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1.
  • Griswold, Max G., et al. (författare)
  • Alcohol use and burden for 195 countries and territories, 1990-2016 : a systematic analysis for the Global Burden of Disease Study 2016
  • 2018
  • Ingår i: The Lancet. - : Elsevier. - 0140-6736 .- 1474-547X. ; 392:10152, s. 1015-1035
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. With our comprehensive approach to health accounting within the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we generated improved estimates of alcohol use and alcohol-attributable deaths and disability-adjusted life-years (DALYs) for 195 locations from 1990 to 2016, for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older.Methods: Using 694 data sources of individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use, we produced estimates of the prevalence of current drinking, abstention, the distribution of alcohol consumption among current drinkers in standard drinks daily (defined as 10 g of pure ethyl alcohol), and alcohol-attributable deaths and DALYs. We made several methodological improvements compared with previous estimates: first, we adjusted alcohol sales estimates to take into account tourist and unrecorded consumption; second, we did a new meta-analysis of relative risks for 23 health outcomes associated with alcohol use; and third, we developed a new method to quantify the level of alcohol consumption that minimises the overall risk to individual health.Findings: Globally, alcohol use was the seventh leading risk factor for both deaths and DALYs in 2016, accounting for 2.2% (95% uncertainty interval [UI] 1.5-3.0) of age-standardised female deaths and 6.8% (5.8-8.0) of age-standardised male deaths. Among the population aged 15-49 years, alcohol use was the leading risk factor globally in 2016, with 3.8% (95% UI 3.2-4-3) of female deaths and 12.2% (10.8-13-6) of male deaths attributable to alcohol use. For the population aged 15-49 years, female attributable DALYs were 2.3% (95% UI 2.0-2.6) and male attributable DALYs were 8.9% (7.8-9.9). The three leading causes of attributable deaths in this age group were tuberculosis (1.4% [95% UI 1. 0-1. 7] of total deaths), road injuries (1.2% [0.7-1.9]), and self-harm (1.1% [0.6-1.5]). For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27.1% (95% UI 21.2-33.3) of total alcohol-attributable female deaths and 18.9% (15.3-22.6) of male deaths. The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0.0-0.8) standard drinks per week.Interpretation: Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption.
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  • Feigin, Valery L, et al. (författare)
  • Global, Regional, and Country-Specific Lifetime Risks of Stroke, 1990 and 2016.
  • 2018
  • Ingår i: The New England journal of medicine. - 1533-4406 .- 0028-4793. ; 379:25, s. 2429-2437
  • Tidskriftsartikel (refereegranskat)abstract
    • The lifetime risk of stroke has been calculated in a limited number of selected populations. We sought to estimate the lifetime risk of stroke at the regional, country, and global level using data from a comprehensive study of the prevalence of major diseases.We used the Global Burden of Disease (GBD) Study 2016 estimates of stroke incidence and the competing risks of death from any cause other than stroke to calculate the cumulative lifetime risks of first stroke, ischemic stroke, or hemorrhagic stroke among adults 25 years of age or older. Estimates of the lifetime risks in the years 1990 and 2016 were compared. Countries were categorized into quintiles of the sociodemographic index (SDI) used in the GBD Study, and the risks were compared across quintiles. Comparisons were made with the use of point estimates and uncertainty intervals representing the 2.5th and 97.5th percentiles around the estimate.The estimated global lifetime risk of stroke from the age of 25 years onward was 24.9% (95% uncertainty interval, 23.5 to 26.2); the risk among men was 24.7% (95% uncertainty interval, 23.3 to 26.0), and the risk among women was 25.1% (95% uncertainty interval, 23.7 to 26.5). The risk of ischemic stroke was 18.3%, and the risk of hemorrhagic stroke was 8.2%. In high-SDI, high-middle-SDI, and low-SDI countries, the estimated lifetime risk of stroke was 23.5%, 31.1% (highest risk), and 13.2% (lowest risk), respectively; the 95% uncertainty intervals did not overlap between these categories. The highest estimated lifetime risks of stroke according to GBD region were in East Asia (38.8%), Central Europe (31.7%), and Eastern Europe (31.6%), and the lowest risk was in eastern sub-Saharan Africa (11.8%). The mean global lifetime risk of stroke increased from 22.8% in 1990 to 24.9% in 2016, a relative increase of 8.9% (95% uncertainty interval, 6.2 to 11.5); the competing risk of death from any cause other than stroke was considered in this calculation.In 2016, the global lifetime risk of stroke from the age of 25 years onward was approximately 25% among both men and women. There was geographic variation in the lifetime risk of stroke, with the highest risks in East Asia, Central Europe, and Eastern Europe. (Funded by the Bill and Melinda Gates Foundation.).
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  • Lozano, Rafael, et al. (författare)
  • Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017
  • 2018
  • Ingår i: The Lancet. - : Elsevier. - 1474-547X .- 0140-6736. ; 392:10159, s. 2091-2138
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods: We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings: The global median health-related SDG index in 2017 was 59·4 (IQR 35·4–67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6–14·0) to a high of 84·9 (83·1–86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation: The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains—curative interventions in the case of NCDs—towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions—or inaction—today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030.
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5.
  • Stanaway, Jeffrey D., et al. (författare)
  • Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017
  • 2018
  • Ingår i: The Lancet. - 1474-547X .- 0140-6736. ; 392:10159, s. 1923-1994
  • Tidskriftsartikel (refereegranskat)abstract
    • Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk-outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk-outcome pairs, and new data on risk exposure levels and risk- outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017.
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6.
  • Murray, Christopher J. L., et al. (författare)
  • Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017
  • 2018
  • Ingår i: The Lancet. - 1474-547X .- 0140-6736. ; 392:10159, s. 1995-2051
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. Methods: We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10–54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10–14 years and 50–54 years was estimated from data on fertility in women aged 15–19 years and 45–49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. Findings: From 1950 to 2017, TFRs decreased by 49·4% (95% uncertainty interval [UI] 46·4–52·0). The TFR decreased from 4·7 livebirths (4·5–4·9) to 2·4 livebirths (2·2–2·5), and the ASFR of mothers aged 10–19 years decreased from 37 livebirths (34–40) to 22 livebirths (19–24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83·8 million people per year since 1985. The global population increased by 197·2% (193·3–200·8) since 1950, from 2·6 billion (2·5–2·6) to 7·6 billion (7·4–7·9) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2·0%; this rate then remained nearly constant until 1970 and then decreased to 1·1% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2·5% in 1963 to 0·7% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2·7%. The global average age increased from 26·6 years in 1950 to 32·1 years in 2017, and the proportion of the population that is of working age (age 15–64 years) increased from 59·9% to 65·3%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1·0 livebirths (95% UI 0·9–1·2) in Cyprus to a high of 7·1 livebirths (6·8–7·4) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0·08 livebirths (0·07–0·09) in South Korea to 2·4 livebirths (2·2–2·6) in Niger, and the TFR over age 30 years (TFO30; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0·3 livebirths (0·3–0·4) in Puerto Rico to a high of 3·1 livebirths (3·0–3·2) in Niger. TFO30 was higher than TFU25 in 145 countries and territories in 2017. 33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2·0% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger. Interpretation: Population trends create demographic dividends and headwinds (ie, economic benefits and detriments) that affect national economies and determine national planning needs. Although TFRs are decreasing, the global population continues to grow as mortality declines, with diverse patterns at the national level and across age groups. To our knowledge, this is the first study to provide transparent and replicable estimates of population and fertility, which can be used to inform decision making and to monitor progress. Funding: Bill & Melinda Gates Foundation.
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7.
  • Burstein, R., et al. (författare)
  • Mapping 123 million neonatal, infant and child deaths between 2000 and 2017
  • 2019
  • Ingår i: Nature. - : Nature Publishing Group. - 0028-0836 .- 1476-4687. ; 574:7778, s. 353-358
  • Tidskriftsartikel (refereegranskat)abstract
    • Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations. © 2019, The Author(s).
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  • Agah, Shahram, et al. (författare)
  • Systematic review with meta-analysis: Effects of probiotic supplementation on symptoms in functional dyspepsia
  • 2020
  • Ingår i: Journal of Functional Foods. - : Elsevier BV. - 1756-4646. ; 68
  • Forskningsöversikt (refereegranskat)abstract
    • The pathophysiology of functional dyspepsia (FD) remains poorly understood, but alterations of the small intestinal microbiome have been observed. The place of probiotics in treatment is uncertain. We performed a systematic review and meta-analysis of the currently available randomized, controlled trials (RCTs) to evaluate the potential beneficial effects and risks of probiotics in FD. Pubmed, EMBASE, Scopus, Web of Science and the Cochrane Controlled Trials Register were searched (up to May 2019) for RCTs evaluating the effects of probiotic supplementation compared to placebo in adults with FD. Two reviewers independently assessed eligibility, trial quality and extracted information from identified articles. To compare the effects of probiotics with placebo, risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using random effects models. Six trials, including 422 participants were included but only three RCTs could be included in the meta-analysis. Lactobacillus strains showed potential positive effects in terms of improving upper gastrointestinal (GI) symptoms in patients with FD. Probiotic supplementation tended to improve global dyspepsia score (n = 3 RCTs, risk ratio [RR]: 1.35, 95% CI 0.99 to 1.84; P = 0.061) and bacterial composition in the GI tract. Probiotics were well tolerated without any serious adverse events. While the available data suggest that supplementation with probiotics may improve GI symptoms in patients with FD, the evidence is insufficient to draw clear conclusions regarding efficacy. Thus, high-quality RCTs are needed to establish the beneficial effects of probiotic supplementation on FD outcomes.
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  • Banach, Maciej, et al. (författare)
  • Association between phenotypic familial hypercholesterolaemia and telomere length in US adults: results from a multi-ethnic survey
  • 2018
  • Ingår i: European Heart Journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 39:40, s. 3635-3640
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims: Familial hypercholesterolaemia (FH) accelerates atherosclerotic cardiovascular disease (ASCVD) and accordingly is the most potent hereditary cause of premature coronary heart disease. The association between telomere length (TL), a biological index of ageing, and FH has not been hitherto investigated. We addressed this question using data from the US National Health and Education National Surveys (NHANES, 1999-2002).Methods and results: We included individuals, who had TL measurements (with quantitative polymerase chain reaction method) and a phenotypic diagnosis of FH based on the Dutch Lipid Clinic Network (DLCN) criteria. Sample weights were applied for unequal probabilities of selection, non-response bias, and oversampling by complex sample analysis. The adult prevalence of FH in NHANES was 0.43% [95% confidence interval (95% CI) 0.33-0.57]. The frequencies of probable FH (mean DLCN score: 6.2) and definite FH (mean DLCN score: 8.9) were 0.42% (95% CI 0.32-0.48) and 0.03% (95% CI 0.02-0.06), respectively. Subjects with FH had a higher prevalence of non-communicable diseases (hypertension, diabetes 2 type, and obesity) and early atherosclerosis (2.9% in overall population vs. 42.2% in FH). Overall, the mean TL in the non-FH population was 1.09 (95% CI 1.06-1.12) (T/S ratio) and 1.09 (95% CI 1.03-1.12) [(T/S ratio) for total FH]. Telomere length adjusted for age, sex, race, and body mass index was shorter in FH compared with healthy subjects (FH 0.89, 95% CI 0.84-0.93 vs. healthy: 1.05, 95% CI 0.97-1.11 T/S ratio; P < 0.001). Subjects with longer TL (highest quartile) had 12% less chance of having FH compared with those with TL in the lowest quartile (Q1, 95% CI 0.78-0.93).Conclusions: These preliminary data suggest an association between TL, an index of biological age, and the presence of FH, the most common inherited cause of premature ASCVD. Given our relatively low sample size, the findings need confirmation in larger studies.
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  • Eriksen, Anne Kirstine, et al. (författare)
  • Effects of whole-grain wheat, rye, and lignan supplementation on cardiometabolic risk factors in men with metabolic syndrome: A randomized crossover trial
  • 2020
  • Ingår i: American Journal of Clinical Nutrition. - : Elsevier BV. - 0002-9165 .- 1938-3207. ; 111:4, s. 864-876
  • Tidskriftsartikel (refereegranskat)abstract
    • A whole-grain (WG)-rich diet has shown to have potential for both prevention and treatment of the metabolic syndrome (MetS), which is a cluster of risk factors that increase the risk of type 2 diabetes and cardiovascular disease. Different WGs may have different health effects. WG rye, in particular, may improve glucose homeostasis and blood lipids, possibly mediated through fermentable dietary fiber and lignans. Recent studies have also suggested a crucial role of the gut microbiota in response to WG. Objectives: The aim was to investigate WG rye, alone and with lignan supplements [secoisolariciresinol diglucoside (SDG)], and WG wheat diets on glucose tolerance [oral-glucose-tolerance test (OGTT)], other cardiometabolic outcomes, enterolignans, and microbiota composition. Moreover, we exploratively evaluated the role of gut microbiota enterotypes in response to intervention diets. Methods: Forty men with MetS risk profile were randomly assigned to WG diets in an 8-wk crossover study. The rye diet was supplemented with 280 mg SDG at weeks 4-8. Effects of treatment were evaluated by mixed-effects modeling, and effects on microbiota composition and the role of gut microbiota as a predictor of response to treatment were analyzed by random forest plots. Results: The WG rye diet (± SDG supplements) did not affect the OGTT compared with WG wheat. Total and LDL cholesterol were lowered (-0.06 and -0.09 mmol/L, respectively; P < 0.05) after WG rye compared with WG wheat after 4 wk but not after 8 wk. WG rye resulted in higher abundance of Bifidobacterium [fold-change (FC) = 2.58, P < 0.001] compared with baseline and lower abundance of Clostridium genus compared with WG wheat (FC = 0.54, P = 0.02). The explorative analyses suggest that baseline enterotype is associated with total and LDL-cholesterol response to diet. Conclusions: WG rye, alone or with SDG supplementation, compared with WG wheat did not affect glucose metabolism but caused transient LDL-cholesterol reduction. The effect of WG diets appeared to differ according to enterotype. This trial was registered at www.clinicaltrials.gov as NCT02987595.
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  • Farajbakhsh, Ali, et al. (författare)
  • Sesame oil and vitamin E co-administration may improve cardiometabolic risk factors in patients with metabolic syndrome: a randomized clinical trial
  • 2019
  • Ingår i: European Journal of Clinical Nutrition. - : Springer Science and Business Media LLC. - 0954-3007 .- 1476-5640. ; 73:10, s. 1403-1411
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: Metabolic syndrome (MetS) represents a clustering of metabolic abnormalities that are associated with an increased risk of type 2 diabetes and cardiovascular disease. We aimed to evaluate the effects of sesame oil enriched with vitamin E (vit E), sesame oil alone and sunflower oil on lipid profile, fasting blood glucose (FBG), malondialdehyde (MDA), high-sensitivity C-reactive protein (Hs-CRP), homeostatic model assessment (HOMA-IR), and blood pressure (BP) in patients with MetS. Subjects: Overall, 75 individuals with MetS (aged 30–70 years) participated in this randomized, single-blind controlled trial. Patients were randomly allocated to: (1) Group A (n = 25): sesame oil (30 ml/day) enriched with vit E (400 mg/day), (2) Group B (n = 25): sesame oil (30 ml/day), (3) Group C (n = 25): sunflower oil (30 ml/day). Anthropometric data, dietary intake, blood pressure, and biochemical markers, including fasting serum lipids, FBG, serum insulin, MDA, and hs-CRP were measured at baseline and at week 8. Results: In individuals in the sesame oil enriched with vit E group (Group A), there were significant reductions in serum total cholesterol (TC), triglycerides (TG), FBG, HOMA-IR, MDA, hs-CRP, high-density lipoprotein (HDL-C) systolic and diastolic BP (for all the comparison p < 0.02). Similarly, in Group B (taking sesame oil alone), TC, TG, FBG, HOMA-IR, MDA, systolic and diastolic BP were significantly improved (for all the comparison p < 0.025), while there were no significant changes in serum HDL (baseline = 35.9 ± 7.2 mg/dL vs. 36.4 ± 6.2 mg/dL, p = 0.432) and hs-CRP (baseline = 4.38 ± 1.34 mg/dL vs. week 8 = 3.96 ± 1.7 mg/dL, p = 0.057) in second group. No significant changes in any of the studied clinical and anthropometric data were found in Group C (on sunflower oil). Conclusion: Sesame oil (±vit E) was shown to beneficially affect several cardiometabolic indices (including lipids, FBG, BP, HOMA-IR, and MDA) in patients with MetS.
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  • Maierean, Serban M., et al. (författare)
  • The potential role of statins in preeclampsia and dyslipidemia during gestation: a narrative review
  • 2018
  • Ingår i: Expert Opinion on Investigational Drugs. - : Informa UK Limited. - 1354-3784 .- 1744-7658. ; 27:5, s. 427-435
  • Forskningsöversikt (refereegranskat)abstract
    • Introduction: Statins have several pleiotropic effects that have the potential to be beneficial during pregnancy. This study evaluates the available evidence for the teratogenicity of statins, and their utility in treating preeclampsia and dyslipidemia in pregnancy, as good alternatives in these domains are currently lacking. Areas covered: The possible teratogenicity of statins is a primary focus of this paper. We also evaluated for some possible non-teratogenic effects, such as changes in birth weight and rates of spontaneous abortion, among mothers exposed to statins during pregnancy. Regarding potential uses, this study mainly discusses statin utility in preventing and treating preeclampsia and treating dyslipidemia in pregnancy. Within the latter, we explore the relationship between dyslipidemia and preeclampsia, the potential consequences of delaying statin therapy where indicated, and the impact of supra-physiological levels of cholesterol in utero on offspring. The literature search was conducted using Embase, Web of Science, PubMed, and Scopus. Expert opinion: Based on current evidence, statins are likely not teratogenic. Limited, but promising evidence exists for their efficacy in treating and preventing preeclampsia. In utero exposure to high cholesterol may negatively impact offspring, and should be thoroughly investigated.
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17.
  • Mazidi, Mohsen, 1989, et al. (författare)
  • A high consumption of tomato and lycopene is associated with a lower risk of cancer mortality: results from a multi-ethnic cohort
  • 2020
  • Ingår i: Public Health Nutrition. - 1368-9800 .- 1475-2727. ; 23:9, s. 1569-1575
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: We investigated the association between the consumption of tomato and lycopene and cancer mortality among US adults. Design: Prospective. Setting: The National Health and Nutrition Examination Survey (1999-2010). Participants: Participants with estimated dietary data on tomato and lycopene consumption were included. Outcome data up until 31 December 2011 were also ascertained. Cox proportional hazard regression models were used to relate baseline tomato and lycopene consumption with cancer mortality. We conducted a competing-risk survival analysis to account for deaths from other causes. Results: Adjusted Cox models showed that tomato and lycopene intake were inversely related (hazard ratio (95 % CI)) to cancer mortality: 0 center dot 86 (0 center dot 81, 0 center dot 92) and 0 center dot 79 (0 center dot 74, 0 center dot 82), respectively. In the adjusted competing-risk models, the sub-hazard ratios (95 % CI) were 0 center dot 89 (0 center dot 83, 0 center dot 94) and 0 center dot 82 (0 center dot 78, 0 center dot 86) for cancer mortality for tomato and lycopene intake, respectively. No significant interaction was found for the association between tomato and lycopene consumption and cancer mortality while comparing older (aged >50 years) v. younger adults (P-interaction > 0 center dot 173 for all) and obese v. non-obese (P-interaction > 0 center dot 352 for all). Conclusions: Our results demonstrate the potential beneficial effects of a high dietary intake of tomato and lycopene on cancer death. Further prospective studies are needed to explore the association.
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18.
  • Mazidi, Mohsen, 1989, et al. (författare)
  • A higher flavonoid intake is associated with less likelihood of nonalcoholic fatty liver disease: results from a multiethnic study
  • 2019
  • Ingår i: Journal of Nutritional Biochemistry. - : Elsevier BV. - 0955-2863 .- 1873-4847. ; 65, s. 66-71
  • Tidskriftsartikel (refereegranskat)abstract
    • Limited information exists on the impact of flavonoid intake on nonalcoholic fatty liver disease (NAFLD). We evaluated the link between flavonoid intake, liver tests and risk of NAFLD in a randomly selected sample of US adults (from the National Health and Nutrition Examination Survey, NHANES, 2005–2010). Of the 17,685 participants, 46.9% were men and 45.4% had NAFLD. NAFLD patients had a significantly lower mean flavonoid intake than healthy individuals (111.3±3.6 vs. 201.3±2.3 mg/d, respectively; P<.001). Fatty liver index (FLI) and serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were significantly higher in the first tertile (T1) of flavonoid intake compared with the highest tertile (T3: with the highest flavonoid intake) (FLI: 67.1 vs. 36.2, AST: 31.2 VS 26.8 U/L and, ALT: 34.2 vs. 24.2 U/L, respectively; P<.001 for all comparisons). Adjusted linear regression displayed significant and negative associations between FLI, AST, ALT and flavonoid intake (P<.001 for all comparisons). Multivariable logistic regression showed that the risk for NAFLD significantly decreased as flavonoid intake tertiles increased in a stepwise manner (odds ratio: 0.81, 95% confidence interval: 0.78–0.86). Moderation analysis revealed that C-reactive protein (CRP) strongly modulated the impact of flavonoid intake on FLI; participants with higher CRP levels benefited less from flavonoid intake compared with those with lower CRP concentrations. In conclusions, our results suggest a reverse significant association between flavonoid consumption, liver tests and the risk for NAFLD. Furthermore, CRP was shown to essentially moderate this relationship. These findings support recommendations for consumption of flavonoid-rich foods to prevent cardiometabolic diseases.
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19.
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20.
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21.
  • Mazidi, Mohsen, 1989, et al. (författare)
  • Association of ideal cardiovascular health metrics with serum uric acid, inflammation and atherogenic index of plasma: A population-based survey
  • 2019
  • Ingår i: Atherosclerosis. - : Elsevier BV. - 1879-1484 .- 0021-9150. ; 284, s. 44-49
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and aims: We aimed to evaluate the link between inflammatory score [consisting of C-reactive protein (CRP) and white blood cells], serum uric acid (SUA) and atherogenic index of plasma (AIP) and the cardiovascular health (CVH) score. Methods: We used the cross-sectional National Health and Nutrition Examination Survey database. Statistical analyses accounted for the survey design and sample weights. Results: Overall, there were 23,004 participants (mean age = 47.2 years, 46.5% males). Participants with an ideal CVH level had the highest ratio of poverty to income (3.62%, p < 0.001), as well as lower levels of CRP, SUA and AIP (p < 0.001 for all comparisons). In adjusted linear regression, a significant negative association was observed between inflammatory score (β = −0.052, p < 0.001), SUA (β = −0.041, p < 0.001) and AIP (β = −0.039, p < 0.001) and CVH score, i.e. participants with a better (greater) CVH score had a lower inflammatory score. Results from adjusted logistic regression showed reduction in the likelihood of “high-risk atherosclerosis” (defined as AIP ≥0.21) [intermediate: odds ratio (OR) = 0.90, 95% confidence interval (CI):0.85–0.95, ideal: OR = 0.81, 95%CI: 0.74–0.88] and “high CVD risk” (defined as CRP ≥3 mg/l) [intermediate: OR = 0.86, 95%CI:0.73–0.98, ideal: OR = 0.82, 95%CI:0.69–0.95] across the categories of CVH. Conclusions: Our findings highlight that CVH metrics were associated with inflammatory score, SUA and AIP. Furthermore, participants with a better CVH score had a lower CVD risk. These results reinforce the importance of implementing healthy behaviours as proposed by the American Heart Association. If confirmed in clinical trials, this knowledge may have implications for CVD prevention and management.
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22.
  • Mazidi, Mohsen, 1989, et al. (författare)
  • Associations between risk of overall mortality, cause-specific mortality and level of inflammatory factors with extremely low and high high-density lipoprotein cholesterol levels among American adults
  • 2019
  • Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 276, s. 242-247
  • Tidskriftsartikel (refereegranskat)abstract
    • Background The health outcomes associated with extremely low or high plasma concentrations of high-density lipoprotein cholesterol (HDL-C) are not well documented mainly because of the small numbers of participants with such values included in the clinical trials. Objective We prospectively investigated the association between extremely low and high HDL-C with: 1) the risk of overall, coronary heart disease (CHD), cerebrovascular and cancer mortality, and, 2) their link with inflammatory factors. Methods Analysis was based on subjects ≥18 years old from the National Health and Nutrition Examination Surveys (NHANES). We categorized HDL-C levels as follows: [low HDL-C group ≤30 (extremely low), 30–40 (low), and ≥40 (reference)] [high HDL-C group = 40–80 (reference), 80–100 (high) and ≥100 mg/dl (extremely high). Cox proportional hazard regression models and analysis of covariance accounted for survey design, masked variance and sample weights. Results After adjustment for age, race and sex, we found that the very low HDL-C category (<30 mg/dl) had a greater risk of total mortality (risk ratio [RR]: 3.00, 95%CI: 2.20–4.09). RR for CHD and stroke mortality was 2.00 and 2.53, respectively; there was no link between cancer and level of HDL-C (p = 0.235). The association between total mortality, CHD and stroke with the level of HDL-C attenuated but remained significant even after adjustment for demographics, dietary, cardiovascular risk factors and treatment for dyslipidemia (all p < 0.001). After adjustments, subjects with extremely high HDL-C levels had a higher risk of mortalities (all p < 0.001). Mexican-American ethnicity, subjects in the low level of HDL-C (30–40 mg/dl) category had higher risk of mortalities than those with a very low level (all p < 0.001). Concentration of C-reactive protein, fibrinogen and white blood count significantly decreased as the level of the HDL-C increased; these findings were robust after adjustment for demographics, dietary, cardiovascular risk factors and treatment for dyslipidemia (all p < 0.001); further subjects with extremely high HDL-C levels have a greater levels of inflammatory factors (all p < 0.001). Conclusions Both extremely low and high HDL-C levels were associated with greater risk of mortalities (total, CHD and stroke) and higher level of inflammatory factors, while there was no link between level of HDL-C and risk of cancer. Moreover, we found evidence of an HDL-C paradox in Mexican-American ethnicity
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23.
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24.
  • Mazidi, Mohsen, 1989, et al. (författare)
  • Consumption of dairy product and its association with total and cause specific mortality – A population-based cohort study and meta-analysis
  • 2019
  • Ingår i: Clinical Nutrition. - : Elsevier BV. - 1532-1983 .- 0261-5614. ; 38:6, s. 2833-2845
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The intake of dairy products has been thought to be associated with an increased risk of coronary heart diseases (CHD) and total mortality due to its relatively high content of saturated fat. However, reports on this association particularly among US adults are conflicting and controversial. Therefore, we used data from the 1999–2010 National Health and Nutrition Examination Surveys (NHANES) study to examine whether consumption of total dairy and dairy subgroups was associated with total and cause specific (CHD, cerebrovascular and cancer) mortality. Further we carried out a systematic review and meta-analysis of prospective studies to check for consistency with the NHANES findings. Methods: In the NHANES cohort vital status through December 31, 2011 was ascertained. Cox proportional hazard regression models were used to relate baseline dairy intake with all-cause and cause-specific mortality. For the systematic review PubMed, SCOPUS, Web of Science and Google Scholar databases were searched (up to December 2017). The DerSimonian-Laird method and generic inverse variance methods were used for quantitative data synthesis. Results: In the NHANES data set of 24,474 participants, 3520 deaths occurred during follow-up. In multivariate adjusted Cox models, total mortality risk was lower when comparing the top (Q4) with the lower (Q1) quartiles of total dairy (hazard ratio [HR] 0.98, 95% confidence interval [CI]: 0.95–0.99) and cheese (HR: 0.92, 95% CI: 0.87–0.97) consumption. Using a similar model, we have found a negative association between total dairy and milk consumption with risk of cerebrovascular mortality (HR: 0.96, 95% CI: 0.94–0.98, HR: 0.93, 95% CI: 0.91–0.96, respectively), while milk consumption was associated with increased CHD mortality (HR: 1.04, 95% CI: 1.02–1.06). The meta-analysis with 636,726 participants indicated a significant inverse association between fermented dairy products and total mortality (RR: 0.97, 95% CI: 0.96–0.99), while milk consumption was associated with higher CHD mortality (RR: 1.04, 95% CI: 1.01–1.05). These findings were robust in sensitivity analyses. Conclusions: Among American adults, higher total dairy consumption was associated with lower total and cerebrovascular mortality, while higher milk consumption was associated with higher risk of CHD. These findings do not support dogmatic public health advice to reduce total dairy fat consumption, although the association between milk consumption and CHD mortality requires further study.
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25.
  • Mazidi, Mohsen, 1989, et al. (författare)
  • Diet with greater inflammatory potential is associated with higher prevalence of fatty liver among US adults
  • 2019
  • Ingår i: European Journal of Clinical Nutrition. - : Springer Science and Business Media LLC. - 0954-3007 .- 1476-5640. ; 73:12, s. 1653-1656
  • Tidskriftsartikel (refereegranskat)abstract
    • The prevalence of non-alcoholic fatty liver disease (NAFLD) is rising—caused, at least in part, by unhealthy lifestyles including poor dietary choices. We examined the link between the inflammatory potential of diet as measured by the Dietary Inflammatory Index (DII®) and liver function tests [summarised by the fatty liver index (FLI)]. Of 20,643 US NHANES participants, 48.7% were men and the mean age was 47.3 years. Significant associations were apparent between increasing DII score and prevalent fatty liver. Individuals in the fourth DII quartile had nearly a six-fold higher likelihood of fatty liver [odds ratio (OR) = 5.97, 95% confidence interval: 4.44–8.02] compared with those in the first quartile. Moderation analysis indicated a significant impact of adiposity on the link between FLI and DII score (p < 0.001). This study provides further evidence of an association between the inflammatory potential of diet and fatty liver.© 2018, Springer Nature Limited.
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26.
  • Mazidi, Mohsen, 1989, et al. (författare)
  • Dietary Choline is Positively Related to Overall and Cause-Specific Mortality: Results from Individuals of the National Health and Nutrition Examination Survey and Pooling Prospective Data
  • 2019
  • Ingår i: British Journal of Nutrition. - 0007-1145 .- 1475-2662.
  • Tidskriftsartikel (refereegranskat)abstract
    • Little is known about the association between dietary choline intake and mortality. We evaluated the link between choline consumption and overall as well as cause-specific mortality by using both individual data and pooling prospective studies by meta-analysis and systematic review. Furthermore, adjusted means of cardiometabolic risk factors across choline intake quartiles were calculated. Data from the National Health and Nutrition Examination Survey (1999-2010) were collected. Adjusted Cox regression was performed to determine the risk ratio (RR) and 95 % CI (95 % CI), as well as random-effects models and generic inverse variance methods to synthesise quantitative and pooling data, followed by a leave-one-out method for sensitivity analysis. After adjustments, we found that individuals consuming more choline had worse lipid profile and glucose homeostasis, but lower CRP levels (p < 0·001 for all comparisons) with no significant differences in anthropometric parameters and blood pressure. Multivariable Cox regression models revealed that individuals in the highest quartile (Q4) of choline consumption had a greater risk of total (23 %), cardiovascular disease (CVD) (33 %) and stroke (30 %) mortality compared with the first quartile (Q1) (p < 0·001 for all comparison). These results were confirmed in a meta-analysis, showing that choline intake was positively and significantly associated with overall (RR: 1·12, 95 % CI: 1·08-1·17, I2: 2·9) and CVD (RR: 1·28, 95 % CI: 1·17-1·39, I2: 9·6) mortality risk. In contrast, the positive association between choline consumption and stroke mortality became non-significant (RR: 1·18, 95 % CI: 0·97-1·43, p = 0·092, I2: 1·1). Our findings shed light on the potential adverse effects of choline intake on selected cardiometabolic risk factors and mortality risk.
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27.
  • Mazidi, Mohsen, 1989, et al. (författare)
  • Dietary inflammatory index and cardiometabolic risk in US adults
  • 2018
  • Ingår i: Atherosclerosis. - : Elsevier BV. - 1879-1484 .- 0021-9150. ; 276, s. 23-27
  • Tidskriftsartikel (refereegranskat)abstract
    • Background and aims: We investigated the association between Dietary Inflammatory Index (DII®) scores and cardio-metabolic risk factors singly and in combination as metabolic syndrome (MetS). Methods: We used data from participants selected from the US National Health and Nutrition Examination Survey (NHANES). Analyses were restricted to participants with data available on dietary intake, biochemical data, and anthropometric measurements from 2005 to 2012. Statistical analyses used the SPSS®Complex Samples v22.0 (IBM Corp, Armonk, NY) and accounted for the survey design and sample weights. Energy-adjusted-DII (E-DII®) expressed per 1000 kcal was calculated from 24-h dietary recalls. Of the 17,689 participants with evaluable data, 8607 (48.3%) were men. The mean age was 45.8 years in the overall sample, with men being slightly younger than women (44.9 vs. 46.5 years, p = 0.05). Results: In multivariable-adjusted regression models, the odds of MetS, its components, as well as obesity, and elevated high-sensitivity C-reactive protein (hsCRP) increased across increasing quartiles of E-DII (p < 0.001). In age, sex, race, income-to-poverty ratio-adjusted models, these and other cardiovascular disease risk factors (triglycerides/high density lipoprotein cholesterol (HDL-C) ratio, apolipoprotein (B) and HbA1C) increased across quartiles of the E-DII (all p < 0.001), while HDL-C levels decreased (p < 0.001). Conclusions: This study suggests associations between MetS, its components, subclinical inflammation, and the DII. These results reinforce the view that diet plays an important role in the occurrence of cardiovascular diseases.
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28.
  • Mazidi, Mohsen, 1989, et al. (författare)
  • Effect of Dietary Insulinemia on All-Cause and Cause-Specific Mortality: Results From a Cohort Study
  • 2020
  • Ingår i: Journal of the American College of Nutrition. - : Informa UK Limited. - 0731-5724 .- 1541-1087. ; 39:5, s. 407-413
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Insulin response to diet might predict the risk of mortality; however, the evidence is limited. We prospectively evaluated the link between the dietary hyperinsulinemia index (DHI) and dietary insulin resistance index (DIRI) with all-cause and cause-specific (cardiovascular disease [CVD] and cancer) mortality. Methods: The National Health and Nutrition Examination Survey (1999-2010) database was used. Vital status through December 31, 2011, was ascertained. Stepwise linear regression models consisted of 39 macro/micronutrients applied, and fasting plasma C-peptide for the DHI and triglyceride/high-density lipoprotein cholesterol ratio (TG/HDL-C) for the DIRI were used. Adjusted Cox regression (followed by propensity score matching) was performed to determine the hazard ratios (HRs) and 95% confidence interval (95% CIs). Results: Overall, 22,246 participants were included (mean age = 47.8 years; 48.9% men). There was a significant increasing risk of mortality across the quartiles of DHI, i.e., participants with a highest score of DHI (Q4) had a greater risk of all-cause (HR: 1.21, 95% CI: 1.17-1.26), CVD (HR: 1.17, 95% CI: 1.07-1.29), and cancer (HR: 1.15, 95% CI: 1.08-1.23) mortality compared with the first quartile (Q1; p
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29.
  • Mazidi, Mohsen, 1989, et al. (författare)
  • Food Patterns are Associated with Likelihood of CKD in US Adults
  • 2018
  • Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322 .- 2045-2322. ; 8:1
  • Tidskriftsartikel (refereegranskat)abstract
    • We investigated the association between dietary patterns and prevalent chronic kidney diseases (CKD), in participants of the 2005-2012 US National Health and Nutrition Examination Survey (NHANES) conducted between 2005 and 2012, who had measured data on dietary intake and kidney function. Analyse of covariance (ANCOVA) and logistic regression models were employed to account for the survey design and sample weights. A total of 21,649 eligible participants (634 with and 20,015 without prevalent CKD) were included in the final analysis. Three food patterns together explained 50.8% of the variance of the dietary nutrients consumption. The first food pattern was representative of a diet containing high levels of saturated and mono-unsaturated fatty acids; the second food pattern comprised vitamins and trace elements; and the third food pattern was mainly representative of polyunsaturated fatty acids. The odd of prevalent CKD decreased across increasing quarters of vitamins and trace elements, so that the top quarter was associated with a 53% (95%CI: 42-62%) lower odds of CKD in age, sex and race adjusted logistic regression models. These results suggest that vitamins and trace elements intake are associated with lower risk of prevalent CKD.
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30.
  • Mazidi, Mohsen, 1989, et al. (författare)
  • Higher adherence to plant-based diets are associated with lower likelihood of fatty liver
  • 2019
  • Ingår i: Clinical Nutrition. - : Elsevier BV. - 1532-1983 .- 0261-5614. ; 38:4, s. 1672-1677
  • Tidskriftsartikel (refereegranskat)abstract
    • Some plant-based diets have been suggested to have a beneficial impact on liver disease risk. We examined the association of the overall plant-based diet (PDI), hypothesized healthful PDI (hPDI) and unhealthful PDI (uPDI) with non-alcoholic fatty liver disease (NAFLD) in US adults from the 2005–2010 National Health and Nutrition Examination Survey (NHANES2005-2010). Analysis of covariance, linear and logistic regression models accounted for the survey design and sample weights. Overall, 18,345 participants were included, with a mean age of 47.9 years and comprising 51.7% women. Liver function tests including alanine aminotransferase (ALT), aspartate aminotransferase (AST) and fatty liver index (FLI) decreased across increasing thirds of PDI and hPDI (all p < 0.001), while adjusted mean of ALT, AST and FLI increased across increasing thirds of uPDI. Adjusted linear regressions showed that PDI and hPDI had negative and significant associations with ALT (PDI = β:-0.095, hPDI = β:-0.128), AST (PDI = β:-0.101, hPDI = β:-0.138) and FLI (PDI = β:-0.153, hPDI = β:-0.265), while uPDI had a positive and significant association with ALT (β: 0.103), AST (β: 0.112) and FLI (β: 0.241). After adjustment, participants in the upper third of PDI had 21% lower odd of NAFLD compared with those in the lowest third [odds ratio (OR): 0.79, 95% confidence interval (95%CI): 0.74–0.82]. A similar trend was observed with hPDI; and the opposite across increasing thirds of uPDI. Our findings confirm that healthy plant-based diets are associated with lower NAFLD risk and more favorable liver function tests profile.
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31.
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32.
  • Mazidi, Mohsen, 1989, et al. (författare)
  • Higher Plasma Levels of Valerate Produced by Gut Microbiota May Have a Beneficial Impact on Renal Function
  • 2023
  • Ingår i: Journal of the American Nutrition Association. - : Informa UK Limited. - 2769-7061 .- 2769-707X. ; 42:6, s. 534-540
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: Observational studies have evaluated the relationships among plasma short chain fatty acids (SCFA) produced by gut microbiota, renal function, and risk of chronic kidney disease (CKD). In the present study, Mendelian Randomization (MR) analysis was applied to obtain unconfounded estimates of the casual association of genetically determined plasma valerate (an SCFA) with kidney function and risk of CKD. Method: MR was performed by using summary-level data from the largest genome-wide association studies (GWAS) conducted on plasma valerate, CKD, and estimated glomerular filtration rate (eGFR; separately in diabetic and nondiabetic individuals). Inverse variance weighted method (IVW), weighted median–based method, MR-Egger, as well as MR-Pleiotropy RESidual Sum and Outlier (PRESSO) were applied. Sensitivity analysis was conducted using the leave-one-out method. Results: No significant association was observed between plasma valerate and CKD (IVW: β = 0.234, p = 0.744). In contrast, plasma valerate was positively associated with eGFR in the total population (IVW: β = 0.049, p = 0.022) and among nondiabetic individuals (IVW: β = 0.058, p = 0.009), but not in the diabetic population (IVW: β = −0.052, p = 0.603). None of the estimated associations was subjected to significant level of heterogeneity. Furthermore, MR-PRESSO analysis did not show any chance of outlier for all estimates. The pleiotropy test, with very a negligible intercept and insignificant p value, also indicated no chance of pleiotropy for all of our estimations (all p > 0.539). The results of the MR-Robust Adjusted Profile Score were identical with the IVW estimates, highlighting again no possibility of pleiotropy. Results of the leave-one-out method demonstrated that the links were not driven by single-nucleotide polymorphisms. Conclusions: Individuals with higher plasma valerate levels had better renal function, defined by eGFR. This finding was observed in the total population and in nondiabetic subjects, but not in those with diabetes. Further research is needed to elucidate the links among plasma valerate, kidney function, and CKD.
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33.
  • Mazidi, Mohsen, 1989, et al. (författare)
  • Ideal cardiovascular health associated with fatty liver: Results from a multi-ethnic survey
  • 2019
  • Ingår i: Atherosclerosis. - : Elsevier BV. - 1879-1484 .- 0021-9150. ; 284, s. 129-135
  • Tidskriftsartikel (refereegranskat)abstract
    • © 2018 Background and aims: Little is known about the role of liver enzymes as predictors of non-liver-related morbidity and mortality. The ideal cardiovascular health (CVH) score proposed by the American Heart Association (AHA) can be used to predict mortality and morbidity. We investigated the association of the CVH score with liver enzymes and the risk of non-alcoholic fatty liver disease (NAFLD) among US adults. Methods: By using the National Health and Nutrition Examination Survey database (cross-sectional), the CVH score was calculated as meeting ideal levels of the following components: 4 behaviors (smoking, body mass index, physical activity and diet adherence) and 3 factors (total cholesterol, blood pressure and fasting glucose). Results: Individuals with a higher CVH score (“better CVH”) had a more favorable profile of liver biomarkers. Adjusted (for age, gender, race, poverty to income ratio, education, marital status and alcohol intake) linear regression indicated significant and negative associations between liver biomarkers and CVH score: (β = −0.069, p
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34.
  • Mazidi, Mohsen, 1989, et al. (författare)
  • Impact of serum 25-hydroxyvitamin D 25(OH) on telomere attrition: A Mendelian Randomization study
  • 2020
  • Ingår i: Clinical Nutrition. - : Elsevier BV. - 1532-1983 .- 0261-5614. ; 39:9, s. 2730-2733
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Conventional observational studies have suggested that 25-hydroxyvitamin D (25(OH)D) is inversely associated with telomere shortening. We aimed to apply two-sample Mendelian randomization (MR) to assess the causal association between serum 25(OH) D and telomere length (TL). Methods: MR was implemented by using summary-level data from the largest genome-wide association studies (GWAS) on vitamin D (n = 73 699) and TL (n = 37 684). Inverse variance weighted method (IVW) was used to estimate the causal estimates. Weighted median (WM)-based method, and MR-Egger, leave-one-out were applied as sensitivity analysis. Results: The results of MR demonstrated no effect of 25(OH)D on TL (IVW = β:-0.104, p = 0.219, WM = β:-0.109, p = 0.188; MR Egger = β:-0.127, p = 0.506). None of the 25(OH)D-related single nucleotide polymorphisms (SNPs) were significantly associated with TL. Heterogeneity tests did not detect heterogeneity. Furthermore, MR pleiotropy residual sum and outlier (MR-PRESSO) did not highlight any outliers (p = 0.424). Results of leave-one-out method demonstrated that the links are not driven because of the single SNPs. Conclusions: Our study does not support any causal effect of 25(OH) D on TL.
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35.
  • Mazidi, Mohsen, 1989, et al. (författare)
  • Inverse association between serum antioxidant levels and inflammatory markers is moderated by adiposity: a report based on a large representative population sample of American adults
  • 2018
  • Ingår i: British Journal of Nutrition. - 0007-1145 .- 1475-2662. ; 120:11, s. 1272-1278
  • Tidskriftsartikel (refereegranskat)abstract
    • We examined the association between plasma antioxidant levels and markers of inflammation, including C-reactive protein (CRP) and fibrinogen (FG) in US adults. National Health and Nutrition Examination Survey participants examined between 2001 and 2002 were included, if data on CRP or FG levels. Serum vitamins A and E, two retinyl esters, and six carotenoids were measured using HPLC with photodiode array detection. Multivariable-adjusted linear regression analyses accounted for the survey design and sample weights. A total of 784 eligible participants were included; 47.5 % (n 372) were men. In multivariable linear regression models, serum alpha-carotene, trans-beta-carotene, cis-beta-carotene, beta-cryptoxanthin, combined lutein/zeaxanthin, trans-lycopene, retinyl palmitate, alpha-tocopherol, retinol and 25-hydroxy vitamin D were negatively associated with serum CRP (P3 mg/l, decreased with increasing levels of antioxidants (alpha-carotene, trans-beta-carotene, cis-beta-carotene, vitamins A and E). Furthermore, we found a moderate impact of adiposity on the link between antioxidants and CRP. Our results suggest that the lower the antioxidants levels, the higher the inflammatory burden, based on CRP and FG levels. Adiposity moderately affects this association. Furthermore, an inverse relationship between CVD risk and antioxidant levels was observed. This finding suggests that reduced levels of vitamins with antioxidant properties may predispose to increased CVD risk.
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36.
  • Mazidi, Mohsen, 1989, et al. (författare)
  • Link between plasma trans-fatty acid and fatty liver is moderated by adiposity
  • 2018
  • Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 272:1 December 2018, s. 316-322
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: The prevalence of non-alcoholic fatty liver disease (NAFLD) is rising. This increase may be associated with obesity. It has been suggested that trans-fatty acids (TFAs) play an important role in non-communicable diseases. Aim: We examined the link between liver tests, fatty liver index (FLI) and plasma TFAs. Furthermore, we evaluated the impact of adiposity on this link. Methods: The National Health and Nutrition Examination Survey (NHANES) was used to obtain the data on TFAs and liver function biomarkers. We took account of complex NHANES data, masked variance and weighting methodology. Results: Of the 4252 participants, 46.4% were men. The mean age was 50.6 years overall; 51.3 years for men and 49.8 years for women (p = 0.206). In a fully adjusted model (demographic and clinical factors), FLI increased as trans-9-hexadecenoic acid and trans-11-octadecenoic acid levels increased; FLI was 38.1 and 42.3 for the first quarter (Q1) of trans-9-hexadecenoic acid and trans-11-octadecenoic acid, respectively, reaching 65.1 and 69.3 for the highest quarters (Q4) (p < 0.001 for all comparisons). Multivariable logistic regression showed for all four studied TFAs, the likelihood of NAFLD (determined by FLI) increased with increasing TFAs levels (quartiles) in a stepwise manner (p < 0.001 for all comparisons). Based on moderation analysis, a strong impact of body mass index (BMI) on the link between FLI and TFAs was observed. Conclusions: Our results suggest a direct significant association between plasma TFAs, liver tests and NAFLD (assessed by FLI). Furthermore, BMI was shown to mediate this relationship. These findings highlight the importance of avoiding TFAs consumption in order to minimize cardiometabolic risk.
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37.
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38.
  • Mazidi, Mohsen, 1989, et al. (författare)
  • Plasma Trans Fatty Acids Concentrations Are Inversely Related to Bone Mineral Density and This Appears to Be Independent of Inflammation
  • 2023
  • Ingår i: Journal of the American Nutrition Association. - : Informa UK Limited. - 2769-7061 .- 2769-707X. ; 42:5, s. 427-434
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To investigate the association between plasma trans fatty acids (TFAs) and bone mineral density (BMD) and risk of fracture among US adults. Furthermore, we have evaluated the impact of inflammation on this relationship. Methods: Participants (the National Health and Nutrition Examination Survey) with measured data on BMD and TFAs were included. TFAs were measured by gas chromatography–mass spectrometry and BMD was measured using dual-energy x-ray absorptiometry densitometers. Results: Of the 4022 eligible participants, 48.1% were men. The mean age of the population sample was 44.6 years. In the model adjusted for age, sex, race, education, income, physical activity, smoking, fasting blood glucose, systolic and diastolic blood pressure, body mass index, diabetes, and hypertension, across the increasing quartiles (Q) of individual plasma TFAs, BMD decreased for most of the sites measure: for example, Q1 vs. Q4 1.04 vs. 0.095 g/cm2 for palmitelaidic acid and 1.11 vs. 0.099 g/cm2 for elaidic acid (all p < 0.001). In models using the same adjustment, linear regression displayed a significant negative association between plasma TFAs and BMD for most of the sites measured (all p < 0.001). Moderation analysis revealed that inflammation [assessed as a serum C-reactive protein (CRP)] was not significantly implicated in the relationship between BMD and TFAs. There was no significant difference in percentage of fractures (hip, spine, wrist) observed across quartiles of plasma TFAs (all p > 0.125). Conclusions: Our findings highlight, for the first time, the potentially detrimental impact of plasma TFAs on bone health that does not appear to be moderated through inflammation.
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39.
  • Mazidi, Mohsen, 1989, et al. (författare)
  • Prevalence of childhood and adolescent overweight and obesity in Asian countries: A systematic review and meta-analysis
  • 2018
  • Ingår i: Archives of Medical Science. - : Termedia Sp. z.o.o.. - 1734-1922 .- 1896-9151. ; 14:6, s. 1185-1203
  • Forskningsöversikt (refereegranskat)abstract
    • Introduction: We conducted a systematic review and meta-analysis to estimate the prevalence of overweight and obesity in children (aged 5-12 years) and adolescents (aged 12-19 years) in Asian countries. Study design: Systematic review and meta-analysis. Material and methods: We comprehensively searched specialised databases for relevant studies conducted in Asian countries between January 1, 1999, and May 30, 2017. Random effects models (using the DerSimonian-Laird method) and generic inverse variance methods were used for quantitative data synthesis. Sensitivity analysis was conducted using the 'leave-one-out' method. Heterogeneity was quantitatively assessed using the I2 index. Systematic review registration: CRD42016033061. Results: Among 22,286 identified citations, 41 studies met the inclusion criteria with n = 71,998 and n = 353,513 for children and adolescents. The pooled prevalence (overall, boys and girls) was 5.8% (n = 4175), 7.0% (n = 2631) and 4.8% (n = 1651) for obesity in children aged 5-11 years; 8.6% (n = 30,402), 10.1% (n = 17,990) and 6.2% (n = 10,874) for obesity in adolescents age 12-19 years. For overweight in children the values for overall, boys and girls were 11.2% (n = 7900), 11.7% (n = 4280) and 10.9% (n = 3698) respectively; and for overweight in adolescents, 14.6% (n = 46,886), 15.9% (27,183), and 13.7% (20,574). These findings were robust in sensitivity analyses. In children and adolescents a higher percentage of boys than girls are obese (children = 7.0 vs. 4.8%, adolescents = 10.1 vs. 6.2%, p < 0.001, respectively). Furthermore, in children and adolescents a higher percentage of boys than girls are overweight (children = 11.7 vs. 10.9%, adolescents = 15.9 vs. 13.7%, p < 0.001, respectively). Conclusions: In view of the number of children who are overweight or obese, the associated detrimental effects on health, and the cost to health-care systems, implementation of programmes to monitor and prevent unhealthy weight gain in children and adolescents is needed throughout Asian countries.
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40.
  • Mazidi, Mohsen, 1989, et al. (författare)
  • Serum lipophilic antioxidants levels are associated with leucocyte telomere length among US adults
  • 2018
  • Ingår i: Lipids in Health and Disease. - : Springer Science and Business Media LLC. - 1476-511X. ; 17:1
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: To examine the association between serum concentrations of antioxidant and telomere length (TL) in U.S adults. Methods: Participants of the National Health and Nutrition Examination Survey (NHANES) with data available on TL measures from 2001 to 2002 were included. Serum lipophilic antioxidants level was measured using high performance liquid chromatography with photodiode array detection. We used analysis of co-variance and multivariable-adjusted linear regression models, accounting for the survey design and sample weights. Results: Of the 5992 eligible participants, 47.5% (n = 2844) were men. The mean age was 46.9 years overall, 47.2 years in men and 46.6 in women (p = 0.071). In age, sex, race, education, marital status, adiposity, smoking, C-reactive protein adjusted linear regressions, antioxidant, serum α-carotene, trans-β-carotene, cis- β-carotene, β-cryptoxanthin and combined Lutein/zeaxanthin were positively and significantly associated with TL (all p < 0.001). Conclusions: Our findings support a possible positive association between serum concentrations of lipophylic antioxidant and TL. The implications of this association deserve further investigation.
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41.
  • Mazidi, Mohsen, 1989, et al. (författare)
  • The Association of Red Meat Intake with Inflammation and Circulating Intermediate Biomarkers of Type 2 Diabetes Is Mediated by Central Adiposity
  • 2021
  • Ingår i: British Journal of Nutrition. - 0007-1145 .- 1475-2662. ; 125:9, s. 1043-1050
  • Tidskriftsartikel (refereegranskat)abstract
    • © The Author(s) 2019. We explored the role of lipid accumulation products and visceral adiposity on the association between red meat consumption and markers of insulin resistance (IR) and inflammation in US adults. Data on red meat consumption, and health outcome measurements were extracted from the 2005-2010 US National Health and Nutrition Examination Surveys. Overall 16,621 participants were included in the analysis (mean age = 47.1 years, 48.3% men). Analysis of co-variance and "conceptus causal mediation" models were applied, while accounting for survey design. In adjusted models, a lower red meat consumption was significantly associated with a cardio-protective profile of IR and inflammation. Body mass index (BMI) had significant mediation effects on the associations between red meat consumption and C-reactive protein (CRP), Apolipoprotein-B, fasting glucose (FBG), insulin, homeostatic model assessment (HOMA) IR and β-cell function, glycated haemoglobin (HbA1c), triglyceride to high density lipoprotein (TG:HDL) ratio and triglyceride-glucose (TyG) index (all p < 0.05). Both waist circumference and anthropometrically predicted visceral adipose tissue (apVAT) mediated the association between red meat consumption with CRP, FBG, HbA1c, TG: HDL ratio and TyG index (all p < 0.05). Our findings suggest that adiposity, particularly the accumulation of abdominal fat, accounts for a significant proportion of the associations between red meat consumption IR and inflammation.
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42.
  • Mazidi, Mohsen, 1989, et al. (författare)
  • The Link between Serum 25-Hydroxyvitamin D, Inflammation and Glucose/ Insulin Homeostasis Is Mediated by Adiposity Factors in American Adults
  • 2023
  • Ingår i: British Journal of Nutrition. - 0007-1145 .- 1475-2662. ; 130:3, s. 423-432
  • Tidskriftsartikel (refereegranskat)abstract
    • Prior studies have suggested a significant association between 25-hydroxyvitamin D (25(OH)D) concentrations with markers of inflammation and glucose and insulin homeostasis. However, it is unclear whether these associations are confounded or mediated by adiposity. We used an established mediation analysis to investigate the role of adiposity in the relation between serum 25(OH)D with markers of inflammation and glucose and insulin metabolism. We used data from National Health and Nutrition Examination Survey (2005-2010), to evaluate the associations between serum 25(OH)D and markers of insulin resistance or inflammation, and whether these associations are mediated by adiposity factors including body mass index (BMI, marker of body adiposity), waist circumference (WC, marker of central adiposity), anthropometrically predicted visceral adipose tissue (apVAT), and Visceral Adiposity Index (VAI). Analysis of co-variance and conceptual causal mediation analysis were conducted taking into consideration the survey design and sample weights. A total of 16,621 individuals were included; 8607 (48.3%) participants were men and the mean age of the population was 47.1 years. Mean 25(OH)D serum concentration for the overall population was 57.9±0.1 nmol/L with minimal differences between men and women (57.5±0.2 nmol/L and 58.2±0.2 nmol/L, respectively). After adjustment for age, sex, season and race/ethnicity, mean levels of C-reactive protein (CRP), apolipoprotein B (apo-B), fasting blood glucose (FBG), insulin, homeostatic model assessment of IR (HOMA-IR) and β cell function (HOMA-β), haemoglobin A1c (HbA1c), and 2-h glucose were lower for the top quartile of serum 25(OH)D (all p<0.001). Body mass index (BMI) was found to have significant mediation effects (to varied extent) on the associations between serum 25(OH)D and CRP, apo-B, fasting glucose, insulin, HOMA-IR, HOMA-B and HbA1c (all p<0.05). Both waist circumference and apVAT were also found to partly mediate the associations between serum 25(OH)D with CRP, FBG, HbA1c, triglycerides and HDL-cholesterol (all P < 0.05). VAI was found to have mediation effects on CRP only (p<0.001). Using a mediation model, our findings suggest that the relationship between serum 25(OH)D, insulin resistance and inflammation, may be in part mediated by adiposity. These findings support the importance of optimizing 25(OH)D status in conditions with abnormal adiposity (i.e., obesity) and treatments for the prevention of cardio-metabolic diseases affecting adipose tissue metabolism (i.e., weight loss).
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43.
  • Mazidi, Mohsen, 1989, et al. (författare)
  • Tomato and Lycopene Consumption Is Inversely Associated with Total and Cause-Specific Mortality: A Population-based Cohort Study, on behalf of the International Lipid Expert Panel (ILEP)
  • 2020
  • Ingår i: British Journal of Nutrition. - 0007-1145 .- 1475-2662. ; 124:12, s. 1303-1310
  • Tidskriftsartikel (refereegranskat)abstract
    • No data exist on the associations of dietary tomato and lycopene consumption with total and cause-specific mortality. Using the National Health and Nutrition Examination Surveys (NHANES) 1999-2010, we evaluted the long-term impact of tomato and lycopene intake on total and cause-specific (coronary heart disease [CHD] and cerebrovascular disease) mortality. We also assessed the changes in cardio-metabolic risk factors according to tomato and lycopene intake. Vital status through December 31, 2011 was ascertained. Cox proportional hazard regression models (followed by propensity score-matching) were used to investigate the link between tomato and lycopene consumption total, CHD and cerebrovascular mortality. Among the 23,935 participants included (mean age = 47.6 years, 48.8% men), 3403 deaths occurred during 76.4 months of follow-up. Tomato intake was inversely associated with total (risk ratio (RR):0.86, 95% confidence interval (CI):0.81-0.92), CHD (0.76, 95%CI: 0.70-0.85) and cerebrovascular (0.70, 95%CI: 0.62-0.81) mortality. Similar inverse associations were found between lycopene consumption, total (0.76, 95%CI: 0.72-0.81), CHD (0.73, 95%CI: 0.65-0.83) and cerebrovascular (0.71, 95%CI: 0.65-0.78) mortality; these associations were independent of anthropometric, clinical and nutritional parameters. Age and obesity did not affect the associations of tomato and lycopene consumption with total, CHD and cerebrovascular mortality. C-reactive protein significantly moderated the link between lycopene and tomato intake with total, CHD and cerebrovascular mortality. Analysis of co-variance showed that participants with a higher tomato and lycopene consumption had a more cardio-protective profile compared with those with a lower intake. Our results highlighted the favorable effect of tomato and lycopene intake on total and cause-specific mortality as well as to cardio-metabolic risk factors. These findings should be taken into consideration for public health strategies.
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44.
  • Mazidi, Mohsen, 1989, et al. (författare)
  • Α higher ratio of serum uric acid to serum creatinine could predict the risk of total and cause specific mortality- insight from a US national survey
  • 2021
  • Ingår i: International Journal of Cardiology. - : Elsevier BV. - 0167-5273 .- 1874-1754. ; 326, s. 189-193
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction: The link between serum uric acid to serum creatinine ratio (SUA/SCr) and mortality has not been studied yet. Methods: We prospectively evaluated the association between SUA/SCr and risk of total and cause specific [cardiovascular disease (CVD) and cancer] mortality by applying on the National Health and Nutrition Examination Surveys (NHANES, 1999–2010). Vital status through December 31, 2011 was ascertained. Adjusted Cox proportional hazard regression models were performed to determine the links between SUA/SCr and mortality. Results: Overall, 20,209 individuals were included (mean age = 47.5 years, 48.9% men) and 3523 deaths occurred during the 76.4 months of follow-up. In a fully adjusted model, individuals in the fourth (Q4) and third (Q3) quartile of SUA/SCr had a 44 and 35% greater risk of total mortality [risk ratio (RR): 1.44 (95% confidence interval, 95%CI: 1.05–1.98) and 1.35 (1.10–1.66), respectively], as well as a 69 and 47% higher risk of CVD death [RR: 1.69 (1.09–2.62) and 1.47 (1.14–1.89), respectively] compared with the lowest (Q1) quartile. With regard to SUA/SCr and cancer mortality, a significant association was found only between participants in Q4 and those in Q1 [RR: 1.12 (1.06–1.19)] in the partially adjusted model, whereas this relationship became non-significant after further adjustments [RR: 1.15 (0.96–1.39)]. Conclusions: This is the first time that SUA/SCr has been associated with total and cause specific mortality in a large, representative sample of US adults. Further studies are needed to confirm these findings and establish their clinical implications.
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45.
  • Motlagh, Hoda Ahmadniay, et al. (författare)
  • Effect of flaxseed consumption on central obesity, serum lipids, and adiponectin level in overweight or obese women: A randomised controlled clinical trial
  • 2021
  • Ingår i: International Journal of Clinical Practice. - : Hindawi Limited. - 1368-5031 .- 1742-1241. ; 75:10
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Flaxseed may be beneficial for the management of obesity due to its high content of alpha-linolenic acid, fibre, and lignans. Objective: We aim to evaluate the effect of flaxseed consumption on serum lipids, adiponectin, leptin, and anthropometric indices in overweight or obese women. Methods: This randomised controlled clinical trial involved 60 overweight or obese women. Participants were randomly allocated into two groups: (a) a balanced diet plus 30 g/day milled flaxseed (as treatment group) and (b) a balanced diet plus 30 g/day milled rice (as control group). Anthropometric indices, serum lipids, leptin, and adiponectin level were measured at baseline and at the end of intervention after 12 weeks. Results: After 12 weeks of intervention, there was significantly higher reduction rate in waist circumference (WC) and waist-to-hip ratio (WHR) (both P < .05) in the flaxseed-consuming group compared with the control group. Moreover, adiponectin level was significantly increased from (12.11 +/- 7.1) to (17.15 +/- 6.1) in the flaxseed-consuming group compared with the control group from (12.48 +/- 4.7) to (12.01 +/- 5.8) (P = .002). However, no significant difference was observed in serum lipid level in the study groups before and after the intervention (all P > .05). Conclusion: Flaxseed consumption may improve adiposity markers, such as adiponectin level. Thus, flaxseed consumption could be an adjunctive therapy to attenuate central obesity. Serum lipid profile has not changed meaningfully after flaxseed consumption.
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46.
  • Ofori-Asenso, Richard, et al. (författare)
  • Adherence, Persistence, and Switching Among People Prescribed Sodium Glucose Co-transporter 2 Inhibitors: A Nationwide Retrospective Cohort Study
  • 2019
  • Ingår i: Advances in Therapy. - : Springer Science and Business Media LLC. - 0741-238X .- 1865-8652. ; 36:11, s. 3265-3278
  • Tidskriftsartikel (refereegranskat)abstract
    • Introduction : Non-adherence and non-persistence to diabetes medications are associated with worse clinical outcomes. In this study, we aimed to characterise the 1-year switching, adherence, and persistence patterns among people with diabetes aged 18 years and older prescribed sodium-glucose co-transporter 2 inhibitors (SGLT2is) in Australia. Methods : Using data from Australia’s national Pharmaceutical Benefits Scheme (PBS), we identified 11,981 adults (mean age 60.9 years; 40.5% female) newly initiated on SGLT2is (5993 dapagliflozin; 5988 empagliflozin) from September 2015 to August 2017. Adherence was assessed via the proportion of days covered (PDC), persistence was defined as the continuous use of SGLT2i without a gap of ≥ 90 days, and switching was defined as the first change from dapagliflozin to empagliflozin or vice versa. Generalised linear models (GLMs) were used to compare the adherence (PDC = continuous), logistic regression models were used to compare the likelihoods of being adherent (PDC ≥ 0.80), and Cox proportional hazard models were used to compare the likelihoods of persistence and switching between people prescribed empagliflozin and dapagliflozin. Results : Overall, 65.8% (7879/11,981) of people dispensed SGLT2is were adherent (PDC ≥ 0.80) and 72.1% (8644/11,981) were persistent at 12 months. The mean PDC was 0.79 ± 0.27. The use of empagliflozin was associated with higher adherence (PDC = continuous) [odds ratio (OR) 1.04, 95% confidence interval (CI) 1.03–1.05], being adherent (OR 1.39, 95% CI 1.29–1.51), and persisting for 12 months [hazard ratio (HR) 1.14, 95% CI 1.06–1.22] compared with dapagliflozin. Only 4.3% (509/11,981) of people switched between the SGLT2i. Compared with dapagliflozin, people initiated on empagliflozin were less likely to switch [HR 0.46, 95% CI 0.38–0.55]. Conclusions : A considerable proportion of Australians prescribed SGLT2is were non-adherent or non-persistent. However, empagliflozin was associated with better adherence and persistence rates and a lower likelihood of switching compared with dapagliflozin.
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47.
  • Ofori-Asenso, Richard, et al. (författare)
  • Global Incidence of Frailty and Prefrailty Among Community-Dwelling Older Adults A Systematic Review and Meta-analysis
  • 2019
  • Ingår i: JAMA network open. - : American Medical Association (AMA). - 2574-3805. ; 2:8
  • Tidskriftsartikel (refereegranskat)abstract
    • IMPORTANCE Frailty is a common geriatric syndrome of significant public health importance, yet there is limited understanding of the risk of frailty development at a population level. OBJECTIVE To estimate the global incidence of frailty and prefrailty among community-dwelling adults 60 years or older. DATA SOURCES MEDLINE, Embase, PsycINFO, Web of Science, CINAHL Plus, and AMED (Allied and Complementary Medicine Database) were searched from inception to January 2019 without language restrictions using combinations of the keywords frailty, older adults, and incidence. The reference lists of eligible studies were hand searched. STUDY SELECTION In the systematic review, 2 authors undertook the search, article screening, and study selection. Cohort studies that reported or had sufficient data to compute incidence of frailty or prefrailty among community-dwelling adults 60 years or older at baseline were eligible. DATA EXTRACTION AND SYNTHESIS The methodological quality of included studies was assessed using The Joanna Briggs Institute's Critical Appraisal Checklist for Prevalence and Incidence Studies. Meta-analysis was conducted using a random-effects (DerSimonian and Laird) model. MAIN OUTCOMES AND MEASURES Incidence of frailty (defined as new cases of frailty among robust or prefrail individuals) and incidence of prefrailty (defined as new cases of prefrailty among robust individuals), both over a specified duration. RESULTS Of 15 176 retrieved references, 46 observational studies involving 120 805 nonfrail (robust or prefrail) participants from 28 countries were included in this systematic review. Among the nonfrail individuals who survived a median follow-up of 3.0 (range, 1.0-11.7) years, 13.6%(13 678 of 100 313) became frail, with the pooled incidence rate being 43.4 (95% CI, 37.3-50.4; I-2 = 98.5%) cases per 1000 person-years. The incidence of frailty was significantly higher in prefrail individuals than robust individuals (pooled incidence rates, 62.7 [95% CI, 49.2-79.8; I-2 = 97.8%] vs 12.0 [95% CI, 8.2-17.5; I-2 = 94.9%] cases per 1000 person-years, respectively; P for difference < .001). Among robust individuals in 21 studies who survived a median follow-up of 2.5 (range, 1.0-10.0) years, 30.9% (9974 of 32 268) became prefrail, with the pooled incidence rate being 150.6 (95% CI, 123.3-184.1; I-2 = 98.9%) cases per 1000 person-years. The frailty and prefrailty incidence rates were significantly higher in women than men (frailty: 44.8 [95% CI, 36.7-61.3; I-2 = 97.9%] vs 24.3 [95% CI, 19.6-30.1; I-2 = 8.94%] cases per 1000 person-years; prefrailty: 173.2 [95% CI, 87.9-341.2; I-2 = 99.1%] vs 129.0 [95% CI, 73.8-225.0; I-2 = 98.5%] cases per 1000 person-years). The incidence rates varied by diagnostic criteria and country income level. The frailty and prefrailty incidence rates were significantly reduced when accounting for the risk of death. CONCLUSIONS AND RELEVANCE Results of this study suggest that community-dwelling older adults are prone to developing frailty. Increased awareness of the factors that confer high risk of frailty in this population subgroup is vital to inform the design of interventions to prevent frailty and to minimize its consequences.
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48.
  • Penson, Peter E., et al. (författare)
  • Associations between very low concentrations of low density lipoprotein cholesterol, high sensitivity C-reactive protein, and health outcomes in the Reasons for Geographical and Racial Differences in Stroke (REGARDS) study
  • 2018
  • Ingår i: European Heart Journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 39:40, s. 3641-3653
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims: Recent findings have demonstrated the important contribution of inflammation to the risk of cardiovascular disease (CVD) in individuals with optimally managed low density lipoprotein cholesterol (LDL-C). We explored relationships between LDL-C, high sensitivity C-reactive protein (hs-CRP), and clinical outcomes in a free-living US population.Methods and results: We used data from the REasons for Geographical And Racial Differences in Stroke (REGARDS), and selected individuals at 'high risk' for coronary events with a Framingham Coronary Risk Score of ≥10% or atherosclerotic cardiovascular disease (ASCVD) risk ≥7.5% in order to explore relationships between low LDL-C [<70 mg/dL (1.8 mmol/L) in comparison to ≥70 mg/dL (1.8 mmol/L)]; hs-CRP <2 compared with ≥2 mg/L and clinical outcomes [all-cause mortality, incident coronary heart disease (CHD), and incident stroke]. To assess the association between the LDL-C and hs-CRP categories and each outcome, a series of incremental Cox proportional hazards models were employed on complete cases. To account for missing observations, the most adjusted model was used to interrogate the data using multiple imputation with chained equations (MICE). In this analysis, 6136 REGARDS high-risk participants were included. In the MICE analysis, participants with high LDL-C (≥70 mg/dL) and low hs-CRP (<2 mg/L) had a lower risk of incident stroke [hazard ratio (HR) 0.69, 0.47-0.997], incident CHD (HR 0.71, 0.53-0.95), and CHD death (HR 0.70, 0.50-0.99) than those in the same LDL-C category high hs-CRP (≥2 mg/L). In participants with high hs-CRP (≥2 mg/dL), low LDL-C [<70 mg/dL (1.8 mmol/L)] was not associated with additional risk reduction of any investigated outcome, but with the significant increase of all-cause mortality (HR 1.37, 1.07-1.74).Conclusions: In this high-risk population, we found that low hs-CRP (<2 mg/L) appeared to be associated with reduced risk of incident stroke, incident CHD, and CHD death, whereas low LDL-C (<70 mg/dL) was not associated with protective effects. Thus, our results support other data with respect to the importance of inflammatory processes in the pathogenesis of CVD.
  •  
49.
  • Shannon, Oliver M., et al. (författare)
  • Mediterranean Diet Increases Endothelial Function in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
  • 2020
  • Ingår i: Journal of Nutrition. - : Elsevier BV. - 1541-6100 .- 0022-3166. ; 150:5, s. 1151-1159
  • Forskningsöversikt (refereegranskat)abstract
    • Background: The endothelium plays a key role in the maintenance of vascular health and represents a potential physiological target for dietary and other lifestyle interventions designed to reduce the risk of cardiovascular diseases (CVD) including stroke or coronary heart disease. Objective: To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating the effects of the Mediterranean dietary pattern (MedDiet) on endothelial function. Methods: Medline, Embase, and Scopus databases were searched from inception until January 2019 for studies that met the following criteria: 1) RCTs including adult participants, 2) interventions promoting the MedDiet, 3) inclusion of a control group, and 4) measurements of endothelial function. A random-effects meta-analysis was conducted. Metaregression and subgroup analyses were performed to identify whether effects were modified by health status (i.e., healthy participants versus participants with existing comorbidities), type of intervention (i.e., MedDiet alone or with a cointervention), study duration, study design (i.e., parallel or crossover), BMI, and age of participants. Results: Fourteen articles reporting data for 1930 participants were included in the meta-analysis. Study duration ranged from 4 wk to 2.3 y. We observed a beneficial effect of the MedDiet on endothelial function [standardized mean difference (SMD): 0.35; 95% CI: 0.17, 0.53; P <0.001; I-2 = 73.68%]. MedDiet interventions improved flow-mediated dilation (FMD)-the referencemethod for noninvasive, clinical measurement of endothelial function-by 1.66% (absolute change; 95% CI: 1.15, 2.17; P <0.001; I-2 = 0%). Effects of the MedDiet on endothelial function were not modified by health status, type of intervention, study duration, study design, BMI, or age of participants (P >0.05). Conclusions: MedDiet interventions improve endothelial function in adults, suggesting that the protective effects of the MedDiet are evident at early stages of the atherosclerotic process with important implications for the early prevention of CVD.
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50.
  • Xue, Kun, et al. (författare)
  • Impact of a Fermented High-Fiber Rye Diet on Helicobacter pylori and Cardio-Metabolic Risk Factors : A Randomized Controlled Trial Among Helicobacter pylori-Positive Chinese Adults
  • 2021
  • Ingår i: Frontiers in Nutrition. - : Progressive Frontiers Press. - 2296-861X. ; 7
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: High dietary fiber intake has been associated with reduced risk of Helicobacter pylori infection and co-morbidities such as gastric cancer but also with reduced risk of cardiovascular disease. It has been suggested that fermented rye could affect Helicobacter pylori bacterial load and that high- fiber rye may be superior to wheat for improvement of several cardiometabolic risk factors, but few long-term interventions with high fiber rye foods have been conducted.Objective: To examine the effect of high-fiber wholegrain rye foods with added fermented rye bran vs. refined wheat on Helicobacter pylori infection and cardiometabolic risk markers in a Chinese population with a low habitual consumption of high fiber cereal foods.Design: A parallel dietary intervention was set up and 182 normal- or overweight men and women were randomized to consume wholegrain rye products containing fermented rye bran (FRB) or refined wheat (RW) for 12 weeks. Anthropometric measurements, fasting blood sample collection and 13C-urea breath test (13C-UBT) were performed at baseline and after 6 and 12 weeks of intervention as well as 12 weeks after the end of the intervention.Results: No difference between diets on Helicobacter pylori bacterial load measured by 13C-UBT breath test or in virulence factors of Helicobacter pylori in blood samples were found. Low density lipoprotein cholesterol (LDL-C) and high sensitivity C-reactive protein (hs-CRP) were significantly lower in the FRB group, compared to the RW group after 12 weeks of intervention. The intervention diets did not affect markers of glucose metabolism or insulin sensitivity.Conclusions: While the results of the present study did not support any effect of FRB on Helicobacter pylori bacterial load, beneficial effects on LDL-C and hs-CRP were clearly shown. This suggest that consumption of high fiber rye foods instead of refined wheat could be one strategy for primary prevention of cardiovascular disease.
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