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Sun X, Yon DK, Nguyen TT, Tanisawa K, Son K, Zhang L, Shu J, Peng W, Yang Y, Branca F, Wahlqvist ML, Lim H, Wang Y. Dietary and other lifestyle factors and their influence on non-communicable diseases in the Western Pacific region. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 43:100842. [PMID: 38456094 PMCID: PMC10920053 DOI: 10.1016/j.lanwpc.2023.100842] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 06/20/2023] [Accepted: 06/25/2023] [Indexed: 03/09/2024]
Abstract
The Western Pacific region is a diverse region experiencing fast economic growth and nutrition transition. We systematically examined 94 cohort studies on the associations of dietary and other lifestyle factors on non-communicable diseases (NCDs) in the region. These studies were mainly from China, Japan, the Republic of Korea, and Singapore. Patterns and changes in lifestyle risk factors for NCDs based on national surveys were examined. They showed some dietary intake improvements over the past three decades, featured as increased consumption of unsaturated oils, fruits, and vegetables, and decreased consumption of sodium and unhealthy fat. Despite a decrease in smoking rate and salt intake, the values remained higher than the global levels in 2019. The ultra-processed food intake in the region increased at a higher rate than the global estimate. National guidelines relevant to NCDs in five selected countries were highlighted. Strong future actions and policies are needed to tackle NCDs.
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Affiliation(s)
- Xiaomin Sun
- The First Affiliated Hospital of Xi'an Jiaotong University Public Health Institute, Global Health Institute, School of Public Health, Xi’an Jiaotong University, Xi’an 710061, People’s Republic of China
- International Obesity and Metabolic Disease Research Center, Xi’an Jiaotong University, Xi’an 710061, China
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul 02447, Republic of Korea
| | | | - Kumpei Tanisawa
- Faculty of Sport Sciences, Waseda University, Saitama 359-1192, Japan
| | - Kumhee Son
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Republic of Korea
- Research Institute of Medical Nutrition, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Ling Zhang
- School of Public Health, Capital Medical University, Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China
| | - Jing Shu
- The First Affiliated Hospital of Xi'an Jiaotong University Public Health Institute, Global Health Institute, School of Public Health, Xi’an Jiaotong University, Xi’an 710061, People’s Republic of China
- International Obesity and Metabolic Disease Research Center, Xi’an Jiaotong University, Xi’an 710061, China
| | - Wen Peng
- Nutrition and Health Promotion Center, Department of Public Health, Medical College, Qinghai University, Xining 810008, China
- Qinghai Provincial Key Laboratory of Prevention and Control of Glucolipid Metabolic Diseases with Traditional Chinese Medicine, Xining 810008, China
| | - Yuexin Yang
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Francesco Branca
- Department of Nutrition and Food Safety, World Health Organization, Geneva 1211, Switzerland
| | | | - Hyunjung Lim
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Republic of Korea
- Research Institute of Medical Nutrition, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Youfa Wang
- The First Affiliated Hospital of Xi'an Jiaotong University Public Health Institute, Global Health Institute, School of Public Health, Xi’an Jiaotong University, Xi’an 710061, People’s Republic of China
- International Obesity and Metabolic Disease Research Center, Xi’an Jiaotong University, Xi’an 710061, China
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Ramel A, Nwaru BI, Lamberg-Allardt C, Thorisdottir B, Bärebring L, Söderlund F, Arnesen EK, Dierkes J, Åkesson A. White meat consumption and risk of cardiovascular disease and type 2 diabetes: a systematic review and meta-analysis. Food Nutr Res 2023; 67:9543. [PMID: 38187786 PMCID: PMC10770644 DOI: 10.29219/fnr.v67.9543] [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: 09/12/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 01/09/2024] Open
Abstract
Objectives The aim was to systematically review the associations among white meat consumption, cardiovascular diseases (CVD), and type 2 diabetes (T2D). Methods Databases MEDLINE, Embase, and Cochrane Central Register of Controlled Trials and Scopus were searched (15th October 2021) for randomized intervention trials (RCTs, ≥ 4 weeks of duration) and prospective cohort studies (≥12 month of follow-up) assessing the consumption of white meat as the intervention/exposure. Eligible outcomes for RCTs were cardiometabolic risk factors and for cohorts, fatal and non-fatal CVD and incident T2D. Risk of bias was estimated using the Cochrane's RoB2 and Risk of Bias for Nutrition Observational Studies. Meta-analysis was conducted in case of ≥3 relevant intervention studies or ≥5 cohort studies using random-effects models. The strength of evidence was evaluated using the World Cancer Research Fund's criteria. Results The literature search yielded 5,795 scientific articles, and after screening 43 full-text articles, 23 cohort studies and three intervention studies were included. All included intervention studies matched fat content of intervention and control diets, and none of them showed any significant effects on the selected outcomes of white meat when compared to red meat. Findings from the cohort studies generally did not support any associations between white meat intake and outcomes. Meta-analyses were conducted for CVD mortality (RR: 0.95, 95% CI: 0.87-1.02, P = 0.23, I2 = 25%) and T2D incidence (RR: 0.98, 95% CI: 0.87-1.11, P = 0.81, I2 = 82%). Conclusion The currently available evidence does not indicate a role, beneficial or detrimental, of white meat consumption for CVD and T2D. Future studies investigating potentially different health effects of processed versus unprocessed white meat and substitution of red meat with white meat are warranted.Registration: Prospero registration CRD42022295915.
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Affiliation(s)
- Alfons Ramel
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland
| | - Bright I. Nwaru
- Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | | | | | - Linnea Bärebring
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Fredrik Söderlund
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Solna, Sweden
| | - Erik Kristoffer Arnesen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Jutta Dierkes
- Centre for Nutrition, Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Department of Laboratory Medicine and Pathology, Haukeland University Hospital, Bergen, Norway
| | - Agneta Åkesson
- Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Solna, Sweden
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Jeong Y, Lee KW, Kim H, Kim Y. Association of milk and dairy product consumption with the incidence of cardio-cerebrovascular disease incidence in middle-aged and older Korean adults: a 16-year follow-up of the Korean Genome and Epidemiology Study. Nutr Res Pract 2023; 17:1225-1237. [PMID: 38053820 PMCID: PMC10694427 DOI: 10.4162/nrp.2023.17.6.1225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 03/19/2023] [Accepted: 07/26/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND/OBJECTIVES Unhealthy dietary behaviors constitute one of risk the factors for chronic and cardiovascular diseases, which are prevalent in middle-aged and older populations. Milk and dairy products are high-quality foods and important sources of calcium. Calcium protects against osteoporosis and cardiovascular disease. Therefore, this study investigated the association of milk and dairy product consumption with cardio-cerebrovascular disease incidence in middle-aged and older Korean adults. SUBJECTS/METHODS Data were derived from the Ansan-Anseong cohort study, and a total of 8,009 individuals aged 40-69 years were selected and followed up biennially. Cox proportional hazard models were used to examine the association of milk and dairy product consumption with cardio-cerebrovascular disease incidence. RESULTS During a mean follow-up period of 96.5 person-months, 552 new cases of cardio-cerebrovascular disease were documented. Milk consumers (< 1 serving/day) exhibited a 23% lower risk of cardio-cerebrovascular disease incidence than non-milk consumers (hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.61-0.97; P for trend = 0.842). High yogurt consumption was associated with a 29% lower incidence risk (≥ 0.5 servings/day vs. none: HR, 0.71; 95% CI, 0.53-0.96; P for trend = 0.049), whereas high ice cream consumption was associated with a 70% higher risk of cardio-cerebrovascular disease incidence (≥ 0.5 servings/day vs. none: HR, 1.70; 95% CI, 1.01-2.88; P for trend = 0.070). CONCLUSIONS This study indicates that less than one serving of milk and high yogurt consumption are associated with a lower cardio-cerebrovascular disease risk in the middle-aged and older populations.
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Affiliation(s)
- Yeseung Jeong
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Korea
| | - Kyung Won Lee
- Department of Home Economics Education, Korea National University of Education, Cheongju 28173, Korea
| | - Hyekyeong Kim
- Department of Health Convergence, Ewha Womans University, Seoul 03760, Korea
| | - Yuri Kim
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Korea
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Neuenschwander M, Stadelmaier J, Eble J, Grummich K, Szczerba E, Kiesswetter E, Schlesinger S, Schwingshackl L. Substitution of animal-based with plant-based foods on cardiometabolic health and all-cause mortality: a systematic review and meta-analysis of prospective studies. BMC Med 2023; 21:404. [PMID: 37968628 PMCID: PMC10652524 DOI: 10.1186/s12916-023-03093-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/25/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND There is growing evidence that substituting animal-based with plant-based foods is associated with a lower risk of cardiovascular diseases (CVD), type 2 diabetes (T2D), and all-cause mortality. Our aim was to summarize and evaluate the evidence for the substitution of any animal-based foods with plant-based foods on cardiometabolic health and all-cause mortality in a systematic review and meta-analysis. METHODS We systematically searched MEDLINE, Embase, and Web of Science to March 2023 for prospective studies investigating the substitution of animal-based with plant-based foods on CVD, T2D, and all-cause mortality. We calculated summary hazard ratios (SHRs) and 95% confidence intervals (95% CI) using random-effects meta-analyses. We assessed the certainty of evidence (CoE) using the GRADE approach. RESULTS In total, 37 publications based on 24 cohorts were included. There was moderate CoE for a lower risk of CVD when substituting processed meat with nuts [SHR (95% CI): 0.73 (0.59, 0.91), n = 8 cohorts], legumes [0.77 (0.68, 0.87), n = 8], and whole grains [0.64 (0.54, 0.75), n = 7], as well as eggs with nuts [0.83 (0.78, 0.89), n = 8] and butter with olive oil [0.96 (0.95, 0.98), n = 3]. Furthermore, we found moderate CoE for an inverse association with T2D incidence when substituting red meat with whole grains/cereals [0.90 (0.84, 0.96), n = 6] and red meat or processed meat with nuts [0.92 (0.90, 0.94), n = 6 or 0.78 (0.69, 0.88), n = 6], as well as for replacing poultry with whole grains [0.87 (0.83, 0.90), n = 2] and eggs with nuts or whole grains [0.82 (0.79, 0.86), n = 2 or 0.79 (0.76, 0.83), n = 2]. Moreover, replacing red meat for nuts [0.93 (0.91, 0.95), n = 9] and whole grains [0.96 (0.95, 0.98), n = 3], processed meat with nuts [0.79 (0.71, 0.88), n = 9] and legumes [0.91 (0.85, 0.98), n = 9], dairy with nuts [0.94 (0.91, 0.97), n = 3], and eggs with nuts [0.85 (0.82, 0.89), n = 8] and legumes [0.90 (0.89, 0.91), n = 7] was associated with a reduced risk of all-cause mortality. CONCLUSIONS Our findings indicate that a shift from animal-based (e.g., red and processed meat, eggs, dairy, poultry, butter) to plant-based (e.g., nuts, legumes, whole grains, olive oil) foods is beneficially associated with cardiometabolic health and all-cause mortality.
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Affiliation(s)
- Manuela Neuenschwander
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, Düsseldorf, Germany
| | - Julia Stadelmaier
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Julian Eble
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Kathrin Grummich
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Edyta Szczerba
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Partner Düsseldorf, Düsseldorf, Germany
| | - Eva Kiesswetter
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sabrina Schlesinger
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany.
- German Center for Diabetes Research (DZD), Partner Düsseldorf, Düsseldorf, Germany.
| | - Lukas Schwingshackl
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Zhang R, Zhang H, Wang Y, Tang LJ, Li G, Huang OY, Chen SD, Targher G, Byrne CD, Gu BB, Zheng MH. Higher consumption of animal organ meat is associated with a lower prevalence of nonalcoholic steatohepatitis. Hepatobiliary Surg Nutr 2023; 12:645-657. [PMID: 37886189 PMCID: PMC10598295 DOI: 10.21037/hbsn-21-468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 03/23/2022] [Indexed: 10/28/2023]
Abstract
Background Animal organ meat (offal) is a food with high nutrient density that is popular in different parts of the world, but its relationship with nonalcoholic steatohepatitis (NASH) is unclear. We aimed to examine whether daily animal organ meat consumption is associated with the presence of NASH in individuals with nonalcoholic fatty liver disease (NAFLD). Methods A total of 136 Chinese adults with biopsy-proven NAFLD were included. Definite NASH was defined as NAFLD activity score ≥4 and at least one point for steatosis, ballooning, and lobular inflammation. Daily animal organ meat consumption was estimated using a self-administered validated food frequency questionnaire. Logistic regression analysis was performed to assess the association between animal organ meat intake and liver disease severity. Results The 136 participants (80.9% men) of the study had a mean ± standard deviation (SD) age of 39.0±12.5 years and body mass index of 27.4±3.6 kg/m2. Prevalence of definite NASH was 65.4%. Daily median organ meat consumption was 1.30 g/1,000 kcal. Animal organ meat consumption was inversely associated with the presence of NASH even after adjustment of demographics, lifestyle variables, metabolic and dietary factors, as well as liver fibrosis stage; adjusted-odds ratios (95% confidence intervals) for NASH were 0.15 (0.03, 0.69) for the highest tertile and 0.18 (0.05, 0.70) for the medium tertile, compared to the lowest (reference) tertile of animal organ meat intake (P value for trend =0.024). Conclusions Our results suggest for the first time that higher animal organ meat consumption is associated with a lower prevalence of NASH in Chinese individuals with biopsy-proven NAFLD.
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Affiliation(s)
- Rui Zhang
- Department of Nutrition, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Huai Zhang
- Biostatistics and Medical Quality Management Office, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yi Wang
- Department of Nutrition, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Liang-Jie Tang
- MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Gang Li
- MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ou-Yang Huang
- MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Sui-Dan Chen
- Department of Pathology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Giovanni Targher
- Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy
| | - Christopher D. Byrne
- Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton, Southampton General Hospital, Southampton, UK
| | - Bin-Bin Gu
- Department of Nutrition, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ming-Hua Zheng
- MAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- Institute of Hepatology, Wenzhou Medical University, Wenzhou, China
- Key Laboratory of Diagnosis and Treatment for The Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, China
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Connolly G, Campbell WW. Poultry Consumption and Human Cardiometabolic Health-Related Outcomes: A Narrative Review. Nutrients 2023; 15:3550. [PMID: 37630747 PMCID: PMC10459134 DOI: 10.3390/nu15163550] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/08/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
Poultry meats, in particular chicken, have high rates of consumption globally. Poultry is the most consumed type of meat in the United States (US), with chicken being the most common type of poultry consumed. The amounts of chicken and total poultry consumed in the US have more than tripled over the last six decades. This narrative review describes nutritional profiles of commonly consumed chicken/poultry products, consumption trends, and dietary recommendations in the US. Overviews of the scientific literature pertaining to associations between, and effects of consuming chicken/poultry on, body weight and body composition, cardiovascular disease (CVD), and type II diabetes mellitus (T2DM) are provided. Limited evidence from randomized controlled trials indicates the consumption of lean unprocessed chicken as a primary dietary protein source has either beneficial or neutral effects on body weight and body composition and risk factors for CVD and T2DM. Apparently, zero randomized controlled feeding trials have specifically assessed the effects of consuming processed chicken/poultry on these health outcomes. Evidence from observational studies is less consistent, likely due to confounding factors such as a lack of a description of and distinctions among types of chicken/poultry products, amounts consumed, and cooking and preservation methods. New experimental and observational research on the impacts of consuming chicken/poultry, especially processed versions, on cardiometabolic health is sorely needed.
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Affiliation(s)
| | - Wayne W. Campbell
- Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA;
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Shi W, Huang X, Schooling CM, Zhao JV. Red meat consumption, cardiovascular diseases, and diabetes: a systematic review and meta-analysis. Eur Heart J 2023; 44:2626-2635. [PMID: 37264855 DOI: 10.1093/eurheartj/ehad336] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 04/01/2023] [Accepted: 05/16/2023] [Indexed: 06/03/2023] Open
Abstract
AIMS Observational studies show inconsistent associations of red meat consumption with cardiovascular disease (CVD) and diabetes. Moreover, red meat consumption varies by sex and setting, however, whether the associations vary by sex and setting remains unclear. METHODS AND RESULTS This systematic review and meta-analysis was conducted to summarize the evidence concerning the associations of unprocessed and processed red meat consumption with CVD and its subtypes [coronary heart disease (CHD), stroke, and heart failure], type two diabetes mellitus (T2DM), and gestational diabetes mellitus (GDM) and to assess differences by sex and setting (western vs. eastern, categorized based on dietary pattern and geographic region). Two researchers independently screened studies from PubMed, Web of Science, Embase, and the Cochrane Library for observational studies and randomized controlled trials (RCTs) published by 30 June 2022. Forty-three observational studies (N = 4 462 810, 61.7% women) for CVD and 27 observational studies (N = 1 760 774, 64.4% women) for diabetes were included. Red meat consumption was positively associated with CVD [hazard ratio (HR) 1.11, 95% confidence interval (CI) 1.05 to 1.16 for unprocessed red meat (per 100 g/day increment); 1.26, 95% CI 1.18 to 1.35 for processed red meat (per 50 g/day increment)], CVD subtypes, T2DM, and GDM. The associations with stroke and T2DM were higher in western settings, with no difference by sex. CONCLUSION Unprocessed and processed red meat consumption are both associated with higher risk of CVD, CVD subtypes, and diabetes, with a stronger association in western settings but no sex difference. Better understanding of the mechanisms is needed to facilitate improving cardiometabolic and planetary health.
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Affiliation(s)
- Wenming Shi
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 7 Sassoon Road, Southern District, Hong Kong SAR, China
| | - Xin Huang
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 7 Sassoon Road, Southern District, Hong Kong SAR, China
| | - C Mary Schooling
- School of Public Health and Health Policy, City University of New York, 55 W 125th St, New York, NY 10027, USA
| | - Jie V Zhao
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 7 Sassoon Road, Southern District, Hong Kong SAR, China
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Association of dietary patterns and food groups intake with multimorbidity: A prospective cohort study. Clin Nutr ESPEN 2022; 51:359-366. [PMID: 36184228 DOI: 10.1016/j.clnesp.2022.07.019] [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: 07/25/2022] [Accepted: 07/29/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Although diet has been extensively studied in relation to individual chronic conditions, studies linking diet with multiple chronic conditions (multimorbidity) remained scarce. We aimed to undertake a comprehensive analysis evaluating associations of overall dietary patterns and specific food groups with long-term risk of multimorbidity. METHODS The study included 348,290 participants from UK Biobank who completed eligible food frequency questionnaires (FFQ) and were not diagnosed with any of the 38 chronic or mental health conditions of interest at baseline (2006-2010). Dietary patterns were identified using exploratory factor analysis. Cox regression models were used to estimate corresponding hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS The median follow-up was 8.01 years, and 50,837 (14.60%) participants developed multimorbidity. Among the three identified dietary patterns, the Western Pattern was associated with an increased risk of multimorbidity (HRQ5 vs Q1 = 1.06, 95% CI: 1.03-1.09), while inverse associations were observed for moderate adherence to the White Meat Pattern (HRQ3vs Q1 = 0.97, 95% CI: 0.94-0.99) and highest adherence to the Prudent Pattern (HRQ5 vs Q1 = 0.92, 95% CI: 0.90-0.95). For specific food groups, more frequent intakes of processed meat and poultry were associated with higher risks of multimorbidity, whereas higher intake frequency of fish and more intakes of fruits and cereal were associated with decreased risks. CONCLUSION Dietary patterns and specific food groups are associated with the risk of multimorbidity. These findings suggest the importance of considering dietary interventions in the prevention and management of multimorbidity.
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Papp RE, Hasenegger V, Ekmekcioglu C, Schwingshackl L. Association of poultry consumption with cardiovascular diseases and all-cause mortality: a systematic review and dose response meta-analysis of prospective cohort studies. Crit Rev Food Sci Nutr 2021; 63:2366-2387. [PMID: 34542332 DOI: 10.1080/10408398.2021.1975092] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
According to previous cohort studies it is suggested that a high intake of poultry does not adversely affect cardiovascular disease (CVD) risk. Therefore, the aim of this systematic review and meta-analysis is to summarize and analyze the association between dietary poultry intake and the risk for CVDs, coronary heart disease (CHD), stroke and all-cause mortality (ACM). Twenty-four cohort studies were included, and the results showed a trivial inverse association for the highest vs. lowest intake category between poultry and ACM (risk ratio [RR] = 0.96; 95% CI: 0.93, 0.98; I2 = 5%). For all other outcomes no association was observed in the high vs. low intake meta-analysis. The results from the primary pooled data for each 100 g/d increase in poultry intake indicated no association for all outcomes. Further, the non-linear dose-response analysis showed some evidence for non-linearity between poultry consumption and risk for CVD and ACM. Additionally, substituting red and/or processed meat with poultry was inversely associated with the risk for ACM, CVDs, CHD and stroke. The certainty of evidence was rated as very low or low. This meta-analysis suggests that based upon the results from the substitution analyses poultry could be a healthier alternative to red and processed meat.
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Affiliation(s)
| | - Verena Hasenegger
- Department of Nutritional Sciences, University of Vienna, Wien, Austria
| | - Cem Ekmekcioglu
- Department of Environmental Health, Center for Public Health, Medical University of Vienna, Wien, Austria
| | - Lukas Schwingshackl
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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10
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Im J, Park K. Association between Soy Food and Dietary Soy Isoflavone Intake and the Risk of Cardiovascular Disease in Women: A Prospective Cohort Study in Korea. Nutrients 2021; 13:1407. [PMID: 33922001 PMCID: PMC8143453 DOI: 10.3390/nu13051407] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/12/2021] [Accepted: 04/20/2021] [Indexed: 12/17/2022] Open
Abstract
The association between soy food and soy isoflavone intake and cardiovascular disease (CVD) risk is uncertain, especially in women. We aimed to investigate this association in Korean women. We analyzed data from the Korean Genome and Epidemiology Study, including 4713 Korean women aged 40-69 years with no CVD or cancer at baseline. Dietary information was obtained using a validated semi-quantitative food frequency questionnaire, and the incidence of CVD was assessed using biennial self-reported questionnaires on medical history. The mean follow-up time was 7.4 years, during which 82 premenopausal and 200 postmenopausal women reported CVD incidence. The highest tofu, total soy foods, and dietary soy isoflavone intake groups were significantly associated with a decreased CVD risk in premenopausal women (tofu: hazard ratio (HR) 0.39; 95% confidence interval (CI), 0.19-0.80; total soy food: HR 0.36; 95% CI, 0.18-0.70; dietary soy isoflavones: HR 0.44; 95% CI, 0.22-0.89), whereas no association was observed in postmenopausal women. Other soy foods showed no association with CVD incidence. Dietary soy isoflavones and total soy foods are associated with a decreased CVD risk in premenopausal women. Among soy foods, only tofu showed significant health benefits.
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Affiliation(s)
| | - Kyong Park
- Department of Food and Nutrition, Yeungnam University, Gyeongsan 38541, Korea;
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11
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Inverse Association of Poultry, Fish, and Plant Protein Consumption with the Incidence of Cardiovascular Disease. Cardiol Rev 2021; 30:247-252. [PMID: 33883452 DOI: 10.1097/crd.0000000000000392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Cardiovascular disease (CVD) remains a major cause of death and disability worldwide and food intake plays an important role in its onset or prevention. It is also well known that consumption of red meat (processed and unprocessed) is associated with an increased incidence of CVD, coronary heart disease (CHD), and premature death. However, little is known about the association of consumption of poultry, fish, and plant protein with the incidence of CVD, CHD, and mortality. Several recent studies, reviews and meta-analyses have shown an inverse association of consumption of these foods with the incidence of CVD, CHD, and death. In order to get a better perspective about the current consumption of these foods, a focused Medline search of the English language literature was conducted between 2010 and 2020 using the terms poultry, fish, plant protein consumption, cardiovascular disease, coronary heart disease, mortality; 28 papers with pertinent information were retrieved. The analysis of data from these papers suggest an inverse relationship between the consumption of these foods and the incidence of de novo CVD or worsening of preexisting CVD. They also demonstrate that the consumption of these foods is still low and that great effort should be made to inform the public about the benefits of switching from red meat to an increased consumption of poultry, fish, and plant protein. All the data from the retrieved papers regarding the consumption of these foods, together with collateral literature, will be discussed in this review.
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Lupoli R, Vitale M, Calabrese I, Giosuè A, Riccardi G, Vaccaro O. White Meat Consumption, All-Cause Mortality, and Cardiovascular Events: A Meta-Analysis of Prospective Cohort Studies. Nutrients 2021; 13:nu13020676. [PMID: 33672599 PMCID: PMC7924043 DOI: 10.3390/nu13020676] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 02/05/2021] [Accepted: 02/15/2021] [Indexed: 01/22/2023] Open
Abstract
The association of meat consumption with mortality and morbidity for non-communicable diseases has been extensively studied. However, the relation of white meat consumption with health outcomes remains controversial. The present meta-analysis was conducted to comprehensively analyze the available evidence on the consistency and strength of the association between the consumption of white meat, death from any cause and incidence of fatal and non-fatal cardiovascular (CV) events. PubMed, Web of Science, Scopus and Embase databases were searched for articles published up to April 30, 2020. We included prospective cohort studies reporting relative risks and pertinent 95% confidence intervals (CI) for all-cause mortality and/or CV events (fatal or non-fatal). A total of 22 studies were included in the meta-analysis. Eleven studies (14 data sets) reported data on all-cause mortality, 10 studies (15 datasets) on cardiovascular disease (CVD) mortality and 10 studies (11 datasets) on non-fatal CV events. When comparing the highest versus the lowest consumption of white meat, the pooled OR and pertinent 95% CI were 0.94 (0.90, 0.97, p < 0.001) for all-cause mortality, 0.95 (0.89, 1.01, p = 0.13) for CV mortality, and 0.99 (0.95, 1.02, p = 0.48) for non-fatal CV events. In conclusion, the study shows for the first time a robust and inverse association between white meat consumption and all-cause mortality and a neutral association with CV mortality and morbidity. This highlights the importance of differentiating the meat types for what concerns their health effects and suggests that white meat might be a healthier alternative to read and processed meat consumption.
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Affiliation(s)
- Roberta Lupoli
- Department of Clinical Medicine and Surgery, “Federico II” University, 80131 Naples, Italy; (R.L.); (M.V.); (I.C.); (A.G.)
| | - Marilena Vitale
- Department of Clinical Medicine and Surgery, “Federico II” University, 80131 Naples, Italy; (R.L.); (M.V.); (I.C.); (A.G.)
| | - Ilaria Calabrese
- Department of Clinical Medicine and Surgery, “Federico II” University, 80131 Naples, Italy; (R.L.); (M.V.); (I.C.); (A.G.)
| | - Annalisa Giosuè
- Department of Clinical Medicine and Surgery, “Federico II” University, 80131 Naples, Italy; (R.L.); (M.V.); (I.C.); (A.G.)
| | - Gabriele Riccardi
- Department of Clinical Medicine and Surgery, “Federico II” University, 80131 Naples, Italy; (R.L.); (M.V.); (I.C.); (A.G.)
- Correspondence: ; Tel.: +390817462117; Fax: +390817464736
| | - Olga Vaccaro
- Department of Pharmacy, “Federico II” University, 80131 Naples, Italy;
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Akter S, Mizoue T, Nanri A, Goto A, Noda M, Sawada N, Yamaji T, Iwasaki M, Inoue M, Tsugane S. Low carbohydrate diet and all cause and cause-specific mortality. Clin Nutr 2020; 40:2016-2024. [PMID: 33046262 DOI: 10.1016/j.clnu.2020.09.022] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 09/12/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND Evidence is limited regarding the association between low-carbohydrate diet (LCD) score and mortality among Asians, a population that consumes a large amount of carbohydrates. OBJECTIVE The present study examined the association between low-carbohydrate diet (LCD) score (based on percentage of energy as carbohydrate, fat, and protein) and the risk of total and cause-specific mortality among Asians. DESIGN This study was a prospective cohort study in Japan with follow-up for a median of 16.9 years involving 43008 men and 50646 women aged 45-75 years. Association of LCD score, LCD score based on animal sources of protein and fat, and LCD score based on plant sources of protein and fat with risk of mortality was assessed using Cox proportional hazards model. RESULTS A U-shaped association was observed between LCD score and total mortality: the multivariable-adjusted hazard ratios (HRs) (95% CI) of total mortality for lowest through highest scores were 1.00, 0.95 (0.91, 1.01), 0.93 (0.88, 0.98), 0.93 (0.88, 0.98), and 1.01 (0.95, 1.07) (P-non-linearity <0.01). A similar association was found for mortality from cardiovascular disease (CVD) and heart disease. LCD score based on carbohydrate, animal protein, and animal fat also showed a U-shaped association for total mortality (P-non-linearity <0.01). In contrast, LCD score based on carbohydrate, plant protein, and plant fat was linearly associated with lower total (HR, 0.89; 95% CI: 0.83, 0.94 for highest versus lowest quintile), CVD [0.82 (0.73, 0.92)], heart disease [0.83 (0.71, 0.98)], and cerebrovascular disease [0.75 (0.62, 0.91) mortality. CONCLUSIONS Both LCD with high animal protein and fat and high-carbohydrate diet with low animal protein and fat were associated with higher risk of mortality. Meanwhile, LCD high in plant-based sources of protein and fat was associated with a lower risk of total and CVD mortality.
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Affiliation(s)
- Shamima Akter
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Akiko Nanri
- Department of Food and Health Sciences, Fukuoka Women's University, Fukuoka, Japan
| | - Atsushi Goto
- Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Mitsuhiko Noda
- Department of Diabetes Metabolism and Endocrinology, Ichikawa Hospital, International University of Health and Welfare, Chiba, Japan
| | - Norie Sawada
- Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Taiki Yamaji
- Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Motoki Iwasaki
- Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Manami Inoue
- Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Shoichiro Tsugane
- Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
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14
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Lee HA, An H, Lee E. Dietary patterns related to cardiovascular disease based on reduced rank regression analysis of healthy middle-aged Koreans: data from the community-based Korean Genome and Epidemiology Study (KoGES) cohort. Am J Clin Nutr 2020; 111:1159-1169. [PMID: 32338724 DOI: 10.1093/ajcn/nqaa078] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 03/27/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Dietary patterns (DPs) provide a comprehensive picture of the foods consumed by an individual. OBJECTIVES Using 12-y follow-up data from the Korean Genome Epidemiology Study (KoGES), we determined the associations of DPs with incident cardiovascular disease (CVD) using reduced rank regression (RRR). METHODS This study analyzed the data of 7354 CVD-free subjects aged 40-69 y drawn from the community-based KoGES cohort. Based on the daily intake of 26 food groups at baseline, we identified DPs based on retinol, vitamin B-2 (riboflavin), and vitamin B-3 (niacin) intakes using RRR. The effects of the DPs on incident CVD were assessed using HRs with 95% CIs. Furthermore, using a marginal structural model, the association between DPs and incident CVD was evaluated after adjusting for time-varying confounders. RESULTS The incidence of CVD during the follow-up period was 3.7 per 1000 person-years (n = 274). The identified DP accounted for 28.99% of the variation in the response variables (i.e., the intake amounts of all 3 nutrients) and was characterized by high intakes of eggs, fish, milk, and dairy products. The effect of DP quintile on incident CVD differed by sex (Pinteraction = 0.03); the highest DP quintile was associated with a protective effect against the development of CVD in women (HR: 0.44; 95% CI: 0.22, 0.89), but not in men (HR: 1.57; 95% CI: 0.82, 3.00), compared with the lowest quintile. Even after adjusting for time-dependent variables, the effect of DP on incident CVD was significant in women (HR: 0.43; 95% CI: 0.22, 0.84), but not in men (HR: 1.49; 95% CI: 0.71, 3.10). CONCLUSIONS In this study, we identified DPs related to CVD, and a DP characterized by high intakes of eggs, fish, milk, and dairy products protected against incident CVD in women.
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Affiliation(s)
- Hye Ah Lee
- Clinical Trial Center, Mokdong Hospital, Ewha Womans University, Seoul, Korea
| | - Hyoin An
- Department of Statistics, Ewha Womans University, Seoul, Korea
| | - EunJin Lee
- Department of Statistics, Ewha Womans University, Seoul, Korea
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Yu J, Song F, Li Y, Zheng Z, Jia H, Sun Y, Jin L, Yu X. Multimorbidity Analysis of 13 Systemic Diseases in Northeast China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061817. [PMID: 32168832 PMCID: PMC7142480 DOI: 10.3390/ijerph17061817] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 03/04/2020] [Accepted: 03/08/2020] [Indexed: 12/15/2022]
Abstract
Background: Multimorbidity not only affects the quality of patients’ lives, but can also bring a heavy economic burden to individuals, families and society. The purpose of this study was to reveal the connections between diseases, especially the important role each disease played in the entire multimorbidity network. Methods: A total of 1,155,734 inpatients were enrolled through multistage stratified random sampling in Jilin Province in 2017. Categorical variables were compared using the Rao–Scott-χ2 test. Weighted networks were adopted to present the complex relationships of multimorbidity. Results: The distributions of the number of diseases differed significantly by gender, age and health insurance scheme (P < 0.001). Diseases of the respiratory system had the highest weight in multimorbidity in young people. Endocrine, nutritional and metabolic diseases and circulatory system diseases were often associated with other systemic diseases in middle aged and old people. Conclusions: Multimorbidity with respiratory system diseases in young people should not be overlooked. Additionally, effective prevention efforts that target endocrine, nutritional and metabolic diseases and circulatory system diseases are needed in middle aged and old people.
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Affiliation(s)
- Jianxing Yu
- Social Medicine and Health Service Management, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun 130021, Jilin, China; (J.Y.); (F.S.); (Y.L.); (Z.Z.); (H.J.); (Y.S.)
| | - Fangying Song
- Social Medicine and Health Service Management, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun 130021, Jilin, China; (J.Y.); (F.S.); (Y.L.); (Z.Z.); (H.J.); (Y.S.)
| | - Yingying Li
- Social Medicine and Health Service Management, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun 130021, Jilin, China; (J.Y.); (F.S.); (Y.L.); (Z.Z.); (H.J.); (Y.S.)
| | - Zhou Zheng
- Social Medicine and Health Service Management, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun 130021, Jilin, China; (J.Y.); (F.S.); (Y.L.); (Z.Z.); (H.J.); (Y.S.)
| | - Huanhuan Jia
- Social Medicine and Health Service Management, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun 130021, Jilin, China; (J.Y.); (F.S.); (Y.L.); (Z.Z.); (H.J.); (Y.S.)
| | - Yuzhe Sun
- Social Medicine and Health Service Management, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun 130021, Jilin, China; (J.Y.); (F.S.); (Y.L.); (Z.Z.); (H.J.); (Y.S.)
| | - Lina Jin
- Epidemiology and Biostatistics, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun 130021, Jilin, China;
| | - Xihe Yu
- Social Medicine and Health Service Management, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun 130021, Jilin, China; (J.Y.); (F.S.); (Y.L.); (Z.Z.); (H.J.); (Y.S.)
- Correspondence:
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16
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Kim J, Hoang T, Bu SY, Kim JM, Choi JH, Park E, Lee SM, Park E, Min JY, Lee IS, Youn SY. Associations of Dietary Intake with Cardiovascular Disease, Blood Pressure, and Lipid Profile in the Korean Population: a Systematic Review and Meta-Analysis. J Lipid Atheroscler 2020; 9:205-229. [PMID: 32821732 PMCID: PMC7379076 DOI: 10.12997/jla.2020.9.1.205] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 01/09/2020] [Accepted: 01/10/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Previous studies have separately reported the contributions of dietary factors to the risk of cardiovascular disease (CVD) and its markers, including blood pressure (BP) and lipid profile. This study systematically reviewed the current evidence on this issue in the Korean population. METHODS Sixty-two studies from PubMed and Embase were included in this meta-analysis. We performed a random-effects model to analyze pooled odds ratios (ORs) and hazard ratios (HRs) and their 95% confidence intervals (CIs) for the consumption of 14 food items, three macro- and eight micro-nutrients, two dietary patterns, and three dietary indices. RESULTS An analysis of pooled effect sizes from at least four individual study populations showed significant associations between coffee consumption and CVD (OR/HR, 0.71; 95% CI, 0.52-0.97) and elevated/high triglycerides (TG) (OR, 0.84; 95% CI, 0.78-0.90), sugar-sweetened beverage intake and elevated BP (OR/HR, 1.20; 95% CI, 1.09-1.33), and milk and dairy intake and elevated/high TG and low high-density lipoprotein cholesterol (HDL-C) (OR/HR, 0.82; 95% CI, 0.76-0.89 for both). Carbohydrate consumption and the low-carbohydrate-diet score were consistently related to an approximately 25% risk reduction for elevated TG and low HDL-C. A lower risk of elevated total cholesterol, but not low-density lipoprotein, was additionally observed for those with a higher low-carbohydrate-diet score. A healthy dietary pattern was only associated with a reduced risk of elevated TG in the Korea National Cancer Screenee Cohort (OR, 0.81; 95% CI, 0.67-0.98). CONCLUSION This study showed that milk and dairy and coffee had protective effects for CVD and its risk factors, such as BP and lipid profile, while sugar-sweetened beverages exerted harmful effects.
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Affiliation(s)
- Jeongseon Kim
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
| | - Tung Hoang
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
| | - So Young Bu
- Department of Food and Nutrition, Daegu University, Gyeongsan, Korea
| | - Ji-Myung Kim
- Food and Nutrition Major, Division of Food Science and Culinary Arts, Shinhan University, Uijeongbu, Korea
| | - Jeong-Hwa Choi
- Department of Food and Nutrition, Keimyung University, Daegu, Korea
| | - Eunju Park
- Department of Food and Nutrition, Kyungnam University, Changwon, Korea
| | - Seung-Min Lee
- Department of Food and Nutrition, Yonsei University, Seoul, Korea
| | - Eunmi Park
- Department of Food and Nutrition, Hannam University, Daejeon, Korea
| | - Ji Yeon Min
- Dietetics and Nutrition Services Team, Asan Medical Center, Seoul, Korea
| | - In Seok Lee
- Nutrition Support Team, Kyung Hee University Medical Center, Seoul, Korea
| | - So Young Youn
- Clinical Nutrition Part, Samsung Medical Center, Seoul, Korea
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Identification of Dietary Patterns Related to Metabolic Diseases and Their Association with Cardiovascular Disease: From the Korean Genome and Epidemiology Study. Nutrients 2019; 11:nu11102434. [PMID: 31614783 PMCID: PMC6835220 DOI: 10.3390/nu11102434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 10/02/2019] [Accepted: 10/09/2019] [Indexed: 12/11/2022] Open
Abstract
Using data from the community-based cohort of the Korean Genome and Epidemiology Study (KoGES), we evaluated the dietary patterns (DPs) related to metabolic diseases and their associations with the incidence of non-fatal cardiovascular disease (CVD). After excluding those with a history of CVD or cancer, we analyzed the data of 8352 subjects aged 40-69 years. Based on their daily intake of 26 food groups at baseline, the DPs of the subjects with metabolic diseases (n = 1679, 20.1%) were analyzed using principal component analysis. Due to regional differences in the effect of DPs on CVD, we performed analyses stratified by region. The association between DPs and the incidence of non-fatal CVD was evaluated by calculating the hazard ratio (HR) and 95% confidence interval (CI) using the Cox proportional hazards model. During the 12-year follow-up, the incidence of non-fatal CVD was 5.4 per 1000 person-years (n = 431). An animal-based DP made the greatest contribution to the total variance and was characterized by a high intake of pork, beef, chicken, fish, and shellfish. The effect of DP on CVD differed by region (industrial/rural regions, p < 0.05) and was dominant in industrial regions, irrespective of metabolic disease status. In industrial regions, subjects in the top quintile of DP had a 0.42-fold (95% CI = 0.24-0.74) lower risk of incident CVD than those in the bottom quintile, even after adjusting for various covariates. In addition, the risk of CVD was high in individuals with a history of metabolic disease in both regions (HR = 1.74, 95% CI = 1.24-2.43 in industrial regions; HR = 1.88, 95% CI = 1.42-2.48 in rural regions). DP and a history of metabolic diseases, but not their interaction, were independently associated with incident CVD. In our study, an animal-based DP related to metabolic disease was independently associated with incident CVD, and this effect was noticeable only in industrial regions.
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Jang JY, Moon S, Cho S, Cho KH, Oh CM. Visit-to-visit HbA1c and glucose variability and the risks of macrovascular and microvascular events in the general population. Sci Rep 2019; 9:1374. [PMID: 30718626 PMCID: PMC6362217 DOI: 10.1038/s41598-018-37834-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 12/14/2018] [Indexed: 12/18/2022] Open
Abstract
This study evaluate association between glycemic variability and adverse vascular events in nondiabetic middle-aged adults. From 10,020 Ansung-Ansan cohort, Korean Genome, and Epidemiology Study (KoGES) data. 6,462 nondiabetic adults aged <65 years was analyzed. The mean and coefficient of variation (CV) of all biannually recorded HbA1c, fasting blood glucose(FBG), and post 2 hr blood glucose (PBG) were calculated and divided into 3 groups based on tertile of CV at each measurement, respectively. Primary endpoint was composite of Macro (composite of Coronary artery disease, Myocardial infarction, Congestive heart failure or Stroke) and Microvascular event (Creatine Clearance <60 ml/min/1.73 m2). The participants (mean age: 50 years, 50% men) were followed for a median of 9.9 (9.1-10.0) years. The high HbA1c-CV tertile (odds ratio 1.30; 1.01-1.66) was independent risk factor for microvascular events. In contrast, high FBG-CV tertile (2.32; 1.30-4.12) and PBG-CV (1.85; 1.05-3.26) was for macrovascular events. In this 10-year prespective cohort study, higher HbA1c-CV tertile was associated with higher composite of macro- and microvascular events and independent risk factor in non-DM middle-aged participants. In addition, higher tertile of FBG-CV and PBG-CV were risk factors for macrovascular events.
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Affiliation(s)
- Ji-Yong Jang
- Department of Internal Medicine, Chungju Medical Center, Chungju-si, South Korea
| | - Shinje Moon
- Department of Endocrinology and Metabolism, Hallym University College of Medicine, Chuncheon, South Korea
| | - Sungsoo Cho
- Department of Internal Medicine, Dankook University Hospital, Dankook University School of Medicine, Cheonan-si, South Korea
| | - Kyoo Ho Cho
- Department of Neurology, Yonsei University College of Medicine, Seoul, South Korea.
| | - Chang-Myung Oh
- Department of Endocrinology and Metabolism, CHA Bundang Medical Center, School of Medicine CHA University, Seongnam, South Korea.
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Kim OY, Kwak SY, Lim H, Shin MJ. Genotype effects of glucokinase regulator on lipid profiles and glycemic status are modified by circulating calcium levels: results from the Korean Genome and Epidemiology Study. Nutr Res 2018; 60:96-105. [PMID: 30527264 DOI: 10.1016/j.nutres.2018.09.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 09/23/2018] [Accepted: 09/27/2018] [Indexed: 11/29/2022]
Abstract
Single nucleotide polymorphisms (SNPs) in the glucokinase regulator (GCKR) are associated with major cardiovascular risk factors (ie, lipid profile and glycemic status). Recently, GCKR was shown to be related to circulating calcium levels involved in lipid and glycemic controls. Therefore, we hypothesized that GCKR SNPs are associated with major cardiovascular risk factors in the Korean population, and the association is modified by circulating calcium levels. Epidemiological data and GCKR SNPs (rs780093T>C, rs780094 T>C, and rs1260326 T>C) were collected from a subset of Ansung-Ansan cohort in the Korean Genome and Epidemiology Study (n = 7815). Consistent with the results of previous studies, GCKR SNPs were significantly associated with decreased total cholesterol and triglyceride levels and increased glucose levels and insulin resistance. Minor C allele carriers, particularly CC homozygotes, had lower serum calcium levels than TT homozygotes for all 3 SNPs. Particularly, the effect of GCKR SNPs on total cholesterol, triglyceride, fasting glucose, and insulin resistance was apparent when serum calcium levels were in normal range (8.8-10.1 mg/dL). When serum calcium levels were high (≥10.2 mg/dL), CC homozygotes also had significantly lower triglyceride and higher fasting glucose than TT homozygotes. However, the associations were not observed when serum calcium levels were low (<8.8 mg/dL). In conclusion, GCKR SNPs are associated with lipid profiles and glycemic status in the Korean population, and the genetic effect is modified by basal circulating calcium levels, particularly in normal or high ranges. It provides important information for individualized prevention and management of cardiovascular risk associated with GCKR SNPs.
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Affiliation(s)
- Oh Yoen Kim
- Department of Food Science and Nutrition, Dong-A University, Busan 604-714, Republic of Korea
| | - So-Young Kwak
- Department of Public Health Sciences, BK21PLUS Program in Embodiment, Health-Society Interaction, Graduate School, Korea University, Seoul 136-701, Republic of Korea
| | - Hyunjung Lim
- Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin 17104, Republic of Korea
| | - Min-Jeong Shin
- Department of Public Health Sciences, BK21PLUS Program in Embodiment, Health-Society Interaction, Graduate School, Korea University, Seoul 136-701, Republic of Korea; Korea University Guro Hospital, Korea University, Seoul 152-703, Republic of Korea.
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Diet-Related Risk Factors for Incident Hypertension During an 11-Year Follow-Up: The Korean Genome Epidemiology Study. Nutrients 2018; 10:nu10081077. [PMID: 30104485 PMCID: PMC6115751 DOI: 10.3390/nu10081077] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 08/06/2018] [Accepted: 08/09/2018] [Indexed: 12/28/2022] Open
Abstract
Using long-term follow-up cohort data from the Korean Genome Epidemiology Study, we assessed the dietary risk factors for incident hypertension (HTN). In total, 6792 subjects (3300 males and 3492 females) aged 40⁻69 years were included in the study. Physician-diagnosed HTN self-reported by the participants was used as the outcome. Daily intake of 20 food groups was assessed while using a dish-based semi-quantitative food-frequency questionnaire. After controlling for known risk factors, the food groups that were most closely associated with HTN were identified by forward stepwise selection while using the Cox proportional hazards model. The median follow-up period was 11.5 years (interquartile range, 6.0⁻11.7 years) and the incidence of HTN was 20 per 1000 person-years. Older age, obesity, lower education level, high alcohol intake, and having at least one parent with HTN were associated with the risk for HTN. In addition, a high intake of salted seafood and a low intake of eggs and meat were independently associated with the incidence of HTN after controlling for the known risk factors. Those in the top quartile of salted seafood intake had a 28% greater risk for incident HTN than those in the bottom quartile. The population-attributable fraction of three dietary factors accounted for 29.0% of the incidence of HTN. A high intake of salted seafood and a low intake of eggs and meat were associated with a greater risk for HTN.
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Yu J, Tao Y, Dou J, Ye J, Yu Y, Jin L. The dose-response analysis between BMI and common chronic diseases in northeast China. Sci Rep 2018. [PMID: 29523859 PMCID: PMC5845012 DOI: 10.1038/s41598-018-22551-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
High body mass index (BMI) predisposes to several chronic diseases, but a large-scale systematic and detailed study of dose-response relationship between BMI and chronic diseases has not been reported previously. In this study, we aimed to investigate the relationship between BMI and 3 chronic diseases (hypertension, dyslipidemia and MetS) in northeast China. A sample of 16412 participants aged 18~79 years old were included in Jilin province in 2012. The lambda-mu-sigma (LMS) method was applied to examine the trend of BMI by age, and the restricted cubic splines were used to investigate the non-linear associations (dose-response curve) between BMI and chronic diseases. It was pointed out that BMI increased rapidly when young, then kept steady in middle age, and finally declined slowly in old age, and accordingly age was divided into 3 segments, which were different by gender. The odds ratios (ORs) of BMI for the chronic diseases increased relatively slowly when young, then increased dramatically in middle-age and old population, especially for men. Further, the ORs of BMI among non-smokers were lower than those among smokers, and the same trend was shown to be more apparent among drinkers and non-drinkers. The risk of BMI for common chronic diseases increased dramatically in middle-aged, especially for men with drinking and smoking habits.
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Affiliation(s)
- Jianxing Yu
- Epidemiology and Biostatistics, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021, China
| | - Yuchun Tao
- Epidemiology and Biostatistics, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021, China
| | - Jing Dou
- Epidemiology and Biostatistics, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021, China
| | - Junsen Ye
- Epidemiology and Biostatistics, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021, China
| | - Yaqin Yu
- Epidemiology and Biostatistics, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021, China
| | - Lina Jin
- Epidemiology and Biostatistics, School of Public Health, No. 1163 Xinmin Street, Jilin University, Changchun, Jilin, 130021, China.
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