scholarly journals Definitions, regulations, and new frontiers for dietary fiber and whole grains

2020 ◽  
Vol 78 (Supplement_1) ◽  
pp. 6-12
Author(s):  
Renee Korczak ◽  
Joanne L Slavin
Keyword(s):  
Cardiovascular Disease ◽  
Cohort Studies ◽  
Dietary Fiber ◽  
Prospective Cohort ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
The United States ◽  
Whole Grains ◽  
Whole Grain ◽  
Prospective Cohort Studies

Abstract The aim of this article is to review the definitions and regulations for dietary fiber and whole grains worldwide and to discuss barriers to meeting recommended intake levels. Plant foods, such as whole grains, that are rich in dietary fiber are universally recommended in dietary guidance. Foods rich in dietary fiber are recommended for all, but dietary recommendations for whole grains and dietary fiber depend on definitions and regulations. Official recommendations for dietary fiber in the United States and Canada are denoted by dietary reference intakes (DRIs), which are developed by the Institute of Medicine. An adequate intake (AI) for dietary fiber was based on prospective cohort studies of dietary fiber intake and cardiovascular disease risk that found 14 grams of dietary fiber per 1000 kilocalories protected against cardiovascular disease (CVD). This value was used to set AIs for dietary fiber across the life cycle based on recommended calorie intakes. Actual intakes of dietary fiber are generally about half of the recommended levels. Recommendations for whole grain intake are equally challenging, as definitions for whole grain foods are needed to set recommendations. The 2005 Dietary Guidelines for Americans recommended that half of all grain servings be whole grains, but usual intakes are generally less than 1 serving per day, rather than the recommended 3 servings per day. Scientific support for whole grain recommendations is based on the same prospective cohort studies and links to CVD protection used to inform dietary fiber guidance. Thus, dietary fiber is a recommended nutrient and whole grains are a recommended dietary pattern in dietary guidance in North America and around the world. Challenges for attaining recommended intakes of dietary fiber and whole grains include low-carbohydrate diets, low-gluten diets, and public health recommendations to avoid processed foods.

scholarly journals Egg consumption and risk of cardiovascular disease: three large prospective US cohort studies, systematic review, and updated meta-analysis

BMJ ◽  
2020 ◽  
pp. m513 ◽  
Author(s):  
Jean-Philippe Drouin-Chartier ◽  
Siyu Chen ◽  
Yanping Li ◽  
Amanda L Schwab ◽  
Meir J Stampfer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Cohort Studies ◽  
Prospective Cohort ◽  
Disease Risk ◽  
Meta Analysis ◽  
Cardiovascular Disease Risk ◽  
Egg Consumption ◽  
Prospective Cohort Studies ◽  
Incident Cardiovascular Disease

Abstract Objective To evaluate the association between egg intake and cardiovascular disease risk among women and men in the United States, and to conduct a meta-analysis of prospective cohort studies. Design Prospective cohort study, and a systematic review and meta-analysis of prospective cohort studies. Setting Nurses’ Health Study (NHS, 1980-2012), NHS II (1991-2013), Health Professionals’ Follow-Up Study (HPFS, 1986-2012). Participants Cohort analyses included 83 349 women from NHS, 90 214 women from NHS II, and 42 055 men from HPFS who were free of cardiovascular disease, type 2 diabetes, and cancer at baseline. Main outcome measures Incident cardiovascular disease, which included non-fatal myocardial infarction, fatal coronary heart disease, and stroke. Results Over up to 32 years of follow-up (>5.54 million person years), 14 806 participants with incident cardiovascular disease were identified in the three cohorts. Participants with a higher egg intake had a higher body mass index, were less likely to be treated with statins, and consumed more red meats. Most people consumed between one and less than five eggs per week. In the pooled multivariable analysis, consumption of at least one egg per day was not associated with incident cardiovascular disease risk after adjustment for updated lifestyle and dietary factors associated with egg intake (hazard ratio for at least one egg per day v less than one egg per month 0.93, 95% confidence interval 0.82 to 1.05). In the updated meta-analysis of prospective cohort studies (33 risk estimates, 1 720 108 participants, 139 195 cardiovascular disease events), an increase of one egg per day was not associated with cardiovascular disease risk (pooled relative risk 0.98, 95% confidence interval 0.93 to 1.03, I 2 =62.3%). Results were similar for coronary heart disease (21 risk estimates, 1 411 261 participants, 59 713 coronary heart disease events; 0.96, 0.91 to 1.03, I 2 =38.2%), and stroke (22 risk estimates, 1 059 315 participants, 53 617 stroke events; 0.99, 0.91 to 1.07, I 2 =71.5%). In analyses stratified by geographical location (P for interaction=0.07), no association was found between egg consumption and cardiovascular disease risk among US cohorts (1.01, 0.96 to 1.06, I 2 =30.8%) or European cohorts (1.05, 0.92 to 1.19, I 2 =64.7%), but an inverse association was seen in Asian cohorts (0.92, 0.85 to 0.99, I 2 =44.8%). Conclusions Results from the three cohorts and from the updated meta-analysis show that moderate egg consumption (up to one egg per day) is not associated with cardiovascular disease risk overall, and is associated with potentially lower cardiovascular disease risk in Asian populations. Systematic review registration PROSPERO CRD42019129650.

scholarly journals Changes in Nut Consumption and Subsequent Cardiovascular Disease Risk Among US Men and Women: 3 Large Prospective Cohort Studies

2020 ◽  
Vol 9 (7) ◽  
Author(s):  
Xiaoran Liu ◽  
Marta Guasch‐Ferré ◽  
Jean‐Philippe Drouin‐Chartier ◽  
Deirdre K. Tobias ◽  
Shilpa N. Bhupathiraju ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cohort Studies ◽  
Prospective Cohort ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Men And Women ◽  
Prospective Cohort Studies ◽  
Large Prospective Cohort

scholarly journals An overview and update on the epidemiology of flavonoid intake and cardiovascular disease risk

2020 ◽  
Vol 11 (8) ◽  
pp. 6777-6806
Author(s):  
Benjamin H. Parmenter ◽  
Kevin D. Croft ◽  
Jonathan M. Hodgson ◽  
Frederik Dalgaard ◽  
Catherine P. Bondonno ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cohort Studies ◽  
Prospective Cohort ◽  
Lower Risk ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Prospective Cohort Studies ◽  
Flavonoid Intake

Higher intakes of flavonoid-rich foods are associated with a lower risk of cardiovascular disease in prospective cohort studies.

scholarly journals Whole-grain consumption and the risk of all-cause, CVD and cancer mortality: a meta-analysis of prospective cohort studies

2016 ◽  
Vol 116 (3) ◽  
pp. 514-525 ◽  
Author(s):  
Honglei Wei ◽  
Zong Gao ◽  
Rui Liang ◽  
Zengqiang Li ◽  
Hong Hao ◽  
...  
Keyword(s):  
Cohort Studies ◽  
Cancer Mortality ◽  
Prospective Cohort ◽  
Meta Analysis ◽  
Whole Grains ◽  
Whole Grain ◽  
Prospective Cohort Studies ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Cancer Specific Mortality

AbstractResults of the relationships between dietary whole-grain consumption and the risk of all-cause, CVD and cancer-specific mortality are mixed. We summarised the evidence based on a meta-analysis of prospective cohort studies. Pertinent studies were identified by searching articles in the MEDLINE and EMBASE databases up to 20 January 2016 and by reviewing the reference lists of the retrieved articles. Random-effects models were used to calculate summary relative risks (SRR) and 95 % CI. In all, eleven prospective studies (ten publications) were included in the meta-analysis. There were a total of 816 599 subjects and 89 251 cases of all-cause mortality. On the basis of the highest v. the lowest categories of intake, whole grains may be associated with a lower risk of mortality from all causes (SRR 0·87; 95 % CI 0·84, 0·90), CVD (SRR 0·81; 95 % CI 0·75, 0·89) and all cancers (SRR 0·89; 95 % CI 0·82, 0·96). For each 3 servings/d increase in whole-grain intake, there was a 19 % reduction in the risk of all-cause mortality (SRR 0·81; 95 % CI 0·76, 0·85), a 26 % reduction in CVD mortality (SRR 0·74; 95 % CI 0·66, 0·83) and a 9 % reduction in cancer mortality (SRR 0·91; 95 % CI 0·84, 0·98). The current meta-analysis provides some evidence that high intake of whole grains was inversely associated with the risk of all-cause, CVD and cancer-specific mortality. Further well-designed studies, including clinical trials and in different populations, are required to confirm our findings.

Shift work and risk of cardiovascular disease morbidity and mortality: A dose–response meta-analysis of cohort studies

2018 ◽  
Vol 25 (12) ◽  
pp. 1293-1302 ◽  
Author(s):  
Dongming Wang ◽  
Wenyu Ruan ◽  
Zhenlong Chen ◽  
Ying Peng ◽  
Wenzhen Li
Keyword(s):  
Cardiovascular Disease ◽  
Cohort Studies ◽  
Shift Work ◽  
Dose Response ◽  
Disease Risk ◽  
Meta Analysis ◽  
Cardiovascular Disease Risk ◽  
Morbidity And Mortality ◽  
Prospective Cohort Studies ◽  
Disease Mortality

Background Previous studies have suggested that shift work is associated with a higher risk of cardiovascular disease. However, the quantitative dose–response relationship between duration of shift work and cardiovascular disease risk is still unknown. We aimed to evaluate the dose–response association between duration of shift work and risk of cardiovascular disease morbidity and mortality. Design A systematic review and meta-analysis. Methods PubMed and Embase were searched from inception to 1 December 2017. Prospective cohort studies that reported the associations between duration of shift work and cardiovascular disease risk with at least three categories were included. Data were pooled by using fixed or random effect models. The continuous dose–response associations were assessed by using fixed effect restricted cubic splines with four knots. Results Five prospective cohort studies with 10 reports were included. No evidence of a curvilinear association was observed between duration of shift work and risk of cardiovascular disease, similar findings were observed in cardiovascular disease morbidity and mortality. The summary relative risk (RR) of an increase of 5 years of shift work was 1.05 (1.04–1.07) with moderate heterogeneity ( P = 0.142, I2 = 33.2%) for cardiovascular disease, 1.06 (1.04–1.08) with low heterogeneity ( P = 0.279, I2 = 21.7%) for cardiovascular disease morbidity, and 1.04 (1.02–1.06) with moderate heterogeneity ( P = 0.135, I2 = 38.5%) for cardiovascular disease mortality, respectively. Conclusions Shift work could probably increase the risk of cardiovascular disease and cardiovascular disease mortality in a dose–response way. These findings could have implications for guideline recommendations regarding the risk related to shift schedules.

scholarly journals Lessons Learned from Development of a Mobile App for Cardiovascular Health Awareness

2021 ◽  
Vol 13 (11) ◽  
pp. 5985
Author(s):  
Bryan Weichelt ◽  
Jeffrey VanWormer ◽  
Yin Xu ◽  
Chris Kadolph ◽  
Simon Lin
Keyword(s):  
Cardiovascular Disease ◽  
Health Information ◽  
Healthcare System ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
The United States ◽  
Mobile App ◽  
Lessons Learned ◽  
Health Concern ◽  
Development Processes

Cardiovascular disease (CVD) is a major public health concern in the United States. In response to the federally sponsored Million Hearts Risk Check Challenge, a team of programmers, software developers, health-information technologists, and clinicians in an integrated healthcare system in Wisconsin collaborated to develop Heart Health MobileTM (HHM), designed to improve awareness of cardiovascular disease risk and promote risk factor control among users. This paper outlines the development processes and highlights key lessons learned for mobile health applications. An agile project management methodology was used to dedicate adequate resources and employ adaptive planning and iterative development processes with a self-organized, cross-functional team. The initial HHM iOS app was developed and tested, and after additional modifications, gamified and HTML 5 versions of the app were released. The development of an iOS app is low in cost and sustainable by a healthcare system. Future app modifications to enhance data security and link self-reported cardiovascular risk assessment data to patient medical records may improve performance, patient relevance, and clinician acceptance of HHM in the primary-care setting. Legal and institutional barriers regarding the capture and analyses of protected health information must be mitigated to fully capture, analyze, and report patient health outcomes for future studies.

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