Showing papers by "Johanna M. Geleijnse published in 2010"

N-3 fatty acids and cardiovascular events after myocardial infarction.

Abstract: Background Results from prospective cohort studies and randomized, controlled trials have provided evidence of a protective effect of n−3 fatty acids against cardiovascular diseases. We examined the effect of the marine n−3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and of the plant-derived alpha-linolenic acid (ALA) on the rate of cardiovascular events among patients who have had a myocardial infarction. Methods In a multicenter, double-blind, placebo-controlled trial, we randomly assigned 4837 patients, 60 through 80 years of age (78% men), who had had a myocardial infarction and were receiving state-of-the-art antihypertensive, antithrombotic, and lipid-modifying therapy to receive for 40 months one of four trial margarines: a margarine supplemented with a combination of EPA and DHA (with a targeted additional daily intake of 400 mg of EPA–DHA), a margarine supplemented with ALA (with a targeted additional daily intake of 2 g of ALA), a margarine supplemented with EPA–DHA an...

Dietary Protein and Blood Pressure: A Systematic Review

Abstract: Background: Elevated blood pressure (BP), which is a major risk factor for cardiovascular disease, is highly prevalent worldwide. Recently, interest has grown in the role of dietary protein in human BP. We performed a systematic review of all published scientific literature on dietary protein, including protein from various sources, in relation to human BP. Methodology/Principal Findings: We performed a MEDLINE search and a manual search to identify English language studies on the association between protein and blood pressure, published before June 2010. A total of 46 papers met the inclusion criteria. Most observational studies showed no association or an inverse association between total dietary protein and BP or incident hypertension. Results of biomarker studies and randomized controlled trials indicated a beneficial effect of protein on BP. This beneficial effect may be mainly driven by plant protein, according to results in observational studies. Data on protein from specific sources (e.g. from fish, dairy, grain, soy, and nut) were scarce. There was some evidence that BP in people with elevated BP and/or older age could be more sensitive to dietary protein. Conclusions/Significance: In conclusion, evidence suggests a small beneficial effect of protein on BP, especially for plant protein. A blood pressure lowering effect of protein may have important public health implications. However, this warrants further investigation in randomized controlled trials. Furthermore, more data are needed on protein from specific sources in relation to BP, and on the protein-BP relation in population subgroups.

Effects of Happiness on All-Cause Mortality During 15 Years of Follow-Up: The Arnhem Elderly Study

Abstract: Positive psychological characteristics may be beneficial for physical health. However, prospective data on the effects of happiness on survival is scarce. In a population-based cohort study, the Arnhem Elderly Study, happiness was measured by two items, being: “I have many moments of happiness” and “I often laugh happily”. In Cox proportional hazard models, happiness was analyzed as a predictor of 15 year all-cause mortality for 861 (85%) of 1,012 elderly subjects aged 65–85 years. Results showed that happiness was inversely associated with mortality (age- and sex-adjusted hazard ratio of 0.78 for happy subjects versus unhappy subjects; 95% confidence interval 0.64–0.95, P = 0.01 for trend), but that this relationship was no longer statistically significant after adjustment for physical activity and prevalent morbidity. Thus, happiness predicts for lower mortality, which may partly be mediated by more physical activity and lower morbidity.

Raw and processed fruit and vegetable consumption and 10-year coronary heart disease incidence in a population-based cohort study in the Netherlands.

Abstract: Background - Prospective cohort studies have shown that high fruit and vegetable consumption is inversely associated with coronary heart disease (CHD). Whether food processing affects this association is unknown. Therefore, we quantified the association of fruit and vegetable consumption with 10-year CHD incidence in a population-based study in the Netherlands and the effect of processing on these associations. Methods - Prospective population-based cohort study, including 20,069 men and women aged 20 to 65 years, enrolled between 1993 and 1997 and free of cardiovascular disease at baseline. Diet was assessed using a validated 178-item food frequency questionnaire. Hazard ratios (HR) were calculated for CHD incidence using multivariable Cox proportional hazards models. Results - During a mean follow-up time of 10.5y, 245 incident cases of CHD were documented, which comprised 211 non-fatal acute myocardial infarctions and 34 fatal CHD events. The risk of CHD incidence was 34% lower for participants with a high intake of total fruit and vegetables (>475 g/d; HR: 0.66; 95% CI: 0.45–0.99) compared to participants with a low total fruit and vegetable consumption (=241 g/d). Intake of raw fruit and vegetables (>262 g/d vs =92 g/d; HR: 0.70; 95% CI: 0.47–1.04) as well as processed fruit and vegetables (>234 g/d vs =113 g/d; HR: 0.79; 95% CI: 0.54–1.16) were inversely related with CHD incidence. Conclusion - Higher consumption of fruit and vegetables, whether consumed raw or processed, may protect against CHD incidence

Marine (n-3) Fatty Acids, Fish Consumption, and the 10-Year Risk of Fatal and Nonfatal Coronary Heart Disease in a Large Population of Dutch Adults with Low Fish Intake

Abstract: We assessed the dose-response relations within a low range of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) and fish intake on fatal coronary heart disease (CHD) and nonfatal myocardial infarction (MI). In a Dutch population-based cohort study, EPA+DHA and fish intake were assessed at baseline among 21,342 participants aged 20-65 y with no history of MI or stroke. Hazard ratios were calculated with Cox proportional-hazard models. During 9-14 y of follow-up (mean 11.3 y), 647 participants (3%) died, of which 82 of CHD. Fatal CHD mainly comprised MI (64 cases). In total, 252 participants survived an MI. Median intakes in quartiles of EPA+DHA were 40, 84, 151, and 234 mg/d. Medians of fish consumption in quartiles were 1.1, 4.2, 10.7, and 17.3 g/d. Compared with the lowest quartile of EPA+DHA, participants in the top quartile had a 49% lower risk of fatal CHD (95% CI: 6-73%) and a 62% lower risk of fatal MI (95% CI: 23-81%). We observed inverse dose-response relations for EPA+DHA intake and fatal CHD (P-trend = 0.05) and fatal MI (P-trend = 0.01). Results were similar for fish consumption. Nonfatal MI was not associated with EPA+DHA or fish intake. In conclusion, in populations with a low fish consumption, EPA+DHA and fish may lower fatal CHD and MI risk in a dose-responsive manner. Low intakes of EPA+DHA or fish do not seem to protect against nonfatal MI.

Evaluation of cardiovascular risk predicted by different SCORE equations: The Netherlands as an example

Abstract: Background: In Europe, for primary prevention of cardiovascular diseases (CVD), the Systematic COronary Risk Evaluation (SCORE) risk charts for high-risk and low-risk regions (SCORE-high and SCORE-low, respectively) are used. For the Dutch ‘Clinical Practice Guideline for Cardiovascular Risk Management’ an adapted SCORE risk chart (SCORE-NL) was developed in collaboration with the SCORE group. We evaluated these three SCORE equations using Dutch risk factor and mortality data. Design: Prospective cohort study with 10-year follow-up. Methods: Baseline data were collected between 1987 and 1997 in 32 885 persons aged 37.5–62.5 years. Vital status was checked and causes of death were obtained from Statistics Netherlands. On the basis of the level of risk factors, the expected number of CVD deaths was calculated by applying the three SCORE equations and compared with the observed number. Results: The observed CVD mortality was three-fold higher in men (n=242; 1.6%) than in women (n=83; 0.5%). On the basis of SCORE-NL, 8.5% of the men and 0.8% of the women had a CVD mortality risk of 5% or more. The ratio of the observed-to-expected number of CVD deaths was 0.75 for men and 0.55 for women using SCORE-NL, 0.54 and 0.56 using SCORE-high, and 1.11 and 0.95 using SCORE-low. Conclusion: At the population level, SCORE-low predicts the number of CVD deaths well, whereas both SCORE-NL and SCORE-high overestimate the number of CVD deaths by a factor 1.5–2

Alpha-Linolenic Acid: Is It Essential to Cardiovascular Health?

Abstract: There is a large body of scientific evidence that has been confirmed in randomized controlled trials indicating a cardioprotective effect for omega-3 fatty acids from fish. For alpha-linolenic acid (ALA), which is the omega-3 fatty acid from plants, the relation to cardiovascular health is less clear. We reviewed the recent literature on dietary ALA intake, ALA tissue concentrations, and cardiovascular health in humans. Short-term trials (6–12 weeks) in generally healthy participants mostly showed no or inconsistent effects of ALA intake (1.2–3.6 g/d) on blood lipids, low-density lipoprotein oxidation, lipoprotein(a), and apolipoproteins A-I and B. Studies of ALA in relation to inflammatory markers and glucose metabolism yielded conflicting results. With regard to clinical cardiovascular outcomes, there is observational evidence for a protective effect against nonfatal myocardial infarction. However, no protective associations were observed between ALA status and risk of heart failure, atrial fibrillation, and sudden death. Findings from long-term trials of ALA supplementation are awaited to answer the question whether food-based or higher doses of ALA could be important for cardiovascular health in cardiac patients and the general population.

Suboptimal potassium intake and potential impact on population blood pressure.

Abstract: S mall reductions in blood pressure (BP) on a population level could have a substantial impact on cardiovascular disease risk. This is especially relevant considering that the majority of the population has suboptimal BP levels. Dietary sodium reduction is a clearly established lifestyle change that has great potential to improve public health. Potassium, on the contrary, received much less attention. Nevertheless, a substantial body of data shows that increasing potassium intake lowers BP. We reviewed population data on potassium intake and estimated the potential impact of increased potassium intake on population BP levels.

Lactopeptides and human blood pressure

Abstract: Purpose of review: Since the mid-1990s, a number of randomized controlled trials have been published that showed an antihypertensive effect of peptides derived from milk. Research has mainly focused on isoleucine-proline-proline and valine-proline-proline (IPP + VPP), two lactotripeptides that can inhibit the angiotensin-converting enzyme (ACE) in vitro. In Finnish and Japanese subjects with (mild) hypertension, systolic blood pressure (SBP) reductions of approximately 5 mmHg were reported during 4-12 weeks of IPP + VPP supplementation. This review was performed to summarize new data from human intervention studies. Recent findings: The effect of lactotripeptides on blood pressure has recently been examined in six double-blind, placebo-controlled trials that involved a total of 780 subjects with high-normal blood pressure or untreated hypertension from the UK and The Netherlands. Intervention periods lasted 4-8 weeks, and IPP + VPP intake ranged from 2 to 10 mg/day. Contrary to earlier trials, there was little evidence for an antihypertensive effect of IPP + VPP. Furthermore, no ACE inhibition was observed in vivo. Summary: Recent data do not support a role for lactotripeptides in blood pressure regulation. However, we cannot exclude a beneficial effect in hypertensive subjects from specific populations (e.g. Finland, Japan). Should this be confirmed, more research is needed on mechanisms other than the renin-angiotensin-aldosterone system that could be involved

Dietary protein and risk of hypertension in a Dutch older population: The Rotterdam study

Abstract: AB Background: Several observational studies suggest an inverse association of protein with blood pressure (BP). However, little is known about the role of dietary protein from specific sources in BP. Method: We examined the relation between several types of dietary protein (total, plant, animal, dairy, meat, grain, fish, soy, and nut) and incident hypertension in 2241 participants from the Rotterdam Study, aged at least 55 years, who were free of hypertension at baseline. Hazard ratios, with 95% confidence intervals (CIs), for incident hypertension during 6 years of follow-up were obtained per standard deviation (SD) of energy-adjusted intake of protein. Hazard ratios were adjusted for age, sex, body mass index (BMI), baseline systolic blood pressure (SBP) smoking, educational level, alcohol, intake of carbohydrates, other nutrients, and other types of protein (if applicable). We conducted stratified analyses by age (cut-off 70 years), sex, and BMI (cut-off 25 kg/m2). Results: The risk of hypertension in the total cohort (1113 cases) was not related to intake of total protein or types of protein (all hazard ratios ~1.00 per SD). Sex and BMI did not significantly modify the associations of dietary protein with hypertension. In 559 participants aged at least 70 years, the intake of animal protein was positively related to risk of hypertension (hazard ratio 1.37 per SD, 95% CI 1.09-1.72). For participants aged below 70 years no association was found (hazard ratio 0.92, 95% CI 0.81-1.06). Conclusion: Total dietary protein or types of protein are not related to incident hypertension in this older population. In the more aged, however, high intake of animal protein may increase the risk of hypertension, which warrants further investigation

Plasma Protein Profiling Reveals Protein Clusters Related to BMI and Insulin Levels in Middle-Aged Overweight Subjects

Abstract: Background - Biomarkers that allow detection of the onset of disease are of high interest since early detection would allow intervening with lifestyle and nutritional changes before the disease is manifested and pharmacological therapy is required. Our study aimed to improve the phenotypic characterization of overweight but apparently healthy subjects and to identify new candidate profiles for early biomarkers of obesity-related diseases such as cardiovascular disease and type 2 diabetes. Methodology/Principal Findings - In a population of 56 healthy, middle-aged overweight subjects Body Mass Index (BMI), fasting concentration of 124 plasma proteins and insulin were determined. The plasma proteins are implicated in chronic diseases, inflammation, endothelial function and metabolic signaling. Random Forest was applied to select proteins associated with BMI and plasma insulin. Subsequently, the selected proteins were analyzed by clustering methods to identify protein clusters associated with BMI and plasma insulin. Similar analyses were performed for a second population of 20 healthy, overweight older subjects to verify associations found in population I. In both populations similar clusters of proteins associated with BMI or insulin were identified. Leptin and a number of pro-inflammatory proteins, previously identified as possible biomarkers for obesity-related disease, e.g. Complement 3, C Reactive Protein, Serum Amyloid P, Vascular Endothelial Growth Factor clustered together and were positively associated with BMI and insulin. IL-3 and IL-13 clustered together with Apolipoprotein A1 and were inversely associated with BMI and might be potential new biomarkers. Conclusion/ Significance - We identified clusters of plasma proteins associated with BMI and insulin in healthy populations. These clusters included previously reported biomarkers for obesity-related disease and potential new biomarkers such as IL-3 and IL-13. These plasma protein clusters could have potential applications for improved phenotypic characterization of volunteers in nutritional intervention studies or as biomarkers in the early detection of obesity-linked disease development and progression

Association of n-3 long-chain PUFA and fish intake with depressive symptoms and low dispositional optimism in older subjects with a history of myocardial infarction.

Abstract: Individuals with CHD are at increased risk of poor mental well-being. Dietary intake of EPA and DHA, the main n-3 fatty acids from fish, may be beneficial to mental well-being. We examined the association of EPA+DHA and fish intake with mental well-being in 644 participants, aged 60-80 years, with a history of myocardial infarction. Habitual food intake was assessed with a 203-item FFQ. Depressive symptoms were assessed with the self-report geriatric depression scale, and dispositional optimism was assessed with the revised life orientation test (LOT-R) and a four-item questionnaire (4Q). In Cox-regression models modified for cross-sectional analyses, we adjusted for sex, age, energy intake, BMI, family history of depression, education, marital status, smoking, physical activity and intake of saturated fat, alcohol and fibre. Compared with the lower tertile, subjects in the higher tertile of EPA+DHA intake had a lower prevalence of depressive symptoms, but this association was not statistically significant (prevalence ratio (PR) 0.78; 95 % CI 0.50, 1.22, P-trend 0.27). The higher tertile of EPA+DHA intake was positively associated with dispositional optimism measured with the 4Q (PR 0.69; 95 % CI 0.46, 1.03, P-trend 0.05), but not according to the LOT-R. Fish intake was not related to either depressive symptoms or dispositional optimism. In conclusion, intake of EPA+DHA was positively associated with dispositional optimism assessed with the 4Q, but not with optimism assessed with the LOT-R or with depressive symptoms.

Milk and dairy consumption and incidence of cardiovascular diseases and all-cause mortality: dose-response meta-analysis of prospective

Abstract: Background: The consumption of dairy products may influence the risk of cardiovascular disease (CVD) and total mortality, but conflicting findings have been reported. Objective: The objective was to examine the associations of milk, total dairy products, and high- and low-fat dairy intakes with the risk of CVD [including coronary heart disease (CHD) and stroke] and total mortality. Design: PubMed, EMBASE, and SCOPUS were searched for articles published up to February 2010. Of .5000 titles evaluated, 17 met the inclusion criteria, all of which were original prospective cohort studies. Random-effects meta-analyses were performed with summarized dose-response data. Milk as the main dairy product was pooled in these analyses. Results: In 17 prospective studies, there were 2283 CVD, 4391 CHD, 15,554 stroke, and 23,949 mortality cases. A modest inverse association was found between milk intake and risk of overall CVD [4 studies; relative risk (RR): 0.94 per 200 mL/d; 95% CI: 0.89, 0.99]. Milk intake was not associated with risk of CHD (6 studies; RR: 1.00; 95% CI: 0.96, 1.04), stroke (6 studies; RR: 0.87; 95% CI: 0.72, 1.05), or total mortality (8 studies; RR per 200 mL/d: 0.99; 95% CI: 0.95, 1.03). Limited studies of the association of total dairy products and of total high-fat and total low-fat dairy products (per 200 g/d) with CHD showed no significant associations. Conclusion: This dose-response meta-analysis of prospective studies indicates that milk intake is not associated with total mortality but may be inversely associated with overall CVD risk; however, these findings are based on limited numbers. Am J Clin Nutr 2011;93:158‐71.