Whole grain and cereal fibre intake in the Australian Health Survey: associations to CVD risk factors

2020 ◽  
Vol 23 (8) ◽  
pp. 1404-1413 ◽  
Author(s):  
Eden M Barrett ◽  
Marijka J Batterham ◽  
Eleanor J Beck
Keyword(s):  
Risk Factors ◽  
Health Survey ◽  
Fasting Glucose ◽  
Lifestyle Factors ◽  
Lipid Lowering ◽  
Whole Grain ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Fibre Intake ◽  
Australian Health

AbstractObjective:To explore associations of whole grain and cereal fibre intake to CVD risk factors in Australian adults.Design:Cross-sectional analysis. Intakes of whole grain and cereal fibre were examined in association to BMI, waist circumference (WC), blood pressure (BP), serum lipid concentrations, C-reactive protein, systolic BP, fasting glucose and HbA1c.Setting:Australian Health Survey 2011–2013.Participants:A population-representative sample of 7665 participants over 18 years old.Results:Highest whole grain consumers (T3) had lower BMI (T0 26·8 kg/m2, T3 26·0 kg/m2, P < 0·0001) and WC (T0 92·2 cm, T3 90·0 cm, P = 0·0005) compared with non-consumers (T0), although only WC remained significant after adjusting for dietary and lifestyle factors, including cereal fibre intake (P = 0·03). Whole grain intake was marginally inversely associated with fasting glucose (P = 0·048) and HbA1c (P = 0·03) after adjusting for dietary and lifestyle factors, including cereal fibre intake. Cereal fibre intake was inversely associated with BMI (P < 0·0001) and WC (P < 0·0008) and tended to be inversely associated with total cholesterol, LDL-cholesterol and apo-B concentrations, although associations were attenuated after further adjusting for BMI and lipid-lowering medication use.Conclusions:The extent to which cereal fibre is responsible for the CVD-protective associations of whole grains may vary depending on the mediators involved. Longer-term intervention studies directly comparing whole grain and non-whole grain diets of similar cereal fibre contents (such as through the use of bran or added-fibre refined grain products) are needed to confirm independent effects.

scholarly journals Whole grain intake compared with cereal fibre intake in association to CVD risk factors: a cross-sectional analysis of the National Diet and Nutrition Survey (UK)

2020 ◽  
Vol 23 (8) ◽  
pp. 1392-1403 ◽  
Author(s):  
Eden M Barrett ◽  
Birdem Amoutzopoulos ◽  
Marijka J Batterham ◽  
Sumantra Ray ◽  
Eleanor J Beck
Keyword(s):  
Risk Factors ◽  
Whole Grains ◽  
Whole Grain ◽  
C Reactive Protein ◽  
Cvd Risk Factors ◽  
Nutrition Survey ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Fibre Intake ◽  
Reactive Protein

AbstractObjective:To investigate how intakes of whole grains and cereal fibre were associated to risk factors for CVD in UK adults.Design:Cross-sectional analyses examined associations between whole grain and cereal fibre intakes and adiposity measurements, serum lipid concentrations, C-reactive protein, systolic blood pressure, fasting glucose, HbA1c, homocysteine and a combined CVD relative risk score.Setting:The National Diet and Nutrition Survey (NDNS) Rolling Programme 2008–2014.Participants:A nationally representative sample of 2689 adults.Results:Participants in the highest quartile (Q4) of whole grain intake had lower waist–hip ratio (Q1 0·872; Q4 0·857; P = 0·04), HbA1c (Q1 5·66 %; Q4 5·47 %; P = 0·01) and homocysteine (Q1 9·95 µmol/l; Q4 8·76 µmol/l; P = 0·01) compared with participants in the lowest quartile (Q1), after adjusting for dietary and lifestyle factors, including cereal fibre intake. Whole grain intake was inversely associated with C-reactive protein using multivariate analysis (P = 0·02), but this was not significant after final adjustment for cereal fibre. Cereal fibre intake was also inversely associated with waist–hip ratio (P = 0·03) and homocysteine (P = 0·002) in multivariate analysis.Conclusions:Similar inverse associations between whole grain and cereal fibre intakes to CVD risk factors suggest the relevance of cereal fibre in the protective effects of whole grains. However, whole grain associations often remained significant after adjusting for cereal fibre intake, suggesting additional constituents may be relevant. Intervention studies are needed to compare cereal fibre intake from non-whole grain sources to whole grain intake.

scholarly journals Comparing Whole Grain with Cereal Fibre – Associations to Markers of Cardiovascular Disease Risk in the UK National Diet and Nutrition Survey and the Australian Health Survey (P08-079-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Eden Barrett ◽  
Birdem Amoutzopoulos ◽  
Marijka Batterham ◽  
Sumantra Ray ◽  
Eleanor Beck
Keyword(s):  
Cardiovascular Disease ◽  
Health Survey ◽  
Whole Grains ◽  
Whole Grain ◽  
Nutrition Survey ◽  
Cvd Risk ◽  
Fibre Intake ◽  
Australian Health ◽  
Waist Hip Ratio ◽  
The Uk

Abstract Objectives Whole grain intake is associated with lower risk of cardiovascular disease (CVD) and related risk factors. Cereal fibre content of whole grains may be responsible, although it is not clear to what extent. Inconsistent definitions of whole grains used within previous studies, such as including bran as a whole grain source, confound findings and limit the ability to separate the two exposures. We compared how intakes of whole grain and cereal fibre were separately associated with markers of CVD risk in adult participants within the UK National Diet and Nutrition Survey (NDNS) and the Australian Health Survey (AHS). Methods Cross-sectional analyses of the NDNS Rolling Programme 2008–14 and the 2011–13 AHS examined associations between whole grain and cereal fibre intakes and markers of CVD risk using multivariate linear regression analysis. Whole grain was defined as containing the endosperm, germ and bran components in the expected proportions, and food composition databases were used to estimate intakes. Results Within the NDNS, participants in the highest quartile (Q4) of whole grain intake had lower waist-hip ratio (Q1 0.872; Q4 0.857; P = 0.04), HbA1c (Q1 5.66%; Q4 5.47%; P = 0.01) and homocysteine (Q1 9.95 µmol/L; Q4 8.76 µmol/L; P = 0.01) compared to participants in the lowest quartile (Q1) after adjustment for cereal fibre intake. Participants in the highest tertile of whole grain intake within the AHS had lower waist circumferences (P = 0.03), HbA1c (P = 0.03) and fasting blood glucose (P = 0.048) compared to non-whole grain consumers after adjustment for cereal fibre intake. Cereal fibre intake, when analysed separately, was inversely associated with waist-hip ratio (P = 0.03) and homocysteine (P = 0.002) in the NDNS, and BMI (P < 0.0001) and waist circumference (P = 0.0008) in the AHS. Conclusions Similar inverse associations between whole grain and cereal fibre intakes to multiple markers of CVD risk suggest cereal fibre may play a role in protective associations of whole grains. However, whole grain associations often remained significant after adjustment for cereal fibre intake, suggesting additional constituents may be relevant. Future research should ensure use of consistent definitions when examining health associations of whole grains and their specific constituents. Funding Sources Nil funding.

scholarly journals Cardiovascular risk factors and COVID-19 outcomes in hospitalised patients: a prospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e045482
Author(s):  
Didier Collard ◽  
Nick S Nurmohamed ◽  
Yannick Kaiser ◽  
Laurens F Reeskamp ◽  
Tom Dormans ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cox Regression ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Icu Admission ◽  
Lowering Therapy ◽  
Secondary Outcomes ◽  
Age And Sex

ObjectivesRecent reports suggest a high prevalence of hypertension and diabetes in COVID-19 patients, but the role of cardiovascular disease (CVD) risk factors in the clinical course of COVID-19 is unknown. We evaluated the time-to-event relationship between hypertension, dyslipidaemia, diabetes and COVID-19 outcomes.DesignWe analysed data from the prospective Dutch CovidPredict cohort, an ongoing prospective study of patients admitted for COVID-19 infection.SettingPatients from eight participating hospitals, including two university hospitals from the CovidPredict cohort were included.ParticipantsAdmitted, adult patients with a positive COVID-19 PCR or high suspicion based on CT-imaging of the thorax. Patients were followed for major outcomes during the hospitalisation. CVD risk factors were established via home medication lists and divided in antihypertensives, lipid-lowering therapy and antidiabetics.Primary and secondary outcomes measuresThe primary outcome was mortality during the first 21 days following admission, secondary outcomes consisted of intensive care unit (ICU) admission and ICU mortality. Kaplan-Meier and Cox regression analyses were used to determine the association with CVD risk factors.ResultsWe included 1604 patients with a mean age of 66±15 of whom 60.5% were men. Antihypertensives, lipid-lowering therapy and antidiabetics were used by 45%, 34.7% and 22.1% of patients. After 21-days of follow-up; 19.2% of the patients had died or were discharged for palliative care. Cox regression analysis after adjustment for age and sex showed that the presence of ≥2 risk factors was associated with increased mortality risk (HR 1.52, 95% CI 1.15 to 2.02), but not with ICU admission. Moreover, the use of ≥2 antidiabetics and ≥2 antihypertensives was associated with mortality independent of age and sex with HRs of, respectively, 2.09 (95% CI 1.55 to 2.80) and 1.46 (95% CI 1.11 to 1.91).ConclusionsThe accumulation of hypertension, dyslipidaemia and diabetes leads to a stepwise increased risk for short-term mortality in hospitalised COVID-19 patients independent of age and sex. Further studies investigating how these risk factors disproportionately affect COVID-19 patients are warranted.

Abstract P139: Association of Energy Flux with Change in Cardiovascular Risk Factors in Weight Stable Individuals

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Baqiyyah Conway ◽  
Peter Giacobbi ◽  
Clemens Drenowatz ◽  
Stephen Blair ◽  
Gregory Hand
Keyword(s):  
Risk Factors ◽  
Energy Flux ◽  
Impaired Fasting Glucose ◽  
Fasting Glucose ◽  
Exercise Group ◽  
C Reactive Protein ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Reactive Protein ◽  
Group Assignment

Background: It is generally accepted that body weight is maintained when there is energy balance between intake and expenditure. Energy balance can be achieved at different rates of expenditure through exercise and caloric intake which has been referred to as energy flux: high flux reflects high expenditure and high intake while low flux describes low energy expenditure and intake. Overweight, obesity, and diabetes are major risk factors for cardiovascular disease and CVD risk factors tend to increase with hyperglycemia and BMI. Exercise is a viable way to achieve weight maintenance, however, there is limited data about the role of energy flux on CVD risk factors when individuals maintain their body weight. We investigated the effect of energy flux and change in energy flux on CVD risk factors in when body weight is maintained. Methods: One hundred and thirteen overweight or obese class I adults ages 21 to 45 were randomized to a control group, moderate exercise (17.5 kcal/kg/week) or high exercise group (35 kcal/kg/week). The exercise groups performed supervised exercise at and intensity of 70-75% of their heart rate maximum. Impaired fasting glucose was defined as a fasting glucose of 100-125 mg/dL. General linear models were used to test the relationship of exercise intensity and impaired fasting glucose on change in energy flux from baseline to six months, as well as the relationship of 6-month change in energy flux with change in CVD risk factors, namely, HDLc, LDLc, vLDLc, total cholesterol, triglycerides, Apolipoprotein B (ApoB), and C-reactive protein. Results: Seventy-two percent of the population was overweight and 22% were obese. Mean change in energy flux from baseline to month six was 128.8 kcal/day. In multivariable analyses including age, sex, BMI, impaired fasting glucose, and energy expenditure group assignment, neither exercise group assignment nor baseline obesity status had any effect on change in energy flux, lipids, or inflammatory markers. Impaired fasting glucose was associated with a significantly greater increase in energy flux from baseline to six months (p=0.03). There was a stepwise change in C-reactive protein from baseline to six months, with a decrease (-2.46 mg/dL) in controls, a moderate increase (+0.32 mg/dL) in the moderate intensity exercise group and a larger increase (+0.82 mg/dL) in the very intensive exercise group, p= 0.03 for moderate intensity and p=0.02 for very intensive exercise groups compared to controls. Finally, increases in energy flux from baseline to six months were associated with increased ApoB (p=0.04), though there were no significant changes in energy flux by group assignment. Conclusion: Intensification of exercise and increases in energy flux while maintaining stable weight is associated with increases in certain cardiovascular risk factors, namely C-reactive protein and ApoB.

Abstract 14731: Glyc A, a Novel Marker of Inflammation, Predicts Cardiovascular Events in HIV-Positive Patients: Results of SMART Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Daniel Duprez ◽  
Jacqueline Neuhaus ◽  
James Otvos ◽  
James D Neaton ◽  
Jens D Lundgren
Keyword(s):  
Risk Factors ◽  
Acute Phase ◽  
Acute Phase Proteins ◽  
Lipid Lowering ◽  
Hiv Positive ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Hiv Patients ◽  
Smart Study ◽  
Increased Risk

Background: Cardiovascular disease (CVD) is increasing in HIV-infected patients. Glyc A is a novel nuclear magnetic resonance (NMR) spectroscopy signal in plasma arising from the glycosylation of circulating acute phase proteins. The acute phase proteins have been independently associated with CVD in HIV patients, but the association of Glyc A and CVD has not been studied. We aimed to quantify the risk of CVD associated with Glyc A at baseline in HIV-positive patients enrolled in the Strategies for Management of Anti-Retroviral Therapy (SMART) study. Methods: In a nested case-control study, Glyc A was measured using NMR at baseline in 246 HIV positive patients [median age, interquartile range (IQR): 49 (44,56) years, 81 % male], who experienced a CVD event (defined as coronary heart disease (CHD), myocardial infarction, coronary artery disease requiring revascularization, atherosclerotic non-CHD (stroke and peripheral arterial disease), congestive heart failure and CVD or unwitnessed death) over an average of 2.8 years of follow-up and 472 matched controls. Odds ratios (ORs) associated with baseline levels of Glyc A for CVD were estimated using conditional logistic regression unadjusted and after adjustment for BMI, race, HIV-RNA and antiretroviral therapy status, smoking, prior CVD, diabetes, total/high-density lipoprotein cholesterol ratio, use of blood pressure and lipid-lowering drugs, hepatitis co-infection, CD4+ and major baseline ECG abnormalities. Results: At baseline median Glyc A (IQR) was 383 (333, 442) μmol/L in patients who developed a CVD event and 368 (322, 419) μmol/L in controls (P < 0.001 for difference). The unadjusted OR for CVD (highest versus lowest quartile) was 2.18 (with 95% confidence interval (CI) 1.38-3.44, P < 0.001). After adjustment for baseline covariates and CVD risk factors, OR was 2.20 (95% CI, 1.29-3.76, P = 0.004). Conclusion: Higher levels of Glyc A are associated with increased risk of CVD in HIV patients after considering established CVD risk factors.

Abstract P370: Risk Factors for Progression of Coronary Artery Calcification in Patients with Chronic Kidney Disease

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Joshua D Bundy ◽  
Lawrence J Appel ◽  
Matthew Budoff ◽  
Jing Chen ◽  
Alan S Go ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Coronary Artery ◽  
Kidney Disease ◽  
Cystatin C ◽  
Coronary Artery Calcification ◽  
Lipid Lowering ◽  
Cvd Risk Factors ◽  
Cvd Risk

Introduction: Coronary artery calcification (CAC) is prevalent among patients with chronic kidney disease (CKD) and predicts the risk of cardiovascular disease (CVD). Risk factors for the progression of CAC in patients with CKD have not been well studied. Hypothesis: We assessed the hypothesis that several established and novel CVD risk factors are associated with progression of CAC among patients with CKD. Methods: In a random subsample of 1,123 participants from the Chronic Renal Insufficiency Cohort (CRIC) Study, CAC was measured at baseline and the follow-up visit using electron beam computed tomography (CT) or multidetector CT. CAC progression was defined as an increase of Agatston score ≥100 units during follow-up. Multiple logistic regression and mixed-effects regression models were used to assess risk factors for progression of CAC. Results: Over an average of 3-year follow-up, 332 (29.6%) participants developed CAC progression. After adjusting for age, sex, race, clinical site, total cholesterol, HDL-cholesterol, systolic blood pressure, antihypertensive treatment, diabetes, and current smoking in the multivariable models, history of CVD (odds ratio [OR] 1.53, 95% CI 1.09-2.15, p=0.02), lipid-lowering treatment (OR 1.81, 95% CI 1.28-2.55, p<0.001), higher serum phosphate (OR 1.37, 95% CI 1.17-1.61, p<0.001), hemoglobin A1c (OR 1.32, 95% CI 1.10-1.58, p=0.002), and cystatin C (OR 1.24, 95% CI 1.06-1.45, p=0.007), and lower estimated-glomerular filtration rate (eGFR) (OR 1.32, 95% CI 1.10-1.56, p=0.002) were associated with CAC progression. In addition, lower physical activity, lipid-lowering treatment, body-mass index, LDL-cholesterol, lower serum calcium, phosphate, total parathyroid hormone, fibrinogen, interleukin-6, tumor necrosis factor-α, fibroblast growth factor-23, lower eGFR, cystatin C, and 24-hour urine albumin were associated with square root transformed change in CAC score from baseline in multiple-adjusted models. These findings persisted after additional adjustment for baseline CAC score. Conclusions: In conclusion, these data suggest that reduced kidney function, calcium and phosphate metabolic disorders and inflammation, in addition to established CVD risk factors, might play a role in CAC progression among patients with CKD.

scholarly journals Associations of obesity with modifiable risk factors for the development of cardiovascular disease in patients with rheumatoid arthritis

2008 ◽  
Vol 68 (2) ◽  
pp. 242-245 ◽  
Author(s):  
A Stavropoulos-Kalinoglou ◽  
G S Metsios ◽  
V F Panoulas ◽  
K M J Douglas ◽  
A M Nevill ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Insulin Resistance ◽  
Cardiovascular Disease ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
The Metabolic Syndrome ◽  
And Gender

Objectives:To assess the association of body mass index (BMI) with modifiable cardiovascular disease (CVD) risk factors in patients with rheumatoid arthritis (RA).Methods:BMI, disease activity, selected CVD risk factors and CVD medication were assessed in 378 (276 women) patients with RA. Patients exceeding accepted thresholds in ⩾3 CVD risk factors were classified as having the metabolic syndrome (MetS).Results:BMI independently associated with hypertension (OR = 1.28 (95% CI = 1.22 to 1.34); p = 0.001), high-density lipoprotein (OR = 1.10 (95% CI = 1.06 to 1.15); p = 0.025), insulin resistance (OR = 1.13 (95% CI = 1.08 to 1.18); p = 0.000) and MetS (OR = 1.15 (95% CI = 1.08 to 1.21); p = 0.000). In multivariable analyses, BMI had the strongest associations with CVD risk factors (F1–354 = 8.663, p = 0.000), and this was followed by lipid-lowering treatment (F1–354 = 7.651, p = 0.000), age (F1–354 = 7.541, p = 0.000), antihypertensive treatment (F1–354 = 4.997, p = 0.000) and gender (F1–354 = 4.707, p = 0.000). Prevalence of hypertension (p = 0.004), insulin resistance (p = 0.005) and MetS (p = 0.000) was significantly different between patients with RA who were normal, overweight and obese, and BMI differed significantly according to the number of risk factors present (p = 0.000).Conclusions:Increasing BMI associates with increased CVD risk independently of many confounders. RA-specific BMI cut-off points better identify patients with RA at increased CVD risk. Weight-loss regimens should be developed and applied in order to reduce CVD in patients with RA.

scholarly journals Cardiovascular risk factors are independently associated with COVID-19 mortality: a prospective cohort study

2020 ◽  
Author(s):  
Didier Collard ◽  
Nick S. Nurmohamed ◽  
Yannick Kaiser ◽  
Laurens F. Reeskamp ◽  
Tom Dormans ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Lowering Therapy ◽  
High Prevalence ◽  
Secondary Outcomes ◽  
Age And Sex

AbstractObjectivesRecent reports suggest a high prevalence of hypertension and diabetes in COVID-19 patients, but the role of cardiovascular disease (CVD) risk factors in the clinical course of COVID-19 is unknown. We evaluated the time-to-event relationship between hypertension, dyslipidemia, diabetes, and COVID-19 outcomes.DesignWe analyzed data from the prospective Dutch COVID-PREDICT cohort, an ongoing prospective study of patients admitted for COVID-19 infection.SettingPatients from 8 participating hospitals, including two university hospitals from the COVID-PREDICT cohort were included.ParticipantsAdmitted, adult patients with a positive COVID-19 polymerase chain reaction (PCR) or high suspicion based on CT-imaging of the thorax. Patients were followed for major outcomes during hospitalization. CVD risk factors were established via home medication lists and divided in antihypertensives, lipid lowering therapy, and antidiabetics.Primary and secondary outcomes measuresThe primary outcome was mortality during the first 21 days following admission, secondary outcomes consisted of ICU-admission and ICU-mortality. Kaplan-Meier and Cox-regression analyses were used to determine the association with CVD risk factors.ResultsWe included 1604 patients with a mean age of 66±15 of whom 60.5% were men. Antihypertensives, lipid lowering therapy, and antidiabetics were used by 45%, 34.7%, and 22.1% of patients. After adjustment for age and sex, the presence of ≥2 risk factors was associated with increased mortality risk (HR 1.52, 95%CI 1.15-2.02), but not with ICU-admission. Moreover, the use of ≥2 antidiabetics and ≥2 antihypertensives was associated with mortality independent of age and sex with HRs of respectively 2.09 (95%CI 1.55-2.80) and 1.46 (95%CI 1.11-1.91).ConclusionsThe accumulation of hypertension, dyslipidemia and diabetes leads to a stepwise increased risk for short-term mortality in hospitalized COVID-19 patients independent of age and sex. Further studies investigating how these risk factors disproportionately affect COVID-19 patients are warranted.Strengths and limitations of this studyWhile previous data reported a high prevalence of CVD risk factors in COVID-19 patients, this study investigated whether diabetes, dyslipidemia and hypertension predict adverse outcomes.This study is limited by the use of medication as surrogate for cardiovascular risk factorsThe causality of the investigated risk factors remains to be addressed in future studies.

Defining whole-grain foods – does it change estimations of intakes and associations with CVD risk factors: an Australian and Swedish perspective

2021 ◽  
pp. 1-12
Author(s):  
Katrina R. Kissock ◽  
Eva Warensjö Lemming ◽  
Cecilia Axelsson ◽  
Elizabeth P. Neale ◽  
Eleanor J. Beck
Keyword(s):  
Risk Factors ◽  
Dry Weight ◽  
Food Composition ◽  
Whole Grain ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Anthropometric Measures ◽  
Mean Differences ◽  
The Impact ◽  
Swedish Data

Abstract Historically, there are inconsistencies in the calculation of whole-grain intake, particularly through use of highly variable whole-grain food definitions. The current study aimed to determine the impact of using a whole-grain food definition on whole-grain intake estimation in Australian and Swedish national cohorts and investigate impacts on apparent associations with CVD risk factors. This utilised the Australian National Nutrition and Physical Activity Survey 2011–2012, the Swedish Riksmaten adults 2010–2011 and relevant food composition databases. Whole-grain intakes and associations with CVD risk factors were determined based on consumption of foods complying with the Healthgrain definition (≥30 % whole grain (dry weight), more whole than refined grain and meeting accepted standards for ‘healthy foods’ based on local regulations) and compared with absolute whole-grain intake. Compliance of whole-grain containing foods with the Healthgrain definition was low in both Sweden (twenty-nine of 155 foods) and Australia (214 of 609 foods). Significant mean differences of up to 24·6 g/10 MJ per d of whole-grain intake were highlighted using Swedish data. Despite these large differences, application of a whole-grain food definition altered very few associations with CVD risk factors, specifically, changes with body weight and blood glucose associations in Australian adults where a whole-grain food definition was applied, and some anthropometric measures in Swedish data where a high percentage of whole-grain content was included. Use of whole-grain food definitions appears to have limited impact on measuring whole-grain health benefits but may have greater relevance in public health messaging.

Survey of cardiovascular disease and risk factor management in patients with rheumatoid arthritis across 5 world regions: results from the SURF-RA

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A.N.N.E Semb ◽  
E Ikdahl ◽  
J Sexton ◽  
G Kitas ◽  
P Van Riel ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Lipid Lowering ◽  
Funding Source ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
East Europe ◽  
World Regions ◽  
The Mean

Abstract Background Patients with rheumatoid arthritis (RA) are at high risk for cardiovascular disease (CVD). Purpose The aim of this survey was to evaluate updated information on CVD risk factors, comorbidities, RA disease characteristics, RA and CVD preventive medication in patient with RA. Methods The audit is termed SUrvey of cardiovascular disease Risk Factors in patients with Rheumatoid Arthritis (SURF-RA) and was performed in 53 centres/19 countries/5 world regions in 2014–2019. SURF-RA have been performed in patients with coronary heart disease, in primary care, and now in patients with stroke, SLE and antiphophlipid syndrome. The survey was approved by the Data Protection Officer (2017/7243) and a GDPR evaluation has been performed (10/10–2018). Results Among 14 503 patients with RA in West (n=8 493) and East (n=923) Europe, Latin (n=407) and North (n=4 030) America and Asia (n=650) the mean (SD) age was 59.9 (13.6) years, and 2/3 or more were female (table). RA disease duration was comparable across the world regions, ranging from 9.9 to 12.6 years. The prevalence of atherosclerotic CVD (ASCVD) was lowest in Latin America (2.5%) and highest in East Europe (21.4%), and this pattern was similar regarding familial premature CVD. The mean prevalence (% of each entity) of blood pressure above 140/90 mmHg was 5.3%, of low density lipoprotein cholesterol &gt;2.5 mmol/L: 63.3%. Overall, 29% used antihypertensive medication, lowest in West Europe (17.4%) and highest in East Europe (57.0%), and 26.4% used lipid lowering agent(s), lowest in Asia (7.2%) and highest in North America (31.1%). Body mass index &gt;30 kg/m2 was present in 26.6%, with the smallest waist circumference in Asia [mean (SD): 84.1 (13.6) cm] and highest in East Europe [92.5 (15.5) cm]. The proportion of current smokers was on average: 16.2%, lowest in Asia (7.8%) and highest in East Europe (28.5%). Conclusion The high prevalence of CVD risk factors and ASCVD in patients with RA across five world regions shows that there is still an unmet need for vigilance and improved implementation of preventive measures in this high CVD risk patient population. Funding Acknowledgement Type of funding source: Other. Main funding source(s): Lilly

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