Nutrition Metabolism and Cardiovascular Diseases最新文献

Aims: Among the risk factors leading to cardiovascular disease (CVD), hypercholesterolemia stands out as a key driver of vascular dysfunction and the development of atherosclerotic CVD. This review is aimed to highlight the emergent evidence showing that maternal supraphysiological hypercholesterolemia (MSPH) is a key risk factor for transgenerational CVD risk and to advocate for the development of strategies for the early prediction and prevention of MSPH.

Data synthesis: Increasing evidence suggests that an individual's lifetime CVD risk may be modified by in utero exposure. However, the contribution of maternal lipid levels to pregnancy has been neglected. In women, chronic hypercholesterolemia occurs during pregnancy, during which total cholesterol (TC) and low-density lipoprotein cholesterol (LDL) levels rise to meet fetal growth demands. Two patterns of increased pregnancy cholesterol levels have been described in the literature: i) those with maternal physiological hypercholesterolemia (MPH), characterized by increased TC levels at the end of gestation up to 280 mg/dl, and ii) those with MSPH, characterized by TC levels at the end of pregnancy above 280 mg/dl in combination with elevated LDL levels. This overlooked distinction is crucial considering the increased evidence linking MSPH to elevated cardiovascular risk in both mothers and offspring.

Conclusion: Available data suggest that MSPH is associated with increased CVD risk in mothers in addition to fetal atherogenesis and increased lifetime risk of CVD in offspring. The implementation of early detection and interventions to mitigate MSPH could potentially improve acute and long-term health outcomes for both mothers and babies.

Background and aims: High blood pressure (BP), a key modifiable risk factor for cardiovascular disease, often begins in childhood. While adult meta-analyses have shown consistent associations between ultra-processed food (UPF) intake and elevated BP, findings in children remain inconsistent. Given that UPFs make up majority of Canadian children's diets, we examined associations between early childhood UPF intake and BP in mid-childhood, and assessed the impact of substituting UPFs with minimally processed foods (MPF).

Methods and results: In this study, among 1408 participants from the Canadian CHILD Cohort Study, UPF, defined based on the NOVA classification system, was assessed at three years of age. BP was measured at age eight. We examined associations using multivariable-adjusted mixed-effects linear regression, evaluated substitution models to estimate the effect of replacing UPFs with MPFs, and examined body mass index (BMI) as a potential mediator. At age three, UPFs contributed 44.3% of total daily energy intake. At age eight, mean systolic and diastolic BP were 104 (SD 9) and 59 (SD 6) mmHg, respectively. Each 10% increase in UPF intake was associated with 0.31 mmHg higher diastolic BP (95% CI: 0.01, 0.61), driven by "Breads and cereals" and "Ready-to-eat/heat mixed dishes" categories. Replacing 10% of energy from UPFs with MPFs, in simulated substitution analyses, was associated with 0.45 mmHg lower diastolic BP. The associations between UPF and diastolic BP were partially mediated (∼27%) by child BMI.

Conclusions: Higher UPF intake in early childhood was statistically associated with higher diastolic blood pressure at age eight, with simulated substitution models suggesting modest reductions in diastolic blood pressure when substituting energy contributed from UPFs with MPFs. While these effect sizes are small, these findings underscore the importance of early dietary guidance and UPF reduction in pediatric preventive care.

Background and aims: Little is known about the relationships between lipoprotein subclasses and the risk of cardiovascular disease (CVD) in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD). We sought to elucidate the associations of lipoprotein subclasses with the risk of CVD in individuals with MASLD.

Methods and results: This study included 51,472 individuals with MASLD from the UK biobank. Concentrations of lipoprotein subclasses were quantified by nuclear magnetic resonance. Multivariable-adjusted Cox proportional hazards model was used to evaluate the associations between lipoprotein subclasses and the incidence/mortality of CVD. During median follow-ups of 13.3-13.5 years, 6208 incident CVD cases, 5206 coronary heart disease cases, 1270 stroke cases, and 559 CVD-related deaths were documented. Most very-low-density lipoprotein (VLDL) [hazard ratio (HR) range: 1.03-1.13; P <0.05], intermediate-density lipoprotein (HR range: 1.08-1.11; P <0.05), low-density lipoprotein (HR range: 1.05-1.11; P <0.05), very large high-density lipoprotein (HDL) particles and triglycerides in small HDL subclasses (HR range: 1.04-1.16; P <0.05) were positively associated with the risk of incident CVD, whereas other HDL particles and their subclasses were related to reduced risks of incident CVD (HR range: 0.86-0.95; P <0.05). Moreover, the association of VLDL particles with CVD strengthened as the diameter of VLDL decreased.

Conclusion: These findings suggest that associations between lipoprotein subclasses and the risk of CVD differed by particle diameter in individuals with MASLD. Integrating lipoprotein subclass assessment into clinical management and promoting subclass‑targeted lipid‑lowering strategies may strengthen CVD prevention in MASLD.

Aim: Kefir, a traditional fermented milk, is rich in probiotics including, lactic acid producing bacteria and yeasts which act as fermentation starters. Studies have suggested its metabolic health benefits, though findings remain inconsistent. This systematic review and meta-analysis evaluated the effects of kefir consumption on anthropometric measures, metabolic profile, and inflammation.

Data synthesis: A comprehensive literature search across Scopus, Embase, and PubMed (up to 25-01, 2025) identified 24 relevant interventional studies from 702 articles. Mean ± SD values were obtained for both intervention and control groups. Forest plots and sub-group analyses by kefir dosage were generated using Cochrane Program Review Manager version 5.4.

Conclusion: Kefir consumption induced a significant reduction of fasting blood glucose (MD= -8.46 mg/dL, p = 0.006), and HOMA-IR (MD= -1.71, p = 0.004). However, no significant effects were observed on anthropometric measures, lipid profile, or inflammatory markers. In conclusion, regular kefir consumption may improve blood glucose and insulin sensitivity, but further research is needed for definitive recommendations.

Background and aims: The Bariatric Surgery and LDL Cholesterol (BASALTO) randomized clinical trial reported differential LDL cholesterol responses after Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG). In this exploratory analysis of BASALTO we characterized lipidomic changes associated with both procedures and their relationship with LDL cholesterol response.

Methods and results: Plasma samples of 30 patients with obesity and high LDL cholesterol (15 RYGB, 15 SG) were analyzed using targeted mass spectrometry to quantify over 50 pre-defined lipid species at baseline, 3 months, and 12 months after surgery. At 12 months, RYGB induced consistent reductions in LDL cholesterol, whereas SG showed marked interindividual variability. Both procedures were associated with shared and procedure-specific lipidomic changes, including divergent patterns in cholesterol absorption. No significant associations between lipidomic changes and LDL cholesterol were observed after RYGB. In contrast, after SG, changes in monoacylglycerols (16:0, 20:4, 18:1) at 3 months and increases in cholestanol (pFDR = 0.039) and HexCer 18:0 (pFDR = 0.031) at 12 months were directly associated with LDL cholesterol response.

Conclusion: LDL cholesterol reduction after RYGB appears independent of shifts in selected lipids, whereas variability after SG may be partly driven by cholesterol absorption and ceramide-related pathways.

Clinical trial registration: NCT03975478.

Background and aims: The triglycerides, total cholesterol and body weight index (TCBI) is a novel nutritional marker that has shown prognostic value in various cardiovascular conditions, with low TCBI indicating poor nutritional status and being associated with adverse outcomes. However, limited data exist on the relationship between TCBI and cardiac function and outcomes in patients hospitalized with acute heart failure (AHF). This study aimed to investigate whether low TCBI is associated with impaired cardiac function and adverse outcomes in AHF.

Methods and results: We performed a post-hoc analysis of a prospective, dual-center observational cohort study of patients admitted with AHF (2022-2024). Transthoracic echocardiography, lung ultrasound and laboratory testing were performed shortly after admission. Outcomes evaluated were all-cause mortality and the composite of all-cause mortality or heart failure (HF) readmission. Unadjusted and adjusted Cox regression and Fine-Gray analyses were conducted to assess the relationship between TCBI and outcomes. The study included 487 patients, stratified into TCBI tertiles (T1: TCBI<949.6, T2: 949.6≤TCBI≤1690, T3: TCBI>1690). Low TCBI was associated with echocardiographic signs of higher filling pressures, impaired right ventricular function, higher pulmonary pressure and more B-lines on LUS. Low TCBI was associated with a higher risk of all-cause mortality compared with moderate TCBI (T1 vs T2: HR 1.54, 95 % CI [1.06-2.24], p = 0.024). Low TCBI was not independently associated with HF readmission and the composite of all-cause mortality or HF readmission.

Conclusion: Low TCBI is associated with greater signs of congestion and increased all-cause mortality risk.

Background and aim: Sarcopenia, characterized by decreased muscle mass or muscle dysfunction, is associated with cardiovascular disease and mortality. However, the mediating effect of sarcopenia on the relationship between aging or obesity (especially central obesity) and adverse outcomes remains unclear.

Methods and results: Sarcopenia was defined using functional criteria in the China Health and Retirement Longitudinal Study (CHARLS) and the English Longitudinal Study of Ageing (ELSA). In the National Health and Nutrition Examination Survey (NHANES) sarcopenia was determined using the skeletal muscle index (SMI) derived from appendicular skeletal muscle mass. A causal mediation analysis using counterfactual framework was conducted to estimate the mediating effect of sarcopenia on mortality associated with aging, obesity or central obesity. Sarcopenia was consistently associated with increased all-cause mortality, particularly among older adults. The combination of aging and sarcopenia amplified both mortality and cardiovascular disease (CVD) risks across cohorts. Sarcopenia partially meditated age-related all-cause mortality and cardiovascular outcomes by 8.67 % and 8.5 % in CHARLS (n = 9433), 8.56 % and 7.48 % in ELSA (n = 4389), 4.36 % and 3.95 % in NHANES (n = 16511), respectively. In NHANES but not other two cohorts, sarcopenia attenuated the adverse effects of obesity on mortality, and mediated the impact of central obesity on all-cause mortality. Subgroup and sensitivity analyses confirmed the robustness of these findings, showing similar mediation patterns across BMI categories or continuous exposure variables.

Conclusions: Sarcopenia partially mediates age-related mortality and cardiovascular risk, and modulates obesity-related outcomes variably across cohorts. Evidence-based sarcopenia prevention strategies may offer a promising strategy to reduce age- and obesity-associated health risks.

The integrity of the vascular endothelium is fundamental to regulating cardio-metabolic and neurological functions. Endothelial dysfunction (ED) is a key driver of atherosclerosis and is strongly linked to the pathogenesis of heart disease, peripheral arterial disease, and stroke. This review describes the relationship between dietary patterns and endothelial health, focusing on observational and experimental studies that investigate the protective effects of healthy dietary patterns in the maintenance of endothelial integrity and prevention of ED. Plant-based diets, including Mediterranean and Dietary Approaches to Stop Hypertension (DASH) dietary patterns, have been linked to improvement of endothelial function through multiple mechanisms such as increased nitric oxide bioavailability, reduced oxidative stress and inflammation, and fostering a healthy gut microbiome. Traditional Japanese, Nordic, and Palaeolithic dietary patterns also show potential cardiovascular benefits through improved vascular biomarkers and significant anti-inflammatory effects, though evidence on effects on endothelial function remains less established. The consequences of poor endothelial health extend to all systems, and the brain is one of the organs crucially affected by ED. ED has been increasingly recognised as a critical contributor to cognitive decline, dementia, and stroke, largely accounted and explained by mechanisms impairing cerebral blood flow, neuronal metabolism, neuro-vascular coupling and compromised integrity of the blood-brain barrier. This review highlights the importance of maintaining endothelial health as a protective strategy for cognitive function and reduction of dementia risk. Adherence to dietary patterns with protective effects on endothelial integrity may represent an effective strategy to promote lifelong health for both the heart and brain.

Background and aims: Whole-grain intake is critical to lower cardio-metabolic disease risk, yet global consumption remains below recommended levels. Online grocery shopping offers an opportunity to provide consumers with clearer whole-grain content information, potentially leading to healthier choices. This study assessed whether whole-grain labelling in an online shopping context could increase selection of whole-grain products and perceived healthfulness.

Methods and results: Australian adults (n = 2013) participated in an online choice experiment, where respondents were randomised to either an intervention (with colour-coded whole-grain labelling) or a control group (no labelling). All participants were shown four food categories, each with three food alternatives varying in whole-grain content. For each food category, participants were asked to select which product they would purchase and rank products from most to least healthy. Prevalence ratios for selecting the 'best choice' (i.e. highest in whole grains) and correctly ranking products healthfulness were calculated using log binomial regression. The prevalence of choosing the 'best choice' product was significant, between 1.33 (95 % CI 1.19-1.48; p < 0.001) and 1.77 (1.58-1.99; p < 0.001) times as high in the intervention group compared to the control group across food categories. The prevalence of correctly ranking product healthfulness was significantly higher in the intervention group, with prevalence ratios ranging from 1.37 (95 % CI: 1.24-1.50; p < 0.001) to 2.00 (1.81-2.22; p < 0.001) across food categories.

Conclusion: Providing whole-grain information and interpretive labelling at the online point-of-sale may increase choice of whole-grain food and enhance perceptions of healthfulness. This strategy has the potential to improve public health by increasing whole-grain consumption.