Staff Publications

Staff Publications

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    'Staff publications' is the digital repository of Wageningen University & Research

    'Staff publications' contains references to publications authored by Wageningen University staff from 1976 onward.

    Publications authored by the staff of the Research Institutes are available from 1995 onwards.

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Health Gain by Salt Reduction in Europe: A Modelling Study
Hendriksen, M.A.H. ; Raaij, J.M.A. van; Geleijnse, J.M. ; Breda, J. ; Boshuizen, H.C. - \ 2015
PLoS One 10 (2015)3. - ISSN 1932-6203
dietary-sodium intake - h urinary sodium - cardiovascular-disease - cost-effectiveness - blood-pressure - heart-failure - adults - prevention - risk - interventions
Excessive salt intake is associated with hypertension and cardiovascular diseases. Salt intake exceeds the World Health Organization population nutrition goal of 5 grams per day in the European region. We assessed the health impact of salt reduction in nine European countries (Finland, France, Ireland, Italy, Netherlands, Poland, Spain, Sweden and United Kingdom). Through literature research we obtained current salt intake and systolic blood pressure levels of the nine countries. The population health modeling tool DYNAMO-HIA including country-specific disease data was used to predict the changes in prevalence of ischemic heart disease and stroke for each country estimating the effect of salt reduction through its effect on blood pressure levels. A 30% salt reduction would reduce the prevalence of stroke by 6.4% in Finland to 13.5% in Poland. Ischemic heart disease would be decreased by 4.1% in Finland to 8.9% in Poland. When salt intake is reduced to the WHO population nutrient goal, it would reduce the prevalence of stroke from 10.1% in Finland to 23.1% in Poland. Ischemic heart disease would decrease by 6.6% in Finland to 15.5% in Poland. The number of postponed deaths would be 102,100 (0.9%) in France, and 191,300 (2.3%) in Poland. A reduction of salt intake to 5 grams per day is expected to substantially reduce the burden of cardiovascular disease and mortality in several European countries.
High urinary homoarginine excretion is associated with low rates of all-cause mortality and graft failure in renal transplant recipients
Tsikas, D. ; Frenay, A.S. ; Kayacelebi, A.A. ; Beckmann, B. ; Soedamah-Muthu, S.S. ; Borst, M.H. de; Berg, E. van den; Bakker, S.J.L. - \ 2015
Amino Acids 47 (2015)9. - ISSN 0939-4451 - p. 1827 - 1836.
glomerular-filtration-rate - nitric-oxide synthase - cardiovascular risk - heart-failure - substrate-specificity - blood-pressure - l-arginine - disease - serum - dysfunction
Renal transplant recipients (RTR) have an increased cardiovascular risk profile. Low levels of circulating homoarginine (hArg) are a novel risk factor for mortality and the progression of atherosclerosis. The kidney is known as a major source of hArg, suggesting that urinary excretion of hArg (UhArg) might be associated with mortality and graft failure in RTR. hArg was quantified by mass spectrometry in 24-h urine samples of 704 RTR (functioning graft =1 year) and 103 healthy subjects. UhArg determinants were identified with multivariable linear regression models. Associations of UhArg with all-cause mortality and graft failure were assessed using multivariable Cox regression analyses. UhArg excretion was significantly lower in RTR compared to healthy controls [1.62 (1.09–2.61) vs. 2.46 (1.65–4.06) µmol/24 h, P <0.001]. In multivariable linear regression models, body surface area, diastolic blood pressure, eGFR, pre-emptive transplantation, serum albumin, albuminuria, urinary excretion of urea and uric acid and use of sirolimus were positively associated with UhArg, while donor age and serum phosphate were inversely associated (model R 2 = 0.43). During follow-up for 3.1 (2.7–3.9) years, 83 (12 %) patients died and 45 (7 %) developed graft failure. UhArg was inversely associated with all-cause mortality [hazard risk (HR) 0.52 (95 % CI 0.40–0.66), P <0.001] and graft failure [HR 0.58 (0.42–0.81), P = 0.001]. These associations remained independent of potential confounders. High UhArg levels are associated with reduced all-cause mortality and graft failure in RTR. Kidney-derived hArg is likely to be of particular importance for proper maintenance of cardiovascular and renal systems.
Dietary patterns, cognitive decline, and dementia: a systematic review
Rest, O. van de; Berendsen, A.M. ; Haveman-Nies, A. ; Groot, C.P.G.M. de - \ 2015
Advances in Nutrition 6 (2015). - ISSN 2161-8313 - p. 154 - 168.
healthy eating index - mediterranean diet - alzheimers-disease - nutritional epidemiology - stop hypertension - physical-activity - randomized-trial - cluster-analysis - elderly-people - blood-pressure
Nutrition is an important modifiable risk factor that plays a role in the strategy to prevent or delay the onset of dementia. Research on nutritional effects has until now mainly focused on the role of individual nutrients and bioactive components. However, the evidence for combined effects, such as multinutrient approaches, or a healthy dietary pattern, such as the Mediterranean diet, is growing. These approaches incorporate the complexity of the diet and possible interaction and synergy between nutrients. Over the past few years, dietary patterns have increasingly been investigated to better understand the link between diet, cognitive decline, and dementia. In this systematic review we provide an overview of the literature on human studies up to May 2014 that examined the role of dietary patterns (derived both a priori as well as a posteriori) in relation to cognitive decline or dementia. The results suggest that better adherence to a Mediterranean diet is associated with less cognitive decline, dementia, or Alzheimer disease, as shown by 4 of 6 cross-sectional studies, 6 of 12 longitudinal studies, 1 trial, and 3 meta-analyses. Other healthy dietary patterns, derived both a priori (e.g., Healthy Diet Indicator, Healthy Eating Index, and Program National Nutrition Santé guideline score) and a posteriori (e.g., factor analysis, cluster analysis, and reduced rank regression), were shown to be associated with reduced cognitive decline and/or a reduced risk of dementia as shown by all 6 cross-sectional studies and 6 of 8 longitudinal studies. More conclusive evidence is needed to reach more targeted and detailed guidelines to prevent or postpone cognitive decline.
Non-linear associations between serum 25-OH vitamin D and indices of arterial stiffness and arteriosclerosis in an older population
Dijk, S.C. van; Sohl, E. ; Oudshoorn, C. ; Enneman, A.W. ; Ham, A.C. ; Swart, K.M.A. ; Wijngaarden, J.P. van; Brouwer, E.M. ; Zwaluw, N.L. van der; Uitterlinden, A.G. ; Groot, C.P.G.M. de; Dhonukshe-Rutten, R.A.M. ; Lips, P. ; Schoor, N.M. van; Blom, H.J. ; Geleijnse, J.M. ; Feskens, E.J.M. - \ 2015
Age and Ageing 44 (2015)1. - ISSN 0002-0729 - p. 136 - 142.
nutrition examination survey - 3rd national-health - cardiovascular-disease - blood-pressure - d deficiency - risk - 25-hydroxyvitamin-d - hypertension - mortality - system
Background: several studies have been pointing towards a non-linear relationship between serum 25(OH)D and cardiovascular disease. Next to vitamin D deficiency, also higher levels of 25(OH)D have been reported to be associated with increased cardiovascular risk. We aimed to investigate the nature of the relationship between serum 25(OH)D and measures of arterial stiffness and arteriosclerosis in an elderly population. Design: cross-sectional. Setting/subjects: a subgroup of the B-PROOF study was included to determine associations between serum 25(OH)D and arterial stiffness and atherosclerosis (n = 567, 57% male, age 72.6 ± 5.6 years, mean serum 25(OH)D 54.6 ± 24.1 nmol/l). Methods: carotid intima media thickness (IMT) was assessed using ultrasonography and pulse wave velocity (PWV) was determined with applanation tonometry. Associations were tested using multivariable restricted cubic spline functions and stratified linear regression analysis. Results: the associations between serum 25(OH)D and carotid IMT or PWV were non-linear. Spline functions demonstrated a difference between 25(OH)D deficient and sufficient individuals. In serum 25(OH)D sufficient participants (=50 nmol/l; n = 287), a positive association with IMT and serum 25(OH)D was present (ß 1.24; 95%CI [0.002; 2.473]). PWV levels were slightly lower in vitamin D deficient individuals, but the association with 25(OH)D was not significant. Conclusion: our study demonstrates that associations of serum 25(OH)D and PWV and IMT in an elderly population are not linear. In particular from serum 25(OH)D levels of 50 nmol/l and up, there is a slight increase of IMT with increasing 25(OH)D levels.
National prevalence and associated risk factors of hypertension and prehypertension among Vietnamese adults
Ha, Do T.P. ; Geleijnse, J.M. ; Le, M.B. ; Kok, F.J. ; Feskens, E.J.M. - \ 2015
American Journal of Hypertension 28 (2015)1. - ISSN 0895-7061 - p. 89 - 97.
blood-pressure - double burden - population - awareness - health - prevention - nutrition - countries - consumption - strategies
BACKGROUND Hypertension has recently been identified as the leading risk factor for global mortality. This study aims to present the national prevalence of hypertension and prehypertension and, their determinants in Vietnamese adults. METHODS Nationally representative data were obtained from the National Adult Overweight Survey 2005. This one visit survey included 17,199 subjects aged 25–64 years, with a mean body mass index (BMI) of 20.7kg/m2. RESULTS The overall census-weighted JNC7 (the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure) defined prevalence of hypertension was 20.7% (95% confidence interval (CI) = 19.4–22.1); the prevalence of prehypertension was 41.8% (95% CI = 40.4–43.1). Hypertension and prehypertension were more prevalent in men. Higher age, overweight, alcohol use (among men), and living in rural areas (among women) were independently associated with a higher prevalence of hypertension, whereas higher physical activity and education level were inversely associated. Age, BMI, and living in rural areas were independently associated with an increased prevalence of prehypertension. Among the hypertensives, 25.9% were aware of their hypertension, 12.2% were being treated, and 2.8% had their blood pressure under control; among the treated hypertensives, 32.4% had their blood pressure controlled.
Higher dietary salt intake is associated with microalbuminuria, but not with retinopathy in individuals with type 1 diabetes: the EURODIAB Prospective Complications Study
Engelen, L. ; Soedamah-Muthu, S.S. ; Geleijnse, J.M. ; Toeller, M. ; Chaturvedi, N. ; Fuller, J.H. ; Schalkwijk, C.G. ; Stehouwer, C.D. - \ 2014
Diabetologia 57 (2014)11. - ISSN 0012-186X - p. 2315 - 2323.
urinary albumin excretion - blood-pressure - risk-factors - sodium-excretion - hypertension - mellitus - disease - system - iddm - aldosterone
Aims/hypothesis High dietary salt intake has been associated with elevated BP and may also have a deleterious effect on microvascular complications. We studied the cross-sectional associations between dietary salt intake (estimated from 24 h urinary sodium excretion) and urinary potassium excretion on the one hand, and the prevalence of microvascular complications on the other, in individuals with type 1 diabetes. Methods We measured sodium and potassium concentrations in two 24 h urine samples in 1,212 individuals with type 1 diabetes (40¿±¿10 years old, 51% men) who participated in the EURODIAB Prospective Complications Study. We used multiple logistic regression analyses to investigate associations between dietary salt intake and microvascular complications adjusted for age and sex, and additionally for BMI, smoking, urinary potassium excretion, antihypertensive medication and physical activity, and total energy, protein, alcohol, saturated fat and fibre intake. Results After full adjustment, 1 g/day higher dietary salt intake was positively associated with the presence of microalbuminuria (OR 1.06 [95% CI 1.01, 1.10]), but not macroalbuminuria (OR 0.99 [95% CI 0.94, 1.05]), non-proliferative retinopathy (OR 1.00 (95% CI 0.96, 1.04]) or proliferative retinopathy (OR 1.02 (95% CI 0.95, 1.08]). After excluding individuals with cardiovascular disease and/or antihypertensive medication (n¿=¿418), we found a non-significant association with microalbuminuria (OR 1.04 [95% CI 0.99, 1.10]) and macroalbuminuria (OR 1.05 [95% CI 0.96, 1.16]). The association between dietary salt intake and microalbuminuria was stronger in individuals with a BMI above 25 kg/m2 (OR 1.11 [95% CI 1.04, 1.18]) than in those with BMI below 25 kg/m2 (OR 1.03 [95% CI 0.97, 1.09]). No significant associations were found between urinary potassium excretion and microvascular complications. Conclusions/interpretation In individuals with type 1 diabetes, higher dietary salt intake, as determined by 24 h urinary sodium excretion, may be positively associated with microalbuminuria, particularly in overweight individuals.
Optimizing soaking and germination conditions to improve gamma-aminobutyric acid content in japonica and indica germinated brown rice
Zhang, Q. ; Xiang, J. ; Zhang, L. ; Zhu, X. ; Evers, J.B. ; Werf, W. van der; Duan, L. - \ 2014
Journal of Functional Foods 10 (2014). - ISSN 1756-4646 - p. 283 - 291.
glutamate-decarboxylase - protease activities - blood-pressure - water soaking - giant-embryo - gaba - accumulation - metabolism - beans - rats
Germinated brown rice is a well-known functional food due to its high content of gamma-aminobutyric acid (GABA). This study was designed to test the difference of producing GABA in two domesticated rice genotypes (indica and japonica rice), and the effects of adding exogenous glutamic acid or gibberellin, and processing conditions. Soaking at 30¿°C and germination at 35¿°C during 36¿h resulted in the highest GABA in distilled soaking water with pH¿7. The indica rice showed higher GABA levels than japonica rice. GABA was increased under acidic soaking conditions or by adding L-glutamic acid (L-Glu) at the optimal concentration of 1.0¿g¿L-1 and gibberellin A3 (GA3) at the optimal concentration of 0.25¿mg¿L-1. The lower accumulation of GABA in japonica rice could be remedied by adding exogenous L-Glu and GA3, and providing acidic soaking conditions. The results help to efficiently produce GABA enriched functional food.
Unravelling of the health effects of polyphenols is a complex puzzle complicated by metabolism
Hollman, P.C.H. - \ 2014
Archives of Biochemistry and Biophysics 559 (2014)2014. - ISSN 0003-9861 - p. 100 - 105.
cardiovascular-disease mortality - flavonoid intake - blood-pressure - prospective cohort - adhesion molecule - vascular function - heart-disease - cancer-risk - diet - consumption
Plant metabolism creates complex mixtures of polyphenols in plant foods. Epidemiology and human trials reduced this complexity, by studying specific foods; subclasses of polyphenols; individual polyphenols, or total antioxidant capacity (TAC). This implies the following assumptions: (1) a limited number of potent polyphenols exists; (2) well-defined natural potent mixtures of polyphenols exist; (3) polyphenols share a common biological activity (e.g. antioxidant activity). To find potent polyphenols (1st assumption), in vitro screening has been widely applied, but most published results are of limited use because metabolism, changing biological activity profoundly, has frequently not been considered. The abundant anecdotal evidence for natural potent mixtures of polyphenols (2nd assumption) on the internet is very hard to verify. Additionally, cross-cultural studies have revealed the potency of e.g. cocoa. Polyphenols share the antioxidant phenolic group which inspired researchers to measure their antioxidant activity, thus greatly reducing complexity (3rd assumption). Unfortunately, the elegant antioxidant hypothesis has to be rejected, because poor absorption and extensive metabolism annihilate any contribution to the endogenous body antioxidants. In conclusion, the above assumptions are hard to verify, and no quick answers are to be expected. Future research should focus on structure–activity relations at nanomolar levels and explore metabolomics.
Potential effect of salt reduction in processed foods on health
Hendriksen, M.A.H. ; Hoogenveen, R.T. ; Hoekstra, J. ; Geleijnse, J.M. ; Boshuizen, H.C. ; Raaij, J.M.A. van - \ 2014
American Journal of Clinical Nutrition 99 (2014)3. - ISSN 0002-9165 - p. 446 - 453.
cardiovascular-disease - blood-pressure - sodium restriction - cost-effectiveness - dietary-sodium - iodine intake - hypertension - metaanalysis - mortality - interventions
Background: Excessive salt intake has been associated with hypertension and increased cardiovascular disease morbidity and mortality. Reducing salt intake is considered an important public health strategy in the Netherlands. Objective: The objective was to evaluate the health benefits of salt-reduction strategies related to processed foods for the Dutch population. Design: Three salt-reduction scenarios were developed: 1) substitution of high-salt foods with low-salt foods, 2) a reduction in the sodium content of processed foods, and 3) adherence to the recommended maximum salt intake of 6 g/d. Health outcomes were obtained in 2 steps: after salt intake was modeled into blood pressure levels, the Chronic Disease Model was used to translate modeled blood pressures into incidences of cardiovascular diseases, disability-adjusted life years (DALYs), and life expectancies. Health outcomes of the scenarios were compared with health outcomes obtained with current salt intake. Results: In total, 4.8% of acute myocardial infarction cases, 1.7% of congestive heart failure cases, and 5.8% of stroke cases might be prevented if salt intake meets the recommended maximum intake. The burden of disease might be reduced by 56,400 DALYs, and life expectancy might increase by 0.15 y for a 40-y-old individual. Substitution of foods with comparable low-salt alternatives would lead to slightly higher salt intake reductions and thus to more health gain. The estimates for sodium reduction in processed foods would be slightly lower. Conclusion: Substantial health benefits might be achieved when added salt is removed from processed foods and when consumers choose more low-salt food alternatives.
Rapid and sustained systemic circulation of conjugated gut microbiol catabolites after single-dose black tea extract consumption
Duynhoven, J.P.M. van; Hooft, J.J.J. van der; Dorsten, F.A. van; Peters, S. ; Foltz, M. ; Gomez-Roldan, V. ; Vervoort, J.J.M. ; Vos, R.C.H. de - \ 2014
Journal of Proteome Research 13 (2014)5. - ISSN 1535-3893 - p. 2668 - 2678.
randomized controlled-trial - red wine/grape juice - green tea - mass-spectrometry - in-vitro - dietary polyphenols - blood-pressure - catechins - metabolites - humans
Gut microbial catabolites of black tea polyphenols (BTPs) have been proposed to exert beneficial cardiovascular bioactivity. This hypothesis is difficult to verify because the conjugation patterns and pharmacokinetics of these catabolites are largely unknown. The objective of our study was to identify, quantify, and assess the pharmacokinetics of conjugated BTP metabolites in plasma of healthy humans by means of an a priori untargeted LC–MS-based metabolomics approach. In a randomized, open, placebo-controlled, crossover study, 12 healthy men consumed a single bolus of black tea extract (BTE) or a placebo. The relative and, in several cases, absolute concentrations of a wide range of metabolites were determined using U(H)PLC-LTQ-Orbitrap-FTMS. Following BTE consumption, a kinetic response in plasma was observed for 59 BTP metabolites, 11 of these in a quantitative manner. Conjugated and unconjugated catechins appeared in plasma without delay, at 2–4 h, followed by a range of microbial catabolites. Interindividual variation in response was greater for gut microbial catabolites than for directly absorbed BTPs. The rapid and sustained circulation of conjugated catabolites suggests that these compounds may be particularly relevant to proposed health benefits of BTE. Their presence and effects may depend on individual variation in catabolic capacity of the gut microbiota.
Reprint of: A parallel randomized trial on the effect of a healthful diet on inflammageing and its consequences in European elderly people: Design of the NU-AGE dietary intervention study
Berendsen, A.M. ; Santoro, A. ; Pini, E. ; Cevenini, E. ; Ostan, R. ; Pietruszka, B. ; Rolf, K. ; Cano, N. ; Caille, A. ; Lyon-Belgy, N. ; Fairweather-Tait, S. ; Feskens, E.J.M. ; Franceschi, C. ; Groot, C.P.G.M. de - \ 2014
Mechanisms of Ageing and Development 136-137 (2014). - ISSN 0047-6374 - p. 14 - 21.
cardiovascular risk-factors - mediterranean diet - vitamin-d - metabolic syndrome - older-adults - nutritional-status - blood-pressure - fatty-acids - weight-loss - life-style
Background The proportion of European elderly is expected to increase to 30% in 2060. Combining dietary components may modulate many processes involved in ageing. So, it is likely that a healthful diet approach might have greater favourable impact on age-related decline than individual dietary components. This paper describes the design of a healthful diet intervention on inflammageing and its consequences in the elderly. Methods The NU-AGE study is a parallel randomized one-year trial in 1250 apparently healthy, independently living European participants aged 65–80 years. Participants are randomised into either the diet group or control group. Participants in the diet group received dietary advice aimed at meeting the nutritional requirements of the ageing population. Special attention was paid to nutrients that may be inadequate or limiting in diets of elderly, such as vitamin D, vitamin B12, and calcium. C-reactive protein is measured as primary outcome. Discussion The NU-AGE study is the first dietary intervention investigating the effect of a healthful diet providing targeted nutritional recommendations for optimal health and quality of life in apparently healthy European elderly. Results of this intervention will provide evidence on the effect of a healthful diet on the prevention of age related decline.
Comined effects of smoking and alcohol on metabolic syndrome: the lifelines cohort study
Slagter, S.N. ; Vliet-Ostaptchouk, J.V. ; Vonk, J.M. ; Boezen, H.M. ; Dullaart, R.P.F. ; Muller Kobold, A.C. ; Feskens, E.J.M. ; Beek, A.P. van; Klauw, M.M. van der; Wolffenbuttel, B.H.R. - \ 2014
PLoS One 9 (2014)4. - ISSN 1932-6203 - 9 p.
genome-wide association - nutrition examination survey - coronary-heart-disease - body-mass index - blood-pressure - waist circumference - cigarette-smoking - physical-activity - national-health - dietary-intake
Introduction - The development of metabolic syndrome (MetS) is influenced by environmental factors such as smoking and alcohol consumption. We determined the combined effects of smoking and alcohol on MetS and its individual components. Methods - 64,046 participants aged 18–80 years from the LifeLines Cohort study were categorized into three body mass index (BMI) classes (BMI1 drink/day) and tobacco showed higher triglycerides levels. Up to 2 drinks/day was associated with a smaller waist circumference in overweight and obese individuals. Consumption of >2 drinks/day increased blood pressure, with the strongest associations found for heavy smokers. The overall metabolic profile of wine drinkers was better than that of non-drinkers or drinkers of beer or spirits/mixed drinks. Conclusion - Light alcohol consumption may moderate the negative associations of smoking with MetS. Our results suggest that the lifestyle advice that emphasizes smoking cessation and the restriction of alcohol consumption to a maximum of 1 drink/day, is a good approach to reduce the prevalence of MetS. Figures
Sodium excretion and risk of developing coronary heart disease
Joosten, M.M. ; Gansevoort, R.T. ; Mukamal, K.J. ; Lambers Heerspink, H. ; Geleijnse, J.M. ; Feskens, E.J.M. ; Navis, G. ; Bakker, S.J.L. - \ 2014
Circulation 129 (2014). - ISSN 0009-7322 - p. 1121 - 1128.
modest salt reduction - blood-pressure - potassium intake - cardiovascular-disease - dietary-sodium - urinary sodium - natriuretic-peptide - hypertension prevention - randomized-trials - public-health
Background—Despite compelling evidence for sodium’s adverse effects on blood pressure, it remains uncertain whether excess sodium intake is a risk factor for coronary heart disease (CHD) in the overall population and in potentially more susceptible subgroups. Methods and Results—We prospectively followed 7543 adults aged 28 to 75 years and free of cardiovascular and kidney disease in 1997/1998 of the Prevention of Renal and Vascular End-stage Disease (PREVEND) study. Sodium excretion was measured in two 24-hour urine collections at baseline. Potential susceptibility factors were blood pressure and plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP). Median 24-hour sodium excretion was 137 mmol (Q1–Q3, 106–171 mmol). During a median follow-up of 10.5 (Q1–Q3: 9.9–10.8) years, 452 CHD events occurred. In the entire cohort, there was no association between each 1-g/d (43 mmol/24 h) increment in sodium excretion and CHD risk (adjusted hazard ratio, 1.07; 95% confidence interval, 0.98–1.18; P=0.15). However, the association of sodium excretion with CHD risk tended to be modified by mean arterial pressure (Pinteraction=0.08) and was modified by NT-proBNP (Pinteraction=0.002). When stratified, each 1-g/d increment in sodium excretion was associated with an increased risk for CHD in subjects with hypertension (adjusted hazard ratio, 1.14; 95% confidence interval, 1.01–1.28; n=2363) and in subjects with NT-proBNP concentrations above the sex-specific median (adjusted hazard ratio, 1.16; 95% confidence interval, 1.03–1.30; n=3771). Conclusions—Overall, there was no association between sodium excretion and risk of CHD. The association between sodium excretion and CHD risk was modified by NT-proBNP. Higher sodium excretion was associated with an increased CHD risk among subjects with increased NT-proBNP concentrations or with hypertension.
The use of predefined diet quality scores in the context of CVD risk during urbanization in the South African Prospective Urban and Rural Epidemiological (PURE) study
Dolman, R.C. ; Wentzel-Viljoen, E. ; Jerling, J.C. ; Feskens, E.J.M. ; Kruger, A. ; Pieters, M. - \ 2014
Public Health Nutrition 17 (2014)8. - ISSN 1368-9800 - p. 1706 - 1716.
cardiovascular-disease - nutrition transition - income countries - blood-pressure - beta-carotene - lung-cancer - population - metaanalysis - mortality - calcium
Objective Urbanization is generally associated with increased CVD risk and accompanying dietary changes. Little is known regarding the association between increased CVD risk and dietary changes using approaches such as diet quality. The relevance of predefined diet quality scores (DQS) in non-Western developing countries has not yet been established. Design The association between dietary intakes and CVD risk factors was investigated using two DQS, adapted to the black South African diet. Dietary intake data were collected using a quantitative FFQ. CVD risk was determined by analysing known CVD risk factors. Setting Urban and rural areas in North West Province, South Africa. Subjects Apparently healthy volunteers from the South African Prospective Urban and Rural Epidemiological (PURE) study population (n 1710). Results CVD risk factors were significantly increased in the urban participants, especially women. Urban men and women had significantly higher intakes of both macro- and micronutrients with macronutrient intakes well within the recommended CVD guidelines. While micronutrient intakes were generally higher in the urban groups than in the rural groups, intakes of selected micronutrients were low in both groups. Both DQS indicated improved diet quality in the urban groups and good agreement was shown between the scores, although they seemed to measure different aspects of diet quality. Conclusions The apparent paradox between improved diet quality and increased CVD risk in the urban groups can be explained when interpreting the cut-offs used in the scores against the absolute intakes of individual nutrients. Predefined DQS as well as current guidelines for CVD prevention should be interpreted with caution in non-Western developing countries.
Metabolic mediators of the effects of body-mass index, overweight, and obesity on coronary heart disease and stroke: a pooled analysis of 97 prospective cohorts with 1.8 million participants
Kromhout, D. ; Soedamah-Muthu, S.S. ; Groot, C.P.G.M. de; Hollander, E.L. de; Geleijnse, J.M. ; Feskens, E.J.M. - \ 2014
The Lancet 383 (2014)9921. - ISSN 0140-6736 - p. 970 - 983.
all-cause mortality - cardiovascular-disease - blood-pressure - systematic analysis - risk-factors - weight-loss - noncommunicable diseases - scientific statement - randomized-trials - bariatric surgery
Background - Body-mass index (BMI) and diabetes have increased worldwide, whereas global average blood pressure and cholesterol have decreased or remained unchanged in the past three decades. We quantified how much of the effects of BMI on coronary heart disease and stroke are mediated through blood pressure, cholesterol, and glucose, and how much is independent of these factors. Methods - We pooled data from 97 prospective cohort studies that collectively enrolled 1·8 million participants between 1948 and 2005, and that included 57¿161 coronary heart disease and 31¿093 stroke events. For each cohort we excluded participants who were younger than 18 years, had a BMI of lower than 20 kg/m2, or who had a history of coronary heart disease or stroke. We estimated the hazard ratio (HR) of BMI on coronary heart disease and stroke with and without adjustment for all possible combinations of blood pressure, cholesterol, and glucose. We pooled HRs with a random-effects model and calculated the attenuation of excess risk after adjustment for mediators. Findings - The HR for each 5 kg/m2 higher BMI was 1·27 (95% CI 1·23–1·31) for coronary heart disease and 1·18 (1·14–1·22) for stroke after adjustment for confounders. Additional adjustment for the three metabolic risk factors reduced the HRs to 1·15 (1·12–1·18) for coronary heart disease and 1·04 (1·01–1·08) for stroke, suggesting that 46% (95% CI 42–50) of the excess risk of BMI for coronary heart disease and 76% (65–91) for stroke is mediated by these factors. Blood pressure was the most important mediator, accounting for 31% (28–35) of the excess risk for coronary heart disease and 65% (56–75) for stroke. The percentage excess risks mediated by these three mediators did not differ significantly between Asian and western cohorts (North America, western Europe, Australia, and New Zealand). Both overweight (BMI =25 to
Joint Association of Dietary Pattern and Physical Activity Level with Cardiovascular Disease Risk Factors among Chinese Men: A Cross-Sectional Study
Wang, D. ; He, Y. ; Li, Y.P. ; Luan, D.C. ; Zhai, F.Y. ; Yang, X.G. ; Ma, G.S. - \ 2013
PLoS One 8 (2013)6. - ISSN 1932-6203
diabetes prevention program - impaired glucose-tolerance - life-style - metabolic syndrome - blood-pressure - attributable risk - plasma biomarkers - us adults - population - hypertension
The purpose of this cross-sectional study was to investigate the joint associations of physical activity level (PAL) and dietary patterns in relation to cardiovascular disease (CVD) risk factors among Chinese men. The study population consisted of 13 511 Chinese males aged 18-59 years from the 2002 China National Nutrition and Health Survey. Based on dietary data collected by a food frequency questionnaire, four dietary patterns were identified and labeled as "Green Water'' (high consumption of rice, vegetables, seafood, pork, and poultry), "Yellow Earth'' (high consumption of wheat flour products and starchy tubers), "New Affluent'' (high consumption of animal sourced foods and soybean products), and "Western Adopter'' (high consumption of animal sourced foods, cakes, and soft drinks). From the information collected by a 1-year physical activity questionnaire, PAL was calculated and classified into 4 categories: sedentary, low active, active, and very active. As compared with their counterparts from the New Affluent pattern, participants who followed the Green Water pattern had a lower likelihood of abdominal obesity (AO; 50.2%), hypertension (HT; 37.9%), hyperglycemia (HG; 41.5%), elevated triglyceride (ETG; 14.5%), low HDL (LHDL; 39.8%), and metabolic syndrome (MS; 51.9%). When compared to sedentary participants, the odds ratio of participants with very active PAL was 0.62 for AO, 0.85 for HT, 0.71 for HG, 0.76 for ETG, 0.74 for LHDL, and 0.58 for MS. Individuals who followed both very active PAL and the Green Water pattern had a lower likelihood of CVD risk factors (AO: 65.8%, HT: 39.1%, HG: 57.4%, ETG: 35.4%, LHDL: 56.1%, and MS: 75.0%), compared to their counterparts who followed both sedentary PAL and the New Affluent pattern. In addition, adherence to both healthy dietary pattern and very active PAL presented a remarkable potential for CVD risk factor prevention.
Dietary patterns as compared with physical activity in relation to metabolic syndrome among Chinese adults
He, Y. ; Li, Y. ; Lai, J. ; Wang, D. ; Zhang, J. ; Fu, P. ; Yang, X. ; Qi, L. - \ 2013
Nutrition, Metabolism & Cardiovascular Diseases 23 (2013)10. - ISSN 0939-4753 - p. 920 - 928.
blood-pressure - population - prevalence - women - management - shanghai - health - risk
Aims: To examine the nationally-representative dietary patterns and their joint effects with physical activity on the likelihood of metabolic syndrome (MS) among 20,827 Chinese adults. Methods and results: CNNHS was a nationally representative cross-sectional observational study. Metabolic syndrome was defined according to the Joint Interim Statement definition. The "Green Water" dietary pattern, characterized by high intakes of rice and vegetables and moderate intakes in animal foods was related to the lowest prevalence of MS (15.9%). Compared to the "GreenWater" dietary pattern, the "Yellow Earth" dietary pattern, characterized by high intakes of refined cereal products, tubers, cooking salt and salted vegetable was associated with a significantly elevated odds of MS (odds ratio 1.66, 95% CI: 1.40e1.96), after adjustment of age, sex, socioeconomic status and lifestyle factors. The "Western/new affluence" dietary pattern characterized by higher consumption of beef/lamb, fruit, eggs, poultry and seafood also significantly associated with MS (odds ratio: 1.37, 95% CI: 1.13e1.67). Physical activity showed significant interactions with the dietary patterns in relation to MS risk (P for interaction = 0.008). In the joint analysis, participants with the combination of sedentary activity with the "Yellow Earth" dietary pattern or the "Western/new affluence" dietary pattern both had more than three times (95% CI: 2.8-6.1) higher odds of MS than those with active activity and the "Green Water" dietary pattern. Conclusions: Our findings from the large Chinese national representative data indicate that dietary patterns affect the likelihood of MS. Combining healthy dietary pattern with active lifestyle may benefit more in prevention of MS. (C) 2012 Elsevier B.V. All rights reserved.
Comparison of a sodium-based and a chloride-based approach for the determination of sodium chloride content of processed foods in the Netherlands
Capuano, E. ; Veer, G. van der; Verheijen, P.J.J. ; Heenan, S.P. ; Laak, L.F.J. van de; Koopmans, H.B.M. ; Ruth, S.M. van - \ 2013
Journal of Food Composition and Analysis 31 (2013)1. - ISSN 0889-1575 - p. 129 - 136.
blood-pressure - salt intake - reduction - disease - health - world - costs - risk
This study reports and discusses the sodium content of a set of 1016 processed food samples collected in the Netherlands, which covered 10 food groups (cakes/pastries, chips/nuts, sauces, processed meat, conserves, snacks, ready-to-eat products, cheese, bread, and soups) and 100 food commodities. The food groups that showed highest sodium contents were processed meat (1030 mg Na 100 g-1), cheese (820 mg Na 100 g-1), and sauces (752 mg Na 100 g-1). Lowest sodium concentrations were determined in conserves (286 mg Na 100 g-1), cakes/pastries (322 mg Na 100 g-1), and soups (355 mg Na 100 g-1). In addition, two different approaches for the assessment of sodium chloride content in the same sample set have been compared for all 1016 samples: determination of sodium by flame emission spectroscopy and determination of chloride by potentiometric titration. The sodium chloride content was then calculated converting the sodium and chloride content into the corresponding salt (NaCl) content. For the NaCl contents determined by the two approaches, significant differences for seven out of the ten food groups were observed, and the sodium contents of nearly half of the commodities showed significantly different NaCl levels. At food group level, the NaCl contents calculated from sodium were significantly higher (p <0.05) than the NaCl content calculated from chloride for cakes/pastries, processed meat, snacks, cheese and soups, whereas it was significantly lower for the chips/nuts and the bread group. These differences can be explained by additional sources of sodium and/or chloride, e.g. certain food additives and the natural sodium and chloride content of the ingredients. Although most legal recommendations specify NaCl levels, the present study shows that sodium and chloride concentrations do not go necessarily hand in hand since they may originate from different sources.
A parallel randomized trial on the effect of a healthful diet on inflammageing and its consequences in European elderly people: Design of the NU-AGE dietary intervention study
Berendsen, A.M. ; Santoro, A. ; Pini, E. ; Cevenini, E. ; Ostan, R. ; Pietruszka, B. ; Rolf, K. ; Cano, R. ; Caille, A. ; Lyon-Belgy, N. ; Fairweather-Tait, S. ; Feskens, E.J.M. ; Franceschi, C. ; Groot, C.P.G.M. de - \ 2013
Mechanisms of Ageing and Development 134 (2013)11-12. - ISSN 0047-6374 - p. 523 - 530.
cardiovascular risk-factors - mediterranean diet - vitamin-d - metabolic syndrome - older-adults - nutritional-status - blood-pressure - fatty-acids - weight-loss - life-style
Background The proportion of European elderly is expected to increase to 30% in 2060. Combining dietary components may modulate many processes involved in ageing. So, it is likely that a healthful diet approach might have greater favourable impact on age-related decline than individual dietary components. This paper describes the design of a healthful diet intervention on inflammageing and its consequences in the elderly. Methods The NU-AGE study is a parallel randomized one-year trial in 1250 apparently healthy, independently living European participants aged 65–80 years. Participants are randomised into either the diet group or control group. Participants in the diet group received dietary advice aimed at meeting the nutritional requirements of the ageing population. Special attention was paid to nutrients that may be inadequate or limiting in diets of elderly, such as vitamin D, vitamin B12, and calcium. C-reactive protein is measured as primary outcome. Discussion The NU-AGE study is the first dietary intervention investigating the effect of a healthful diet providing targeted nutritional recommendations for optimal health and quality of life in apparently healthy European elderly. Results of this intervention will provide evidence on the effect of a healthful diet on the prevention of age related decline.
Protein intake in relation to risk of hypertension and microalbuminuria in patients with type 1 diabetes: the EURODIAB Prospective Complications Study
Altorf-van der Kuil, W. ; Engberink, M.F. ; Ijpma, I. ; Verberne, L.D.M. ; Geleijnse, J.M. ; Toeller, M. ; Chaturvedi, N. ; Fuller, J.H. ; Soedamah-Muthu, S.S. - \ 2013
Journal of Hypertension 31 (2013)6. - ISSN 0263-6352 - p. 1151 - 1159.
randomized controlled-trials - coronary-heart-disease - low-fat diet - blood-pressure - iddm complications - epidemiologic evidence - urinary albumin - dairy-products - life-style - nephropathy
Background & aims A carbohydrate (CHO) drink given preoperatively changes the fasted state into a fed state. The ESPEN guidelines for perioperative care include preoperative CHO loading and re-establishment of oral feeding as early as possible after surgery. An intestinal ischaemia reperfusion (IR) animal model was used to investigate whether preoperative CHO loading increases spontaneous postoperative food intake, intestinal barrier function and the catabolic response. Methods Male Wistar rats (n = 65) were subjected to 16 h fasting with ad libitum water and: A) sham laparotomy (Sham fasted, n = 24); B) intestinal ischaemia (IR fasted, n = 27); and C) intestinal ischaemia with preoperatively access to a CHO drink (IR CHO, n = 14). Spontaneous food intake, intestinal barrier function, insulin sensitivity, intestinal motility and plasma amino acids were measured after surgery. Results The IR CHO animals started eating significantly earlier and also ate significantly more than the IR fasted animals. Furthermore, preoperative CHO loading improved the intestinal barrier function, functional enterocyte metabolic mass measured by citrulline and reduced muscle protein catabolism, as indicated by normalization of the biomarker 3-methylhistidine. Conclusions Preoperative CHO loading improves food intake, preserves the GI function and reduces the catabolic response in an IR animal model. These findings suggest that preoperative CHO loading preserves the intestinal function in order to accelerate recovery and food intake. If this effect is caused by overcoming the fasted state or CHO loading remains unclear
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