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Heidarzadeh-Esfahani N, Hajahmadi S, Pasdar Y, Darbandi M, Najafi F, Moradinazar M, Bonyani M, Feyz-BashiPoor R, Soltani S. Diet-related inflammation is positively associated with atherogenic indices. Sci Rep 2024; 14:13190. [PMID: 38851843 PMCID: PMC11162500 DOI: 10.1038/s41598-024-63153-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 05/25/2024] [Indexed: 06/10/2024] Open
Abstract
Current evidence suggests that non-traditional serum lipid ratios are more effective than traditional serum lipid parameters in predicting vascular diseases, and both of them are associated with dietary patterns. Therefore, this study aimed to investigate the relationship between the dietary inflammatory index (DII) and atherogenic indices using traditional serum lipid parameters (triglyceride (TG), total cholesterol (TC), LDL cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c)) and non-traditional serum lipid ratios (atherogenic index of plasma (AIP), Castelli's index-I (CRI_I), Castelli's index-II (CRI_II), the lipoprotein combination index (LCI), and the atherogenic coefficient (AC)). Basic information from the Ravansar Non-Communicable Diseases cohort study was utilized in the present cross-sectional observational study. The study included 8870 adults aged 35-65 years. A validated food frequency questionnaire (FFQ) was used to measure DII. We compared the distributions of outcomes by DII score groups using multivariable linear regression. The difference between DII score groups was evaluated by the Bonferroni test. The mean ± SD DII was - 2.5 ± 1.43, and the prevalence of dyslipidemia was 44%. After adjusting for age, sex, smoking status, alcohol consumption status, physical activity, systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood sugar (FBS), body mass index (BMI) and socioeconomic status (SES), participants in the highest quartile of DII had a greater risk for CRI_I (β = 0.11, CI 0.05, 0.18), CRI_II (β = 0.06, CI 0.01, 0.11), LCI (β = 0.11, CI 288.12, 8373.11), AC (β = 0.11, CI 0.05, 0.17) and AIP (β = 0.06, CI 0.02, 0.10). Moreover, according to the adjusted logistic regression model, the risk of dyslipidemia significantly increased by 24% (OR: 1.24, 95% CI 1.08-1.41), 7% (OR: 1.07, 95% CI 0.94, 1.21) and 3% (OR: 1.03, 95% CI 0.91, 1.16) in Q4, Q3 and Q2 of the DII, respectively. Finally, diet-related inflammation, as estimated by the DII, is associated with a higher risk of CRI-I, CRI-II, LCI, AC, and AIP and increased odds of dyslipidemia.
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Affiliation(s)
- Neda Heidarzadeh-Esfahani
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Nutritional Sciences Department, School of Nutrition Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Ala Cancer Control and Prevention Centre, Isfahan, Iran
| | - Salimeh Hajahmadi
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Yahya Pasdar
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mitra Darbandi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farid Najafi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehdi Moradinazar
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mitra Bonyani
- Medical Education Development Centre, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Roxana Feyz-BashiPoor
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahin Soltani
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
- Student Research Committee, Kermanshah University Of Medical Sciences, Kermanshah, Iran.
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Dal N, Bilici S. An Overview of the Potential Role of Nutrition in Mental Disorders in the Light of Advances in Nutripsychiatry. Curr Nutr Rep 2024; 13:69-81. [PMID: 38329691 PMCID: PMC11133159 DOI: 10.1007/s13668-024-00520-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE OF REVIEW As research on the potential impact of nutrition on mental disorders, a significant component of global disability continues to grow the concepts of "nutritional psychiatry, psycho-dietetics/nutripsychiatry" have taken their place in the literature. This review is a comprehensive examination of the literature on the the potential mechanisms between common mental disorders and nutrition and evaluates the effectiveness of dietary interventions. RECENT FINDINGS Inflammation, oxidative stress, intestinal microbiota, mitochondrial dysfunction, and neural plasticity are shown as potential mechanisms in the relationship between mental disorders and nutrition. As a matter of fact, neurotrophic factors, which make important contributions to repair mechanisms throughout life, and neuronal plasticity, which plays a role in mental disorders, are affected by nutritional factors. In metabolism, the antioxidant defense system works with nutritional cofactors and phytochemicals. A balanced, planned diet that provides these components is more likely to provide nutrients that increase resilience against the pathogenesis of mental disorders. Nutrition can be considered a risk factor for mental disorders. Therefore, developing public health strategies focused on improving diet may help reduce the global burden of mental disorders and other related diseases.
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Affiliation(s)
- Nursel Dal
- Department of Nutrition and Dietetics, Bandirma Onyedi Eylul University, Balikesir, Turkey.
| | - Saniye Bilici
- Department of Nutrition and Dietetics, Gazi University, Ankara, Turkey
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English CJ, Mayr HL, Lohning AE, Reidlinger DP. The association between dietary patterns and the novel inflammatory markers platelet-activating factor and lipoprotein-associated phospholipase A2: a systematic review. Nutr Rev 2022; 80:1371-1391. [PMID: 34651191 PMCID: PMC9086773 DOI: 10.1093/nutrit/nuab051] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
CONTEXT Atherosclerosis is a disease of chronic inflammation. Recent research has identified 2 novel inflammatory biomarkers: platelet-activating factor (PAF) and lipoprotein-associated phospholipase A2 (Lp-PLA2). Diet has been proposed as a mediator of inflammation, but to date, the focus for these novel biomarkers has been on individual foods and nutrients rather than overall dietary patterns. OBJECTIVE To systematically review the literature on the association between dietary patterns and PAF and Lp-PLA2. DATA SOURCES The PubMed, Embase, CINAHL, and Cochrane CENTRAL literature databases were searched. DATA ANALYSIS Study quality was evaluated using the Quality Criteria Checklist. Sixteen studies (n = 4 observational and n = 12 interventional) were included and assessed for associations between dietary patterns and PAF and Lp-PLA2. CONCLUSION Study quality varied from neutral (n = 10) to positive (n = 6). Mediterranean, heart healthy, and vegetarian dietary patterns were associated with improved levels of PAF and Lp-PLA2. Conversely, Western dietary patterns were less favorable. A range of well-established, healthier dietary patterns may lower inflammation and the risk of atherosclerosis. More well-designed studies are needed to confirm these findings and identify other dietary patterns that improve inflammation.
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Affiliation(s)
- Carolyn J English
- Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia
| | - Hannah L Mayr
- Faculty of Health Sciences and Medicine, Bond University, Robina , Queensland, Australia
- Department of Nutrition and Dietetics, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Anna E Lohning
- Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia
| | - Dianne P Reidlinger
- Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia
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Defagó MD, Mozaffarian D, Irazola VE, Gutierrez L, Poggio R, Serón P, Mores N, Calandrelli M, Ponzo J, Rubinstein AL, Elorriaga N. Dietary patterns and blood pressure in Southern Cone of Latin America. Nutr Metab Cardiovasc Dis 2021; 31:3326-3334. [PMID: 34629255 DOI: 10.1016/j.numecd.2021.08.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 08/20/2021] [Accepted: 08/25/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIMS in the Southern Cone of Latin America, previous studies have shown that blood hypertension is one of the most significant risk factor for cardiovascular disease, and diet plays a fundamental role. We analyzed the cross-sectional relationship between dietary patterns (DP) and blood pressure values in people involved in the CESCAS I Study. METHODS AND RESULTS the participants (n = 4626) were derived from randomly selected samples in 4 cities (Bariloche and Marcos Paz, Argentina; Temuco, Chile; and Pando-Barros Blancos, Uruguay). To define DP, a food-frequency questionnaire was applied and principal component analysis was performed. Blood pressure was determined according to standardized guidelines. A multivariate regression model was developed to determine the association between each DP and blood pressure values, according to the quartile (Q) of adherence to DP. Two predominant DP were detected, Prudent (PDP, higher consumption of fruits, vegetables, legumes, whole grains, fish, seafood and nuts) and Western (WDP, higher consumption of red and processed meats, dressings, sweets, snacks and refined grains). A significant inverse association was found between adherence to PDP and systolic and diastolic blood pressure (-1.85 and -1.29 mmHg for Q4 vs Q1, respectively). Adherence to WDP was positively associated with systolic blood pressure (2.09 mmHg for Q4 vs Q1). CONCLUSION the WDP detected in the studied population is positively associated with higher levels of blood pressure, while greater adherence to healthy DP has a positive impact on blood pressure.
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Affiliation(s)
- María D Defagó
- Instituto de Investigaciones en Ciencias de la Salud (INICSA), CONICET, Universidad Nacional de Córdoba, Córdoba, Argentina; Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba, Argentina; Southern Cone American Center of Excellence for Cardiovascular Health, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina; Lown Scholars Program, Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Dariush Mozaffarian
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Vilma E Irazola
- Southern Cone American Center of Excellence for Cardiovascular Health, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Laura Gutierrez
- Southern Cone American Center of Excellence for Cardiovascular Health, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Rosana Poggio
- Southern Cone American Center of Excellence for Cardiovascular Health, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Pamela Serón
- Universidad de La Frontera, CIGES, Temuco, Chile
| | - Nora Mores
- Municipalidad de Marcos Paz, Buenos Aires, Argentina
| | - Matias Calandrelli
- Southern Cone American Center of Excellence for Cardiovascular Health, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Jacqueline Ponzo
- Escuela de Medicina, Universidad de la República, Montevideo, Uruguay
| | - Adolfo L Rubinstein
- Southern Cone American Center of Excellence for Cardiovascular Health, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
| | - Natalia Elorriaga
- Southern Cone American Center of Excellence for Cardiovascular Health, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina; Centro de Investigaciones en Epidemiología y Salud Pública (CIESP-CONICET), Buenos Aires, Argentina
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Hart MJ, Torres SJ, McNaughton SA, Milte CM. Dietary patterns and associations with biomarkers of inflammation in adults: a systematic review of observational studies. Nutr J 2021; 20:24. [PMID: 33712009 PMCID: PMC7955619 DOI: 10.1186/s12937-021-00674-9] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 02/15/2021] [Indexed: 12/11/2022] Open
Abstract
Background Evidence indicates that low-grade inflammation is involved in manychronic diseases of ageing. Modifiable lifestyle factors including dietcan affect low-grade inflammation. Dietary patterns allow assessment of the complex interactions of food nutrients and health and may be associated with inflammatory status. This systematic review aimed to summarises current evidence from observational studies for associations between dietary patterns and inflammatory biomarkers in the general adult population. This review followed the PRISMA guidelines. Methods We conducted a systematic search in Embase, CINAHL Complete, Global Health and MEDLINE complete databases. Search terms included terms for diet (“dietary patterns”, “diet scores”) and inflammation (“inflammation“, “c-reactive protein“, “interleukin“). Results The search produced 7161 records. Duplicates were removed leaving 3164 for screening. There were 69 studies included (60 cross-sectional, 9 longitudinal). Papers included studies that were: 1) observational studies; 2) conducted in community-dwelling adults over 18 years of age; 3) assessed dietary patterns; 4) measured specified biomarkers of inflammation and 5) published in English. Dietary patterns were assessed using diet scores (n = 45), data-driven approaches (n = 22), both a data-driven approach and diet score (n = 2). The most frequently assessed biomarkers were CRP (n = 64) and/or IL-6 (n = 22). Cross-sectionally the majority of analyses reported an association between higher diet scores (mostly Mediterranean and anti-inflammatory diet scores) and lower inflammatory markers with 82 significant associations from 133 analyses. Only 22 of 145 cross-sectional analyses using data-driven approaches reported an association between a dietary patterns and lower inflammatory markers; the majority reported no association. Evidence of an association between dietary patterns and inflammatory markers longitudinally is limited, with the majority reporting no association. Conclusions Adherence to healthy, Mediterranean and anti-inflammatory dietary scores, appear to be associated with lower inflammatory status cross-sectionally. Future research could focus on longitudinal studies using a potential outcomes approach in the data analysis. Trial registration PROSPERO Registration Number CRD42019114501. Supplementary Information The online version contains supplementary material available at 10.1186/s12937-021-00674-9.
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Affiliation(s)
- Michael J Hart
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia.
| | - Susan J Torres
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
| | - Sarah A McNaughton
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
| | - Catherine M Milte
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, 3220, Australia
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Associations between Dietary Patterns and Inflammatory Markers during Pregnancy: A Systematic Review. Nutrients 2021; 13:nu13030834. [PMID: 33806342 PMCID: PMC8000934 DOI: 10.3390/nu13030834] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/24/2021] [Accepted: 02/25/2021] [Indexed: 12/16/2022] Open
Abstract
Elevated inflammation in pregnancy has been associated with multiple adverse pregnancy outcomes and potentially an increased susceptibility to future chronic disease. How maternal dietary patterns influence systemic inflammation during pregnancy requires further investigation. The purpose of this review was to comprehensively evaluate studies that assessed dietary patterns and inflammatory markers during pregnancy. This review was guided by the Preferred Reporting Items for Systematic Review and Meta-Analyses. Included studies were sourced from EMBASE, PubMed, Web of Science, and Scopus and evaluated using The Quality Assessment Tool for Quantitative Studies. Inclusion criteria consisted of human studies published in English between January 2007 and May 2020 that addressed associations between dietary patterns and inflammatory markers during pregnancy. Studies focused on a single nutrient, supplementation, or combined interventions were excluded. A total of 17 studies were included. Despite some inconsistent findings, maternal diets characterized by a higher intake of animal protein and cholesterol and/or a lower intake of fiber were shown to be associated with certain pro-inflammatory markers (C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF- α), IL-8, serum amyloid A (SAA), and glycoprotein acetylation (GlycA)). Future studies that explore a broader range of inflammatory markers in the pregnant population, reduce measurement errors, and ensure adequate statistical adjustment are warranted.
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Najafi M, Mozaffari H, Yahya Jalilpiran, Mokhtari P, Teymouri M, Faghih S. The associations between dietary patterns and cardiovascular risk factors among adults: A cross-sectional study. Clin Nutr ESPEN 2020; 40:300-308. [PMID: 33183554 DOI: 10.1016/j.clnesp.2020.09.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/21/2020] [Accepted: 09/02/2020] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Cardiovascular diseases (CVDs) are the major causes of death, worldwide. Although for decades the associations between individual foods and nutrients and CVDs have been investigated, little attention has been paid to dietary patterns. Therefore, this study was conducted to examine the association between dietary patterns and CVD risk factors among Iranian adults. METHODS This cross-sectional study was performed on 236 adults who attended public health centers. Dietary intakes were collected using a valid food frequency questionnaire. Sociodemographic characteristics, anthropometric measures, and biochemical biomarkers were measured using standardized methods. Dietary patterns derived using the factor analysis. Logistic regression assessed the odds of CVD risk factors across tertiles of data-driven dietary patterns. RESULTS We identified three dietary patterns. After adjusting for possible confounders, we observed that participants in the third category of the healthy dietary pattern (HDP) had lower odds of low HDL-C (OR = 0.26; 95% CI: 0.10-0.64) compared to those in the first category. Adherence to the mixed pattern was associated with increased odds of high serum TC in men only (OR = 3.69; 95% CI: 1.06-12.81). However, women with higher adherence to the Western dietary pattern (WDP) had higher odds of high serum TG (OR = 5.61; 95% CI: 1.69-18.59), and those with a greater adherence to HDP had lower odds of low HDL-C (OR = 0.25; 95% CI: 0.07-0.98). CONCLUSION This study showed that adherence to HDP may protect against a low level of HDL-C, whereas mixed and Western-type diets may contribute to high serum TG levels. Future longitudinal studies are needed to assess the potential causality of the observed associations.
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Affiliation(s)
- Maryam Najafi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hadis Mozaffari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Yahya Jalilpiran
- Department of Clinical Nutrition, School of Nutritional Science and Dietetics, Tehran University of Medical Sciences, Tehran, Iran; Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Pari Mokhtari
- Department of Nutrition and Integrative Physiology, College of Health, University of Utah, Salt Lake City, USA
| | - Maryam Teymouri
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shiva Faghih
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
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Firth J, Veronese N, Cotter J, Shivappa N, Hebert JR, Ee C, Smith L, Stubbs B, Jackson SE, Sarris J. What Is the Role of Dietary Inflammation in Severe Mental Illness? A Review of Observational and Experimental Findings. Front Psychiatry 2019; 10:350. [PMID: 31156486 PMCID: PMC6529779 DOI: 10.3389/fpsyt.2019.00350] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 05/03/2019] [Indexed: 12/14/2022] Open
Abstract
Severe mental illnesses (SMI), including major depressive disorder, bipolar disorder, and schizophrenia, are associated with increased inflammation. Given diet's role in modulating inflammatory processes, excessive calorie-dense, nutrient-deficient processed food intake may contribute toward the heightened inflammation observed in SMI. This review assesses the evidence from observational and experimental studies to investigate how diet may affect physical and mental health outcomes in SMI through inflammation-related pathways. Cross-sectional studies indicate that individuals with SMI, particularly schizophrenia, consume more pro-inflammatory foods and fewer anti-inflammatory nutrients than the general population. Cohort studies indicate that high levels of dietary inflammation are associated with increased risk of developing depression, but there is currently a lack of evidence for schizophrenia or bipolar disorder. Randomized controlled trials show that dietary interventions improve symptoms of depression, but none have tested the extent to which these benefits are due to changes in inflammation. This review summarizes evidence on dietary inflammation in SMI, explores the directionality of these links, and discusses the potential use of targeted nutritional interventions for improving psychological well-being and physical health outcomes in SMI. Establishing the extent to which diet explains elevated levels of inflammatory markers observed in SMI is a priority for future research.
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Affiliation(s)
- Joseph Firth
- NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom
| | - Nicola Veronese
- Laboratory of Nutritional Biochemistry, Research Hospital, IRCCS “S. de Bellis”, Castellana Grotte, Italy
- Aging Branch, Neuroscience Institute, National Research Council, Padua, Italy
| | - Jack Cotter
- Cambridge Cognition, Cambridge, United Kingdom
| | - Nitin Shivappa
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- Connecting Health Innovations LLC, Columbia, SC, United States
| | - James R. Hebert
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
- Connecting Health Innovations LLC, Columbia, SC, United States
| | - Carolyn Ee
- NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, United Kingdom
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Sarah E. Jackson
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Jerome Sarris
- NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia
- Department of Psychiatry, University of Melbourne, The Melbourne Clinic Professorial Unit, Melbourne, VIC, Australia
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Secular trends in Dietary Inflammatory Index among adults in the United States, 1999-2014. Eur J Clin Nutr 2018; 73:1343-1351. [PMID: 30542148 DOI: 10.1038/s41430-018-0378-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 11/28/2018] [Accepted: 11/29/2018] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The objective of this study was to evaluate secular trends in Dietary Inflammatory Index (DII) scores in the United States between 1999 and 2014. METHODS Data from adults over 19 years from the 1999 to 2014 National Health and Nutrition Examination Survey (N = 39,191) were used. DII scores, at each 2-year cycle, were evaluated from a 24-h recall, including 26 food parameters for DII calculation. Analyses were conducted in 2018. RESULTS For the entire sample, there was a quadratic trend (Ptrend < 0.001), with the DII scores peaking in 2003-2004, and then decreasing during the cycles from 2005 to 2014. Similar quadratic trends (Ptrend < 0.001) were observed by age, gender, race-ethnicity, and education. CONCLUSION Males, non-Hispanic Blacks, younger adults, and those with less education adults had the highest DII scores (i.e., indicating the greatest inflammatory potential). The overall DII scores of the US population showed a quadratic trend from 1999 to 2014. Continued monitoring of DII changes is needed to better understand changes in the inflammatory potential of diet of American adults, and how they relate to changes in the risk of chronic disease.
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Adherence to Mediterranean-style diet and risk of sepsis in the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. Br J Nutr 2018; 120:1415-1421. [PMID: 30375291 PMCID: PMC6753832 DOI: 10.1017/s0007114518002866] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Sepsis – syndrome of infection complicated by organ dysfunction – is responsible for over 750 000 hospitalisations and 200 000 deaths in the USA annually. Despite potential nutritional benefits, the association of diet and sepsis is unknown. Therefore, we sought to determine the association between adherence to a Mediterranean-style diet (Med-style diet) and long-term risk of sepsis in the REasons for Geographic Differences in Stroke (REGARDS) cohort. We analysed data from REGARDS, a population-based cohort of 30 239 community-dwelling adults age ≥45 years. We determined dietary patterns from a baseline FFQ. We defined Med-style diet as a high consumption of fruit, vegetables, legumes, fish, cereal and low consumption of meat, dairy products, fat and alcohol categorising participants into Med-style diet tertiles (low: 0–3, moderate: 4–5, high: 6–9). We defined sepsis events as hospital admission for serious infection and at least two systematic inflammatory response syndrome criteria. We used Cox proportional hazard models to determine the association between Med-style diet tertiles and first sepsis events, adjusting for socio-demographics, lifestyle factors, and co-morbidities. We included 21 256 participants with complete dietary data. Dietary patterns were: low Med-style diet 32⋅0%, moderate Med-style diet 42⋅1% and high Med-style diet 26⋅0%. There were f 109 (5⋅2%) first sepsis events. High Med-style diet was independently associated with sepsis risk; low Med-style diet referent, moderate Med-style diet adjusted hazard ratio (HR) 0⋅93 (95% CI 0⋅81, 1⋅08), high Med-style diet adjusted HR=0⋅74 (95% CI 0⋅61, 0⋅88). High Med-style diet adherence is associated with lower risk of sepsis. Dietary modification may potentially provide an option for reducing sepsis risk.
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Khatibi N, Shahvazi S, Nadjarzadeh A, Samadi M, Zare F, Salehi-Abargouei A. Empirically derived dietary patterns and serum inflammatory markers in Iranian female teachers: A cross-sectional study. Nutr Diet 2018; 76:462-471. [PMID: 30112865 DOI: 10.1111/1747-0080.12463] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 03/18/2018] [Accepted: 07/01/2018] [Indexed: 02/06/2023]
Abstract
AIM To examine the relationship between dietary patterns and inflammatory markers including serum high sensitivity C-reactive protein (hs-CRP) and interleukin 17A (IL-17A) in females. METHODS In the present cross-sectional study in female teachers living in Yazd, central Iran, data on anthropometric measurements and general information were gathered. A food frequency questionnaire was completed by participants and then, subjects were invited to give blood samples. Major dietary patterns were derived using principal component analysis and serum inflammatory markers were compared according to quintiles of dietary patterns scores. RESULTS In total, 320 subjects aged 40.38 ± 8.08 years were included. Three dietary patterns were derived: (i) 'traditional' with a high intake of poultry, salt, eggs, other vegetables and red meat; (ii) 'vegetables and fruits' with a higher intake of tomatoes, yoghurt drinks, green leafy vegetables, dried fruits, fruits, other vegetables and organ meats and (iii) 'dairy and saturated fat' with a high loading of high-fat dairy products, butter, low-fat dairy, margarine, eggs, other vegetables and green leafy vegetables. Participants in the highest quintile of the 'vegetables and fruits' dietary pattern had significantly lower serum hs-CRP levels compared to those in the lowest quintile (3.6 ± 0.4 mg/L vs 2.6 ± 0.4 mg/L, respectively; P < 0.05). None of the dietary patterns were associated with circulating IL-17 levels. CONCLUSIONS Higher consumption of fruits and vegetables is inversely associated with serum hs-CRP but not IL-17 levels. Studies investigating the dietary patterns in association with IL-17 in other populations are recommended.
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Affiliation(s)
- Nasim Khatibi
- Nutrition and Food Security Research Centre, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Simin Shahvazi
- Nutrition and Food Security Research Centre, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Azadeh Nadjarzadeh
- Nutrition and Food Security Research Centre, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Morteza Samadi
- Recurrent Abortion Research Centre, Research and Clinical Centre for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Reproductive Immunology Research Centre, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Research Centre for Food Hygiene and Safety, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Fateme Zare
- Recurrent Abortion Research Centre, Research and Clinical Centre for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Reproductive Immunology Research Centre, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Research Centre for Food Hygiene and Safety, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amin Salehi-Abargouei
- Nutrition and Food Security Research Centre, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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12
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Wallace ML, Buysse DJ, Germain A, Hall MH, Iyengar S. Variable Selection for Skewed Model-Based Clustering: Application to the Identification of Novel Sleep Phenotypes. J Am Stat Assoc 2018; 113:95-110. [PMID: 31086426 DOI: 10.1080/01621459.2017.1330202] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
In sleep research, applying finite mixture models to sleep characteristics captured 8 through multiple data types, including self-reported sleep diary, a wrist monitor capturing movement (actigraphy), and brain waves (polysomnography), may suggest new phenotypes that reflect underlying disease mechanisms. However, a direct mixture model application is challenging because there are many sleep variables from which to choose, and sleep variables are often highly skewed even in homogenous samples. Moreover, previous sleep research findings indicate that some of the most clinically interesting solutions will be those that incorporate all three data types. Thus, we present two novel skewed variable selection algorithms based on the multivariate skew normal (MSN) distribution: one that selects the best set of variables ignoring data type and another that embraces the exploratory nature of clustering and suggests multiple statistically plausible sets of variables that each incorporate all data types. Through a simulation study we empirically compare our approach with other asymmetric and normal dimension reduction strategies for clustering. Finally, we demonstrate our methods using a sample of older adults with and without insomnia. The proposed MSN-based variable selection algorithm appears to be suitable for both MSN and multivariate normal cluster distributions, especially with moderate to large sample sizes.
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Affiliation(s)
- Meredith L Wallace
- Department of Statistics, University of Pittsburgh.,Department of Psychiatry, University of Pittsburgh
| | | | - Anne Germain
- Department of Psychiatry, University of Pittsburgh
| | | | - Satish Iyengar
- Department of Statistics, University of Pittsburgh.,Department of Psychiatry, University of Pittsburgh
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13
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Wirth MD, Sevoyan M, Hofseth L, Shivappa N, Hurley TG, Hébert JR. The Dietary Inflammatory Index is associated with elevated white blood cell counts in the National Health and Nutrition Examination Survey. Brain Behav Immun 2018; 69:296-303. [PMID: 29217263 PMCID: PMC5857420 DOI: 10.1016/j.bbi.2017.12.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 11/28/2017] [Accepted: 12/02/2017] [Indexed: 11/29/2022] Open
Abstract
White blood cells (WBCs) are considered a reliable biomarker of inflammation. Elevations in both WBCs and pro-inflammatory cytokines are associated with several chronic conditions. Diet is a strong moderator of inflammation and WBCs. The purpose of this study was to examine the association between the Dietary Inflammatory Index (DII®) and WBCs using data from the United States National Health and Nutrition Examination Survey (NHANES). NHANES is a cross-sectional study that occurs in two-year cycles. Respondents from five cycles (n = 26,046) with available data on diet (collected through a single 24-h dietary recall [24HR]) and WBCs (derived using the Coulter method) were included. The DII (theoretical range is about -8 to +8) was derived from the micro and macronutrients calculated from the 24HR. Linear regression models, using survey design procedures, were used to estimate adjusted mean WBC (i.e., total, lymphocytes, monocytes, and neutrophils) counts and percentages by DII quartiles. Among all participants no statistically significant difference in WBCs were observed when comparing DII quartile 4 (most pro-inflammatory) to quartile 1 (most anti-inflammatory). However, a one-unit increase in the DII was associated with a 0.028 (1000 per µL) increase in total WBCs (p = .01). Additionally, a 0.024 increase in neutrophils (p < .01) was observed for a one-unit increase in the DII. In the group of participants with normal body mass index (BMI, 18.5-24.9 kg/m2), those in DII quartile 4 had higher levels of total WBCs compared to subjects with normal BMI in DII quartile 1 (7.12 vs. 6.88, p = .01). Similar comparisons were observed for monocytes and neutrophils. However, these relationships were not observed for participants who were overweight or obese, which are pro-inflammatory conditions. Normal-weight individuals consuming more pro-inflammatory diets were more likely to have elevated WBCs. Because of its cross-sectional design, NHANES cannot inform directly on temporal relations, thus limiting causal inference. Future research is needed to examine the impact of anti-inflammatory diet adoption on lowering levels of WBCs, in addition to other inflammatory mediators.
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Affiliation(s)
- Michael D. Wirth
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208,Department of Epidemiology and Biostatistics, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208,Connecting Health Innovations, LLC, 915 Greene Street, Suite 200, Columbia, SC 29208
| | - Maria Sevoyan
- Department of Epidemiology and Biostatistics, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208
| | - Lorne Hofseth
- University of South Carolina, South Carolina College of Pharmacy, 715 Sumter Street, CLS 513B, Columbia, SC 29208
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208,Department of Epidemiology and Biostatistics, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208,Connecting Health Innovations, LLC, 915 Greene Street, Suite 200, Columbia, SC 29208
| | - Thomas G. Hurley
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208,Department of Epidemiology and Biostatistics, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208
| | - James R. Hébert
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208,Department of Epidemiology and Biostatistics, University of South Carolina, 915 Greene Street, Suite 200, Columbia, SC 29208,Connecting Health Innovations, LLC, 915 Greene Street, Suite 200, Columbia, SC 29208
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14
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Nelder M, Cahill F, Zhang H, Zhai G, Gulliver W, Teng W, Shan Z, Sun G. The Association Between an Addictive Tendency Toward Food and Metabolic Characteristics in the General Newfoundland Population. Front Endocrinol (Lausanne) 2018; 9:661. [PMID: 30473679 PMCID: PMC6237829 DOI: 10.3389/fendo.2018.00661] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 10/23/2018] [Indexed: 12/05/2022] Open
Abstract
Background: Our previous study of 29 obese food addiction (FA) patients found that FA is associated with lipid profiles and hormones which may be a factor in cardiovascular disease (CVD) and insulin resistance (IR). However, there is currently no data available regarding the relationship between FA symptoms and metabolic characteristics of CVD and IR in the general population. We designed this study to investigate the correlation between FA symptoms with lipid profiles and IR in men and women of the general Newfoundland population. Methods: 710 individuals (435 women and 275 men) recruited from the general Newfoundland population were used in analysis. FA symptoms were evaluated using the Yale Food Addiction Scale (YFAS). Glucose, insulin, HDL, LDL, total cholesterol and triglycerides levels were measured. IR was evaluated using the homeostatic model of assessment (HOMA). Participants were grouped by sex and menopausal status. Age, physical activity, calories and total % body fat were controlled. Results: Partial correlation analysis revealed that in men, YFAS symptom counts were significantly correlated with HOMA-β (r = 0.196, p = 0.021), triglycerides (r = 0.140, p = 0.025) and inversely correlated with HDL (r = -0.133, p = 0.033). After separating by menopausal status, pre-menopausal women exhibited no correlations and post-menopausal women had a significantcorrelation with triglycerides (r = 0.198, p = 0.016). Conclusion: FA is significantly correlated with several markers of metabolic disturbance in men and to a lesser extent, post-menopausal women, in the general population. Further research is required to explain sex specific associations and elucidate any potentially causal mechanisms behind this correlation.
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Affiliation(s)
- Matthew Nelder
- Complex Disease Laboratory, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
- *Correspondence: Matthew Nelder
| | - Farrell Cahill
- Complex Disease Laboratory, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Hongwei Zhang
- Complex Disease Laboratory, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Guangju Zhai
- Complex Disease Laboratory, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Wayne Gulliver
- Complex Disease Laboratory, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Weiping Teng
- Liaoning Provincial Key Laboratory of Endocrine Diseases, Department of Endocrinology and Metabolism, Endocrine Institute, First Hospital of China Medical University, Shenyang, China
| | - Zhongyan Shan
- Liaoning Provincial Key Laboratory of Endocrine Diseases, Department of Endocrinology and Metabolism, Endocrine Institute, First Hospital of China Medical University, Shenyang, China
| | - Guang Sun
- Complex Disease Laboratory, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
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15
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Vallejo J, Dunér P, Fredrikson GN, Nilsson J, Bengtsson E. Autoantibodies against aldehyde-modified collagen type IV are associated with risk of development of myocardial infarction. J Intern Med 2017; 282:496-507. [PMID: 28944562 DOI: 10.1111/joim.12659] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND Oxidation of LDL particles entrapped in the extracellular matrix of the arterial wall is a key factor in the development of atherosclerosis. Lipid oxidation products, such as malondialdehyde (MDA), react with surrounding extracellular matrix proteins and cause modifications that are recognized by the immune system. MDA modification of collagen type IV is increased in carotid lesions from symptomatic patients and correlates with autoantibodies against MDA-modified collagen type IV in plasma. OBJECTIVE The aim of this study was to determine whether autoantibodies against MDA-modified collagen type IV predict risk of development of myocardial infarction (MI). METHODS Plasma levels of MDA-modified collagen type IV IgM and IgG antibodies were analysed by enzyme-linked immunosorbent assay in 385 subjects with incident MI during 13 years of follow-up and 410 age- and sex-matched controls in the Malmö Diet and Cancer study. RESULTS MDA-modified collagen type IV IgG levels were higher in cases with incident MI than in controls. Subjects in the highest tertile of MDA-modified collagen type IV IgG had an increased risk of MI (hazard ratio 1.56, 95% confidence interval 1.22-2.00, P for trend 0.0004). This association remained significant after adjusting for factors included in the Framingham risk score and diabetes. High levels of MDA-collagen type IV IgG were associated with increased carotid intima-media thickness and elevated plasma levels of matrix metalloproteinase 10 and 12. CONCLUSIONS Immune responses against MDA-modified collagen type IV are associated with more severe carotid disease and increased risk of MI. These immune responses may reflect LDL oxidation in the artery wall, but could also affect the atherosclerotic disease process.
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Affiliation(s)
- J Vallejo
- Department of Clinical Sciences Malmö, Skåne University Hospital, Lund University, Malmö, Sweden
| | - P Dunér
- Department of Clinical Sciences Malmö, Skåne University Hospital, Lund University, Malmö, Sweden
| | - G N Fredrikson
- Department of Clinical Sciences Malmö, Skåne University Hospital, Lund University, Malmö, Sweden
| | - J Nilsson
- Department of Clinical Sciences Malmö, Skåne University Hospital, Lund University, Malmö, Sweden
| | - E Bengtsson
- Department of Clinical Sciences Malmö, Skåne University Hospital, Lund University, Malmö, Sweden
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16
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Bordoni A, Danesi F, Dardevet D, Dupont D, Fernandez AS, Gille D, Nunes dos Santos C, Pinto P, Re R, Rémond D, Shahar DR, Vergères G. Dairy products and inflammation: A review of the clinical evidence. Crit Rev Food Sci Nutr 2017; 57:2497-2525. [DOI: 10.1080/10408398.2014.967385] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Alessandra Bordoni
- Department of Agri-Food Sciences and Technologies, University of Bologna, Bologna, Italy
| | - Francesca Danesi
- Department of Agri-Food Sciences and Technologies, University of Bologna, Bologna, Italy
| | - Dominique Dardevet
- INRA, UMR 1019, UNH, CRNH Auvergne, Clermont-Ferrand, France
- Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, Clermont-Ferrand, France
| | - Didier Dupont
- INRA, Joint Research Unit 1253, Science & Technology of Milk and Egg Products, Rennes, France
| | - Aida S. Fernandez
- Department of Human Nutrition, Leatherhead Food Research, Leatherhead, United Kingdom
| | - Doreen Gille
- Agroscope, Federal Department of Economic Affairs, Education and Research EAER, Berne, Switzerland
| | - Claudia Nunes dos Santos
- Instituto de Tecnologia Química e Biológica, Universidade Nova de Lisboa, Lisbon, Portugal
- Insituto de Biologia Experimental e Tecnológica, Oeiras, Portugal
| | - Paula Pinto
- Instituto de Tecnologia Química e Biológica, Universidade Nova de Lisboa, Lisbon, Portugal
- Escola Superior Agrária, Insituto Politécnico de Santarém, Santarém Portugal
| | - Roberta Re
- Department of Human Nutrition, Leatherhead Food Research, Leatherhead, United Kingdom
| | - Didier Rémond
- INRA, UMR 1019, UNH, CRNH Auvergne, Clermont-Ferrand, France
- Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, Clermont-Ferrand, France
| | - Danit R. Shahar
- The S. Daniel Abraham International Center for Health and Nutrition, Department of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Guy Vergères
- Agroscope, Federal Department of Economic Affairs, Education and Research EAER, Berne, Switzerland
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17
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Bodén S, Wennberg M, Van Guelpen B, Johansson I, Lindahl B, Andersson J, Shivappa N, Hebert JR, Nilsson LM. Dietary inflammatory index and risk of first myocardial infarction; a prospective population-based study. Nutr J 2017; 16:21. [PMID: 28376792 PMCID: PMC5379659 DOI: 10.1186/s12937-017-0243-8] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 03/26/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic, low-grade inflammation is an established risk factor for cardiovascular disease. The inflammatory impact of diet can be reflected by concentrations of inflammatory markers in the bloodstream and the inflammatory potential of diet can be estimated by the dietary inflammatory index (DIITM), which has been associated with cardiovascular disease risk in some previous studies. We aimed to examine the association between the DII and the risk of first myocardial infarction (MI) in a population-based study with long follow-up. METHOD We conducted a prospective case-control study of 1389 verified cases of first MI and 5555 matched controls nested within the population-based cohorts of the Northern Sweden Health and Disease Study (NSHDS), of which the largest is the ongoing Västerbotten Intervention Programme (VIP) with nearly 100 000 participants during the study period. Median follow-up from recruitment to MI diagnosis was 6.4 years (6.2 for men and 7.2 for women). DII scores were derived from a validated food frequency questionnaire (FFQ) administered in 1986-2006. Multivariable conditional logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI), using quartile 1 (most anti-inflammatory diet) as the reference category. For validation, general linear models were used to estimate the association between the DII scores and two inflammatory markers, high-sensitivity C-reactive protein (hsCRP) and interleukin 6 (IL-6) in a subset (n = 605) of the study population. RESULTS Male participants with the most pro-inflammatory DII scores had an increased risk of MI [ORQ4vsQ1 = 1.57 (95% CI 1.21-2.02) P trend = 0.02], which was essentially unchanged after adjustment for potential confounders, including cardiovascular risk factors [ORQ4vsQ1 = 1.50 (95% CI 1.14-1.99), P trend = 0.10]. No association was found between DII and MI in women. An increase of one DII score unit was associated with 9% higher hsCRP (95% CI 0.03-0.14) and 6% higher IL-6 (95% CI 0.02-0.11) in 605 controls with biomarker data available. CONCLUSION A pro-inflammatory diet was associated with an elevated risk of first myocardial infarction in men; whereas for women the relationship was null. Consideration of the inflammatory impact of diet could improve prevention of cardiovascular disease.
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Affiliation(s)
- Stina Bodén
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, SE-901 87, Sweden.
| | - Maria Wennberg
- Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, SE-901 87, Sweden
| | - Bethany Van Guelpen
- Department of Radiation Sciences, Oncology, Umeå University, Umeå, SE-901 87, Sweden
| | - Ingegerd Johansson
- Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, SE-901 87, Sweden
| | - Bernt Lindahl
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, SE-901 87, Sweden
| | - Jonas Andersson
- Department of Public Health and Clinical Medicine, Research Unit Skellefteå, Umeå University, Umeå, SE-901 87, Sweden
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 241, Columbia, SC, 29208, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.,Connecting Health Innovations LLC, 1417 Gregg St., Columbia, SC, 29201, USA
| | - James R Hebert
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 241, Columbia, SC, 29208, USA.,Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.,Connecting Health Innovations LLC, 1417 Gregg St., Columbia, SC, 29201, USA
| | - Lena Maria Nilsson
- Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, SE-901 87, Sweden.,Arctic Research Centre (Arcum), Umeå University, Umeå, SE-901 87, Sweden
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18
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Gonçalves I, Hultman K, Dunér P, Edsfeldt A, Hedblad B, Fredrikson GN, Björkbacka H, Nilsson J, Bengtsson E. High levels of cathepsin D and cystatin B are associated with increased risk of coronary events. Open Heart 2016; 3:e000353. [PMID: 26848396 PMCID: PMC4731836 DOI: 10.1136/openhrt-2015-000353] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 12/19/2015] [Accepted: 12/23/2015] [Indexed: 12/01/2022] Open
Abstract
Objective The majority of acute coronary syndromes are caused by plaque ruptures. Proteases secreted by macrophages play an important role in plaque ruptures by degrading extracellular matrix proteins in the fibrous cap. Matrix metalloproteinases have been shown to be markers for cardiovascular disease whereas the members of the cathepsin protease family are less studied. Methods Cathepsin D, cathepsin L and cystatin B were measured in plasma at baseline from 384 individuals who developed coronary events (CEs), and from 409 age-matched and sex-matched controls from the Malmö Diet and Cancer cardiovascular cohort. Results Cathepsin D (180 (142–238) vs 163 (128–210), p<0.001), cathepsin L (55 (44–73) vs 52 (43–67), p<0.05) and cystatin B levels (45 (36–57) vs 42 (33–52), p<0.001) were significantly increased in CE cases compared to controls. In addition, increased cathepsin D (220 (165–313) vs 167 (133–211), p<0.001), cathepsin L (61 (46–80) vs 53 (43–68), p<0.05) and cystatin B (46 (38–58) vs 43 (34–54), p<0.05) were associated with prevalent diabetes. Furthermore, cathepsin D and cystatin B were increased in smokers. The HRs for incident CE comparing the highest to the lowest tertile(s) of cathepsin D and cystatin B were 1.34 (95% CI 1.02 to 1.75) and 1.26 (95% CI 1.01 to 1.57), respectively, after adjusting for age, sex, low-density lipoprotein/high-density lipoprotein ratio, triglycerides, body mass index, hypertension and glucose, but these associations did not remain significant after further addition of smoking to the model. In addition, cathepsin D was increased in incident CE cases among smokers after adjusting for cardiovascular risk factors. Conclusions The associations of cathepsin D and cystatin B with future CE provide clinical support for a role of these factors in cardiovascular disease, which for cathepsin D may be of particular importance for smokers.
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Affiliation(s)
- Isabel Gonçalves
- Experimental Cardiovascular Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden; Department of Cardiology, Skåne University Hospital, Malmö, Sweden
| | - Karin Hultman
- Experimental Cardiovascular Research Unit, Department of Clinical Sciences , Lund University , Malmö , Sweden
| | - Pontus Dunér
- Experimental Cardiovascular Research Unit, Department of Clinical Sciences , Lund University , Malmö , Sweden
| | - Andreas Edsfeldt
- Experimental Cardiovascular Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden; Department of Cardiology, Skåne University Hospital, Malmö, Sweden
| | - Bo Hedblad
- Department of Clinical Sciences , Lund University , Malmö , Sweden
| | - Gunilla Nordin Fredrikson
- Experimental Cardiovascular Research Unit, Department of Clinical Sciences , Lund University , Malmö , Sweden
| | - Harry Björkbacka
- Experimental Cardiovascular Research Unit, Department of Clinical Sciences , Lund University , Malmö , Sweden
| | - Jan Nilsson
- Experimental Cardiovascular Research Unit, Department of Clinical Sciences , Lund University , Malmö , Sweden
| | - Eva Bengtsson
- Experimental Cardiovascular Research Unit, Department of Clinical Sciences , Lund University , Malmö , Sweden
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19
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Gutiérrez OM, Judd SE, Voeks JH, Carson AP, Safford MM, Shikany JM, Wang HE. Diet patterns and risk of sepsis in community-dwelling adults: a cohort study. BMC Infect Dis 2015; 15:231. [PMID: 26072206 PMCID: PMC4465736 DOI: 10.1186/s12879-015-0981-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 06/09/2015] [Indexed: 11/15/2022] Open
Abstract
Background Sepsis is the syndrome of body-wide inflammation triggered by infection and is a major public health problem. Diet plays a vital role in immune health but its association with sepsis in humans is unclear. Methods We examined 21,404 participants with available dietary data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a national cohort of 30,239 black and white adults ≥45 years of age living in the US. The primary exposures of interest were five empirically derived diet patterns identified via factor analysis within REGARDS participants: “Convenience” (Chinese and Mexican foods, pasta, pizza, other mixed dishes), “Plant-based” (fruits, vegetables), “Southern” (added fats, fried foods, organ meats, sugar-sweetened beverages), “Sweets/Fats” (sugary foods) and “Alcohol/Salads” (alcohol, green-leafy vegetables, salad dressing). The main outcome of interest was investigator-adjudicated first hospitalized sepsis events. Results A total of 970 first sepsis events were observed over ~6 years of follow-up. In unadjusted analyses, greater adherence to Sweets/Fats and Southern patterns was associated with higher cumulative incidence of sepsis, whereas greater adherence to the Plant-based pattern was associated with lower incidence. After adjustment for sociodemographic, lifestyle and clinical factors, greater adherence to the Southern pattern remained associated with higher risk of sepsis (hazard ratio [HR] comparing the fourth to first quartile, HR 1.39, 95 % CI 1.11,1.73). Race modified the association of the Southern diet pattern with sepsis (Pinteraction = 0.01), with the Southern pattern being associated with modestly higher adjusted risk of sepsis in black as compared to white participants (HR comparing fourth vs. first quartile HR 1.42, 95 % CI 0.75,2.67 vs. 1.21, 95 % CI 0.93,1.57, respectively). Conclusion A Southern pattern of eating was associated with higher risk of sepsis, particularly among black participants. Determining reasons for these findings may help to devise strategies to reduce sepsis risk. Electronic supplementary material The online version of this article (doi:10.1186/s12879-015-0981-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Orlando M Gutiérrez
- Departments of Medicine, University of Alabama at Birmingham, ZRB 614, 1720 2nd AVE S, Birmingham, AL, 35294-0006, USA. .,Departments of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Suzanne E Judd
- Departments of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Jenifer H Voeks
- Department of Neurosciences, Medical University of South Carolina, Charleston, SC, USA.
| | - April P Carson
- Departments of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Monika M Safford
- Departments of Medicine, University of Alabama at Birmingham, ZRB 614, 1720 2nd AVE S, Birmingham, AL, 35294-0006, USA.
| | - James M Shikany
- Departments of Medicine, University of Alabama at Birmingham, ZRB 614, 1720 2nd AVE S, Birmingham, AL, 35294-0006, USA.
| | - Henry E Wang
- Departments of Emergency Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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20
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Tabung FK, Steck SE, Ma Y, Liese AD, Zhang J, Caan B, Hou L, Johnson KC, Mossavar-Rahmani Y, Shivappa N, Wactawski-Wende J, Ockene JK, Hebert JR. The association between dietary inflammatory index and risk of colorectal cancer among postmenopausal women: results from the Women's Health Initiative. Cancer Causes Control 2015; 26:399-408. [PMID: 25549833 PMCID: PMC4334706 DOI: 10.1007/s10552-014-0515-y] [Citation(s) in RCA: 150] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 12/18/2014] [Indexed: 01/08/2023]
Abstract
PURPOSE Inflammation is a process central to carcinogenesis and in particular to colorectal cancer (CRC). Previously, we developed a dietary inflammatory index (DII) from extensive literature review to assess the inflammatory potential of diet. In the current study, we utilized this novel index in the Women's Health Initiative to prospectively evaluate its association with risk of CRC in postmenopausal women. METHODS The DII was calculated from baseline food frequency questionnaires administered to 152,536 women aged 50-79 years without CRC at baseline between 1993 and 1998 and followed through 30 September 2010. Incident CRC cases were ascertained through a central physician adjudication process. Multiple covariate-adjusted Cox proportional hazards regression models were used to estimate hazard ratios (HR) and 95 % confidence intervals (95 % CI) for colorectal, colon (proximal/distal locations), and rectal cancer risk, by DII quintiles (Q). RESULTS During an average 11.3 years of follow-up, a total of 1,920 cases of CRC (1,559 colon and 361 rectal) were identified. Higher DII scores (representing a more pro-inflammatory diet) were associated with an increased incidence of CRC (HRQ5-Q1 1.22; 95 % CI 1.05, 1.43; p trend = 0.02) and colon cancer, specifically proximal colon cancer (HRQ5-Q1 1.35; 95 % CI 1.05, 1.67; p trend = 0.01) but not distal colon cancer (HRQ5-Q1 0.84; 95 % CI 0.61, 1.18; p trend = 0.63) or rectal cancer (HRQ5-Q1 1.20; 95 % CI 0.84, 1.72; p trend = 0.65). CONCLUSION Consumption of pro-inflammatory diets is associated with an increased risk of CRC, especially cancers located in the proximal colon. The absence of a significant association for distal colon cancer and rectal cancer may be due to the small number of incident cases for these sites. Interventions that may reduce the inflammatory potential of the diet are warranted to test our findings, thus providing more information for colon cancer prevention.
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Affiliation(s)
- Fred K. Tabung
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
| | - Susan E. Steck
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
- Center for Research in Nutrition and Health Disparities, University of South Carolina, Columbia, SC
| | - Yunsheng Ma
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA
| | - Angela D. Liese
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
- Center for Research in Nutrition and Health Disparities, University of South Carolina, Columbia, SC
| | - Jiajia Zhang
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
| | - Bette Caan
- Kaiser Permanente Division of Research, Oakland, CA
| | - Lifang Hou
- Department of Preventive Medicine and The Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Karen C. Johnson
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, University at Buffalo, The State University of New York, Buffalo, NY
| | - Judith K. Ockene
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA
| | - James R. Hebert
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC
- Center for Research in Nutrition and Health Disparities, University of South Carolina, Columbia, SC
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Defagó MD, Elorriaga N, Irazola VE, Rubinstein AL. Influence of food patterns on endothelial biomarkers: a systematic review. J Clin Hypertens (Greenwich) 2014; 16:907-13. [PMID: 25376124 DOI: 10.1111/jch.12431] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2014] [Revised: 09/04/2014] [Accepted: 09/04/2014] [Indexed: 01/19/2023]
Abstract
The purpose of this study was to conduct a systematic review on the association of food patterns (FPs) and endothelial biomarkers. An electronic literature search from 1990 to 2012 was conducted and reference lists and experts were consulted. Studies without dietary intervention and without language restrictions were considered. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were employed. Methodological quality was assessed by Strengthening the Reporting of Observational Studies in Epidemiology guidelines. A total of 546 references were identified, of which 8 were finally included. Several FPs were identified. Healthy FPs (abundant in fruits and vegetables) had a beneficial impact on endothelial function as estimated by circulating levels of biomarkers such as C-reactive protein, soluble intercellular adhesion molecule 1, soluble vascular adhesion molecule 1, and E-selectin molecules. Westernized patterns (higher intakes of processed meats, sweets, fried foods, and refined grains) were positively associated with inflammation molecules and atherogenic promoters. The study of FPs in relation to endothelial function contributes to the development of dietary recommendations for improved cardiovascular health and therefore a better lifestyle.
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Affiliation(s)
- María Daniela Defagó
- Centro de Excelencia en Salud Cardiovascular para el Cono Sur (CESCAS/SACECH), Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina; Facultad de Ciencias Médicas, Escuela de Nutrición, Universidad Nacional de Córdoba, Córdoba, Argentina
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22
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Friedman DB, Freedman DA, Choi SK, Anadu EC, Brandt HM, Carvalho N, Hurley TG, Young VM, Hebert JR. Provider communication and role modeling related to patients' perceptions and use of a federally qualified health center-based farmers' market. Health Promot Pract 2014; 15:288-97. [PMID: 23986503 PMCID: PMC3871943 DOI: 10.1177/1524839913500050] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Farmers' markets have the potential to improve the health of underserved communities, shape people's perceptions, values, and behaviors about healthy eating, and serve as a social space for both community members and vendors. This study explored the influence of health care provider communication and role modeling for diabetic patients within the context of a farmers' market located at a federally qualified health center. Although provider communication about diet decreased over time, communication strategies included: providing patients with "prescriptions" and vouchers for market purchases; educating patients about diet; and modeling healthy purchases. Data from patient interviews and provider surveys revealed that patients enjoyed social aspects of the market including interactions with their health care provider, and providers distributed prescriptions and vouchers to patients, shopped at the market, and believed that the market had potential to improve the health of staff and patients of the federally qualified health center. Provider modeling of healthy behaviors may influence patients' food-related perceptions and dietary behaviors.
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Affiliation(s)
- Daniela B. Friedman
- Department of Health Promotion, Education, and Behavior,
University of South Carolina, Columbia SC
- Statewide Cancer Prevention and Control Program, University
of South Carolina, Columbia SC
| | - Darcy A. Freedman
- Statewide Cancer Prevention and Control Program, University
of South Carolina, Columbia SC
- College of Social Work, University of South Carolina,
Columbia SC
| | - Seul Ki Choi
- Department of Health Promotion, Education, and Behavior,
University of South Carolina, Columbia SC
- Statewide Cancer Prevention and Control Program, University
of South Carolina, Columbia SC
| | | | - Heather M. Brandt
- Department of Health Promotion, Education, and Behavior,
University of South Carolina, Columbia SC
- Statewide Cancer Prevention and Control Program, University
of South Carolina, Columbia SC
| | - Natalia Carvalho
- Statewide Cancer Prevention and Control Program, University
of South Carolina, Columbia SC
| | - Thomas G. Hurley
- Statewide Cancer Prevention and Control Program, University
of South Carolina, Columbia SC
| | - Vicki M. Young
- South Carolina Primary Heath Care Association, Columbia
SC
| | - James R. Hebert
- Statewide Cancer Prevention and Control Program, University
of South Carolina, Columbia SC
- Department of Epidemiology & Biostatistics,
University of South Carolina, Columbia SC
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Abstract
Healthy longevity is a tangible possibility for many individuals and populations, with nutritional and other lifestyle factors playing a key role in modulating the likelihood of healthy ageing. Nevertheless, studies of effects of nutrients or single foods on ageing often show inconsistent results and ignore the overall framework of dietary habits. Therefore, the use of dietary patterns (e.g. a Mediterranean dietary pattern) and the specific dietary recommendations (e.g. dietary approaches to stop hypertension, Polymeal and the American Healthy Eating Index) are becoming more widespread in promoting lifelong health. A posteriori defined dietary patterns are described frequently in relation to age-related diseases but their generalisability is often a challenge since these are developed specifically for the population under study. Conversely, the dietary guidelines are often developed based on prevention of disease or nutrient deficiency, but often less attention is paid to how well these dietary guidelines promote health outcomes. In the present paper, we provide an overview of the state of the art of dietary patterns and dietary recommendations in relation to life expectancy and the risk of age-related disorders (with emphasis on cardiometabolic diseases and cognitive outcomes). According to both a posteriori and a priori dietary patterns, some key 'ingredients' can be identified that are associated consistently with longevity and better cardiometabolic and cognitive health. These include high intake of fruit, vegetables, fish, (whole) grains and legumes/pulses and potatoes, whereas dietary patterns rich in red meat and sugar-rich foods have been associated with an increased risk of mortality and cardiometabolic outcomes.
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24
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Kuczmarski MF, Mason MA, Allegro D, Zonderman AB, Evans MK. Diet quality is inversely associated with C-reactive protein levels in urban, low-income African-American and white adults. J Acad Nutr Diet 2013; 113:1620-31. [PMID: 24035460 PMCID: PMC3833870 DOI: 10.1016/j.jand.2013.07.004] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 06/24/2013] [Indexed: 12/28/2022]
Abstract
BACKGROUND C-reactive protein (CRP), an inflammatory biomarker, is influenced by many factors, including socioeconomic position, genetics, and diet. The inverse association between diet and CRP is biologically feasible because micronutrients with antioxidative properties may enable the body to manage the balance between production and accumulation of reactive species that cause oxidative stress. OBJECTIVE To determine the quality of the diet consumed by urban, low-income African-American and white adults aged 30 to 64 years, and association of diet quality with CRP. DESIGN Data from a cross-sectional study were used to evaluate diet quality assessed by mean adequacy ratio (MAR). Two 24-hour recalls were collected by trained interviewers using the US Department of Agriculture automated multiple pass method. PARTICIPANTS The sample consisted of Healthy Aging in Neighborhoods of Diversity across the Life Span baseline study participants, 2004-2009, who completed both recalls (n=2,017). MAIN OUTCOME MEASURES MAR equaled the average of the ratio of intakes to Recommended Dietary Allowance for 15 vitamins and minerals. CRP levels were assessed by the nephelometric method utilizing latex particles coated with CRP monoclonal antibodies. STATISTICAL ANALYSIS Linear ordinary least square regression and generalized linear models were performed to determine the association of MAR (independent variable) with CRP (dependent variable) while adjusting for potential confounders. RESULTS MAR scores ranged from 74.3 to 82.2. Intakes of magnesium and vitamins A, C, and E were the most inadequate compared with Estimated Average Requirements. CRP levels were significantly associated with MAR, dual-energy x-ray absorptiometry-measured body fat, and hypertension. A 10% increase in MAR was associated with a 4% decrease in CRP. CONCLUSIONS The MAR was independently and significantly inversely associated with CRP, suggesting diet is associated with the regulation of inflammation. Interventions to assist people make better food choices may not only improve diet quality but also their health, thereby possibly reducing risk for cardiovascular disease.
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Affiliation(s)
- Marie Fanelli Kuczmarski
- Professor Co-Investigator, HANDLS study, Department of Behavioral Health and Nutrition, 010 Carpenter Sports Building, University of Delaware, Newark, Delaware 19716, Ph: 302-831-8765, Fax: 302-831-4261
| | - Marc A Mason
- Manager, Statistical Information Systems, Biostatistician, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, 251 Bayview Blvd. Suite 03A524, Baltimore, Maryland 21224-6825, Ph: 410-558-8663, Fax: 410-558-8387
| | - Deanne Allegro
- HANDLS Dietary Research Manager, Department of Behavioral Health and Nutrition, 123 Carpenter Sports Building, University of Delaware, Newark, Delaware 19716, Ph: 302-831-8055, Fax: 302-831-4261
| | - Alan B. Zonderman
- Chief, Lifespan, Cognition and Health Section, Co-Principal Investigator, HANDLS study, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, 251 Bayview Boulevard, Suite 100, Baltimore, Maryland 21224-6825, Ph: 410-558-8280, Fax: 410-558-8281
| | - Michele K. Evans
- NIA Deputy Scientific Director, Co-Principal Investigator, HANDLS study, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIH, 251 Bayview Boulevard, Suite 100, National Institute on Aging Baltimore, Maryland 21224-6825, Ph: 410-558-8110, Fax: 410-558-8268
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25
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Harrison DG. The mosaic theory revisited: common molecular mechanisms coordinating diverse organ and cellular events in hypertension. ACTA ACUST UNITED AC 2013; 7:68-74. [PMID: 23321405 DOI: 10.1016/j.jash.2012.11.007] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Accepted: 11/20/2012] [Indexed: 12/12/2022]
Abstract
More than 60 years ago, Dr. Irvine Page proposed the Mosaic Theory of hypertension, which states that many factors, including genetics, environment, adaptive, neural, mechanical, and hormonal perturbations interdigitate to raise blood pressure. In the past two decades, it has become clear that common molecular and cellular events in various organs underlie many features of the Mosaic Theory. Two of these are the production of reactive oxygen species and inflammation. These factors increase neuronal firing in specific brain centers, increase sympathetic outflow, alter vascular tone and morphology, and promote sodium retention in the kidney. Moreover, factors such as genetics and environment contribute to oxidant generation and inflammation. Other common cellular signals, including calcium signaling and endoplasmic reticulum stress are similarly perturbed in different cells in hypertension and contribute to components of Page's theory. Thus, Page's Mosaic Theory formed a framework for future studies of molecular and cellular signals in the context of hypertension, and has greatly aided our understanding of this complex disease.
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Affiliation(s)
- David G Harrison
- Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee 37232, USA.
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26
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Barbaresko J, Koch M, Schulze MB, Nöthlings U. Dietary pattern analysis and biomarkers of low-grade inflammation: a systematic literature review. Nutr Rev 2013; 71:511-27. [PMID: 23865797 DOI: 10.1111/nure.12035] [Citation(s) in RCA: 387] [Impact Index Per Article: 35.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
The purpose of the present literature review was to investigate and summarize the current evidence on associations between dietary patterns and biomarkers of inflammation, as derived from epidemiological studies. A systematic literature search was conducted using PubMed, Web of Science, and EMBASE, and a total of 46 studies were included in the review. These studies predominantly applied principal component analysis, factor analysis, reduced rank regression analysis, the Healthy Eating Index, or the Mediterranean Diet Score. No prospective observational study was found. Patterns identified by reduced rank regression as being statistically significantly associated with biomarkers of inflammation were almost all meat-based or "Western" patterns. Studies using principal component analysis or a priori-defined diet scores found that meat-based or "Western-like" patterns tended to be positively associated with biomarkers of inflammation, predominantly C-reactive protein, while vegetable- and fruit-based or "healthy" patterns tended to be inversely associated. While results of the studies were inconsistent, interventions with presumed healthy diets resulted in reductions of almost all investigated inflammatory biomarkers. In conclusion, prospective studies are warranted to confirm the reported findings and further analyze associations, particularly by investigating dietary patterns as risk factors for changes in inflammatory markers over time.
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Affiliation(s)
- Janett Barbaresko
- Department of Nutrition and Food Sciences, Nutritional Epidemiology, University of Bonn, Bonn, Germany.
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27
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Empirically-derived dietary patterns, diet quality scores, and markers of inflammation and endothelial dysfunction. Curr Nutr Rep 2013; 2:97-104. [PMID: 23750327 DOI: 10.1007/s13668-013-0045-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Atherosclerosis is one of the most important contributors to the global burden of cardiovascular diseases. With the recognition of atherosclerosis as an inflammatory disease, nutrition research interest has expanded towards the role of dietary patterns in the prevention of atherosclerosis primarily focused on associations with early inflammatory markers. This review summarizes the latest evidence from January 2010 until January 2013 of eight observational studies on the associations between empirically-derived dietary patterns and diet quality scores with markers of inflammation and endothelial function. Overall, results of recently published cohort studies support those of previously published cross-sectional studies suggesting that consuming a healthy type of diet characteristically abundant in fruits and vegetables is associated with lower concentrations of C-reactive protein and other inflammatory markers. Unfavourable associations were found between eating a Western dietary pattern high in meat and inflammatory markers. Different statistical approaches of deriving dietary patterns were applied in these studies and most of them lacked in reporting absolute intakes of foods and/or food groups. Future prospective cohort studies are needed to evaluate long-term associations between dietary patterns and changes in inflammatory markers by comparing various approaches of dietary pattern derivation within a population. Reporting absolute intakes of foods and/or food groups may also facilitate the identification of a typical dietary pattern that may beneficially influence inflammation.
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28
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Abstract
Inflammation mediates several chronic diseases. Micronutrients can act on inflammation, either through modulating cytokine production or by scavenging by-products of activated white cells. Identifying dietary patterns (DP) reflecting these mechanisms and relating them to inflammation is of interest. The objective of the study was to identify DP specifically associated with intakes of nutrients potentially involved in inflammatory processes in a middle-aged population and investigate long-term associations between these DP and C-reactive protein (CRP) status assessed several years later. Subjects included in the Supplementation in Vitamins and Mineral Antioxidants 2 cohort study, having available data on dietary assessment carried out in 1994-5 and CRP measurement in 2007-9, were included in the analysis. DP were extracted with reduced rank regression (RRR), using antioxidant micronutrients and PUFA as response variables. Associations between CRP measurements >3 mg/l and extracted DP were then examined with logistic regression models providing OR and 95% CI. A total of 2031 subjects (53·2% women, mean follow-up duration: 12·5 years) were included in the analyses. Of the four extracted DP, a DP with high loading values of vegetables and vegetable oils, leading to high intakes of antioxidant micronutrients and essential fatty acids, was significantly and negatively associated with risk of elevated CRP (OR 0·88; 95% CI 0·78, 0·98). Conversely, a DP reflecting a high n-6:n-3 fatty acid intake ratio was positively and significantly associated with elevated CRP (adjusted OR 1·15; 95% CI 1·00, 1·32). DP extracted with RRR provide support for further exploration of relationships between dietary behaviour and inflammation.
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29
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Hsiao PY, Mitchell DC, Coffman DL, Craig Wood G, Hartman TJ, Still C, Jensen GL. Dietary patterns and relationship to obesity-related health outcomes and mortality in adults 75 years of age or greater. J Nutr Health Aging 2013; 17:566-72. [PMID: 23732554 PMCID: PMC4558554 DOI: 10.1007/s12603-013-0014-y] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The prevalence of obesity-related adverse health outcomes is increasing among older adults. Because it is thought that nutrition plays an important role in successful aging, there has been considerable interest in the association between dietary patterns of older adults and obesity-related health outcomes. OBJECTIVE This study examined the association between dietary patterns and mortality and prevalence of obesity-related health outcomes, namely cardiovascular disease (CVD), type 2 diabetes mellitus, hypertension, and metabolic syndrome (MetSyn), over a 5-year follow-up period in adults aged 75 years or greater. DESIGN A longitudinal observational study with cross-sectional dietary assessment. SETTING Rural Central Pennsylvania. PARTICIPANTS Community-dwelling older adults (N = 449; 76.5 years old; 57% female). MEASUREMENTS Multiple, unannounced, 24-hour dietary recalls were used to collect dietary intake. Cluster analysis was used to derive dietary patterns. Prevalence of CVD, diabetes mellitus, hypertension, and MetSyn was extracted from outpatient electronic medical records. Logistic regression was used to examine the associations between dietary patterns and health outcomes and mortality. RESULTS 'Sweets and Dairy', 'Health-Conscious' and 'Western' dietary patterns were identified. Compared to the 'Health-Conscious' pattern, those in the 'Sweets and Dairy' pattern had increased odds of hypertension over the follow-up period; adjusted odds ratio (95% CI) was 2.18 (1.11-4.30). No significant associations were found for CVD, diabetes mellitus, MetSyn or mortality with dietary patterns. CONCLUSIONS These findings support the potential value of healthy dietary patterns in the management of hypertension in older adults. We did not observe any other strong associations between dietary patterns and health outcomes or mortality in persons ≥ 75 years of age; thus failing to support the use of overly restrictive diet prescriptions for older persons, especially where food intake may be inadequate.
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Affiliation(s)
- P Y Hsiao
- The Pennsylvania State University, 110 Chandlee Laboratory, University Park, PA 16802, USA.
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30
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Wiacek M, Zubrzycki IZ, Bojke O, Kim HJ. Menopause and age-driven changes in blood level of fat- and water-soluble vitamins. Climacteric 2012; 16:689-99. [PMID: 23215463 DOI: 10.3109/13697137.2012.742504] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE The purpose of this cross-sectional study was to assess the association of the menopausal transition with changes in vitamins. METHODS The study group comprised women aged 17-85 years from the Third National Health and Nutrition Examination Survey (NHANES), which was conducted between 1988 and 1994, and from the NHANES surveys conducted between 1999 and 2006. Menopausal status was defined using the time since the last period, < 2, 2-12, and > 12 months, for the pre-, peri-, and postmenopause, respectively. The data-cleaning technique employing serum follicle stimulating hormone activity resulted in pre-, peri- and postmenopausal samples encompassing the following age brackets: 17-50, 42-51, and 46-85 years. Statistical inferences were analyzed using non-parametric techniques. RESULTS Significant increases in vitamin A and vitamin E concentrations across all phases of the menopausal transition were observed. There was a gradual decrease in the vitamin C concentration across all stages of the menopause but a fairly stable concentration of vitamin B12. There was a statistically significant increase in vitamin D between the pre- and postmenopause. Body mass index correlated negatively with serum vitamin concentration in the pre- and postmenopause. CONCLUSIONS Vitamin A should be supplemented in postmenopausal women to decrease the risk of bone fracture. The daily diet should be supplemented with vitamin B12, to avoid possible neurological symptoms due to vitamin B12 deficiency, and with vitamin D to decrease the risk of developing secondary hyperparathyroidism. Due to an adverse influence on serum vitamin concentration, body mass index should be monitored in pre- and postmenopausal women.
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Affiliation(s)
- M Wiacek
- Jędrzej Śniadecki Academy of Physical Education and Sport , Gdańsk , Poland
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31
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Constantinides A, Kerstens MN, Dikkeschei BD, van Pelt LJ, Tellis CC, Tselepis AD, Dullaart RPF. Plasma Lp-PLA(2) mass and apoB-lipoproteins that carry Lp-PLA(2) decrease after sodium. Eur J Clin Invest 2012; 42:1235-43. [PMID: 22957745 DOI: 10.1111/j.1365-2362.2012.02719.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Lipoprotein-associated phospholipase A(2) (Lp-PLA(2) ) is a novel cardiovascular risk marker, which is predominantly complexed to apolipoprotein (apo) B-containing lipoproteins in human plasma. As increasing dietary sodium intake may decrease plasma apoB-containing lipoproteins, we tested whether a sodium challenge lowers plasma Lp-PLA(2) mass, as well as the levels of apoB-containing lipoprotein particles carrying Lp-PLA(2) (apoB-Lp-PLA(2) ), employing a newly developed enzyme-linked immunosorbent assay. MATERIALS AND METHODS In 45 women and 31 men (mean age 44 ± 14 years), plasma Lp-PLA(2) mass (turbidimetric immunoassay), the level of apoB-Lp-PLA(2) , expressed in apoB concentration and lipoproteins were measured in response to a 3-day challenge with 9 g sodium chloride tablets daily. RESULTS Urinary sodium excretion increased from 165 ± 60 to 321 ± 70 mmol/24 h (P<0.001) after salt loading. Plasma Lp-PLA(2) mass decreased from 618 (493-719) to 588 (465-698) μg/L (P<0.001), and apoB-Lp-PLA(2) decreased from 0.276 (0.200-0.351) to 0.256 (0.189-0.328) g LDL protein/L (P=0.004) in response to the sodium challenge together with decreases in plasma total cholesterol, nonhigh-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, apolipoprotein B and the total cholesterol/HDL cholesterol ratio (P<0.01 for all). Changes in plasma Lp-PLA(2) mass were correlated positively with changes in total cholesterol, LDL cholesterol and non-HDL cholesterol (r=0.260-0.276, P<0.05 to P<0.02), whereas changes in apoB-Lp-PLA(2) were correlated positively with changes in non-HDL cholesterol and in the total cholesterol/HDL cholesterol ratio (r=0.232-0.385, P<0.05-0.01). CONCLUSION Both plasma Lp-PLA(2) mass levels and apoB-Lp-PLA(2) decrease in response to a short-term oral sodium challenge.
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Affiliation(s)
- Alexander Constantinides
- Department of Endocrinology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
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32
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The use of cluster analysis to derive dietary patterns: methodological considerations, reproducibility, validity and the effect of energy mis-reporting. Proc Nutr Soc 2012; 71:599-609. [DOI: 10.1017/s0029665112000729] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Over the last three decades, dietary pattern analysis has come to the forefront of nutritional epidemiology, where the combined effects of total diet on health can be examined. Two analytical approaches are commonly used: a priori and a posteriori. Cluster analysis is a commonly used a posteriori approach, where dietary patterns are derived based on differences in mean dietary intake separating individuals into mutually exclusive, non-overlapping groups. This review examines the literature on dietary patterns derived by cluster analysis in adult population groups, focusing, in particular, on methodological considerations, reproducibility, validity and the effect of energy mis-reporting. There is a wealth of research suggesting that the human diet can be described in terms of a limited number of eating patterns in healthy population groups using cluster analysis, where studies have accounted for differences in sex, age, socio-economic status, geographical area and weight status. Furthermore, patterns have been used to explore relationships with health and chronic diseases and more recently with nutritional biomarkers, suggesting that these patterns are biologically meaningful. Overall, it is apparent that consistent trends emerge when using cluster analysis to derive dietary patterns; however, future studies should focus on the inconsistencies in methodology and the effect of energy mis-reporting.
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Wallström P, Sonestedt E, Hlebowicz J, Ericson U, Drake I, Persson M, Gullberg B, Hedblad B, Wirfält E. Dietary fiber and saturated fat intake associations with cardiovascular disease differ by sex in the Malmö Diet and Cancer Cohort: a prospective study. PLoS One 2012; 7:e31637. [PMID: 22384046 PMCID: PMC3288044 DOI: 10.1371/journal.pone.0031637] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2011] [Accepted: 01/10/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The aim of the study was to examine associations between intake of macronutrients and dietary fiber and incident ischemic cardiovascular disease (iCVD) in men and women. METHODS We used data from 8,139 male and 12,535 female participants (aged 44-73 y) of the Swedish population-based Malmö Diet and Cancer cohort. The participants were without history of CVD and diabetes mellitus, and had reported stable dietary habits in the study questionnaire. Diet was assessed by a validated modified diet history method, combining a 7-d registration of cooked meals and cold beverages, a 168-item food questionnaire (covering other foods and meal patterns), and a 1-hour diet interview. Sociodemographic and lifestyle data were collected by questionnaire. iCVD cases, which included coronary events (myocardial infarctions or deaths from chronic ischemic heart disease) and ischemic strokes, were ascertained via national and local registries. Nutrient-disease associations were examined by multivariate Cox regressions. RESULTS During a mean follow-up of 13.5 years, we identified 1,089 male and 687 female iCVD cases. High fiber intakes were associated with lower incidence rates of iCVD in women and of ischemic stroke in men. In post-hoc analysis, we discovered statistically significant interactions between intake of fiber and saturated fat; these interactions also differed between men and women (p<0.001). CONCLUSIONS In this well-defined population, a high fiber intake was associated with lower risk of iCVD, but there were no robust associations between other macronutrients and iCVD risk. Judging from this study, gender-specific nutrient analysis may be preferable in epidemiology.
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Affiliation(s)
- Peter Wallström
- Nutrition Epidemiology Research Group, Department of Clinical Sciences, Lund University, Malmö, Sweden.
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