Nutrition and Cardiovascular Diseases

Association between the geriatric nutritional risk index with the risk of frailty and mortality in the elderly population

Frailty is a major health concern among older adults. The Geriatric Nutrition Risk Index (GNRI) is an important instrument for evaluating the nutritional condition in older individuals. Despite its relevance, there remains a paucity of research exploring the relationship between GNRI with the risk of frailty and adverse outcomes. This study aims to investigate the relationship between the GNRI and the risk of frailty and mortality in older adults. Three distinct models were developed, and the association between GNRI and frailty prevalence was investigated using multivariable logistic regression. To explore the relationship between GNRI and mortality among frail individuals, Cox regression analysis was applied. Potential non-linear associations were assessed using restricted cubic spline (RCS) analysis. Interaction tests and stratified analyses were performed to further evaluate the consistency of these associations. This study included 6,753 eligible participants from 2003 to 2018, of whom 34.36% were diagnosed with frailty. After adjusting for all potential covariates, an increase of 1 unit in GNRI was associated with a 7% reduction in frailty prevalence (OR 0.93, 95% CI 0.91-0.95, P < 0.0001). Compared to the low GNRI group, individuals in the high GNRI group had a lower likelihood of being frail (OR 0.41, 95% CI 0.30-0.55, P < 0.0001). Among frail individuals, those with a higher GNRI had a lower risk of mortality relative to those with a lower GNRI (cardiovascular mortality: HR: 0.61, 95% CI 0.43-0.86, P = 0.004; all-cause mortality: HR: 0.58, 95% CI 0.45-0.75, P < 0.0001). The associations between GNRI and frailty prevalence, as well as mortality risk, exhibited consistency in most cases (P for interaction > 0.05). A higher GNRI is significantly related to a diminished prevalence of frailty. In frail older adults, a lower GNRI is an independent predictor of enhanced risk of both total and cardiovascular mortality.

Relationships Between Body Image and Body Parameters in Men Under Long-Term Fasting Conditions

Background/Objectives: Fasting and physical exertion positively affect body mass and composition. This study aimed to examine the effects of physical changes induced by eight days of water-only fasting and a physical exertion test and their influence on body satisfaction and body image parameters in middle-aged men. Methods: Fifteen participants were assessed for physical (height, body mass, and body composition) and psychological (body satisfaction, evaluation of body parts, and body image determinants) aspects before and after the fasting intervention, both at rest and post-exercise. Correlation and concordance coefficients were calculated for the analyzed variables. Results: It was found that the fasting intervention led to a reduction in body mass and a favorable shift in body composition, while also increasing satisfaction with one's body and its specific parts. This positively impacted volunteers' self-assessment of their health status. Selected body image parameters remained at an average level for the male population and did not change following the fasting. Attitudes toward body weight control methods and their perceived effectiveness did not change either. Participants favored reducing food intake and eliminating high-calorie products from their diet, rejecting the use pathological methods typically associated with eating disorders. A few associations between physical and psychological aspects of corporeality were observed, whereas significant correlations between satisfaction with body parts and parameters and a positive body image were confirmed. Conclusions: The above suggest that physical conditions and their changes resulting from fasting and physical exertion lead to a positive influence on body satisfaction and its components but do not alter body image.

Geriatric nutrition risk index in the prediction of all-cause and cardiovascular mortality in older adults with hyperlipidemia: NHANES 1999-2018

BACKGROUND

Malnutrition is linked to a higher risk of unfavorable outcomes in various illnesses. The present investigation explored the correlation between inadequate nutritional condition and outcomes in older individuals diagnosed with hyperlipidemia.

METHODS

The geriatric nutritional risk index (GNRI) was used to evaluate the nutritional status. All patients were divided into two groups according to GNRI. A Kaplan-Meier analysis was used to assess the survival rates of different groups at risk of malnutrition. In addition, GNRI was used in COX proportional risk regression models to evaluate its predictive effect on both overall mortality and cardiovascular mortality among patients with hyperlipidemia. Furthermore, the study employed restricted cubic splines (RCS) to examine the nonlinear correlation between GNRI and mortality.

RESULTS

The study included 4,532 elderly individuals diagnosed with hyperlipidemia. During a median follow-up duration of 139 months, a total of 1498 deaths from all causes and 410 deaths from cardiovascular causes occurred. The Kaplan-Meier analysis demonstrated significantly poorer survival among individuals at risk of malnutrition, as indicated by the GNRI. In the malnutrition risk group, the modified COX proportional hazards model revealed that a decrease in GNRI was associated with a higher risk of all-cause mortality (HR=1.686, 95% CI 1.212-2.347) and cardiovascular mortality (HR=3.041, 95% CI 1.797-5.147). Furthermore, the restricted cubic splines revealed a non-linear association between GNRI and both all-cause mortality and cardiovascular mortality (p-value for non-linearity = 0.0039, p-value for non-linearity=0.0386).

CONCLUSIONS

In older patients with hyperlipidemia, lower levels of GNRI are associated with mortality. The GNRI could potentially be used to predict all-cause mortality and cardiovascular mortality.

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.

Research trends and hotpots on the relationship between high salt and hypertension: A bibliometric and visualized analysis

INTRODUCTION

A high salt diet is a significant risk factor for hypertension, and scholarly investigations into this relationship have garnered considerable attention worldwide. However, bibliometric analyses in this field remain underdeveloped. This study aimed to conduct a bibliometric and visual analysis of research progress on the link between high salt and hypertension from 2011 to 2022 with the goal of identifying future research trends and providing valuable insights for this field.

METHODS

High salt and hypertension data were obtained from the Web of Science Core Collection database. Microsoft Excel, Scimago Graphica, CiteSpace, and VOSviewer software were employed to analyze publication output trends, the most productive countries or regions, journals, authors, co-cited references, and keywords.

RESULTS

After screening, 1470 papers met the inclusion criteria. Relevant publications increased annually by 3.66% from 2011 to 2022. The United States led in research productivity, with The Journal of Hypertension publishing the most papers, and David L. Mattson as the most prolific author. Oxidative stress has emerged as a prominent research topic, and extensive investigations have been conducted on related mechanisms. "Oxidative stress," "gut microbiota," and "kidney injury" are recent hotspots that are expected to remain so, and this study carefully characterizes the mechanism of high salt-induced hypertension based on these hotspots.

CONCLUSION

This study utilized bibliometric and visualization analysis to identify the development trends and hotspots of publications related to high salt and hypertension. The findings of this study offer valuable insights into the forefront of emerging trends and future directions in this field.

Prognostic impacts of geriatric nutritional risk index in patients with ischemic heart failure after percutaneous coronary intervention

BACKGROUND

Malnutrition has been proven to be associated with increased risk of poor prognosis in a series of diseases. This study explored the association between poor nutritional status and prognosis in patients with ischemic heart failure (IHF) undergoing percutaneous coronary intervention (PCI).

METHODS

The study enrolled 1745 patients with IHF undergoing PCI. The mean follow-up time was 28.7 months. Nutritional status was assessed by geriatric nutritional risk index (GNRI). All patients were divided into four groups according to GNRI quartiles (median and interquartile range: 103.8, 99.9-107.7). The primary endpoint was major adverse cardiovascular events (MACE), and the secondary endpoints were each component of the primary endpoint as follows: all-cause mortality, non-fatal myocardial infarction (MI), and any revascularization. The Kaplan-Meier survival analyses were performed to evaluate the incidence of the endpoints among 4 groups. The multivariate Cox proportional hazards analysis confirmed the independent effect of GNRI on the primary endpoint and secondary endpoints. The restricted cubic spline (RCS) was performed to evaluate the non-linear association of GNRI with MACE.

RESULT

The negative correlation of the GNRI with MACE (Log-rank P < 0.001), all-cause mortality (Log-rank P < 0.001) and any revascularization (Log-rank P < 0.001) was confirmed through the Kaplan-Meier curves. Multivariate analysis showed that the decreased GNRI was independently related to increased risk of MACE (Quartile 1 versus Quartile 4: HR, 95% CI: 2.66, 2.01-3.51, P < 0.001), all-cause mortality (Quartile 1 versus Quartile 4: HR, 95% CI: 2.33, 1.54-3.50, P < 0.001) and any revascularization (Quartile 1 versus Quartile 4: HR, 95% CI: 3.42, 2.22-5.27, P < 0.001). In addition, the non-linear association of GNRI with MACE was shown through RCS and the risk of MACE decreased as the GNRI increased in general (Non-linear P < 0.001).

CONCLUSION

Decreased GNRI was an independent risk factor of MACE in IHF patients undergoing PCI.

Comparing Digital Therapeutic Intervention with an Intensive Obesity Management Program: Randomized Controlled Trial

In this study, we evaluated whether the digital program Vitadio achieves comparable results to those of an intensive in-person lifestyle intervention in obesity management. This is a 12-month prospective, randomized controlled trial. Obese patients with insulin resistance, prediabetes or type 2 diabetes were included. The intervention group (IG) used Vitadio. The control group (CG) received a series of in-person consultations. Body weight and various metabolic parameters were observed and analyzed with ANOVA. The trial is ongoing and the presented findings are preliminary. Among 100 participants (29% men; mean age, 43 years; mean BMI, 40.1 kg/m2), 78 completed 3-month follow-up, and 51 have completed the 6-month follow-up so far. Participants significantly (p < 0.01) reduced body weight at 3 months (IG: −5.9 ± 5.0%; CG: −4.2 ± 5.0%) and 6 months (IG: −6.6±6.1%; CG: −7.1 ± 7.1%), and the difference between groups was not significant. The IG achieved favorable change in body composition; significant improvement in TAG (−0.6 ± 0.9 mmol/l, p < 0.01), HDL (0.1 ± 0.1%, p < 0.05), HbA1c (−0.2 ± 0.5%, p < 0.05) and FG (−0.5 ± 1.5 mmol/l, p < 0.05); and a superior (p = 0.02) HOMA-IR reduction (−2.5 ± 5.2, p < 0.01). The digital intervention achieved comparable results to those of the intensive obesity management program. The results suggest that Vitadio is an effective tool for supporting patients in obesity management and diabetes prevention.