Effect of low-fat, high-fat, and fiber-supplemented high-fat diets on colon cancer risk factors in feces of healthy subjects.

Normal healthy volunteers (n = 8) received low- and high-fat (14% and 53% energy/day, respectively) and dietary fiber-supplemented high-fat diets (fiber 25 g/day, fat 52% energy/day) for 10 days each. Colon cancer risk factors in feces were measured by colonic nuclear aberration assay, the Ames Salmonella test using strain TA100, and measurement of bile acids and calcium soaps. Nuclear aberrations in colonic epithelium increased during the high-fat diet period and then decreased during the fiber-supplemented high-fat diet period. There were no significant differences in the mutagenicity on Salmonella TA100 or in the concentration of bile acids during the high-fat diet period. Bile acids decreased during the fiber supplementation period. The marked increase in calcium soaps during the high-fat diet period indicates an increase in long-chain fatty acids in the fecal lipid component and conversion of these fatty acids to insoluble calcium soaps when enough calcium is present.     

The Medi-RIVAGE study: reduction of cardiovascular disease risk factors after a 3-mo intervention with a Mediterranean-type diet or a low-fat diet

BACKGROUND: Epidemiologic studies link Mediterranean-type diets to a low incidence of cardiovascular disease; however, few dietary intervention studies have been undertaken, especially in primary prevention. OBJECTIVES: In the Mediterranean Diet, Cardiovascular Risks and Gene Polymorphisms (Medi-RIVAGE) study, the effects of a Mediterranean-type diet (Med group) or a low-fat diet (low-fat group) on risk factors were evaluated in 212 volunteers (men and women) with moderate risk factors for cardiovascular disease. DESIGN: After the 3-mo dietary intervention, changes in many risk factors were evaluated. Dietary questionnaires and plasma nutritional markers were used to test compliance. RESULTS: Although the dietary goals were only partially reached, changes in dietary habits were observed in both groups (n = 169): protein, carbohydrate, and fiber intakes increased and fat quality (decreased saturated fat and increased monounsaturated or polyunsaturated fat) improved. BMI, total and triacylglycerol-rich lipoprotein (TRL) cholesterol, triacylglycerols, TRL triacylglycerols, apolipoproteins A-I and B, insulinemia, glycemia, and the homeostasis model assessment score were significantly lower after 3 mo. The reductions in total cholesterol, triacylglycerols, and insulinemia remained significant after adjustment for BMI. There was a trend for a diet-by-time interaction for LDL cholesterol (P = 0.09). Our data predicted a 9% reduction in cardiovascular disease risk with the low-fat diet and a 15% reduction with this particular Mediterranean diet. CONCLUSION: After a 3-mo intervention, both diets significantly reduced cardiovascular disease risk factors to an overall comparable extent.     

Rheumatic diseases as risk factors for cardiovascular disease

Cardiovascular disease is the leading cause of death in patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS) and systemic lupus erythematosus (SLE). In addition to mortality, cardiovascular morbidity is also markedly increased in these patients, compared with the general population. The increased cardiovascular risk can be explained only partially by an increased prevalence of classical risk factors for cardiovascular disease; it also appears to be related to inflammation. Prospective intervention trials aimed at the modification of cardiovascular risk factors are needed to determine the impact of cardiovascular risk reduction in patients with rheumatic disease. In addition to SLE, RA and AS should be acknowledged as new risk factors for cardiovascular disease.     

Mediterranean diet and cognitive decline in women with cardiovascular disease or risk factors

BackgroundCardiovascular disease and vascular risk factors increase rates of cognitive impairment, but very little is known regarding prevention in this high-risk group. The heart-healthy Mediterranean-type dietary pattern may beneficially influence both vascular and cognitive outcomes.ObjectivesWe examined the association between Mediterranean-style diet and cognitive decline in women with prevalent vascular disease or ≥3 coronary risk factors.Design/participants/settingProspective cohort study among 2,504 women participants in the Women's Antioxidant Cardiovascular Study (WACS), a cohort of female health professionals. Adherence to a Mediterranean-style diet was determined at WACS baseline (1995-1996) using a 0- to 9-point scale with higher scores indicating higher adherence. In 1998-2000, participants aged ≥65 years underwent a telephone cognitive battery including five tests of global cognition, verbal memory, and category fluency. Tests were administered three additional times across 5.4 years.Statistical analyses performedWe used multivariable-adjusted generalized linear models for repeated measures to compare the annual rates of cognitive score changes across tertiles of Mediterranean diet score, as assessed at WACS baseline.ResultsIn both basic- and multivariable-adjusted models, consuming a Mediterranean-style diet was not related to cognitive decline. No effect modification was detected by age, education, depression, cardiovascular disease severity at WACS baseline, or level of cognition at initial assessment.ConclusionsIn women at higher risk of cognitive decline due to vascular disease or risk factors, adherence to a Mediterranean-style diet was not associated with subsequent 5-year cognitive change.     

Major risk factors for cardiovascular disease in elderly migrants in Sweden

Objective. The knowledge of elderly migrants' health, particularly those who are retired or in transition to retirement is limited. The purpose of this study was to analyse the association between migration, socio-economic status (SES), and risk factors for cardiovascular disease (CVD). Design. A simple random sample of 253 foreign-born persons and 2847 Swedish-born persons aged 55-74 were drawn from the Swedish Population Registry. They were interviewed by Statistics Sweden in 1988-89. Outcome variables were leisure-time physical inactivity, smoker/non-smoker status, body mass index (BMI), hypertension, and diabetes mellitus. Explanatory variables were sex, age, marital status, migration status (country of birth), and SES (income). Logistic and linear regression were used. Results. Elderly foreign-born people ran an increased risk of engaging in no physical activity (men only), being a current smoker, and having an increased BMI after adjustment for background factors. In addition, a low income (first tertile) was an independent risk factor for physical inactivity (men only), as was being a current smoker (men only), BMI, hypertension, and diabetes mellitus. Thus, the burden of being an elderly migrant increases the risk of a disadvantaged lifestyle between 50 and 80% compared with Swedes. Conclusions. This study shows that migrants who are retired or in transition to retirement have a disadvantaged risk profile for cardiovascular disease. It might be possible to improve this situation by intervention, as for example by increasing a person's interest in walking.     

军队干部心血管疾病危险因素和临界危险因素调查分析

目的了解军队干部心血管疾病危险因素和临界危险因素的流行现状,为下一步实施有效个体化干预提供数据资料。方法采用心血管疾病流行病学调查表,整群调查陆军机关、院校、野战部队干部809人,分析军队干部心血管疾病危险因素及临界危险因素的流行现状。结果军队干部多数存在不健康生活方式,其中摄盐过多者为43.0%,喜欢食肉者为58.59%,不喜欢运动者为53.89%。心血管疾病危险因素患病率为43.51%,临界危险因素患病率为74.29%,17.06%的人无任何危险因素。其中心血管疾病危险因素患病率位居前3位的分别是吸烟(29.42%)、肥胖(10.38%)、高血压(10.01%);临界危险因素患病率位居前三位的分别是超重(50.56%)、临界高血脂(40.67%)、临界高血压(34.73%)。分组研究结果显示,心血管疾病危险因素,年龄每增加10岁就有显著性增多(P<0.05);临界危险因素,在50岁之前,年龄每增加10岁就有显著性增多(P<0.05),然后进入一个平台期。结论军队干部心血管疾病危险因素患病率明显低于社会普通人群,但临界危险因素存在现象较为普遍。     

Effects of cocoa flavanols on risk factors for cardiovascular disease

Epidemiologic investigations support the hypothesis that regular consumption of flavonoid-containing foods can reduce the risk of cardiovascular diseases (CVD). While flavonoids are ubiquitous in plants, cocoa can be particularly rich in a sub-class of flavonoids known as flavanols. A number of human dietary intervention trials with flavanol-containing cocoa products have demonstrated improvements in endothelial and platelet function, as well as blood pressure. These studies provide direct evidence for the potential cardiovascular benefits of flavanol-containing foods and help to substantiate the epidemiological data. In this review, results from selective published trials with cocoa and chocolate focused on risk for CVD will be discussed along with a study we recently completed evaluating the effects of the daily consumption of flavanol-containing dark chocolate (CocoaVia?) with and without plant sterol esters on CVD markers in a normotensive population with mild hypercholesterolemia. In this study, the daily consumption of flavanol-containing dark chocolate was associated with a significant mean reduction of 5.8 mmHg in systolic blood pressure. Together the results of these human dietary intervention trials provide scientific evidence of the vascular effects of cocoa flavanols and suggest that the regular consumption of cocoa products containing flavanols may reduce risk of CVD.     

Race-ethnicity-specific waist circumference cutoffs for identifying cardiovascular disease risk factors

BACKGROUND: Waist circumferences (WCs) in white men and women that represent a risk of cardiovascular disease (CVD) equivalent to that of body mass indexes (BMIs; in kg/m2) of 25 and 30 have been identified. However, WC cutoffs for other race-ethnicity groups remain unknown. OBJECTIVE: The objective was to determine WC cutoffs for CVD risk in non-Hispanic blacks (blacks), Mexican Americans (MA), and non-Hispanic whites (whites). DESIGN: Data from 10,969 participants in the third National Health and Nutrition Examination Survey (1988-1994) were analyzed. The presence of CVD risk factors was the main outcome. Sex- and race-ethnicity-specific WC cutoffs were determined with logistic regression models by linking WC cutoffs with equivalent CVD risk based on BMI cutoffs for overweight and obesity. WC cutoffs for metabolic syndrome risk factors were similarly calculated. RESULTS: Correlations between WC and lipid profiles, blood pressure, and glucose were significantly higher than those between BMI and these same variables in all groups. The WC cutoffs were approximately 5-6 cm greater for white than for black men at BMIs between 25 and 40, and those for MA were intermediate. In women, few differences in WC cutoffs were observed between the groups. Simplified WC cutoffs corresponding to BMIs of 25 and 30, largely independent of age, for the 3 race-ethnicity groups were 89 and 101 cm for men and 83 and 94 cm for women. Minimal distances in receiver operating characteristic curves tended to be shorter when WC cutoffs rather than BMI cutoffs were used. CONCLUSIONS: WC is a better indicator of CVD risk than is BMI in the 3 race-ethnicity groups studied. The proposed WC cutoffs are more sensitive than are BMI cutoffs in predicting CVD risk.     

Age and secular trends in risk factors for cardiovascular disease in Busselton

Abstract: Mortality rates from heart disease and stroke in Australia have been falling for more than 20 years. No completely satisfactory explanations for this trend exist However, it is believed to be due, at least in part, to changes in the incidence of cardiovascular disease arising from changes in the prevalence and severity of risk factors for cardiovascular disease. The adult community of Busselton in Western Australia participated in cross-sectional health surveys every three years from 1966 to 1981. This paper describes secular trends from 1966 to 1981 and age trends from 25 to 80 years for cardiovascular risk factors in Busselton men and women. Downwards secular trends were observed for mean blood pressure and smoking for men and women, upwards trends were observed for body mass index in men, and mean cholesterol was approximately constant over this period. The age and secular trends were consistent with other Australian studies conducted in the 1980s and with overseas studies. An estimated 67 per cent of the decline in cardiovascular mortality rates among Busselton men and 22 per cent of the decline among Busselton women may be attributed to changes in the prevalence of risk factors for cardiovascular disease.     

Measuring achievement: Changes in risk factors for cardiovascular disease in Australia

A possible measure for evaluating health system performance is the achievement index, which can be calculated using prevalence and distribution of a health measure across different socioeconomic groups. This study extends this approach by examining how achievement can be represented on a two-dimensional plane with the x-axis being the difference in mean ill-health and the y-axis being the difference in an absolute measure of inequality based on the generalised concentration index. The achievement plane is an easily understandable visual aid which provides a method of tracking changes in health and inequality over time, as well as uncertainty around these measures. We also demonstrate how comparisons over time and at different levels of inequality aversion can be undertaken using measures of net achievement. To illustrate the use of the achievement plane, we compared changes in prevalence of various cardiovascular risk factors and absolute inequality in the distribution of these factors, using data from four successive Australian National Health Surveys conducted between 1989 and 2005. While self-reported rates of smoking and high cholesterol have been declining, inequalities have been rising as the greatest reductions in these risk factors have been among higher income groups. Conversely for risk factors where the prevalence has been increasing, health inequalities are either not changing (i.e. diabetes and obesity), or diminishing over time (overweight/obese). All of these changes can be summarized using an achievement plane and graphs of net achievement to examine changes in prevalence and distribution of these risk factors over time.     

Dietary fiber intake and risk factors for cardiovascular disease in French adults

BACKGROUND: Increased consumption of dietary fiber is widely recommended to maintain or improve health, but knowledge of the relation between dietary fiber sources and cardiovascular disease risk factors is limited. OBJECTIVE: We examined the relation between the source or type of dietary fiber intake and cardiovascular disease risk factors in a cohort of adult men and women. DESIGN: In a cross-sectional study, quintiles of fiber intake were determined from dietary records, separately for 2532 men and 3429 women. Age- and multivariate-controlled logistic models investigated the odds ratios of abnormal markers for quintiles 2-5 of fiber intake compared with the lowest quintile. RESULTS: The highest total dietary fiber and nonsoluble dietary fiber intakes were associated with a significantly (P < 0.05) lower risk of overweight and elevated waist-to-hip ratio, blood pressure, plasma apolipoprotein (apo) B, apo B:apo A-I, cholesterol, triacylglycerols, and homocysteine. Soluble dietary fiber was less effective. Fiber from cereals was associated with a lower body mass index, blood pressure, and homocysteine concentration; fiber from vegetables with a lower blood pressure and homocysteine concentration; and fiber from fruit with a lower waist-to-hip ratio and blood pressure. Fiber from dried fruit or nuts and seeds was associated with a lower body mass index, waist-to-hip ratio, and fasting apo B and glucose concentrations. Fiber from pulses had no specific effect. CONCLUSION: Dietary fiber intake is inversely correlated with several cardiovascular disease risk factors in both sexes, which supports its protective role against cardiovascular disease and recommendations for its increased consumption.     

Plasma fibrinogen and factor VII as risk factors for cardiovascular disease

The importance of the thrombotic component of coronary heart disease is increasingly recognised, and in particular the role of the ccoagulation system in this process.The Northwick Park Heart study was the first major prospective study to identify both fibrinogen and factor VII as risk factors, as powerful as total cholesterol in predicting ischaemic events.     

中老年人群心血管危险因素流行病学调查及分析

目的 通过研究心血管危险因素流行状况的调查分析,为部队中老年群体的医疗保健及心血管病防治提供更有利的依据.方法 以弗明汉心脏研究中心冠心病流行病学研究为模式,采用统一自制调查表对北京军区驻京部队17个休干所和机关在职、离退休干部进行心血管危险因素流行病学调查,并进行综合评估.结果 1 926例被调查者以男性为主,占91.32%,年龄分布以≥60～90岁老年为主,共占84.63%.68.06%的人有体重异常.高血压占58.56%,血压控制未达标者占高血压总数的59.9%.血脂异常总患病率高达65.9%.血糖异常的检出率为26.4%,其中明确糖尿病占10.85%.具有3种以上心血管危险因素的占78.2%.冠心病患病率高达52.13%.结论 78.2%的调查对象存在3个以上危险因素,提示该群体是一个多种危险因素聚集一体的高危人群.多种危险因素控制是当前预防心血管病的最佳策略.     

Plasma fibrinogen and factor VII as risk factors for cardiovascular disease

The importance of the thrombotic component of coronary heart disease is increasingly recognised, and in particular the role of the ccoagulation system in this process.The Northwick Park Heart study was the first major prospective study to identify both fibrinogen and factor VII as risk factors, as powerful as total cholesterol in predicting ischaemic events.Since then, a number of epidemiological studies have confirmed the importance of fibrinogen, not just in CHD but in stroke as well. A variety of environmental factors are known to influence levels of factor VII and fibrinogen and therefore support their role in the development of coronary thrombosis. Both are known to increase with age and body weight and are relatively elevated in diabetes.Fibrinogen is strongly related to smoking habit and a substantial proportion of the IHD risk associated with smoking is mediated through this relationship. There is a dose response effect between number of cigarettes smoked and level of fibrinogen and an inverse relationship with time since cessation of the habit.Factor VII is known to correlate with total cholesterol level, and there is a relationship between dietary variability of fat intake and factor VII, which is likely to play an important role in the risk of CHD.The case for using either anticoagulation or anti platelet agents in secondary pevention of myocardial infarction is now clear, but there are still uncertainties in primary prevention which relate to the ideal dose intensity of either aspirin or anti-coagulation and the type of patient most likely to benefit.The ongoing Thrombosis Prevention Trial identifies middle-aged males at high risk of a myocardial infarction. These are then randomised in a double blind placebo controlled factorial design to receive one of four treatments: 75 mg of aspirin and warfarin at a low intensity level of anticoagulation titrated to achieve an international normalised ratio of 1.5, either agent singly, or two types of placebo. The progress of this trial is discussed.     

中老年人群心血管危险因素流行病学调查及分析

目的通过研究心血管危险因素流行状况的调查分析,为部队中老年群体的医疗保健及心血管病防治提供更有利的依据。方法以弗明汉心脏研究中心冠心病流行病学研究为模式,采用统一自制调查表对北京军区驻京部队17个休干所和机关在职、离退休干部进行心血管危险因素流行病学调查,并进行综合评估。结果1926例被调查者以男性为主,占91.32%,年龄分布以≥60~90岁老年为主,共占84.63%。68.06%的人有体重异常。高血压占58.56%,血压控制未达标者占高血压总数的59.9%。血脂异常总患病率高达65.9%。血糖异常的检出率为26.4%,其中明确糖尿病占10.85%。具有3种以上心血管危险因素的占78·2%。冠心病患病率高达52.13%。结论78.2%的调查对象存在3个以上危险因素,提示该群体是一个多种危险因素聚集一体的高危人群。多种危险因素控制是当前预防心血管病的最佳策略。