Multivariate Analysis of Influence of Vitamin Intake on Vascular Function Parameters by Sex in the General Spanish Population: EVA Study.

The influence of vitamin intake on vascular function parameters in the Spanish general population has not been studied. The main objective of this study is to analyze the influence of vitamin intake on vascular function and as a secondary objective the adequacy of vitamin intake in a sample of the Spanish population without previous cardiovascular disease and analyze the differences according to sex. Methods: We included 501 individuals obtained by simple random sampling with replacement (reference population 43,946). The average age was 55.90 ± 14.24 years, 49.70% men. Participants recorded the intake of vitamins using the EVIDENT app, previously validated, during a period of 3 days. Vascular function was assessed by measuring carotid-femoral pulse wave velocity (cfPWV) with the SphygmoCor device, cardio-ankle vascular index (CAVI) with the VaSera device and brachial-ankle pulse wave velocity (baPWV) by using a validated equation. Results: The vitamins with the least adequate intake was vitamin D, less than 5%, and vitamin B9, less than 35%. Vitamins with an adequate intake percentage, close to 100%, were B12 and B6. The multiple regression analysis showed a negative association between cfPWV and vitamin B2 in both sexes, and a positive one with retinol in men and B3 in women. baPWV was negatively associated with vitamins B1 and B12 in women and B9 in men, while being positively linked with B6 in men. CAVI presented a negative association with vitamin D in women. The results were similar in the canonical correspondence analysis. In conclusion, the results of this study suggest that the influence of vitamins on vascular function is not homogeneous and varies according to the parameter analyzed. Thus, in men, vitamins B2 and retinol were associated with cfPWV and vitamins B6 and B9 with baPWV. In women, vitamins B2 and B3 were related cfPWV, vitamins B1 and B12 with cfPWV and vitamin D with CAVI.

Postprandial effects of breakfast glycaemic index on cognitive performance among young, healthy adults: A crossover clinical trial.

Objective: To evaluate the postprandial effects of high and low glycaemic index (GI) breakfasts on cognitive performance in young, healthy adults.Methods: A crossover clinical trial including 40 young, healthy adults (aged 20-40 years, 50% females) recruited from primary healthcare centres in Salamanca, Spain. Verbal memory, phonological fluency, attention, and executive functions were examined 0, 60, and 120 minutes after consuming a low GI (LGI), high GI (HGI), or water breakfast. Every subject tried each breakfast variant, in a randomized order, separated by a washout period of 7 days, for a total of 3 weeks.Results: A significant interaction between the type of breakfast consumed and immediate verbal memory was identified (P<.05). We observed a trend towards better performance in verbal memory (delayed and immediate), attention, and phonological fluency following an LGI breakfast.Discussion: Cognitive performance during the postprandial phase in young, healthy adults was minimally affected by the GI of breakfast. The potential for breakfast's GI modulation to improve short- and long-term cognitive functioning requires further research.

Postprandial Effects of Breakfast Glycemic Index on Vascular Function among Young Healthy Adults: A Crossover Clinical Trial.

This study aimed to evaluate the postprandial effects of high and low glycemic index (GI) breakfasts on vascular function. It was a crossover trial that included 40 young healthy adults (50% women), aged 20-40 years, who were recruited at primary care settings. They consumed three experimental breakfasts in randomized order, each one separated by a 1-week washout period: (1) control conditions (only water); (2) low GI (LGI) breakfast (29.4 GI and 1489 KJ energy); and (3) high GI (HGI) breakfast (64.0 GI and 1318 KJ energy). Blood samples were collected at 60 and 120 min after each breakfast to determine glucose and insulin levels. Vascular parameters were measured at 15 min intervals. Augmentation index (AIx) was studied as a primary outcome. Secondary outcomes comprised glucose, insulin, heart rate (HR) and pulse pressures (PPs). We found a trend toward increased AIx, HR and PPs for the HGI versus the LGI breakfast. A significant interaction between the type of breakfast consumed and all measured parameters was identified (p < 0.05) except for central PP. Stratifying data by sex, this interaction remained significant for AIx and augmentation pressure only in males (p < 0.05). In conclusion, breakfast GI could affect postprandial vascular responses in young healthy adults.

Diet and physical activity in people with intermediate cardiovascular risk and their relationship with the health-related quality of life: results from the MARK study.

BACKGROUND: To analyze the interplay between diet, physical activity and health-related quality of life in a Spanish randomly selected sample of individuals attended in general practitioners offices with intermediate cardiovascular risk. METHODS: This study analyzed 314 subjects, aged 35-74 years (50.6% women), from the MARK study, conducted in Spain. Health related quality of life was measured by the SF-12 questionnaire. The assessment of the lifestyles included the diet quality index, the adherence to the Mediterranean diet and the leisure time physical activity practice. RESULTS: The highest values of health related quality of life were obtained in the area of vitality (51.05 ± 11.13), while the lowest were found in the general health (39.89 ± 8.85). In the multiple linear regression analysis, after adjustment for age, gender and other confounders, for each point of increase in the Mediterranean diet adherence score, there was an increase of 1.177 points in the mental component value (p < 0.01). Similarly, for each point of increase in the Diet Quality Index Score, there was an increase in the mental component of 0.553 (p < 0.05). Likewise, the physical activity was positively associated with the physical function and vitality (ß = 0.090 and 0.087, (p < 0.01 and p < 0.05), respectively). CONCLUSIONS: In people with intermediate cardiovascular risk, better food habits and greater adherence to the Mediterranean diet are associated with higher scores on the mental component of quality of life. Likewise, increased physical activity is related with positive scores on the physical function.

Postprandial effect of breakfast glycaemic index on vascular function, glycaemic control and cognitive performance (BGI study): study protocol for a randomised crossover trial.

BACKGROUND: Postprandial glycaemic response affects cognitive and vascular function. The acute effect of breakfast glycaemic index on vascular parameters is not sufficiently known. Also, the influence of breakfasts with different glycaemic index on cognitive performance has been mostly studied in children and adolescents with varying results. Therefore, the purpose of this study is to analyse the postprandial effect of high and low glycaemic index breakfasts on vascular function and cognitive performance and their relationship with postprandial glycaemic response in healthy young adults. METHODS/DESIGN: This is a crossover clinical trial targeting adults (aged 20-40 years, free from cardiovascular disease) selected by consecutive sampling at urban primary care health clinics in Salamanca (Spain). Each subject will complete three interventions with a washout period of one week: a control condition (consisting of water); a low glycaemic index breakfast (consisting of dark chocolate, walnuts, yogurt and an apple, with an overall glycaemic index of 29.4 and an energy contribution of 1489 kJ); and a high glycaemic index breakfast (consisting of bread, grape juice and strawberry jam, with an overall glycaemic index of 64.0 and an energy contribution of 1318 kJ). The postprandial effect will be assessed at 60 and 120 minutes from each breakfast including blood sampling and cognitive performance evaluations. Measurements of arterial stiffness and central haemodynamic parameters will be taken at -10, 0, 15, 30, 45, 60, 75, 90, 105 and 120 minutes. DISCUSSION: The differences in postprandial glycaemic response due to breakfast glycaemic index could affect vascular parameters and cognitive performance with important applications and implications for the general population. This could provide necessary information for the establishment of new strategies in terms of nutritional education and work performance improvement. TRIAL REGISTRATION: ClinicalTrials.gov:  NCT02616276 . Registered on 19 November 2015.

Central blood pressure and pulse wave velocity: relationship to target organ damage and cardiovascular morbidity-mortality in diabetic patients or metabolic syndrome. An observational prospective study. LOD-DIABETES study protocol.

BACKGROUND: Diabetic patients show an increased prevalence of non-dipping arterial pressure pattern, target organ damage and elevated arterial stiffness. These alterations are associated with increased cardiovascular risk.The objectives of this study are the following: to evaluate the prognostic value of central arterial pressure and pulse wave velocity in relation to the incidence and outcome of target organ damage and the appearance of cardiovascular episodes (cardiovascular mortality, myocardial infarction, chest pain and stroke) in patients with type 2 diabetes mellitus or metabolic syndrome. DESIGN: This is an observational prospective study with 5 years duration, of which the first year corresponds to patient inclusion and initial evaluation, and the remaining four years to follow-up. SETTING: The study will be carried out in the urban primary care setting. STUDY POPULATION: Consecutive sampling will be used to include patients diagnosed with type 2 diabetes between 20-80 years of age. A total of 110 patients meeting all the inclusion criteria and none of the exclusion criteria will be included. MEASUREMENTS: Patient age and sex, family and personal history of cardiovascular disease, and cardiovascular risk factors. Height, weight, heart rate and abdominal circumference. Laboratory tests: hemoglobin, lipid profile, creatinine, microalbuminuria, glomerular filtration rate, blood glucose, glycosylated hemoglobin, blood insulin, fibrinogen and high sensitivity C-reactive protein. Clinical and 24-hour ambulatory (home) blood pressure monitoring and self-measured blood pressure. Common carotid artery ultrasound for the determination of mean carotid intima-media thickness. Electrocardiogram for assessing left ventricular hypertrophy. Ankle-brachial index. Retinal vascular study based on funduscopy with non-mydriatic retinography and evaluation of pulse wave morphology and pulse wave velocity using the SphygmoCor system. The medication used for diabetes, arterial hypertension and hyperlipidemia will be registered, together with antiplatelet drugs. DISCUSSION: The results of this study will help to know and quantify the prognostic value of central arterial pressure and pulse wave velocity in relation to the evolution of the subclinical target organ damage markers and the possible incidence of cardiovascular events in patients with type 2 diabetes mellitus.