Effects of the Modified DASH Diet on Adults With Elevated Blood Pressure or Hypertension: A Systematic Review and Meta-Analysis

Background: The modified Dietary Approaches to Stop Hypertension (DASH) diet was a potentially effective treatment for pre-hypertensive and hypertensive patients. The evidence for the effect of the modified DASH diet on blood pressure reduction was inconsistent. The study was designed to assess the effects of the modified DASH diet on blood pressure (BP) in hypertensive and pre-hypertensive adults.Methods: We searched Medline, Embase, CENTRAL, CNKI, VIP, Wanfang Data, SINOMED, Google Scholar, the World Health Organization's International Clinical Trials Registry Platform, and Clinicaltrials.gov from inception to July 1st, 2021. Randomized controlled trials (RCTs) assessing the effects of the modified DASH diet on systolic and diastolic BP, cardiovascular risk factors (body weight, body mass index, waist circumference, fasting glucose, blood lipids), cardiovascular events, and all-cause mortality were included. Statistical analysis was performed using Stata software. Risk of bias was assessed with the Cochrane tool and quality of evidence with GRADE.Results: A total of 10 RCTs were included. Compared with control diet, the modified DASH diet could reduce mean systolic (−3.26 mmHg; 95% confidence interval −5.58, −0.94 mmHg; P = 0.006) and diastolic (−2.07 mmHg; 95% confidence interval −3.68, −0.46 mmHg; P = 0.01) BP. Compared with the controlling diet, the modified DASH diet could reduce systolic BP to a greater extent in trials with a mean baseline BP ≥ 140/90 mmHg compared with <140/90 mmHg. Diastolic BP reduction was greater when the mean body mass index was ≥30 kg/m2 than <30 kg/m2. Diastolic BP reduction was more marked in trials with a follow-up time of >8 weeks compared with ≤8 weeks. The modified DASH diet could affect mean waist circumference (difference: 1.57 cm; 95% confidence interval −2.98, −0.15) and triglyceride concentration (difference: 1.04 mol/L; 95% confidence interval −1.47, −0.60).Conclusions: The modified DASH diet can reduce BP, waist circumference, and triglyceride concentration in hypertension patients. A higher baseline BP is associated with more marked systolic and diastolic BP reduction.Systematic Review Registration: PROSPERO registration number: CRD42020190860.

1 Prospective associations of aerobic fitness and lipoprotein subclasses in a cohort of norwegian schoolchildren: the active smarter kids (ASK) study

AimAerobic fitness is associated with cardiometabolic risk factors in children. Associations with traditional measures of lipid metabolism are uncertain. We investigated whether higher levels of fitness benefit lipid metabolism by exploring cross-sectional and prospective associations between aerobic fitness and a comprehensive lipoprotein profile.MethodsWe used targeted proton nuclear magnetic resonance (1H NMR) spectroscopy to profile 29 measures of lipoprotein metabolism for 811 fifth-grade Norwegian schoolchildren (50.1% girls; mean age 10.2 years). Serum samples were taken on two occasions across the academic year. Aerobic fitness was measured at baseline using the Andersen aerobic fitness test. We used multiple linear regression adjusted for potential confounders to examine both cross-sectional and prospective — adjusted for baseline lipoprotein measure — associations between aerobic fitness and lipoprotein profiles.ResultsHigher levels of aerobic fitness were associated with all measures of lipoprotein metabolism in the cross-sectional analysis. There were inverse associations with the apolipoprotein B-containing (apo B) lipoprotein subclasses, including cholesterol and triglyceride concentration. The associations between aerobic fitness and the concentration of high-density lipoprotein (HDL) particles were divergent between larger and smaller subclasses. In the prospective analysis, the inverse associations between aerobic fitness and the measures of larger apo B-containing lipoprotein subclasses persisted as did all but one of the associations with triglyceride concentrations. Additional adjustment for adiposity attenuated most associations in both cross-sectional and prospective models, but an independent effect of fitness remained for certain measures.ConclusionsHigher levels of aerobic fitness are associated with a favourable lipoprotein profile, partly independent of adiposity. Associations tended to be stronger and more consistent over time for the larger apo B-containing lipoprotein measures and those of triglyceride concentration. Our results suggest that improving children’s fitness levels should have beneficial effects on lipoprotein metabolism, though a concomitant reduction in adiposity would likely be more effective.ReferencesAnderssen SA, Cooper AR, Riddoch C, Sardinha LB, Harro M, Brage S, et al. Low cardiorespiratory fitness is a strong predictor for clustering of cardiovascular disease risk factors in children independent of country, age and sex. Eur J Cardiovasc Prev Rehabil 2007.Mintjens S, Menting MD, Daams JG, van Poppel MNM, Roseboom TJ, Gemke RJBJ. Cardiorespiratory fitness in childhood and adolescence affects future cardiovascular risk factors: a systematic review of longitudinal studies. Sports Med 2018 Nov 1;48(11):2577–605.

Association of muscle mass and fat mass on low-density-lipoprotein cholesterol and triglyceride plasma concentration in children and adolescents

Objectives Obesity has often been associated with high low-density-lipoprotein cholesterol (LDL-C) and triglyceride plasma concentrations, known risk factors for diabetes mellitus and cardiovascular disease. Study objective was to evaluate the association of LDL-C and triglyceride plasma concentration with muscle and fat mass in children and adolescents. Methods We analyzed data of the National Health and Nutrition Examination Survey (1999–2004) to estimate lean muscle and fat mass assessed by dual-energy X-ray absorptiometry (DXA) of participants whose lipid profiles had been examined. Fat mass was operationalized by DXA-determined fat mass index (FMI). Muscle mass was assessed by appendicular lean mass index (aLMI). High LDL-C and triglyceride concentration was defined as above 130 mg/dL. Results For the evaluation of the association of LDL-C and triglyceride plasma concentration with LMI and FMI Z-scores, the data of 2,487 children and adolescents (age 8–19 years) (984 females) were eligible. High aLMI showed no association with LDL-C or triglyceride concentration, but high FMI showed significant association with LDL-C and triglyceride plasma concentration in the bivariate regression analysis. Conclusions Isolated muscle mass increase may not be protective against high LDL-C and triglycerides plasma levels in children and adolescents. Thus, exercise may lead to risk factor reduction mainly through fat mass reduction.

Changes in lipid-synthesizing function of the liver in congenital cytomegalovirus infection in death newborns

Aim. To assess the change in the lipid-synthesizing function of the liver in congenital cytomegalovirus infection (CMVI) in dead newborns.Materials and methods. The study of the lipid spectrum of umbilical cord blood in the first minutes of life was carried out in 59 full-term newborns with antenatal ontogenesis, unburdened and burdened with congenital CMVI. The first group consisted of 25 newborns of early neonatal age (control group) from mothers without moderate and severe obstetric and somatic pathology, as well as respiratory viral diseases and sexually transmitted infections. The second group included 18 children of the same age (comparison group), whose mothers suffered exacerbation of CMVI in the second trimester of pregnancy, which did not lead to antenatal viral aggression. The third group was represented by 16 newborns with congenital CMVI. The life expectancy of children was 2-5 days. In the first group, the main cause of death of children was prolonged ante- and intranatal hypoxia, atelectasis and hyaline membranes of the lungs, in the second group – prolonged antenatal hypoxia, intranatal hypoxia and atelectatic, hyaline and edematous-hemorrhagic pneumopathies, and in the third group – congenital CMVI, which manifested itself as cerebral ischemia of moderate and severe degree, meningoencephalitis, ventriculomegaly, pseudocysts of the vascular plexus and subarachnoid hemorrhages, monocytosis, vesiculopustulosis, hepatitis and pneumonia. In the blood serum from the umbilical vein during biochemical analysis, the concentration (mmol/L) of total cholesterol, high-density lipoproteins, low-density lipoproteins and triglycerides was estimated.Results. In newborns of the second group in the blood serum from the umbilical cord vein, the concentration of total cholesterol was 1.90±0.04 mmol/L, high-density lipoproteins – 1.49±0.06 mmol/L, low-density lipoproteins - 0.26±0,02 mmol/L and triglycerides – 0.49±0.03 mmol/L (in the first group, respectively, 1.93±0.06 mmol/L, p>0.05; 1.37±0.06 mmol/L, p>0.05; 0.43±0.02 mmol/L, p<0.001; 0.45±0.02 mmol/L, p>0.05). In the third group, compared with the second one, there was a decrease in the level of total cholesterol to 1.79±0.04 mmol/L (p<0.05) and high-density lipoproteins – to 1.28±0.06 (p><0.05) against the background of an increase in triglyceride concentration up to 0.59±0.03 mmol/L (p><0.05). Conclusion. The above changes in the lipid-synthesizing function of the liver indicate a direct and indirect effect of congenital CMVI on the morphological structure of hepatocytes and the activity of enzyme systems. Key words: full-term newborns, congenital cytomegalovirus infection, total cholesterol, high-density lipoproteins, lowdensity lipoproteins, triglyceride>˂ 0.05) and high-density lipoproteins – to 1.28±0.06 (p<0.05) against the background of an increase in triglyceride concentration up to 0.59±0.03 mmol/L (p><0.05). Conclusion. The above changes in the lipid-synthesizing function of the liver indicate a direct and indirect effect of congenital CMVI on the morphological structure of hepatocytes and the activity of enzyme systems. Key words: full-term newborns, congenital cytomegalovirus infection, total cholesterol, high-density lipoproteins, lowdensity lipoproteins, triglycerides>˂ 0.05) against the background of an increase in triglyceride concentration up to 0.59±0.03 mmol/L (p˂ 0.05).Conclusion. The above changes in the lipid-synthesizing function of the liver indicate a direct and indirect effect of congenital CMVI on the morphological structure of hepatocytes and the activity of enzyme systems.

The Safety of Continuous Infusion Propofol in Mechanically Ventilated Adults With Coronavirus Disease 2019

Background: Propofol is commonly used to achieve ventilator synchrony in critically ill patients with coronavirus disease 2019 (COVID-19), yet its safety in this patient population is unknown. Objective: To evaluate the safety, in particular the incidence of hypertriglyceridemia, of continuous infusion propofol in patients with COVID-19. Methods: This was a retrospective study at 1 academic medical center and 1 affiliated teaching hospital in New York City. Adult, critically ill patients with COVID-19 who received continuous infusion propofol were included. Patients who received propofol for <12 hours, were transferred from an outside hospital while on mechanical ventilation, or did not have a triglyceride concentration obtained during the infusion were excluded. Results: A total of 252 patients were included. Hypertriglyceridemia (serum triglyceride concentration ≥ 400 mg/dL) occurred in 38.9% of patients after a median cumulative dose of 4307 mg (interquartile range [IQR], 2448-9431 mg). The median time to triglyceride elevation was 3.8 days (IQR, 1.9-9.1 days). In the multivariable regression analysis, obese patients had a significantly greater odds of hypertriglyceridemia (odds ratio = 1.87; 95% CI = 1.10, 3.21). There was no occurrence of acute pancreatitis. The incidence of possible propofol-related infusion syndrome was 3.2%. Conclusion and Relevance: Hypertriglyceridemia occurred frequently in patients with COVID-19 who received propofol but did not lead to acute pancreatitis. Elevated triglyceride concentrations occurred more often and at lower cumulative doses than previously reported in patients without COVID-19. Application of these data may aid in optimal monitoring for serious adverse effects of propofol in patients with COVID-19.

PERBEDAAN KADAR TRIGLISERIDA ANTARA ANGGOTA SENAM BODY LANGUAGE DENGAN ANGGOTA SENAM HIGH IMPACT SETELAH PEMBERIAN ASUPAN MAKANAN YANG SEBELUMNYA MELAKUKAN SENAM BODY LANGUAGE DAN SENAM HIGH IMPACT

The majority of studies have found that aerobic exercise can reduce the increment of triglyceride postprandial in plasma. Therefore, the author is doing this research to know the difference of triglyceride concentration in plasma between-group who joint high impact exercise and group who joint body language exercise after given the same amount and dietary composition which had done high impact and body language exercise before. Twenty men (19-39 years old) did high impact or body language exercises for 1 hour. Two hours later, they were given dietary composition with carbohydrates 60% and fat 25%. Then the triglyceride postprandial concentrations were measured 3, 5, and 6 hours after the given dietary food. The result showed that the triglyceride concentration of high impact group was higher than body language group 3 hours after given dietary food (122.167 ± 17.11627 vs 111.67± 7.86554 mg/dL) and there was no difference between the high impact and body language group 5 hours (96.167 ± 7.25029 vs 94.0 ± 16.66133mg/dL) and 6 hours after given dietary food (77.5 ± 8.8261 vs 78.167 ± 14.27469 mg/dL).In conclusion, the triglyceride concentration of the high impact group was higher than the body language group 3 hours after given the same amount and dietary composition. But, there was no difference between triglycerides concentration of body language group and high impact group 5 and 6 hours after given the same amount and dietary composition which had done high impact and body language exercise before.

The Influence of Caffeine and Genistein Ingestion on Plasma Triglycerides Status in Male Soccer Players

Background Scientific literature provides more and more information on compounds supporting fat metabolism. More research is needed to fully characterize the effects of compounds that increase concentration triglycerides. The aim of our study was to test the influence of caffeine and genistein consumption on triglyceride status in athletes.Methods Fourteen Polish adult sub-elite soccer players (23.1 ± 2.1 years; 179.6 ± 8.5 cm; 74.1 ± 8.5 kg; 12.4 ± 3.8% body fat) were accepted for research. The athletes for this randomized, double-blind study were joining fasted. After consuming a standardized milk meal, participants took caffeine (400 mg), genistein (120 mg), or placebo (400 mg of vitamin C). Athletes ate the compound if it saw a sequentially increase and decrease in triglyceride concentration after eating the test meal. Participants had their glucose levels measured every 15 minutes with a glucometer (Accu-Chek Active) and their triglyceride levels with CardioChek PA. The subject was terminating the study when he had sequentially increased and decreased triglyceride concentration after the compound. If no such reaction occurred, measurements were taken for up to 90 minutes. In order to determine statistically significant differences between the variables, non-parametric Kruskal-Wallis and U Mann-Whitney tests were used. The significance level of α = 0.05 was adopted for both of these tests. The relationships between the variables were determined using the Spearman R correlation. The correlations were statistically significant at p ≤ 0.100.Results A statistically significant difference was demonstrated between the initial and maximum triglyceride concentration after caffeine consumption compared to placebo (p = 0.049). After consuming caffeine, the athletes had a significant difference in trigliceride concentration at 30 min (p = 0.018) and 60 min (p = 0.036) compared to placebo. In the group taking genistein, only a statistically significant difference was noticed compared to placebo only in 60 min (p = 0.029).Conclusion Our research results show that after acute caffeine and genistein supplementation, triglyceride concentration increase in soccer players.

Study on Correlation between Lipid Accumulation Product and Thyroid Stimulating Hormone Levels in Hypothyroidism

Introduction:Cardiovascular Disease (CVD) is one of the established causes of mortality and morbidity in hypothyroid patients. A predictor of cardiovascular risk in hypothyroid patients becomes essential to prevent the occurrence of cardiac event. One such prognosticator of CVD is the Lipid Accumulation Product (LAP). Aim: To compare the trend of LAP scores in hypothyroid patients with that of healthy controls. Materials and Methods: After obtaining approval from the Ethics Committee, this cross-sectional study was conducted. After obtaining written informed consent, details such as age, gender, waist circumference, serum Thyroid Stimulating Hormone (TSH), and serum triglyceride levels were collected.LAP was calculated among study participants as follows: LAP for men={Waist circumference (cm)-65}×{Triglyceride concentration (mmol/L)}.LAP for women={Waist circumference (cm)-58}×{Triglyceride concentration (mmol/L)}. Statistical analysis was performed with Microsoft excel and Statistical Package for the Social Sciences (SPSS) software version 24.0 for Windows. Results: The total number of participants were 118 among which 59 (50%) were hypothyroid cases and 59 (50%) were healthy controls. The two groups had statistically significant difference in their LAP scores. The mean LAP score among cases and controls was 38.6±15.6 cm.mmol/L and 30.9±13.2 cm.mmol/L, respectively with a p-value of 0.004. The LAP scores showed positive correlation with TSH levels with r-value of 0.784 and p-value <0.001 by Pearson’s correlation. Conclusion: The study concludes that there is a significant correlation between LAP score and TSH levels and LAP scores are significantly higher in hypothyroid patients.

Clinical Characteristics, Residual Beta-Cell Function and Pancreatic Auto-Antibodies in Thai people with Long-Standing Type 1 Diabetes Mellitus

Objectives. To describe the characteristics of long-standing T1DM in Thai patients and assess residual beta-cell function with status of pancreatic autoantibodies. Methodology. This is a cross-sectional study of Thai subjects with T1DM and disease duration ≥25 years seen at the Theptarin Hospital. Random plasma C-peptide and pancreatic auto-antibodies (Anti-GAD, Anti-IA2, and Anti-ZnT8) were measured. Patients who developed complications were compared with those who remained free of complications. Results. A total of 20 patients (males 65%, mean age 49.4±12.0 years, BMI 22.5±3.1 kg/m2, A1C 7.9±1.6%) with diabetes duration of 31.9±5.1 years were studied. Half of the participants remained free from any diabetic complications while the proportions reporting retinopathy, nephropathy, and neuropathy were 40%, 30%, and 15%, respectively. HDL cholesterol was significantly higher and triglyceride concentration significantly lower in patients who were free from diabetic nephropathy but not in those who were free from other complications. The prevalence rates of anti-GAD, anti-IA2, and anti-ZnT8 were 65%, 20%, and 10%, respectively. None of the patients who tested negative for both anti-GAD and anti-IA2 was positive for anti-ZnT8. Residual beta-cell function based on detectable random plasma C-peptide (≥0.1 ng/mL) and MMTT was found in only 3 patients (15%). There was no relationship between residual beta-cell function and protective effects of diabetic complications. Conclusion. Endogenous insulin secretion persists in some patients with long-standing T1DM and half of longstanding T1DM in Thai patients showed no diabetic complications. HDL cholesterol was significantly higher and triglyceride concentration significantly lower in patients who were free from diabetic nephropathy.