R. di Giuseppe

Consumption of healthy foods at different content of antioxidant vitamins and phytochemicals and metabolic risk factors for cardiovascular disease in men and women of the Moli-sani study.

Background/Objectives:To categorize healthy food groups into categories of low-antioxidant (LAC) or high-antioxidant vitamins and phytochemicals content (HAC) and comparatively associate them with metabolic risk factors for cardiovascular disease (CVD).Subjects/Methods:A total of 6879 women (55±12 years) and 6892 men (56±12 years) were analyzed from the Moli–sani cohort, randomly recruited from the general population. The European Prospective Investigation into Cancer and Nutrition Food Frequency Questionnaire was used for dietary assessment. The antioxidant content of each food group was evaluated using Istituto Nazionale di Ricerca per gli Alimenti e la Nutrizione and United States Department of Agriculture (USDA) food composition tables. Healthy foods, according to a Mediterranean dietary pattern, were categorized into HAC or LAC; total food antioxidant content (FAC) score was constructed for a comparative evaluation of the consumption of these two groups.Results:In men, an increase in FAC score, which represents an increased consumption of HAC with respect to LAC foods, was associated with a decrease in systolic blood pressure, diastolic blood pressure and C-reactive protein (CRP) (β=−0.5, P=0.02, β=−0.3, P=0.02 and β=−0.03, P=0.03, respectively). Logistic regression analyses showed that in men 15% (30 units) increase in FAC score was associated with 6% decrease in the likelihood of having hypertension (odds ratio (OR)=0.94, 95% confidence interval (CI) 0.91–0.98) and 3% decrease in the likelihood of having a high CRP risk level (OR=0.97, 95% CI 0.94–0.99). No significant associations were observed in women.Conclusions:A possible greater protective role of healthy HAC as compared with healthy LAC foods on hypertension and inflammation was detected in men. These results stress the importance of studying healthy foods according to their content in antioxidant vitamins and phytochemicals, in primary prevention of CVD.

Total dietary antioxidant capacity and lung function in an Italian population: a favorable role in premenopausal/never smoker women

Background/Objectives:Antioxidant-rich foods may favorably influence lung function. We examined possible associations between the total dietary antioxidant capacity (TAC) and pulmonary function in a healthy Italian population.Subjects/Methods:Until May 2009, 22 300 persons were randomly recruited from the general population in the Moli-sani project. A sample only including healthy women (5824) and men (5848) was analyzed. TAC was measured in foods by three different assays and the ferric reducing-antioxidant power (FRAP) assay was selected as the better indicator of dietary TAC. The European Investigation into Cancer and Nutrition Food Frequency Questionnaire was used for dietary assessment. The association between quintiles of dietary FRAP and pulmonary indexes was assessed using analysis of variance separately for men and women.Results:After adjustment for confounders, women in the highest quintile of FRAP intake had +39 ml forced expiratory volume in the first second (FEV1) and +54 ml forced vital capacity, compared with those in the lowest quintile (P for trend ⩽0.006). Stratified analysis showed that this relationship only occurred in women who were premenopausal/never smokers. In this subgroup, the observed effect of higher FRAP intake on FEV1 was equivalent to an improvement in pulmonary age of 3.3 years. In men, all significant associations between pulmonary function and TAC were lost after adjustment for confounding.Conclusions:Dietary TAC may have a favorable role in respiratory health, particularly in premenopausal/never smoker women.

Association between erythrocyte membrane fatty acids and biomarkers of dyslipidemia in the EPIC-Potsdam study.

Correction to: European Journal of Clinical Nutrition (2014) 68, 517–525; doi:10.1038/ejcn.2014.18; published online 26 February 2014 Since publication, the authors have found an SAS coding error in the LDL-cholesterol calculation. The other biomarker outcomes of the paper (HDL-cholesterol, non-HDL-cholesterol and triglycerides) are not affected by the error.

A Mediterranean-style diet, its components and the risk of heart failure: a prospective population-based study in a non-Mediterranean country

Background/Objectives:Growing evidence emerged about the role of diet in heart failure (HF) development, but data are sparse and inconclusive. We examined the association between a Mediterranean-style diet, its components and HF risk.Subjects/Methods:Analyses were carried out in 24 008 middle-aged participants of the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam (Germany), including 209 incident HF cases within 8.2 years. The traditional Greek Mediterranean diet score (tMED) was used to assess dietary adherence. Cox’s proportional hazards regression was applied to estimate the relationship between the adherence to the Mediterranean-style diet, its components and HF risk.Results:After adjustment for age, sex and energy intake, a 2-unit increment in the tMED was associated with 26% lower risk of HF (HR (95% confidence interval (CI)): 0.76 (0.60–0.97)). After multivariable adjustment, this association was slightly attenuated and lost significance [HR (95%CI): 0.82 (0.64–1.05)]. Interestingly, we observed a significant association in multivariable adjusted models when milk products were excluded from the score (HR (95% CI): 0.75 (0.59–0.96)). Three score components were significantly associated with HF risk: alcohol (HR (95%CI): 0.73 (0.55–0.97) for moderate versus low/high intakes), meat: 2.04 (1.17–3.55) and fish: 0.59 (0.36–0.95), both for the highest versus the lowest quintile.Conclusions:The tMED was not significantly associated with HF risk, but low meat, high fish and moderate alcohol intake were inversely associated with HF risk in our non-Mediterranean population. Minor dietary changes could be valuable primary prevention measures, particularly the increase of fish consumption while reducing the intake of meat.

The association between nut consumption and the risk of total and ischemic stroke in a German cohort study

Background/Objectives:Nuts have beneficial effects on coronary heart disease and many cardiovascular risk factors. However, their effect on stroke is less established, and no studies on the topic are available in Northern and Central European populations. Therefore, we aimed at investigating the association between nut consumption and the risk of stroke in a German population.Subjects/Methods:We used data from a prospective cohort of 26 285 participants of the European Prospective Investigation into the Cancer and Nutrition Potsdam Study. During a median follow-up time of 8.3 years (interquartile range: 7.5–9.2), 288 incident cases of stroke occurred. Nut consumption (standard portion size of 50 g) was assessed at baseline with a semiquantitative food-frequency questionnaire.Results:The median nut intake was 0.82 g per day, interquartile range: 0.41–4.11. In the multivariable model, an increased risk of stroke was observed among participants who never consumed nuts (hazard ratio (HR): 1.56, 95% confidence interval: 1.17–2.08), compared with those consuming <½ portion/week. However, there was no evidence of a dose–response relationship between nut consumption and stroke. Compared with those who consumed <½ portion/week, the multivariable HR for total stroke was 1.06 (0.75–1.52) among those who consumed ½ to 1 portion/week and 1.37 (0.92–2.05) for those who consumed >1 portion/week. Similar nonsignificant associations were observed in stratified analysis for gender, or for fatal and nonfatal stroke.Conclusions:We could not observe an association between nut consumption and the risk of developing stroke (fatal/nonfatal) in a population with low habitual nut consumption.

Fibroblast Growth Factor-23 and Risks of Cardiovascular and Noncardiovascular Diseases: A Meta-Analysis

Background Fibroblast growth factor-23 (FGF-23) has been hypothesized to play a role in the increased risk of cardiovascular disease in patients with CKD.Methods We identified prospective studies reporting associations between FGF-23 concentration and risk of cardiovascular events. Maximally adjusted risk ratios (RRs) were extracted for each outcome and scaled to a comparison of the top versus bottom third of the baseline FGF-23 concentration, and the results aggregated.Results Depending on the assay used, median FGF-23 concentrations were 43-74 RU/ml and 38-47 pg/ml in 17 general population cohorts; 102-392 RU/ml in nine cohorts of patients with CKD not requiring dialysis; and 79-4212 RU/ml and 2526-5555 pg/ml in eight cohorts of patients on dialysis. Overall, comparing participants in the top and bottom FGF-23 concentration thirds, the summary RRs (95% confidence intervals [95% CIs]) were 1.33 (1.12 to 1.58) for myocardial infarction, 1.26 (1.13 to 1.41) for stroke, 1.48 (1.29 to 1.69) for heart failure, 1.42 (1.27 to 1.60) for cardiovascular mortality, and 1.70 (1.52 to 1.91) for all-cause mortality. The summary RR for noncardiovascular mortality, calculated indirectly, was 1.52 (95% CI, 1.28 to 1.79). When studies were ordered by average differences in FGF-23 concentration between the top and bottom thirds, there was no trend in RRs across the studies.Conclusions The similarly-sized associations between increased FGF-23 concentration and cardiovascular (atherosclerotic and nonatherosclerotic) and noncardiovascular outcomes, together with the absence of any exposure-response relationship, suggest that the relationship between FGF-23 and cardiovascular disease risk may be noncausal.

Associated factors of estimated desaturase activity in the EPIC-Potsdam study

BACKGROUND AND AIMS Altered activity of desaturase enzymes may be involved in the development of metabolic diseases like type 2-diabetes. Desaturase activities might be modifiable by diet and lifestyle-related factors, but no study has systematically investigated such factors so far. We aimed to evaluate the association of demographic, anthropometric, dietary and lifestyle characteristics with estimated Δ5-, Δ6- and Δ9-desaturase activity. METHODS AND RESULTS A subsample (n = 1782) of the EPIC-Potsdam study was used for a cross-sectional analysis, involving men and women, mainly aged 35-65 years. Fatty acid (FA) product-to-precursor ratios, derived from the FA composition of erythrocyte membrane phospholipids, were used to estimate desaturase activities. Multiple linear regression models were used with estimated Δ5-, Δ6- and Δ9-desaturase activity as outcome and demographic (age, sex), anthropometric (BMI, WHR), dietary intake (FAs, carbohydrates) and lifestyle (physical activity, smoking, alcohol consumption) factors as exposure variables. Alcohol intake was positively associated with estimated Δ6- (explained variance in desaturase activity: 1.52%) and estimated Δ9-desaturase activity (explained variance: 5.53%). BMI and WHR showed a weak inverse association with estimated Δ5-desaturase activity (explained variance: BMI: 1.07%; WHR: 1.02%) and weak positive associations with estimated Δ6-(explained variance: BMI: 1.17%; WHR: 1.19%) and estimated Δ9-desaturase activities (explained variance: BMI: 0.70%; WHR: 0.96%). Age, sex, physical activity, smoking and dietary factors were only weakly associated with the estimated desaturase activities. CONCLUSION Our findings suggest that alcohol intake as well as obesity measures are associated with the FA ratios reflecting desaturase activity.

The Role of Dark Chocolate on Inflammation: A Bitter Taste for a Better Life

Chocolate research has received much attention over the past years, in particular as far as the role of dark chocolate on inflammation is concerned. Inflammation – here defined as the complex biological response of vascular tissues to harmful stimuli – is sustained by several mediators involved in the regulation of vascular changes and inflammatory cell recruitment. All such mediators can be inhibited by dark chocolate.

The Role of Dark Chocolate on Inflammation

Chocolate research has received much attention over the past years, in particular as far as the role of dark chocolate on inflammation is concerned. Inflammation – here defined as the complex biological response of vascular tissues to harmful stimuli – is sustained by several mediators involved in the regulation of vascular changes and inflammatory cell recruitment. All such mediators can be inhibited by dark chocolate.

Chapter 27 – The Role of Dark Chocolate on Inflammation: A Bitter Taste for a Better Life

Chocolate research has received much attention over the past years, in particular as far as the role of dark chocolate on inflammation is concerned. Inflammation – here defined as the complex biological response of vascular tissues to harmful stimuli – is sustained by several mediators involved in the regulation of vascular changes and inflammatory cell recruitment. All such mediators can be inhibited by dark chocolate.