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Effects of vitamin D, omega-3 and a simple strength exercise programme in cardiovascular disease prevention: The DO-HEALTH randomized controlled trial.
Gaengler, S, Sadlon, A, De Godoi Rezende Costa Molino, C, Willett, WC, Manson, JE, Vellas, B, Steinhagen-Thiessen, E, Von Eckardstein, A, Ruschitzka, F, Rizzoli, R, et al
The journal of nutrition, health & aging. 2024;28(2):100037
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There is an increased risk of developing cardiovascular disease in older adults with an increase in metabolic markers such as lipid levels and blood pressure in old age. Previous studies have shown that non-pharmaceutical interventions such as supplementation with marine omega-3 fatty acids and vitamin D and increasing physical activity may help reduce these metabolic marker levels. This DO-HEALTH double-blinded, randomised, placebo-controlled trial investigated the benefits of marine omega-3 fatty acids, vitamin D3 and a strength training home exercise programme (SHEP) in reducing the lipid levels, hypertension, and other cardiovascular biomarkers and reducing the risk of major cardiovascular events in active older adults. The interventions included supplementation of vitamin D3 2000 IU/day, 1 g omega-3 PUFA of marine origin (330 mg EPA: 660 mg DHA) and 30 minutes of strength training for three days a week. The Do-Health study ran for three years and 2157 active older adults enrolled into the study. This trial showed that omega-3 fatty acid supplementation decreased triglycerides and increased High-density lipoprotein levels. Omega 3 supplementation also showed a non-significant reduction in low-density lipoproteins, non-HDL and total cholesterol in older active adults. The intervention strategies did not show any benefits on hypertension or prevention of major cardiovascular events. Further robust studies using different dosages of supplements and different study durations are required to determine the efficacy of omega-3 fatty acid and vitamin D3 supplementation and strength training in reducing metabolic and cardiovascular biomarkers. However, healthcare professionals can use the results of this trial to understand the benefits of omega-3 fatty acid supplementation in older active adults.
Abstract
BACKGROUND The effects of non-pharmaceutical interventions in the prevention of cardiovascular diseases (CVD) in older adults remains unclear. Therefore, the aim was to investigate the effect of 2000 IU/day of vitamin D3, omega-3 fatty acids (1 g/day), and a simple home strength exercise program (SHEP) (3×/week) on lipid and CVD biomarkers plasma changes over 3 years, incident hypertension and major cardiovascular events (MACE). METHODS The risk of MACE (coronary heart event or intervention, heart failure, stroke) was an exploratory endpoint of DO-HEALTH, incident hypertension and change in biomarkers were secondary endpoints. DO-HEALTH is a completed multicentre, randomised, placebo-controlled, 2 × 2 × 2 factorial design trial enrolling 2157 Europeans aged ≥70 years. RESULTS Participants' median age was 74 [72, 77] years, 61.7% were women, 82.5% were at least moderately physically active, and 40.7% had 25(OH)D < 20 ng/mL at baseline. Compared to their controls, omega-3 increased HDL-cholesterol (difference in change over 3 years: 0.08 mmol/L, 95% CI 0.05-0.10), decreased triglycerides (-0.08 mmol/L, (95%CI -0.12 to -0.03), but increased total- (0.15 mmol/L, 95%CI 0.09; 0.2), LDL- (0.11 mmol/L, 0.06; 0.16), and non-HDL-cholesterol (0.07 mmol/L, 95%CI 0.02; 0.12). However, neither omega-3 (adjustedHR 1.00, 95%CI 0.64-1.56), nor vitamin D3 (aHR 1.37, 95%CI 0.88-2.14), nor SHEP (aHR 1.18, 95%CI 0.76-1.84) reduced risk of MACE or incident hypertension compared to control. CONCLUSION Among generally healthy, active, and largely vitamin D replete, older adults, treatment with omega-3, vitamin D3, and/or SHEP had no benefit on MACE prevention. Only omega-3 supplementation changed lipid biomarkers, but with mixed effects. TRIAL REGISTRATION CLINICALTRIALS. GOV IDENTIFIER NCT01745263.
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Effectiveness of an intermittent fasting diet versus regular diet on fat loss in overweight and obese middle-aged and elderly people without metabolic disease: a systematic review and meta-analysis of randomized controlled trials.
Yao, K, Su, H, Cui, K, Gao, Y, Xu, D, Wang, Q, Ha, Z, Zhang, T, Chen, S, Liu, T
The journal of nutrition, health & aging. 2024;28(3):100165
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People with obesity and overweight are at increased risk of developing metabolic diseases. Intermittent fasting is considered an effective non-pharmaceutical management strategy for reducing weight and body fat. This systematic review and meta-analysis included nine randomised controlled trials to evaluate the effectiveness of intermittent fasting on lipids, body composition, and body morphology in middle-aged and elderly people without metabolic diseases. Included studies used different intermittent fasting strategies such as alternate-day fasting (ADF), 5:2 fasting (2DW), time-restricted eating (TRF), and Ramadan fasting (FCR). The duration of intervention in the included studies ranged from six weeks to twelve weeks. This systematic review and meta-analysis found that intermittent fasting improved body weight, body mass index, fat mass, and triglycerides in adults over forty without metabolic diseases compared to a regular diet. Healthcare professionals can use the results of this study to understand that intermittent fasting could be an effective strategy for reducing fat mass and weight in middle-aged and elderly people without metabolic diseases. Further robust studies are needed to confirm the benefits of intermittent fasting due to the high variability between included studies.
Abstract
OBJECTIVE As the number of adults aged over 40 with obesity increases dramatically, intermittent fasting interventions (IF) may help them to lose fat and weight. This systematic review investigated the most recent research on the effects of intermittent fasting and a regular diet on body composition and lipids in adults aged over 40 with obesity without the metabolic disease. DATA SOURCES Randomized controlled trials (RCTs) on IF on adults aged over 40 with obesity were retrieved from PubMed, Web of Science, EBSCO, China Knowledge Network (CNKI), VIP database, Wanfang database with the experimental group using IF and the control group using a regular diet. Revman was used for meta-analysis. Effect sizes are expressed as weighted mean differences (WMD) and 95% confidence intervals (CI). STUDY SELECTION A total of 9 articles of randomised controlled trials that met the requirements were screened for inclusion. Studies typically lasted 2-6 weeks. The experimental population was aged 42-66 years, with a BMI range of 25.7-35 kg/m2. SYNTHESIS A total of 9 RCTs were included. meta-analysis showed that body weight (MD: -2.05 kg; 95% CI (-3.84, -0.27); p = 0.02), BMI (MD: -0.73 kg/m2; 95% CI (-1.05, -0.41); p < 0.001), fat mass (MD: -2.14 kg; 95% CI (-3.81, 0.47); p = 0.01), and TG (MD = -0.32 mmol/L, 95% CI (-0.50, -0.15, p < 0.001) were significantly lower in the experimental group than in the control group. No significant reduction in lean body mass (MD: -0.31 kg; 95% CI (-0.96, 0.34); p = 0.35). CONCLUSION IF had a reduction in body weight, BMI, fat mass, and TG in adults aged over 40 with obesity without metabolic disease compared to RD, and IF did not cause a significant decrease in lean body mass, which suggests healthy and effective fat loss. However, more long-term and high-quality trials are needed to reach definitive conclusions.
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Effects of Garlic on Glucose Parameters and Lipid Profile: A Systematic Review and Meta-Analysis on Randomized Controlled Trials.
Zhao, X, Cheng, T, Xia, H, Yang, Y, Wang, S
Nutrients. 2024;16(11)
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Glucose and lipids are essential nutrients that provide energy to cells. In healthy individuals, glucose and lipid metabolism is precisely regulated. Disorders of glucose and lipid metabolism can lead to several chronic diseases. The aim of this study was to investigate the effects of garlic on blood lipid and glucose levels. This study was a systematic review and meta-analysis of 22 randomised controlled trials. Results showed that garlic consumption improved some lipid indices and outperformed the control group in various aspects. However, there was no significant difference in the effect of garlic intervention on patients' triglyceride levels. Authors concluded that garlic therapy should be considered as beneficial for patients with disorders related to glucose and lipid metabolism. However, larger sample size trials in other populations may be needed to confirm these findings.
Abstract
(1) Background: The effect of garlic on glucose and lipid metabolism in humans remains controversial. The aim of this study was to investigate the effects of garlic on blood lipid levels and glucose levels in humans through a systematic review and meta-analysis. (2) Methods: We extensively searched four databases, including PubMed, Web of Science, Embase, and the Cochrane Library, up to February 2024. To assess the collective impact of garlic and its supplements on fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG), an analysis was conducted using a random effects model. Subgroup analyses were performed when I2 < 50%. (3) Result: We found that the garlic intervention was effective in controlling FBG (mean difference = -7.01; 95% CI: -8.53, -5.49, p < 0.001), HbA1c (mean deviation = -0.66; 95% CI: -0.76, -0.55, p < 0.001, I2 = 62.9%), TC (mean difference = -14.17; 95% CI: -19.31, -9.03, p < 0.001), and LDL-C (mean difference = -8.20; 95% CI: -15.58, -0.81, p = 0.03); moreover, it also increased the level of HDL-C in humans (mean difference = 2.06; 95% CI: 1.54, 2.59; p < 0.001). Nonetheless, the intervention involving garlic did not yield a substantial impact on triglyceride (TG) levels. (4) Conclusion: The intervention of garlic is beneficial to control blood glucose and blood lipids in humans.
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Transform-Us! cluster RCT: 18-month and 30-month effects on children's physical activity, sedentary time and cardiometabolic risk markers.
Salmon, J, Arundell, L, Cerin, E, Ridgers, ND, Hesketh, KD, Daly, RM, Dunstan, D, Brown, H, Della Gatta, J, Della Gatta, P, et al
British journal of sports medicine. 2023;57(5):311-319
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Regular physical activity is beneficial to children’s physical, social and mental health. However, most children fail to meet the recommended 60+ min of moderate-intensity to vigorous-intensity physical activity every day. The Transform-Us! school-based and home-based intervention was developed to determine the impact of strategies to promote children’s moderate-to-vigorous physical activity versus reduce sedentary behaviour or a combination of these strategies, on behavioural and health outcomes. The main aim of this study was to determine the efficacy of the independent and combined intervention approaches to promoting physical activity and reducing sedentary behaviour on children’s moderate-to-vigorous physical activity and sedentary time after 18 and 30 months compared with usual practice. This study is a 30-month 2×2 factorial design cluster randomised controlled trial delivered in 20 primary schools with additional home intervention components. After recruitment, schools were then randomly allocated to one of four groups. Results show that Transform-Us! had stronger effects on children’s sedentary behaviour than physical activity in both the physical activity (PA) and sedentary behaviour (SB) interventions, and there were beneficial effects on children’s adiposity for both intervention approaches. However, no clear conclusions could be drawn regarding which intervention (PA or SB) had the strongest or more consistent effects on children’s health outcomes. Authors conclude that, based on their findings, government education departments and schools should consider adopting and implementing whole-of-school programmes to promote children’s physical activity and reduce sitting through active pedagogy and supportive social and physical environments at school and home to benefit children’s sedentary time and some markers of cardiometabolic health.
Abstract
OBJECTIVE To test the efficacy of the Transform-Us! school- and home-based intervention on children's physical activity (PA), sedentary behaviour (SB) and cardiometabolic risk factor profiles. METHODS A 30-month 2×2 factorial design cluster randomised controlled trial delivered in 20 primary schools (148 Year 3 classes) in Melbourne, Australia (2010-2012), that used pedagogical and environmental strategies to reduce and break up SB, promote PA or a combined approach, compared with usual practice. Primary outcomes (accelerometry data; n=348) were assessed at baseline, 18 and 30 months. Secondary outcomes included body mass index (BMI) and waist circumference (WC) (n=564), blood pressure (BP) (n=537) and biomarkers (minimum n=206). Generalised linear mixed models estimated the interactive effects of the PA and SB interventions on the outcomes. If there was no interaction, the main effects were assessed. RESULTS At 18 months, there were intervention effects on children's weekday SB (-27 min, 95% CI: -47.3 to -5.3) for the PA intervention, and on children's average day PA (5.5 min, 95% CI: 0.1 to 10.8) for the SB intervention. At 30 months, there was an intervention effect for children's average day SB (-33.3 min, 95% CI: -50.6 and -16.0) for the SB intervention. Children's BMI (PA and SB groups) and systolic BP (combined group) were lower, and diastolic BP (PA group) was higher. There were positive effects on WC at both time points (SB intervention) and mixed effects on blood parameters. CONCLUSIONS The Transform-Us! PA and SB interventions show promise as a pragmatic approach for reducing children's SB and adiposity indicators; but achieving substantial increases in PA remains challenging. TRIAL REGISTRATION ISRCTN83725066; ACTRN12609000715279.
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Comparative effects of vitamin and mineral supplements in the management of type 2 diabetes in primary care: A systematic review and network meta-analysis of randomized controlled trials.
Xia, J, Yu, J, Xu, H, Zhou, Y, Li, H, Yin, S, Xu, D, Wang, Y, Xia, H, Liao, W, et al
Pharmacological research. 2023;188:106647
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Type 2 diabetes mellitus (T2DM), characterised by sustained hyperglycaemia and insulin resistance, remains a severe driver of chronic metabolic diseases such as cardiovascular diseases. The aim of this study was to investigate and compare the efficacy of vitamin and mineral supplements in the management of glycaemic control and lipid metabolism for type 2 diabetic patients to inform clinical practice. This study is a systematic review and meta-analysis of one hundred and seventy articles with a total of 4223 adults with T2DM. Participants were randomised to either the placebo/no treatment group (n= 6345) or to the treatment group (n= 7878). Results show that: - chromium was the most effective micronutrient for decreasing fasting blood glucose and insulin resistance. - vitamin K was the top-ranked micronutrient in reducing haemoglobin A1C and fasting insulin levels. - vanadium was the top-ranked micronutrient in total cholesterol reductions. - niacin was ranked as the most effective in triglycerides reductions and increasing high-density lipoprotein cholesterol levels. - vitamin E was the top-ranked micronutrient in low-density lipoprotein cholesterol reductions. Authors conclude that micronutrient supplements especially chromium, vitamin E, vitamin K, vanadium, and niacin supplements, may be more effective in the management of T2DM compared with other micronutrients.
Expert Review
Conflicts of interest:
None
Take Home Message:
- Clinicians could consider the adjunctive effect of micronutrients supplements, such as chromium, vitamin E, vitamin K, vanadium, and niacin supplements in a nutrition protocol to manage T2DM and slow or prevent its complications.
- The study authors state that the vitamin and mineral supplements under review had a statistically significant improvement, however they did not reach the study threshold for clinical significance. Therefore they advise caution in utilising micronutrient supplements in the management of glucose and lipid metabolism for T2DM.
Evidence Category:
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A: Meta-analyses, position-stands, randomized-controlled trials (RCTs)
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B: Systematic reviews including RCTs of limited number
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C: Non-randomized trials, observational studies, narrative reviews
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D: Case-reports, evidence-based clinical findings
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E: Opinion piece, other
Summary Review:
Objectives
The aim of this systematic review was to evaluate the comparative effects of vitamin and mineral supplements on managing glycemic control and lipid metabolism for type 2 diabetes mellitus (T2DM).
Methodology
This systematic review is registered with PROSPERO and adhered to PRISMA-2020 guidelines for network meta-analysis
The Cochrane Collaboration’s risk-of-bias tool was used to assess eligible randomised trials
8 prespecified markers identified and assessed in this study : 1) HbA1c (%), 2) fasting blood glucose (mmol/L), 3) total cholesterol (mmol/L), 4) triglycerides (mmol/L), 5) fasting insulin (μIU/mL), 6) HOMA-IR, 7) LDL-c (mmol/L), and 8) HDL-c (mmol/L).
Results
- 170 RCT trials of 14223 participants with T2DM treated with vitamin supplements, mineral supplements, or placebo/no treatment were included
- Low to very low certainty evidence established chromium supplements as the most effective in reducing fasting blood glucose levels and homeostasis model assessment of insulin resistance (SUCRAs: 90.4% and 78.3%, respectively)
- Vitamin K supplements ranked best in reducing glycated haemoglobin A1c and fasting insulin levels (SUCRAs: 97.0% and 82.3%, respectively), with moderate to very low certainty evidence
- Vanadium supplements ranked best in lowering total cholesterol levels with very low evidence certainty (SUCRAs:100%)
- Niacin supplements ranked best in triglyceride reductions and increasing high-density lipo-protein cholesterol levels with low to very low evidence certainty (SUCRAs:93.7% and 94.6%, respectively)
- Vitamin E supplements ranked best in reducing low-density lipoprotein cholesterol levels with very low evidence certainty (SUCRAs:80.0%).
Conclusion
- Micronutrient supplements, such as chromium, vitamin E, vitamin K, vanadium, and niacin supplements, may be efficacious in managing T2DM
- It should be noted that the evidence certainty for all was low.
Clinical practice applications:
- Chromium plays an important role in carbohydrate and lipid metabolism and was the most effective micronutrient for decreasing fasting blood glucose, HbA1c, fasting insulin, and HOMA-IR reductions. More pronounced effects were seen for chromium than vitamin E, vitamin C, niacin, selenium, and magnesium supplements
- Vitamin K was the top-ranked micronutrient in reducing HbA1c and fasting insulin levels. The mechanism through which Vitamin K affects glucose metabolism is proposed as activation of the AMP-activated protein kinase/sirtuin 1, that in turn increases phosphocreatine 3-kinase and glucose transporter 2 to decrease insulin resistance and fasting glucose.
- Vanadium was the top-ranked micronutrient in total cholesterol (TC) reductions, where supplementation dosage should be carefully considered, as vanadium compounds can be moderately or highly toxic. Vanadium supplementation is only recommended in cases of vanadium deficiency or diabetes, hyperlipidemia, and hypertension, where the intake of vanadium from food should be enhanced in preference to supplementation
- Niacin was ranked as the most effective in triglyceride (TG) reductions and increasing HDL cholesterol levels. The dose of niacin could not be determined
- Vitamin E was the top-ranked micronutrient in low-density lipo- protein (LDL) cholesterol reductions.
Considerations for future research:
- Considering the clinical importance of these findings, new research is needed to get better insight into the efficacy of micronutrient supplements in managing T2DM
- Selenium homeostasis, selenoprotein, insulin signaling/secretion, and carbohydrate/lipid metabolism are linked in multiple and complex ways but the authors could not explain why chromium supplementation would lower blood glucose more effectively than selenium supplementation, and suggest more research is needed to clarify this
- While vitamin K status could be an emerging treatment target in T2DM prevention and management, it remains to be determined whether vitamin K supplementation has an advantage over other nutrients in terms of hypoglycemic effect, and further research is necessary
- The beneficial effect of vitamin E and niacin supplements regarding lipid metabolism warrant investigation through more rigorous comparative studies.
Abstract
Medical nutrition treatment can manage diabetes and slow or prevent its complications. The comparative effects of micronutrient supplements, however, have not yet been well established. We aimed at evaluating the comparative effects of vitamin and mineral supplements on managing glycemic control and lipid metabolism for type 2 diabetes mellitus (T2DM) to inform clinical practice. Electronic and hand searches for randomized controlled trials (RCTs) were performed until June 1, 2022. We selected RCTs enrolling patients with T2DM who were treated with vitamin supplements, mineral supplements, or placebo/no treatment. Data were pooled via frequentist random-effects network meta-analyses. A total of 170 eligible trials and 14223 participants were included. Low to very low certainty evidence established chromium supplements as the most effective in reducing fasting blood glucose levels and homeostasis model assessment of insulin resistance (SUCRAs: 90.4% and 78.3%, respectively). Vitamin K supplements ranked best in reducing glycated hemoglobin A1c and fasting insulin levels (SUCRAs: 97.0% and 82.3%, respectively), with moderate to very low certainty evidence. Vanadium supplements ranked best in lowering total cholesterol levels with very low evidence certainty (SUCRAs:100%). Niacin supplements ranked best in triglyceride reductions and increasing high-density lipoprotein cholesterol levels with low to very low evidence certainty (SUCRAs:93.7% and 94.6%, respectively). Vitamin E supplements ranked best in reducing low-density lipoprotein cholesterol levels with very low evidence certainty (SUCRAs:80.0%). Our analyses indicated that micronutrient supplements, especially chromium, vitamin E, vitamin K, vanadium, and niacin supplements, may be more efficacious in managing T2DM than other micronutrients. Considering the clinical importance of these findings, new research is needed to get better insight into this issue.
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Dietary Strawberries Improve Serum Metabolites of Cardiometabolic Risks in Adults with Features of the Metabolic Syndrome in a Randomized Controlled Crossover Trial.
Basu, A, Izuora, K, Hooyman, A, Scofield, HR, Ebersole, JL
International journal of molecular sciences. 2023;24(3)
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Metabolic syndrome has been identified as a major risk factor for type 2 diabetes and its cardiovascular complications. Several dietary strategies, especially the use of different forms of dietary supplements, continue to be investigated for the prevention and management of this condition. The aim of this study was to examine the serum metabolites (targeted and untargeted) that may be affected by strawberry supplementation. This study was a randomised, double-blind, controlled crossover trial which enrolled adult participants with one or more features of metabolic syndrome. Participants were assigned to one of the three arms for four weeks separated by a one-week washout period. Results show that several targeted and untargeted serum metabolites were modulated with strawberry supplementation. In fact, strawberry supplementation improved the serum metabolic profiles which are associated with decreased risks of insulin resistance and diabetes, as well as endothelial dysfunction in adults with features of metabolic syndrome. Authors conclude that adding whole strawberries to the habitual diet may be a beneficial and feasible strategy to improve the cardiometabolic health in adults.
Abstract
Dietary strawberries have been shown to improve cardiometabolic risks in multiple clinical trials. However, no studies have reported effects on serum metabolomic profiles that may identify the target pathways affected by strawberries as underlying mechanisms. We conducted a 14-week randomized, controlled crossover study in which participants with features of metabolic syndrome were assigned to one of the three arms for four weeks separated by a one-week washout period: control powder, 1 serving (low dose: 13 g strawberry powder/day), or 2.5 servings (high dose: 32 g strawberry powder/day). Blood samples, anthropometric measures, blood pressure, and dietary and physical activity data were collected at baseline and at the end of each four-week phase of intervention. Serum samples were analyzed for primary metabolites and complex lipids using different mass spectrometry methods. Mixed-model ANOVA was used to examine differences in the targeted metabolites between treatment phases, and LASSO logistic regression was used to examine differences in the untargeted metabolites at end of the strawberry intervention vs. the baseline. The findings revealed significant differences in the serum branched-chain amino acids valine and leucine following strawberry intervention (high dose) compared with the low-dose and control phases. Untargeted metabolomic profiles revealed several metabolites, including serum phosphate, benzoic acid, and hydroxyphenyl propionic acid, that represented improved energy-metabolism pathways, compliance measures, and microbial metabolism of strawberry polyphenols, respectively. Thus, dietary supplementation of strawberries significantly improves the serum metabolic profiles of cardiometabolic risks in adults.
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Olive pomace oil can improve blood lipid profile: a randomized, blind, crossover, controlled clinical trial in healthy and at-risk volunteers.
González-Rámila, S, Sarriá, B, Seguido, MA, García-Cordero, J, Mateos, R, Bravo, L
European journal of nutrition. 2023;62(2):589-603
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Morbidity and mortality from cardiovascular diseases (CVD) are increasing. It is known that a healthy diet and physical exercise can modulate the risk of CVD. In this regard, the Mediterranean Diet (MD) is considered a model of healthy eating and olive oil is an essential component of this diet, as its primary fat source. The aims of this study were to assess the possible beneficial role of consuming olive pomace oil (OPO) as the main source of fat in the diet on serum lipid concentrations (primary outcome) and other biomarkers of cardiovascular health such as blood pressure, endothelial function and inflammation (secondary outcomes) in at-risk (hypercholesterolaemic) subjects. This study was a randomised, blind, crossover, controlled clinical trial in free-living subjects. Participants, men and women aged 18–55 years, were randomly assigned to one of the two groups; normocholesterolaemic or hypercholesterolaemic group. Results showed that consumption of OPO for four weeks resulted in an improved blood lipid profile, decreasing low-density lipoprotein cholesterol, Apo B and low-density lipoprotein/ high-density lipoprotein ratio both in healthy and at-risk volunteers, in contrast to the opposite effect observed with high-oleic acid sunflower oil (HOSO), with no significant changes in other CVD risk factors. Furthermore, no changes were observed in relation to blood pressure, and biomarkers linked to inflammation and endothelial function. Authors conclude that OPO could have hypolipidemic actions in healthy consumers and in subjects with high blood cholesterol, contributing to cardiovascular disease prevention.
Abstract
PURPOSE This study aimed to assess the effect of dietary consumption of olive pomace oil (OPO) on blood lipids (primary outcome) and other cardiovascular disease (CVD) risk factors (blood pressure, inflammation and endothelial function as secondary outcomes). METHODS A randomized, controlled, blind, crossover intervention was carried out in healthy and at-risk (hypercholesterolemic) subjects. Participants consumed daily 45 g of OPO or high-oleic acid sunflower oil (HOSO) as control oil during 4 weeks. RESULTS OPO significantly reduced low-density lipoprotein cholesterol (LDL-C; P = 0.003) and apolipoprotein B (Apo B; P = 0.022) serum concentrations, and LDL/HDL ratio (P = 0.027) in healthy and at-risk volunteers. These effects were not observed with HOSO. Blood pressure, peripheral artery tonometry (PAT), endothelial function and inflammation biomarkers were not affected. CONCLUSIONS Regular consumption of OPO in the diet could have hypolipidemic actions in subjects at cardiovascular risk as well as in healthy consumers, contributing to CVD prevention. CLINICAL TRIAL REGISTRY NCT04997122, August 8, 2021, retrospectively registered.
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Effect of high intensity interval training on arterial stiffness in obese hypertensive women: a randomized controlled trial.
Taha, MM, Aneis, YM, Hasanin, ME, Felaya, EE, Aldhahi, MI, Abdeen, HAA
European review for medical and pharmacological sciences. 2023;27(9):4069-4079
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Hypertension is considered one of the risk factors for cardiovascular disease. Hypertension is a multifactorial condition in which arterial stiffness is one of its manifestations. Exercise is a nonpharmaceutical intervention, and it is known to induce cardiovascular benefits. The aim of this study was to evaluate if the mechanistic effect of high-intensity interval training (HIIT) would affect arterial stiffness parameters in sedentary obese hypertensive women. This study is a randomised controlled trial which enrolled sixty hypertensive women between the ages of 40 and 50 years. Participants were randomly assigned to one of two groups: 1) 12-week of high-intensity interval training or 2) a control group. Results show that HIIT has a beneficial effect on lowering arterial stiffness in obese hypertensive women. Furthermore, HIIT resulted in significant improvements in several metabolic parameters namely blood pressure, total cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, and triglycerides. Authors conclude that HIIT for 12 weeks reduces cardiometabolic risk factors and improves arterial stiffness indices in obese hypertensive women. Thus, HIIT should be included in the treatment of obese hypertensive women to reduce their risk of cardiovascular disease.
Abstract
OBJECTIVE High-intensity interval training (HIIT) has been linked to a lower risk of cardiovascular disease and mortality. The study's overarching goal is to evaluate the impact of HIIT on arterial stiffness in obese hypertensive women. PATIENTS AND METHODS Sixty obese hypertensive women aged between 40-50 years were randomized to group A (Intervention group, n = 30) or group B (Control group, n = 30). Intervention group received HIIT (4 minutes of cycling at 85-90% of peak HR interspersed with 3-minute active recovery time at 60 - 70% of peak HR, three times per week). Arteriovenous stiffness indicators, the augmentation index corrected for heart rate 75 (AIx@75HR), and oscillometric pulse wave velocity (o-PWV), as well as cardio-metabolic parameters, were assessed before and after 12 weeks of treatment. RESULTS Finding between-group analysis showed a significant difference in AIx@75HR (95% CI: -8.45 to 0.30) , o-PWV ( 95% CI: -1.14 to 0.15), total cholesterol, (95% CI: -31.25 to -1.12), HDL-cholesterol (95% CI: 8.92 to 0.94), LDL-cholesterol (95% CI: -25.35 to -0.06) , and triglycerides (95% CI: -53.58 to -2.51). CONCLUSIONS High-intensity interval training for 12 weeks has a favorable effect on arterial stiffness in obese hypertensive women and lowers associated cardio-metabolic risk factors.
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Effects of different exercise modalities on lipid profile in the elderly population: A meta-analysis.
Yun, H, Su, W, Zhao, H, Li, H, Wang, Z, Cui, X, Xi, C, Gao, R, Sun, Y, Liu, C
Medicine. 2023;102(29):e33854
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Hyperlipidemia is characterised by abnormally elevated levels of lipids in the blood which increases the risk of developing age-related health issues including cardiovascular diseases. Engaging in regular physical activity can lower the risk of developing metabolism-related health problems. However, the effect of different types of exercise on lipid levels may vary in elderly people. This meta-analysis of twenty randomised controlled trials compared the effects of different exercise modalities on lipid profiles in the elderly population. The results of this study showed that aerobic exercise exhibited greater benefits in mitigating lipid profile compared to resistance training alone or a combination of aerobic exercise, resistance training and high-intensity interval training in the elderly population. Healthcare professionals can better understand the effects of aerobic exercise on glycolipid metabolism in elderly people using the results of this study. However, further robust studies are required due to the heterogeneity between the included studies to understand the duration and intensity of aerobic exercise required to ameliorate the lipid profile in elderly people.
Abstract
BACKGROUND Dyslipidemia, characterized by elevated total cholesterol (TC), triglycerides, and low-density lipoprotein cholesterol (LDL-C), as well as decreased high-density lipoprotein cholesterol (HDL-C), has long been recognized as a major risk factor for age-related diseases. Recent studies have shown that exercise can be effective in mitigating dyslipidemia in older adults. The aim of this study was to systematically evaluate the effects of different exercise modalities (aerobic exercise [AE], resistance exercise [RE], aerobic+resistance exercise [AE+RE], and high-intensity interval training) on lipid profile in the elderly population, in order to identify the most effective exercise modality for maintaining lipid profile health in older adults. METHODS A comprehensive database search of PubMed, EBSCO, Web of Science, China National Knowledge Infrastructure, and Wanfang database. Eligible studies were individually assessed according to the Cochrane Risk of Bias Tool version 2, and the data were analyzed and processed using RevMan 5.4.1 analysis software. RESULTS This study identified 20 randomized controlled trials with a total of 988 subjects, of which 541 were in the exercise group and 447 in the control group. Our analysis showed that AE significantly reduced TC (P < .05), triglycerides (P < .01), and LDL-C (P < .01), while increasing HDL-C (P < .01) in the elderly population. RE significantly reduced the elevation of TC (P < .01) and LDL-C (P < .05) indices in the elderly population, while AE+RE had a significant effect on decreasing TC (P < .01) and LDL-C (P < .01) indices. CONCLUSION Our analysis indicates that AE is the most effective exercise modality for reducing dyslipidemia in older adults, compared to RE, AE+RE, and high-intensity interval training. These findings suggest that AE should be promoted as an important lifestyle intervention to improve lipid profile health in the elderly population. However, further research is needed to investigate the optimal duration, frequency, and intensity of AE required to achieve the most beneficial effects on lipid profile health in older adults.
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A multidisciplinary lifestyle program for metabolic syndrome-associated osteoarthritis: the "Plants for Joints" randomized controlled trial.
Walrabenstein, W, Wagenaar, CA, van de Put, M, van der Leeden, M, Gerritsen, M, Twisk, JWR, van der Esch, M, van Middendorp, H, Weijs, PJM, Roorda, LD, et al
Osteoarthritis and cartilage. 2023;31(11):1491-1500
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Osteoarthritis (OA) is a chronic condition that mostly affects the hands, hips and knees. Having OA is associated with a 2-fold higher risk of metabolic syndrome and obesity. Metabolic syndrome-associated osteoarthritis (MSOA) is a distinct phenotype of OA, based on studies showing associations between OA and the components of metabolic syndrome. The aim of this study was to determine the effectiveness of the “Plants for Joints” programme, which integrates a whole food plant-based diet, physical activity, and stress management, in patients with MSOA. This study was a 16-week open label randomised controlled trial that involved patients with hip or knee MSOA who were allocated to either the intervention group or the control group. Results showed that after 16 weeks, the intervention group showed a significant improvement in the Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) score, with an 11-point larger improvement compared to the control group. Additionally, the intervention group experienced weight loss, reduced fat mass, and decreased waist circumference Authors concluded that the “Plants for Joints” lifestyle programme was found to be effective in reducing stiffness, alleviating pain, and enhancing physical function in individuals with hip or knee MSOA, offering a promising approach to managing this condition.
Abstract
OBJECTIVE To determine the effectiveness of the "Plants for Joints" multidisciplinary lifestyle program in patients with metabolic syndrome-associated osteoarthritis (MSOA). DESIGN Patients with hip or knee MSOA were randomized to the intervention or control group. The intervention group followed a 16-week program in addition to usual care based on a whole food plant-based diet, physical activity, and stress management. The control group received usual care. The patient-reported Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) total score (range 0-96) was the primary outcome. Secondary outcomes included other patient-reported, anthropometric, and metabolic measures. An intention-to-treat analysis with a linear-mixed model adjusted for baseline values was used to analyze between-group differences. RESULTS Of the 66 people randomized, 64 completed the study. Participants (84% female) had a mean (SD) age of 63 (6) years and body mass index of 33 (5) kg/m2. After 16 weeks, the intervention group (n = 32) had a mean 11-point larger improvement in WOMAC-score (95% CI 6-16; p = 0.0001) compared to the control group. The intervention group also lost more weight (-5 kg), fat mass (-4 kg), and waist circumference (-6 cm) compared to the control group. Patient-Reported Outcomes Measurement Information System (PROMIS) fatigue, pain interference, C-reactive protein, hemoglobin A1c, fasting glucose, and low-density lipoproteins improved in the intervention versus the control group, while other PROMIS measures, blood pressure, high-density lipoproteins, and triglycerides did not differ significantly between the groups. CONCLUSION The "Plants for Joints" lifestyle program reduced stiffness, relieved pain, and improved physical function in people with hip or knee MSOA compared to usual care.
