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Ahmed FS, Wade AT, Guenther BA, Murphy KJ, Elias MF. Adherence to a Mediterranean diet associated with lower blood pressure in a US sample: Findings from the Maine-Syracuse Longitudinal Study. J Clin Hypertens (Greenwich) 2020; 22:2276-2284. [PMID: 33045144 DOI: 10.1111/jch.14068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/04/2020] [Accepted: 09/12/2020] [Indexed: 11/30/2022]
Abstract
Hypertension is a key modifiable risk factor for cardiovascular disease. The Mediterranean diet (MedDiet) may be associated with improvements in blood pressure. However, few studies have examined the association between MedDiet adherence and blood pressure in non-Mediterranean populations, and findings are mixed. We analyzed cross-sectional data (Wave 6) for 851 participants of the Maine-Syracuse Longitudinal Study. MedDiet adherence was calculated using food frequency questionnaire data and a literature-based MedDiet adherence score. Dependent variables included systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), and mean arterial pressure (MAP). Separate linear robust regression analyses revealed significant associations between MedDiet adherence and for SBP (b = -0.69, 95% CI = [-1.25, -0.20]), DBP (b = -0.33, 95% CI = [-0.58, -0.04]), and MAP (b = -0.45, 95% CI = [-0.77, -0.11]), but not for PP. These findings indicate that the MedDiet is associated with some metrics of blood pressure in a large, community-based, non-Mediterranean sample.
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Affiliation(s)
- Fayeza S Ahmed
- Department of Psychology, University of Maine, Orono, ME, USA
| | - Alexandra T Wade
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | | | - Karen J Murphy
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia.,Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Merrill F Elias
- Department of Psychology, University of Maine, Orono, ME, USA.,Graduate School of Biomedical Science and Engineering, University of Maine, Orono, ME, USA
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102
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Oliveira M, De Gasperi Portella C, Ramalhosa MJ, Delerue-Matos C, Sant'Ana LS, Morais S. Polycyclic aromatic hydrocarbons in wild and farmed whitemouth croaker and meagre from different Atlantic Ocean fishing areas: Concentrations and human health risk assessment. Food Chem Toxicol 2020; 146:111797. [PMID: 33027612 DOI: 10.1016/j.fct.2020.111797] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/27/2020] [Accepted: 09/29/2020] [Indexed: 02/06/2023]
Abstract
This work assessed the concentrations of 18 polycyclic aromatic hydrocarbons (PAHs) in edible tissues of whitemouth croaker (Micropogonias furnieri) and meagre (Argyrosomus regius) captured in different Atlantic Ocean fishing areas and available to Brazilian and Portuguese consumers. Total PAH (∑PAHs) levels ranged from 1.32 to 5.41 μg/kg ww in wild-caught croaker and 2.66 (wild)-18.0 (farmed) μg/kg ww in meagre. Compounds with 2- and 3-rings represented 54-86% of ∑PAHs in the muscle tissues of wild-caught species (croaker and meagre) being naphthalene, fluorene, and phenanthrene the predominant compounds. ∑PAHs in farmed meagre were 4-7 times higher than in wild-caught meagre, with 2-, 3-, 4-, 5-, and 6-ring compounds representing 15, 18, 44, 22, and 1% of ∑PAHs, respectively. Benzo(a)pyrene levels in farmed meagre varied between 0.06 and 0.34 μg/kg ww. Crude oil refining and combustion sources were identified as the major sources of PAHs in FAO 27, 34 and 41 Atlantic Ocean fishing areas. The biometric characteristics (length, weight, moisture, and fat content) and ∑PAHs allowed to discriminate between wild-caught and farmed meagre samples and between meagre and croaker. Assessment of carcinogenic risks suggested that a diet exclusive on farmed meagre may pose additional risks for the health of European top consumers fish.
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Affiliation(s)
- Marta Oliveira
- REQUIMTE-LAQV, Instituto Superior de Engenharia, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida 431, 4249-015, Porto, Portugal
| | - Carolina De Gasperi Portella
- REQUIMTE-LAQV, Instituto Superior de Engenharia, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida 431, 4249-015, Porto, Portugal; UNESP, Centro de Aquicultura (CAUNESP), Via de Acesso Prof. Paulo Donato Castellane s/n, Jaboticabal, São Paulo, Brazil
| | - Maria João Ramalhosa
- REQUIMTE-LAQV, Instituto Superior de Engenharia, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida 431, 4249-015, Porto, Portugal
| | - Cristina Delerue-Matos
- REQUIMTE-LAQV, Instituto Superior de Engenharia, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida 431, 4249-015, Porto, Portugal
| | - L S Sant'Ana
- UNESP, Centro de Aquicultura (CAUNESP), Via de Acesso Prof. Paulo Donato Castellane s/n, Jaboticabal, São Paulo, Brazil
| | - Simone Morais
- REQUIMTE-LAQV, Instituto Superior de Engenharia, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida 431, 4249-015, Porto, Portugal.
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103
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Jalilpiran Y, Darooghegi Mofrad M, Mozaffari H, Bellissimo N, Azadbakht L. Adherence to dietary approaches to stop hypertension (DASH) and Mediterranean dietary patterns in relation to cardiovascular risk factors in older adults. Clin Nutr ESPEN 2020; 39:87-95. [DOI: 10.1016/j.clnesp.2020.07.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 07/21/2020] [Accepted: 07/24/2020] [Indexed: 01/28/2023]
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104
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Marcos-Pardo PJ, González-Gálvez N, Espeso-García A, Abelleira-Lamela T, López-Vivancos A, Vaquero-Cristóbal R. Association among Adherence to the Mediterranean Diet, Cardiorespiratory Fitness, Cardiovascular, Obesity, and Anthropometric Variables of Overweight and Obese Middle-Aged and Older Adults. Nutrients 2020; 12:nu12092750. [PMID: 32927609 PMCID: PMC7551167 DOI: 10.3390/nu12092750] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/07/2020] [Accepted: 09/07/2020] [Indexed: 02/06/2023] Open
Abstract
The aim of this study was to evaluate the independent and combined associations between adherence to the Mediterranean diet (AMedDiet), cardiorespiratory fitness (CRF), and different parameters of overweight and obese middle-aged and older adults. Sixty-two participants were enrolled in this cross-sectional study. Fat mass was measured with Dual energy X-ray absorptiometry. AMedDiet and physical activity (PA) were assessed with the PREDIMED and Global PA Questionnaire (GPAQ). Maximal aerobic power was assessed using the 6-min walk test. Systolic (SBP) and diastolic (DBP) blood pressure (BP) were measured with Omron M6, and double product (DP) and mean BP (MBP) were calculated. Kinanthropometry proportionality variables related to obesity were also calculated. Participants with a low CRF as an independent factor or together with a low AMedDiet obtained significantly higher BP, total and trunk fat mass, and proportionality variables (all p ˂ 0.0001). According to the multiple nonlinear regression analysis, Vo2max, AMedDiet, and sex explained 53.4% of SBP, with this formula: 238.611 − (3.63*Vo2max) + (0.044*Vo2max2) − (13.051*AMedDiet) + (0.68*AMedDiet2) + (12.887*sex). SBP and p rediction SBP with the new formula showed a correlation of 0.731 (p ˂ 0.0001); showing a difference between the values of −0.278 (p = 0.883). In conclusion, CRF as an independent factor and combined with AMedDiet can be associated with BP, body composition, and proportionality in overweight and obese middle-aged and older adults.
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Affiliation(s)
- Pablo J. Marcos-Pardo
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM), Catholic University San Antonio of Murcia, Campus de los Jerónimos, Guadalupe, 30107 Murcia, Spain; (P.J.M.-P.); (A.E.-G.); (T.A.-L.); (A.L.-V.)
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain;
| | - Noelia González-Gálvez
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM), Catholic University San Antonio of Murcia, Campus de los Jerónimos, Guadalupe, 30107 Murcia, Spain; (P.J.M.-P.); (A.E.-G.); (T.A.-L.); (A.L.-V.)
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain;
- Correspondence: ; Tel.: +34-968-278-824
| | - Alejandro Espeso-García
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM), Catholic University San Antonio of Murcia, Campus de los Jerónimos, Guadalupe, 30107 Murcia, Spain; (P.J.M.-P.); (A.E.-G.); (T.A.-L.); (A.L.-V.)
| | - Tomás Abelleira-Lamela
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM), Catholic University San Antonio of Murcia, Campus de los Jerónimos, Guadalupe, 30107 Murcia, Spain; (P.J.M.-P.); (A.E.-G.); (T.A.-L.); (A.L.-V.)
| | - Abraham López-Vivancos
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM), Catholic University San Antonio of Murcia, Campus de los Jerónimos, Guadalupe, 30107 Murcia, Spain; (P.J.M.-P.); (A.E.-G.); (T.A.-L.); (A.L.-V.)
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain;
| | - Raquel Vaquero-Cristóbal
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain;
- Sports Injury Prevention Research Group, Catholic University San Antonio of Murcia, Campus de los Jerónimos, Guadalupe, 30107 Murcia, Spain
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105
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Lantseva MA, Sasunova AN, Vlasova AV, Kropochev VS, Pilipenko VI, Morozov SV, Isakov VA. [Association of nutritional patterns and arterial hypertension in Russia: does it exist?]. TERAPEVT ARKH 2020; 92:79-85. [PMID: 33346466 DOI: 10.26442/00403660.2020.08.000771] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Indexed: 02/07/2023]
Abstract
AIM To evaluate nutritional patterns in patient with arterial hypertension (AH) compared to the control group without elevated blood pressure. MATERIALS AND METHODS Retrospective search for unique records of the patients aged 1875 y.o. with complete data on usual nutrition with food frequency methods who had no mentions of diabetes mellitus, food intolerance or allergies, and history of major abdominal surgery, as well as signs of secondary reasons of AH. Nutritional patterns were assessed with the use of healthy eating pyramid principles. Ststistical analysis was performed with the use of SPSS 13.0 for Windows software (SPSS Inc., USA). RESULTS The data of 711 patients were available for the final analysis (595 of them in AH group). Both groups consumed lower compared to the recommended amounts of fruits, dairy and higher amounts of meat. Those with AH consumed larger amounts of vegetables (1.130.74 compared to the values of healthy eating pyramid vs 0.940.63 in the control group; p=0.004), fruits (0.800.66 vs 0.520.57; p=0.001), meat (1.851.05 vs 1.620.91; p=0.002) and fats (0.770.60 vs 0.490.55; p=0.001). On the other hand, there were lower rates of consumption of sugars, and confectionaries in the structure of nutritional patterns in patients with AH compared to the control group: (0.350.44 of the healthy eating pyramid in AH vs 1.930.98, in the control group; p=0.0001). CONCLUSION Nutritional patterns of patients with arterial hypertension significantly differ compared to the control group. The obtained data may be used for diet modification in patients with arterial hypertension.
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Affiliation(s)
- M A Lantseva
- Federal Research Centre of Nutrition, Biotechnology and Food Safety
| | - A N Sasunova
- Federal Research Centre of Nutrition, Biotechnology and Food Safety
| | - A V Vlasova
- Federal Research Centre of Nutrition, Biotechnology and Food Safety
| | - V S Kropochev
- Federal Research Centre of Nutrition, Biotechnology and Food Safety
| | - V I Pilipenko
- Federal Research Centre of Nutrition, Biotechnology and Food Safety
| | - S V Morozov
- Federal Research Centre of Nutrition, Biotechnology and Food Safety
| | - V A Isakov
- Federal Research Centre of Nutrition, Biotechnology and Food Safety
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106
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The Japanese Society of Hypertension Guidelines for the Management of Hypertension (JSH 2019). Hypertens Res 2020; 42:1235-1481. [PMID: 31375757 DOI: 10.1038/s41440-019-0284-9] [Citation(s) in RCA: 964] [Impact Index Per Article: 241.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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107
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Food processing and risk of hypertension: Cohort of Universities of Minas Gerais, Brazil (CUME Project). Public Health Nutr 2020; 24:4071-4079. [DOI: 10.1017/s1368980020002074] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AbstractObjective:To analyse the association between food consumption according to the degree of processing and incidence of hypertension in CUME project participants.Design:Longitudinal study in which food consumption was evaluated according to the percentage contribution of daily energetic intake (%/d) of each NOVA classification group (unprocessed/minimally processed foods and culinary preparations (U/MPF&CP); processed foods and ultra-processed foods (UPF)). Hypertension was defined according to American College of Cardiology/American Heart Association (ACC/AHA) criteria. Adjusted relative risks (RR) and their 95% confidence intervals (95 % CI) were estimated by Poisson regression models with robust variances.Setting:Brazil.Participants:1221 graduates classified as non-hypertensive at baseline and monitored for 2 years.Results:Daily energetic percentage from each group according to degree of processing was 64·3 (sd 12) % for U/MPF&CP; 9·9 (sd 5·8) % for processed foods and 25·8 (sd 11) % for UPF. Incidence of hypertension was high (152/1000 person-years; n 113, 193/1000 person-years in males and n 257, 138/1000 person-years in females). After adjusting for potential confounders, participants in the upper quintile of daily energetic intake of U/MPF&CP presented a reduced risk of hypertension (RR: 0·72; 95 % CI 0·52, 0·98), while those in the upper quintile of daily energetic intake of UPF presented an increased risk of the outcome (RR: 1·35; 95 % CI 1·01, 1·81).Conclusions:In this prospective cohort of Brazilian middle-aged adult university graduates, the highest consumptions of U/MPF&CP and UPF were associated with, respectively, reduced and increased risk of hypertension. Additional longitudinal studies are needed to confirm our results.
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108
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Nobles CJ, Mendola P, Mumford SL, Silver RM, Kim K, Andriessen VC, Connell M, Sjaarda L, Perkins NJ, Schisterman EF. Preconception Blood Pressure and Its Change Into Early Pregnancy: Early Risk Factors for Preeclampsia and Gestational Hypertension. Hypertension 2020; 76:922-929. [PMID: 32755413 DOI: 10.1161/hypertensionaha.120.14875] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Preeclampsia and gestational hypertension are common complications of pregnancy associated with significant maternal and infant morbidity. Despite extensive research evaluating risk factors during pregnancy, most women who develop a hypertensive disorder of pregnancy are not considered high-risk and strategies for prevention remain elusive. We evaluated preconception blood pressure and its change into early pregnancy as novel risk markers for development of a hypertensive disorder of pregnancy. The EAGeR (Effects of Aspirin in Gestation and Reproduction) trial (2007-2011) randomized 1228 healthy women with a history of pregnancy loss to preconception-initiated low-dose aspirin versus placebo and followed participants for up to 6 menstrual cycles attempting pregnancy and throughout pregnancy if they became pregnant. Blood pressure was measured during preconception and throughout early gestation. The primary outcomes, preterm preeclampsia, term preeclampsia, and gestational hypertension, were abstracted from medical records. Among 586 women with a pregnancy >20 weeks' gestation, preconception blood pressure levels were higher for preterm preeclampsia (87.3±6.7 mm Hg mean arterial pressure), term preeclampsia (88.3±9.8 mm Hg), and gestational hypertension (87.9±9.1 mm Hg) as compared with no hypertensive disorder of pregnancy (83.9±8.6 mm Hg). Change in blood pressure from preconception into very early pregnancy was associated with development of preeclampsia (relative risk, 1.13 [95% CI, 1.02-1.25] per 2 mm Hg increase in mean arterial pressure at 4 weeks' gestation), particularly preterm preeclampsia (relative risk, 1.21 [95% CI, 1.01-1.45]). Randomization to aspirin did not alter blood pressure trajectory or risk of hypertension in pregnancy. Preconception blood pressure and longitudinal changes during early pregnancy are underexplored but crucial windows in the detection and prevention of hypertensive disorders of pregnancy. Registration- URL: http://www.clinicaltrials.gov. Unique identifier: NCT00467363.
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Affiliation(s)
- Carrie J Nobles
- From the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (C.J.N., P.M., S.L.M., K.K., V.C.A., M.C., L.S., N.J.P., E.F.S.)
| | - Pauline Mendola
- From the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (C.J.N., P.M., S.L.M., K.K., V.C.A., M.C., L.S., N.J.P., E.F.S.)
| | - Sunni L Mumford
- From the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (C.J.N., P.M., S.L.M., K.K., V.C.A., M.C., L.S., N.J.P., E.F.S.)
| | - Robert M Silver
- Obstetrics and Gynecology, School of Medicine, University of Utah (R.M.S.)
| | - Keewan Kim
- From the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (C.J.N., P.M., S.L.M., K.K., V.C.A., M.C., L.S., N.J.P., E.F.S.)
| | - Victoria C Andriessen
- From the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (C.J.N., P.M., S.L.M., K.K., V.C.A., M.C., L.S., N.J.P., E.F.S.)
| | - Matthew Connell
- From the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (C.J.N., P.M., S.L.M., K.K., V.C.A., M.C., L.S., N.J.P., E.F.S.)
| | - Lindsey Sjaarda
- From the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (C.J.N., P.M., S.L.M., K.K., V.C.A., M.C., L.S., N.J.P., E.F.S.)
| | - Neil J Perkins
- From the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (C.J.N., P.M., S.L.M., K.K., V.C.A., M.C., L.S., N.J.P., E.F.S.)
| | - Enrique F Schisterman
- From the Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (C.J.N., P.M., S.L.M., K.K., V.C.A., M.C., L.S., N.J.P., E.F.S.)
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109
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Cano A, Marshall S, Zolfaroli I, Bitzer J, Ceausu I, Chedraui P, Durmusoglu F, Erkkola R, Goulis DG, Hirschberg AL, Kiesel L, Lopes P, Pines A, van Trotsenburg M, Lambrinoudaki I, Rees M. The Mediterranean diet and menopausal health: An EMAS position statement. Maturitas 2020; 139:90-97. [PMID: 32682573 DOI: 10.1016/j.maturitas.2020.07.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Globally, 985 million women are aged 50 and over, leading to increasing concerns about chronic conditions such as cardiovascular disease, osteoporosis, dementia, and cognitive decline, which can adversely affect quality of life and independent living. AIM To evaluate the evidence from observational studies and randomized trials on the effects of the Mediterranean diet on short- and long-term menopausal health: estrogen deficiency symptoms, cardiovascular disease, osteoporosis, cognitive and mental health, breast cancer, and all-cause mortality. MATERIALS AND METHODS Literature review and consensus of expert opinion. SUMMARY RECOMMENDATIONS The Mediterranean diet is a non-restrictive dietary pattern common in the olive-growing areas of the Mediterranean basin. It may improve vasomotor symptoms, cardiovascular risk factors such as blood pressure, cholesterol and blood glucose levels, as well as mood and symptoms of depression. Long-term adherence may: improve cardiovascular risk and events, and death; improve bone mineral density; prevent cognitive decline; and reduce the risk of breast cancer and all-cause mortality.
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Affiliation(s)
- Antonio Cano
- Department of Pediatrics, Obstetrics and Gynecology, University of Valencia and INCLIVA, Valencia, Spain.
| | - Skye Marshall
- Nutrition Research Australia, New South Wales, Australia; Bond University Nutrition & Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia
| | - Irene Zolfaroli
- Department of Pediatrics, Obstetrics and Gynecology, University of Valencia and INCLIVA, Valencia, Spain
| | - Johannes Bitzer
- Department of Obstetrics and Gynecology, University Hospital, Basel, Switzerland
| | - Iuliana Ceausu
- Department of Obstetrics and Gynecology I, "Dr. I. Cantacuzino" Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Peter Chedraui
- Instituto de Investigación e Innovación de Salud Integral (ISAIN), Facultad de Ciencias Médicas, Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador
| | - Fatih Durmusoglu
- Istanbul Medipol International School of Medicine, Istanbul, Turkey
| | - Risto Erkkola
- Department of Obstetrics and Gynecology, University Central Hospital Turku, Finland
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Greece
| | - Angelica Lindén Hirschberg
- Department of Women's and Children's Health, Karolinska Institutet and Department of Gynecology and Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Ludwig Kiesel
- Department of Gynecology and Obstetrics, University of Münster, Münster, Germany
| | - Patrice Lopes
- Nantes, France Polyclinique de l'Atlantique Saint Herblain, F 44819 St Herblain France, Université de Nantes F 44093 Nantes Cedex, France
| | - Amos Pines
- Sackler Faculty of Medicine, Tel-Aviv University, Israel
| | - Mick van Trotsenburg
- Department of Obstetrics and Gynecology, University Hospital St. Poelten-Lilienfeld, Austria
| | - Irene Lambrinoudaki
- Second Department of Obstetrics and Gynecology, Aretaieio Hospital, Medical School, National and Kapodistrian University of Athens, Greece
| | - Margaret Rees
- Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK
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110
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Dinu M, Pagliai G, Angelino D, Rosi A, Dall'Asta M, Bresciani L, Ferraris C, Guglielmetti M, Godos J, Del Bo’ C, Nucci D, Meroni E, Landini L, Martini D, Sofi F. Effects of Popular Diets on Anthropometric and Cardiometabolic Parameters: An Umbrella Review of Meta-Analyses of Randomized Controlled Trials. Adv Nutr 2020; 11:815-833. [PMID: 32059053 PMCID: PMC7360456 DOI: 10.1093/advances/nmaa006] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 11/19/2019] [Accepted: 01/14/2020] [Indexed: 12/14/2022] Open
Abstract
The prevalence of overweight, obesity, and their related complications is increasing worldwide. The purpose of this umbrella review was to summarize and critically evaluate the effects of different diets on anthropometric parameters and cardiometabolic risk factors. Medline, Embase, Scopus, Cochrane Database of Systematic Reviews, and Web of Science, from inception to April 2019, were used as data sources to select meta-analyses of randomized controlled trials that examined the effects of different diets on anthropometric parameters and cardiometabolic risk factors. Strength and validity of the evidence were assessed through a set of predefined criteria. Eighty articles reporting 495 unique meta-analyses were examined, covering a wide range of popular diets: low-carbohydrate (n = 21 articles), high-protein (n = 8), low-fat (n = 9), paleolithic (n = 2), low-glycemic-index/load (n = 12), intermittent energy restriction (n = 6), Mediterranean (n = 11), Nordic (n = 2), vegetarian (n = 9), Dietary Approaches to Stop Hypertension (DASH) (n = 6), and portfolio dietary pattern (n = 1). Great variability in terms of definition of the intervention and control diets was observed. The methodological quality of most articles (n = 65; 81%), evaluated using the "A MeaSurement Tool to Assess systematic Reviews-2" questionnaire, was low or critically low. The strength of evidence was generally weak. The most consistent evidence was reported for the Mediterranean diet, with suggestive evidence of an improvement in weight, BMI, total cholesterol, glucose, and blood pressure. Suggestive evidence of an improvement in weight and blood pressure was also reported for the DASH diet. Low-carbohydrate, high-protein, low-fat, and low-glycemic-index/load diets showed suggestive and/or weak evidence of a reduction in weight and BMI, but contrasting evidence for lipid, glycemic, and blood pressure parameters, suggesting potential risks of unfavorable effects. Evidence for paleolithic, intermittent energy restriction, Nordic, vegetarian, and portfolio dietary patterns was graded as weak. Among all the diets evaluated, the Mediterranean diet had the strongest and most consistent evidence of a beneficial effect on both anthropometric parameters and cardiometabolic risk factors. This review protocol was registered at www.crd.york.ac.uk/PROSPERO/ as CRD42019126103.
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Affiliation(s)
- Monica Dinu
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Giuditta Pagliai
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Donato Angelino
- Faculty of Bioscience and Technology for Food, Agriculture, and Environment, University of Teramo, Teramo, Italy
| | - Alice Rosi
- Human Nutrition Unit, Department of Food and Drug, University of Parma, Parma, Italy
| | - Margherita Dall'Asta
- Department of Animal Science, Food, and Nutrition, Università Cattolica del Sacro Cuore, Piacenza, Italy
| | - Letizia Bresciani
- Human Nutrition Unit, Department of Veterinary Science, University of Parma, Parma, Italy
| | - Cinzia Ferraris
- Human Nutrition and Eating Disorder Research Center, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Monica Guglielmetti
- Human Nutrition and Eating Disorder Research Center, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | | | - Cristian Del Bo’
- Department of Food, Environmental, and Nutritional Sciences, Università degli Studi di Milano, Milan, Italy
| | - Daniele Nucci
- Digestive Endoscopy Unit, Veneto Institute of Oncology, Padua, Italy
| | - Erika Meroni
- Department of Food, Environmental, and Nutritional Sciences, Università degli Studi di Milano, Milan, Italy
| | - Linda Landini
- Medical Affairs Janssen, Cologno-Monzese, Milan, Italy
| | | | - Francesco Sofi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- Unit of Clinical Nutrition, University Hospital of Careggi, Florence, Italy
- Don Carlo Gnocchi Foundation Italy, Onlus, Florence, Italy
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111
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Healthy and unhealthy dietary patterns and the risk of chronic disease: an umbrella review of meta-analyses of prospective cohort studies. Br J Nutr 2020; 124:1133-1144. [PMID: 32600500 DOI: 10.1017/s0007114520002330] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
We aimed to fully review the association of empirical dietary patterns with the risk of non-communicable chronic diseases and to rate the quality of the evidence. Published meta-analyses of observational studies investigating the association of empirically derived dietary patterns with the risk of chronic diseases were identified by searching PubMed and Scopus till September 2019. Two independent reviewers extracted the information and rated the quality of the evidence by NutriGrade score. For each meta-analysis, cross-sectional and case–control studies were excluded and then summary relative risk was recalculated by using a random-effects model. Sixteen meta-analyses of prospective cohort studies, reporting eighteen SRR for healthy dietary patterns and sixteen SRR for unhealthy patterns obtained from 116 primary prospective cohort studies with 4·8 million participants, were included. There was moderate quality of evidence for the inverse association of healthy dietary patterns with the risk of type 2 diabetes (T2D), fracture and colorectal and breast cancers. There was also low-quality evidence for the inverse relation between healthy dietary patterns and the risk of all-cause and cardiovascular mortality, depression, CHD and respiratory diseases. There was moderate quality of evidence for a positive association between unhealthy dietary patterns and the risk of T2D, fracture and the metabolic syndrome. Adopting a healthy dietary pattern may reduce the risk of T2D, CHD and premature death. More research is needed for outcomes for which the quality of the evidence was rated low, such as respiratory disease, mental illness and site-specific cancers.
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Yasutake K, Imai K, Abe S, Iwamoto M, Kawate H, Moriguchi R, Ono M, Ueno H, Miya M, Tsuda H, Nakano S. Food intake and dietary patterns that affect urinary sodium excretion in young women. J Clin Hypertens (Greenwich) 2020; 22:1090-1097. [DOI: 10.1111/jch.13906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 04/16/2020] [Accepted: 04/20/2020] [Indexed: 11/27/2022]
Affiliation(s)
| | - Katsumi Imai
- Health Promotion Center Nakamura Gakuen University Fukuoka Japan
| | - Shimako Abe
- Health Promotion Center Nakamura Gakuen University Fukuoka Japan
| | - Masako Iwamoto
- Health Promotion Center Nakamura Gakuen University Fukuoka Japan
| | - Hisaya Kawate
- Health Promotion Center Nakamura Gakuen University Fukuoka Japan
| | - Ririko Moriguchi
- Health Promotion Center Nakamura Gakuen University Fukuoka Japan
| | - Misaki Ono
- Health Promotion Center Nakamura Gakuen University Fukuoka Japan
| | - Hiromi Ueno
- Health Promotion Center Nakamura Gakuen University Fukuoka Japan
| | - Mana Miya
- Health Promotion Center Nakamura Gakuen University Fukuoka Japan
| | - Hiroko Tsuda
- Health Promotion Center Nakamura Gakuen University Fukuoka Japan
| | - Shuji Nakano
- Health Promotion Center Nakamura Gakuen University Fukuoka Japan
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Effects of Vegetarian Diets on Blood Pressure Lowering: A Systematic Review with Meta-Analysis and Trial Sequential Analysis. Nutrients 2020; 12:nu12061604. [PMID: 32486102 PMCID: PMC7352826 DOI: 10.3390/nu12061604] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 03/26/2020] [Accepted: 03/27/2020] [Indexed: 12/27/2022] Open
Abstract
The beneficial effects of a vegetarian diet on blood pressure (BP) control have been reported in previous systematic reviews; however, so far, their relative effectiveness is not well established. Here, we performed a systematic review together with trial sequential analysis to determine the effect of a vegetarian diet on the reduction of blood pressure. We searched the randomized controlled trial (RCT) through Medline, PubMed and Cochrane Central Register. Fifteen eligible RCTs with 856 subjects were entered into the analysis. The pooled results demonstrated that vegetarian diet consumption significantly lowered the systolic blood pressure (weighted mean difference (WMD), −2.66 mmHg (95% confidence interval (CI) = −3.76, −1.55, p < 0.001) and diastolic BP was WMD, −1.69 95% CI = −2.97, −0.41, p < 0.001) as compared to an omnivorous diet. In subgroup analysis, a vegan diet demonstrated a greater reduction in systolic BP (WMD, −3.12 mmHg; 95% CI = −4.54, −1.70, p < 0.001) as compared with a lacto-ovo-vegetarian diet (WMD, −1.75 mmHg, 95% CI −5.38, 1.88, p = 0.05). The vegan diet has showed a similar trend in terms of diastolic blood pressure reduction (WMD, −1.92 mmHg (95% CI = −3.18, −0.66, p < 0.001) but those with a lacto-ovo-vegetarian diet showed no changes in diastolic BP reduction (WMD, 0.00, 95% CI = 0.00, 0.00), p = 0.432). In conclusion, vegetarian diets are associated with significant reductions in BP compared with omnivorous diets, suggesting that they may play a key role in the primary prevention and overall management of hypertension.
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Massaro M, Scoditti E, Carluccio MA, Calabriso N, Santarpino G, Verri T, De Caterina R. Effects of Olive Oil on Blood Pressure: Epidemiological, Clinical, and Mechanistic Evidence. Nutrients 2020; 12:nu12061548. [PMID: 32466599 PMCID: PMC7352724 DOI: 10.3390/nu12061548] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/21/2020] [Accepted: 05/22/2020] [Indexed: 12/14/2022] Open
Abstract
The increasing access to antihypertensive medications has improved longevity and quality of life in hypertensive patients. Nevertheless, hypertension still remains a major risk factor for stroke and myocardial infarction, suggesting the need to implement management of pre- and hypertensive patients. In addition to antihypertensive medications, lifestyle changes, including healthier dietary patterns, such as the Dietary Approaches to Stop Hypertension (DASH) and the Mediterranean diet, have been shown to favorably affect blood pressure and are now recommended as integrative tools in hypertension management. An analysis of the effects of nutritional components of the Mediterranean diet(s) on blood pressure has therefore become mandatory. After a literature review of the impact of Mediterranean diet(s) on cardiovascular risk factors, we here analyze the effects of olive oil and its major components on blood pressure in healthy and cardiovascular disease individuals and examine underlying mechanisms of action. Both experimental and human studies agree in showing anti-hypertensive effects of olive oil. We conclude that due to its high oleic acid and antioxidant polyphenol content, the consumption of olive oil may be advised as the optimal fat choice in the management protocols for hypertension in both healthy and cardiovascular disease patients.
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Affiliation(s)
- Marika Massaro
- National Research Council (CNR) Institute of Clinical Physiology, 73100 Lecce, Italy; (E.S.); (M.A.C.); (N.C.)
- Correspondence: (M.M.); (R.D.C.); Tel.: +39-083-229-8860 (M.M.); +39-050-996-751 (R.D.C.)
| | - Egeria Scoditti
- National Research Council (CNR) Institute of Clinical Physiology, 73100 Lecce, Italy; (E.S.); (M.A.C.); (N.C.)
| | - Maria Annunziata Carluccio
- National Research Council (CNR) Institute of Clinical Physiology, 73100 Lecce, Italy; (E.S.); (M.A.C.); (N.C.)
| | - Nadia Calabriso
- National Research Council (CNR) Institute of Clinical Physiology, 73100 Lecce, Italy; (E.S.); (M.A.C.); (N.C.)
- Laboratory of Biochemistry and Molecular Biology, Department of Biological and Environmental Sciences and Technologies, University of Salento, 73100 Lecce, Italy
| | - Giuseppe Santarpino
- Cardiovascular Center, Paracelsus Medical University, 90471 Nuremberg, Germany;
- GVM Care & Research, Città di Lecce Hospital, 73100 Lecce, Italy
- Cardiac Surgery Unit, Department of Experimental and Clinical Medicine, University “Magna Graecia”, 88100 Catanzaro, Italy
| | - Tiziano Verri
- Laboratory of Applied Physiology, Department of Biological and Environmental Sciences and Technologies, University of Salento, 73100 Lecce, Italy;
| | - Raffaele De Caterina
- Institute of Cardiology, University of Pisa, 56126 Pisa, Italy
- Correspondence: (M.M.); (R.D.C.); Tel.: +39-083-229-8860 (M.M.); +39-050-996-751 (R.D.C.)
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115
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Dietary Approaches to Stop Hypertension (DASH) Score and Its Association with Sleep Quality in a National Survey of Middle-Aged and Older Men and Women. Nutrients 2020; 12:nu12051510. [PMID: 32455945 PMCID: PMC7284419 DOI: 10.3390/nu12051510] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/11/2020] [Accepted: 05/19/2020] [Indexed: 11/23/2022] Open
Abstract
Complex processes appear to link sleep duration and quality with dietary patterns. Numerous studies show healthful benefits of the Dietary Approaches to Stop Hypertension (DASH) diet, but few have examined its association with sleep duration or quality. The current study tested cross-sectional associations of DASH diet quality score with sleep quality among adults. Analyses of participants were from the 2005–2008 wave of the National Health and Nutrition Examination Surveys (n = 3941 adults ≥30 years of age, complete data). We performed sex- and age group-stratified multiple OLS regression analyses with DASH total score and components as main predictors and sleep quality as main outcomes, adjusting sequentially for socio-demographic, behavioral and health-related factors. Sex and age differences in associations of DASH with sleep quality, adjusting for covariates, were also examined by incorporating two-way interaction terms between sex/age and the DASH score in each unstratified model. We found that the DASH diet score was inversely related to poor sleep-related daytime dysfunction adjusted by age, sex, demographic and socio-economic factors. Some sex-specific associations were detected between DASH diet component scores and sleep quality. Notably, the potassium DASH component was inversely associated with Factor 1 (“sleepiness and sleep disturbance”) among women. The fiber DASH component was associated with better sleep quality and inversely related to Factor 2 (“sleep-related daytime dysfunction”) in younger subjects. This study indicates health benefits of the DASH diet for sleep duration and quality. Future longitudinal studies and randomized placebo-controlled trials are required to ascertain protective effects.
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117
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Franconi F, Campesi I, Romani A. Is Extra Virgin Olive Oil an Ally for Women's and Men's Cardiovascular Health? Cardiovasc Ther 2020; 2020:6719301. [PMID: 32454893 PMCID: PMC7212338 DOI: 10.1155/2020/6719301] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 03/04/2020] [Indexed: 02/06/2023] Open
Abstract
Noncommunicable diseases are long-lasting and slowly progressive and are the leading causes of death and disability. They include cardiovascular diseases (CVD) and diabetes mellitus (DM) that are rising worldwide, with CVD being the leading cause of death in developed countries. Thus, there is a need to find new preventive and therapeutic approaches. Polyphenols seem to have cardioprotective properties; among them, polyphenols and/or minor polar compounds of extra virgin olive oil (EVOO) are attracting special interest. In consideration of numerous sex differences present in CVD and DM, in this narrative review, we applied "gender glasses." Globally, it emerges that olive oil and its derivatives exert some anti-inflammatory and antioxidant effects, modulate glucose metabolism, and ameliorate endothelial dysfunction. However, as in prescription drugs, also in this case there is an important gender bias because the majority of the preclinical studies are performed on male animals, and the sex of donors of cells is not often known; thus a sex/gender bias characterizes preclinical research. There are numerous clinical studies that seem to suggest the benefits of EVOO and its derivatives in CVD; however, these studies have numerous limitations, presenting also a considerable heterogeneity across the interventions. Among limitations, one of the most relevant in the era of personalized medicine, is the non-attention versus women that are few and, also when they are enrolled, sex analysis is lacking. Therefore, in our opinion, it is time to perform more long, extensive and lessheterogeneous trials enrolling both women and men.
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Affiliation(s)
- Flavia Franconi
- Laboratorio Nazionale sulla Farmacologia e Medicina di Genere, Istituto Nazionale Biostrutture Biosistemi, 07100 Sassari, Italy
| | - Ilaria Campesi
- Laboratorio Nazionale sulla Farmacologia e Medicina di Genere, Istituto Nazionale Biostrutture Biosistemi, 07100 Sassari, Italy
- Dipartimento di Scienze Biomediche, Università Degli Studi di Sassari, 07100 Sassari, Italy
| | - Annalisa Romani
- Laboratorio PHYTOLAB (Pharmaceutical, Cosmetic, Food Supplement Technology and Analysis), DiSIA Università Degli Studi di Firenze, 50019 Florence, Italy
- Laboratorio di Qualità Delle Merci e Affidabilità di Prodotto, Università Degli Studi di Firenze, 59100 Florence, Italy
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118
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Filippou CD, Tsioufis CP, Thomopoulos CG, Mihas CC, Dimitriadis KS, Sotiropoulou LI, Chrysochoou CA, Nihoyannopoulos PI, Tousoulis DM. Dietary Approaches to Stop Hypertension (DASH) Diet and Blood Pressure Reduction in Adults with and without Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Adv Nutr 2020; 11:1150-1160. [PMID: 32330233 PMCID: PMC7490167 DOI: 10.1093/advances/nmaa041] [Citation(s) in RCA: 150] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 10/29/2019] [Accepted: 03/11/2020] [Indexed: 02/07/2023] Open
Abstract
The Dietary Approaches to Stop Hypertension (DASH) diet is recognized as an effective dietary intervention to reduce blood pressure (BP). However, among randomized controlled trials (RCTs) investigating the DASH diet-mediated BP reduction, there are significant methodological and clinical differences. The purpose of this study was to comprehensively assess the DASH diet effect on BP in adults with and without hypertension, accounting for underlying methodological and clinical confounders. We systematically searched Medline and the Cochrane Collaboration Library databases and identified 30 RCTs (n = 5545 participants) that investigated the BP effects of the DASH diet compared with a control diet in hypertensive and nonhypertensive adults. Both random-effects and fixed-effect models were used to calculate the mean attained systolic BP (SBP) and diastolic BP (DBP) differences during follow-up. Subgroup and meta-regression analyses were also conducted. Compared with a control diet, the DASH diet reduced both SBP and DBP (difference in means: -3.2 mm Hg; 95% CI: -4.2, -2.3 mm Hg; P < 0.001, and -2.5 mm Hg; 95% CI: -3.5, -1.5 mm Hg; P < 0.001, respectively). Hypertension status did not modify the effect on BP reduction. The DASH diet compared with a control diet reduced SBP levels to a higher extent in trials with sodium intake >2400 mg/d than in trials with sodium intake ≤2400 mg/d, whereas both SBP and DBP were reduced more in trials with mean age <50 y than in trials of older participants. The quality of evidence was rated as moderate for both outcomes according to the Grading of Recommendations, Assessment, Development, and Evaluation approach. The adoption of the DASH diet was accompanied by significant BP reduction in adults with and without hypertension, although higher daily sodium intake and younger age enhanced the BP-lowering effect of the intervention. This meta-analysis was registered at www.crd.york.ac.uk/prospero as CRD42019128120.
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Affiliation(s)
- Christina D Filippou
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Costas P Tsioufis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece,Address correspondence to CPT (e-mail: )
| | | | - Costas C Mihas
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Kyriakos S Dimitriadis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Lida I Sotiropoulou
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Christina A Chrysochoou
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Petros I Nihoyannopoulos
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
| | - Dimitrios M Tousoulis
- First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece
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Sánchez-Sánchez ML, García-Vigara A, Hidalgo-Mora JJ, García-Pérez MÁ, Tarín J, Cano A. Mediterranean diet and health: A systematic review of epidemiological studies and intervention trials. Maturitas 2020; 136:25-37. [PMID: 32386663 DOI: 10.1016/j.maturitas.2020.03.008] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 03/15/2020] [Accepted: 03/24/2020] [Indexed: 12/20/2022]
Abstract
Diet is a crucial variable for a healthy life. A rapidly growing number of studies in recent years support the hypothesis that the Mediterranean diet (MedDiet) has a beneficial effect on certain body systems, but the highly varied objectives and quality of these publications warrants an updated assessment. In the present review we performed a comprehensive evaluation of current evidence on the impact of the MedDiet on human health, assessing its effect on the incidence or progression of the main non-communicable diseases and their intermediate outcomes and risk factors. We scrutinised the clinical evidence from observational studies and randomised controlled trials. Cardiovascular disease was the condition with most information. The MedDiet showed a general preventive effect, which was reproduced to varying degrees for certain intermediate cardiovascular outcomes such as blood pressure, lipids, obesity, metabolic syndrome and diabetes. Benefits were also found for several types of cancer, brain function (including cognition, mood and to a lesser extent Parkinson's disease) and mortality. The quality of the published evidence was, however, generally moderate or low. In conclusion, the MedDiet shows a favourable impact on health. General adoption of a MedDiet is concordant with current policies promoting healthy and sustainable nutrition worldwide. Nonetheless, more high-quality research is needed to improve the consistency of the findings.
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Affiliation(s)
| | - Alicia García-Vigara
- Service of Obstetrics and Gynecology, Hospital Clínico Universitario - INCLIVA, Av. Blasco Ibáñez 17, 46010, Valencia, Spain.
| | - Juan José Hidalgo-Mora
- Service of Obstetrics and Gynecology, Hospital Clínico Universitario - INCLIVA, Av. Blasco Ibáñez 17, 46010, Valencia, Spain.
| | - Miguel-Ángel García-Pérez
- Department of Genetics, Faculty of Biological Sciences, University of Valencia, Burjassot, and INCLIVA, Av. Blasco Ibáñez 17, 46010, Valencia, Spain.
| | - Juan Tarín
- Department of Cellular Biology, Functional Biology and Physical Anthropology, Faculty of Biological Sciences, University of Valencia, Burjassot, 46100, Valencia, Spain.
| | - Antonio Cano
- Service of Obstetrics and Gynecology, Hospital Clínico Universitario - INCLIVA, Av. Blasco Ibáñez 17, 46010, Valencia, Spain; Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Av. Blasco Ibáñez 15, 46010, Valencia, Spain.
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120
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John JR, Tannous WK, Jones A. Effectiveness of a patient-centered medical home model of primary care versus standard care on blood pressure outcomes among hypertensive patients. Hypertens Res 2020; 43:892-902. [DOI: 10.1038/s41440-020-0431-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 02/18/2020] [Accepted: 02/24/2020] [Indexed: 01/03/2023]
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121
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Understanding the nutritional functions of thermally-processed whole grain highland barley in vitro and in vivo. Food Chem 2020; 310:125979. [DOI: 10.1016/j.foodchem.2019.125979] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 11/26/2019] [Accepted: 11/28/2019] [Indexed: 12/21/2022]
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122
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Chiu THT, Chang HR, Wang LY, Chang CC, Lin MN, Lin CL. Vegetarian diet and incidence of total, ischemic, and hemorrhagic stroke in 2 cohorts in Taiwan. Neurology 2020; 94:e1112-e1121. [PMID: 32102976 PMCID: PMC7220235 DOI: 10.1212/wnl.0000000000009093] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 10/10/2019] [Indexed: 02/06/2023] Open
Abstract
Objective To determine how a vegetarian diet affects stroke incidence in 2 prospective cohorts and to explore whether the association is modified by dietary vitamin B12 intake. Methods Participants without stroke in the Tzu Chi Health Study (cohort 1, n = 5,050, recruited in 2007–2009) and the Tzu Chi Vegetarian Study (cohort 2, n = 8,302, recruited in 2005) were followed until the end of 2014. Diet was assessed through food frequency questionnaires in both cohorts at baseline. Stroke events and baseline comorbidities were identified through the National Health Insurance Research Database. A subgroup of 1,528 participants in cohort 1 were assessed for serum homocysteine, vitamin B12, and folate. Associations between vegetarian diet and stroke incidences were estimated by Cox regression with age as time scale, adjusted for sex, education, smoking, alcohol, physical activities, body mass index (only in cohort 1), hypertension, diabetes, dyslipidemia, and ischemic heart diseases. Results Vegetarians had lower serum vitamin B12 and higher folate and homocysteine than nonvegetarians. In cohort 1, 54 events occurred in 30,797 person-years follow-up. Vegetarians (vs nonvegetarians) experienced lower risk of ischemic stroke (hazard ratio [HR], 0.26; 95% confidence interval [CI], 0.08–0.88). In cohort 2, 121 events occurred in 76,797 person-years follow-up. Vegetarians (vs nonvegetarians) experienced lower risk of overall stroke (HR, 0.52; 95% CI, 0.33–0.82), ischemic stroke (HR, 0.41; 95% CI, 0.19–0.88), and hemorrhagic stroke (HR, 034; 95% CI, 0.12–1.00). Our explorative analysis showed that vitamin B12 intake may modify the association between vegetarian diet and overall stroke (p interaction = 0.046). Conclusion Taiwanese vegetarian diet is associated with a lower risk of ischemic and hemorrhagic strokes.
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Affiliation(s)
- Tina H T Chiu
- From the Department of Nutritional Science (T.H.T.C.), Fu Jen Catholic University, New Taipei City; Division of Cardiology, Department of Internal Medicine (H.-R.C.), Epidemiology and Biostatistics Consulting Center, Department of Medical Research (L.-Y.W.), and Department of Pharmacy (L.-Y.W.), Buddhist Tzu Chi General Hospital; School of Medicine (H.-R.C., C.-L.L.), Tzu Chi University; Department of Medical Research (C.-C.C.), Buddhist Tzu Chi Medical Foundation, Hualien; Departments of Family Medicine (M.-N.L.) and Internal Medicine (C.-L.L.), Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi; and Department of Family Medicine, School of Medicine (M.-N.L.), Tzu Chi University, Hualien, Taiwan
| | - Huai-Ren Chang
- From the Department of Nutritional Science (T.H.T.C.), Fu Jen Catholic University, New Taipei City; Division of Cardiology, Department of Internal Medicine (H.-R.C.), Epidemiology and Biostatistics Consulting Center, Department of Medical Research (L.-Y.W.), and Department of Pharmacy (L.-Y.W.), Buddhist Tzu Chi General Hospital; School of Medicine (H.-R.C., C.-L.L.), Tzu Chi University; Department of Medical Research (C.-C.C.), Buddhist Tzu Chi Medical Foundation, Hualien; Departments of Family Medicine (M.-N.L.) and Internal Medicine (C.-L.L.), Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi; and Department of Family Medicine, School of Medicine (M.-N.L.), Tzu Chi University, Hualien, Taiwan
| | - Ling-Yi Wang
- From the Department of Nutritional Science (T.H.T.C.), Fu Jen Catholic University, New Taipei City; Division of Cardiology, Department of Internal Medicine (H.-R.C.), Epidemiology and Biostatistics Consulting Center, Department of Medical Research (L.-Y.W.), and Department of Pharmacy (L.-Y.W.), Buddhist Tzu Chi General Hospital; School of Medicine (H.-R.C., C.-L.L.), Tzu Chi University; Department of Medical Research (C.-C.C.), Buddhist Tzu Chi Medical Foundation, Hualien; Departments of Family Medicine (M.-N.L.) and Internal Medicine (C.-L.L.), Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi; and Department of Family Medicine, School of Medicine (M.-N.L.), Tzu Chi University, Hualien, Taiwan
| | - Chia-Chen Chang
- From the Department of Nutritional Science (T.H.T.C.), Fu Jen Catholic University, New Taipei City; Division of Cardiology, Department of Internal Medicine (H.-R.C.), Epidemiology and Biostatistics Consulting Center, Department of Medical Research (L.-Y.W.), and Department of Pharmacy (L.-Y.W.), Buddhist Tzu Chi General Hospital; School of Medicine (H.-R.C., C.-L.L.), Tzu Chi University; Department of Medical Research (C.-C.C.), Buddhist Tzu Chi Medical Foundation, Hualien; Departments of Family Medicine (M.-N.L.) and Internal Medicine (C.-L.L.), Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi; and Department of Family Medicine, School of Medicine (M.-N.L.), Tzu Chi University, Hualien, Taiwan
| | - Ming-Nan Lin
- From the Department of Nutritional Science (T.H.T.C.), Fu Jen Catholic University, New Taipei City; Division of Cardiology, Department of Internal Medicine (H.-R.C.), Epidemiology and Biostatistics Consulting Center, Department of Medical Research (L.-Y.W.), and Department of Pharmacy (L.-Y.W.), Buddhist Tzu Chi General Hospital; School of Medicine (H.-R.C., C.-L.L.), Tzu Chi University; Department of Medical Research (C.-C.C.), Buddhist Tzu Chi Medical Foundation, Hualien; Departments of Family Medicine (M.-N.L.) and Internal Medicine (C.-L.L.), Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi; and Department of Family Medicine, School of Medicine (M.-N.L.), Tzu Chi University, Hualien, Taiwan.
| | - Chin-Lon Lin
- From the Department of Nutritional Science (T.H.T.C.), Fu Jen Catholic University, New Taipei City; Division of Cardiology, Department of Internal Medicine (H.-R.C.), Epidemiology and Biostatistics Consulting Center, Department of Medical Research (L.-Y.W.), and Department of Pharmacy (L.-Y.W.), Buddhist Tzu Chi General Hospital; School of Medicine (H.-R.C., C.-L.L.), Tzu Chi University; Department of Medical Research (C.-C.C.), Buddhist Tzu Chi Medical Foundation, Hualien; Departments of Family Medicine (M.-N.L.) and Internal Medicine (C.-L.L.), Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi; and Department of Family Medicine, School of Medicine (M.-N.L.), Tzu Chi University, Hualien, Taiwan.
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Brown AW, Kaiser KA, Keitt A, Fontaine K, Gibson M, Gower BA, Shikany JM, Vorland CJ, Beitz DC, Bier DM, Brenna JT, Jacobs DR, Kris-Etherton P, Maki K, Miller M, St-Onge MP, Teran-Garcia M, Allison DB. Science dialogue mapping of knowledge and knowledge gaps related to the effects of dairy intake on human cardiovascular health and disease. Crit Rev Food Sci Nutr 2020; 61:179-195. [PMID: 32072820 DOI: 10.1080/10408398.2020.1722941] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Dairy has been described as everything from a superfood to a poison; yet, arguments, assumptions, and data justifying these labels are not always clear. We used an issue-based information system, "dialogue mapping™," to summarize scientific points of a live panel discussion on the putative effects of dairy on cardiovascular diseases (CVD) from a day-long session among experts in nutrition and CVD. Dialogue mapping captures relations among ideas to explicitly, logically, and visually connect issues/questions, ideas, pro/con arguments, and agreements, even if discussed at different times. Experts discussed two propositions: for CVD risk, consumption of full-fat dairy products 1) should be minimized, in part because of their saturated fat content, or 2) need not be minimized, despite their saturated fat content. The panel discussed the dairy-CVD relation through blood lipids, diabetes, obesity, energy balance, blood pressure, dairy bioactives, biobehavioral components, and other putative causal pathways. Associations and effects reported in the literature have varied by fat content of dairy elements considered, study design, intake methods, and biomarker versus disease outcomes. Two conceptual topics emerged from the discussion: 1) individual variability: whether recommendations should be targeted only to those at high CVD risk; 2) quality of evidence: whether data on dairy-CVD relations are strong enough for reliable conclusions-positive, negative, or null. Future procedural improvements for science dialog mapping include using singular rather than competing propositions for discussion.
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Affiliation(s)
- Andrew W Brown
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, USA
| | - Kathryn A Kaiser
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Andrew Keitt
- Department of History, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Kevin Fontaine
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Madeline Gibson
- School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Barbara A Gower
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - James M Shikany
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Colby J Vorland
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, USA
| | - Donald C Beitz
- Departments of Animal Science and Biochemistry, Biophysics, and Molecular Biology, Iowa State University, Ames, Iowa, USA
| | - Dennis M Bier
- Baylor College of Medicine, Department of Pediatrics, Children's Nutrition Research Center, Houston, Texas, USA
| | - J Thomas Brenna
- Dell Pediatric Research Institute, Deptartments of Pediatrics, of Chemistry, and of Nutrition, University of Texas at Austin, Austin, Texas, USA
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Penny Kris-Etherton
- Distinguished Professor of Nutrition, Department of Nutritional Sciences, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Kevin Maki
- Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, USA.,Midwest Biomedical Research/Center for Metabolic and Cardiovascular Health, Addison, Illinois, USA
| | - Michael Miller
- Epidemiology & Public Health, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Marie-Pierre St-Onge
- Division of Endocrinology and Sleep center of excellence, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Margarita Teran-Garcia
- Extension Specialist Hispanic Health Programs, Department of Human Development and Family Studies, Cooperative Extension, Division of Nutritional Sciences, Carle Illinois College of Medicine, University of Illinois Urbana-Champaign, Urbana, Illinois, USA
| | - David B Allison
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, Indiana, USA
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Adherence to the Dietary Approaches to Stop Hypertension (DASH) and hypertension risk: results of the Longitudinal Study of Adult Health (ELSA-Brasil). Br J Nutr 2020; 123:1068-1077. [PMID: 31959262 DOI: 10.1017/s0007114520000124] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
We investigated whether high adherence to the Dietary Approaches to Stop Hypertension (DASH) diet was independently associated with lower risk of incident hypertension. Participants included 5632 adults, without hypertension at the baseline (2008-2010) of the Longitudinal Study of Adult Health, who took part in the second follow-up visit (2012-2014). Adherence to the DASH diet was estimated at baseline using a score based on eight food items (final scores from 8 to 40 points) and was categorised as high adherence (≥30 points, or ≥75 %) and low adherence (<75 %; reference). Hypertension was defined as systolic blood pressure (BP) ≥140 mmHg or diastolic BP ≥90 mmHg, or use of antihypertensive drugs. The association between adherence to the DASH diet and the risk of incident hypertension was estimated using Cox regression models adjusted by covariates. In total, 780 new cases of hypertension (13·8 %) were identified in about 3·8-year follow-up. Participants with high adherence to the DASH diet had 26 % lower risk of hypertension (hazard ratio (HR) 0·74; 95 % CI 0·57, 0·95) after adjustment for socio-demographic characteristics, health-related behaviours, diabetes and family history of hypertension. The HR reduced to 0·81 (95 % CI 0·63, 1·04) and was of borderline statistical significance after adjustment for BMI, suggesting that lower body weight explains about 10 % of the association between high adherence to the DASH diet and hypertension risk reduction. The results indicate that high adherence to the DASH diet lowered the risk of hypertension by one-fourth over a relatively short follow-up period.
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Margerison C, Riddell LJ, McNaughton SA, Nowson CA. Associations between dietary patterns and blood pressure in a sample of Australian adults. Nutr J 2020; 19:5. [PMID: 31937324 PMCID: PMC6961350 DOI: 10.1186/s12937-019-0519-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 12/29/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Investigating effects of whole diets on blood pressure (BP) can contribute to development of diet-based recommendations for health. Our aim was to assess the relationship between dietary patterns and BP in a sample of free-living Australian adults. METHODS Usual dietary patterns of participants recruited to dietary intervention studies were assessed using factor analysis (two 24-h recalls). The mean of seven days of daily, seated BP measurements were used. RESULTS Complete data from 251 participants (112 males; mean age 55.1(9.1) (SD) years; body mass index (BMI) 29.5(3.9) kg/m2) was included. Three dietary patterns were identified. Only Dietary Pattern 2 was positively associated with home systolic BP (β = 1.88, 95% CI 0.16, 3.60) after adjusting for age, sex, BMI, anti-hypertensive medication, smoking, education, physical activity and energy intake. This dietary pattern was characterised by high consumption of low-fibre bread, pasta, noodles and rice, meat dishes, poultry dishes and egg dishes, mixed cereal dishes, salted nuts and low consumption of milk and yoghurt (low-fat), vegetable juice, vegetables and high-fibre bread. Dietary Pattern 2 was also positively associated with intakes of energy (P = 0.002) and sodium (P = 0.005) and inversely associated with potassium intake (P = 0.002). After adjustment for energy, only the inverse association with potassium remained (P < 0.001). CONCLUSIONS In this sample of Australian adults, Dietary Pattern 2 was associated with higher BP and thus chronic disease risk, supporting the evidence that diets high in energy and sodium, and low in potassium from vegetables and dairy, are detrimental to cardiovascular health.
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Affiliation(s)
- Claire Margerison
- Deakin University Institute for Physical Activity and Nutrition, Locked Bag 20000, Waurn 11 Ponds, Geelong, VIC, 3220, Australia.
| | - Lynnette J Riddell
- Deakin University Institute for Physical Activity and Nutrition, Locked Bag 20000, Waurn 11 Ponds, Geelong, VIC, 3220, Australia
| | - Sarah A McNaughton
- Deakin University Institute for Physical Activity and Nutrition, Locked Bag 20000, Waurn 11 Ponds, Geelong, VIC, 3220, Australia
| | - Caryl A Nowson
- Deakin University Institute for Physical Activity and Nutrition, Locked Bag 20000, Waurn 11 Ponds, Geelong, VIC, 3220, Australia
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Rancourt-Bouchard M, Gigleux I, Guay V, Charest A, Saint-Gelais D, Vuillemard JC, Lamarche B, Couture P. Effects of regular-fat and low-fat dairy consumption on daytime ambulatory blood pressure and other cardiometabolic risk factors: a randomized controlled feeding trial. Am J Clin Nutr 2020; 111:42-51. [PMID: 31584063 DOI: 10.1093/ajcn/nqz251] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 09/09/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The extent to which dairy products and their fat content influence cardiovascular health remains uncertain. OBJECTIVE This study aimed to assess how consumption of low-fat milk and regular-fat cheese enriched in γ-aminobutyric acid (GABA) influences daytime ambulatory blood pressure (BP) and other cardiometabolic risk factors. METHODS In this crossover controlled feeding study, 55 healthy men and women with high-normal daytime BP were randomly assigned to sequences of three 6-wk isoenergetic diets, each comprising 1) no dairy (control diet), 2) 3 daily servings of 1% fat milk, and 3) 1 daily serving of 31% fat cheddar cheese naturally enriched in GABA. Total proteins, carbohydrates, and fats were matched across all 3 diets. The additional 2% of energy from SFAs in the cheese diet was replaced by n-6 PUFAs in the other diets. RESULTS Comparison of postdiet ambulatory systolic BP revealed no difference (P = 0.34), which was also the case for ambulatory diastolic BP (P = 0.45). The cheese diet increased serum LDL-cholesterol concentrations compared with the control and milk diets (+5.8%, P = 0.006 and +7.0%, P = 0.0008, respectively) and increased LDL particle size compared with the milk diet (P = 0.02). HDL-cholesterol concentrations after the milk diet were lower than after the control diet (-4.1%; P = 0.009). The milk and cheese diets increased triglycerides compared with the control diet (+9.9%, P = 0.01 and +10.5%, P = 0.007, respectively). There was no significant difference between all diets for C-reactive protein concentrations and markers of glucose/insulin homeostasis. CONCLUSIONS These results suggest that short-term consumption of dairy products, whether low or regular in fat, has no overall effect on daytime ambulatory BP compared with a dairy-free diet. Other cardiometabolic risk factors may be differently modified according to the fat content of the dairy product. This trial was registered at clinicaltrials.gov as NCT02763930.
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Affiliation(s)
- Maryka Rancourt-Bouchard
- Institute of Nutrition and Functional Foods, Laval University, Quebec City, Quebec, Canada.,School of Nutrition, Laval University, Quebec City, Quebec, Canada
| | - Iris Gigleux
- Institute of Nutrition and Functional Foods, Laval University, Quebec City, Quebec, Canada
| | - Valérie Guay
- Institute of Nutrition and Functional Foods, Laval University, Quebec City, Quebec, Canada
| | - Amélie Charest
- Institute of Nutrition and Functional Foods, Laval University, Quebec City, Quebec, Canada
| | - Daniel Saint-Gelais
- Institute of Nutrition and Functional Foods, Laval University, Quebec City, Quebec, Canada.,Saint-Hyacinthe Research and Development Centre, Agriculture and Agri-Food Canada, Saint-Hyacinthe, Quebec, Canada
| | | | - Benoît Lamarche
- Institute of Nutrition and Functional Foods, Laval University, Quebec City, Quebec, Canada.,School of Nutrition, Laval University, Quebec City, Quebec, Canada
| | - Patrick Couture
- Institute of Nutrition and Functional Foods, Laval University, Quebec City, Quebec, Canada.,CHU de Québec Research Center, Laval University, Quebec City, Quebec, Canada
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Deora S, Mathur D, Kaushik A, Bhardwaj P, Singh K. Awareness, medication adherence, and diet pattern among hypertensive patients attending teaching institution in western Rajasthan, India. J Family Med Prim Care 2020; 9:2342-2349. [PMID: 32754499 PMCID: PMC7380809 DOI: 10.4103/jfmpc.jfmpc_193_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 03/13/2020] [Accepted: 03/26/2020] [Indexed: 11/04/2022] Open
Abstract
Background and Objectives: Hypertension is an important disease of public health concern. Awareness and medication adherence with diet modification have an important effect on the control of blood pressure and its associated morbidity and mortality. Therefore, this study was conducted to assess the awareness of hypertension, medication adherence, and dietary pattern in hypertensive population of western Rajasthan. Materials and Methods: The study was hospital based cross-sectional. Blood pressure measurements were taken in a sitting position in right arm after a 5-min rest using nonmercury sphygmomanometer and required cuff size. A prevalidated and pretested questionnaire for the assessment of awareness of hypertension was used. Results: Out of the total 384 patients, the majority of the patients were males (62.5%). There was a statistically significant difference found in awareness of hypertension among rural and urban patients. Nonadherence to antihypertensive medications was seen more in males (60.0%) as compared to females (40.0%). The most common reason for nonadherence was found to be forgetfulness (27.6%) followed by poor knowledge about the hypertension and ignorance of long-term treatment (22.9%). Out of the total hypertensive patient studied, 54.9% were taking normal salt intake and 45.1% of the subjects were found to be taking excess intake of salt. Interpretation and Conclusions: In the present study, good awareness about hypertension was found with urban patients. Among all the variables, education and employment status showed a positive and significant association with awareness. The most common reason of poor adherence was found to be forgetfulness behavior followed by poor knowledge and lack of awareness about hypertension.
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Hidalgo-Mora JJ, García-Vigara A, Sánchez-Sánchez ML, García-Pérez MÁ, Tarín J, Cano A. The Mediterranean diet: A historical perspective on food for health. Maturitas 2019; 132:65-69. [PMID: 31883665 DOI: 10.1016/j.maturitas.2019.12.002] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 11/26/2019] [Accepted: 12/02/2019] [Indexed: 12/11/2022]
Abstract
The Mediterranean diet (MedDiet) represents the crystallisation of the centuries-old cooking legacies of different civilisations. The association of the MedDiet with longevity and low cardiovascular risk prompted the Seven Countries Study, which provided epidemiological evidence on the health effects of diet. This led to further studies, both epidemiological and interventional. Scales to measure adherence as well as studies of food components have consolidated a body of knowledge that is of great interest to institutions and governmental agencies. The recognition of its benefits for health has made the widespread introduction of the MedDiet an urgent challenge. Parallel efforts are being made to extend research through experimental and clinical studies. The purpose of this review is to present the historical background of the MedDiet, the main steps leading to the recognition of its health benefits, and the current strategy to facilitate its global implementation.
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Affiliation(s)
- Juan José Hidalgo-Mora
- Service of Obstetrics and Gynecology, Hospital Clínico Universitario - INCLIVA, Av Blasco Ibáñez 17, 46010, Valencia, Spain.
| | - Alicia García-Vigara
- Service of Obstetrics and Gynecology, Hospital Clínico Universitario - INCLIVA, Av Blasco Ibáñez 17, 46010, Valencia, Spain.
| | | | - Miguel-Ángel García-Pérez
- Department of Genetics, Faculty of Biological Sciences, University of Valencia, Burjassot, and INCLIVA, Av Blasco Ibáñez 17, 46010 Valencia, Spain.
| | - Juan Tarín
- Department of Cellular Biology, Functional Biology and Physical Anthropology, Faculty of Biological Sciences, University of Valencia, Burjassot, 46100 Valencia, Spain.
| | - Antonio Cano
- Service of Obstetrics and Gynecology, Hospital Clínico Universitario - INCLIVA, Av Blasco Ibáñez 17, 46010, Valencia, Spain; Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Av Blasco Ibáñez 15, 46010 Valencia, Spain.
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Das Gupta R, Haider SS, Hashan MR, Rahman MA, Sarker M. Association between height and hypertension in the adult Nepalese population: Findings from a nationally representative survey. Health Sci Rep 2019; 2:e141. [PMID: 31890899 PMCID: PMC6920697 DOI: 10.1002/hsr2.141] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 09/27/2019] [Accepted: 10/07/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND AIMS The burden of hypertension is increasing in Nepal. Different studies have evaluated the relationship between height and blood pressure in different regions, with mixed results. The relationship between height and hypertension has not yet been explored in the Nepalese context. Given this knowledge gap, this study aims to determine the relationship between height and hypertension among Nepalese adults (aged ≥18 years). METHODS This study utilized the dataset from the Nepal Demographic and Health Survey (NDHS) 2016. Hypertension was defined as systolic blood pressure ≥ 140 mmHg and/or a diastolic blood pressure ≥ 90 mmHg. Height, measured in centimeters (cm), was analyzed as a continuous variable. Based on previous evidence, the following covariates were considered: age, sex, presence of overweight or obesity, educational status, household wealth status, and place, province, and ecological zone of residence. Multilevel multivariable logistic regression was done to evaluate the association between height and hypertension. Both crude odds ratio (COR) and adjusted odds ratio (AOR) are reported, along with a 95% confidence interval (CI). Sample weight of NDHS was adjusted during analysis. RESULTS Among 13 393 weighted individuals over the age of 18 years, the prevalence of hypertension in Nepal was found to be 21.1% (95% CI, 19.9%-22.4%). In the final multivariable model, after adjusting for relevant covariates, it was found that height was inversely associated with hypertension. For a Nepalese adult, the odds of hypertension decreased by 10% with each 10-cm increase in height (AOR 0.9; 95% CI 0.8-0.9; P = 0.003). CONCLUSION Awareness should be raised among people with low stature for prevention of hypertension. Longitudinal studies are recommended to include genetic and social/environmental determinants of stature in the analyses.
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Affiliation(s)
- Rajat Das Gupta
- Centre of Excellence for Non‐Communicable Diseases and Nutrition, BRAC James P Grant School of Public HealthBRAC UniversityDhakaBangladesh
- Centre of Excellence for Science of Implementation and Scale‐Up, BRAC James P Grant School of Public HealthBRAC UniversityDhakaBangladesh
- Department of Epidemiology and Biostatistics, Arnold School of Public HealthUniversity of South CarolinaColumbiaSouth CarolinaUnited States of America
| | - Shams Shabab Haider
- Centre of Excellence for Science of Implementation and Scale‐Up, BRAC James P Grant School of Public HealthBRAC UniversityDhakaBangladesh
| | - Mohammad Rashidul Hashan
- Infectious Diseases DivisionInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
| | - Muhammad Aziz Rahman
- School of Nursing and Healthcare ProfessionsFederation UniversityVictoriaAustralia
- School of Nursing and MidwiferyLa Trobe UniversityHeidelbergAustralia
| | - Malabika Sarker
- Centre of Excellence for Non‐Communicable Diseases and Nutrition, BRAC James P Grant School of Public HealthBRAC UniversityDhakaBangladesh
- Centre of Excellence for Science of Implementation and Scale‐Up, BRAC James P Grant School of Public HealthBRAC UniversityDhakaBangladesh
- Institute of Public HealthHeidelberg UniversityHeidelbergGermany
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Domènech M, Serra-Mir M, Roth I, Freitas-Simoes T, Valls-Pedret C, Cofán M, López A, Sala-Vila A, Calvo C, Rajaram S, Sabaté J, Ros E. Effect of a Walnut Diet on Office and 24-Hour Ambulatory Blood Pressure in Elderly Individuals. Hypertension 2019; 73:1049-1057. [PMID: 30879358 PMCID: PMC6467552 DOI: 10.1161/hypertensionaha.118.12766] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Supplemental Digital Content is available in the text. Nut consumption lowers blood cholesterol and is associated with reduced cardiovascular disease, but effects on blood pressure (BP) are inconsistent. We assessed the 2-year effects of a walnut diet versus a control diet on office BP and 24-hours ambulatory BP in free-living elders participating in the Walnuts and Healthy Aging study, a randomized trial testing the effects of walnuts at ≈15% energy on age-related disorders. In a prespecified analysis, we enrolled 305 participants, of whom 236 (75%) completed the study (65% women; age, 69 years; 60% with mild hypertension). Walnuts were well tolerated, and compliance was >98%. Mean baseline office BP was 128/79 mm Hg. Adjusted changes from baseline in mean office systolic BP were −4.61 mm Hg (95% CI, −7.43 to −1.79 mm Hg) in the walnut group and −0.59 mm Hg (−3.38 to 2.21 mm Hg) in controls (P=0.051). Respective changes in mean systolic 24-hour ambulatory BP were −3.86 mm Hg (CI, −5.45 to −2.26 mm Hg) and −2.00 mm Hg (CI, −3.58 to −0.42 mm Hg; P=0.111). No changes in diastolic BP were observed. In participants in the upper tertile of baseline 24-hour ambulatory systolic BP (>125 mm Hg), mean 2-year systolic 24-hour BP was −8.5 mm Hg (CI, −12 to −5.0 mm Hg) in the walnut group and −2.5 mm Hg (CI, −6.3 to 1.3 mm Hg) in controls (P=0.034). During the trial, participants in the walnut group required less uptitration of antihypertensive medication and had better overall BP regulation than controls. Walnut consumption reduces systolic BP in elderly subjects, particularly in those with mild hypertension.
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Affiliation(s)
- Mónica Domènech
- From the Lipid Clinic, Endocrinology and Nutrition Service, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain (M.D., M.S.-M., I.R., T.F.-S., C.V.-P., M.C., A.L., A.S.-V., C.C., E.R.)
- Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain (M.D., M.S.-M., C.V.-P., M.C., A.L., A.S.-V., C.C., E.R.)
- Faculty of Medicine and Health Sciences. University of Barcelona (M.D.)
| | - Mercè Serra-Mir
- From the Lipid Clinic, Endocrinology and Nutrition Service, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain (M.D., M.S.-M., I.R., T.F.-S., C.V.-P., M.C., A.L., A.S.-V., C.C., E.R.)
- Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain (M.D., M.S.-M., C.V.-P., M.C., A.L., A.S.-V., C.C., E.R.)
| | - Irene Roth
- From the Lipid Clinic, Endocrinology and Nutrition Service, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain (M.D., M.S.-M., I.R., T.F.-S., C.V.-P., M.C., A.L., A.S.-V., C.C., E.R.)
| | - Tania Freitas-Simoes
- From the Lipid Clinic, Endocrinology and Nutrition Service, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain (M.D., M.S.-M., I.R., T.F.-S., C.V.-P., M.C., A.L., A.S.-V., C.C., E.R.)
| | - Cinta Valls-Pedret
- From the Lipid Clinic, Endocrinology and Nutrition Service, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain (M.D., M.S.-M., I.R., T.F.-S., C.V.-P., M.C., A.L., A.S.-V., C.C., E.R.)
- Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain (M.D., M.S.-M., C.V.-P., M.C., A.L., A.S.-V., C.C., E.R.)
| | - Montserrat Cofán
- From the Lipid Clinic, Endocrinology and Nutrition Service, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain (M.D., M.S.-M., I.R., T.F.-S., C.V.-P., M.C., A.L., A.S.-V., C.C., E.R.)
- Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain (M.D., M.S.-M., C.V.-P., M.C., A.L., A.S.-V., C.C., E.R.)
| | - Anna López
- From the Lipid Clinic, Endocrinology and Nutrition Service, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain (M.D., M.S.-M., I.R., T.F.-S., C.V.-P., M.C., A.L., A.S.-V., C.C., E.R.)
- Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain (M.D., M.S.-M., C.V.-P., M.C., A.L., A.S.-V., C.C., E.R.)
| | - Aleix Sala-Vila
- From the Lipid Clinic, Endocrinology and Nutrition Service, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain (M.D., M.S.-M., I.R., T.F.-S., C.V.-P., M.C., A.L., A.S.-V., C.C., E.R.)
- Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain (M.D., M.S.-M., C.V.-P., M.C., A.L., A.S.-V., C.C., E.R.)
| | - Carlos Calvo
- From the Lipid Clinic, Endocrinology and Nutrition Service, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain (M.D., M.S.-M., I.R., T.F.-S., C.V.-P., M.C., A.L., A.S.-V., C.C., E.R.)
- Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain (M.D., M.S.-M., C.V.-P., M.C., A.L., A.S.-V., C.C., E.R.)
| | - Sujatha Rajaram
- Center for Nutrition, Healthy Lifestyle and Disease Prevention, School of Public Health, Loma Linda University, CA (S.R., J.S.)
| | - Joan Sabaté
- Center for Nutrition, Healthy Lifestyle and Disease Prevention, School of Public Health, Loma Linda University, CA (S.R., J.S.)
| | - Emilio Ros
- From the Lipid Clinic, Endocrinology and Nutrition Service, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain (M.D., M.S.-M., I.R., T.F.-S., C.V.-P., M.C., A.L., A.S.-V., C.C., E.R.)
- Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain (M.D., M.S.-M., C.V.-P., M.C., A.L., A.S.-V., C.C., E.R.)
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Pourmasoumi M, Hadi A, Mohammadi H, Rouhani MH. Effect of pycnogenol supplementation on blood pressure: A systematic review and meta-analysis of clinical trials. Phytother Res 2019; 34:67-76. [PMID: 31637782 DOI: 10.1002/ptr.6515] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 08/31/2019] [Accepted: 09/04/2019] [Indexed: 01/30/2023]
Abstract
Several studies investigated the impact of pycnogenol on blood pressure. Nevertheless, the results are inconclusive. The aim of the present systematic review and meta-analysis was to clarify the effect of pycnogenol supplementation on blood pressure. PubMed, Scopus, Web of Science, and Google Scholar were systematically searched until March 2018 to find clinical trials, which examined the effect of pycnogenol supplementation on systolic and diastolic blood pressure in adults. A subgroup analysis was applied to find out potential sources of interstudy heterogeneity. A total of 12 clinical trials (922 participants) were included in the meta-analysis. Pooled analysis suggested that pycnogenol supplementation can reduced systolic blood pressure (SBP) of (-3.22 mmHg; 95% CI [-5.52, -0.92]) and diastolic blood pressure (DBP; -1.91 mmHg; 95% CI [-3.64, -0.18]). Effect of pycnogenol on SBP was more pronounce in subgroup in which pycnogenol was administered along with other treatments. A significant effect of pycnogenol on DBP in studies with >12-week duration, whereas this favorable effect was not observed in subgroup with ≤12-week supplementation. The present systematic review and meta-analysis suggest that pycnogenol had a favorable effect on SBP and DBP. Further, high quality randomized clinical trials are needed to confirm this result.
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Affiliation(s)
- Makan Pourmasoumi
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Amir Hadi
- Halal Research Center of IRI, FDA, Tehran, Iran.,Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hamed Mohammadi
- Department of Clinical Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hossein Rouhani
- Food Security Research Center, Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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Sodium Intake from Foods Exceeds Recommended Limits in the Spanish Population: The ANIBES Study. Nutrients 2019; 11:nu11102451. [PMID: 31615065 PMCID: PMC6835313 DOI: 10.3390/nu11102451] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 09/20/2019] [Accepted: 10/03/2019] [Indexed: 02/08/2023] Open
Abstract
Excessive sodium consumption is associated with adverse health effects. An elevated dietary intake of salt (sodium chloride) has been related to high blood pressure or hypertension, a major but modifiable risk factor for cardiovascular disease, as well as to other ill health conditions. In the present work, our aim was to describe the contribution of foods to sodium consumption within the Spanish population in a representative sample from the “anthropometric data, macronutrients and micronutrients intake, practice of physical activity, socioeconomic data and lifestyles in Spain” (ANIBES) study (9–75 years), to identify high consumer groups, as well as the major food groups that contribute to sodium intake in the Spanish diet. Intakes were assessed by 3-day food records collected on a tablet device. Sodium intakes across the ANIBES study population exceeded recommendations, as total intakes reached 2025 ± 805 mg of sodium per day, that is approximately 5.06 g/day of salt (excluding discretionary salt, added at the table or during cooking). Sodium intakes were higher in males than in females and within the youngest groups. Main dietary sources of sodium were meat and meat products (27%), cereals and grains (26%), milk and dairy products (14%) and ready-to-eat meals (13%). Given the established health benefits of dietary salt reduction, it would be advisable to continue and even improve the current national initiatives of awareness and educational campaigns and particularly food reformulation to decrease overall salt intakes across the Spanish population.
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133
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Tsuchihashi T. Practical and personal education of dietary therapy in hypertensive patients. Hypertens Res 2019; 43:6-12. [PMID: 31576021 DOI: 10.1038/s41440-019-0340-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 08/26/2019] [Accepted: 09/01/2019] [Indexed: 01/08/2023]
Abstract
The guidelines for the management of hypertension by the Japanese Society of Hypertension (JSH2019) defined blood pressure (BP) levels of 130-139/80-89 mmHg as "elevated blood pressure". The JSH2019 also revised the target level of BP control to a lower level. Thus, lifestyle modifications are quite important regardless of the use of antihypertensive drugs. Among the lifestyle modifications, salt reduction is most important, especially among East Asian people, who still consume a significant amount of salt. Since the awareness of salt reduction may not necessarily lead to actual salt reduction, the assessment of individual salt intake is essential when members of the medical staff provide practical guidance regarding salt reduction. The evaluation methods of salt intake are classified as the assessment of dietary contents and the measurement of urinary sodium (Na) excretion. Since highly reliable methods, such as the measurement of 24-h urinary Na excretion, are not convenient in practical clinical settings, the combination of the assessment of dietary contents using questionnaires and the estimation of salt intake using spot urine is recommended as a practical evaluation procedure. Repeated assessment of salt intake and practical guidance from dieticians are useful for long-term adherence to salt reduction. The Japanese Society of Hypertension Salt Reduction Committee began to certify flavorful foods as being low in salt content in 2013. More than 200 products have been certified as of April 2019. The utilization of these products is expected to aid in the salt reduction of hypertensive individuals as well as the Japanese general population.
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Dietary Patterns and Cardiometabolic Outcomes in Diabetes: A Summary of Systematic Reviews and Meta-Analyses. Nutrients 2019; 11:nu11092209. [PMID: 31540227 PMCID: PMC6770579 DOI: 10.3390/nu11092209] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/11/2019] [Accepted: 09/11/2019] [Indexed: 11/24/2022] Open
Abstract
The Diabetes and Nutrition Study Group (DNSG) of the European Association for the Study of Diabetes (EASD) conducted a review of existing systematic reviews and meta-analyses to explain the relationship between different dietary patterns and patient-important cardiometabolic outcomes. To update the clinical practice guidelines for nutrition therapy in the prevention and management of diabetes, we summarize the evidence from these evidence syntheses for the Mediterranean, Dietary Approaches to Stop Hypertension (DASH), Portfolio, Nordic, liquid meal replacement, and vegetarian dietary patterns. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of evidence. We summarized the evidence for disease incidence outcomes and risk factor outcomes using risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs), respectively. The Mediterranean diet showed a cardiovascular disease (CVD) incidence (RR: 0.62; 95%CI, 0.50, 0.78), and non-significant CVD mortality (RR: 0.67; 95%CI, 0.45, 1.00) benefit. The DASH dietary pattern improved cardiometabolic risk factors (P < 0.05) and was associated with the decreased incidence of CVD (RR, 0.80; 95%CI, 0.76, 0.85). Vegetarian dietary patterns were associated with improved cardiometabolic risk factors (P < 0.05) and the reduced incidence (0.72; 95%CI: 0.61, 0.85) and mortality (RR, 0.78; 95%CI, 0.69, 0.88) of coronary heart disease. The Portfolio dietary pattern improved cardiometabolic risk factors and reduced estimated 10-year coronary heart disease (CHD) risk by 13% (−1.34% (95%CI, −2.19 to −0.49)). The Nordic dietary pattern was correlated with decreased CVD (0.93 (95%CI, 0.88, 0.99)) and stroke incidence (0.87 (95%CI, 0.77, 0.97)) and, along with liquid meal replacements, improved cardiometabolic risk factors (P < 0.05). The evidence was assessed as low to moderate certainty for most dietary patterns and outcome pairs. Current evidence suggests that the Mediterranean, DASH, Portfolio, Nordic, liquid meal replacement and vegetarian dietary patterns have cardiometabolic advantages in populations inclusive of diabetes.
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Role of Nutrition and Exercise Programs in Reducing Blood Pressure: A Systematic Review. J Clin Med 2019; 8:jcm8091393. [PMID: 31492032 PMCID: PMC6780911 DOI: 10.3390/jcm8091393] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 08/27/2019] [Accepted: 09/03/2019] [Indexed: 12/24/2022] Open
Abstract
The combined effect of diet and strength training (ST) on blood pressure (BP) seems to be very important for the treatment of prehypertension and hypertension (HT). Therefore, the aim of this study was to determine whether ST alone or combined with nutrition or supplementation has an impact on the arterial pressure reduction in normotensive and hypertensive populations. A systematic computerized literature search was performed according to the PRISMA guidelines using PubMed, Scopus and Google Scholar; only English language studies published from 1999 until 2018 were included. This systematic search identified the results of 303 individuals from nine studies. The ST program alone had a similar effectiveness as the nutrition program (NP) alone; however, their combination did not result in increased effectiveness in terms of a high BP reduction. The consumption of L-citrulline had a similar effect as ST on lowering BP; on the other hand, caffeine led to an increase in BP during the ST session. Our data suggest that a combination of ST 2-3 times a week at moderate intensity and a NP seems to be equally effective in terms of lowering BP (systolic and diastolic) as ST and NP alone.
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136
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Naja F, Itani L, Hwalla N, Sibai AM, Kharroubi SA. Identification of dietary patterns associated with elevated blood pressure among Lebanese men: A comparison of principal component analysis with reduced rank regression and partial least square methods. PLoS One 2019; 14:e0220942. [PMID: 31419246 PMCID: PMC6697315 DOI: 10.1371/journal.pone.0220942] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 07/27/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND To examine the associations of dietary patterns with odds of elevated Blood Pressure (BP) among Lebanese adult males using principal component analysis (PCA), and compare the results to two other data reduction methods, including reduced rank regression (RRR) and partial least-squares (PLS) regression. METHODS Data from the National Nutrition and Non-Communicable Disease Risk Factor Survey conducted in Lebanon between years 2008 and 2009 were used. Dietary intake data were collected by a 61-item food frequency questionnaire (FFQ). In addition, anthropometric and blood pressure measurements were obtained following standard techniques. For the purpose of this study, data of males older than 20 years with no history of chronic diseases were selected (n = 673). Elevated BP was indicated if the systolic blood pressure was > = 130mm Hg and/or the diastolic blood pressure > = 85 mm Hg. Dietary patterns were constructed using PCA, PLS and RRR and compared based on the performance to identify plausible patterns associated with elevated BP. For PLS and RR, the response variables were BMI, waist circumference and percent body fat. Multiple logistic regression was used to evaluate the associations between the dietary pattern scores of each method and risk of elevated BP. RESULTS Three dietary patterns were identified using PCA: Western, Traditional Lebanese, and Fish and alcohol. Both the Western and the Traditional Lebanese patterns were associated with higher odds of elevated BP in the study population (OR = 1.23, CI 1.03, 1.46; OR = 1.29, CI 1.09, 1.52 respectively). The comparison among the three methods for dietary patterns derivation showed that PLS and RRR derived patterns explained greater variance in the outcome (PCA: 1.2%; PLS: 14.1%; RRR: 15.36%) and were significantly associated with elevated BP, while the PCA dietary patterns were descriptive of the study population's real dietary habits (PCA: 23.6%; PLS: 19.8%; RRR: 11.3%). CONCLUSIONS The Western and Traditional Lebanese dietary patterns were associated with higher odds of elevated BP among Lebanese males. The findings of this study showed that, compared to PCA, the use of RRR method resulted in more significant associations with the outcome while the PCA-derived patterns were more related to the real habits in the study population.
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Affiliation(s)
- Farah Naja
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Laila Itani
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University Beirut, Lebanon
| | - Nahla Hwalla
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Abla M Sibai
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Samer A Kharroubi
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
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Zaganjor H, Bishop Kendrick K, Onufrak S, Ralston Aoki J, Whitsel LP, Kimmons J. Food Service Guideline Policies on Local Government-Controlled Properties. Am J Health Promot 2019; 33:1166-1173. [PMID: 31370672 DOI: 10.1177/0890117119865146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE Local governments can implement food service guideline (FSG) policies, which, in large cities, may reach millions of people. This study identified FSG policies among the 20 largest US cities and analyzed them for key FSG policy attributes. DESIGN Quantitative research. SETTING Local government facilities. PARTICIPANTS Twenty largest US cities. MEASURES Frequency of FSG policies and percent alignment to tool. ANALYSIS Using municipal legal code libraries and other data sources, FSG policies enacted as of December 31, 2016, were identified. Full-text reviews were conducted of identified policies to determine whether they met inclusion criteria. Included policies were analyzed for key policy attributes specific to nutrition, behavioral design, implementation, and facility efficiency. RESULTS Searches identified 469 potential FSG policies, of which 6 policies across 5 cities met inclusion criteria. Five policies met a majority of criteria assessed by the classification tool. Overall alignment to the tool ranged from 17% to 88%. Of the 6 policies, 5 met a majority of the nutrition attributes and 5 met at least 50% of attributes associated with implementation. No policies met the attributes associated with facility efficiency. CONCLUSION The FSG policies were identified in 5 of the 20 US cities. Policy alignment was high for nutrition and implementation attributes. This analysis suggests that when cities adopt FSG policies, many develop policies that align with key policy attributes. These policies can serve as models for other jurisdictions to create healthier food access through FSGs.
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Affiliation(s)
- Hatidza Zaganjor
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Stephen Onufrak
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Joel Kimmons
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Lee HY, Shin J, Kim GH, Park S, Ihm SH, Kim HC, Kim KI, Kim JH, Lee JH, Park JM, Pyun WB, Chae SC. 2018 Korean Society of Hypertension Guidelines for the management of hypertension: part II-diagnosis and treatment of hypertension. Clin Hypertens 2019; 25:20. [PMID: 31388453 PMCID: PMC6670135 DOI: 10.1186/s40885-019-0124-x] [Citation(s) in RCA: 165] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 06/25/2019] [Indexed: 02/06/2023] Open
Abstract
The standardized techniques of blood pressure (BP) measurement in the clinic are emphasized and it is recommended to replace the mercury sphygmomanometer by a non-mercury sphygmomanometer. Out-of-office BP measurement using home BP monitoring (HBPM) or ambulatory BP monitoring (ABPM) and even automated office BP (AOBP) are recommended to correctly measure the patient’s genuine BP. Hypertension (HTN) treatment should be individualized based on cardiovascular (CV) risk and the level of BP. Based on the recent clinical study data proving benefits of intensive BP lowering in the high risk patients, the revised guideline recommends the more intensive BP lowering in high risk patients including the elderly population. Lifestyle modifications, mostly low salt diet and weight reduction, are strongly recommended in the population with elevated BP and prehypertension and all hypertensive patients. In patients with BP higher than 160/100 mmHg or more than 20/10 mmHg above the target BP, two drugs can be prescribed in combination to maximize the antihypertensive effect and to achieve rapid BP control. Especially, single pill combination drugs have multiple benefits, including maximizing reduction of BP, minimizing adverse effects, increasing adherence, and preventing cardiovascular disease (CVD) and target organ damage.
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Affiliation(s)
- Hae-Young Lee
- 1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Jinho Shin
- 2Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Gheun-Ho Kim
- 2Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Sungha Park
- 3Department of Internal Medicine, Yonsei University, Seoul, Korea
| | - Sang-Hyun Ihm
- 4Division of Cardiology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun Chang Kim
- 3Department of Internal Medicine, Yonsei University, Seoul, Korea
| | - Kwang-Il Kim
- 5Department of Internal Medicine, Seoul National University, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ju Han Kim
- Department of Internal Medicine, School of Medicine, Chonnam University, GwangJu, Korea
| | - Jang Hoon Lee
- 7Division of Cardiology, Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jong-Moo Park
- 8Department of Neurology, Nowon Eulji Medical Center, Eulji University, Seoul, Korea
| | - Wook Bum Pyun
- 9Cardiovascular Center, Seoul Hospital, Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Shung Chull Chae
- 7Division of Cardiology, Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea
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Lelong H, Blacher J, Baudry J, Adriouch S, Galan P, Fezeu L, Hercberg S, Kesse-Guyot E. Combination of Healthy Lifestyle Factors on the Risk of Hypertension in a Large Cohort of French Adults. Nutrients 2019; 11:nu11071687. [PMID: 31340445 PMCID: PMC6683281 DOI: 10.3390/nu11071687] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 07/18/2019] [Accepted: 07/19/2019] [Indexed: 02/07/2023] Open
Abstract
Background: Healthy lifestyle factors are widely recommended for hypertension prevention and control. Nevertheless, little is known about their combined impact on hypertension, in the general population. Our aim was to compute a Healthy Lifestyle Index (HLI) comprising the main non-pharmacological measures usually recommended to improve hypertension prevention: normal weight, regular physical activity, limited alcohol consumption, adoption of a healthy diet; to evaluate their combined impact on hypertension incidence. Methods: We prospectively followed the incidence of hypertension among 80,426 French adults participating in the NutriNet-Santé cohort study. Self-reported dietary, socio-demographic, lifestyle and health data were assessed at baseline and yearly using a dedicated website; the association between HLI and hypertension risk was assessed by multivariable Cox proportional hazards models adjusted for age, sex, family history of hypertension, socio-demographic and lifestyle factors. Hypothetical Population Attributable Risks associated to each factor were estimated. Results: During a median follow-up of 3.5 years (IQR: 1.5–5.3), 2413 incident cases of hypertension were identified. Compared with no or one healthy lifestyle factor, the hazard ratios (HR) for hypertension were 0.76 (95% CI, 0.67–0.85) for two factors, 0.47 (95% CI, 0.42–0.53) for three factors and 0.35 (95% CI, 0.30–0.41) for all healthy lifestyle factors (p-trend <0.0001). Compared with adhering to 0, 1, 2 or 3 healthy lifestyles, adhering to all of them was found associated with a reduction of the hypertension risk of half (HR = 0.55 (95% CI, 0.46–0.65)). Conclusion: Active promotion of healthy lifestyle factors at population level is a key leverage to fight the hypertension epidemic.
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Affiliation(s)
- Helene Lelong
- AP-HP, Diagnosis and Therapeutic Center, Faculty of Medicine, Hôtel-Dieu Hospital, Paris-Descartes University, 75004 Paris, France.
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France.
| | - Jacques Blacher
- AP-HP, Diagnosis and Therapeutic Center, Faculty of Medicine, Hôtel-Dieu Hospital, Paris-Descartes University, 75004 Paris, France
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France
| | - Julia Baudry
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France
| | - Solia Adriouch
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France
| | - Pilar Galan
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France
| | - Leopold Fezeu
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France
| | - Serge Hercberg
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France
- Department of Public Health, Avicenne Hospital, 93000 Bobigny, France
| | - Emmanuelle Kesse-Guyot
- UREN (Nutritional Epidemiology Research Unit)-U557 INSERM, U1125 INRA, CNAM, CRNH IdF, Paris 13, Sorbonne Paris Cité University, 93000 Bobigny, France
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140
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Lopez PD, Cativo EH, Atlas SA, Rosendorff C. The Effect of Vegan Diets on Blood Pressure in Adults: A Meta-Analysis of Randomized Controlled Trials. Am J Med 2019; 132:875-883.e7. [PMID: 30851264 DOI: 10.1016/j.amjmed.2019.01.044] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 01/29/2019] [Accepted: 01/30/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Vegan diets are increasing in popularity and have beneficial effects on glycemia and blood lipids, but the evidence is inconclusive regarding their effect on blood pressure. The purpose of this study was to review the effect of vegan diets on blood pressure in adults. METHODS We searched MEDLINE, EMBASE, CENTRAL, and ClinicalTrials.gov for records that compared a vegan diet with any less restrictive diet and reported pre- and postintervention systolic and diastolic blood pressures. Two reviewers independently screened abstracts for randomized, controlled clinical trials in individuals ≥18 years of age and older. We used the PRISMA guidelines to select 11 clinical trials from 1673 records. Data synthesis was performed through a random-effects model. RESULTS The pooled data included 983 participants. Compared with less restrictive diets, a vegan diet did not result in a significant change in systolic (-1.33 mm Hg; 95% confidence interval [CI], -3.50-0.84; P = .230) or diastolic (-1.21 mm Hg; 95% CI, -3.06-0.65; P = .203) blood pressure. A prespecified subgroup analysis of studies with baseline systolic blood pressure ≥130 mm Hg revealed that a vegan diet resulted in a mean decrease in the systolic (-4.10 mm Hg; 95% CI, -8.14 to -0.06; P = .047) and diastolic (-4.01 mm Hg; 95% CI, -5.97 to -2.05; P = 0.000) blood pressures. CONCLUSION The changes in blood pressure induced by a vegan diet without caloric restrictions are comparable with those induced by dietary approaches recommended by medical societies and portion-controlled diets.
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Affiliation(s)
- Persio D Lopez
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY; Cardiology/Hypertension Research Program, James J. Peters Veterans Administration Medical Center, Bronx, NY
| | - Eder H Cativo
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY; Cardiology/Hypertension Research Program, James J. Peters Veterans Administration Medical Center, Bronx, NY
| | - Steven A Atlas
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY; Cardiology/Hypertension Research Program, James J. Peters Veterans Administration Medical Center, Bronx, NY
| | - Clive Rosendorff
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY; Cardiology/Hypertension Research Program, James J. Peters Veterans Administration Medical Center, Bronx, NY.
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141
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Relationship between Nutrition and Alcohol Consumption with Blood Pressure: The ESTEBAN Survey. Nutrients 2019; 11:nu11061433. [PMID: 31242675 PMCID: PMC6627946 DOI: 10.3390/nu11061433] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 06/19/2019] [Accepted: 06/24/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Dietary interventions are recommended for the prevention of hypertension. The aim of this study was to evaluate and quantify the relationship between alcohol consumption and the DASH (Dietary Approaches to Stop Hypertension) score with blood pressure (BP) stratified by gender. METHODS Cross-sectional analyses were performed using data from 2105 adults from the ESTEBAN survey, a representative sample of the French population. Pearson correlation analyses were used to assess the correlation between the DASH score and alcohol with BP. Regressions were adjusted by age, treatment, socio-economic level, tobacco, exercise, Body mass index (BMI), and cardiovascular risk factors and diseases. RESULTS The DASH score was negatively correlated with systolic (SBP) and diastolic BP (DBP) (p < 0.0001). Alcohol was positively associated with increased BP only in men. The worst quintile of the DASH score was associated with an 1.8 mmHg increase in SBP and an 0.6 mmHg increase in SBP compared to the greatest quintile in men and with a 1.5 mmHg increase in SBP and an 0.4 mmHg increase in SBP in women. Male participants in the worst quintile of alcohol consumption showed an increase of 3.0 mmHg in SBP and 0.8 mmHg in DBP compared to those in the greatest quintile. CONCLUSION A high DASH score and a reduction in alcohol consumption could be effective nutritional strategies for the prevention of hypertension.
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142
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Iqbal S, Klammer N, Ekmekcioglu C. The Effect of Electrolytes on Blood Pressure: A Brief Summary of Meta-Analyses. Nutrients 2019; 11:nu11061362. [PMID: 31212974 PMCID: PMC6627949 DOI: 10.3390/nu11061362] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 06/12/2019] [Accepted: 06/13/2019] [Indexed: 12/11/2022] Open
Abstract
Nutrition is known to exert an undeniable impact on blood pressure with especially salt (sodium chloride), but also potassium, playing a prominent role. The aim of this review was to summarize meta-analyses studying the effect of different electrolytes on blood pressure or risk for hypertension, respectively. Overall, 32 meta-analyses evaluating the effect of sodium, potassium, calcium and magnesium on human blood pressure or hypertension risk were included after literature search. Most of the meta-analyses showed beneficial blood pressure lowering effects with the extent of systolic blood pressure reduction ranging between -0.7 (95% confidence interval: -2.6 to 1.2) to -8.9 (-14.1 to -3.7) mmHg for sodium/salt reduction, -3.5 (-5.2 to -1.8) to -9.5 (-10.8 to -8.1) mmHg for potassium, and -0.2 (-0.4 to -0.03) to -18.7 (-22.5 to -15.0) mmHg for magnesium. The range for diastolic blood pressure reduction was 0.03 (-0.4 to 0.4) to -5.9 (-9.7 to -2.1) mmHg for sodium/salt reduction, -2 (-3.1 to -0.9) to -6.4 (-7.3 to -5.6) mmHg for potassium, and -0.3 (-0.5 to -0.03) to -10.9 (-13.1 to -8.7) mmHg for magnesium. Moreover, sufficient calcium intake was found to reduce the risk of gestational hypertension.
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Affiliation(s)
- Sehar Iqbal
- Department of Environmental Health, Center for Public Health, Medical University Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria.
| | - Norbert Klammer
- Department of Environmental Health, Center for Public Health, Medical University Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria.
| | - Cem Ekmekcioglu
- Department of Environmental Health, Center for Public Health, Medical University Vienna, Kinderspitalgasse 15, 1090 Vienna, Austria.
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143
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Lambert EA, Esler MD, Schlaich MP, Dixon J, Eikelis N, Lambert GW. Obesity-Associated Organ Damage and Sympathetic Nervous Activity. Hypertension 2019; 73:1150-1159. [DOI: 10.1161/hypertensionaha.118.11676] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Elisabeth A. Lambert
- From the Iverson Health Innovation Research Institute and School of Health Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC, Australia (E.A.L., N.E., G.W.L.)
- Human Neurotransmitters Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia (E.A.L., M.D.E., N.E., G.W.L.)
| | - Murray D. Esler
- Human Neurotransmitters Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia (E.A.L., M.D.E., N.E., G.W.L.)
| | - Markus P. Schlaich
- Dobney Hypertension Centre, School of Medicine–Royal Perth Hospital Unit, University of Western Australia (M.P.S.)
| | - John Dixon
- Clinical Obesity Research Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia (J.D.)
| | - Nina Eikelis
- From the Iverson Health Innovation Research Institute and School of Health Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC, Australia (E.A.L., N.E., G.W.L.)
| | - Gavin W. Lambert
- From the Iverson Health Innovation Research Institute and School of Health Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC, Australia (E.A.L., N.E., G.W.L.)
- Human Neurotransmitters Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia (E.A.L., M.D.E., N.E., G.W.L.)
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144
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Abstract
PURPOSE OF REVIEW This review discusses recent evidence on the association of dietary carbohydrates (quantity, quality, and timing of intake) with hypertension (HTN) risk and out-of-clinic blood pressure (BP) measures. RECENT FINDINGS Studies on carbohydrate quantity are inconclusive, but low carbohydrate diets may be associated with lower BP. Plant-based carbohydrate-containing foods such as fruits, vegetables, and whole grains may lower HTN risk and 24-h BP. Excessive sugar intakes from sugar-sweetened beverages are associated with higher BP levels and HTN risk, with evidence of a dose-response relationship. Preliminary data suggest that timing of carbohydrate intake may influence HTN risk and 24-h BP. The role of carbohydrate nutrition in HTN's etiology warrants further investigation. Additional studies are needed to investigate the influence of dietary carbohydrates on HTN risk and the circadian pattern of BP, evaluate potential sex and racial/ethnic differences in these associations, and elucidate underlying mechanisms.
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145
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Naude CE, Schoonees A, Nguyen KA, Senekal M, Young T, Garner P, Chaplin M, Volmink J. Low carbohydrate versus balanced carbohydrate diets for reducing weight and cardiovascular risk. Hippokratia 2019. [DOI: 10.1002/14651858.cd013334] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Celeste E Naude
- Stellenbosch University; Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences; Francie van Zijl Drive Cape Town South Africa
| | - Anel Schoonees
- Stellenbosch University; Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences; Francie van Zijl Drive Cape Town South Africa
| | - Kim A Nguyen
- Stellenbosch University; Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences; Francie van Zijl Drive Cape Town South Africa
| | - Marjanne Senekal
- University of Cape Town; Division of Human Nutrition, Faculty of Health Sciences; Cape Town South Africa
| | - Taryn Young
- Stellenbosch University; Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences; Francie van Zijl Drive Cape Town South Africa
| | - Paul Garner
- Liverpool School of Tropical Medicine; Department of Clinical Sciences; Liverpool UK L3 5QA UK
| | - Marty Chaplin
- Liverpool School of Tropical Medicine; Department of Clinical Sciences; Liverpool UK L3 5QA UK
| | - Jimmy Volmink
- Stellenbosch University; Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences; Francie van Zijl Drive Cape Town South Africa
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146
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Alvarez-Alvarez I, Toledo E, Lecea O, Salas-Salvadó J, Corella D, Buil-Cosiales P, Zomeño MD, Vioque J, Martinez JA, Konieczna J, Barón-López FJ, López-Miranda J, Estruch R, Bueno-Cavanillas A, Alonso-Gómez ÁM, Tur JA, Tinahones FJ, Serra-Majem L, Martín V, Ortega-Calvo M, Vázquez C, Pintó X, Vidal J, Daimiel L, Delgado-Rodríguez M, Matía P, González JI, Díaz-López A, Paz-Graniel I, Muñoz MA, Fito M, Pertusa-Martinez S, Abete I, García-Ríos A, Ros E, Ruiz-Canela M, Martínez-González MÁ. Adherence to a priori dietary indexes and baseline prevalence of cardiovascular risk factors in the PREDIMED-Plus randomised trial. Eur J Nutr 2019; 59:1219-1232. [PMID: 31073885 DOI: 10.1007/s00394-019-01982-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 04/26/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE Cardiovascular disease remains the global leading cause of death. We evaluated at baseline the association between the adherence to eight a priori high-quality dietary scores and the prevalence of individual and clustered cardiovascular risk factors (CVRF) in the PREDIMED-Plus cohort. METHODS All PREDIMED-Plus participants (6874 men and women aged 55-75 years, with overweight/obesity and metabolic syndrome) were assessed. The prevalence of 4 CVRF (hypertension, obesity, diabetes, and dyslipidaemia), using standard diagnoses criteria, were considered as outcomes. The adherence to eight a priori-defined dietary indexes was calculated. Multivariable models were fitted to estimate differences in mean values of factors and prevalence ratios for individual and clustered CVRF. RESULTS Highest conformity to any dietary pattern did not show inverse associations with hypertension. The modified Mediterranean Diet Score (PR = 0.95; 95% CI 0.90-0.99), Mediterranean Diet Adherence Score (MEDAS) (PR = 0.94; 95% CI 0.89-0.98), the pro-vegetarian dietary pattern (PR = 0.95; 95% CI 0.90-0.99) and the Alternate Healthy Eating Index 2010 (PR = 0.92; 95% CI 0.87-0.96) were inversely associated with prevalence of obesity. We identified significant inverse trend among participants who better adhered to the MEDAS and the Prime Diet Quality Score (PDQS) in the mean number of CVRF across categories of adherence. Better adherence to several high-quality dietary indexes was associated with better blood lipid profiles and anthropometric measures. CONCLUSIONS Highest adherence to dietary quality indexes, especially Mediterranean-style and PDQS scores, showed marginal associations with lower prevalence of individual and clustered CVRF among elderly adults with metabolic syndrome at high risk of cardiovascular disease.
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Affiliation(s)
- Ismael Alvarez-Alvarez
- Department of Preventive Medicine and Public Health, University of Navarra-IdiSNA, C/Irunlarrea 1, 31080, Pamplona, Navarra, Spain
| | - Estefanía Toledo
- Department of Preventive Medicine and Public Health, University of Navarra-IdiSNA, C/Irunlarrea 1, 31080, Pamplona, Navarra, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Oscar Lecea
- Department of Preventive Medicine and Public Health, University of Navarra-IdiSNA, C/Irunlarrea 1, 31080, Pamplona, Navarra, Spain.,Atención Primaria, Osasunbidea-Servicio Navarro de Salud, Pamplona, Spain
| | - Jordi Salas-Salvadó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana IISPV, Hospital Universitari Sant Joan de Reus, Rovira i Virgili University, Reus, Spain
| | - Dolores Corella
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Pilar Buil-Cosiales
- Department of Preventive Medicine and Public Health, University of Navarra-IdiSNA, C/Irunlarrea 1, 31080, Pamplona, Navarra, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Atención Primaria, Osasunbidea-Servicio Navarro de Salud, Pamplona, Spain
| | - María Dolores Zomeño
- Cardiovascular Risk and Nutrition, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain.,Blanquerna School of Life Sciences, Universitat Ramon Llull, Barcelona, Spain
| | - Jesús Vioque
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Nutritional Epidemiology Unit, Miguel Hernandez University, ISABIAL-FISABIO, Alicante, Spain
| | - J Alfredo Martinez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Nutrition, Food Sciences and Physiology, University of Navarra, Pamplona, Spain.,Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Jadwiga Konieczna
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Health Research Institute of the Balearic Islands (IdISBa), University Hospital Son Espases, Palma, Spain
| | | | - José López-Miranda
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain
| | - Ramon Estruch
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Internal Medicine, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Aurora Bueno-Cavanillas
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Preventive Medicine, University of Granada, Granada, Spain
| | - Ángel M Alonso-Gómez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Cardiology Organización Sanitaria Integrada (OSI) ARABA, University Hospital Araba, Vitoria-Gasteiz, Spain.,University of the Basque Country, UPV/EHU, Vitoria-Gasteiz, Spain
| | - Josep A Tur
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Research Group on Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma de Mallorca, Spain
| | - Francisco J Tinahones
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Endocrinology, Hospital Virgen de la Victoria (IBIMA), University of Málaga, Málaga, Spain
| | - Lluís Serra-Majem
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Institute for Biomedical Research, University of Las Palmas de Gran Canaria, Las Palmas, Spain
| | - Vicente Martín
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Institute of Biomedicine (IBIOMED), University of León, León, Spain
| | - Manuel Ortega-Calvo
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Family Medicine, Healthcare centre Las Palmeritas, Distrito Sanitario Atención Primaria Sevilla, Seville, Spain
| | - Clotilde Vázquez
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Endocrinology, Fundación Jiménez-Díaz, Madrid, Spain
| | - Xavier Pintó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
| | - Josep Vidal
- CIBER Diabetes y enfermedades metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Endocrinology, IDIBAPS, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Lidia Daimiel
- Nutritional Genomics and Epigenomics Group, IMDEA Food, CEI UAM + CSIC, Madrid, Spain
| | - Miguel Delgado-Rodríguez
- CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Division of Preventive Medicine, University of Jaén, Jaén, Spain
| | - Pilar Matía
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - José I González
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Andrés Díaz-López
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana IISPV, Hospital Universitari Sant Joan de Reus, Rovira i Virgili University, Reus, Spain
| | - Indira Paz-Graniel
- Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana IISPV, Hospital Universitari Sant Joan de Reus, Rovira i Virgili University, Reus, Spain
| | - Miguel A Muñoz
- Gerencia territorial de Barcelona, Institut Català de la Salut, Barcelona, Spain.,Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Montse Fito
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Cardiovascular Risk and Nutrition, IMIM-Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Salvador Pertusa-Martinez
- Nutritional Epidemiology Unit, Miguel Hernandez University, ISABIAL-FISABIO, Alicante, Spain.,Healthcare centre Cabo Huertas, Alicante, Spain
| | - Itziar Abete
- Department of Nutrition, Food Sciences and Physiology, University of Navarra, Pamplona, Spain
| | - Antonio García-Ríos
- Lipids and Atherosclerosis Unit, Department of Internal Medicine, Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Reina Sofía University Hospital, University of Córdoba, Córdoba, Spain
| | - Emilio Ros
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.,Department of Endocrinology and Nutrition, Lipid Clinic, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain
| | - Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, University of Navarra-IdiSNA, C/Irunlarrea 1, 31080, Pamplona, Navarra, Spain.,CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Miguel Á Martínez-González
- Department of Preventive Medicine and Public Health, University of Navarra-IdiSNA, C/Irunlarrea 1, 31080, Pamplona, Navarra, Spain. .,CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. .,Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, USA.
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147
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Jama HA, Beale A, Shihata WA, Marques FZ. The effect of diet on hypertensive pathology: is there a link via gut microbiota-driven immunometabolism? Cardiovasc Res 2019; 115:1435-1447. [DOI: 10.1093/cvr/cvz091] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 02/07/2019] [Accepted: 04/03/2019] [Indexed: 12/23/2022] Open
Abstract
Abstract
Over the past decade, the immune system has emerged as an important component in the aetiology of hypertension. There has been a blooming interest in the contribution of the gut microbiota, the microbes that inhabit our small and large intestine, to blood pressure (BP) regulation. The gastrointestinal tract houses the largest number of immune cells in our body, thus, it is no surprise that its microbiota plays an important functional role in the appropriate development of the immune system through a co-ordinated sequence of events leading to immune tolerance of commensal bacteria. Importantly, recent evidence supports that the gut microbiota can protect or promote the development of experimental hypertension and is likely to have a role in human hypertension. One of the major modulators of the gut microbiota is diet: diets that emphasize high intake of fermentable fibre, such as the Mediterranean diet and the Dietary Approaches to Stop Hypertension, promote expansion of protective microbes that release gut metabolites such as short-chain fatty acids, which are immune-, BP-, and cardio-protective, likely acting through G-coupled protein receptors. In contrast, diets lacking fibre or high in salt and fat, such as the Western diet, reduce prevalence of commensal microbial species and support a pathogenic and pro-inflammatory environment, including the release of the pro-atherosclerotic trimethylamine N-oxide. Here, we review the current understanding of the gut microbiota-driven immune dysfunction in both experimental and clinical hypertension, and how these changes may be addressed through dietary interventions.
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Affiliation(s)
- Hamdi A Jama
- Heart Failure Research Group, Baker Heart and Diabetes Institute, 75 Commercial Rd, Melbourne, VIC, Australia
- Hypertension Research Laboratory, School of Biological Sciences, Faculty of Science, Monash University, 25 Rainforest Walk, Clayton, Melbourne, VIC, Australia
| | - Anna Beale
- Heart Failure Research Group, Baker Heart and Diabetes Institute, 75 Commercial Rd, Melbourne, VIC, Australia
| | - Waled A Shihata
- Heart Failure Research Group, Baker Heart and Diabetes Institute, 75 Commercial Rd, Melbourne, VIC, Australia
| | - Francine Z Marques
- Heart Failure Research Group, Baker Heart and Diabetes Institute, 75 Commercial Rd, Melbourne, VIC, Australia
- Hypertension Research Laboratory, School of Biological Sciences, Faculty of Science, Monash University, 25 Rainforest Walk, Clayton, Melbourne, VIC, Australia
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148
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Igwe EO, Charlton KE, Probst YC. Usual dietary anthocyanin intake, sources and their association with blood pressure in a representative sample of Australian adults. J Hum Nutr Diet 2019; 32:578-590. [PMID: 30916431 DOI: 10.1111/jhn.12647] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Anthocyanins represent an important subgroup of non-nutritive components of food as evidence continues to build related to their beneficial bioactive effects. Using a recently developed Australian anthocyanin database, the present study aimed to estimate the intake of both total anthocyanins and their subclasses, identify food sources of anthocyanins, and determine associations between anthocyanin intake and measured blood pressure (BP). METHODS The present study comprised a secondary analysis of the 2011-12 National Nutrition and Physical Activity component of the Australian Health Survey. Anthocyanin intake was estimated using an Australian anthocyanin database. Usual anthocyanin intake, as estimated from 24-h diet recall data, was computed using multiple source methods, whereas food sources were determined by calculating contribution of food groups to total anthocyanin intake. Regression analysis, adjusted for covariates (age, gender, body mass index, high BP diagnosis, smoking status and physical activity) assessed the relationship between anthocyanin intake and BP in adults aged ≥50 years. RESULTS Mean anthocyanin intake was 24.17 ± 0.32 mg day-1 . Across age groups, berries were the top sources: blackberry (5-65%), cherry (2-24%), blueberry (2-13%) and raspberry (3-12%). There was a significant inverse association between anthocyanin intake and systolic BP (β = -0.04, F = 16.8, d.f. = 6, r2 = 0.05, P < 0.01) and diastolic BP (β = 0.01, F = 5.35, d.f. = 6, R2 = 0.013, P < 0.01), in models that adjusted for covariates. CONCLUSIONS In comparison with the world composite database, anthocyanin intake in the Australian population was above average [mean (SD): 24.17 (0.32) mg day-1 versus 18.05 (21.14) mg day-1 ]. Berries were the primary source of anthocyanins. Anthocyanin intake in older adults aged ≥50 years was inversely associated with BP.
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Affiliation(s)
- E O Igwe
- Faculty of Science, Medicine and Health, School of Medicine, University of Wollongong, Wollongong, NSW, Australia
| | - K E Charlton
- Faculty of Science, Medicine and Health, School of Medicine, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Y C Probst
- Faculty of Science, Medicine and Health, School of Medicine, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
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149
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Kokubo Y, Padmanabhan S, Iwashima Y, Yamagishi K, Goto A. Gene and environmental interactions according to the components of lifestyle modifications in hypertension guidelines. Environ Health Prev Med 2019; 24:19. [PMID: 30857519 PMCID: PMC6410507 DOI: 10.1186/s12199-019-0771-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 02/24/2019] [Indexed: 12/24/2022] Open
Abstract
Risk factors for hypertension consist of lifestyle and genetic factors. Family history and twin studies have yielded heritability estimates of BP in the range of 34–67%. The most recent paper of BP GWAS has explained about 20% of the population variation of BP. An overestimation of heritability may have occurred in twin studies due to violations of shared environment assumptions, poor phenotyping practices in control cohorts, failure to account for epistasis, gene-gene and gene-environment interactions, and other non-genetic sources of phenotype modulation that are suspected to lead to underestimations of heritability in GWAS. The recommendations of hypertension guidelines in major countries consist of the following elements: weight reduction, a healthy diet, dietary sodium reduction, increasing physical activity, quitting smoking, and moderate alcohol consumption. The hypertension guidelines are mostly the same for each country or region, beyond race and culture. In this review, we summarize gene-environmental interactions associated with hypertension by describing lifestyle modifications according to the hypertension guidelines. In the era of precision medicine, clinicians who are responsible for hypertension management should consider the gene-environment interactions along with the appropriate lifestyle components toward the prevention and treatment of hypertension. We briefly reviewed the interaction of genetic and environmental factors along the constituent elements of hypertension guidelines, but a sufficient amount of evidence has not yet accumulated, and the results of genetic factors often differed in each study.
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Affiliation(s)
- Yoshihiro Kokubo
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, 5-7-1, Fujishiro-dai, Suita, Osaka, 565-8565, Japan. .,Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
| | - Sandosh Padmanabhan
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Yoshio Iwashima
- Division of Hypertension and Nephrology, Department of Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
| | - Atsushi Goto
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
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150
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Fruit, vegetable intake and blood pressure trajectories in older age. J Hum Hypertens 2019; 33:671-678. [PMID: 30842546 PMCID: PMC6760602 DOI: 10.1038/s41371-019-0189-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 11/07/2018] [Accepted: 02/19/2019] [Indexed: 12/21/2022]
Abstract
Diet rich in fruits and vegetables (F&V) is an established protective factor for hypertension, but the available evidence regarding the impact of F&V consumption on age-related blood pressure change is limited. We examined whether systolic (SBP) and diastolic (DBP) blood pressure trajectories are influenced by F&V intakes in an ageing Russian cohort. Dietary data was available for 8997 men and women in the Health, Alcohol and Psychosocial Factors in Eastern Europe prospective cohort study. Blood pressure measurements were taken at three time-points over 12 years of follow-up, during which time the mean age of the sample changed from 58 to 69 years. The relationships between F&V intake and SBP and DBP were assessed using mixed-effect multilevel models. In the multivariable adjusted models, fruit intake was inversely related to both systolic and diastolic blood pressure at baseline (mean SBP and DBP was 3.5 mmHg and 1.4 mm Hg lower in the highest compared to the lowest intake tertiles, respectively (both p values < 0.001)). However, it was not associated with blood pressure change over time (difference in annual SBP and DBP change was 0.11 mmHg (p value = 0.138) and 0.01 mmHg (p value = 0.894), respectively). We found no significant link between vegetable intake and blood pressure, neither cross-sectionally nor longitudinally. In addition to the association with diet, we observed increasing SBP and mostly steady DBP over age, with deceleration and downward turn after the ages of 55–59 years. On the whole, this analysis found no consistent association between F&V intake and trajectories of blood pressure in older age.
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