Consumption of some food groups is associated with the risk of cardiovascular disease among Jordanians

Strong evidence suggests the effects certain food groups have reducing or increasing the risk factors for cardiovascular diseases (CVD). However, findings seem to be inconsistent across different populations and even scare in Middle Eastern setting where cardiovascular diseases are endemic. This study aimed at investigating the associations between food groups and risk of cardiovascular disease among Jordanians. A case control study was conducted using convenient sampling method with a total of 400 participants who underwent coronary angiography. Diagnosis of CVD was confirmed by coronary angiography. Case and controls were matched by age and gender with 1:1 ratio. Standardized and validated questionnaires were used to collect socio-demographic, health, lifestyle, and dietary data. Mean age of participants was 56.2+0.55 and 57.2+0.82 for males and females respectively. Food groups with significant influence on prevention or increasing risks for CVD identified in this study are fruits (p=0.024) and Vegetables (p=0.025) but contrary to previous findings, this study identified lower consumption of sweets and sugar among cases of CVD (p=0.007). A U-shape relationship was identified between risk of CVD and consumption of vegetable oil, nuts and seeds (p>0.05). Increased consumption of fruits, vegetables and moderate consumption of vegetables oil and seeds and nuts are may be associated with decreased risk of CVD among Jordanian population.We thank the patients who participated in the study, and the hospital management for facilitating the data collection and all other aspects of this research. Also, we would like to thank Qatar University for funding the publication of this article.Scopu

La ingesta de grasas y el riesgo de enfermedad coronaria de los jordanos

Introduction: dietary fat has been reported as one of the significant risk factors in the development of cardiovascular diseases (CVD). Objective: this study aimed at assessing the possible association between fat intake and CVD. Methods: the present case-control study was conducted in the center of coronary angiography. Three-hundred and ninety nine patients who referred for elective coronary angiography with clinical suspicion of coronary artery disease were enrolled. Dietary data were collected from each patient using an interview-based food frequency questionnaire. Results: the findings of the present study revealed no significant differences between cases and controls regarding the intake of all types of fat either before or after energy adjustment. For both cases and controls the percentage of fat intake from total energy and the intakes of polyunsaturated and monounsaturated fats, cholesterol, omega-6 and omega-3 were within the recommended amounts. The intake of all fat types (except trans-fat) was not associated with the risk of developing CVD. Trans-fat intake in the second and third quartile increased the risk of CVD by OR 1.86 (95% CI: 1.03-3.34) and 2.01 (95% CI: 1.12-3.60), respectively. Conclusions: while trans-fats may be significantly associated with the development of CVD in the first two quartiles, no association has been detected with other fat types.Introducción: se ha establecido que la grasa en la dieta es uno de los factores de riesgo significativos en el desarrollo de enfermedades cardiovasculares (ECV). Objetivo: este estudio tuvo como objetivo evaluar la posible asociación entre la ingesta de grasa y la ECV. Métodos: el presente estudio de casos y controles se realizó en el centro de la angiografía coronaria. Se inscribieron 399 pacientes que fueron remitidos para una angiografía coronaria electiva con sospecha clínica de enfermedad coronaria. Los datos dietéticos se obtuvieron de cada paciente mediante un cuestionario de frecuencia de alimentos basado en entrevistas. Resultados: los hallazgos del presente estudio no revelaron diferencias significativas entre los casos y los controles con respecto a la ingesta de todos los tipos de grasa, ya sea antes o después del ajuste de energía. Para ambos casos y controles, el porcentaje de ingesta de grasas de la energía total y las ingestas de grasas poliinsaturadas y monoinsaturadas, colesterol, omega-6 y omega-3 se encuentran dentro de las cantidades recomendadas. La ingesta de todos los tipos de grasa (excepto las grasas trans) no se asoció con el riesgo de desarrollar ECV. La ingesta de grasas trans en el segundo y tercer cuartil aumentó el riesgo de ECV en OR 1,86 (IC 95 %: 1,03-3,34) y 2,01 (IC 95 %: 1,12-3,60), respectivamente. Conclusiones: si bien las grasas trans pueden estar asociadas significativamente con el desarrollo de ECV en los dos primeros cuartiles, no se ha detectado asociación con otros tipos de gras

Fruit and vegetable consumption and cardiovascular diseases among jordanians: A case-control study

Objectives: Fruit and vegetable intake has been reported as one of the significant protective factors against the development of cardiovascular diseases (CVD). This study aimed to assess the possible preventive effect of fruit and vegetable consumption on developing CVD. Methods: A total of 398 participants (205 cases and 193 controls) referred for elective coronary angiography with clinical suspicion of coronary artery disease to Prince Hamza Hospital in Amman were enrolled in this case-control study. Dietary data were collected separately from each patient using interview-based food frequency questionnaire. Results: The findings of the present study revealed that a total consumption of 3 servings of vegetable per day decreased significantly the risk of CVD to about 54% (OR = 0.46, 95% CI: 0.22-0.97, p = 0.033). Consumption of banana was found to reduce the risk of CVD to about 44% and 62% when consuming 1-2 and 3-6 servings/week, respectively, with p-value for trend 0.004. For the vegetables, the consumption of grape leaves and stuffed vegetables in general was significantly associated with lower risk of CVD. Increasing cauliflower consumption of 1-2 servings per week decreased CVD risk to about 37% (OR = 0.63, 95% CI: 0.38-0.98). Consuming up to 3-6 servings per week of mixed vegetables (OR = 0.10, 95% CI: 0.01-0.83) and onion (OR = 0.42, 95% CI: 0.22-0.80) revealed an inverse association with CVD development. Conclusions: Adding to the present evidence, consumption of some fruits and vegetables could be considered as preventive factor against developing CVD. However, the association of consuming vegetables with preventing CVD was higher than the fruit consumption. 2020, Czech National Institute of Public Health. All rights reserved.Scopu

Association of Lung CT Findings in Coronavirus Disease 2019 (COVID-19) With Patients' Age, Body Weight, Vital Signs, and Medical Regimen

Objective: This study aimed to detect possible associations between lung computed tomography (CT) findings in COVID-19 and patients' age, body weight, vital signs, and medical regimen in Jordan. Methods: The present cross-sectional study enrolled 230 patients who tested positive for COVID-19 in Prince Hamza Hospital in Jordan. Demographic data, as well as major lung CT scan findings, were obtained from the hospital records of the COVID-19 patients. Results: The main observed major lung changes among the enrolled COVID-19 patients included ground-glass opacification in 47 (20.4%) patients and consolidation in 22 (9.6%) patients. A higher percentage of patients with major lung changes (24%) was observed among patients above 60 years old, while (50%) of patients with no changes in their lung findings were in the age group of 18–29 years old. Results obtained from the present study showed that only patients with major CT lung changes (9.7%) were prescribed more than three antibiotics. Additionally, 41.6 % of patients with major lung CT scan changes had either dry (31.0%) or productive (10.6%) cough at admission. Conclusion: Several factors have been identified by this study for their ability to predict lung changes. Early assessment of these predictors could help provide a prompt intervention that may enhance health outcomes and reduce the risk for further lung changes

Nutrition Management in COVID-19 Quarantine: Hospital-Based Study

Background: This hospital-based study aimed to evaluate the nutritional status and dietary habits for COVID-19 patients, the amount of nutrients provided to the patients in the hospital and to detect the predictors of severity among COVID-19 patients in Jordan. Methods: A hospital-based study (N = 367, mean age 42.3, SD 15.4, 66.0% men) was conducted between March 17th and July 25th, 2020 in Prince Hamza Hospital. Data about socio-demographic, anthropometric, dietary habits, and macro-and micronutrient were collected from the patients’ medical files and some missing data were collected by phone directly from the patients. Results: The results of the linear regression only age was significantly and positively (ß=0.454, p-value=0.001) associated with severity of the disease among the study patients. Around 57% of the COVID-19 patients consumed three meals daily, while around 31-34% consumed one to two snacks daily. The majority (64%) of the patients drank more than five cups of water daily. About 24% of the patients complained of eating problems such as taste and/or smell loss, low appetite, and swallowing difficulty. The intakes of the vitamins B1, B2, B3, and B6 and vitamin C, as well as calcium, magnesium, phosphorus, selenium and sodium, were within the recommended dietary allowances (RDA). Conclusion: The servings of the five food groups as well as most of the macro-and micronutrient requirements were within the recommended intakes and RDA

A prospective study of extraesophageal reflux and potential microaspiration in patients hospitalized with COVID-19 in Jordan

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) lung infection has represented a global challenge. Intriguingly, it has been shown that the alveolar lung epithelium expresses little Angiotensin Converting Enzyme receptor protein (ACE2), the entry receptor for SARS-CoV-2. Upper airway establishment of infection and translocation to the lung is well documented but other anatomical niches may be relevant to potentially serious lung infection. ACE2 is heavily expressed in the gastrointestinal tract and gastrointestinal symptoms support a clinical diagnosis of Coronavirus disease 2019 (COVID-19). This suggests a research question and the need to gather patient data exploring potential aerodigestive links in SARS-CoV-2 tranlocation and infection which may be relevant in the peripheral lung. This recognizes anatomical proximity and concepts of bi-directional movement between the Gastrointestinal and lung systems in normal physiology and disease. We have therefore explored the potential for gastro oesophageal reflux disease (GORD) micro aspiration and aeorodigestive pathophysiology in a novel prospective investigation of patients hospitalized with COVID-19. Methods This is a prospective descriptive cohort study of 210 patients who were hospitalized with a confirmed diagnosis of COVID-19. The cohort was divided into three groups of patients based on symptom severity and radiological results. The Reflux Symptom Index (RSI) was used to evaluate the presence and severity of GOR. An RSI greater than 13 is considered to be abnormal. Patients’ saliva samples were tested using enzyme-linked immunosorbent assay (ELISA) to determine the level of salivary pepsin among the cohort of patients. Results A total of 210 patients with COVID-19 were enrolled in the study with 55.2% (116/210) classified as mildly ill, 31.9% (67/210) moderately ill and 12.9% (27/210) as severely ill. 34% (72/210) of the patients had an RSI score of over 13 and a median salivary pepsin value of 54 ± 29 ng/ml which suggested an incidence of extraesophageal reflux (EOR) in around a third of patients. The presence of respiratory comorbid conditions, an RSI score of over 13 and a salivary pepsin level of > 76ng/ml increased the risk of developing a more severe COVID-19 infection. Conclusion The study showed a high prevalence of EOR among the study cohort and provide the first prospective evidence suggesting the potential for aerodigestive pathophysiology including microaspiration in COVID-19 disease. We believe that the results of our study support the need for more extensive research

Association between Grain and Legume Consumption and the Risk of Coronary Artery Obstruction among Jordanians Based on Angiography Results

Accumulating evidence suggests that consumption of whole grains and legumes is associated with reduced risk of cardiovascular disease (CVD), whereas the risk is increased by consuming refined grains and cereals. This study aimed to investigate the association between grain and legume consumption and the risk of CVD. The study was conducted using a convenient sampling method with a total of 399 participants who underwent coronary angiography. Cases and controls were matched by age with a 1:1 ratio. Standardized and validated questionnaires were used to collect socio-demographic, health, lifestyle, and dietary data. Intake of more than 1 serving/d of white bread increased the risk of CVD significantly with an adjusted odds ratio (AOR) of 3.06 [95% confidence interval (CI): 1.37∼6.84], while consuming more than 1 serving/d of wholegrain bread reduced the risk significantly to approximately 53% (AOR: 0.47, 95% CI: 0.24 ∼0.93). Similar trends between consuming white bread on daily basis and increased risk of CVD, and consuming wholegrain bread and reduced risk of CVD were also observed. In addition, consuming unsweetened cornflakes on a weekly basis had a protective effect against CVD (AOR: 0.15, 95% CI: 0.03∼0.96). Intake of legumes reduced the risk of CVD, although only insignificantly for all the tested legumes. The present study calls for consideration of consuming wholegrain bread prevent CVD in the Jordanian population

Risk factors for coronary artery disease in patients undergoing elective coronary angiography in Jordan

Abstract Background Unhealthy lifestyle factors such as smoking, obesity, inactivity and type 2 diabetes are endemic in the Middle East. The public health consequences might be detrimental; however, local studies on risk factors for coronary artery disease (CAD) are scarce. Methods Patients referred for coronary angiography at a tertiary hospital in Amman, Jordan, between January and December 2015, were included in this study. Risk factors for CAD were assessed in a multivariate logistic regression model, and presented as odds ratio (OR) with 95% confidence interval (CI). Results Among 557 participants, 356 (63.9%) had CAD and 201 (36.1%) had a normal cardiogram. The majority (n = 395, 70.9%) were male, and median age was 55 years (interquartile range 47–64). Two-hundred-and-fifteen (38.6%) individuals reported previous diabetes, and 287 (51.5%) were current or previous smokers. In multivariate analysis, male gender (OR 3.7, 95% CI 2.3–6.0), age (45–54 years: OR 4.8, 95% CI 2.7–8.5; 55–64 years: OR 6.0, 95% CI 3.2–11.4; ≥65 years: OR 15.7, 95% CI 7.8–31.3), previous diabetes (OR 2.6, 95% CI 1.7–4.1) and current/previous smoking (OR 2.1, 95% CI 1.3–3.4) were significant predictors of CAD. Conclusions Age, gender, diabetes and smoking were strong and significant risk factors for CAD in Jordan. Public health interventions to reduce the prevalence of smoking and diabetes are urgently needed

Anti-S and Anti-N Antibody Responses of COVID-19 Vaccine Recipients

The long-term immunoglobulin responses of COVID-19 vaccinations is important to determine the efficacy of these vaccinations. This study aimed to investigate and compare the long-term immunoglobulin response of COVID-19 vaccination recipients, using anti-S IgG, anti-N IgG, and IgM titer levels. This study included 267 participants, comprising individuals who tested positive for COVID-19 through PCR testing (n = 125), and those who received the Pfizer (n = 133), Sinopharm (n = 112), AstraZeneca (n = 20), or Sputnik (n = 2) vaccines. Female participants comprised the largest share of this study (n = 147, 55.1%). This study found that most participants had positive IgG antibodies, with 96.3% having anti-S IgG and 75.7% having anti-N IgG. Most participants (90.3%) tested negative for anti-N IgM antibodies. Sinopharm-vaccinated individuals exhibited a notably lower rate of positive anti-S IgG (93.8%) and a significantly higher rate of positive anti-N IgG antibodies (91%). Anti-N IgG levels were significantly correlated with the number of prior COVID-19 infections (p = 0.015). Specifically, individuals with a history of four COVID-19 infections had higher anti-N IgG titers (14.1 ± 1.4) than those with only one experience of COVID-19 infection (9.4 ± 7.2). Individuals who were infected with COVID-19 after receiving the vaccine demonstrated higher levels of anti-N IgG, exhibiting a 25% increase in mean titer levels compared to those who were infected prior to vaccination. There was a statistically significant association between anti-N IgG positivity with age (p = 0.034), and smoking status (p = 0.006) of participants. Participants younger than 20 and older than 60 showed the highest positivity rate of anti-N (>90%). Smokers had a low positivity rate of anti-N (68.8%) compared to nonsmokers (83.6%). In conclusion, this study demonstrated that most COVID-19 vaccination recipients had positive IgG antibodies, with differences in the long-term immunoglobulin response depending on the type of vaccine administered and occurrence of COVID-19 infection

Association between Grain and Legume Consumption and the Risk of Coronary Artery Obstruction among Jordanians Based on Angiography Results

Accumulating evidence suggests that consumption of whole grains and legumes is associated with reduced risk of cardiovascular disease (CVD), whereas the risk is increased by consuming refined grains and cereals. This study aimed to investigate the association between grain and legume consumption and the risk of CVD. The study was conducted using a convenient sampling method with a total of 399 participants who underwent coronary angiography. Cases and controls were matched by age with a 1:1 ratio. Standardized and validated questionnaires were used to collect sociodemographic, health, lifestyle, and dietary data. Intake of more than 1 serving/d of white bread increased the risk of CVD significantly with an adjusted odds ratio (AOR) of 3.06 [95% confidence interval (CI): 1.37∼6.84], while consuming more than 1 serving/d of wholegrain bread reduced the risk significantly to approximately 53% (AOR: 0.47, 95% CI: 0.24∼0.93). Similar trends between consuming white bread on daily basis and increased risk of CVD, and consuming wholegrain bread and reduced risk of CVD were also observed. In addition, consuming unsweetened cornflakes on a weekly basis had a protective effect against CVD (AOR: 0.15, 95% CI: 0.03∼0.96). Intake of legumes reduced the risk of CVD, although only insignificantly for all the tested legumes. The present study calls for consideration of consuming wholegrain bread prevent CVD in the Jordanian population