Diet and Cardiovascular Disease: Effects of Foods and Nutrients in Classical and Emerging Cardiovascular Risk Factors

Associations of DNA Methylation Algorithms of Aging With Cardiovascular Disease and Mortality Risk Among US Older Adults

BACKGROUND

Several DNA methylation (DNAm) algorithms have recently emerged as robust predictors of aging and adverse health outcomes in older adults, offering valuable insights into cardiovascular disease (CVD) risk stratification. However, their predictive performance for CVD varies significantly. This study aimed to systematically investigate the associations of 12 widely used DNAm algorithms with CVD and mortality risk.

METHODS

Data from the NHANES (National Health and Nutrition Examination Survey) 1999 to 2002 were used to assess 12 DNAm algorithms (eg, HannumAgeacc, PhenoAgeacc, GrimAgeMortacc, GrimAge2Mortacc) in relation to CVD risk and mortality. Two cohorts were analyzed: one for CVD risk (n=1230) and another for CVD mortality risk (n=1606). DNAm was measured using the Infinium Methylation EPIC BeadChip kit (Illumina). Odds ratios (ORs) and hazard ratios (HRs), along with 95% CIs per SD increase of these DNAm algorithms, were calculated.

RESULTS

Significant associations were observed for GrimAgeMortacc and GrimAge2Mortacc with coronary heart disease and heart attack, with multivariable-adjusted ORs per SD increase ranging from 2.15 to 2.76. However, several algorithms exhibited no significant association with self-reported prevalent CVD. For mortality risk, HannumAgeacc, PhenoAgeacc, ZhangAgeacc, GrimAgeMortacc, and GrimAge2Mortacc were significantly associated with CVD mortality. The multivariable-adjusted HRs per SD increase were 1.19 (95% CIs, 1.05-1.34), 1.13 (95% CIs, 1.01-1.26), 1.63 (95% CI, 1.08-2.47), 1.90 (95% CIs, 1.51-2.40), and 1.87 (95% CIs, 1.51-2.32), respectively. These associations were consistent across biological sex, age (≥50 and <65 versus ≥65 years), and race and ethnicity groups.

CONCLUSIONS

DNAm algorithms, particularly GrimAgeMortacc and GrimAge2Mortacc, may serve as valuable tools for CVD risk stratification and mortality risk assessment.

Dietary Approaches to Stop Hypertension (DASH) for the primary and secondary prevention of cardiovascular diseases

BACKGROUND

The Dietary Approaches to Stop Hypertension (DASH) diet is designed to lower blood pressure and improve cardiovascular health by reducing sodium and unhealthy fats while increasing nutrients, including potassium, calcium, magnesium, and fibre. While evidence supports its benefits for managing cardiovascular risk factors, gaps remain in understanding its long-term impact on preventing cardiovascular disease (CVD), particularly in terms of hard clinical outcomes such as myocardial infarction and stroke.

OBJECTIVES

To assess the effects of the DASH diet for the primary and secondary prevention of cardiovascular diseases.

SEARCH METHODS

We used standard extensive Cochrane search methods. The latest search date was in May 2024.

SELECTION CRITERIA

We included randomised controlled trials (RCTs) comparing a DASH diet intervention to no intervention (including usual care), minimal intervention, or other dietary interventions. In the context of this review, 'minimal intervention' includes brief dietary advice or informational leaflets provided during a medical consultation, without a structured dietary intervention. 'Other dietary interventions' include any other dietary programme besides the DASH diet. Participants were adults with or without CVD. The minimum duration of eligible interventions was eight weeks and the minimum follow-up was three months.

DATA COLLECTION AND ANALYSIS

We used standard Cochrane methods. Primary outcomes were myocardial infarction, heart failure, and stroke. Secondary outcomes were the need for coronary revascularisation, carotid revascularisation, peripheral revascularisation, all-cause mortality, cardiovascular mortality, changes in blood pressure, blood lipids, the occurrence of type 2 diabetes, health-related quality of life, and adverse effects. We used GRADE to assess the certainty of evidence for each outcome.

MAIN RESULTS

Five RCTs involving 1397 participants met our inclusion criteria and were included in this review. All five trials contributed at least one intervention arm to one or more of the three prespecified comparisons. In total, 1075 participants across eligible arms were included in the meta-analyses. The difference reflects trial arms that did not meet our prespecified intervention and comparison definitions, and were therefore not analysed, though all participants were randomised within eligible trials and are accounted for in the review total. The trials assessed the DASH diet in a primary prevention setting; none evaluated its effects in secondary prevention. Participants were generally healthy adults aged 18 years or older, without diagnosed cardiovascular disease. The intervention duration ranged from 16 weeks to 12 months, with follow-up periods between 16 weeks and 18 months (medium- and long-term). The trials were conducted in the USA and Poland, with funding from public institutions, including the National Institutes of Health, the National Heart, Lung, and Blood Institute, and the Institute of Cardiology in Poland. DASH diet versus no intervention (including usual care) Myocardial infarction: one trial (144 participants) reported no myocardial infarctions in either group over a one-year follow-up. The GRADE certainty rating was low due to the high risk of performance bias and imprecision. Stroke: one trial (144 participants) reported no strokes in either group over the same follow-up period. The GRADE rating was low for similar reasons. All-cause mortality: one trial (90 participants) reported no deaths over a six-month follow-up. The GRADE rating was very low due to unclear risk of selection bias, high risk of performance bias, and imprecision. No data were available for heart failure or revascularisation needs (coronary, carotid, or peripheral) in this comparison. DASH diet versus minimal intervention Myocardial infarction: two trials (902 participants in total; 629 participants were in trial arms eligible for this comparison, based on our prespecified intervention and comparison definitions) reported limited events, with no clear differences between groups over one year (risk ratio (RR) 2.99, 95% confidence interval (CI) 0.12 to 73.04). The GRADE rating was low due to high risk of performance bias and imprecision. Stroke: two trials (reporting on the same 629 participants) reported no strokes in either group over follow-up periods ranging from six months to one year. The GRADE rating was low due to similar concerns. No data were available for heart failure, revascularisation needs (coronary, carotid, or peripheral), or all-cause mortality in this comparison. DASH diet versus another dietary intervention All-cause mortality: one trial (261 participants) reported no clear difference between the groups over one year (RR 2.98, 95% CI 0.12 to 72.42). The GRADE rating was very low due to multiple risks of bias and imprecision. No data were available for myocardial infarction, stroke, heart failure, or revascularisation needs in this comparison.

AUTHORS' CONCLUSIONS

The effect of the DASH diet on major cardiovascular outcomes - including myocardial infarction, stroke, cardiovascular mortality, and all-cause mortality - remains inconclusive due to a lack of robust long-term evidence. Additionally, no trials have assessed its impact on heart failure or the need for revascularisation procedures, such as coronary, carotid, or peripheral interventions. While the DASH diet may reduce blood pressure, total cholesterol, and triglyceride levels while increasing high-density lipoprotein (HDL) cholesterol compared to no intervention or usual care, it appears to have little to no effect on low-density lipoprotein (LDL) cholesterol. Evidence comparing the DASH diet to a minimal intervention or alternative dietary approaches remains limited. Although the DASH diet has minimal reported adverse effects, the absence of long-term safety data prevents definitive conclusions on its use in individuals with or without cardiovascular disease. The certainty of evidence is low to very low, primarily due to design limitations such as high risk of bias, small sample sizes, and short follow-up periods in the included trials. Most studies focused on cardiovascular risk factors rather than long-term clinical outcomes, and all eligible trials assessed primary prevention, with no data on secondary prevention. Given these uncertainties, well-designed, long-term randomised controlled trials are needed to evaluate the DASH diet's impact on major cardiovascular events, its effectiveness in secondary prevention, and its long-term safety.

Association Between the Dietary Inflammatory Index and Middle Ear Disease in Adults: An NHANES Analysis

OBJECTIVE

This study aimed to investigate the relationship between the dietary inflammatory index (DII) and middle ear disease (MED) in adults using data from the National Health and Nutrition Examination Survey (NHANES) 2015 to 2020.

STUDY DESIGN

A cross-sectional analysis was conducted on a sample of American adults to explore the association between DII and MED.

SETTING

The study utilized data from 3 NHANES cycles (2015-2020), assessing the health and nutritional status of adults and children in the United States.

METHODS

We analyzed data from 3743 participants aged 20 and older, with MED defined by abnormal tympanogram results. DII was calculated based on dietary intake data recorded during the 24 hours before the interview. Logistic regression models were used to examine the association between DII and MED, adjusted for various demographic and health-related factors.

RESULTS

The results revealed a significant positive association between higher DII scores and the likelihood of MED, particularly in individuals under 60 years of age. A nonlinear relationship was identified, with a threshold effect at a DII value of 2.74, below which higher DII was associated with increased risk of MED, while the association weakened above this threshold.

CONCLUSION

This study suggests that inflammatory dietary patterns are associated with an increased risk of MED, especially in younger adults. The findings underscore the importance of dietary interventions in preventing and managing MED and warrant further prospective studies to confirm these results and understand the mechanisms by which diet affects middle ear health.

Role of Phytonutrients in the Prevention and Treatment of Chronic Diseases: A Concrete Review

Delving into the intricate role of phytonutrients is paramount to effectively preventing and treating chronic diseases. Phytonutrients are "plant-based nutrients" that positively affect human health. Phytonutrients perform primary therapeutic functions in the management and treatment of various diseases. It is reported that different types of pathogenesis occur due to the excessive production of oxidants (reactive nitrogen species and reactive oxygen species). The literature shows that a higher intake of fruits, vegetables, and other plant-based food is inversely related to treating different chronic diseases. Due to many phytonutrients (antioxidants) in fruits, vegetables, and other medicinal plants, they are considered major therapeutic agents for various diseases. The main purpose of this review is to summarize the major phytonutrients involved in preventing and treating diseases. Fourteen major phytonutrients are discussed in this review, such as polyphenols, anthocyanin, resveratrol, phytosterol (stigmasterol), flavonoids, isoflavonoids, limonoids, terpenoids, carotenoids, lycopene, quercetin, phytoestrogens, glucosinolates, and probiotics, which are well-known for their beneficial effects on the human body and treatment of different pathological conditions. It is concluded that phytonutrients play a major role in the prevention and treatment of diabetes mellitus, obesity, hypertension, cardiovascular disorders, other types of cancers, neurological disorders, age-related diseases, and inflammatory disorders and are also involved in various biological activities.

Blueberry leaves as a promising sustainable source of polyphenols: Chemical composition, functional activities and future application perspectives

Blueberry leaves are a byproduct of blueberry cultivation, often overlooked despite their potential value. As global consumption of blueberries continues to rise, the area under cultivation expands, leading to an increased production of blueberry leaves. Blueberry leaves are a rich source of polyphenols, and in recent years, extensive research has been conducted on the composition and biological functions of these compounds. However, studies on blueberry leaves are often fragmented and lack a comprehensive overview of their potential applications. This review outlines the biosynthetic pathways of polyphenols in plants and compares the variations in polyphenol content and composition in blueberry leaves, influenced by factors such as cultivars, harvesting seasons, and extraction methods. Current research indicates that the primary constituents of blueberry leaf polyphenols (BLPs) are caffeoyl quinic acids, flavonols, and flavan-3-ols. These active compounds endow blueberry leaves with a range of functional properties, including antioxidant, anti-inflammatory, antibacterial, antiviral, antitumor, and metabolic syndrome-modulating effects. As a cost-effective and potentially beneficial by-product of agricultural production, blueberry leaves represent a promising area for further development. Therefore, this review discusses the opportunities and challenges associated with the applications of blueberry leaves, offering insights into their future processing, utilization, and potential for sustainable development.

Inverse associations of the lifestyle critical 9 with cardiorenal syndrome: the mediating role of the dietary inflammatory index

Background

Cardiorenal syndrome (CRS) represents a burgeoning global health concern characterized by its increasing prevalence. Life's Crucial 9 (LC9), an innovative tool for cardiovascular health assessment, and the Dietary Inflammatory Index (DII), which quantifies diet's impact on body inflammation, have not been previously studied in conjunction regarding their association with CRS.

Objective

This study aims to explore the relationship between LC9 and CRS, using data from the National Health and Nutrition Examination Survey (NHANES), and to examine whether DII serves as a mediator in this association.

Methods

This research included data from 25,792 NHANES participants spanning from 2005 to 2018. The study leverages the dataset's comprehensive representativeness and robust statistical power to ensure generalizable and reliable findings. We employed weighted logistic regression to evaluate the association between LC9 scores and CRS presence, conducted subgroup analyses, and performed mediation analysis to investigate the role of DII.

Results

Our analysis demonstrated a significant inverse relationship between LC9 and CRS. Upon controlling for confounders, each 10-point rise in LC9 correlates with a 26% reduction in CRS prevalence (p < 0.001). Additionally, stratifying LC9 into tertiles with T1 as the reference group revealed that T2 (OR = 0.59, 95% CI = 0.48-0.72, p < 0.001) and T3 (OR = 0.57, 95% CI = 0.38-0.88, p < 0.001) exhibited a strong negative correlation trend. The dose-response curve illustrates a linear relationship between LC9 and CRS; as LC9 increases, the occurrence of CRS decreases. DII shows a significant positive connection with CRS (p < 0.001), but DII indicates a decreasing trend when LC9 rises (β = -0.65, p < 0.001). Mediation analysis reveals that DII mediates the association between LC9 and CRS, with a mediation proportion of 12.5% (p < 0.001).

Conclusion

The findings indicate a robust inverse correlation between LC9 scores and CRS incidence, with DII is associated with this relationship. This suggests potential preventive strategies against CRS through lifestyle modifications guided by LC9.

The relationship between negative psychological state and quality of life among cardiovascular disease patients in China: the masking effect of abnormal dietary behavior

Background

It is well known that abnormal dietary behavior increases the risk for cardiovascular disease especially if the person is depressed and/or anxious. The purpose of this study was to construct a moderated mediation model to explore the roles of abnormal dietary behavior and family health in the mechanism through which depression/anxiety influences Quality of life (QoL) in patients with cardiovascular disease.

Methods

A field survey was conducted in China and ultimately included 730 patients with cardiovascular disease aged 20-60 years. Data were collected using the Europe Quality of five-dimensional five-level questionnaire, Short-Form of the Eating Behavior Scale, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and the Chinese version of the short-form of the Family Health Scale. All data were analyzed using SPSS Statistics 23.0.

Results

(1) Depression was negatively associated with QoL (r = -0.386/-0.230, p < 0.001), and was positively correlated with abnormal dietary behavior (r = 0.377, p < 0.001). Anxiety was negatively associated with QoL (r = -0.383/-0.231, p < 0.001), and was positively correlated with abnormal dietary behavior (r = 0.333, p < 0.001). Abnormal dietary behavior was negatively correlated with QoL (r = -0.077/-0.119, p = 0.039/0.001). (2) In the mediation model, abnormal dietary behavior only had a masking effect on the relationship between depression and QoL, with a mediating effect size of 7.18%. The mediating effect of abnormal dietary behavior between anxiety and QoL was not significant. (3) The mediating effect size of abnormal dietary behavior between depression/anxiety and QoL increased to 14.77% and 13.57% in unhealthy families. The above masking mediation effect was not significant in healthy families.

Conclusions

Abnormal dietary behavior positively mediated the relationship between depression and QoL and attenuated the negative effect of depression on QoL in patients with cardiovascular disease. The masking mediating effect of abnormal dietary behavior between depression/anxiety and QoL was stronger for patients in unhealthy families.

The effects of 6 months dietary counseling on diet quality and cardiovascular risk profile in patients with cardiovascular disease: A randomized controlled trial

BACKGROUND & AIMS

A healthy diet improves cardiovascular disease (CVD) risk factors. However, dietary counseling is not yet widely implemented in health care for patients with CVD. We assessed how dietary counseling by a dietitian, focused on improving diet quality, influenced the cardiovascular risk profile of patients with CVD.

METHODS

In this 6-month trial, 124 patients with CVD (68.1 ± 9.5 years, 72 % men) were randomly assigned to counseling by a dietitian (n = 63) or usual care (n = 61). Difference in cardiovascular risk profile between groups was assessed with a 10-year composite cardiovascular risk prediction score including changes in blood pressure and low-density lipoprotein cholesterol (LDL-C). Secondary outcomes included adherence to a healthy diet as assessed with the Dutch Healthy Eating Index-2015 (DHD15-index), individual risk factors (LDL-C, blood pressure, body weight, and high-sensitivity C-reactive protein [hs-CRP]) as well as depressive symptoms and optimism scores.

RESULTS

DHD15-index at baseline was 103 ± 18 out of 160 and increased 5.7 points more in the dietary counseling group compared to the usual care group (95 % confidence interval (CI): 1.3; 10.1). Multivariate analysis revealed no statistically significant differences in changes over time in 10-year cardiovascular risk score (0.6 %, 95%CI: -4.1 %; 5.3 %), blood pressure (-2 mmHg, 95%CI: -7; 4), LDL-C (0.0 mmol/l, 95%CI: 0.2; 0.2), body weight (-0.7 kg, 95%CI: -2.9; 1.5), hs-CRP (0.71 mg/dl, 95%CI: -1.20; 2.62) or depressive symptoms and optimism scores between groups.

CONCLUSIONS

Dietary counseling for patients with CVD for 6 months only slightly improved adherence to a healthy diet in patients with established CVD and did not result in substantial improvement in cardiovascular risk profile or depressive symptoms and optimism scores.

CLINICAL TRIAL REGISTRATION

This trial was registered at www.

CLINICALTRIALS

gov/study/NCT05071092.

A Comparative Study of the Biological Properties of Eugenia uniflora L. Fruits and Leaves Related to the Prevention of Cardiovascular Diseases

Cardiovascular diseases (CVDs) remain the leading cause of death globally, emphasizing the need for effective preventive strategies. Plant-based foods, rich in phytochemicals, offer a promising potential in CVD prevention. This study investigated the antioxidant, anti-inflammatory, and antihypertensive properties of two Eugenia uniflora L. varieties (orange and purple pitanga) and their leaves. Their antioxidant activity was assessed using 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) radical cation scavenging activity assays, while their antihypertensive activity was evaluated through angiotensin-converting enzyme (ACE) inhibition. Their anti-inflammatory potential was determined via protein denaturation inhibition. Both fruit varieties exhibited similar bioactivities, with the purple variety showing a slightly higher activity, except in the DPPH and ABTS assays. The leaves consistently demonstrated the lowest activities across all assays. Free polyphenols, dominated by gallic acid, were quantified using µ-QuEChERS followed by ultrahigh-performance liquid chromatography (UHPLC-PDA). The orange variety contained the highest concentration of gallic acid (13.1 mg/100 g DW). These findings highlight the potential of Eugenia uniflora L. extracts as natural antioxidant, anti-inflammatory, and antihypertensive agents, suggesting their value in food, pharmaceutical, and cosmetic applications for promoting human health and preventing CVDs.

Association between composite dietary antioxidant index and hyperlipidemia in adults based on the NHANES

Hyperlipidemia, a major risk factor for cardiovascular diseases, can potentially be alleviated by dietary antioxidants. This study explored the relationship between hyperlipidemia and the Composite Dietary Antioxidant Index (CDAI), which measures antioxidant intake from carotenoids, selenium, zinc, and vitamins A, C, and E. Analyzing data from 27,493 participants aged 20 and older from the National Health and Nutrition Examination Survey (NHANES) conducted between 2001 and 2018, we used weighted regression models to assess this association while adjusting for multiple covariates. Restricted cubic splines were also applied to check for any non-linear relationships. Findings revealed that higher CDAI scores significantly correlated with lower hyperlipidemia prevalence. Specifically, each unit increase in log-transformed CDAI was linked to a 14% decrease in hyperlipidemia risk (OR = 0.86, 95% CI: 0.77-0.95). Participants in the top CDAI quartile had a 15% lower hyperlipidemia prevalence compared to those in the bottom quartile (OR = 0.85, 95% CI: 0.77-0.95). No significant non-linear relationship was observed (p = 0.822). In conclusion, increased antioxidant intake, as measured by CDAI, is associated with reduced hyperlipidemia, underscoring the role of antioxidants in its management.

Stearic acid metabolism in human health and disease

Named after the Greek term for "hard fat", stearic acid has gradually entered people's field of vision. As an important component of various physiological cellular functions, stearic acid plays a regulatory role in diverse aspects of energy metabolism and signal transduction. Its applications range from serving as a bodily energy source to participating in endogenous biosynthesis. Similar to palmitate, stearic acid serves as a primary substrate for the stearoyl coenzyme A desaturase, which catalyzes the conversion of stearate to oleate and is involved in the synthesis of triglyceride and other complex lipids. Additionally, stearic acid functions as a vital signaling molecule in pathological processes such as cardiovascular diseases, diabetes development, liver injury and even nervous system disorders. Therefore, we conduct a comprehensive review of stearic acid, summarizing its role in various diseases and attempting to provide a systematic overview of its homeostasis, physiological functions, and pathological process. From a medical standpoint, we also explore potential applications and discuss stearic acid as a potential therapeutic target for the treatment of human diseases.

Investigation of Potential Food Intake Biomarkers by LC-MS/MS: Suitability Under Conditions Close to Everyday Live

SCOPE

Food intake biomarkers are proposed to be a more reliable tool for investigating the nutritional status compared to food diaries or food frequency questionnaires. Nevertheless, biomarkers have some disadvantages such as the influence of the individual lifestyle, different metabolism, nutrient-nutrient interaction or the specificity of the used biomarkers. To evaluate the suitability of several biomarkers, a study under conditions close to everyday life was conducted.

METHODS AND RESULTS

Ten healthy volunteers were divided into three groups who followed different meal plans for 24 h and collected their entire urine. Afterward, several potential biomarkers were quantified using an LC-MS/MS approach. To further investigate the suitability of those biomarkers, the results were investigated with the main goal of grouping the participants according to their provided diet, while the first author did not have any knowledge of the meal plans or other specific knowledge about the study design.

CONCLUSION

The use of different biomarkers enables the evaluation of different eating habits without any prior wash out period or bigger than usual portion sizes. Especially long-term biomarkers seem to have a good suitability. Very high intakes and very low intakes are easier to distinguish than a moderate intake. Food intake biomarkers are proposed as a more reliable tool than food diaries or food frequency questionnaires. Nevertheless, data under realistic conditions are rarely available. In this study, ten volunteers were divided into three groups with different meal plans. An LC-MS/MS approach was performed and the data were further investigated with the main goal of grouping the participants according their provided diet, while the first author did not have any knowledge about the meal plans.

Combined effect of triglyceride-glucose index and atherogenic index of plasma on cardiovascular disease: a national cohort study

The triglyceride-glucose (TyG) index and the Atherogenic Index of Plasma (AIP) are both predictors of cardiovascular diseases (CVD). However, their combined and individual contributions to CVD risk are not well understood. This study evaluate the joint and individual associations of the TyG index and AIP with CVD events in middle-aged and older Chinese adults. This nationwide, retrospective cohort study utilized data from CHARLS. The diagnosis of CVD in this study was determined based on self-reported information provided by participants regarding their medical history( heart disease and/or stroke). Cross-sectional analyses in 2011 and longitudinal analyses over a 9-year follow-up were conducted to assess these associations. In the cross-sectional analysis, 8,531 participants were included at baseline. The odds ratio (OR) for TyG alone was 1.06 (95% CI 0.96-1.22) for CVD, while the OR for AIP alone was 1.16 (95% CI 1.02-1.33). Combined analysis showed that compared to the low TyG & low AIP group, the OR for the high TyG & high AIP group was 1.23 (95% CI 1.07-1.42) for CVD. In the survival Analysis, the hazard ratio (HR) for TyG alone was 1.19 (95% CI 1.04-1.35) for CVD, while the HR for AIP alone was 1.25 (95% CI 1.09-1.43). Combined analysis showed that compared to the low TyG & low AIP group, the HR for the high TyG & high AIP group was 1.27 (95% CI 1.10-1.43) for CVD. The findings underscore the significant coexposure effects of the TyG index and AIP on CVD, particularly in middle-aged adults.

Probiotics: A Potential Strategy for Preventing and Managing Cardiovascular Disease

Probiotics are gaining recognition as a viable strategy for mitigating cardiovascular risk factors. Specifically, recent studies highlight their potential benefits in managing cholesterol levels, blood pressure, and inflammation, which are critical components in the prevention of cardiovascular diseases (CVD). This comprehensive review aims to elucidate the impact of probiotic consumption on major cardiovascular risk factors, including individuals with hypertension, type II diabetes mellitus, metabolic syndrome, hypercholesterolemia, and in secondary prevention in coronary artery disease. Scientific evidence based on human studies suggests that probiotic consumption is associated with positive effects on anthropometric measures, inflammation markers, blood pressure, glucose metabolism markers, lipid profiles, and endothelial function. However, these findings should be interpreted pragmatically and acknowledge the significant variability in results. This variability may be attributed to factors such as probiotic composition (single strain or multiple strains), the characteristics of the delivery matrix (food, capsules, and sachets), the duration of the intervention, the dosage regimen, and baseline health profiles of the participants. Incorporating probiotics as part of a comprehensive and healthy lifestyle approach can be considered a feasible strategy for both the prevention and management of CVD. However, further research is needed on factors influencing the effect of probiotics, such as: (i) optimal probiotic strain(s), (ii) appropriate dosage, (iii) duration of treatment, (iv) optimal delivery vehicle, and (v) sex-specific differences.

Musculoskeletal and cardiovascular considerations for transgender athletes

OBJECTIVE

Participation in athletics is essential for the overall well-being of transgender athletes and should be included as part of gender-affirming care. Surveys show physicians and athletic trainers want to provide appropriate care for transgender athletes but lack the proper knowledge and training to do so. Gender Affirming Hormone Therapy (GAHT) is part of gender-affirming care, yet the effects of GAHT on the cardiovascular and musculoskeletal health of transgender athletes is not well-understood. The purpose of this review was to discuss important musculoskeletal and cardiovascular considerations unique to transgender athletes and improve physician understanding in caring for transgender athletes.

METHODS

A representative selection of literature on the effects of GAHT on cardiovascular and musculoskeletal health was included in this review.

RESULTS

Estrogen therapy may increase the risk of venous thromboembolism (VTE) and stroke, and decrease blood pressure levels among transgender women, while studies on lipid profile are inconsistent among both transgender men and women. Transgender women receiving GAHT may also be at greater risk for bone fracture and ligamentous injuries.

CONCLUSION

Exercise is essential for the well-being of transgender individuals and special considerations regarding the cardiovascular and musculoskeletal health of transgender athletes should be incorporated into standard medical education. Educational programs for transgender patients and their support team should focus on preventative measures that can be taken to reduce the risk of adverse musculoskeletal and cardiovascular events. The PPE is an invaluable tool available to physicians to monitor the health and safety of transgender athletes and should be regularly updated as research on the health of transgender individuals continues to grow. Longitudinal and prospective studies should examine the effects of GAHT on the musculoskeletal and cardiovascular health of transgender athletes. Lastly, health care providers play an important role in the advancement of gender-neutral policies.

The link between the risk of cardiovascular diseases and the intake of different types of dietary carbohydrates in Iranian adults

Background

The risk of cardiovascular diseases (CVDs) may be influenced by dietary carbohydrates. The aim of this study was to investigate the link between CVDs and the intake of carbohydrates.

Methods

In this cross-sectional study, data was extracted from the Prospective Epidemiologic Research Studies in Iran (PERSIAN) cohort in Sabzevar, Iran. A total of 4241 adults, including 1535 patients with CVDs and 2706 people without CVDs, were included. A validated 237-item food frequency questionnaire was used to estimate the intake of different types of dietary carbohydrates.

Results

A positive association was found between stroke and dietary intake of starch (OR = 1.108; 95% CI, 1.005-1.220; P = 0.039). Additionally, a negative association was found between stroke and dietary intake of sucrose (OR = 0.97; 95%CI, 0.94-0.99; P = 0.037). No association was found between other types of CVDs and the intake of different types of carbohydrates.

Conclusion

This study provided some evidence for the association between CVDs and different types of dietary carbohydrates. Consumption of starch may increase the risk of stroke, while a higher intake of sucrose may decrease the risk of stroke. Further studies are warranted.

Association between olive oil consumption and all-cause, cardiovascular and cancer mortality in adult subjects: a systematic review and meta-analysis

Background: The Mediterranean diet is characterized by the preferential use of olive oil (OO) and has been associated with health benefits possibly mediated by its bioactive compounds. Objectives: We aimed to analyze the association between OO consumption and changes in all-cause mortality, cardiovascular mortality and cancer mortality in the adult population. Methods: A systematic review was conducted using the Pubmed, Scopus, Web of Science and Cochrane Library databases up to October 2024. DerSimonian and Laird's random effects method was used to calculate pooled estimates of hazard ratios (HRs) and their 95% confidence intervals (95% CIs) to determine the association between OO use and changes in all-cause mortality, cardiovascular mortality, and cancer mortality. Results: Fourteen studies were included in the systematic review and seven in the meta-analysis. Our results showed an association between OO consumption and reduction in all-cause mortality (HR: 0.85; 95% CI: 0.80-0.91), cardiovascular mortality (HR: 0.84; 95% CI: 0.76-0.93) and cancer mortality (HR: 0.89; 95% CI: 0.86-0.93). Conclusions: Consumption of OO particularly reduces cardiovascular mortality (16%), followed by all-cause mortality (15%) and cancer mortality (11%) in the adult population. However, further studies are needed to clarify the underlying mechanisms.

Mediating effect of oxidative stress on blood pressure elevation in workers exposed to low concentrations of benzene, toluene, and xylene (BTX)

To investigate the mediating effect of oxidative stress on the relationships between low-concentration benzene, toluene, and xylene (BTX) exposure and blood pressure in workers. A cross-sectional study involving 841 workers from a petroleum refining enterprise in Hainan, China, was conducted. Among the workers, 615 workers were exposed to low-concentration BTX, and 216 workers were in the control group. S-phenylmercapturic acid (S-PMA), hippuric acid (HA), and methyl hippuric acid (MHA, including the three isomers 2-MHA, 3-MHA, and 4-MHA) were measured in the urine of workers via high-performance liquid chromatography‒tandem triple quadrupole mass spectrometry to assess the internal BTX burden. Oxidative stress markers, blood pressure, and their correlations were analysed in both the exposed and control groups of workers. Mediation analysis was used to investigate the potential role of oxidative stress in the relationship between BTX exposure and blood pressure. The concentrations of BTX at the sampling points in the enterprise were all below the limits stipulated in China's national occupational health criteria: occupational exposure limits for hazardous agents. With respect to the internal burden of BTX, the concentrations of the benzene metabolite S-PMA, the toluene metabolite HA, and the xylene metabolites 3-MHA and 4-MHA in the urine samples in the exposure group were greater than those in the control group (P < 0.05). The correlation analysis results revealed that the concentration of the benzene metabolite S-PMA in workers' urine was positively correlated with diastolic blood pressure (DBP) (r = 0.265, P < 0.05). Compared with those in the control group, DBP was greater (β = 1.363, 95% CI 0.088 -2.639), serum superoxide dismutase (SOD) activity was lower (β = - 0.037, 95% CI - 0.060 to - 0.013), and the serum malondialdehyde (MDA) concentration was greater (β = 0.066, 95% CI 0.022-0.110) in the exposure group. Partial correlation analysis revealed a positive correlation between DBP and MDA (rs = 0.115, P < 0.01). The results of the mediation analysis indicated that MDA was a complete mediator between low BTX exposure and DBP (P < 0.05). Occupational exposure to low concentrations of BTX elevates blood pressure and oxidative stress among workers. A positive correlation between DBP and MDA was observed, with MDA acting as a complete mediator between low-concentration BTX exposure and DBP elevation.

Demographic risk factors of pro-inflammatory diet: a narrative review

While inflammation is a known beneficial mechanism, pro-inflammatory nutrients can lead to chronic inflammation. The energy-adjusted dietary inflammatory index (E-DII) has revealed positive associations with chronic inflammatory diseases. However, more evidence about the demographic risk factors for high E-DII is needed. Therefore, the present study reviewed the high-risk groups of people for high E-DII scores. Men had higher E-DII than women worldwide, which could be explained by the craving for energy induced by stress and higher physical activity. However, in some societies, women had higher consumption of a pro-inflammatory diet, which could be induced by compulsive eating and craving for more sweets and carbohydrates during menstruation and also can be seen among women with premenopausal syndrome. The pro-inflammatory diets were more common among elders in southern America, East Asia, and Arab countries, while some other studies had contradictory results. The proliferation of unhealthy foods, such as fast food and Western dietary patterns enriched with a pro-inflammatory diet, increased youth's E-DII and decreased the healthy eating index among older people. Also, smokers and alcoholics tended to consume a diet with a higher E-DII, which should be investigated in further studies. Black people consumed the most pro-inflammatory diets compared with White people, especially in pregnant women. Education had a negative association with E-DII, while socioeconomic status was positively associated with a pro-inflammatory diet. Therefore, E-DII consumption had no association with access to healthy foods but is more associated with knowledge and cultural dietary habits. Moreover, further nutritional interventions are required to educate the vulnerable populations and also provide better availability of healthy food enriched with anti-inflammatory nutrients in the future.

Tooth Loss is a Risk Factor for Cardiovascular Disease Mortality: A Systematic Review with Meta-analyses

INTRODUCTION

The current evidence linking tooth loss and cardiovascular disease mortality is inconclusive. Thus, the aim of this systematic review was to explore the association between tooth loss and cardiovascular disease (CVD) mortality.

METHODS

A comprehensive literature search of databases and gray literature included: Web of Science, Scopus, PubMed, Cochrane Central Register of Controlled Trials, Google Scholar, various digital repositories. The included studies reported on CVD mortality and tooth loss. The Newcastle-Ottawa scale was used to assess the quality of included studies. Random-effects meta-analysis method, sub-group analysis (based on the tooth loss categories (edentulous and fewer than 10 teeth present), meta-regression (based on the number. of confounders), publication bias, and sensitivity analysis were performed.

RESULTS

Twelve articles met the eligibility criteria with an overall "Good" quality. A significant association between tooth loss (edentulous or less than 10 teeth present) and CVD mortality was found in the primary meta-analysis, which compiled data from 12 studies. The estimated hazard ratio was 1.66 (95% CI: 1.32-2.09), and there was high heterogeneity (I2 = 82.42). Subgroup analysis revealed that the edentulous subgroup showed a higher risk with no significant heterogeneity, while the subgroup with fewer than 10 teeth showed a higher risk with substantial heterogeneity. Meta-regression analysis did not reveal any significant impact (P = .626) on whether variations in the number of confounders across studies would substantially affect the overall findings. No publication bias was detected and the sensitivity analysis based on the critical confounders also confirmed that tooth loss as a risk factor for CVD mortality (hazard ratio = 1.52, 95% CI: 1.28-1.80), (I2 51.82%).

CONCLUSION

The present systematic review reported that being edentulous or having lesser than 10 teeth is a predictive indicator of CVD mortality.

Psycho-social dimensions of cardiovascular risk: exploring the impact of social isolation and loneliness in middle-aged and older adults

BACKGROUND

Cardiovascular disease (CVD) is a major health concern for middle-aged and older adults, with lifestyle and metabolic risk factors well-studied. However, the role of psychosocial factors in CVD remains underexplored.

OBJECTIVE

This study aims to delve into the connection between psychosocial factors and the occurrence of CVD.

METHODS

We utilized data from the UK Biobank, a large-scale study covering adults aged 38 to 73 recruited from various centers across the UK between 2006 and 2010. We employed Cox proportional hazards models to analyze the relationship between social isolation, loneliness, and incident CVD. CVD diagnoses were confirmed through hospital records and death-register data. Additionally, we conducted mediation analyses to assess the impact of low-grade inflammation.

RESULTS

The study encompassed 427,942 participants free from CVD, 55.8% of whom are women. High levels of social isolation and loneliness were linked to a higher risk of CVD (HRs 1.11, 95% CI 1.06-1.16; HRs 1.17, 95% CI 1.11-1.23). Depression also emerged as a predictor of CVD onset (HRs 1.25, 95% CI 1.19-1.31), with each psychosocial factor independently contributing to increased CVD risk. Mediation analyses pinpointed inflammation as a crucial mediator, especially for loneliness (indirect effect proportion: 4.7%).

CONCLUSIONS

This study underscores the significance of psychosocial factors in relation to CVD. Integrating assessments for social isolation, loneliness, and depression into routine healthcare could potentially aid in CVD prevention among middle-aged and elderly individuals. This study underscores the significance of psychosocial factors in relation to CVD, emphasizing the association between social isolation or loneliness and the heightened risk of CVD.

Dietary inflammatory potential and arterial stiffness in a French cohort: Insights from the STANISLAS study

BACKGROUND AND AIMS

Chronic inflammation plays a key role in arterial stiffness pathogenesis. Dietary components can display anti- or pro-inflammatory properties. Nonetheless, the association between the diet's overall inflammatory potential and arterial stiffness is unclear. This study aimed to assess the association between the diet's overall inflammatory potential and arterial stiffness assessed by carotid-femoral pulse wave velocity (cfPWV).

METHODS AND RESULTS

This cross-sectional study included 1307 participants from the STANISLAS family cohort study. Dietary data were collected using a validated food frequency questionnaire. The adapted dietary inflammatory index (ADII) score was calculated to assess the inflammatory potential of the participants' diet. The association of ADII score quartile with cfPWV was assessed using IPW-weighted linear mixed models with random family effect. The median (Q1-Q3) ADII score was 0.45 (-1.57, 2.04). Participants exhibiting higher ADII scores demonstrated elevated energy intake, dietary saturated fat, and ultra-processed foods. Conversely, individuals with lower ADII scores exhibited higher vitamins and omega intakes, and a higher diet quality, as assessed by the DASH score. Despite these observations from the descriptive analyses, ADII score quartiles were not significantly associated with cfPWV (β(95% CI) were 0.01 (-0.02,0.04) for Q2, 0.02 (-0.01,0.05) for Q3, and 0.02 (-0.01,0.05) for Q4 compared to Q1).

CONCLUSION

In this cross-sectional study, participants had a relatively modest consumption of pro-inflammatory foods, no substantial associations were observed between the diet inflammatory potential and arterial stiffness. Further longitudinal studies in larger cohorts are needed to better understand the link between inflammatory diet and arterial stiffness.

HbA1c and fasting plasma glucose levels are equally related to incident cardiovascular risk in a high CVD risk population without known diabetes

OBJECTIVES

Type 2 diabetes (T2DM) is associated with increased risk for cardiovascular disease (CVD). Whether screen-detected T2DM, based on fasting plasma glucose (FPG) or on HbA1c, are associated with different risks of incident CVD in high-risk populations and which one is preferable for diabetes screening in these populations, remains unclear.

METHODS

A total of 8,274 high-risk CVD participants were included from the UCC-SMART cohort. Participants were divided into groups based on prior T2DM diagnosis, and combinations of elevated/non-elevated FPG and HbA1c (cut-offs at 7 mmol/L and 48 mmol/mol, respectively): Group 0: known T2DM; group 1: elevated FPG/HbA1c; group 2: elevated FPG, non-elevated HbA1c; group 3: non-elevated FPG, elevated HbA1c; group 1 + 2: elevated FPG, regardless of HbA1c; group 1 + 3: elevated HbA1c, regardless of FPG; and group 4 (reference), non-elevated FPG/HbA1c.

RESULTS

During a median follow-up of 6.3 years (IQR 3.3-9.8), 712 cardiovascular events occurred. Compared to the reference (group 4), group 0 was at increased risk (HR 1.40; 95 % CI 1.16-1.68), but group 1 (HR 1.16; 95 % CI 0.62-2.18), 2 (HR 1.18; 95 % CI 0.84-1.67), 3 (HR 0.61; 95 % CI 0.15-2.44), 1 + 2 (HR 1.17; 95 % CI 0.86-1.59) and 1 + 3 (HR 1.01; 95 % CI 0.57-1.79) were not. However, spline interpolation showed a linearly increasing risk with increasing HbA1c/FPG, but did not allow for identification of other cut-off points.

CONCLUSIONS

Based on current cut-offs, FPG and HbA1c at screening were equally related to incident CVD in high-risk populations without known T2DM. Hence, neither FPG, nor HbA1c, is preferential for diabetes screening in this population with respect to risk of incident CVD.

Let food be your medicine - dietary fiber

Dietary fiber (DF) cannot be digested and absorbed by the digestive tract, nor can it provide the energy needed to be burned for metabolic activities. Therefore, from the 1950s to the 1980s, DF received little attention in nutrition studies. With in-depth research and developments in global nutrition, people have gradually paid attention to the fact that DF occupies an essential position in the structure of nutrition, and it can ensure the healthy development of human beings. As early as 390 B.C., the ancient Greek physician Hippocrates proposed, "Let your food be your medicine, and your medicine be your food". This concept has been more systematically validated in modern scientific research, with numerous epidemiological studies showing that the dietary intake of DF-rich foods such as whole grains, root vegetables, legumes, and fruits has the potential to regulate the balance of the gut microbiota and thereby prevent diseases. However, the crosstalk between different types of DF and the gut microbiota is quite complex, and the effects on the organism vary. In this paper, we discuss research on DF and the gut microbiota and related diseases, aiming to understand the relationship between all three better and provide a reference basis for the risk reduction of related diseases.

Reparative effects after low-dose radiation exposure: Inhibition of atherosclerosis by reducing NETs release

OBJECTIVE

The cardiovascular system effects of environmental low-dose radiation exposure on radiation practitioners remain uncertain and require further investigation. The aim of this study was to initially investigate and explore the mechanisms by which low-dose radiation may contribute to atherosclerosis through a multi-omics joint comprehensive basic experiment.

METHODS

We used WGCNA and differential analyses to identify shared genes and potential pathways between radiation injury and atherosclerosis sequencing datasets, as well as tissue transcriptome immune infiltration level extrapolation and single-cell transcriptome data correction using the CIBERSORT deconvolution algorithm. Animal models were constructed by combining a high-fat diet with 5 Gy γ-ray whole-body low-dose ionizing radiation. The detection of NETs release was validated by enzyme-linked immunosorbent assay.

RESULTS

Analysis reveals shared genes in both datasets of post-irradiation and atherosclerosis, suggesting that immune system neutrophils may be a key node connecting radiation to atherosclerosis. NETs released by neutrophil death can influence the development of atherosclerosis. Animal experiments showed that the number of neutrophils decreased (P < 0.05) and the concentration of NETs reduced after low-dose radiation compared with the control group, and the concentration of NETs significantly increased (P < 0.05) in the HF group. Endothelial plaques were significantly increased in the high-fat feed group and significantly decreased in the low-dose radiation group compared with the control group.

CONCLUSIONS

Long-term low-dose ionizing radiation exposure stimulates neutrophils and inhibits their production of NETs, resulting in inhibition of atherosclerosis.

Effects of Mediterranean diets and nutrigenomics on cardiovascular health

The field of nutrigenomics studies the interaction between nutrition and genetics, and how certain dietary patterns can impact gene expression and overall health. The Mediterranean diet (MedDiet), characterized by a high intake of fruits, vegetables, whole grains, and healthy fats, has been linked to better cardiovascular health (CVH) outcomes. This review summarizes the current state of research on the effects of nutrigenomics and MedDiet on cardiovascular health. Results suggest that MedDiet, through its impact on gene expression, can positively influence CVH markers such as blood pressure, lipid profile, and inflammation. However, more research is needed to fully understand the complex interactions between genetics, nutrition, and CVH, and to determine the optimal dietary patterns for individualized care. The aim of this scientific review is to evaluate the current evidence on the effects of nutrigenomics and MedDiet on cardiovascular health. The review summarizes the available studies that have investigated the relationship between nutrition, genetics, and cardiovascular health, and explores the mechanisms by which certain dietary patterns can impact CVH outcomes. The review focuses on the effects of MedDiet, a dietary pattern that is rich in whole foods and healthy fats, and its potential to positively influence CVH through its impact on gene expression. The review highlights the limitations of current research and the need for further studies to fully understand the complex interplay between nutrition, genetics, and cardiovascular health.

Selected Psychosocial Factors, Nutritional Behavior, and the Analysis of Concentrations of Selected Vitamins in Patients with Cardiovascular Diseases

Cardiovascular diseases (CVD) are the leading cause of death worldwide, influenced by the interaction of factors, including age, sex, genetic conditions, overweight/obesity, hypertension, an abnormal lipid profile, vitamin deficiencies, diabetes, and psychological factors. This study aimed to assess the relationships between psychosocial and nutritional factors in a group of 61 patients with CVD (i.e., atherosclerosis, hypertension, ischemic heart disease, and myocardial infarction) and their possible impact on the course of the disease. The plasma concentrations of vitamins A, E, D, and β-carotene were determined using validated HPLC-MS/MS, while the lipid profile was analyzed enzymatically. Psychosocial factors and nutritional behaviors were assessed using author-designed questionnaires. Over 50% of patients had 25-OH-D3 and retinol deficiencies, while >85% of patients exhibited significant deficiencies in α-tocopherol and β-carotene. The lipid profile showed no specific relationship with any particular CVD. Dietary behavior minimally impacted biochemical parameters except for higher β-carotene concentrations in the group with higher fruit and vegetable intake. The negative impact of the CVD on selected parameters of quality of life was noticed. To increase the effectiveness of the prevention and treatment of CVD, the need for interdisciplinary cooperation observed between doctors, psychologists, and specialists in human nutrition seems to be justified.

Two cosmoses, one universe: a narrative review exploring the gut microbiome's role in the effect of urban risk factors on vascular ageing

In the face of rising global urbanisation, understanding how the associated environment and lifestyle impact public health is a cornerstone for prevention, research, and clinical practice. Cardiovascular disease is the leading cause of morbidity and mortality worldwide, with urban risk factors contributing greatly to its burden. The current narrative review adopts an exposome approach to explore the effect of urban-associated physical-chemical factors (such as air pollution) and lifestyle on cardiovascular health and ageing. In addition, we provide new insights into how these urban-related factors alter the gut microbiome, which has been associated with an increased risk of cardiovascular disease. We focus on vascular ageing, before disease onset, to promote preventative research and practice. We also discuss how urban ecosystems and social factors may interact with these pathways and provide suggestions for future research, precision prevention and management of vascular ageing. Most importantly, future research and decision-making would benefit from adopting an exposome approach and acknowledging the diverse and boundless universe of the microbiome.

Sulforaphane Improves Redox Homeostasis and Right Ventricular Contractility in a Model of Pulmonary Hypertension

ABSTRACT

Pulmonary arterial hypertension (PAH) is characterized by increased pulmonary vascular resistance (PVR), imposing overload on the right ventricle (RV) and imbalance of the redox state. Our study investigated the influence of treatment with sulforaphane (SFN), found in cruciferous vegetables, on RV remodeling and redox homeostasis in monocrotaline (MCT)-induced PAH. Male Wistar rats were separated into 4 groups: control (CTR); CTR + SFN; MCT; and MCT + SFN. PAH induction was implemented by a single dose of MCT (60 mg/kg intraperitoneally). Treatment with SFN (2.5 mg/kg/day intraperitoneally) started on the seventh day after the MCT injection and persisted for 2 weeks. After 21 days of PAH induction, echocardiographic, hemodynamic, and oxidative stress evaluation was performed. The MCT group showed an increase in RV hypertrophy, RV systolic area, RV systolic, mean pulmonary artery pressure, and PVR and exhibited a decrease in the RV outflow tract acceleration time/ejection time ratio, RV fractional shortening, and tricuspid annular plane systolic excursion compared to CTR ( P < 0.05). SFN-treated PAH attenuated detrimental changes in tricuspid annular plane systolic excursion, mean pulmonary artery pressure, and PVR parameters. Catalase levels and the glutathione/Glutathione disulfide (GSSG) ratio were diminished in the MCT group compared to CTR ( P < 0.05). SFN increased catalase levels and normalized the glutathione/GSSG ratio to control levels ( P < 0.05). Data express the benefit of SFN treatment on the cardiac function of rats with PAH associated with the cellular redox state.

Standard and New Echocardio Techniques, Such as Global Longitudinal Strain, to Monitor the Impact of Diets on Cardiovascular Diseases and Heart Function

"The Seven Countries Study", published in 1984, was the first study to find a correlation between diet and mortality related to cardiovascular diseases (CVDs). Since then, many investigations have addressed the relationship between type of diet, or specific nutrients, and CVDs. Based on these findings, some traditional dietary models, such as the Mediterranean or Nordic diet, are recommended to prevent CVDs. Meanwhile, new diets have been proposed for optimal nutrition therapy, for example, the Dietary Approaches to Stop Hypertension (DASH) and the Mediterranean-DASH Intervention Diet for Neurodegenerative Delay (MIND). The main outcomes evaluated after implementing these dietary models are as follows: CVD-related death; the development of specific CVDs, such as myocardial infarction and hypertension; or biochemical parameters related to CVDs, i.e., non-HDL cholesterol, C-reactive protein (CPR) and homocysteine. However, the early impact of diet on heart functionality is less evaluated. Recently, the echographic measurement of left ventricle (LV) deformation by global longitudinal strain (GLS) has been introduced as a novel marker of clinical and subclinical cardiac dysfunction. This technology allows a subclinical evaluation of heart functionality since, differently from the traditional evaluation of left ventricle ejection fraction (LVEF), it is capable of detecting early myocardial dysfunction. In this review, we analyzed the available studies that correlate dietetic regimens to cardiovascular diseases, focusing on the relevance of LV strain to detect subclinical myocardial alteration related to diet. Evidence is presented that DASH and MIND can have a positive impact on heart functionality and that myocardial strain is useful for early detection of diet-related changes in cardiac function.

Research Progress in Pharmacological Effects and Mechanisms of Angelica sinensis against Cardiovascular and Cerebrovascular Diseases

Angelica sinensis (Oliv.) Diels (A. sinensis) is a medicinal and edible values substance, which could promote blood circulation and enrich blood. It possesses rich chemical components and nutrients, which have significant therapeutic effects on cardiovascular and cerebrovascular diseases. It is commonly used for the prevention and treatment of cardiovascular and cerebrovascular diseases in the elderly, especially in improving ischemic damage to the heart and brain, protecting vascular cells, and regulating inflammatory reactions. This article reviews the main pharmacological effects and clinical research of A. sinensis on cardiovascular and cerebrovascular diseases in recent years, explores the effect of its chemical components on cardiovascular and cerebrovascular diseases by regulating the expression of functional proteins and inhibiting inflammation, anti-apoptosis, and antioxidant mechanisms. It provides a reference for further research on A. sinensis and the development of related drugs. It provides a new reference direction for the in-depth research and application of A. sinensis in the prevention, improvement, and treatment of cardiovascular and cerebrovascular diseases.

Mitofilin in cardiovascular diseases: Insights into the pathogenesis and potential pharmacological interventions

The impact of mitochondrial dysfunction on the pathogenesis of cardiovascular disease is increasing. However, the precise underlying mechanism remains unclear. Mitochondria produce cellular energy through oxidative phosphorylation while regulating calcium homeostasis, cellular respiration, and the production of biosynthetic chemicals. Nevertheless, problems related to cardiac energy metabolism, defective mitochondrial proteins, mitophagy, and structural changes in mitochondrial membranes can cause cardiovascular diseases via mitochondrial dysfunction. Mitofilin is a critical inner mitochondrial membrane protein that maintains cristae structure and facilitates protein transport while linking the inner mitochondrial membrane, outer mitochondrial membrane, and mitochondrial DNA transcription. Researchers believe that mitofilin may be a therapeutic target for treating cardiovascular diseases, particularly cardiac mitochondrial dysfunctions. In this review, we highlight current findings regarding the role of mitofilin in the pathogenesis of cardiovascular diseases and potential therapeutic compounds targeting mitofilin.

The Role of Diet in the Cardiovascular Health of Childhood Cancer Survivors-A Systematic Review

BACKGROUND

Childhood cancer survivors (CCSs) face an increased risk of cardiovascular disease (CVD). This systematic review aims to provide the first synthesis of observational and interventional studies on the relationship between diet and cardiovascular health in CCSs.

METHODS

A comprehensive search was conducted for studies published between 1990 and July 2023 in PubMed, MEDLINE, CINAHL, Child Development & Adolescent Studies, and Cochrane Library. Eligible studies included observational and interventional studies examining the associations or effects of dietary factors on CVD incidence, cardiac dysfunction, or CVD risk factors in CCSs diagnosed before age 25 years.

RESULTS

Ten studies met the inclusion criteria (nine observational and one interventional). Collectively, they comprised 3485 CCSs (male, 1734; female, 1751). The outcomes examined across observational studies included characteristics of obesity, diabetes biomarkers, hypertension indicators, dyslipidaemia biomarkers, and metabolic syndrome. The evidence suggested that greater adherence to healthy diets was associated with lower body mass index, blood pressure, glucose, and triglycerides and higher high-density lipoprotein cholesterol. The 12-week lifestyle intervention study in childhood leukaemia survivors found no impact on obesity indicators.

CONCLUSION

The review results indicate the potentially protective effects of healthy diets. However, the available research remains preliminary and limited, underscoring the need for more rigorous, adequately powered studies.

The Effect of a Program to Improve Adherence to the Mediterranean Diet on Cardiometabolic Parameters in 7034 Spanish Workers

BACKGROUND

Cardiovascular and metabolic diseases include a large group of pathologies and constitute one of the most serious chronic health problems facing the 21st century, with high rates of morbidity and mortality worldwide. Unhealthy diets influence the development of these pathologies. The Mediterranean diet can be an important part in the treatment of these diseases. The objective of this study was to assess the effect of a program that aims to increase adherence to the Mediterranean diet on the improvement of different cardiometabolic risk parameters.

METHODS

A prospective intervention study was carried out on 7034 Spanish workers. Prior to the intervention, 22 cardiometabolic risk scales were evaluated. Participants in this study were informed both orally and in writing of the characteristics and benefits of the Mediterranean diet and were given the website of the Ministry of Health, Consumption and Social Welfare of Spain, which provides advice on nutrition. Adherence to the Mediterranean diet was reinforced by sending a monthly SMS to their mobile phones. After six months of follow-up, the 22 risk scales were re-evaluated to assess changes. Means and standard deviations were calculated using Student's t test to analyse quantitative variables. Prevalence was calculated using the Chi-square test when the variables were qualitative.

RESULTS

All the cardiometabolic risk scales studied decreased after implementing a program to improve and enhance adherence to the Mediterranean diet. The number of losses in the sample was very low, standing at 4.31%.

CONCLUSIONS

The Mediterranean diet is effective in reducing all cardiovascular risk scales evaluated. The mean values and prevalence of high values of the different cardiometabolic risk scales analysed led to lower values after the implementation of the program to increase adherence to the Mediterranean diet. We observed a significant positive difference in metabolic age in both sexes. We have obtained a significant improvement in the insulin resistance index, especially in the SPISE-IR index, data that we have not found in previous publications. Easy access to the Internet and new information and communication technologies facilitate adherence to a diet and can reduce the number of losses.

Combined effect of falling difficulty and cardiovascular diseases on the risk of all-cause and cardiovascular mortality in older adults: an analysis of the National Health and Nutrition Examination Survey

PURPOSE

Older adults with cardiovascular diseases (CVD) are prone to falls. This study aimed to analyze the combined effect of falling difficulty and CVD on the risk of all-cause- and CVD mortality in older adults.

METHODS

In this retrospective cohort study, people aged ≥60 years with information on falling difficulty and CVD from the 1999-2004 National Health and Nutrition Examination Survey (NHANES) were selected. Multivariable Cox proportional hazards regression model was used to assess the associations of falling difficulty and CVD with all-cause- and CVD mortality.

RESULTS

A total of 1409 participants were included, of whom 868 (58.1%) participants died, and 237 (15.0%) died of CVD. The mean age of participants was 72.1 (0.3) years and 825 (64.7%) were female. Older adults with falling difficulty or CVD were associated with an increased risk of all-cause- and CVD mortality. Older adults in the no falling difficulty & CVD group [hazard ratio (HR) = 1.45, 95% confidence interval (CI) 1.19-1.78], the falling difficulty & no CVD group (HR = 1.45, 95%CI 1.12-1.89), and the falling difficulty & CVD group (HR = 2.13, 95%CI 1.77-2.56) were related to a higher risk of all-cause mortality compared to those in the no falling difficulty & no CVD group. The combined effect of falling difficulty and CVD was positively correlated with the risk of all-cause mortality (HR = 1.26, 95%CI: 1.18-1.34; P-trend <0.001) and CVD mortality (HR = 1.36, 95%CI: 1.18-1.56; P-trend <0.001).

CONCLUSION

The combined effect of falling difficulty and CVD was positively associated with the risk of all-cause- and CVD mortality in older adults.

Maternal Seafood Consumption during Pregnancy and Cardiovascular Health of Children at 11 Years of Age

Nutrition is critical during pregnancy for the healthy growth of the developing infant, who is fully dependent on maternal dietary omega-3 supply for development. Fatty fish, a main dietary source of omega-3, is associated with decreased cardiovascular risk in adults. We conducted a longitudinal study based on a mother-offspring cohort as part of the project Infancia y Medio Ambiente (INMA) in order to assess whether fish intake during pregnancy relates to cardiovascular health in children. A total of 657 women were included and followed throughout pregnancy until birth, and their children were enrolled at birth and followed up until age 11-12. A semi-quantitative food frequency questionnaire was used to assess the daily intake of foods during the 1st and 3rd trimesters of pregnancy. Cardiovascular assessments included arterial stiffness (assessed by carotid-femoral pulse wave velocity [PWV]) and retinal microcirculation (photographic assessment of central retinal arteriolar and venular equivalent [CRAE and CRVE]). The association between maternal fish consumption and cardiovascular outcomes of offspring at 11 years of age was evaluated using multivariable linear regression models. There were no statistically significant differences in any cardiovascular endpoint in children whose mothers had a higher fish consumption during pregnancy compared to those with a lower fish consumption. We found a slightly higher PWV (β = 0.1, 95% CI = 0.0; 0.2, p for trend = 0.047) in children whose mothers had a higher consumption of canned tuna during the 1st trimester of pregnancy. Fish intake during pregnancy was found to be unrelated to the offspring's cardiovascular health at 11 years of age. The beneficial cardiovascular effects of fish consumption during pregnancy on the offspring are still inconclusive.

Changes in environmental exposures over decades may influence the genetic architecture of severe spermatogenic failure

STUDY QUESTION

Do the genetic determinants of idiopathic severe spermatogenic failure (SPGF) differ between generations?

SUMMARY ANSWER

Our data support that the genetic component of idiopathic SPGF is impacted by dynamic changes in environmental exposures over decades.

WHAT IS KNOWN ALREADY

The idiopathic form of SPGF has a multifactorial etiology wherein an interaction between genetic, epigenetic, and environmental factors leads to the disease onset and progression. At the genetic level, genome-wide association studies (GWASs) allow the analysis of millions of genetic variants across the genome in a hypothesis-free manner, as a valuable tool for identifying susceptibility risk loci. However, little is known about the specific role of non-genetic factors and their influence on the genetic determinants in this type of conditions.

STUDY DESIGN, SIZE, DURATION

Case-control genetic association analyses were performed including a total of 912 SPGF cases and 1360 unaffected controls.

PARTICIPANTS/MATERIALS, SETTING, METHODS

All participants had European ancestry (Iberian and German). SPGF cases were diagnosed during the last decade either with idiopathic non-obstructive azoospermia (n = 547) or with idiopathic non-obstructive oligozoospermia (n = 365). Case-control genetic association analyses were performed by logistic regression models considering the generation as a covariate and by in silico functional characterization of the susceptibility genomic regions.

MAIN RESULTS AND THE ROLE OF CHANCE

This analysis revealed 13 novel genetic association signals with SPGF, with eight of them being independent. The observed associations were mostly explained by the interaction between each lead variant and the age-group. Additionally, we established links between these loci and diverse non-genetic factors, such as toxic or dietary habits, respiratory disorders, and autoimmune diseases, which might potentially influence the genetic architecture of idiopathic SPGF.

LARGE SCALE DATA

GWAS data are available from the authors upon reasonable request.

LIMITATIONS, REASONS FOR CAUTION

Additional independent studies involving large cohorts in ethnically diverse populations are warranted to confirm our findings.

WIDER IMPLICATIONS OF THE FINDINGS

Overall, this study proposes an innovative strategy to achieve a more precise understanding of conditions such as SPGF by considering the interactions between a variable exposome through different generations and genetic predisposition to complex diseases.

STUDY FUNDING/COMPETING INTEREST(S)

This work was supported by the "Plan Andaluz de Investigación, Desarrollo e Innovación (PAIDI 2020)" (ref. PY20_00212, P20_00583), the Spanish Ministry of Economy and Competitiveness through the Spanish National Plan for Scientific and Technical Research and Innovation (ref. PID2020-120157RB-I00 funded by MCIN/ AEI/10.13039/501100011033), and the 'Proyectos I+D+i del Programa Operativo FEDER 2020' (ref. B-CTS-584-UGR20). ToxOmics-Centre for Toxicogenomics and Human Health, Genetics, Oncology and Human Toxicology, is also partially supported by the Portuguese Foundation for Science and Technology (Projects: UIDB/00009/2020; UIDP/00009/2020). The authors declare no competing interests.

TRIAL REGISTRATION NUMBER

N/A.

Isoflavones Effects on Vascular and Endothelial Outcomes: How Is the Gut Microbiota Involved?

Isoflavones are a group of (poly)phenols, also defined as phytoestrogens, with chemical structures comparable with estrogen, that exert weak estrogenic effects. These phytochemical compounds have been targeted for their proven antioxidant and protective effects. Recognizing the increasing prevalence of cardiovascular diseases (CVD), there is a growing interest in understanding the potential cardiovascular benefits associated with these phytochemical compounds. Gut microbiota may play a key role in mediating the effects of isoflavones on vascular and endothelial functions, as it is directly implicated in isoflavones metabolism. The findings from randomized clinical trials indicate that isoflavone supplementation may exert putative effects on vascular biomarkers among healthy individuals, but not among patients affected by cardiometabolic disorders. These results might be explained by the enzymatic transformation to which isoflavones are subjected by the gut microbiota, suggesting that a diverse composition of the microbiota may determine the diverse bioavailability of these compounds. Specifically, the conversion of isoflavones in equol-a microbiota-derived metabolite-seems to differ between individuals. Further studies are needed to clarify the intricate molecular mechanisms behind these contrasting results.

Proteomic and Metabolomic Signatures of Diet Quality in Young Adults

The assessment of "omics" signatures may contribute to personalized medicine and precision nutrition. However, the existing literature is still limited in the homogeneity of participants' characteristics and in limited assessments of integrated omics layers. Our objective was to use post-prandial metabolomics and fasting proteomics to identify biological pathways and functions associated with diet quality in a population of primarily Hispanic young adults. We conducted protein and metabolite-wide association studies and functional pathway analyses to assess the relationships between a priori diet indices, Healthy Eating Index-2015 (HEI) and Dietary Approaches to Stop Hypertension (DASH) diets, and proteins (n = 346) and untargeted metabolites (n = 23,173), using data from the MetaAIR study (n = 154, 61% Hispanic). Analyses were performed for each diet quality index separately, adjusting for demographics and BMI. Five proteins (ACY1, ADH4, AGXT, GSTA1, F7) and six metabolites (undecylenic acid, betaine, hyodeoxycholic acid, stearidonic acid, iprovalicarb, pyracarbolid) were associated with both diets (p < 0.05), though none were significant after adjustment for multiple comparisons. Overlapping proteins are involved in lipid and amino acid metabolism and in hemostasis, while overlapping metabolites include amino acid derivatives, bile acids, fatty acids, and pesticides. Enriched biological pathways were involved in macronutrient metabolism, immune function, and oxidative stress. These findings in young Hispanic adults contribute to efforts to develop precision nutrition and medicine for diverse populations.

Is the Habitual Dietary Intake of Foods of Plant or Animal Origin Associated with Circulating Hemostatic Factors?-Results of the Population-Based KORA-Fit Study

Blood coagulation is a complex physiological process critical for maintaining hemostasis, and disruptions in this system can lead to various health complications. Since the effects of specific food groups on a series of circulating coagulation parameters in the population are not well established, this study examines such associations in the population-based KORA-Fit study. A total of 595 subjects (263 men and 332 women) born between 1945 and 1964 and living in the study region of Augsburg were included in the study. Habitual food intake was estimated based on a combination of repeated 24-h food lists (24HFLs) and a food frequency questionnaire (FFQ). Antithrombin III, D-dimers, factor VIII, fibrinogen, protein C, protein S, aPTT, Quick value and INR were measured in citrate plasma. Multivariable linear regression models were applied to investigate associations between the consumption of specific foods of plant or animal origin and hemostatic factors. We found that the consumption of plant-based food groups, including green leafy vegetables (rich in vitamin K1), were hardly associated with coagulation parameters. Surprisingly, a high consumption of dairy products and especially butter were associated with higher D-dimer concentrations. These findings need further evaluation in prospective studies.

A cross-sectional analysis of zinc and copper levels and their relationship to cardiovascular disease risk markers in Qatar biobank participants

Cardiovascular diseases (CVD) are the leading cause of mortality and morbidity worldwide. Dietary intake, particularly zinc (Zn) and copper (Cu) has been strongly associated with CVD. These trace elements play a crucial role in human enzyme activity, suppressing inflammation, catalyzing lipid metabolism enzymes, reducing oxidative stress, and regulating glucose metabolism. However, imbalances in these elements are linked to cardiovascular disturbances. Thus, this study aimed to investigate the association between circulating levels of Zn, Cu, and Zn/Cu ratio with CVD risk factors in the Qatari population. Bivariate logistic regression, adjusted for age, nationality, gender, and education was performed to examine the impact of Zn, Cu, and Zn/Cu ratio (as independent variables) on major CVD risk markers (as dependent variables). Participants in the highest Zn tertiles (T2 and T3) were at greater odds ratio (OR) of unfavorable metabolic functions such as elevated HbA1C [OR = 2.5, p = 0.015 (T2) and OR = 3.2, p = 0.002 (T3)], triglycerides [OR = 2.17, p = 0.015 (T2), and TyG index [OR = 2.21, p = 0.004 (T2), and OR = 2.67, p < 0.001 (T3)] compared to T1. Conversely, they had significantly lower ORs for prolonged prothrombin time [OR = 0.37, p = 0.001 (T3)]. Higher levels of Cu (T2 and T3) had higher OR for elevated HDL-C levels [OR = 1.69, p = 0.046 (T2), and OR = 2.27, p = 0.002 (T3)] and lower OR for elevated levels of triglycerides (OR = 0.4, p = 0.009, T3), diastolic blood pressure [OR = 0.41, p = 0.024 (T2), and OR = 0.47, p = 0.049 (T3)], and creatinine kinase (OR = 0.27, p = 0.014, T3) compared to T1. Higher levels of Cu (T2 and T3) were associated with a higher risk for elevated fibrinogen levels [OR = 3.1, p = 0.035 (T2), and OR = 5.04, p = 0.002 (T3)]. Additionally, higher Zn/Cu ratio (T2 and T3) were associated with lower ORs for elevated fibrinogen levels [OR = 0.3, p = 0.005 (T2), and OR = 0.27, p = 0.005 (T3)] compared to T1, indicating a lower risk of developing CVD. The study reveals a link between Zn, Cu, and the Zn/Cu ratio and cardiovascular disease risk. A higher Zn/Cu ratio may protect against CVD, while elevated Cu levels are linked to obesity, fibrinogen levels, and HbA1C. Maintaining optimal levels of these trace elements, either through diet or supplementation, may help reduce CVD risk.

The correlation between nuts and algae-less diet and children's blood pressure: from a cross-sectional study in Chongqing

BACKGROUND

Nuts and algae have been shown to improve BP levels, but their effectiveness is controversial.

AIMS

This study aims to illustrate the effect of dietary pattern with nuts and algae-less on BP levels in children and adolescents from a cross-sectional study.

METHODS

A total of 5645 children from the Chongqing Children's Health Cohort, aged 9.34 ± 1.74 years with 52.05% males, were analyzed. Stratified analysis was conducted to explore the differences between the two dietary patterns in urban or rural areas, as well as the differences in different gender. Logistic regression was used to analyze the influence factors of increased BP. And a GLM was used to analyze the influence of the two dietary patterns on systolic blood pressure (SBP, mmHg), diastolic blood pressure (DBP, mmHg), and mean arterial pressure (MAP, mmHg).

RESULTS

Children with nuts and algae-less dietary patterns had higher SBP (104.68 ± 10.31 vs 103.81 ± 9.74, P = .006), DBP (64.27 ± 7.53 vs 63.55 ± 7.52, P = .002), and MAP (77.74 ± 7.75 vs 76.97 ± 7.52, P = .001) compared with those children with a balanced diet. After adjusting for covariates, the nuts and algae-less diet was a risk factor for hypertension in children when compared with the balanced diet(OR(95%CI):1.455(1.097,1.930), P = .009). The nuts and algae-less diet has a significant influence on SBP (104.68 ± 10.31 mmHg vs.103.81 ± 9.74 mmHg, P = .006). Stratified analysis by sex showed that nuts and algae-less dietary patterns had a more significant impact on females than males.

CONCLUSION

Nuts and algae-less dietary pattern correlated with increased BP levels in children, and a greater impact on SBP levels was found in females, suggesting that a balanced diet with appropriate nuts and algae should be proposed for children in China.

Identifying barriers and facilitators to adopting healthier dietary choices in clinical care: a cross-sectional observational study

Background and aims

Adopting healthier diets can drastically improve societal health. Our environment plays a crucial role in daily dietary choices and hospitals in particular can stimulate patients to adopt healthier eating habits. Unfortunately, no robust clinically applicable cuing tools exist to help guide in-hospital dietary interventions. The purpose of this study was to identify patient-related barriers and facilitators to adopting healthier dietary choices.

Methods and results

This cross-sectional observational study was conducted on the cardiology ward of a university medical center between June 2020 and January 2021. Of the 594 patients asked and the 312 completed surveys on healthy eating intentions, 285 responses were considered for analysis. Notably, the majority of respondents were male (68.8%), with an average hospital stay of 3.3 days. The results indicate that cardiac patients attribute significantly greater influence on their dietary behavior to doctors compared to other caregivers, including dieticians (X2 = 37.09, df = 9, p < 0.001). Also, younger patients (below 70 years of age) were more inclined to plan changing dietary behavior than older patients. Most mentioned facilitators for adopting a healthier diet were more information/counseling, help in preparing food, support from family and friends, and more emphasis from a doctor.

Conclusion

The study highlights the importance of involving doctors in formulating dietary policies and patient-directed interventions within hospital settings. It also sheds light on the barriers and facilitators for promoting healthier dietary behaviors among patients during their hospitalization.

The Interplay between Helicobacter pylori and Gut Microbiota in Non-Gastrointestinal Disorders: A Special Focus on Atherosclerosis

The discovery of Helicobacter pylori (H. pylori) in the early 1980s by Nobel Prize winners in medicine Robin Warren and Barry Marshall led to a revolution in physiopathology and consequently in the treatment of peptic ulcer disease. Subsequently, H. pylori has also been linked to non-gastrointestinal diseases, such as autoimmune thrombocytopenia, acne rosacea, and Raynaud's syndrome. In addition, several studies have shown an association with cardiovascular disease and atherosclerosis. Our narrative review aims to investigate the connection between H. pylori infection, gut microbiota, and extra-gastric diseases, with a particular emphasis on atherosclerosis. We conducted an extensive search on PubMed, Google Scholar, and Scopus, using the keywords "H. pylori", "dysbiosis", "microbiota", "atherosclerosis", "cardiovascular disease" in the last ten years. Atherosclerosis is a complex condition in which the arteries thicken or harden due to plaque deposits in the inner lining of an artery and is associated with several cardiovascular diseases. Recent research has highlighted the role of the microbiota in the pathogenesis of this group of diseases. H. pylori is able to both directly influence the onset of atherosclerosis and negatively modulate the microbiota. H. pylori is an important factor in promoting atherosclerosis. Progress is being made in understanding the underlying mechanisms, which could open the way to interesting new therapeutic perspectives.

Higher intakes of fiber, total vegetables, and fruits may attenuate the risk of all-cause and cause-specific mortality: findings from a large prospective cohort study

BACKGROUND

Although studies have reported an inverse association between fruits, vegetables, and fiber consumption and all-cause and cause-specific mortality, the issue remains incompletely defined in the Middle Eastern population.

AIMS

The current study aimed to investigate the association between dietary fiber, fruit, and vegetable intake and all-cause and cause-specific mortality.

METHODS

A total of 48632 participants (mean age = 52years), 57.5% (n = 27974) women and 42.5% (n = 20658) men, were recruited from an ongoing large-scale prospective cohort study (the Golestan Cohort Study (GCS)), in the north of Iran. Using a validated semi-quantitative 116-item food questionnaire, dietary intakes were collected. Hazard ratios (HRs) and 95% confidence intervals (95%CIs) of all-cause and cause-specific mortality were reported.

RESULTS

After approximately 14 years of follow-up, 10,774 deaths were recorded. In the fully adjusted model, compared to those in the lowest quintile of intake, those in the second and third quintiles of dietary fiber intake had a 7%-10% reduction in risk of all-cause mortality, and a 15%-17% reduction in the risk of mortality from other causes. Increasing consumption of fruits was also associated with a decreased risk of mortality for all-cause mortality by 9%-11%, and all cancer by 15-20%. Further, those in the third and fourth quintiles of vegetables intake had 11%-12% lower risk for CVD mortality.

DISCUSSION

The results from the GCS further support the current recommendations on following a healthy diet containing proper amounts of fiber, vegetables, and fruits, as health-protective dietary items.

CONCLUSIONS

Higher intake of dietary fiber, fruits, and vegetables has the potential to reduce both overall and cause-specific mortality rates. However, additional cohort studies with larger sample size and long-term follow-up durations are required to establish these findings.

The Interaction of Dietary Patterns and Genetic Variants on the Risk of Cardiovascular Diseases in Chinese Patients with Type 2 Diabetes

SCOPE

Diabetes is an important risk factor for cardiovascular disease (CVD), which in turn is the most common and serious complication of diabetes. This study analyzes dietary patterns and single nucleotide polymorphisms (SNPs) in 543 diabetes patients with new-onset cardiovascular events and 461 diabetic patients without.

METHODS AND RESULTS

SNPs are determined and analyzed using real time PCR and gene chip method. Factor analysis and logistic regression are used to determine dietary patterns and evaluate the level of associations and interaction effects, respectively. The legumes and edible fungi pattern and vegetable pattern show a significant negative correlation with complication risk. ADIPOQ rs37563 and legumes and edible fungi pattern have a significant interactive effect on disease, and patients with a high score of C polymorphism genotype (GC + CC) have a lower risk of disease. 5-10-Methylenetetrahydrofolate reductase (MTHFR) rs1801131 and vegetable pattern have a borderline interaction effect on disease, and those patients with TT genotype have a lower risk of disease.

CONCLUSION

These findings provide new insights into the role of the interactive protection of dietary patterns and SNPs. And participants with specific alleles show a lower risk of cardiovascular complications.

Associations of the MIND Diet with Cardiometabolic Diseases and Their Risk Factors: A Systematic Review

Purpose

Recent studies have expanded the scope of research on the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet beyond its impact on cognitive performance. These investigations have specifically explored its potential to provide protection against cardiometabolic diseases and associated risk factors, including obesity and dyslipidemia.

Methods

We systematically summarized and evaluated all existing observational and trial evidence for the MIND diet in relation to cardiometabolic diseases and their risk factors in adults. PubMed, Embase, CINAHL and Cochrane Library databases were systematically searched to extract original studies on humans published until September 2023, without date restrictions. A total of 491 studies were initially retrieved, out of which 23 met the eligibility criteria and were included in the final review. Duplicated and irrelevant studies were screened out by five independent reviewers using the Rayyan platform. Quality assessment was ascertained using the Newcastle-Ottawa scale for observational studies and the Cochrane risk-of-bias tool (RoB 2) for randomized trials.

Results

Across the different study designs, the MIND diet was generally associated with an improvement in anthropometric measures and other cardiometabolic outcomes, such as blood pressure, glycemic control, lipid profile, inflammation and stroke. The effects of the MIND eating pattern on some cardiovascular diseases are less conclusive.

Conclusion

The findings of this systematic review support the recommendation of the MIND diet as a strategy to reduce cardiometabolic risk in adults. Further well-designed and long-term studies are warranted.

Roles of pyroptosis in atherosclerosis pathogenesis

Pyroptosis is a pro-inflammatory type of regulated cell death (RCD) characterized by gasdermin protein-mediated membrane pore formation, cell swelling, and rapid lysis. Recent studies have suggested that pyroptosis is closely related to atherosclerosis (AS). Previous studies reported that pyroptosis involving endothelial cells (ECs), macrophages, and smooth muscle cells (SMCs) plays an important role in the formation and development of AS. Pyroptosis not only causes local inflammation but also amplifies the inflammatory response and it aggravates plaque instability, leading to plaque rupture and thrombosis, eventually resulting in acute cardiovascular events. In this review, we clarified some novel pathways and mechanics and presented some potential drugs.

Predicting Cardiovascular Disease Mortality: Leveraging Machine Learning for Comprehensive Assessment of Health and Nutrition Variables

Cardiovascular disease (CVD) is one of the primary causes of death around the world. This study aimed to identify risk factors associated with CVD mortality using data from the National Health and Nutrition Examination Survey (NHANES). We created three models focusing on dietary data, non-diet-related health data, and a combination of both. Machine learning (ML) models, particularly the random forest algorithm, demonstrated robust consistency across health, nutrition, and mixed categories in predicting death from CVD. Shapley additive explanation (SHAP) values showed age, systolic blood pressure, and several other health factors as crucial variables, while fiber, calcium, and vitamin E, among others, were significant nutritional variables. Our research emphasizes the importance of comprehensive health evaluation and dietary intake in predicting CVD mortality. The inclusion of nutrition variables improved the performance of our models, underscoring the utility of dietary intake in ML-based data analysis. Further investigation using large datasets with recurring dietary recalls is necessary to enhance the effectiveness and interpretability of such models.