A recent study at the American Heart Association (AHA) Scientific Sessions 2022* revealed unexpected changes in the electrical conduction system of the first genetically-modified porcine-to-human heart xenotransplant.
Xenotransplantation is the procedure of transplantation/implantation into a human of organs from non-human animal sources. The first pig-to-human heart xenograft was transplanted in January 2022 at the University of Maryland. The recipient survived for 61 days after receiving the xenograft. Research efforts have been underway for this xenotransplantation for over three decades.
Harvesting genetically-modified porcine hearts, the genes of which have been altered for safe transplantation into humans, would become a reality if successful. However, xenotransplantation of organs into a human carries several inherent challenges. With these transplant procedures, there is always the risk of graft rejection, infection, and abnormal heart rhythms.
Study and Results
In the present study, researchers performed a 12-lead electrocardiogram (ECG) during the postoperative period of the patient who underwent the first pig-to-human heart transplantation. The ECG data were obtained every day after the xenotransplantation. The researchers reviewed the following ECG measures: PR interval, QRS complex, and QT interval.
The ECG parameters of the “accepted pig heart transplant in the ‘pig body’” show short PR (50 to 10 milliseconds, ms) and QT (260 to 380 ms) intervals and short QRS (70 to 90 ms). However, the first ECG of the pig-to-human heart xenotransplant showed a relatively longer PR interval of 190 ms, QT interval of 538 ms, and QRS duration of 138 ms.
Prolonged intrinsic PR intervals were stable in the postoperative period with 210 ms. There was evidence of decremental intra-atrial conduction delay on day 12 post-transplantation (PR interval: 380 ms). QRS duration was prolonged but shortened in the postoperative course. High QT intervals (509 ms) persisted with dynamic fluctuations, with the lowest (428 ms) on day 14 post-transplantation.
Conclusion
The ECG of the pig-to-human xenograft revealed prolongation of the typical ECG measures in the donor that included changes in depolarization and repolarization. It was a novel finding that the pig heart in the human showed different ECG parameters compared to the commonly observed findings for native pig hearts.
The protracted ECG parameters persisted and showed dynamic changes in the postoperative period. These are the first insights into the evolving novel field of xenografts suggesting the complex interplay of porcine denervation and inter-species physiology besides the postoperative and medication-associated changes.
Source:
https://www.news-medical.net/news/20221101/First-pig-to-human-cardiac-transplant-alters-hearts-electrical-signals.aspx
Researchers performed a prospective cohort study to investigate the shared genetic etiology between chronic diseases, such as cardiovascular diseases (CVDs), asthma, rheumatoid arthritis (RA), and pathogenesis of heart failure (HF) and whether leukocyte telomere length (LTL), a biomarker of biological aging, modified these relationships.
They performed all study analyses on the clinical and genetic data of a cohort of 404,883 European participants from the United Kingdom (UK) Biobank.
Study
In the present study, researchers used a multi-step approach to explore the associations between genetic susceptibility to chronic diseases, LTL, and HF risk in the UK Biobank data of 404,883 European participants, of which 9,989 were incident HF cases, as observed through the 12.3-year follow-up.
To this end, they first used multivariable Cox regression to prospectively evaluate the associations between 24 previously derived cancer-, inflammation-, and CVD-related polygenic risk scores (PRSs) and future HF risk.
Next, the team used quantitative polymerase chain reaction (qPCR) to investigate how the identified PRSs interacted with measured LTL to modify HF risk. They further analyzed PRSs showing multiplicative interactions with LTL, stratified by LTL quartiles.
Additionally, they evaluated measured associations between LTL and 24 PRSs to determine qualitatively overlapping results with the PRS-HF analyses. Finally, the researchers pursued evidence of the effect of altered LTL (reflecting the aging process) on significant PRSs of HF risk. Mediation analyses helped them estimate the PRSs acting indirectly through LTL.
Findings
The researchers identified nine PRSs associated with HF risk, including those for various CVDs, RA, and asthma, in a dose-dependent manner. Increased genetic susceptibility to asthma was markedly associated with increased HF risk (P=1.8E-08).
In agreement with previous analyses, they also found evidence that longer phenotypic LTL mediated and strengthened the positive association between asthma genetic susceptibility and HF risk independent of the PRSs. They attributed its role as an effect modifier to the environmentally-determined LTL components (not genetic components). Thus, future studies should incorporate LTL and genetic data into risk stratification analyses.
Intriguingly, the asthma PRS exhibited a super-multiplicative interaction with LTL even though phenotypic LTL was inversely associated with HF. However, LTL mediated 1.13% of the total effect of the asthma PRS on HF risk.
Nonetheless, the study findings reinstate the notion that there is a link between pulmonary diseases, cardiac function, and inflammation. Future studies should elucidate the molecular mechanisms by which LTL exerts its effects and the nature of biological interactions between PRSs and LTL components.
Furthermore, the authors noted a significant overlap between the PRSs for asthma, CVD, CAD, ischemic stroke (ISS) and associations identified in the PRS-HF analyses, indicating potential associations between genetic susceptibility to cardiovascular and pulmonary diseases, phenotypic LTL, and future HF risk.
Conclusion
To summarize, the researchers discovered a high-risk subpopulation for HF comprising people with longer LTL and increased genetic susceptibility to asthma.
The study also highlighted that non-malignant respiratory diseases and LTLs act as effect modifiers in the pathogenesis of HF, a fatal downstream consequence of cardiac dysfunction with a mortality rate as high as some cancers.
Thus, future studies should further investigate the role of LTL and genetics in future HF risk stratification analyses.
Source:
https://www.news-medical.net/news/20230810/Study-examines-shared-genetic-etiology-of-chronic-diseases-and-links-leukocyte-telomere-length-to-heart-failure-risk.aspx
A recent study evaluated how the combination of Mediterranean diet (MedDiet) supplement and dairy foods affected the gut microbiome in Australians at a high risk of cardiovascular disease (CVD).
Study
The current randomized controlled trial (RCT) followed a 2 × 2 cross-over design to compare the benefits of MedDiet supplemented with dairy food (MedDairy) and low-fat (LFD) diet (control) in Australians at high risk of CVD.
This study recruited adults between the ages of 45 and 75 years. All participants had high systolic blood pressure (SBP) but were not under any medication. Individuals who consumed medicinal levels of calcium or omega-3 supplements daily were excluded.
Participants were randomly assigned to any one of the groups, i.e., MedDairy (Group 1) or LFD (Group 2), and dietary interventions continued for 8 weeks, separated by an 8-week washout phase where participants followed their habitual diet. Complete fecal and clinical samples were collected at baseline and at 8 weeks to assess both groups.
Results
At baseline, there were no significant differences between the study groups. Group 1 contained 18 participants, and group 2 contained 16 participants. All participants who were not following MedDiet at baseline exhibited increased MedDiet adherence through the MedDairy intervention. Along with the MedDiet, participants received 3 to 4 servings of any one of the dairy products, such as low-fat Greek yogurt, low-fat milk, cheese (hard, soft, semi-soft), and tzatziki dip.
Fecal microbiota analysis indicated no significant difference in the overall structure and composition of the fecal microbiota between the two study groups. However, a modest decrease in microbial diversity was observed in the LFD group. It must be noted that the MedDairy diet did not result in a significant change in the gut microbiota but considerably altered the abundance of selected bacterial taxa, such as Butyricicoccus, Lachnospiraceae, and Streptococcus, and a reduction in Colinsella and Veillonella.
Conclusion
The findings of the current study highlighted that 8 weeks of a Mediterranean diet supplemented with dairy foods resulted in changes in the relative abundance of certain bacterial taxa. MedDairy diet enhanced Butyricicoccus, which has a positive effect on systolic blood pressure. Therefore, adherence to the MedDairy diet could reduce CVD risks.
Source:
https://www.news-medical.net/news/20230831/Mediterranean-diet-with-a-dairy-twist-shows-promise-in-lowering-heart-disease-risk.aspx
Researchers compared the cardiovascular outcomes of refined grains to wholegrains in children. Their randomized cross-over study comprised a cohort of 55 Danish children who were given diets containing either wholegrain or refined oats and rye for eight weeks. Their study findings revealed that wholegrain consumption significantly reduced low-density lipoprotein (LDL) cholesterol, triacylglycerol, and the ratio of total: high-density lipoprotein cholesterol. Wholegrain diets were additionally found to promote the growth of beneficial gut microbiota and reduce fatigue without any negative impacts on child health.
Study
In the present study, researchers employed a randomized cross-over study design to elucidate the outcomes of wholegrain rye and oats (WG) on cardiometabolic risk markers, body composition, and body mass index (BMI) of children aged 8-13. To verify the potential benefits of wholegrains, they compared these outcomes to those from a refined grain (RG) diet.
The study was conducted at the University of Copenhagen and comprised healthy but overweight (BMI +1 standard deviation [SD] above Danish median) Danish children who consumed cereal and bread daily. Children with allergies to whole- or refined grains and those consuming supplements altering their lipid or cardiometabolic profiles were excluded from the study. Recruitment for the study was carried out between August through December 2020.
Wholegrain products consisted of standard breakfast, lunch, and dinner snacks, wherein wholegrains comprised at least 50% of their dry weight. Refined grain products, in contrast, had low quantities of wholegrain and high amounts of refined wheat, corn, and rice. The nutrient and fiber content of WG and RG were separately measured via the Uppsala method at the Swedish University of Agricultural Sciences.
Daily intake of study products (WG or RG) was recorded in grams using kitchen weight balances. Additionally, prior to follow-up examinations, a 4-day dietary record of all food and beverages consumed was reported using the web-based Madlog Classic software. Using the Likert scale, a questionnaire was used to record and assess stool frequency and seven predefined gut symptoms.
Anthropomorphic measurements included weight, height, waist circumference, blood pressure (systolic and diastolic), age, body composition (using dual-energy X-ray absorptiometry [DXA]), and sex-adjusted BMI z-scores. Blood samples were collected for plasma analyses.
Statistical analyses comprised linear mixed models for continuous variables and cumulative link mixed models for ordinal variables.
Results
Weight classification for the 55 included children reported 22% as normal weight, 60% as overweight, and 18% as obese. Of these, 52 completed the study, 26 (50%) of whom were male. Self-reported dietary compliance was high, which was clinically confirmed by plasma alkylresorcinols (AR). Blood analyses revealed that WG diets were associated with lower energy, lower carbohydrates, higher protein, and higher fat than RG diets.
Whole grain diets were observed to reduce plasma LDL cholesterol, triacylglycerol (TG), and total cholesterol while increasing acetate and propionate compared to RG diets. Feces showed an increase in butyrate during the WG diet, but no differences in insulin or glucose could be found between diets. Serum C-reactive protein (CRP) was found to be lower in WG diets, but no changes in BMI or adiposity were found.
Gut microbiota analyses from feces revealed that WG diets resulted in an increase in Faecalibacterium and Dialister populations and a reduction in Collinsella and Ruminococcus.
Conclusion
In the present study, researchers investigated the effects of wholegrains on the cardiovascular health and gut microbiota compositions of Danish children between the ages of 8-13. Their findings reveal that compared to refined grains, WG diets are associated with lower cholesterol and triacylglycerol levels, which previous research has reported are beneficial to long-term cardiovascular health. WG diets also result in improved energy levels and lower fatigue while leaving other body composition metrics unchanged.
Source:
https://www.news-medical.net/news/20231030/Wholegrains-give-kids-a-heart-healthy-boost-says-new-Danish-study.aspx
Reports that maternal fish intake during pregnancy does not impact the cardiovascular health of children born to these mothers at 11 years of age.
Study
The current longitudinal study enrolled 657 pregnant women who were monitored throughout their pregnancy until the birth of their child. All children born to these mothers were enrolled in the study at birth and followed up until they reached 11 to 12 years of age.
The women were asked to complete a semi-quantitative food frequency questionnaire to allow the researchers to assess their daily food intake during the first and third trimesters of pregnancy. The cardiovascular health of the children born to these mothers was evaluated by arterial stiffness and retinal microcirculation.
Arterial stiffness was assessed by carotid-femoral pulse wave velocity. Retinal microcirculation was assessed by photographic measurement of the central retinal arteriolar and venular equivalent. Importantly, both arterial stiffness and retinal microcirculation are widely used parameters to assess cardiovascular outcomes.
Results
At baseline, about 88% of the women enrolled in the current study had normal pre-pregnancy body mass index (BMI) values. About 44% of children had one parent with a history of at least one cardiovascular event, including heart attack, angina, stroke, atherosclerosis, high cholesterol, diabetes, and hypertension.
Women who reported high fish intake had significantly higher energy intake during pregnancy as compared to those with low fish intake. The median maternal total seafood consumption during the first and third trimesters of pregnancy were 451.9 and 433.8 g/week, respectively.
Children born to mothers with high fish intake during pregnancy similarly reported significantly higher fish intake. Notably, the distribution of genders among children born to mothers of different tertiles of fish consumption was similar.
The researchers did not identify any significant difference in the evaluated cardiovascular parameters between children born to mothers with higher and lower fish intake during the first and third trimesters of pregnancy. Nevertheless, slightly higher arterial stiffness was observed in children whose mothers had a higher intake of canned tuna during the first trimester of pregnancy.
Conclusion
Maternal fish intake during pregnancy does not appear to influence the cardiovascular health of children by 11 years of age. These observations align with many other studies that have reported no beneficial effect of fish intake during pregnancy on the cardiovascular health of children.
Significant limitations of the current study include the overall young and healthy status of the study participants, which may have prevented any significant differences from being observed among minor variances between these individuals. Furthermore, reduced pulse wave velocity is often reported in adults with pre-existing health conditions like obesity, diabetes, and high cholesterol that increase the risk of cardiovascular diseases.
Additionally, the overall high levels of fish consumption reported in the study cohort may increase the risk that the children born to these mothers were exposed to higher levels of mercury, which would inevitably reduce the potential cardiovascular benefits associated with fish consumption. Other limitations include the observational nature of the study and the use of a food frequency questionnaire that is vulnerable to measurement errors.
Despite these limitations, the current study has several strengths, including the exploration of total fish intake and the intake of different types of seafood. Furthermore, the robust follow-up protocol allowed the researchers to measure cardiovascular endpoints in a pediatric population that is often understudied.
Source:
https://www.news-medical.net/news/20240328/Eating-fish-during-pregnancy-doesnt-shape-kids-heart-health-study-finds.aspx
A group of researchers explored the link between lowering alcohol intake and the occurrence of major adverse cardiovascular events (MACEs) in heavy drinkers, focusing on different subtypes of cardiovascular disease (CVD).
Introduction
Alcohol consumption significantly influences both individual and public health, with research showing its complex relationship with CVD. While light to moderate drinking is believed to offer some protection against CVD, this effect varies by the type of CVD, and the relationship between alcohol intake and heart health is not linear. Previous studies have typically measured alcohol consumption at a single point in time and compared drinkers to non-drinkers without considering changes in drinking habits over time. Further research is essential to understand the mechanisms underlying the cardiovascular benefits of reduced alcohol consumption and to establish tailored guidelines for different populations and CVD subtypes.
Study
In the present study, researchers utilized data from the Korean National Health Insurance Service–Health Screening (NHIS-HEALS) database to examine a representative sample of Korean adults aged 40 to 79. Approved by Chungbuk National University Hospital's institutional review board (IRB) and adhering to the Declaration of Helsinki and Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines, the study utilized the National Health Screening Program's (NHSP's) broad coverage to analyze information on demographics, medical histories, and lifestyle factors, including alcohol consumption. This careful documentation provided a foundation for a detailed investigation into the effects of alcohol on health.
Participant selection was methodical, excluding non-drinkers in the latter period to avoid confounding factors like the sick-quitter effect. The study's rigor extended to defining heavy drinking based on established criteria and dividing participants into groups based on their drinking habits over time.
Confounding variables were identified with precision, including a range of demographic, health, and lifestyle factors. The study's outcomes centered on MACEs, with detailed coding and procedures to ensure accuracy. Statistical analyses were conducted with sophisticated tools and methods, including propensity score matching (PSM) and multivariate Cox proportional hazards regression models, to draw reliable conclusions about the relationship between alcohol consumption and cardiovascular health.
Findings
In the comprehensive study analyzing 21,011 participants with initially high alcohol consumption levels, 14,220 maintained their heavy drinking habits, while 6,791 reduced their intake to mild or moderate levels. Predominantly male (90.3%) and averaging 56 years of age, this cohort provided a detailed snapshot of baseline health and lifestyle characteristics. Initially, the heavy drinkers were younger on average and had a higher proportion of males compared to those who reduced their alcohol consumption.
Clinical indicators such as body mass index (BMI), blood pressure, and various biochemical markers showed differences between the groups, with the sustained heavy drinkers generally presenting poorer health metrics. Interestingly, despite the health disparities, after PSM, these groups were closely aligned on most variables, allowing for a more accurate comparison of outcomes.
Over the course of the study, the incidence of MACEs was notably higher in the group that continued heavy drinking compared to those who reduced their intake, with a significant divergence in outcomes over time. Specifically, reduced drinking was associated with a 23% lower risk of experiencing a MACE. When examining specific CVDs, reductions in alcohol consumption significantly lowered the risk of coronary artery disease (CAD), angina, any stroke, ischemic stroke, and all-cause mortality, while no benefits were observed for nonfatal myocardial infarction (MI) or hemorrhagic stroke.
Subgroup analyses highlighted the cardiovascular advantages of reducing alcohol intake across various demographics and health statuses, including age, gender, BMI, smoking status, and levels of physical activity. Notably, these benefits were evident regardless of pre-existing conditions like atrial fibrillation and chronic kidney disease and were consistent across different socioeconomic statuses and comorbidities.
Further sensitivity analyses, which excluded variables potentially modifiable by alcohol consumption changes, reaffirmed the cardiovascular benefits of reducing alcohol intake.
Conclusion
To summarize, in the study, heavy drinkers who reduced their alcohol intake demonstrated a significantly lower risk of cardiovascular events over a decade, with notable health improvements visible three years post-reduction. This reduction in alcohol consumption correlated with a broad array of cardiovascular benefits, especially in lowering the risk of ischemic stroke and angina-related interventions. The study clarifies the complex biological mechanisms through which moderate alcohol consumption may confer cardiovascular protection, highlighting improvements in lipid regulation, endothelial function, and reduced inflammation. Importantly, it revealed specific reductions in CAD and ischemic stroke risk among heavy drinkers, underlining the potential health benefits of moderating alcohol intake.
Source:
https://www.news-medical.net/news/20240331/Heavy-drinkers-who-cut-back-see-major-heart-health-benefits-study-finds.aspx
Researchers conducted the Randomized Evaluation of Decreased Usage of Beta-Blockers after Acute Myocardial Infarction (REDUCE-AMI) trial to determine whether long-term oral beta-blocker therapy could reduce the risk of any cause or incident MI-related mortality among individuals with acute myocardial infarction but preserved left ventricular ejection fraction compared to no beta-blocker treatment.
Introduction
Beta-blockers are beneficial in treating heart failure patients and those with reducing ejection fractions; however, these findings are from 1980s trials of patients with massive myocardial infarctions and systolic dysfunction in the left ventricle. Meta-analytical research indicated that beta-blockers do not appear to lower mortality in contemporary reperfusion techniques.
There is a lack of data from recent randomized clinical studies on the efficacy of long-term use of beta-blockers among acute myocardial infarction patients with intact ejection fraction. Previous Cochrane reviews underscore the need for novel research studies in this target population. Despite the absence of convincing scientific evidence of medication benefit, current recommendations strongly advocate beta-blocker therapy following a myocardial infarction.
Study
In the present open-label, prospective, parallel-group trial, researchers evaluated the impact of beta-blocker therapy on reducing mortality among acute MI patients.
The team conducted the registry-based trial between September 2017 and May 2023 at 45 sites across New Zealand, Sweden, and Estonia. They randomized participants with prior acute MI who underwent coronary angiographies and had ≥50% ejection fraction from the left ventricle to receive 1:1 long-term therapy with beta-blockers such as ≥100 mg/day of metoprolol or ≥5 mg/day of bisoprolol (intervention group) or no such therapy.
All participants had obstructive coronary heart disease, as determined from coronary angiographies (i.e., ≥50% stenosis, ≤0.8 fractional flow reserves, or ≤0.9 instant wave-free segment ratios) before randomization. The primary outcome was the composite measure of all-cause or incident MI-related mortality. Secondary outcomes included cardiovascular disease-related mortality and hospital admission for atrial fibrillations or heart failure.
Safety outcomes included hospital admission for hypotension, second and third-degree atrioventricular blocks, bradycardia, syncope, or pacemaker implantation, and hospital admission due to chronic obstructive pulmonary disease (COPD), asthma, or stroke. Other endpoints included dyspnea [diagnosed using the New York Heart Association (NYHA) recommendations] and angina pectoris (diagnosed using the Canadian Cardiovascular Society guidelines) six to 10.0 weeks or 11.0 to 13.0 months after treatment. The team used Cox proportional-hazards regressions to determine the hazard ratios (HR) for analysis. They performed sensitivity analyses, adjusting for age, country, diabetes, and prior myocardial infarction. The Swedish population registry provided data on death or emigration, and the Swedish Web System for Enhancement and Development of Evidence-based Care in Heart Disease Evaluated According to Recommended Therapies (SWEDEHEART) register collected data on incident myocardial infarctions. The national cause-of-death registry provided cardiovascular-related mortality data, while the national patient registry provided data on atrial fibrillation, heart failure, and safety outcomes.
Findings and Conclusion
The researchers enrolled 5,020 MI patients (95% from Sweden) who followed up for a median of 3.50 years until November 16, 2023. The median participant age was 65.0 years, 23% were female, and 35% had myocardial infarction with an elevation in the ST segment. Among the participants, 46% were hypertensive, 14% were diabetic, and 7.1% had a prior myocardial infarction. Of 2,508 beta-blocker recipients, 1,560 (62%) and 948 (38%) received metoprolol and bisoprolol, respectively.
Coronary angiography showed one-vessel involvement among 55% of MI patients, two vessels involved among 27%, and three vessels involved among 17% of patients. The team performed percutaneous coronary interventions in 96% of patients, with coronary artery bypass grafting (CABG) among 3.9%. At hospital discharge, 97% received aspirin, P2Y12 receptor blockers, angiotensin-converting enzyme (ACE) inhibitors, and statins.
The researchers observed the primary endpoint among 7.9% (199 out of 2,508) of beta-blocker recipients and 8.3% (208 out of 2,512) of non-recipients (HR, 0.96). Beta-blockers did not lower the cumulative incidence rates of secondary endpoints (all-cause mortality, 3.90% and 4.10% among beta-blocker recipients and non-recipients, respectively); cardiovascular disease-related mortality, 1.50% and 1.30%, respectively; myocardial infarctions, 4.50% and 4.70%; hospital admission due to atrial fibrillations, 1.10% and 1.40%; and hospital admission due to heart failures, 0.80% and 0.90%).
Concerning safety endpoints, the researchers observed hospital admission due to atrioventricular blocks, bradycardia, syncope, hypotension, or pacemaker implantation among 3.40% of beta-blocker recipients and 3.20% of non-recipients; hospital admission due to COPD or asthma in 0.60% and 0.60%, respectively, and hospital admission due to stroke among 1.40% and 1.80% of beta-blocker recipients and non-recipients, respectively. Subgroup analyses yielded similar results.
Overall, the study findings showed that long-term use of beta-blockers did not reduce the risk of all-cause or incident myocardial infarction-related mortality in patients with an acute MI who underwent coronary angiography but retained ≥50% ejection fraction from the left ventricle compared to no treatment with beta-blockers.
Source:
https://www.news-medical.net/news/20240408/Beta-blockers-show-no-benefit-for-heart-attack-patients-with-normal-heart-function.aspx
An article published provides a detailed overview of the nutritional adequacy of three low-carbohydrate diets with differing carbohydrate content.
Study
The study analyzed the nutrient content of two very low-carbohydrate diets and a low-carbohydrate diet, which provided 20, 40, and 100 grams of net carbohydrate per day, respectively. Net carbohydrate refers to the total non-fiber saccharides that are digestible in humans.
The nutrients of public health concern identified in the 2020 Dietary Guidelines for Americans were considered when selecting food items for diet plans. Specifically, these diet plans were designed based on dietary patterns utilized in studies of ketogenic and low-carbohydrate diets as well as commercial low-carbohydrate diets.
Diet plan nutrient content was analyzed using the US Department of Agriculture Food Data Central, which includes five distinct data types that provide information on food and nutrient profiles.
Study Findings
The energy and nutrient analysis of three diet plans indicated that two very low-carbohydrate diets with 20 grams and 40 grams of carbohydrates (VLCD20 and VLCD40) and the low-carbohydrate diet with 100 grams of carbohydrate (LCD100) provide 91%, 94%, and 100% of the RDA for energy, respectively, in females aged 31 – 70 years.
In older females aged 51 – 70, VLCD20 and VLCD40 met the RDA for energy; however, LCD100 provided 12% higher energy than the RDA. In males, none of the diet plans could meet the RDA for energy across all age groups.
In both males and females aged 31 – 70, VLCD20, VLCD40, and LCD100 provided 37, 55, and 98% of the RDA for dietary carbohydrates, respectively. In females aged 31 – 70, VLCD40 and LCD100 provided 9 and 16% higher dietary fiber than the RDA, respectively. However, VLCD20 could not meet the RDA for dietary fiber in this age group.
In older females aged 51 – 70, VLCD20 provided adequate dietary fiber, and VLCD40 and LCD100 exceeded the RDA by more than 20%. In males aged 31 – 70 years, none of the diet plans could meet the RDA for dietary fiber; however, VLCD40 and LCD100 met the requirement in older males aged 51 – 70 years.
All three diet plans provided higher amounts of proteins than the RDA in males and females aged 31 – 70 years. However, the amounts were within the Acceptable Macronutrient Distribution Range of 10–35% of energy.
Regarding saturated fat and sodium, all diet plans slightly exceeded the RDA. However, the study highlights that despite this, the ratio of omega-6 to omega-3 fatty acids was significantly lower than the average American diet, which may offer protective benefits against chronic diseases. The sodium-to-potassium ratio in all three diets was also favorable, remaining well below one, which is considered beneficial for cardiovascular health. This is particularly noteworthy given that most American diets exceed the recommended sodium intake and fall short on potassium, a pattern associated with increased cardiovascular risk.
Conclusion
The study indicates that low-carbohydrate diets intentionally designed to provide lower amounts of carbohydrates than the RDA can deliver adequate amounts of fiber and micronutrients to Americans' diets.
Moreover, the findings suggest that these well-constructed diet plans not only meet but can potentially exceed the nutritional requirements for essential micronutrients in specific populations, particularly females aged 31–50, who are the most likely to follow these diets. This challenges the common perception that low-carbohydrate diets are nutritionally inadequate and underscores the importance of considering dietary quality, not just carbohydrate quantity, in dietary guidelines.
The study also emphasizes the importance of the ratio of omega-6 to omega-3 fatty acids and sodium to potassium provided by the diets, especially for individuals with existing metabolic health issues. These ratios could play a critical role in mitigating the risk of chronic diseases, such as cardiovascular disease, in populations adhering to low-carbohydrate diets.
Source:
https://www.news-medical.net/news/20240905/Low-carb-diets-exceed-nutrient-needs-and-promote-heart-health-by-improving-key-dietary-ratios.aspx
Researchers investigated how cardiovascular risk and obesity impact brain volume and whether the apolipoprotein (APOE) genotype affects this relationship in females and males of various ages.
Their findings indicate specific age ranges as the most vulnerable to the impact of obesity and cardiovascular risk on brain volume, with implications for neurodegeneration prevention and the development of Alzheimer’s disease.
Study
Researchers studied 34,425 people who participated in the UK Biobank study, a large-scale prospective research program. The participants were between the ages of 45 and 82, with an average age of 63.6. Participants underwent abdominal and structural brain magnetic resonance imaging (MRI) scans.
Cardiovascular risk was calculated based on factors such as diabetes, smoking, blood pressure, cholesterol, and age. A well-established scoring system, the Framingham risk score, was used to quantify cardiovascular risk. Abdominal MRI is used to measure subcutaneous and visceral adipose tissue volumes, indicating obesity. Visceral adipose tissue is linked to higher cardiovascular risk, insulin resistance, and metabolic syndrome.
The APOE genotype, a marker of Alzheimer’s disease risk, was analyzed to assess its role in cardiovascular risk and brain health. To evaluate brain volume, structural brain scans were performed using high-resolution MRI.
Voxel-based morphometry (VBM), which detects volume changes and allows for unbiased evaluation across cortical regions, was used to analyze changes in brain volume at minute scales. Grey and white matter images were processed and analyzed using specialized software. The analysis also accounted for individual differences in head size using total intracranial volume.
Linear models were used to assess the influence of cardiovascular risk, obesity, and APOE genotype on brain volume. They were run separately for multiple age groups and genders and adjusted for total intracranial volume.
Results
Using data from 34,425 participants with abdominal and brain MRI scans, researchers found that higher cardiovascular risk was linked to lower grey matter volume across the brain. Specifically, the postcentral gyrus, frontal lobe, thalamus, and temporal lobe showed the most significant loss in brain volume.
Both APOE ε4 carriers and non-carriers were affected by cardiovascular risk, showing similar brain volume reductions.
The strongest effects were seen between the ages of 55 and 74, with 67% of grey matter showing reduced volume in males during these years. The temporal lobe was most affected in males between 45 and 54 and over 75. Among males, researchers found minor associations between cardiovascular risk and brain volume loss (1-2% grey matter).
In women, the strongest effects were seen between 65 and 74 (43% loss in the volume of grey matter) and 55 and 64 (27% loss). Smaller effects were seen in women younger than 54 and over 75, indicating a bell-shaped relationship.
Both subcutaneous and visceral adipose tissue volumes were linked to reduced brain volume, with the precentral and postcentral gyrus, frontal areas, thalamus, and temporal pole particularly affected. Associations remained consistent in both APOE ε4 carriers and non-carriers.
The strongest links between abdominal fat (subcutaneous and visceral) and volume of lower grey matter were found in males aged 55–64 and 65–74. In younger males (45–54), the associations were present but less pronounced. In females, weaker associations were observed.
Cardiovascular risk had a stronger and earlier impact on the volume of grey matter in males, especially in the 55–64 age group. Interestingly, visceral adipose tissue in older females (65–74) showed a stronger link with grey matter loss, suggesting an interaction between sex and cardiovascular risk.
Conclusion
This study suggests that cardiovascular risk and obesity are strongly linked to neurodegeneration, with the timing and impact varying by sex and age. Males, particularly between 55–64 years, show the earliest and most significant brain volume loss due to obesity and cardiovascular risk.
These findings underline the importance of early intervention strategies tailored to sex-specific risk profiles. Targeting cardiovascular risk factors (like obesity and hypertension) early on may help prevent Alzheimer’s disease and other forms of neurodegeneration. Drugs used for obesity and type 2 diabetes, like glucagon-like-peptide-1 receptor agonists, could be repurposed for Alzheimer’s treatment.
Source:
https://www.news-medical.net/news/20241201/Men-face-sharper-brain-aging-from-obesity-and-heart-risks.aspx
Researchers investigated the impact of diet quality and energy intake during breakfast on cardiometabolic health among older adults. Both high- and low-energy breakfasts and low-quality breakfasts were found to increase triglyceride levels and body fat, worsen kidney function, and reduce high-density lipoprotein (HDL) cholesterol levels.
Study
In the current study, researchers explore how the proportion of daily energy consumed at breakfast and breakfast quality relate to changes over time in cardiometabolic traits like body mass index (BMI), blood pressure, triglycerides, and kidney function in older adults with metabolic syndrome.
The study was part of a larger intervention investigating the effects of a Mediterranean diet (MedDiet) with and without exercise on cardiovascular disease in adults with metabolic syndrome. Study participants between 55 and 75 years of age followed a MedDiet with breakfast consisting of low-fat dairy, whole grains, protein, olive oil, nuts, and fruits, without specific guidance on portion sizes.
To assess breakfast habits, all study participants completed three-day food records at baseline, 24 months, and 36 months. This allowed the researchers to analyze energy intake at breakfast and meal quality using the Meal Balance Index.
Cardiometabolic risk factors were measured at various intervals, and various statistical models were utilized to evaluate how breakfast energy and quality influenced these factors over time. All results were adjusted for confounding factors, including baseline health conditions such as hypertension and diabetes, physical activity, sex, and age.
Results
The current study included 383 obese or overweight older adults with metabolic syndrome and high cardiovascular risk factors. No significant differences in baseline characteristics were identified between groups categorized by breakfast energy intake or quality.
In terms of association with adiposity, study participants with low or high breakfast energy intake exhibited greater BMI and waist circumference (WC) over time compared to the reference group. Both low and high breakfast energy intake was associated with higher triglyceride and lower HDL cholesterol levels, with the high-energy group experiencing more pronounced effects. Study participants with low breakfast quality also experienced a rebound in triglycerides and lower HDL levels.
No significant systolic or diastolic blood pressure changes were observed based on breakfast energy intake. However, slightly higher blood pressure levels were observed in those with low breakfast quality.
Likewise, no significant differences in glucose or glycated hemoglobin levels were reported among the breakfast groups; however, study participants with low breakfast quality had slightly higher levels. Furthermore, the estimated glomerular filtration rate (eGFR), an indicator of kidney function, was somewhat lower in participants with low breakfast quality.
Conclusion
Both energy intake and breakfast quality independently influence health outcomes; however, no significant interaction was observed between these two factors on cardiometabolic risk markers.
The current study found that consuming insufficient energy at breakfast correlates with greater adiposity, which supports previous research. However, a higher breakfast energy intake of over 30% also correlated with greater adiposity, which is a novel finding.
Participants who consumed 20-30% of their daily calories at breakfast experienced improvements in lipid profiles, with lower triglycerides and higher HDL cholesterol levels. A high-quality breakfast rich in nutrients like protein and carbohydrates was associated with lower waist circumference, higher HDL cholesterol, and better kidney function.
These findings indicate that breakfast quantity and quality are important for maintaining cardiovascular and metabolic health, especially in high-risk individuals.
Source:
https://www.news-medical.net/news/20241216/Balanced-breakfasts-improve-heart-and-metabolic-health-in-older-adults.aspx
Researchers assessed the relationship between dietary cholesterol intake and the risk of myocardial infarction (MI) among United States (U.S.) veterans participating in the Million Veteran Program (MVP).
Study
The present study collected data from 180,156 veterans with comprehensive dietary intake information. The study population was predominantly male (90%) and White (80%), which may affect the generalizability of the findings. To minimize confounding, participants with pre-existing cancer or cardiovascular disease at baseline were excluded. Dietary cholesterol intake was assessed using a validated semi-quantitative food frequency questionnaire.
Information on demographics, medical history, smoking status, physical activity, and medication use was obtained from self-reported surveys and electronic health records. Incident MI cases were identified using validated algorithms incorporating International Classification of Diseases (ICD) codes, natural language processing, and medical record reviews.
Cox proportional hazard models were employed to estimate the relative risk (RR) of MI associated with dietary cholesterol intake, adjusting for age, sex, smoking status, alcohol intake, total calorie intake, physical activity, body mass index, family history of heart disease, cholesterol-lowering medication use, and adherence to the DASH diet. Both linear and nonlinear dose-response relationships were evaluated. Sensitivity analyses were conducted to assess the impact of potential confounders, including saturated fat intake and statin use.
Findings
The mean follow-up period among 180,156 veterans was 3.5 years. Participants consuming more than 300 mg/day of dietary cholesterol had a 15% increased risk of MI compared to those consuming less. A dose-response relationship was observed, where each additional 100 mg/day of dietary cholesterol intake was associated with a 5% higher risk of MI (RR, 1.05; 95% Confidence Interval [CI], 1.02-1.08).
Dietary cholesterol intake varied among participants. Those in the highest quartile (≥400 mg/day) had a higher prevalence of obesity, lower adherence to the DASH diet, and a greater likelihood of statin use. The primary dietary sources of cholesterol were eggs, poultry, and red meat. Increased cholesterol consumption correlated with lower consumption of fruits, vegetables, and whole grains.
Adherence to the DASH diet significantly modified the association between dietary cholesterol and MI risk. Veterans with poor adherence to the DASH diet and high cholesterol intake (≥300 mg/day) had a 36% higher risk of MI compared to those following a high-quality diet with lower cholesterol intake. Individually, poor DASH adherence and high cholesterol intake were each associated with approximately a 20% increased risk of MI, though the combined risk was not necessarily additive beyond what was expected from each individual factor.
Secondary analyses explored the potential interaction between dietary cholesterol intake and statin use. Among statin users, high dietary cholesterol intake was associated with a 15% increased MI risk, while non-statin users exhibited a 23% increased risk. However, the statistical interaction was not significant (p = 0.82), suggesting that the difference in risk between these groups could be due to chance rather than a true modifying effect of statin use.
Adjustments for saturated fat intake slightly attenuated the risk estimates, but the association remained significant, indicating an independent effect of dietary cholesterol on MI risk. Further sensitivity analyses confirmed the robustness of these findings. Adjustments for dietary intake of fruits, vegetables, whole grains, and polyunsaturated fatty acids did not materially alter the results, reinforcing the reliability of the observed relationship. The findings align with prior studies indicating that diets rich in cholesterol contribute to increased cardiovascular risk.
Conclusion
To summarize, this large-scale cohort study provides strong evidence that higher dietary cholesterol intake is associated with an increased risk of myocardial infarction among U.S. veterans. The observed dose-response relationship underscores the importance of dietary modifications to mitigate cardiovascular risk. While findings support limiting cholesterol intake, particularly from sources such as eggs and red meat, it is also essential to consider overall dietary patterns, including fruit, vegetable, and whole grain consumption, to optimize heart health. Additionally, adherence to heart-healthy dietary patterns, such as the DASH and Mediterranean diets, may further protect against MI. These findings support current dietary guidelines that recommend limiting cholesterol consumption to improve cardiovascular health.
Source:
https://www.news-medical.net/news/20250210/High-cholesterol-diets-increase-heart-attack-risk-in-US-veterans-study-warns.aspx
Observational accounts have led many clinicians to believe that, unlike their adult counterparts, children generally experience milder outcomes from SARS-CoV-2 infection. However, the underlying metabolic effects have not been fully characterized. In a recent study, a collaborative research team from the Australian National Phenome Centre and Harvard analysed blood plasma samples (n = 147) from pediatric patients to investigate these effects.
Advanced blood characterization tools identified acute disruptions in lipid and lipoprotein metabolism, known markers of long-term cardiovascular risk. During acute COVID-19 infections, children exhibit plasma signatures similar to those observed in adults with severe COVID-19, which contain markers associated with long-term cardiovascular risk. This study challenges the assumptions of a universally mild pediatric COVID-19 and calls for further investigation and monitoring in children to mitigate future cardiovascular disease (CVD) risk.
Study
The present study aims to address existing scientific knowledge gaps by conducting a comprehensive suite of advanced biochemical and proteomic assays on children during acute COVID-19 and MIS-C.
Study data were obtained from the Massachusetts General Hospital Pediatric COVID-19 Biorepository, Boston, US, and included sociodemographic information and medical health records. Biometric measures and plasma samples were collected once from each participant during their acute illness.
US Centers for Disease Control and Prevention (CDC) definitions were used to classify the study participants into three categories: 1. Healthy children who had never been infected by SARS-CoV-2 (healthy), 2. Acute COVID-19 (COVID-19), and 3. Confirmed MIS-C cases (MIS-C). All participant plasma samples were subjected to high-resolution liquid chromatography-tandem mass spectrometry (LC-MS/MS) to facilitate the identification of a broad spectrum of metabolites.
To obtain a detailed metabolic fingerprint, researchers used nuclear magnetic resonance (NMR) data to identify and quantify cholesterol and its derivatives, triglycerides, and inflammatory markers. They then compared these metabolic profiles to those from a previously studied cohort of adults with COVID-19.
Statistical analyses included principal component analyses (PCAs) to identify the primary sources of data variation, random forest data imputation (for missing data), and orthogonal projection to latent structures-discriminant analysis (OPLS-DA) for elucidating infection-associated data variance. The data were subsequently analyzed and visualized using multivariate analyses, adjusted for demographics and other confounding factors.
Results
The final study sample cohort comprised 147 children. CDC guidelines classified these participants into three groups: 1. 66 healthy children (no SARS-CoV-2 infections), 2. 55 with acute COVID-19 infections (25% severe), and 3. 26 with MIS-C. MIS-C patients exhibited symptoms involving the cardiovascular, mucocutaneous, and gastrointestinal systems.
Children with COVID-19 (particularly those with MIS-C) demonstrated marked alterations in lipid metabolism during their acute illness. These include elevated triglyceride levels indicative of pediatric hypertriglyceridemia, marked reductions in high-density lipoprotein (HDL) concentrations, and increased inflammatory lipoproteins, as well as certain low-density lipoprotein (LDL) particles.
Elevated triglycerides and specific LDL particles are hallmarks of early cardiovascular disease, while HDL cholesterol is a known protective factor against cardiovascular disease (CVD) risk. These findings hence suggest that children with acute COVID-19 (especially MIS-C patients) exhibit a profile that may place them at increased risk of chronic CVD outcomes.
Lipoprotein analyses revealed that the inflammatory lipoproteins in children with COVID-19 and MIS-C showed a strong similarity to those seen in adults with severe COVID-19.
The authors also noted a high prevalence of overweight and obesity in the patient cohorts, which they suggest could be a contributing factor that exacerbates the observed lipid abnormalities and future cardiovascular risk.
Notably, individuals in the healthy control group did not mirror any of these findings, suggesting a COVID-19-specific metabolic shift in childhood patients.
Conclusion
The present study debunks the comforting assumption that children experience mild COVID-19 infections without lasting consequences. It highlights that children with acute COVID-19 and MIS-C develop metabolic profiles closely resembling those containing markers of future cardiovascular risk. MIS-C patients, in particular, showed significant metabolic disruption, foreshadowing potential long-term cardiovascular risk.
These insights underscore the need for further investigation into the lasting effects of SARS-CoV-2 infection on pediatric health. Clinicians and public health officials must now consider that follow-up beyond respiratory recovery may be warranted to facilitate timely treatment and mitigate potential long-term health implications.
Source:
https://www.news-medical.net/news/20250616/COVID-19-triggers-metabolic-signatures-in-kids-that-mirror-adult-heart-risk.aspx
Researchers analyzed whether higher levels of marine microplastics in ocean water near US coastlines are linked to greater county-level prevalence of stroke, coronary artery disease, or type 2 diabetes.
After adjusting for local vulnerabilities and demographic factors, coastal counties with very high levels of microplastics had significantly higher prevalences of all three conditions than those with low levels.
Study
This study was designed to fill an important research gap by assessing the relationship between ocean microplastic pollution near US coastlines and local rates of major cardiometabolic diseases.
To investigate this link, the researchers utilized ocean microplastic concentration data spanning the years 2015 to 2020. They mapped microplastic levels within 200 nautical miles of the US coastline, aligning with the United Nations’ definition of exclusive economic zones where coastal nations manage ocean resources.
They identified 152 US counties bordering these coastal waters and calculated the average microplastic levels for each of these areas. Counties were then grouped into four categories: low, medium, high, or very high microplastic levels and linked to county-level estimates for stroke, coronary artery disease, and type 2 diabetes from 2019 to 2020.
To account for other factors influencing health, they included demographic details such as sex and age, physician availability, and broader social, environmental, and infrastructure vulnerabilities, using tools like the Climate Vulnerability Index (CVI).
Statistical analysis involved quasi-Poisson regression, which is suited for data with overdispersion and non-normal distributions. Population weights were applied to ensure that counties with larger populations had appropriate influence.
Results
Counties bordering ocean waters with very high microplastic concentrations had significantly greater average rates of stroke, coronary heart disease, and type 2 diabetes compared to counties with low microplastic levels.
Specifically, the mean prevalence of diabetes was about 13% in areas with very high microplastic levels, compared to 11.2% in areas with low levels. Likewise, stroke and coronary heart disease were also more common where microplastic pollution was greatest.
Statistical models confirmed this trend even after adjusting for key factors like sex, age, ethnic and racial composition, healthcare access, and environmental and socioeconomic vulnerabilities. In the fully adjusted models, very high microplastic levels were associated with a 5% to 6% higher prevalence of diabetes and artery disease, and about a 4% increase for stroke compared to low-level areas (with the finding for stroke being on the margin of statistical significance).
Regional patterns also emerged. The prevalence of all three diseases was highest in counties along the Gulf of Mexico, while the highest microplastic concentrations were measured off the Atlantic coast, both in contrast to the Pacific coast, which had lower disease rates and microplastic levels.
Conclusion
This ecological study provides population-level evidence that higher marine microplastic pollution may be associated with a greater burden of cardiometabolic diseases in US coastal regions.
Proposed pathways include contamination of seafood and groundwater, which supplies about 35% of U.S. drinking water, as well as possible inhalation or skin contact near polluted shores. Experimental studies and animal models back the plausibility of microplastics causing vascular damage, inflammation, and metabolic disruption.
However, limitations exist: the analysis is ecological and cross-sectional, so individual cause-and-effect relationships cannot be confirmed. There was also no direct measurement of human microplastic exposure or detailed analysis of different plastic types. Population movement, other confounding factors, and variations in local pollution controls could have influenced results.
Despite these gaps, the study highlights a concerning environmental health risk and underscores the need for further research to establish clear exposure thresholds and elucidate the underlying biological mechanisms. Policymakers should consider stronger regulations to curb plastic pollution and protect communities that rely on seafood and coastal waters.
Source:
https://www.news-medical.net/news/20250619/Higher-ocean-microplastics-linked-to-more-diabetes-stroke-and-heart-disease.aspx
Researchers investigated the association between adhering to four different dietary patterns and multimorbidity. They found that following certain eating patterns, such as the Mediterranean diet, was associated with a slower increase in chronic disease burden. In contrast, higher scores on the Empirical Dietary Inflammatory Index (EDII), indicating diets high in pro-inflammatory foods, were linked to a faster accumulation of diseases.
Notably, in some secondary analyses, higher adherence to the Alternate Mediterranean Diet (AMED) was unexpectedly associated with a faster rate of musculoskeletal disease accumulation. However, this was not a primary outcome, and the clinical significance remains uncertain.
Study
This longitudinal study used data from a Swedish cohort that included community-dwelling adults aged 60 and older. Participants were assessed at regular intervals over 15 years, with dietary data collected during the first three waves and multimorbidity tracked across all six waves.
From an initial sample of 3,363, researchers analyzed data from 2,473 individuals after excluding those with missing dietary or key demographic information.
Dietary intake was measured via food frequency questionnaires, and adherence to four dietary patterns, the Empirical Dietary Inflammatory Index (EDII), AHEI, the Alternate Mediterranean Diet (AMED), and the MIND (Mediterranean–DASH Intervention for Neurodegenerative Delay), was calculated. Multimorbidity was defined as the number of chronic diseases and grouped by organ system (musculoskeletal, cardiovascular, and neuropsychiatric).
Chronic conditions were diagnosed using clinical assessments and national registry data. Statistical analyses used linear mixed models to examine how dietary adherence affected the rate of disease accumulation over time, adjusting for potential confounders. Multiple sensitivity analyses were conducted to test the robustness of the findings. Associations were also analyzed using trajectory modeling to explore differences in disease accumulation speed among subgroups.
Results
The study followed 2,473 Swedish older adults with an average age of 71.5 years over 15 years. Most participants had multimorbidity at baseline, and healthier dietary patterns such as AMED, AHEI, and MIND were linked to a slower increase in total chronic disease count, while a pro-inflammatory diet (EDII) was associated with faster accumulation.
For instance, those with the highest adherence to MIND and AHEI diets accumulated about two fewer chronic conditions over 15 years compared to those with the lowest adherence. These patterns were particularly evident for cardiovascular and neuropsychiatric conditions, but no significant associations were observed for musculoskeletal diseases across any of the dietary patterns.
Sex and age differences emerged: The benefits of healthy diets for cardiovascular health were more pronounced in females, but these sex differences were not statistically significant after correcting for multiple comparisons. In participants over age 78, the MIND and AHEI diets showed stronger associations with reduced neuropsychiatric disease accumulation.
Sensitivity analyses supported these findings. However, when participants with multimorbidity at baseline were excluded, the associations for some dietary patterns, including MIND and AMED, were weakened and sometimes lost statistical significance.
Dietary adherence also influenced the likelihood of following faster or slower disease trajectories. For example, higher EDII adherence increased the odds of being in faster disease accumulation groups. Associations for AMED with cardiometabolic multimorbidity were weaker than for AHEI or MIND and were not statistically significant in some analyses.
Overall, AHEI generally showed the strongest protective association among the dietary patterns.
Conclusion
This study found that long-term adherence to healthy dietary patterns, particularly the AMED, AHEI, and MIND, was linked to a slower accumulation of chronic diseases, especially cardiovascular and neuropsychiatric conditions, in older adults. In contrast, a pro-inflammatory diet was associated with faster disease accumulation.
Some associations were stronger in women and the oldest participants, although none of these interactions remained statistically significant after correction for multiple comparisons.
The protective effects of diet may be explained by reduced inflammation, a key factor in aging-related diseases. Strengths of the study include the 15-year follow-up, repeated dietary assessments, and robust sensitivity analyses.
Limitations involve reliance on self-reported dietary data, lack of pre-baseline diet information, potential for reverse causality, and the study’s urban, highly educated sample, which limits generalizability. Importantly, the findings highlight the organ-system specificity of diet effects, with no evidence of benefit for musculoskeletal multimorbidity.
Source:
https://www.news-medical.net/news/20250729/A-15-year-study-reveals-which-diets-best-protect-your-brain-and-heart-in-later-life.aspx
Researchers evaluated the cardiovascular and endothelial effects of naringin, a flavonoid found in citrus fruits.
Cardiovascular diseases are the leading cause of death worldwide. Among the various cardioprotective dietary bioactive compounds, flavonoids have gained significant attention for their antioxidant and anti-inflammatory capacities. Naringin is a flavanone glycoside mainly found in citrus fruits, especially in mandarin oranges and grapefruit. It has attracted considerable interest due to its multifaceted biological actions and potential cardioprotective role, though its clinical translation is limited by low oral bioavailability (<5%), prompting research into advanced delivery systems like liposomal encapsulation.
Study
In the present systematic review, researchers evaluated the cardiovascular and endothelial effects of naringin across cellular, animal, and human studies. First, they searched the Web of Science, PubMed, Embase, and Scopus databases to identify relevant articles published from January 2000 to June 2025. Original experimental research studies evaluating the effects of naringin on myocardial or endothelial function were included.
Reviews, editorials, abstracts, and studies without cardiovascular endpoints were excluded. Titles/abstracts were screened, followed by full text analysis based on the Population, Intervention, Comparator, and Outcomes (PICO) framework. Studies in human subjects, cell cultures, and animal models were retained. Cardiovascular or endothelial function outcomes included myocardial infarct size, blood pressure, markers of endothelial function, and cardiac remodeling, among others.
Data on study type, dose, model, treatment duration, endpoints, and mechanistic findings were extracted. A narrative synthesis approach was used due to heterogeneity in model systems, study design, and endpoints. A qualitative synthesis was performed to stratify results by primary endpoints (myocardial or endothelial function) and model type (human, cell, animal).
Results
The database search identified 2,884 unique records. The full texts of 165 records were assessed for eligibility, and 62 studies were included. These included 28 in vitro, 29 animal, and five human studies. Eight in vitro studies focused on endothelial cells and showed that naringin had protective effects on vascular endothelial cells via suppression of NF-κB signaling and adhesion molecules (e.g., VCAM-1, ICAM-1). Naringin attenuated inflammation activation and preserved normal function in cultured human endothelial cells.
Nineteen in vitro studies were on cardiovascular cell types, including five on vascular smooth muscle cells (VSMCs), and 14 on cardiac cells. Naringin was found to blunt apoptotic and hypertrophic responses in cardiomyocyte and cardiomyoblast models through modulation of PI3K/Akt and Nrf2 pathways. The anti-hypertrophic effect was related to its ability to inhibit downstream ion transporters and carbonic anhydrase II. Moreover, naringin has been shown to protect cardiomyocytes from simulated in vitro ischemia-reperfusion (I/R) by inhibiting ferroptosis and cGAS-STING pathways.
In a model of hypoxia/reoxygenation injury, naringin reduced oxidative stress, improved cell survival, and preserved mitochondrial membrane potential post-injury. Naringin has been shown to protect cardiomyocytes against doxorubicin-induced cardiotoxicity by reducing reactive oxygen species (ROS) generation and apoptosis. Further, naringin has been found to exert anti-atherogenic effects in VSMCs by curbing abnormal migration and proliferation.
Among animal studies, 15 used metabolic disorder models, with nine specifically focusing on myocardial I/R injury or hypertension. Animal models of endothelial injury and hyperlipidemia have demonstrated the anti-atherosclerotic effects of naringin. In rabbit models fed cholesterol, chronic naringin treatment reduced atherosclerotic lesion development.
Studies on hypercholesterolemic rabbits reported significant attenuation of aortic atherosclerosis with naringin treatment, associated with reduced expression of intercellular adhesion molecule 1 (ICAM-1) in the endothelium. In an atherosclerosis-prone mouse model, naringin inhibited plaque formation, protected vascular endothelium, and promoted endothelial nitric oxide synthase (eNOS) protein expression via PI3K/Akt activation.
Moreover, naringin has demonstrated anti-hypertensive effects linked to renin-angiotensin system (RAS) modulation, preventing cardiac remodeling. Studies on animal models of diet-induced metabolic syndrome have reported that naringin reduces cardiac hypertrophy and apoptosis. Beyond ischemia-reperfusion, benefits extended to diabetic cardiomyopathy, sepsis-induced myocardial dysfunction, and doxorubicin cardiotoxicity models.
In addition, naringin has consistently demonstrated cardioprotective effects in animal models of I/R injury and myocardial infarction (MI). For instance, naringin pretreatment significantly improved cardiac function and reduced myocardial damage in a rat model of I/R injury. This cardioprotection was associated with reductions in myocardial oxidative stress, inflammation, and apoptosis via PI3K/Akt and Nrf2/GPX4 pathways. In a rat model of MI, naringin pretreatment prevented myocardial necrosis and oxidative stress.
Naringin was found to improve cardiac function and histology in diabetic cardiomyopathy models and attenuate sepsis and lipopolysaccharide-induced myocardial dysfunction in other models. Further, compared to preclinical studies, few studies have examined the effects of naringin in humans. Although still limited, evidence on the cardiovascular effects of naringin in humans stems from dietary intervention studies and clinical trials.
A randomized controlled trial reported significant improvements in cardiometabolic parameters in adults who received naringin for 90 days, showing a favorable lipid-modulating effect. Notably, one trial also documented improved arterial stiffness (reduced pulse wave velocity) with naringin-rich grapefruit juice. A dietary intervention study of adults with moderate hypercholesterolemia reported that naringin intake for eight weeks did not change plasma cholesterol levels; this lack of effect might be due to insufficient dose or treatment duration, as effective preclinical doses translate to ~1 g/day in humans.
Conclusion
In sum, a substantial body of evidence positions naringin as a potent compound with cardiovascular benefits. Preclinical studies have documented its ability to protect the myocardium and improve endothelial function through multi-targeted actions on oxidative stress (Nrf2), inflammation (NF-κB), cell survival (PI3K/Akt), and RAS modulation. It can suppress oxidative stress and inflammation, preserve endothelial integrity, and activate pro-survival signaling in cells.
Despite the positive findings of naringin, further research is needed to define optimal dosing, improve bioavailability, and validate effects in large-scale human trials to cement its role in clinical practice.
Source:
https://www.news-medical.net/news/20250818/Researchers-investigate-how-citrus-bioflavonoid-naringin-could-reduce-inflammation-and-heart-risk.aspx
A recent study investigated the potential of EPA-rich or DHA-rich Omega-3 supplements to modify physiological responses to submaximal exercise and evaluate their effects on exercise physiology and performance in endurance-trained males.
Study
The current double-blinded, block randomized parallel control trial assessed the differential impact of supplementation with EPA-rich fish oil, or DHA-rich algae oil, compared with a true placebo (coconut oil), on the omega-3 index, submaximal exercise responses, such as HR, respiratory exchange ratio (RER), rate of perceived exertion (RPE), and TT performance test. The EPA-rich oil contained 1.8 g of EPA and 1.2 g of DHA, while DHA-rich oil consisted of 2 g of DHA and 1 g of EPA.
The current study hypothesized that six weeks of supplementation would elevate the omega-3 index in DHA-rich algae and EPA-rich fish oil conditions, but not in the placebo condition.
A total of 69 endurance-trained male amateurs associated with swimming, cycling, rowing, running, and team sports were recruited. However, only 55 participants completed the study and were included in the final analysis. All male participants were between 18 and 50, healthy, endurance-trained, and non-smokers. Participants who enrolled in another clinical trial, had a recent or recurring injury, regularly consumed more than two portions of oily fish a week, or took omega-3 supplements were excluded.
Participants were matched in groups of three depending on their sporting discipline, predicted V̇O2max, and body composition. For a proof-of-concept study, participants were given three g/day of either EPA-rich fish oil, DHA-rich algae oil, or coconut oil (placebo) for 41 days. Blood samples were collected before and after the supplementation period.
Results
The current double-blinded, block randomized parallel control trial assessed the differential impact of supplementation with EPA-rich fish oil, or DHA-rich algae oil, compared with a true placebo (coconut oil), on the omega-3 index, submaximal exercise responses, such as HR, respiratory exchange ratio (RER), rate of perceived exertion (RPE), and TT performance test. The EPA-rich oil contained 1.8 g of EPA and 1.2 g of DHA, while DHA-rich oil consisted of 2 g of DHA and 1 g of EPA.
The current study hypothesized that six weeks of supplementation would elevate the omega-3 index in DHA-rich algae and EPA-rich fish oil conditions, but not in the placebo condition.
A total of 69 endurance-trained male amateurs associated with swimming, cycling, rowing, running, and team sports were recruited. However, only 55 participants completed the study and were included in the final analysis. All male participants were between 18 and 50, healthy, endurance-trained, and non-smokers. Participants who enrolled in another clinical trial, had a recent or recurring injury, regularly consumed more than two portions of oily fish a week, or took omega-3 supplements were excluded.
Participants were matched in groups of three depending on their sporting discipline, predicted V̇O2max, and body composition. For a proof-of-concept study, participants were given three g/day of either EPA-rich fish oil, DHA-rich algae oil, or coconut oil (placebo) for 41 days. Blood samples were collected before and after the supplementation period.
Conclusion
The findings documented here demonstrate that for the omega-3 index to reach a physiologically meaningful level, a 6-week supplementation with either DHA-rich or EPA-rich omega-3 fatty acids is sufficient. Both EPA-rich and DHA-rich supplementation also lowered submaximal HR, suggesting improved cardiac efficiency, but these physiological changes did not translate into superior endurance performance compared to placebo.
Future studies should ideally include both male and female participants to ensure the findings are generalizable to all sexes.
Source:
https://www.news-medical.net/news/20250828/Omega-3-supplements-lower-heart-rate-in-male-athletes.aspx
Researchers in the United States examined whether daylight saving time (DST) transitions affect the incidence of acute myocardial infarction (AMI) and in-hospital outcomes by comparing the weeks before, during, and after spring and fall clock changes, and estimated adjusted effects using a national registry.
Study
This cross-sectional analysis utilized the American College of Cardiology (ACC) National Cardiovascular Data Registry (NCDR) Chest Pain-Myocardial Infarction (MI) Registry to compare patterns one week before, during, and one week after DST in spring and fall across the United States (US) from 2013 to 2022. Unique consecutive patients with ST-elevation myocardial infarction (STEMI) or non-ST-elevation myocardial infarction (NSTEMI) were included; non-AMI encounters and residents of states without DST were excluded. The primary outcome was in-hospital mortality. Secondary outcomes were in-hospital stroke, reperfusion for STEMI, and revascularization for NSTEMI via percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). Incidence ratio (IR) compared DST weeks with adjacent weeks, adjusting for the 23-hour “spring forward” and 25-hour “fall back” days.
Generalized estimating equations (GEE) logistic models generated adjusted odds ratios (aORs), accounting for hospital clustering and covariates like demographics, presentation, comorbidities, and laboratory, including body mass index (BMI), left ventricular ejection fraction (LVEF), and troponin relative to the upper limit of normal (ULN). Analyses were conducted in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Sensitivity analyses compared DST weeks with three weeks before or after and examined Arizona and Hawaii.
Findings
The final cohort included 168,870 patients treated at 1124 hospitals (median age, 65 years; 57,023 women (33.8%); 111,847 men (66.2%)). In spring, 28,596 patients presented the week before DST, 28,678 during DST week, and 28,169 the week after. In fall, 27,365 presented the week before, 27,942 during DST week, and 28,120 the week after. Baseline demographics, comorbidities, presentation type, and procedural carev were closely matched across weeks in both seasons. STEMI comprised 37.4–37.9% in every week examined, with balanced distributions by region and hospital type. Door-to-balloon times remained consistent at 57–58 minutes, coronary angiography use exceeded 91%, primary PCI for STEMI was used in more than 90% of eligible cases in spring and roughly 81% in fall, and revascularization for NSTEMI was stable at 61–63% across all weeks.
Across the entire period, incidence ratios (IRs) showed no significant difference in AMI during spring DST week compared with one week prior or one week after, and no difference for fall DST week versus its adjacent weeks. Year-by-year plots were flat around unity, with one notable exception: in 2020, the spring DST week showed a 21% higher IR compared to the following week and a 6% lower IR compared to the prior week, patterns that overlapped with the onset of coronavirus disease 2019 (COVID-19). Daily analyses during DST weeks mirrored the overall null findings.
In-hospital outcomes were likewise stable. Mortality rates were 4.5% before, 4.6% during, and 4.4% after spring DST; and 4.8% before, 4.9% during, and 4.7% after fall DST. aORs for death comparing DST week with the prior or subsequent week hovered at 1.00–1.02, and adjusted estimates for any stroke were similarly nonsignificant. Subgroup analyses by STEMI and NSTEMI yielded no meaningful differences in aORs across seasons or weeks.
Sensitivity checks supported accuracy: In a separate sensitivity analysis of Arizona and Hawaii, which were excluded from the primary cohort because they do not observe DST, IRs across the corresponding calendar windows were similar; three-week windows were null overall, with an exception in 2020 where IRs were higher in the 3 weeks after spring DST; and excluding 2020-2021 did not change conclusions. Overall, in contemporary practice, clock changes were not associated with surges in AMI presentations or worse in-hospital course.
Conclusion
In this extensive, contemporary registry, DST transitions did not raise AMI incidence or worsen in-hospital outcomes. These findings are consistent across STEMI and NSTEMI strata and adjusted for demographic, clinical, and laboratory covariates using GEE models. For patients, families, and health systems, the message is reassuring: the lost or gained hour is unlikely to trigger heart attacks or complicate hospital care.
Public debate about time standards should weigh other endpoints, such as out-of-hospital cardiac arrest, traffic risk, and sleep health, rather than AMI alone. The authors also note that other conditions, such as ischemic stroke and vehicular crashes, may still show temporal associations with DST changes.
Source:
https://www.news-medical.net/news/20250910/Daylight-saving-time-does-not-increase-heart-attack-risk-study-shows.aspx