The relationship between ultra processed food consumption and premature coronary artery disease: Iran premature coronary artery disease study (IPAD)

The Association Between Ultra-Processed Foods Consumption and Disorders of Gut-Brain Interaction: The Isfahan Functional Disorders (ISFUN) Study

BACKGROUND

Ultra-processed foods (UPFs) may lead to dysbiosis of gut microbiota, which significantly contributes to the development of disorders of gut-brain interaction (DGBI). However, knowledge regarding the association of UPFs with DGBI is scarce. Therefore, we aimed to evaluate the association of UPFs with DGBI and its common subtypes in Iranian adults.

METHODS

In this cross-sectional study, a total of 1892 adults were included. Dietary intake of participants was evaluated using a validated version of a dish-based food frequency questionnaire, and UPFs were defined using the NOVA system classification. DGBI, including heartburn, functional dyspepsia (FD), and irritable bowel syndrome (IBS), were examined using the ROME IV questionnaire. The odds of suffering from any DGBI and its subtypes across the tertiles of UPFs were assessed using logistic regression.

RESULTS

After controlling for potential confounders, being in the highest versus lowest tertile of UPFs consumption was associated with increased risk of DGBI (OR = 1.62; 95% CI: 1.20, 2.17) and IBS (OR = 1.89; 95% CI: 1.01, 3.55). However, UPFs consumption was not significantly associated with odds of FD and heartburn in the fully adjusted model. In stratified analysis by sex, females in the highest tertile of UPFs consumption had higher risks of DGBI, IBS, and FD than those in the lowest tertile. In males, in the fully adjusted model, no significant association was found between UPFs consumption and risk of DGBI and its subtypes.

CONCLUSION

Higher consumption of UPFs was significantly associated with an increased risk of total DGBI and IBS in Iranian adults. However, considering the limitations of the available evidence regarding processed foods and DGBI, further large-scale prospective studies are needed to provide more data.

Ultra-processed foods and coronary artery disease severity: a cross-sectional study of at-risk normal-weight and overweight patients undergoing elective angiography

INTRODUCTION

There is growing interest in the connection between ultra-processed food (UPF) and cardiovascular diseases. This study explores how UPF intake relates to the severity of coronary artery disease (CAD) in at-risk patients undergoing elective angiography.

METHODS

Data covering demographic, and clinical details, and dietary intakes (using a validated food frequency questionnaire) were gathered from the Nutrition Heshmat Registry (NUTHER) in Rasht, Iran. UPF consumption was evaluated using the NOVA food classification system, with the exception of core grain foods. The study comprised 1,015 participants, who were classified based on the severity of CAD using the Gensini score (severe-CAD = Gensini score ≥ 60). Logistic regression was used to analyze the odd ratio (OR) and 95%confidence interval (95%CI) for severe-CAD across UPF quartiles (percentage of energy), and for each 10% increase in UPF intake. Restricted cubic spline (RCS) regression was employed to explore nonlinear relationships between UPF and severe-CAD.

RESULTS

Following controlling for potential confounders, normal-weight participants in the highest quartile of UPF exhibited about 5 times greater odds of severe-CAD than those in the lowest category (OR(95%CI): 5.01 (1.89, 13.29); P-for-trend = 0.002). Overweight/obese participants in the higher UPF quartiles had approximately 2-3.5 times greater odds for severe-CAD than those in the 1st quartile (ORs (95%CIs): 3rd quartile 1.91 (1.14, 3.21); and 4th quartile: 3.53 (2.07, 5.99); P-for-trend < 0.001). Each 10% increase in daily energy intake from UPF was associated with about 1.6-2 times increased severe-CAD risk among overweight/obese and normal-weight individuals (ORs (95%CIs) of 1.64 (1.28, 2.11), and 2.24 (1.24, 4.05), respectively). RCS analysis showed an upward trend toward higher UPF intake in relation to increased risk of severe-CAD (P-for-overall-trend < 0.0001; P-for-nonlinearity = 0.005).

CONCLUSION

The findings obtained underscore a direct association between UPF and the risk of CAD progression among at-risk patients, independent of BMI. However, further prospective studies are essential to confirm these results and better understand this relationship.

Dairy consumption and premature coronary artery disease onset: Iran premature coronary artery disease (IPAD) study insights

Evidence has argued about the association between dairy intake and premature coronary artery disease (PCAD) development aimed to be discussed in this study. This case-control study was conducted on 813 individuals with PCAD and 471 healthy controls. The dairy intake of participants was assessed by a validated semi-quantitative food frequency questionnaire. Binary and ordinal logistic regression was applied to determine the association of dairy intake with PCAD and its severity, respectively. Compared to the first quartile, the highest quartile of total dairy consumption was associated with an increased risk of PCAD [Odds ratio (OR):1.56; 95% confidence interval (95%CI): 1.13, 2.14; P = 0.008] in the crude model. It was strengthened after full adjustment [OR: 2.44, 95% CI; 1.50,3.97; P < 0.001]. Both low-fat and high-fat dairy intake revealed no association with the risk of PCAD in the crude model. However, in the fully adjusted model, respectively highest quartile of high-fat and low-fat dairy intake had a relationship with a higher risk of SCAD. [(OR:1.68; 95%CI: 1.05,2.69; P-value for trend = 0.011) and (OR:1.99; 95%CI: 1.20,3.27; P-value for trend = 0.005). After adjustment for potential confounders, the highest amount of intake of high-fat dairy was related to increased severity of PCAD (OR:1.84; 95%CI: 1.27,2.68), but not for total and low-fat dairy intake (OR:0.98; 95%CI: 0.67,1.44 and OR: 0.74; 0.51,1.07; respectively). Dairy consumption regardless of its fat content was associated with increased risk for PCAD. The severe atherosclerotic manifestations in the coronary arteries were only associated with higher intake of high-fat dairy.

Dietary patterns and premature coronary artery disease: result from the Iran premature coronary artery disease (IPAD) study

BACKGROUND

Premature coronary artery disease (PCAD) is one of the major health concerns leading to considerable death and disabilities. This study aimed to evaluate the relationship of dietary patterns with risk of PCAD.

METHODS

Iran premature coronary diseases (IPAD) is a case-control study consists of 3159 participants. Obstructive CAD in ≥ 75% of at least one coronary artery or ≥ 50% in the left main artery based on coronary angiography in women under 70 and men under 60 years old was considered PCAD. The habitual dietary intake of participants was collected using a semi-quantitative validated food frequency questionnaire (SFFQ). Principal Component Analysis (PCA) was used to extract dietary patterns.

RESULTS

Three main dietary patterns including healthy, Western and high-fat, high-sugar were identified. Patients categorized in the last tertile of the healthy dietary pattern had a decreased risk of PCAD (OR = 0.77, 95% CI: 0.64-0.93), while those in the top tertile of Western (OR = 2.38, 95 CI:1.97-2.86) and High-fat simple carbohydrate (HFSC) (OR = 3.10, 95% CI:2.57-3.75) diets had increased risk of PCAD.

CONCLUSIONS

A healthy dietary pattern was significantly related to a decreased risk of PCAD presence, whereas Western and HFSC diets were connected to a higher risk of PCAD.

Ultra-processed food consumption and risk of cardiovascular events: a systematic review and dose-response meta-analysis

Background

Ultra-processed food (UPF) consumption continues to increase worldwide. However, evidences from meta-analyses are limited regarding the effects on cardiovascular events (CVEs).

Methods

A meta-analysis was performed to assess the dose-response relationship of UPF consumption and CVEs risk (including the morbidity and mortality of cardiovascular causes, and myocardial infarction, stroke, transient ischemic attack, coronary intervention). Databases (PubMed, EMBASE, Cochrane Library, and Web of Science) were searched for observational studies published in English language up to October 24, 2023. Generalized least squares regression and restricted cubic splines were used to estimate the linear/nonlinear relationship. PROSPERO CRD 42023391122.

Findings

Twenty studies with 1,101,073 participants and 58,201 CVEs cases with a median follow-up of 12.2 years were included. A positive linear relationship between UPF intake and CVEs risk was identified. In addition, positive correlation between coronary heart disease and UPF consumption in terms of daily serving and daily energy proportion. No significant association of UPF consumption with the risk of cerebrovascular disease was observed. Briefly, 10% increase of UPF by daily weight proportion was associated with a 1.9% increase of CVEs risk (RR = 1.019; 95% CI, 1.007-1.031; P = 0.002), an additional daily serving corresponding to 2.2% CVEs risk increase (RR = 1.022; 95% CI, 1.013-1.031; P < 0.001), and 10% increase by daily energy proportion corresponding to 1.6% CVEs risk increase (RR = 1.016; 95% CI, 1.002-1.030; P = 0.022).

Interpretation

UPF consumption were associated with a higher risk of CVEs in the positive linear relationship. Our findings highlight the importance of minimizing UPF consumption for cardiovascular health and might be help to pursue public health policies in control of UPF consumption.

Funding

This work was supported by the Key Research and Development Program of Shaanxi Province (2023-ZDLSF-22), the Innovative Talent Support Program of Shaanxi Province (2022KJXX-106), and the Key Research and Development Program of Shaanxi Province (2023-YBSF-424).