Is fatty acid intake a predictor of arterial stiffness and blood pressure in men? Evidence from the Caerphilly Prospective Study

Vascular ageing: moving from bench towards bedside

Prevention of cardiovascular disease (CVD) remains one of the largest public health challenges of our time. Identifying individuals at increased cardiovascular risk at an asymptomatic, sub-clinical stage is of paramount importance for minimizing disease progression as well as the substantial health and economic burden associated with overt CVD. Vascular ageing (VA) involves the deterioration in vascular structure and function over time and ultimately leads to damage in the heart, brain, kidney, and other organs. Vascular ageing encompasses the cumulative effect of all cardiovascular risk factors on the arterial wall over the life course and thus may help identify those at elevated cardiovascular risk, early in disease development. Although the concept of VA is gaining interest clinically, it is seldom measured in routine clinical practice due to lack of consensus on how to characterize VA as physiological vs. pathological and various practical issues. In this state-of-the-art review and as a network of scientists, clinicians, engineers, and industry partners with expertise in VA, we address six questions related to VA in an attempt to increase knowledge among the broader medical community and move the routine measurement of VA a little closer from bench towards bedside.

Longitudinal Associations Between Fat-Derived Dietary Patterns and Early Markers of Cardiovascular Disease Risk in the UK Biobank Study

Background Although the impact of dietary fats on cardiovascular disease (CVD) risk is widely researched, longitudinal associations between dietary patterns (DPs) based on fat type and early markers of CVD risk remain unclear. Methods and Results UK Biobank participants (46.9% men, mean age 55 years) with data on early markers of CVD risk (n=12 706) were followed longitudinally (2014-2020; mean 8.4 years). Two DPs (DP1, DP2) were derived using reduced rank regression (response variables: monounsaturated fat, polyunsaturated fat, and saturated fat based on two 24-hour dietary assessments. Multivariable logistic and linear regression were used to investigate associations between DPs and odds of elevated CVD risk (using the nonlaboratory Framingham Risk Score) and changes in early CVD markers, respectively. DP1 (characterized by higher nuts and seeds and lower fruit and legumes intake) was positively correlated with saturated fat, monounsaturated fat, and polyunsaturated fat; DP2 (characterized by higher butter and high-fat cheese, lower nuts and seeds intake) was positively correlated with saturated fat and negatively with polyunsaturated fat and monounsaturated fat. DP2 was associated with slightly higher odds of elevated CVD risk (odds ratio, 1.04 [95% CI, 1.00-1.07]). DP1 was associated with higher diastolic blood pressure (β, 0.20 [95% CI, 0.01-0.37]) and lower cardiac index (β, -0.02 [95% CI, -0.04 to -0.01]); DP2 was associated with higher carotid intima medial thickness (β, 1.80 [95% CI, 0.01-3.59]) and lower left ventricular ejection fraction (β, -0.15 [95% CI, -0.24 to -0.07]) and cardiac index (β, -0.01 [95% CI, -0.02 to -0.01]). Conclusions This study suggests small but statistically significant associations between DPs based on fat type and some early markers of CVD risk. Further research is needed to confirm these associations.

Aortic Stiffness: Epidemiology, Risk Factors, and Relevant Biomarkers

Aortic stiffness (AoS) is a maladaptive response to hemodynamic stress and both modifiable and non-modifiable risk factors, and elevated AoS increases afterload for the heart. AoS is a non-invasive marker of cardiovascular health and metabolic dysfunction. Implementing AoS as a diagnostic tool is challenging as it increases with age and varies amongst races. AoS is associated with lifestyle factors such as alcohol and smoking, as well as hypertension and comorbid conditions including metabolic syndrome and its components. Multiple studies have investigated various biomarkers associated with increased AoS, and this area is of particular interest given that these markers can highlight pathophysiologic pathways and specific therapeutic targets in the future. These biomarkers include those involved in the inflammatory cascade, anti-aging genes, and the renin-angiotensin aldosterone system. In the future, targeting AoS rather than blood pressure itself may be the key to improving vascular health and outcomes. In this review, we will discuss the current understanding of AoS, measurement of AoS and the challenges in interpretation, associated biomarkers, and possible therapeutic avenues for modulation of AoS.

The verification of the reliability of a triglyceride-glucose index and its availability as an advanced tool

BACKGROUND

The triglyceride-glucose (TyG) index has been considered as insulin resistance (IR) assessment index. The current study aimed to verify the reliability of the TyG index as an IR assessment marker; the study of plasma fatty acids and body fat composition to determine potential metabolic syndrome (MetS) participants with a body mass index (BMI) of between 25.0 and 29.9 kg/m².

METHODS

The study included 378 overweight participants with a body mass index of between 25.0 and 29.9 kg/m². They were divided into tertiles according to the homeostasis model assessment of IR (HOMA-IR) or the TyG index. The role of the IR assessment index and the relationship with IR-related diseases and the risk factors using gas chromatograph-mass spectrometry, computed tomography, and dual energy X-ray absorptiometry, was investigated.

RESULTS

It was only in the TyG index tertile that the higher TyG index participants showed considerably higher LDL-cholesterol levels. More markedly, a close relationship was observed between the TyG index and the omega-6 polyunsaturated fatty acids compared with the HOMA-IR. Unlike HOMA-IR, with regard to the risks of developing chronic diseases, the MetS, the third tertile of the TyG index, showed an approximately 33.7 times greater odds ratio (OR) of the MetS occurring, compared with the first tertile of the TyG index.

CONCLUSIONS

The TyG index may be considered as an IR assessment index. In addition, the TyG index is an advanced tool that reflects the relevance of pro-inflammation levels and the presence of IR-related chronic diseases.

Molecular Immune-Inflammatory Connections between Dietary Fats and Atherosclerotic Cardiovascular Disease: Which Translation into Clinics?

Current guidelines recommend reducing the daily intake of dietary fats for the prevention of ischemic cardiovascular diseases (CVDs). Avoiding saturated fats while increasing the intake of mono- or polyunsaturated fatty acids has been for long time the cornerstone of dietary approaches in cardiovascular prevention, mainly due to the metabolic effects of these molecules. However, recently, this approach has been critically revised. The experimental evidence, in fact, supports the concept that the pro- or anti-inflammatory potential of different dietary fats contributes to atherogenic or anti-atherogenic cellular and molecular processes beyond (or in addition to) their metabolic effects. All these aspects are hardly translatable into clinics when trying to find connections between the pro-/anti-inflammatory potential of dietary lipids and their effects on CVD outcomes. Interventional trials, although providing stronger potential for causal inference, are typically small sample-sized, and they have short follow-up, noncompliance, and high attrition rates. Besides, observational studies are confounded by a number of variables and the quantification of dietary intakes is far from optimal. A better understanding of the anatomic and physiological barriers for the absorption and the players involved in the metabolism of dietary lipids (e.g., gut microbiota) might be an alternative strategy in the attempt to provide a first step towards a personalized dietary approach in CVD prevention.

The Relationship Between Dietary Choices and Health and Premature Vascular Ageing

The paper aims to review the available data about the main mechanisms enabling improvement or accelerating vascular ageing due to food choices, considering recent experimental and clinical data, and emphasising potential implications for clinical practice and therapy. The main food choices which will be discussed are diets rich in fruits and vegetables, the Mediterranean diet, polyunsaturated fatty acids, cocoa, caffeine, tea, meat, dairy products, sodium, and potassium intake.

Association between egg consumption and arterial stiffness: a longitudinal study

BACKGROUND

Inconsistent associations between egg consumption and cardiovascular disease (CVD) risk have been observed in previous studies. This study aims to longitudinally investigate the association between egg consumption and altered risk of arterial stiffness, a major pre-clinical pathogenic change of CVD, which was assessed by brachial-ankle pulse wave velocity (baPWV).

METHODS

A total of 7315 Chinese participants from the Kailuan Study, free of CVD and cancer were included in this study. Egg consumption was assessed by a semi-quantitative validated food frequency questionnaire in 2014. baPWV was repeatedly measured at baseline and during follow-up (mean follow-up: 3.41 years). General linear regression was used to calculate means of baPWV change rate across different egg consumption groups, adjusting for age, sex, baseline baPWV, healthy eating index, total energy, social-economic status, blood pressure, obesity, smoking, lipid profiles, and fasting glucose concentrations.

RESULTS

Compared to the annual baPWV change rate in participants with 0-1.9 eggs/wk. (adjusted mean: 35.9 ± 11.2 cm/s/y), those consuming 3-3.9 eggs/wk. (adjusted mean: 0.2 ± 11.4 cm/s/y) had the lowest increase in baPWV during follow-up (P-difference = 0.002). Individuals with low (0-1.9 eggs/wk) vs. high (5+ eggs /wk) egg intake showed similar changes in baPWV.

CONCLUSIONS

In this large-scale longitudinal analysis, we did not find a significant difference in arterial stiffness, as assessed by baPWV level, between low and high egg consumption groups. However, moderate egg consumption (3-3.9 eggs/wk) appeared to have beneficial effects on arterial stiffness.

ANTHROPOMETRIC MEASUREMENTS, DIETARY HABITS, SERUM LIPID AND GLUCOSE LEVELS IN RELATION TO HIGH BLOOD PRESSURE AMONG ADOLESCENT BOYS AND GIRLS IN CROATIA

The aim was to determine differences in anthropometric measurements, dietary habits, serum lipid and glucose levels in relation to high blood pressure (BP) among adolescent boys and girls in Croatia. The specific aim was to determine the effect of dietary habits and lifestyle on high BP in adolescents according to sex. The study included 260 (68.2%) adolescent girls and 121 (31.8%) boys with anthropometric data obtained (without missing values) from 246 girls and 111 boys. Participants answered questions from the questionnaire and anthropometric BP and blood test values were obtained. Non-parametric tests were used in analyses of reference intervals of systolic and diastolic BP in adolescent boys and girls according to age. High BP was defined as ≥90^th percentile for adolescent girls and boys, with a value of ≥135/87.5 mm Hg. Mann-Whitney U test was used to analyze differences in anthropometric and laboratory values between the groups of girls and boys with high (≤90^th percentile) and normal BP. Increase in systolic and diastolic BP was noted in the adolescents. In girls, BP values showed a decreasing systolic and increasing diastolic BP trend with age. Girls with high BP had a significantly higher body mass index (BMI) (p=0.020), waist circumference (WC) (p=0.002), waist-to-height ratio (WHtR) (p=0.016), waist-to-hip ratio (WHR) (p=0.043), hip circumference (HC) (p=0.015), triglyceride (TG) levels (p=0.021), higher prevalence of unhealthy diet at school breakfast (p=0.008) and lower prevalence of eating fish (p=0.02). Boys with high BP had a significantly higher BMI (p=0.045), WC (p=0.004), WHtR (p=0.017), WHR (p=0.022) and higher prevalence of eating meat products (p=0.015). Effective health interventions are needed to reduce the risk of developing cardiovascular diseases and preventing age-related illness.

Secular trends in hypertension and elevated blood pressure among Korean children and adolescents in the Korea National Health and Nutrition Examination Survey 2007-2015

The prevalence of elevated blood pressure (BP) among US children and adolescents has reportedly declined over the past decade. As no Korean data have been analyzed, we aimed to determine recent trends in BP levels among Korean children and adolescents. This study examines data from the Korea National Health and Nutrition Examination Survey segregated into 3 time periods (2007-2009, 2010-2012, and 2013-2015). A total of 7804 Korean children and adolescents aged 10-18 years were included in the analysis. Hypertension (≥95th percentile) and elevated BP (>90th percentile) were defined using the sex-, age-, and height-specific BP standards from 2017 American Academy of Pediatrics guidelines. Mean systolic BP from 2007-2009 to 2013-2015 increased by 3.9 mm Hg, and there was no significant change in diastolic BP. Body mass index (BMI) z-scores significantly increased in the total population from 2007-2009 to 2013-2015. In 2013-2015, the prevalence rates of elevated BP and hypertension were 8.8% and 9.0%, respectively. The prevalence of hypertension in 2013-2015 increased in the total population compared with those in 2007-2009, especially in the obese subgroup, in which the hypertension prevalence was 27.7% in 2013-2015. The prevalence of elevated BP increased during these time period. Associated factors were sex, age, BMI z-score, and survey period for elevated BP; and sex, age, and BMI z-score for hypertension. During our study, mean systolic BP increased, and the prevalence of hypertension in 2013-2015 increased in the pediatric population. A possible influencing factor is obesity, and further long-term data are necessary.

Comparison of Trends in Blood Pressure and the Prevalence of Obesity Among Korean and American Adolescents: A 12-Years Cross-sectional Study

OBJECTIVES

This study was conducted to explore recent trends in the prevalence of pediatric elevated blood pressure and hypertension (HTN) in Korea and the United States, applying the new HTN reference values for adolescents.

METHODS

This study analyzed 17 339 (8755 Korean and 8584 American) adolescents aged 10 to 17 who participated in the Korea National Health and Nutrition Examination Survey and the National Health and Nutrition Examination Survey, respectively, between 2005 and 2016. HTN was defined using percentile-based reference values for non-overweight adolescents from 7 nations, and obesity was defined by body mass index (BMI) based on country-specific growth charts. All analyses were stratified by sex and year-over-year changes were evaluated by calculating the p for trend.

RESULTS

Systolic blood pressure showed a statistically meaningful upward trend in Korean boys and girls, while diastolic blood pressure did not show any significant changes. Both systolic and diastolic blood pressure levels declined among United States boys and girls. The prevalence of elevated blood pressure and HTN remained similar in Korean adolescents, but declined in both sexes among United States adolescents. BMI increased in both sexes among Korean adolescents, although the overweight and obesity rates stayed the same. No significant trends were found in any obesity indices among United States adolescents. The prevalence of elevated blood pressure and HTN by obesity level was higher among Korean adolescents than among their United States peers in both sexes, and the gap became higher at more severe levels of obesity.

CONCLUSIONS

Despite the strong correlation between obesity and HTN, recent trends in the prevalence of HTN and obesity among Korean and United States adolescents were strikingly different. Follow-up studies are necessary to determine why the prevalence of HTN was more than twice as high among Korean adolescents than among their United States counterparts.

Dairy Foods and Body Mass Index over 10-Year: Evidence from the Caerphilly Prospective Cohort Study

The association between dairy product consumption and body mass index (BMI) remains controversial. The aim of the present study was to investigate the association between total dairy, milk, cheese, cream and butter consumption and BMI change over a 10-year follow-up by using long-term follow-up cohort data from the Caerphilly Prospective Cohort Study (CAPS). The CAPS included 2512 men aged 45⁻59 years at baseline, who were followed up at 5-year intervals for over 20-year. A semi-quantitative food frequency questionnaire estimated the intake of dairy consumption, including milk, cheese, cream and butter at baseline, 5-year and 10-year follow-up. In total, men free of cardiovascular disease, diabetes and cancer (n = 1690) were included in current analysis. General linear regression and logistic regression were used for data analysis. The results showed higher cheese consumption was associated with lower BMI at the 5-year follow-up (p = 0.013). There was no evidence that higher consumption of total dairy, milk, cream and butter were significantly associated with BMI during the over the 10-year following-up. This study suggest that cheese consumption have beneficial effects on lowering BMI, which needs further investigation.

Association of macronutrient consumption with arterial aging in adults without clinically overt cardiovascular disease: a 5-year prospective cohort study

PURPOSE

There is limited and inconsistent evidence regarding longitudinal effects of macronutrients on blood pressure (BP) haemodynamics and arterial aging in populations without cardiovascular disease (CVD). We aimed to prospectively investigate potential association of dietary macronutrients with long-term changes in peripheral and central haemodynamics and arterial stiffness.

METHODS

One hundred and fifteen subjects (46.7 ± 8.73 years, 70 women), free of clinically overt CVD were consecutively recruited. Dietary macronutrient intake was evaluated using 3-day food records at baseline. Aortic stiffness and arterial wave reflections were assessed at baseline and in one follow-up visit 5 years later by pulse wave velocity (PWV) and augmentation index (AI), respectively.

RESULTS

Individuals with the highest consumption of saturated fatty acids (SFA) presented the highest rate of progression in PWV, AI and aortic diastolic BP (p < 0.05 for all) after adjustment for age, gender, smoking, body mass index, hyperlipidemia, insulin resistance, changes in systolic BP and treatment with antihypertensive and hypolipidemic drugs. After similar multivariable adjustments, high consumption of carbohydrates was associated with higher progression of AI, whereas high consumption of monounsaturated fatty acids (MUFA) and fibre with lower progression in aortic and peripheral systolic and diastolic BP (p < 0.05 for all).

CONCLUSIONS

In subjects without CVD, high consumption of SFA is related to accelerated arterial stiffening, while high consumption of MUFA and fibre and low intake of carbohydrates is associated with attenuated progression in blood pressure and arterial wave reflections, respectively. These findings expand current knowledge on the association of macronutrient consumption with arterial aging in the general population.

Low levels of linoleic acid and α-linolenic acid and high levels of arachidonic acid in plasma phospholipids are associated with hypertension

Dietary fat is an important determinant in the development and progression of high blood pressure (BP), a major risk factor for cardiovascular diseases and mortality. The aim of the present study was to determine the association between plasma phospholipid fatty acids and hypertension in Japanese men. The plasma level of linoleic acid (LA) in the subjects with hypertension (systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg) was identified to be significantly higher than that in the healthy controls. Following adjustment for age, body mass index, physical activity, smoking status, alcohol consumption, salt intake, and serum levels of glucose and hemoglobin A1c, higher plasma levels of LA and α-linolenic acid (ALA), and lower levels of arachidonic acid (AA) were significantly associated with a lower prevalence of hypertension. The odds ratio (OR) for the highest quartile (Q4) versus the lowest quartile (Q1) of LA was 0.17 (P=0.003), the OR for Q4 versus Q1 of ALA was 0.26 (P=0.042) and the OR for Q4 versus Q1 of AA was 2.04 (P=0.047). These results indicate that elevated levels of LA and ALA, and reduced levels of AA in the plasma prevent hypertension.

A New Age for Quercus spp. Fruits: Review on Nutritional and Phytochemical Composition and Related Biological Activities of Acorns

The current global food system must adapt to the expected growth of world population (about 9 billion individuals by 2050). This adaptation will probably include an increased consumption of edible wild foods, due to their richness in micronutrients and bioactive compounds, besides providing a cost-effective and sustainable way of improving caloric food security. A striking example of such natural matrices is the Quercus genus, which has the additional advantage of being widespread throughout the Northern Hemisphere. In a traditional sense, Quercus fruits (acorns) were mainly used in animal feeding, despite their potentially important role on the rural economy. But this preconception is changing. In fact, their nutritional value, high contents in phytochemical compounds, biological activity (such as antioxidant, anticarcinogenic, and cardioprotective properties) and use in the treatment of specific diseases (such as atherosclerosis, diabetes, or Alzheimer's disease) have raised the interest in integrating acorns into the human diet. Accordingly, this comprehensive overview was designed to provide an evidence-based review of the literature, with the objective to achieve useful conclusions regarding the nutritional properties, methodologies of extraction, identification, and characterization of a wide variety of bioactive compounds and scientifically validated bioactivities in Quercus species worldwide. The industrial by-products from acorn oil extraction or flour production are also included. Data regarding the analytical techniques, individual compounds, and their bioactivities, are organized in tables. The reported data are discussed and directions for further investigations are suggested, highlighting the use of acorns in food, nutraceutical, and pharmaceutical applications.

Trends in Elevated Blood Pressure Among US Children and Adolescents: 1999-2012

BACKGROUND

The prevalence of elevated blood pressure (BP) has been reported to increase significantly among the US children and adolescents from 1988-1994 to 1999-2008. We aimed to examine the recent trends in BP levels and prevalence of elevated BP, as well as related influencing factors among US children and adolescents.

METHODS

Data of National Health and Nutrition Examination Survey (NHANES) 1999-2012 were combined into 3 time periods (1999-2002, 2003-2008, and 2009-2012) for the analysis. A total of 14,270 US children and adolescents aged 8-17 years were included in the current analysis. The sex-, age-, and height-BP standards recommended by the US Fourth Report were used to define high BP and elevated BP (including pre-HBP and HBP).

RESULTS

Mean systolic BP (SBP) and diastolic BP (DBP) decreased by 0.7 and 4.2mm Hg from 1999-2002 to 2009-2012, respectively. In 2009-2012, the prevalence of elevated BP and HBP in children and adolescents were 9.6% and 1.6%, with the absolute reduction of 2.8% and 1.3% from 1999-2002 to 2009-2012, respectively. In addition, daily intakes of total energy, carbohydrate, total saturated fatty acids, and caffeine decreased during the period between 1999-2002 and 2009-2012 (all P < 0.05), whereas daily intake of total polyunsaturated fatty acids and dietary fiber increased (P < 0.05).

CONCLUSIONS

Mean BP levels as well as the prevalence of elevated BP and HBP among US children and adolescents have declined during the past decade. In addition, there might be an associated change in dietary factors.

Intake of polyunsaturated fat in relation to mortality among statin users and non-users in the Southern Community Cohort Study

BACKGROUND AND AIMS

Consumption of polyunsaturated fatty acids (PUFA), especially the n3-series, may protect against cardiovascular disease (CVD), but recent randomized studies have failed to demonstrate these benefits. One of the prevailing hypotheses is that PUFA intake may not confer benefits beyond those provided by statins, but studies comparing statin users to non-users with regard to effects of PUFA are lacking.

METHODS AND RESULTS

Black and white men and women (n = 69,559) in the Southern Community Cohort Study were studied. Cox regression models adjusting for age, sex, race, BMI, recruitment site, education, income, smoking, diabetes, and dietary variables were used.

RESULTS

At baseline the mean ± SD age was 52 ± 9 years, 60% of participants were women, 54% had hypertension and 16% used statins. We observed modest inverse associations between n3-PUFA and n6-PUFA intake with mortality among non-statin users but not among statin users. In adjusted analyses, the HRs (95% CIs) for all-cause mortality (6,396 deaths over a median of 6.4 years) comparing the highest to the lowest quintile were 0.90 (0.82-1.00) for n3-PUFA and 0.80 (0.70-0.92) for n6-PUFA among non-statin users, whereas they were 1.06 (0.87-1.28) and 0.96 (0.78-1.19) for n3-PUFA and n6-PUFA, respectively, among statin users.

CONCLUSIONS

Our results suggest potential benefits of PUFA consumption on mortality which are only apparent in the absence of statin therapy. It seems prudent to consider the potential benefit of PUFA consumption in the primary prevention of CVD among patients who are not candidates for statin therapy but are at increased risk for CVD and mortality.

Higher Plasma Phospholipid n-3 PUFAs, but Lower n-6 PUFAs, Are Associated with Lower Pulse Wave Velocity among Older Adults

BACKGROUND

Higher intake of polyunsaturated fatty acids (PUFAs) and higher circulating PUFAs are associated with lower cardiovascular disease (CVD) risk. The positive influence of PUFAs might be via lowering arterial stiffness, resulting in a better CVD risk profile; however, studies investigating circulating PUFAs in relation to arterial stiffness in a general population are limited.

OBJECTIVE

We investigated the associations of plasma phospholipid n-3 (ω-3) and n-6 PUFAs and fish oil intake with arterial stiffness.

METHODS

We used data from a subgroup of the Age, Gene/Environment Susceptibility-Reykjavik (AGES-Reykjavik) Study (n = 501, 75.0 ± 4.96 y, 46% men), a population-based study of community-dwelling older adults. Plasma phospholipid PUFAs were measured by GC at baseline, and fish oil intake was assessed at 3 time points: early life (ages 14-19 y), midlife (ages 40-50 y), and late life (ages 66-96 y, AGES-Reykjavik baseline) with the use of a validated food-frequency questionnaire. Arterial stiffness was determined as carotid-femoral pulse wave velocity (cf-PWV) with the use of an electrocardiogram after a mean follow-up of 5.2 ± 0.3 y. Regression coefficients (95% CIs), adjusted for demographics, follow-up time, risk factors, cholesterol, triglycerides, and serum vitamin D, were calculated by linear regression per SD increment in PUFAs.

RESULTS

Plasma total n-3 PUFAs, eicosapentaenoic acid, and docosahexaenoic acid were associated with lower cf-PWV [β (95% CI): -0.036 (-0.064, -0.008); -0.031 (-0.059, -0.003); -0.036 (-0.064, -0.009), respectively]. In contrast, plasma total n-6 PUFAs and linoleic acid were associated with higher cf-PWV [0.035 (0.009, 0.061) and 0.034 (0.008, 0.059)]. Regular fish oil consumption at early-, mid-, and late-life was not associated with cf-PWV.

CONCLUSIONS

Our results show a positive association between plasma n-6 PUFAs and arterial stiffness, and suggest that higher concentrations of plasma long-chain n-3 PUFAs are associated with less arterial stiffness and therein may be one of the mechanisms underlying the association between plasma n-3 PUFAs and lower CVD risk.

Weight Loss, Dietary Intake and Pulse Wave Velocity

We have recently conducted a meta-analysis to determine the effect of weight loss achieved by an energy-restricted diet with or without exercise, anti-obesity drugs or bariatric surgery on pulse wave velocity (PWV) measured at all arterial segments. Twenty studies, including 1,259 participants, showed that modest weight loss (8% of the initial body weight) caused a reduction in PWV measured at all arterial segments. However, due to the poor methodological design of the included studies, the results of this meta-analysis can only be regarded as hypothesis generating and highlight the need for further research in this area. In the future, well-designed randomised controlled trials are required to determine the effect of diet-induced weight loss on PWV and the mechanisms involved. In addition, there is observational evidence that dietary components such as fruit, vegetables, dairy foods, sodium, potassium and fatty acids may be associated with PWV, although evidence from well-designed intervention trials is lacking. In the future, the effect of concurrently improving dietary quality and achieving weight loss should be assessed in randomised controlled trials.

Castanea sativa by-products: a review on added value and sustainable application

Castanea sativa Mill. is a species of the family Fagaceae abundant in south Europe and Asia. The fruits (chestnut) are an added value resource in producing countries. Chestnut economic value is increasing not only for nutritional qualities but also for the beneficial health effects related with its consumption. During chestnut processing, a large amount of waste material is generated namely inner shell, outer shell and leaves. Studies on chestnut by-products revealed a good profile of bioactive compounds with antioxidant, anticarcinogenic and cardioprotective properties. These agro-industrial wastes, after valorisation, can be used by other industries, such as pharmaceutical, food or cosmetics, generating more profits, reducing pollution costs and improving social, economic and environmental sustainability. The purpose of this review is to provide knowledge about the type of chestnut by-products produced, the studies concerning its chemical composition and biological activity, and also to discuss other possible applications of these materials.

Comparative effect of dairy fatty acids on cell adhesion molecules, nitric oxide and relative gene expression in healthy and diabetic human aortic endothelial cells

OBJECTIVE

Dairy intake, despite its high saturated fatty acid (SFA) content, is associated with a lower risk of cardiovascular disease and diabetes. This in vitro study determined the effect of individual fatty acids (FA) found in dairy, and FA mixtures representative of a high SFA and a low SFA dairy lipid on markers of endothelial function in healthy and type II diabetic aortic endothelial cells.

METHODS

Cells were incubated for 24 h with FA mixtures (400 μM) and individual FA: oleic acid (OA; 150 μM); palmitic acid (PA; 150 μM); stearic acid (SA: 40 μM); trans-palmitelaidic acid (trans-PA; 20 μM); trans-vaccenic acid (trans-VA; 20 μM); α-linolenic acid (ALA; 20 μM) and linoleic acid (LA; 20 μM). Cellular adhesion molecules (sICAM-1, sVCAM-1 and sE-selectin) and nitric oxide (NO) were measured using ELISA and a chemiluminescent-based assay, respectively. Relative gene expression of these markers, including the insulin receptor, was performed using real-time PCR as well as FA compositions of cell pellets by gas chromatography.

RESULTS

FA mixtures affected sE-selectin concentrations (P = 0.008), with concentrations lower following the high SFA compared to the low SFA mixture (P = 0.004), while NO concentrations were higher in diabetic compared to healthy cells (P = 0.029). Individual FA affected NO (P = 0.007) and sE-selectin (P = 0.040) concentrations with an increase following PA incubation relative to all other FA treatments (P < 0.05). PA increased sE-selectin compared with other FA treatments (P < 0.05). sE-selectin concentrations were also higher in healthy compared to diabetic cells (P = 0.023). Expression of ICAM-1 and insulin receptor was up-regulated in healthy compared to diabetic cells (P = 0.014 and P = 0.006 respectively).

CONCLUSIONS

Healthy and type II diabetic cells respond differently to incubation with FA treatments. Overall, physiological concentrations of dairy FA, but not dairy FA mixtures, substantially affected markers of endothelial function.