Correction to: Effect of periodic abstinence from dairy products for approximately half of the year on bone health in adults following the Christian Orthodox Church fasting rules for decades.

The original version of this article, published on 27 June 2019, unfortunately contained a mistake.

Effect of periodic abstinence from dairy products for approximately half of the year on bone health in adults following the Christian Orthodox Church fasting rules for decades.

Christian Orthodox Church (COC) fasting is characterized by periodic abstinence from animal foods (including dairy products). We found that, despite this, older individuals adhering to COC fasting for decades did not differ in bone mineral density, bone mineral content, or prevalence of osteoporosis at five sites from non-fasting controls. PURPOSE: The present observational study investigated whether adherence to COC fasting, characterized by periodic abstinence from animal foods (including dairy products), affects bone health and the prevalence of osteoporosis in older individuals. METHODS: Participants were 200 men and women, of whom 100 had been following the fasting rules of the COC for a median of 31 years and 100 were non-fasters, all aged 50 to 78 years. Participants underwent measurements of bone mineral density (BMD) and bone mineral content (BMC) at the lumbar spine, right hip, left hip, right femoral neck, and left femoral neck; completed a 3-day food intake record and food frequency questionnaire; and provided blood samples for biochemical measurements. RESULTS: Fasters did not differ from non-fasters in demographic characteristics, anthropometric measures, BMD, BMC, or prevalence of osteopenia or osteoporosis at any of the five sites measured (P > 0.05). Fasters had lower daily calcium intake than non-fasters (median 532 vs 659 mg, P = 0.010), daily protein intake (0.67 vs 0.71 g/kg, P = 0.028), and consumption of dairy and soy products (10.3 vs 15.3 servings per week, P < 0.001). Groups did not differ in serum calcium, vitamin D, or urea concentrations. CONCLUSIONS: Despite lower calcium intake and lower consumption of dairy and soy products, older individuals adhering to COC fasting did not differ in BMD, BMC, or prevalence of osteoporosis from controls. Thus, periodic abstinence from dairy and, generally, animal products does not seem to compromise bone health in older individuals.

Brain Natriuretic Peptide mediates the prognostic role of renal function toward 10-year cardiovascular mortality in patients with Acute Coronary Syndrome: the HHF study (2006-2016).

BACKGROUND/INTRODUCTION: Risk stratification in chronic heart failure (HF) remains a challenge. Renal function and B-natriuretic peptide (BNP) might confer predictive value towards long-term mortality in HF patients after an acute coronary syndrome (ACS). METHODS: From May 2006 to March 2009, 1,000 consecutive patients who were hospitalized with ACS diagnosis were enrolled in the study. In 2016, the 10-year follow-up (2006 -2016) was performed in 745 participants. GFR was evaluated through the MDRD formula. HF phenotype was defined according to baseline ejection fraction (EF); HF with reduced EF (i.e. <40%) (HFrEF), preserved EF (i.e. ≥50%) (HFpEF) and mid-range EF (i.e. 40 -49%) (HFmrEF). RESULTS: 10-year mortality was 21%. Deceased patients presented significantly lower GFR and higher BNP values at the baseline, compared with their alive counterparts (p <0.001 for both). By multivariable logistic regression analysis, GFR independently predicted all-cause mortality (OR = 0.98, p = 0.04). After adjusting for baseline BNP, GFR lost its predictive role while BNP was independently associated with 10-year mortality (OR = 1.39 for a 2-fold increase, p = 0.001). A significant interaction was observed between EF and BNP levels on the tested outcome (p for interaction < 0.001). In stratified analysis, BNP predicted all cause death only in HFmrEF (OR=1.43, p = 0.04) and in HFpEF (OR=1.80, p = 0.01). CONCLUSION: BNP mediates the predictive role of GFR towards long-term mortality in ACS-induced HF patients with retained systolic performance of the left ventricle (HFmrEF and HFpEF).

The "overweight paradox" in the prognosis of acute coronary syndrome for patients with heart failure-A truth for all? A 10-year follow-up study.

OBJECTIVES: In established acute coronary syndrome (ACS) with major complications (i.e. heart failure), overweight/obese patients usually have a survival advantage. To what extent this is irrespective of other characteristics remains inconclusive. The role of body mass index (BMI) in ACS prognosis (fatal/recurrent non-fatal cardiac episodes) and background potential interactions were evaluated. STUDY DESIGN: In 2006-2009, 1000 consecutive patients, hospitalized at First Cardiology Clinic of Athens with a diagnosis of ACS were enrolled in the study. All patients were classified according to heart failure phenotypes. One-month, 1-, 2- and 10-year follow-up examinations were performed (75% participation rate). MAIN OUTCOME MEASURES: Overweight was defined as 25≤BMI≤29.9kg/m2 and obesity as BMI >29.9kg/m2. RESULTS: BMI status and 10-year ACS prognosis followed a J-shape association (p=0.009). Overweight patients had significantly better ACS prognosis than their normal-weight counterparts (OR=0.45, 95% CI (0.23, 0.90)). Significant interactions were observed between sociodemographic, clinical and lifestyle parameters and BMI on 10-year ACS prognosis (all ps for interaction≤10%); the aforementioned paradoxical association was retained only in patients who: were female (OR=0.37, 95% CI (0.16, 0.82)); were aged ≤65 years (OR=0.25, 95% CI (0.09, 0.69)), HFrEF (OR=0.35, 95% CI (0.13, 0.89)); were hypercholesterolemic (OR=0.23, 95% CI (0.07, 0.81)); had no hypertension (OR=0.31, 95% CI (0.12, 0.82)) or diabetes mellitus (OR=0.29, 95% CI (0.09, 0.95)); had moderate/high adherence to a Mediterranean diet (OR=0.43, 95% CI (0.22, 0.86)); and were physically active (OR=0.37, 95% CI (0.15, 0.88)). CONCLUSIONS: Although the overweight paradox was observed in the 10-year ACS prognosis of heart failure patients, this paradoxical association was not the case for all.