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1.
PLoS Med ; 17(9): e1003331, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32941436

RESUMO

BACKGROUND: It is unclear whether the effect on mortality of a higher body mass index (BMI) can be compensated for by adherence to a healthy diet and whether the effect on mortality by a low adherence to a healthy diet can be compensated for by a normal weight. We aimed to evaluate the associations of BMI combined with adherence to a Mediterranean-like diet on all-cause and cardiovascular disease (CVD) mortality. METHODS AND FINDINGS: Our longitudinal cohort design included the Swedish Mammography Cohort (SMC) and the Cohort of Swedish Men (COSM) (1997-2017), with a total of 79,003 women (44%) and men (56%) and a mean baseline age of 61 years. BMI was categorized into normal weight (20-24.9 kg/m2), overweight (25-29.9 kg/m2), and obesity (30+ kg/m2). Adherence to a Mediterranean-like diet was assessed by means of the modified Mediterranean-like diet (mMED) score, ranging from 0 to 8; mMED was classified into 3 categories (0 to <4, 4 to <6, and 6-8 score points), forming a total of 9 BMI × mMED combinations. We identified mortality by use of national Swedish registers. Cox proportional hazard models with time-updated information on exposure and covariates were used to calculate the adjusted hazard ratios (HRs) of mortality with their 95% confidence intervals (CIs). Our HRs were adjusted for age, baseline educational level, marital status, leisure time physical exercise, walking/cycling, height, energy intake, smoking habits, baseline Charlson's weighted comorbidity index, and baseline diabetes mellitus. During up to 21 years of follow-up, 30,389 (38%) participants died, corresponding to 22 deaths per 1,000 person-years. We found the lowest HR of all-cause mortality among overweight individuals with high mMED (HR 0.94; 95% CI 0.90, 0.98) compared with those with normal weight and high mMED. Using the same reference, obese individuals with high mMED did not experience significantly higher all-cause mortality (HR 1.03; 95% CI 0.96-1.11). In contrast, compared with those with normal weight and high mMED, individuals with a low mMED had a high mortality despite a normal BMI (HR 1.60; 95% CI 1.48-1.74). We found similar estimates among women and men. For CVD mortality (12,064 deaths) the findings were broadly similar, though obese individuals with high mMED retained a modestly increased risk of CVD death (HR 1.29; 95% CI 1.16-1.44) compared with those with normal weight and high mMED. A main limitation of the present study is the observational design with self-reported lifestyle information with risk of residual or unmeasured confounding (e.g., genetic liability), and no causal inferences can be made based on this study alone. CONCLUSIONS: These findings suggest that diet quality modifies the association between BMI and all-cause mortality in women and men. A healthy diet may, however, not completely counter higher CVD mortality related to obesity.


Assuntos
Doenças Cardiovasculares/dietoterapia , Doenças Cardiovasculares/mortalidade , Dieta Mediterrânea/psicologia , Idoso , Índice de Massa Corporal , Causas de Morte , Estudos de Coortes , Dieta Saudável , Feminino , Humanos , Estilo de Vida , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/dietoterapia , Sobrepeso , Modelos de Riscos Proporcionais , Fatores de Risco , Fumar , Suécia
2.
Lancet Diabetes Endocrinol ; 8(11): 915-930, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32949497

RESUMO

Prospective observational studies support the use of long-chain omega-3 polyunsaturated fatty acids (PUFAs) in the primary prevention of atherosclerotic cardiovascular disease; however, randomised controlled trials, have often reported neutral findings. There is a long history of debate about the potential harmful effects of a high intake of omega-6 PUFAs, although this idea is not supported by prospective observational studies or randomised controlled trials. Health effects of PUFAs might be influenced by Δ-5 and Δ-6 desaturases, the key enzymes in the metabolism of PUFAs. The activity of these enzymes and modulation by variants in encoding genes (FADS1-2-3 gene cluster) are linked to several cardiometabolic traits. This Review will further consider non-genetic determinants of desaturase activity, which have the potential to modify the availability of PUFAs to tissues. Finally, we discuss the consequences of altered desaturase activity in the context of PUFA intake, that is, gene-diet interactions and their clinical and public health implications.


Assuntos
Doenças Cardiovasculares/dietoterapia , Doenças Cardiovasculares/metabolismo , Ácidos Graxos Ômega-3/metabolismo , Ácidos Graxos Ômega-6/metabolismo , Doenças Metabólicas/dietoterapia , Doenças Metabólicas/metabolismo , Animais , Ácidos Graxos Ômega-3/administração & dosagem , Ácidos Graxos Ômega-6/administração & dosagem , Interação Gene-Ambiente , Humanos , Estado Nutricional/fisiologia , Estudos Prospectivos , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos
3.
Cardiovasc Ther ; 2020: 2342837, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32547635

RESUMO

Cardiovascular diseases (CVD) represent one of the biggest causes of death globally, and their prevalence, aetiology, and outcome are related to genetic, metabolic, and environmental factors, among which sex- and age-dependent differences may play a key role. Among CVD risk factors, platelet hyperactivity deserves particular mention, as it is involved in the pathophysiology of main cardiovascular events (including stroke, myocardial infarction, and peripheral vascular injury) and is closely related to sex/age differences. Several determinants (e.g., hormonal status and traditional cardiovascular risk factors), together with platelet-related factors (e.g., plasma membrane composition, receptor signaling, and platelet-derived microparticles) can elucidate sex-related disparity in platelet functionality and CVD onset and outcome, especially in relation to efficacy of current primary and secondary interventional strategies. Here, we examined the state of the art concerning sex differences in platelet biology and their relationship with specific cardiovascular events and responses to common antiplatelet therapies. Moreover, as healthy nutrition is widely recognized to play a key role in CVD, we also focused our attention on specific dietary components (especially polyunsaturated fatty acids and flavonoids) and patterns (such as Mediterranean diet), which also emerged to impact platelet functions in a sex-dependent manner. These results highlight that full understanding of gender-related differences will be useful for designing personalized strategies, in order to prevent and/or treat platelet-mediated vascular damage.


Assuntos
Plaquetas/efeitos dos fármacos , Doenças Cardiovasculares/dietoterapia , Doenças Cardiovasculares/tratamento farmacológico , Dieta Saudável , Dieta Mediterrânea , Disparidades nos Níveis de Saúde , Inibidores da Agregação de Plaquetas/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Plaquetas/metabolismo , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estado Nutricional , Valor Nutritivo , Prevenção Primária , Fatores de Risco , Comportamento de Redução do Risco , Prevenção Secundária , Fatores Sexuais , Resultado do Tratamento , Adulto Jovem
4.
Acta Diabetol ; 57(7): 853-860, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32114641

RESUMO

AIMS: Gut microbiota significantly impacts human health and is influenced by dietary changes. We evaluated the effects of diets naturally rich in polyphenols (PP) and/or long-chain n-3 polyunsaturated fatty acids (LCn3) on microbiota composition in an ancillary analysis of a randomized controlled trial in individuals at high cardiometabolic risk. METHODS: Seventy-eight individuals with high waist circumference and at least one additional component of the metabolic syndrome were randomized to an isoenergetic 8-week diet: (a) low LCn3 and PP; (b) high LCn3; (c) high PP; or (d) high LCn3 and PP. Microbiota analysis was performed on feces collected before and after the intervention. DGGE analysis of the predominant bacteria, Eubacterium rectale and Blautia coccoides group (Lachnospiraceae, EREC), Clostridium leptum (Ruminococcaceae, CLEPT), Bacteroides spp., Bifidobacteria, and Lactobacillus group was performed. A quantitative real-time PCR was performed for the same group, additionally including Atopobium cluster (Coriobatteriaceae). Before and after the intervention, participants underwent a 75 g OGTT and a high-fat test meal to evaluate glucose and lipid response. RESULTS: Adherence to the four diets was optimal. PP significantly increased microbial diversity (p = 0.006) and CLEPT (p = 0.015), while it reduced EREC (p = 0.044). LCn3 significantly increased the numbers of Bifidobacteria (p = 0.041). Changes in CLEPT numbers correlated with changes in early insulin secretion (r = 0.263, p = 0.030). Changes in Atopobium numbers correlated with postprandial triglycerides in plasma (r = 0.266, p = 0.026) and large VLDL (r = 0.313, p = 0.009), and cholesterol in large VLDL (r = 0.319, p = 0.008). CONCLUSIONS: Diets naturally rich in PP or LCn3 influenced gut microbiota composition in individuals at high cardiometabolic risk. These modifications were associated with changes in glucose/lipid metabolism.


Assuntos
Doenças Cardiovasculares/microbiologia , Dieta , Ácidos Graxos Ômega-3/farmacologia , Microbioma Gastrointestinal/efeitos dos fármacos , Síndrome Metabólica/microbiologia , Polifenóis/farmacologia , Adulto , Idoso , Doenças Cardiovasculares/dietoterapia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle , Ácidos Graxos Ômega-3/administração & dosagem , Fezes/microbiologia , Feminino , Humanos , Masculino , Refeições , Síndrome Metabólica/dietoterapia , Síndrome Metabólica/etiologia , Síndrome Metabólica/prevenção & controle , Pessoa de Meia-Idade , Polifenóis/administração & dosagem , Fatores de Risco
5.
Cochrane Database Syst Rev ; 3: CD003177, 2020 02 29.
Artigo em Inglês | MEDLINE | ID: mdl-32114706

RESUMO

BACKGROUND: Omega-3 polyunsaturated fatty acids from oily fish (long-chain omega-3 (LCn3)), including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)), as well as from plants (alpha-linolenic acid (ALA)) may benefit cardiovascular health. Guidelines recommend increasing omega-3-rich foods, and sometimes supplementation, but recent trials have not confirmed this. OBJECTIVES: To assess the effects of increased intake of fish- and plant-based omega-3 fats for all-cause mortality, cardiovascular events, adiposity and lipids. SEARCH METHODS: We searched CENTRAL, MEDLINE and Embase to February 2019, plus ClinicalTrials.gov and World Health Organization International Clinical Trials Registry to August 2019, with no language restrictions. We handsearched systematic review references and bibliographies and contacted trial authors. SELECTION CRITERIA: We included randomised controlled trials (RCTs) that lasted at least 12 months and compared supplementation or advice to increase LCn3 or ALA intake, or both, versus usual or lower intake. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trials for inclusion, extracted data and assessed validity. We performed separate random-effects meta-analysis for ALA and LCn3 interventions, and assessed dose-response relationships through meta-regression. MAIN RESULTS: We included 86 RCTs (162,796 participants) in this review update and found that 28 were at low summary risk of bias. Trials were of 12 to 88 months' duration and included adults at varying cardiovascular risk, mainly in high-income countries. Most trials assessed LCn3 supplementation with capsules, but some used LCn3- or ALA-rich or enriched foods or dietary advice compared to placebo or usual diet. LCn3 doses ranged from 0.5 g a day to more than 5 g a day (19 RCTs gave at least 3 g LCn3 daily). Meta-analysis and sensitivity analyses suggested little or no effect of increasing LCn3 on all-cause mortality (risk ratio (RR) 0.97, 95% confidence interval (CI) 0.93 to 1.01; 143,693 participants; 11,297 deaths in 45 RCTs; high-certainty evidence), cardiovascular mortality (RR 0.92, 95% CI 0.86 to 0.99; 117,837 participants; 5658 deaths in 29 RCTs; moderate-certainty evidence), cardiovascular events (RR 0.96, 95% CI 0.92 to 1.01; 140,482 participants; 17,619 people experienced events in 43 RCTs; high-certainty evidence), stroke (RR 1.02, 95% CI 0.94 to 1.12; 138,888 participants; 2850 strokes in 31 RCTs; moderate-certainty evidence) or arrhythmia (RR 0.99, 95% CI 0.92 to 1.06; 77,990 participants; 4586 people experienced arrhythmia in 30 RCTs; low-certainty evidence). Increasing LCn3 may slightly reduce coronary heart disease mortality (number needed to treat for an additional beneficial outcome (NNTB) 334, RR 0.90, 95% CI 0.81 to 1.00; 127,378 participants; 3598 coronary heart disease deaths in 24 RCTs, low-certainty evidence) and coronary heart disease events (NNTB 167, RR 0.91, 95% CI 0.85 to 0.97; 134,116 participants; 8791 people experienced coronary heart disease events in 32 RCTs, low-certainty evidence). Overall, effects did not differ by trial duration or LCn3 dose in pre-planned subgrouping or meta-regression. There is little evidence of effects of eating fish. Increasing ALA intake probably makes little or no difference to all-cause mortality (RR 1.01, 95% CI 0.84 to 1.20; 19,327 participants; 459 deaths in 5 RCTs, moderate-certainty evidence),cardiovascular mortality (RR 0.96, 95% CI 0.74 to 1.25; 18,619 participants; 219 cardiovascular deaths in 4 RCTs; moderate-certainty evidence), coronary heart disease mortality (RR 0.95, 95% CI 0.72 to 1.26; 18,353 participants; 193 coronary heart disease deaths in 3 RCTs; moderate-certainty evidence) and coronary heart disease events (RR 1.00, 95% CI 0.82 to 1.22; 19,061 participants; 397 coronary heart disease events in 4 RCTs; low-certainty evidence). However, increased ALA may slightly reduce risk of cardiovascular disease events (NNTB 500, RR 0.95, 95% CI 0.83 to 1.07; but RR 0.91, 95% CI 0.79 to 1.04 in RCTs at low summary risk of bias; 19,327 participants; 884 cardiovascular disease events in 5 RCTs; low-certainty evidence), and probably slightly reduces risk of arrhythmia (NNTB 91, RR 0.73, 95% CI 0.55 to 0.97; 4912 participants; 173 events in 2 RCTs; moderate-certainty evidence). Effects on stroke are unclear. Increasing LCn3 and ALA had little or no effect on serious adverse events, adiposity, lipids and blood pressure, except increasing LCn3 reduced triglycerides by ˜15% in a dose-dependent way (high-certainty evidence). AUTHORS' CONCLUSIONS: This is the most extensive systematic assessment of effects of omega-3 fats on cardiovascular health to date. Moderate- and low-certainty evidence suggests that increasing LCn3 slightly reduces risk of coronary heart disease mortality and events, and reduces serum triglycerides (evidence mainly from supplement trials). Increasing ALA slightly reduces risk of cardiovascular events and arrhythmia.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Suplementos Nutricionais , Ácidos Graxos Ômega-3/uso terapêutico , Prevenção Primária , Prevenção Secundária , Adiposidade , Adulto , Arritmias Cardíacas/epidemiologia , Doenças Cardiovasculares/dietoterapia , Doenças Cardiovasculares/mortalidade , Causas de Morte , Doença das Coronárias/mortalidade , Ácidos Docosa-Hexaenoicos/uso terapêutico , Ácido Eicosapentaenoico/uso terapêutico , Ácidos Graxos Ômega-3/efeitos adversos , Hemorragia/epidemiologia , Humanos , Embolia Pulmonar/epidemiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Análise de Regressão , Acidente Vascular Cerebral/epidemiologia , Resultado do Tratamento , Ácido alfa-Linoleico/uso terapêutico
7.
S D Med ; 73(2): 72-76, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32135055

RESUMO

IMPORTANCE AND OBJECTIVE: Dietary supplements and herbs (called naturoceuticals) are commonly used by Americans, but little is known about their use in cardiovascular disease patient populations. The objective was to evaluate naturoceutical use in a sample population of cardiovascular disease patients in the U.S. DESIGN, SETTING and PARTICIPANTS: A non-blinded, single medical center clinic open questionnaire was delivered to cardiovascular clinic patients with known cardiovascular diseases. MAIN OUTCOMES AND MEASURES, AND RESULTS: Estimation of naturoceutical usage prevalence and frequency in the sample population of cardiovascular disease patients. A total of 163 patients (n = 99 males, 64 females) participated (mean age: males, 66 years; females, 64 years). Overall, 76.7 percent of participants reported using naturoceuticals. Of them, about 63.2 percent took more than one type, and 90.3 percent reported daily usage. Of the naturoceuticals reportedly being taken, multivitamins containing vitamin K were the most commonly consumed (32.3 percent male, 29.7 percent female), followed by vitamin D (23.2 percent male, 31.3 percent female) and fish oil (24.2 percent male, 15.6 percent female). CONCLUSIONS AND RELEVANCE: The present study revealed that naturoceutical use was very popular in cardiovascular disease patients, largely due to the belief that they could reduce and/or prevent symptoms and disease in general. The benefits and hazards of those naturoceuticals being used concurrent with other prescription medications were discussed.


Assuntos
Doenças Cardiovasculares , Suplementos Nutricionais , Medicamentos sob Prescrição , Idoso , Doenças Cardiovasculares/dietoterapia , Suplementos Nutricionais/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Vitaminas/uso terapêutico
8.
Am J Clin Nutr ; 111(4): 739-748, 2020 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-32020168

RESUMO

BACKGROUND: Modifying dairy fat composition by increasing the MUFA content is a potential strategy to reduce dietary SFA intake for cardiovascular disease (CVD) prevention in the population. OBJECTIVES: To determine the effects of consuming SFA-reduced, MUFA-enriched (modified) dairy products, compared with conventional dairy products (control), on the fasting cholesterol profile (primary outcome), endothelial function assessed by flow-mediated dilatation (FMD; key secondary outcome), and other cardiometabolic risk markers. METHODS: A double-blind, randomized, controlled crossover 12-wk intervention was conducted. Participants with a 1.5-fold higher (moderate) CVD risk than the population mean replaced habitual dairy products with study products (milk, cheese, and butter) to achieve a high-fat, high-dairy isoenergetic daily dietary exchange [38% of total energy intake (%TE) from fat: control (dietary target: 19%TE SFA; 11%TE MUFA) and modified (16%TE SFA; 14%TE MUFA) diet]. RESULTS: Fifty-four participants (57.4% men; mean ± SEM age: 52 ± 3 y; BMI: 25.8 ± 0.5 kg/m2) completed the study. The modified diet attenuated the rise in fasting LDL cholesterol observed with the control diet (0.03 ± 0.06 mmol/L and 0.19 ± 0.05 mmol/L, respectively; P = 0.03). Relative to baseline, the %FMD response increased after the modified diet (0.35% ± 0.15%), whereas a decrease was observed after the control diet (-0.51% ± 0.15%; P< 0.0001). In addition, fasting plasma nitrite concentrations increased after the modified diet, yet decreased after the control diet (0.02 ± 0.01 µmol/L and -0.03 ± 0.02 µmol/L, respectively; P = 0.01). CONCLUSIONS: In adults at moderate CVD risk, consumption of a high-fat diet containing SFA-reduced, MUFA-enriched dairy products for 12 wk showed beneficial effects on fasting LDL cholesterol and endothelial function compared with conventional dairy products. Our findings indicate that fatty acid modification of dairy products may have potential as a public health strategy aimed at CVD risk reduction. This trial was registered at clinicaltrials.gov as NCT02089035.


Assuntos
Doenças Cardiovasculares/prevenção & controle , LDL-Colesterol/metabolismo , Gorduras Insaturadas/metabolismo , Ácidos Graxos Insaturados/metabolismo , Doenças Cardiovasculares/dietoterapia , Doenças Cardiovasculares/metabolismo , Gorduras na Dieta/metabolismo , Dilatação , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
9.
PLoS One ; 15(1): e0225348, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31935216

RESUMO

BACKGROUND: Low-carbohydrate diets are associated with cardiovascular risk factors; however, the results of different studies are inconsistent. PURPOSE: The aim of this meta-analysis was to assess the relationship between low-carbohydrate diets and cardiovascular risk factors. METHOD: Four electronic databases (PubMed, Embase, Medline, and the Cochrane Library) were searched from their inception to November 2018. We collected data from 12 randomized trials on low-carbohydrate diets including total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides, and blood pressure levels, as well as weight as the endpoints. The average difference (MD) was used as the index to measure the effect of a low-carbohydrate diet on cardiovascular risk factors with a fixed-effects model or random-effects model. The analysis was further stratified by factors that might affect the results of the intervention. RESULTS: From 1292 studies identified in the initial search results, 12 randomized studies were included in the final analysis, which showed that a low-carbohydrate diet was associated with a decrease in triglyceride levels of -0.15mmol/l (95% confidence interval -0.23 to -0.07). Low-carbohydrate diet interventions lasting less than 6 months were associated with a decrease of -0.23mmol/l (95% confidence interval -0.32 to -0.15), while those lasting 12-23 months were associated with a decrease of -0.17mmol/l (95% confidence interval -0.32 to -0.01). The change in the body weight in the observation groups was -1.58kg (95% confidence interval -1.58 to -0.75); with for less than 6 months of intervention,this change was -1.14 kg (95% confidence interval -1.65 to -0.63),and with for 6-11 months of intervention, this change was -1.73kg (95% confidence interval -2.7 to -0.76). The change in the systolic blood pressure of the observation group was -1.41mmHg (95% confidence interval-2.26 to -0.56); the change in diastolic blood pressure was -1.71mmHg (95% confidence interval-2.36 to -1.06); the change in plasma HDL-C levels was 0.1mmHg (95% confidence interval 0.08 to 0.12); and the change in serum total cholesterol was 0.13mmol/l (95% confidence interval 0.08 to 0.19). The plasma LDL-C level increased by 0.11mmol/l (95% confidence interval 0.02 to 0.19), and the fasting blood glucose level changed 0.03mmol/l (95% confidence interval -0.05 to 0.12),which was not significant. CONCLUSIONS: This meta-analysis confirms that low-carbohydrate diets have a beneficial effect on cardiovascular risk factors but that the long-term effects on cardiovascular risk factors require further research.


Assuntos
Doenças Cardiovasculares/dietoterapia , Dieta com Restrição de Carboidratos , Dieta com Restrição de Gorduras , Ingestão de Energia , Pressão Sanguínea , Peso Corporal , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/epidemiologia , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Risco , Triglicerídeos/sangue
10.
Crit Rev Food Sci Nutr ; 60(7): 1123-1140, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30638042

RESUMO

Several studies have been conducted on the effects of peanut consumption on cardiovascular diseases (CVD) risk factors. However, the findings are conflicting and appear inconsistent. The aim of this review is to summarize the findings on the effect of peanut consumption on the risk factors of CVDs. We used relevant keywords and searched through PubMed, Scopus and Web of Science for articles published studies up to November 2018. Randomized controlled trials (RCTs) were included in this meta-analysis. Random or fixed-effects meta-analysis method depending on the results of heterogeneity tests was used to estimate the effect size. Between-study heterogeneity was assessed by Q test and I2 index. Subgroup analysis was conducted to find any excess relationship. Publication bias was checked by Egger's test and funnel plot. Quality of studies was assessed by the Cochrane criteria. According to the results of 13 RCTs, peanuts has no significant effect on weight (WMD: -0.11 kg, P = 0.773), waist circumference (WMD: -1.41 cm, P = 0.139), body mass index (WMD: -0.14 kg/m2, P = 0.428), systolic and diastolic blood pressure (WMD: -0.09 mmHg, P = 0.939 and WMD: 0.60 mmHg, P = 0.652, respectively), low-density lipoprotein cholesterol (WMD: -3.31 mg/dl, P = 0.472), triglyceride (WMD: -7.59 mg/dl, P = 0.180), total cholesterol (WMD: 3.15 mg/dl, P = 0.171), fasting blood sugar (WMD: 0.57 mg/dl, P = 0.604) and serum insulin (WMD: -0.40, P = 0.582). Also, this meta-analysis showed that peanut had a positive significant effect on high-density lipoprotein cholesterol (HDL) (WMD: 2.72 mg/dl, P = 0.001). Peanuts consumption has a positive significant effect on HDL especially at the type of peanut oil, high-oleic peanut and peanut sprout and in healthy subjects and for consumption more than 12 weeks, while has no significant effect on other CVD risk factors.


Assuntos
Arachis , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/prevenção & controle , HDL-Colesterol/sangue , Doenças Cardiovasculares/dietoterapia , LDL-Colesterol/sangue , Voluntários Saudáveis , Humanos , Fatores de Risco , Triglicerídeos/sangue
11.
Crit Rev Food Sci Nutr ; 60(9): 1515-1522, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30896289

RESUMO

The beneficial effect of fresh tomatoes or processed tomato products on platelet aggregation depends on the presence of bioactive compounds in these products, in sufficient quantities, to produce a relevant physiological effect, when consumed as part of a normal diet. This work is focused on reviewing the development on tomato products bioactive compounds, particularly with reference to its potential biological activity with beneficial effect on the prevention of platelet aggregation.The most relevant studies found show that all bioactive compounds found in Water-soluble tomato concentrate are in tomato fruit and other tomato products, and there is enough evidence of their beneficial effects. According to the European Food Safety Authority requirements, further intervention studies (human clinical trials) using valid markers should be performed in order to demonstrate the beneficial effects of tomato products as consumer products (paste, puree, sauce or juice) on platelet aggregation. Our PubMed review results support the development of promising nutritional strategies involving tomatoes and tomato products to tackle cardiovascular disease as antiplatelet aggregation.


Assuntos
Doenças Cardiovasculares/dietoterapia , Lycopersicon esculentum/química , Agregação Plaquetária , Frutas/química , Humanos
12.
Aten. prim. (Barc., Ed. impr.) ; 51(10): 645-653, dic. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-185947

RESUMO

La hipertensión arterial (HTA) es el principal factor de riesgo cardiovascular modificable. La HTA se puede relacionar con el consumo elevado de sal. Para medir la ingesta no todas las encuestas de alimentación son comparables y válidas. El procedimiento de referencia para valorar la ingesta de sal consiste en medir la excreción urinaria de sodio en orina recolectada durante 24 h, aunque se han propuesto métodos alternativos, como las recolecciones de muestras de orina puntuales y cronometradas. En esta revisión analizamos qué instrumentos permiten valorar la ingesta de sal y cuáles de ellos han aportado una mayor validez y fiabilidad a través de los estudios de concordancia con la eliminación de sodio en orina. Las encuestas actuales de consumo de alimentos son inadecuados debido a su amplia variabilidad y relativamente baja correlación con la eliminación de sodio en orina de 24 h. Su principal limitación es la necesidad de validación en diferentes grupos poblacionales. En Atención Primaria se debería valorar la ingesta de sal mediante la utilización de cuestionarios de frecuencia de consumo que recojan alimentos con elevado contenido en sal, el consumo de platos preelaborados y preguntas que cuantifiquen la adición de sal en la preparación de alimentos o en la mesa. Para la validación de estos cuestionarios debe emplearse como gold standard la eliminación de sodio en orina de 24 h ajustada según el aclaramiento de creatinina


High blood pressure (HBP) is the main modifiable cardiovascular risk factor. HBP can be related to high salt intake. To measure intake, not all feeding surveys are comparable and valid. The reference procedure for assessing salt intake consists of measuring the urinary excretion of sodium in urine collected during 24 hours, although alternative methods have been proposed, such as the collection of punctual and timed urine samples. In this review, we analyze which instruments allow the assessment of salt intake and which of them have provided greater validity and reliability through studies of concordance with the elimination of sodium in urine. Current food consumption surveys are inadequate because of their wide variability and relatively low correlation with the elimination of sodium in 24-hour urine. Its main limitation is the need for validation in different population groups. In primary care, salt intake should be assessed by using frequency-of-consumption questionnaires that collect foods with a high salt content, the consumption of preprepared dishes and questions that quantify the addition of salt in the preparation of food or at the table. For the validation of these questionnaires, the standard gold elimination of 24-hour urine sodium adjusted according to creatinine clearance should be used


Assuntos
Humanos , Criança , Adolescente , Adulto , Hipertensão , Doenças Cardiovasculares/prevenção & controle , Sódio/administração & dosagem , Sódio na Dieta/uso terapêutico , Natriurese , Doenças Cardiovasculares/dietoterapia , Sódio/urina , Promoção da Saúde
13.
Nutrients ; 11(11)2019 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-31718066

RESUMO

Cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) are two chronic diseases that have claimed more lives globally than any other disease. Dietary supplementation of functional foods containing bioactive compounds is recognised to result in improvements in free-radical-mediated oxidative stress. Emerging evidence indicates that bioactive compounds derived from rice bran (RB) have therapeutic potential against cellular oxidative stress. This review aims to describe the mechanistic pathways behind CVD and T2DM development and the therapeutic potential of polyphenols derived from RB against these chronic diseases.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus Tipo 2 , Fibras na Dieta , Oryza , Animais , Doenças Cardiovasculares/dietoterapia , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus Tipo 2/dietoterapia , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/prevenção & controle , Alimento Funcional , Humanos , Polifenóis , Ratos , Fatores de Risco
14.
Curr Cardiol Rep ; 21(11): 132, 2019 10 17.
Artigo em Inglês | MEDLINE | ID: mdl-31624930

RESUMO

PURPOSE OF REVIEW: This review presents the current available evidence of the effects of several dietary patterns on atherosclerotic cardiovascular disease (ASCVD) risk in patients with type 2 diabetes (T2D). RECENT FINDINGS: Evidence demonstrates improvements in cardiovascular risk factors with some dietary patterns in the general population. However, evidence is limited for glycemic control and cardiovascular benefit in patients with T2D for Dietary Approaches to Stop Hypertension and plant-based dietary patterns. Evidence suggests that carbohydrate-restricted dietary patterns improve glycemic control and decrease the use of anti-hyperglycemic medications. The Mediterranean dietary pattern has the most evidence for glycemic control and decreased ASCVD risk in patients with T2D. There is no evidence on ASCVD outcomes in patients with T2D for any other dietary pattern. The Mediterranean dietary pattern has the most evidence for cardiovascular benefit in patients with T2D. Future research should examine the effect of dietary patterns on ASCVD outcomes.


Assuntos
Aterosclerose/dietoterapia , Doenças Cardiovasculares/dietoterapia , Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus Tipo 2/complicações , Aterosclerose/etiologia , Aterosclerose/prevenção & controle , Doenças Cardiovasculares/etiologia , Dieta , Humanos
15.
Food Funct ; 10(11): 6987-6998, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31637390

RESUMO

Cardiovascular disease (CVD) is the greatest cause of premature death and disability globally. Consequently, numerous therapeutic strategies have been developed in order to prevent the onset of adverse cardiovascular events including nutritional approaches. This includes strawberries as they have a high oxidant and micronutrient content, so we examined the extent to which dietary supplementation impacts on CVD risk factors. A comprehensive literature search without any limitation on language was conducted using the following bibliographical databases: ISI Web of Science, Scopus, PubMed and Cochrane Library. Search was conducted between 1985 and February 2019. The mean difference (MD) of the reported effects was calculated using a random effect model. A total of 20 groups from 14 clinical trials were included for final analysis. The pooled effect size showed that strawberry supplementation decreased circulating oxidized LDL (MD = -5.8 ng ml-1, p = 0.012), malondialdehyde (0.309 µmol L-1, p = 0.002), C-reactive protein (MD = -0.472 mg L-1, p = 0.003), total cholesterol (MD = -6.49 mg dL-1, p = 0.019), and diastolic blood pressure (MD = -2.220 mmHg, p = 0.033). It also demonstrated raised fasting blood sugar (MD = 2.083 mg dl-1; p = 0.040), but had no effect on other CVD risk factors examined. Dietary supplementation with strawberries improved specific CVD risk factors, suggesting that larger well-designed, adequately powered, and longer-term follow up studies should now be undertaken.


Assuntos
Doenças Cardiovasculares/dietoterapia , Fragaria/metabolismo , Adulto , Pressão Sanguínea , Doenças Cardiovasculares/genética , Doenças Cardiovasculares/metabolismo , Doenças Cardiovasculares/fisiopatologia , HDL-Colesterol/metabolismo , LDL-Colesterol/metabolismo , Feminino , Fragaria/química , Frutas/química , Frutas/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados Aleatórios como Assunto , Adulto Jovem
17.
Adv Exp Med Biol ; 1178: 113-127, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31493225

RESUMO

Both morbidity and mortality due to cardiovascular diseases (CVDs) elevate with age. The elevated prevalence of cardiovascular risk factors with age and cardiovascular aging contribute to the relationship between aging and CVDs. Dietary restriction (DR) consisting of calorie restriction (CR) and alternate-day fasting (ADF) is an approved nutritional intervention and shows anti-aging impacts. Recent studies demonstrate that DR makes an active defense response in stressful states. At the core of this response are cardiovascular protective signals, which consist of the mammalian target of rapamycin (mTOR), AMP-activated kinase, sirtuins and endothelial nitric oxide synthase. These make a network with positive and negative feedback regulation. Hence, DR is a hopeful intervention for controlling cardiovascular aging and managing individuals with CVDs.


Assuntos
Restrição Calórica , Doenças Cardiovasculares , Jejum , Envelhecimento/fisiologia , Doenças Cardiovasculares/dietoterapia , Humanos
18.
Arch. prev. riesgos labor. (Ed. impr.) ; 22(3): 129-133, jul.-sept. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-186415

RESUMO

Se presenta el caso de un profesor de 47 años, no fumador, con riesgo-cardiovascular (RCV) moderado (2%) según HeartScore: obesidad (Índice-masa-muscular: 32,8 kg/m2); índice cintura-cadera: 1,08, tensión-arterial alta: 150/101mmHg, hipercolesterolemia: 223 mg/dl. La anamnesis-alimentaria inicial (2016) muestra consumo: 2100 kcal/día (distribuidas en 24% proteínas, 45% grasas, 31% carbohidratos) y, potasio (51%) y vitamina-D (42%) bajos; consume 2 bebidas-alcohólicas/semana. El tratamiento dietético consistió en 2500kcal/día (distribuidas en 14% proteína, 32% grasas, 51% carbohidratos) y aumento vitamina-D (10,50 μg/día), basado en directrices de la Guía Europea de Prevención Cardiovascular. Después de 1 año de tratamiento se mostraron cambios favorables: Índice-masa-muscular (30,5 kg/m2), índice cintura-cadera (0,98), tensión-arterial (128/90mmHg) evidenciados por datos bioquímicos y dietéticos. Este artículo presenta aspectos relevantes de una intervención dietético-nutricional individualizada de factores de RCV en el ámbito laboral y destacan las competencias del dietista-nutricionista y la coordinación del Servicio-Prevención-universitario como activos de salud comunitarios, para revertir parámetros de RCV especialmente antropométricos y tensión-arterial


We present the case of a 47 year old nonsmoking university professor with moderate cardiovascular risk (CVR) (2%) according to HeartS-core: obesity (body mass index, 32.8kg/m2); waist-to-hip ratio: 1.08; high blood pressure, 150/101 mmHg; and hypercholesterolemia: 223 mg/dL). The initial food inventory (2016) showed a consumption pattern of 2100 kcal/day (24% proteins, 45% fats, 31% carbohydrates); low intake of potassium (51%) and vitamin-D (42%); consumption of two alcoholic drinks/ per week. Dietary treatment consisted of 2500 kcal/day (distributed as 14% protein, 32% fat, 51% carbohydrates), and increased vitamin D intake (10.50 μg/day), following the European Cardiovascular Prevention Guide. Favorable changes were apparent after one year of treatment: body mass index (30.5kg/m2), waist-to-hip ratio (0.98), blood pressure (128/90mmHg), supported by laboratory and dietary data. This article presents relevant aspects of an individualized nutritional intervention targeting CVR factors in the workplace. It highlights the competencies of the dietitian and the coordination of the university-based occupational health service as community health assets, to revert CVR parameters, especially anthropometric and blood pressure data


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/dietoterapia , Doenças Cardiovasculares/dietoterapia , Doenças Cardiovasculares/prevenção & controle , Terapia Nutricional/métodos , Serviços de Saúde do Trabalhador , Fatores de Risco
19.
J Oleo Sci ; 68(9): 811-816, 2019 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-31413246

RESUMO

Cardiovascular disease (CVD) has emerged as the leading cause of dealth worldwide today. Lowering circulating total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) is one of the most effective approaches of CVD prevention. Dietary guidelines and health organizations approved using plant sterols (PS) as the alternative to conventional method in attenuating circulating TC and LDL-C levels and risk of CVD. However, current findings apprear to be controversial on the efficacy of PS. Giving the rise of the field "Nutrigenetics", single nucleotide polymorphisms (SNPs) such as CYP7A1-rs3808607 have been identified that strongly associate with cholesterol metabolism in response to PS intake, towards causing inter-individual variations. This review article aims to discuss the efficacy of dietary PS in managing cholesterol levels based on findings from recent studies. The scope includes reviewing evidence on supporting the efficacy, the metabolic claims, inter-individual variations as well as sitosterolemia associated with PS intake.


Assuntos
Anticolesterolemiantes/uso terapêutico , Fitosteróis/uso terapêutico , Animais , Anticolesterolemiantes/efeitos adversos , Doenças Cardiovasculares/dietoterapia , Colesterol/sangue , Colesterol/metabolismo , Colesterol 7-alfa-Hidroxilase/genética , LDL-Colesterol/sangue , LDL-Colesterol/metabolismo , Humanos , Fitosteróis/efeitos adversos , Polimorfismo de Nucleotídeo Único
20.
Clín. investig. arterioscler. (Ed. impr.) ; 31(4): 186-201, jul.-ago. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-182713

RESUMO

El actual paradigma en las ciencias de la nutrición establece que la unidad nutricional básica no son los nutrientes, sino los alimentos que los contienen (aceites, frutos secos, productos lácteos, huevos, carnes rojas o procesadas, etc.), que actúan como matriz alimentaria en la que los diferentes nutrientes modulan sinérgica o antagónicamente sus efectos sobre diversas vías metabólicas determinantes para la salud y la enfermedad. La alimentación no se basa en nutrientes ni en alimentos aislados sino en complejas mezclas de unos y otros que forman parte de un patrón alimentario concreto, concepto que se ha señalado como el más pertinente para evaluar las asociaciones entre nutrición y salud o enfermedad. Este documento resume las evidencias disponibles sobre la relación existente entre los diferentes alimentos y la salud cardiovascular, y ofrece recomendaciones sencillas para ser implementadas en el consejo dietético que se ofrezca por parte del profesional sanitario


The current paradigm in the nutrition sciences states that the basic nutritional unit is not the nutrients, but the foods that contain them (oils, nuts, dairy products, eggs, red or processed meats, etc.). These act as a food matrix in which the different nutrients synergistically or antagonistically modulate their effects on the various metabolic pathways determining health and disease. Food is not based on nutrients or isolated foods but on complex mixtures of one and the other that are part of a specific food pattern, a concept that has been targeted as the most pertinent to evaluate the associations between nutrition and health or disease. This document presents a summary of the available evidence on the relationship between different foods and cardiovascular health, and offers simple recommendations to be implemented in the dietary advice offered by the health professional


Assuntos
Humanos , Consenso , Doenças Cardiovasculares/dietoterapia , Doenças Cardiovasculares/prevenção & controle , Atenção Primária à Saúde , Estilo de Vida , Dieta Mediterrânea , Gorduras na Dieta , Consumo de Alimentos
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