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Liu J, Wang Y, Wu L, Wang L, Fang H. Study on the influencing factors of primary dysmenorrhea in female college students: Systematic review and meta-analysis. Medicine (Baltimore) 2024; 103:e40906. [PMID: 39654168 PMCID: PMC11631030 DOI: 10.1097/md.0000000000040906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 11/16/2024] [Accepted: 11/22/2024] [Indexed: 12/12/2024] Open
Abstract
BACKGROUND The influencing factors of primary dysmenorrhea in female college students were analyzed through meta-analysis to provide the corresponding basis for its prevention and treatment. METHODS The databases, including China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, VIP database, China Biology Medicine Disc, Pubmed, Embase, Cochrane library, and Web of science were searched for the literature on the influencing factors of primary dysmenorrhea in female college students was retrieved from the science database from the establishment of the database to July 17, 2023. The Newcastle-Ottawa Quality Scale was used to score the quality of cohort and case-control studies included in the study. The cross-sectional studies were scored by the Agency for Healthcare Research and Quality. Two researchers independently screened the literature, and if there was no consensus, the third party would make a judgment on whether to include the literature. The extracted content included the first author, publication year, country, study type, sample size, and influencing factors. Stata17.0 software was used for meta-analysis. RESULTS A total of 23 studies were included, with a total sample size of 18,080 cases. Current evidence shows that the prevalence of primary dysmenorrhea in female college students is 70.3% (95%CI: 62.7-77.9%), and the combined odd ratio values (95%CI) of the main influencing factors are: family history of dysmenorrhea 2.116 (1.613-2.776), early age at menarche 2.200 (1.392-3.477), irregular menstrual cycle 1.662 (1.166-2.367), drinking cold drinks 1.717 (1.220-2.417), high caffeine intake 2.082 (1.379-3.144), stress 1.895 (1.515-2.282), medical specialty 1.827 (1.365-2.445), and adequate sleep 0.328 (0.232-0.463). CONCLUSION The prevalence of primary dysmenorrhea is high in female college students, and adequate sleep is a protective factor for primary dysmenorrhea. Family history of dysmenorrhea, early age at menarche, irregular menstrual cycle, drinking cold drinks, high caffeine intake, stress, and medical specialty were all risk factors.
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Affiliation(s)
- Jingyu Liu
- Department of Nursing, The First Affiliated Hospital of Bengbu Medical University, Bengbu, China
| | - Yimu Wang
- College of Nursing, Anhui University of Chinese Medicine, Hefei, China
| | - Lingsha Wu
- Department of Nursing, Jiaxing Second Hospital, Jiaxing, China
| | - Lingyu Wang
- College of Nursing, Anhui University of Chinese Medicine, Hefei, China
| | - Haiyan Fang
- College of Nursing, Anhui University of Chinese Medicine, Hefei, China
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2
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Ungvari Z, Kunutsor SK. Coffee consumption and cardiometabolic health: a comprehensive review of the evidence. GeroScience 2024; 46:6473-6510. [PMID: 38963648 PMCID: PMC11493900 DOI: 10.1007/s11357-024-01262-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Accepted: 06/21/2024] [Indexed: 07/05/2024] Open
Abstract
This review provides a comprehensive synthesis of longitudinal observational and interventional studies on the cardiometabolic effects of coffee consumption. It explores biological mechanisms, and clinical and policy implications, and highlights gaps in the evidence while suggesting future research directions. It also reviews evidence on the causal relationships between coffee consumption and cardiometabolic outcomes from Mendelian randomization (MR) studies. Findings indicate that while coffee may cause short-term increases in blood pressure, it does not contribute to long-term hypertension risk. There is limited evidence indicating that coffee intake might reduce the risk of metabolic syndrome and non-alcoholic fatty liver disease. Furthermore, coffee consumption is consistently linked with reduced risks of type 2 diabetes (T2D) and chronic kidney disease (CKD), showing dose-response relationships. The relationship between coffee and cardiovascular disease is complex, showing potential stroke prevention benefits but ambiguous effects on coronary heart disease. Moderate coffee consumption, typically ranging from 1 to 5 cups per day, is linked to a reduced risk of heart failure, while its impact on atrial fibrillation remains inconclusive. Furthermore, coffee consumption is associated with a lower risk of all-cause mortality, following a U-shaped pattern, with the largest risk reduction observed at moderate consumption levels. Except for T2D and CKD, MR studies do not robustly support a causal link between coffee consumption and adverse cardiometabolic outcomes. The potential beneficial effects of coffee on cardiometabolic health are consistent across age, sex, geographical regions, and coffee subtypes and are multi-dimensional, involving antioxidative, anti-inflammatory, lipid-modulating, insulin-sensitizing, and thermogenic effects. Based on its beneficial effects on cardiometabolic health and fundamental biological processes involved in aging, moderate coffee consumption has the potential to contribute to extending the healthspan and increasing longevity. The findings underscore the need for future research to understand the underlying mechanisms and refine health recommendations regarding coffee consumption.
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Affiliation(s)
- Zoltan Ungvari
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, USA
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- International Training Program in Geroscience, Doctoral College/Department of Preventive Medicine and Public Health, Semmelweis University, Budapest, Hungary
| | - Setor K Kunutsor
- Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4WP, UK.
- Section of Cardiology, Department of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, Saint Boniface Hospital, Winnipeg, MB, R2H 2A6, Canada.
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3
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Lopes CR, Cunha RA. Impact of coffee intake on human aging: Epidemiology and cellular mechanisms. Ageing Res Rev 2024; 102:102581. [PMID: 39557300 DOI: 10.1016/j.arr.2024.102581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2024] [Revised: 11/09/2024] [Accepted: 11/12/2024] [Indexed: 11/20/2024]
Abstract
The conception of coffee consumption has undergone a profound modification, evolving from a noxious habit into a safe lifestyle actually preserving human health. The last 20 years also provided strikingly consistent epidemiological evidence showing that the regular consumption of moderate doses of coffee attenuates all-cause mortality, an effect observed in over 50 studies in different geographic regions and different ethnicities. Coffee intake attenuates the major causes of mortality, dampening cardiovascular-, cerebrovascular-, cancer- and respiratory diseases-associated mortality, as well as some of the major causes of functional deterioration in the elderly such as loss of memory, depression and frailty. The amplitude of the benefit seems discrete (17 % reduction) but nonetheless corresponds to an average increase in healthspan of 1.8 years of lifetime. This review explores evidence from studies in humans and human tissues supporting an ability of coffee and of its main components (caffeine and chlorogenic acids) to preserve the main biological mechanisms responsible for the aging process, namely genomic instability, macromolecular damage, metabolic and proteostatic impairments with particularly robust effects on the control of stress adaptation and inflammation and unclear effects on stem cells and regeneration. Further studies are required to detail these mechanistic benefits in aged individuals, which may offer new insights into understanding of the biology of aging and the development of new senostatic strategies. Additionally, the safety of this lifestyle factor in the elderly prompts a renewed attention to recommending the maintenance of coffee consumption throughout life as a healthy lifestyle and to further exploring who gets the greater benefit with what schedules of which particular types and doses of coffee.
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Affiliation(s)
- Cátia R Lopes
- CNC-Center for Neuroscience and Cell Biology, Portugal; Faculty of Medicine, Portugal
| | - Rodrigo A Cunha
- CNC-Center for Neuroscience and Cell Biology, Portugal; Faculty of Medicine, Portugal; MIA-Portugal, Multidisciplinary Institute of Aging, University of Coimbra, Portugal; Centro de Medicina Digital P5, Escola de Medicina da Universidade do Minho, Braga, Portugal.
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4
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Nour El-Deen AES, Taha AM, Elsayed A, Ali AN, Taha RS. Impact of co-administration of apricot kernels and caffeine on adult male diabetic albino rats. Front Physiol 2024; 15:1358177. [PMID: 39611078 PMCID: PMC11602279 DOI: 10.3389/fphys.2024.1358177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 05/22/2024] [Indexed: 11/30/2024] Open
Abstract
The purpose of this study is to evaluate the impacts of apricot kernels and caffeine on blood glucose, lipid profile, insulin secretion, and antioxidant effect in diabetic rats. Forty adult male albino rats were divided into five groups: normal control, diabetic control, diabetic rats treated with apricot kernels, diabetic rats treated with caffeine, and diabetic rats treated with apricot kernels plus caffeine. Fasting samples were collected at the end of the study for analysis, and pieces of liver and pancreatic tissues were removed for histological analysis. There was a significant decrease in blood glucose, glycated hemoglobin, body weight, total cholesterol, triglyceride, and low-density lipoprotein cholesterol (LDL-C) levels and a significant increase in insulin and high-density lipoprotein cholesterol (HDL-C) levels in the kernel and caffeine-treated groups. However, there was little histological alteration in the liver or pancreas, and no significant differences were observed in the histological findings between groups. Overall, it can be concluded that apricot kernel and caffeine had a positive effect in decreasing blood glucose and harmful lipid profile and that caffeine had a synergistic effect on the apricot kernel.
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Affiliation(s)
- Ahmed El Sayed Nour El-Deen
- Department of Basic Medical and Dental Sciences, Faculty of Dentistry, Zarqa University, Zarqa, Jordan
- Department of Physiology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Ahmad Mohamad Taha
- Department of Basic Medical and Dental Sciences, Faculty of Dentistry, Zarqa University, Zarqa, Jordan
- Department of Physiology, Faculty of Medicine, Port Said University, Port Said, Egypt
| | - Almoatazbellah Elsayed
- Department of Basic Medical and Dental Sciences, Faculty of Dentistry, Zarqa University, Zarqa, Jordan
- Department of Pathology, Faculty of Medicine, Al-Azhar University, Assiut, Egypt
| | - Ahmed Noaman Ali
- Department of Basic Medical and Dental Sciences, Faculty of Dentistry, Zarqa University, Zarqa, Jordan
- Department of Oral Pathology, Faculty of Dentistry, Tanta University, Tanta, Egypt
| | - Reda Samir Taha
- Department of Basic Medical and Dental Sciences, Faculty of Dentistry, Zarqa University, Zarqa, Jordan
- Department of Anatomy, Faculty of Medicine in Damietta, Al-Azhar University, Assiut, Egypt
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5
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Thorpe HHA, Fontanillas P, Pham BK, Meredith JJ, Jennings MV, Courchesne-Krak NS, Vilar-Ribó L, Bianchi SB, Mutz J, Elson SL, Khokhar JY, Abdellaoui A, Davis LK, Palmer AA, Sanchez-Roige S. Genome-wide association studies of coffee intake in UK/US participants of European ancestry uncover cohort-specific genetic associations. Neuropsychopharmacology 2024; 49:1609-1618. [PMID: 38858598 PMCID: PMC11319477 DOI: 10.1038/s41386-024-01870-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 04/03/2024] [Accepted: 04/17/2024] [Indexed: 06/12/2024]
Abstract
Coffee is one of the most widely consumed beverages. We performed a genome-wide association study (GWAS) of coffee intake in US-based 23andMe participants (N = 130,153) and identified 7 significant loci, with many replicating in three multi-ancestral cohorts. We examined genetic correlations and performed a phenome-wide association study across hundreds of biomarkers, health, and lifestyle traits, then compared our results to the largest available GWAS of coffee intake from the UK Biobank (UKB; N = 334,659). We observed consistent positive genetic correlations with substance use and obesity in both cohorts. Other genetic correlations were discrepant, including positive genetic correlations between coffee intake and psychiatric illnesses, pain, and gastrointestinal traits in 23andMe that were absent or negative in the UKB, and genetic correlations with cognition that were negative in 23andMe but positive in the UKB. Phenome-wide association study using polygenic scores of coffee intake derived from 23andMe or UKB summary statistics also revealed consistent associations with increased odds of obesity- and red blood cell-related traits, but all other associations were cohort-specific. Our study shows that the genetics of coffee intake associate with substance use and obesity across cohorts, but also that GWAS performed in different populations could capture cultural differences in the relationship between behavior and genetics.
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Affiliation(s)
- Hayley H A Thorpe
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | | | - Benjamin K Pham
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - John J Meredith
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Mariela V Jennings
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | | | - Laura Vilar-Ribó
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sevim B Bianchi
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Julian Mutz
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Jibran Y Khokhar
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Abdel Abdellaoui
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Lea K Davis
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Abraham A Palmer
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Institute for Genomic Medicine, University of California San Diego, La Jolla, CA, USA
| | - Sandra Sanchez-Roige
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
- Institute for Genomic Medicine, University of California San Diego, La Jolla, CA, USA.
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Karagöz MF, Koçyiğit E, Koçak T, Özturan Şirin A, Icer MA, Ağagündüz D, Coreta-Gomes F. Decoding coffee cardiometabolic potential: Chemical composition, nutritional, and health relationships. Compr Rev Food Sci Food Saf 2024; 23:e13414. [PMID: 39137004 DOI: 10.1111/1541-4337.13414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 06/28/2024] [Accepted: 07/01/2024] [Indexed: 08/15/2024]
Abstract
Coffee is one of the most consumed beverages worldwide, recognized for its unique taste and aroma and for its social and health impacts. Coffee contains a plethora of nutritional and bioactive components, whose content can vary depending on their origin, processing, and extraction methods. Gathered evidence in literature shows that the regular coffee consumption containing functional compounds (e.g., polysaccharides, phenolic compounds, and melanoidins) can have potential beneficial effects on cardiometabolic risk factors such as abdominal adiposity, hyperglycemia, and lipogenesis. On the other hand, coffee compounds, such as caffeine, diterpenes, and advanced glycation end products, may be considered a risk for cardiometabolic health. The present comprehensive review provides up-to-date knowledge on the structure-function relationships between different chemical compounds present in coffee, one of the most prevalent beverages present in human diet, and cardiometabolic health.
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Affiliation(s)
- Mustafa Fevzi Karagöz
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, Ankara, Türkiye
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hitit University, Çorum, Türkiye
| | - Emine Koçyiğit
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ordu University, Ordu, Türkiye
| | - Tevfik Koçak
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Gümüşhane University, Gümüşhane, Türkiye
| | - Ayçıl Özturan Şirin
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Aydın Adnan Menderes University, Aydın, Turkey
| | - Mehmet Arif Icer
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Amasya University, Amasya, Türkiye
| | - Duygu Ağagündüz
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, Ankara, Türkiye
| | - Filipe Coreta-Gomes
- LAQV-REQUIMTE, Chemistry Department, University of Aveiro, Aveiro, Portugal
- Department of Chemistry, Coimbra Chemistry Centre, Institute of Molecular Sciences (CQC-IMS), University of Coimbra, Coimbra, Portugal
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7
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Tsai KZ, Huang WC, Sui X, Lavie CJ, Lin GM. Moderate or greater daily coffee consumption is associated with lower incidence of metabolic syndrome in Taiwanese militaries: results from the CHIEF cohort study. Front Nutr 2023; 10:1321916. [PMID: 38156279 PMCID: PMC10752930 DOI: 10.3389/fnut.2023.1321916] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 12/05/2023] [Indexed: 12/30/2023] Open
Abstract
BACKGROUND Daily moderate coffee intake was found with a lower risk of specific metabolic abnormalities, e.g., hypertension and hyperglycemia, while the association of coffee intake and incident metabolic syndrome (MetS) has not been clarified in prior studies, particularly in young adults. METHODS A total of 2,890 military personnel, aged 18-39 years, free of MetS were followed for incident MetS from baseline (2014) until the end of 2020 in Taiwan. Daily coffee amount consumed was grouped to those ≥3 cups or 600 mL (moderate or more amount) and those without. Incidence of MetS was identified in annual health examinations. MetS was diagnosed on the basis of the guideline of the International Diabetes Federation. Multivariable Cox regression model with adjustments for sex, age, body mass index, physical activity and substance use status at baseline was performed to determine the association. RESULTS At baseline, there were 145 subjects with daily coffee intake ≥3 cups or 600 mL (5.0%) in the overall cohort. During a mean follow-up of 6.0 years, 673 incident MetS (23.3%) were found. As compared to those consuming less coffee or none, those consuming daily coffee ≥3 cups had a lower risk of MetS [hazard ratio (HR): 0.69 (95% confidence interval: 0.48, 0.99)]. CONCLUSION This study suggests that adhering to the guideline recommended moderate or greater daily coffee consumption for promoting health, may confer advantages in preventing the development of MetS among young adults.
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Affiliation(s)
- Kun-Zhe Tsai
- Department of Stomatology of Periodontology, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien City, Taiwan
- Department of Periodontology, School of Dentistry, National Defense Medical Center and Tri-Service General Hospital, Taipei, Taiwan
| | - Wei-Chun Huang
- Department of Critical Care Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Xuemei Sui
- Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Carl J. Lavie
- Ochsner Clinical School, John Ochsner Heart and Vascular Institute, The University of Queensland School of Medicine, New Orleans, LA, United States
| | - Gen-Min Lin
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien City, Taiwan
- Department of Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
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Zhou J, Qin L. Associations of urinary caffeine and caffeine metabolites with metabolic syndrome in US adults. Front Nutr 2023; 10:1280215. [PMID: 38107745 PMCID: PMC10722267 DOI: 10.3389/fnut.2023.1280215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 11/03/2023] [Indexed: 12/19/2023] Open
Abstract
Aims The relationship between caffeine and metabolic syndrome (MetS) has only been evaluated from the perspective of caffeine consumption. The association between urinary caffeine and MetS is still unclear. This study examined the associations between urinary caffeine and its metabolites and MetS and its components among adults. Methods Data from the United States (US) National Health and Nutrition Examination Survey (NHANES) 2011-2014 was analyzed. NHANES is a stratified, multi-stage survey of all non-institutionalized persons in the US. A total of 2,394 subjects aged ≥ 18 years without missing data were selected in this study. Urinary caffeine and caffeine metabolite levels were quantified using high-performance liquid chromatography-electrospray ionization-tandem quadrupole mass spectrometry (HPLC-ESI-MS/MS) with stable isotope-labeled internal standards. We performed principal components analysis (PCA) to investigate the underlying correlation structure of 15 features of urinary caffeine and its metabolites and then used these principal components (PCs) as independent variables to conduct logistic regression analysis with or without restricted cubic spline (RCS) terms to explore the associations between caffeine metabolites and MetS. Results Two main PCs that were derived from the PCA explained 90.67% of the total variance of caffeine and its metabolites. The first PC (PC1, strongly correlated with 1-MU, 1,3-DMU, 1,7-DMU, 1,3,7-TMU, 1-MX, 1,3-DMX, 1,7-DMX, 1,3,7-TMX, and AAMU) was positively correlated with risk of MetS (OR = 1.27, p < 0.001) and all its components (all ORs > 1, all p-values < 0.001) in the unadjusted models, while in the adjusted models, it was positively correlated with MetS (OR = 1.16, p = 0.042) and central obesity (OR = 1.22, p < 0.001). In the unadjusted model, there were significant associations between the second PC (PC2, correlated with 3-MU, 7-MU, 3,7-DMU, 3-MX, 7-MX, and 3,7-DMX) and MetS (OR = 1.11, P = 0.030) and central obesity (OR = 1.16, P < 0.001), while in the adjusted models (adjustment variables include gender, age, race/ethnicity, education level and income-poverty ratio, smoking status, drinking, and physical activity), PC2 was positively associated with MetS (OR = 1.15, p = 0.035) and central obesity (OR = 1.15, p = 0.005) and negatively associated with raised triglycerides (TG) (OR = 0.84, p = 0.008). Moreover, we observed U-shaped associations between PC1 and the risk of raised TG both in unadjusted (Pnon-linear = 0.017) and adjusted (Pnon-linear = 0.014) models. Conclusion Urinary caffeine metabolites were positively associated with the risk of MetS and its components through different linear or non-linear patterns.
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Affiliation(s)
- Jianli Zhou
- Department of Science and Education, Guilin People’s Hospital, Guilin, China
| | - Linyuan Qin
- Department of Epidemiology and Health Statistics, School of Public Health, Guilin Medical University, Guilin, China
- Guangxi Key laboratory of Environmental Exposomics and Entire Lifecycle Health, Guilin, China
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Thorpe HHA, Fontanillas P, Pham BK, Meredith JJ, Jennings MV, Courchesne-Krak NS, Vilar-Ribó L, Bianchi SB, Mutz J, Elson SL, Khokhar JY, Abdellaoui A, Davis LK, Palmer AA, Sanchez-Roige S. Genome-Wide Association Studies of Coffee Intake in UK/US Participants of European Ancestry Uncover Gene-Cohort Influences. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.09.09.23295284. [PMID: 37745582 PMCID: PMC10516045 DOI: 10.1101/2023.09.09.23295284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Coffee is one of the most widely consumed beverages. We performed a genome-wide association study (GWAS) of coffee intake in US-based 23andMe participants (N=130,153) and identified 7 significant loci, with many replicating in three multi-ancestral cohorts. We examined genetic correlations and performed a phenome-wide association study across thousands of biomarkers and health and lifestyle traits, then compared our results to the largest available GWAS of coffee intake from UK Biobank (UKB; N=334,659). The results of these two GWAS were highly discrepant. We observed positive genetic correlations between coffee intake and psychiatric illnesses, pain, and gastrointestinal traits in 23andMe that were absent or negative in UKB. Genetic correlations with cognition were negative in 23andMe but positive in UKB. The only consistent observations were positive genetic correlations with substance use and obesity. Our study shows that GWAS in different cohorts could capture cultural differences in the relationship between behavior and genetics.
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Affiliation(s)
- Hayley H A Thorpe
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | | | - Benjamin K Pham
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - John J Meredith
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Mariela V Jennings
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | | | - Laura Vilar-Ribó
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d’Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sevim B Bianchi
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Julian Mutz
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
| | - 23andMe Research Team
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Sarah L Elson
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Jibran Y Khokhar
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Abdel Abdellaoui
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Lea K Davis
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Abraham A Palmer
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Institute for Genomic Medicine, University of California San Diego, La Jolla, CA, USA
| | - Sandra Sanchez-Roige
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
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10
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Yang Z, Shao Z, Ouyang W, Ying L, Guo R, Hao M, Liang Y, Zhang W, Chen X, Chen R, Yu C, Prabahar K, Găman MA, Kord-Varkaneh H, Li H, Zhao B. The effect of green coffee extract supplementation on obesity indices: critical umbrella review of interventional meta-analyses. Crit Rev Food Sci Nutr 2023; 64:10537-10545. [PMID: 37341701 DOI: 10.1080/10408398.2023.2225614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
Despite a multitude of investigations assessing the impact of green coffee extract supplementation on obesity indices, there is still a great deal of heated debate regarding the benefits of this intervention in obesity management. Therefore, in order to clarify the effect of green coffee extract on waist circumference (WC), body mass index (BMI) and body weight (BW), we conducted an umbrella review of interventional meta-analyses. The Web of Science, Scopus, PubMed/Medline, and Embase databases were searched using specific keywords and word combinations. The umbrella meta-analysis was performed using the Stata software version 17 (Stata Corp. College Station, Texas, USA). We pooled effect sizes (ES) and confidence intervals (CI) for the outcomes using the random effects model (the DerSimonian and Laird method). In total, 5 eligible meta-analyses were included in the final quantitative assessment. Data pooled from 5 eligible papers revealed that green coffee extract can reduce BW (WMD: -1.22 kg, 95% CI: -1.53 to -0.92, p < 0.001), BMI (WMD: -0.48 kg/m2, 95% CI: -0.67 to -0.29, p < 0.001) and WC (WMD: -0.55 cm, 95% CI: -0.80 to -0.31, p < 0.001). Subgroup analyses highlighted that green coffee extract supplementation in dosages ≤600 mg/day and interventions lasting >7 wk are more likely to decrease BW. The present umbrella meta-analysis confirms the beneficial effects of green coffee extract in reducing WC, BMI, and BW. Thus, we may infer that green coffee extract can be used as a complementary therapy in the management of obesity.
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Affiliation(s)
- Zhao Yang
- College of Life Science and Technology, Innovation Center of Molecular Diagnostics, Beijing University of Chemical Technology, Beijing, China
- School of Public Health, Jining Medical University, Jining, Shandong, China
| | - Zhuo Shao
- Department of Clinical Laboratory, China-Japan Friendship Hospital, Beijing, China
| | - Weiyi Ouyang
- College of Life Science and Technology, Innovation Center of Molecular Diagnostics, Beijing University of Chemical Technology, Beijing, China
| | - Lu Ying
- College of Life Science and Technology, Innovation Center of Molecular Diagnostics, Beijing University of Chemical Technology, Beijing, China
| | - Rui Guo
- College of Life Science and Technology, Innovation Center of Molecular Diagnostics, Beijing University of Chemical Technology, Beijing, China
| | - Mingxuan Hao
- College of Life Science and Technology, Innovation Center of Molecular Diagnostics, Beijing University of Chemical Technology, Beijing, China
| | - Youfeng Liang
- College of Life Science and Technology, Innovation Center of Molecular Diagnostics, Beijing University of Chemical Technology, Beijing, China
| | - Wenjing Zhang
- College of Life Science and Technology, Innovation Center of Molecular Diagnostics, Beijing University of Chemical Technology, Beijing, China
| | - Xiaoyang Chen
- College of Life Science and Technology, Innovation Center of Molecular Diagnostics, Beijing University of Chemical Technology, Beijing, China
| | - Ruolan Chen
- College of Life Science and Technology, Innovation Center of Molecular Diagnostics, Beijing University of Chemical Technology, Beijing, China
| | - Changyuan Yu
- College of Life Science and Technology, Innovation Center of Molecular Diagnostics, Beijing University of Chemical Technology, Beijing, China
| | - Kousalya Prabahar
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia
| | - Mihnea-Alexandru Găman
- Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania & Center of Hematology and Bone Marrow Transplantation, Fundeni Clinical Institute, Bucharest, Romania
| | - Hamed Kord-Varkaneh
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hao Li
- School of Public Health, Jining Medical University, Jining, Shandong, China
| | - Binbin Zhao
- Institute of Gerontology, Hubei University of Chinese Medicine, Wuhan, Hubei, China
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11
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Virgili J, Motitis P, Julal G, Mavrommatis Y, Pilic L. The impact of genetic variability on the relationship between caffeine and cardiometabolic outcomes: A systematic review. NUTR BULL 2023; 48:28-42. [PMID: 36842137 DOI: 10.1111/nbu.12606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 01/09/2023] [Accepted: 01/11/2023] [Indexed: 02/27/2023]
Abstract
The relationship between caffeine consumption and cardiometabolic health has been reported, however with heterogenous results. Discrepancies in study results may be due to inter-individual variability between study participants. This systematic review aimed to identify the impact of genetics on the relationship between caffeine consumption and cardiometabolic outcomes. Electronic databases (PubMed and EMBASE) were searched for studies published until July 2021. Selected studies were of both intervention and observational design and included (1) analysis of at least one of the selected cardiometabolic outcome (type 2 diabetes, glucose/insulin levels, cardiovascular disease [CVD], blood pressure [BP] or hypertension, and blood lipid and catecholamine levels), (2) adults aged 18-65 years, and (3) genetic analysis of individuals consuming caffeine. Seventeen studies were included: four randomised controlled trials and an interventional and quasi-experimental study, six population-based prospective cohort studies, three cross-sectional studies, and three case-control studies. CYP1A2 rs762551 and ADORA rs5751876 were associated with glucose response when caffeine was consumed with carbohydrates. CYP1A2 rs762551 moderated the association between coffee intake and hypertension. Moreover, ADORA2A rs5751876 and the ADRA2B I variants moderated the associations between caffeine and BP. Studies that investigated the effects of genetic variations on CVD and caffeine consumption reported equivocal findings (CYP1A2) or warrant replication (COMT, ADORA and TRIB1). Elucidating the extent to which these genes moderate the association between caffeine and cardiometabolic outcomes will enable caffeine consumption advice to be tailored to specific individuals to optimise health.
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Affiliation(s)
- Jessica Virgili
- Department of Health Science, Faculty of Sport, Allied Health and Performance Sciences, St Mary's University Twickenham, Twickenham, UK
| | - Petros Motitis
- Department of Health Science, Faculty of Sport, Allied Health and Performance Sciences, St Mary's University Twickenham, Twickenham, UK
| | - Gabrielle Julal
- Department of Health Science, Faculty of Sport, Allied Health and Performance Sciences, St Mary's University Twickenham, Twickenham, UK
| | - Yiannis Mavrommatis
- Department of Health Science, Faculty of Sport, Allied Health and Performance Sciences, St Mary's University Twickenham, Twickenham, UK
| | - Leta Pilic
- Department of Health Science, Faculty of Sport, Allied Health and Performance Sciences, St Mary's University Twickenham, Twickenham, UK
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12
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Siri G, Nikrad N, Keshavari S, Jamshidi S, Fayyazishishavan E, Ardekani AM, Farhangi MA, Jafarzadeh F. A high Diabetes Risk Reduction Score (DRRS) is associated with a better cardio-metabolic profile among obese individuals. BMC Endocr Disord 2023; 23:31. [PMID: 36737726 PMCID: PMC9896813 DOI: 10.1186/s12902-023-01279-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 01/23/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Dietary indices and scores are valuable predictive markers against chronic diseases. Several previous studies have revealed the beneficial effects of diabetes risk reduction score (DRRS) against diabetes and cancer incidence. However, its association with metabolic abnormalities among obese individuals have not been revealed before. In the current study, we aimed to investigate the association between DRRS and metabolic risk factors among obese individuals. METHODS In the current cross-sectional study, 342 obese individuals [Body mass index (BMI) ≥ 30 kg/m2] aged 20-50 years were included. Dietary intake was assessed by a validated semi-quantitative food frequency questionnaire (FFQ) of 168 food items and DRRS was calculated. Metabolic syndrome (MetS) was defined based on the guidelines of the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III). Enzymatic methods were used to assess serum lipids, glucose, and insulin concentrations. Blood pressure was measured by a sphygmomanometer and body composition with bioelectrical impedance analysis (BIA). RESULTS Those with a higher adherence to DRRS had a significantly higher intake of energy, fiber, and lower protein compared with those in the lower quartiles. Moreover, lower intakes of trans fats, meat, sugar sweetened beverages (SSB), and glycemic index (GI) with higher intakes of fruits, cereal fiber, polyunsaturated fatty acids/ saturated fatty acids (PUFA/ SFA) ratio, coffee, and nuts were observed in the highest versus lowest DRRS categories. Lower systolic blood pressure, diastolic blood pressure, triglyceride and, higher high-density lipoprotein values were observed in higher DRRS categories. Logistic regression analysis showed that hypertension was significantly associated with adherence to DRRS among obese individuals, the odds ratio (OR) was 0.686 (95% confidence interval [CI], 0.26-0.84) after adjustment for potential confounders. But the risk of other components of MetS was not significantly associated with higher quartiles of adherence to DRRS. Also, a non-significantly lower prevalence of MetS was observed in the higher quartile of DRRS. CONCLUSIONS According to the results of the current study, higher DRRS was associated with lower blood pressure, modified serum lipids, and lower Mets prevalence. Further studies in different populations are warranted for better generalization of the obtained findings.
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Affiliation(s)
- Goli Siri
- Department of Internal Medicine, Amir Alam Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Negin Nikrad
- Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sheida Keshavari
- Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Saideh Jamshidi
- Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ehsan Fayyazishishavan
- Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX77030 USA
| | - Abnoos Mokhtari Ardekani
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Science & Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahdieh Abbasalizad Farhangi
- Drug Applied Research Center, Tabriz University of Medical Sciences, Attar Neyshabouri, Daneshgah Blv, Tabriz, Iran
| | - Faria Jafarzadeh
- Department of Internal Medicine, School of Medicine, North Khorasan University of Medical Sciences, Bojnourd, Iran
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13
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Mattioli AV. Coffee consumption effects on bioelectrical impedance parameters: does gender matter? Eur J Clin Nutr 2022; 76:1622-1623. [PMID: 35388165 DOI: 10.1038/s41430-022-01136-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/20/2022] [Accepted: 03/25/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Anna Vittoria Mattioli
- Surgical, Medical and Dental Department of Morphological Sciences related to Transplant, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy.
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14
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Chen D, Zhang H, Shao J, Tang L, Wu J, Ye Z. Summary of the best evidence of diet and physical activity management in patients with metabolic syndrome. Zhejiang Da Xue Xue Bao Yi Xue Ban 2022; 51:27-37. [PMID: 35576114 PMCID: PMC9109769 DOI: 10.3724/zdxbyxb-2021-0378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/10/2022] [Indexed: 06/15/2023]
Abstract
To evaluate and summarize the evidence of diet and physical activity management in patients with metabolic syndrome (MS). BMJ Best Practice, UpToDate, Joanna Briggs Institute (JBI) database, Agency for Healthcare Research and Quality (AHRQ) network, National Institute for Health and Clinical Excellence (NICE) network, Scottish Intercollegiate Guidelines Network (SIGN), Guidelines International Network (GIN), Medlive, Registered Nurses' Association of Ontario (RNAO) network, American Diabetes Association (ADA) network, New Zealand Guideline Group (NZGG) network, Canadian medical association clinical practice guidelines network, PubMed, EmBase, Web of Science, CINAHL, Cochrane Library, CNKI, China Science and Technology Journal Database, Wanfang Knowledge Data Service Platform and Chinese biomedical database were searched systematically to obtain guidelines, evidence summary, expert consensus, best practice information book, clinical decision-making, recommended practice, and systematic review on diet and physical activity management in patients with MS. The retrieval period is from the establishment of database to November 2021. Two researchers with evidence-based medicine background evaluated the quality and evidence level of the included literature. A total of 36 articles met the criteria, including 3 guidelines, 5 expert consensus, 1 clinical decision and 27 systematic reviews. We summarized 49 pieces of evidence related to diet and physical activity in patients with MS, involving 15 aspects, namely diet goals, diet patterns, diet time, carbohydrate intake, fat intake, fiber intake, salt intake, fruits, vegetables and grains intake, coffee intake, effects of diet, principle of physical activity, intensity, form, time of physical activity, effects of physical activity, physical activity prescription of patients with MS and cardiovascular disease, and the joint effects of diet and physical activity. Diet and physical activity management can effectively improve the health outcomes of patients with MS. Health professionals should choose and apply the best evidence with consideration of the clinical situation and patient preference.
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Affiliation(s)
- Dandan Chen
- 1. Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Hui Zhang
- 2. Department of Cardiology, Guizhou Provincial People's Hospital, Guiyang 550002, China
| | - Jing Shao
- 3. Institute of Nursing Research, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Leiwen Tang
- 1. Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Jingjie Wu
- 1. Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
| | - Zhihong Ye
- 1. Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
- 3. Institute of Nursing Research, Zhejiang University School of Medicine, Hangzhou 310058, China
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15
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Meli AM, Ali A, Mhd Jalil AM, Mohd Yusof H, Tan MMC. Effects of Physical Activity and Micronutrients on Cognitive Performance in Children Aged 6 to 11 Years: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. MEDICINA (KAUNAS, LITHUANIA) 2021; 58:medicina58010057. [PMID: 35056365 PMCID: PMC8781636 DOI: 10.3390/medicina58010057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/20/2021] [Accepted: 12/23/2021] [Indexed: 11/16/2022]
Abstract
Background and Objectives: Cognitive performance is essential for children, given this is a critical stage of brain growth and development. This systematic review and meta-analysis aimed to ascertain if physical activity or micronutrients impact cognitive performance in children. Materials and Methods: Electronic databases (PubMed and Scopus®) were searched for relevant articles published between 2012 and 2021. We emphasized randomized controlled trials (RCTs) that examined the effect of physical activity and micronutrients on cognitive performance. Data from eligible studies were gathered and evaluated using random-, fixed- or pooled-effects models with 95% confidence intervals (95% CI). Results: Physical activity appeared to improve both Mathematics (d = 1.12, 95% CI: 0.56, 1.67) and attention (d = 0.65, 95% CI: 0.15, 1.14) performances. The micronutrient vitamin B12 had a positive effect on Mathematics (d = 2.39, 95% CI: 0.79, 3.98), English (d = 5.29, 95% CI: 2.76, 7.83), Geography (d = 5.29, 95% CI: 2.76, 7.83), Science (d = 3.39, 95% CI: 2.62, 4.16) and Arts (d = 3.32, 95% CI: 1.84, 4.79). Zinc was found to positively affect English (d = 3.78, 95% CI: 0.44, 7.13), Geography (d = 4.77, 95% CI: 0.56, 8.98) and Arts (d = 2.39, CI: 0.33, 4.45). Iron positively affected Mathematics (d = 1.29, 95% CI: 0.54, 2.06), English (d = 1.29, 95% CI: 0.44, 7.13), Geography (d = 4.77, 95% CI: 0.56, 8.98) and Arts (d = 2.39, 95% CI: 0.33, 4.45). Conclusions: A more comprehensive intervention with a specific dose/level of physical activity, an increased range of cognitive performance, and a well-designed study design that accounts for dietary intake and other health outcomes are required for future studies.
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Affiliation(s)
- Atiah Munirah Meli
- Department of Food Science, Faculty of Fisheries and Food Science, Universiti Malaysia Terengganu, Kuala Terengganu 21030, Malaysia; (A.M.M.); (H.M.Y.)
| | - Asma’ Ali
- Department of Food Science, Faculty of Fisheries and Food Science, Universiti Malaysia Terengganu, Kuala Terengganu 21030, Malaysia; (A.M.M.); (H.M.Y.)
- Correspondence: ; Tel.: +609-6684969
| | - Abbe Maleyki Mhd Jalil
- School of Nutrition and Dietetics, Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Kuala Terengganu 21300, Malaysia;
| | - Hayati Mohd Yusof
- Department of Food Science, Faculty of Fisheries and Food Science, Universiti Malaysia Terengganu, Kuala Terengganu 21030, Malaysia; (A.M.M.); (H.M.Y.)
| | - Michelle M. C. Tan
- Global Public Health, School of Medicine and Health Sciences, Monash University, Subang Jaya 47500, Malaysia;
- South East Asia Community Observatory (SEACO), Monash University, Subang Jaya 47500, Malaysia
- Victorian Heart Institute, Monash University, Clayton 3168, Australia
- Charles Perkins Centre, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia
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