scholarly journals Association between plant-based diets and blood pressure in the INTERMAP study

2020 ◽  
pp. bmjnph-2020-000077
Author(s):  
Ghadeer Aljuraiban ◽  
Queenie Chan ◽  
Rachel Gibson ◽  
Jeremiah Stamler ◽  
Martha L Daviglus ◽  
...  

BackgroundPlant-based diets are associated with a lower risk of cardiovascular diseases; however, little is known how the healthiness of the diet may be associated with blood pressure (BP). We aimed to modify three plant -based diet indices: overall plant-based diet index (PDI), healthy PDI (hPDI), and unhealthy PDI (uPDI) according to country-specific dietary guidelines to enable use across populations with diverse dietary patterns – and assessed their associations with BP.DesignWe used cross-sectional data including 4,680 men and women ages 40–59y in Japan, China, the United Kingdom, and the United States from the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP). During four visits, eight BP measurements, and four 24-h dietary recalls were collected. Multivariable regression coefficients were estimated, pooled, weighted, and adjusted extensively for lifestyle/dietary confounders.ResultsModified PDI was not associated with BP. Consumption of hPDI higher by 1SD was inversely associated with systolic (-0.82 mm Hg;95% CI:-1.32,-0.49) and diastolic BP (-0.49 mm Hg; 95% CI:-0.91, -0.28). In contrast, consumption of an uPDI was directly associated with systolic (0.77 mm Hg;95% CI:0.30,1.20). Significant associations between hPDI with BP were attenuated with separate adjustment for vegetables and whole grains; associations between uPDI and BP were attenuated after adjustment for refined grains, sugar-sweetened beverages, and meat.ConclusionAn hPDI is associated with lower BP while a uPDI is adversely related to BP. Plant-based diets rich in vegetables and whole grains and limited in refined grains, sugar-sweetened beverages, and total meat may contribute to these associations. In addition to current guidelines, the nutritional quality of consumed plant foods is as important as limiting animal-based components.Trial registration numberThe observational INTERMAP study was registered at www.clinicaltrials.gov as NCT00005271.

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Jaya Khushalani ◽  
Frederick Cudhea ◽  
Donatus Ekwueme ◽  
Diane Harris ◽  
Dariush Mozaffarian ◽  
...  

Abstract Objectives Suboptimal diet has been estimated as a major preventable cost of cancer. We aimed to quantify the 5-year direct medical costs for the estimated proportion of cancers attributed to suboptimal consumption of 7 dietary factors (fruits, vegetables, whole grains, processed meats, red meats, sodium, and sugar-sweetened beverages) among US adults. Methods A Comparative Risk Assessment model was used to estimate the population attributable fractions (PAFs) for each diet-cancer pair and joint PAFs for 15 cancers. A Markov cohort model with Monte Carlo simulations was used to compute 5-year cancer costs attributable to suboptimal diet using PAFs, phase-specific costs of cancer care, and probability of death. Data inputs include national dietary data from the 2011–14 National Health and Nutrition Examination Survey (NHANES), optimal intake from the Global Burden of Disease (GBD) estimates, cancer incidence and survival from the Surveillance, Epidemiology, and End Results (SEER) program, and phase-specific costs of cancer care and projections from published literature. Results The estimated 5-year direct medical cost of 15 cancers attributed to 7 dietary factors was $4.5 billion (95% uncertainty interval [UI]: $4.3-$4.8). Largest costs (82%) were from colorectal cancer ($2.8 billion, 95% UI: $2.6-$3.0), and due to consumption of insufficient whole grains ($1.9 billion, 95% UI: $1.7-$2.1) and excess processed meat ($1.1 billion, 95% UI: $1.0-$1.3). Total estimated 5-year direct medical costs for cancer attributable to other dietary factors included $0.8 and $0.5 billion for insufficient vegetable and fruit consumption, respectively and $0.4, $0.2 and $0.2 billion for high intake of red meat, sodium and sugar-sweetened beverages, respectively. Conclusions These novel findings highlight the opportunity to reduce cancer and associated costs via nutritional policies for the primary prevention of cancer. The results can also inform and serve as inputs for economic evaluation and design and testing of diet-related interventions to prevent cancer in the U.S. Funding Sources None. Supporting Tables, Images and/or Graphs


2021 ◽  
pp. e1-e11
Author(s):  
Lu Wang ◽  
Mengxi Du ◽  
Frederick Cudhea ◽  
Christina Griecci ◽  
Dominique S. Michaud ◽  
...  

Objectives. To quantify disparities in health and economic burdens of cancer attributable to suboptimal diet among US adults. Methods. Using a probabilistic cohort state-transition model, we estimated the number of new cancer cases and cancer deaths, and economic costs of 15 diet-related cancers attributable to suboptimal intake of 7 dietary factors (a low intake of fruits, vegetables, dairy, and whole grains and a high intake of red and processed meats and sugar-sweetened beverages) among a closed cohort of US adults starting in 2017. Results. Suboptimal diet was estimated to contribute to 3.04 (95% uncertainty interval [UI] = 2.88, 3.20) million new cancer cases, 1.74 (95% UI = 1.65, 1.84) million cancer deaths, and $254 (95% UI = $242, $267) billion economic costs among US adults aged 20 years or older over a lifetime. Diet-attributable cancer burdens were higher among younger adults, men, non-Hispanic Blacks, and individuals with lower education and income attainments than other population subgroups. The largest disparities were for cancers attributable to high consumption of sugar-sweetened beverages and low consumption of whole grains. Conclusions. Suboptimal diet contributes to substantial disparities in health and economic burdens of cancer among young adults, men, racial/ethnic minorities, and socioeconomically disadvantaged groups. (Am J Public Health. Published online ahead of print October 14, 2021:e1–e11. https://doi.org/10.2105/AJPH.2021.306475 )


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Fayrouz Sakr Ashour ◽  
Edwina Wambogo ◽  
Nadine Sahyoun

Abstract Objectives 1) Examine diet quality of OAANSP meals, 2) examine diet quality of complementary food consumed in addition to the CM/HDM meal, and 3) examine diet quality of daily intake by individuals who did versus did not consume a CM/HDM meal. Background: Older adults are becoming a larger proportion of the US population, a phenomenon that will continue over the next few decades. Congregate (CM) and home-delivered meals (HDM) of the Older Americans Act Nutrition Program (OAANP) have beneficial effects on the lives of older adults. Yet, data demonstrating value remains relatively limited, arguably leading to underfunding. Methods Data from the Administration for Community Living (ACL) Outcomes Evaluation Study was collected using a multistage clustered sample design. Data collection tools comprised a survey (including information on respondent's sociodemographics, health status, self-reported weight and height, social relationships, dietary self-reliance, participation in other nutrition assistance programs, and food security) and two 24-hour recalls. HEI-2010 was used to calculate individual and mean scores using the simple HEI scoring algorithm and the population ratio method, respectively. Radar plots were used to visualize HEI comparisons, and multiple logistic regression models were built to examine associations between diet quality and OAANSP. Results OAANSP participation was associated with HEI (P < 0.0001 and P = 0.04 for CM and HDM, respectively) and so was number of meals/day (P = 0.007 and P = 0.03 for CM and HDM, respectively). Compared to the complementary diet, OAANSP meals had better scores for total vegetables (P < 0.0001), and greens and beans (P < 0.001). The complementing diet quality for CM participants had better scores than the meal for total fruit, whole grains, seafood and plant proteins; and whole grains for HDM participant. Meals and complementing foods exceeded the dietary guidelines for sodium, refined grains, saturated fat, added sugar and total protein. HDM participants’ mean HEI score was lower on no meal-day compared to meal-day (P < 0.0001). Conclusions CM/HDM meals may need to be revised, especially for sodium, added sugar and refined grains. Adding another meal daily and expanding nutrition education may be important for a healthier diet. Funding Sources None.


Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2233
Author(s):  
Xuxiu Zhuang ◽  
Yang Liu ◽  
Joel Gittelsohn ◽  
Emma Lewis ◽  
Shenzhi Song ◽  
...  

(1) Background: The present study aimed to investigate the association between home-related factors, community environmental factors, and sugar-sweetened beverages (SSBs) intake among Northeastern Chinese children. (2) Methods: Cross-sectional. Children with complete data were included in the analysis (n = 901). A questionnaire modified according to BEVQ-15 measured the intake of SSBs. Logistic regression was applied to determine the factors associated with the consumption of SSBs. IBM SPSS Statistics 23.0 was applied to perform all statistical analyses. (3) Results: The mean total amount of SSBs consumed on a weekly basis was 2214.04 ± 2188.62 mL. Children’s weekly pocket money, frequency of SSBs purchase, SSBs availability at home, the number of accessible supermarkets, and frequency of weekly visits to convenience stores were all found to be associated with a high intake of SSBs among all children. Among children of normal weight, the findings indicated that weekly pocket money, SSBs availability at home, and number of accessible supermarkets were associated with a high SSBs intake. At the same time, frequency of SSBs purchase, mother’s SSBs intake, and frequency of weekly visits to convenience stores were associated with a high SSBs intake among children with obesity. (4) Conclusions: Given the potential negative health effects of high SSBs intake, it is crucial to pay attention to home-related factors and community environment.


2014 ◽  
Vol 113 (9) ◽  
pp. 1574-1580 ◽  
Author(s):  
Aaqib Habib Malik ◽  
Yasir Akram ◽  
Suchith Shetty ◽  
Senada Senda Malik ◽  
Valentine Yanchou Njike

2021 ◽  
pp. 1-9
Author(s):  
Thanh-Huyen T Vu ◽  
Linda Van Horn ◽  
Martha L Daviglus ◽  
Queenie Chan ◽  
Alan R Dyer ◽  
...  

Abstract Objectives: To investigate associations of egg intake with blood pressure (BP) and the role of dietary variables and other macro- and micro-nutrients in the association. Design: We used cross-sectional data for the USA as part of the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP). INTERMAP was surveyed between 1996 and 1999, including four 24-h dietary recalls, two 24-h urine collections and eight measurements of systolic BP and diastolic BP (SBP, DBP). Average egg intake (g/d) was calculated. Multivariable linear regression models were used to estimate the association between egg intake (per each 50 g/d or per quintile) and BP. The roles of dietary variables and other macro- and micro-nutrients in this association were also investigated. Setting: In the USA. Participants: In total, 2195 US INTERMAP men and women aged 40–59 years. Results: Participants were 50 % female, 54 % non-Hispanic White and 16 % non-Hispanic Black. Mean egg intake (sd) in men and women was 30·4(29·8) and 21·6(20·5) g/d, respectively. Adjusting for demographics, socio-economics, lifestyle and urinary Na:K excretion ratios, we found non-linear associations with BP in non-obese women (P-quadratic terms: 0·004 for SBP and 0·035 for DBP).The associations remained after adjusting for dietary variables, macro/micro nutrients or minerals. Dietary cholesterol was highly correlated with egg intake and may factor in the association. No association was found in obese women and in obese or non-obese men. Conclusion: Egg intake was non-linearly associated with SBP and DBP in non-obese women, but not in obese women or men. Underlying mechanisms require additional study regarding the role of obesity and sex.


2011 ◽  
Vol 14 (2) ◽  
Author(s):  
Grace Lordan ◽  
John Quiggin

The idea of using 'fat taxes’ to curb obesity rates has been raised by many. In particular, the idea of taxing sugar-sweetened beverages (SSBs) has received considerable attention in the United States and has recently been discussed by President Obama. Rather less attention has been given to the alternative of 'thin subsidies’, that is, subsidies for the consumption of foods or beverages likely to be associated with reduced incidence of obesity. This commentary examines the case for a subsidy for artificially sweetened beverages (ASBs) or 'diet soft drinks’. In this commentary, we outline the evidence on the relationship between health outcomes, most notably obesity, and the consumption of SSBs and ASBs. In the light of the evidence we consider the economic effects of taxing SSBs, and the way in which those effects would be modified by the adoption of the alternative 'thin subsidy’ based on subsidising ASBs.


Nutrients ◽  
2018 ◽  
Vol 10 (10) ◽  
pp. 1350 ◽  
Author(s):  
Marika Dello Russo ◽  
Wolfgang Ahrens ◽  
Stefaan De Henauw ◽  
Gabriele Eiben ◽  
Antje Hebestreit ◽  
...  

Sugar, particularly as free sugars or sugar-sweetened beverages, significantly contributes to total energy intake, and, possibly, to increased body weight. Excessive consumption may be considered as a proxy of poor diet quality. However, no previous studies evaluated the association between the habit of adding sugars to “healthy” foods, such as plain milk and fresh fruit, and indicators of adiposity and/or dietary quality in children. To answer to these research questions, we Panalysed the European cohort of children participating in the IDEFICS study. Anthropometric variables, frequency of consumption of sugars added to milk and fruit (SAMF), and scores of adherence to healthy dietary pattern (HDAS) were assessed at baseline in 9829 children stratified according to age and sex. From this cohort, 6929 children were investigated again after two years follow-up. At baseline, a direct association between SAMF categories and adiposity indexes was observed only in children aged 6–<10 years, while the lower frequency of SAMF consumption was significantly associated with a higher HDAS. At the two year follow-up, children with higher baseline SAMF consumption showed significantly higher increases in all the anthropometric variables measured, with the exception of girls 6–<10 years old. The inverse association between SAMF categories and HDAS was still present at the two years follow-up in all age and sex groups. Our results suggest that the habit to adding sugars to foods that are commonly perceived as healthy may impact the adherence to healthy dietary guidelines and increase in adiposity risk as well.


Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Josiemer Mattei ◽  
Vasanti Malik ◽  
Frank B Hu ◽  
Hannia Campos

Introduction: Consumption of sugar sweetened beverages (SSB) has been consistently associated with metabolic syndrome (MetS), while results on the role of fruit juice intake are conflicting. Hispanics consume both SSB and traditional fruit-based beverages; however, studies conducted on such ethnic group are scarce. Given the high prevalence of MetS among Hispanics, describing putative contributors to this condition is essential in proposing approaches that may successfully reduce its prevalence and avoid further complications. Hypothesis: We assessed the hypothesis that substituting fruit-based beverages traditionally consumed by Hispanics for SSB may be associated with lower odds of MetS. Methods: To determine the cross-sectional association between beverages consumed by Hispanics, and MetS and its components, data were analyzed in 1,872 Costa Rican adults who served as controls of a population-based case-control study of coronary heart disease. Multivariate adjusted means were calculated for components of MetS by servings (never, <1/week, 2–6/week, ≥1/day) of two traditional fruit-based beverages (‘fresco’ and homemade fruit juice, separately) and two SSB (instant drinks and regular sodas, separately and combined). Prevalence ratio (PR) of MetS was calculated for each beverage, and odds ratio (OR) was calculated by substituting one serving of homemade fruit juice or water for one of SSB. Results: Significant positive trends were observed for increasing servings of instant drinks and combined SSB with plasma triglyceride and waist circumference, and for regular soda with waist circumference (all P -trend<0.001). Increasing servings of homemade fruit juice were associated positively with HDL-C ( P -trend=0.033). Consuming ≥1 serving/day of instant drinks was associated with higher PR of MetS (1.42, 95%CI: 1.11, 1.83) compared to no consumption; similar results were obtained for combined SSB. Substituting one serving of homemade fruit juice for instant drink was associated with 29% (95% CI=7, 47%) lower odds of MetS, and for regular soda with 30% (1, 50%) lower odds. Substituting water for combined SSB was marginally significant (OR=0.86 (0.74, 1.00). Conclusion: In conclusion, reducing consumption of SSB and substituting them with homemade fruit juices in moderation, may be a culturally-appropriate approach to lower metabolic syndrome among Hispanics. Our study provides the groundwork for interventions on beverage intake that aim to prevent MetS and type 2 diabetes in Hispanic ethnic subgroups, and may support current public health efforts on limiting availability and intake of SSB, while substituting with a healthy beverage.


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