest that clinical recommendations for older adults with hearing loss should encourage hearing intervention that could benefit communicative function and potentially have positive downstream effects on other aspects of health.

On the issue of legal support for long-term strategy in prevention of chronic non-communicable diseases in Russia.

On the issue of legal support for long-term strategy in prevention of chronic non-communicable diseases in Russia.

Industry 4.0-Compliant Occupational Chronic Obstructive Pulmonary Disease Prevention: Literature Review and Future Directions.

Chronic obstructive pulmonary disease (COPD) is among prevalent occupational diseases, causing early retirement and disabilities. This paper looks into occupational-related COPD prevention and intervention in the workplace for Industry 4.0-compliant occupation health and safety management. The economic burden and other severe problems caused by COPD are introduced. Subsequently, seminal research in relevant areas is reviewed. The prospects and challenges are introduced and discussed based on critical management approaches. An initial design of an Industry 4.0-compliant occupational COPD prevention system is presented at the end.

Assessing support for substance use policies among the general public and policy influencers in two Canadian provinces

BackgroundExamining support for substance use policies, including those for harm reduction, among the general public and policy influencers is a fundamental step to map the current policy landscape and leverage policy opportunities. Yet, this is a knowledge gap in Canada. Our paper identifies the level of support for substance use policies in two provinces in Canada and describes how the level of support is associated with intrusiveness and sociodemographic variables.MethodsData came from the 2019 Chronic Disease Prevention Survey. The representative sample included members of the general public (Alberta n = 1648, Manitoba n = 1770) as well as policy influencers (Alberta n = 204, Manitoba n = 98). We measured the level of support for 22 public policies concerning substance use through a 4-point Likert-scale. The Nuffield Council on Bioethics Intervention Ladder framework was applied to assess intrusiveness. We used cumulative link models to run ordinal regressions for identification of explanatory sociodemographic variables.ResultsOverall, there was generally strong support for the policies assessed. The general public in Manitoba was significantly more supportive of policies than its Alberta counterpart. Some differences were found between provinces and samples. For certain substance use policies, there was stronger support among women than men and among those with higher education than those with less education.ConclusionsThe results highlight areas where efforts are needed to increase support from both policy influencers and general public for adoption, implementation, and scaling of substance use policies. Socio-demographic variables related to support for substance use policies may be useful in informing strategies such as knowledge mobilization to advance the policy landscape in Western Canada.

Prospective associations between an empirically derived dietary pattern and life satisfaction in Malaysian adolescents

BackgroundLittle is known on the prospective associations between an empirically derived dietary pattern (DP) and life satisfaction among adolescents. This PUTRA-Adol follow-up study aimed to assess the prospective associations between the empirically derived DP and life satisfaction during adolescence.MethodsA total of 585 and 262 adolescents participated in the baseline PUTRA-Adol study in 2016 and PUTRA-Adol follow-up study in 2019–2020, respectively. These adolescents were recruited from three southern states in peninsular Malaysia, namely Negeri Sembilan, Melaka and Johor. Dietary assessments were estimated using a validated food frequency questionnaire (FFQ) while a Multidimensional Students’ Life Satisfaction Scale (MSLSS) was used to measure life satisfaction at baseline in 2016 as well as at follow-up in 2019–2020. A DP characterised by foods high in free sugar and energy dense was identified using reduced rank regression (RRR), cross-sectionally at baseline and was reported elsewhere. Similar RRR analysis was used to find a DP that best explained the variation in response variables linked to poorer life satisfaction, including dietary energy density (DED), fiber density, and percentage of energy from total fat and sugar at the PUTRA-Adol follow-up study. Prospective relationship between adherence to the identified DPs and overall life satisfaction scores as well as its domains between 2016 and 2019–2020 were evaluated using generalized estimating equation models (GEE).ResultsA DP characterized by high intakes of percentage energy from sugar, fibre and low in DED and percentage energy from total fat was identified at the 2019–2020 follow-up. The identified DP explained 11% of total variations in the response variables and was characterized by high intakes of sweets, sugar sweetened beverages (SSB) and fruits. Female adolescents [67.6(8.9)] had a mean (SD) of life satisfaction that was higher than male adolescents [67.5(10.8)] p < 0.05 in 2019–2020. Prospective analysis found a significant positive association between the identified DP and school domain, in male adolescents (β = 0.117; 95% CI 0.001, 0.234) and an inverse relationship between the DP z-score and self-domain in all adolescents (β = − 0.060; 95% CI − 0.115, − 0.005) from 2016 to 2019–2020.ConclusionsAn increasing score for the predominant ‘High sugar and High fibre’ DP was prospectively associated with increasing life satisfaction score for the school domain in male adolescents and decreasing score for self-domain in both male and females during adolescence. A lifestyle intervention targeting reduced dietary intakes, particularly sugar, may improve life satisfaction in adolescents and promote healthier future without compromising dietary intakes for chronic disease prevention later in life.

Investigation on Phenomics of Traditional Chinese Medicine from the Diabetes

AbstractWith thousands of years of application history, traditional Chinese medicine (TCM) has unique advantages in the prevention of various chronic diseases, and in recent years, the development of TCM has presented a situation where opportunities and challenges coexist. Phenomics is an emerging area of life science research, which has numerous similarities to the cognitive perspective of TCM. Thus, how to carry out the interdisciplinary research between TCM and phenomics deserves in-depth discussion. Diabetes is one of the most common chronic non-communicable diseases around the world, and TCM plays an important role in all stages of diabetes treatment, but the molecular mechanisms are difficult to elucidate. Phenomics research can not only reveal the hidden scientific connotations of TCM, but also provide a bridge for the confluence and complementary between TCM and Western medicine. Facing the challenges of the TCM phenomics research, we suggest applying the State-target theory (STT) to overall plan relevant researches, namely, focusing on the disease development, change trends, and core targets of each stage, and to deepen the understanding of TCM disease phenotypes and the therapeutic mechanisms of herbal medicine.

Patient Perspectives on Lifestyle Medicine Virtual Group Visits

Lifestyle Medicine Virtual Group Visits (LMVGVs) have potential for providing effective lifestyle education and counseling to patients who have or are at risk for chronic disease. The purpose of this study was to assess primary care patients’ motivations for participation in and preferences for future engagement with LMVGVs. This was a cross-sectional survey conducted in an academic community-based clinic. A total of 111 patients who signed up for LMVGVs between September 2020 and August 2021 completed the survey between February and April 2022. Patient demographics and LMVGV attendance data were collected from the medical record. The most common reported reasons for signing up for LMVGVs were to focus on lifestyle changes and to lower chronic disease risk. The most common reasons for attending subsequent LMVGVs were the focus on healthy lifestyle changes and the positive focus of the groups. Almost all (98%) respondents who attended ≥5 LMVGVs indicated they would recommend LMVGVs to family or friends. Most respondents preferred monthly LMVGVs, including 71% of those who attended ≥5 LMVGVs. These findings inform efforts to develop LMVGVs that are feasible and acceptable to patients, contributing to the promotion of lifestyle behaviors that aid in the prevention and treatment of chronic disease.

Digital Intervention for behaviouR changE and Chronic disease prevenTION (DIRECTION): Study protocol for a randomized controlled trial of a web-based platform integrating nutrition, physical activity, and mindfulness for individuals with obesity

Excess body weight, suboptimal diet, physical inactivity, alcohol consumption, sleep disruption, and elevated stress are modifiable risk factors associated with the development of chronic diseases. Digital behavioural interventions targeting these factors have shown promise in improving health and reducing chronic disease risk. The Digital Intervention for behaviouR changE and Chronic disease prevenTION (DIRECTION) study is a parallel group, two-arm, randomized controlled trial evaluating the effects of adding healthcare professional guidance and peer support via group-based sessions to a web-based wellness platform (experimental group, n = 90) compared to a self-guided use of the platform (active control group, n = 90) among individuals with a body mass index (BMI) of 30–35 kg/m2 and aged 40–65 years. Obesity is defined by a high BMI. The web-based wellness platform employed in this study is My Viva Plan (MVP)®, which holistically integrates nutrition, physical activity, and mindfulness programs. Over 16 weeks, the experimental group uses the web-based wellness platform daily and engages in weekly online support group sessions. The active control group exclusively uses the web-based wellness platform daily. Assessments are conducted at baseline and weeks 8 and 16. The primary outcome is between-group difference in weight loss (kg) at week 16, and secondary outcomes are BMI, percent weight change, proportion of participants achieving 5 % or more weight loss, dietary intake, physical activity, alcohol consumption, sleep, and stress across the study. A web-based wellness platform may be a scalable approach to promote behavioural changes that positively impact health. This study will inform the development and implementation of interventions using web-based wellness platforms and personalized digital interventions to improve health outcomes and reduce chronic disease risk among individuals with obesity.

Social prescribing in Canada: linking the Ottawa Charter for Health Promotion with health care's Quintuple Aim for a collaborative approach to health.

Social prescribing offers a practical mechanism by which public health and health care systems can work together toward a future in which well-being is prioritized, health equity is addressed and people and communities thrive. The articles in this second part of the Health Promotion and Chronic Disease Prevention in Canada special issue on social prescribing explore how social prescribing in Canada supports action on two frameworks important to public health and health care communities: the Ottawa Charter for Health Promotion, which emphasizes building healthy public policy, creating supportive environments, strengthening community action, developing personal skills and reorienting health services, and the Quintuple Aim for health care improvement, which focusses on improved population health, health equity, patient experience, care team well-being and reduced costs.

Bioactivity and Therapeutic Applications of Punica granatum L. Peel: Evidence and Prospects

Background: Inclination of the world towards natural and super foods has intended researchers and nutritionists to develop foods that are highly nutritious, feasible, eco-friendly along with immuno-boosting potential. Massive amounts of agro-industrial waste are generated across the world which can be turned-up into a functional ingredient by utilization and transformation of these wastes into wealth. An Indian balanced diet consists of foods from all food categories, with fruits and vegetables constituting one-fourth of the diet. Since ancient times, pomegranate (Punica granatum) and its various parts have been well-known for their therapeutic properties and delicious flavor. Worldwide approximately million tons of pomegranate peels are produced per annum which are a considerable source of vitamins, minerals, and numerous bioactive compounds such as phenolics, flavonoids (anthocyanins, flavonols, flavones) and tannins. Consequently, it has many health benefits, including antioxidative, anticancer, antidiabetic, anti-inflammatory, anti-microbial, antimutagenic, cardio-protective, hepato-protective, nephro-protective properties as well as it is also helpful in the prevention of many other chronic diseases. Its safety and efficacy for consumption have been proved by incorporating it in food products and industrial applications. The main aim of this review is to focus on the vital bioactive compounds present in pomegranate peel and their positive health benefits on human health.

How does chronic disease influence subjective life expectancy among middle-aged and older adults? Evidence from the China Health and Retirement Longitudinal Study (CHARLS) 2018 cross-sectional data.

Chronic diseases have become one of the most important factors threatening human health. Subjective life expectancy (SLE) describes an individual's expectation or subjective perception of lifespan. This article aims to explore the relationship between chronic diseases and SLE, as well as the differences among different age groups and different types of chronic diseases in this relationship. China Health and Retirement Longitudinal Study (CHARLS) is a nationwide longitudinal study that evaluates the social, economic, and health conditions of middle-aged and older adult families and individuals aged 45 and above in China. In this study, CHARLS used probability proportional to size sampling (PPS sampling) to ensure the breadth and representativeness of the sample. This study selected cross-sectional data from CHARLS 2018, removed missing values, and obtained a valid sample of 10,658 middle-aged and older individuals, of whom 8564 had chronic diseases. After controlling demographic, health behavior, socioeconomic, psychological, and social security factors, an ordered logistic regression was performed to explore the relationship between chronic disease and SLE in middle-aged and older adults. The results show that chronic diseases negatively correlate with SLE in middle-aged and older adults. Middle-aged and older adults with chronic diseases are 36.2% less likely to have high life expectancy than those without chronic diseases. Many different types of chronic diseases are negatively correlated with SLE. Cancer is most negatively correlated with SLE, far exceeding other chronic diseases. Chronic disease and SLE of middle-aged and older adults have age-heterogeneous differences. For middle-aged people aged 45-59 and young older adults aged 60-79, there is a significant correlation between chronic diseases and SLE. However, there is no correlation between chronic diseases and subjective life expectancy in the older population aged 80 and above. The government and society should pay close attention to the prevention and treatment of chronic diseases among middle-aged and older adults and adjust policies and measures according to the population's age structure. In addition, the government and society should pay attention to the spiritual needs of middle-aged and older adults. The government and society should pay more attention to cancer patients. Finally, the scientific research team should also strengthen research on chronic diseases, research and development of specific drugs and vaccines, improve the cure rate of chronic diseases, promote people's health, and make people no longer afraid of diseases.

The Burden of Chronic Diseases with the Status of Family Medical History Among Older Adults in India.

This study aims to assess and compare the prevalence of chronic diseases by the first-degree Family Medical History (FMH) and also explores the relationship between FMH and selected Non-communicable diseases (NCDs) among older adults in India. The present study collated secondary data from the Longitudinal Ageing Study in India (LASI, 2017-18). The eligible respondents for the analysis of this study were aged 45years and above, where the final study sample consistedof 65,562 older adults across all Indian states and union territories. The LASI dataset collected responses onself-reported diseases: Hypertension, Stroke, Heart disease, Cancer, and Diabetes. These diseases have a high prevalence among the population and are considered in the present study. Along with disease status, respondents' first-degree relatives FMH were used to fulfil the objective. Descriptive statistical analysis and multiple logistic regression techniques were used to accomplish the objectives analysis. This approach was chosen due to the binary nature of our primary dependent variables. The study found that the prevalence of selected NCDs was considerably higher among older adults with FMH than those without FMH. It revealed that NCDs and the status of FMH of parents and siblings were significantly associated. Based on the multivariate-adjusted model, we foundsignificantly higher odds for developing the NCDs when the respondents have FMH among at least one of the first-degree relative. The likelihood among those with FMHof having hypertension (AOR: 2.058), diabetes (AOR: 2.94), heart diseases (AOR: 2.39), stroke (AOR: 1.62) and cancer (AOR: 2.32) was higher compared to no FMH of respective diseases. Similarly, significant associations were observed according to the different stratification of the number offirst-degree relatives FMH. The present study demonstrated that first-degree relatives FMH is indeed a dominant associated risk factor for chronic disease among the older adults of India. This study supports the promotion of a disease history tool for chronic disease prevention and early detection approaches as a valuable measure of NCD risk. Public health practitioners can take several steps to access FMH and incorporate FMH into public health programs for the screening of the risk population.

A Comprehensive Review of the Triangular Relationship among Diet-Gut Microbiota-Inflammation.

The human gastrointestinal tract hosts a complex and dynamic community of microorganisms known as the gut microbiota, which play a pivotal role in numerous physiological processes, including digestion, metabolism, and immune function. Recent research has highlighted the significant impact of diet on the gut microbiota composition and functionality, and the consequential effects on host health. Concurrently, there is growing evidence linking the gut microbiota to inflammation, a key factor in many chronic diseases such as inflammatory bowel disease (IBD), obesity, diabetes, and cardiovascular diseases (CVDs). This review explores how dietary components influence the gut microbiota composition, how these microbial changes affect inflammatory pathways, and the therapeutic implications of modulating this axis for chronic inflammatory disease prevention and management. Beneficial dietary patterns, such as the Mediterranean diet (MD) and plant-based diets, promote a diverse and balanced gut microbiota composition, supporting anti-inflammatory pathways. Conversely, the Western diet (WD), high in saturated fats and refined sugars, is associated with dysbiosis and increased inflammation. With all the links between the three variables considered, this review attempts to offer a thorough examination of the triangle formed by inflammation, the gut microbiota, and food.

Is per capita fish consumption in Latin America aligned with international recommendations for a healthy diet?

The World Health Organization (WHO) is urging Latin American countries to prioritize the prevention of chronic noncommunicable diseases. Diet is a crucial factor in determining one’s health, and healthy eating recommendations emphasize the consumption of fish at least twice a week due to its protein, vitamin, mineral, and essential fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). This review was designed to compare the status of fish consumption as a source of EPA and DHA fatty acids in some Latin American countries (namely Brazil, Chile, Colombia, and Ecuador), and comparisons with international recommendations within a healthy diet could contribute to the WHO’s call for a focus on preventing the aforementioned diseases in the region. A comprehensive literature search was conducted from January to October 2022 using PubMed, Scopus, EBSCO, and government compendia. Keywords included “fish,” “consumption,” “fatty acids,” “nutrients,” and “Latin America;” and “fish,” “chronic non-communicable diseases,” “all-cause mortality,” “obesity,” “cancer,” “neurodegenerative diseases,” “metabolic diseases,” “diabetes,” “polycystic ovary syndrome,” and “metabolic syndrome.” In countries such as Chile, Brazil, and Colombia, per capita fish consumption falls below WHO’s recommended levels, and the most commonly eaten species do not contain sufficient polyunsaturated fatty acids to provide an optimal intake of EPA and DHA. It is therefore recommended that each country review its dietary guidelines and fish recommendations based on the most commonly consumed species to ensure that their populations obtain the recommended intake of EPA and DHA fatty acids and thus the benefits related to the prevention of chronic noncommunicable diseases.

Association of dietary behavior patterns of middle-aged and older adults with their obesity metabolic phenotype: a cross-sectional study

BackgroundMiddle-aged and elderly individuals are the most susceptible groups for metabolic diseases, with their dietary behaviors being significant influencing factors. Exploring the association between overall dietary behaviors and obesity metabolic phenotypes is crucial for early prevention and control of chronic diseases, precision treatment and personalized interventions.MethodsWe conducted a cross-sectional study of 15,160 middle-aged and older adults between June 2019 and August 2021 to collect information on their body mass index (BMI), biochemical indices and disease history. The population was classified into four categories by the criteria of obesity metabolic phenotypes: metabolically healthy non-obesity (MHNO), metabolically unhealthy non-obesity (MUNO), metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO). Scores were calculated based on compliance with healthy eating behavior patterns (appropriate or light dietary taste, moderately soft and hard food, slightly hot food temperature, medium or slow eating speed, daily intake of dietary supplements and eating with others), and the population was categorized into subgroups 0–2 (did not meet and met only 1 or 2), 3–4 (met 3 or 4), 5–6 (met 5 or 6). The relationship between dietary behavior patterns and different obesity metabolic phenotypes in middle-aged and elderly people were analyzed by multi-categorical logistic regression model.ResultsCompared with the 5–6 subgroup, the dietary behavior patterns of 0–2 and 3–4 scores were risk factors for MUNO, MHO and MUO (P < 0.05), and the lower the scores of the dietary behavior patterns, the higher the multiplicity of the occurrence of MUNO, MHO and MUO, especially for females and adults between 45–60 years old. Appropriate or light dietary taste, moderately soft and hard food, and slightly hot food temperature were protective factors for MUNO and MUO (P < 0.05); medium or slow eating speed and daily intake of dietary supplements were protective factors for MUNO, MHO and MUO (P < 0.05).ConclusionDietary behavior patterns in middle-aged and older adults are associated with different obesity metabolic phenotypes, and healthy dietary behaviors may be beneficial for the prevention and control of MUNO, MHO and MUO.

Impact of health policy changes on population health

Recent health policy changes have had a profound impact on population health, reflecting diverse approaches and outcomes across different regions. The affordable care act (ACA) in the United States expanded healthcare coverage, improving access to preventive services and chronic disease management. Despite these advancements, disparities in health outcomes persist, particularly among minority and low-income populations. In Europe, universal healthcare systems like those in Germany and the Netherlands have achieved near-universal coverage and high public satisfaction. However, socioeconomic inequalities continue to influence health outcomes, necessitating policies that address broader social determinants of health. Low- and middle-income countries (LMICs) have implemented universal health coverage (UHC) initiatives, such as Thailand's UHC scheme and Rwanda's community-based health insurance. These reforms have led to significant improvements in maternal and child health, reduced out-of-pocket expenditures, and increased healthcare utilization among the poor. However, disparities between urban and rural populations remain a challenge, underscoring the need for comprehensive strategies that strengthen healthcare systems and infrastructure. Future directions for health policy improvement include addressing health disparities, integrating technology, and promoting preventive care. Community-based interventions and cultural competency training for healthcare providers can reduce disparities and enhance patient satisfaction. The integration of telemedicine, electronic health records, and health information exchanges can improve care coordination and access to services, although equitable access to digital health tools is essential. Emphasizing preventive care through increased funding, incentivizing providers, and raising public awareness can significantly reduce the burden of chronic diseases. Engaging patients in their healthcare decisions and promoting shared decision-making fosters a collaborative and effective healthcare environment. Policymakers must adopt comprehensive and adaptable strategies to address persistent disparities, integrate technology, and promote preventive care, ultimately leading to more equitable and effective health outcomes for diverse populations.

Evaluating bioactivity retention in metabolism: a comparative study of chlorogenic acid and its metabolite dihydrocaffeic acid on antioxidant, anti-inflammatory, and anti-obesogenic activities in vitro

ABSTRACT This study investigates the bioactivity retention of chlorogenic acid (CGA) and its metabolite dihydrocaffeic acid (DHCA) by comparing their antioxidant, anti-inflammatory, and anti-obesogenic properties in vitro. CGA, found in coffee, fruits, and vegetables, is metabolized into DHCA, potentially enhancing bioactivity. Antioxidant capacity was assessed in Caco-2 cells, with DHCA showing superior activity at lower concentrations than CGA. Anti-inflammatory effects were evaluated in LPS-stimulated RAW 264.7 cells, where DHCA exhibited significant dose-dependent inhibition of nitrite production, surpassing CGA. Anti-obesogenic potential was analyzed in 3T3-L1 cells, with DHCA demonstrating stronger inhibition of adipogenesis and notable downregulation of adipogenic genes like PPARγ and C/EBPα. These results suggest that DHCA’s enhanced therapeutic potential due to its simplified structure and increased bioavailability. This study highlights the importance of metabolic transformations in dietary polyphenols for chronic disease prevention and management.

Regional and socioeconomic disparities in calcium scans

IntroductionDisparities in cardiovascular care are well recognized, with socioeconomic status being one of the strongest determinants of cardiovascular disease outcomes. This study evaluates whether these disparities translate to coronary artery calcium (CAC) scan utilization. Specifically, we aim to describe regional variation and socioeconomic variables that impact CAC utilization across the United States relative to the prevalence of coronary artery disease (CAD) and related comorbidities. MethodsThis cross-sectional study integrates county-level CAC utilization with CAD prevalence and publicly available socioeconomic variables including self-identified ethnicity, education, and adjusted gross income. CAC utilization rates were sourced from 2022 hospital commercial claims, outpatient Medicare service claims, and independent imaging center claims. Heart disease prevalence and socioeconomic variables were extracted from the Centers for Disease Control and Prevention and the National Center for Chronic Disease Prevention and Health Promotion. Adjusted gross income per capita was gathered from Internal Revenue Service data. ResultsCAC utilization was evaluated across 808 counties within the United States, representing 600,379 claims. Median utilization was 1.62 scans per 1,000 persons with a range of 0.03 to 104.39. The West had the highest CAC scan utilization rate (median 3.09 scans per 1,000 persons) with a CAD prevalence of 548 per 100,000 persons. In contrast, the Midwest had the lowest utilization rate (median 1.24 scans per 1,000 persons) with a CAD prevalence of 635 per 100,000 persons.Socioeconomic factors that favor higher CAC utilization include a larger density of White/Caucasian ethnicity (p = 0.007) and a higher adjusted gross income per capita (p = 0.006). Counties with the lowest rates of CAC utilization have a higher population of African Americans (p <0.001) and a higher proportion of females (p <0.001). ConclusionThis analysis highlights regional and socioeconomic differences in CAC utilization in the United States. Under-represented ethnicities such as African Americans have among the lowest rates of CAC utilization despite having a higher burden and mortality from heart disease. Discordance between CAC utilization, heart disease prevalence and socioeconomic status reveals a need for targeted interventions and policies aimed at mitigating structural barriers that perpetuate health inequities.

Plant-based diets for kidney disease prevention and treatment.

Plant-based diets are associated with a lower risk of hypertension, diabetes, cardiovascular disease, and mortality. Using the most recent evidence, we critically appraised the role of plant-based diets in primary and secondary prevention of chronic kidney disease (CKD) with a focus on key nutritional factors (dietary acid load, phosphorus, potassium, sodium, and fiber). In healthy individuals, observational studies found that greater intake of plant protein and higher adherence to plant-based diets (overall, healthful, and provegetarian) was associated with a lower risk of CKD. In those with CKD, plant-based diets were associated with a lower risk of mortality, improved kidney function, and favorable metabolic profiles (fibroblast growth factor-23, uremic toxins, insulin sensitivity, inflammatory biomarkers). Only few studies reported nutrient content of plant-based diets. These studies found that plant-based diets had lower dietary acid load, lower or no significant difference in phosphorus and sodium, and higher potassium and fiber. One study reported that vegetarian diets were associated with severe vitamin D deficiency compared to nonvegetarian diets. Plant-based diets provide several benefits for prevention and management of CKD, with little risk for individuals with CKD. Incorporation of vitamin D rich foods in plant-based diets may be helpful.