Cardiovascular health and cancer risk associated with plant based diets: An umbrella review.

CONTEXT: Cardiovascular diseases (CVDs) and cancer are the two main leading causes of death and disability worldwide. Suboptimal diet, poor in vegetables, fruits, legumes and whole grain, and rich in processed and red meat, refined grains, and added sugars, is a primary modifiable risk factor. Based on health, economic and ethical concerns, plant-based diets have progressively widespread worldwide. OBJECTIVE: This umbrella review aims at assessing the impact of animal-free and animal-products-free diets (A/APFDs) on the risk factors associated with the development of cardiometabolic diseases, cancer and their related mortalities. DATA SOURCES: PubMed and Scopus were searched for reviews, systematic reviews, and meta-analyses published from 1st January 2000 to 31st June 2023, written in English and involving human subjects of all ages. Primary studies and reviews/meta-analyses based on interventional trials which used A/APFDs as a therapy for people with metabolic diseases were excluded. DATA EXTRACTION: The umbrella review approach was applied for data extraction and analysis. The revised AMSTAR-R 11-item tool was applied to assess the quality of reviews/meta-analyses. RESULTS: Overall, vegetarian and vegan diets are significantly associated with better lipid profile, glycemic control, body weight/BMI, inflammation, and lower risk of ischemic heart disease and cancer. Vegetarian diet is also associated with lower mortality from CVDs. On the other hand, no difference in the risk of developing gestational diabetes and hypertension were reported in pregnant women following vegetarian diets. Study quality was average. A key limitation is represented by the high heterogeneity of the study population in terms of sample size, demography, geographical origin, dietary patterns, and other lifestyle confounders. CONCLUSIONS: Plant-based diets appear beneficial in reducing cardiometabolic risk factors, as well as CVDs, cancer risk and mortality. However, caution should be paid before broadly suggesting the adoption of A/AFPDs since the strength-of-evidence of study results is significantly limited by the large study heterogeneity alongside the potential risks associated with potentially restrictive regimens.

Language barriers during vaccination practice, the point of view of healthcare providers.

Background: Language barriers are one of the main obstacles faced by migrants in accessing healthcare services. A compromised communication between migrants and Healthcare Providers in vaccination setting can result in increased vaccine hesitancy and decreased vaccine uptake. The objective of the current study is to investigate Healthcare Providers' perceptions about linguistic barriers faced during both routinary vaccination practice and the extraordinary vaccination program for Ukrainian refugees in the Local Health Authorities of Bologna and Romagna (Italy). Methods: A cross-sectional study was conducted through the administration of a questionnaire examining Healthcare Providers' perceptions. A descriptive analysis and a multiple logistic regression model were adopted to analyze the collected data. Results: Language barriers resulted as an obstacle to informed consent and to doctor-patient relationship. The strategies adopted were perceived as helpful in increasing vaccination adherence, despite communication difficulties were still experienced during refugees' vaccinations. Results suggest that the implementation of translated material and the use of professional interpreters may represent important strategies to overcome linguistic barriers, along with Healthcare Providers' training. Healthcare Providers' opinions could assist the implementation of new tools capable of countering language barriers. Conclusions: The current study represents an example of providers' involvement in understanding the complexities behind the issue of language barriers in vaccination practice.

Impacts of Urban Green on Cardiovascular and Cerebrovascular Diseases-A Systematic Review and Meta-Analysis.

Cardiovascular diseases (CVDs) are a leading cause of mortality globally. In particular, ischemic heart diseases (IHDs) and cerebrovascular diseases (CBVDs) represent the main drivers of CVD-related deaths. Many literature examples have assessed the association between CVD risk factors and urban greenness. Urban green (UG) may positively affect physical activity, reduce air and noise pollution, and mitigate the heat island effect, which are known risk factors for CVD morbidity. This systematic review aims to assess the effects of urban green spaces on CVD morbidity and mortality. Peer-reviewed research articles with a quantitative association between urban green exposure variables and cardiovascular and cerebrovascular outcomes were included. Meta-analyses were conducted for each outcome evaluated in at least three comparable studies. Most of the included studies' results highlighted an inverse correlation between exposure to UG and CVD outcomes. Gender differences were found in four studies, with a protective effect of UG only statistically significant in men. Three meta-analyses were performed, showing an overall protective effect of UG on CVD mortality (HR (95% CI) = 0.94 (0.91, 0.97)), IHD mortality (HR (95% CI) = 0.96 (0.93, 0.99)), and CBVD mortality (HR (95% CI) = 0.96 (0.94, 0.97)). The results of this systematic review suggest that exposure to UG may represent a protective factor for CVDs.