Lower Incidence Of Cardiovascular Disease Research Articles

Obesity-Related Chronic Kidney Disease: Principal Mechanisms and New Approaches in Nutritional Management.

Obesity is the epidemic of our era and its incidence is supposed to increase by more than 30% by 2030. It is commonly defined as a chronic and metabolic disease with an excessive accumulation of body fat in relation to fat-free mass, both in terms of quantity and distribution at specific points on the body. The effects of obesity have an important impact on different clinical areas, particularly endocrinology, cardiology, and nephrology. Indeed, increased rates of obesity have been associated with increased risk of cardiovascular disease (CVD), cancer, type 2 diabetes (T2D), dyslipidemia, hypertension, renal diseases, and neurocognitive impairment. Obesity-related chronic kidney disease (CKD) has been ascribed to intrarenal fat accumulation along the proximal tubule, glomeruli, renal sinus, and around the kidney capsule, and to hemodynamic changes with hyperfiltration, albuminuria, and impaired glomerular filtration rate. In addition, hypertension, dyslipidemia, and diabetes, which arise as a consequence of overweight, contribute to amplifying renal dysfunction in both the native and transplanted kidney. Overall, several mechanisms are closely related to the onset and progression of CKD in the general population, including changes in renal hemodynamics, neurohumoral pathways, renal adiposity, local and systemic inflammation, dysbiosis of microbiota, insulin resistance, and fibrotic process. Unfortunately, there are no clinical practice guidelines for the management of patients with obesity-related CKD. Therefore, dietary management is based on the clinical practice guidelines for the nutritional care of adults with CKD, developed and published by the National Kidney Foundation, Kidney Disease Outcome Quality Initiative and common recommendations for the healthy population. Optimal nutritional management of these patients should follow the guidelines of the Mediterranean diet, which is known to be associated with a lower incidence of CVD and beneficial effects on chronic diseases such as diabetes, obesity, and cognitive health. Mediterranean-style diets are often unsuccessful in promoting efficient weight loss, especially in patients with altered glucose metabolism. For this purpose, this review also discusses the use of non-classical weight loss approaches in CKD, including intermittent fasting and ketogenic diet to contrast the onset and progression of obesity-related CKD.

Intake and Sources of Dietary Fiber, Inflammation, and Cardiovascular Disease in Older US Adults

Higher intake of dietary fiber has been associated with lower inflammation, but whether there are differences in this association by source of dietary fiber (ie, cereal, vegetable, or fruit) has not been studied to date. To evaluate the associations of total fiber intake and source (ie, cereal, vegetable, and fruit fiber intake) with inflammation and to evaluate whether inflammation mediates the inverse association between dietary fiber intake and cardiovascular disease (CVD). At the baseline visit (1989-1990) of 4125 adults aged 65 years or older in an ongoing US cohort study, dietary intake was assessed by a food frequency questionnaire among study participants without prevalent CVD (stroke and myocardial infarction) at enrollment. Inflammation was assessed from blood samples collected at baseline with immunoassays for markers of inflammation. Multivariable linear regression models tested the association of dietary fiber intake with inflammation. Also assessed was whether each inflammatory marker and its composite derived from principal component analysis mediated the association of baseline cereal fiber intake with development of CVD (stroke, myocardial infarction, and atherosclerotic cardiovascular death) through June 2015. Data from June 1, 1989, through June 30, 2015, were analyzed. Total fiber intake and sources of fiber (cereal, vegetable, and fruit). Systemic markers of inflammation. Cardiovascular disease was the outcome in the mediation analysis. Of 4125 individuals, 0.1% (n = 3) were Asian or Pacific Islander, 4.4% (n = 183) were Black, 0.3% (n = 12) were Native American, 95.0% (n = 3918) were White, and 0.2% (n = 9) were classified as other. Among these 4125 individuals (2473 women [60%]; mean [SD] age, 72.6 [5.5] years; 183 Black individuals [4.4%]; and 3942 individuals of other races and ethnicitites [95.6%] [ie, race and ethnicity other than Black, self-classified by participant]), an increase in total fiber intake of 5 g/d was associated with significantly lower concentrations of C-reactive protein (adjusted mean difference, -0.05 SD; 95% CI, -0.08 to -0.01 SD; P = .007) and interleukin 1 receptor antagonist (adjusted mean difference, -0.04 SD; 95% CI, -0.07 to -0.01 SD; P < .02) but with higher concentrations of soluble CD163 (adjusted mean difference, 0.05 SD; 95% CI, 0.02-0.09 SD; P = .005). Among fiber sources, only cereal fiber was consistently associated with lower inflammation. Similarly, cereal fiber intake was associated with lower CVD incidence (adjusted hazard ratio, 0.90; 95% CI, 0.81-1.00; 1941 incident cases). The proportion of the observed association of cereal fiber with CVD mediated by inflammatory markers ranged from 1.5% for interleukin 18 to 14.2% for C-reactive protein, and 16.1% for their primary principal component. Results of this study suggest that cereal fiber intake was associated with lower levels of various inflammatory markers and lower risk of CVD and that inflammation mediated approximately one-sixth of the association between cereal fiber intake and CVD.

Favorable Cardiovascular Health Is Associated With Lower Prevalence, Incidence, Extent, and Progression of Extracoronary Calcification: MESA.

Ideal cardiovascular health (CVH) is associated with a lower incidence of cardiovascular disease. Extracoronary calcification (ECC)-measured at the aortic valve, mitral annulus, ascending thoracic aorta, and descending thoracic aorta-is an indicator of systemic atherosclerosis. This study examined whether favorable CVH was associated with a lower risk of ECC. We analyzed data from MESA (Multi-Ethnic Study of Atherosclerosis) participants aged 45 to 84 years without cardiovascular disease at baseline. ECC was measured by noncontrast cardiac computed tomography scan at baseline and after an average of 2.4 years. Prevalent ECC was defined as an Agatston score >0 at the baseline scan. Incident ECC was defined as Agatston score >0 at the follow-up scan among participants with Agatston score of 0 at the baseline scan. Each CVH metric (smoking, physical activity, body mass index, diet, blood pressure, total cholesterol, and blood glucose) was scored 0 to 2 points, with 2 indicating ideal; 1, intermediate; and 0, poor. The aggregated CVH score was 0 to 14 points (0-8, inadequate; 9-10, average; 11-14, optimal). We used Poisson and linear mixed-effects regression models to examine the association between CVH and ECC adjusted for sociodemographic factors. Of 6504 participants, 53% were women with a mean age (SD) of 62 (10) years. Optimal and average CVH scores were associated with lower ECC prevalence, incidence, and extent. For example, optimal CVH scores were associated with 57%, 56%, 70%, and 54% lower risk of incident aortic valve calcification, mitral annulus calcification, ascending thoracic aorta calcification, and descending thoracic aorta calcification, respectively. In addition, optimal and average CVH scores were associated with lower ECC progression at 2 years, although these associations were only significant for mitral annulus calcification and descending thoracic aorta calcification. In this multiethnic cohort, favorable CVH was associated with a lower risk of extracoronary atherosclerosis. These findings emphasize the importance of primordial prevention as an intervention to reduce the burden of cardiovascular disease.

Red Fruits Composition and Their Health Benefits—A Review

The probability that fruit ingestion may protect human health is an intriguing vision and has been studied around the world. Therefore, fruits are universally promoted as healthy. Over the past few decades, the number of studies proposing a relationship between fruit intake and reduced risk of major chronic diseases has continued to grow. Fruits supply dietary fiber, and fiber intake is linked to a lower incidence of cardiovascular disease and obesity. Fruits also supply vitamins and minerals to the diet and are sources of phytochemicals that function as phytoestrogens, antioxidant and anti-inflammatory agents, and other protective mechanisms. So, this review aims to summarize recent knowledge and describe the most recent research regarding the health benefits of some selected red fruits.

The Effect of Oestrogen Supplementation on Antioxidant Enzymes and Mitochondrial Respiratory Function After Myocardial Infarction of Ovariectomized Rats.

Acute myocardial infarction (MI) is the leading cause of mortality worldwide with premenopausal women showing a lower incidence of cardiovascular disease compared with men of the same age. After menopause, this advantage disappears, suggesting that sex hormones play a cardioprotective role. This study was aimed to assess on the activity of antioxidant enzymes in plasma and the respiratory function of isolated heart mitochondria after the induction of MI in rats after ovariectomy and estradiol benzoate supplementation. Sprague-Dawley female rats were ovariectomized 3 months before the induction of MI and supplemented/not supplemented with oestrogen 3 months before/7 days after the induction of MI. No significant differences in glutathione peroxidase activities were found in any group. Differences between values were only significant in the ovariectomized not supplemented group (P < 0.01) for the glutathione reductase activity and glutathione concentrations. In isolated mitochondria (7 days after MI), the decline in respiration was observed comparing the ovariectomized and nonovariectomized group. Respiratory functions did not show significant differences between animals supplemented with oestrogen before MI or treated with oestrogen after MI. Ovariectomy worsened mitochondrial dysfunction after MI, and oestrogen supplementation before or after the induction of MI did not improve mitochondrial function.

Implicações nutricionais da alimentação vegetariana e vegana no desenvolvimento infantil: uma revisão narrativa

OBJECTIVES: To analyze the risks and benefits of vegetarian and vegan diet in child development, showing possible nutritional deficits and how to manage them. METHODS: This is a current narrative review, related to vegetarian and vegan diets in children and their repercussions on development, searched in MEDLINE®, PubMed® and SciELO databases, using the keywords “vegetarian diet”, “vegan diet”, “child development”. RESULTS: Despite vegetarian and vegan diets presents risks due to deficit of nutrients involved in vital biological functions, a diet based on vegetables provides clinical benefits, such as a lower incidence of cardiovascular disease, cancer and diabetes. Vegan women who desire to become pregnant should have a well-planned and balanced diet. Breastfeeding is the ideal way and the first option to feed vegetarian/vegan babies; however, if exists an impossibility, there are soy-based formulas on the market. The first meals, at six months, should be rich in protein, iron, zinc and the vitamin B12 is the most worrying nutrient due to its participation in child’s neurological development and must be supplemented if necessary. CONCLUSION: Pediatricians should guide families, alert them about the risks and enlighten that a high-class and well-planned diet does not change child development, although requires periodic monitoring for evaluation and possible supplementation.

The Association of Higher Composite Biomarker Score of Antioxidant Vitamins with Lower Cardiovascular Diseases Risk: A Cross-Sectional Study

Biomarkers for the dietary system, which includes a mixed fruit and vegetable (FV), are needed to understand the association of FV intake with a reduction in cardiovascular diseases risk. This is a cross-sectional study that aims to find the potential relationship between a high composite score comprised of antioxidant vitamins and a lower incidence of cardiovascular diseases (CVD). A total of 94 (42 males and 52 females) participants (mean age ± SD: 51.7 ± 9.4 years) completed a specific questionnaire including a quick food scan, which has designed by the American National Institutes of Health. The vitamins A, C, and E were determined using high-performance liquid chromatography (HPLC). An enzymatic colorimetric method was used to determine other biomarkers [fasting blood sugar (FBS), haemoglobin A1c (HbA1c), and lipid profile]. A Composite Biomarker Score (CBS) comprising of the plasma vitamins (A, C, and E) have been derived. The results showed that male participants demonstrated significantly higher atherosclerotic cardiovascular disease (ASCVD) risk than female participants. Female participants with greater ASCVD risk were associated with significantly higher age, total cholesterol, and triglyceride concentrations. Additionally, there is a significant relationship between the CBS with lower ASCVD risk. Consequently, it can be concluded that higher concentrations of serum antioxidant vitamins are related to a reduction in cardiovascular diseases risk.

Med-index: a food product labeling system to promote adherence to the mediterranean diet encouraging producers to make healthier and more sustainable food products

Consumers are increasingly demanding transparency in food labeling as they want more and better information about what they are eating and where their food comes from. Several food indexes have been developed in the last decades to promote healthy eating with the aim of reducing certain diseases such as obesity, cancer, and diabetes. The Mediterranean diet is known to be one of the healthiest dietary patterns, and it is associated with a lower incidence of mortality from all-causes, and it is also related to a lower incidence of cardiovascular diseases, type 2 diabetes, certain types of cancer, and neurodegenerative diseases; however, a comprehensive index that quantifies the Mediteraneaness of foods is still missing. The real European challenge is to identify a uniform labeling system for the whole of Europe which promotes a healthy lifestyle. This article describes the development of the Mediterranean Index (MI), which aims to accurately measure the degree of food Mediterraneaness. The MI simultaneously integrates nutritional and sustainability characteristics of foods. The MI may provide an objective basis for the use of the “Mediterraneaness” label on food products, which can ultimately promote adherence to the Mediterranean diet encouraging producers to make healthier and more sustainable food products. Growing consumer concern toward health foods for better health can be a factor useful to promote the applicability of the precision nutrition principles by means of conscious choice.

Abstract 9819: Real World Data: Off-Label Metformin in Patients with Prediabetes is Associated with Improved Cardiovascular Outcomes

Background: Metformin is not FDA-approved for prediabetes but it is being prescribed off-label for this condition. Per the American Diabetes Association (ADA), metformin “should be considered” for prediabetes patients with a BMI &gt; 35. Prediabetes is associated with a higher risk of cardiovascular disease (CVD). We report on real-world, off-label use of metformin and its association with lower incidence of CVD in a large population with prediabetes, by age, BMI, and race. Methods: This analysis used insurance claims linked to electronic health records from Jan 2016 to Sept 2020. Patients in the metformin cohort had &gt; 180-day supply: &gt; 90 days pre- and &gt; 90 days post diagnosis of prediabetes. All had continuous enrollment for &gt; 24 months. We excluded age &lt;25; FDA-approved metformin indications; type 1 DM; CVD; CKD; or gestational diabetes. Inclusion criteria: Prediabetes ICD-10 code R73, or HbA1c 5.7-6.4, or fasting glucose 100-125 mg/dL or OGTT 140-199 mg/dL. Results: Of 149,654 patients with prediabetes, 8,624 (5.8%) were prescribed metformin. Table 1 describes metformin and non-metformin patients. At a 2.8-year mean follow-up, 24% of prediabetes patients developed CVD. Table 2 describes metformin use and CVD outcomes by BMI, gender, race, and age. As a whole and by gender, a BMI &gt; 35 was associated with lower CVD. A similar effect was seen for AA &gt; 65 with a BMI &gt; 35 Conclusion: Patients with BMI &gt; 35 showed an association between metformin use and lower incidence of CVD, including African Americans older than age 65. The data suggest that morbidly obese patients with prediabetes may benefit from the use of metformin as recommended by the ADA.

Abstract 13917: A Harmonized Meta-Analysis of the Associations of Steps per Day With Incident Cardiovascular Disease

Introduction: The goal of 10,000 steps/day is widely promoted. There is limited evidence, however, of the number of steps/day associated with risk of developing cardiovascular disease (CVD). Hypothesis: We hypothesize a dose-response association between higher device-measured steps/day with lower CVD incidence. Methods: The Steps for Health Collaborative conducted a meta-analysis of seven prospective studies with device-measured steps/day and followed participants for CVD events. Participants without CVD at baseline were included. CVD was defined as coronary heart disease, stroke, and/or heart failure. Data were analyzed at the study level. Study-specific associations of quartiles of steps/day with incident CVD was assessed using Cox proportional hazards regression models and summarized using random effects meta-analysis. Models were adjusted for age, race/ethnicity, sex, body mass index, device wear time, and study-specific indicators for education or income, smoking, alcohol intake, blood pressure, dysglycemia, and hyperlipidemia. Study heterogeneity was assessed using I2 statistic. Results: The meta-analysis included 16,906 adults (mean age 62 years; 51% women), with median follow-up of 6.3 years (limits 2.9-10.7 years) and 1370 (8.1%) CVD events. Medians of study-specific steps/day were 1,951 (first quartile, Q1), 3,823 (second quartile, Q2), 5,685 (third quartile, Q3), and 9,487 (fourth quartile, Q4). Compared with Q1, summary hazard ratios for CVD were 0.83 (Q2, 95% confidence interval 0.72-0.95), 0.68 (Q3, 0.58-0.80), and 0.60 (Q4, 0.47-0.78) (Figure). There was low to moderate heterogeneity; I2 values were 0% for Q2, 2% for Q3, and 37% for Q4. Conclusions: Higher steps/day were associated with progressively lower risk of CVD. Monitoring and promoting steps/day can be a simple, easy to interpret metric used for clinician-patient communication and population health to reduce the risk of CVD.

Habitual consumption of instant coffee is favorably associated with arterial stiffness but not with atheromatosis.

Epidemiological data suggest that moderate habitual coffee consumption associates with lower cardiovascular disease (CVD) risk; however scarce data exist regarding the association of coffee with subclinical vascular disease (SVD). We aimed at investigating the above association with habitual instant coffee consumption - a widely consumed coffee in Greece-in high CVD risk but free of established CVD adults. In a cross-sectional design study we measured: (i) two 24h dietary recalls to assess coffee consumption, (ii) arterial stiffness, by carotid to femoral pulse wave velocity - (PWV) and carotid compliance, arterial remodeling by carotid intima-media thickness (IMT), pressure wave reflection by augmentation index (AIx) and atheromatosis by carotid plaques. In 1041 participants (55.6% females, 53.6±14.0 years), 30% habitually consumed instant coffee (0.53±1.15 cups/day). Consumption of instant coffee was inversely associated with systolic blood pressure (β=-1.19, p=0.007), AIx (β=-0.71, p=0.043), PWV (β=-0.22, p=0.000) and IMT (β=-0.01, p=0.025), but these associations lost their significance after multiple adjustments for confounders. Instant coffee consumption was positively associated with carotid compliance independent from all possible confounders (β=0.005, p=0.003). Habitual moderate instant coffee consumption is inversely associated with arterial stiffening and potential with arterial remodeling. These favorable vascular associations offer a potential pathophysiological link between habitual coffee consumption and lower incidence of CVD. Future studies are needed to examine the long-term effects of habitual instant coffee consumption on vascular structure and function.

Sodium Intake and Health: What Should We Recommend Based on the Current Evidence?

Several health organizations recommend low sodium intake (below 2.3 g/day, 5.8 g/day of salt) for entire populations, on the premise that lowering of sodium intake, irrespective of its level of intake, will lower blood pressure and, in turn, will result in a lower incidence of cardiovascular disease. These guidelines were developed without effective interventions to achieve long term sodium intakes at low levels in free-living individuals and without high-quality evidence that low sodium intake reduces cardiovascular events (compared with average levels of intake). In this review, we examine whether advice to consume low amounts of sodium is supported by robust evidence. We contend that current evidence indicates that most people around the world consume a moderate range of dietary sodium (3 to 5 g/day), that this level of intake is associated with the lowest risk of cardiovascular disease and mortality, and that the risk of adverse health outcomes increases when sodium intakes exceeds 5 g/day or is below 3 g/day. While the current evidence has limitations, it is reasonable, based upon prospective cohort studies, to suggest a mean target of below 5 g/day in populations, while awaiting the results of large randomized controlled trials of sodium reduction on cardiovascular disease and death.

Dietary intakes of green leafy vegetables and incidence of cardiovascular diseases.

Low- and middle-income countries (LMICs) are currently experiencing increasing cardiovascular disease (CVD) rates. Green leafy vegetables (GLV), which are abundant in these countries, are known to be particularly rich in cardioprotective nutrients. This study sought to determine the specific effect of GLV intake on the incidence of CVD. Previously published cohort studies on GLV intake and incidence of CVD were retrieved through a systematic search of Google Scholar, EMBASE, MEDLINE, HINARI and Cochrane Library. A methodological evaluation of studies was carried out using the network of Ottawa scale, and a fixed-effect meta-analysis was applied to estimate pooled relative risk (RR) and 95% confidence interval (CI). Heterogeneity was determined using the I2 statistic. Sensitivity analysis was done using the leave-one-study-out technique. All statistical analysis was carried out at p < 0.05 using RevMan 5.4. The pooled RR (95% CI) of incident CVD events from 17 studies was 0.93 (0.92-0.95). Specifically, GLV intake was inversely related with incident cerebral infarction (RR: 0.92; 95% CI: 0.88-0.96), heart disease (RR: 0.93; 95% CI: 0.87-0.99) and other CVD events (RR: 0.95; 95% CI: 0.93-0.98). GLV intake was associated with a lower incidence of CVD, and may be a promising primary-prevention strategy against CVD events. The findings are especially important in LMICs where the burden of CVD remains high.

Effects of a Mediterranean diet on the development of diabetic complications: A longitudinal study from the nationwide diabetes report of the National Program for Prevention and Control of Diabetes (NPPCD 2016-2020)

ObjectiveTo evaluate the effectiveness of a Mediterranean dietary pattern on the incidence of macrovascular and microvascular complications of diabetes, namely cardiovascular disease (CVD), diabetic foot disorders, diabetic retinopathy, nephropathy, and neuropathy. MethodsThis longitudinal study was conducted among 71392 adults with diabetes who attended academic tertiary-care outpatient clinics from February 2016 to March 2020 across Iran using the National Program for Prevention and Control of Diabetes database. Among them, 22187 patients with diabetes (type 1 and type 2) completed 2–11 follow-up visits after baseline registration. The association between adherence to a Mediterranean diet and diabetic complications was assessed using pooled logistic regression models. This association was adjusted for potential confounders. The effect of time was assessed using fractional polynomials. ResultsA total of 22187 participants were included in the analysis (30.22% men and 69.78% women) with either type 1 (mean age 50.7 years) or type 2 (mean age 59.9 years) diabetes. After adjustment for confounding variables, there was a negative correlation between adherence to a Mediterranean diet and the incidence of CVD among patients with type 1 diabetes (T1D) and 2 diabetes (T2D) (OR= 0.53, 95% CI: 0.37 – 0.75, p-value <0.001 and OR= 0.61, 95% CI: 0.57 – 0.89, p-value <0.001, respectively). Also, the diet had a statistically significant protective effect against incident symptomatic neuropathy (OR= 0.32, 95% CI: 0.23 – 0.43, p-value <0.001, and OR= 0.68, 95% CI: 0.64 – 0.72, p-value <0.001, respectively), nephropathy (OR= 0.42, 95% CI: 0.30 – 0.58, p-value <0.001, and OR= 0.88, 95% CI: 0.80 – 0.96, p-value= 0.007, respectively), and retinopathy (OR= 0.32, 95% CI: 0.24 – 0.44, p-value <0.001, and OR= 0.68, 95% CI: 0.61 – 0.71, p-value <0.001, respectively) in T1D and T2D. ConclusionThe Mediterranean dietary pattern is associated with a lower incidence of CVD and microvascular complications (i.e. diabetic retinopathy, nephropathy, and neuropathy) among a cohort of patients with T1D and T2D in Iran.

Cardiovascular health in emerging adults with type 1 diabetes.

Individuals with type 1 diabetes (T1D) face increased risk for cardiovascular disease (CVD). Controlling individual cardiovascular risk factors can prevent or slow the onset of CVD. Ideal cardiovascular health is associated with a lower incidence of CVD. Identifying areas of suboptimal cardiovascular health can help guide CVD prevention interventions. To assess cardiovascular health and explore the barriers and facilitators to achieving ideal cardiovascular health in a sample of young adults with T1D. We used a sequential mixed-method design to assess the seven factors of cardiovascular health according to American Heart Association. Qualitative interviews, guided by Pender's Health Promotion Model, were used to discuss participant's cardiovascular health results and the barriers and facilitators to achieving ideal cardiovascular health. We assessed the frequency of ideal levels of each factor. The qualitative data were analysed using content analysis. Qualitative and quantitative data were integrated in the final analysis phase. The sample (n = 50) was majority female (70%), White (86%), with a mean age of 22 ± 2.4 and diabetes duration of 10.7 ± 5.5 years. Achievement of the seven factors of cardiovascular health were: non-smoking (96%); cholesterol <200 mg/dL (76%); body mass index <25 kg/m2 (54%); blood pressure <120/<80 mmHg (46%); meeting physical activity guidelines (38%); haemoglobin A1c <7% (40%); and healthy diet (14%). Emerging qualitative themes related to the perceived benefits of action, interpersonal influences on their diabetes self-management, and perceived self-efficacy. We found areas of needed improvement for cardiovascular health. However, these young adults expressed a strong interest in healthy habits which can be supported by their healthcare providers.

Development of a Portfolio Diet Score and Its Concurrent and Predictive Validity Assessed by a Food Frequency Questionnaire.

The Portfolio Diet, a plant-based portfolio of cholesterol-lowering foods, has been shown to reduce low-density lipoprotein cholesterol (LDL-C), and other cardiovascular risk factors, in randomized controlled trials (RCTs). It is not known if these beneficial effects translate to a lower incidence OF cardiovascular disease (CVD). To support examinations between Portfolio Diet adherence and disease, a Portfolio Diet score (PDS) was developed and its predictive and concurrent validity was assessed within the Toronto Healthy Diet Study, a six-month RCT in overweight adults. Predictive validity was assessed using change in the PDS measured by food frequency questionnaire (FFQ) and concomitant change in LDL-C from baseline to six months using multiple linear regression, adjusted for potential confounders (n = 652). Concurrent validity was assessed in a subset of participants (n = 50) who completed the FFQ and a 7-day diet record (7DDR) at baseline. The PDS determined from each diet assessment method was used to derive correlation coefficients and Bland–Altman plots to assess the between-method agreement. The change in PDS was inversely associated with change in LDL-C (β coefficients: −0.01 mmol/L (95% confidence intervals (CIs): −0.02, −0.002; p = 0.02). The correlation between the PDS from the FFQ and 7DDR was 0.69 (95% CIs: 0.48, 0.85). The Bland–Altman plot showed reasonable agreement between the score from the FFQ and 7DDR. These findings indicate predictive validity of the PDS with lower LDL-C, and reasonable concurrent validity of the PDS as assessed by an FFQ against a 7DDR.

Physical resilience after a diagnosis of cardiovascular disease among offspring of long-lived siblings.

The online version contains supplementary material available at 10.1007/s10433-021-00641-7.

Endothelial function in type 1 diabetes: Gender differences

Background and Aims: Premenopausal healthy women have lower incidence of cardiovascular disease (CVD) compared to age-matched men. Type 1 Diabetes (T1D) seems to abolish the female sex protection seen in nondiabetic population, even inverting this trend. Endothelial dysfunction (ED) has been identified as an early biomarker of CVD and predictor of future CVD. We designed our study to evaluate sex differences in ED in a cohort of T1D subjects.

Effect of the addition of psyllium (Plantago Ovata Forsk) on the total and bioaccessible concentration of the minerals sodium and potassium in frozen banana pulp

Increased blood pressure is one of the main risk factors for cardiovascular disease. The World Health Organization (WHO) recommends that sodium intake should be moderate and potassium intake can be increased, as its intake is associated with a lower incidence of cardiovascular disease. Banana is a fruit rich in potassium and has large post-harvest losses due to its perishability. The production of frozen pulps is an alternative to reduce these losses. To add nutritional and functional benefits to the fruit pulp, it is possible to add soluble fiber, since its high intake is known to have a protective effect against cardiovascular disease and its intake by individuals does not meet the recommended minimum. There is evidence that psyllium dietary fiber contributes to lowering blood pressure, lowering cholesterol, lowering blood glucose and its incorporation into foods may offer health benefits such as preventing high blood pressure. Knowing that sodium and potassium intake is related to blood pressure, this study aimed to investigate the content of the minerals sodium and potassium in frozen banana pulp added with psyllium and to verify the concentrations of bioaccessibility in in vitro digestion. Our results showed that the addition of psyllium contributed to an increase in the content of the minerals potassium and sodium and that after the simulated digestions we verified that the final concentrations of the mineral potassium are in agreement with other results present in the literature, we also saw that despite increasing the sodium content, the final concentration of the dialysate (which would be absorbed by the human body) was 0.17%, being very low and ideal for preventing high blood pressure.

Association of daily composition of physical activity and sedentary behaviour with incidence of cardiovascular disease in older adults

BackgroundModerate-to-vigorous physical activity (MVPA) is proposed as key for cardiovascular diseases (CVD) prevention. At older ages, the role of sedentary behaviour (SB) and light intensity physical activity (LIPA) remains unclear. Evidence so far is based on studies examining movement behaviours as independent entities ignoring their co-dependency. This study examines the association between daily composition of objectively-assessed movement behaviours (MVPA, LIPA, SB) and incident CVD in older adults.MethodsWhitehall II accelerometer sub-study participants free of CVD at baseline (N = 3319, 26.7% women, mean age = 68.9 years in 2012–2013) wore a wrist-accelerometer from which times in SB, LIPA, and MVPA during waking period were extracted over 7 days. Compositional Cox regression was used to estimate the hazard ratio (HR) for incident CVD for daily compositions of movement behaviours characterized by 10 (20 or 30) minutes greater duration in one movement behaviour accompanied by decrease in another behaviour, while keeping the third behaviour constant, compared to reference composition. Analyses were adjusted for sociodemographic, lifestyle, cardiometabolic risk factors and multimorbidity index.ResultsOf the 3319 participants, 299 had an incident CVD over a mean (SD) follow-up of 6.2 (1.3) years. Compared to daily movement behaviour composition with MVPA at recommended 21 min per day (150 min/week), composition with additional 10 min of MVPA and 10 min less SB was associated with smaller risk reduction – 8% (HR, 0.92; 95% CI, 0.87–0.99) – than the 14% increase in risk associated with a composition of similarly reduced time in MVPA and more time in SB (HR, 1.14; 95% CI, 1.02–1.27). For a given MVPA duration, the CVD risk did not differ as a function of LIPA and SB durations.ConclusionsAmong older adults, an increase in MVPA duration at the expense of time in either SB or LIPA was found associated with lower incidence of CVD. This study lends support to public health guidelines encouraging increase in MVPA or at least maintain MVPA at current duration.