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108 results on '"Mozaffarian, Dariush"'

1. Plasma Trimethylamine‐N ‐Oxide and Incident Ischemic Stroke: The Cardiovascular Health Study and the Multi‐Ethnic Study of Atherosclerosis

Author

Lemaitre, Rozenn N, Jensen, Paul N, Wang, Zeneng, Fretts, Amanda M, Sitlani, Colleen M, Nemet, Ina, Sotoodehnia, Nona, de Oliveira Otto, Marcia C, Zhu, Weifei, Budoff, Matt, Longstreth, WT, Psaty, Bruce M, Siscovick, David S, Hazen, Stanley L, and Mozaffarian, Dariush

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Neurosciences, Brain Disorders, Cardiovascular, Atherosclerosis, Stroke, Aging, Cerebrovascular, Women's Health, Good Health and Well Being, Aged, Female, Humans, Ischemic Stroke, Methylamines, Oxides, Prospective Studies, Risk Factors, United States, TMAO, epidemiology, risk factors, stroke, Cardiorespiratory Medicine and Haematology, Cardiovascular medicine and haematology
Abstract

Background The association of circulating trimethylamine-N-oxide (TMAO) with stroke has received limited attention. To address this gap, we examined the associations of serial measures of plasma TMAO with incident ischemic stroke. Methods and Results We used a prospective cohort design with data pooled from 2 cohorts. The settings were the CHS (Cardiovascular Health Study), a cohort of older adults, and the MESA (Multi-Ethnic Study of Atherosclerosis), both in the United States. We measured plasma concentrations of TMAO at baseline and again during the follow-up using high-performance liquid chromatography and mass spectrometry. We assessed the association of plasma TMAO with incident ischemic stroke using proportional hazards regression adjusted for risk factors. The combined cohorts included 11 785 participants without a history of stroke, on average 73 (CHS) and 62 (MESA) years old at baseline, including 60% (CHS) and 53% (MESA) women. We identified 1031 total incident ischemic strokes during a median 15-year follow-up in the combined cohorts. In multivariable analyses, TMAO was significantly associated with incident ischemic stroke risk (hazard ratios comparing a doubling of TMAO: 1.11 [1.03-1.18], P=0.004). The association was linear over the range of TMAO concentrations and appeared restricted to those without diagnosed coronary heart disease. An association with hemorrhagic stroke was not found. Conclusions Plasma TMAO levels are associated with incident ischemic stroke in a diverse population. Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT00005133.

Published
2023

2. Trimethylamine N-oxide is associated with long-term mortality risk: the multi-ethnic study of atherosclerosis.

Author

Wang, Meng, Li, Xinmin, Wang, Zeneng, de Oliveira Otto, Marcia, Lemaitre, Rozenn, Fretts, Amanda, Sotoodehnia, Nona, Nemet, Ina, DiDonato, Joseph, Tang, Wai, Psaty, Bruce, Siscovick, David, Hazen, Stanley, Mozaffarian, Dariush, and Budoff, Matthew

Subjects
Cardiovascular disease, Microbiome, Mortality, Red meat, Trimethylamine N-oxide, Adult, Humans, Risk Factors, Biomarkers, Methylamines, Cardiovascular Diseases, Renal Insufficiency, Atherosclerosis, Neoplasms, Dementia
Abstract

AIMS: Little is known about associations of trimethylamine N-oxide (TMAO), a novel gut microbiota-generated metabolite of dietary phosphatidylcholine and carnitine, and its changes over time with all-cause and cause-specific mortality in the general population or in different race/ethnicity groups. The study aimed to investigate associations of serially measured plasma TMAO levels and changes in TMAO over time with all-cause and cause-specific mortality in a multi-ethnic community-based cohort. METHODS AND RESULTS: The study included 6,785 adults from the Multi-Ethnic Study of Atherosclerosis. TMAO was measured at baseline and year 5 using mass spectrometry. Primary outcomes were adjudicated all-cause mortality and cardiovascular disease (CVD) mortality. Secondary outcomes were deaths due to kidney failure, cancer, or dementia obtained from death certificates. Cox proportional hazards models with time-varying TMAO and covariates assessed the associations with adjustment for sociodemographics, lifestyles, diet, metabolic factors, and comorbidities. During a median follow-up of 16.9 years, 1704 participants died and 411 from CVD. Higher TMAO levels associated with higher risk of all-cause mortality [hazard ratio (HR): 1.12, 95% confidence interval (CI): 1.08-1.17], CVD mortality (HR: 1.09, 95% CI: 1.00-1.09), and death due to kidney failure (HR: 1.44, 95% CI: 1.25-1.66) per inter-quintile range, but not deaths due to cancer or dementia. Annualized changes in TMAO levels associated with higher risk of all-cause mortality (HR: 1.10, 95% CI: 1.05-1.14) and death due to kidney failure (HR: 1.54, 95% CI: 1.26-1.89) but not other deaths. CONCLUSION: Plasma TMAO levels were positively associated with mortality, especially deaths due to cardiovascular and renal disease, in a multi-ethnic US cohort.

Published
2023

3. Dietary Meat, Trimethylamine N-Oxide-Related Metabolites, and Incident Cardiovascular Disease Among Older Adults: The Cardiovascular Health Study.

Author

Wang, Meng, Wang, Zeneng, Lee, Yujin, Lai, Heidi, de Oliveira Otto, Marcia, Lemaitre, Rozenn, Fretts, Amanda, Sotoodehnia, Nona, DiDonato, Joseph, McKnight, Barbara, Tang, W, Psaty, Bruce, Siscovick, David, Hazen, Stanley, Mozaffarian, Dariush, and Budoff, Matthew

Subjects
cardiovascular diseases, microbiome, myocardial infarction, red meat, stroke, trimethylamine N-oxide, Animals, Atherosclerosis, Cardiovascular Diseases, Carnitine, Humans, Meat, Methylamines, Risk Factors
Abstract

BACKGROUND: Effects of animal source foods (ASF) on atherosclerotic cardiovascular disease (ASCVD) and underlying mechanisms remain controversial. We investigated prospective associations of different ASF with incident ASCVD and potential mediation by gut microbiota-generated trimethylamine N-oxide, its L-carnitine-derived intermediates γ-butyrobetaine and crotonobetaine, and traditional ASCVD risk pathways. METHODS: Among 3931 participants from a community-based US cohort aged 65+ years, ASF intakes and trimethylamine N-oxide-related metabolites were measured serially over time. Incident ASCVD (myocardial infarction, fatal coronary heart disease, stroke, other atherosclerotic death) was adjudicated over 12.5 years median follow-up. Cox proportional hazards models with time-varying exposures and covariates examined ASF-ASCVD associations; and additive hazard models, mediation proportions by different risk pathways. RESULTS: After multivariable-adjustment, higher intakes of unprocessed red meat, total meat, and total ASF associated with higher ASCVD risk, with hazard ratios (95% CI) per interquintile range of 1.15 (1.01-1.30), 1.22 (1.07-1.39), and 1.18 (1.03-1.34), respectively. Trimethylamine N-oxide-related metabolites together significantly mediated these associations, with mediation proportions (95% CI) of 10.6% (1.0-114.5), 7.8% (1.0-32.7), and 9.2% (2.2-44.5), respectively. Processed meat intake associated with a nonsignificant trend toward higher ASCVD (1.11 [0.98-1.25]); intakes of fish, poultry, and eggs were not significantly associated. Among other risk pathways, blood glucose, insulin, and C-reactive protein, but not blood pressure or blood cholesterol, each significantly mediated the total meat-ASCVD association. CONCLUSIONS: In this large, community-based cohort, higher meat intake associated with incident ASCVD, partly mediated by microbiota-derived metabolites of L-carnitine, abundant in red meat. These novel findings support biochemical links between dietary meat, gut microbiome pathways, and ASCVD.

Published
2022

4. Trimethylamine N-oxide and hip fracture and bone mineral density in older adults: The cardiovascular health study.

Author

Elam, Rachel, Bůžková, Petra, Barzilay, Joshua, Wang, Zeneng, Nemet, Ina, Budoff, Matthew, Cauley, Jane, Fink, Howard, Lee, Yujin, Robbins, John, Wang, Meng, Hazen, Stanley, Mozaffarian, Dariush, and Carbone, Laura

Subjects
Animal food, Bone mineral density, Gut microbiome, Hip fracture, Osteoporosis, Trimethylamine N-oxide, Absorptiometry, Photon, Aged, Bone Density, Female, Hip Fractures, Humans, Male, Methylamines, Risk Factors
Abstract

CONTEXT: Gut microbiota-derived metabolite trimethylamine N-oxide (TMAO) may adversely affect bone by inducing oxidative stress. Whether this translates into increased fracture risk in older adults is uncertain. OBJECTIVE: Determine the associations of plasma TMAO with hip fracture and bone mineral density (BMD) in older adults. DESIGN AND SETTING: Cox hazard models and linear regression stratified by sex examined the associations of TMAO with hip fracture and BMD in the longitudinal cohort of the Cardiovascular Health Study. PARTICIPANTS: 5019 U.S. adults aged ≥65 years. EXPOSURE: Plasma TMAO. MAIN OUTCOME MEASURES: Incident hip fractures; total hip BMD dual x-ray absorptiometry in a subset (n = 1400). RESULTS: Six hundred sixty-six incident hip fractures occurred during up to 26 years of follow-up (67,574 person-years). After multivariable adjustment, TMAO was not significantly associated with hip fracture (women: hazard ratio (HR) [95% confidence interval (CI)] of 1.00[0.92,1.09] per TMAO doubling; men: 1.12[0.95,1.33]). TMAO was also not associated with total hip BMD (women: BMD difference [95% CI] of 0.42 g/cm2*100 [-0.34,1.17] per TMAO doubling; men: 0.19[-1.04,1.42]). In exploratory analyses, we found an interaction between body mass index (BMI) and the association of TMAO with hip fracture (P

Published
2022

5. Trans Fatty Acid Biomarkers and Incident Type 2 Diabetes: Pooled Analysis of 12 Prospective Cohort Studies in the Fatty Acids and Outcomes Research Consortium (FORCE).

Author

Lai, Heidi TM, Imamura, Fumiaki, Korat, Andres V Ardisson, Murphy, Rachel A, Tintle, Nathan, Bassett, Julie K, Chen, Jiaying, Kröger, Janine, Chien, Kuo-Liong, Senn, Mackenzie, Wood, Alexis C, Forouhi, Nita G, Schulze, Matthias B, Harris, William S, Vasan, Ramachandran S, Hu, Frank, Giles, Graham G, Hodge, Allison, Djousse, Luc, Brouwer, Ingeborg A, Qian, Frank, Sun, Qi, Wu, Jason HY, Marklund, Matti, Lemaitre, Rozenn N, Siscovick, David S, Fretts, Amanda M, Shadyab, Aladdin H, Manson, JoAnn E, Howard, Barbara V, Robinson, Jennifer G, Wallace, Robert B, Wareham, Nick J, Chen, Yii-Der Ida, Rotter, Jerome I, Tsai, Michael Y, Micha, Renata, and Mozaffarian, Dariush

Subjects
Epidemiology, Biomedical and Clinical Sciences, Health Sciences, Diabetes, Clinical Research, Metabolic and endocrine, Adolescent, Adult, Biomarkers, Cohort Studies, Diabetes Mellitus, Type 2, Fatty Acids, Humans, Outcome Assessment, Health Care, Prospective Studies, Risk Factors, Trans Fatty Acids, Fatty Acids and Outcomes Research Consortium, Medical and Health Sciences, Endocrinology & Metabolism, Biomedical and clinical sciences, Health sciences
Abstract

ObjectiveTrans fatty acids (TFAs) have harmful biologic effects that could increase the risk of type 2 diabetes (T2D), but evidence remains uncertain. We aimed to investigate the prospective associations of TFA biomarkers and T2D by conducting an individual participant-level pooled analysis.Research design and methodsWe included data from an international consortium of 12 prospective cohorts and nested case-control studies from six nations. TFA biomarkers were measured in blood collected between 1990 and 2008 from 25,126 participants aged ≥18 years without prevalent diabetes. Each cohort conducted de novo harmonized analyses using a prespecified protocol, and findings were pooled using inverse-variance weighted meta-analysis. Heterogeneity was explored by prespecified between-study and within-study characteristics.ResultsDuring a mean follow-up of 13.5 years, 2,843 cases of incident T2D were identified. In multivariable-adjusted pooled analyses, no significant associations with T2D were identified for trans/trans-18:2, relative risk (RR) 1.09 (95% CI 0.94-1.25); cis/trans-18:2, 0.89 (0.73-1.07); and trans/cis-18:2, 0.87 (0.73-1.03). Trans-16:1n-9, total trans-18:1, and total trans-18:2 were inversely associated with T2D (RR 0.81 [95% CI 0.67-0.99], 0.86 [0.75-0.99], and 0.84 [0.74-0.96], respectively). Findings were not significantly different according to prespecified sources of potential heterogeneity (each P ≥ 0.1).ConclusionsCirculating individual trans-18:2 TFA biomarkers were not associated with risk of T2D, while trans-16:1n-9, total trans-18:1, and total trans-18:2 were inversely associated. Findings may reflect the influence of mixed TFA sources (industrial vs. natural ruminant), a general decline in TFA exposure due to policy changes during this period, or the relatively limited range of TFA levels.

Published
2022

6. PUFA ω-3 and ω-6 biomarkers and sleep: a pooled analysis of cohort studies on behalf of the Fatty Acids and Outcomes Research Consortium (FORCE)

Author

Murphy, Rachel A, Tintle, Nathan, Harris, William S, Darvishian, Maryam, Marklund, Matti, Virtanen, Jyrki K, Hantunen, Sari, de Mello, Vanessa D, Tuomilehto, Jaakko, Lindström, Jaana, Bolt, Matthew A, Brouwer, Ingeborg A, Wood, Alexis C, Senn, Mackenzie, Redline, Susan, Tsai, Michael Y, Gudnason, Vilmundur, Eiriksdottir, Gudny, Lindberg, Eva, Shadyab, Aladdin H, Liu, Buyun, Carnethon, Mercedes, Uusitupa, Matti, Djousse, Luc, Risérus, Ulf, Lind, Lars, van Dam, Rob M, Koh, Woon-Puay, Shi, Peilin, Siscovick, David, Lemaitre, Rozenn N, and Mozaffarian, Dariush

Subjects
Biomedical and Clinical Sciences, Nutrition and Dietetics, Nutrition, Clinical Research, Sleep Research, Good Health and Well Being, Biomarkers, Cohort Studies, Cross-Sectional Studies, Fatty Acids, Fatty Acids, Omega-3, Humans, Outcome Assessment, Health Care, Sleep, sleep quality, omega-3, fatty acids, diet, public health, biomarkers, Engineering, Medical and Health Sciences, Nutrition & Dietetics, Clinical sciences, Nutrition and dietetics
Abstract

Backgroundn-3 and n-6 PUFAs have physiologic roles in sleep processes, but little is known regarding circulating n-3 and n-6 PUFA and sleep parameters.ObjectivesWe sought to assess associations between biomarkers of n-3 and n-6 PUFA intake with self-reported sleep duration and difficulty falling sleeping in the Fatty Acids and Outcome Research Consortium.MethodsHarmonized, de novo, individual-level analyses were performed and pooled across 12 cohorts. Participants were 35-96 y old and from 5 nations. Circulating measures included α-linolenic acid (ALA), EPA, docosapentaenoic acid (DPA), DHA, EPA + DPA + DHA, linoleic acid, and arachidonic acid. Sleep duration (10 cohorts, n = 18,791) was categorized as short (≤6 h), 7-8 h (reference), or long (≥9 h). Difficulty falling asleep (8 cohorts, n = 12,500) was categorized as yes or no. Associations between PUFAs, sleep duration, and difficulty falling sleeping were assessed by cross-sectional multinomial logistic regression using standardized protocols and covariates. Cohort-specific multivariable-adjusted ORs per quintile of PUFAs were pooled with inverse-variance weighted meta-analysis.ResultsIn pooled analysis adjusted for sociodemographic characteristics and health status, participants with higher very long-chain n-3 PUFAs were less likely to have long sleep duration. In the top compared with the bottom quintiles, the multivariable-adjusted ORs (95% CIs) for long sleep were 0.78 (95% CI: 0.65, 0.95) for DHA and 0.76 (95% CI: 0.63, 0.93) for EPA + DPA + DHA. Significant associations for ALA and n-6 PUFA with short sleep duration or difficulty falling sleeping were not identified.ConclusionsParticipants with higher concentrations of very long-chain n-3 PUFAs were less likely to have long sleep duration. While objective biomarkers reduce recall bias and misclassification, the cross-sectional design limits assessment of the temporal nature of this relation. These novel findings across 12 cohorts highlight the need for experimental and biological assessments of very long-chain n-3 PUFAs and sleep duration.

Published
2022

7. Longitudinal Plasma Measures of Trimethylamine N‐Oxide and Risk of Atherosclerotic Cardiovascular Disease Events in Community‐Based Older Adults

Author

Lee, Yujin, Nemet, Ina, Wang, Zeneng, Lai, Heidi TM, de Oliveira Otto, Marcia C, Lemaitre, Rozenn N, Fretts, Amanda M, Sotoodehnia, Nona, Budoff, Matthew, DiDonato, Joseph A, McKnight, Barbara, Tang, WH Wilson, Psaty, Bruce M, Siscovick, David S, Hazen, Stanley L, and Mozaffarian, Dariush

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Aging, Nutrition, Cardiovascular, Clinical Research, Heart Disease - Coronary Heart Disease, Prevention, Kidney Disease, Heart Disease, Atherosclerosis, Good Health and Well Being, Aged, Biomarkers, Cardiovascular Diseases, Humans, Methylamines, Middle Aged, Prospective Studies, Risk Factors, animal food, atherosclerotic cardiovascular disease, renal function, trimethylamine N-oxide, trimethylamine N‐oxide, Cardiorespiratory Medicine and Haematology, Cardiovascular medicine and haematology
Abstract

Background Trimethylamine N-oxide (TMAO) is a gut microbiota-dependent metabolite of dietary choline, L-carnitine, and phosphatidylcholine-rich foods. On the basis of experimental studies and patients with prevalent disease, elevated plasma TMAO may increase risk of atherosclerotic cardiovascular disease (ASCVD). TMAO is also renally cleared and may interact with and causally contribute to renal dysfunction. Yet, how serial TMAO levels relate to incident and recurrent ASCVD in community-based populations and the potential mediating or modifying role of renal function are not established. Methods and Results We investigated associations of serial measures of plasma TMAO, assessed at baseline and 7 years, with incident and recurrent ASCVD in a community-based cohort of 4131 (incident) and 1449 (recurrent) older US adults. TMAO was measured using stable isotope dilution liquid chromatography-tandem mass spectrometry (laboratory coefficient of variation,

Published
2021

8. Sugar-Sweetened Beverage Consumption May Modify Associations Between Genetic Variants in the CHREBP (Carbohydrate Responsive Element Binding Protein) Locus and HDL-C (High-Density Lipoprotein Cholesterol) and Triglyceride Concentrations.

Author

Haslam, Danielle E, Peloso, Gina M, Guirette, Melanie, Imamura, Fumiaki, Bartz, Traci M, Pitsillides, Achilleas N, Wang, Carol A, Li-Gao, Ruifang, Westra, Jason M, Pitkänen, Niina, Young, Kristin L, Graff, Mariaelisa, Wood, Alexis C, Braun, Kim VE, Luan, Jian'an, Kähönen, Mika, Kiefte-de Jong, Jessica C, Ghanbari, Mohsen, Tintle, Nathan, Lemaitre, Rozenn N, Mook-Kanamori, Dennis O, North, Kari, Helminen, Mika, Mossavar-Rahmani, Yasmin, Snetselaar, Linda, Martin, Lisa W, Viikari, Jorma S, Oddy, Wendy H, Pennell, Craig E, Rosendall, Frits R, Ikram, M Arfan, Uitterlinden, Andre G, Psaty, Bruce M, Mozaffarian, Dariush, Rotter, Jerome I, Taylor, Kent D, Lehtimäki, Terho, Raitakari, Olli T, Livingston, Kara A, Voortman, Trudy, Forouhi, Nita G, Wareham, Nick J, de Mutsert, Renée, Rich, Steven S, Manson, JoAnn E, Mora, Samia, Ridker, Paul M, Merino, Jordi, Meigs, James B, Dashti, Hassan S, Chasman, Daniel I, Lichtenstein, Alice H, Smith, Caren E, Dupuis, Josée, Herman, Mark A, and McKeown, Nicola M

Subjects
Humans, Triglycerides, Polymorphism, Single Nucleotide, Adult, Middle Aged, Female, Male, Basic Helix-Loop-Helix Leucine Zipper Transcription Factors, Cholesterol, HDL, Meta-Analysis as Topic, Sugar-Sweetened Beverages, carbohydrates, dyslipidemia, epidemiology, genetics, nutrition, sugars, triglyceride, Cardiovascular, Genetics, Human Genome
Abstract

BackgroundChREBP (carbohydrate responsive element binding protein) is a transcription factor that responds to sugar consumption. Sugar-sweetened beverage (SSB) consumption and genetic variants in the CHREBP locus have separately been linked to HDL-C (high-density lipoprotein cholesterol) and triglyceride concentrations. We hypothesized that SSB consumption would modify the association between genetic variants in the CHREBP locus and dyslipidemia.MethodsData from 11 cohorts from the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium (N=63 599) and the UK Biobank (N=59 220) were used to quantify associations of SSB consumption, genetic variants, and their interaction on HDL-C and triglyceride concentrations using linear regression models. A total of 1606 single nucleotide polymorphisms within or near CHREBP were considered. SSB consumption was estimated from validated questionnaires, and participants were grouped by their estimated intake.ResultsIn a meta-analysis, rs71556729 was significantly associated with higher HDL-C concentrations only among the highest SSB consumers (β, 2.12 [95% CI, 1.16-3.07] mg/dL per allele; P

Published
2021

9. Cardiovascular, respiratory, and related disorders: key messages from Disease Control Priorities, 3rd edition

Author

Prabhakaran, Dorairaj, Anand, Shuchi, Watkins, David, Gaziano, Thomas, Wu, Yangfeng, Mbanya, Jean Claude, Nugent, Rachel, Ajay, Vamadevan S, Afshin, Ashkan, Adler, Alma, Ali, Mohammed K, Bateman, Eric, Bettger, Janet, Bonow, Robert O, Brouwer, Elizabeth, Bukhman, Gene, Bull, Fiona, Burney, Peter, Capewell, Simon, Chan, Juliana, Chandrasekar, Eeshwar K, Chen, Jie, Criqui, Michael H, Dirks, John, Dugani, Sagar B, Engelgau, Michael, Nahas, Meguid El, Fall, Caroline HD, Feigin, Valery, Fowkes, F Gerald R, Glassman, Amanda, Goenka, Shifalika, Gupta, Rajeev, Hasan, Babar, Hersch, Fred, Hu, Frank, Huffman, Mark D, Jabbour, Samer, Jarvis, Deborah, Jeemon, Panniyammakal, Joshi, Rohina, Kamano, Jemima H, Kengne, Andre Pascal, Kudesia, Preeti, Kumar, R Krishna, Kumaran, Kalyanaraman, Lambert, Estelle V, Lee, Edward S, Li, Chaoyun, Luo, Rong, Magee, Matthew, Malik, Vasanti S, Marin-Neto, J Antonio, Marks, Guy, Mayosi, Bongani, McGuire, Helen, Micha, Renata, Miranda, J Jaime, Montoya, Pablo Aschner, Moran, Andrew E, Mozaffarian, Dariush, Naicker, Saraladevi, Naidoo, Nadraj G, Narayan, KM Venkat, Nikolic, Irina, O'Donnell, Martin, Onen, Churchill, Osmond, Clive, Patel, Anushka, Perez-Padilla, Rogelio, Poulter, Neil, Pratt, Michael, Rabkin, Miriam, Rajan, Vikram, Rassi, Anis, Rawal, Ishita, Remuzzi, Giuseppe, Riella, Miguel, Roth, Greg A, Roy, Ambuj, Rubinstein, Adolfo, Sakuma, Yuna, Sampson, Uchechukwu KA, Siegel, Karen R, Sliwa, Karen, Suhrcke, Marc, Tandon, Nikhil, Thomas, Bernadette, Vaca, Claudia, Vedanthan, Rajesh, Verguet, Stéphane, Webb, Michael, Weber, Mary Beth, Whitsel, Laurie, Wong, Gary, Yan, Lijing L, Yancy, Clyde W, Zhang, Ping, and Zhao, Dong

Subjects
Biomedical and Clinical Sciences, Public Health, Health Sciences, Cardiovascular, Health Services, Clinical Research, Prevention, Good Health and Well Being, Cardiovascular Diseases, Developing Countries, Health Priorities, Humans, Respiratory Tract Diseases, Disease Control Priorities-3 Cardiovascular, Respiratory, and Related Disorders Author Group, Medical and Health Sciences, General & Internal Medicine, Biomedical and clinical sciences, Health sciences
Abstract

Cardiovascular, respiratory, and related disorders (CVRDs) are the leading causes of adult death worldwide, and substantial inequalities in care of patients with CVRDs exist between countries of high income and countries of low and middle income. Based on current trends, the UN Sustainable Development Goal to reduce premature mortality due to CVRDs by a third by 2030 will be challenging for many countries of low and middle income. We did systematic literature reviews of effectiveness and cost-effectiveness to identify priority interventions. We summarise the key findings and present a costed essential package of interventions to reduce risk of and manage CVRDs. On a population level, we recommend tobacco taxation, bans on trans fats, and compulsory reduction of salt in manufactured food products. We suggest primary health services be strengthened through the establishment of locally endorsed guidelines and ensured availability of essential medications. The policy interventions and health service delivery package we suggest could serve as the cornerstone for the management of CVRDs, and afford substantial financial risk protection for vulnerable households. We estimate that full implementation of the essential package would cost an additional US$21 per person in the average low-income country and $24 in the average lower-middle-income country. The essential package we describe could be a starting place for low-income and middle-income countries developing universal health coverage packages. Interventions could be rolled out as disease burden demands and budgets allow. Our outlined interventions provide a pathway for countries attempting to convert the UN Sustainable Development Goal commitments into tangible action.

Published
2018

10. Dairy Consumption and Body Mass Index Among Adults: Mendelian Randomization Analysis of 184802 Individuals from 25 Studies

Author

Huang, Tao, Ding, Ming, Bergholdt Helle, KM, Wang, Tiange, Heianza, Yoriko, Sun, Dianjianyi, Frazier-Wood Alexis, C, Aslibekyan, Stella, North Kari, E, Voortman, Trudy, Graff, Mariaelisa, Smith Caren, E, Lai, Chao-Qiang, Varbo, Anette, Lemaitre, Rozenn N, de Jonge, M Ester AL, Fumeron, Frédéric, Corella, Dolores, Wang, Carol A, Tjønneland, Anne, Overvad, Kim, Sørensen, Thorkild IA, Feitosa, Mary F, Wojczynski, Mary K, Kähönen, Mika, Renström, Frida, Psaty, Bruce M, Siscovick, David S, Barroso, Inês, Johansson, Ingegerd, Hernandez, Dena, Ferrucci, Luigi, Bandinelli, Stefania, Linneberg, Allan, Zillikens, M Carola, Sandholt, Camilla Helene, Pedersen, Oluf, Hansen, Torben, Schulz, Christina-Alexandra, Sonestedt, Emily, Orho-Melander, Marju, Chen, Tzu-An, Rotter, Jerome I, Allison, Mathew A, Rich, Stephen S, Sorlí, Jose V, Coltell, Oscar, Pennell, Craig E, Eastwood, Peter, Hofman, Albert, Uitterlinden, Andre G, van Rooij, Frank JA, Chu, Audrey Y, Rose, Lynda M, Ridker, Paul M, Viikari, Jorma, Raitakari, Olli, Lehtimäki, Terho, Mikkilä, Vera, Willett, Walter C, Wang, Yujie, Tucker, Katherine L, Ordovas, Jose M, Kilpeläinen, Tuomas O, Province, Michael A, Franks, Paul W, Arnett, Donna K, Tanaka, Toshiko, Toft, Ulla, Ericson, Ulrika, Franco, Oscar H, Mozaffarian, Dariush, Hu, Frank B, Chasman, Daniel I, Nordestgaard, Børge G, Ellervik, Christina, and Qi, Lu

Subjects
Biomedical and Clinical Sciences, Nutrition and Dietetics, Prevention, Genetics, Adult, Body Mass Index, Body Weight, Cross-Sectional Studies, Dairy Products, Genotype, Humans, Mendelian Randomization Analysis, Polymorphism, Genetic, Polymorphism, Single Nucleotide, Prospective Studies, Mendelian Randomization of Dairy Consumption Working Group, Medical Biotechnology, Medical Biochemistry and Metabolomics, Clinical Sciences, General Clinical Medicine, Clinical sciences, Medical biochemistry and metabolomics
Abstract

BackgroundAssociations between dairy intake and body mass index (BMI) have been inconsistently observed in epidemiological studies, and the causal relationship remains ill defined.MethodsWe performed Mendelian randomization (MR) analysis using an established dairy intake-associated genetic polymorphism located upstream of the lactase gene (LCT-13910 C/T, rs4988235) as an instrumental variable (IV). Linear regression models were fitted to analyze associations between (a) dairy intake and BMI, (b) rs4988235 and dairy intake, and (c) rs4988235 and BMI in each study. The causal effect of dairy intake on BMI was quantified by IV estimators among 184802 participants from 25 studies.ResultsHigher dairy intake was associated with higher BMI (β = 0.03 kg/m2 per serving/day; 95% CI, 0.00-0.06; P = 0.04), whereas the LCT genotype with 1 or 2 T allele was significantly associated with 0.20 (95% CI, 0.14-0.25) serving/day higher dairy intake (P = 3.15 × 10-12) and 0.12 (95% CI, 0.06-0.17) kg/m2 higher BMI (P = 2.11 × 10-5). MR analysis showed that the genetically determined higher dairy intake was significantly associated with higher BMI (β = 0.60 kg/m2 per serving/day; 95% CI, 0.27-0.92; P = 3.0 × 10-4).ConclusionsThe present study provides strong evidence to support a causal effect of higher dairy intake on increased BMI among adults.

Published
2018

11. Genome-wide association meta-analysis of fish and EPA+DHA consumption in 17 US and European cohorts

Author

Mozaffarian, Dariush, Dashti, Hassan S, Wojczynski, Mary K, Chu, Audrey Y, Nettleton, Jennifer A, Männistö, Satu, Kristiansson, Kati, Reedik, Mägi, Lahti, Jari, Houston, Denise K, Cornelis, Marilyn C, van Rooij, Frank JA, Dimitriou, Maria, Kanoni, Stavroula, Mikkilä, Vera, Steffen, Lyn M, de Oliveira Otto, Marcia C, Qi, Lu, Psaty, Bruce, Djousse, Luc, Rotter, Jerome I, Harald, Kennet, Perola, Markus, Rissanen, Harri, Jula, Antti, Krista, Fischer, Mihailov, Evelin, Feitosa, Mary F, Ngwa, Julius S, Xue, Luting, Jacques, Paul F, Perälä, Mia-Maria, Palotie, Aarno, Liu, Yongmei, Nalls, Nike A, Ferrucci, Luigi, Hernandez, Dena, Manichaikul, Ani, Tsai, Michael Y, Jong, Jessica C Kiefte-de, Hofman, Albert, Uitterlinden, André G, Rallidis, Loukianos, Ridker, Paul M, Rose, Lynda M, Buring, Julie E, Lehtimäki, Terho, Kähönen, Mika, Viikari, Jorma, Lemaitre, Rozenn, Salomaa, Veikko, Knekt, Paul, Metspalu, Andres, Borecki, Ingrid B, Cupples, L Adrienne, Eriksson, Johan G, Kritchevsky, Stephen B, Bandinelli, Stefania, Siscovick, David, Franco, Oscar H, Deloukas, Panos, Dedoussis, George, Chasman, Daniel I, Raitakari, Olli, and Tanaka, Toshiko

Subjects
Biological Sciences, Biomedical and Clinical Sciences, Genetics, Epidemiology, Health Sciences, Nutrition and Dietetics, Human Genome, Prevention, Complementary and Integrative Health, Nutrition, Cardiovascular, Oral and gastrointestinal, Cancer, Stroke, Adult, Aged, Cohort Studies, Docosahexaenoic Acids, Eicosapentaenoic Acid, Europe, Female, Genome-Wide Association Study, Humans, Male, Middle Aged, Seafood, United States, White People, General Science & Technology
Abstract

BackgroundRegular fish and omega-3 consumption may have several health benefits and are recommended by major dietary guidelines. Yet, their intakes remain remarkably variable both within and across populations, which could partly owe to genetic influences.ObjectiveTo identify common genetic variants that influence fish and dietary eicosapentaenoic acid plus docosahexaenoic acid (EPA+DHA) consumption.DesignWe conducted genome-wide association (GWA) meta-analysis of fish (n = 86,467) and EPA+DHA (n = 62,265) consumption in 17 cohorts of European descent from the CHARGE (Cohorts for Heart and Aging Research in Genomic Epidemiology) Consortium Nutrition Working Group. Results from cohort-specific GWA analyses (additive model) for fish and EPA+DHA consumption were adjusted for age, sex, energy intake, and population stratification, and meta-analyzed separately using fixed-effect meta-analysis with inverse variance weights (METAL software). Additionally, heritability was estimated in 2 cohorts.ResultsHeritability estimates for fish and EPA+DHA consumption ranged from 0.13-0.24 and 0.12-0.22, respectively. A significant GWA for fish intake was observed for rs9502823 on chromosome 6: each copy of the minor allele (FreqA = 0.015) was associated with 0.029 servings/day (~1 serving/month) lower fish consumption (P = 1.96x10-8). No significant association was observed for EPA+DHA, although rs7206790 in the obesity-associated FTO gene was among top hits (P = 8.18x10-7). Post-hoc calculations demonstrated 95% statistical power to detect a genetic variant associated with effect size of 0.05% for fish and 0.08% for EPA+DHA.ConclusionsThese novel findings suggest that non-genetic personal and environmental factors are principal determinants of the remarkable variation in fish consumption, representing modifiable targets for increasing intakes among all individuals. Genes underlying the signal at rs72838923 and mechanisms for the association warrant further investigation.

Published
2017

12. Effect of fish oil on monoepoxides derived from fatty acids during cardiac surgery 1 [S]

Author

Akintoye, Emmanuel, Wu, Jason HY, Hou, Tao, Song, Xiaoling, Yang, Jun, Hammock, Bruce, and Mozaffarian, Dariush

Subjects
Biomedical and Clinical Sciences, Nutrition and Dietetics, Clinical Sciences, Cardiovascular, Nutrition, Prevention, Clinical Research, Dietary Supplements, Heart Disease, Clinical Trials and Supportive Activities, Complementary and Integrative Health, Prevention of disease and conditions, and promotion of well-being, 3.3 Nutrition and chemoprevention, Cardiac Surgical Procedures, Epoxy Compounds, Fatty Acids, Unsaturated, Female, Fish Oils, Humans, Male, Middle Aged, diet and dietary lipids, inflammation, omega-3 fatty acids, phospholipids, vascular biology, randomized controlled trial, Biochemistry and Cell Biology, Medical Biochemistry and Metabolomics, Biochemistry & Molecular Biology, Biochemistry and cell biology, Medical biochemistry and metabolomics
Abstract

Our objective was to assess the dynamics of monoepoxides derived from polyunsaturated fatty acids (MEFAs), and their response to n-3 PUFA supplementation, in the setting of acute tissue injury and inflammation (cardiac surgery) in humans. Patients (479) undergoing cardiac surgery in three countries were randomized to perioperative fish oil (EPA + DHA; 8-10 g over 2-5 days preoperatively, then 2 g/day postoperatively) or placebo (olive oil). Plasma MEFAs derived from n-3 and n-6 PUFAs were measured 2 days postoperatively. Based on serial measures in a subset of the placebo group, levels of all MEFAs declined substantially following surgery (at postoperative day 2), with declines ranging from 37% to 63% (P < 0.05 each). Compared with placebo at postoperative day 2, levels of EPA- and DHA-derived MEFAs were 40% and 18% higher, respectively (P ≤ 0.004). The n-3 PUFA supplementation did not significantly alter the decline in n-6 PUFA-derived MEFAs. Both enrollment level and changes in plasma phospholipid EPA and DHA were associated with their respective MEFAs at postoperative day 2 (P < 0.001). Under the acute stress of cardiac surgery, n-3 PUFA supplementation significantly ameliorated the reduction in postoperative n-3 MEFAs, but not n-6 MEFAs, and the degree of increase in n-3 MEFAs related positively to the circulating level of their n-3 PUFA precursors.

Published
2016

13. Heart Disease and Stroke Statistics—2016 Update

Author

Mozaffarian, Dariush, Benjamin, Emelia J, Go, Alan S, Arnett, Donna K, Blaha, Michael J, Cushman, Mary, Das, Sandeep R, de Ferranti, Sarah, Després, Jean-Pierre, Fullerton, Heather J, Howard, Virginia J, Huffman, Mark D, Isasi, Carmen R, Jiménez, Monik C, Judd, Suzanne E, Kissela, Brett M, Lichtman, Judith H, Lisabeth, Lynda D, Liu, Simin, Mackey, Rachel H, Magid, David J, McGuire, Darren K, Mohler, Emile R, Moy, Claudia S, Muntner, Paul, Mussolino, Michael E, Nasir, Khurram, Neumar, Robert W, Nichol, Graham, Palaniappan, Latha, Pandey, Dilip K, Reeves, Mathew J, Rodriguez, Carlos J, Rosamond, Wayne, Sorlie, Paul D, Stein, Joel, Towfighi, Amytis, Turan, Tanya N, Virani, Salim S, Woo, Daniel, Yeh, Robert W, and Turner, Melanie B

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Health Sciences, Clinical Sciences, Sports Science and Exercise, American Heart Association, Data Interpretation, Statistical, Heart Diseases, Humans, Life Style, Research Report, Stroke, United States, AHA Scientific Statements, cardiovascular diseases, epidemiology, risk factors, statistics, stroke, Writing Group Members, American Heart Association Statistics Committee, Stroke Statistics Subcommittee, Cardiorespiratory Medicine and Haematology, Public Health and Health Services, Cardiovascular System & Hematology, Cardiovascular medicine and haematology, Clinical sciences, Sports science and exercise
Published
2016

14. Executive Summary

Author

Mozaffarian, Dariush, Benjamin, Emelia J, Go, Alan S, Arnett, Donna K, Blaha, Michael J, Cushman, Mary, Das, Sandeep R, de Ferranti, Sarah, Després, Jean-Pierre, Fullerton, Heather J, Howard, Virginia J, Huffman, Mark D, Isasi, Carmen R, Jiménez, Monik C, Judd, Suzanne E, Kissela, Brett M, Lichtman, Judith H, Lisabeth, Lynda D, Liu, Simin, Mackey, Rachel H, Magid, David J, McGuire, Darren K, Mohler, Emile R, Moy, Claudia S, Muntner, Paul, Mussolino, Michael E, Nasir, Khurram, Neumar, Robert W, Nichol, Graham, Palaniappan, Latha, Pandey, Dilip K, Reeves, Mathew J, Rodriguez, Carlos J, Rosamond, Wayne, Sorlie, Paul D, Stein, Joel, Towfighi, Amytis, Turan, Tanya N, Virani, Salim S, Woo, Daniel, Yeh, Robert W, and Turner, Melanie B

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Health Sciences, Clinical Sciences, Sports Science and Exercise, American Heart Association, Data Interpretation, Statistical, Health Behavior, Heart Diseases, Humans, Research Report, Stroke, United States, AHA Scientific Statements, cardiovascular diseases, epidemiology, risk factors, statistics, stroke, Writing Group Members, American Heart Association Statistics Committee, Stroke Statistics Subcommittee, Cardiorespiratory Medicine and Haematology, Public Health and Health Services, Cardiovascular System & Hematology, Cardiovascular medicine and haematology, Clinical sciences, Sports science and exercise
Published
2016

15. Executive Summary: Heart Disease and Stroke Statistics--2016 Update: A Report From the American Heart Association.

Author

Writing Group Members, Mozaffarian, Dariush, Benjamin, Emelia J, Go, Alan S, Arnett, Donna K, Blaha, Michael J, Cushman, Mary, Das, Sandeep R, de Ferranti, Sarah, Després, Jean-Pierre, Fullerton, Heather J, Howard, Virginia J, Huffman, Mark D, Isasi, Carmen R, Jiménez, Monik C, Judd, Suzanne E, Kissela, Brett M, Lichtman, Judith H, Lisabeth, Lynda D, Liu, Simin, Mackey, Rachel H, Magid, David J, McGuire, Darren K, Mohler, Emile R, Moy, Claudia S, Muntner, Paul, Mussolino, Michael E, Nasir, Khurram, Neumar, Robert W, Nichol, Graham, Palaniappan, Latha, Pandey, Dilip K, Reeves, Mathew J, Rodriguez, Carlos J, Rosamond, Wayne, Sorlie, Paul D, Stein, Joel, Towfighi, Amytis, Turan, Tanya N, Virani, Salim S, Woo, Daniel, Yeh, Robert W, Turner, Melanie B, American Heart Association Statistics Committee, and Stroke Statistics Subcommittee

Subjects
Writing Group Members, American Heart Association Statistics Committee, Stroke Statistics Subcommittee, Humans, Heart Diseases, Data Interpretation, Statistical, Health Behavior, American Heart Association, United States, Stroke, Research Report, AHA Scientific Statements, cardiovascular diseases, epidemiology, risk factors, statistics, stroke, Data Interpretation, Statistical, Clinical Sciences, Cardiorespiratory Medicine and Haematology, Public Health and Health Services, Cardiovascular System & Hematology
Published
2016

16. Heart Disease and Stroke Statistics-2016 Update: A Report From the American Heart Association.

Author

Writing Group Members, Mozaffarian, Dariush, Benjamin, Emelia J, Go, Alan S, Arnett, Donna K, Blaha, Michael J, Cushman, Mary, Das, Sandeep R, de Ferranti, Sarah, Després, Jean-Pierre, Fullerton, Heather J, Howard, Virginia J, Huffman, Mark D, Isasi, Carmen R, Jiménez, Monik C, Judd, Suzanne E, Kissela, Brett M, Lichtman, Judith H, Lisabeth, Lynda D, Liu, Simin, Mackey, Rachel H, Magid, David J, McGuire, Darren K, Mohler, Emile R, Moy, Claudia S, Muntner, Paul, Mussolino, Michael E, Nasir, Khurram, Neumar, Robert W, Nichol, Graham, Palaniappan, Latha, Pandey, Dilip K, Reeves, Mathew J, Rodriguez, Carlos J, Rosamond, Wayne, Sorlie, Paul D, Stein, Joel, Towfighi, Amytis, Turan, Tanya N, Virani, Salim S, Woo, Daniel, Yeh, Robert W, Turner, Melanie B, American Heart Association Statistics Committee, and Stroke Statistics Subcommittee

Subjects
Writing Group Members, American Heart Association Statistics Committee, Stroke Statistics Subcommittee, Humans, Heart Diseases, Data Interpretation, Statistical, Life Style, American Heart Association, United States, Stroke, Research Report, AHA Scientific Statements, cardiovascular diseases, epidemiology, risk factors, statistics, stroke, Data Interpretation, Statistical, Clinical Sciences, Cardiorespiratory Medicine and Haematology, Public Health and Health Services, Cardiovascular System & Hematology
Published
2016

17. Consumption of meat is associated with higher fasting glucose and insulin concentrations regardless of glucose and insulin genetic risk scores: a meta-analysis of 50,345 Caucasians 1 , 2

Author

Fretts, Amanda M, Follis, Jack L, Nettleton, Jennifer A, Lemaitre, Rozenn N, Ngwa, Julius S, Wojczynski, Mary K, Kalafati, Ioanna Panagiota, Varga, Tibor V, Frazier-Wood, Alexis C, Houston, Denise K, Lahti, Jari, Ericson, Ulrika, van den Hooven, Edith H, Mikkilä, Vera, Kiefte-de Jong, Jessica C, Mozaffarian, Dariush, Rice, Kenneth, Renström, Frida, North, Kari E, McKeown, Nicola M, Feitosa, Mary F, Kanoni, Stavroula, Smith, Caren E, Garcia, Melissa E, Tiainen, Anna-Maija, Sonestedt, Emily, Manichaikul, Ani, van Rooij, Frank JA, Dimitriou, Maria, Raitakari, Olli, Pankow, James S, Djoussé, Luc, Province, Michael A, Hu, Frank B, Lai, Chao-Qiang, Keller, Margaux F, Perälä, Mia-Maria, Rotter, Jerome I, Hofman, Albert, Graff, Misa, Kähönen, Mika, Mukamal, Kenneth, Johansson, Ingegerd, Ordovas, Jose M, Liu, Yongmei, Männistö, Satu, Uitterlinden, André G, Deloukas, Panos, Seppälä, Ilkka, Psaty, Bruce M, Cupples, L Adrienne, Borecki, Ingrid B, Franks, Paul W, Arnett, Donna K, Nalls, Mike A, Eriksson, Johan G, Orho-Melander, Marju, Franco, Oscar H, Lehtimäki, Terho, Dedoussis, George V, Meigs, James B, and Siscovick, David S

Subjects
Biomedical and Clinical Sciences, Nutrition and Dietetics, Prevention, Diabetes, Genetics, Aging, Cardiovascular, Nutrition, Metabolic and endocrine, Blood Glucose, Cohort Studies, Genetic Association Studies, Genetic Predisposition to Disease, Genome-Wide Association Study, Humans, Hyperglycemia, Hyperinsulinism, Insulin, Insulin Resistance, Insulin Secretion, Insulin-Secreting Cells, Meat, Meat Products, Middle Aged, Polymorphism, Single Nucleotide, Risk Factors, diet, gene–diet interaction, glucose, insulin, meat intake, meta-analysis, Engineering, Medical and Health Sciences, Nutrition & Dietetics, Clinical sciences, Nutrition and dietetics
Abstract

BackgroundRecent studies suggest that meat intake is associated with diabetes-related phenotypes. However, whether the associations of meat intake and glucose and insulin homeostasis are modified by genes related to glucose and insulin is unknown.ObjectiveWe investigated the associations of meat intake and the interaction of meat with genotype on fasting glucose and insulin concentrations in Caucasians free of diabetes mellitus.DesignFourteen studies that are part of the Cohorts for Heart and Aging Research in Genomic Epidemiology consortium participated in the analysis. Data were provided for up to 50,345 participants. Using linear regression within studies and a fixed-effects meta-analysis across studies, we examined 1) the associations of processed meat and unprocessed red meat intake with fasting glucose and insulin concentrations; and 2) the interactions of processed meat and unprocessed red meat with genetic risk score related to fasting glucose or insulin resistance on fasting glucose and insulin concentrations.ResultsProcessed meat was associated with higher fasting glucose, and unprocessed red meat was associated with both higher fasting glucose and fasting insulin concentrations after adjustment for potential confounders [not including body mass index (BMI)]. For every additional 50-g serving of processed meat per day, fasting glucose was 0.021 mmol/L (95% CI: 0.011, 0.030 mmol/L) higher. Every additional 100-g serving of unprocessed red meat per day was associated with a 0.037-mmol/L (95% CI: 0.023, 0.051-mmol/L) higher fasting glucose concentration and a 0.049-ln-pmol/L (95% CI: 0.035, 0.063-ln-pmol/L) higher fasting insulin concentration. After additional adjustment for BMI, observed associations were attenuated and no longer statistically significant. The association of processed meat and fasting insulin did not reach statistical significance after correction for multiple comparisons. Observed associations were not modified by genetic loci known to influence fasting glucose or insulin resistance.ConclusionThe association of higher fasting glucose and insulin concentrations with meat consumption was not modified by an index of glucose- and insulin-related single-nucleotide polymorphisms. Six of the participating studies are registered at clinicaltrials.gov as NCT0000513 (Atherosclerosis Risk in Communities), NCT00149435 (Cardiovascular Health Study), NCT00005136 (Family Heart Study), NCT00005121 (Framingham Heart Study), NCT00083369 (Genetics of Lipid Lowering Drugs and Diet Network), and NCT00005487 (Multi-Ethnic Study of Atherosclerosis).

Published
2015

18. Dietary fatty acids modulate associations between genetic variants and circulating fatty acids in plasma and erythrocyte membranes: Meta‐analysis of nine studies in the CHARGE consortium

Author

Smith, Caren E, Follis, Jack L, Nettleton, Jennifer A, Foy, Millennia, Wu, Jason HY, Ma, Yiyi, Tanaka, Toshiko, Manichakul, Ani W, Wu, Hongyu, Chu, Audrey Y, Steffen, Lyn M, Fornage, Myriam, Mozaffarian, Dariush, Kabagambe, Edmond K, Ferruci, Luigi, Chen, Yii-Der Ida, Rich, Stephen S, Djoussé, Luc, Ridker, Paul M, Tang, Weihong, McKnight, Barbara, Tsai, Michael Y, Bandinelli, Stefania, Rotter, Jerome I, Hu, Frank B, Chasman, Daniel I, Psaty, Bruce M, Arnett, Donna K, King, Irena B, Sun, Qi, Wang, Lu, Lumley, Thomas, Chiuve, Stephanie E, Siscovick, David S, Ordovás, José M, and Lemaitre, Rozenn N

Subjects
Biomedical and Clinical Sciences, Nutrition and Dietetics, Prevention, Complementary and Integrative Health, Nutrition, Genetics, Acetyltransferases, Acyltransferases, Adaptor Proteins, Signal Transducing, Carboxy-Lyases, Delta-5 Fatty Acid Desaturase, Diet, Docosahexaenoic Acids, Eicosapentaenoic Acid, Erythrocyte Membrane, Fatty Acid Desaturases, Fatty Acid Elongases, Fatty Acids, Fatty Acids, Omega-3, Female, Humans, Male, Middle Aged, Polymorphism, Single Nucleotide, FADS1, Gene-diet interactions, Meta-analysis, Omega-3 fatty acids, Food Sciences, Public Health and Health Services, Food Science, Nutrition & Dietetics, Food sciences, Nutrition and dietetics
Abstract

ScopeTissue concentrations of omega-3 fatty acids may reduce cardiovascular disease risk, and genetic variants are associated with circulating fatty acids concentrations. Whether dietary fatty acids interact with genetic variants to modify circulating omega-3 fatty acids is unclear. We evaluated interactions between genetic variants and fatty acid intakes for circulating alpha-linoleic acid, eicosapentaenoic acid, docosahexaenoic acid, and docosapentaenoic acid.Methods and resultsWe conducted meta-analyses (N = 11 668) evaluating interactions between dietary fatty acids and genetic variants (rs174538 and rs174548 in FADS1 (fatty acid desaturase 1), rs7435 in AGPAT3 (1-acyl-sn-glycerol-3-phosphate), rs4985167 in PDXDC1 (pyridoxal-dependent decarboxylase domain-containing 1), rs780094 in GCKR (glucokinase regulatory protein), and rs3734398 in ELOVL2 (fatty acid elongase 2)). Stratification by measurement compartment (plasma versus erthyrocyte) revealed compartment-specific interactions between FADS1 rs174538 and rs174548 and dietary alpha-linolenic acid and linoleic acid for docosahexaenoic acid and docosapentaenoic acid.ConclusionOur findings reinforce earlier reports that genetically based differences in circulating fatty acids may be partially due to differences in the conversion of fatty acid precursors. Further, fatty acids measurement compartment may modify gene-diet relationships, and considering compartment may improve the detection of gene-fatty acids interactions for circulating fatty acid outcomes.

Published
2015

19. Heart disease and stroke statistics--2015 update: a report from the American Heart Association.

Author

Mozaffarian, Dariush, Benjamin, Emelia J, Go, Alan S, Arnett, Donna K, Blaha, Michael J, Cushman, Mary, de Ferranti, Sarah, Després, Jean-Pierre, Fullerton, Heather J, Howard, Virginia J, Huffman, Mark D, Judd, Suzanne E, Kissela, Brett M, Lackland, Daniel T, Lichtman, Judith H, Lisabeth, Lynda D, Liu, Simin, Mackey, Rachel H, Matchar, David B, McGuire, Darren K, Mohler, Emile R, Moy, Claudia S, Muntner, Paul, Mussolino, Michael E, Nasir, Khurram, Neumar, Robert W, Nichol, Graham, Palaniappan, Latha, Pandey, Dilip K, Reeves, Mathew J, Rodriguez, Carlos J, Sorlie, Paul D, Stein, Joel, Towfighi, Amytis, Turan, Tanya N, Virani, Salim S, Willey, Joshua Z, Woo, Daniel, Yeh, Robert W, Turner, Melanie B, and American Heart Association Statistics Committee and Stroke Statistics Subcommittee

Subjects
American Heart Association Statistics Committee and Stroke Statistics Subcommittee, Humans, Heart Diseases, Risk Reduction Behavior, American Heart Association, United States, Stroke, Research Report, AHA Scientific Statements, cardiovascular diseases, epidemiology, risk factors, statistics, stroke, Cardiorespiratory Medicine and Haematology, Clinical Sciences, Public Health and Health Services, Cardiovascular System & Hematology
Published
2015

20. Habitual sleep duration is associated with BMI and macronutrient intake and may be modified by CLOCK genetic variants 2–4

Author

Dashti, Hassan S, Follis, Jack L, Smith, Caren E, Tanaka, Toshiko, Cade, Brian E, Gottlieb, Daniel J, Hruby, Adela, Jacques, Paul F, Lamon-Fava, Stefania, Richardson, Kris, Saxena, Richa, Scheer, Frank AJL, Kovanen, Leena, Bartz, Traci M, Perälä, Mia-Maria, Jonsson, Anna, Frazier-Wood, Alexis C, Kalafati, Ioanna-Panagiota, Mikkilä, Vera, Partonen, Timo, Lemaitre, Rozenn N, Lahti, Jari, Hernandez, Dena G, Toft, Ulla, Johnson, W Craig, Kanoni, Stavroula, Raitakari, Olli T, Perola, Markus, Psaty, Bruce M, Ferrucci, Luigi, Grarup, Niels, Highland, Heather M, Rallidis, Loukianos, Kähönen, Mika, Havulinna, Aki S, Siscovick, David S, Räikkönen, Katri, Jørgensen, Torben, Rotter, Jerome I, Deloukas, Panos, Viikari, Jorma SA, Mozaffarian, Dariush, Linneberg, Allan, Seppälä, Ilkka, Hansen, Torben, Salomaa, Veikko, Gharib, Sina A, Eriksson, Johan G, Bandinelli, Stefania, Pedersen, Oluf, Rich, Stephen S, Dedoussis, George, Lehtimäki, Terho, and Ordovás, José M

Subjects
Aging, Sleep Research, Obesity, Prevention, Nutrition, Genetics, Neurosciences, Behavioral and Social Science, Oral and gastrointestinal, Cardiovascular, Metabolic and endocrine, Cancer, Adult, Body Mass Index, CLOCK Proteins, Cohort Studies, Cross-Sectional Studies, Diet, Dietary Proteins, Energy Intake, Fatty Acids, Unsaturated, Female, Gene-Environment Interaction, Genetic Predisposition to Disease, Humans, Male, Middle Aged, Polymorphism, Single Nucleotide, Sleep, White People, Young Adult, CLOCK, circadian rhythm, dietary intake, gene-environment interaction, sleep duration, gene-environment, interaction, Engineering, Medical and Health Sciences, Nutrition & Dietetics
Abstract

BackgroundShort sleep duration has been associated with greater risks of obesity, hypertension, diabetes, and cardiovascular disease. Also, common genetic variants in the human Circadian Locomotor Output Cycles Kaput (CLOCK) show associations with ghrelin and total energy intake.ObjectivesWe examined associations between habitual sleep duration, body mass index (BMI), and macronutrient intake and assessed whether CLOCK variants modify these associations.DesignWe conducted inverse-variance weighted, fixed-effect meta-analyses of results of adjusted associations of sleep duration and BMI and macronutrient intake as percentages of total energy as well as interactions with CLOCK variants from 9 cohort studies including up to 14,906 participants of European descent from the Cohorts for Heart and Aging Research in Genomic Epidemiology Consortium.ResultsWe observed a significant association between sleep duration and lower BMI (β ± SE = 0.16 ± 0.04, P < 0.0001) in the overall sample; however, associations between sleep duration and relative macronutrient intake were evident in age- and sex-stratified analyses only. We observed a significant association between sleep duration and lower saturated fatty acid intake in younger (aged 20-64 y) adults (men: 0.11 ± 0.06%, P = 0.03; women: 0.10 ± 0.05%, P = 0.04) and with lower carbohydrate (-0.31 ± 0.12%, P < 0.01), higher total fat (0.18 ± 0.09%, P = 0.05), and higher PUFA (0.05 ± 0.02%, P = 0.02) intakes in older (aged 65-80 y) women. In addition, the following 2 nominally significant interactions were observed: between sleep duration and rs12649507 on PUFA intake and between sleep duration and rs6858749 on protein intake.ConclusionsOur results indicate that longer habitual sleep duration is associated with lower BMI and age- and sex-specific favorable dietary behaviors. Differences in the relative intake of specific macronutrients associated with short sleep duration could, at least in part, explain previously reported associations between short sleep duration and chronic metabolic abnormalities. In addition, the influence of obesity-associated CLOCK variants on the association between sleep duration and macronutrient intake suggests that longer habitual sleep duration could ameliorate the genetic predisposition to obesity via a favorable dietary profile.

Published
2015

21. Common variation in fatty acid metabolic genes and risk of incident sudden cardiac arrest

Author

Lemaitre, Rozenn N, Johnson, Catherine O, Hesselson, Stephanie, Sotoodhenia, Nona, McKnight, Barbara, Sitlani, Colleen M, Rea, Thomas D, King, Irena B, Kwok, Pui-Yan, Mak, Angel, Li, Guo, Brody, Jennifer, Larson, Eric, Mozaffarian, Dariush, Psaty, Bruce M, Huertas-Vazquez, Adriana, Tardif, Jean-Claude, Albert, Christine M, Lyytikäinen, Leo-Pekka, Arking, Dan E, Kääb, Stefan, Huikuri, Heikki V, Krijthe, Bouwe P, Eijgelsheim, Mark, Wang, Ying A, Reinier, Kyndaron, Lehtimäki, Terho, Pulit, Sara L, Brugada, Ramon, Müller-Nurasyid, Martina, Newton-Cheh, Chris H, Karhunen, Pekka J, Stricker, Bruno H, Goyette, Philippe, Rotter, Jerome I, Chugh, Sumeet S, Chakravarti, Aravinda, Jouven, Xavier, and Siscovick, David S

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Cardiovascular, Clinical Research, Prevention, Genetics, Aetiology, 2.1 Biological and endogenous factors, 1-Acylglycerophosphocholine O-Acyltransferase, Aged, Algorithms, Alleles, Case-Control Studies, Death, Sudden, Cardiac, Fatty Acids, Female, Genetic Predisposition to Disease, Genetic Variation, Genotype, Humans, Male, Polymorphism, Single Nucleotide, Risk Factors, Death, Sudden, Genetic epidemiology, Biomedical Engineering, Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology, Cardiovascular medicine and haematology
Abstract

BackgroundThere is limited information on genetic factors associated with sudden cardiac arrest (SCA).ObjectiveTo assess the association of common variation in genes in fatty acid pathways with SCA risk.MethodsWe selected 85 candidate genes and 1155 single nucleotide polymorphisms (SNPs) tagging common variation in each gene. We investigated the SNP associations with SCA in a population-based case-control study. Cases (n = 2160) were from a repository of SCA in the greater Seattle area. Controls (n = 2615), frequency-matched on age and sex, were from the same area. We used linear logistic regression to examine SNP associations with SCA. We performed permutation-based p-min tests to account for multiple comparisons within each gene. The SNP associations with a corrected P value of

Published
2014

22. Heart Disease and Stroke Statistics—2014 Update

Author

Go, Alan S, Mozaffarian, Dariush, Roger, Véronique L, Benjamin, Emelia J, Berry, Jarett D, Blaha, Michael J, Dai, Shifan, Ford, Earl S, Fox, Caroline S, Franco, Sheila, Fullerton, Heather J, Gillespie, Cathleen, Hailpern, Susan M, Heit, John A, Howard, Virginia J, Huffman, Mark D, Judd, Suzanne E, Kissela, Brett M, Kittner, Steven J, Lackland, Daniel T, Lichtman, Judith H, Lisabeth, Lynda D, Mackey, Rachel H, Magid, David J, Marcus, Gregory M, Marelli, Ariane, Matchar, David B, McGuire, Darren K, Mohler, Emile R, Moy, Claudia S, Mussolino, Michael E, Neumar, Robert W, Nichol, Graham, Pandey, Dilip K, Paynter, Nina P, Reeves, Matthew J, Sorlie, Paul D, Stein, Joel, Towfighi, Amytis, Turan, Tanya N, Virani, Salim S, Wong, Nathan D, Woo, Daniel, and Turner, Melanie B

Subjects
American Heart Association, Cardiology, Heart Diseases, Humans, Stroke, United States, AHA Scientific Statements, cardiovascular diseases, epidemiology, risk factors, statistics, stroke, American Heart Association Statistics Committee and Stroke Statistics Subcommittee, Cardiorespiratory Medicine and Haematology, Clinical Sciences, Public Health and Health Services, Cardiovascular System & Hematology
Abstract

Each year, the American Heart Association (AHA), in conjunction with the Centers for Disease Control and Prevention, the National Institutes of Health, and other government agencies, brings together the most up-to-date statistics on heart disease, stroke, other vascular diseases, and their risk factors and presents them in its Heart Disease and Stroke Statistical Update. The Statistical Update is a critical resource for researchers, clinicians, healthcare policy makers, media professionals, the lay public, and many others who seek the best available national data on heart disease, stroke, and other cardiovascular disease-related morbidity and mortality and the risks, quality of care, use of medical procedures and operations, and costs associated with the management of these diseases in a single document. Indeed, since 1999, the Statistical Update has been cited >10 500 times in the literature, based on citations of all annual versions. In 2012 alone, the various Statistical Updates were cited ≈3500 times (data from Google Scholar). In recent years, the Statistical Update has undergone some major changes with the addition of new chapters and major updates across multiple areas, as well as increasing the number of ways to access and use the information assembled. For this year's edition, the Statistics Committee, which produces the document for the AHA, updated all of the current chapters with the most recent nationally representative data and inclusion of relevant articles from the literature over the past year. This year's edition includes a new chapter on peripheral artery disease, as well as new data on the monitoring and benefits of cardiovascular health in the population, with additional new focus on evidence-based approaches to changing behaviors, implementation strategies, and implications of the AHA's 2020 Impact Goals. Below are a few highlights from this year's Update. © 2013 American Heart Association, Inc.

Published
2014

23. Executive Summary

Author

Go, Alan S, Mozaffarian, Dariush, Roger, Véronique L, Benjamin, Emelia J, Berry, Jarett D, Blaha, Michael J, Dai, Shifan, Ford, Earl S, Fox, Caroline S, Franco, Sheila, Fullerton, Heather J, Gillespie, Cathleen, Hailpern, Susan M, Heit, John A, Howard, Virginia J, Huffman, Mark D, Judd, Suzanne E, Kissela, Brett M, Kittner, Steven J, Lackland, Daniel T, Lichtman, Judith H, Lisabeth, Lynda D, Mackey, Rachel H, Magid, David J, Marcus, Gregory M, Marelli, Ariane, Matchar, David B, McGuire, Darren K, Mohler, Emile R, Moy, Claudia S, Mussolino, Michael E, Neumar, Robert W, Nichol, Graham, Pandey, Dilip K, Paynter, Nina P, Reeves, Matthew J, Sorlie, Paul D, Stein, Joel, Towfighi, Amytis, Turan, Tanya N, Virani, Salim S, Wong, Nathan D, Woo, Daniel, and Turner, Melanie B

Subjects
American Heart Association, Cardiology, Heart Diseases, Humans, Prevalence, Research Report, Risk Factors, Stroke, United States, AHA Scientific Statements, cardiovascular diseases, epidemiology, risk factors, statistics, stroke, American Heart Association Statistics Committee and Stroke Statistics Subcommittee, Cardiorespiratory Medicine and Haematology, Clinical Sciences, Public Health and Health Services, Cardiovascular System & Hematology
Abstract

Each year, the American Heart Association (AHA), in conjunction with the Centers for Disease Control and Prevention, the National Institutes of Health, and other government agencies, brings together the most up-to-date statistics on heart disease, stroke, other vascular diseases, and their risk factors and presents them in its Heart Disease and Stroke Statistical Update. The Statistical Update is a critical resource for researchers, clinicians, healthcare policy makers, media professionals, the lay public, and many others who seek the best available national data on heart disease, stroke, and other cardiovascular disease-related morbidity and mortality and the risks, quality of care, use of medical procedures and operations, and costs associated with the management of these diseases in a single document. Indeed, since 1999, the Statistical Update has been cited >10 500 times in the literature, based on citations of all annual versions. In 2012 alone, the various Statistical Updates were cited ≈3500 times (data from Google Scholar). In recent years, the Statistical Update has undergone some major changes with the addition of new chapters and major updates across multiple areas, as well as increasing the number of ways to access and use the information assembled. For this year's edition, the Statistics Committee, which produces the document for the AHA, updated all of the current chapters with the most recent nationally representative data and inclusion of relevant articles from the literature over the past year. This year's edition includes a new chapter on peripheral artery disease, as well as new data on the monitoring and benefits of cardiovascular health in the population, with additional new focus on evidence-based approaches to changing behaviors, implementation strategies, and implications of the AHA's 2020 Impact Goals. Below are a few highlights from this year's Update. © 2013 American Heart Association, Inc.

Published
2014

24. Executive summary: heart disease and stroke statistics--2014 update: a report from the American Heart Association.

Author

Go, Alan S, Mozaffarian, Dariush, Roger, Véronique L, Benjamin, Emelia J, Berry, Jarett D, Blaha, Michael J, Dai, Shifan, Ford, Earl S, Fox, Caroline S, Franco, Sheila, Fullerton, Heather J, Gillespie, Cathleen, Hailpern, Susan M, Heit, John A, Howard, Virginia J, Huffman, Mark D, Judd, Suzanne E, Kissela, Brett M, Kittner, Steven J, Lackland, Daniel T, Lichtman, Judith H, Lisabeth, Lynda D, Mackey, Rachel H, Magid, David J, Marcus, Gregory M, Marelli, Ariane, Matchar, David B, McGuire, Darren K, Mohler, Emile R, Moy, Claudia S, Mussolino, Michael E, Neumar, Robert W, Nichol, Graham, Pandey, Dilip K, Paynter, Nina P, Reeves, Matthew J, Sorlie, Paul D, Stein, Joel, Towfighi, Amytis, Turan, Tanya N, Virani, Salim S, Wong, Nathan D, Woo, Daniel, Turner, Melanie B, and American Heart Association Statistics Committee and Stroke Statistics Subcommittee

Subjects
American Heart Association Statistics Committee and Stroke Statistics Subcommittee, Humans, Heart Diseases, Prevalence, Risk Factors, Cardiology, American Heart Association, United States, Stroke, Research Report, AHA Scientific Statements, cardiovascular diseases, epidemiology, risk factors, statistics, stroke, Cardiovascular System & Hematology, Cardiorespiratory Medicine and Haematology, Clinical Sciences, Public Health and Health Services
Published
2014

25. The state of US health, 1990-2010: burden of diseases, injuries, and risk factors.

Author

Murray, Christopher JL, Atkinson, Charles, Bhalla, Kavi, Birbeck, Gretchen, Burstein, Roy, Chou, David, Dellavalle, Robert, Danaei, Goodarz, Ezzati, Majid, Fahimi, A, Flaxman, D, Foreman, Gabriel, Sherine, Gakidou, Emmanuela, Kassebaum, Nicholas, Khatibzadeh, Shahab, Lim, Stephen, Lipshultz, Steven E, London, Stephanie, Lopez, MacIntyre, Michael F, Mokdad, AH, Moran, A, Moran, Andrew E, Mozaffarian, Dariush, Murphy, Tasha, Naghavi, Moshen, Pope, C, Roberts, Thomas, Salomon, Joshua, Schwebel, David C, Shahraz, Saeid, Sleet, David A, Murray, Abraham, Jerry, Ali, Mohammed K, Bartels, David H, Chen, Honglei, Criqui, Michael H, Dahodwala, Jarlais, Ding, Eric L, Dorsey, E Ray, Ebel, Beth E, Fahami, Flaxman, S, Flaxman, AD, Gonzalez-Medina, Diego, Grant, Bridget, Hagan, Holly, Hoffman, Howard, Leasher, Janet L, Lin, John, Lozano, Rafael, Lu, Yuan, Mallinger, Leslie, McDermott, Mary M, Micha, Renata, Miller, Ted R, Mokdad, AA, Naghavi, Mohsen, Narayan, KM Venkat, Omer, Saad B, Pelizzari, Pamela M, Phillips, David, Ranganathan, Dharani, Rivara, Frederick P, Sampson, Uchechukwu, Sanman, Ella, Sapkota, Amir, Sharaz, Saeid, Shivakoti, Rupak, Singh, Gitanjali M, Singh, David, Tavakkoli, Mohammad, Towbin, Jeffrey A, Wilkinson, James D, Zabetian, Azadeh, Ali, Mohammad K, Alvardo, Miriam, Baddour, Larry M, Benjamin, Emelia J, and Bolliger, Ian

Subjects
U.S. Burden of Disease Collaborators, Humans, Wounds and Injuries, Chronic Disease, Life Expectancy, Morbidity, Risk Factors, Health Status, Cost of Illness, Developed Countries, Adolescent, Adult, Aged, Aged, 80 and over, Middle Aged, Child, Child, Preschool, Infant, Disabled Persons, United States, Female, Male, Mortality, Premature, Global Health, Burden of Illness, Prevention, Aging, Nutrition, Aetiology, 2.4 Surveillance and distribution, Good Health and Well Being, Medical and Health Sciences, General & Internal Medicine
Abstract

ImportanceUnderstanding the major health problems in the United States and how they are changing over time is critical for informing national health policy.ObjectivesTo measure the burden of diseases, injuries, and leading risk factors in the United States from 1990 to 2010 and to compare these measurements with those of the 34 countries in the Organisation for Economic Co-operation and Development (OECD) countries.DesignWe used the systematic analysis of descriptive epidemiology of 291 diseases and injuries, 1160 sequelae of these diseases and injuries, and 67 risk factors or clusters of risk factors from 1990 to 2010 for 187 countries developed for the Global Burden of Disease 2010 Study to describe the health status of the United States and to compare US health outcomes with those of 34 OECD countries. Years of life lost due to premature mortality (YLLs) were computed by multiplying the number of deaths at each age by a reference life expectancy at that age. Years lived with disability (YLDs) were calculated by multiplying prevalence (based on systematic reviews) by the disability weight (based on population-based surveys) for each sequela; disability in this study refers to any short- or long-term loss of health. Disability-adjusted life-years (DALYs) were estimated as the sum of YLDs and YLLs. Deaths and DALYs related to risk factors were based on systematic reviews and meta-analyses of exposure data and relative risks for risk-outcome pairs. Healthy life expectancy (HALE) was used to summarize overall population health, accounting for both length of life and levels of ill health experienced at different ages.ResultsUS life expectancy for both sexes combined increased from 75.2 years in 1990 to 78.2 years in 2010; during the same period, HALE increased from 65.8 years to 68.1 years. The diseases and injuries with the largest number of YLLs in 2010 were ischemic heart disease, lung cancer, stroke, chronic obstructive pulmonary disease, and road injury. Age-standardized YLL rates increased for Alzheimer disease, drug use disorders, chronic kidney disease, kidney cancer, and falls. The diseases with the largest number of YLDs in 2010 were low back pain, major depressive disorder, other musculoskeletal disorders, neck pain, and anxiety disorders. As the US population has aged, YLDs have comprised a larger share of DALYs than have YLLs. The leading risk factors related to DALYs were dietary risks, tobacco smoking, high body mass index, high blood pressure, high fasting plasma glucose, physical inactivity, and alcohol use. Among 34 OECD countries between 1990 and 2010, the US rank for the age-standardized death rate changed from 18th to 27th, for the age-standardized YLL rate from 23rd to 28th, for the age-standardized YLD rate from 5th to 6th, for life expectancy at birth from 20th to 27th, and for HALE from 14th to 26th.Conclusions and relevanceFrom 1990 to 2010, the United States made substantial progress in improving health. Life expectancy at birth and HALE increased, all-cause death rates at all ages decreased, and age-specific rates of years lived with disability remained stable. However, morbidity and chronic disability now account for nearly half of the US health burden, and improvements in population health in the United States have not kept pace with advances in population health in other wealthy nations.

Published
2013

26. Heart disease and stroke statistics--2013 update: a report from the American Heart Association.

Author

Go, Alan S, Mozaffarian, Dariush, Roger, Véronique L, Benjamin, Emelia J, Berry, Jarett D, Borden, William B, Bravata, Dawn M, Dai, Shifan, Ford, Earl S, Fox, Caroline S, Franco, Sheila, Fullerton, Heather J, Gillespie, Cathleen, Hailpern, Susan M, Heit, John A, Howard, Virginia J, Huffman, Mark D, Kissela, Brett M, Kittner, Steven J, Lackland, Daniel T, Lichtman, Judith H, Lisabeth, Lynda D, Magid, David, Marcus, Gregory M, Marelli, Ariane, Matchar, David B, McGuire, Darren K, Mohler, Emile R, Moy, Claudia S, Mussolino, Michael E, Nichol, Graham, Paynter, Nina P, Schreiner, Pamela J, Sorlie, Paul D, Stein, Joel, Turan, Tanya N, Virani, Salim S, Wong, Nathan D, Woo, Daniel, Turner, Melanie B, and American Heart Association Statistics Committee and Stroke Statistics Subcommittee

Subjects
American Heart Association Statistics Committee and Stroke Statistics Subcommittee, Humans, Heart Diseases, Prevalence, Risk Factors, American Heart Association, United States, Stroke, AHA Scientific Statements, cardiovascular diseases, epidemiology, risk factors, statistics, stroke, Cardiorespiratory Medicine and Haematology, Clinical Sciences, Public Health and Health Services, Cardiovascular System & Hematology
Abstract

Each year, the American Heart Association (AHA), in conjunction with the Centers for Disease Control and Prevention, the National Institutes of Health, and other government agencies, brings together the most up-to-date statistics on heart disease, stroke, other vascular diseases, and their risk factors and presents them in its Heart Disease and Stroke Statistical Update*The Statistical Update is a valuable resource for researchers, clinicians, healthcare policy makers, media professionals, the lay public, and many others who seek the best national data available on heart disease, stroke, and other cardiovascular disease-related morbidity and mortality and the risks, quality of care, medical procedures and operations, and costs associated with the management of these diseases in a single document*Indeed, since 1999, the Statistical Update has been cited >10 500 times in the literature, based on citations of all annual versions*In 2011 alone, the various Statistical Updates were cited ≈1500 times (data from ISI Web of Science)*In recent years, the Statistical Update has undergone some major changes with the addition of new chapters and major updates across multiple areas, as well as increasing the number of ways to access and use the information assembled*For this year's edition, the Statistics Committee, which produces the document for the AHA, updated all of the current chapters with the most recent nationally representative data and inclusion of relevant articles from the literature over the past year*This year's edition also implements a new chapter organization to reflect the spectrum of cardiovascular health behaviors and health factors and risks, as well as subsequent complicating conditions, disease states, and outcomes*Also, the 2013 Statistical Update contains new data on the monitoring and benefits of cardiovascular health in the population, with additional new focus on evidence-based approaches to changing behaviors, implementation strategies, and implications of the AHA's 2020 Impact Goals*Below are a few highlights from this year's Update . © 2013 American Heart Association, Inc.

Published
2013

27. Executive summary: heart disease and stroke statistics--2013 update: a report from the American Heart Association.

Author

Go, Alan S, Mozaffarian, Dariush, Roger, Véronique L, Benjamin, Emelia J, Berry, Jarett D, Borden, William B, Bravata, Dawn M, Dai, Shifan, Ford, Earl S, Fox, Caroline S, Franco, Sheila, Fullerton, Heather J, Gillespie, Cathleen, Hailpern, Susan M, Heit, John A, Howard, Virginia J, Huffman, Mark D, Kissela, Brett M, Kittner, Steven J, Lackland, Daniel T, Lichtman, Judith H, Lisabeth, Lynda D, Magid, David, Marcus, Gregory M, Marelli, Ariane, Matchar, David B, McGuire, Darren K, Mohler, Emile R, Moy, Claudia S, Mussolino, Michael E, Nichol, Graham, Paynter, Nina P, Schreiner, Pamela J, Sorlie, Paul D, Stein, Joel, Turan, Tanya N, Virani, Salim S, Wong, Nathan D, Woo, Daniel, Turner, Melanie B, and American Heart Association Statistics Committee and Stroke Statistics Subcommittee

Subjects
American Heart Association Statistics Committee and Stroke Statistics Subcommittee, Humans, Heart Diseases, Obesity, Prevalence, Age Distribution, American Heart Association, United States, Stroke, AHA Scientific Statements, cardiovascular diseases, epidemiology, risk factors, statistics, stroke, Cardiorespiratory Medicine and Haematology, Clinical Sciences, Public Health and Health Services, Cardiovascular System & Hematology
Abstract

Each year, the American Heart Association (AHA), in conjunction with the Centers for Disease Control and Prevention, the National Institutes of Health, and other government agencies, brings together the most up-to-date statistics on heart disease, stroke, other vascular diseases, and their risk factors and presents them in its Heart Disease and Stroke Statistical Update.*The Statistical Update is a valuable resource for researchers, clinicians, healthcare policy makers, media professionals, the lay public, and many others who seek the best national data available on heart disease, stroke, and other cardiovascular disease-related morbidity and mortality and the risks, quality of care, medical procedures and operations, and costs associated with the management of these diseases in a single document Indeed, since 1999, the Statistical Update has been cited >10 500 times in the literature, based on citations of all annual versions. In 2011 alone, the various Statistical Updates were cited ∼1500 times (data from ISI Web of Science). In recent years, the Statistical Update has undergone some major changes with the addition of new chapters and major updates across multiple areas, as well as increasing the number of ways to access and use the information assembled. For this year's edition, the Statistics Committee, which produces the document for the AHA, updated all of the current chapters with the most recent nationally representative data and inclusion of relevant articles from the literature over the past year. This year's edition also implements a new chapter organization to reflect the spectrum of cardiovascular health behaviors and health factors and risks, as well as subsequent complicating conditions, disease states, and outcomes. Also, the 2013 Statistical Update contains new data on the monitoring and benefits of cardiovascular health in the population, with additional new focus on evidence-based approaches to changing behaviors, implementation strategies, and implications of the AHA's 2020 Impact Goals. Below are a few highlights from this year's Update. © 2013 American Heart Association, Inc.

Published
2013

28. Population Approaches to Improve Diet, Physical Activity, and Smoking Habits

Author

Mozaffarian, Dariush, Afshin, Ashkan, Benowitz, Neal L, Bittner, Vera, Daniels, Stephen R, Franch, Harold A, Jacobs, David R, Kraus, William E, Kris-Etherton, Penny M, Krummel, Debra A, Popkin, Barry M, Whitsel, Laurie P, and Zakai, Neil A

Subjects
Biomedical and Clinical Sciences, Public Health, Health Sciences, Cardiovascular, Cancer, Prevention, Tobacco Smoke and Health, Behavioral and Social Science, Nutrition, Tobacco, Clinical Research, 3.1 Primary prevention interventions to modify behaviours or promote wellbeing, Prevention of disease and conditions, and promotion of well-being, Good Health and Well Being, American Heart Association, Cardiovascular Diseases, Diet, Reducing, Health Promotion, Humans, Life Style, Motor Activity, Smoking Prevention, United States, AHA Scientific Statements, diet, nutrition, obesity, overweight, physical activity, prevention, public policy, smoking, American Heart Association Council on Epidemiology and Prevention, Council on Nutrition, Physical Activity and Metabolism, Council on Clinical Cardiology, Council on Cardiovascular Disease in the Young, Council on the Kidney in Cardiovasc, Cardiorespiratory Medicine and Haematology, Clinical Sciences, Public Health and Health Services, Cardiovascular System & Hematology, Cardiovascular medicine and haematology, Clinical sciences, Sports science and exercise
Abstract

BackgroundPoor lifestyle behaviors, including suboptimal diet, physical inactivity, and tobacco use, are leading causes of preventable diseases globally. Although even modest population shifts in risk substantially alter health outcomes, the optimal population-level approaches to improve lifestyle are not well established.Methods and resultsFor this American Heart Association scientific statement, the writing group systematically reviewed and graded the current scientific evidence for effective population approaches to improve dietary habits, increase physical activity, and reduce tobacco use. Strategies were considered in 6 broad domains: (1) Media and educational campaigns; (2) labeling and consumer information; (3) taxation, subsidies, and other economic incentives; (4) school and workplace approaches; (5) local environmental changes; and (6) direct restrictions and mandates. The writing group also reviewed the potential contributions of healthcare systems and surveillance systems to behavior change efforts. Several specific population interventions that achieved a Class I or IIa recommendation with grade A or B evidence were identified, providing a set of specific evidence-based strategies that deserve close attention and prioritization for wider implementation. Effective interventions included specific approaches in all 6 domains evaluated for improving diet, increasing activity, and reducing tobacco use. The writing group also identified several specific interventions in each of these domains for which current evidence was less robust, as well as other inconsistencies and evidence gaps, informing the need for further rigorous and interdisciplinary approaches to evaluate population programs and policies.ConclusionsThis systematic review identified and graded the evidence for a range of population-based strategies to promote lifestyle change. The findings provide a framework for policy makers, advocacy groups, researchers, clinicians, communities, and other stakeholders to understand and implement the most effective approaches. New strategic initiatives and partnerships are needed to translate this evidence into action.

Published
2012

29. Trans fatty acid biomarkers and incident type 2 diabetes: pooled analysis of 12 prospective cohort studies in the Fatty Acids and Outcomes Research Consortium (FORCE)

Author

Lai, Heidi T.M., Imamura, Fumiaki, Korat, Andres V. Ardisson, Murphy, Rachel A., Tintle, Nathan, Bassett, Julie K., Chen, Jiaying, Kröger, Janine, Chien, Kuo-Liong, Senn, Mackenzie, Wood, Alexis C., Forouhi, Nita G., Schulze, Matthias B., Harris, William S., Vasan, Ramachandran S., Hu, Frank, Giles, Graham G., Hodge, Allison, Djousse, Luc, Brouwer, Ingeborg A., Qian, Frank, Sun, Qi, Wu, Jason H.Y., Marklund, Matti, Lemaitre, Rozenn N., Siscovick, David S., Fretts, Amanda M., Shadyab, Aladdin H., Manson, JoAnn E., Howard, Barbara V., Robinson, Jennifer G., Wallace, Robert B., Wareham, Nick J., Chen, Yii-Der Ida, Rotter, Jerome I., Tsai, Michael Y., Micha, Renata, Mozaffarian, Dariush, Health Sciences, APH - Health Behaviors & Chronic Diseases, and APH - Mental Health

Subjects
Adult, Advanced and Specialized Nursing, Adolescent, Endocrinology, Diabetes and Metabolism, Fatty Acids, Trans Fatty Acids, Fatty Acids and Outcomes Research Consortium (FORCE), Cohort Studies, Endocrinology & Metabolism, Diabetes Mellitus, Type 2, SDG 3 - Good Health and Well-being, Risk Factors, Outcome Assessment, Health Care, Internal Medicine, Humans, Prospective Studies, Epidemiology/Health Services Research, Biomarkers, 11 Medical and Health Sciences
Abstract

OBJECTIVE Trans fatty acids (TFAs) have harmful biologic effects that could increase the risk of type 2 diabetes (T2D), but evidence remains uncertain. We aimed to investigate the prospective associations of TFA biomarkers and T2D by conducting an individual participant-level pooled analysis. RESEARCH DESIGN AND METHODS We included data from an international consortium of 12 prospective cohorts and nested case-control studies from six nations. TFA biomarkers were measured in blood collected between 1990 and 2008 from 25,126 participants aged ≥18 years without prevalent diabetes. Each cohort conducted de novo harmonized analyses using a prespecified protocol, and findings were pooled using inverse-variance weighted meta-analysis. Heterogeneity was explored by prespecified between-study and within-study characteristics. RESULTS During a mean follow-up of 13.5 years, 2,843 cases of incident T2D were identified. In multivariable-adjusted pooled analyses, no significant associations with T2D were identified for trans/trans-18:2, relative risk (RR) 1.09 (95% CI 0.94–1.25); cis/trans-18:2, 0.89 (0.73–1.07); and trans/cis-18:2, 0.87 (0.73–1.03). Trans-16:1n-9, total trans-18:1, and total trans-18:2 were inversely associated with T2D (RR 0.81 [95% CI 0.67–0.99], 0.86 [0.75–0.99], and 0.84 [0.74–0.96], respectively). Findings were not significantly different according to prespecified sources of potential heterogeneity (each P ≥ 0.1). CONCLUSIONS Circulating individual trans-18:2 TFA biomarkers were not associated with risk of T2D, while trans-16:1n-9, total trans-18:1, and total trans-18:2 were inversely associated. Findings may reflect the influence of mixed TFA sources (industrial vs. natural ruminant), a general decline in TFA exposure due to policy changes during this period, or the relatively limited range of TFA levels.

Published
2022

30. Global, regional, and national consumption of animal-source foods between 1990 and 2018: findings from the Global Dietary Database

Author

Miller, Victoria, Reedy, Julia, Cudhea, Frederick, Zhang, Jianyi, Shi, Peilin, Erndt-Marino, Josh, Coates, Jennifer, Micha, Renata, Webb, Patrick, Mozaffarian, Dariush, Abbott, Pamela, Abdollahi, Morteza, Abedi, Parvin, Abumweis, Suhad, Adair, Linda, Al Nsour, Mohannad, Al-Daghri, Nasser, Al-Hamad, Nawal, Al-Hooti, Suad, Al-Zenki, Sameer, Alam, Iftikhar, Ali, Jemal, Alissa, Eman, Anderson, Simon, Anzid, Karim, Arambepola, Carukshi, Arici, Mustafa, Arsenault, Joanne, Asciak, Renzo, Barbieri, Helene, Barengo, Noël, Barquera, Simon, Bas, Murat, Becker, Wulf, Beer-Borst, Sigrid, Bergman, Per, Biró, Lajos, Boindala, Sesikeran, Bovet, Pascal, Bradshaw, Debbie, Bukhary, Noriklil Bi, Bundhamcharoen, Kanitta, Caballero, Mauricio, Calleja, Neville, Cao, Xia, Capanzana, Mario, Carmikle, Jan, Castetbon, Katia, Castro, Michelle, Cerdena, Corazon, Chang, Hsing-Yi, Charlton, Karen, Chen, Yu, Chen, Mei, Chiplonkar, Shashi, Cho, Yoonsu, Chuah, Khun-Aik, Costanzo, Simona, Cowan, Melanie, Damasceno, Albertino, Dastgiri, Saeed, de Henauw, Stefaan, Deridder, Karin, Ding, Eric, Dommarco, Rivera, Don, Rokiah, Duante, Charmaine, Duleva, Vesselka, Duran Aguero, Samuel, Ekbote, Veena, El Ati, Jalila, El Hamdouchi, Asmaa, El-Kour, Tatyana, Eldridge, Alison, Elmadfa, Ibrahim, Esteghamati, Alireza, Etemad, Zohreh, Fadzil, Fariza, Farzadfar, Farshad, Fernandez, Anne, Fernando, Dulitha, Fisberg, Regina, Forsyth, Simon, Gamboa-Delgado, Edna, Garriguet, Didier, Gaspoz, Jean-Michel, Gauci, Dorothy, Geleijnse, Marianne, Ginnela, Brahmam, Grosso, Giuseppe, Guessous, Idris, Gulliford, Martin, Gunnarsdottir, Ingibjorg, Hadden, Wilbur, Hadziomeragic, Aida, Haerpfer, Christian, Hakeem, Rubina, Haque, Aminul, Hashemian, Maryam, Hemalatha, Rajkumar, Henjum, Sigrun, Hinkov, Hristo, Hjdaud, Zaiton, Hoffman, Daniel, Hopping, Beth, Houshiar-Rad, Anahita, Hsieh, Yao-Te, Hung, Shu-Yi, Huybrechts, Inge, Hwalla, Nahla, Ibrahim, Hajah, Ikeda, Nayu, Illescas-Zarate, Daniel, Inoue, Manami, Janakiram, Chandrashekar, Jayawardena, Ranil, Jeewon, Rajesh, Jitnarin, Nattinee, Johansson, Lars, Jonsdottir, Olof, Jundishapur, Ahvaz, Kally, Ola, Kandiah, Mirnalini, Karupaiah, Tilakavati, Keinan-Boker, Lital, Kelishadi, Roya, Khadilkar, Anuradha, Kim, Cho-Il, Koksal, Eda, Konig, Jurgen, Korkalo, Liisa, Koster, Jeremy, Kovalskys, Irina, Krishnan, Anand, Kruger, Herculina, Kuriyan-Raj, Rebecca, Kweon, Sanghui, Lachat, Carl, Lai, Yuen, Lanerolle, Pulani, Laxmaiah, Avula, Leclercq, Catherine, Lee, Meei-Shyuan, Lee, Hae-Jeung, Lemming, Eva, Li, Yanping, Lindström, Jaana, Ling, Annie, Liputo, Nur Il, Lopez-Jaramillo, Patricio, Luke, Amy, Lukito, Widjaja, Lupotto, Elisabette, Ma, Yi, Mahdy, Zaleha, Malekzadeh, Reza, Manan, Wan, Marchioni, Dirce, Marques, Lydia, Marques-Vidal, Pedro, Martin-Prével, Yves, Mathee, Angie, Matsumura, Yasuhiro, Mazumdar, Paramita, Memon, Anjum, Mensink, Gert, Meyer, Alexa, Mirmiran, Parvin, Mirzaei, Masoud, Misra, Puneet, Misra, Anoop, Mitchell, Claudette, Mohamed, Hamid Jbj, Mohammadi-Nasrabadi, Fatemeh, Mohammadifard, Noushin, Moy, Foong, Musaiger, Abdulrahman, Mwaniki, Elizabeth, Myhre, Jannicke, Nagalla, Balakrishna, Naska, Androniki, Ng, Swee, Ng, Shu, Ngoan, Le Tn, Noshad, Sina, Ochoa, Angelica, Ocke, Marga, Odenkirk, Jillian, Oh, Kyungwon, Oleas, Mariana, Olivares, Sonia, Orfanos, Philippos, Ortiz-Ulloa, Johana, Otero, Johanna, Ovaskainen, Marja-Leena, Pakseresht, Mohammadreza, Palacios, Cristina, Palmer, Pam, Pan, Wen-Harn, Panagiotakos, Demosthenes, Parajuli, Rajendra, Park, Myungsook, Pekcan, Gulden, Petrova, Stefka, Piaseu, Noppawan, Pitsavos, Christos, Polasa, Kalpagam, Posada, Luz, Pourfarzi, Farhad, Preston, Alan, Rached, Ingrid, Rahbar, Ali, Rehm, Colin, Richter, Almut, Riley, Leanne, Salanave, Benoit, Sánchez-Romero, Luz, Sarrafzadegan, Nizal, Sawada, Norie, Sekiyama, Makiko, Selamat, Rusidah, Shamsuddin, Khadijah, Shariff, Zalilah, Sharma, Sangita, Sibai, Abla, Sinkko, Harri, Sioen, Isabelle, Sisa, Ivan, Skeaff, Sheila, Steingrimsdottir, Laufey, Strand, Tor, Suarez-Ortegon, Milton, Swaminathan, Sumathi, Swan, Gillian, Sygnowska, Elzbieta, Szabo, Maria, Szponar, Lucjan, Tan-Khouw, Ilse, Tapanainen, Heli, Tayyem, Reema, Tedla, Bemnet, Tedstone, Alison, Templeton, Robert, Termote, Celine, Thanopoulou, Anastasia, Thorgeirsdottir, Holmfridur, Thorsdottir, Inga, Trichopoulos, Dimitrios, Trichopoulou, Antonia, Tsugane, Shoichiro, Turrini, Aida, van Oosterhout, Coline, Vartiainen, Erkki, Veerman, J Lennert, Virtanen, Suvi, Vollenweider, Peter, Vossenaar, Marieke, Waidyatilaka, Indu, Waskiewicz, Anna, Waterham, Eveline, Wieler, Lothar, Wondwossen, Tizita, Wu, Suh, Yaakub, Roseyati, Yap, Mabel, Yusof, Safiah, Zaghloul, Sahar, Zajkás, Gábor, Zapata, Maria, Zarina, Khairul, Zohoori, Fatemeh, Phd, Micha, Phd, Webb, Friedman School of Nutrition Science and Policy [Boston, MA, USA], Tufts University School of Medicine [Boston], Novartis Institute for Tropical Diseases (NITD), Departments of Epidemiology and Nutrition, Harvard School of Public Health, Tufts University [Medford], Chair for Biomarkers of Chronic Diseases [Riyadh, Kingdom of Saudi Arabia] (Biochemistry Department), Qassim University [Kingdom of Saudi Arabia]-College of Science [Riyadh, Kingdom of Saudi Arabia], Kuwait Institute for Scientific Research (KISR), Montpellier Interdisciplinary center on Sustainable Agri-food systems (Social and nutritional sciences) (UMR MoISA), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut de Recherche pour le Développement (IRD)-Centre International de Hautes Etudes Agronomiques Méditerranéennes - Institut Agronomique Méditerranéen de Montpellier (CIHEAM-IAMM), Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut Agro Montpellier, Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro), and Bill & Melinda Gates Foundation and American Heart Association

Subjects
Health (social science), Meat, Health Policy, Eggs, Public Health, Environmental and Occupational Health, Human health, Medicine (miscellaneous), food and beverages, Dietary surveys, Bayes Theorem, Global Health, Diet, Animal-source foods, Animals, Humans, Dairy Products, Environmental sustainability, Dietary intakes, [SDV.AEN]Life Sciences [q-bio]/Food and Nutrition
Abstract

Background\ud Diet is a major modifiable risk factor for human health and overall consumption patterns affect planetary health. We aimed to quantify global, regional, and national consumption levels of animal-source foods (ASF) to inform intervention, surveillance, and policy priorities.\ud \ud Methods\ud Individual-level dietary surveys across 185 countries conducted between 1990 and 2018 were identified, obtained, standardised, and assessed among children and adults, jointly stratified by age, sex, education level, and rural versus urban residence. We included 499 discrete surveys (91·2% nationally or subnationally representative) with data for ASF (unprocessed red meat, processed meat, eggs, seafood, milk, cheese, and yoghurt), comprising 3·8 million individuals from 134 countries representing 95·2% of the world population in 2018. We used Bayesian hierarchical models to account for differences in survey methods and representativeness, time trends, and input data and modelling uncertainty, with five-fold cross-validation.\ud \ud Findings\ud In 2018, mean global intake per person of unprocessed red meat was 51 g/day (95% uncertainty interval [UI] 48–54; region-specific range 7–114 g/day); 17 countries (23·9% of the world's population) had mean intakes of at least one serving (100 g) per day. Global mean intake of processed meat was 17 g/day (95% UI 15–21 g/day; region-specific range 3–54 g/day); seafood, 28 g/day (27–30 g/day; 12–44 g/day); eggs, 21 g/day (18–24 g/day; 6–35 g/day); milk 88 g/day (84–93 g/day; 45–185 g/day); cheese, 8 g/day (8–10 g/day; 1–34 g/day); and yoghurt, 20 g/day (17–23 g/day; 7–84 g/day). Mean national intakes were at least one serving per day for processed meat (≥50 g/day) in countries representing 6·9% of the global population; for cheese (≥42 g/day) in 2·3%; for eggs (≥55 g/day) in 0·7%; for milk (≥245 g/day) in 0·3%; for seafood (≥100 g/day) in 0·8%; and for yoghurt (≥245 g/day) in less than 0·1%. Among the 25 most populous countries in 2018, total ASF intake was highest in Russia (5·8 servings per day), Germany (3·8 servings per day), and the UK (3·7 servings per day), and lowest in Tanzania (0·9 servings per day) and India (0·7 servings per day). Global and regional intakes of ASF were generally similar by sex. Compared with children, adults generally consumed more unprocessed red meat, seafood and cheese, and less milk; energy-adjusted intakes of other ASF were more similar. Globally, ASF intakes (servings per week) were higher among more-educated versus less-educated adults, with greatest global differences for milk (0·79), eggs (0·47), unprocessed red meat (0·42), cheese (0·28), seafood (0·28), yoghurt (0·22), and processed meat (0·21). This was also true for urban compared to rural areas, with largest global differences (servings per week) for unprocessed red meat (0·47), milk (0·38), and eggs (0·20). Between 1990 and 2018, global intakes (servings per week) increased for unprocessed red meat (1·20), eggs (1·18), milk (0·63), processed meat (0·50), seafood (0·44), and cheese (0·14).\ud \ud Interpretation\ud Our estimates of ASF consumption identify populations with both lower and higher than optimal intakes. These estimates can inform the targeting of intervention, surveillance, and policy priorities relevant to both human and planetary health.\ud \ud Funding\ud Bill & Melinda Gates Foundation and American Heart Association.

Published
2022

31. Association of Trimethylamine N-Oxide and Related Metabolites in Plasma and Incident Type 2 Diabetes

Author

Lemaitre, Rozenn N., Jensen, Paul N., Wang, Zeneng, Fretts, Amanda M., McKnight, Barbara, Nemet, Ina, Biggs, Mary L., Sotoodehnia, Nona, de Oliveira Otto, Marcia C., Psaty, Bruce M., Siscovick, David S., Hazen, Stanley L., and Mozaffarian, Dariush

Subjects
Aged, 80 and over, Male, Research, United States, Cohort Studies, Online Only, Diabetes and Endocrinology, Methylamines, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Humans, Insulin, Female, Prospective Studies, Biomarkers, Original Investigation, Aged, Glucose Metabolism Disorders
Abstract

Key Points Question What is the association of trimethylamine N-oxide (TMAO) and related metabolites with the risk of type 2 diabetes? Findings In this cohort study that included 4442 older adults, plasma concentrations of TMAO and related metabolites were not associated with the risk of incident type 2 diabetes. However, elevated concentrations of TMAO, carnitine, crotonobetaine, and γ-butyrobetaine were each cross-sectionally associated with increased fasting insulin levels, a marker of insulin resistance, whereas betaine and choline were associated with decreased fasting insulin levels and an increased index of insulin sensitivity. Meaning Although replication is needed, these findings suggest the possibility of early involvement of TMAO metabolites with glucose-insulin homeostasis, which is detrimental for TMAO and carnitine and favorable for betaine and choline., Importance Although rodent studies suggest that trimethylamine N-oxide (TMAO) influences glucose homeostasis and risk of type 2 diabetes, evidence in humans is limited. Objective To examine the associations of serial measures of plasma TMAO and related metabolite concentrations with incident type 2 diabetes, fasting plasma insulin and glucose levels, and the Gutt insulin sensitivity index (ISI). Design, Setting, and Participants This prospective cohort design assessed the association of plasma TMAO and related metabolite concentrations with diabetes outcome, whereas a cross-sectional design assessed the association with insulin and glucose levels and Gutt ISI. The participants were a cohort of older US adults from the Cardiovascular Health Study (CHS). Data from June 1989 to May 1990, from November 1992 to June 1993, and from June 1995 to June 1997 were included, with follow-up through June 2010. Levels of TMAO and related metabolites were measured in CHS plasma samples. Data were analyzed from July 2019 to September 2020. Exposures Plasma concentrations of TMAO, carnitine, betaine, choline, crotonobetaine, and γ-butyrobetaine, measured by high-performance liquid chromatography and mass spectrometry. Main Outcomes and Measures Linear regression for associations of TMAO and related metabolites with insulin and glucose levels and Gutt ISI, and proportional hazards regression for associations with diabetes. Results The study included 4442 participants without diabetes at baseline (mean [SD] age, 73 [6] years at entry; 2710 [61%] women). In multivariable analyses, plasma TMAO, carnitine, crotonobetaine, and γ-butyrobetaine concentrations were positively associated with fasting insulin level (insulin mean geometric ratio comparing fifth with first quintiles of metabolite concentration: 1.07 [95% CI, 1.04-1.10] for TMAO; 1.07 [95% CI, 1.03-1.10] for carnitine; 1.05 [95% CI, 1.02-1.08] for crotonobetaine; and 1.06 [95% CI, 1.02-1.09] for γ-butyrobetaine). In contrast, betaine and choline concentrations were associated with greater insulin sensitivity (mean difference in Gutt ISI comparing fifth with first quintiles: 6.46 [95% CI, 4.32-8.60] and 2.27 [95% CI, 0.16-4.38], respectively). Incident diabetes was identified in 661 participants during a median 12.1 (interquartile range, 6.9-17.1) years of follow-up. In multivariable analyses, TMAO and metabolites were not significantly associated with type 2 diabetes risk (hazard ratios of diabetes comparing fifth with first quintile: 1.20 [95% CI, 0.94-1.55] for TMAO; 0.96 [95% CI, 0.74-1.24] for choline; 0.88 [95% CI, 0.67-1.15] for betaine; 1.07 [95% CI, 0.83-1.37] for carnitine; 0.79 [95% CI, 0.60-1.04] for γ-butyrobetaine; and 1.06 [95% CI, 0.83-1.35] for crotonobetaine). Conclusions and Relevance Plasma TMAO and related metabolites were not significantly associated with type 2 diabetes among older adults. The metabolites TMAO, carnitine, γ-butyrobetaine, and crotonobetaine may be associated with insulin resistance, and betaine and choline may be associated with greater insulin sensitivity, but temporality of the associations was not established., This cohort study assesses the associations of trimethylamine N-oxide and related metabolites with incident type 2 diabetes and its early markers in older US adults in the Cardiovascular Health Study.

Published
2021

32. n-3 Fatty Acid Biomarkers and Incident Type 2 Diabetes: An Individual Participant-Level Pooling Project of 20 Prospective Cohort Studies

Author

Qian, Frank, Ardisson Korat, Andres V, Imamura, Fumiaki, Marklund, Matti, Tintle, Nathan, Virtanen, Jyrki K, Zhou, Xia, Bassett, Julie K, Lai, Heidi, Hirakawa, Yoichiro, Chien, Kuo-Liong, Wood, Alexis C, Lankinen, Maria, Murphy, Rachel A, Samieri, Cecilia, Pertiwi, Kamalita, De Mello, Vanessa D, Guan, Weihua, Forouhi, Nita G, Wareham, Nick, Hu, InterAct Consortium Frank B, Riserus, Ulf, Lind, Lars, Harris, William S, Shadyab, Aladdin H, Robinson, Jennifer G, Steffen, Lyn M, Hodge, Allison, Giles, Graham G, Ninomiya, Toshiharu, Uusitupa, Matti, Tuomilehto, Jaakko, Lindström, Jaana, Laakso, Markku, Siscovick, David S, Helmer, Catherine, Geleijnse, Johanna M, Wu, Jason HY, Fretts, Amanda, Lemaitre, Rozenn N, Micha, Renata, Mozaffarian, Dariush, Sun, Qi, Fatty Acids And Outcomes Research Consortium (FORCE), Qian, Frank [0000-0002-5579-3410], Virtanen, Jyrki K [0000-0002-0648-999X], Hirakawa, Yoichiro [0000-0002-4405-4399], Pertiwi, Kamalita [0000-0003-2861-9051], de Mello, Vanessa D [0000-0003-3414-6983], Forouhi, Nita G [0000-0002-5041-248X], Ninomiya, Toshiharu [0000-0003-1345-9032], Laakso, Markku [0000-0002-3394-7749], Lemaitre, Rozenn N [0000-0002-7038-1844], Sun, Qi [0000-0002-8480-1563], and Apollo - University of Cambridge Repository

Subjects
Cohort Studies, Diabetes Mellitus, Type 2, Docosahexaenoic Acids, Eicosapentaenoic Acid, Fatty Acids, Omega-3, Humans, Prospective Studies, Biomarkers
Abstract

OBJECTIVE: Prospective associations between n-3 fatty acid biomarkers and type 2 diabetes (T2D) risk are not consistent in individual studies. We aimed to summarize the prospective associations of biomarkers of α-linolenic acid (ALA), eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA) with T2D risk through an individual participant-level pooled analysis. RESEARCH DESIGN AND METHODS: For our analysis we incorporated data from a global consortium of 20 prospective studies from 14 countries. We included 65,147 participants who had blood measurements of ALA, EPA, DPA, or DHA and were free of diabetes at baseline. De novo harmonized analyses were performed in each cohort following a prespecified protocol, and cohort-specific associations were pooled using inverse variance-weighted meta-analysis. RESULTS: A total of 16,693 incident T2D cases were identified during follow-up (median follow-up ranging from 2.5 to 21.2 years). In pooled multivariable analysis, per interquintile range (difference between the 90th and 10th percentiles for each fatty acid), EPA, DPA, DHA, and their sum were associated with lower T2D incidence, with hazard ratios (HRs) and 95% CIs of 0.92 (0.87, 0.96), 0.79 (0.73, 0.85), 0.82 (0.76, 0.89), and 0.81 (0.75, 0.88), respectively (all P < 0.001). ALA was not associated with T2D (HR 0.97 [95% CI 0.92, 1.02]) per interquintile range. Associations were robust across prespecified subgroups as well as in sensitivity analyses. CONCLUSIONS: Higher circulating biomarkers of seafood-derived n-3 fatty acids, including EPA, DPA, DHA, and their sum, were associated with lower risk of T2D in a global consortium of prospective studies. The biomarker of plant-derived ALA was not significantly associated with T2D risk.

Published
2021

33. Dairy Foods, Obesity, and Metabolic Health: The Role of the Food Matrix Compared with Single Nutrients

Author

Mozaffarian, Dariush

Subjects
0301 basic medicine, Calorie, Saturated fat, microbiome, Medicine (miscellaneous), Type 2 diabetes, Nutrition Policy, calories, 03 medical and health sciences, 0302 clinical medicine, Nutrient, Metabolic Diseases, Risk Factors, Weight loss, medicine, Humans, Obesity, 030212 general & internal medicine, Food science, dietary guidelines, 030109 nutrition & dietetics, Nutrition and Dietetics, business.industry, Nutrients, vitamins, medicine.disease, Diet, probiotics, Cardiovascular Diseases, dairy, Lean body mass, Dairy Products, weight loss, Diet, Healthy, medicine.symptom, business, Weight gain, Food Analysis, Supplement, Food Science
Abstract

In the 20th century, scientific and geopolitical events led to the concept of food as a delivery system for calories and specific isolated nutrients. As a result, conventional dietary guidelines have focused on individual nutrients to maintain health and prevent disease. For dairy foods, this has led to general dietary recommendations to consume 2–3 daily servings of reduced-fat dairy foods, without regard to type (e.g., yogurt, cheese, milk), largely based on theorized benefits of isolated nutrients for bone health (e.g., calcium, vitamin D) and theorized harms of isolated nutrients for cardiovascular diseases (CVDs) and obesity (e.g., total fat, saturated fat, total calories). However, advances in nutrition science have demonstrated that foods represent complex matrices of nutrients, minerals, bioactives, food structures, and other factors (e.g., phoshopholipids, prebiotics, probiotics) with correspondingly complex effects on health and disease. The present evidence suggests that whole-fat dairy foods do not cause weight gain, that overall dairy consumption increases lean body mass and reduces body fat, that yogurt consumption and probiotics reduce weight gain, that fermented dairy consumption including cheese is linked to lower CVD risk, and that yogurt, cheese, and even dairy fat may protect against type 2 diabetes. Based on the current science, dairy consumption is part of a healthy diet, without strong evidence to favor reduced-fat products; while intakes of probiotic-containing unsweetened and fermented dairy products such as yogurt and cheese appear especially beneficial.

Published
2019

34. Effects of animal protein supplementation of mothers, preterm infants, and term infants on growth outcomes in childhood: a systematic review and meta-analysis of randomized trials

Author

Pimpin, Laura, Kranz, Sarah, Liu, Enju, Shulkin, Masha, Karageorgou, Dimitra, Miller, Victoria, Fawzi, Wafaie, Duggan, Christopher, Webb, Patrick, and Mozaffarian, Dariush

Subjects
child, birth weight, Infant, weight, Maternal Nutritional Physiological Phenomena, Growth, Development, and Pediatrics, meta-analysis, Original Research Communications, maternal, dietary protein, Child Development, Pregnancy, Animals, Humans, Premature Birth, Female, Dietary Proteins, anthropometric, Infant Nutritional Physiological Phenomena, height
Abstract

Background Child stunting is a major public health problem, afflicting 155 million people worldwide. Lack of animal-source protein has been identified as a risk, but effects of animal protein supplementation are not well established. Objective The aim of this study was to investigate effects of animal protein supplementation in mothers, preterm infants, and term infants/children on birth and growth outcomes. Methods PubMed, EMBASE, Cochrane library, Web of Science, Cumulative Index of Nursing and Allied Health Literature, and Latin American and Caribbean Health Sciences Literature were searched for randomized controlled trials of animal protein supplementation in mothers or infants and children (≤age 5 y), evaluating measures of anthropometry (≤age 18 y). Main outcomes included birth weight, low birth weight, small for gestational age at birth; height, height-for-age, weight, weight-for-age, weight-for-length, stunting, and wasting ≤18 y of age. Data were extracted independently in duplicate, and findings pooled using inverse variance meta-analysis. Heterogeneity was explored using I2, stratified analysis, and meta-regression, and publication bias by funnel plots, Egger's test, and fill/trim methods. Results Of 6808 unique abstracts and 357 full-text articles, 62 trials were included. The 62 trials comprised over 30,000 participants across 5 continents, including formula-based supplementation in infants and food-based supplementation in pregnancy and childhood. Maternal supplementation increased birth weight by 0.06 kg, and both formula and food-based supplementation in term infants/young children increased weight by ≤0.14 kg. Neither formula nor food-based supplementation for term infants/young children increased height, whereas the height-for-age z-score was increased in the food-based (+0.06 z-score) but not formula-based (−0.11 z-score) trials reporting this outcome. In term infants, the weight-for-length z-score was increased in trials of formula (+0.24 z-score) and food supplementation (+0.06 z-score), whereas food supplementation was also associated with reduced odds of stunting (−13%). Conclusions Supplementation of protein from animal-source foods generally increased weight and weight-for-length in children, but with more limited effects on other growth outcomes such as attained height.

Published
2019

35. Impact of diet on cardiovascular disease and diabetes mortality in Latin America and the Caribbean: a comparative risk assessment analysis

Author

Sisa, Ivan, Abeyá-Gilardon, Enrique, Fisberg, Regina Mara, Jackson, Maria D., Mangialavori, Guadalupe Luciana, Sichieri, Rosely, Cudhea, Frederick, Bannuru, Raveendhara R., Ruthazer, Robin, Mozaffarian, Dariush, and Singh, Gitanjali M.

Subjects
Adult, Latin America, Cardiovascular Diseases, Risk Factors, Diabetes Mellitus, Humans, Nuts, Feeding Behavior, Nutrition Surveys, Risk Assessment, Article, Diet
Abstract

OBJECTIVE: To quantify diet-related burdens of cardiometabolic diseases (CMD) by country, age, and sex in Latin America and Caribbean (LAC). DESIGN: Intakes of 11 key dietary factors were obtained from the Global Dietary Database Consortium. Etiologic effects of dietary factors on CMD outcomes were obtained from meta-analyses. We combined these inputs with cause-specific mortality data to compute country-, age-, and sex-specific absolute and proportional CMD mortality of 11 dietary factors in 1990 and 2010. SETTING: 32 countries in LAC. PARTICIPANTS: adults aged 25 years and older. RESULTS: In 2010, an estimated 513,371 (95% [UI]: 423,286-547,841; 53.8%) cardiometabolic deaths were related to suboptimal diet. Largest diet-related CMD burdens were related to low intake of nuts/seeds (109,831 deaths [95% UI: 71,920-121,079]; 11.5%), low fruit intake (106,285 deaths [94,904-112,320]; 11.1%), and high processed meat consumption (89,381 deaths [82,984-97,196]; 9.4%). Among countries, highest CMD burdens (deaths per million adults) attributable to diet were in Trinidad & Tobago (1779) and Guyana (1700); the lowest were in Peru (492) and The Bahamas (504). Between 1990 and 2010, greatest decline (35%) in diet-attributable CMD mortality was related to greater consumption of fruit, while greatest increase (7.2%) was related to increased intakes of sugar-sweetened beverages. CONCLUSIONS: Suboptimal intakes of commonly-consumed foods were associated with substantial CMD mortality in LAC with significant heterogeneity across countries. Improved access to healthful foods, such as nuts and fruits, and limits in availability of unhealthful factors, such as processed foods would reduce diet-related burdens of CMD in LAC.

Published
2020

36. Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

Author

Kinyoki, Damaris K., Ross, Jennifer M., Lazzar-Atwood, Alice, Munro, Sandra B., Schaeffer, Lauren E., Abbasalizad-Farhangi, Mahdieh, Abbasi, Masoumeh, Abbastabar, Hedayat, Abdelalim, Ahmed, Abdoli, Amir, Abdollahi, Mohammad, Abdollahpour, Ibrahim, Abdulkader, Rizwan Suliankatchi, Abebe, Nebiyu Dereje, Abebo, Teshome Abuka, Abegaz, Kedir Hussein, Abolhassani, Hassan, Abreu, Lucas Guimarães, Abrigo, Michael R. M., Abushouk, Abdelrahman I., Accrombessi, Manfred Mario Kokou, Acharya, Dilaram, Adabi, Maryam, Adebiyi, Akindele Olupelumi, Adedeji, Isaac Akinkunmi, Adekanmbi, Victor, Adeoye, Abiodun Moshood, Adetokunboh, Olatunji O., Adham, Davoud, Aduroja, Posi Emmanuel, Advani, Shailesh M., Afarideh, Mohsen, Aghaali, Mohammad, Agrawal, Anurag, Ahmad, Tauseef, Ahmadi, Keivan, Ahmadi, Sepideh, Ahmed, Muktar Beshir, Ahmed, Rushdia, Ajumobi, Olufemi, Akal, Chalachew Genet, Akalu, Temesgen Yihunie, Akinyemiju, Tomi, Akombi, Blessing, Al-Aly, Ziyad, Alam, Samiah, Alamene, Genet Melak, Alanzi, Turki M., Rabanal, Jacqueline Elizabeth Alcalde, Alema, Niguse Meles, Ali, Beriwan Abdulqadir, Ali, Muhammad, Alijanzadeh, Mehran, Alinia, Cyrus, Alipour, Vahid, Alizade, Hesam, Aljunid, Syed Mohamed, Almasi, Afshin, Almasi-Hashiani, Amir, Al-Mekhlafi, Hesham M., Al-Raddadi, Rajaa M., Altirkawi, Khalid, Alvis-Guzman, Nelson, Alvis-Zakzuk, Nelson J., Amare, Azmeraw T., Amegah, Adeladza Kofi, Amini, Saeed, Rarani, Mostafa Amini, Amiri, Fatemeh, Amit, Arianna Maever Loreche, Anber, Nahla Hamed, Andrei, Catalina Liliana, Ansari, Fereshteh, Ansari-Moghaddam, Alireza, Anteneh, Zelalem Alamrew, Antonio, Carl Abelardo T., Antriyandarti, Ernoiz, Anvari, Davood, Anwer, Razique, Appiah, Seth Christopher Yaw, Arabloo, Jalal, Arab-Zozani, Morteza, Araya, Ephrem Mebrahtu, Arefi, Zohreh, Aremu, Olatunde, Ärnlöv, Johan, Arzani, Afsaneh, Asadi-Aliabadi, Mehran, Asadi-Pooya, Ali A., Asgari, Samaneh, Asghari, Babak, Ashagre, Alebachew Fasil, Asrat, Anemaw A., Ataeinia, Bahar, Atalay, Hagos Tasew, Atnafu, Desta Debalkie, Atout, Maha Moh’d Wahbi, Ausloos, Marcel, Avokpaho, Euripide F. G. A., Awasthi, Ashish, Quintanilla, Beatriz Paulina Ayala, Ayanore, Martin Amogre, Aynalem, Yared A. Asmare, Azadmehr, Abbas, Azari, Samad, Azarian, Ghasem, Azene, Zelalem Nigussie, Babaee, Ebrahim, Badawi, Alaa, Badiye, Ashish D., Bahrami, Mohamad Amin, Baig, Atif Amin A., Bakhtiari, Ahad, Bakkannavar, Shankar M., Balakrishnan, Senthilkumar, Bali, Ayele Geleto, Banach, Maciej, Banik, Palash Chandra, Baradaran-Seyed, Zahra, Baraki, Adhanom Gebreegziabher, Barboza, Miguel A., Bärnighausen, Till Winfried, Barua, Lingkan, Basaleem, Huda, Basu, Sanjay, Bayati, Mohsen, Bayih, Mulat Tirfie, Baynes, Habtamu Wondifraw, Bedi, Neeraj, Behzadifar, Masoud, Behzadifar, Meysam, Bekele, Yibeltal Alemu, Bennett, Derrick A., Berbada, Dessalegn Ajema, Berhe, Kidanemaryam, Berhe, Abadi Kidanemariam, Berman, Adam E., Bernstein, Robert S., Bhageerathy, Reshmi, Bhandari, Dinesh, Bharadwaj, Pankaj, Bhattacharjee, Natalia V., Bhattacharyya, Krittika, Bijani, Ali, Bikbov, Boris, Bilano, Ver, Bililign, Nigus, Sayeed, Muhammad Shahdaat Bin, Birara, Setognal, Birhane, Minuye Biniam Biniam, Birhanu, Minyichil, Biswas, Raaj Kishore, Bitew, Zebenay Workneh, Bogale, Kassawmar Angaw, Bohlouli, Somayeh, Bolla, Srinivasa Rao, Boloor, Archith, Borzì, Antonio M., Borzouei, Shiva, Brady, Oliver J., Bragazzi, Nicola Luigi, Braithwaite, Dejana, Briko, Nikolay Ivanovich, Britton, Gabrielle, Budhathoki, Shyam S., Nagaraja, Sharath Burugina, Busse, Reinhard, Butt, Zahid A., Cahuana-Hurtado, Lucero, Cámera, Luis Alberto, Campos-Nonato, Ismael R., Cano, Jorge, Car, Josip, Cárdenas, Rosario, Carrero, Juan J., Carvalho, Félix, Castaldelli-Maia, João Mauricio, Castañeda-Orjuela, Carlos A., Castro, Franz, Cerin, Ester, Chansa, Collins, Charan, Jaykaran, Chatterjee, Pranab, Chattu, Vijay Kumar, Chauhan, Bal Govind, Chavshin, Ali Reza, Chehrazi, Mohammad, Chichiabellu, Tesfaye Yitna, Chin, Ken Lee, Christopher, Devasahayam J., Chu, Dinh-Toi, Cicuttini, Flavia M., Collison, Michael L., Cork, Michael A., Cormier, Natalie, Cortesi, Paolo Angelo, Costa, Vera M., Dadi, Abel Fekadu Fekadu, Dagnew, Baye, Dahlawi, Saad M. A., Damiani, Giovanni, Darwish, Amira Hamed, Daryani, Ahmad, Das, Jai K., Gupta, Rajat Das, Dávila-Cervantes, Claudio, Davis Weaver, Nicole, Leo, Diego De, Neve, Jan-Walter De, Demeke, Feleke Mekonnen, Demis, Asmamaw Bizuneh, Demissie, Dereje Bayissa, Demoz, Gebre Teklemariam, Denova-Gutiérrez, Edgar, Deribe, Kebede, Desai, Rupak, Desalegn, Beruk Berhanu, Desalew, Assefa, Deshpande, Aniruddha, Dey, Sagnik, Dharmaratne, Samath Dhamminda, Dhillon, Preeti, Dhimal, Meghnath, Dhungana, Govinda Prasad, Nasab, Mostafa Dianati, Diaz, Daniel, Forooshani, Zahra Sadat Dibaji, Dinsa, Girmaye Deye, Dipeolu, Isaac Oluwafemi, Djalalinia, Shirin, Do, Hoa Thi, Do, Huyen Phuc, Doku, Paul Narh, Dorostkar, Fariba, Doshmangir, Leila, Dubey, Manisha, Adema, Bereket Duko, Dunachie, Susanna J., Duncan, Bruce B., Cousin, Ewerton, Durães, Andre R., Earl, Lucas, Leylabadlo, Hamed Ebrahimzadeh, Eftekhari, Aziz, El Sayed, Iman, El Sayed Zaki, Maysaa, El Tantawi, Maha, Elbarazi, Iffat, Elemineh, Demelash Abewa, El-Jaafary, Shaimaa I., El-Khatib, Ziad, Elsharkawy, Aisha, El-Sherbiny, Yasser Mohamed, Elyazar, Iqbal R. F., Emamian, Mohammad Hassan, Enany, Shymaa, Endalew, Daniel Adane, Endalifer, Melese Linger, Eskandari, Khalil, Eskandarieh, Sharareh, Esmaeilnejad, Saman, Esteghamati, Alireza, Etemadi, Arash, Etisso, Atkilt Esaiyas, Fanzo, Jessica, Farahmand, Mohammad, Faraj, Anwar, Farashi, Sajjad, Fareed, Mohammad, Farioli, Andrea, Faro, Andre, Farzadfar, Farshad, Farzam, Hossein, Fatima, Syeda Sadia, Fattahi, Nazir, Fauk, Nelsensius Klau, Fazaeli, Ali Akbar, Fentahun, Netsanet, Ferede, Tomas Y., Fereshtehnejad, Seyed-Mohammad, Fernandes, Eduarda, Fernandes, João C., Feyissa, Garumma Tolu, Filip, Irina, Fischer, Florian, Flohr, Carsten, Foigt, Nataliya A., Folayan, Morenike Oluwatoyin, Fomenkov, Artem Alekseevich, Foroutan, Masoud, Förster, Jana, Francis, Joel Msafiri, Fukumoto, Takeshi, Gayesa, Reta Tsegaye, Geberemariyam, Biniyam Sahiledengle, Gebrehiwot, Tsegaye Tewelde, Gebremariam, Hadush, Gebremariam, Kidane Tadesse, Gebremedhin, Ketema Bizuwork Bizuwork, Gebremeskel, Gebreamlak Gebremedhn, Gebreslassie, Assefa Ayalew Ayalew, Gebretsadik, Gebretsadkan G. G., Gedefaw, Getnet Azeze, Geramo, Yilma Chisha Dea, Gesesew, Hailay Abrha, Geta, Birhanu, Getenet, Agegnehu Bante, Gezae, Kebede Embaye, Ghaffarifar, Fatemeh, Ghafourifard, Mansour, Ghajar, Alireza, Ghajarzadeh, Mahsa, Ghashghaee, Ahmad, Ghiasvand, Hesam, Gholamian, Asadollah, Gilani, Syed Amir, Gill, Tiffany K., Ginawi, Ibrahim Abdelmageed, Goli, Srinivas, Gomes, Nelson G. M., Gopalani, Sameer Vali, Goudarzi, Houman, Goulart, Alessandra C., Govindakarnavar, Arunkumar, Grada, Ayman, Grivna, Michal, Guimarães, Rafael Alves, Guled, Rashid Abdi, Guo, Yuming, Gupta, Rahul, Gupta, Rajeev, Hafezi-Nejad, Nima, Haile, Michael Tamene, Haj-Mirzaian, Arvin, Haj-Mirzaian, Arya, Hall, Brian J., Halvaei, Iman, Hamadeh, Randah R., Hamidi, Yadollah, Handiso, Demelash Woldeyohannes, Hankey, Graeme J., Haririan, Hamidreza, Hariyani, Ninuk, Hasaballah, Ahmed I., Hasan, Md. 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D., Iwu, Chinwe Juliana, Izadi, Neda, Jaafari, Jalil, Jaca, Anelisa, Jadidi-Niaragh, Farhad, Balalami, Nader Jafari, Jafarinia, Morteza, Jahani, Mohammad Ali, Jakovljevic, Mihajlo, Jalali, Amir, Jalilian, Farzad, Jayatilleke, Achala Upendra, Jeemon, Panniyammakal, Jehan, Fyezah, Jenabi, Ensiyeh, Jha, Ravi Prakash, Jha, Vivekanand, Ji, John S., Jia, Peng, John, Oommen, John-Akinola, Yetunde O., Johnson, Kimberly B., Jonas, Jost B., Joseph, Nitin, Joukar, Farahnaz, Jozwiak, Jacek Jerzy, Jungari, Suresh Banayya, Jürisson, Mikk, Kabir, Ali, Kabir, Zubair, Kahsay, Amaha, Kahssay, Molla, Kalani, Hamed, Kalankesh, Leila L., Kalhor, Rohollah, Kamiab, Zahra, Kanchan, Tanuj, Kapil, Umesh, Kapoor, Neeti, Karami, Manoochehr, Matin, Behzad Karami, Karch, André, Karim, Mohd A., Karki, Surendra, Kasaeian, Amir, Kasahun, Gebremicheal Gebreslassie, Kasaye, Habtamu Kebebe, Kassa, Tesfaye Dessale, Kassaye, Hagazi Gebremedhin, Kassebaum, Nicholas J., Karyani, Ali Kazemi, Kengne, Andre Pascal, Ketema, Daniel Bekele, Khader, Yousef Saleh, Khafaie, Morteza Abdullatif, Khaksarian, Mojtaba, Khalid, Nauman, Khalil, Ibrahim A., Khalilov, Rovshan, Khan, Asad, Khan, Ejaz Ahmad, Khan, Md Nuruzzaman, Khan, Mohammad Saud, Khan, Muhammad Shahzeb, Khatab, Khaled, Khater, Amir, Khater, Mona M., Khatib, Mahalqua Nazli, Khayamzadeh, Maryam, Khazaei-Pool, Maryam, Khazaei, Mohammad, Khazaei, Salman, Khodayari, Mohammad Taghi, Khosravi, Mohammad Hossein, Khundkar, Roba, Kiadaliri, Ali, Kianipour, Neda, Kiirithio, Daniel N., Kim, Yun Jin, Kimokoti, Ruth W., Kisa, Adnan, Kisa, Sezer, Kolola, Tufa, Komaki, Hamidreza, Kondlahalli, Shivakumar K. 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G., Krishan, Kewal, Krohn, Kris J., Kugbey, Nuworza, Kumar, Manasi, Kumar, Pushpendra, Kumar, Vivek, Kurmi, Om P., Kuti, Oluwatosin, Vecchia, Carlo La, Lacey, Ben, Lad, Deepesh P., Lal, Aparna, Lal, Dharmesh Kumar, Lami, Faris Hasan, Lamichhane, Prabhat, Lang, Justin J., Lansingh, Van C., Lasrado, Savita, Lebedev, Georgy, Lee, Paul H., Lee, Shaun Wen Huey, Leili, Mostafa, Letourneau, Ian D., Lewycka, Sonia, Li, Shanshan, Lim, Lee-Ling, Linn, Shai, Liu, Shiwei, Liu, Simin, Lodha, Rakesh, Longbottom, Joshua, Lopez, Jaifred Christian F., Lorkowski, Stefan, Macarayan, Erlyn Rachelle King, Madadin, Mohammed, El Razek, Hassan Magdy Abd, El Razek, Muhammed Magdy Abd, Maghavani, Dhaval P., Mahasha, Phetole Walter, Mahotra, Narayan Bahadur, Maled, Venkatesh, Maleki, Afshin, Maleki, Shokofeh, Malta, Deborah Carvalho, Manafi, Ali, Manafi, Farzad, Manafi, Navid, Manohar, Narendar Dawanu, Mansour-Ghanaei, Fariborz, Mansouri, Borhan, Mansournia, Mohammad Ali, Mapoma, Chabila Christopher, Marami, Dadi, Marczak, Laurie B., Arnedo, Carlos Alberto Marrugo, Martins-Melo, Francisco Rogerlândio, Masaka, Anthony, Massenburg, Benjamin Ballard, Maulik, Pallab K., Mayala, Benjamin K., Mazidi, Mohsen, Mehndiratta, Man Mohan, Mehri, Freshteh, Mehta, Kala M., Meitei, Wahengbam Bigyananda, Mekonnen, Fantahun Ayenew, Mekonnen, Teferi, Meles, Gebrekiros Gebremichael, Meles, Hagazi Gebre, Melese, Addisu, Mendoza, Walter, Menezes, Ritesh G., Mengesha, Meresa Berwo, Mensah, George A., Meretoja, Tuomo J., Miazgowski, Tomasz, Kostova, Neda Milevska, Miller, Ted R., Mills, Edward J., Mini, G. 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L., Murthy, G. V. S., Musa, Kamarul Imran, Mustafa, Ghulam, Muthupandian, Saravanan, Nabavizadeh, Behnam, Naderi, Mehdi, Nadkarni, Girish N., Nagarajan, Ahamarshan Jayaraman, Naghavi, Mohsen, Naheed, Aliya, Naik, Gurudatta, Najafi, Farid, Nansseu, Jobert Richie, Narayan, K. M. Venkat, Nascimento, Bruno Ramos, Nayak, Vinod, Nazari, Javad, Ndwandwe, Duduzile Edith, Negoi, Ionut, Negoi, Ruxandra Irina, Ngunjiri, Josephine W., Nguyen, Cuong Tat, Nguyen, Huong Lan Thi, Nigatu, Dabere, Nigatu, Yeshambel T., Nikbakhsh, Rajan, Ningrum, Dina Nur Anggraini, Nnaji, Chukwudi A., Nong, Vuong Minh, Noubiap, Jean Jacques, Nowak, Christoph, Oancea, Bogdan, Ofori-Asenso, Richard, Oghenetega, Onome Bright, Oh, In-Hwan, Oladimeji, Olanrewaju, Oladnabi, Morteza, Olagunju, Andrew T., Olagunju, Tinuke O., Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Oluwasanu, Mojisola Morenike, Omer, Muktar Omer, Onwujekwe, Obinna E., Asante, Kwaku Oppong, Oren, Eyal, Orisakwe, Orish Ebere, Ortiz, Alberto, Osarenotor, Osayomwanbo, Osgood-Zimmerman, Aaron E., Owolabi, Mayowa Ojo, P. 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Departamento de Medicina, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (IIS-FJD), Instituto de Investigación Sanitaria Hospital Universitario de La Princesa (IIS-IP), Veritati - Repositório Institucional da Universidade Católica Portuguesa, Biosciences, University of Helsinki, Clinicum, HUS Comprehensive Cancer Center, Institute for Molecular Medicine Finland, Department of Earth Observation Science, UT-I-ITC-ACQUAL, Faculty of Geo-Information Science and Earth Observation, Sálfræðideild (HR), Department of Psychology (RU), Samfélagssvið (HR), School of Social Sciences (RU), Háskólinn í Reykjavík, Reykjavik University, Instituto de Investigación Sanitaria Fundación Jiménez Díaz (ISS-FJD), Kinyoki, D, Ross, J, Lazzar-Atwood, A, Munro, S, Schaeffer, L, Abbasalizad-Farhangi, M, Abbasi, M, Abbastabar, H, Abdelalim, A, Abdoli, A, Abdollahi, M, Abdollahpour, I, Abdulkader, R, Abebe, N, Abebo, T, Abegaz, K, Abolhassani, H, Abreu, L, Abrigo, M, Abushouk, A, Accrombessi, M, 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A, Chehrazi, M, Chichiabellu, T, Chin, K, Christopher, D, Chu, D, Cicuttini, F, Collison, M, Cork, M, Cormier, N, Cortesi, P, Costa, V, Dadi, A, Dagnew, B, Dahlawi, S, Damiani, G, Darwish, A, Daryani, A, Das, J, Gupta, R, Davila-Cervantes, C, Davis Weaver, N, Leo, D, Neve, J, Demeke, F, Demis, A, Demissie, D, Demoz, G, Denova-Gutierrez, E, Deribe, K, Desai, R, Desalegn, B, Desalew, A, Deshpande, A, Dey, S, Dharmaratne, S, Dhillon, P, Dhimal, M, Dhungana, G, Nasab, M, Diaz, D, Forooshani, Z, Dinsa, G, Dipeolu, I, Djalalinia, S, Do, H, Doku, P, Dorostkar, F, Doshmangir, L, Dubey, M, Adema, B, Dunachie, S, Duncan, B, Duraes, A, Earl, L, Leylabadlo, H, Eftekhari, A, El Sayed, I, El Sayed Zaki, M, El Tantawi, M, Elbarazi, I, Elemineh, D, El-Jaafary, S, El-Khatib, Z, Elsharkawy, A, El-Sherbiny, Y, Elyazar, I, Emamian, M, Enany, S, Endalew, D, Endalifer, M, Eskandari, K, Eskandarieh, S, Esmaeilnejad, S, Esteghamati, A, Etemadi, A, Etisso, A, Fanzo, J, Farahmand, M, Faraj, A, Farashi, S, Fareed, M, Farioli, A, Faro, A, Farzadfar, F, Farzam, H, Fatima, S, Fattahi, N, Fauk, N, Fazaeli, A, Fentahun, N, Ferede, T, Fereshtehnejad, S, Fernandes, E, Fernandes, J, Feyissa, G, Filip, I, Fischer, F, Flohr, C, Foigt, N, Folayan, M, Fomenkov, A, Foroutan, M, Forster, J, Francis, J, Fukumoto, T, Gayesa, R, Geberemariyam, B, Gebrehiwot, T, Gebremariam, H, Gebremariam, K, Gebremedhin, K, Gebremeskel, G, Gebreslassie, A, Gebretsadik, G, Gedefaw, G, Geramo, Y, Gesesew, H, Geta, B, Getenet, A, Gezae, K, Ghaffarifar, F, Ghafourifard, M, Ghajar, A, Ghajarzadeh, M, Ghashghaee, A, Ghiasvand, H, Gholamian, A, Gilani, S, Gill, T, Ginawi, I, Goli, S, Gomes, N, Gopalani, S, Goudarzi, H, Goulart, A, Govindakarnavar, A, Grada, A, Grivna, M, Guimaraes, R, Guled, R, Guo, Y, Hafezi-Nejad, N, Haile, M, Haj-Mirzaian, A, Hall, B, Halvaei, I, Hamadeh, R, Hamidi, Y, Handiso, D, Hankey, G, Haririan, H, Hariyani, N, Hasaballah, A, Hasan, M, Hasankhani, M, Hasanpoor, E, Hasanzadeh, A, Hashemian, M, Hassanipour, S, Hassen, H, Havmoeller, R, Hawkes, C, Hayat, K, Hayelom, D, Heidari, B, Heidari-Soureshjani, R, Hendrie, D, Henok, A, Henry, N, Herrero, M, Herteliu, C, Heydarpour, F, de Hidru, H, Hoang, C, Hoek, H, Hole, M, Holla, R, Hollerich, G, Rad, E, Hong, S, Hoogar, P, Horino, M, Hossain, N, Hosseini, M, Hosseinzadeh, M, Hostiuc, M, Hostiuc, S, Housseh, M, Hsairi, M, Hu, G, Huda, T, Humayun, A, Hwang, B, Ibitoye, S, Ilesanmi, O, Ilic, M, Imani-Nasab, M, Inbaraj, L, Iqbal, U, Irvani, S, Islam, S, Iwu, C, Izadi, N, Jaafari, J, Jaca, A, Jadidi-Niaragh, F, Balalami, N, Jafarinia, M, Jahani, M, Jakovljevic, M, Jalali, A, Jalilian, F, Jayatilleke, A, Jeemon, P, Jehan, F, Jenabi, E, Jha, R, Jha, V, Ji, J, Jia, P, John, O, John-Akinola, Y, Johnson, K, Jonas, J, Joseph, N, Joukar, F, Jozwiak, J, Jungari, S, Jurisson, M, Kabir, A, Kabir, Z, Kahsay, A, Kahssay, M, Kalani, H, Kalankesh, L, Kalhor, R, Kamiab, Z, Kanchan, T, Kapil, U, Kapoor, N, Karami, M, Matin, B, Karch, A, Karim, M, Karki, S, Kasaeian, A, Kasahun, G, Kasaye, H, Kassa, T, Kassaye, H, Kassebaum, N, Karyani, A, Kengne, A, Ketema, D, Khader, Y, Khafaie, M, Khaksarian, M, Khalid, N, Khalil, I, Khalilov, R, Khan, A, Khan, E, Khan, M, Khatab, K, Khater, A, Khater, M, Khatib, M, Khayamzadeh, M, Khazaei-Pool, M, Khazaei, M, Khazaei, S, Khodayari, M, Khosravi, M, Khundkar, R, Kiadaliri, A, Kianipour, N, Kiirithio, D, Kim, Y, Kimokoti, R, Kisa, A, Kisa, S, Kolola, T, Komaki, H, Kondlahalli, S, Koolivand, A, Koul, P, Koyanagi, A, Kraemer, M, Krishan, K, Krohn, K, Kugbey, N, Kumar, M, Kumar, P, Kumar, V, Kurmi, O, Kuti, O, Vecchia, C, Lacey, B, Lad, D, Lal, A, Lal, D, Lami, F, Lamichhane, P, Lang, J, Lansingh, V, Lasrado, S, Lebedev, G, Lee, P, Lee, S, Leili, M, Letourneau, I, Lewycka, S, Li, S, Lim, L, Linn, S, Liu, S, Lodha, R, Longbottom, J, Lopez, J, Lorkowski, S, Macarayan, E, Madadin, M, El Razek, H, El Razek, M, Maghavani, D, Mahasha, P, Mahotra, N, Maled, V, Maleki, A, Maleki, S, Malta, D, Manafi, A, Manafi, F, Manafi, N, Manohar, N, Mansour-Ghanaei, F, Mansouri, B, Mansournia, M, Mapoma, C, Marami, D, Marczak, L, Arnedo, C, Martins-Melo, F, Masaka, A, Massenburg, B, Maulik, P, Mayala, B, Mazidi, M, Mehndiratta, M, Mehri, F, Mehta, K, Meitei, W, Mekonnen, F, Mekonnen, T, Meles, G, Meles, H, Melese, A, Mendoza, W, Menezes, R, Mengesha, M, Mensah, G, Meretoja, T, Miazgowski, T, Kostova, N, Miller, T, Mills, E, Mini, G, Mir, S, Miri, M, Mirjalali, H, Mirrakhimov, E, Mirzaei, H, Mirzaei, M, Mirzaei, R, Mirzaei-Alavijeh, M, Mithra, P, Moazen, B, Mohamadi, E, Mohamadi-Bolbanabad, A, Mohammad, K, Mohammad, Y, Mohammad, D, Darwesh, A, Mezerji, N, Mohammadian-Hafshejani, A, Mohammadnia-Afrouzi, M, Mohammadoo-Khorasani, M, Mohammadpourhodki, R, Mohammed, S, Mohammed, J, Mohammed, A, Mohebi, F, Mokari, A, Mokdad, A, Montanez, J, Montero-Zamora, P, Moodley, Y, Moossavi, M, Moradi, G, Moradi, M, Moradi, Y, Moradi-Joo, M, Moradi-Lakeh, M, Moradpour, F, Moradzadeh, R, Moraga, P, Morrison, S, Mosapour, A, Mosser, J, Mouodi, S, Khaneghah, A, Mozaffarian, D, Mueller, U, Murray, C, Murthy, G, Musa, K, Mustafa, G, Muthupandian, S, Nabavizadeh, B, Naderi, M, Nadkarni, G, Nagarajan, A, Naghavi, M, Naheed, A, Naik, G, Najafi, F, Nansseu, J, Narayan, K, Nascimento, B, Nayak, V, Nazari, J, Ndwandwe, D, Negoi, I, Negoi, R, Ngunjiri, J, Nguyen, C, Nguyen, H, Nigatu, D, Nigatu, Y, Nikbakhsh, R, Ningrum, D, Nnaji, C, Nong, V, Noubiap, J, Nowak, C, Oancea, B, Ofori-Asenso, R, Oghenetega, O, Oh, I, Oladimeji, O, Oladnabi, M, Olagunju, A, Olagunju, T, Olusanya, B, Olusanya, J, Oluwasanu, M, Omer, M, Onwujekwe, O, Asante, K, Oren, E, Orisakwe, O, Ortiz, A, Osarenotor, O, Osgood-Zimmerman, A, Owolabi, M, P. A, M, Padubidri, J, Pakshir, K, Pana, A, Panda-Jonas, S, Parsian, H, Pashaei, T, Pasupula, D, Patel, S, Pathak, A, Pathak, M, Pati, S, Patle, A, Patton, G, Paulos, K, Toroudi, H, Pepito, V, Perico, N, Petri, W, Pickering, B, Pigott, D, Pirestani, M, Piroozi, B, Pirsaheb, M, Pokhrel, K, Postma, M, Pourjafar, H, Pourmalek, F, Kalhori, R, Pourshams, A, Poustchi, H, Prada, S, Preotescu, L, Pribadi, D, Syed, Z, Rabiee, M, Rabiee, N, Radfar, A, Rafiei, A, Rahim, F, Rahimi-Movaghar, V, Rahman, M, Rahman, S, Rai, R, Rajabpour-Sanati, A, Rajati, F, Ramezanzadeh, K, Rana, S, Ranabhat, C, Rao, S, Rasella, D, Rashedi, V, Rastogi, P, Rathi, P, Rawaf, S, Rawaf, D, Rawal, L, Ray, S, Remuzzi, G, Renjith, V, Renzaho, A, Resnikoff, S, Rezaei, N, Rezaeian, S, Rezai, M, Rezapour, A, Riahi, S, Ribeiro, A, Rickard, J, Rodriguez, A, Roever, L, Roro, E, Roshandel, G, Rostami, A, Rubagotti, E, Saad, A, Saadatagah, S, Sabde, Y, Sabour, S, Sadeghi, E, Sadeghi, M, Safari, S, Safari, Y, Safarpour, H, Sagar, R, Sahebkar, A, Sahraian, M, Sajadi, S, Salahshoor, M, Salam, N, Salehi, F, Zahabi, S, Salem, H, Salem, M, Salimi, Y, Salimzadeh, H, Kafil, H, Sambala, E, Samy, A, Santos, I, Jose, B, Saraswathy, S, Sarker, A, Sartorius, B, Sarveazad, A, Sathian, B, Satpathy, M, Saxena, S, Sayyah, M, Sbarra, A, Schipp, M, Schmidt, M, Schutte, A, Schwebel, D, Senbeta, A, Senthilkumaran, S, Seyedmousavi, S, Shaahmadi, F, Shafaat, O, Shahabi, S, Shaikh, M, Shalash, A, Shams-Beyranvand, M, Shamshirian, A, Shamsizadeh, M, Shannawaz, M, Sharafi, K, Sharif, M, Sharma, R, Shehata, H, Sheikhtaheri, A, Shibuya, K, Shiferaw, W, Shigematsu, M, Shin, J, Shiri, R, Shirkoohi, R, Shiue, I, Shuval, K, Siabani, S, Siddiqi, T, Sigfusdottir, I, Silva, D, Simonetti, B, Singh, A, Singh, P, Singh, V, Singh, J, Sinha, D, Sintayehu, Y, Sisay, M, Soheili, A, Soleymani, B, Soltani, F, Soltani, S, Soriano, J, Sorrie, M, Soshnikov, S, Soyiri, I, Spotin, A, Sreeramareddy, C, Srivastava, R, Starodubova, A, Sudaryanto, A, Sufiyan, M, Suleria, H, Sulo, G, Sunguya, B, Sykes, B, Tabares-Seisdedos, R, Tabuchi, T, Tadesse, B, Taherkhani, A, Tamirat, K, Tassew, S, Taveira, N, Teklehaimanot, B, Tekulu, G, Temsah, M, Terkawi, A, Tessema, Z, Thomas, N, Titova, M, Tlaye, K, Tohidinik, H, Tonelli, M, Tovani-Palone, M, Traini, E, Tran, K, Tripathi, M, Uddin, R, Ullah, I, Unnikrishnan, B, Upadhyay, E, Useh, U, Usman, M, Uthman, O, Vacante, M, Vaezghasemi, M, Valdez, P, Vanderheide, J, Varavikova, E, Varughese, S, Vasankari, T, Vasseghian, Y, Veisani, Y, Venkatesh, S, Venketasubramanian, N, Verma, M, Vidale, S, Violante, F, Vlassov, V, Vollmer, S, Vukovic, R, Waheed, Y, Wang, H, Wang, Y, Weldesamuel, G, Werdecker, A, Wiangkham, T, Wiens, K, Wijeratne, T, Wolde, H, Wondafrash, D, Wonde, T, Wondmieneh, A, Wu, A, Xu, G, Yadegar, A, Yadollahpour, A, Jabbari, S, Yamada, T, Yano, Y, Yaya, S, Yazdi-Feyzabadi, V, Yeshaneh, A, Yeshaw, Y, Yeshitila, Y, Yilma, M, Yip, P, Yonemoto, N, Yoon, S, Youm, Y, Younis, M, Yousefi, Z, Yousof, H, Yu, C, Yusefzadeh, H, Moghadam, T, Zaki, L, Zaman, S, Zamani, M, Zamanian, M, Zandian, H, Zarafshan, H, Zepro, N, Zerfu, T, Zewale, T, Zhang, Y, Zhang, Z, Zhao, X, Zodpey, S, Zomorodian, K, Zotor, F, Afshin, A, Hay, S, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), and Microbes in Health and Disease (MHD)

Subjects
Male, Local patterns, Double burden, Börn, Research & Experimental Medicine, Sjúkdómseinkenni, DOUBLE BURDEN, Childhood overweight, Lífefnafræði, Læknisfræði, 0302 clinical medicine, Syndemic, Child, 11 Medical and Health Sciences, under 5 years of age, General Medicine, 3. Good health, Geography, Medicine, Research & Experimental, Child, Preschool, Income, GROWTH, AFRICA, medicine.medical_specialty, Biochemistry & Molecular Biology, RJ, Medicina, Immunology, education, MODELS, wa_395, General Biochemistry, Genetics and Molecular Biology, Article, 03 medical and health sciences, Humans, Author Correction, Developing Countries, Poverty, Biology, LBD Double Burden of Malnutrition Collaborators, Demography, Science & Technology, Wasting Syndrome, Public health, MORTALITY, Infant, Næringarskortur, medicine.disease, Obesity, TRENDS, signs and symptoms, Social Class, Risk factors, Sameindalíffræði, ITC-ISI-JOURNAL-ARTICLE, UNDERNUTRITION, Human medicine, Clinical Medicine, 030217 neurology & neurosurgery, Pediatric Obesity, obesity, Offita, Áhættuþættir, Geographic Mapping, Overweight, RA0421, Global health, risk factors, 030212 general & internal medicine, Signs and symptoms, Wasting, Malnutrition, Global Burden of Diseases, Global Nutrition, low- and middle-income countries, 2. Zero hunger, 1. No poverty, Public Health, Global Health, Social Medicine and Epidemiology, A900 Others in Medicine and Dentistry, Childhood wasting, PREVALENCE, Chemistry, Mapping, Female, Lýðheilsa, medicine.symptom, Life Sciences & Biomedicine, GROWTH FAILURE, Nutritional Status, malnutrition, ITC-HYBRID, ws_115, children, Environmental health, medicine, Erfðafræði, wd_200, Malnutrition, Infant, Newborn, Klinisk medicin, Cell Biology, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, 3121 General medicine, internal medicine and other clinical medicine, NA
Abstract

Artículo con numerosos autores, sólo se mencionan el primero, los de la UAM y grupo colectivo, A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of, This work was primarily supported by grant OPP1132415 from the Bill & Melinda Gates Foundation awarded to S.I.H.

Published
2020

37. Associations of circulating very-long-chain saturated fatty acids and incident type 2 diabetes: a pooled analysis of prospective cohort studies

Author

Fretts, Amanda M, Imamura, Fumiaki, Marklund, Matti, Micha, Renata, Wu, Jason HY, Murphy, Rachel A, Chien, Kuo-Liong, McKnight, Barbara, Tintle, Nathan, Forouhi, Nita G, Qureshi, Waqas T, Virtanen, Jyrki K, Wong, Kerry, Wood, Alexis C, Lankinen, Maria, Rajaobelina, Kalina, Harris, Tamara B, Djoussé, Luc, Harris, Bill, Wareham, Nick J, Steffen, Lyn M, Laakso, Markku, Veenstra, Jenna, Samieri, Cécilia, Brouwer, Ingeborg A, Yu, Chaoyu Ian, Koulman, Albert, Steffen, Brian T, Helmer, Catherine, Sotoodehnia, Nona, Siscovick, David, Gudnason, Vilmundur, InterAct Consortium, Wagenknecht, Lynne, Voutilainen, Sari, Tsai, Michael Y, Uusitupa, Matti, Kalsbeek, Anya, Berr, Claudine, Mozaffarian, Dariush, Lemaitre, Rozenn N, Imamura, Fumiaki [0000-0002-6841-8396], Forouhi, Nita [0000-0002-5041-248X], Wareham, Nicholas [0000-0003-1422-2993], Koulman, Albert [0000-0001-9998-051X], and Apollo - University of Cambridge Repository

Subjects
Adult, Aged, 80 and over, Male, Fatty Acids and Outcomes Research Consortium, diabetes, Fatty Acids, Middle Aged, very-long-chain saturated fatty acids, meta-analysis, Diabetes Mellitus, Type 2, Eicosanoic Acids, Cohorts for Heart and Aging Research in Genomic Epidemiology, Humans, saturated fatty acids, Female, Prospective Studies, Aged
Abstract

BACKGROUND: Saturated fatty acids (SFAs) of different chain lengths have unique metabolic and biological effects, and a small number of recent studies suggest that higher circulating concentrations of the very-long-chain SFAs (VLSFAs) arachidic acid (20:0), behenic acid (22:0), and lignoceric acid (24:0) are associated with a lower risk of diabetes. Confirmation of these findings in a large and diverse population is needed. OBJECTIVE: We investigated the associations of circulating VLSFAs 20:0, 22:0, and 24:0 with incident type 2 diabetes in prospective studies. METHODS: Twelve studies that are part of the Fatty Acids and Outcomes Research Consortium participated in the analysis. Using Cox or logistic regression within studies and an inverse-variance-weighted meta-analysis across studies, we examined the associations of VLSFAs 20:0, 22:0, and 24:0 with incident diabetes among 51,431 participants. RESULTS: There were 14,276 cases of incident diabetes across participating studies. Higher circulating concentrations of 20:0, 22:0, and 24:0 were each associated with a lower risk of incident diabetes. Pooling across cohorts, the RR (95% CI) for incident diabetes comparing the 90th percentile to the 10th percentile was 0.78 (0.70, 0.87) for 20:0, 0.84 (0.77, 0.91) for 22:0, and 0.75 (0.69, 0.83) for 24:0 after adjustment for demographic, lifestyle, adiposity, and other health factors. Results were fully attenuated in exploratory models that adjusted for circulating 16:0 and triglycerides. CONCLUSIONS: Results from this pooled analysis indicate that higher concentrations of circulating VLSFAs 20:0, 22:0, and 24:0 are each associated with a lower risk of diabetes.

Published
2019

38. Correction: Global, Regional, and National Consumption of Sugar-Sweetened Beverages, Fruit Juices, and Milk: A Systematic Assessment of Beverage Intake in 187 Countries

Author

Singh, Gitanjali M., Micha, Renata, Khatibzadeh, Shahab, Shi, Peilin, Lim, Stephen, Andrews, Kathryn G., Engell, Rebecca E., Ezzati, Majid, and Mozaffarian, Dariush

Subjects
Adult, Male, Correction, Bayes Theorem, Feeding Behavior, Middle Aged, Global Health, Nutrition Surveys, Beverages, Fruit and Vegetable Juices, Young Adult, Milk, Sweetening Agents, Dietary Carbohydrates, Animals, Humans, Female, Aged
Abstract

Sugar-sweetened beverages (SSBs), fruit juice, and milk are components of diet of major public health interest. To-date, assessment of their global distributions and health impacts has been limited by insufficient comparable and reliable data by country, age, and sex.To quantify global, regional, and national levels of SSB, fruit juice, and milk intake by age and sex in adults over age 20 in 2010.We identified, obtained, and assessed data on intakes of these beverages in adults, by age and sex, from 193 nationally- or subnationally-representative diet surveys worldwide, representing over half the world's population. We also extracted data relevant to milk, fruit juice, and SSB availability for 187 countries from annual food balance information collected by the United Nations Food and Agriculture Organization. We developed a hierarchical Bayesian model to account for measurement incomparability, study representativeness, and sampling and modeling uncertainty, and to combine and harmonize nationally representative dietary survey data and food availability data.In 2010, global average intakes were 0.58 (95%UI: 0.37, 0.89) 8 oz servings/day for SSBs, 0.16 (0.10, 0.26) for fruit juice, and 0.57 (0.39, 0.83) for milk. There was significant heterogeneity in consumption of each beverage by region and age. Intakes of SSB were highest in the Caribbean (1.9 servings/day; 1.2, 3.0); fruit juice consumption was highest in Australia and New Zealand (0.66; 0.35, 1.13); and milk intake was highest in Central Latin America and parts of Europe (1.06; 0.68, 1.59). Intakes of all three beverages were lowest in East Asia and Oceania. Globally and within regions, SSB consumption was highest in younger adults; fruit juice consumption showed little relation with age; and milk intakes were highest in older adults.Our analysis highlights the enormous spectrum of beverage intakes worldwide, by country, age, and sex. These data are valuable for highlighting gaps in dietary surveillance, determining the impacts of these beverages on global health, and targeting dietary policy.

Published
2019

39. Health effects of dietary risks in 195 countries, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017

Author

Afshin, Ashkan, Sur, Patrick John, Fay, Kairsten A., Cornaby, Leslie, Ferrara, Giannina, Salama, Joseph S., Mullany, Erin C., Abate, Kalkidan Hassen, Abbafati, Cristiana, Abebe, Zegeye, Afarideh, Mohsen, Aggarwal, Anju, Agrawal, Sutapa, Akinyemiju, Tomi, Alahdab, Fares, Bacha, Umar, Bachman, Victoria F., Badali, Hamid, Badawi, Alaa, Bensenor, Isabela M., Bernabe, Eduardo, Biryukov, Stan H., Biadgilign, Sibhatu Kassa K., Cahill, Leah E., Carrero, Juan J., Cercy, Kelly M., Dandona, Lalit, Dandona, Rakhi, Dang, Anh Kim, Degefa, Meaza Girma, Zaki, Maysaa El Sayed, Esteghamati, Alireza, Esteghamati, Sadaf, Fanzo, Jessica, Farinha, Carla Sofia E. Sa, Farvid, Maryam S., Farzadfar, Farshad, Feigin, Valery L., Fernandes, Joao C., Flor, Luisa Sorio, Foigt, Nataliya A., Forouzanfar, Mohammad H., Ganji, Morsaleh, Geleijnse, Johanna M., Gillum, Richard F., Goulart, Alessandra C., Grosso, Giuseppe, Guessous, Idris, Hamidi, Samer, Hankey, Graeme J., Harikrishnan, Sivadasanpillai, Hassen, Hamid Yimam, Hay, Simon I., Hoang, Chi Linh, Horino, Masako, Islami, Farhad, Jackson, Maria D., James, Spencer L., Johansson, Lars, Jonas, Jost B., Kasaeian, Amir, Khader, Yousef Saleh, Khalil, Ibrahim A., Khang, Young-Ho, Kimokoti, Ruth W., Kokubo, Yoshihiro, Kumar, G. Anil, Lallukka, Tea, Lopez, Alan D., Lorkowski, Stefan, Lotufo, Paulo A., Lozano, Rafael, Malekzadeh, Reza, Marz, Winfried, Meier, Toni, Melaku, Yohannes A., Mendoza, Walter, Mensink, Gert B. M., Micha, Renata, Miller, Ted R., Mirarefin, Mojde, Mohan, Viswanathan, Mokdad, Ali H., Mozaffarian, Dariush, Nagel, Gabriele, Naghavi, Mohsen, Nguyen, Cuong Tat, Nixon, Molly R., Ong, Kanyin L., Pereira, David M., Poustchi, Hossein, Qorbani, Mostafa, Rai, Rajesh Kumar, Razo-Garcia, Christian, Rehm, Colin D., Rivera, Juan A., Rodriguez-Ramirez, Sonia, Roshandel, Gholamreza, Roth, Gregory A., Sanabria, Juan, Sanchez-Pimienta, Tania G., Sartorius, Benn, Schmidhuber, Josef, Schutte, Aletta Elisabeth, Sepanlou, Sadaf G., Shin, Min-Jeong, Sorensen, Reed J. D., Springmann, Marco, Szponar, Lucjan, Thorne-Lyman, Andrew L., Thrift, Amanda G., Touvier, Mathilde, Tran, Bach Xuan, Tyrovolas, Stefanos, Ukwaja, Kingsley Nnanna, Ullah, Irfan, Uthman, Olalekan A., Vaezghasemi, Masoud, Vasankari, Tommi Juhani, Vollset, Stein Emil, Vos, Theo, Vu, Giang Thu, Vu, Linh Gia, Weiderpass, Elisabete, Werdecker, Andrea, Wijeratne, Tissa, Willett, Walter C., Wu, Jason H., Xu, Gelin, Yonemoto, Naohiro, Yu, Chuanhua, Murray, Christopher J. L., GBD 2017 Diet Collaborators, and Springmann, M

Subjects
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Humans, preventable risk factor, Public Health, Global Health, Social Medicine and Epidemiology, non-communicable diseases, burden of disease, Human medicine, Article, Diet, Global Burden of Disease
Abstract

Background: Suboptimal diet is an important preventable risk factor for non-communicable diseases (NCDs); however, its impact on the burden of NCDs has not been systematically evaluated. This study aimed to evaluate the consumption of major foods and nutrients across 195 countries and to quantify the impact of their suboptimal intake on NCD mortality and morbidity. Methods: By use of a comparative risk assessment approach, we estimated the proportion of disease-specific burden attributable to each dietary risk factor (also referred to as population attributable fraction) among adults aged 25 years or older. The main inputs to this analysis included the intake of each dietary factor, the effect size of the dietary factor on disease endpoint, and the level of intake associated with the lowest risk of mortality. Then, by use of disease-specific population attributable fractions, mortality, and disability-adjusted life-years (DALYs), we calculated the number of deaths and DALYs attributable to diet for each disease outcome. Findings: In 2017, 11 million (95% uncertainty interval [UI] 10–12) deaths and 255 million (234–274) DALYs were attributable to dietary risk factors. High intake of sodium (3 million [1–5] deaths and 70 million [34–118] DALYs), low intake of whole grains (3 million [2–4] deaths and 82 million [59–109] DALYs), and low intake of fruits (2 million [1–4] deaths and 65 million [41–92] DALYs) were the leading dietary risk factors for deaths and DALYs globally and in many countries. Dietary data were from mixed sources and were not available for all countries, increasing the statistical uncertainty of our estimates. Interpretation: This study provides a comprehensive picture of the potential impact of suboptimal diet on NCD mortality and morbidity, highlighting the need for improving diet across nations. Our findings will inform implementation of evidence-based dietary interventions and provide a platform for evaluation of their impact on human health annually.

Published
2019

40. Fish Oil and Peri-operative Bleeding: Insights from the Omega-3 Fatty Acids for Prevention of Postoperative Atrial Fibrillation (OPERA) Randomized Trial

Author

Akintoye, Emmanuel, Sethi, Prince, Harris, William S., Thompson, Paul A., Marchioli, Roberto, Tavazzi, Luigi, Latini, Roberto, Pretorius, Mias, Brown, Nancy J., Libby, Peter, and Mozaffarian, Dariush

Subjects
Male, Risk, Fish Oils, Double-Blind Method, Dietary Supplements, Odds Ratio, Humans, Female, Coronary Artery Bypass, Middle Aged, Postoperative Hemorrhage, Article, Aged
Abstract

Background Fish oil is among the most common natural supplements for treatment of hypertriglyceridemia or prevention of cardiovascular disease. However, concerns about theoretical bleeding risk have led to recommendations that patients should stop taking fish oil before surgery or delay in elective procedures for patients taking fish oil by some health care professionals. Methods and Results We tested the effect of fish oil supplementation on perioperative bleeding in a multinational, placebo-controlled trial involving 1516 patients who were randomized to perioperative fish oil (eicosapentaenoic acid+docosahexaenoic acid; 8-10 g for 2-5 days preoperatively, and then 2 g/d postoperatively) or placebo. Primary outcome was major perioperative bleeding as defined by the Bleeding Academic Research Consortium. Secondary outcomes include perioperative bleeding per thrombolysis in myocardial infarction and International Society on Thrombosis and Hemostasis definitions, chest tube output, and total units of blood transfused. Participants' mean (SD) age was 63 (13) years, and planned surgery included coronary artery bypass graft (52%) and valve surgery (50%). The primary outcome occurred in 92 patients (6.1%). Compared with placebo, risk of Bleeding Academic Research Consortium bleeding was not higher in the fish oil group: odds ratio, 0.81; 95% CI, 0.53-1.24; absolute risk difference, 1.1% lower (95% CI, -3.0% to 1.8%). Similar findings were seen for secondary bleeding definitions. The total units of blood transfused were significantly lower in the fish oil group compared with placebo (mean, 1.61 versus 1.92; P0.001). Evaluating achieved plasma phospholipid omega-3 polyunsaturated fatty acids levels with supplementation (on the morning of surgery), higher levels were associated with lower risk of Bleeding Academic Research Consortium bleeding, with substantially lower risk in the third (odds ratio, 0.30 [95% CI, 0.11-0.78]) and fourth (0.36 [95% CI, 0.15-0.87]) quartiles, compared with the lowest quartile. Conclusions Fish oil supplementation did not increase perioperative bleeding and reduced the number of blood transfusions. Higher achieved n-3-PUFA levels were associated with lower risk of bleeding. These novel findings support the need for reconsideration of current recommendations to stop fish oil or delay procedures before cardiac surgery. Clinical Trial Registration URL: https://www.clinicaltrials.gov . Unique identifier: NCT00970489.

Published
2018

41. A global database of food and nutrient consumption

Author

Khatibzadeh, Shahab, Saheb Kashaf, Michael, Micha, Renata, Fahimi, Saman, Shi, Peilin, Elmadfa, Ibrahim, Kalantarian, Shadi, Wirojratana, Pattra, Ezzati, Majid, Powles, John, Mozaffarian, Dariush, and Calleja, Neville

Subjects
0301 basic medicine, Time Factors, Databases, Factual, Nutrition surveys, Population, Developing country, Food supply, Nutrition -- Evaluation, Global Health, computer.software_genre, Food Supply, Food group, 03 medical and health sciences, Age Distribution, 0302 clinical medicine, Residence Characteristics, Environmental health, Global health, Per capita, medicine, Humans, Food consumption, 030212 general & internal medicine, Sex Distribution, education, education.field_of_study, 030109 nutrition & dietetics, Data collection, Database, Public Health, Environmental and Occupational Health, medicine.disease, Malnutrition, Geography, Food, Survey data collection, computer, Perspectives
Abstract

In every region of the world, poor diet is a leading cause of both malnutrition and chronic diseases including diabetes, cardiovascular diseases and specific cancers. In 2013, 38.3 million deaths occurred due to chronic diseases globally (70% of all deaths), with most of these deaths occurring in developing countries. Anecdotal evidence and more formal evaluations in a limited number of countries suggest that changes in traditional eating patterns and a growing reliance on new types of foods are major drivers of these transitions. However, data on global patterns of dietary habits, as well as differences by population characteristics are not well established. An empirical assessment of dietary intakes is needed for evidence-based policy-making to address global health challenges, peer-reviewed

Published
2016

42. Associations of Plasma Phospholipid SFAs with Total and Cause-Specific Mortality in Older Adults Differ According to SFA Chain Length1234

Author

Fretts, Amanda M, Mozaffarian, Dariush, Siscovick, David S, King, Irena B, McKnight, Barbara, Psaty, Bruce M, Rimm, Eric B, Sitlani, Colleen, Sacks, Frank M, Song, Xiaoling, Sotoodehnia, Nona, Spiegelman, Donna, and Lemaitre, Rozenn N

Subjects
Aged, 80 and over, Male, saturated fat, Fatty Acids, Palmitic Acid, mortality, elderly, Dietary Fats, Diet, Eicosanoic Acids, Risk Factors, Cause of Death, SFAs, Nutritional Epidemiology, Humans, Female, Prospective Studies, plasma phospholipid FAs, Phospholipids, Stearic Acids, Aged
Abstract

Background: Not much is known about the relations of circulating saturated fatty acids (SFAs), which are influenced by both metabolic and dietary determinants, with total and cause-specific mortality. Objective: We examined the associations of plasma phospholipid SFAs with total and cause-specific mortality among 3941 older adults from the Cardiovascular Health Study, a population-based prospective study of adults aged ≥65 y who were followed from 1992 through 2011. Methods: The relations of total and cause-specific mortality with plasma phospholipid palmitic acid (16:0), stearic acid (18:0), arachidic acid (20:0), behenic acid (22:0), and lignoceric acid (24:0) were assessed using Cox proportional hazards models. Results: During 45,450 person-years of follow-up, 3134 deaths occurred. Higher concentrations of the plasma phospholipid SFAs 18:0, 22:0, and 24:0 were associated with a lower risk of total mortality [multivariable-adjusted HRs (95% CIs)] for the top compared with the bottom quintile: 0.85 (0.75, 0.95) for 18:0; 0.85 (0.75, 0.95) for 22:0; and 0.80 (0.71, 0.90) for 24:0. In contrast, plasma 16:0 concentrations in the highest quintile were associated with a higher risk of total mortality compared with concentrations in the lowest quintile [1.25 (1.11, 1.41)]. We also found no association of plasma phospholipid 20:0 with total mortality. Conclusions: These findings suggest that the associations of plasma phospholipid SFAs with the risk of death differ according to SFA chain length and support future studies to better characterize the determinants of circulating SFAs and to explore the mechanisms underlying these relations.

Published
2015

43. Assessing dietary intakes from household budget surveys: A national analysis in Bangladesh

Author

Karageorgou, Dimitra, Imamura, Fumiaki, Zhang, Jianyi, Shi, Peilin, Mozaffarian, Dariush, Micha, Renata, Imamura, Fumiaki [0000-0002-6841-8396], and Apollo - University of Cambridge Repository

Subjects
Adult, Male, Bangladesh, Family Characteristics, Adolescent, lcsh:R, lcsh:Medicine, Feeding Behavior, Middle Aged, Nutrition Surveys, Diet Surveys, Diet, Young Adult, Income, Humans, Female, lcsh:Q, Micronutrients, Child, Energy Intake, lcsh:Science
Abstract

BACKGROUND: Accurate national information on dietary intakes, including heterogeneity among individuals, is critical to inform health implications and policy priorities. In low- and middle-income countries, household expenditure surveys constitute the major source of food data, but with uncertain validity for individual-level intakes. OBJECTIVE: To investigate how individualized dietary consumption estimated from household survey data compared with individual-level 24-hr dietary recalls (24hR); and to assess potential heterogeneity by method for individualizing household intakes, dietary indicator, and individual characteristics (age, sex, education, religion, household income). METHODS: We evaluated data from the 2011-2012 Bangladesh Household Integrated Survey (BIHS), which included household-level consumption data (5,503 households) and individual-level dietary data based on 24hR from these households (22,173 participants). Household and 24hR estimates were standardized and harmonized for 33 dietary indicators, including 9 food groups, total energy, 8 macronutrients, and 15 micronutrients. Individual consumption was estimated from household data using two approaches, the Adult Male Equivalent (AME) and per capita (PC) approach. For each dietary indicator, differences in household vs. individual mean estimates were evaluated overall and by strata of individual characteristics, using Spearman's correlations and univariate and multivariate linear regression models. RESULTS: Individualized household estimates overestimated individual intakes from 24hR for all dietary factors using either estimation method (P

Published
2018

44. Priority interventions to improve maternal and child diets in Sub‐Saharan Africa and South Asia

Author

Masters, William A., Rosettie, Katherine, Kranz, Sarah, Pedersen, Sarah H., Webb, Patrick, Danaei, Goodarz, and Mozaffarian, Dariush

Subjects
Adult, Male, Asia, food systems, Malnutrition, Original Articles, diet quality, Maternal Nutritional Physiological Phenomena, priority setting, Diet, nutrition‐sensitive agriculture, Pregnancy, Child, Preschool, Feasibility Studies, Humans, Original Article, programme design, Female, Program Development, Child Nutritional Physiological Phenomena, Africa South of the Sahara
Abstract

Nutrition‐sensitive interventions to improve overall diet quality are increasingly needed to improve maternal and child health. This study demonstrates feasibility of a structured process to leverage local expertise in formulating programmes tailored for current circumstances in South Asia and Africa. We assembled 41 stakeholders in 2 regional workshops and followed a prespecified protocol to elicit programme designs listing the human and other resources required, the intervention's mechanism for impact on diets, target foods and nutrients, target populations, and contact information for partners needed to implement the desired programme. Via this protocol, participants described 48 distinct interventions, which we then compared against international recommendations and global goals. Local stakeholders' priorities focused on postharvest food systems to improve access to nutrient‐dense products (75% of the 48 programmes) and on production of animal sourced foods (58%), as well as education and social marketing (23%) and direct transfers to meet food needs (12.5%). Each programme included an average of 3.2 distinct elements aligned with those recommended by United Nations system agencies in the Framework for Action produced by the Second International Conference on Nutrition in 2014 and the Compendium of Actions for Nutrition developed for the Renewed Efforts Against Child Hunger initiative in 2016. Our results demonstrate that a participatory process can help local experts identify their own priorities for future investments, as a first step in a novel process of rigorous, transparent, and independent priority setting to improve diets among those at greatest risk of undernutrition.

Published
2017

45. Assessing global dietary habits: a comparison of national estimates from the FAO and the Global Dietary Database1234

Author

Del Gobbo, Liana C, Khatibzadeh, Shahab, Imamura, Fumiaki, Micha, Renata, Shi, Peilin, Smith, Matthew, Myers, Samuel S, and Mozaffarian, Dariush

Subjects
Adult, Male, Databases, Factual, United Nations, digestive, oral, and skin physiology, global diet, food availability, food and beverages, dietary intakes, Feeding Behavior, Middle Aged, Nutrition Surveys, FAO, Nutrition Policy, Young Adult, food balance sheets, nutrition, Nutritional Epidemiology and Public Health, Calibration, Humans, Female, Energy Intake, Aged
Abstract

Background: Accurate data on dietary habits are crucial for understanding impacts on disease and informing policy priorities. Nation-specific food balance sheets from the United Nations FAO provided the only available global dietary estimates but with uncertain validity. Objectives: We investigated how FAO estimates compared with nationally representative, individual-based dietary surveys from the Global Dietary Database (GDD) and developed calibration equations to improve the validity of FAO data to estimate dietary intakes. Design: FAO estimates were matched to GDD data for 113 countries across the following 9 major dietary metrics for 30 y of data (1980–2009): fruit, vegetables, beans and legumes, nuts and seeds, whole grains, red and processed meats, fish and seafood, milk, and total energy. Both absolute and percentage differences in FAO and GDD mean estimates were evaluated. Linear regression was used to evaluate whether FAO estimates predicted GDD dietary intakes and whether this prediction varied according to age, sex, region, and time. Calibration equations were developed to adjust FAO estimates to approximate national dietary surveys validated by using randomly split data sets. Results: For most food groups, FAO estimates substantially overestimated individual-based dietary intakes by 74.5% (vegetables) and 270% (whole grains) while underestimating beans and legumes (−50%) and nuts and seeds (−29%) (P < 0.05 for each). In multivariate regressions, these overestimations and underestimations for each dietary factor further varied by age, sex, region, and time (P < 0.001 for each). Split–data set calibration models, which accounted for country-level covariates and other sources of heterogeneity, effectively adjusted FAO estimates to approximate estimates from national survey data (r = 0.47–0.80) with small SEs of prediction (generally 1–5 g/d). Conclusions: For all food groups and total energy, FAO estimates substantially exceeded or underestimated individual-based national surveys of individual intakes with significant variation depending on age, sex, region, and time. Calibration models effectively adjusted the comprehensive, widely accessible FAO data to facilitate a more-accurate estimation of individual-level dietary intakes nationally and by age and sex.

Published
2015

46. Genome-wide meta-analysis identifies six novel loci associated with habitual coffee consumption

Author

Consortium, Coffee and Caffeine Genetics, Cornelis, Marilyn C, Renstrom, Frida, Rasheed, Asif, Mason, Marc A, Zonderman, Alan B, Franke, Lude, Kristal, Bruce S, Consortium, International Parkinson’s Disease Genomics, Consortium, North American Brain Expression, Consortium, UK Brain Expression, Karjalainen, Juha, Reed, Danielle R, Ngwa, Julius S, Westra, Harm-Jan, Evans, Michele K, Saleheen, Danish, Harris, Tamara B, Dedoussis, George, Curhan, Gary, Stumvoll, Michael, Beilby, John, Pasquale, Louis R, Feenstra, Bjarke, Huikari, Ville, Bandinelli, Stefania, Ordovas, Jose M, Chan, Andrew T, Peters, Ulrike, Ohlsson, Claes, Gieger, Christian, Martin, Nicholas G, Waldenberger, Melanie, Siscovick, David S, Raitakari, Olli, Cavadino, Alana, Eriksson, Johan G, Mitchell, Paul, Hunter, David J, Kraft, Peter, Rimm, Eric B, Boomsma, Dorret I, Borecki, Ingrid B, Loos, Ruth Jf, Wareham, Nicholas J, Vollenweider, Peter, Nolte, Ilja M, Caporaso, Neil, Grabe, Hans Jörgen, Neuhouser, Marian L, Wolffenbuttel, Bruce Hr, Hu, Frank B, Hyppönen, Elina, Järvelin, Marjo-Riitta, Cupples, L Adrienne, Franks, Paul W, Ridker, Paul M, Teumer, Alexander, van Duijn, Cornelia M, Heiss, Gerardo, Metspalu, Andres, North, Kari E, Ingelsson, Erik, Nettleton, Jennifer A, van Dam, Rob M, Chasman, Daniel I, Nalls, Michael A, Plagnol, Vincent, Yu, Kai, Hernandez, Dena G, Sharma, Manu, Sheerin, Una-Marie, Saad, Mohamad, Simón-Sánchez, Javier, Schulte, Claudia, Lesage, Suzanne, Sveinbjörnsdóttir, Sigurlaug, Arepalli, Sampath, Barker, Roger, Marques-Vidal, Pedro, Ben-Shlomo, Yoav, Berendse, Henk W, Berg, Daniela, Bhatia, Kailash, de Bie, Rob M A, Biffi, Alessandro, Bloem, Bas, Bochdanovits, Zoltan, Bonin, Michael, Bras, M., Rawal, Rajesh, Brockmann, Kathrin, Brooks, Janet, Burn, David J, Charlesworth, Gavin, Chen, Honglei, Chinnery, Patrick F, Chong, Sean, Clarke, Carl E, Cookson, Mark R, Cooper, J Mark, Manichaikul, Ani, Corvol, Jean Christophe, Counsell, Carl, Damier, Philippe, Dartigues, Jean-François, Deloukas, Panos, Deuschl, Günther, Dexter, David T, van Dijk, Karin D, Dillman, Allissa, Durif, Frank, Byrne, Enda M, Wojczynski, Mary K, Dürr, Alexandra, Edkins, Sarah, Evans, Jonathan R, Foltynie, Thomas, Dong, Jing, Gardner, Michelle, Gibbs, J Raphael, Goate, Alison, Gray, Emma, Guerreiro, Rita, Vink, Jacqueline M, Harris, Clare, van Hilten, Jacobus J, Hofman, Albert, Hollenbeck, Albert, Holton, Janice, Hu, Michele, Huang, Xuemei, Hershey, Milton S, Wurster, Isabel, Mätzler, Walter, Zhao, Jing Hua, Hudson, Gavin, Hunt, Sarah E, Huttenlocher, Johanna, Illig, Thomas, München, Helmholtz Zentrum, Jónsson, Pálmi V, Lambert, Jean-Charles, Langford, Cordelia, Lees, Andrew, Lichtner, Peter, Burlutsky, George, Limousin, Patricia, Lopez, Grisel, Lorenz, Delia, McNeill, Alisdair, Moorby, Catriona, Moore, Matthew, Morris, Huw R, Morrison, Karen E, O' Sullivan, Sean S, Lahti, Jari, Pearson, Justin, Perlmutter, Joel S, Pétursson, Hjörvar, Pollak, Pierre, Potter, Simon, Ravina, Bernard, Revesz, Tamas, Riess, Olaf, Rivadeneira, Fernando, Rizzu, Patrizia, Mikkilä, Vera, Ryten, Mina, Sawcer, Stephen, Schapira, Anthony, Scheffer, Hans, Shaw, Karen, Sidransky, Ellen, Smith, Colin, Spencer, Chris C A, Stefánsson, Hreinn, Bettella, Francesco, Lemaitre, Rozenn N, Stockton, Joanna D, Strange, Amy, Talbot, Kevin, Tanner, M., Tashakkori-Ghanbaria, Avazeh, Tison, François, Trabzuni, Daniah, Traynor, Bryan J, Uitterlinden, André G, Velseboer, Daan, Eriksson, Joel, Vidailhet, Marie, Walker, Robert, van de Warrenburg, Bart, Wickremaratchi, Mirdhu, Williams, Nigel, Williams-Gray, Caroline H, Winder-Rhodes, Sophie, Stefánsson, Kári, Martinez, Maria, Sabatier, Paul, Musani, Solomon K, Wood, Nicholas W, Hardy, John, Heutink, Peter, Brice, Alexis, Gasser, Thomas, Singleton, Andrew B, Singleton, Andrew, Cookson, Mark, Hernandez, Dena, Tanaka, Toshiko, Nalls, Michael, Zonderman, Alan, Ferrucci, Luigi, Johnson, Robert, Longo, Dan, O'Brien, Richard, Traynor, Bryan, Troncoso, Juan, Esko, Tõnu, Geller, Frank, van der Brug, Marcel, Zielke, Ronald, Weale, Michael, Ramasamy, Adaikalavan, Box, P. O., Luan, Jian'an, Hui, Jennie, Mägi, Reedik, Dimitriou, Maria, Garcia, Melissa E, Ho, Weang-Kee, Wright, Margaret J, Rose, Lynda M, Magnusson, Patrik Ke, Pedersen, Nancy L, Couper, David, Oostra, Ben A, Ikram, Mohammad Arfan, Tiemeier, Henning W, Uitterlinden, Andre G, van Rooij, Frank Ja, Barroso, Inês, Johansson, Ingegerd, Ganna, Andrea, Xue, Luting, Kaakinen, Marika, Milani, Lili, Power, Chris, Snieder, Harold, Stolk, Ronald P, Baumeister, Sebastian E, Biffar, Reiner, Gu, Fangyi, Bastardot, François, Paynter, Nina, Kutalik, Zoltán, Jacobs, David R, Forouhi, Nita G, Mihailov, Evelin, Lind, Lars, Lindgren, Cecilia, Michaëlsson, Karl, Morris, Andrew, Jensen, Majken, Khaw, Kay-Tee, Monda, Keri L, Luben, Robert N, Wang, Jie Jin, Männistö, Satu, Perälä, Mia-Maria, Kähönen, Mika, Lehtimäki, Terho, Viikari, Jorma, Mozaffarian, Dariush, Mukamal, Kenneth, Psaty, Bruce M, Amin, Najaf, Döring, Angela, Heath, Andrew C, Montgomery, Grant W, Dahmen, Norbert, Carithers, Teresa, Tucker, Katherine L, Boyd, Heather A, Melbye, Mads, Treur, Jorien L, Fischer, Krista, Mellström, Dan, Hottenga, Jouke Jan, Prokopenko, Inga, Tönjes, Anke, Kanoni, Stavroula, Lorentzon, Mattias, Houston, Denise K, Liu, Yongmei, Danesh, John, Biological Psychology, Nutrition and Health, Neuroscience Campus Amsterdam - Neurobiology of Mental Health, The, Coffee, Cornelis, MC, Byrne, Enda, Esko, Tonu, Nalls, MA, Hyppönen, Elina, Chasman, DI, The Coffee and Caffeine Genetics Consortium, International Parkinson's Disease Genomics Consortium (IPDGC), UK Brain Expression Consortium (UKBEC), North American Brain Expression Consortium (NABEC), Epidemiology, Surgery, Public Health, Cell biology, Hematology, Clinical Genetics, Internal Medicine, Life Course Epidemiology (LCE), Lifestyle Medicine (LM), Groningen Institute for Gastro Intestinal Genetics and Immunology (3GI), Center for Liver, Digestive and Metabolic Diseases (CLDM), Stem Cell Aging Leukemia and Lymphoma (SALL), ANS - Amsterdam Neuroscience, Neurology, Graduate School, Pediatric surgery, VU University medical center, NCA - neurodegeneration, Human genetics, NCA - Brain mechanisms in health and disease, and NCA - Neurobiology of mental health

Subjects
INVOLVEMENT, Netherlands Twin Register (NTR), GCKR protein, human, PROTEIN, Genome-wide association study, VARIANTS, genetics [Brain-Derived Neurotrophic Factor], chemistry.chemical_compound, 0302 clinical medicine, Polymorphism (computer science), genetics [Adaptor Proteins, Signal Transducing], BINDING, BRAIN, Genetics, 0303 health sciences, Basic Helix-Loop-Helix Leucine Zipper Transcription Factors, Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3], 3. Good health, Psychiatry and Mental health, Phenotype, genetics [Polymorphism, Single Nucleotide], genetics [Cytochrome P-450 CYP1A2], Caffeine, CAFFEINE, Single-nucleotide polymorphism, Biology, Article, 03 medical and health sciences, Cellular and Molecular Neuroscience, SDG 3 - Good Health and Well-being, Cytochrome P-450 CYP1A2, SNP, Humans, ddc:610, Allele, genetics [Basic Helix-Loop-Helix Leucine Zipper Transcription Factors], Molecular Biology, 030304 developmental biology, Adaptor Proteins, Signal Transducing, MLXIPL protein, human, RECEPTOR, Brain-Derived Neurotrophic Factor, Coffea, ta1182, Feeding Behavior, biology.organism_classification, ta3124, BDNF, chemistry, Behavioral medicine, Developmental Psychopathology, 030217 neurology & neurosurgery, GLUCOKINASE, metabolism [Coffea], Genome-Wide Association Study
Abstract

Contains fulltext : 155360.pdf (Publisher’s version ) (Closed access) Coffee, a major dietary source of caffeine, is among the most widely consumed beverages in the world and has received considerable attention regarding health risks and benefits. We conducted a genome-wide (GW) meta-analysis of predominately regular-type coffee consumption (cups per day) among up to 91,462 coffee consumers of European ancestry with top single-nucleotide polymorphisms (SNPs) followed-up in ~30 062 and 7964 coffee consumers of European and African-American ancestry, respectively. Studies from both stages were combined in a trans-ethnic meta-analysis. Confirmed loci were examined for putative functional and biological relevance. Eight loci, including six novel loci, met GW significance (log10Bayes factor (BF)>5.64) with per-allele effect sizes of 0.03-0.14 cups per day. Six are located in or near genes potentially involved in pharmacokinetics (ABCG2, AHR, POR and CYP1A2) and pharmacodynamics (BDNF and SLC6A4) of caffeine. Two map to GCKR and MLXIPL genes related to metabolic traits but lacking known roles in coffee consumption. Enhancer and promoter histone marks populate the regions of many confirmed loci and several potential regulatory SNPs are highly correlated with the lead SNP of each. SNP alleles near GCKR, MLXIPL, BDNF and CYP1A2 that were associated with higher coffee consumption have previously been associated with smoking initiation, higher adiposity and fasting insulin and glucose but lower blood pressure and favorable lipid, inflammatory and liver enzyme profiles (P

Published
2015

47. Dairy consumption, systolic blood pressure, and risk of hypertension : Mendelian randomization study

Author

Ding, Ming, Huang, Tao, Bergholdt, Helle K. M., Nordestgaard, Borge G., Ellervik, Christina, Qi, Lu, Frazier-Wood, Alexis C., Aslibekyan, Stella, North, Kari E., Voortman, Trudy, Graff, Mariaelisa, Smith, Caren E., Lai, Chao-Qiang, Varbo, Anette, Lemaitre, Rozenn N., de Jonge, Ester A. L., Fumeron, Frederic, Corella, Dolores, Wang, Carol A., Tjonneland, Anne, Overvad, Kim, Sorensen, Thorkild I. A., Feitosa, Mary F., Wojczynski, Mary K., Kahonen, Mika, Ahmad, Shafqat, Renström, Frida, Psaty, Bruce M., Siscovick, David S., Barroso, Ines, Johansson, Ingegerd, Hernandez, Dena, Ferrucci, Luigi, Bandinelli, Stefania, Linneberg, Allan, Sandholt, Camilla Helene, Pedersen, Oluf, Hansen, Torben, Schulz, Christina-Alexandra, Sonestedt, Emily, Orho-Melander, Marju, Chen, Tzu-An, Rotter, Jerome I., Allison, Mathew A., Rich, Stephen S., Sorli, Jose V., Coltell, Oscar, Pennell, Craig E., Eastwood, Peter R., Hofman, Albert, Uitterlinden, Andre G., Zillikens, MCarola, van Rooij, Frank J. A., Chu, Audrey Y., Rose, Lynda M., Ridker, Paul M., Viikari, Jorma, Raitakari, Olli, Lehtimaki, Terho, Mikkila, Vera, Willett, Walter C., Wang, Yujie, Tucker, Katherine L., Ordovas, Jose M., Kilpelainen, Tuomas O., Province, Michael A., Franks, Paul W., Arnett, Donna K., Tanaka, Toshiko, Toft, Ulla, Ericso, Ulrika, Franco, Oscar H., Mozaffarian, Dariush, Hu, Frank B., Chasman, Daniel I., Department of Food and Nutrition, and University of Helsinki

Subjects
medicine.medical_treatment, Blood Pressure, Review, 030204 cardiovascular system & hematology, Corrections, law.invention, 0302 clinical medicine, MILK, Randomized controlled trial, law, GENETIC-VARIANTS, Cardiac and Cardiovascular Systems, 030212 general & internal medicine, Prospective cohort study, METABOLIC SYNDROME, Lactase, Randomized Controlled Trials as Topic, 2. Zero hunger, Kardiologi, Nutrition and Dietetics, General Medicine, 16. Peace & justice, 3. Good health, CONTROLLED-TRIALS, Näringslära, Observational Studies as Topic, BODY-WEIGHT, CARDIOVASCULAR-DISEASE, Hypertension, 3143 Nutrition, medicine.medical_specialty, Polymorphism, Single Nucleotide, 03 medical and health sciences, Internal medicine, Mendelian randomization, medicine, Journal Article, Humans, Genetic Predisposition to Disease, business.industry, INCIDENT HYPERTENSION, Research, Odds ratio, ADULTS, Feeding Behavior, ta3121, Mendelian Randomization Analysis, Confidence interval, Surgery, Lactase persistence, Blood pressure, FAT, 3121 General medicine, internal medicine and other clinical medicine, DOSE-RESPONSE METAANALYSIS, Dairy Products, business, Meta-Analysis
Abstract

Objective To examine whether previous observed inverse associations of dairy intake with systolic blood pressure and risk of hypertension were causal. Design Mendelian randomization study using the single nucleotide polymorphism rs4988235 related to lactase persistence as an instrumental variable. Setting CHARGE (Cohorts for Heart and Aging Research in Genomic Epidemiology) Consortium. Participants Data from 22 studies with 171 213 participants, and an additional 10 published prospective studies with 26 119 participants included in the observational analysis. Main outcome measures The instrumental variable estimation was conducted using the ratio of coefficients approach. Using meta-analysis, an additional eight published randomized clinical trials on the association of dairy consumption with systolic blood pressure were summarized. Results Compared with the CC genotype (CC is associated with complete lactase deficiency), the CT/TT genotype (TT is associated with lactose persistence, and CT is associated with certain lactase deficiency) of LCT-13910 (lactase persistence gene) rs4988235 was associated with higher dairy consumption (0.23 (about 55 g/day), 95% confidence interval 0.17 to 0.29) serving/day; P

Published
2017

48. Genome-wide meta-analysis of observational studies shows common genetic variants associated with macronutrient intake1234

Author

Tanaka, Toshiko, Ngwa, Julius S, van Rooij, Frank JA, Zillikens, M Carola, Wojczynski, Mary K, Frazier-Wood, Alexis C, Houston, Denise K, Kanoni, Stavroula, Lemaitre, Rozenn N, Luan, Jian'an, Mikkilä, Vera, Renstrom, Frida, Sonestedt, Emily, Zhao, Jing Hua, Chu, Audrey Y, Qi, Lu, Chasman, Daniel I, de Oliveira Otto, Marcia C, Dhurandhar, Emily J, Feitosa, Mary F, Johansson, Ingegerd, Khaw, Kay-Tee, Lohman, Kurt K, Manichaikul, Ani, McKeown, Nicola M, Mozaffarian, Dariush, Singleton, Andrew, Stirrups, Kathleen, Viikari, Jorma, Ye, Zheng, Bandinelli, Stefania, Barroso, Inês, Deloukas, Panos, Forouhi, Nita G, Hofman, Albert, Liu, Yongmei, Lyytikäinen, Leo-Pekka, North, Kari E, Dimitriou, Maria, Hallmans, Goran, Kähönen, Mika, Langenberg, Claudia, Ordovas, Jose M, Uitterlinden, André G, Hu, Frank B, Kalafati, Ioanna-Panagiota, Raitakari, Olli, Franco, Oscar H, Johnson, Andrew, Emilsson, Valur, Schrack, Jennifer A, Semba, Richard D, Siscovick, David S, Arnett, Donna K, Borecki, Ingrid B, Franks, Paul W, Kritchevsky, Stephen B, Lehtimäki, Terho, Loos, Ruth JF, Orho-Melander, Marju, Rotter, Jerome I, Wareham, Nicholas J, Witteman, Jacqueline CM, Ferrucci, Luigi, Dedoussis, George, Cupples, L Adrienne, and Nettleton, Jennifer A

Subjects
Genotype, Quantitative Trait Loci, Atherosclerosis, Dietary Fats, Polymorphism, Single Nucleotide, White People, Body Mass Index, Fibroblast Growth Factors, Nutritional Epidemiology and Public Health, Surveys and Questionnaires, Dietary Carbohydrates, Humans, Gene-Environment Interaction, Genetic Predisposition to Disease, Dietary Proteins, Obesity, Prospective Studies, Energy Intake, Life Style, Alleles, Follow-Up Studies, Genome-Wide Association Study
Abstract

Background: Macronutrient intake varies substantially between individuals, and there is evidence that this variation is partly accounted for by genetic variants. Objective: The objective of the study was to identify common genetic variants that are associated with macronutrient intake. Design: We performed 2-stage genome-wide association (GWA) meta-analysis of macronutrient intake in populations of European descent. Macronutrients were assessed by using food-frequency questionnaires and analyzed as percentages of total energy consumption from total fat, protein, and carbohydrate. From the discovery GWA (n = 38,360), 35 independent loci associated with macronutrient intake at P < 5 × 10−6 were identified and taken forward to replication in 3 additional cohorts (n = 33,533) from the DietGen Consortium. For one locus, fat mass obesity-associated protein (FTO), cohorts with Illumina MetaboChip genotype data (n = 7724) provided additional replication data. Results: A variant in the chromosome 19 locus (rs838145) was associated with higher carbohydrate (β ± SE: 0.25 ± 0.04%; P = 1.68 × 10−8) and lower fat (β ± SE: −0.21 ± 0.04%; P = 1.57 × 10−9) consumption. A candidate gene in this region, fibroblast growth factor 21 (FGF21), encodes a fibroblast growth factor involved in glucose and lipid metabolism. The variants in this locus were associated with circulating FGF21 protein concentrations (P < 0.05) but not mRNA concentrations in blood or brain. The body mass index (BMI)–increasing allele of the FTO variant (rs1421085) was associated with higher protein intake (β ± SE: 0.10 ± 0.02%; P = 9.96 × 10−10), independent of BMI (after adjustment for BMI, β ± SE: 0.08 ± 0.02%; P = 3.15 × 10−7). Conclusion: Our results indicate that variants in genes involved in nutrient metabolism and obesity are associated with macronutrient consumption in humans. Trials related to this study were registered at clinicaltrials.gov as NCT00005131 (Atherosclerosis Risk in Communities), NCT00005133 (Cardiovascular Health Study), NCT00005136 (Family Heart Study), NCT00005121 (Framingham Heart Study), NCT00083369 (Genetic and Environmental Determinants of Triglycerides), NCT01331512 (InCHIANTI Study), and NCT00005487 (Multi-Ethnic Study of Atherosclerosis).

Published
2013

49. ω-3 Polyunsaturated Fatty Acid Biomarkers and Coronary Heart Disease: Pooling Project of 19 Cohort Studies

Author

Del Gobbo, Liana C, Imamura, Fumiaki, Aslibekyan, Stella, Marklund, Matti, Virtanen, Jyrki K, Wennberg, Maria, Yakoob, Mohammad Y, Chiuve, Stephanie E, Dela Cruz, Luicito, Frazier-Wood, Alexis C, Fretts, Amanda M, Guallar, Eliseo, Matsumoto, Chisa, Prem, Kiesha, Tanaka, Tosh, Wu, Jason HY, Zhou, Xia, Helmer, Catherine, Ingelsson, Erik, Yuan, Jian-Min, Barberger-Gateau, Pascale, Campos, Hannia, Chaves, Paulo HM, Djoussé, Luc, Giles, Graham G, Gómez-Aracena, Jose, Hodge, Allison M, Hu, Frank B, Jansson, Jan-Håkan, Johansson, Ingegerd, Khaw, Kay-Tee, Koh, Woon-Puay, Lemaitre, Rozenn N, Lind, Lars, Luben, Robert N, Rimm, Eric B, Risérus, Ulf, Samieri, Cecilia, Franks, Paul W, Siscovick, David S, Stampfer, Meir, Steffen, Lyn M, Steffen, Brian T, Tsai, Michael Y, van Dam, Rob M, Voutilainen, Sari, Willett, Walter C, Woodward, Mark, Mozaffarian, Dariush, Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Fatty Acids and Outcomes Research Consortium (FORCe), Imamura, Fumiaki [0000-0002-6841-8396], Khaw, Kay-Tee [0000-0002-8802-2903], Luben, Robert [0000-0002-5088-6343], and Apollo - University of Cambridge Repository

Subjects
Cohort Studies, Male, Docosahexaenoic Acids, Incidence, Fatty Acids, Omega-3, Fatty Acids, Unsaturated, Odds Ratio, Humans, alpha-Linolenic Acid, Coronary Disease, Female, Biomarkers
Abstract

IMPORTANCE: The role of ω-3 polyunsaturated fatty acids for primary prevention of coronary heart disease (CHD) remains controversial. Most prior longitudinal studies evaluated self-reported consumption rather than biomarkers. OBJECTIVE: To evaluate biomarkers of seafood-derived eicosapentaenoic acid (EPA; 20:5ω-3), docosapentaenoic acid (DPA; 22:5ω-3), and docosahexaenoic acid (DHA; 22:6ω-3) and plant-derived α-linolenic acid (ALA; 18:3ω-3) for incident CHD. DATA SOURCES: A global consortium of 19 studies identified by November 2014. STUDY SELECTION: Available prospective (cohort, nested case-control) or retrospective studies with circulating or tissue ω-3 biomarkers and ascertained CHD. DATA EXTRACTION AND SYNTHESIS: Each study conducted standardized, individual-level analysis using harmonized models, exposures, outcomes, and covariates. Findings were centrally pooled using random-effects meta-analysis. Heterogeneity was examined by age, sex, race, diabetes, statins, aspirin, ω-6 levels, and FADS desaturase genes. MAIN OUTCOMES AND MEASURES: Incident total CHD, fatal CHD, and nonfatal myocardial infarction (MI). RESULTS: The 19 studies comprised 16 countries, 45 637 unique individuals, and 7973 total CHD, 2781 fatal CHD, and 7157 nonfatal MI events, with ω-3 measures in total plasma, phospholipids, cholesterol esters, and adipose tissue. Median age at baseline was 59 years (range, 18-97 years), and 28 660 (62.8%) were male. In continuous (per 1-SD increase) multivariable-adjusted analyses, the ω-3 biomarkers ALA, DPA, and DHA were associated with a lower risk of fatal CHD, with relative risks (RRs) of 0.91 (95% CI, 0.84-0.98) for ALA, 0.90 (95% CI, 0.85-0.96) for DPA, and 0.90 (95% CI, 0.84-0.96) for DHA. Although DPA was associated with a lower risk of total CHD (RR, 0.94; 95% CI, 0.90-0.99), ALA (RR, 1.00; 95% CI, 0.95-1.05), EPA (RR, 0.94; 95% CI, 0.87-1.02), and DHA (RR, 0.95; 95% CI, 0.91-1.00) were not. Significant associations with nonfatal MI were not evident. Associations appeared generally stronger in phospholipids and total plasma. Restricted cubic splines did not identify evidence of nonlinearity in dose responses. CONCLUSIONS AND RELEVANCE: On the basis of available studies of free-living populations globally, biomarker concentrations of seafood and plant-derived ω-3 fatty acids are associated with a modestly lower incidence of fatal CHD.

Published
2016

50. Effects of Saturated Fat, Polyunsaturated Fat, Monounsaturated Fat, and Carbohydrate on Glucose-Insulin Homeostasis: A Systematic Review and Meta-analysis of Randomised Controlled Feeding Trials

Author

Imamura, Fumiaki, Micha, Renata, Wu, Jason HY, de Oliveira Otto, Marcia C, Otite, Fadar O, Abioye, Ajibola I, Mozaffarian, Dariush, Imamura, Fumiaki [0000-0002-6841-8396], Otite, Fadar O [0000-0003-2167-5034], Abioye, Ajibola I [0000-0002-6632-613X], and Apollo - University of Cambridge Repository

Subjects
Adult, Blood Glucose, Glycated Hemoglobin, food and beverages, Fats, Unsaturated, Fatty Acids, Monounsaturated, Dietary Carbohydrates, Fatty Acids, Unsaturated, Homeostasis, Humans, Insulin, Medicine, Randomized Controlled Trials as Topic
Abstract

BackgroundEffects of major dietary macronutrients on glucose-insulin homeostasis remain controversial and may vary by the clinical measures examined. We aimed to assess how saturated fat (SFA), monounsaturated fat (MUFA), polyunsaturated fat (PUFA), and carbohydrate affect key metrics of glucose-insulin homeostasis.Methods and findingsWe systematically searched multiple databases (PubMed, EMBASE, OVID, BIOSIS, Web-of-Knowledge, CAB, CINAHL, Cochrane Library, SIGLE, Faculty1000) for randomised controlled feeding trials published by 26 Nov 2015 that tested effects of macronutrient intake on blood glucose, insulin, HbA1c, insulin sensitivity, and insulin secretion in adults aged ≥18 years. We excluded trials with non-isocaloric comparisons and trials providing dietary advice or supplements rather than meals. Studies were reviewed and data extracted independently in duplicate. Among 6,124 abstracts, 102 trials, including 239 diet arms and 4,220 adults, met eligibility requirements. Using multiple-treatment meta-regression, we estimated dose-response effects of isocaloric replacements between SFA, MUFA, PUFA, and carbohydrate, adjusted for protein, trans fat, and dietary fibre. Replacing 5% energy from carbohydrate with SFA had no significant effect on fasting glucose (+0.02 mmol/L, 95% CI = -0.01, +0.04; n trials = 99), but lowered fasting insulin (-1.1 pmol/L; -1.7, -0.5; n = 90). Replacing carbohydrate with MUFA lowered HbA1c (-0.09%; -0.12, -0.05; n = 23), 2 h post-challenge insulin (-20.3 pmol/L; -32.2, -8.4; n = 11), and homeostasis model assessment for insulin resistance (HOMA-IR) (-2.4%; -4.6, -0.3; n = 30). Replacing carbohydrate with PUFA significantly lowered HbA1c (-0.11%; -0.17, -0.05) and fasting insulin (-1.6 pmol/L; -2.8, -0.4). Replacing SFA with PUFA significantly lowered glucose, HbA1c, C-peptide, and HOMA. Based on gold-standard acute insulin response in ten trials, PUFA significantly improved insulin secretion capacity (+0.5 pmol/L/min; 0.2, 0.8) whether replacing carbohydrate, SFA, or even MUFA. No significant effects of any macronutrient replacements were observed for 2 h post-challenge glucose or insulin sensitivity (minimal-model index). Limitations included a small number of trials for some outcomes and potential issues of blinding, compliance, generalisability, heterogeneity due to unmeasured factors, and publication bias.ConclusionsThis meta-analysis of randomised controlled feeding trials provides evidence that dietary macronutrients have diverse effects on glucose-insulin homeostasis. In comparison to carbohydrate, SFA, or MUFA, most consistent favourable effects were seen with PUFA, which was linked to improved glycaemia, insulin resistance, and insulin secretion capacity.

Published
2016

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