scholarly journals Whole grain intake compared with cereal fibre intake in association to CVD risk factors: a cross-sectional analysis of the National Diet and Nutrition Survey (UK)

2020 ◽  
Vol 23 (8) ◽  
pp. 1392-1403 ◽  
Author(s):  
Eden M Barrett ◽  
Birdem Amoutzopoulos ◽  
Marijka J Batterham ◽  
Sumantra Ray ◽  
Eleanor J Beck

AbstractObjective:To investigate how intakes of whole grains and cereal fibre were associated to risk factors for CVD in UK adults.Design:Cross-sectional analyses examined associations between whole grain and cereal fibre intakes and adiposity measurements, serum lipid concentrations, C-reactive protein, systolic blood pressure, fasting glucose, HbA1c, homocysteine and a combined CVD relative risk score.Setting:The National Diet and Nutrition Survey (NDNS) Rolling Programme 2008–2014.Participants:A nationally representative sample of 2689 adults.Results:Participants in the highest quartile (Q4) of whole grain intake had lower waist–hip ratio (Q1 0·872; Q4 0·857; P = 0·04), HbA1c (Q1 5·66 %; Q4 5·47 %; P = 0·01) and homocysteine (Q1 9·95 µmol/l; Q4 8·76 µmol/l; P = 0·01) compared with participants in the lowest quartile (Q1), after adjusting for dietary and lifestyle factors, including cereal fibre intake. Whole grain intake was inversely associated with C-reactive protein using multivariate analysis (P = 0·02), but this was not significant after final adjustment for cereal fibre. Cereal fibre intake was also inversely associated with waist–hip ratio (P = 0·03) and homocysteine (P = 0·002) in multivariate analysis.Conclusions:Similar inverse associations between whole grain and cereal fibre intakes to CVD risk factors suggest the relevance of cereal fibre in the protective effects of whole grains. However, whole grain associations often remained significant after adjusting for cereal fibre intake, suggesting additional constituents may be relevant. Intervention studies are needed to compare cereal fibre intake from non-whole grain sources to whole grain intake.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 808.2-808
Author(s):  
N. Hammam ◽  
G. Salem ◽  
D. Fouad ◽  
S. Rashad

Background:Osteoarthritis (OA) is the most common joint disease that results in patient’s morbidity and disabilities. There is strong evidence that OA is a significant risk factor for cardiovascular disease (CVD). Red cell distribution width (RDW) blood test is a measure of the variation in red blood cell volume and size. Elevated RDW has recently been found to correlate with CVD risk in patients with and without heart disease and autoimmune diseases. RDW may be a marker for factors driving CVS risk.Objectives:: To investigate whether RDW can serve as a potential parameter for indicating cardiovascular risk in OA patients.Methods:A subsample of 819 OA patients was extracted from 2003-2006 National Health & Nutrition Examination Survey in a cross-sectional study. 63.7% of them were females. Their mean age was 66.4 ± 14.1 yrs. Demographic, medical data, inflammatory markers & lipid panel were obtained. Only patients with Haemoglobin>12 mg/dl were included. Functional limitations were assessed using a physical function questionnaire.Results:Elevated levels of RDW were associated with CVD risk factors in OA patients. 532 (65.8%) OA patients had functional limitations, while 78 (9.5%) and 63 (7.6%) known to have heart attacks or stroke ever. Mean RDW was 12.9±1.1fL. There was a positive significant correlation between RDW & CVD risk factors including body mass index (r=0.17, p<0.001), C-reactive protein (r=0.29, p<0.001), serum uric acid (r=0.12, p<0.001), and functional limitation (0.16, p<0.001). No significant association between RDW & lipid panel was found. In multiple regression analysis controlling for age, sex as covariates, body mass index (β =0.02, 95%CI: 0.01, 0.03, p=0.002), C-reactive protein (β =0.35, 95%CI: 0.26, 0.45, p<0.001), and functional limitation (β =0.18, 95%CI: 0.13, 0.35, p=0.03).Conclusion:In addition to known CVD risk in OA patients, elevated RDW levels should prompt physicians to aggressively screen and treat their patients for modifiable CVS risk factors, in addition to OA.Disclosure of Interests:None declared


Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Robert Kaplan ◽  
Larissa M Avilés-Santa ◽  
Christina M Parrinello ◽  
Sheila Castañeda ◽  
Arlene L Hankinson ◽  
...  

Introduction: Prevalence of severe obesity is increasing, especially among the young Hispanic population. Methods: In the HCHS/SOL cohort of 18-74 year old US Hispanics, we examined gradients across BMI and age in CVD risk factors. Results: Approximately one in five males (total N = 6,547) and one in ten females (total N=9,797) met criteria for class II obesity (BMI 35 - 40 kg/m 2 ) or class III obesity (BMI ≥ 40 kg/m 2 ). The prevalence of hypertension, diabetes, and elevated C-reactive protein rose with each successive class of overweight/obesity. In contrast, the prevalence of elevated levels of total cholesterol, LDL-c and triglycerides increased across normal weight, overweight (BMI 25 - 30 kg/m 2 ), and class I obese (BMI 30 - 35 kg/m 2 ) groups, but did not increase in frequency across class I, class II, and class III obesity groups. The Figure depicts isolines that identify age- specific subgroups of the normal-weight and class II - III obese groups that had the same estimated prevalence of CVD risk factors, with 95 percent confidence intervals. Among young adults with class II or III obesity, the prevalence of hypertension, diabetes, and the combination of three or more CVD risk factors was similar to that among normal-weight individuals (BMI 18.5 - 25 kg/m 2 ) who were 15 to 30 years older. Among young obese individuals, the prevalence of low HDL-c levels and high C-reactive protein levels exceeded that among the oldest adults in the cohort. CVD risk factors had stronger, more consistent gradients across the BMI categories among men than among women. Conclusion: Class II and III obesity, defined as BMI ≥ 35 kg/m 2 , are common in the Hispanic/Latino population. Young adults with these severe forms of obesity have dramatically increased frequency of cardiometabolic risk factors. The age-related accumulation of multiple CVD risk factors, such as is typically seen in normal-weight individuals, is accelerated by 1-2 decades in severly overweight women and by 2-3 decades in severely overweight men.


Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Baqiyyah Conway ◽  
Peter Giacobbi ◽  
Clemens Drenowatz ◽  
Stephen Blair ◽  
Gregory Hand

Background: It is generally accepted that body weight is maintained when there is energy balance between intake and expenditure. Energy balance can be achieved at different rates of expenditure through exercise and caloric intake which has been referred to as energy flux: high flux reflects high expenditure and high intake while low flux describes low energy expenditure and intake. Overweight, obesity, and diabetes are major risk factors for cardiovascular disease and CVD risk factors tend to increase with hyperglycemia and BMI. Exercise is a viable way to achieve weight maintenance, however, there is limited data about the role of energy flux on CVD risk factors when individuals maintain their body weight. We investigated the effect of energy flux and change in energy flux on CVD risk factors in when body weight is maintained. Methods: One hundred and thirteen overweight or obese class I adults ages 21 to 45 were randomized to a control group, moderate exercise (17.5 kcal/kg/week) or high exercise group (35 kcal/kg/week). The exercise groups performed supervised exercise at and intensity of 70-75% of their heart rate maximum. Impaired fasting glucose was defined as a fasting glucose of 100-125 mg/dL. General linear models were used to test the relationship of exercise intensity and impaired fasting glucose on change in energy flux from baseline to six months, as well as the relationship of 6-month change in energy flux with change in CVD risk factors, namely, HDLc, LDLc, vLDLc, total cholesterol, triglycerides, Apolipoprotein B (ApoB), and C-reactive protein. Results: Seventy-two percent of the population was overweight and 22% were obese. Mean change in energy flux from baseline to month six was 128.8 kcal/day. In multivariable analyses including age, sex, BMI, impaired fasting glucose, and energy expenditure group assignment, neither exercise group assignment nor baseline obesity status had any effect on change in energy flux, lipids, or inflammatory markers. Impaired fasting glucose was associated with a significantly greater increase in energy flux from baseline to six months (p=0.03). There was a stepwise change in C-reactive protein from baseline to six months, with a decrease (-2.46 mg/dL) in controls, a moderate increase (+0.32 mg/dL) in the moderate intensity exercise group and a larger increase (+0.82 mg/dL) in the very intensive exercise group, p= 0.03 for moderate intensity and p=0.02 for very intensive exercise groups compared to controls. Finally, increases in energy flux from baseline to six months were associated with increased ApoB (p=0.04), though there were no significant changes in energy flux by group assignment. Conclusion: Intensification of exercise and increases in energy flux while maintaining stable weight is associated with increases in certain cardiovascular risk factors, namely C-reactive protein and ApoB.


2008 ◽  
Vol 54 (6) ◽  
pp. 1027-1037 ◽  
Author(s):  
Alyson Kelley-Hedgepeth ◽  
Donald M Lloyd-Jones ◽  
Alicia Colvin ◽  
Karen A Matthews ◽  
Janet Johnston ◽  
...  

Abstract Background: Limited data exist regarding the ethnic differences in C-reactive protein (CRP) concentrations, an inflammatory marker associated with risk of cardiovascular disease (CVD). We hypothesized that known CVD risk factors, including anthropometric characteristics, would explain much of the observed ethnic variation in CRP. Methods: We performed a cross-sectional analysis of 3154 women, without known CVD and not receiving hormone therapy, enrolled in the Study of Women’s Health Across the Nation (SWAN), a multiethnic prospective study of pre- and perimenopausal women. Results: The study population was 47.4% white, 27.7% African-American, 8.5% Hispanic, 7.7% Chinese, and 8.6% Japanese; mean age was 46.2 years. African-American women had the highest median CRP concentrations (3.2 mg/L), followed by Hispanic (2.3 mg/L), white (1.5 mg/L), Chinese (0.7 mg/L), and Japanese (0.5 mg/L) women (all pairwise P &lt; 0.001 compared with white women). Body mass index (BMI) markedly attenuated the association between ethnicity and CRP. After adjusting for age, socioeconomic status, BMI, and other risk factors, African-American ethnicity was associated with CRP concentrations &gt;3 mg/L (odds ratio 1.37, 95% CI 1.07–1.75), whereas Chinese and Japanese ethnicities were inversely related (0.58, 0.35–0.95, and 0.43, 0.26–0.72, respectively). Conclusions: Modifiable risk factors, particularly BMI, account for much but not all of the ethnic differences in CRP concentrations. Further study is needed of these ethnic differences and their implications for the use of CRP in CVD risk prediction.


2015 ◽  
Vol 113 (8) ◽  
pp. 1244-1253 ◽  
Author(s):  
Alexis C. Frazier-Wood ◽  
Jihye Kim ◽  
Jennifer S. Davis ◽  
Su Yon Jung ◽  
Shine Chang

The role that BMI plays in the association between dietary quality and CVD risk is not known. We aimed to better understand this relationship using statistical methods which correct for sex-specific underreporting of dietary intake. Overall, dietary quality was assessed using the Healthy Eating Index (HEI) on data from 9797 non-pregnant adults (aged >20 years) who participated in the National Health and Nutrition Examination Survey from 2005 to 2010. CVD risk factors included blood pressure, fasting glucose and insulin, homeostatic models of insulin resistance (HOMA-IR), HDL- and LDL-cholesterol (HDL-C and LDL-C), TAG and C-reactive protein (CRP). We controlled for demographic and lifestyle covariates, and we used the population ratio approach (which adjusts for the underreporting of intake) to compare mean HEI scores between the top and bottom quartiles of covariate-adjusted CVD risk factors. In women, the total HEI score was not associated with any CVD risk factors (all Q>0·11). In men, the total HEI score was associated with covariate-adjusted residuals for fasting insulin (Q< 0·001), HOMA-IR (Q< 0·001), HDL-C (Q= 0·01), TAG (Q= 0·03) and CRP (Q< 0·001). When we additionally adjusted for BMI, the association with total HEI score was not significant (all P>0·10). In the present analyses, dietary quality was associated with five CVD risk factors in a sex-specific manner. Moreover, the association of BMI with CVD risk attenuated the relationship between CVD risk and diet, which suggests that BMI is an important factor in heart disease prevention.


2020 ◽  
Vol 125 (1) ◽  
pp. 79-91
Author(s):  
Emiko Okada ◽  
Chika Okada ◽  
Mai Matsumoto ◽  
Aya Fujiwara ◽  
Hidemi Takimoto

AbstractFew studies have reported associations between the Na:K ratio and risk factors related to CVD among the general population in Asian countries. This study aimed to investigate the dietary Na:K ratio association with CVD risk factors among Japanese adults. This retrospective cross-sectional study included 48 800 Japanese participants (19 386 men and 29 414 women) aged ≥20 years, registered in the 2003–2017 National Health and Nutrition Survey. Multivariate OR and 95 % CI for risk of hypertension, high glycated HbA1c levels, hypercholesterolaemia, low serum levels of HDL-cholesterol and high non-HDL-cholesterol levels according to the Na:K ratio were estimated using logistic regression models. Dietary Na:K ratio decreased for both men and women from 2003 to 2017. Higher Na:K ratio and higher hypertension prevalence were observed (multivariate OR (fifth v. first quintiles) 1·27, 95 % CI 1·15, 1·40; Pfor trend < 0·001 for men and 1·12, 95 % CI 1·01, 1·23; Pfor trend = 0·007 for women). Higher Na:K ratio was associated with higher prevalence of high HbA1c levels in men (multivariate OR 1·56, 95 % CI 1·24, 1·96). Prevalence of low HDL-cholesterol levels was increased with higher Na:K ratio (Pfor trend =0·002 for men and <0·001 for women). No significant associations were found between Na:K ratio and hypercholesterolaemia in men or high non-HDL-cholesterol levels in both men and women. Our findings suggest that dietary Na:K ratio is associated with several CVD risk factors among Japanese adults.


Author(s):  
Beatriz Gonzalez Navarro ◽  
Enric Jané Salas ◽  
Jose Lopez Lopez ◽  
Xavier Pintó Sala

Background Dental pathology [dental caries (DC) and apical periodontitis (AP)] and/or periodontal pathology (PD) could influence the onset of cardiovascular disease (CVD). The relationship between conventional CVD risk factors and dento-periodontal pathology has been well demonstrated; however, there is less evidence of the relationship between these pathologies and emerging or unconventional CVD risk factors, including C-reactive protein (CRP), Homocysteine ​​(Hcy) and Lipoprotein a (Lp (a). Methods This case-control study included 99 patients with CVD and 50 healthy controls. All participants underwent a detailed medical history, an intraoral examination, an orthopantomography and a blood test. All the analyses were performed on the data set, using all available information with intention to treat criteria. Results A greater number of patients in the study group presented PD (p <0.001) and AP (p <0.001) compared to the control group. However, we did not find significant differences in the prevalence of caries between both groups (p <0.287). Moreover, none of oral variables was significantly related to concentrations of CRP, Hcy or Lp(a). Conclusions Patients with CVD present more PD and a greater number of AP, suggesting an association between dento-periodontal pathology and cardiovascular pathology. The concentrations of CRP, homocysteine and Lp(a) are not related to the degree of dento-periodontal pathology, so we believe that more studies are necessary to assess this possible association.


2020 ◽  
Vol 23 (8) ◽  
pp. 1404-1413 ◽  
Author(s):  
Eden M Barrett ◽  
Marijka J Batterham ◽  
Eleanor J Beck

AbstractObjective:To explore associations of whole grain and cereal fibre intake to CVD risk factors in Australian adults.Design:Cross-sectional analysis. Intakes of whole grain and cereal fibre were examined in association to BMI, waist circumference (WC), blood pressure (BP), serum lipid concentrations, C-reactive protein, systolic BP, fasting glucose and HbA1c.Setting:Australian Health Survey 2011–2013.Participants:A population-representative sample of 7665 participants over 18 years old.Results:Highest whole grain consumers (T3) had lower BMI (T0 26·8 kg/m2, T3 26·0 kg/m2, P < 0·0001) and WC (T0 92·2 cm, T3 90·0 cm, P = 0·0005) compared with non-consumers (T0), although only WC remained significant after adjusting for dietary and lifestyle factors, including cereal fibre intake (P = 0·03). Whole grain intake was marginally inversely associated with fasting glucose (P = 0·048) and HbA1c (P = 0·03) after adjusting for dietary and lifestyle factors, including cereal fibre intake. Cereal fibre intake was inversely associated with BMI (P < 0·0001) and WC (P < 0·0008) and tended to be inversely associated with total cholesterol, LDL-cholesterol and apo-B concentrations, although associations were attenuated after further adjusting for BMI and lipid-lowering medication use.Conclusions:The extent to which cereal fibre is responsible for the CVD-protective associations of whole grains may vary depending on the mediators involved. Longer-term intervention studies directly comparing whole grain and non-whole grain diets of similar cereal fibre contents (such as through the use of bran or added-fibre refined grain products) are needed to confirm independent effects.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Eden Barrett ◽  
Birdem Amoutzopoulos ◽  
Marijka Batterham ◽  
Sumantra Ray ◽  
Eleanor Beck

Abstract Objectives Whole grain intake is associated with lower risk of cardiovascular disease (CVD) and related risk factors. Cereal fibre content of whole grains may be responsible, although it is not clear to what extent. Inconsistent definitions of whole grains used within previous studies, such as including bran as a whole grain source, confound findings and limit the ability to separate the two exposures. We compared how intakes of whole grain and cereal fibre were separately associated with markers of CVD risk in adult participants within the UK National Diet and Nutrition Survey (NDNS) and the Australian Health Survey (AHS). Methods Cross-sectional analyses of the NDNS Rolling Programme 2008–14 and the 2011–13 AHS examined associations between whole grain and cereal fibre intakes and markers of CVD risk using multivariate linear regression analysis. Whole grain was defined as containing the endosperm, germ and bran components in the expected proportions, and food composition databases were used to estimate intakes. Results Within the NDNS, participants in the highest quartile (Q4) of whole grain intake had lower waist-hip ratio (Q1 0.872; Q4 0.857; P = 0.04), HbA1c (Q1 5.66%; Q4 5.47%; P = 0.01) and homocysteine (Q1 9.95 µmol/L; Q4 8.76 µmol/L; P = 0.01) compared to participants in the lowest quartile (Q1) after adjustment for cereal fibre intake. Participants in the highest tertile of whole grain intake within the AHS had lower waist circumferences (P = 0.03), HbA1c (P = 0.03) and fasting blood glucose (P = 0.048) compared to non-whole grain consumers after adjustment for cereal fibre intake. Cereal fibre intake, when analysed separately, was inversely associated with waist-hip ratio (P = 0.03) and homocysteine (P = 0.002) in the NDNS, and BMI (P < 0.0001) and waist circumference (P = 0.0008) in the AHS. Conclusions Similar inverse associations between whole grain and cereal fibre intakes to multiple markers of CVD risk suggest cereal fibre may play a role in protective associations of whole grains. However, whole grain associations often remained significant after adjustment for cereal fibre intake, suggesting additional constituents may be relevant. Future research should ensure use of consistent definitions when examining health associations of whole grains and their specific constituents. Funding Sources Nil funding.


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