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BACKGROUND/OBJECTIVES: Studies suggest that the Mediterranean-style diet (MSD) may improve glucose metabolism in patients with type 2 diabetes (T2D), but the results are inconsistent. We conducted a meta-analysis of randomized controlled trials (RCTs) to explore the effects of MSD on glycemic control, weight loss and cardiovascular risk factors in T2D patients. SUBJECTS/METHODS: We performed searches of EMBASE, Cochrane Library and PubMed databases up to February 2014. We included RCTs that compared the MSD with control diets in patients with T2D. Effect size was estimated as mean difference with 95% confidence interval (CI) by using random effect models. RESULTS: The meta-analysis included nine studies with 1178 patients. Compared with control diets, MSD led to greater reductions in hemoglobin A1c (mean difference, -0.30;95% CI, -0.46 to -0.14), fasting plasma glucose (-0.72 mmol/l; CI, -1.24 to -.21), fasting insulin (-0.55 [micro]U/ml; CI,-0.81 to -0.29), body mass index (-0.29 kg/[m.sup.2]; CI, -0.46 to -0.12) and body weight (-0.29 kg; CI, -0.55 to -0.04). Likewise, concentrations of total cholesterol and triglyceride were decreased (-0.14 mmol/l; CI, -0.19 to -0.09 and -0.29 mmol/l; CI, -0.47 to -0.10, respectively), and high-density lipoprotein was increased (0.06 mmol/l; CI, 0.02 to 0.10). In addition, MSD was associated with a decline of 1.45 mm Hg (CI, -1.97 to -0.94) for systolic blood pressure and 1.41 mm Hg (CI, -1.84 to -0.97) for diastolic blood pressure. CONCLUSIONS: The present meta-analysis provides evidence that MSD improves outcomes of glycemic control, body weight and cardiovascular risk factors in T2D patients. European Journal of Clinical Nutrition (2015) 69, 1200-1208; doi: 10.1038/ejcn.2014.243; published online 5 November 2014, INTRODUCTION Type 2 diabetes (T2D) is a global epidemic and a main threat to human health. It is estimated that about 552 million cases worldwide will suffer from T2D by [...]

Author(s): Maarten J. G. Leening 1,2,3, M. Arfan Ikram 1,* Shortly after World War II, coronary heart disease was recognized as an epidemic. Cardiovascular disease (CVD) had become the leading [...]

Background Clinical practice guidelines have traditionally recommended blood pressure treatment based primarily on blood pressure thresholds. In contrast, using predicted cardiovascular risk has been advocated as a more effective strategy to guide treatment decisions for cardiovascular disease (CVD) prevention. We aimed to compare outcomes from a blood pressure-lowering treatment strategy based on predicted cardiovascular risk with one based on systolic blood pressure (SBP) level. Methods and findings We used individual participant data from the Blood Pressure Lowering Treatment Trialists' Collaboration (BPLTTC) from 1995 to 2013. Trials randomly assigned participants to either blood pressure-lowering drugs versus placebo or more intensive versus less intensive blood pressure-lowering regimens. We estimated 5-y risk of CVD events using a multivariable Weibull model previously developed in this dataset. We compared the two strategies at specific SBP thresholds and across the spectrum of risk and blood pressure levels studied in BPLTTC trials. The primary outcome was number of CVD events avoided per persons treated. We included data from 11 trials (47,872 participants). During a median of 4.0 y of follow-up, 3,566 participants (7.5%) experienced a major cardiovascular event. Areas under the curve comparing the two treatment strategies throughout the range of possible thresholds for CVD risk and SBP demonstrated that, on average, a greater number of CVD events would be avoided for a given number of persons treated with the CVD risk strategy compared with the SBP strategy (area under the curve 0.71 [95% confidence interval (CI) 0.70-0.72] for the CVD risk strategy versus 0.54 [95% CI 0.53-0.55] for the SBP strategy). Compared with treating everyone with SBP [greater than or equal to] 150 mmHg, a CVD risk strategy would require treatment of 29% (95% CI 26%-31%) fewer persons to prevent the same number of events or would prevent 16% (95% CI 14%-18%) more events for the same number of persons treated. Compared with treating everyone with SBP [greater than or equal to] 140 mmHg, a CVD risk strategy would require treatment of 3.8% (95% CI 12.5% fewer to 7.2% more) fewer persons to prevent the same number of events or would prevent 3.1% (95% CI 1.5%-5.0%) more events for the same number of persons treated, although the former estimate was not statistically significant. In subgroup analyses, the CVD risk strategy did not appear to be more beneficial than the SBP strategy in patients with diabetes mellitus or established CVD. Conclusions A blood pressure-lowering treatment strategy based on predicted cardiovascular risk is more effective than one based on blood pressure levels alone across a range of thresholds. These results support using cardiovascular risk assessment to guide blood pressure treatment decision-making in moderate- to high-risk individuals, particularly for primary prevention., Author(s): Kunal N. Karmali 1, Donald M. Lloyd-Jones 1, Joep van der Leeuw 2, David C. Goff 3, Salim Yusuf 4, Alberto Zanchetti 5, Paul Glasziou 6, Rodney Jackson 7, [...]

The objective of the study was to evaluate the efficacy of an interdisciplinary intervention known as Educoeur in reducing cardiovascular risk and improving health behaviors in people without evidence of cardiovascular disease and to compare the Educoeur program to interventions in a specialized clinic and in usual care family practice. In a parallel, randomized, controlled trial of 185 adults with at least two modifiable cardiovascular risk factors, patients were randomly assigned to either Educoeur, specialized clinic or usual care. Cardiovascular risk, biological and lifestyle measures were assessed at baseline and at 2 years. In Educoeur, measurements were also taken before and after the lifestyle group treatment program. In 12 weeks, patients in Educoeur significantly lowered their cardiovascular risk, weight, body mass index, waist circumference, systolic blood pressure, kilocalories intake and improved their V[O.sub.2] Max and mental health. Changes remained significant at 2 years. Between group comparisons at 2 years demonstrated that Educoeur was significantly better in reducing cardiovascular risk than interventions in usual care. Together, these results highlight the importance of providing interdisciplinary programs that optimize cardiovascular risk reduction and promote active lifestyles in patients at risk of cardiovascular disease. Keywords Cardiovascular risk factors * Primary prevention * Cardiovascular disease * Hypertension * Interdisciplinary lifestyle intervention * Health behavior * Nutritional intervention * Exercise, Introduction An estimated 16.7 million of total global deaths result from various forms of cardiovascular disease (World Health Organization, 2003), and several very well-identified lifestyle factors influence the development of [...]

ARTICLE INFO Keywords: Saiko-ka-ryukotsu-borei-To Endothelial progenitor cell Oxidative stress IL-6 Spontaneously hypertensive rat ABSTRACT Endothelial progenitor cells (EPCs) are known to repair vascular injuries. Recent studies suggest that Saiko-ka-ryukotsu-borei-To (SKRBT), [...]

Resveratrol (RS), a polyphenol compound found in grapes and grape products, including wine, peanuts and berries, exists in cis- and trans-isomeric forms. RS is believed to decrease circulating low-density lipoprotein cholesterol levels and reduce cardiovascular disease (CVD) risk. However, it is possible that RS has other mechanisms to reduce the risk of CVD without altering lipid levels. The objective of this review is to critically examine results from recent research concerning potential effects of RS on CVD. RS exerts several health benefits including anti-atherogenic, anti-inflammatory and anti-cancer effects. RS may also prevent lipid oxidation, platelet aggregation, arterial vasodilation and modulates the levels of lipids and lipoproteins. As a potent, anti-oxidant RS reduces oxidative stress and regenerates a-tocopherol, which further strengthens the anti-oxidant defense mechanism. RS has been considered safe as no significant toxic effects have been identified, even when consumed at higher concentrations. This evidence identified RS as an effective anti-atherogenic agent, which could be used in the prevention and treatment of CVD. European Journal of Clinical Nutrition (2010) 64, 660-668; doi: 10.1038/ejcn.2010.77; published online 19 May 2010 Keywords: resveratrol; atherosclerosis; lipids; anti-inflammatory; anti-oxidant, Introduction Resveratrol (RS) naturally occurs as a polyphenol found in grapes and grape products, including wine, as well as other sources including nuts (Cavallaro et al., 2003). RS is also [...]

CORRELATIONS BETWEEN CALCIUM, MAGNESIUM AND HARDNESS OF WATER IN THE DRINKING WATERS OF DECATUR COUNTY GEORGIA AND THE INCIDENCE OF CARDIOVASCULAR AND CEREBROVASCULAR DISEASES, Abe A. Ojo (1) and Manju [...]

Inflammation early in the rheumatoid arthritis (RA) disease course is associated with 2 measures of arterial stiffness, increased pulse-wave velocity (PWV) and augmentation index (AIx), after 15 years. Early, active [...]

Background: Insurance coverage of tobacco cessation medications increases their use and reduces smoking prevalence in a population. However, uncertainty about the impact of this coverage on health care utilization and costs is a barrier to the broader adoption of this policy, especially by publicly funded state Medicaid insurance programs. Whether a publicly funded tobacco cessation benefit leads to decreased medical claims for tobacco-related diseases has not been studied. We examined the experience of Massachusetts, whose Medicaid program adopted comprehensive coverage of tobacco cessation medications in July 2006. Over 75,000 Medicaid subscribers used the benefit in the first 2.5 years. On the basis of earlier secondary survey work, it was estimated that smoking prevalence declined among subscribers by 10% during this period. Methods and Findings: Using claims data, we compared the probability of hospitalization prior to use of the tobacco cessation pharmacotherapy benefit with the probability of hospitalization after benefit use among Massachusetts Medicaid beneficiaries, adjusting for demographics, comorbidities, seasonality, influenza cases, and the implementation of the statewide smoke-free air law using generalized estimating equations. Statistically significant annualized declines of 46% (95% confidence interval 2%-70%) and 49% (95% confidence interval 6%-72%) were observed in hospital admissions for acute myocardial infarction and other acute coronary heart disease diagnoses, respectively. There were no significant decreases in hospitalizations rates for respiratory diagnoses or seven other diagnostic groups evaluated. Conclusions: Among Massachusetts Medicaid subscribers, use of a comprehensive tobacco cessation pharmacotherapy benefit was associated with a significant decrease in claims for hospitalizations for acute myocardial infarction and acute coronary heart disease, but no significant change in hospital claims for other diagnoses. For low-income smokers, removing the barriers to the use of smoking cessation pharmacotherapy has the potential to decrease short-term utilization of hospital services. Please see later in the article for the Editors' Summary., Introduction Cigarette smoking is the leading preventable cause of death in the United States. It also contributes to health disparities, as tobacco use is highest in individuals with less education [...]

Cancer has long been known to be associated with obesity, and one of the most surprising and welcome benefits of successful bariatric surgery has been the near halving of cancer [...]

High levels of high-density lipoprotein (HDL) in the blood are associated with protection from cardiovascular disease. How HDL also exerts anti-inflammatory properties is now shown in mouse models of acute [...]

There is a common perception among physicians and the general public that obesity is behavioral7 and that weight reduction can be achieved by deciding to eat less and exercise more. [...]