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Bays HE. Obesity, dyslipidemia, and cardiovascular disease: A joint expert review from the Obesity Medicine Association and the National Lipid Association 2024. OBESITY PILLARS 2024; 10:100108. [PMID: 38706496 PMCID: PMC11066689 DOI: 10.1016/j.obpill.2024.100108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 05/07/2024]
Abstract
Background This joint expert review by the Obesity Medicine Association (OMA) and National Lipid Association (NLA) provides clinicians an overview of the pathophysiologic and clinical considerations regarding obesity, dyslipidemia, and cardiovascular disease (CVD) risk. Methods This joint expert review is based upon scientific evidence, clinical perspectives of the authors, and peer review by the OMA and NLA leadership. Results Among individuals with obesity, adipose tissue may store over 50% of the total body free cholesterol. Triglycerides may represent up to 99% of lipid species in adipose tissue. The potential for adipose tissue expansion accounts for the greatest weight variance among most individuals, with percent body fat ranging from less than 5% to over 60%. While population studies suggest a modest increase in blood low-density lipoprotein cholesterol (LDL-C) levels with excess adiposity, the adiposopathic dyslipidemia pattern most often described with an increase in adiposity includes elevated triglycerides, reduced high density lipoprotein cholesterol (HDL-C), increased non-HDL-C, elevated apolipoprotein B, increased LDL particle concentration, and increased small, dense LDL particles. Conclusions Obesity increases CVD risk, at least partially due to promotion of an adiposopathic, atherogenic lipid profile. Obesity also worsens other cardiometabolic risk factors. Among patients with obesity, interventions that reduce body weight and improve CVD outcomes are generally associated with improved lipid levels. Given the modest improvement in blood LDL-C with weight reduction in patients with overweight or obesity, early interventions to treat both excess adiposity and elevated atherogenic cholesterol (LDL-C and/or non-HDL-C) levels represent priorities in reducing the risk of CVD.
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Affiliation(s)
- Harold Edward Bays
- Corresponding author. Louisville Metabolic and Atherosclerosis Research Center, Louisville, KY, 40213, USA.
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Agarwala A, Dixon DL, Gianos E, Kirkpatrick CF, Michos ED, Satish P, Birtcher KK, Braun LT, Pillai P, Watson K, Wild R, Mehta LS. Dyslipidemia management in women of reproductive potential: An expert clinical consensus from the national lipid association. J Clin Lipidol 2024:S1933-2874(24)00188-0. [PMID: 38824114 DOI: 10.1016/j.jacl.2024.05.005] [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: 04/30/2024] [Accepted: 05/20/2024] [Indexed: 06/03/2024]
Abstract
Cardiovascular disease (CVD) is the leading cause of death among women and its incidence has been increasing recently, particularly among younger women. Across major professional society guidelines, dyslipidemia management remains a central tenet for atherosclerotic CVD prevention for both women and men. Despite this, women, particularly young women, who are candidates for statin therapy are less likely to be treated and less likely to achieve their recommended therapeutic objectives for low-density lipoprotein cholesterol (LDL-C) levels. Elevated LDL-C and triglycerides are the two most common dyslipidemias that should be addressed during pregnancy due to the increased risk for adverse pregnancy outcomes, such as preeclampsia, gestational diabetes mellitus, and pre-term delivery, as well as pancreatitis in the presence of severe hypertriglyceridemia. In this National Lipid Association Expert Clinical Consensus, we review the roles of nutrition, physical activity, and pharmacotherapy as strategies to address elevated levels of LDL-C and/or triglycerides among women of reproductive age. We include a special focus on points to consider during the shared decision-making discussion regarding pharmacotherapy for dyslipidemia during preconception planning, pregnancy, and lactation.
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Affiliation(s)
- Anandita Agarwala
- Center for Cardiovascular Disease Prevention Cardiovascular Division, Baylor Scott and White Health Heart Hospital Baylor Plano, Plano, TX, USA (Dr Agarwala).
| | - Dave L Dixon
- Department of Pharmacotherapy & Outcomes Science, Virginia Commonwealth University School of Pharmacy, Richmond, Virginia, USA (Dr Dixon); Center for Pharmacy Practice Innovation, Virginia Commonwealth University, Richmond, Virginia, USA (Dr Dixon)
| | - Eugenia Gianos
- Department of Cardiology, Northwell Health, New Hyde Park, Cardiovascular Institute, Lenox Hill Hospital Northwell, New York, NY, USA (Dr Gianos)
| | - Carol F Kirkpatrick
- Midwest Biomedical Research, Addison, IL, USA (Dr Kirkpatrick); Kasiska Division of Health Sciences, Idaho State University, Pocatello, ID, USA (Dr Kirkpatrick)
| | - Erin D Michos
- Division of Cardiology, Department of Medicine Johns Hopkins University School of Medicine Baltimore, MD, USA (Dr Michos)
| | - Priyanka Satish
- The University of Texas at Austin Dell School of Medicine, Ascension Texas Cardiovascular, Austin, TX, USA (Dr Satish)
| | - Kim K Birtcher
- University of Houston College of Pharmacy, Houston, TX, USA (Dr Birtcher)
| | - Lynne T Braun
- Rush University College of Nursing, Rush Heart Center for Women, Chicago, IL, USA (Dr Braun)
| | - Priyamvada Pillai
- Baylor Scott and White Health Heart Hospital Baylor Plano, Plano, TX, USA (Dr Pillai)
| | - Karol Watson
- Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA (Dr Watson)
| | - Robert Wild
- Oklahoma University Health Sciences Center, Oklahoma City, OK, USA (Dr Wild)
| | - Laxmi S Mehta
- Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA (Dr Mehta)
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Barkas F, Sener YZ, Golforoush PA, Kheirkhah A, Rodriguez-Sanchez E, Novak J, Apellaniz-Ruiz M, Akyea RK, Bianconi V, Ceasovschih A, Chee YJ, Cherska M, Chora JR, D'Oria M, Demikhova N, Kocyigit Burunkaya D, Rimbert A, Macchi C, Rathod K, Roth L, Sukhorukov V, Stoica S, Scicali R, Storozhenko T, Uzokov J, Lupo MG, van der Vorst EPC, Porsch F. Advancements in risk stratification and management strategies in primary cardiovascular prevention. Atherosclerosis 2024; 395:117579. [PMID: 38824844 DOI: 10.1016/j.atherosclerosis.2024.117579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 04/29/2024] [Accepted: 05/14/2024] [Indexed: 06/04/2024]
Abstract
Atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of morbidity and mortality worldwide, highlighting the urgent need for advancements in risk assessment and management strategies. Although significant progress has been made recently, identifying and managing apparently healthy individuals at a higher risk of developing atherosclerosis and those with subclinical atherosclerosis still poses significant challenges. Traditional risk assessment tools have limitations in accurately predicting future events and fail to encompass the complexity of the atherosclerosis trajectory. In this review, we describe novel approaches in biomarkers, genetics, advanced imaging techniques, and artificial intelligence that have emerged to address this gap. Moreover, polygenic risk scores and imaging modalities such as coronary artery calcium scoring, and coronary computed tomography angiography offer promising avenues for enhancing primary cardiovascular risk stratification and personalised intervention strategies. On the other hand, interventions aiming against atherosclerosis development or promoting plaque regression have gained attention in primary ASCVD prevention. Therefore, the potential role of drugs like statins, ezetimibe, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, omega-3 fatty acids, antihypertensive agents, as well as glucose-lowering and anti-inflammatory drugs are also discussed. Since findings regarding the efficacy of these interventions vary, further research is still required to elucidate their mechanisms of action, optimize treatment regimens, and determine their long-term effects on ASCVD outcomes. In conclusion, advancements in strategies addressing atherosclerosis prevention and plaque regression present promising avenues for enhancing primary ASCVD prevention through personalised approaches tailored to individual risk profiles. Nevertheless, ongoing research efforts are imperative to refine these strategies further and maximise their effectiveness in safeguarding cardiovascular health.
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Affiliation(s)
- Fotios Barkas
- Department of Internal Medicine, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
| | - Yusuf Ziya Sener
- Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | | | - Azin Kheirkhah
- Institute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Elena Rodriguez-Sanchez
- Division of Cardiology, Department of Medicine, Department of Physiology, and Molecular Biology Institute, UCLA, Los Angeles, CA, USA
| | - Jan Novak
- 2(nd) Department of Internal Medicine, St. Anne's University Hospital in Brno and Faculty of Medicine of Masaryk University, Brno, Czech Republic; Department of Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Maria Apellaniz-Ruiz
- Genomics Medicine Unit, Navarra Institute for Health Research - IdiSNA, Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Pública de Navarra (UPNA), Pamplona, Spain
| | - Ralph Kwame Akyea
- Centre for Academic Primary Care, School of Medicine, University of Nottingham, United Kingdom
| | - Vanessa Bianconi
- Department of Medicine and Surgery, University of Perugia, Italy
| | - Alexandr Ceasovschih
- Internal Medicine Department, Grigore T. Popa University of Medicine and Pharmacy, Iasi, Romania
| | - Ying Jie Chee
- Department of Endocrinology, Tan Tock Seng Hospital, Singapore
| | - Mariia Cherska
- Cardiology Department, Institute of Endocrinology and Metabolism, Kyiv, Ukraine
| | - Joana Rita Chora
- Unidade I&D, Grupo de Investigação Cardiovascular, Departamento de Promoção da Saúde e Doenças Não Transmissíveis, Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal; Universidade de Lisboa, Faculdade de Ciências, BioISI - Biosystems & Integrative Sciences Institute, Lisboa, Portugal
| | - Mario D'Oria
- Division of Vascular and Endovascular Surgery, Department of Medical Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Nadiia Demikhova
- Sumy State University, Sumy, Ukraine; Tallinn University of Technology, Tallinn, Estonia
| | | | - Antoine Rimbert
- Nantes Université, CNRS, INSERM, l'institut du Thorax, Nantes, France
| | - Chiara Macchi
- Department of Pharmacological and Biomolecular Sciences "Rodolfo Paoletti", Università Degli Studi di Milano, Milan, Italy
| | - Krishnaraj Rathod
- Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom; Barts Interventional Group, Barts Heart Centre, St. Bartholomew's Hospital, London, United Kingdom
| | - Lynn Roth
- Laboratory of Physiopharmacology, University of Antwerp, Antwerp, Belgium
| | - Vasily Sukhorukov
- Laboratory of Cellular and Molecular Pathology of Cardiovascular System, Petrovsky National Research Centre of Surgery, Moscow, Russia
| | - Svetlana Stoica
- "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania; Institute of Cardiovascular Diseases Timisoara, Timisoara, Romania
| | - Roberto Scicali
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Tatyana Storozhenko
- Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium; Department of Prevention and Treatment of Emergency Conditions, L.T. Malaya Therapy National Institute NAMSU, Kharkiv, Ukraine
| | - Jamol Uzokov
- Republican Specialized Scientific Practical Medical Center of Therapy and Medical Rehabilitation, Tashkent, Uzbekistan
| | | | - Emiel P C van der Vorst
- Institute for Molecular Cardiovascular Research (IMCAR), RWTH Aachen University, 52074, Aachen, Germany; Aachen-Maastricht Institute for CardioRenal Disease (AMICARE), RWTH Aachen University, 52074, Aachen, Germany; Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximilians-University Munich, 80336, Munich, Germany; Interdisciplinary Center for Clinical Research (IZKF), RWTH Aachen University, 52074, Aachen, Germany
| | - Florentina Porsch
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
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da Cunha Agostini L, Cota E Souza LA, Silva NNT, Lopes ACF, de Medeiros Teixeira LF, de Almeida Belo V, Coura-Vital W, da Silva GN, Lima AA. Assessing levels of uric acid and other cardiovascular markers in prehypertensive and hypertensive adults. HIPERTENSION Y RIESGO VASCULAR 2024:S1889-1837(24)00057-6. [PMID: 38697879 DOI: 10.1016/j.hipert.2024.04.003] [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: 09/26/2023] [Revised: 01/11/2024] [Accepted: 04/10/2024] [Indexed: 05/05/2024]
Abstract
INTRODUCTION Although some studies have reported the association between uric acid (UA) and hypertension, evidence on prehypertension is still lacking. Therefore, the objective of this study was to determine the levels of UA and other cardiovascular markers among prehypertensive and hypertensive patients and assess their risk for developing arterial hypertension. METHODS 157 individuals were recruited: 67 normotensive, 23 pre-hypertensive and 67 hypertensive. Blood samples were collected to measure biochemical parameters and anthropometric measurements and blood pressure were evaluated. We calculated the product of lipid accumulation and the visceral adiposity index to assess cardiovascular risk. RESULTS Our data showed an increase in UA levels in normotensives (4.9±1.3mg/dL), prehypertensives (5.2±1.3mg/dL) and hypertensives (5.9±1.6mg/dL) (p=0.004). We found a higher frequency of hyperuricemia in the hypertensive group (34.3%) than in the normotensive group (13.4%, p<0.05). Hypertensive volunteers had lower levels of HDL-C (p=0.004 and p=0.003) and higher body mass indexes (p<0.001 and p=0.007), glucose (p<0.001 and p=0.033), triglycerides (p=0.001 and p=0.005), visceral adiposity index (p<0.001 and p=0.002) and lipid accumulation product (p<0.001 and p=0.007) than normotensive and prehypertensive participants. We also observed that individuals with UA≥6.2mg/dL had an increased risk of hypertension of 4.77 (p=0.003) compared to individuals with levels≤4.3mg/dL. CONCLUSION Our results showed that UA is associated with increased blood pressure and unfavorable changes in anthropometric and biochemical parameters, which represent risk factors for hypertension and cardiovascular diseases.
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Affiliation(s)
- L da Cunha Agostini
- Programa de Pós-Graduação em Ciências Farmacêuticas (CiPharma), Escola de Farmácia, Universidade Federal de Ouro Preto, CEP 35400-000, Ouro Preto, Minas Gerais, Brazil
| | - L A Cota E Souza
- Programa de Pós-Graduação em Ciências Farmacêuticas (CiPharma), Escola de Farmácia, Universidade Federal de Ouro Preto, CEP 35400-000, Ouro Preto, Minas Gerais, Brazil
| | - N N T Silva
- Departamento de Análises Clínicas (DEACL), Escola de Farmácia, Universidade Federal de Ouro Preto, CEP 35400-000, Ouro Preto, Minas Gerais, Brazil
| | - A C F Lopes
- Departamento de Análises Clínicas (DEACL), Escola de Farmácia, Universidade Federal de Ouro Preto, CEP 35400-000, Ouro Preto, Minas Gerais, Brazil
| | - L F de Medeiros Teixeira
- Departamento de Análises Clínicas (DEACL), Escola de Farmácia, Universidade Federal de Ouro Preto, CEP 35400-000, Ouro Preto, Minas Gerais, Brazil
| | - V de Almeida Belo
- Programa de Pós-Graduação em Ciências Farmacêuticas (CiPharma), Escola de Farmácia, Universidade Federal de Ouro Preto, CEP 35400-000, Ouro Preto, Minas Gerais, Brazil; Departamento de Farmácia (DEFAR), Escola de Farmácia, Universidade Federal de Ouro Preto, CEP 35400-000, Ouro Preto, Minas Gerais, Brazil
| | - W Coura-Vital
- Programa de Pós-Graduação em Ciências Farmacêuticas (CiPharma), Escola de Farmácia, Universidade Federal de Ouro Preto, CEP 35400-000, Ouro Preto, Minas Gerais, Brazil; Departamento de Análises Clínicas (DEACL), Escola de Farmácia, Universidade Federal de Ouro Preto, CEP 35400-000, Ouro Preto, Minas Gerais, Brazil
| | - G N da Silva
- Programa de Pós-Graduação em Ciências Farmacêuticas (CiPharma), Escola de Farmácia, Universidade Federal de Ouro Preto, CEP 35400-000, Ouro Preto, Minas Gerais, Brazil; Departamento de Análises Clínicas (DEACL), Escola de Farmácia, Universidade Federal de Ouro Preto, CEP 35400-000, Ouro Preto, Minas Gerais, Brazil.
| | - A A Lima
- Programa de Pós-Graduação em Ciências Farmacêuticas (CiPharma), Escola de Farmácia, Universidade Federal de Ouro Preto, CEP 35400-000, Ouro Preto, Minas Gerais, Brazil; Departamento de Análises Clínicas (DEACL), Escola de Farmácia, Universidade Federal de Ouro Preto, CEP 35400-000, Ouro Preto, Minas Gerais, Brazil
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Jagielski NP, Rai AK, Rajan KS, Mangal V, Garikipati VNS. A contemporary review of snoRNAs in cardiovascular health: RNA modification and beyond. MOLECULAR THERAPY. NUCLEIC ACIDS 2024; 35:102087. [PMID: 38178918 PMCID: PMC10765057 DOI: 10.1016/j.omtn.2023.102087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
As cardiovascular diseases continue to be the leading cause of death worldwide, groundbreaking research is being conducted to mitigate their effects. This review looks into the potential of small nucleolar RNAs (snoRNAs) and the opportunity to use these molecular agents as therapeutic biomarkers for cardiovascular issues specific to the heart. Through an investigation of snoRNA biogenesis, functionality, and roles in cardiovascular diseases, this review relates our past and present knowledge of snoRNAs to the current scientific literature. Considering the initial discovery of snoRNAs and the studies thereafter analyzing the roles of snoRNAs in disease, we look forward to uncovering many other noncanonical functions that could lead researchers closer to finding preventive and curative solutions for cardiovascular diseases.
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Affiliation(s)
- Noah Peter Jagielski
- Aging + Cardiovascular Discovery Center, Department of Cardiovascular Sciences, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Amit Kumar Rai
- Aging + Cardiovascular Discovery Center, Department of Cardiovascular Sciences, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - K. Shanmugha Rajan
- Department of Chemical and Structural Biology, Weizmann Institute, Rehovot 76100 001, Israel
| | - Vatsal Mangal
- Aging + Cardiovascular Discovery Center, Department of Cardiovascular Sciences, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Venkata Naga Srikanth Garikipati
- Aging + Cardiovascular Discovery Center, Department of Cardiovascular Sciences, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
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Markkanen JO, Oikarinen N, Savolainen MJ, Merikallio H, Nyman V, Salminen V, Virkkula T, Karppinen P, Oinas-Kukkonen H, Hukkanen J. Mobile health behaviour change support system as independent treatment tool for obesity: a randomized controlled trial. Int J Obes (Lond) 2024; 48:376-383. [PMID: 38062218 PMCID: PMC10896717 DOI: 10.1038/s41366-023-01426-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 11/01/2023] [Accepted: 11/23/2023] [Indexed: 02/28/2024]
Abstract
BACKGROUND/OBJECTIVES Digital health interventions are increasingly utilized as an adjunct to face-to-face counselling in the treatment of obesity. However, previous studies have shown inconsistent efficacy when digital interventions are used as stand-alone treatment. The purpose of this study was to investigate whether a mobile health behaviour change support system (mHBCSS) is effective in weight reduction and weight loss maintenance without additional counselling. Furthermore, changes in cardiometabolic risk factors were investigated. METHODS In this randomized controlled trial, a mHBCSS intervention was conducted for 200 volunteers with obesity (BMI 30-40 kg/m² and age 18-65 years). The study participants were randomly assigned into two groups: immediate access to mHBCSS intervention or wait-list control with access to mHBCSS after 6 months. Anthropometric and metabolic traits were also measured. The primary outcome was weight loss from the baseline to the 6-month visit. RESULTS Among 200 participants (88.5% women), mean BMI (SD) was 34.3 kg/m² (2.8) and age 46.5 years (9.5). The retention rate was 98.5% and 89.0% at the 6- and 12-month visits, respectively. At the 6-month visit, those with immediate access to mHBCSS had significantly greater weight loss (-2.5%, 95% CI -3.4 to -1.6, p < 0.001) compared with the wait-list control group (0.2%, 95% CI -0.4 to 0.9, p = 0.466; between groups p < 0.001). Weight loss was maintained until the 12-month time point in the mHBCSS group (-2.1%, 95% CI -3.3 to -0.9, p = 0.001). The usage of mHBCSS had no significant effect on metabolic traits. CONCLUSION The mHBCSS as a stand-alone treatment of obesity results in weight reduction and weight loss maintenance with remarkable adherence rate. Further studies are needed to establish how to best implement the scalable and resource-efficient mHBCSS into the standard care of obesity to achieve optimal weight loss results.
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Affiliation(s)
- Jaakko O Markkanen
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland
| | - Noora Oikarinen
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland
| | - Markku J Savolainen
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Medicine, Oulu University Hospital, Oulu, Finland
| | - Heta Merikallio
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Ville Nyman
- Oulu Advanced Research on Service and Information Systems, University of Oulu, Oulu, Finland
| | - Ville Salminen
- Oulu Advanced Research on Service and Information Systems, University of Oulu, Oulu, Finland
| | - Teppo Virkkula
- Oulu Advanced Research on Service and Information Systems, University of Oulu, Oulu, Finland
| | - Pasi Karppinen
- Oulu Advanced Research on Service and Information Systems, University of Oulu, Oulu, Finland
| | - Harri Oinas-Kukkonen
- Oulu Advanced Research on Service and Information Systems, University of Oulu, Oulu, Finland
| | - Janne Hukkanen
- Research Unit of Biomedicine and Internal Medicine, University of Oulu, Oulu, Finland.
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
- Biocenter Oulu, Oulu, Finland.
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Pavis GF, Iniesta RR, Roper H, Theobald HE, Derbyshire EJ, Finnigan TJA, Stephens FB, Wall BT. A four-week dietary intervention with mycoprotein-containing food products reduces serum cholesterol concentrations in community-dwelling, overweight adults: A randomised controlled trial. Clin Nutr 2024; 43:649-659. [PMID: 38306892 DOI: 10.1016/j.clnu.2024.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/18/2024] [Accepted: 01/18/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND Substituting dietary meat and fish for mycoprotein, a fungal-derived food source rich in protein and fibre, decreases circulating cholesterol concentrations in laboratory-controlled studies. However, whether these findings can be translated to a home-based setting, and to decrease cholesterol concentrations in overweight and hypercholesterolemic individuals, remains to be established. OBJECTIVE We investigated whether a remotely-delivered, home-based dietary intervention of mycoprotein-containing food products would affect various circulating cholesterol moieties and other markers of cardio-metabolic health in overweight (BMI >27.5 kg⋅m-2) and hypercholesterolaemic (>5.0 mmol⋅L-1) adults. METHODS Seventy-two participants were randomized into a controlled, parallel-group trial conducted in a free-living setting, in which they received home deliveries of either meat/fish control products (CON; n = 39; BMI 33 ± 1 kg⋅m-2; 13 males, 26 females) or mycoprotein-containing food products (MYC; n = 33; BMI 32 ± 1 kg⋅m-2; 13 males, 20 females) for 4 weeks. Fingertip blood samples were collected and sent via postal service before and after the dietary intervention period and analysed for concentrations of serum lipids, blood glucose and c-peptide. RESULTS Serum total cholesterol concentrations were unchanged throughout the intervention in CON, but decreased by 5 ± 2 % in MYC (from 5.4 ± 0.2 to 5.1 ± 0.2 mmol⋅L-1; P < 0.05). Serum low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol concentrations were also unchanged in CON, but decreased in MYC by 10 ± 3 % and 6 ± 2 % (both by 0.3 ± 0.1 mmol⋅L-1; P < 0.05). Serum high-density lipoprotein cholesterol and free triglyceride concentrations were unaffected in CON or MYC. Post-intervention, MYC displayed lower mean blood glucose (3.7 ± 0.2 versus 4.3 ± 0.2 mmol⋅L-1) and c-peptide (779 ± 76 vs. 1064 ± 86 pmol⋅L-1) concentrations (P < 0.05) vs. CON. CONCLUSIONS We show that a home-based dietary intervention of mycoprotein-containing food products effectively lowers circulating cholesterol concentrations in overweight, hypercholesterolemic adults. This demonstrates that mycoprotein consumption is a feasible and ecologically valid dietary strategy to improve markers of cardio-metabolic health in an at-risk population under free living conditions. CLINICAL TRIAL REGISTRATION NCT04773483 (https://classic. CLINICALTRIALS gov/ct2/show/NCT04773483).
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Affiliation(s)
- George F Pavis
- Nutritional Physiology Group, Department of Public Health and Sport Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, Devon, UK
| | - Raquel Revuelta Iniesta
- Nutritional Physiology Group, Department of Public Health and Sport Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, Devon, UK
| | - Holly Roper
- Marlow Foods Ltd., Stokesley, North Yorkshire, UK
| | | | | | | | - Francis B Stephens
- Nutritional Physiology Group, Department of Public Health and Sport Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, Devon, UK
| | - Benjamin T Wall
- Nutritional Physiology Group, Department of Public Health and Sport Sciences, Faculty of Health and Life Sciences, University of Exeter, Exeter, Devon, UK.
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Lee MK, Han K, Kim B, Kim JD, Jung Kim M, Kim B, Heo J, Ahn J, Sohn SY, Lee JH. Cumulative exposure to hypertriglyceridemia and risk of type 2 diabetes in young adults. Diabetes Res Clin Pract 2024; 208:111109. [PMID: 38262520 DOI: 10.1016/j.diabres.2024.111109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 01/14/2024] [Accepted: 01/18/2024] [Indexed: 01/25/2024]
Abstract
AIM This study aimed to examine whether cumulative exposure to hypertriglyceridemia is associated with an increased risk of developing type 2 diabetes in young adults. METHODS The study included 1,840,251 participants aged 20-39 years who had undergonefourconsecutiveannualhealth checkups and had no history of type 2 diabetes. Participants werecategorized into five groups (exposure score 0-4) based on the frequencies of hypertriglyceridemia diagnosis over a four-year period. The primary outcome was newly diagnosed type 2 diabetes. Exploratory analyses were performed for the different subgroups. RESULTS During a follow-up period of 6.53 years, 40,286 participants developed type 2 diabetes. The cumulative incidence of type 2 diabetes significantly increased with higher exposure scores for hypertriglyceridemia (log-rank test, P < 0.001). The multivariable-adjusted hazard ratios for incident diabetes were 1.674 (95 % CI, 1.619, 1.732), 2.192 (95 % CI, 2.117, 2.269), 2.637 (95 % CI, 2.548, 2.73), and 3.715 (95 % CI, 3.6, 3.834) for participants with scores of 1-4, respectively, compared with those with an exposure score of 0. CONCLUSIONS In this large-scale prospective cohort study of young adults, cumulative exposure to hypertriglyceridemia was significantly associated with an increased risk of type 2 diabetes, independent of lifestyle-related factors.
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Affiliation(s)
- Min-Kyung Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine, Gyeonggi-do, Republic of Korea.
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Bongsung Kim
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Jong-Dai Kim
- Division of Endocrinology, Department of Internal Medicine, Konayng University Hospital, Daejeon, Republic of Korea
| | - Moon Jung Kim
- Department of Laboratory Medicine, Myongji Hospital, Hanyang University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Byungpyo Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Jung Heo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Jiyeon Ahn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Seo-Young Sohn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine, Gyeonggi-do, Republic of Korea
| | - Jae-Hyuk Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine, Gyeonggi-do, Republic of Korea
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9
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Candás-Estébanez B, Fernández-Cidón B, Corbella E, Tebé C, Fanlo-Maresma M, Esteve-Luque V, Salas-Salvadó J, Fitó M, Riera-Mestre A, Ros E, Pintó X. The Impact of the Mediterranean Diet and Lifestyle Intervention on Lipoprotein Subclass Profiles among Metabolic Syndrome Patients: Findings of a Randomized Controlled Trial. Int J Mol Sci 2024; 25:1338. [PMID: 38279337 PMCID: PMC10817060 DOI: 10.3390/ijms25021338] [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: 12/04/2023] [Revised: 12/31/2023] [Accepted: 01/05/2024] [Indexed: 01/28/2024] Open
Abstract
Metabolic syndrome (MetS) is associated with alterations of lipoprotein structure and function that can be characterized with advanced lipoprotein testing (ADLT). The effect of the Mediterranean diet (MedDiet) and weight loss on the lipoprotein subclass profile has been scarcely studied. Within the PREDIMED-Plus randomized controlled trial, a sub-study conducted at Bellvitge Hospital recruiting center evaluated the effects of a weight loss program based on an energy-reduced MedDiet (er-MedDiet) and physical activity (PA) promotion (intervention group) compared with energy-unrestricted MedDiet recommendations (control group) on ADLT-assessed lipoprotein subclasses. 202 patients with MetS (n = 107, intervention; n = 95, control) were included. Lipid profiles were determined, and ADLT was performed at baseline, 6, and 12 months. Linear mixed models were used to assess the effects of intervention on lipoprotein profiles. Compared to the control diet, at 12 months, the er-MedDiet+PA resulted in a significant additional 4.2 kg of body weight loss, a decrease in body mass index by 1.4 kg/m2, reduction in waist circumference by 2.2 cm, decreased triglycerides, LDL-cholesterol and non-HDL-cholesterol, and increased HDL-cholesterol. In er-MedDiet+PA participants, ADLT revealed a decrease in small dense-LDL-cholesterol (sd-LDL-C), intermediate-density lipoproteins, VLDL-triglyceride, and HDL-Triglyceride, and an increase in large LDL and large VLDL particles. In conclusion, compared to an ad libitum MedDiet (control group), er-MedDiet+PA decreased plasma triglycerides and the triglyceride content in HDL and VLDL particles, decreased sd-LDL-C, and increased large LDL particles, indicating beneficial changes against cardiovascular disease.
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Affiliation(s)
- Beatriz Candás-Estébanez
- Clinical Laboratory, Bellvitge University Hospital, 08907 L’Hospitalet de Llobregat, Spain; (B.C.-E.); (B.F.-C.)
- Clinical Laboratory, SCIAS-Barcelona Hospital, 08036 Barcelona, Spain
| | - Bárbara Fernández-Cidón
- Clinical Laboratory, Bellvitge University Hospital, 08907 L’Hospitalet de Llobregat, Spain; (B.C.-E.); (B.F.-C.)
- Department of Biochemistry, Molecular Biology and Biomedicine, Autonomous University of Barcelona (UAB), 08193 Barcelona, Spain
| | - Emili Corbella
- Lipids and Vascular Risk Unit, Internal Medicine Department, Bellvitge University Hospital, 08907 L’Hospitalet de Llobregat, Spain; (E.C.); (M.F.-M.); (V.E.-L.); (A.R.-M.)
- Bellvitge Biomedical Research Institute (IDIBELL), 08907 L’Hospitalet de Llobregat, Spain;
- Center for Biomedical Research in Obesity and Nutrition Physiopathology Network (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (J.S.-S.); (M.F.); (E.R.)
| | - Cristian Tebé
- Bellvitge Biomedical Research Institute (IDIBELL), 08907 L’Hospitalet de Llobregat, Spain;
| | - Marta Fanlo-Maresma
- Lipids and Vascular Risk Unit, Internal Medicine Department, Bellvitge University Hospital, 08907 L’Hospitalet de Llobregat, Spain; (E.C.); (M.F.-M.); (V.E.-L.); (A.R.-M.)
- Bellvitge Biomedical Research Institute (IDIBELL), 08907 L’Hospitalet de Llobregat, Spain;
- Center for Biomedical Research in Obesity and Nutrition Physiopathology Network (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (J.S.-S.); (M.F.); (E.R.)
| | - Virginia Esteve-Luque
- Lipids and Vascular Risk Unit, Internal Medicine Department, Bellvitge University Hospital, 08907 L’Hospitalet de Llobregat, Spain; (E.C.); (M.F.-M.); (V.E.-L.); (A.R.-M.)
- Bellvitge Biomedical Research Institute (IDIBELL), 08907 L’Hospitalet de Llobregat, Spain;
- Center for Biomedical Research in Obesity and Nutrition Physiopathology Network (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (J.S.-S.); (M.F.); (E.R.)
| | - Jordi Salas-Salvadó
- Center for Biomedical Research in Obesity and Nutrition Physiopathology Network (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (J.S.-S.); (M.F.); (E.R.)
- Nutrition Unit, Department of Biochemistry and Biotechnology, Rovira i Virgili University Human, 43204 Reus, Spain
- Pere Virgili Health Research Institute (IISPV), San Joan de Reus University Hospital, 43204 Reus, Spain
| | - Montserrat Fitó
- Center for Biomedical Research in Obesity and Nutrition Physiopathology Network (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (J.S.-S.); (M.F.); (E.R.)
- Hospital del Mar Medical Research Institute (IMIM), 08003 Barcelona, Spain
| | - Antoni Riera-Mestre
- Lipids and Vascular Risk Unit, Internal Medicine Department, Bellvitge University Hospital, 08907 L’Hospitalet de Llobregat, Spain; (E.C.); (M.F.-M.); (V.E.-L.); (A.R.-M.)
- Bellvitge Biomedical Research Institute (IDIBELL), 08907 L’Hospitalet de Llobregat, Spain;
- Department of Medicine, School of Medicine, Bellvitge Campus, Barcelona University, 08007 Barcelona, Spain
| | - Emilio Ros
- Center for Biomedical Research in Obesity and Nutrition Physiopathology Network (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (J.S.-S.); (M.F.); (E.R.)
- Lipid Clinic, Department of Endocrinology and Nutrition, Institut d’Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, 08036 Barcelona, Spain
| | - Xavier Pintó
- Lipids and Vascular Risk Unit, Internal Medicine Department, Bellvitge University Hospital, 08907 L’Hospitalet de Llobregat, Spain; (E.C.); (M.F.-M.); (V.E.-L.); (A.R.-M.)
- Bellvitge Biomedical Research Institute (IDIBELL), 08907 L’Hospitalet de Llobregat, Spain;
- Center for Biomedical Research in Obesity and Nutrition Physiopathology Network (CIBEROBN), Carlos III Health Institute, 28029 Madrid, Spain; (J.S.-S.); (M.F.); (E.R.)
- Department of Medicine, School of Medicine, Bellvitge Campus, Barcelona University, 08007 Barcelona, Spain
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10
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Nyström T, Schwarz E, Dahlqvist S, Wijkman M, Ekelund M, Holmer H, Bolinder J, Hellman J, Imberg H, Hirsch IB, Lind M. Evaluation of Effects of Continuous Glucose Monitoring on Physical Activity Habits and Blood Lipid Levels in Persons With Type 1 Diabetes Managed With Multiple Daily Insulin Injections: An Analysis Based on the GOLD Randomized Trial (GOLD 8). J Diabetes Sci Technol 2024; 18:89-98. [PMID: 35677967 PMCID: PMC10899843 DOI: 10.1177/19322968221101916] [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] [Indexed: 11/17/2022]
Abstract
BACKGROUND People with type 1 diabetes generally view it easier to exercise when having continuous information of the glucose levels. We evaluated whether patients with type 1 diabetes managed with multiple daily insulin injections (MDI) exercised more after initiating continuous glucose monitoring (CGM) and whether the improved glycemic control and well-being associated with CGM translates into improved blood lipids and markers of inflammation. METHOD The GOLD trial was a randomized cross-over trial over 16 months where patients used either CGM or capillary self-monitoring of blood glucose (SMBG) over six months, with a four-month wash-out period between the two treatment periods. We compared grade of physical activity, blood lipids, apolipoproteins, and high-sensitivity C-reactive protein (hsCRP) levels during CGM and SMBG. RESULTS There were 116 patients with information of physical activity estimated by the International Physical Activity Questionnaire (IPAQ) during both CGM and SMBG. No changes were found during CGM or SMBG, IPAQ scores 3305 versus 3878 (P = .16). In 136 participants with information of blood lipid levels with no change in lipid-lowering medication during the two treatment periods, HbA1c differed by 4.2 mmol/mol (NGSP 0.39%) between SMBG and CGM treatment (P < .001). No significant changes existed in low-density lipoprotein, high-density lipoprotein, triglycerides, total cholesterol, apolipoprotein A1, apolipoprotein B1, or hsCRP, during CGM and SMBG. CONCLUSION Although many patients experience it easier to perform physical activity when monitoring glucose levels with CGM, it does not influence the amount of physical activity in persons with type 1 diabetes. Blood lipids, apolipoprotein, and hsCRP levels were similar during CGM and SMBG.
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Affiliation(s)
- Thomas Nyström
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Erik Schwarz
- Department of Internal Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Sofia Dahlqvist
- Department of Medicine, NU-Hospital Group, Uddevalla, Sweden
- Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Magnus Wijkman
- Department of Internal Medicine and Department of Medical and Health Sciences, Linköping University, Norrköping, Sweden
| | - Magnus Ekelund
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Helen Holmer
- Department of Internal Medicine, Centralsjukhuset, Kristianstad, Sweden
| | - Jan Bolinder
- Department of Medicine, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, Sweden
| | - Jarl Hellman
- Department of Medical Sciences, Clinical Diabetes and Metabolism, Uppsala University, Uppsala, Sweden
| | - Henrik Imberg
- Statistiska Konsultgruppen, Gothenburg, Sweden
- Department of Mathematical Sciences, Chalmers University of Technology and University of Gothenburg, Gothenburg, Sweden
| | - Irl B. Hirsch
- School of Medicine, University of Washington, Seattle, WA, USA
| | - Marcus Lind
- Department of Medicine, NU-Hospital Group, Uddevalla, Sweden
- Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Internal Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
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11
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Tremblett M, Poon AYX, Aveyard P, Albury C. What advice do general practitioners give to people living with obesity to lose weight? A qualitative content analysis of recorded interactions. Fam Pract 2023; 40:789-795. [PMID: 36510443 PMCID: PMC10745272 DOI: 10.1093/fampra/cmac137] [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] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Guidelines recommend general practitioners (GPs) take every opportunity to talk to people living with obesity about their weight, and evidence shows even very brief advice is associated with weight loss. However, little is known about what GPs say when giving brief behavioural advice, and if it reflects evidence-based recommendations for people living with obesity. To understand what behavioural advice GPs give, we categorized the content and delivery of GPs' advice during brief interventions. METHODS Qualitative content analysis was applied to 159 audio recordings of consultations from the Brief Interventions for Weight Loss (BWeL) trial, where GPs gave brief weight-loss advice to patients with a body mass index ≥30 kg/m2 (or ≥25 kg/m2 if Asian) in 137 UK surgeries. Similar content was grouped into descriptive clusters. RESULTS The results comprised 4 clusters, illuminating different aspects of the advice given: (i) Content of diet and physical activity advice, showing this was highly varied; (ii) Content of "implementation tips" given to support changes, e.g. using smaller plates; (iii) Content of signposting support, either towards further clinician support, or other resources, e.g. information booklets; (iv) Style of advice delivery, showing GPs rarely gave personalized advice, or reasons for their advice. CONCLUSIONS AND IMPLICATIONS Weight-loss advice from GPs to patients with obesity rarely included effective methods, mostly communicating a general "eat less, do more" approach. Advice was mostly generic, and rarely tailored to patients' existing knowledge and behaviours. Effectiveness of brief weight-loss advice could be improved if GPs were given clearer guidance on evidence-based recommendations.
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Affiliation(s)
- Madeleine Tremblett
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Annabel Y X Poon
- Medical Sciences, Faculty of Biology, University of Cambridge, Cambridge, United Kingdom
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Charlotte Albury
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
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12
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Lima do Vale MR, Buckner L, Mitrofan CG, Tramontt CR, Kargbo SK, Khalid A, Ashraf S, Mouti S, Dai X, Unwin D, Bohn J, Goldberg L, Golubic R, Ray S. A synthesis of pathways linking diet, metabolic risk and cardiovascular disease: a framework to guide further research and approaches to evidence-based practice. Nutr Res Rev 2023; 36:232-258. [PMID: 34839838 DOI: 10.1017/s0954422421000378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Cardiovascular disease (CVD) is the most common non-communicable disease occurring globally. Although previous literature has provided useful insights into the important role that diet plays in CVD prevention and treatment, understanding the causal role of diets is a difficult task considering inherent and introduced weaknesses of observational (e.g. not properly addressing confounders and mediators) and experimental research designs (e.g. not appropriate or well designed). In this narrative review, we organised current evidence linking diet, as well as conventional and emerging physiological risk factors, with CVD risk, incidence and mortality in a series of diagrams. The diagrams presented can aid causal inference studies as they provide a visual representation of the types of studies underlying the associations between potential risk markers/factors for CVD. This may facilitate the selection of variables to be considered and the creation of analytical models. Evidence depicted in the diagrams was systematically collected from studies included in the British Nutrition Task Force report on diet and CVD and database searches, including Medline and Embase. Although several markers and disorders linked to conventional and emerging risk factors for CVD were identified, the causal link between many remains unknown. There is a need to address the multifactorial nature of CVD and the complex interplay between conventional and emerging risk factors with natural and built environments, while bringing the life course into the spotlight.
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Affiliation(s)
| | - Luke Buckner
- NNEdPro Global Centre for Nutrition and Health, Cambridge, UK
| | | | | | | | - Ali Khalid
- NNEdPro Global Centre for Nutrition and Health, Cambridge, UK
| | - Sammyia Ashraf
- NNEdPro Global Centre for Nutrition and Health, Cambridge, UK
| | - Saad Mouti
- University of California Berkeley, Consortium for Data Analytics in Risk, Berkeley, CA, USA
| | - Xiaowu Dai
- University of California Berkeley, Consortium for Data Analytics in Risk, Berkeley, CA, USA
| | | | - Jeffrey Bohn
- University of California Berkeley, Consortium for Data Analytics in Risk, Berkeley, CA, USA
- Swiss Re Institute, Zürich, Switzerland
| | - Lisa Goldberg
- University of California Berkeley, Consortium for Data Analytics in Risk, Berkeley, CA, USA
| | - Rajna Golubic
- NNEdPro Global Centre for Nutrition and Health, Cambridge, UK
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Diabetes Trials Unit, University of Oxford, Oxford, UK
| | - Sumantra Ray
- NNEdPro Global Centre for Nutrition and Health, Cambridge, UK
- University of Ulster, School of Biomedical Sciences, Coleraine, UK
- University of Cambridge, School of the Humanities and Social Sciences, Cambridge, UK
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13
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Khadilkar A, Oza C, Mondkar SA. Insulin Resistance in Adolescents and Youth With Type 1 Diabetes: A Review of Problems and Solutions. Clin Med Insights Endocrinol Diabetes 2023; 16:11795514231206730. [PMID: 37901890 PMCID: PMC10604500 DOI: 10.1177/11795514231206730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 09/21/2023] [Indexed: 10/31/2023] Open
Abstract
Though insulin resistance (IR) was previously considered a feature of only type 2 Diabetes (T2DM), its development in type 1 Diabetes (T1DM) is not an uncommon occurrence, the causes of which are multifactorial (gender, pubertal status, diabetes duration, ethnicity, genetics, adiposity, glycemic control, chronic inflammation). Despite improvements in glucose, blood pressure and lipid profile, vascular complications (coronary artery disease and nephropathy) continue to remain common causes of morbidity and mortality in T1DM. Aggressive glycemic control reduces but does not eliminate the risk of IR. IR accelerates the development of micro and macrovascular complications, many of which can be potentially reversed if diagnosed and managed early. Lack of endogenous insulin production makes estimation of insulin sensitivity in T1DM difficult. As hyperinsulinemic-euglycemic clamp studies are cumbersome and invasive, the use of prediction equations for calculating estimated insulin sensitivity may prove to be useful. Along with intensive insulin therapy, dietary modifications and increasing physical activity, the role of Metformin in managing IR in T1DM is becoming increasingly popular. Metformin adjunct therapy in T1DM has been shown to improve insulin sensitivity, glycemic control, lipid profile, body composition, vascular smooth muscle function, thereby reducing the risk of vascular complications, as well as reversal of early vascular dysfunction. However, further studies to assess long-term efficacy and safety of Metformin use in adolescents and youth with T1DM are needed. This review aims at revisiting the pathophysiology of IR in T1DM and techniques of identifying those at risk so as to put into action various strategies for management of the same.
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Affiliation(s)
- Anuradha Khadilkar
- Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
- Interdisciplinary School of Health Sciences, Savitribai Phule University, Pune, Maharashtra, India
| | - Chirantap Oza
- Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
| | - Shruti A Mondkar
- Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
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14
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Henry JA, Astbury NM, Hartmann-Boyce J, Koshiaris C, Jebb SA. Use of Cognitive and Behavioral Strategies During a Weight Loss Program: A Secondary Analysis of the Doctor Referral of Overweight People to Low-Energy Total Diet Replacement Treatment (DROPLET) Trial. J Acad Nutr Diet 2023; 123:1417-1428.e17. [PMID: 37019430 PMCID: PMC10895506 DOI: 10.1016/j.jand.2023.03.016] [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: 04/06/2022] [Revised: 03/20/2023] [Accepted: 03/30/2023] [Indexed: 04/05/2023]
Abstract
BACKGROUND Achieving a sustained energy deficit is essential for weight loss, but the cognitive and behavioral strategies that support this goal are unclear. OBJECTIVE The goal of this study was to investigate the number and type of cognitive and behavioral strategies used by participants who were enrolled in a 1-year weight loss trial and to explore associations between strategies and magnitude of weight loss at 3 months and 1 year. DESIGN The study is a secondary post-hoc exploratory analysis of data collected as part of the Doctor Referral of Overweight People to Low-Energy total diet replacement Treatment (DROPLET), a randomized controlled trial conducted in general practices in England, United Kingdom, between January 2016 and August 2017. PARTICIPANTS/SETTING This study involved 164 participants from both intervention and control groups of the DROPLET trial who completed the Oxford Food and Behaviours (OxFAB) questionnaire to assess the use of 115 strategies grouped into 21 domains used to manage their weight. INTERVENTIONS Participants were randomized to either a behavioral weight loss program involving 8 weeks total diet replacement (TDR) and 4 weeks of food reintroduction or a program delivered by a medical practice nurse over a 3-month period (usual care [UC]). MAIN OUTCOME MEASURES Weight was objectively measured at baseline, 3 months, and 1 year. Cognitive and behavioral strategies used to support weight loss were assessed using the OxFAB questionnaire at 3 months. STATISTICAL ANALYSIS PERFORMED Exploratory factor analysis was used to generate data-driven patterns of strategy use, and a linear mixed-effects model was used to examine associations between use of these patterns and weight change. RESULTS No evidence was found of a difference in the number of strategies (mean difference, 2.41; 95% confidence interval [CI], -0.83, 5.65) or the number of domains used (mean difference, -0.23; 95% CI, -0.69, 0.23) between the TDR group and the UC group. The number of strategies was not associated with weight loss at either 3 months (-0.02 kg; 95% CI, -0.11, 0.06) or 1 year (-0.05 kg; 95% CI, -0.14, 0.02). Similarly, the number of domains used was not associated with weight loss at 3 months (-0.02 kg; 95% CI, -0.53, 0.49) or 1 year (-0.07 kg; 95% CI, -0.60, 0.46). Factor analysis identified four coherent patterns of strategy use, identified as Physical Activity, Motivation, Planned Eating, and Food Purchasing patterns. Greater use of strategies in the Food Purchasing (-2.6 kg; 95% CI, -4.42, -0.71) and Planned Eating patterns (-3.20 kg; 95% CI, -4.94, -1.46) was associated with greater weight loss at 1 year. CONCLUSIONS The number of cognitive and behavioral strategies or domains used does not appear to influence weight loss, but the types of strategy appear of greater importance. Supporting people to adopt strategies linked to planned eating and food purchasing may aid long-term weight loss.
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Affiliation(s)
| | - Nerys M. Astbury
- Address correspondence to: Nerys M. Astbury, PhD, Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care, Woodstock Road, Oxford OX2 6GG UK.
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15
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Abstract
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the United States. The development and progression of atherosclerotic CVD are largely dependent on a multitude of modifiable and nonmodifiable risk factors. Current therapeutic strategies involve risk factor modification, especially dyslipidemia. The treatment of dyslipidemia continues to be dynamic, and in this paper, we review the current strategies for risk assessment, diagnosis, and treatment. As treatments for the management of dyslipidemia continue to evolve with ever-increasing options for therapeutic targets, an understanding of lipid-lowering therapies remains an essential topic of understanding for all health care providers.
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Affiliation(s)
- Jennifer Ballard-Hernandez
- Cardiology Division, Department of Medicine; Department of Veterans Affairs, VA Long Beach Healthcare System, 5901 East 7th Street, Long Beach, CA 90822, USA.
| | - James Sall
- Evidence-Based Practice Program, Veterans Health Administration, 811 Vermont Avenue, Northwest, Washington, DC 20420, USA
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16
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Maimaitiyiming M, Yang H, Li H, Xu C, Li S, Zhou L, Zhang X, Wang Y. The association of obesity-related dietary patterns and main food groups derived by reduced-rank regression with cardiovascular diseases incidence and all-cause mortality: findings from 116,711 adults. Eur J Nutr 2023; 62:2605-2619. [PMID: 37219593 DOI: 10.1007/s00394-023-03177-x] [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: 10/26/2022] [Accepted: 05/15/2023] [Indexed: 05/24/2023]
Abstract
PURPOSE Research about using reduced-rank regression (RRR) to simultaneously study the effects of both individual and combined consumption of foods on cardiovascular diseases (CVD) is scarce. METHODS This study included 116,711 CVD-free participants (a median of 11.8 year follow-up) with 2 or more 24-h online dietary assessments. A total of 210 food items were classified into 45 food groups, and the mean amount of each food group was used in RRR to derive dietary patterns (DPs) explaining the maximum shared variation in obesity-related indicators. The associations of DPs and its main food groups (|factor loading| [Formula: see text] 0.2) with the incident CVD and all-cause mortality were examined by Cox model. In cross-sectional analyses, the associations of DP scores with cardiometabolic risk factors (biomarkers) were examined by linear regression. RESULTS The derived DP was characterized by higher intakes of beer and cider, high-sugar beverages, processed meat, red meat, artificial sweetener, and crisps, chips and savory snacks, and lower intakes of olive oil, high fiber breakfast cereals, tea, and vegetable. Compared to the lowest dietary score quintile, those in the highest were associated with higher risks of total CVD (adjusted-HR: 1.45, 95% CI 1.33-1.57) and all-cause mortality (adjusted-HR 1.31, 95% CI 1.18-1.45). We observed consumption alone of these food groups had a consistent but limited health effect on total CVD and all-cause death incidence. These associations were modified by age and sex. Higher DP scores were related to adverse biomarkers profiles. CONCLUSIONS We developed obesity-related DPs prospectively associated with increased risks of CVD and all-cause mortality.
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Affiliation(s)
| | - Hongxi Yang
- Department of Bioinformatics, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Huiping Li
- School of Public Health, Tianjin Medical University, Qixiangtai Road 22, Heping District, Tianjin, 300070, China
| | - Chenjie Xu
- School of Public Health, Hangzhou Normal University, Hangzhou, China
| | - Shu Li
- School of Management, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Lihui Zhou
- School of Public Health, Tianjin Medical University, Qixiangtai Road 22, Heping District, Tianjin, 300070, China
| | - Xinyu Zhang
- School of Public Health, Tianjin Medical University, Qixiangtai Road 22, Heping District, Tianjin, 300070, China
| | - Yaogang Wang
- School of Public Health, Tianjin Medical University, Qixiangtai Road 22, Heping District, Tianjin, 300070, China.
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17
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Khalafi M, Sakhaei MH, Kazeminasab F, Rosenkranz SK, Symonds ME. Exercise training, dietary intervention, or combined interventions and their effects on lipid profiles in adults with overweight and obesity: A systematic review and meta-analysis of randomized clinical trials. Nutr Metab Cardiovasc Dis 2023; 33:1662-1683. [PMID: 37414662 DOI: 10.1016/j.numecd.2023.05.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/09/2023] [Accepted: 05/18/2023] [Indexed: 07/08/2023]
Abstract
AIMS We performed a systematic review and meta-analysis to compare the effects of Ex (exercise training) vs. DI (dietary intervention) vs. combined Ex and DI on total cholesterol (TC), low-density lipoprotein cholesterol (LDL), triglycerides (TG), and high-density lipoprotein cholesterol (HDL) in adults with overweight and obesity. DATA SYNTHESIS PubMed, Web of Science, and Scopus were searched to identify original articles published until March 2022, using keywords for the categories "exercise training," "dietary intervention," "overweight and obesity," and "randomized." Studies that included lipid profiles as outcomes and performed in adults with body mass indexes (BMIs) ≥ 25 kg/m2 were included. A total of 80 studies involving 4804 adult participants were included in the meta-analysis. Ex was not as effective as DI for reducing TC and TG and was less effective for reducing LDL. In addition, Ex increased HDL to a greater extent than DI. Combined interventions decreased TC, TG, and LDL but did not increase HDL more than Ex alone. Combined interventions failed to reduce TC or LDL but decreased TG and increased HDL more than DI alone. CONCLUSIONS Our results suggest that the combination of Ex and DI can be more effective than either Ex or DI alone in improving lipid profiles in adults with overweight and obesity.
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Affiliation(s)
- Mousa Khalafi
- Department of Physical Education and Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran.
| | - Mohammad Hossein Sakhaei
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Guilan, Guilan, Iran.
| | - Fatemeh Kazeminasab
- Department of Physical Education and Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran.
| | - Sara K Rosenkranz
- Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, NV, USA.
| | - Michael E Symonds
- Centre for Perinatal Research, Academic Unit of Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, United Kingdom.
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Capra ME, Biasucci G, Crivellaro E, Banderali G, Pederiva C. Dietary intervention for children and adolescents with familial hypercholesterolaemia. Ital J Pediatr 2023; 49:77. [PMID: 37349839 DOI: 10.1186/s13052-023-01479-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 05/25/2023] [Indexed: 06/24/2023] Open
Abstract
Familial hypercholesterolaemia (FH) is a frequent genetic disorder characterised by high plasma levels of total and LDL-cholesterol and premature atherosclerosis. If left untreated, affected subjects have a high risk of cardiovascular disease, as they are exposed to very high levels of LDL-cholesterol from birth. Healthy dietary habits and lifestyle are the first treatment option and, if started from childhood, represent a milestone in the prevention of atherosclerotic disease, both as a starting point and in combination with drug therapy. In this work, based on the main consensus documents available so far, we have evaluated the most up-to-date indications of the dietetic-nutritional intervention for the treatment of FH, delving into the peculiar aspects of the diet of the child/adolescent affected by FH. After an analysis of the macro- and micronutrients and the most common dietary patterns currently recommended, we highlighted some practical aspects, some frequent errors and some risks we could fall into when dealing with paediatric nutritional treatment. In conclusion, the dietary intervention for the child/adolescent with FH is a complex task, that should be individualised and tailored taking into account, first of all, the nutritional adequacy for growth and development, but also the multiple aspects linked to the child/adolescent's age, tastes and preferences, the family they belong to, the socio-economic context and the Country they live in.
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Affiliation(s)
- Maria Elena Capra
- Centre for Paediatric DyslipidaemiasPaediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, University of Parma, 29121, Piacenza, Italy
- Department of Translational Medical and Surgical Sciences, University of Parma, 43126, Parma, Italy
- Società Italiana Di Nutrizione Pediatrica (SINUPE), 20126, Milan, Italy
| | - Giacomo Biasucci
- Centre for Paediatric DyslipidaemiasPaediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, University of Parma, 29121, Piacenza, Italy.
- Società Italiana Di Nutrizione Pediatrica (SINUPE), 20126, Milan, Italy.
| | | | - Giuseppe Banderali
- Società Italiana Di Nutrizione Pediatrica (SINUPE), 20126, Milan, Italy
- Clinical Service for DyslipidaemiasStudy and Prevention of Atherosclerosis in ChildhoodPediatrics Unit, ASST-Santi Paolo E Carlo, 20142, Milan, Italy
| | - Cristina Pederiva
- Società Italiana Di Nutrizione Pediatrica (SINUPE), 20126, Milan, Italy
- Clinical Service for DyslipidaemiasStudy and Prevention of Atherosclerosis in ChildhoodPediatrics Unit, ASST-Santi Paolo E Carlo, 20142, Milan, Italy
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Peila R, Xue X, Qi Q, Dannenberg AJ, Allison MA, Johnson KC, LaMonte MJ, Wild RA, Haring B, Pan K, Tindle HA, Foraker R, Saquib N, Barac A, Rohan TE. Healthy Lifestyle Index and Risk of Cardiovascular Disease Among Postmenopausal Women With Normal Body Mass Index. J Am Heart Assoc 2023; 12:e029111. [PMID: 37306150 PMCID: PMC10356042 DOI: 10.1161/jaha.122.029111] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/30/2023] [Indexed: 06/13/2023]
Abstract
Background A lifestyle comprising a healthy diet, light alcohol consumption, no smoking, and moderate or intense physical activity has been associated with reduced risk of cardiovascular disease (CVD). We examined the association of a healthy lifestyle index (HLI), derived from scores for each of these components plus waist circumference, with the risk of incident CVD and CVD subtypes in postmenopausal women with normal body mass index (18.5-<25.0 kg/m2). Methods and Results We studied 40 118 participants in the Women's Health Initiative, aged 50 to 79 years at enrollment, with a normal body mass index and no history of CVD. The HLI score was categorized into quintiles. We estimated multivariable adjusted hazard ratios (HR) and 95% CIs for the association of HLI with risk of CVD and CVD subtypes using Cox regression models. A total of 3821 cases of incident CVD were ascertained during a median follow-up of 20.1 years. Compared with the lowest quintile (unhealthiest lifestyle), higher HLI quintiles showed inverse associations with the risk of CVD (HRquintile-2=0.74 [95% CI, 0.67-0.81]; HRquintile-3=0.66 [95% CI, 0.60-0.72]; HRquintile-4=0.57 [95% CI, 0.51-0.63]; and HRquintile-5=0.48 [95% CI, 0.43-0.54], P-trend=<0.001). HLI was also inversely associated with risks of stroke, coronary heart disease, myocardial infarction, angina, and coronary revascularization. Subgroup analyses, stratified by age (≤63 years vs >63 years), body mass index (≥ 22.0 kg/m2), and general health status (absence/presence of hypertension, diabetes, or lipid-lowering drug use) also showed inverse associations between HLI and risk of CVD. Conclusions Among postmenopausal women with a normal body mass index, adherence to a healthy lifestyle is associated with a reduced risk of clinical CVD and CVD subtypes, underscoring the cardiovascular benefits of maintaining a healthy lifestyle, even for women with a healthy weight.
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Affiliation(s)
- Rita Peila
- Department of Epidemiology and Population HealthAlbert Einstein College of Medicine, BronxNYNew York CityUSA
| | - Xiaonan Xue
- Department of Epidemiology and Population HealthAlbert Einstein College of Medicine, BronxNYNew York CityUSA
| | - Qibin Qi
- Department of Epidemiology and Population HealthAlbert Einstein College of Medicine, BronxNYNew York CityUSA
| | | | | | - Karen C. Johnson
- Department of Preventive MedicineThe University of TennesseeTNMemphisUSA
| | - Michael J. LaMonte
- Department of Epidemiology and Environmental HealthUniversity of BuffaloNYUSA
| | - Robert A. Wild
- Department of Obstetrics and Gynecology and Biostatistics and EpidemiologyUniversity of Oklahoma Health Sciences CenterOKOklahoma CityUSA
| | - Bernhard Haring
- Department of CardiologyUniversity Heart Center Graz, Medical University of GrazGrazAustria
| | - Kathy Pan
- Department of Hematology/OncologyKaiser Permanente Southern CaliforniaCADowneyUSA
| | - Hilary A. Tindle
- Department of MedicineVanderbilt University Medical CenterTNNashvilleUSA
| | - Randi Foraker
- Department of MedicineWashington University at St. LouisMOSt. LouisUSA
| | - Nazmus Saquib
- College of Medicine at Sulaiman Al Rajhi UniversityBukariyahSaudi Arabia
| | - Ana Barac
- MedStar Heart and Vascular InstituteGeorgetown UniversityDCWashingtonUSA
| | - Thomas E. Rohan
- Department of Epidemiology and Population HealthAlbert Einstein College of Medicine, BronxNYNew York CityUSA
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20
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Cachero K, Mollard R, Myrie S, MacKay D. A clinically managed weight loss program evaluation and the impact of COVID-19. Front Nutr 2023; 10:1167813. [PMID: 37396123 PMCID: PMC10311994 DOI: 10.3389/fnut.2023.1167813] [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: 02/16/2023] [Accepted: 05/19/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction With the prevalence of obesity increasing, many weight-loss programs were created to aid in combating the trend. The Weight Loss Clinic (WLC) was created to provide personalized support for lifestyle changes using a multidisciplinary team with medical oversight. This study evaluated the clinically-managed weight loss program at the Wellness Institute. Methods This was a prospective evaluation of a newly established program between January 2019-August 2020. Participants who entered the weight loss program were approached to learn about the evaluation. A total of 41 participants were included. The primary outcomes included changes in body weight and achievement of more than 5% initial body weight loss. Outcome measures were collected pre-and post-program and the data was analyzed through paired t-tests on R studio. Results Greater body weight-loss was seen in completers pre-COVID-19 compared to those who completed during the pandemic (Mean, ±SD; 7.51 ± 6.24 kg n = 13 p < 0.001 vs. 1.75 ± 4.43 kg n = 9, p = 0.02). Completers pre-COVID-19 demonstrated improvements in waist circumference, Framingham risk score, blood pressure, hemoglobin A1C, and body fat percentage. Conclusions and implications Though the sample size was small to show definitve evidence, the results may suggest the program worked well prior to the pandemic but the pandemic created barriers to weight-loss for participants.
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Affiliation(s)
- Katrina Cachero
- Department of Food and Human Nutritional Sciences, University of Manitoba and the Chronic Disease Innovation Centre, Winnipeg, MB, Canada
| | - Rebecca Mollard
- Department of Food and Human Nutritional Sciences, University of Manitoba and the Chronic Disease Innovation Centre, Winnipeg, MB, Canada
- Chronic Disease Innovation Centre, Seven Oaks General Hospital, Winnipeg, MB, Canada
| | - Semone Myrie
- Department of Food and Human Nutritional Sciences, University of Manitoba and the Chronic Disease Innovation Centre, Winnipeg, MB, Canada
| | - Dylan MacKay
- Department of Food and Human Nutritional Sciences, University of Manitoba and the Chronic Disease Innovation Centre, Winnipeg, MB, Canada
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21
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Li YY, Yang YM, Zhu S, Cheng H, Hernandez J, Huang W, Wang HHX, Li YT. Changes in body weight and cardiovascular risk factors in a Chinese population with type 2 diabetes mellitus: a longitudinal study. Front Endocrinol (Lausanne) 2023; 14:1112855. [PMID: 37124734 PMCID: PMC10130380 DOI: 10.3389/fendo.2023.1112855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 03/03/2023] [Indexed: 05/02/2023] Open
Abstract
Introduction The primary care management of blood glucose, blood pressure, lipid profiles, and body weight is important among patients with type 2 diabetes mellitus (T2DM) to prevent disease progression. Information on how weight changes would improve or deteriorate cardiovascular (CV) risk factors is warranted for making primary care recommendations. We aimed to investigate the changes in body weight and CV risk factors and to analyse their association in a Chinese population with T2DM. Methods We retrieved longitudinal data between 2020 and 2021 from 1,758 adult primary care patients enrolled in a diabetic retinopathy (DR) screening programme. Linear associations of changes in body weight with CV risk factors were explored. Multivariable logistic regression analysis was performed to examine associations between different weight change categories and the worsening of CV risk factors. Results The mean age of all the participants was 63.71 years, and over half of participants were females. During a one-year follow-up period, 24.7% of patients had a weight loss of ≥3%, while 22.2% of patients had a weight gain of ≥3%. Patients who had a weight loss of ≥3% were more likely to prevent the worsening of haemoglobin A1c (HbA1c) and triglycerides, while those who had a weight gain of ≥3% tended to have worsened HbA1c, lipid profiles, and blood pressure. Conclusion Results from this real-world investigation suggested the concurrent need for weight loss intervention among patients who are overweight or obese and weight gain prevention among patients whose body weight falls within the normal range in the context of community-based diabetes management.
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Affiliation(s)
- Yun-Yi Li
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Yu-Meng Yang
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Sufen Zhu
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Hui Cheng
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Jose Hernandez
- Faculty of Medicine and Health, EDU, Digital Education Holdings Ltd., Kalkara, Malta
- Green Templeton College, University of Oxford, Oxford, United Kingdom
| | - Wenyong Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Harry H. X. Wang
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Usher Institute, Deanery of Molecular, Genetic & Population Health Sciences, The University of Edinburgh, Scotland, United Kingdom
| | - Yu Ting Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
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22
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Kwon SY, Kim G, Lee J, Park J, Lee YB, Jin SM, Hur KY, Kim JH. Association of body weight change with all-cause and cause-specific mortality: A nationwide population-based study. Diabetes Res Clin Pract 2023; 199:110666. [PMID: 37031890 DOI: 10.1016/j.diabres.2023.110666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 03/09/2023] [Accepted: 04/04/2023] [Indexed: 04/11/2023]
Abstract
AIMS Weight gain and loss increase the risk of all-cause mortality. This study explored the association of short-term weight change with all-cause and cause-specific mortality in middle-aged to older people. METHODS This was a 8.4-year retrospective cohort study of 645,260 adults aged 40 to 80 who underwent health checkups twice within a 2-year interval between January 2009 and December 2012. Cox analyses were used to analyze the association between short-term weight change and all-cause and cause-specific mortality. RESULTS Weight gain and loss were associated with an increased risk of all-cause mortality: the hazard ratios were 2.05 (95% confidence interval [CI], 1.93-2.16), 1.21 (95% CI, 1.16-1.25), 1.12 (95% CI 1.08-1.17), and 1.60 (95% CI, 1.49-1.70) for the severe weight loss, moderate weight loss, moderate weight gain, and severe weight gain groups, respectively. This U-shaped association was also seen between weight change and cause-specific mortality. Within the weight loss group, those who regained weight after two years had a reduced mortality risk. CONCLUSIONS In a middle-aged and elderly population, weight gain or loss of more than 3% during a 2-year interval was related to an elevated risk of all-cause and cause-specific mortality.
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Affiliation(s)
- So Yoon Kwon
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam‑gu, Seoul, Korea
| | - Gyuri Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam‑gu, Seoul, Korea
| | - Jungkuk Lee
- Data Science Team, Hanmi Pharm. Co., Ltd., Seoul, Korea
| | - Jiyun Park
- Division of Endocrine and Metabolism, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Bundang-gu, Seongnam, Gyeonggi-do, Korea
| | - You-Bin Lee
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam‑gu, Seoul, Korea
| | - Sang-Man Jin
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam‑gu, Seoul, Korea
| | - Kyu Yeon Hur
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam‑gu, Seoul, Korea
| | - Jae Hyeon Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam‑gu, Seoul, Korea; Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, Korea.
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23
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Sato N, Miyamoto M, Santa R, Homma C, Shibuya K. The effect of background music tempo on eating speed and food intake volume within in healthy women. Nutr Health 2023:2601060231158234. [PMID: 36802995 DOI: 10.1177/02601060231158234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
BACKGROUND The effects of the different tempos of background music (BGM) on food intake and eating speed have not been fully studied. AIM The study aimed to investigate the influence of changing the tempo of BGM during meals on food intake and to explore strategies to support appropriate eating behavior. METHODS Twenty-six healthy young adult women participated in this study. In the experimental phase, each participant ate a meal under three separate conditions: fast (120% speed), moderate (original, 100% speed), and slow (80% speed) BGM. The same music was used for each condition, and appetite before and after eating, the amount of food consumed, and eating speed were recorded. RESULTS The results showed that food intake (g, mean ± standard error (SE)) was slow: 317.9 ± 22.2, moderate: 400.7 ± 16.0, and fast: 342.9 ± 22.0. Eating speed (g/s, mean ± SE) was slow: 28.1 ± 2.8, moderate: 34.2 ± 2.7, and fast: 27.2 ± 2.4. The analysis showed that the moderate condition showed greater speed than the fast and slow conditions (slow-fast: p = .008; moderate-slow: p = .012; moderate-fast: p = .004). Moreover, the food intake in the moderate condition was significantly higher than that in the slow and fast conditions (moderate-slow: p < .001; moderate-fast: p < .001), and there was no significant difference between the slow and fast conditions in this regard (p = .077). CONCLUSION These results suggest that original tempo BGM led to higher food intake compared to the faster and slower tempo conditions. These findings suggest that listening to music at an original tempo during meals may support appropriate eating behavior.
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Affiliation(s)
- Naoto Sato
- Graduate School of Health and Welfare, Niigata University of Health and Welfare, Japan
- Department of Health and Nutrition, 526830Yamagata Prefectural Yonezawa University of Nutrition Sciences, Japan
| | - Mana Miyamoto
- Department of Health and Nutrition, 52757Niigata University of Health and Welfare, Japan
| | - Risa Santa
- Department of Health and Nutrition, 52757Niigata University of Health and Welfare, Japan
| | - Chihiro Homma
- Department of Health and Nutrition, 52757Niigata University of Health and Welfare, Japan
| | - Kenichi Shibuya
- Department of Health and Nutrition, 52757Niigata University of Health and Welfare, Japan
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Pekarovics S, Beres A, Kelly C, Billes SK, Heaton AL. Stress-associated weight gain, fibromyalgia symptoms, cardiometabolic markers, and human growth hormone suppression respond to an amino acid supplement blend: Results of a prospective, cohort study. Front Endocrinol (Lausanne) 2023; 14:1053692. [PMID: 36998474 PMCID: PMC10043493 DOI: 10.3389/fendo.2023.1053692] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 01/31/2023] [Indexed: 03/18/2023] Open
Abstract
INTRODUCTION An orally administered amino acid-based test supplement was recently shown to increase human growth hormone (hGH) in healthy adults. This prospective, observational, single-center, single-arm cohort study investigated the effects of 24 weeks of daily oral administration of the test supplement in individuals with stress-related weight gain, fibromyalgia (FM) and stress-related low-normal hGH production (15-30th percentile for age-appropriate levels) on insulin-like growth factor 1 (IGF-1), an indicator of hGH levels caused by stress related stimulation of somatostatin. METHODS Participants continued to receive standard care. The primary endpoint was the change from baseline to endpoint (Week 24) in serum IGF-1. Additional endpoints included the change in body weight, clinical symptoms (assessed with the Revised Fibromyalgia Impact Questionnaire [FIQR], range 0-100, and Perceived Stress Scale [PSS], range 0-40), fasting cardiometabolic markers, tolerability, and safety. The study enrolled 84 fibromyalgia patients with low-normal age-adjusted IGF-1 serum levels. High mean ± Standard Deviation (SD) baseline FIQR and PSS scores of 76 ± 16 and 32 ± 5, respectively, indicated poor to moderate symptom management with standard care. All individuals completed 24 weeks. RESULTS Serum IGF-1 levels increased with a Week 24 mean± Standard Error (SE) change of 28.4 ± 3.0 ng/mL (p<0.001). Body weight was reduced with a Week 24 mean ± SE change of -5.5 ± 0.3 kg (p<0.001) (a 6.5% weight loss from baseline). The change from baseline in FIQR and PSS scores were -29.1 ± 1.1 and -20.0 ± 0.8, respectively (both p<0.001), indicating a substantial improvement. Statistically significant improvements from baseline to Week 24 were observed in systolic and diastolic blood pressure, HbA1c, LDL and HDL cholesterol, and triglycerides (all p<0.001). The supplement was well tolerated; no adverse events were reported. DISCUSSION Sustained augmentation of IGF-1 with the test supplement may represent a novel method of improving clinical symptoms, including stress-related weight gain, in individuals with fibromyalgia and stress-associated low-normal hGH.
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Affiliation(s)
- Susan Pekarovics
- Susan Pekarovics, MD, Professional Medical Corporation, Los Angeles, CA, United States
- Attending Physician, Cedars-Sinai Medical Center, Los Angeles, CA, United States
- *Correspondence: Susan Pekarovics,
| | - Adam Beres
- Susan Pekarovics, MD, Professional Medical Corporation, Los Angeles, CA, United States
| | - Colleen Kelly
- Kelly Statistical Consulting, San Diego, CA, United States
| | | | - Amy L. Heaton
- Sierra Research Group, LLC, Salt Lake City, UT, United States
- Pennington Biomedical Research Center, Baton Rouge, LA, United States
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25
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Zeng B, Pan H, Li F, Ye Z, Liu Y, Du J. Comparative efficacy of different eating patterns in the management of type 2 diabetes and prediabetes: An arm-based Bayesian network meta-analysis. J Diabetes Investig 2022; 14:263-288. [PMID: 36514864 PMCID: PMC9889690 DOI: 10.1111/jdi.13935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/26/2022] [Accepted: 10/13/2022] [Indexed: 12/15/2022] Open
Abstract
AIMS/INTRODUCTION Diet therapy is a vital approach to manage type 2 diabetes and prediabetes. However, the comparative efficacy of different eating patterns is not clear enough. We aimed to compare the efficacy of various eating patterns for glycemic control, anthropometrics, and serum lipid profiles in the management of type 2 diabetes and prediabetes. MATERIALS AND METHODS We conducted a network meta-analysis using arm-based Bayesian methods and random effect models, and drew the conclusions using the partially contextualized framework. We searched twelve databases and yielded 9,534 related references, where 107 studies were eligible, comprising 8,909 participants. RESULTS Eleven diets were evaluated for 14 outcomes. Caloric restriction was ranked as the best pattern for weight loss (SUCRA 86.8%) and waist circumference (82.2%), low-carbohydrate diets for body mass index (81.6%), and high-density lipoprotein (84.0%), and low-glycemic-index diets for total cholesterol (87.5%) and low-density lipoprotein (86.6%). Other interventions showed some superiorities, but were imprecise due to insufficient participants and needed further investigation. The attrition rates of interventions were similar. Meta-regression suggested that macronutrients, energy intake, and weight may modify outcomes differently. The evidence was of moderate-to-low quality, and 38.2% of the evidence items met the minimal clinically important differences. CONCLUSIONS The selection and development of dietary strategies for diabetic/prediabetic patients should depend on their holistic conditions, i.e., serum lipid profiles, glucometabolic patterns, weight, and blood pressure. It is recommended to identify the most critical and urgent metabolic indicator to control for one specific patient, and then choose the most appropriate eating pattern accordingly.
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Affiliation(s)
| | - Hui‐qing Pan
- School of MedicineTongji UniversityShanghaiChina
| | - Feng‐dan Li
- Nursing DepartmentXiang'an Hospital of Xiamen UniversityXiamenChina
| | - Zhen‐yu Ye
- School of MedicineXiamen UniversityXiamenChina
| | - Yang Liu
- School of MedicineXiamen UniversityXiamenChina
| | - Ji‐wei Du
- Institute of EducationXiamen UniversityXiamenChina,Present address:
The University of Hong Kong‐Shenzhen Hospital Ringgold standard institution ‐ Nursing Department1 Haiyuan 1st RoadShenzhen518040China
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26
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Tremblett M, Webb H, Ziebland S, Stokoe E, Aveyard P, Albury C. Talking delicately: Providing opportunistic weight loss advice to people living with obesity. SSM. QUALITATIVE RESEARCH IN HEALTH 2022; 2:None. [PMID: 36531292 PMCID: PMC9748302 DOI: 10.1016/j.ssmqr.2022.100162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 08/24/2022] [Accepted: 08/24/2022] [Indexed: 01/26/2023]
Abstract
Obesity is a major worldwide public health problem. Clinicians are asked to communicate public health messages, including encouraging and supporting weight loss, during consultations with patients living with obesity. However, research shows that talking about weight with patients rarely happens and both parties find it difficult to initiate. Current guidelines on how to have such conversations do not include evidence-based examples of what to say, when to say it and how to avoid causing offence (a key concern for clinicians). To address this gap, we examined 237 audio recorded consultations between clinicians and patients living with obesity in the UK in which weight was discussed opportunistically. Conversation analysis revealed that framing advice as depersonalised generic information was one strategy clinicians used when initiating discussions. This contrasted to clinicians who made advice clearly relevant and personalised to the patient by first appraising their weight. However not all personalised forms of advice worked equally well. Clinicians who spoke delicately when personalising the discussion avoided the types of patient resistance that we found when clinicians were less delicate. More delicate approaches included forecasting upcoming discussion of weight along with delicacy markers in talk (e.g. strategic use of hesitation). Our findings suggest that clinicians should not avoid talking about a patient's weight, but should speak delicately to help maintain good relationships with patients. The findings also demonstrate the need to examine communication practices to develop better and specific guidance for clinicians. Data are in British English.
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Affiliation(s)
- Madeleine Tremblett
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
| | - Helena Webb
- School of Computer Science, University of Nottingham, UK
| | - Sue Ziebland
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
| | - Elizabeth Stokoe
- Discourse and Rhetoric Group, Loughborough University, Loughborough, UK
| | - Paul Aveyard
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
| | - Charlotte Albury
- Nuffield Department of Primary Care Health Sciences, University of Oxford, UK
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27
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Dhungana RR, Pedisic Z, de Courten M. Implementation of non-pharmacological interventions for the treatment of hypertension in primary care: a narrative review of effectiveness, cost-effectiveness, barriers, and facilitators. BMC PRIMARY CARE 2022; 23:298. [PMID: 36418958 PMCID: PMC9686020 DOI: 10.1186/s12875-022-01884-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 10/13/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The current guidelines for the prevention, detection, evaluation, and management of hypertension recommend six types of non-pharmacological interventions: alcohol reduction, salt intake reduction, increased potassium intake, physical activity, weight loss, and heart-healthy diets. However, the non-pharmacological interventions are still not widely used in primary care. In this paper, we, therefore, reviewed and summarised the evidence on the effectiveness, cost-effectiveness, barriers, and facilitators of non-pharmacological interventions for the treatment of hypertension in primary care. METHODS A thorough literature search was conducted in Embase, Google Scholar, and PubMed databases, to identify the most recent reviews or, in their absence, primary studies on alcohol reduction, salt intake reduction, potassium supplementation, physical activity, weight reduction, heart-healthy diets, and other non-pharmacological interventions for the treatment of hypertension in primary care. RESULTS Alcohol reduction is a non-pharmacological intervention for the treatment of hypertension in primary care with proven effectiveness, feasibility, and acceptability. Interventions for sodium intake reduction, physical activity, and weight reduction are effective but there is insufficient evidence regarding their feasibility and acceptability in primary care settings. Evidence on the effectiveness of potassium intake and heart-healthy diets is limited and inconsistent. There is a lack of evidence on the cost-effectiveness of non-pharmacological interventions in the treatment of hypertension. The most common barriers to deliver such interventions related to healthcare providers include a lack of time, knowledge, self-confidence, resources, clear guidelines, and financial incentives. The most common barriers related to patients include a lack of motivation and educational resources. Less evidence is available on facilitators of implementing non-pharmacological interventions in primary care. Besides, facilitators differed by different types of interventions. CONCLUSIONS Available evidence suggests that more pragmatic, clinically feasible, and logistically simple interventions are required for sodium intake reduction, physical activity, and weight reduction in primary care settings. Future studies should provide further evidence on the effectiveness of weight control, potassium intake, and heart-healthy diets. More research is also needed on cost-effectiveness and facilitators of all types of effective non-pharmacological interventions for the treatment of hypertension in primary care.
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Affiliation(s)
- Raja Ram Dhungana
- Institute for Health and Sport, Victoria University, Melbourne, Australia.
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
| | - Zeljko Pedisic
- Institute for Health and Sport, Victoria University, Melbourne, Australia
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28
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He M, Wang J, Liang Q, Li M, Guo H, Wang Y, Deji C, Sui J, Wang YW, Liu Y, Zheng Y, Qian B, Chen H, Ma M, Su S, Geng H, Zhou WX, Guo X, Zhu WZ, Zhang M, Chen Z, Rensen PC, Hui CC, Wang Y, Shi B. Time-restricted eating with or without low-carbohydrate diet reduces visceral fat and improves metabolic syndrome: A randomized trial. Cell Rep Med 2022; 3:100777. [PMID: 36220069 PMCID: PMC9589024 DOI: 10.1016/j.xcrm.2022.100777] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 07/24/2022] [Accepted: 09/20/2022] [Indexed: 11/30/2022]
Abstract
Overconsumption of carbohydrate-rich food combined with adverse eating patterns contributes to the increasing incidence of metabolic syndrome (MetS) in China. Therefore, we conducted a randomized trial to determine the effects of a low-carbohydrate diet (LCD), an 8-h time-restricted eating (TRE) schedule, and their combination on body weight and abdominal fat area (i.e., primary outcomes) and cardiometabolic outcomes in participants with MetS. Compared with baseline, all 3-month treatments significantly reduce body weight and subcutaneous fat area, but only TRE and combination treatment reduce visceral fat area (VFA), fasting blood glucose, uric acid (UA), and dyslipidemia. Furthermore, compared with changes of LCD, TRE and combination treatment further decrease body weight and VFA, while only combination treatment yields more benefits on glycemic control, UA, and dyslipidemia. In conclusion, without change of physical activity, an 8-h TRE with or without LCD can serve as an effective treatment for MetS (ClinicalTrials.gov: NCT04475822).
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Affiliation(s)
- Mingqian He
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Jingya Wang
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Qian Liang
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Meng Li
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Hui Guo
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Yue Wang
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Cuomu Deji
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Jing Sui
- Department of Endocrinology and International Medical Center, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Ya-wen Wang
- Biobank, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China,Department of Laboratory Medicine, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Yufeng Liu
- Biobank, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Yixuan Zheng
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Buyue Qian
- Network and Information Center, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Huaixi Chen
- Network and Information Center, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Mao Ma
- Physical Examination Center, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Shi Su
- Physical Examination Center, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Hui Geng
- Physical Examination Center, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Wen-xu Zhou
- Department of Internal Medicine, The Hospital of Xi’an JiaoTong University, No. 28, West Xianning Road, Xi’an, Shaanxi 710049, P.R. China
| | - Xiaoxiao Guo
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Wen-zhi Zhu
- Med-X institute, Center for Immunological and Metabolic Diseases, the First Affiliated Hospital of Xi’an JiaoTong University, Xi’an JiaoTong University, Xi’an, Shaanxi 710061, P.R. China
| | - Meng Zhang
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Ziyi Chen
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China
| | - Patrick C.N. Rensen
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China,Department of Medicine, Division of Endocrinology, Leiden University Medical Center, P.O. Box 9600, 2300 Leiden, the Netherlands
| | - Chi-chung Hui
- Program in Developmental & Stem Cell Biology, The Hospital for Sick Children, and Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Yanan Wang
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China,Med-X institute, Center for Immunological and Metabolic Diseases, the First Affiliated Hospital of Xi’an JiaoTong University, Xi’an JiaoTong University, Xi’an, Shaanxi 710061, P.R. China,Corresponding author
| | - Bingyin Shi
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, No. 277, West Yanta Road, Xi’an, Shaanxi 710061, P.R. China,Corresponding author
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29
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Konikowska K, Bombała W, Szuba A, Różańska D, Regulska-Ilow B. Metabolic Syndrome Is Associated with Low Diet Quality Assessed by the Healthy Eating Index-2015 (HEI-2015) and Low Concentrations of High-Density Lipoprotein Cholesterol. Biomedicines 2022; 10:biomedicines10102487. [PMID: 36289749 PMCID: PMC9599166 DOI: 10.3390/biomedicines10102487] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 11/16/2022] Open
Abstract
Presenting diet quality of patients with metabolic syndrome (MetS), using a holistic approach is more useful than investigating dietary individual components, but there is still a small amount of research in this area. The aim of this study assessed the diet quality, as measured by the HEI-2015, of MetS patients compared to healthy individuals. The study and control group consisted of 215 patients with MetS and 320 people without MetS, respectively. A nutritional analysis using a semi-quantitative food frequency questionnaire was used to evaluate the nutritional habits in the study and control group. Total HEI-2015 scores were significantly lower in MetS subjects than in those in the control group (65.04 ± 9.71 vs. 66.75 ± 8.88) and the quality of women’s diets was better than the quality of men’s diet (66.83 ± 8.99 vs. 64.75 ± 9.57). We also observed that low HDL-c concentration increased the risk of MetS in the general population the most. Across the population, there was a weak positive correlation between HDL-c concentrations and total HEI-2015 scores and a weak negative correlation between mean waist circumference values and total HEI-2015 scores. HDL-c concentrations may be a key factor in the prevention of MetS and appropriate therapeutic management to increase HDL-c levels may be of key importance in patients diagnosed with MetS.
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Affiliation(s)
- Klaudia Konikowska
- Department of Dietetics, Wroclaw Medical University, Borowska Street 211, 50-556 Wroclaw, Poland
- Correspondence:
| | - Wojciech Bombała
- Statistical Analysis Center, Wroclaw Medical University, Marcinkowski Street 2-6, 50-368 Wroclaw, Poland
| | - Andrzej Szuba
- Department of Angiology, Hypertension and Diabetology, Wroclaw Medical University, Borowska Street 213, 50-556 Wroclaw, Poland
| | - Dorota Różańska
- Department of Dietetics, Wroclaw Medical University, Borowska Street 211, 50-556 Wroclaw, Poland
| | - Bożena Regulska-Ilow
- Department of Dietetics, Wroclaw Medical University, Borowska Street 211, 50-556 Wroclaw, Poland
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30
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Orozco-Beltrán D, Brotons Cuixart C, Banegas Banegas JR, Gil Guillén VF, Cebrián Cuenca AM, Martín Rioboó E, Jordá Baldó A, Vicuña J, Navarro Pérez J. [Cardiovascular preventive recommendations. PAPPS 2022 thematic updates. Working groups of the PAPPS]. Aten Primaria 2022; 54 Suppl 1:102444. [PMID: 36435583 PMCID: PMC9705225 DOI: 10.1016/j.aprim.2022.102444] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 07/21/2022] [Indexed: 11/24/2022] Open
Abstract
The recommendations of the semFYC's Program for Preventive Activities and Health Promotion (PAPPS) for the prevention of cardiovascular diseases (CVD) are presented. The following sections are included: epidemiological review, where the current morbidity and mortality of CVD in Spain and its evolution as well as the main risk factors are described; cardiovascular (CV) risk and recommendations for the calculation of CV risk; main risk factors such as arterial hypertension, dyslipidemia and diabetes mellitus, describing the method for their diagnosis, therapeutic objectives and recommendations for lifestyle measures and pharmacological treatment; indications for antiplatelet therapy, and recommendations for screening of atrial fibrillation, and recommendations for management of chronic conditions. The quality of testing and the strength of the recommendation are included in the main recommendations.
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Affiliation(s)
- Domingo Orozco-Beltrán
- Medicina Familiar y Comunitaria, Unidad de Investigación Centro de Salud Cabo Huertas, Departamento San Juan de Alicante. Departamento de Medicina Clínica, Universidad Miguel Hernández, San Juan de Alicante, España.
| | - Carlos Brotons Cuixart
- Medicina Familiar y Comunitaria. Instituto de Investigación Biomédica (IIB) Sant Pau. Equipo de Atención Primaria Sardenya, Barcelona, España
| | - Jose R Banegas Banegas
- Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, España
| | - Vicente F Gil Guillén
- Medicina Familiar y Comunitaria, Hospital Universitario de Elda. Departamento de Medicina Clínica. Universidad Miguel Hernández, San Juan de Alicante, España
| | - Ana M Cebrián Cuenca
- Medicina Familiar y Comunitaria, Centro de Salud Cartagena Casco Antiguo, Instituto Murciano de Investigación Biosanitaria (IMIB), 30120 Murcia, España
| | - Enrique Martín Rioboó
- Medicina Familiar y Comunitaria, Especialista en Medicina Familiar y Comunitaria, Centro de Salud Poniente, Córdoba, IMIBIC Hospital Reina Sofía Córdoba. Colaborador del grupo PAPPS
| | - Ariana Jordá Baldó
- Medicina Familiar y Comunitaria, Centro de Salud San Miguel, Plasencia, Badajoz, España
| | - Johanna Vicuña
- Medicina Preventiva y Salud Pública, Hospital de la Sant Creu i Sant Pau, Barcelona, España
| | - Jorge Navarro Pérez
- Medicina Familiar y Comunitaria, Hospital Clínico Universitario. Departamento de Medicina. Universidad de Valencia. Instituto de Investigación INCLIVA, Valencia, España
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31
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Woźniak J, Woźniak K, Wojciechowska O, Wrzosek M, Włodarek D. Effect of Age and Gender on the Efficacy of a 12-Month Body Weight Reduction Program Conducted Online-A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12009. [PMID: 36231310 PMCID: PMC9566561 DOI: 10.3390/ijerph191912009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/19/2022] [Accepted: 09/21/2022] [Indexed: 06/16/2023]
Abstract
Overweight and obesity are a cause of many non-communicable diseases leading to an increased risk of death. There are many programs aimed at weight reduction, but few publications have evaluated their effectiveness according to the gender and age of the subjects. The purpose of this study is to evaluate the effects of age and gender on weight loss outcomes in subjects participating in a 12-month online weight loss program. 400 subjects, 190 men and 210 women, were included in the study. The online intervention consisted of a 15% energy deficit diet and training (RESPO method). Changes in body weight over 12 months were similar (p = 0.14) across age groups. Weight reductions by month were statistically significant (p = 0.0001) in both groups. We noted no differences in weight loss between men and women expressed in kilograms. However, women reduced their body weight to a greater extent, i.e., by 2.7 percentage points, than men. Gender is a factor that may influence the effectiveness of weight loss programs, while age demonstrates no such influence. Our study shows that significant weight reduction during weight loss therapy is achieved by both men and women, but women can expect better results.
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Affiliation(s)
- Jakub Woźniak
- Department of Dietetics, Institute of Human Nutrition, Warsaw University of Life Sciences (WULS–SGGW), Nowoursynowska 159 C, 02-776 Warsaw, Poland
| | | | | | | | - Dariusz Włodarek
- Department of Dietetics, Institute of Human Nutrition, Warsaw University of Life Sciences (WULS–SGGW), Nowoursynowska 159 C, 02-776 Warsaw, Poland
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32
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Tannock LR. Management of Dyslipidemia in Endocrine Diseases. Endocrinol Metab Clin North Am 2022; 51:589-602. [PMID: 35963630 PMCID: PMC9382690 DOI: 10.1016/j.ecl.2022.02.003] [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] [Indexed: 11/22/2022]
Abstract
Most endocrine disorders are chronic in nature, and thus even a minor effect to increase risk for cardiovascular disease can lead to a significant impact over prolonged duration. Although robust therapies exist for many endocrine disorders (eg suppression of excess hormone amounts, or replacement of hormone deficiencies), the therapies do not perfectly restore normal physiology. Thus, individuals with endocrine disorders are at potential increased cardiovascular disease risk, and maximizing strategies to reduce that risk are needed. This article reviews various endocrine conditions that can impact lipid levels and/or cardiovascular disease risk.
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Affiliation(s)
- Lisa R Tannock
- Division of Endocrinology, Diabetes, and Metabolism, University of Kentucky, Department of Veterans Affairs, MN145, 780 Rose Street, Lexington, KY 40536, USA.
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Ling J, Tang H, Meng H, Wu L, Zhu L, Zhu S. Two-year outcomes of Roux-en-Y gastric bypass vs medical treatment in type 2 diabetes with a body mass index lower than 32.5 kg/m 2: a multicenter propensity score-matched analysis. J Endocrinol Invest 2022; 45:1729-1740. [PMID: 35596918 DOI: 10.1007/s40618-022-01811-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 04/25/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Roux-en-Y gastric bypass (RYGB) has been widely reported to be safe and feasible, and has a powerful effect on improving metabolism and weight loss in patients with a high body mass index (BMI). A few studies have focused on the comparison of RYGB with medical treatment in type 2 diabetes (T2D) patients with a lower BMI. OBJECTIVES To compare the metabolic effects and safety of RYGB versus medical treatment during a 2 years follow-up in T2D patients with a BMI of 25 to 32.5 kg/m2. METHODS This retrospective and multicenter cohort study participants were extracted from the T2D patients with a lower BMI (25-32.5 kg/m2) from three bariatric centers between 2009 and 2018. Propensity score matching (PSM) was used to minimize bias, and each patient in the surgical group was matched 1:2 to the patients in the medical group with the closest propensity score. Finally, 71 patients who received RYGB and 142 patients who underwent medical treatment with a 2 years follow-up were enrolled to compare the effects of RYGB and medical treatment. The primary endpoint was achievement of the triple endpoint (the simultaneous achievement of hemoglobin A1c (HbA1c) < 7.0%, fasting low-density lipoprotein cholesterol (LDL-C) < 100 mg/dL (2.6 mmol/L), and systolic blood pressure (SBP) < 130 mmHg at the year-1 visit). Changes in weight, BMI, medication usage, complications, and adverse events were assessed. RESULTS In total, 213 patients (mean age of 47.4 ± 9.5 years, 70.4% male, mean BMI of 28.6 ± 2.2 kg/m2) were included in this study. At the end of the first year, 17 patients (23.9%) in the surgical group and 10 (7.0%) in the medical group had achieved the composite triple endpoint (OR 4.64; 95% CI 1.82-11.81; p = 0.001). Additionally, 43 patients (60.6%) in the surgical group and 11 patients (19.7%) in the medical group experienced remission of T2D. However, more complications were observed in the surgical group (36 vs. 22, p < 0.01). CONCLUSIONS Among T2D patients with a BMI between 25.0 and 32.5 kg/m2, RYGB was more effective than medical treatment in resolving metabolic disorders and also resulted in more complications. The risk for complications should be considered in the clinical decision-making process for T2D patients with a low BMI.
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Affiliation(s)
- J Ling
- Department of Metabolic and Bariatric Surgery, The Third Xiangya Hospital of Central South University, 138 Tongzipo Rd, Yuelu District, Changsha, 410013, China
| | - H Tang
- Department of Metabolic and Bariatric Surgery, The Third Xiangya Hospital of Central South University, 138 Tongzipo Rd, Yuelu District, Changsha, 410013, China
| | - H Meng
- Department of General Surgery, The China-Japan Friendship Hospital, Beijing, China
| | - L Wu
- Department of Metabolic Surgery, The Jinshazhou Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - L Zhu
- Department of Metabolic and Bariatric Surgery, The Third Xiangya Hospital of Central South University, 138 Tongzipo Rd, Yuelu District, Changsha, 410013, China.
| | - S Zhu
- Department of Metabolic and Bariatric Surgery, The Third Xiangya Hospital of Central South University, 138 Tongzipo Rd, Yuelu District, Changsha, 410013, China.
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Effectiveness of a 12-Month Online Weight Reduction Program in Cohorts with Different Baseline BMI-A Prospective Cohort Study. Nutrients 2022; 14:nu14163281. [PMID: 36014787 PMCID: PMC9416047 DOI: 10.3390/nu14163281] [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: 06/20/2022] [Revised: 08/06/2022] [Accepted: 08/09/2022] [Indexed: 11/29/2022] Open
Abstract
The purpose of this article was to answer the question of whether people who want to reduce their body weight can achieve different results depending on their baseline BMI and whether the rate of weight loss is constant over the months of intervention. The study included 400 individuals aged 19 to 55 years with a mean BMI of 31.83 ± 4.77 (min 25.1 max 51.8). Men comprised 190 subjects and women 210 subjects. The participants were divided into three groups with the following BMI: overweight, class 1 obesity, and obesity class > 1 (class 2 and 3 combined). BMI groups were randomized by gender, the number of trainings per week, training time, intervention length, and intervention type. The online intervention consisted of a 15% energy deficit diet and training. Over the 12-month dietary intervention, overweight subjects reduced average body weight by 16.6%. The group with class 1 obesity reduced body weight by 15.7%. The group with obesity class > 1 reduced mean body weight by 15.4%. The relative weight reduction in the overweight group was significantly greater than in the other obesity groups (p = 0.007). In all groups, the rate of weight loss from month-to-month was statistically significant (p = 0.0001), ranging between 0.6 and 2.6% per month. The results indicate that overweight individuals are likely to experience a percent greater weight loss as a result of a comprehensive lifestyle intervention. Regardless of baseline BMI, the observed weight loss was consistent from month-to-month throughout the 12-month period, which may indicate that the diet, as well as, the training plan were properly tailored to the subjects’ needs and that they were highly motivated to participate in the program throughout its course. Properly conducted lifestyle intervention enables significant weight loss regardless of baseline BMI values.
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35
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Yannakoulia M, Mamalaki E, Poulimenas D. Intentional weight loss and mortality in middle-aged and older adults: A narrative review. Maturitas 2022; 165:100-103. [DOI: 10.1016/j.maturitas.2022.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/22/2022] [Accepted: 07/27/2022] [Indexed: 11/15/2022]
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36
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Adherence to lifestyle advice and its related cardiovascular disease risk among US adults with high cholesterol. Clin Nutr ESPEN 2022; 51:267-273. [DOI: 10.1016/j.clnesp.2022.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/11/2022] [Indexed: 11/20/2022]
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37
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Effects of Exercise on Heart Failure with Preserved Ejection Fraction: An Updated Review of Literature. J Cardiovasc Dev Dis 2022; 9:jcdd9080241. [PMID: 36005405 PMCID: PMC9409671 DOI: 10.3390/jcdd9080241] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/17/2022] [Accepted: 07/20/2022] [Indexed: 12/12/2022] Open
Abstract
Heart failure with preserved ejection fraction (HFpEF) represents the most common HF phenotype of patients aged > 65 years, with an incidence and a prevalence that are constantly growing. The HFpEF cardinal symptom is exercise intolerance (EI), defined as the impaired ability to perform physical activity and to reach the predicted age-related level of exercise duration in the absence of symptoms—such as fatigue or dyspnea—and is associated with a poor quality of life, a higher number of hospitalizations, and poor outcomes. The evidence of the protective effect between exercise and adverse cardiovascular outcomes is numerous and long-established. Regular exercise is known to reduce cardiovascular events and overall mortality both in apparently healthy individuals and in patients with established cardiovascular disease, representing a cornerstone in the prevention and treatment of many cardio-metabolic conditions. Several studies have investigated the role of exercise in HFpEF patients. The present review aims to dwell upon the effects of exercise on HFpEF. For this purpose, the relevant data from a literature search (PubMed, EMBASE, and Medline) were reviewed. The analysis of these studies underlines the fact that exercise training programs improve the cardiorespiratory performance of HFpEF patients in terms of the increase in peak oxygen uptake, the 6 min walk test distance, and the ventilatory threshold; on the other hand, diastolic or systolic functions are generally unchanged or only partially modified by exercise, suggesting that multiple mechanisms contribute to the improvement of exercise tolerance in HFpEF patients. In conclusion, considering that exercise training programs are able to improve the cardiorespiratory performance of HFpEF patients, the prescription of exercise training programs should be encouraged in stable HFpEF patients, and further research is needed to better elucidate the pathophysiological mechanisms underpinning the beneficial effects described.
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Oo WM, Mobasheri A, Hunter DJ. A narrative review of anti-obesity medications for obese patients with osteoarthritis. Expert Opin Pharmacother 2022; 23:1381-1395. [PMID: 35855642 DOI: 10.1080/14656566.2022.2104636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION : The prevalence of both obesity and osteoarthritis (OA) are increasing worldwide (twindemic), and the association between the two chronic diseases is also well-established. AREAS COVERED : In this narrative review, we will briefly describe the double burdens of both diseases, the impact of weight loss or gain on OA incidence and structural progression and discuss the biomechanical and anti-inflammatory mechanisms mediating these effects. FDA-approved anti-obesity drugs are summarized in terms of their clinical efficacy and safety profile, and the completed or ongoing phase 2/3 clinical trials of such drugs in OA patients with obesity are examined. EXPERT OPINION : We will discuss the perspectives related to principles of prescription of anti-obesity drugs, the potential role of phenotype-guided approach, time to drug effects in clinical trials, sustainability of weight loss based on the real-world studies, the importance of concomitant therapies such as dieting and exercises, and the role of weight loss on non-weight bearing OA joints. Although obesity is the major risk factor for OA pathogenesis and progression, and there are a variety of anti-obesity medications on the market, research on the use of these disease-modifying drugs in OA (DMOAD) is still sparse..
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Affiliation(s)
- Win Min Oo
- Rheumatology Department, Royal North Shore Hospital, and Institute of Bone and Joint Research, Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Department of Physical Medicine and Rehabilitation, Mandalay General Hospital, University of Medicine, Mandalay, Mandalay, Myanmar
| | - Ali Mobasheri
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland.,Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania.,Department of Joint Surgery, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.,World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liege, Belgium
| | - David J Hunter
- Rheumatology Department, Royal North Shore Hospital, and Institute of Bone and Joint Research, Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
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Effects of 2-Year Nutritional and Lifestyle Intervention on Oxidative and Inflammatory Statuses in Individuals of 55 Years of Age and over at High Cardiovascular Risk. Antioxidants (Basel) 2022; 11:antiox11071326. [PMID: 35883817 PMCID: PMC9312253 DOI: 10.3390/antiox11071326] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/30/2022] [Accepted: 07/04/2022] [Indexed: 11/16/2022] Open
Abstract
Obesity and overweight are disorders with high impact on the morbidity and mortality of chronic diseases, such as type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVD). We aim to assess the effects of 2-year nutritional and lifestyle intervention on oxidative and inflammatory status in individuals of 55 years of age and over at high CVD risk. Participants (n = 100 individuals of 55 years of age and over living in the Balearic Islands, Spain) were randomized into control and intervention group. Anthropometric and haematological parameters, blood pressure and physical activity were measured before and after the intervention. Oxidative and inflammatory biomarkers in plasma, urine, peripheral blood mononuclear cells (PBMCs) and neutrophils were determined. A higher reduction in abdominal obesity, blood pressure and triglycerides levels was observed after a 2-year intervention. An improvement of oxidative stress and proinflammatory status was demonstrated with a significant reduction in myeloperoxidase, xanthine oxidase, malondialdehyde and monocyte chemoattractant protein-1 (MCP1) levels, and an increase in polyphenols in plasma was observed. A decrease in reactive oxygen species production in PBMCs and neutrophils levels after zymosan and lipopolysaccharide activation was found in the intervention group with respect to the control group. The intervention with hypocaloric Mediterranean Diet and customized physical activity improves oxidative stress and proinflammatory status and could contribute to decreasing the CVD risk.
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Cholesterol-Lowering Therapy in Patients at Low-to-Moderate Cardiovascular Risk. High Blood Press Cardiovasc Prev 2022; 29:327-336. [PMID: 35759179 PMCID: PMC9262762 DOI: 10.1007/s40292-022-00529-2] [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: 03/21/2022] [Accepted: 06/05/2022] [Indexed: 12/16/2022] Open
Abstract
Elevated low-density lipoprotein cholesterol (LDL-C) is unanimously recognized as a major modifiable risk factor related to the development of atherosclerotic cardiovascular disease (ASCVD). Consistent evidence confirms that reducing LDL-C is associated with reduction of major adverse cardiovascular events (MACEs), with benefits proportionally related to initial individual CV risk and absolute reduction of LDL-C levels. The recent European guidelines on cardiovascular prevention have proposed a revised approach in cardiovascular risk evaluation, taking into account a renewed consideration of the interaction between risk factors and possible confounding factors (e.g., age). Although for patients considered to be at high and very high cardiovascular risk the need for stringent risk factors treatment is clearly stated, for those who are at low-to-moderate cardiovascular risk the issue is more debated. For those latter subjects, current guidelines indicate that risk factor treatment is generally not necessary, unless the impact of CV risk modifiers, lifetime CV risk and treatment benefit may be substantial. In addition, despite the estimated low-to-moderate short-term CV risk, the early appearance of even mild LDL-C level elevations may contribute to impair long-term CV prognosis. Therefore, encouraging the achievement of desired LDL-C goals through tailored conservative lifestyle changes and, if necessary, pharmacologic strategies should not be excluded categorically in all low-to-moderate risk individuals. In this review, we summarize the most recent evidence that may influence the choice to treat or not to treat LDL-C elevations in subjects at low-to-moderate risk and the suggested therapeutic tools aimed at achieving the recommended LDL-C goals.
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Li X, Song Y, Guo T, Xiao G, Li Q. Effect of Glucagon-like Peptide 1 Receptor Agonists on the Renal Protection in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis. DIABETES & METABOLISM 2022; 48:101366. [PMID: 35760374 DOI: 10.1016/j.diabet.2022.101366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 06/15/2022] [Accepted: 06/15/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND . - Glucagon-like peptide 1(GLP-1) receptor agonists are used in patients with type 2 diabetes as hypoglycemic drugs; a growing body of evidence has clarified their renoprotective benefits. We performed a meta-analysis to summarize the most recent evidence on the renal benefits of GLP-1 receptor agonists from clinical trials of patients with type 2 diabetes. METHODS . - This meta-analysis used a fixed-effects model to estimate the risk ratio (RR) with 95% confidence intervals (CIs) to investigate the effect of GLP-1 receptor agonists on the renal protection. The outcomes were a composite renal outcome, estimated glomerular filtration rate (eGFR) decrease, new macroalbuminuria, doubling of serum creatinine, end-stage renal disease (ESRD) and renal death. We also checked the composite renal outcome of the patient subgroups based on the structural source of human GLP-1 or exendin-4. RESULTS . - Among the 12 articles screened, seven studies involving 48101 patients met pre-specified criteria and were included. In general, the use of GLP-1 receptor agonists reduced the risk of the composite renal outcome by 17% (RR 0•83 [95% CI 0•79-0•88]; P < 0•00001), with no significant interaction in subgroups analysis (P = 0.66); the risk of new-onset of persistent macroalbuminuria was reduced by 25% (RR 0•75 [95%CI 0•69-0•81]; P < 0•00001) compared to placebo. However, GLP-1 receptor agonists had no significant effect on eGFR decrease (RR 0•92 [95% CI 0•83-1.01]; P = 0•09), doubling of serum creatinine (RR 0•97 [95% CI 0•78-1.21]; P = 0•79), or end-stage renal disease (RR 0•81 [95% CI 0•62-1.06]; P = 0•12) compared to placebo or insulin glargine (AWARD-7) in patients with type 2 diabetes. CONCLUSION . - GLP-1 receptor agonists, regardless of their structural homology, have significant benefits in reducing the risk of the composite renal outcome, especially in new macroalbuminuria compared with placebo or insulin glargine in patients with type 2 diabetes.
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Affiliation(s)
- Xiang Li
- Department of Endocrinology and Metabolic Diseases, Dalian University Affiliated Xinhua Hospital, Dalian Liaoning 116021, China
| | - Yujie Song
- Department of Endocrinology and Metabolic Diseases, Dalian University Affiliated Xinhua Hospital, Dalian Liaoning 116021, China
| | - Tao Guo
- Department of Endocrinology and Metabolic Diseases, Dalian University Affiliated Xinhua Hospital, Dalian Liaoning 116021, China
| | - Guiying Xiao
- Department of Endocrinology and Metabolic Diseases, Dalian University Affiliated Xinhua Hospital, Dalian Liaoning 116021, China
| | - Qiumei Li
- Department of Endocrinology and Metabolic Diseases, Dalian University Affiliated Xinhua Hospital, Dalian Liaoning 116021, China.
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Grabia M, Markiewicz-Żukowska R, Socha K, Polkowska A, Zasim A, Boruch K, Bossowski A. Prevalence of Metabolic Syndrome in Relation to Cardiovascular Biomarkers and Dietary Factors among Adolescents with Type 1 Diabetes Mellitus. Nutrients 2022; 14:nu14122435. [PMID: 35745165 PMCID: PMC9228781 DOI: 10.3390/nu14122435] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/06/2022] [Accepted: 06/10/2022] [Indexed: 12/18/2022] Open
Abstract
The occurrence of metabolic syndrome (MetS) significantly affects the course of diabetes mellitus (DM), resulting in deterioration of insulin sensitivity and metabolic control, as well as many cardiometabolic complications. The aim of the study was to investigate the relationships between cardiovascular biomarkers, nutritional status, dietary factors and the occurrence of MetS among 120 participants from northeast Poland (adolescents with type 1 DM and healthy peers). MetS was assessed using several criteria: nutritional status by anthropometric measurements, body composition analysis by bioelectrical impedance, and diet using a food diary and questionnaire. MetS was diagnosed in every third diabetic. Compared to healthy peers, MetS patients had higher total body fat (26% vs. 14%, p < 0.001) and visceral fat (77 cm2 vs. 35 cm2, p < 0.001), and lower total antioxidant status (1.249 mmol/L vs. 1.579 mmol/L, p < 0.001). Additionally, their diet was rich in saturated fatty acids, but low in dietary fiber as well as mono- and polyunsaturated fatty acids. The group of diabetics reported many inappropriate eating behaviors. The combination of those with the presence of an excessive content of visceral fat tissue and abnormal values of MetS components may negatively affect metabolic control, thus accelerating the development of cardiometabolic complications.
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Affiliation(s)
- Monika Grabia
- Department of Bromatology, Faculty of Pharmacy with the Division of Laboratory Medicine, Medical University of Białystok, Mickiewicza 2D Street, 15-222 Białystok, Poland; (M.G.); (K.S.)
| | - Renata Markiewicz-Żukowska
- Department of Bromatology, Faculty of Pharmacy with the Division of Laboratory Medicine, Medical University of Białystok, Mickiewicza 2D Street, 15-222 Białystok, Poland; (M.G.); (K.S.)
- Correspondence: ; Tel.: +48-85-748-5469
| | - Katarzyna Socha
- Department of Bromatology, Faculty of Pharmacy with the Division of Laboratory Medicine, Medical University of Białystok, Mickiewicza 2D Street, 15-222 Białystok, Poland; (M.G.); (K.S.)
| | - Agnieszka Polkowska
- Clinic of Paediatrics, Endocrinology, Diabetology with Subdivision of Cardiology, Children’s University Clinical Hospital in Białystok, 15-274 Białystok, Poland; (A.P.); (A.Z.); (A.B.)
| | - Aneta Zasim
- Clinic of Paediatrics, Endocrinology, Diabetology with Subdivision of Cardiology, Children’s University Clinical Hospital in Białystok, 15-274 Białystok, Poland; (A.P.); (A.Z.); (A.B.)
| | - Karolina Boruch
- Clinic of Paediatrics, Rheumatology, Immunology and Bone Metabolic Diseases, Children’s University Clinical Hospital in Białystok, 15-274 Białystok, Poland;
| | - Artur Bossowski
- Clinic of Paediatrics, Endocrinology, Diabetology with Subdivision of Cardiology, Children’s University Clinical Hospital in Białystok, 15-274 Białystok, Poland; (A.P.); (A.Z.); (A.B.)
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Guan C, Zahid S, Minhas AS, Ouyang P, Vaught A, Baker VL, Michos ED. Polycystic ovary syndrome: a "risk-enhancing" factor for cardiovascular disease. Fertil Steril 2022; 117:924-935. [PMID: 35512976 DOI: 10.1016/j.fertnstert.2022.03.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 03/11/2022] [Accepted: 03/11/2022] [Indexed: 12/12/2022]
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women of reproductive age and is hallmarked by hyperandrogenism, oligo-ovulation, and polycystic ovarian morphology. Polycystic ovary syndrome, particularly the hyperandrogenism phenotype, is associated with several cardiometabolic abnormalities, including obesity, dyslipidemia, elevated blood pressure, and prediabetes or type 2 diabetes. Many, but not all, studies have suggested that PCOS is associated with increased risk of cardiovascular disease (CVD), including coronary heart disease and stroke, independent of body mass index and traditional risk factors. Interpretation of the data from these observational studies is limited by the varying definitions and ascertainment of PCOS and CVD across studies. Recent Mendelian randomization studies have challenged the causality of PCOS with coronary heart disease and stroke. Future longitudinal studies with clearly defined PCOS criteria and newer genetic methodologies may help to determine association and causality. Nevertheless, CVD risk screening remains critical in this patient population, as improvements in metabolic profile and reduction in CVD risk are achievable with a combination of lifestyle management and pharmacotherapy. Statin therapy should be implemented in women with PCOS who have elevated atherosclerotic CVD risk. If CVD risk is uncertain, measurement of subclinical atherosclerosis (carotid plaque or coronary artery calcium) may be a useful tool to guide shared decision-making about initiation of statin therapy. Other medications, such as metformin and glucagon-like peptide-1 receptor agonists, also may be useful in reducing CVD risk in insulin-resistant populations. Additional research is needed to determine the best pathways to mitigate PCOS-associated CVD risk.
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Affiliation(s)
- Carolyn Guan
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Salman Zahid
- Sands-Constellation Heart Institute, Rochester General Hospital, Rochester, New York
| | - Anum S Minhas
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Pamela Ouyang
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Arthur Vaught
- Division of Maternal Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Valerie L Baker
- Division of Reproductive Endocrinology and Infertility, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Erin D Michos
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
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Park CS, Choi YJ, Rhee TM, Lee HJ, Lee HS, Park JB, Kim YJ, Han KD, Kim HK. U-Shaped Associations Between Body Weight Changes and Major Cardiovascular Events in Type 2 Diabetes Mellitus: A Longitudinal Follow-up Study of a Nationwide Cohort of Over 1.5 Million. Diabetes Care 2022; 45:1239-1246. [PMID: 35263435 DOI: 10.2337/dc21-2299] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 02/10/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Despite the benefits of weight loss on metabolic profiles in patients with type 2 diabetes mellitus (T2DM), its association with myocardial infarction (MI), ischemic stroke (IS), atrial fibrillation (AF), heart failure (HF), and all-cause death remains elusive. RESEARCH DESIGN AND METHODS Using the National Health Insurance Service Database, we screened subjects who underwent general health checkups twice in a 2-year interval between 2009 and 2012. After identifying 1,522,241 patients with T2DM without a previous history of MI, IS, AF, and HF, we followed them until December 2018. Patients were stratified according to the magnitude of weight changes between two general health checkups: ≤ -10%, -10 to ≤ -5%, -5 to ≤5%, 5 to ≤10%, and >10%. RESULTS During the follow-up (median 7.0 years), 32,106 cases of MI, 44,406 cases of IS, 34,953 cases of AF, 68,745 cases of HF, and 84,635 all-cause deaths occurred. Patients with weight changes of -5 to ≤5% showed the lowest risk of each cardiovascular event. Both directions of weight change were associated with an increased cardiovascular risk. Stepwise increases in the risks of MI, IS, AF, HF, and all-cause death were noted with progressive weight gain (all P < 0.0001). Similarly, the more weight loss occurred, the higher the cardiovascular risks observed (all P < 0.0001). The U-shaped associations were consistently observed in both univariate and multivariate analyses. Explorative subgroup analyses also consistently showed a U-shaped association. CONCLUSIONS Both weight loss and gain >5% within a 2-year interval were associated with an increased risk of major cardiovascular events in patients with T2DM.
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Affiliation(s)
- Chan Soon Park
- Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - You-Jung Choi
- Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Tae-Min Rhee
- Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyun Jung Lee
- Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hee-Sun Lee
- Cardiovascular Center, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Republic of Korea
| | - Jun-Bean Park
- Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Yong-Jin Kim
- Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kyung-Do Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Hyung-Kwan Kim
- Cardiovascular Center, Seoul National University Hospital, Seoul, Republic of Korea
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Overweight, Obesity, and CVD Risk: a Focus on Visceral/Ectopic Fat. Curr Atheroscler Rep 2022; 24:185-195. [PMID: 35235165 DOI: 10.1007/s11883-022-00996-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2021] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW Despite its prevalence and well-documented impact on population health, obesity has not emerged as a strong independent risk factor for cardiovascular disease after control for intermediate risk factors. The purpose of this brief narrative review is to highlight results from imaging studies that have not only documented the remarkable heterogeneity of body fat topography but also the importance of visceral adiposity as a key body fat depot associated with cardiovascular disease risk and type 2 diabetes. RECENT FINDINGS Simple tools are also discussed in order to refine cardiometabolic risk assessment in persons with overweight/obesity. It is proposed that four lifestyle vital signs should be considered in clinical practice to improve discrimination of health risk in individuals with overweight/obesity: waist circumference as a simple marker of abdominal adiposity, cardiorespiratory fitness, overall diet quality, and level of reported physical activity. Heterogeneity of obesity is proposed as an example of a condition that would benefit from a precision lifestyle medicine approach.
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Hu J, Hu Y, Hertzmark E, Yuan C, Liu G, Stampfer MJ, Rimm EB, Hu FB, Wang M, Sun Q. Weight Change, Lifestyle, and Mortality in Patients With Type 2 Diabetes. J Clin Endocrinol Metab 2022; 107:627-637. [PMID: 34741524 PMCID: PMC9006974 DOI: 10.1210/clinem/dgab800] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT The association between weight change and mortality among participants with incident type 2 diabetes (T2D) was unclear. OBJECTIVE To examine above association and evaluate the impact of lifestyle on it. METHODS This prospective analysis included 11 262 incident T2D patients from Nurses' Health Study and Health Professionals Follow-up Study. We assessed weight change bracketing T2D diagnosis in relation to mortality. We also examined potential effect modification by a healthy lifestyle consisting of high-quality diet, regular physical activity, nonsmoking status, and moderate alcohol consumption. RESULTS On average, T2D patients lost 2.3 kg during a 2-year time window spanning the T2D diagnosis, and body weight increased afterwards following a trajectory similar to that of nondiabetics. Compared with patients with a stable weight, T2D patients who lost ≥10% body weight had a 21% (95% CI, 9%-35%) increased all-cause mortality. Lifestyle significantly modified these associations: the hazard ratios (95% CIs) of all-cause mortality comparing ≥10% weight loss with stable weight were 1.63 (1.26-2.09) among participants with a deteriorated lifestyle, 1.27 (1.11-1.46) for a stable lifestyle, and 1.02 (0.81-1.27) for an improved lifestyle (Pinteraction < 0.001). Major weight loss was associated with increased cause-specific mortality and similar effect modifications by lifestyle were also observed. CONCLUSION Significant weight loss upon T2D incidence was associated with increased mortality, although improved lifestyle quality abolished these associations. These results highlight the role of adopting a healthy lifestyle for newly diagnosed T2D patients, especially among those who might lose weight unintentionally, and improving long-term survival.
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Affiliation(s)
| | | | - Ellen Hertzmark
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Chen Yuan
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA
| | - Gang Liu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Meir J Stampfer
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Eric B Rimm
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Molin Wang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Qi Sun
- Correspondence: Qi Sun, MD, ScD, Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Ave., Boston, MA 02115, USA.
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Chlabicz M, Jamiołkowski J, Łaguna W, Dubatówka M, Sowa P, Łapińska M, Szpakowicz A, Zieleniewska N, Zalewska M, Raczkowski A, Kamiński KA. Effectiveness of Lifestyle Modification vs. Therapeutic, Preventative Strategies for Reducing Cardiovascular Risk in Primary Prevention-A Cohort Study. J Clin Med 2022; 11:jcm11030688. [PMID: 35160138 PMCID: PMC8836845 DOI: 10.3390/jcm11030688] [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: 12/30/2021] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Cardiovascular diseases (CVD) are still the leading cause of death in developed countries. The aim of this study was to calculate the potential for CV risk reduction when using three different prevention strategies to evaluate the effect of primary prevention. METHODS A total of 931 individuals aged 20-79 years old from the Bialystok PLUS Study were analyzed. The study population was divided into CV risk classes. The Systematic Coronary Risk Estimation (SCORE), Framingham Risk Score (FRS), and LIFE-CVD were used to assess CV risk. The optimal prevention strategy assumed the attainment of therapeutic goals according to the European guidelines. The moderate strategy assumed therapeutic goals in participants with increased risk factors: a reduction in systolic blood pressure by 10 mmHg when it was above 140 mmHg, a reduction in total cholesterol by 25% when it was above 190 mg/dL, and a reduction in body mass index below 30. The minimal prevention strategy assumed that CV risk would be lowered by lifestyle modifications. The greatest CV risk reduction was achieved in the optimal model and then in the minimal model, and the lowest risk reduction was achieved in the moderate model, e.g., using the optimal model of prevention (Model 1). In the total population, we achieved a reduction of -1.74% in the 10-year risk of CVD death (SCORE) in relation to the baseline model, a -0.85% reduction when using the moderate prevention model (Model 2), and a -1.11% reduction when using the minimal prevention model (Model 3). However, in the low CV risk class, the best model was the minimal one (risk reduction of -0.72%), which showed even better results than the optimal one (reduction of -0.69%) using the FRS. CONCLUSION A strategy based on lifestyle modifications in a population without established CVD could be more effective than the moderate strategy used in the present study. Moreover, applying a minimal strategy to the low CV risk class population may even be beneficial for an optimal model.
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Affiliation(s)
- Małgorzata Chlabicz
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Białystok, 15-259 Białystok, Poland; (M.C.); (J.J.); (M.D.); (P.S.); (M.Ł.); (N.Z.); (M.Z.); (A.R.)
- Department of Invasive Cardiology, Medical University of Białystok, 15-259 Białystok, Poland
| | - Jacek Jamiołkowski
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Białystok, 15-259 Białystok, Poland; (M.C.); (J.J.); (M.D.); (P.S.); (M.Ł.); (N.Z.); (M.Z.); (A.R.)
| | - Wojciech Łaguna
- Faculty of Computer Science, Bialystok University of Technology, 15-259 Białystok, Poland;
| | - Marlena Dubatówka
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Białystok, 15-259 Białystok, Poland; (M.C.); (J.J.); (M.D.); (P.S.); (M.Ł.); (N.Z.); (M.Z.); (A.R.)
| | - Paweł Sowa
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Białystok, 15-259 Białystok, Poland; (M.C.); (J.J.); (M.D.); (P.S.); (M.Ł.); (N.Z.); (M.Z.); (A.R.)
| | - Magda Łapińska
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Białystok, 15-259 Białystok, Poland; (M.C.); (J.J.); (M.D.); (P.S.); (M.Ł.); (N.Z.); (M.Z.); (A.R.)
| | - Anna Szpakowicz
- Department of Cardiology, Medical University of Białystok, 15-259 Białystok, Poland;
| | - Natalia Zieleniewska
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Białystok, 15-259 Białystok, Poland; (M.C.); (J.J.); (M.D.); (P.S.); (M.Ł.); (N.Z.); (M.Z.); (A.R.)
| | - Magdalena Zalewska
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Białystok, 15-259 Białystok, Poland; (M.C.); (J.J.); (M.D.); (P.S.); (M.Ł.); (N.Z.); (M.Z.); (A.R.)
| | - Andrzej Raczkowski
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Białystok, 15-259 Białystok, Poland; (M.C.); (J.J.); (M.D.); (P.S.); (M.Ł.); (N.Z.); (M.Z.); (A.R.)
| | - Karol A. Kamiński
- Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Białystok, 15-259 Białystok, Poland; (M.C.); (J.J.); (M.D.); (P.S.); (M.Ł.); (N.Z.); (M.Z.); (A.R.)
- Department of Cardiology, Medical University of Białystok, 15-259 Białystok, Poland;
- Correspondence: ; Tel.: +48-856-865-371
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49
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Cai X, Luo D, Liu S, Li R, Lu Y, Li M, Qiu S. Four-year changes in central fatness, risk of diabetes, and metabolic control in older adults: a cohort study with mediation analysis. Korean J Intern Med 2022; 37:230-240. [PMID: 34905814 PMCID: PMC8747920 DOI: 10.3904/kjim.2020.629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 03/26/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS Older adults are vulnerable to central obesity, while the association of changes in central fatness with risk of diabetes and metabolic control has not been investigated among this particular population. This study was aimed to address these issues. METHODS A total of 1,815 adults aged ≥ 60 years without diabetes at baseline were followed for 4 years. Incident diabetes was ascertained based on plasma glucose, hemoglobin A1c, medical history, and/or the use of anti-diabetic drugs. Central fatness was assessed by waist circumference (WC), waist-height ratio (WHtR), and body roundness index (BRI). Logistic regression analyses were used to assess the association of changes in central fatness with risk of diabetes, along with dose-response and mediation analyses. RESULTS During the 4-year follow-up, 177 participants developed diabetes. The risk of diabetes was increased by 42%, 41%, and 40% per 1 standard deviation increases in WC, WHtR, and BRI, respectively, in multivariable-adjusted models (all p < 0.01). Moreover, these relationships were all linearly-shaped (all pnonlinearity ≥ 0.11). Increases in WC, WHtR, and BRI correlated with increases in hemoglobin A1c, triglycerides-and-glucose index, triglycerides, white blood cell, and C-reactive protein (all p ≤ 0.04). Yet only changes in hemoglobin A1c and triglycerides-and-glucose index were identified as the possible mediators for risk of diabetes, with their mediating effect being about 35% and 21%, respectively. CONCLUSION Increases in central fatness were related to elevated risk of diabetes, and this association might be partly explained by the worsening of glycemic control and insulin resistance in older adults.
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Affiliation(s)
- Xue Cai
- Institute of Diabetes, Zhongda Hospital, Southeast University, Nanjing,
China
- School of Nursing, Peking University, Beijing,
China
| | - Dan Luo
- School of Nursing, Peking University, Beijing,
China
| | - Shuling Liu
- School of Nursing, Peking University, Beijing,
China
| | - Ruxue Li
- School of Nursing, Peking University, Beijing,
China
| | - Yanhui Lu
- School of Nursing, Peking University, Beijing,
China
| | - Mingzi Li
- School of Nursing, Peking University, Beijing,
China
| | - Shanhu Qiu
- Institute of Diabetes, Zhongda Hospital, Southeast University, Nanjing,
China
- Department of Endocrinology, Shenzhen People’s Hospital, The First Affiliated Hospital of Southern University of Science and Technology, The Second Clinical Medical College of Jinan University, Shenzhen,
China
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50
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Karampatsi D, Zabala A, Wilhelmsson U, Dekens D, Vercalsteren E, Larsson M, Nyström T, Pekny M, Patrone C, Darsalia V. Diet-induced weight loss in obese/diabetic mice normalizes glucose metabolism and promotes functional recovery after stroke. Cardiovasc Diabetol 2021; 20:240. [PMID: 34937562 PMCID: PMC8697500 DOI: 10.1186/s12933-021-01426-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 12/02/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Post-stroke functional recovery is severely impaired by type 2 diabetes (T2D). This is an important clinical problem since T2D is one of the most common diseases. Because weight loss-based strategies have been shown to decrease stroke risk in people with T2D, we aimed to investigate whether diet-induced weight loss can also improve post-stroke functional recovery and identify some of the underlying mechanisms. METHODS T2D/obesity was induced by 6 months of high-fat diet (HFD). Weight loss was achieved by a short- or long-term dietary change, replacing HFD with standard diet for 2 or 4 months, respectively. Stroke was induced by middle cerebral artery occlusion and post-stroke recovery was assessed by sensorimotor tests. Mechanisms involved in neurovascular damage in the post-stroke recovery phase, i.e. neuroinflammation, impaired angiogenesis and cellular atrophy of GABAergic parvalbumin (PV)+ interneurons were assessed by immunohistochemistry/quantitative microscopy. RESULTS Both short- and long-term dietary change led to similar weight loss. However, only the latter enhanced functional recovery after stroke. This effect was associated with pre-stroke normalization of fasting glucose and insulin resistance, and with the reduction of T2D-induced cellular atrophy of PV+ interneurons. Moreover, stroke recovery was associated with decreased T2D-induced neuroinflammation and reduced astrocyte reactivity in the contralateral striatum. CONCLUSION The global diabetes epidemic will dramatically increase the number of people in need of post-stroke treatment and care. Our results suggest that diet-induced weight loss leading to pre-stroke normalization of glucose metabolism has great potential to reduce the sequelae of stroke in the diabetic population.
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MESH Headings
- Animals
- Behavior, Animal
- Biomarkers/blood
- Blood Glucose/metabolism
- Brain/metabolism
- Brain/pathology
- Brain/physiopathology
- Diabetes Mellitus, Type 2/blood
- Diabetes Mellitus, Type 2/diet therapy
- Diabetes Mellitus, Type 2/physiopathology
- Diet, High-Fat
- Disease Models, Animal
- Glycemic Control
- Infarction, Middle Cerebral Artery/blood
- Infarction, Middle Cerebral Artery/diet therapy
- Infarction, Middle Cerebral Artery/pathology
- Infarction, Middle Cerebral Artery/physiopathology
- Male
- Mice, Inbred C57BL
- Obesity/blood
- Obesity/diet therapy
- Obesity/physiopathology
- Recovery of Function
- Stroke/blood
- Stroke/diet therapy
- Stroke/pathology
- Stroke/physiopathology
- Time Factors
- Weight Loss
- Mice
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Affiliation(s)
- Dimitra Karampatsi
- NeuroCardioMetabol Group, Department of Clinical Science and Education, Södersjukhuset, Internal Medicine, Karolinska Institutet, 118 83, Stockholm, Sweden
| | - Alexander Zabala
- NeuroCardioMetabol Group, Department of Clinical Science and Education, Södersjukhuset, Internal Medicine, Karolinska Institutet, 118 83, Stockholm, Sweden
| | - Ulrika Wilhelmsson
- Laboratory of Astrocyte Biology and CNS Regeneration, Department of Clinical Neuroscience and Rehabilitation, Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Doortje Dekens
- NeuroCardioMetabol Group, Department of Clinical Science and Education, Södersjukhuset, Internal Medicine, Karolinska Institutet, 118 83, Stockholm, Sweden
| | - Ellen Vercalsteren
- NeuroCardioMetabol Group, Department of Clinical Science and Education, Södersjukhuset, Internal Medicine, Karolinska Institutet, 118 83, Stockholm, Sweden
| | - Martin Larsson
- NeuroCardioMetabol Group, Department of Clinical Science and Education, Södersjukhuset, Internal Medicine, Karolinska Institutet, 118 83, Stockholm, Sweden
| | - Thomas Nyström
- NeuroCardioMetabol Group, Department of Clinical Science and Education, Södersjukhuset, Internal Medicine, Karolinska Institutet, 118 83, Stockholm, Sweden
| | - Milos Pekny
- Laboratory of Astrocyte Biology and CNS Regeneration, Department of Clinical Neuroscience and Rehabilitation, Center for Brain Repair and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Cesare Patrone
- NeuroCardioMetabol Group, Department of Clinical Science and Education, Södersjukhuset, Internal Medicine, Karolinska Institutet, 118 83, Stockholm, Sweden.
| | - Vladimer Darsalia
- NeuroCardioMetabol Group, Department of Clinical Science and Education, Södersjukhuset, Internal Medicine, Karolinska Institutet, 118 83, Stockholm, Sweden.
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