Andreia Machado Miranda

Association between Polyphenol Intake and Hypertension in Adults and Older Adults: A Population-Based Study in Brazil

Background/Objective Hypertension is an important risk factor for cardiovascular disease, and diet has been identified as a modifiable factor for preventing and controlling hypertension. Besides, epidemiological studies have suggested an inverse association between polyphenol intake and cardiovascular diseases. The aim of this study was to evaluate the association between the intake of polyphenols and hypertension in a general population of Sao Paulo. Methods Data came from the ‘Health Survey of Sao Paulo (ISA-Capital)’ among 550 adults and older adults in Sao Paulo, Brazil. Diet was assessed by two 24-hour dietary recalls (24HR). Usual intakes were calculated using the Multiple Source Method. Polyphenol intake was calculated by matching food consumption data from the 24HR with the Phenol-Explorer database. The associations between the hypertension and tertiles of the total and classes of polyphenols intake were tested by multivariate logistic regression analysis. Results After multivariate adjustment for potential confounding factors the findings showed an inverse and linearly association between the hypertension and highest tertiles of tyrosols (OR = 0.33; 95%CI 0.18, 0.64), alkylphenols (OR = 0.45; 95%CI 0.23, 0.87), lignans (OR = 0.49; 95%CI 0.25, 0.98), as well as stilbenes (OR = 0.60; 95%CI 0.36, 0.98), and other polyphenols (OR = 0.33; 95%CI 0.14, 0.74). However, total polyphenol intake, and phenolic acids were significantly associated only in the middle tertile with hypertension and flavonoids were not significant associated. Conclusion There is an inverse and linearly association between the highest tertile of some classes of polyphenols, such as, tyrosols, alkylphenols, lignans, stilbenes, other polyphenols and hypertension.

Dietary intake and food contributors of polyphenols in adults and elderly adults of Sao Paulo: a population-based study.

A comprehensive estimation of polyphenol intake is needed to gain a better understanding of the association between polyphenol-rich food intake and the potential effects of this intake on chronic diseases. The aim of this study was to estimate the intake of polyphenols and the major dietary contributors in the population of Sao Paulo. Data were obtained from the Health Survey-São Paulo (ISA-Capital 2008) and were reported for 1103 adults and elderly adults. Food intake was estimated by one 24-h dietary recall (24HR). Polyphenol intake was calculated by matching food consumption data from the 24HR with the polyphenol content in foods listed in the Phenol-Explorer database. The mean total intake of polyphenols was 377·5 (se 15·3) mg/d. The main polyphenol classes were phenolic acids (284·8 (se 15·9) mg/d) and flavonoids (54·6 (se 3·5) mg/d). Intakes were higher in the elderly adults than in other adults (P<0·001) and higher in individuals with lower educational level (P=0·01) and current smokers (P=0·02). The main dietary contributors for total polyphenols were coffee (70·5 %), citrus fruits (4·6 %) and tropical fruits (3·4 %). Coffee was the major source of polyphenols, providing 266·2 (se 16·5) mg/d, and contributed 92·3 % of the phenolic acids and 93·1 % of the alkylmethoxyphenols. These findings will be useful for assessing the potential role on health of polyphenols and specific polyphenol-rich foods, such as coffee, and enable a comparison with people from other countries.

High intake of heterocyclic amines from meat is associated with oxidative stress.

High meat intake has been related to chronic diseases such as cancer and CVD. One hypothesis is that heterocyclic amines (HCA), which are formed during the cooking process of meat, can generate reactive species. These compounds can cause oxidation of lipids, proteins and DNA, resulting in oxidative stress, cell damage and loss of biological function. This association has been seen in vitro; however, it remains unclear in vivo. The aim of the present study was to investigate the association between oxidative stress and HCA intake, and oxidative stress and meat intake. Data were from the Health Survey for Sao Paulo--ISA-Capital (561 adult and elderly). Food intake was estimated by one 24-h dietary recall (24HR) complemented by a detailed FFQ with preferences of cooking methods and level of doneness for meat. HCA intake was estimated linking the meat from the 24HR to a database of HCA. Oxidative stress was estimated by malondialdehyde (MDA) concentration in the plasma, after derivatisation with thiobarbituric acid and quantification by HPLC/diode array. Analyses were performed using multivariate logistic regressions adjusted for smoking, sex, age, BMI, skin colour, energy intake, fruit and vegetable intake, and physical activity. A positive association between HCA intake and MDA concentration (OR 1·17; 95% CI 1·01, 1·38) was observed, showing that HCA from meat may contribute to increase oxidative stress, and may consequently increase the risk of chronic diseases.

Association between Coffee Consumption and Its Polyphenols with Cardiovascular Risk Factors: A Population-Based Study

Epidemiological studies have examined the effect of coffee intake on cardiovascular disease, but the benefits and risks for the cardiovascular system remain controversial. Our objective was to evaluate the association between coffee consumption and its polyphenols on cardiovascular risk factors. Data came from the “Health Survey of São Paulo (ISA-Capital)” among 557 individuals, in São Paulo, Brazil. Diet was assessed by two 24-h dietary recalls. Coffee consumption was categorized into <1, 1–3, and ≥3 cups/day. Polyphenol intake was calculated by matching food consumption data with the Phenol-Explorer database. Multiple logistic regression models were used to assess the associations between cardiovascular risk factors (blood pressure, total cholesterol, low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), triglycerides, fasting glucose, and homocysteine) and usual coffee intake. The odds were lower among individuals who drank 1–3 cups of coffee/day to elevated systolic blood pressure (SBP) (Odds Ratio (OR) = 0.45; 95% Confidence Interval (95% CI): 0.26, 0.78), elevated diastolic blood pressure (DBP) (OR = 0.44; 95% CI: 0.20, 0.98), and hyperhomocysteinemia (OR = 0.32; 95% CI: 0.11, 0.93). Furthermore, significant inverse associations were also observed between moderate intake of coffee polyphenols and elevated SBP (OR = 0.46; 95% CI: 0.24, 0.87), elevated DBP (OR = 0.51; 95% CI: 0.26, 0.98), and hyperhomocysteinemia (OR = 0.29; 95% CI: 0.11, 0.78). In conclusion, coffee intake of 1–3 cups/day and its polyphenols were associated with lower odds of elevated SBP, DBP, and hyperhomocysteinemia. Thus, the moderate consumption of coffee, a polyphenol-rich beverage, could exert a protective effect against some cardiovascular risk factors.

Excessive red and processed meat intake: relations with health and environment in Brazil

The aims of the present study were to verify the proportion of population that consumed more red and processed meat than the World Cancer Research Fund (WCRF) dietary recommendation, to estimate the environmental impact of beef intake and the possible reduction of greenhouse gas emissions if the dietary recommendation was followed. We used the largest, cross-sectional, population-based survey entitled the National Dietary Survey (34 003 participants aged 10-104 years). The usual meat intake was obtained by two food records completed on 2 non-consecutive days. The usual intake was estimated by the multiple source method. The environmental impact was analysed according to estimates of CO2 equivalent emissions from beef intake as a proxy for beef production in Brazil. The red and processed meat intake mean was 88 g/d. More than 80 % of the population consumed more red and processed meat than the WCRF recommendation. Beef was the type of meat most consumed, accounting to almost 50 %. Each person contributed 1005 kg of CO2 equivalents from beef intake in 2008, the same quantity of CO2 produced if a car travelled a distance between the extreme north and south of Brazil (5370 km). The entire Brazilian population contributed more than 191 million tons of CO2 equivalents, which could have been reduced to more than 131 million tons if the dietary recommendation was followed. The present study shows that the magnitude of the excessive red and processed meat intake in Brazil can impact on health and the environment, pointing to the urgency of promoting a sustainable diet.

Genetic Variants Involved in One-Carbon Metabolism: Polymorphism Frequencies and Differences in Homocysteine Concentrations in the Folic Acid Fortification Era

Folate and other B vitamins are essential co-factors of one-carbon metabolism, and genetic variants, such as polymorphisms, can alter the metabolism. Furthermore, the adoption of food fortification with folic acid showed a decrease of homocysteine concentration. The aim of this study was to investigate the frequencies of the polymorphisms of enzymes and carrier proteins involved in one-carbon metabolism, and to evaluate homocysteine concentrations in the presence of these genetic variants in a population exposed to mandatory food fortification with folic acid. Using data from a population-based cross-sectional study in São Paulo, Brazil, the study population comprised 750 participants above 12 years of age of both genders. A linear regression model was used to evaluate the homocysteine concentrations according to genetic variants and folate level. The results showed that the minor allelic frequencies were 0.33 for MTHFR (rs1801133), 0.24 for MTHFR (rs1801131), 0.19 for MTR (rs1805087), 0.42 for MTRR (rs1801394), 0.46 for RFC1 (rs1051266), and 0.47 for DHFR (19-bp deletion). The genetic variants of MTHFR 677C>T, MTRR 66A>G and RFC-1 80G>A were different according to race. The homocysteine concentrations increased in the CT and TT compared to CC genotypes of polymorphism MTHFR 677C>T in all populations, and differences between the homocysteine concentrations according to the genotypes of MTHFR 677C>T were observed regardless of folate level.

Coffee Consumption and Coronary Artery Calcium Score: Cross‐Sectional Results of ELSA‐Brasil (Brazilian Longitudinal Study of Adult Health)

Background Available evidence for the relationship between coffee intake and subclinical atherosclerosis is limited and inconsistent. This study aimed to evaluate the association between coffee consumption and coronary artery calcium (CAC) in ELSA‐Brasil (Brazilian Longitudinal Study of Adult Health). Methods and Results This cross‐sectional study is based on baseline data from participants of the ELSA‐Brasil cohort. Only participants living in São Paulo, Brazil, who underwent a CAC measurement (n=4426) were included. Coffee consumption was collected using a food frequency questionnaire. CAC was detected with computed tomography and expressed as Agatston units. CAC was further categorized as an Agatson score ≥100 (CAC ≥100). In multiple logistic regression analysis considering intake of coffee and smoking status interaction, significant inverse associations were observed between coffee consumption (>3 cups/d) and CAC≥100 (odds ratio [OR]: 0.85 [95% confidence interval, 0.58–1.24] for ≤1 cup/d; OR: 0.73 [95% confidence interval, 0.51–1.05] for 1–3 cups/d; OR: 0.33 [95% confidence interval, 0.17–0.65] for >3 cups/d). Moreover, there was a statistically significant interaction effect for coffee consumption and smoking status (P=0.028 for interaction). After stratification by smoking status, the analysis revealed a lower OR of coronary calcification in never smokers drinking >3 cups/d (OR: 0.37 [95% confidence interval, 0.15–0.91]), whereas among current and former smokers, the intake of coffee was not significantly associated with coronary calcification. Conclusions Habitual consumption of >3 cups/d of coffee decreased odds of subclinical atherosclerosis among never smokers. The consumption of coffee could exert a potential beneficial effect against coronary calcification, particularly in nonsmokers.