scholarly journals Diet and physical activity in pregnancy and offspring’s cardiovascular health: a systematic review

2018 ◽  
Vol 10 (3) ◽  
pp. 286-298 ◽  
Author(s):  
T. M. van Elten ◽  
M. D. A. Karsten ◽  
M. N. M. van Poppel ◽  
A. Geelen ◽  
J. Limpens ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Blood Pressure ◽  
Cardiovascular Health ◽  
Data Extraction ◽  
Maternal Diet ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Core Outcome Sets ◽  
Diet And Physical Activity

AbstractThere is increasing evidence linking maternal diet and physical activity before and during pregnancy with offspring’s cardiovascular health. Although many studies examined this association, the evidence has not been reviewed systematically. We therefore undertook a systematic review to synthesize evidence examining the association of maternal diet and physical activity before and during pregnancy with offspring’s blood pressure and vascular health. We systematically searched the databases MEDLINE and EMBASE from inception to June 30, 2017. Eligibility screening, data extraction and quality assessment were performed by two independent reviewers. A total of 19 articles were included comprising three randomized controlled trials and 16 observational studies. Of the studies that examined the association of interest, 60% (three out of five studies) showed that high maternal carbohydrate intake was associated with higher offspring’s blood pressure. Maternal protein intake during pregnancy was negatively associated with offspring carotid intima-media thickness in two out of two studies. No consistent findings for maternal fatty acid intake were found. There were too few studies to draw conclusions on energy intake, fibre intake, protein/carbohydrate ratio, specific foods, dietary patterns and maternal physical activity. Heterogeneity in exposure and outcome assessment hampered pooling. Also, owing to the observational nature of most studies, causality cannot be established. Harmonization of valid exposure and outcome measurements, and the development of core outcome sets are needed to enable more robust conclusions.

scholarly journals Poor cardiovascular health is associated with subclinical atherosclerosis in apparently healthy sub-Saharan African populations: an H3Africa AWI-Gen study

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Engelbert A. Nonterah ◽  
◽  
Nigel J. Crowther ◽  
Abraham Oduro ◽  
Godfred Agongo ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
South Africa ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Cardiovascular Health ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Sub Saharan

Abstract Background The cardiovascular health index (CVHI) introduced by the American Heart Association is a valid, accessible, simple, and translatable metric for monitoring cardiovascular health in a population. Components of the CVHI include the following seven cardiovascular risk factors (often captured as life’s simple 7): smoking, dietary intake, physical activity, body mass index, blood pressure, glucose, and total cholesterol. We sought to expand the evidence for its utility to under-studied populations in sub-Saharan Africa, by determining its association with common carotid intima-media thickness (CIMT). Methods We conducted a cross-sectional study involving 9011 participants drawn from Burkina Faso, Ghana, Kenya, and South Africa. We assessed established classical cardiovascular risk factors and measured carotid intima-media thickness of the left and right common carotid arteries using B-mode ultrasonography. Adjusted multilevel mixed-effect linear regression was used to determine the association of CVHI with common CIMT. In the combined population, an individual participant data meta-analyses random-effects was used to conduct pooled comparative sub-group analyses for differences between countries, sex, and socio-economic status. Results The mean age of the study population was 51 ± 7 years and 51% were women, with a mean common CIMT of 637 ± 117 μm and CVHI score of 10.3 ± 2.0. Inverse associations were found between CVHI and common CIMT (β-coefficients [95% confidence interval]: Burkina Faso, − 6.51 [− 9.83, − 3.20] μm; Ghana, − 5.42 [− 8.90, − 1.95]; Kenya, − 6.58 [− 9.05, − 4.10]; and South Africa, − 7.85 [− 9.65, − 6.05]). Inverse relations were observed for women (− 4.44 [− 6.23, − 2.65]) and men (− 6.27 [− 7.91, − 4.64]) in the pooled sample. Smoking (p < 0.001), physical activity (p < 0.001), and hyperglycemia (p < 0.001) were related to CIMT in women only, while blood pressure and obesity were related to CIMT in both women and men (p < 0.001). Conclusion This large pan-African population study demonstrates that CVHI is a strong marker of subclinical atherosclerosis, measured by common CIMT and importantly demonstrates that primary prevention of atherosclerotic cardiovascular disease in this understudied population should target physical activity, smoking, obesity, hypertension, and hyperglycemia.

scholarly journals Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Lijun Zhang ◽  
Yangyang Wang ◽  
Lianlian Xiong ◽  
Yanfang Luo ◽  
Zhijun Huang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Exercise Therapy ◽  
Cardiovascular Health ◽  
Data Extraction ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Cochrane Library ◽  
Healthy Population ◽  
Short Term

Abstract Background Patients with chronic kidney disease (CKD) have a high prevalence of cardiovascular diseases, which often lead to physical inactivity that correlates with CKD exacerbation. The benefits of regular exercise to cardiovascular health have been well established in healthy population and highly suggestive in patients with CKD. To further strengthen the evidence base for the management of CKD, this meta-analysis was performed to systematically evaluate the effects of exercise therapy on renal function, blood pressure, blood lipid and body mass index (BMI) in non-dialysis CKD patients. Methods This meta-analysis was conducted following a previous protocol. Randomized controlled trials (RCTs) examining the effects of exercise therapy in non-dialysis CKD patients were searched in Pubmed, Embase, Cochrane Library, and three major Chinese biomedical databases (CNKI, WANGFANG and VIP) from their start date to October 30th, 2018. The Cochrane systematic review methods were applied for quality assessment and data extraction, and Revman version 5.3 was used for systematic review and meta-analysis. Results 13 RCTs, representing 421 patients with non-dialysis CKD, were included in this meta-analysis. Compared to the controls, exercise therapy brought an increase in eGFR (MD = 2.62, 95% CI:0.42 to 4.82, P = 0.02, I2 = 22%), and decreases in systolic blood pressure (SBP) (MD = -5.61, 95% CI:-8.99 to − 2.23, P = 0.001, I2 = 44%), diastolic blood pressure (DBP) (MD = -2.87, 95% CI:-3.65 to − 2.08, P < 0.00001, I2 = 16%) and BMI (MD = -1.32, 95% CI:-2.39 to − 0.25, P = 0.02, I2 = 0%) in non-dialysis CKD patients. Exercise therapy of short-term (< 3 months) decreased triglyceride (TG) level (P = 0.0006). However, exercise therapy did not significantly affect serum creatinine (SCr), total cholesterol (TC), high density lipoprotein (HDL) or low density lipoprotein (LDL) in non-dialysis CKD patients. Conclusion Exercise therapy could benefit non-dialysis CKD patients by increasing eGFR while reducing SBP, DBP and BMI. Additionally, short-term intervention of exercise could decrease TG.

Interventions improving health professionals’ practice for addressing patients’ weight management behaviours: systematic review of reviews

2020 ◽  
Author(s):  
Bahareh Yazdizadeh ◽  
Ruth Walker ◽  
Helen Skouteris ◽  
Ellinor K Olander ◽  
Briony Hill
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Systematic Reviews ◽  
Health Professionals ◽  
Data Extraction ◽  
System Level ◽  
Training Interventions ◽  
Cochrane Database ◽  
Physical Activity Advice ◽  
Diet And Physical Activity

Abstract Health professionals require education and training to implement obesity management guidelines and ultimately impact on the health outcomes experienced by their patients. Therefore, a systematic review of systematic reviews that evaluated interventions designed to change the practice of health professionals when addressing diet and physical activity with their patients was conducted. MEDLINE Complete; Cochrane database of systematic reviews; PsycINFO; CINAHL Complete; Global Health; Embase; INFORMIT: Health Subset; Health System Evidence and RX for change were searched in March 2019, with no date or language limits. Identified references underwent screening, full-text analyses and data extraction in duplicate. The search identified 15 230 references. Five systematic reviews that provided a narrative syntheses of a combined 38 studies were included. Health professional participants generally reported being satisfied with the training interventions. Heterogeneity between and within included reviews, non-controlled designs of individual studies and low quality of evidence at an individual study level and review level made it difficult to draw firm conclusions regarding what interventions are most effective in changing health professionals’ knowledge, skills, self-efficacy, attitudes and practice. However, similar gaps in the literature were identified across included reviews. Key areas that could be addressed in future interventions including organization and system-level barriers to providing advice, health professionals’ attitudes and motivation and weight stigma have been highlighted. Health professionals and patients could be more involved in the planning and development of interventions that work towards improving diet and physical activity advice and support provided in healthcare.

Abstract MP21: Achieving Cardiovascular Health in Young Adulthood - Do Adolescent Factors Matter?

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Holly C Gooding ◽  
Carly Milliren ◽  
Christina M Shay ◽  
Tracy K Richmond ◽  
Alison E Field ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Young Adults ◽  
Blood Glucose ◽  
Young Adult ◽  
Young Adulthood ◽  
Cardiovascular Health ◽  
Fasting Blood Glucose ◽  
Healthy Weight ◽  
Diet And Physical Activity

Introduction: Adults who reach middle age with optimal levels of three physiologic factors – blood pressure, cholesterol, and blood glucose – have lower rates of CVD mortality compared to those with one or more of these risk factors in the non-optimal range. The American Heart Association has identified four healthy lifestyle components – BMI, smoking, diet, and physical activity – important for preserving optimal cardiovascular health as people age. However, which lifestyle components in adolescence are most strongly associated with physiologic markers of cardiovascular health in adulthood is unclear. The purpose of this study was to quantify associations between lifestyle components measured in adolescence and optimal physiologic cardiovascular health in young adulthood. Methods: Analyses included 9,697 young adults, age 24-32 years in 2007-2008, who participated in Wave IV of the National Longitudinal Study of Adolescent Health. We defined optimal physiologic cardiovascular heath as untreated blood pressure <120/80 mmHg, untreated fasting blood glucose <100 mg/dL and hemoglobin A1C < 5.7%, untreated total cholesterol in the bottom 7 (women) or 6 (men) deciles for the study population, and absence of diabetes or CVD as measured at Wave IV. We used logistic regression models to estimate the odds of having optimal physiologic cardiovascular health in young adulthood according to BMI category, smoking status, and physical activity patterns measured during Waves I and II when participants were ages 11-20 years. Dietary data were not available. Models were adjusted for age, sex, race, educational attainment, and income in young adulthood. Results: Few young adults (16%, 1,592 of 9,697) had optimal physiologic cardiovascular health. Young adults who had been normal-weighted in adolescence were more likely to have optimal physiologic cardiovascular health (18.4%, 1,382 of 7,206) compared to those who had been overweight (9.4%, 142 of 1,429) or obese (6.9%, 68 of 1,062). In models adjusted for young adult sociodemographic factors, participants who had been overweight or obese as adolescents were less than half as likely as those who had been normal-weighted to have optimal physiologic cardiovascular health in young adulthood (overweight odds ratio (OR) 0.43, 95% confidence interval (CI) 0.35-0.61; obese OR 0.40, 95% CI 0.28-0.57). Adolescent tobacco smoking and physical activity were not associated with young adult cardiovascular health. Conclusions: Maintaining a healthy weight in adolescence may be the most important lifestyle factor for reaching young adulthood with optimal physiologic cardiovascular health. Overweight and obese adolescents should be encouraged to achieve a healthy weight through adherence to diet and physical activity goals.

The association between aortic arterial stiffness, carotid intima-media thickness and carotid plaques in community-dwelling older adults: A population-based study

Vascular ◽  
2020 ◽  
Vol 28 (4) ◽  
pp. 405-412
Author(s):  
Oscar H Del Brutto ◽  
Victor J Del Brutto ◽  
Robertino M Mera ◽  
Aldo F Costa ◽  
Rubén Peñaherrera ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Blood Pressure ◽  
Arterial Stiffness ◽  
High Blood Pressure ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Multivariate Models ◽  
Carotid Plaques ◽  
Independent Association

Objective Information on the associations among arterial stiffness, carotid intima-media thickness (cIMT) and carotid plaques as biomarkers of atherosclerosis is limited in diverse populations. We aimed to assess whether aortic pulse wave velocity (aPWV) – as a surrogate of arterial stiffness – is associated with increased cIMT and the presence of carotid plaques in a cohort of older adults of Amerindian ancestry. Methods Atahualpa residents aged ≥60 years ( n = 320) underwent aPWV determinations, and carotid ultrasounds for cIMT and plaque assessment. Multivariate models were fitted to assess the independent association between the aPWV, and cIMT and carotid plaques, after adjusting for relevant confounders. Differences in risk factors across these biomarkers were investigated. Results Mean values of aPWV were 10.3 ± 1.8 m/s, and those of cIMT were 0.91 ± 0.21 mm (24% had a cIMT >1 mm). Carotid plaques were observed in 118 (37%) subjects. In univariate analyses, risk factors associated with an increased aPWV included age, female gender, poor physical activity and high blood pressure. An increased cIMT was associated with age, male gender, a poor diet, high blood pressure and severe tooth loss. The presence of carotid plaques was associated with increasing age, poor physical activity and high blood pressure. Multivariate models showed a significant association between aPWV and cIMT (β: 0.028; 95% C.I.: 0.001–0.056; p =  0.047) but not between aPWV and carotid plaques (OR: 1.14; 95% C.I.: 0.83–1.56; p =  0.423). Conclusions This study shows an independent association between aPWV and cIMT but not with carotid plaques. These biomarkers may indicate distinct phenotypes for atherosclerosis.

The association between blood pressure and carotid intima-media thickness in children: a systematic review

2017 ◽  
Vol 27 (7) ◽  
pp. 1295-1305 ◽  
Author(s):  
Thomas G. Day ◽  
MinHae Park ◽  
Sanjay Kinra
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Young People ◽  
High Blood Pressure ◽  
Meta Analysis ◽  
Positive Association ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Children And Young People ◽  
Media Thickness

AbstractHigh blood pressure is a risk factor for atherosclerosis in adults, but whether the same is true in children and young people is not known. This is important to guide management of high blood pressure in children and young people. We aimed to investigate the association in children and young people between blood pressure and carotid intima-media thickness, a non-invasive marker of atherosclerosis, through a systematic review. Studies were retrieved from MEDLINE and EMBASE. Articles were eligible for inclusion if they included at least one measurement of blood pressure and at least one measurement of ultrasound-derived carotid intima-media thickness, both measured during childhood (0–19 years), and a measure of effect size or correlation between the two measurements. A total of 3748 studies were identified in the initial search, of which 28 studies were included in this review. The results were mixed, but the largest and highest-quality studies suggested an independent positive association between blood pressure and carotid intima-media thickness in children and young people, even after adjustment for other cardiovascular risk factors. There was no indication of a clear threshold level for the effect of blood pressure on carotid intima-media thickness, hence there are insufficient data to support a pharmacological treatment threshold for the treatment of high blood pressure in children and young people to prevent future cardiovascular disease. The studies included varied widely in terms of quality and design, and it was not possible to combine the data in a meta-analysis. There is likely to be an independent association between blood pressure and carotid intima-media thickness in childhood, but it is not clear at what point this should be treated.

Abstract WP173: The Association Between Aortic Arterial Stiffness, Carotid Intima-Media Thickness and Carotid Plaques in Community-Dwelling Older Adults. A Population-Based Study (the Atahualpa Project)

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Victor J Del Brutto ◽  
Oscar H Del Brutto ◽  
Robertino M Mera ◽  
Mark J Sedler ◽  
Aldo F Costa ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Blood Pressure ◽  
Older Adults ◽  
Arterial Stiffness ◽  
High Blood Pressure ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Carotid Plaques ◽  
Independent Association

Background: Information on the associations among arterial stiffness, carotid intima-media thickness (cIMT) and carotid plaques as biomarkers of atherosclerosis is limited. We aimed to assess whether aortic pulse wave velocity (PWV) - as a surrogate of arterial stiffness - is associated with increased cIMT and the presence of carotid plaques in a cohort of older adults of Amerindian ancestry. Methods: Atahualpa residents aged ≥60 years (n=320) underwent aortic PWV determinations, and carotid ultrasound for cIMT and plaque assessment. Multivariate models were fitted to assess the independent association between the aortic PWV, and cIMT and carotid plaques (as dependent variables), after adjusting for relevant confounders. Differences in risk factors across these biomarkers were investigated. Results: Mean values of aortic PWV were 10.3±1.8 m/s, and those of cIMT were 0.91±0.21 mm (24% had a cIMT >1 mm). Carotid plaques were observed in 118 (37%) subjects. In univariate analyses, risk factors associated with an increased aortic PWV included age, female gender, poor physical activity and high blood pressure. An increased cIMT was associated with age, male gender, poor diet, high blood pressure and severe edentulism. The presence of carotid plaques was associated with increasing age, poor physical activity and high blood pressure. A fully-adjusted generalized linear model showed a significant association between aortic PWV and cIMT (β: 0.028; 95% C.I.: 0.001 - 0.056; p =0.047). In contrast, a logistic regression model showed no association between aortic PWV and carotid plaques (OR: 1.14; 95% C.I.: 0.83 - 1.56; p =0.423), after adjusting for relevant confounders. Conclusions: This study shows an independent association between aortic PWV and cIMT but not with carotid plaques. These biomarkers may indicate distinct phenotypes for atherosclerosis.

Application of the Measurement of Carotid Intima-Media Thickness for Prediction of the Essential Hypertension in Children

2018 ◽  
Vol 69 (6) ◽  
pp. 1550-1553
Author(s):  
Rosana Manea ◽  
Bianca Elena Popovici ◽  
Carmen Daniela Neculoiu ◽  
Dan Minea ◽  
Alina Calin
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Carotid Artery ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Diagnostic Methods ◽  
Control Group ◽  
Study Group ◽  
Media Thickness ◽  
Hypertension In Children

Hypertension is a major risk factor for progression of the atherosclerotic process and for developing of degenerative cardiovascular diseases in adulthood. The aim of this study is to evaluate how the measurement of carotid intima - media thickness for prediction of essential hypertension in children can be used.The study group included 81 children and the control group 61 children, all aged between 5 - 17 years and 11 months old, and admitted in Children Hospital Brasov in the period of 2009 � 2014. The study protocol included: BMI, blood pressure and Doppler echography of the common carotid artery for each group. Mean age of the patients from the study group was 13.67 years, 43.20 % girls and 56.80 % boys, while in the control group, the mean age was 14.07 years, 54.10% girls and 45.90 % boys. 70.37% of the children from the study group presented obesity, while in the control group 40.98% were obese. The IMTC study group ranged from 0.52 - 0.69 mm and the limits of the normotensive subjects were 0.32 -0.54 mm. In both groups the obese patients were found to have increased carotid artery intima-media, which means that IMTC was positively correlated with BMI (p=0.000001).It is necessary to identify diagnostic methods easily applicable for children, allowing involvement of the characteristics of the arterial wall in the degenerative pathological processes. Increased intima-media ratio is positively correlated with high values of blood pressure.

scholarly journals Evaluation of the effectiveness of behavioural economic incentive programmes for the promotion of a healthy diet and physical activity: a protocol for a systematic review and network meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e046035
Author(s):  
Suparee Boonmanunt ◽  
Oraluck Pattanaprateep ◽  
Boonsong Ongphiphadhanakul ◽  
Gareth McKay ◽  
John Attia ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Financial Incentives ◽  
Meta Analysis ◽  
Economic Incentive ◽  
Healthy Diet ◽  
Current Evidence ◽  
Diet And Physical Activity ◽  
Behavioural Economic ◽  
Meta Analyses

IntroductionObesity and being overweight are major risk factors for metabolic syndrome and non-communicable diseases. Despite the recommendation that a healthy diet and physical activity can reduce the severity of these diseases, many fail to adhere to these measures. From a behavioural economic perspective, adherence to such measures can be encouraged through financial incentives. However, additional related behavioural economic approaches may improve the effectiveness of an incentive programme. As such, we have developed a protocol for a systematic review and network meta-analysis to summarise the current evidence from financial incentive programmes with and without behavioural economic insights for promoting healthy diet and physical activity.Methods and analysisPrevious systematic reviews, meta-analyses and individual studies were identified from Medline and Scopus in June 2020 and will be updated until December 2020. Individual studies will be selected and data extracted by two reviewers. Disagreement will be resolved by consensus or adjudicated by a third reviewer. A descriptive analysis will summarise the effectiveness of behavioural economic incentive programmes for promoting healthy diet and physical activity. Moreover, individual studies will be pooled using network meta-analyses where possible. I2 statistics and Cochran’s Q test will be used to assess heterogeneity. Risk of bias and publication bias, if appropriate, will be evaluated, as well as the overall strength of the evidence.Ethics and disseminationEthics approval for a systematic review and meta-analysis is not required. The findings will be published in a peer-reviewed journal.PROSPERO registration numberCRD42020198024.

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