Gender-Related Determinants of Adherence to the Mediterranean Diet in Adults with Ischemic Heart Disease.

BACKGROUND: The reasons behind low adherence to the Mediterranean diet (Med-diet) are still not entirely known. We aimed to evaluate the effect of biological (i.e., sex-related) and psycho-socio-cultural (i.e., gender-related) factors on Med-diet adherence. METHODS: Baseline Med-diet adherence was measured using a self-administered questionnaire among adults with ischemic heart disease (IHD) from the EVA (Endocrine Vascular Disease Approach) study. A multivariable analysis was performed to estimate the effect of sex- and gender-related factors (i.e., identity, roles, relations, and institutionalized gender) on low adherence. RESULTS: Among 366 participants (66 ± 11 years, 31% women), 81 (22%) adults with low adherence demonstrated higher rates of diabetes, no smoking habit, lower male BSRI (Bem Sex Role Inventory) (median (IQR) 4.8 (4.1 to 5.5) vs. 5.1 (4.5 to 5.6) and p = 0.048), and higher Perceived Stress Scale 10 items (PSS-10) (median (IQR) 19 (11 to 23) vs. 15 (11 to 20) and p = 0.07) scores than those with medium-high adherence. In the multivariable analysis, only active smoking (odds ratio, OR = 2.10, 95% confidence interval, CI 1.14 to 3.85 and p = 0.017), PPS-10 (OR = 1.04, 95% CI 1.00 to 1.08, and p = 0.038) and male BSRI scores (OR = 0.70, 95% CI 0.52 to 0.95, and p = 0.021) were independently associated with low adherence. CONCLUSIONS: Male personality traits and perceived stress (i.e., gender identity) were associated with low Med-diet adherence regardless of the sex, age, and comorbidities. Therefore, gender-sensitive interventions should be explored to improve adherence in IHD.

Consumption of nuts and risk of total and cause-specific mortality over 15 years.

BACKGROUND AND AIMS: The published literature shows that nut consumption has a favorable impact on health. We aimed to assess the association between nut consumption and risk of 15-year total mortality, and mortality from cardiovascular disease (CVD) (including ischemic heart disease, IHD, and stroke), and cancer. METHODS AND RESULTS: Prospective analyses involved 2893 participants aged ≥49 years at baseline. Dietary data were collected by using a semi-quantitative food-frequency questionnaire, and nut intakes were calculated. Deaths and cause of death were confirmed by data linkage with the Australian National Death Index. Over 15 years, 1044 participants had died, of these 430 had died from stroke and another 430 had died from IHD. Participants in the second tertile of nut consumption versus those in the first tertile of intake had reduced risk of total mortality: multivariable-adjusted HR 0.76 (95% CI 0.65-0.89). Participants in the second tertile compared to those in the first tertile had 24% and 23% reduced risk of 15-year CVD and IHD mortality, respectively. Associations were more marked in women compared to men. Women in the second versus first tertile of nut consumption had 27%, 39%, 34% and 49% reduced risk of death from all causes (n = 489), CVD (n = 258), IHD (n = 188) and stroke mortality (n = 101), respectively. CONCLUSIONS: Nut consumption was independently associated with a decreased risk of overall and vascular-disease mortality, particularly in women.

Ischemic heart disease and the Mediterranean diet.

Lifestyle modification is primary in cardiovascular (CV) disease prevention. A major contribution is the Mediterranean diet (MedDiet), defined by two of seven components. Italian investigators determined a significant decrease in peripheral arterial disease of 56 % for a high score. Multiple specific CV risk factors are also favorably modified by the MedDiet. This includes beneficial effect on inflammation, vascular endothelium, and insulin resistance. There is also evidence that coronary heart disease, diabetes mellitus, and metabolic syndrome are decreased. Benefit appears to extend to new migrants in France. The economics of dietary adherence are favorable with decreased total lifetime health costs. Although mixed nuts appear to be a major factor in the MedDiet, special emphasis goes to extra virgin olive oil. Benefit also extends to other noncommunicable diseases with a decrease in cancer, Parkinson's disease, and Alzheimer's disease. Further quantitation of benefit and understanding of mechanisms involved in dietary benefit is essential.

Relationships between serum resistin and fat intake, serum lipid concentrations and adiposity in the general population.

AIMS: The serum resistin level is associated with the incidence of ischemic heart disease in the general population. We analyzed the associations between serum resistin and fat intake, serum lipid concentrations and adiposity in the general population. METHODS: A cross-sectional study of 6,637 randomly recruited adults was conducted. The resistin levels were measured in thawed aliquots of serum using an enzyme immunoanalysis technique. RESULTS: The resistin level exhibited a positive nonparametric correlation with saturated fat intake(p < 0.001) and an inverse correlation with adherence to the Mediterranean diet(p < 0.001), monounsaturated fat intake(p < 0.05), total serum cholesterol(p < 0.001), non-HDL cholesterol(p < 0.001), LDL cholesterol(p < 0.001), body mass index(p < 0.001), waist circumference(p < 0.001) and the waist/height ratio(p < 0.001). An elevated resistin concentration(fifth quintile) was associated with adherence to the Mediterranean diet(OR=0.82 CI95%=0.71-0.93), saturated fat intake(OR=1.34 CI95%=1.16-1.56), monounsaturated fat intake(OR=0.88 CI95%=0.78-0.99), a total cholesterol level of ≥200 mg/dL(OR=0.81 CI95%=0.72-0.91), a low HDL cholesterol level(OR=0.84 CI95%= 0.76-0.93), a high non-HDL cholesterol level(OR=0.84 CI95%=0.72-0.99), a high LDL cholesterol level(OR=0.82 CI95%=0.70-0.97) and a waist/height ratio of ≥0.55(OR=0.76 CI95%=0.67-0.85). The multivariate models corroborated the positive associations between the resistin level and saturated fat intake(p < 0.001) and serum triglycerides(p=0.004) and the inverse associations between the resistin level and adherence to the Mediterranean diet(p=0.002), total serum cholesterol(p < 0.001) and cholesterol fractions and the waist/height ratio(p=0.02). CONCLUSIONS: In the general population, the serum resistin level is associated with fat intake: positively with saturated fat intake and inversely with monounsaturated fat intake. As a consequence, the resistin level is also inversely associated with adherence to the Mediterranean diet. In addition, the resistin level is inversely associated with the serum cholesterol level and adiposity.

The consumption of the carp meat and plasma lipids in secondary prevention in the heart ischemic disease patients.

OBJECTIVES: Omega-3 fatty acids (FA) have been shown to be protective against cardiovascular diseases (CVD). The effect of the consumption of carp meat on CVD risk factors has not yet been examined in detail. We ascertained the influence of a diet enriched with carp meat with an elevated content of omega-3FA (200 g twice weekly for 4 weeks) in a group of subjects after cardiac revascularization surgery for ischemic heart disease with a follow-up spa treatment. DESIGN: After cardiac revascularization surgery, the probands consumed either a standard spa diet (56 individuals, 41 males, 15 females, age 41-80 years) or a diet enriched with two portions of carp meat (87 individuals, 64 males, 23 females, age 50-82 years). The differences in body mass index (kg/m²), blood pressure, plasma lipids and C-reactive protein (CRP) of the groups were analyzed. RESULTS: In the group with a higher consumption of carp meat, significantly greater improvements in lipid parameters in comparison to the standard spa diet were detected (total cholesterol p<0.001, triglycerides p<0.001, LDL-C p<0.001, CRP p<0.001, HDL-C p<0.001). No differences between these groups in blood pressure and body mass index were found. CONCLUSION: We conclude that the diet enriched with carp meat significantly improved plasma lipid parameters in patients after major cardiac revascularization surgery.

Dietary broccoli sprouts protect against myocardial oxidative damage and cell death during ischemia-reperfusion.

Cruciferous vegetables are known for antioxidant and anti-carcinogenic effects. In the current study we asked whether dietary broccoli sprouts can protect the heart from ischemia-reperfusion. Rats were fed either control diet (sham and control groups) or a diet mixed with 2% dried broccoli sprouts for 10 days. After 10 days the isolated hearts were subjected to ischemia for 20 min and reperfusion for 2 h, and evaluated for cell death, oxidative damage, and Nrf2-regulated phase 2 enzyme activities. Broccoli sprouts feeding inhibited markers of necrosis (lactate dehydrogenase release) and apoptosis (caspase-3 activity) by 78-86%, and decreased indices of oxidative stress (thiobarbituric acid reactive substances and aconitase inactivation) by 82-116%. While broccoli sprouts increased total glutathione and activities of the phase 2 enzymes glutamate cysteine ligase and quinone reductase in liver, they did not affect these in ischemic-reperfused heart. While the mechanism is not clear, the results show that a relatively short dietary treatment with broccoli sprouts can strongly protect the heart against oxidative stress and cell death caused by ischemia-reperfusion.

A cholesterol-rich diet improves resistance to ischemic insult in mouse hearts but suppresses the beneficial effect of post-conditioning.

BACKGROUND: Conflicting evidence is reported about the beneficial effects of post-conditioning (Post-C) in pathologic conditions. A pathologic mouse model of hypercholesterolemia was used. The study examined the effect of Post-Con cardiac recovery after the ischemia-reperfusion sequence and the effect of Post-Con on low-density lipoprotein receptor-deficient (LDLR(-/-)) mice and control animals. METHODS: LDLR(-/-) and C57bl/6 mice were fed for 8 weeks with a high-cholesterol (1.25%) or normal diet. The hearts were isolated and perfused on a working heart apparatus. The hearts underwent 20 minutes of global total ischemia, followed by 36 minutes of reperfusion. Post-Con was applied at the onset of reperfusion with three 10-second cycles of ischemia-reperfusion. Tissue injury was evaluated (triphenyl-tetrazolium chloride staining), and superoxide anion production was assessed (dihydroethidium). RESULTS: Post-ischemia recovery was very low in the control and LDLR(-/-) groups, and Post-C induced an increase in functional recovery (p < 0.05). The high-cholesterol groups showed better cardiac recovery, but Post-C did not accentuate this improvement. Post-C was associated with a significant reduction in tissue injury and superoxide production in LDLR(-/-) and C57bl/6 (p < 0.05), but these effects were not observed in animals fed the high-cholesterol diet. CONCLUSIONS: Our results demonstrated that control and LDLR(-/-) mice may be protected by Post-C, and an 8-week high-cholesterol diet led to improved recovery of the myocardium after the ischemia-reperfusion sequence in both series. However, the endogenous protective mechanism of Post-C appears to be lost in the presence of hypercholesterolemia.

[The clinical and experimental research of metabolic effects of shark liver oil].

The investigation of influent of antiatherosclerotic diets with shark liver oil on clinical and metabolic parameters in patients with cardiovascular diseases. Results of the study show that enrichment of a diets with shark liver oil in patients with ischemic heart disease and hypertension improved clinic status, antropometric levels, lipid spectrum of blood and immunology status. The mechanism of shark liver oil was investigated in rats.

[The influence of diet with including amaranth oil on lipid metabolism in patients with ischemic heart disease and hyperlipoproteidemia].

It was investigated the influence of a diet supplemented with amaranth oil on dynamic of lipid profile and composition of fatty acids of erythrocytes in patients with ischemic heart disease and hyperlipoproteidemia. The efficacy of diet with different contents of squalene (100, 200, 400 and 600 mg per day) was compared. It was shown that antiatherosclerotic diet with including 600 mg squalene has promoted the most positive changes of the serum cholesterol and triglycerides level and fatty acid composition of erythrocytes membranes as well.

[The influence of a diet with including amaranth oil on antioxidant and immune status in patients with ischemic heart disease and hyperlipoproteidemia].

It was investigated the influence of a diet supplemented with amaranth oil on dynamic of antioxidant and immune status in 125 patients with ischemic heart disease and hyper-lipoproteidemia. The efficacy of diets with different contents of squalene (100, 200, 400, 600 mg per day) was compared. It was shown that antiatherosclerotic diet with inclusion 600 mg squalene has promoted the most positive changes of immune status. The consumption of 200-400 mg of squalene per day produced the more significant antioxidant effect.

Effect of amino acid mixture on the isolated ischemic heart.

Data show that uptake of amino acids correlates with myocardial oxygen consumption after aortic cross-clamp in humans; this suggests a direct link between amino acids and myocardial energy metabolism. The aim of this preliminary study was to investigate the anti-ischemic effects of immediate and long-term supplementation of an amino acid mixture. We tested this hypothesis on isolated rats hearts subjected to global ischemia for 30 minutes. Long-term treatment with an amino acid mixture achieved the following: (1) reduced the increase of diastolic pressure (48 +/- 3 mm Hg vs 21 +/- 4 mm Hg; p <0.05); (2) maintained the tissue content of adenosine triphosphate during ischemia (2.5 +/- 0.6 micromol/g wet wt [gww] vs 7.0 +/- 1.2 micromol/gww; p <0.05); and (3) improved the recovery of developed pressure at the end of postischemic reperfusion (11 +/- 2 mm Hg vs 38 +/- 3 mm Hg; p <0.05), reducing the release of creatine kinase (375 +/- 30 microU/min/gww vs 196 +/- 15 microU/min/gww; p <0.05) and lactate (15 +/- 1.5 mg/min/gww vs 5 +/- 1 mg/min/gww; p <0.05). We conclude that long-term supplementation of an amino acid mixture reduced myocardial ischemic damage.

[Changes in the indices of lipid metabolism in patients with ischemic heart disease occupied in natural gas fields]. / Izmenenie pokazatelei lipidnogo obmena u bol'nykh ishemicheskoi bolezn'iu serdtsa, zaniatykh na proizvodstve po dobyche i pererabotke gaza.

The influence of adaptation to periodic pressure-chamber hypoxia produced on the condition of the lipid spectrum of blood serum before and after adaptation as well as in 3, 6 and 10 months after hypoxic training was studied in 46 patients with ischemic heart disease working at a enterprise specializing in winning and processing the hydrogen-sulfide-containing gas-condensate. The adaptation therapy was found to result in a reliable reduction of the total cholesterol level, of the level of cholesterol of lipoproteins of the low and extra low densities and of triglycerides; it also contributed to the increase of cholesterol of lipoproteins of the high density in blood serum, which, in the end, ensures a reduced atherogenic coefficient. The positive-for-organism changes in the lipid spectrum of blood serum hold on in patients with coronary heart disease for as long as 6 months after the adaptation therapy. The nature and degree of blood lipids' changes depend on an initial level of the atherogenic index; they were maximally pronounced in persons with the index exceeding 3, and virtually absent in IHD patients with the atherogenicity coefficient being below the mentioned figure.

[Use of fish oil enriched with carotenoids isolated from sea cucumbers in the diet therapy of patients with hypertension and ischemic heart disease]. / Ispol'zovanie ryb'ego zhira, obogashchennogo karotinoidami iz morskogo ogurtsa, v dietoterapii bol'nykhg gipertonicheskoi bolezn'iu i ishemicheskoi bolezn'iu serdtsa.

Usage of antisclerotic diet with fish oil and carotinoides in patients with IND and high blood pressure resulted in positive dynamic of clinic manifestation, blood lipid, coagulogramms, antioxygen and immune status.

[Concept of the Mediterranean diet in modern European nutrition]. / Kontseptsiia dieiety seredzemnomor'ia v suchasnii Ievropeis'kii nutrisiologii.

The article is devoted to the analysis of the conception of the Mediterranean diet that has become to be shared by many leading nutritionists of Europe over the last decade as a possible reference model of nutrition for inhabitants of many countries of Central, Northern and Eastern Europe. An association is shown between some nutritional factors and indices for general mortality, mortality from ischemic heart disease and cancer of certain localizations. A positive effect has been unraveled of monounsaturated fatty acids together with negative effects of saturated fatty acids on the process of beta-oxidization and mitochondrial functions in the cardiac muscle. On the basis of the analysis of the existing data a conclusion has been reached that annexes to the existing principles of the A. A. Pokrovsky's optimum nourishment formula are necessary.

[Effects of biologically active supplements on the antioxidant and vitamin status of patients with hypertension and ischemic heart disease]. / Vliianie biologicheski aktivnykh dobavok na antioksidantnyi status i obespechennost' vitaminami u bol'nykh gipertonicheskoi i ishemicheskoi bolezn'iu serdtsa.

Biologically active additives in integrated therapy of patients with cardiovascular diseases against a background body overweight. The influence of antiaterosclerotic diet with including some biologically active additives, which contain vitamins C, E, B2, B6, beta-carotene, Zn, Mg, Na, K, Ca, I was studied in 91 patients with ischemic heart disease, hypertension disease. The usage of biologically active additives during 4 weeks has promoted positive changes of clinical symptoms of diseases against a background of lowering of serum cholesterol, triglycerides and increasing of vitamins A, E, C, B2, B6.

[Study of the state of lipid peroxidation system: antioxidant protection during the use of soy oil in patients with ischemic heart disease and hypertension]. / Izuchenie sostoianiia sistemy perekisnogo okisleniia lipidov--antiokislitel'noi zashchity pri ispol'zovanii soevogo masla u bol'nykh ishemicheskoi bolezn'iu serdtsa i gipertonicheskoi bolezn'iu.

Usage of antisclerotic diet with PUFA n-3 from soy oil in patients with IHD and HBP resulted in positive dynamic of clinic manifestation, blood lipids and coagulogramms of the patients. The decrease of intensity of lipid peroxidation was also revealed. The results showed that soy oil may be recommended for preventive and treatment diets.

[Comparative study on the effect of antiatherosclerotic diet enriched with polyunsaturated omega-3 fatty acids of plant and animal origin on the level of natural antibodies against catecholamines in patients with cardiovascular diseases]. / Sravnitel'nyi analiz vliianiia protivoateroskleroticheskikh diet, obogashchennykh PNZhK omega-3 pastitel'nogo i zhivotnogo proiskhozhdeniia na uroven' estestvennykh antitel k katekholaminam u bol'hykh serdechno-sosudistymi zabolevaniiami.

The levels of natural antibodies against catecholamines in 138 patients with cardiovascular diseases was studied and the comparative analysis of influence of antiatherosclerotic diets with different origin of PUFA omega-3 on dynamic of these parameters was made. For the first time discovered universal action of diets with PUFA omega-3 vegetable and animal origin on parameters of humoral immunity: in case of primary excess of norm of the contents of natural antibodies to adrenaline, noradrenaline and dopamine as a result of treatment these parameters were reduced or did not change; and at is primary a low their level--parameters increased in most cases. The greatest immunocorrection effect was rendered by diet, enriched PUFA omega-3 of freshwater fishes fat.

[Study of metabolic and clinical effects of polyunsaturated fatty acids omega-3 from "Eicovit" in patients with ischemic heart disease and familial hyperlipoproteinemia]. / Izuchenie kliniko-metabolicheskikh éffektov PNZhK omega-3, soderzhashchikhsia v "Eikovite", u bol'nikh ishemicheskoi bolezn'iu serdtsa i semeinymi giperlipoproteidemiiami.

The influence of antiatherosclerotic diet with including 15 g preparation "Eikovit" containing fat of freshwater fish on fat acid composition of erythrocytes membrane was studied in 399 patients with ishemic heart disease and hyperlipidemia. Against a background of positive influence on clinical symptoms of diseases, lipids of blood serum, homeostasis expressed influence of PUFA omega-3 in "Eikovit" on biomembrane fat acid composition was noted. It was shown sharp increasing a quota an eicosapentaenic acid by simultaneous reducing PUFA omega-6 level.

[Effect of anti-atherosclerotic diet with polyunsaturated fatty acids omega-3 from linseed oil on dynamics of natural antibodies to bradykinin and angiotensin II in blood serum of patients with cardiovascular diseases]. / Vliianie protivoateroskleroticheskoi diety s PNZhK omega-3 l'nianogo masla na dinamiku estestvennykh antitel k bradikininu i angiotensinu II v syvorotke krovi bol'nykh serdechno-sosudistymi zabolevaniiami.

The dynamic of natural antibodies against bradykinin and angiotensin II in blood serum was studied in 124 patients with ischemic heart disease, hyperlipidemia and hypertension against a background of usage of basic and modified antiatherosclerotic diet during 4 weeks. Besides favorable influence to a clinical picture of the disease universal normalizing influence of antiatherosclerotic diet with addition of linseed oil, consisting in increase of lowered levels of natural antibodies against bradykinin and angiotensin II and decrease of their contents in blood serum under primary increased concentrations.