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Tessitore E, Branca M, Heg D, Nanchen D, Auer R, Räber L, Klingenberg R, Windecker S, Lüscher TF, Carballo S, Matter CM, Gmel G, Mukamal KJ, Rodondi N, Carballo D, Mach F, Gencer B. Drinking patterns of alcohol and risk of major adverse cardiovascular events after an acute coronary syndrome. Eur J Prev Cardiol 2024; 31:845-855. [PMID: 37995305 DOI: 10.1093/eurjpc/zwad364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 11/14/2023] [Accepted: 11/19/2023] [Indexed: 11/25/2023]
Abstract
AIMS To evaluate the risk of alcohol consumption after acute coronary syndromes (ACS). METHODS AND RESULTS A total of 6557 patients hospitalized for ACS at four Swiss centres were followed over 12 months. Weekly alcohol consumption was collected at baseline and 12 months. Binge drinking was defined as consumption of ≥6 units of alcohol on one occasion. Major adverse cardiovascular events (MACE) were defined as a composite of cardiac death, myocardial infarction, stroke, or clinically indicated target vessel coronary revascularization. Cox regression analysis was performed to assess the risk of MACE in patients with heavy (>14 standard units/week), moderate (7-14 standard units per week), light consumption (<1 standard unit/week), or abstinence, and with binge drinking episodes, adjusted for baseline differences. At baseline, 817 (13.4%) patients reported heavy weekly alcohol consumption. At 1-year follow-up, 695/1667 (41.6%) patients reported having at least one or more episodes of binge drinking per month. The risk for MACE was not significantly higher in those with heavy weekly consumption compared to abstinence [8.6% vs. 10.2%, hazard ratio (HR) 0.97, 95% confidence interval (CI) 0.69-1.36] or light consumption (8.6% vs. 8.5%, HR 1.41, 95% CI 0.97-2.06). Compared to patients with no binge drinking, the risk of MACE was dose-dependently higher in those with binge drinking with less than one episode per month (9.2% vs. 7.8%, HR 1.61, 95% CI 1.23-2.11) or one or more episodes per month (13.6% vs. 7.8%, HR 2.17, 95% CI 1.66-2.83). CONCLUSION Binge drinking during the year following an ACS, even less than once per month, is associated with worse clinical outcomes.
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Affiliation(s)
- Elena Tessitore
- Division of Cardiology, Department of Medicine, Geneva University Hospitals, Rue Gabrielle Perret-Gentil 4, 1205 Geneva, Switzerland
| | - Mattia Branca
- Clinical Trial Unit, University of Bern, Bern, Switzerland
| | - Dik Heg
- Clinical Trial Unit, University of Bern, Bern, Switzerland
| | - David Nanchen
- Department of Health Promotion and Preventions, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Reto Auer
- Department of Health Promotion and Preventions, Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland
| | - Lorenz Räber
- Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Roland Klingenberg
- Department of Cardiology, University Hospital of Zurich, Zurich, Switzerland
- Department of Cardiology, Kerckhoff Heart and Thorax Center, Campus of the Justus Liebig University of Giessen, Bad Nauheim, Germany
- DZHK (German Center for Cardiovascular Research), partner site Rhine-Main, Bad Nauheim, Germany
| | - Stephan Windecker
- Department of Cardiology, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Thomas F Lüscher
- Royal Brompton & Harefield Hospitals GSTT, Imperial College and Kings College, London, UK
- Center for Molecular Cardiology, Schlieren Campus, University Zurich, Zurich, Switzerland
| | - Sebastian Carballo
- Division of General Internal Medicine, Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Christian M Matter
- Department of Cardiology, University Hospital of Zurich, Zurich, Switzerland
| | - Gerhard Gmel
- Addiction Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Kenneth J Mukamal
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Nicolas Rodondi
- Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - David Carballo
- Division of Cardiology, Department of Medicine, Geneva University Hospitals, Rue Gabrielle Perret-Gentil 4, 1205 Geneva, Switzerland
| | - François Mach
- Division of Cardiology, Department of Medicine, Geneva University Hospitals, Rue Gabrielle Perret-Gentil 4, 1205 Geneva, Switzerland
| | - Baris Gencer
- Division of Cardiology, Department of Medicine, Geneva University Hospitals, Rue Gabrielle Perret-Gentil 4, 1205 Geneva, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Mittelstrasse 43, 3012 Bern, Switzerland
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Martínez-González MÁ, Hernández Hernández A. Effect of the Mediterranean diet in cardiovascular prevention. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2024:S1885-5857(24)00043-4. [PMID: 38336153 DOI: 10.1016/j.rec.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 01/25/2024] [Indexed: 02/12/2024]
Abstract
The Mediterranean diet is the best evidence-based model for cardiovascular prevention. In addition to 2 major randomized secondary prevention trials (Lyon Heart and CORDIOPREV) and 1 primary prevention trial (PREDIMED) that have demonstrated these benefits, there is an unprecedented body of high-quality prospective epidemiological evidence supporting these beneficial effects. The key elements of this traditional pattern are the abundant use of extra-virgin olive oil and high consumption of foods of natural plant-based origin (fruits, vegetables, nuts, and legumes) and fish, along with a reduction in processed meats, red meats, and ultraprocessed products. Moderate consumption of wine, preferably red wine, with meals is an essential element of this traditional pattern. Although removing wine consumption from the Mediterranean diet has been associated with a reduction in its preventive efficacy, doubts have recently arisen about the possible adverse effect of even low or moderate intake of any alcoholic beverages. A new large Spanish trial, UNATI, which will begin in June 2024, will randomize 10 000 drinkers aged 50 to 75 years to abstention or moderate consumption. UNATI aims to answer these doubts with the best possible evidence.
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Affiliation(s)
- Miguel Á Martínez-González
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Spain; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, United States.
| | - Aitor Hernández Hernández
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain; Departamento de Cardiología, Clínica Universidad de Navarra, Madrid, Spain
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Domínguez López I, Arancibia-Riveros C, Casas R, Galkina P, Pérez M, Martínez-González MÁ, Fitó M, Ros E, Estruch R, Lamuela-Raventós RM. Moderate wine consumption measured using the biomarker urinary tartaric acid concentration decreases inflammatory mediators related to atherosclerosis. J Nutr Health Aging 2024; 28:100003. [PMID: 38388107 DOI: 10.1016/j.jnha.2023.100003] [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: 10/23/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 02/24/2024]
Abstract
OBJECTIVES Several studies suggest that moderate wine consumption, particularly red wine, may have benefits for cardiovascular health. Red wine contains a variety of bioactive compounds, including polyphenols like phenolic acids, which have demonstrated anti-inflammatory effects in experimental models. The aim of this study was to assess the anti-inflammatory properties of wine, measured as urinary tartaric acid, a new biomarker of wine consumption. DESIGN, SETTINGS, AND PARTICIPANTS One-year longitudinal study that included 217 participants from the PREDIMED trial. MEASUREMENTS Plasma inflammatory biomarkers and urinary tartaric acid were analyzed using xMAP technology and high-performance liquid chromatography, respectively. Multivariable regression analyses were performed to assess the relationship between variations over 1-year in urinary tartaric acid concentrations and 1-year changes in serum inflammatory molecules, including adhesion cell molecules, interleukine-6, tumour necrosis factor alpha, and monocyte chemotactic protein 1. Three categories were built according to tertiles of 1-y changes in urinary tartaric acid. RESULTS Using a ROC curve, urinary tartaric acid was corroborated as a reliable biomarker of wine consumption (AUC = 0.818 (95% CI: 0.76; 0.87). In the continuous analysis, participants with higher increases in tartaric acid significantly reduced their concentrations in soluble vascular adhesion molecule (sVCAM-1) after 1-year of follow-up (-0.20 (-0.38; -9,93) ng/mL per 1-SD increment, p-value = 0.031). Moreover, tertiles 2 and 3 of 1-year changes in tartaric acid presented a significant reduction in soluble intercellular cell adhesion molecule (sICAM-1) as compared to tertile 1 (-0.31 (-0.52; -0.10) ng/mL, p-value = 0.014 and -0.29 (-0.52; -0.07) ng/mL, p-value = 0.023, respectively). Participants in the third tertile also exhibited a reduced concentration of sVCAM-1 compared to those in the first tertile (-0.31 (-0.55; -0.06) ng/mL, p-value = 0.035). CONCLUSIONS Our findings suggest that wine consumption is associated with lower levels of inflammation due to the anti-inflammatory properties of wine compounds.
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Affiliation(s)
- Inés Domínguez López
- Polyphenol Research Group, Departament de Nutrició, Ciències de l'Alimentació i Gastronomía, Facultat de Farmacia, Universitat de Barcelona (UB), Av. de Joan XXII, 27-31, 08028 Barcelona, Spain; Institut de Nutrició i Seguretat Alimentària (INSA), Universitat de Barcelona (UB), 08921 Santa Coloma de Gramanet, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Camila Arancibia-Riveros
- Polyphenol Research Group, Departament de Nutrició, Ciències de l'Alimentació i Gastronomía, Facultat de Farmacia, Universitat de Barcelona (UB), Av. de Joan XXII, 27-31, 08028 Barcelona, Spain; Institut de Nutrició i Seguretat Alimentària (INSA), Universitat de Barcelona (UB), 08921 Santa Coloma de Gramanet, Spain
| | - Rosa Casas
- Institut de Nutrició i Seguretat Alimentària (INSA), Universitat de Barcelona (UB), 08921 Santa Coloma de Gramanet, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; Department of Internal Medicine, Hospital Clinic, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain
| | - Polina Galkina
- Polyphenol Research Group, Departament de Nutrició, Ciències de l'Alimentació i Gastronomía, Facultat de Farmacia, Universitat de Barcelona (UB), Av. de Joan XXII, 27-31, 08028 Barcelona, Spain; Institut de Nutrició i Seguretat Alimentària (INSA), Universitat de Barcelona (UB), 08921 Santa Coloma de Gramanet, Spain
| | - Maria Pérez
- Polyphenol Research Group, Departament de Nutrició, Ciències de l'Alimentació i Gastronomía, Facultat de Farmacia, Universitat de Barcelona (UB), Av. de Joan XXII, 27-31, 08028 Barcelona, Spain; Institut de Nutrició i Seguretat Alimentària (INSA), Universitat de Barcelona (UB), 08921 Santa Coloma de Gramanet, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Miguel Ángel Martínez-González
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; Department of Preventive Medicine and Public Health, University of Navarra, IdiSNA, 31008 Pamplona, Spain
| | - Montserrat Fitó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas (IMIM), 08007 Barcelona, Spain
| | - Emilio Ros
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; Lipid Clinic, Endocrinology and Nutrition Service, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, 08036 Barcelona, Spain
| | - Ramon Estruch
- Institut de Nutrició i Seguretat Alimentària (INSA), Universitat de Barcelona (UB), 08921 Santa Coloma de Gramanet, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; Department of Internal Medicine, Hospital Clinic, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona, 08036 Barcelona, Spain.
| | - Rosa M Lamuela-Raventós
- Polyphenol Research Group, Departament de Nutrició, Ciències de l'Alimentació i Gastronomía, Facultat de Farmacia, Universitat de Barcelona (UB), Av. de Joan XXII, 27-31, 08028 Barcelona, Spain; Institut de Nutrició i Seguretat Alimentària (INSA), Universitat de Barcelona (UB), 08921 Santa Coloma de Gramanet, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain.
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Lombardo M, Feraco A, Camajani E, Caprio M, Armani A. Health Effects of Red Wine Consumption: A Narrative Review of an Issue That Still Deserves Debate. Nutrients 2023; 15:nu15081921. [PMID: 37111141 PMCID: PMC10146095 DOI: 10.3390/nu15081921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/04/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
A strong controversy persists regarding the effect of red wine (RW) consumption and health. Guidelines for the prevention of cardiovascular diseases (CVD) and cancers discourage alcohol consumption in any form, but several studies have demonstrated that low RW intake may have positive effects on CVD risk. This review evaluated randomised controlled trials (RCTs), examining the recent literature on the correlations between acute and chronic RW consumption and health. All RCTs published in English on PubMed from 1 January 2000 to 28 February 2023 were evaluated. Ninety-one RCTs were included in this review, seven of which had a duration of more than six months. We assessed the effect of RW on: (1) antioxidant status, (2) cardiovascular function, (3) coagulation pathway and platelet function, (4) endothelial function and arterial stiffness, (5) hypertension, (6) immune function and inflammation status, (7) lipid profile and homocysteine levels, (8) body composition, type 2 diabetes and glucose metabolism, and (9) gut microbiota and the gastrointestinal tract. RW consumption mostly results in improvements in antioxidant status, thrombosis and inflammation markers, lipid profile, and gut microbiota, with conflicting results on hypertension and cardiac function. Notably, beneficial effects were observed on oxidative stress, inflammation, and nephropathy markers, with a modest decrease in CVD risk in five out of seven studies that evaluated the effect of RW consumption. These studies were conducted mainly in patients with type 2 diabetes mellitus, and had a duration between six months and two years. Additional long-term RCTs are needed to confirm these benefits, and assess the potential risks associated with RW consumption.
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Affiliation(s)
- Mauro Lombardo
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Open University, 00166 Rome, Italy
| | - Alessandra Feraco
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Open University, 00166 Rome, Italy
- Laboratory of Cardiovascular Endocrinology, San Raffaele Research Institute, IRCCS San Raffaele Roma, Via di Val Cannuta, 247, 00166 Rome, Italy
| | - Elisabetta Camajani
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Open University, 00166 Rome, Italy
- Laboratory of Cardiovascular Endocrinology, San Raffaele Research Institute, IRCCS San Raffaele Roma, Via di Val Cannuta, 247, 00166 Rome, Italy
| | - Massimiliano Caprio
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Open University, 00166 Rome, Italy
- Laboratory of Cardiovascular Endocrinology, San Raffaele Research Institute, IRCCS San Raffaele Roma, Via di Val Cannuta, 247, 00166 Rome, Italy
| | - Andrea Armani
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Open University, 00166 Rome, Italy
- Laboratory of Cardiovascular Endocrinology, San Raffaele Research Institute, IRCCS San Raffaele Roma, Via di Val Cannuta, 247, 00166 Rome, Italy
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Ma H, Wang X, Li X, Heianza Y, Qi L. Moderate alcohol drinking with meals is related to lower incidence of type 2 diabetes. Am J Clin Nutr 2022; 116:1507-1514. [PMID: 36250602 PMCID: PMC9761774 DOI: 10.1093/ajcn/nqac207] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 07/26/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Previous studies on alcohol drinking and health largely have ignored the potential impact of the timing of drinking. OBJECTIVES We aimed to investigate the joint associations of the timing of alcohol intake with respect to meals (i.e., with meals or outside of meals) and the amount of alcohol consumed with the risk of type 2 diabetes (T2D). METHODS A total of 312,388 current drinkers from the UK Biobank without T2D at baseline were included. Cox proportional hazards models were used to examine the association between the timing of alcohol intake with respect to meals and the risk of T2D. RESULTS During a median of 10.9 y of follow-up, 8598 incident cases of T2D were documented. After adjustment for covariates and the amount of alcohol consumed, consuming alcohol with meals was significantly associated with a 12% lower risk of T2D (HR: 0.88; 95% CI: 0.83, 0.93) than was consuming alcohol outside of meals. In addition, we found that the timing of alcohol intake with respect to meals significantly modified the relations between the amount of alcohol consumed and risk of T2D (P-interaction = 0.017); the beneficial association of moderate drinking with T2D risk was only observed in participants who consumed alcohol with meals, but not in others. Further analyses on various types of alcoholic beverages indicated that the beneficial associations between alcohol drinking with meals and T2D were mainly driven by wine consumption. Moreover, we found that when consumed together with meals, drinking more wine, rather than other alcoholic beverages, was related to lower concentrations of C-reactive protein. CONCLUSIONS In current drinkers, moderate drinking of alcohol, especially wine, with meals is associated with a lower risk of T2D.
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Affiliation(s)
- Hao Ma
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Xuan Wang
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Xiang Li
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Yoriko Heianza
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
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Reno-Bernstein CM, Oxspring M, Bayles J, Huang EY, Holiday I, Fisher SJ. Vitamin E treatment in insulin-deficient diabetic rats reduces cardiac arrhythmias and mortality during severe hypoglycemia. Am J Physiol Endocrinol Metab 2022; 323:E428-E434. [PMID: 36198111 PMCID: PMC9639754 DOI: 10.1152/ajpendo.00188.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/16/2022] [Accepted: 09/20/2022] [Indexed: 11/22/2022]
Abstract
In people with type 1 diabetes, hypoglycemia can induce cardiac arrhythmias. In rodent experiments, severe hypoglycemia can induce fatal cardiac arrhythmias, especially so in diabetic models. Increased oxidative stress associated with insulin-deficient diabetes was hypothesized to increase susceptibility to severe hypoglycemia-induced fatal cardiac arrhythmias. To test this hypothesis, Sprague-Dawley rats were made insulin deficient with streptozotocin and randomized into two groups: 1) control (n = 22) or 2) vitamin E treated (four doses of α-tocopherol, 400 mg/kg, n = 20). Following 1 week of treatment, rats were either tested for cardiac oxidative stress or underwent a hyperinsulinemic-severe hypoglycemic (10-15 mg/dL) clamp with electrocardiogram recording. As compared with controls, vitamin E-treated rats had threefold less cardiac oxidative stress, sixfold less mortality due to severe hypoglycemia, and sevenfold less incidence of heart block. In summary, vitamin E treatment and the associated reduction of cardiac oxidative stress in diabetic rats reduced severe hypoglycemia-induced fatal cardiac arrhythmias. These results indicate that in the setting of diabetes, pharmacological treatments that reduce oxidative stress may be an effective strategy to reduce the risk of severe hypoglycemia-induced fatal cardiac arrhythmias.NEW & NOTEWORTHY For people with type 1 diabetes, severe hypoglycemia can be fatal. We show in our animal model that insulin-deficient diabetic rats have fatal cardiac arrhythmias during severe hypoglycemia that are associated with increased cardiac oxidative stress. Importantly, treatment with vitamin E, to reduce oxidative stress, decreased fatal cardiac arrhythmias during severe hypoglycemia.
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Affiliation(s)
- Candace M Reno-Bernstein
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Milan Oxspring
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Justin Bayles
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Emily Yiqing Huang
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Ivana Holiday
- Division of Endocrinology, Metabolism, and Diabetes, Department of Internal Medicine, University of Utah, Salt Lake City, Utah
| | - Simon J Fisher
- Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, University of Kentucky, Lexington, Kentucky
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Mukamal KJ, Beulens JWJ. Limited alcohol consumption and lower risk of diabetes: can we believe our own eyes? Am J Clin Nutr 2022; 116:1460-1461. [PMID: 36250722 PMCID: PMC9761770 DOI: 10.1093/ajcn/nqac258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
| | - Joline W J Beulens
- Department of Epidemiology & Data Science, Amsterdam UMC Medical Center, location Vrije Universiteit, Amsterdam, Netherlands,Amsterdam Cardiovascular Sciences, Amsterdam Public Health, Amsterdam, Netherlands,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
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Barbería-Latasa M, Gea A, Martínez-González MA. Alcohol, Drinking Pattern, and Chronic Disease. Nutrients 2022; 14:nu14091954. [PMID: 35565924 PMCID: PMC9100270 DOI: 10.3390/nu14091954] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/01/2022] [Accepted: 05/05/2022] [Indexed: 12/16/2022] Open
Abstract
This review discusses the inconsistent recommendations on alcohol consumption and its association with chronic disease, highlighting the need for an evidence-based consensus. Alcohol is an addictive substance consumed worldwide, especially in European countries. Recommendations on alcohol consumption are controversial. On one hand, many nonrandomized studies defend that moderate consumption has a beneficial cardiovascular effect or a lower risk of all-cause mortality. On the other hand, alcohol is associated with an increased risk of cancer, neurological diseases, or injuries, among others. For years, efforts have been made to answer the question regarding the safe amount of alcohol intake, but controversies remain. Observational studies advocate moderate alcohol consumption following a Mediterranean pattern (red wine with meals avoiding binge drinking) as the best option for current drinkers. However, agencies such as the IARC recommend abstention from alcohol as it is a potent carcinogen. In this context, more randomized trial with larger sample size and hard clinical endpoints should be conducted to clarify the available evidence and provide clinicians with support for their clinical practice.
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Affiliation(s)
- María Barbería-Latasa
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain; (M.B.-L.); (M.A.M.-G.)
| | - Alfredo Gea
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain; (M.B.-L.); (M.A.M.-G.)
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
- Biomedical Research Network Center for Pathophysiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain
- Correspondence:
| | - Miguel A. Martínez-González
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain; (M.B.-L.); (M.A.M.-G.)
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
- Biomedical Research Network Center for Pathophysiology of Obesity and Nutrition (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain
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Effect of Moderate Wine Consumption on Oxidative Stress Markers in Coronary Heart Disease Patients. Nutrients 2022; 14:nu14071377. [PMID: 35405991 PMCID: PMC9002743 DOI: 10.3390/nu14071377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/16/2022] [Accepted: 03/23/2022] [Indexed: 02/08/2023] Open
Abstract
Evidence from research studies reports that wine consumption is associated with lower cardiovascular disease risk, partly through the amelioration of oxidative stress. The aim of the present study was to examine the effect of regular light to moderate wine consumption from coronary heart disease (CHD) patients compared to the effect induced by alcohol intake without the presence of wine microconstituents, on oxidation-induced macromolecular damage as well as on endogenous antioxidant enzyme activity. A randomized, single-blind, controlled, three-arm parallel intervention was carried out, in which 64 CHD patients were allocated to three intervention groups. Group A consumed no alcohol, and Group B (wine) and Group C (ethanol) consumed 27 g of alcohol/day for 8 weeks. Blood and urine samples were collected at baseline and at 4 and 8 weeks. Urine oxidized guanine species levels, protein carbonyls, thiobarbituric acid substances (TBARS) levels, as well as superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities, were measured. Oxidized guanine species and protein carbonyl levels were significantly increased in the ethanol group during the intervention and were significantly decreased in the wine group. These results support the idea that wine’s bioactive compounds may exert antioxidant actions that counteract the macromolecular oxidative damage induced by alcohol in CHD patients.
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Hoek AG, van Oort S, Mukamal KJ, Beulens JWJ. Alcohol Consumption and Cardiovascular Disease Risk: Placing New Data in Context. Curr Atheroscler Rep 2022; 24:51-59. [PMID: 35129737 PMCID: PMC8924109 DOI: 10.1007/s11883-022-00992-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2021] [Indexed: 11/30/2022]
Abstract
Purpose of Review A clear link between excessive alcohol consumption and cardiovascular disease (CVD) has been established, but no consensus exists on the effects of moderate alcohol consumption on CVD. Recent Findings A lower risk of coronary heart disease and myocardial infarction among moderate drinkers compared to abstainers has been consistently observed in epidemiological studies and meta-analyses of these studies. However, ambiguity remains on the effect of alcohol on other CVDs and all-cause mortality. Short-term randomized controlled trials (RCT) have identified potentially beneficial effects of alcohol consumption on cardiovascular risk factors, but studies investigating genetic polymorphisms that influence alcohol consumption (i.e., Mendelian randomization) have yielded inconclusive results. To date, a long-term RCT providing causal evidence is lacking but urgently needed. Summary Triangulation of evidence from different study designs, including long-term RCTs, pragmatic trials and the evaluation of policy measures, combined will lead to the best available evidence.
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Affiliation(s)
- Anna G Hoek
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology & Data Science, Amsterdam Cardiovascular Sciences Research Institute, De Boelelaan 1117, Amsterdam, The Netherlands.
| | - Sabine van Oort
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology & Data Science, Amsterdam Cardiovascular Sciences Research Institute, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Kenneth J Mukamal
- Beth Israel Deaconess Medical Center, Harvard Medical School and Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Joline W J Beulens
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology & Data Science, Amsterdam Cardiovascular Sciences Research Institute, De Boelelaan 1117, Amsterdam, The Netherlands.,University Medical Centre Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht University, Utrecht, The Netherlands
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11
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Fragopoulou E, Argyrou C, Detopoulou M, Tsitsou S, Seremeti S, Yannakoulia M, Antonopoulou S, Kolovou G, Kalogeropoulos P. The effect of moderate wine consumption on cytokine secretion by peripheral blood mononuclear cells: A randomized clinical study in coronary heart disease patients. Cytokine 2021; 146:155629. [PMID: 34247040 DOI: 10.1016/j.cyto.2021.155629] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 06/25/2021] [Accepted: 06/26/2021] [Indexed: 12/14/2022]
Abstract
Many studies conclude that wine consumption is related to lower risk for cardiovascular diseases partially through the amelioration of inflammatory biomarkers. The aim of the present study was to examine the effects of wine consumption on the inflammatory response and to compare these effects with the consumption of similar amount of alcohol without the wine micro-constituents in cardiovascular disease patients. Therefore, a randomized, single-blind, controlled, three-arm parallel intervention study was designed. Cardiovascular disease patients were randomly assigned to one of the three groups. In Group A participants consumed no alcohol, in Group B (ethanol group) and Group C (wine group) participants consumed 27 g of alcohol per day. Biological samples were collected at the beginning, on the 4th and 8th week and several biomarkers were measured. Peripheral blood mononuclear cells that were isolated from patients were incubated under basal and inflammatory conditions for 4 and 24 h and the secretion of interleukin 1β (IL-1β) and tumor necrosis factor α (TNFα) was measured. No significant difference was observed among the three groups before the initiation or during the intervention in the most soluble biomarkers. Higher TNFα secretion by peripheral blood mononuclear cells was observed at basal conditions in the ethanol group both at 4 and 24 h of incubation versus baseline secretion. Furthermore, lower secretion of the ΤNFα was observed after 8 weeks of intake in the wine group versus the ethanol group, both at 4 and 24 h of incubation. In conclusion, the light to moderate wine consumption for 8 weeks revealed an attenuation of the ethanol consumption effect on cytokine secretion at basal conditions from the patients' peripheral blood mononuclear cells.
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Affiliation(s)
- Elizabeth Fragopoulou
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Avenue Kallithea, 17671 Athens, Greece.
| | - Chrysa Argyrou
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Avenue Kallithea, 17671 Athens, Greece
| | - Maria Detopoulou
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Avenue Kallithea, 17671 Athens, Greece
| | - Sofia Tsitsou
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Avenue Kallithea, 17671 Athens, Greece
| | - Sotiria Seremeti
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Avenue Kallithea, 17671 Athens, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Avenue Kallithea, 17671 Athens, Greece
| | - Smaragdi Antonopoulou
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Avenue Kallithea, 17671 Athens, Greece
| | - Genovefa Kolovou
- Cardiology Department, Onassis Cardiac Surgery Center, Athens. Greece
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12
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Ma H, Li X, Zhou T, Sun D, Shai I, Heianza Y, Rimm EB, Manson JE, Qi L. Alcohol Consumption Levels as Compared With Drinking Habits in Predicting All-Cause Mortality and Cause-Specific Mortality in Current Drinkers. Mayo Clin Proc 2021; 96:1758-1769. [PMID: 34218856 PMCID: PMC8262073 DOI: 10.1016/j.mayocp.2021.02.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 01/19/2021] [Accepted: 02/15/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the joint associations of amounts of alcohol consumed and drinking habits with the risks of all-cause mortality and cause-specific mortality. PATIENTS AND METHODS A total of 316,627 healthy current drinkers, with baseline measurements between March 13, 2006, and October 1, 2010, were included in this study. We newly created a drinking habit score (DHS) according to regular drinking (frequency of alcohol intake ≥3 times/wk) and whether consuming alcohol with meals (yes). RESULTS During a median follow-up of 8.9 years, we documented 8652 incident cases of all-cause death, including 1702 cases of cardiovascular disease death, 4960 cases of cancer death, and 1990 cases of other-cause death. After adjustment confounders and amount of alcohol consumed, higher DHS was significantly associated with a lower risk of all-cause mortality, cardiovascular disease mortality, cancer mortality, or other-cause mortality (Ptrend<.001, Ptrend=.03, Ptrend<.001, and Ptrend<.001, respectively). We observed that the amount of alcohol consumed have different relationships with the risks of all-cause mortality and cause-specific mortality among participants with distinct drinking habits, grouped by DHS. For example, in the joint analyses, a J-shaped association between the amount of alcohol consumed and all-cause mortality was observed in participants with unfavorable DHS (Pquadratictrend=.02) while the association appeared to be U-shaped in participants with favorable DHS (Pquadratictrend=.003), with lower risks in those consuming greater than or equal to 50 g/wk and less than 300 g/wk. CONCLUSION Our results indicate that alcohol consumption levels have different relationships with the risk of mortality among current drinkers, depending on their drinking habits.
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Affiliation(s)
- Hao Ma
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Xiang Li
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Tao Zhou
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Dianjianyi Sun
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Iris Shai
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yoriko Heianza
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA
| | - Eric B Rimm
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - JoAnn E Manson
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Lu Qi
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.
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13
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Al-Aubaidy HA, Dayan A, Deseo MA, Itsiopoulos C, Jamil D, Hadi NR, Thomas CJ. Twelve-Week Mediterranean Diet Intervention Increases Citrus Bioflavonoid Levels and Reduces Inflammation in People with Type 2 Diabetes Mellitus. Nutrients 2021; 13:1133. [PMID: 33808180 PMCID: PMC8065815 DOI: 10.3390/nu13041133] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/18/2021] [Accepted: 03/23/2021] [Indexed: 01/06/2023] Open
Abstract
The benefits of a Mediterranean Diet (MedDiet) in the management of diabetes have been reported, but the contribution of polyphenol-rich citrus fruit has not been studied widely. Here, we report the sub-study findings of a previously conducted MedDiet intervention clinical trial in patients with type 2 diabetes mellitus (T2DM), where we aimed to measure the diet intervention effects on plasma citrus bioflavonoids levels and biomarkers of inflammation and oxidative stress. We analysed plasma samples from 19 (of original 27) participants with T2DM who were randomly assigned to consume the MedDiet intervention or their usual diet for 12 weeks and then crossed over to the alternate diet. Compared with baseline, MedDiet significantly increased levels of the citrus bioflavonoids naringin, hesperitin and hesperidin (by 60%, 58% and 39%, respectively, p < 0.05) and reduced plasma levels of the pro-inflammatory cytokine IL-6 (by 49%, p = 0.016). Oxidative stress marker 8-hydroxy-2'-deoxyguanosine (8-OHdG) decreased by 32.4% (p = 0.128). Usual diet did not induce these beneficial changes. The reduced inflammatory profile of T2DM participants may, in part, be attributed to the anti-inflammatory actions of citrus bioflavonoids. Together with indications of improved oxidative stress, these findings add to the scientific evidence base for beneficial consumption of citrus fruit in the MedDiet pattern.
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Affiliation(s)
- Hayder A. Al-Aubaidy
- Department of Physiology, Anatomy and Microbiology, School of Life Sciences, La Trobe University, Melbourne 3086, Australia; (A.D.); (D.J.); (C.J.T.)
| | - Aanchal Dayan
- Department of Physiology, Anatomy and Microbiology, School of Life Sciences, La Trobe University, Melbourne 3086, Australia; (A.D.); (D.J.); (C.J.T.)
| | - Myrna A. Deseo
- ARC Research Hub for Medicinal Agriculture, La Trobe Institute for Agriculture and Food, Department of Animal, Plant and Soil Sciences, School of Life Sciences, La Trobe University, Melbourne 3086, Australia;
| | - Catherine Itsiopoulos
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne 3086, Australia;
| | - Dina Jamil
- Department of Physiology, Anatomy and Microbiology, School of Life Sciences, La Trobe University, Melbourne 3086, Australia; (A.D.); (D.J.); (C.J.T.)
| | - Najah R. Hadi
- Department of Pharmacology and Therapeutics, Faculty of Medicine, University of Kufa, Al-Najaf 0054, Iraq;
| | - Colleen J. Thomas
- Department of Physiology, Anatomy and Microbiology, School of Life Sciences, La Trobe University, Melbourne 3086, Australia; (A.D.); (D.J.); (C.J.T.)
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14
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Mukamal KJ. A safe level of alcohol consumption: the right answer demands the right question. J Intern Med 2020; 288:550-559. [PMID: 32529652 DOI: 10.1111/joim.13129] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 05/05/2020] [Indexed: 01/01/2023]
Abstract
Alcohol has been produced by humans for nearly ten millennia, but gold-standard evidence by which to judge the health effects of limited alcohol consumption remains elusive, introducing serious difficulty in considering the safety of alcohol consumption. To do so, physicians and policymakers must consider the population, dose and context of alcohol consumption and the end-point, preferably a holistic composite, of interest. The limitations of new research trends, such as mega-cohorts, genetic instrumental variable analysis and modelling studies, must also be viewed against the much larger backdrop of existing evidence. Some existing guidelines, such as the 2015-2020 Dietary Guidelines for Americans, succeed remarkably in this task. Nonetheless, large-scale randomized trials are urgently needed if future generations are to enjoy any greater insight into the health effects of population-wide alcohol consumption than the current one has.
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Affiliation(s)
- K J Mukamal
- From the, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
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15
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Maugeri A, Hlinomaz O, Agodi A, Barchitta M, Kunzova S, Bauerova H, Sochor O, Medina-Inojosa JR, Lopez-Jimenez F, Vinciguerra M, Stokin GB, González-Rivas JP. Is Drinking Alcohol Really Linked to Cardiovascular Health? Evidence from the Kardiovize 2030 Project. Nutrients 2020; 12:nu12092848. [PMID: 32957567 PMCID: PMC7551763 DOI: 10.3390/nu12092848] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/14/2020] [Accepted: 09/16/2020] [Indexed: 12/28/2022] Open
Abstract
Existing data have described benefits and drawbacks of alcohol consumption on cardiovascular diseases (CVD), but no research has evaluated its association with the cardiovascular health (CVH) score proposed by the American Heart Association. Here, we conducted a cross-sectional analysis on the Kardiovize cohort (Brno, Czech Republic), to investigate the relationship between alcohol consumption and CVH. We included 1773 subjects (aged 25–64 years; 44.2% men) with no history of CVD. We compared CVD risk factors, CVH metrics (i.e., BMI, healthy diet, physical activity level, smoking status, blood pressure, fasting glucose, and total cholesterol) and CVH score between and within several drinking categories. We found that the relationship between drinking habits and CVH was related to the amount of alcohol consumed, drinking patterns, and beverage choices. Heavy drinkers were more likely to smoke tobacco, and to report diastolic blood pressure, fasting glucose, triglycerides, and low-density lipoprotein (LDL)-cholesterol at higher level than non-drinkers. Among drinkers, however, people who exclusively drank wine exhibited better CVH than those who exclusively drank beer. Although our findings supported the hypothesis that drinking alcohol was related to the CVH in general, further prospective research is needed to understand whether the assessment of CVH should incorporate information on alcohol consumption.
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Affiliation(s)
- Andrea Maugeri
- International Clinical Research Center, St Anne’s University Hospital, 65691 Brno, Czech Republic; (O.H.); (S.K.); (H.B.); (O.S.); (M.V.); (G.B.S.); (J.P.G.-R.)
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95127 Catania, Italy; (A.A.); (M.B.)
- Correspondence:
| | - Ota Hlinomaz
- International Clinical Research Center, St Anne’s University Hospital, 65691 Brno, Czech Republic; (O.H.); (S.K.); (H.B.); (O.S.); (M.V.); (G.B.S.); (J.P.G.-R.)
| | - Antonella Agodi
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95127 Catania, Italy; (A.A.); (M.B.)
| | - Martina Barchitta
- Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, 95127 Catania, Italy; (A.A.); (M.B.)
| | - Sarka Kunzova
- International Clinical Research Center, St Anne’s University Hospital, 65691 Brno, Czech Republic; (O.H.); (S.K.); (H.B.); (O.S.); (M.V.); (G.B.S.); (J.P.G.-R.)
| | - Hana Bauerova
- International Clinical Research Center, St Anne’s University Hospital, 65691 Brno, Czech Republic; (O.H.); (S.K.); (H.B.); (O.S.); (M.V.); (G.B.S.); (J.P.G.-R.)
| | - Ondrej Sochor
- International Clinical Research Center, St Anne’s University Hospital, 65691 Brno, Czech Republic; (O.H.); (S.K.); (H.B.); (O.S.); (M.V.); (G.B.S.); (J.P.G.-R.)
| | - Jose R. Medina-Inojosa
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic and Mayo Medical School, Rochester, MI 55905, USA; (J.R.M.-I.); (F.L.-J.)
| | - Francisco Lopez-Jimenez
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic and Mayo Medical School, Rochester, MI 55905, USA; (J.R.M.-I.); (F.L.-J.)
| | - Manlio Vinciguerra
- International Clinical Research Center, St Anne’s University Hospital, 65691 Brno, Czech Republic; (O.H.); (S.K.); (H.B.); (O.S.); (M.V.); (G.B.S.); (J.P.G.-R.)
| | - Gorazd Bernard Stokin
- International Clinical Research Center, St Anne’s University Hospital, 65691 Brno, Czech Republic; (O.H.); (S.K.); (H.B.); (O.S.); (M.V.); (G.B.S.); (J.P.G.-R.)
| | - Juan Pablo González-Rivas
- International Clinical Research Center, St Anne’s University Hospital, 65691 Brno, Czech Republic; (O.H.); (S.K.); (H.B.); (O.S.); (M.V.); (G.B.S.); (J.P.G.-R.)
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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16
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The effect of grape products containing polyphenols on C-reactive protein levels: a systematic review and meta-analysis of randomised controlled trials. Br J Nutr 2020; 125:1230-1245. [DOI: 10.1017/s0007114520003591] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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17
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Fragopoulou E, Antonopoulou S. The French paradox three decades later: Role of inflammation and thrombosis. Clin Chim Acta 2020; 510:160-169. [PMID: 32653485 DOI: 10.1016/j.cca.2020.07.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 07/04/2020] [Accepted: 07/06/2020] [Indexed: 12/18/2022]
Abstract
Although, three decades have pasted from the introduction of "French Paradox", is still an issue for debate. Epidemiology supports the J-shaped relationship between wine consumption and vascular events as well as cardiovascular mortality with a maximum protection at 21 g of alcohol consumption in the form of wine per day. Nevertheless, the aforementioned studies have used an observational design that raises concerns about potential confounding. Randomized clinical studies may provide data to end the controversy and in parallel with in vitro experiments to elucidate the mechanisms by which wine affects cardiovascular disease. In this concept, this review aims to address the presence of bioactive wine micro constituents, their potential mechanisms of action and also to summarize the cardio-protective effects of wine intake based on clinical trials. The role of wine micro-constituents in inflammation and haemostasis is discussed in detail.
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Affiliation(s)
- Elizabeth Fragopoulou
- School of Health Science and Education, Department of Nutrition and Dietetics, Harokopio University, Greece.
| | - Smaragdi Antonopoulou
- School of Health Science and Education, Department of Nutrition and Dietetics, Harokopio University, Greece
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18
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Anti-Inflammatory Strategies Targeting Metaflammation in Type 2 Diabetes. Molecules 2020; 25:molecules25092224. [PMID: 32397353 PMCID: PMC7249034 DOI: 10.3390/molecules25092224] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/28/2020] [Accepted: 05/02/2020] [Indexed: 02/06/2023] Open
Abstract
One of the concepts explaining the coincidence of obesity and type 2 diabetes (T2D) is the metaflammation theory. This chronic, low-grade inflammatory state originating from metabolic cells in response to excess nutrients, contributes to the development of T2D by increasing insulin resistance in peripheral tissues (mainly in the liver, muscles, and adipose tissue) and by targeting pancreatic islets and in this way impairing insulin secretion. Given the role of this not related to infection inflammation in the development of both: insulin resistance and insulitis, anti-inflammatory strategies could be helpful not only to control T2D symptoms but also to treat its causes. This review presents current concepts regarding the role of metaflammation in the development of T2D in obese individuals as well as data concerning possible application of different anti-inflammatory strategies (including lifestyle interventions, the extra-glycemic potential of classical antidiabetic compounds, nonsteroidal anti-inflammatory drugs, immunomodulatory therapies, and bariatric surgery) in the management of T2D.
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19
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Spiegelman D, Lovato LC, Khudyakov P, Wilkens TL, Adebamowo CA, Adebamowo SN, Appel LJ, Beulens JW, Coughlin JW, Dragsted LO, Edenberg HJ, Eriksen JN, Estruch R, Grobbee DE, Gulayin PE, Irazola V, Krystal JH, Lazo M, Murray MM, Rimm EB, Schrieks IC, Williamson JD, Mukamal KJ. The Moderate Alcohol and Cardiovascular Health Trial (MACH15): Design and methods for a randomized trial of moderate alcohol consumption and cardiometabolic risk. Eur J Prev Cardiol 2020; 27:1967-1982. [PMID: 32250171 DOI: 10.1177/2047487320912376] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Observational studies have documented lower risks of coronary heart disease and diabetes among moderate alcohol consumers relative to abstainers, but only a randomized clinical trial can provide conclusive evidence for or against these associations. AIM The purpose of this study was to describe the rationale and design of the Moderate Alcohol and Cardiovascular Health Trial, aimed to assess the cardiometabolic effects of one alcoholic drink daily over an average of six years among adults 50 years or older. METHODS This multicenter, parallel-arm randomized trial was designed to compare the effects of one standard serving (∼11-15 g) daily of a preferred alcoholic beverage to abstention. The trial aimed to enroll 7800 people at high risk of cardiovascular disease. The primary composite endpoint comprised time to the first occurrence of non-fatal myocardial infarction, non-fatal ischemic stroke, hospitalized angina, coronary/carotid revascularization, or total mortality. The trial was designed to provide >80% power to detect a 15% reduction in the risk of the primary outcome. Secondary outcomes included diabetes. Adverse effects of special interest included injuries, congestive heart failure, alcohol use disorders, and cancer. RESULTS We describe the design, governance, masking issues, and data handling. In three months of field center activity until termination by the funder, the trial randomized 32 participants, successfully screened another 70, and identified ∼400 additional interested individuals. CONCLUSIONS We describe a feasible design for a long-term randomized trial of moderate alcohol consumption. Such a study will provide the highest level of evidence for the effects of moderate alcohol consumption on cardiovascular disease and diabetes, and will directly inform clinical and public health guidelines.
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Affiliation(s)
| | - Laura C Lovato
- Wake Forest School of Medicine, USA.,Department of Internal Medicine, Hospital Clínic, IDIBAPS August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Spain
| | - Polyna Khudyakov
- Harvard TH Chan School of Public Health, USA.,Department of Internal Medicine, Hospital Clínic, IDIBAPS August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Spain
| | | | - Clement A Adebamowo
- Department of Epidemiology and Public Health, Greenebaum Comprehensive Cancer Center, University of Maryland, School of Medicine, USA
| | - Sally N Adebamowo
- Department of Epidemiology and Public Health, Greenebaum Comprehensive Cancer Center, University of Maryland, School of Medicine, USA
| | - Lawrence J Appel
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins ProHealth Clinical Research Center, USA
| | - Joline Wj Beulens
- Amsterdam UMC - location VUmc, Amsterdam Cardiovascular Sciences Research Institute, Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Netherlands
| | - Janelle W Coughlin
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins ProHealth Clinical Research Center, USA
| | | | | | | | - Ramon Estruch
- CIBER de Fisiopatología de la Obesidad y la Nutricion (CIBEROBN), Instituto de Salud Carlos III, Spain.,Department of Internal Medicine, Hospital Clínic, IDIBAPS August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Spain
| | | | | | | | | | - Mariana Lazo
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins ProHealth Clinical Research Center, USA
| | | | - Eric B Rimm
- Harvard TH Chan School of Public Health, USA.,National Institute on Alcohol Abuse and Alcoholism, U.S. National Institutes of Health, USA
| | - Ilse C Schrieks
- Department of Internal Medicine, Hospital Clínic, IDIBAPS August Pi i Sunyer Biomedical Research Institute, University of Barcelona, Spain
| | | | - Kenneth J Mukamal
- Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, USA
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20
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Liberale L, Bonaventura A, Montecucco F, Dallegri F, Carbone F. Impact of Red Wine Consumption on Cardiovascular Health. Curr Med Chem 2019; 26:3542-3566. [PMID: 28521683 DOI: 10.2174/0929867324666170518100606] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 03/05/2017] [Accepted: 03/05/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND The devastating effects of heavy alcohol drinking have been long time recognized. In the last decades, potential benefits of modest red wine drinking were suggested. In European countries in which red wide intake is not negligible (such as France), the association between cholesterol and cardiovascular (CV) risk was less evident, suggesting the action of some protective molecules in red wine or other foods and drinks. METHODS This narrative review is based on the material searched for and obtained via PubMed up to May 2016. The search terms we used were: "red wine, cardiovascular, alcohol" in combination with "polyphenols, heart failure, infarction". RESULTS Epidemiological and mechanistic evidence of a J-shaped relationship between red wine intake and CV risk further supported the "French paradox". Specific components of red wine both in vitro and in animal models were discovered. Polyphenols and especially resveratrol largely contribute to CV prevention mainly through antioxidant properties. They exert beneficial effects on endothelial dysfunction and hypertension, dyslipidemia, metabolic diseases, thus reducing the risk of adverse CV events such as myocardial infarction ischemic stroke and heart failure. Of interest, recent studies pointed out the role of ethanol itself as a potential cardioprotective agent, but a clear epidemiological evidence is still missing. The aim of this narrative review is to update current knowledge on the intracellular mechanism underlying the cardioprotective effects of polyphenols and ethanol. Furthermore, we summarized the results of epidemiological studies, emphasizing their methodological criticisms and the need for randomized clinical trials able to clarify the potential role of red wine consumption in reducing CV risk. CONCLUSION Caution in avowing underestimation of the global burden of alcohol-related diseases was particularly used.
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Affiliation(s)
- Luca Liberale
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy
| | - Aldo Bonaventura
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy
| | - Fabrizio Montecucco
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy.,IRCCS AOU San Martino - IST, Genova, 10 Largo Benzi, 16132 Genoa, Italy.,Centre of Excellence for Biomedical Research (CEBR), University of Genoa, 9 viale Benedetto XV, 16132 Genoa, Italy
| | - Franco Dallegri
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy.,IRCCS AOU San Martino - IST, Genova, 10 Largo Benzi, 16132 Genoa, Italy
| | - Federico Carbone
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 viale Benedetto XV, 16132 Genoa, Italy
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Naame SA, Li D, Huang R. Effects of moderate red wine on cardiovascular risk factors in diabetics: a systematic review and meta-analysis of randomized controlled trials. Toxicol Res (Camb) 2019; 8:979-987. [PMID: 32922738 DOI: 10.1039/c9tx00227h] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 10/28/2019] [Indexed: 12/19/2022] Open
Abstract
Background: Diabetes mellitus is of major public health concerns; its incidence is continuously increasing. Diabetes mellitus is associated with a high risk of cardiovascular complications such as hypertension. Red wine has been reported to reduce cardiovascular risk factors. We quantified the effects of red wine on cardiovascular factors. Methods: We retrieved English-language articles published from January 1990 to April 2019. Cardiovascular risk factors were compared using means with 95% confidence intervals (95% CIs). Results: We identified five eligible randomized controlled trials. Diabetic patients who drank red wine exhibited significantly reduced systolic blood pressure (BP) (mean difference [MD] -1.33, 95% CI -1.81, -0.85) and diastolic BP (MD -1.31, 95% CI -1.80, -0.83) than those who did not. Compared to the observations for diabetics who did not drink red wine, the high-density lipoprotein (HDL) level was significantly higher in red wine drinkers (MD -0.24, 95% CI -0.39, -0.09). However, red wine had no effect on the body mass index (BMI) (MD -0.27, 95% CI -1.80, 1.25), the total cholesterol level (MD 0.13, 95% CI -0.17, 0.44), or the low-density lipoprotein (LDL) level (MD 0.08, 95% CI -0.21, 0.37). Conclusions: Red wine consumption significantly lowered BP and increased the HDL level in diabetics. Red wine had no significant effect on BMI or cholesterol and LDL levels. Given the heterogeneity of the studied populations and the lack of standardization and completeness across the published studies, caution is required while interpreting these findings.
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Affiliation(s)
- Saavia Alice Naame
- Department of Occupational and Environmental Health , Xiangya School of Public Health , Central South University , Changsha , Hunan Province 410078 , P.R. China . ; ; ; ; Tel: +86-731-84805460
| | - Decheng Li
- Department of Occupational and Environmental Health , Xiangya School of Public Health , Central South University , Changsha , Hunan Province 410078 , P.R. China . ; ; ; ; Tel: +86-731-84805460
| | - Ruixue Huang
- Department of Occupational and Environmental Health , Xiangya School of Public Health , Central South University , Changsha , Hunan Province 410078 , P.R. China . ; ; ; ; Tel: +86-731-84805460
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Ye J, Chen X, Bao L. Effects of wine on blood pressure, glucose parameters, and lipid profile in type 2 diabetes mellitus: A meta-analysis of randomized interventional trials (PRISMA Compliant). Medicine (Baltimore) 2019; 98:e15771. [PMID: 31169675 PMCID: PMC6571378 DOI: 10.1097/md.0000000000015771] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Previous studies identified conflicting results about the effects of wine intake on glucose parameters and the risk of cardiovascular diseases in type 2 diabetes mellitus (T2DM). The present study further investigated the association between wine digestion and these outcomes in T2DM patients. MATERIAL AND METHODS A search of PubMed, Embase, and Scopus databases (up to November 2018) was performed for randomized interventional trials which evaluated the effect of wine on blood pressure (BP), glucose parameters and lipid profiles in T2DM people. We used a variety of tests: fixed and random effects models, Q Cochrane test and I index, Egger and Begg tests, forest plots, and sensitivity analysis in our study. RESULTS A total of 9 randomized interventional studies were included in this meta-analysis. Overall, significant association between wine intake with diastolic BP (weighted mean difference [WMD] = 0.10; 95% confidence interval [95% CI]: -0.01 to 0.20, P = .03 I = 13%) and total cholesterol (TC) (WMD = 0.16, 95% CI: 0.02-0.31, P = .03, I = 6%), whereas no noticeable differences in glucose parameters, systolic BP, low-density lipoprotein cholesterol (LDLC), triglyceride (TG) and high-density lipoprotein cholesterol (HDLC) were identified between wine and controls groups (fasting glucose [FG],WMD = -0.00, 95% CI: -0.58 to 0.58; fasting insulin [FI], -0.22, -2.09 to 1.65; HbAc1%, -0.16, -0.40 to 0.07; systolic blood pressure, 0.12, -0.05 to 0.28; LDLC, -0.02, -0.25 to 0.21; TG, -0.34, -1.31 to 0.64; HDLC, 0.22, -0.08 to 0.53]. CONCLUSION This meta-analysis revealed that moderate wine consumption among T2DM patients could reduce the level of diastolic blood pressure and TC, but not glucose parameters and other cardiovascular risk factors.
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Barmano N, Charitakis E, Kronstrand R, Walfridsson U, Karlsson JE, Walfridsson H, Nystrom FH. The association between alcohol consumption, cardiac biomarkers, left atrial size and re-ablation in patients with atrial fibrillation referred for catheter ablation. PLoS One 2019; 14:e0215121. [PMID: 30970005 PMCID: PMC6457637 DOI: 10.1371/journal.pone.0215121] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 03/28/2019] [Indexed: 12/14/2022] Open
Abstract
Background Information on alcohol consumption in patients undergoing radiofrequency ablation (RFA) of atrial fibrillation (AF) is often limited by the reliance on self-reports. The aim of this study was to describe the long-term alcohol consumption, measured as ethyl glucuronide in hair (hEtG), in patients undergoing RFA due to AF, and to examine potential associations with cardiac biomarkers, left atrial size and re-ablation within one year after the initial RFA. Methods The amount of hEtG was measured in patients referred for RFA, and a cut-off of 7 pg/mg was used. N-terminal pro B-type natriuretic peptide (NT-proBNP) and the mid-regional fragment of pro atrial natriuretic peptide (MR-proANP) were examined and maximum left atrium volume index (LAVI) was measured. The number of re-ablations was examined up to one year after the initial RFA. Analyses were stratified by gender, and adjusted for age, systolic blood pressure, body mass index, presence of heart failure and heart rhythm for analyses regarding NT-proBNP, MR-proANP and LAVI and heart rhythm being replaced by type of AF for analyses regarding re-ablation. Results In total, 192 patients were included in the study. Median (25th– 75th percentile) NT-proBNP in men with hEtG ≥ 7 vs. < 7 pg/mg was 250 (96–695) vs. 130 (49–346) pg/ml (p = 0.010), and in women it was 230 (125–480) vs. 230 (125–910) pg/ml (p = 0.810). Median MR-proANP in men with hEtG ≥ 7 vs. < 7 pg/mg was 142 (100–224) vs. 117 (83–179) pmol/l (p = 0.120) and in women it was 139 (112–206) vs. 153 (93–249) pmol/l (p = 0.965). The median of maximum LAVI was 30.1 (26.7–33.9) vs. 25.8 (21.4–32.0) ml/m2 (p = 0.017) in men, and 25.0 (18.9–29.6) vs. 25.7 (21.7–34.6) ml/m2 (p = 0.438) in women, with hEtG ≥ 7 vs. < 7 pg/ml, respectively. Adjusted analyses showed similar results, except for MR-proANP turning out significant in men with hEtG ≥ 7 vs. < 7 pg/mg (p = 0.047). The odds ratio of having a re-ablation was 3.5 (95% CI 1.3–9.6, p = 0.017) in men with hEtG ≥ 7 vs. < 7 pg/mg, while there was no significant difference in women. Conclusions In male patients with AF and hEtG ≥ 7 pg/mg, NT-proBNP and MR-proANP were higher, LA volumes larger, and there was a higher rate of re-ablations, as compared to men with hEtG < 7 pg/mg. This implies that men with an alcohol consumption corresponding to an hEtG-value ≥ 7, have a higher risk for LA remodelling that could potentially lead to a deterioration of the AF situation.
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Affiliation(s)
- Neshro Barmano
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Department of Internal Medicine, County Hospital Ryhov, Jönköping, Sweden
- * E-mail:
| | - Emmanouil Charitakis
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Department of Cardiology, Linköping University Hospital, Linköping, Sweden
| | - Robert Kronstrand
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- National Board of Forensic Medicine, Linköping, Sweden
| | - Ulla Walfridsson
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Department of Cardiology, Linköping University Hospital, Linköping, Sweden
| | - Jan-Erik Karlsson
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Department of Internal Medicine, County Hospital Ryhov, Jönköping, Sweden
| | - Håkan Walfridsson
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Department of Cardiology, Linköping University Hospital, Linköping, Sweden
| | - Fredrik H. Nystrom
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Primary Health Care Centre Centrum, Norrköping, Sweden
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Diets along with interval training regimes improves inflammatory & anti-inflammatory condition in obesity with type 2 diabetes subjects. J Diabetes Metab Disord 2018; 17:253-267. [PMID: 30918861 DOI: 10.1007/s40200-018-0368-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 11/01/2018] [Indexed: 12/11/2022]
Abstract
Background Different physical activities and diets change the regulation of inflammations in both type 2 diabetes (T2D) patients and obese individuals, but the effect of both (Physical activity and diet) on pro/anti-inflammations has remained unknown. We investigated pro/anti-inflammations control, cardiovascular function, and total physiological parameters before and after 24 weeks of low volume high intensity interval training (HIIT) on a cycle ergometer along with four dietary regimes in obesity with T2D patients. Methods 33 non-active obesity T2D patients (BMI ≥ 30) midges (47 yrs. ± 5) were volunteered to participate and randomly divided into three experimental(n = 11) [(1) LCD = low Carbohydrate Diet, (2) LFD = Low Fat Diet and (3) HFD = High Fat Diet)] and one control (n = 9) [ND = normal diet] groups. The whole groups performed underwent 8-week dietary regimes and then performed 3 days/weeks (3 set 10 × 60 s) HIIT on a cycle ergometer for 12 weeks, which followed by a 4-week diet period again. Also, prior to and after 8 weeks diet-12 weeks High Intensity Interval Training (HIIT) and 4 weeks diet 2-h oral glucose tolerance test (OGTT), resting blood pressure, incremental maximal oxygen uptake (VO2peak) cycle ergometer test and blood sample was collected from the subjects in order to measure pro/anti-inflammatory cytokines (IL-6, TNF-α, leptin, resistin, adiponectin, and FGF21). Results After 24 weeks of intervention, the results indicated that the highest improvement in the percentage of changes in glucose happened in LCD (-34.76), insulin in ND (+16.43), cholesterol in LCD (-33.35), LDL in LFD (-9.14), HDL in LCD (+41.81), TG in LCD (-40.71), weight in LCD (-12.49) and HOMA-IR in HFD (-6.82). The results also indicated that after 24 weeks of HIIT and diet interventions, highest benefit percentage change IL-6, resistin and leptin occurred in LCD (-32.10, -28.29 and - 53.92, respectively), TNF-α, FGF21 and adiponectin in LFD (-48.06, +55.30 and + 42.32, respectively). However, these changes were observed in other groups. Conclusions These results demonstrated that HIIT along with low carbohydrate regimes improves overall cardiovascular parameters and reduce pro-inflammatory markers and increase anti-inflammatory markers in type 2 diabetic patients. Additionally, as with HIIT along with low carbohydrate, HIIT coupled with low fat would improve inflammation markers, though these effects were less significant. These findings suggest that HIIT along with low carbohydrate is a beneficial exercise and dietary strategy in T2D patients.
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Abstract
Several epidemiological studies associated the consumption of wine with the reduction of the risk factors for cardiovascular disease and certain cancers, as well as for diabetes. These conditions are characterized by inflammatory mechanisms in addition to other biological mechanisms. Acute and chronic inflammation is mediated by a plethora of biomarkers production and pathway activation. Since the health promoting properties of wine in different pathological conditions may include the reduction of inflammation, the aim of this paper was to collect and review the in vitro, in vivo, and human studies performed to evaluate the effects of wine on different models of inflammation. Although great variability in wine intake, period of consumption, and content of phenolic compounds was observed, data from both human and animal studies showed a positive modulation of inflammatory biomarkers (cytokines, coagulation parameters) and oxidative stress (mainly malondialdehyde) involved in cardiovascular function. In addition, some convincing evidence was obtained in different models suggesting a positive modulation of risk factors for gastric and intestinal inflammation. Contradictory results were obtained for metabolic syndrome and type 2 diabetes. To date, no significant paper has been published in the area of immune function. Integrating in vivo data and in vitro studies, the NF-κB pathway has been identified as a critical target for the protective properties of a moderate wine consumption.
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Fragopoulou E, Choleva M, Antonopoulou S, Demopoulos CA. Wine and its metabolic effects. A comprehensive review of clinical trials. Metabolism 2018; 83:102-119. [PMID: 29408458 DOI: 10.1016/j.metabol.2018.01.024] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Revised: 01/11/2018] [Accepted: 01/25/2018] [Indexed: 12/18/2022]
Abstract
The introduction of the term "French Paradox" motivated an extensive and in-depth research into health benefits of moderate wine consumption. The superiority of wine is thought to be attributed to its micro-constituents and consequent effort was made to isolate and identify these bioactive compounds as well as to elucidate the mechanisms of their action. Controlled trials offer more concrete answers to several raised questions than observational studies. Under this perspective, clinical trials have been implemented, mainly in healthy volunteers and rarely in patients, in order to investigate the acute or chronic effect of wine consumption on metabolism and physio-pathological systems, which are mainly associated with cardiovascular diseases. The aim of this review is to update the knowledge about the acute and long term effect of wine consumption on lipid and glucose/insulin metabolism as well as on the inflammatory and haemostatic systems, based on the reported data of controlled clinical trials. In conclusion, the most repeated result of wine consumption is on lipid metabolism, attributed mainly to ethanol, while wine micro-constituents seem to have an important role mainly in haemostatic and inflammatory/endothelial systems.
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Affiliation(s)
- Elizabeth Fragopoulou
- Department of Nutrition -Dietetics, Harokopio University, 70 El. Venizelou Street, 17671 Athens, Greece.
| | - Maria Choleva
- Department of Nutrition -Dietetics, Harokopio University, 70 El. Venizelou Street, 17671 Athens, Greece
| | - Smaragdi Antonopoulou
- Department of Nutrition -Dietetics, Harokopio University, 70 El. Venizelou Street, 17671 Athens, Greece
| | - Constantinos A Demopoulos
- Department of Chemistry, National and Kapodistrian University of Athens, Panepistimioupolis, 15771 Athens, Greece
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Alcohol and CV Health: Jekyll and Hyde J-Curves. Prog Cardiovasc Dis 2018; 61:68-75. [DOI: 10.1016/j.pcad.2018.02.001] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Accepted: 02/11/2018] [Indexed: 12/16/2022]
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Abstract
PURPOSE OF REVIEW This review aims to discuss the effect of alcohol consumption on various cardiovascular (CV) diseases and CV mortality. RECENT FINDINGS Alcohol intake has consistently shown a J- or U-shaped relationship with several cardiovascular diseases. Light to moderate alcohol intake has been associated with lower risk of coronary artery disease, heart failure (HF), as well as CV mortality. On the other hand, heavy consumption has been associated with deleterious CV outcomes including increased mortality. However, the evidence is based from observational and population-based studies where risk of confounding cannot be excluded even after meticulous methodological approaches. This is compounded by conflicting data such as higher risk of certain CV diseases like HF in former drinkers compared to abstainers. Further, Mendelian randomization studies using genetic polymorphisms in enzymes have recently questioned the beneficial association of low-moderate drinking with CV system. There has been substantial and consistent evidence that light to moderate alcohol consumption have beneficial effect on overall cardiovascular profile and mortality. However, there are considerable limitations in the reported literature to determine a strong causality of a protective effect of moderate alcohol consumption by itself. Further robust studies or possibly a well-structured randomized controlled could bring an end to this debate.
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Affiliation(s)
- Sunny Goel
- Division of Cardiovascular Medicine, Maimonides Medical Center, Brooklyn, NY, USA
| | - Abhishek Sharma
- Division of Cardiovascular Medicine, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA.
- Institute of Cardiovascular Research and Technology, Brooklyn, NY, USA.
| | - Aakash Garg
- Rutgers Robert Wood Johnson Medical School, 69 Duke Street, New Brunswick, NJ, USA
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Corrigenda. Diabet Med 2017; 34:1488. [PMID: 28921716 DOI: 10.1111/dme.13511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Protective effects of tea, red wine and cocoa in diabetes. Evidences from human studies. Food Chem Toxicol 2017; 109:302-314. [PMID: 28893620 DOI: 10.1016/j.fct.2017.09.015] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 09/05/2017] [Accepted: 09/06/2017] [Indexed: 12/14/2022]
Abstract
Prevention of diabetes through the diet has recently received an increasing interest, and polyphenolic compounds, such as flavanols, have become important potential chemopreventive natural agents due to their proved benefits on health, with low toxicity and cost. Tea, red wine and cocoa are good sources of flavanols and these highly consumed foods might contribute to prevent diabetes. In this regard, there is increasing evidence for a protective effect of tea, red wine and cocoa consumption against this disorder. This review summarizes the available epidemiological and interventional human studies providing evidence for and against this effect. Overall observational data suggest a benefit, but results are still equivocal and likely confounded by lifestyle and background dietary factors. The weight of data indicate favourable effects on diabetes risk factors for tea, red wine and cocoa intake, and a number of plausible mechanisms have been elucidated in human studies. However, despite the growing evidence it remains uncertain whether tea, red wine and cocoa consumption should be recommended to the general population or to patients as a strategy to reduce the risk of diabetes.
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Mukamal KJ, Na B, Mu L, Mantzoros CS, Manning WJ, Mittleman MA. Lessons and Challenges from a 6-Month Randomized Pilot Study of Daily Ethanol Consumption: Research Methodology and Study Design. Curr Dev Nutr 2017; 1:e000505. [PMID: 29955710 PMCID: PMC5998356 DOI: 10.3945/cdn.117.000505] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 04/12/2017] [Accepted: 06/14/2017] [Indexed: 01/08/2023] Open
Abstract
Background: Observational studies and crossover feeding studies suggest that moderate alcohol use may benefit cardiovascular risk, but we know of no long-term randomized trials that have tested this hypothesis. Objective: We evaluated the feasibility of an efficacy study of daily ethanol use in a 6-mo randomized pilot study in adults at higher cardiovascular risk. Methods: In a double-blind, randomized, controlled parallel-design trial, we screened 67 adults aged ≥55 y and randomly assigned 45 participants to consume 150 mL of an artificially sweetened beverage with or without 10% grain alcohol daily for 6 mo. Participants were asked to consume no other alcohol and returned monthly to receive the beverage and undergo measurement of HDL cholesterol, liver function tests, and complete blood counts. Results: Of the 45 randomly assigned participants, 39 completed the trial; the primary reason cited for attrition was inconvenience. None of the participants reported problem drinking or developed any serious adverse events or abnormal biochemical findings. However, we observed no differences in concentrations of HDL cholesterol, HDL lipoprotein subclasses, aspartate aminotransferase, alanine aminotransferase, γ-glutamyltransferase, mean corpuscular volume, or adiponectin between the alcohol and control arms, suggesting that adherence was poor. Every participant accurately identified their assigned beverage, most with great certainty. Conclusions: In this parallel-design pilot study of daily alcohol use, we observed none of the expected changes in markers of alcohol intake, which suggests poor adherence to this pure alcohol intervention. Our results suggest that long-term trials of alcohol consumption, if they are conducted in light drinkers similar to these, must use pragmatic designs for maximal feasibility. This study was registered at clinicaltrials.gov as NCT01377727.
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Affiliation(s)
- Kenneth J Mukamal
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Brian Na
- Department of Pediatrics, Case Western Reserve University, Cleveland, OH
| | - Lin Mu
- Yale University School of Medicine, New Haven, CT
| | - Christos S Mantzoros
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Warren J Manning
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Murray A Mittleman
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
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Hirst JA, Aronson JK, Feakins BG, Ma C, Farmer AJ, Stevens RJ. Short- and medium-term effects of light to moderate alcohol intake on glycaemic control in diabetes mellitus: a systematic review and meta-analysis of randomized trials. Diabet Med 2017; 34:604-611. [PMID: 27588354 DOI: 10.1111/dme.13259] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/31/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND People with diabetes are told that drinking alcohol may increase their risk of hypoglycaemia. AIMS To report the effects of alcohol consumption on glycaemic control in people with diabetes mellitus. METHODS Medline, EMBASE and the Cochrane Library databases were searched in 2015 to identify randomized trials that compared alcohol consumption with no alcohol use, reporting glycaemic control in people with diabetes. Data on blood glucose, HbA1c and numbers of hypoglycaemic episodes were pooled using random effects meta-analysis. RESULTS Pooled data from nine short-term studies showed no difference in blood glucose concentrations between those who drank alcohol in doses of 16-80 g (median 20 g, 2.5 units) compared with those who did not drink alcohol at 0.5, 2, 4 and 24 h after alcohol consumption. Pooled data from five medium-term studies showed that there was no difference in blood glucose or HbA1c concentrations at the end of the study between those who drank 11-18 g alcohol/day (median 13 g/day, 1.5 units/day) for 4-104 weeks and those who did not. We found no evidence of a difference in number of hypoglycaemic episodes or in withdrawal rates between randomized groups. CONCLUSIONS Studies to date have not provided evidence that drinking light to moderate amounts of alcohol, with or without a meal, affects any measure of glycaemic control in people with Type 2 diabetes. These results suggest that current advice that people with diabetes do not need to refrain from drinking moderate quantities of alcohol does not need to be changed; risks to those with Type 1 diabetes remain uncertain.
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Affiliation(s)
- J A Hirst
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - J K Aronson
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - B G Feakins
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
- National Institute for Health Research, School for Primary Care Research, University of Oxford, Oxford, UK
| | - C Ma
- Department of Biomedical Sciences, University of Oxford, Oxford, UK
| | - A J Farmer
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - R J Stevens
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Mukamal KJ, Clowry CM, Murray MM, Hendriks HFJ, Rimm EB, Sink KM, Adebamowo CA, Dragsted LO, Lapinski PS, Lazo M, Krystal JH. Moderate Alcohol Consumption and Chronic Disease: The Case for a Long-Term Trial. Alcohol Clin Exp Res 2016; 40:2283-2291. [PMID: 27688006 PMCID: PMC5073014 DOI: 10.1111/acer.13231] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 09/01/2016] [Indexed: 12/21/2022]
Abstract
Drinking within recommended limits is highly prevalent in much of the world, and strong epidemiological associations exist between moderate alcohol consumption and risk of several major chronic diseases, including coronary heart disease, diabetes, and breast cancer. In many cases, plausible biological mediators for these associations have been identified in randomized trials, but gold standard evidence that moderate drinking causes or prevents any chronic disease remains elusive and important concerns about available evidence have been raised. Although long-term randomized trials to test the observed associations have been termed impossible, clinical investigators have now successfully completed randomized trials of complex nutritional interventions in a variety of settings, along with trials of alcohol consumption itself of up to 2 years duration. The successful completion of these trials suggests that objections to the execution of a full-scale, long-term clinical trial of moderate drinking on chronic disease are increasingly untenable. We present potential lessons learned for such a trial and discuss key features to maximize its feasibility and value.
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Affiliation(s)
- Kenneth J Mukamal
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
| | - Catherine M Clowry
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Margaret M Murray
- National Institute on Alcohol Abuse and Alcoholism, Rockville, Maryland
| | | | - Eric B Rimm
- Departments of Nutrition and Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts
| | - Kaycee M Sink
- Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Clement A Adebamowo
- Department of Epidemiology & Public Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - Lars O Dragsted
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - P Scott Lapinski
- Countway Library of Medicine, Harvard University, Boston, Massachusetts
| | - Mariana Lazo
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - John H Krystal
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
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Markoski MM, Garavaglia J, Oliveira A, Olivaes J, Marcadenti A. Molecular Properties of Red Wine Compounds and Cardiometabolic Benefits. Nutr Metab Insights 2016; 9:51-7. [PMID: 27512338 PMCID: PMC4973766 DOI: 10.4137/nmi.s32909] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 06/14/2016] [Accepted: 06/16/2016] [Indexed: 11/05/2022] Open
Abstract
Wine has been used since the dawn of human civilization. Despite many health benefits, there is still a lot of discussion about the real properties of its components and its actions on cells and molecular interactions. A large part of these issues permeate the fine line between the amount of alcohol that causes problems to organic systems and the amount that could be beneficial for the health. However, even after the process of fermentation, wine conserves different organic compounds from grapes, such as polysaccharides, acids, and phenolic compounds, such as flavonoids and nonflavonoids. These substances have known anti-inflammatory and antioxidant capacities, and are considered as regulatory agents in cardiometabolic process. In this study, the main chemical components present in the wine, its interaction with molecules and biological mechanisms, and their interference with intra- and extracellular signaling are reviewed. Finally, the properties of wine that may benefit cardiovascular system are also revised.
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Affiliation(s)
- Melissa M Markoski
- Cellular and Molecular Cardiology Laboratory, Institute of Cardiology of Rio Grande do Sul (IC/FUC), Porto Alegre, Rio Grande do Sul, Brazil.; Postgraduate Program in Health Sciences: Cardiology, Institute of Cardiology of Rio Grande do Sul (IC/FUC), Porto Alegre, Rio Grande do Sul, Brazil
| | - Juliano Garavaglia
- Department of Nutrition, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil.; Institute of Technology in Food for Health, University of Vale do Rio dos Sinos (UNISINOS), São Leopoldo, Rio Grande do Sul, Brazil
| | - Aline Oliveira
- Postgraduate Program in Health Sciences: Cardiology, Institute of Cardiology of Rio Grande do Sul (IC/FUC), Porto Alegre, Rio Grande do Sul, Brazil
| | - Jessica Olivaes
- Cellular and Molecular Cardiology Laboratory, Institute of Cardiology of Rio Grande do Sul (IC/FUC), Porto Alegre, Rio Grande do Sul, Brazil
| | - Aline Marcadenti
- Postgraduate Program in Health Sciences: Cardiology, Institute of Cardiology of Rio Grande do Sul (IC/FUC), Porto Alegre, Rio Grande do Sul, Brazil.; Department of Nutrition, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Rio Grande do Sul, Brazil
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Yedlapati SH, Mendu A, Stewart SH. Alcohol-related diagnoses and increased mortality in acute myocardial infarction patients: An analysis of the nationwide inpatient sample. J Hosp Med 2016; 11:563-7. [PMID: 27043326 DOI: 10.1002/jhm.2584] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 02/01/2016] [Accepted: 02/28/2016] [Indexed: 11/11/2022]
Abstract
BACKGROUND Moderate alcohol consumption has been associated with lower risk of coronary heart disease death, but heavy alcohol consumption may increase risk. OBJECTIVE We sought to determine the association of alcohol-related diagnoses with in-hospital mortality in patients with acute myocardial infarction (AMI). DESIGN/SETTING/PATIENTS Discharge data collected from all admissions recorded in the Nationwide Inpatient Sample (NIS) database from 2011. A cross-sectional analysis was performed using regression methods appropriate for the NIS sample design. MEASURES The outcome measures were in-hospital mortality, length of stay, and cardiac procedures. RESULTS AMI accounted for 610,963 (1.9%) of adult in-patient admissions, with an in-hospital mortality rate of 5.3%. Alcohol-related diagnoses were associated with increased mortality in AMI patients after controlling for factors associated with alcoholism including age, sex, liver disease, hypertension, diabetes, renal failure, peripheral vascular disease, arrhythmias, drug abuse, gastrointestinal bleed, and smoking (adjusted odds ratio [OR]: 1.5, 95% confidence interval [CI]: 1.2-1.7, P < 0.001). This association was significant in both ST-elevation myocardial infarction patients (adjusted OR: 1.7, 95% CI: 1.4-2.2, P < 0.001) and non-ST-elevation myocardial infarction patients (adjusted OR: 1.3, 95% CI: 1.0-1.7, P = 0.025). Chronic alcohol-related diagnoses were significantly associated with death, but acute alcohol effects (as estimated by withdrawal and intoxication) were not associated. CONCLUSION Chronic alcohol-related diagnoses were associated with a modest increase in the risk for death in individuals presenting with AMI. This risk was not accounted for by common alcohol-related comorbidities. As a component of global efforts to limit hospital deaths from AMI, future research should identify the factors underlying this association. Journal of Hospital Medicine 2016;11:563-567. © 2016 Society of Hospital Medicine.
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Affiliation(s)
- Siva Harsha Yedlapati
- Division of General Internal Medicine, University at Buffalo, State University of New York, Buffalo, New York
| | - Anuradha Mendu
- Division of General Internal Medicine, University at Buffalo, State University of New York, Buffalo, New York
| | - Scott H Stewart
- Division of General Internal Medicine, University at Buffalo, State University of New York, Buffalo, New York
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The effects of alcohol on ambulatory blood pressure and other cardiovascular risk factors in type 2 diabetes. J Hypertens 2016; 34:421-8; discussion 428. [DOI: 10.1097/hjh.0000000000000816] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Probst Y, Zammit G. Predictors for Reporting of Dietary Assessment Methods in Food-based Randomized Controlled Trials over a Ten-year Period. Crit Rev Food Sci Nutr 2015. [DOI: 10.1080/10408398.2013.816653] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Abstract
The heart and vascular system are susceptible to the harmful effects of alcohol. Alcohol is an active toxin that undergoes widespread diffusion throughout the body, causing multiple synchronous and synergistic effects. Alcohol consumption decreases myocardial contractility and induces arrhythmias and dilated cardiomyopathy, resulting in progressive cardiovascular dysfunction and structural damage. Alcohol, whether at binge doses or a high cumulative lifetime consumption-both of which should be discouraged-is clearly deleterious for the cardiovascular system, increasing the incidence of total and cardiovascular mortality, coronary and peripheral artery disease, heart failure, stroke, hypertension, dyslipidaemia, and diabetes mellitus. However, epidemiological, case-control studies and meta-analyses have shown a U-type bimodal relationship so that low-to-moderate alcohol consumption (particularly of wine or beer) is associated with a decrease in cardiovascular events and mortality, compared with abstention. Potential confounding influences-alcohol-dose quantification, tobacco use, diet, exercise, lifestyle, cancer risk, accidents, and dependence-can affect the results of studies of both low-dose and high-dose alcohol consumption. Mendelian methodological approaches have led to doubts regarding the beneficial cardiovascular effects of alcohol, and the overall balance of beneficial and detrimental effects should be considered when making individual and population-wide recommendations, as reductions in alcohol consumption should provide overall health benefits.
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Hou X, Han J, Yuan C, Ren H, Zhang Y, Zhang T, Xu L, Zheng Q, Chen W. Cardioprotective Effects of Total Flavonoids Extracted from Xinjiang Sprig Rosa rugosa against Acute Ischemia/Reperfusion-Induced Myocardial Injury in Isolated Rat Heart. Cardiovasc Toxicol 2015; 16:54-66. [DOI: 10.1007/s12012-015-9308-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Yonguc GN, Dodurga Y, Adiguzel E, Gundogdu G, Kucukatay V, Ozbal S, Yilmaz I, Cankurt U, Yilmaz Y, Akdogan I. Grape seed extract has superior beneficial effects than vitamin E on oxidative stress and apoptosis in the hippocampus of streptozotocin induced diabetic rats. Gene 2014; 555:119-26. [PMID: 25445279 DOI: 10.1016/j.gene.2014.10.052] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 10/24/2014] [Accepted: 10/28/2014] [Indexed: 01/16/2023]
Abstract
We aimed to investigate the effects of grape seed extract (GSE) and vitamin E (Vit E) on oxidative stress and apoptosis in the hippocampus of streptozotocin-induced diabetic rats. In Control, Diabetic, and Diabetic treated with GSE (Diabetic+GSE) and vitamin E (Diabetic+Vit E) groups, oxidative stress index (OSI), TUNEL staining and Bcl-2, Bcl-XL, Bax, caspase-3, -9, and -8, Cyt-c, TNF-α, and NF-κB gene expressions were evaluated. OSI was significantly increased in the plasma and hippocampus of the Diabetic compared to Control group and decreased in Diabetic+GSE and Diabetic+Vit E groups compared to Diabetic. TUNEL positive neurons significantly increased in the hippocampus of the Diabetic group compared to Control and decreased in Diabetic+GSE (more prominently) and Diabetic+Vit E groups compared to Diabetic. In the hippocampus of the Diabetic group, Bcl-2 and Bcl-XL gene expressions were significantly decreased; Bax, caspase-3, -9, and -8, Cyt-c, TNF-α, and NF-κB gene expressions were significantly increased compared to Control. In Diabetic+GSE and Diabetic+Vit E groups, Bcl-2 gene expressions were significantly increased; Bcl-XL gene expressions did not differ compared to the Diabetic group. The expression of Bax, caspase-3, -9, and -8, Cyt-c, TNF-α, and NF-κB genes in the Diabetic+GSE group and the expression of caspase-3 and -9, TNF-α, and NF-κB genes in the Diabetic+Vit E group were significantly decreased compared to Diabetic. In conclusion, GSE (more prominently) and vitamin E decreased oxidative stress and neuronal apoptosis occurring in the hippocampus of diabetic rats.
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Affiliation(s)
| | - Yavuz Dodurga
- Pamukkale University School of Medicine, Department of Medical Biology, Denizli, Turkey.
| | - Esat Adiguzel
- Pamukkale University School of Medicine, Department of Anatomy, Denizli, Turkey
| | - Gulsah Gundogdu
- Pamukkale University School of Medicine, Department of Physiology, Denizli, Turkey
| | - Vural Kucukatay
- Pamukkale University School of Medicine, Department of Physiology, Denizli, Turkey
| | - Seda Ozbal
- Dokuz Eylul University School of Medicine, Department of Histology and Embryology, Izmir, Turkey
| | - Ismail Yilmaz
- Izmir Bozyaka Training and Research Hospital, Department of Pharmacology, Izmir, Turkey
| | - Ulker Cankurt
- Dokuz Eylul University School of Medicine, Department of Histology and Embryology, Izmir, Turkey
| | - Yusuf Yilmaz
- Mehmet Akif Ersoy University Faculty of Engineering and Architecture, Department of Food Engineering, Burdur, Turkey
| | - Ilgaz Akdogan
- Pamukkale University School of Medicine, Department of Anatomy, Denizli, Turkey
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Peluso I, Miglio C, Morabito G, Ioannone F, Serafini M. Flavonoids and Immune Function in Human: A Systematic Review. Crit Rev Food Sci Nutr 2014; 55:383-95. [DOI: 10.1080/10408398.2012.656770] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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43
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O'Keefe JH, Bhatti SK, Bajwa A, DiNicolantonio JJ, Lavie CJ. Alcohol and cardiovascular health: the dose makes the poison…or the remedy. Mayo Clin Proc 2014; 89:382-93. [PMID: 24582196 DOI: 10.1016/j.mayocp.2013.11.005] [Citation(s) in RCA: 229] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 10/18/2013] [Accepted: 11/05/2013] [Indexed: 01/01/2023]
Abstract
Habitual light to moderate alcohol intake (up to 1 drink per day for women and 1 or 2 drinks per day for men) is associated with decreased risks for total mortality, coronary artery disease, diabetes mellitus, congestive heart failure, and stroke. However, higher levels of alcohol consumption are associated with increased cardiovascular risk. Indeed, behind only smoking and obesity, excessive alcohol consumption is the third leading cause of premature death in the United States. Heavy alcohol use (1) is one of the most common causes of reversible hypertension, (2) accounts for about one-third of all cases of nonischemic dilated cardiomyopathy, (3) is a frequent cause of atrial fibrillation, and (4) markedly increases risks of stroke-both ischemic and hemorrhagic. The risk-to-benefit ratio of drinking appears higher in younger individuals, who also have higher rates of excessive or binge drinking and more frequently have adverse consequences of acute intoxication (for example, accidents, violence, and social strife). In fact, among males aged 15 to 59 years, alcohol abuse is the leading risk factor for premature death. Of the various drinking patterns, daily low- to moderate-dose alcohol intake, ideally red wine before or during the evening meal, is associated with the strongest reduction in adverse cardiovascular outcomes. Health care professionals should not recommend alcohol to nondrinkers because of the paucity of randomized outcome data and the potential for problem drinking even among individuals at apparently low risk. The findings in this review were based on a literature search of PubMed for the 15-year period 1997 through 2012 using the search terms alcohol, ethanol, cardiovascular disease, coronary artery disease, heart failure, hypertension, stroke, and mortality. Studies were considered if they were deemed to be of high quality, objective, and methodologically sound.
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Affiliation(s)
- James H O'Keefe
- Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, Kansas City, MO.
| | - Salman K Bhatti
- Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, Kansas City, MO
| | - Ata Bajwa
- Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, Kansas City, MO
| | - James J DiNicolantonio
- Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, Kansas City, MO
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, LA
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Affiliation(s)
- R Paul Robertson
- Pacific Northwest Diabetes Research Institute and the Division of Metabolism, Endocrinology, and Nutrition, Departments of Medicine and Pharmacology, University of Washington, Seattle, WA
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45
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Ábel T, Blázovics A, Wimmer A, Bekő G, Gaál B, Blazics B, Eldin M, Fehér J, Szabolcs I, Lengyel G. Beneficial effect of moderate white wine consumption on insulin sensitivity in patients with metabolic syndrome. ACTA ALIMENTARIA 2013. [DOI: 10.1556/aalim.2013.1111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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46
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47
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Peluso I, Raguzzini A, Serafini M. Effect of flavonoids on circulating levels of TNF-α and IL-6 in humans: a systematic review and meta-analysis. Mol Nutr Food Res 2013; 57:784-801. [PMID: 23471810 DOI: 10.1002/mnfr.201200721] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Revised: 12/18/2012] [Accepted: 12/19/2012] [Indexed: 12/29/2022]
Abstract
Epidemiological or in vitro evidence suggests a potential role for flavonoids as anti-inflammatory agents; we investigated the effect of flavonoids-rich foods or supplements on tumor necrosis factor- alpha (TNF-α) and interleukin-6 (IL-6) in long-term placebo-controlled human intervention trials. From 110 human intervention studies selected (MEDLINE, EMBASE, CHORANE, and FSTA databases), 32 long-term placebo-controlled trials were suitable for meta-analysis. After sensitivity analysis, seven studies imputed of bias were excluded and 25 studies were analyzed (TNF-α, n = 2404; IL-6, n = 2174). Levels of TNF-α decreased after flavonoid consumption in the fixed model only (mean difference (MD) (95% CI): -0.098 (-0.188, -0.009), p = 0.032), but metaregression results showed that neither higher dose, nor a longer duration of intervention were associated with a greater effect size. Subgroup analysis did not reveal any significant effect for quercetin and soy, but other sources (red wine, pomegranate, and tea extracts) showed a significant effect size both in fixed (MD (95% CI): TNF-α -0.449 (-0.619, -0.280), p < 0.001; IL-6 -0.346 (-0.612, -0.079), p = 0.011) and random (MD (95% CI): TNF-α -0.783 (-1.476, -0.090), p = 0.027; IL-6, -0.556 (-1.062, -0.050), p = 0.031) effect models. High-quality placebo-controlled trials are needed in order to identify flavonoids as the active ingredients.
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Affiliation(s)
- Ilaria Peluso
- Agricultural Research Council (CRA), Ex National Institute for Food and Nutrition Research (INRAN), Rome, Italy
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Nowlin SY, Hammer MJ, D'Eramo Melkus G. Diet, inflammation, and glycemic control in type 2 diabetes: an integrative review of the literature. J Nutr Metab 2012; 2012:542698. [PMID: 23316349 PMCID: PMC3536332 DOI: 10.1155/2012/542698] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2012] [Accepted: 09/19/2012] [Indexed: 12/19/2022] Open
Abstract
Type 2 diabetes (T2D) is a growing national health problem affecting 35% of adults ≥20 years of age in the United States. Recently, diabetes has been categorized as an inflammatory disease, sharing many of the adverse outcomes as those reported from cardiovascular disease. Medical nutrition therapy is recommended for the treatment of diabetes; however, these recommendations have not been updated to target the inflammatory component, which can be affected by diet and lifestyle. To assess the current state of evidence for which dietary programs contain the most anti-inflammatory and glycemic control properties for patients with T2D, we conducted an integrative review of the literature. A comprehensive search of the PubMed, CINAHL, Scopus, and Web of Science databases from January 2000 to May 2012 yielded 786 articles. The final 16 studies met the selection criteria including randomized control trials, quasiexperimental, or cross-sectional studies that compared varying diets and measured inflammatory markers. The Mediterranean and DASH diets along with several low-fat diets were associated with lower inflammatory markers. The Mediterranean diet demonstrated the most clinically significant reduction in glycosylated hemoglobin (HbA(1c)). Information on best dietary guidelines for inflammation and glycemic control in individuals with T2D is lacking. Continued research is warranted.
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Affiliation(s)
- Sarah Y. Nowlin
- College of Nursing, New York University, 726 Broadway, 10th Floor, New York, NY 10003, USA
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50
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Rosenberg MA, Mukamal KJ. The Estimated Risk of Atrial Fibrillation Related to Alcohol Consumption. J Atr Fibrillation 2012; 5:424. [PMID: 28496744 DOI: 10.4022/jafib.424] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Revised: 12/23/2011] [Accepted: 12/25/2011] [Indexed: 01/19/2023]
Abstract
The risk of acute heavy alcohol intake on the development of atrial fibrillation (AF), aka ?holiday heart syndrome?, has been well-described. However, whether chronic alcohol intake is also associated with increased risk of AF, or might even be protective as has been observed with other cardiac conditions, is more uncertain. A number of studies, from basic science to large cohort studies have been performed to analyze the association between alcohol and AF. Basic-level studies have found that alcohol causes changes in tissue electrophysiology, ion channels, and circulating hormones, which might promote development and maintenance of AF. Clinical studies have generally shown groups with the highest regular intake of alcohol to be at increased risk, with no association with more moderate use. However, these studies have not always accounted for other AF risk factors, been inconsistent in the assessment and validation of the quantity of alcohol consumed across populations, and been unable to completely separate drinking patterns from overall health of participants. As a result, solid conclusions about a threshold level for ?safe? chronic alcohol intake cannot be made with regard to AF risk, but it appears to be safe within currently recommended limits of 1 drink daily for women and 2 for men. In this review, we discuss these findings, limitations, and conclusions.
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Affiliation(s)
- Michael A Rosenberg
- Cardiovascular Institute, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Kenneth J Mukamal
- Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA, USA
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