Reduce Cardiovascular Disease Risk Factors Research Articles

Culturally Adapted Lifestyle Intervention for South Asian Adults With Cardiovascular Risk Factors

South Asian adults in the US experience excess cardiovascular disease (CVD) compared with other racial and ethnic groups. The effectiveness and reach of guideline-recommended lifestyle interventions have not been evaluated in this population. To evaluate whether a culturally adapted, group lifestyle intervention will improve CVD risk factors more effectively than written health education materials among US South Asian adults. This single-blind randomized clinical trial was conducted from March 6, 2018, to February 11, 2023 at community sites in the Chicago, Illinois, metropolitan area. South Asian adults aged 18 to 65 years who were overweight or obese, had no history of CVD events, and had at least 1 additional CVD risk factor (hypertension, dyslipidemia, prediabetes, or diabetes) were eligible for inclusion. A 16-week, culturally adapted, group-based lifestyle intervention led by community health coaches. Lifestyle modification counseling was delivered in English, Gujarati, Hindi, and Urdu. Participants tracked their diet and physical activity (PA) and received 4 optional group maintenance sessions between months 5 and 11 of follow-up. The intervention was delivered in person prior to the onset of the COVID-19 pandemic and via videoconference starting in March 2020. The control group received written health education materials, delivered monthly. Primary outcomes were the between-group differences in CVD risk factor changes from baseline to 12 months, including weight, systolic blood pressure (SBP), diastolic blood pressure (DBP), glycated hemoglobin (HbA1c), and total cholesterol, estimated using multivariate mixed-effects regression models. Secondary outcomes were self-reported diet quality, PA, and self-efficacy, estimated using univariate mixed-effects regression models. Among 549 randomized participants, 318 (57.9%) were women, and mean (SD) participant age was 49.2 (9.5) years. Mean differences in CVD risk factor changes from baseline to 12 months in the intervention vs control group were calculated for weight (mean difference, -0.07 kg; 95% CI, -0.55 to 0.42), SBP (mean difference, 0.47 mm Hg; 95% CI, -1.85 to 2.79), DBP (mean difference, 0.44 mm Hg; 95% CI, -1.06 to 1.95), cholesterol (mean difference, -2.47 mg/dL; 95% CI, -8.51 to 3.57), and HbA1c (mean difference, -0.07%; 95% CI -0.20% to 0.07%). Intervention participation was associated with greater improvements in dietary quality, PA, and self-efficacy than control. In the SAHELI randomized clinical trial, a culturally adapted, group lifestyle intervention was not more effective than written health education materials for CVD risk factor reduction among US South Asian adults, but the intervention was associated with small improvements in self-reported health behaviors. Effective CVD prevention interventions for this elevated-risk population require further investigation. ClinicalTrials.gov Identifier: NCT03336255.

The Effectiveness of Exercise in Reducing Cardiovascular Risk Factors Among Adults: A Systematic Review and Meta-Analysis.

Cardiovascular disease (CVD) remains one of the major causes of sickness and death in the world. However, lifestyle modifications, such as exercise, can significantly reduce the risk of this disease. This study aimed to assess the effectiveness of various forms of physical activity in reducing CVD risk factors among adults. A comprehensive search of the databases PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register of Controlled Trials (CENTRAL), and Excerpta Medica Database (EMBASE) databases was conducted between January 1, 2014, and May 31, 2024, as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Randomized controlled trials (RCTs), cohort studies, and observational studies on the impact of aerobic, resistance, or combined training on cardiovascular risk factors in adults (≥18 years) were considered for inclusion. Data relating to primary outcomes, including stroke and myocardial infarction rates, BP, cholesterol levels, and BMIwere collected. The Cochrane risk-of-bias tool and the Methodological Index for Non-Randomized Studies (MINORS) checklist were used for quality and bias assessment. Meta-analyses were performed using the RevMan software, with heterogeneity evaluated by I² statistics; 17 studies, including 11 RCTs and six cohort studies, met the inclusion criteria. There was a significant reduction in the mean systolic BP (SBP) by 3.32 mmHg [95% confidence interval (CI): 0.85-5.78 mmHg; p<0.0001] and mean diastolic BP (DBP) by 2.99 mmHg (95% CI: 2.34-3.64 mmHg; p < 0.00001) after exercise interventions. Moreover, cholesterol levels and BMI values improved with exercise. Those who exercised had a lower risk of stroke or heart attack compared with the controls [odds ratio (OR): 0.57; 95% CI: 0.28-1.14; p >0.0001], although there was substantial heterogeneity in effect size across the studies (I² = 98%). Different types of physical activity (i.e., aerobic, resistance, or combined exercise) can effectively reduce key cardiovascular risk factors, including BP, cholesterol levels, and BMI values. Regular physical activity is still regarded as the most effective preventive measure against CVD, despite inconsistencies in research findings. Future studies should aim to identify optimal exercise programs and their long-term effects on diverse populations.

The Relationship Between Physical Activity Profiles and Cardiovascular Disease Risk Factors: Results of a Cross-Sectional Survey of Active Duty U.S. Service Members.

This study aimed to identify subgroups of active duty U.S. service members (ADSMs) based on physical activity levels and their association with cardiovascular disease (CVD) risk factors. Our secondary aim was to assess how these profiles vary across sociodemographic factors. A cross-sectional survey of ADSMs, yielding a 9.6% response rate and 17,166 usable surveys, was conducted by the DoD and RAND Corporation in 2018 using stratified random sampling. In this secondary analysis, latent subgroups of ADSMs were determined based on physical activity levels and a weighted multinomial logistic regression was used to examine associations. Three latent subgroups were identified as "High Activity" (17.1%), "Moderate Activity" (45.3%), and "Low Active" (37.6%). Older age, female, White (as compared to Hispanic), cohabiting, Air Force, Navy, and Coast Guard were associated with increased odds of "Low Active" membership. Compared to the "Low Active" class, the "High Active" class showed lower odds of hyperlipidemia (aOR = 0.62, 95% CI: 0.38, 0.99), hypertension (aOR = 0.69, 95% CI: 0.48, 0.98), and multimorbidity (aOR = 0.55, 95% CI: 0.38, 0.80). Compared to the "Low Active" class, the "Moderate Active" class showed lower odds of hyperlipidemia (aOR = 0.62, 95% CI: 0.47, 0.81) and multimorbidity (aOR = 0.66, 95% CI: 0.53, 0.83). Similar patterns of associations were seen in ADSMs who met the objectives for Healthy People 2030 (HP2030) standards. The study emphasizes the importance of combining physical activity and strength training to reduce CVD risk factors, supporting the implementation of tailored physical activity programs within the military to align fitness standards.

Effects of high-quality protein supplementation on cardiovascular risk factors in individuals with metabolic diseases: A systematic review and meta-analysis of randomized controlled trials

BackgroundUncertainties still existed about the effect of high-quality protein supplementation on cardiovascular disease (CVD) risk factors, although high-quality proteins such as soy and milk proteins have proposed to be beneficial for cardiometabolic health. MethodsA systematic search in PubMed, Web of Science, Cochrane Library, Scopus, and Embase was conducted to quantify the impact of high-quality protein on CVD risk factors. Results63 RCTs on 4 types of high-quality protein including soy protein, milk protein, whey, and casein were evaluated. Soy protein supplementation decreased systolic blood pressure (SBP, -1.42 [-2.68, -0.17] mmHg), total cholesterol (TC, -0.18 [-0.30, -0.07] mmol/L), and low-density lipoprotein cholesterol (LDL-C, -0.16 [-0.27, -0.05] mmol/L). Milk protein supplementation decreased SBP (-2.30 [-3.45, -1.15] mmHg) and total cholesterol (-0.27 [-0.51, -0.03] mmol/L). Whey supplementation decreased SBP (-2.20 [-3.89, -0.51] mmHg), diastolic blood pressure (DBP, -1.07 [-1.98, -0.16] mmHg), triglycerides (-0.10 [-0.17, -0.03] mmol/L), TC (-0.18 [-0.35, -0.01] mmol/L), LDL-C (-0.09 [-0.16, -0.01] mmol/L) and fasting blood insulin (FBI, -2.02 [-3.75, -0.29] pmol/L). Casein supplementation decreased SBP (-4.10 [-8.05, -0.14] mmHg). In the pooled analysis of four high-quality proteins, differential effects were seen in individuals with different health status. In hypertensive individuals, high-quality proteins decreased both SBP (-2.69 [-3.50, -1.87] mmHg) and DBP (-1.34 [-2.09, -0.60] mmHg). In overweight/obese individuals, high-quality proteins improved SBP (-1.40 [-2.22, -0.59] mmHg), DBP (-2.59 [-3.20, -1.98] mmHg), triglycerides (-0.09 [-0.15, -0.02] mmol/L), TC (-0.14 [-0.22, -0.05] mmol/L), LDL-C (-0.12 [-0.16, -0.07] mmol/L), and HDL-C levels (0.02 [0.01, 0.04] mmol/L). According to the benefits on CVD risks factors, whey ranked top for improving cardiometabolic health in hypertensive or overweight/obese individuals. ConclusionOur study supports a beneficial role of high-quality protein supplementation to reduce CVD risk factors. Further studies are still warranted to investigate the effects of different high-quality proteins on CVD risks in individuals with cardiometabolic disorders.

Cardiovascular risk among community members in three communities in the Cape Metropole of the Western Cape.

Cardiovascular diseases pose a risk to population health in South Africa and are responsible for almost one in six deaths (17.3%). To determine the cardiovascular risk among community members who attended a community outreach programme. Three communities in the Cape Metropole of the Western Cape. A health survey was conducted with 783 participants, 18 years and older, conveniently sampled. The survey included questions about cardiovascular risk factors, and biometric measurements of blood pressure (BP), height and weight were conducted. A total of 777 participants were included in the study. Most participants were female (529, 68.1%), with an average age of 42.3 years (s.d. 14.2). Risk behaviours reported included smoking (216, 27.8%), consuming more than two drinks of alcohol daily (78, 10%), low physical activity (384, 49.4%), being stressed on most days (436, 56.1%) and unhealthy eating habits (253, 32.6%). More than half of the participants (402, 51.7%) had a body mass index (BMI) ≥ 30, 26.0% (202) had a systolic BP of ≥ 140 mm Hg and 22.4% (174) had a diastolic BP of ≥ 90 mm Hg; 16.6% (130) had a cardiovascular disease (CVD) risk of 10-20 and 19.3% (150) had a CVD risk of 20%. Nearly a fifth of the participants had a significant probability of developing heart disease or experiencing a stroke over the next 10 years.Contribution:There is an urgent need for comprehensive health promotion and behaviour change interventions focused on reducing CVD risk factors at the community level.

Effect of dietary interventions on nutritional status in patients with rheumatoid arthritis and spondyloarthritis - A systematic review and meta-analysis

Background & AimPatients with rheumatoid arthritis (RA) and spondyloarthritis (SpA) have an increased risk of developing altered body composition, such as low muscle mass, and an increased risk of developing cardiovascular diseases (CVD).Thus, investigating how to improve body composition and CVD risk factors is a relevant topic to improve management of RA and SpA. The aim of this study was to identify dietary interventions that can improve body composition, as well as reduce CVD risk factors in RA and SpA. MethodsWe searched the databases Medline, Embase and Cochrane. Duplicates were removed using Endnote and records were screened through Rayyan. The primary outcomes were muscle mass (kg) and fat mass (kg). Secondary outcomes were body weight (kg), body mass index (BMI: kg/m2), waist circumference (cm) and lipid profile (total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides, mmol/L). ResultsA total of 4965 articles were identified, and 17 articles were included in this review, of which 15 were suitable for meta-analysis. We found a reduction in TC and LDL-C, (Mean difference, [95%CI]: -0.36, [-0.63, -0.10], I2 =43%, and -0.20, [-0.35, -0.05], I2=0% respectively). Otherwise, no other significant effect was seen in either primary or secondary outcomes. The evidence was graded as moderate for TC and low for LDL-C. ConclusionDietary interventions might reduce the levels of blood lipids, and consequently, the risk of cardiovascular diseases. However, body composition did not change significantly after a 2-4 month dietary intervention. Both short intervention period and lack of reliable methods to assess body composition are possible explanations for this finding. Further studies of longer duration are needed.

Sleep Attributes Influencing Cardiovascular Morbidity Among Young Adults Pursuing Professional Courses in Dehradun, India: A Cross-Sectional Study.

Cardiovascular diseases (CVDs) are evolving as a cause of mortality and morbidity among young adults. Young adults, particularly those pursuing professional courses in colleges, face unique challenges that may influence their risk of developing CVD. Despite screening guidelines, CVD risk factors often go undetected in the young population, highlighting the need for increased awareness among adolescents. Sleep is an essential indicator of well-being, and its impact on cardiovascular risk factors is increasingly being recognized. An observational cross-sectional study was conducted among young adults aged 18 to 24 years pursuing professional courses in Dehradun, Uttarakhand, India. A total of 156 participants were recruited through multistage, systematic random sampling, and snowball sampling. Data on sleep patterns and cardiovascular morbidity were collected using a pretested questionnaire. Among the study participants, 46.8% reported having less than four hours of sleep on average, and 25% were suffering from sleep problems. The prevalence of diagnosed CVDs was low, with 6.14% reporting arrhythmias and 3.84% reporting hypertension. An association was found between sleep duration, sleep problems, and the presence of CVDs. Participants with shorter sleep durations and more severe sleep problems had a higher prevalence of CVDs. The findings suggest that sleep duration and sleep problems may be modifiable risk factors for CVDs among young adults. Effective health promotion activities focusing on behavior and lifestyle modifications are essential to preventing CVDs from an early age. The study emphasizes the importance of early intervention and health promotion strategies to reduce CVD risk factors in this population. Community-based research and behavior change communication initiatives are recommended to promote healthy sleep habits and prevent cardiovascular diseases among young adults beyond the college setting.

Therapeutic Carbohydrate Restriction as a Metabolic Modality for the Prevention and Treatment of Abnormal Uterine Bleeding.

Therapeutic carbohydrate restriction diets have been becoming increasingly popular over the years, resulting in dramatic weight loss and an improvement in metabolic disorders. Obesity, insulin resistance, and diabetes are the risk factors for many gynecologic morbidities such as uterine leiomyoma, endometrial polyps, and polycystic ovarian syndrome. There is evidence suggesting that the pathogenesis of cardiovascular disease is similar to that seen in many causes of abnormal uterine bleeding. We aim to explain how cardiovascular disease risk factor reduction with the use of therapeutic carbohydrate restriction may prevent and potentially treat these gynecologic disorders.

Prevalence and correlates of metabolic syndrome among women living in urban slums, Mysore, India.

Metabolic Syndrome (MetSyn) is a predictor of cardiovascular disease (CVD). About a third of urban Indians suffer from MetSyn. This study examined the prevalence of MetSyn among women living in urban slums. A cross-sectional survey was carried out between October 2017 and May 2018 among a non-probability sample of slum-dwelling women, 40-64 years of age, in six government-designated slums in Mysore, India. Data were collected on demographics, diet, behavioral risks, anthropometry, blood pressure, serum glucose, hemoglobin A1c, and serum lipids. The study used a definition of MetSyn from the International Diabetes Federation Task Force on Epidemiology and Prevention with an HbA1c measure for average blood glucose. About two-fifths of the 607 participants had MetSyn (41.5%; 95% CI: 37.7-45.5). Of those, 40.9% met three criteria, 38.1% four, and 25.0%, all five criteria. Elevated BP was the most prevalent MetSyn factor (79.6%), followed by increased waist circumference (54.5%), low HDL (50.1%), elevated Hb A1c (37.1%), and elevated triglycerides (36.1%). Odds for MetSyn were 1.52 times greater for those who were 50-59 years of age compared with those 40-49 years of age (adjusted odds ratio[AOR]:1.52; 95% CI:0.96-2.40). Women with mobility issues had 1.29 times higher odds of MetSyn than those without it (AOR: 0.76, 95% CI: 0.96, 1.75). Housewives had 1.29 times greater odds of MetSyn (AOR: 1.29, 95% CI: 1.00, 1.67). There is a high prevalence of MetSyn among urban slum-dwelling women in Mysore. There is a need for interventions aimed at reducing CVD risk factors in this population.

Examining the Use of a Polypill in Cardiovascular Disease Prevention.

Cardiovascular disease (CVD) is a significant cause of death worldwide. To address the global burden of CVD and its risk factors, the polypill, an all-in-one therapy that combines multiple existing medications for preventing CVD and reducing CVD events (such as angiotensin-converting enzyme inhibitor, beta-blocker, statin, or aspirin) into a single combination pill, has emerged as a potential strategy to improve CVD prevention. Clinical trials on the polypill have found that polypill use is associated with significant reductions in CVD events and risk factors in both patients with established CVD and at risk of developing CVD, suggesting a potential benefit in primary and secondary CVD prevention. The polypill has also been demonstrated to be a cost-effective therapy that may potentially increase treatment accessibility, affordability, and availability particularly in low- and middle-income countries. Further, patients on polypill therapy have shown high rates of treatment compliance, with significant improvements in medication adherence for patients with low baseline compliance. Given its potential advantages and benefits, the polypill may become a promising therapy for the prevention of CVD.

Systematic review and meta-analysis of church-based interventions to improve cardiovascular disease risk factors

BackgroundChurch-based interventions have been shown to reduce cardiovascular disease (CVD) risk factors and could reduce health disparities in groups with a high burden of CVD. We aim to conduct a systematic review and meta-analysis to determine the effectiveness of church-based interventions for CVD risk factor improvement and to examine the types of interventions that are effective. MethodsSystematic searches of MEDLINE, Embase, and manual reference searches were conducted through November 2021. Study inclusion criteria were church-based interventions delivered in the United States to address CVD risk factors. Interventions targeted barriers to improving blood pressure, weight, diabetes, physical activity, cholesterol, diet, or smoking. Two investigators independently extracted study data. Random effects meta-analyses were conducted. ResultsA total of 81 studies with 17,275 participants were included. The most common interventions included increasing physical activity (n = 69), improving diet (n = 67), stress management (n = 20), medication adherence (n = 9), and smoking cessation (n = 7). Commonly used approaches for implementation included cultural tailoring of the intervention, health coaching, group education sessions, inclusion of spiritual components in the intervention, and home health monitoring. Church-based interventions were associated with significant reductions in body weight (-3.1 lb, [95% CI, -5.8, -1.2], N = 15), waist circumference (-0.8 in, [CI, -1.4, -0.1], N = 6), and systolic blood pressure (-2.3 mm Hg, [CI, -4.3, -0.3], N = 13). ConclusionsChurch-based interventions targeting CVD risk factors are effective for reducing CVD risk factors, particularly in populations with health disparities. These findings can be used to design future church-based studies and programs to improve cardiovascular health.

Nutrition Intervention Through a Social Media Platform on Nutrition Knowledge and CVD Risk Factors Amongst Firefighters

Introduction: Cardiovascular disease (CVD) is the number one cause of on-duty death for firefighters. Risk factors such as hypertension, obesity, and elevated cholesterol can be used as predictors in the prevention and intervention of CVD. Social media (SM) has become a popular platform for delivering health and wellness information. The aims of this study were to examine the utility of nutrition education through a dedicated social media platform (Instagram) for supporting and enhancing nutrition knowledge and in reducing CVD risk factors amongst firefighters. Methods: In a pilot study, firefighters (n=53) were exposed to a private IG account for 6 weeks. The intervention was delivering daily evidence-based nutrition information via the SM platform. A validated Questionnaire (ANSKQ) was administered before and after the 6-week intervention period. Nutrition knowledge, anthropometric and vitals data were collected pre-post intervention. Results: Data analysis is presented as the mean, ± SD, p&lt;0.05 was deemed significant. ANSKQ results were evaluated by total, general and sports nutrition knowledge scores. The total mean score significantly increased from 46% ± 3.27 to 52% ± 13.43 (p&lt;0.0017). A 5% increase in GNK scores was also observed over the study period [60% ± 15.35 to 65% ± 19.83 (p&lt;0.04409)]. SNK scores increased by 6% over the study period [39% ± 16.01 to 45% ± 14.25 (p&lt;0.0108)]. Participants lost an average of 1.54 kg ± 2.29 (p&lt;0.00007) over the study period. Conclusions: This study suggests that nutrition education that impacts change in habits and health can be delivered over a dedicated interactive social media platform. This can have an impact on nutrition knowledge and health behaviors, as well as health outcomes in fire-fighters.

Abstract P314: Social Determinants of Cardiovascular Risk Factors Among African Immigrants in New York City

Background: African immigrants (AIs) constitute a highly diverse and rapidly growing population in the US, particularly in New York City. Yet, their cardiovascular health remains understudied. We examined the prevalence of cardiovascular disease (CVD) risk factors and identified predictors of increased CVD risk among AIs residing in the five New York City (NYC) boroughs. Objective: To examine the relationship between social determinants (marital status, education, employment, and health insurance) and CVD risk factors among AIs living in NYC. Methods: This cross-sectional study was conducted among AIs ≥30 years residing in NYC. Outcomes of interest were self-reported CVD risk factors assessed individually (hypertension, diabetes, hyperlipidemia, overweight/obesity, and poor sleep). Using logistic regression analyses, we examined the associations between social determinants and individual CVD risk factors, adjusting for age and sex. Results: Of 215 participants, the mean age was 54 (SD: 11.7) years, and 70% were female. The majority (93%) had ≥1 of the 6 CVD risk factors. Smoking was least prevalent, and overweight/obesity was most prevalent (76%); with 42%, and 18% having a prior diagnosis of hypertension and diabetes, respectively. Those who were employed had ≥ bachelor's education were less likely to have hyperlipidemia (adjusted Odds Ratio [aOR]: 0.35, 95%CI: 0.15-0.86, or overweight/obesity (aOR: 0.31, 95%CI: 1.11-0.88); and twice (aOR: 2.14, 95%CI: 1.11-4.15), more likely to report poor sleep. However, being married and having health insurance were associated with a 3-fold (aOR: 3.08, 95%CI: 1.12-8.50) and 4-fold (aOR: 4.07, 95%CI: 1.12-14.73) higher likelihood of being overweight/obese. Conclusions: The prevalence of CVD risk factors among AIs was particularly high. Culturally-appropriate interventions and policies to reduce CVD risk factors are highly recommended for this population.

Effect of a Plant-Based vs Omnivorous Soul Food Diet on Weight and Lipid Levels Among African American Adults

More African American individuals die from cardiovascular disease (CVD) than any other chronic disease condition. Despite this disparity, African American individuals are underrepresented in nutrition and CVD interventions. To compare the effects of an entirely plant-based (vegan) or low-fat omnivorous (omni) diet on change in body weight and lipids during a 2-year intervention. The Nutritious Eating With Soul (NEW Soul) study was a 2-year, randomized clinical trial conducted in 2 cohorts (2018-2020 and 2019-2021) that took place in a university teaching kitchen in Columbia, South Carolina (before March 2020), and via online videoconference sessions (after March 2020). Participants included African American adults aged 18 to 65 years with overweight or obesity (body mass index of 25.0-49.9) and without type 2 diabetes, uncontrolled thyroid disease, recent weight loss, or pregnancy. Data assessors and statisticians were blinded to study condition. Data analysis was performed from March to June 2022. The intervention included weekly nutrition classes for 6 months biweekly classes for 6 months, and monthly classes for 12 months. Dietary interventions either emphasized no animal product intake (vegan) or a low-fat omnivorous diet (omni). Both dietary patterns emphasized soul food cuisine (traditional African American southern foodways). Primary outcomes included change in body weight and lipid measures at 12 months. There were 568 participants who completed an online screening questionnaire; 409 were excluded and 159 were randomized (77 to the vegan group and 82 to the omni group). Of the 159 participants (mean [SD] age, 48.4 [10.6] years; 126 female [79%]) who began the study, the main outcome of body weight was obtained for 121 participants (76%) at 12 months. There were no differences in outcomes between groups, including 12-month changes in weight (mean, -2.39 kg [95% CI, -3.48 to -1.30 kg] for the vegan group vs -2.03 kg [95% CI, -3.07 to -1.00 kg] for the omni group; P = .64), total cholesterol (-1.05 mg/dL [95% CI, -9.60 to 7.50 mg/dL] for the vegan group vs 1.66 mg/dL [95% CI, -7.20 to 10.50 mg/dL] for the omni group; P = .67), or low-density lipoprotein cholesterol (mean, -2.56 mg/dL [95% CI, -9.52 to 4.40 mg/dL] for the vegan group vs -0.79 mg/dL [95% CI, -7.98 to 6.40 mg/dL] for the omni group; P = .73). Weight loss at 12 months among cohort 1, whose weight was assessed in 2019 before the COVID-19 pandemic, was significantly greater than that for cohort 2, whose weight was assessed summer 2020 during COVID-19 (-3.45 kg [95% CI, -4.67 to -2.22 kg] vs -1.24 kg [95% CI, -2.24 to -0.25 kg]; P = .01). In this randomized clinical trial examining weight loss and CVD risk factor reduction among African American adults, there were no differences between the groups, and the magnitude of changes overall was small. ClinicalTrials.gov Identifier: NCT03354377.

Association Between Sex Hormone-Binding Globulin, Atherogenic Indices of Plasma Among Young Sedentary Males.

Males are more likely than females to suffer from cardiovascular disease (CVD). So, sex hormones may modify these variations and affect the lipid profile. We examined the relationship between sex hormone-binding globulin (SHBG) and CVD risk factors among young males in this study. Using a cross-sectional design, we measured total testosterone, SHBG, lipids, glucose, insulin, antioxidant parameters, and anthropometric factors in 48 young males in the age range of 18 to 40 years. Atherogenic indices of plasma were calculated. In this study, a partial correlation analysis was carried out to assess the relationship between SHBG and other variables after adjustment for confounders. According to the results of multivariable analyses adjusted for age and energy, SHBG had a negative correlation with total cholesterol (r = -.454, P =.010), low-density lipoprotein cholesterol (r = -.496, P =.005), quantitative insulin-sensitivity check index, and positive correlation with high-density lipoprotein cholesterol (r = .463, P =.009). No significant correlation was observed between SHBG and triglycerides (P >.05). Several atherogenic indices of plasma have a negative correlation with SHBG levels. These include Atherogenic Index of Plasma (r = -.474, P = .006), Castelli Risk Index (CRI)1 (r = -.581, P < .001), CRI2 (r = -.564, P = .001), and Atherogenic Coefficient (r = -.581, P < .001). Among young men, high plasma SHBG was associated with reduced CVD risk factors, modified lipid profile and atherogenic ratios, and better glycemic markers. Therefore, reduced SHBG concentrations could be a prognostic marker of CVD among young sedentary males.

Vegetarian Diets and Cardiovascular Risk Reduction: Pros.

There is an ongoing need for public health interventions aimed at further mitigating the risk of cardiovascular disease (CVD) through changes in dietary patterns and other lifestyle habits. Plant-based diets (PBDs) are effective in reducing CVD risk factors, a benefit evidenced by the favorable cardio-metabolic profiles observed in vegetarians who abstain from consuming meat, fish, and poultry compared to omnivores. Numerous studies have demonstrated that PBDs, particularly when rich in high-quality plant foods such as whole grains, fruits, vegetables, and nuts, are associated with a lower risk of adverse cardiovascular outcomes. Herein, we briefly review the current evidence regarding the relationship between CVD and PBDs, as well as the potential underlying biological mechanisms.

Micronutrient Supplementation to Reduce Cardiovascular Risk

BackgroundHealthy dietary patterns are rich in micronutrients, but their influence on cardiovascular disease (CVD) risks has not been systematically quantified. ObjectivesThe goal of this study was to provide a comprehensive and most up-to-date evidence-based map that systematically quantifies the impact of micronutrients on CVD outcomes. MethodsThis study comprised a systematic review and meta-analysis of randomized controlled intervention trials of micronutrients on CVD risk factors and clinical events. ResultsA total of 884 randomized controlled intervention trials evaluating 27 types of micronutrients among 883,627 participants (4,895,544 person-years) were identified. Supplementation with n-3 fatty acid, n-6 fatty acid, l-arginine, l-citrulline, folic acid, vitamin D, magnesium, zinc, α-lipoic acid, coenzyme Q10, melatonin, catechin, curcumin, flavanol, genistein, and quercetin showed moderate- to high-quality evidence for reducing CVD risk factors. Specifically, n-3 fatty acid supplementation decreased CVD mortality (relative risk [RR]: 0.93; 95% CI: 0.88-0.97), myocardial infarction (RR: 0.85; 95% CI: 0.78-0.92), and coronary heart disease events (RR: 0.86; 95% CI: 0.80-0.93). Folic acid supplementation decreased stroke risk (RR: 0.84; 95% CI: 0.72-0.97), and coenzyme Q10 supplementation decreased all-cause mortality events (RR: 0.68; 95% CI: 0.49-0.94). Vitamin C, vitamin D, vitamin E, and selenium showed no effect on CVD or type 2 diabetes risk. β-carotene supplementation increased all-cause mortality (RR: 1.10; 95% CI: 1.05-1.15), CVD mortality events (RR: 1.12; 95% CI: 1.06-1.18), and stroke risk (RR: 1.09; 95% CI: 1.01-1.17). ConclusionsSupplementation of some but not all micronutrients may benefit cardiometabolic health. This study highlights the importance of micronutrient diversity and the balance of benefits and risks to promote and maintain cardiovascular health in diverse populations. (Antioxidant Supplementation in the Prevention and Treatment of Cardiovascular Diseases; CRD42022315165)

The Impact of Ballet Program on Appetite Related Hormones, Insulin Resistance, and Body Composition in Postmenopausal Women: A Pilot Study

PURPOSE: Postmenopausal status is associated with an age-related decline in hormones, abnormal appetite regulation, weight gain, and increased risk of cardiovascular disease (CVD). Exercise is a useful non-pharmacological intervention that improves the levels of hormones involved in appetite regulation and weight management while reducing CVD risk factors. The present study aimed to elucidate the effect of a ballet program on menopause-related changes in satiety or levels of appetite regulation hormones, including leptin and ghrelin, homeostatic model of assessing insulin resistance (HOMA-IR).METHODS: The EX group performed the ballet program. In the fasting state, body composition; leptin, ghrelin, insulin, and glucose levels; and HOMA-IR values were assessed before and 12 week after the intervention.RESULTS: A significant group by time interaction (&lt;i&gt;p&lt;/i&gt;&lt;.05) was noted for percentage body fat, leptin, insulin, and HOMA-IR, which significantly decreased (&lt;i&gt;p&lt;/i&gt;&lt;.05), and ghrelin, which significantly increased (&lt;i&gt;p&lt;/i&gt;&lt;.05).CONCLUSIONS: These results indicate that this ballet program may be an attractive and enjoyable intervention for improving menopause-associated appetite regulation hormone changes in postmenopausal women.

The Effect of Different Nutritional Education Models on Reducing Cardiovascular Disease Risk Factors by Improving Dietary Fat Quality in Hemodialysis Patients.

Cardiovascular disease (CVD) is the most common complication in hemodialysis patients. Nutritional education provided by dietitians could improve overall dietary quality and dietary fat quality to reduce the risk of CVD. However, no studies have investigated the relationship between dietary fat quality (using the hypocholesterolemic/hypercholesterolemic ratio, or the h/H) and CVD risk factors in hemodialysis patients. The aim of this study was to examine the association between the h/H and CVD risk factors, and further explore how nutritional education intervention models could improve dietary fat quality and CVD risk factors in hemodialysis patients. A quasi-experimental design was conducted from May 2019 to April 2021 on four groups, including ‘no course for patients and nurses’ as the non-C group, a “course for nurses” as the CN group, a “course for patients” as the CP group, and a “course for patients and nurses” as the CPN group. Nutritional education booklets based on a healthy eating index for hemodialysis patients were developed and provided to patients and nurses. Data of 119 patients were collected at baseline, intervention, and follow-up periods, including patients’ basic information, blood biochemical data, dietary content, and calculated h/H. The results showed that the h/H was negatively correlated with body mass index (BMI) and positively correlated with high-density lipoprotein cholesterol (HDL-C). Compared with the non-C group, the CPN group was significantly higher in the h/H as well as HDL-C, and significantly lower in serum total cholesterol. In conclusion, the h/H was found to predict CVD risk factors, which helps in improving dyslipidemia. Nutritional education for both patients and nurses showed a beneficial impact on reducing CVD risks in hemodialysis patients.

Traditional and Emerging Sex-Specific Risk Factors for Cardiovascular Disease in Women.

Cardiovascular disease (CVD) remains a major health threat in women. While traditional CVD risk factors such as hypertension, hyperlipidemia, diabetes, and smoking have been recognized for over 50 years, optimal control of these risk factors remains a major challenge. Unique sex-specific risk factors such as adverse pregnancy outcomes, premature menopause and low estrogen states, and chronic autoimmune inflammatory disorders also contribute to increased CVD risk in women. In addition, psychological risk factors such as stress, depression, and social determinants of health may have a disproportionately adverse impact in women. An improved understanding of traditional and emerging sex-specific CVD risk factors and management of modifiable factors is critical for clinicians who provide care for women. Early recognition and treatment of risk factors may alter the trajectory of adverse CVD events. A multi-disciplinary approach with team-based care involving multiple specialists and improved, targeted educational efforts are needed to reduce CVD risk factors and its adverse consequences in women.