Effect of the Brazilian Cardioprotective Food Program on the inflammatory markers of patients in secondary prevention for cardiovascular disease,a randomized controlled trial

Introdução:O Programa Alimentar Brasileiro Cardioprotetor (DICA Br) é pautado nas atuais diretrizes para tratamento e prevenção dos fatores de risco para doenças cardiovasculares (DCV). Objetivo:Avaliar o efeito do DICA Br nos biomarcadores inflamatórios de pacientes em prevenção secundária para doença cardiovascular. Métodos:Foram incluídos 369 participantes, referentes à amostra paulistana do DICA Br, com idade superior ou igual a 45 anos e que já tenham tido algum evento cardiovascular nos últimos 10 anos. Estes pacientes foram randomizados em dois grupos e acompanhados seis meses: grupo intervenção, que recebeu o DICA Br e grupo Controle, que recebeu orientação nutricional qualitativa para redução do valor calórico total da dieta e da ingestão de lipídios e sódio. Nas consultas inicial e final (intervalo de 6 meses), foram realizados: antropometria (peso, estatura e circunferência da cintura), avaliação da ingestão alimentar (recordatório alimentar de 24h R24h), dosagem de biomarcadores inflamatórios plasmáticos (interleucina (IL)01, IL06, IL08, IL010, IL012, fator de necrose tumoral (TNF)0, adiponectina e proteína C reativa(PCR)), pressão arterial, glicemia, insulinemia, perfil lipídico e ácidos graxos séricos. Resultados: As características demográficas dos participantes, no momento inicial do estudo,são semelhantes, não havendo diferença significativa entre os grupos. Em seis meses de seguimento, os grupos não diferiram quanto ao impacto das intervenções na concentração plasmática dos biomarcadores inflamatórios. é m, quando a análise é ajustada para presença de resistência à insulina, sexo, peso, sub relato e energia (kcal), foi observado aumento significativo da PCR (p interação=0,030) no grupo controle. Avaliando o impacto das intervenções na concentração plasmática de ácidos graxos, o ácido graxo alfa linolênico aumentou 0,04 cento no grupo intervenção, enquanto, no grupo controle, diminuiu 0,04 cento (p interação=0,008). outro lado, segundo o R24h, o grupo intervenção reduziu significativamente a ingestão de ácidos graxos ômega 06 (p interação=0,007). Além do ômega 06, o colesterol da dieta também apresentou redução significativamente maior no grupo intervenção (012,84 mg, p interação=0,036). Conclusão: Após seis meses de seguimento, o DICA Br não apresentou impacto na concentração plasmática de biomarcadores inflamatórios em indivíduos em prevenção secundária para doença cardiovascular.Introduction: The Brazilian Cardioprotective Food Program (DICA Br) is based on the current guidelines for the treatment and prevention of cardiovascular disease risk factors (CVD). Objective: To evaluate the effect of the Brazilian Cardioprotective Food Program on the inflammatory markers of patients in secondary prevention for cardiovascular disease. Methods: In this Randomized Clinical Trial, atotal of 369 participants were included, referring to the São Paulo sample from the DICA Br study, aged 45 years or older, who had already had a cardiovascular event in the last 10 years. These were randomized into two groups and followed up for six months: Dica Br group and control group, which received a qualitative nutritional orientation to reduce the total caloric value of the diet and the intake of lipids and sodium. In the initial and final visit (6 months), anthropometry (weight,height and waist circumference), food intake evaluation (240hour dietary recall (R24h)), plasma inflammatory biomarkers (IL06, IL08, IL010, IL012, tumor necrosis factor (TNF) 0, adiponectin and C0reactive protein (CRP)), blood pressure, blood glucose, insulinemia, lipid profile and plasma fatty acids were evaluated. Results: The demographic characteristics of the participants at baseline are similar, with no significant difference between groups. At six months follow0up, the groups did not differ on the impact of interventions on inflammatory biomarkers. However, when the analysis was adjusted for the presence of insulin resistance, sex, weight and energy (kcal), a significant increase in CRP (p = 0.030) in the control group were observed. Evaluating the impact of interventions on plasma fatty acid concentration, alpha0linolenic acid increased by 0.04 per cent in the intervention group, while in the control group it decreased by 0.04 per cent (p0interaction = 0.008). On the other hand, according to R24h, the intervention group reduced significantly the intake of omega06 (p0interaction = 0.007). In addition to polyunsaturated fatty acids, dietary cholesterol also showed a significantly greater reduction in the intervention group (012.84 mg, p0interaction = 0.036). Conclusion: After six months of follow0up, DICA Br had no impact on the plasma concentration of inflammatory biomarkers in individuals in secondary prevention for cardiovascular disease

Análise da expressão de ppardelta em tecido adiposo de não obesos e de obesos grau III

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Análise da expressão de ppardelta em tecido adiposo de não obesos e de obesos grau III

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Alto conteúdo de ácidos graxos trans no tecido adiposo visceral de indivíduos obesos mórbidos e não obesos

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The AHA recommendations for a healthy diet and ultra-processed foods : building a new diet quality index

The American Heart Association (AHA) has developed the concept of “ideal cardiovascular health” (ICH), a seven-component score, which includes health dietary metrics. Higher ultra-processed foods intake is related with several cardiometabolic and cardiovascular diseases. We propose to develop and validate the Cardiovascular Health Diet Index (CHDI), a diet quality index that combines the AHA's recommendations of a healthy diet for cardiovascular health and ultra-processed foods. We used dietary data obtained through a 114-item FFQ from 14,779 participants of the Brazilian Longitudinal Study of Adults Health (ELSA-Brasil). The CHDI had 11 components and a total score ranging from 0 to 110 points. Validation and reliability analyses were performed, including principal component analyses, association with selected nutrients, means differences between groups (for example, smokers vs. non-smokers), Cronbach's alpha, and linear regression analyses between CHDI and overall dietary quality. The mean CHDI was 57.1 points (95% CI 47.9:66.0). The CHDI had four dimensions; in addition, it was associated with nutrients related to cardiovascular health, and the points were significantly (p < 0.001) lower in smokers (52.1) than in non-smokers (57.8). Cronbach's alpha value was 0.50. After age and sex adjustment, the CHDI score remained associated with a higher overall dietary quality (β 0.87, 95%CI 0.84:0.89, p < 0.001). The CHDI proved to be valid and reliable for use, in addition to being associated with higher overall dietary quality. The use of CHDI is expected to assess the population's compliance with dietary recommendations for promoting cardiovascular health and preventing cardiovascular disease

Absolute and Relative Agreement between the Current and Modified Brazilian Cardioprotective Nutritional Program Dietary Index (BALANCE DI) and the American Heart Association Healthy Diet Score (AHA-DS) in Post Myocardial Infarction Patients

The American Heart Association Diet Score (AHA-DS) defines the cardiovascular health, and the Brazilian Cardioprotective Nutritional Program Dietary Index (BALANCE DI) was designed to evaluate diet quality in secondary cardiovascular prevention settings. Our aim was to assess the absolute and relative agreement between both tools in Brazilian adults after a myocardial infarction (MI). In this cross-sectional study, 473 individuals were included and had their diet assessed by a 24 h food recall and a semi-quantitative Food Frequency Questionnaire. The weighted Kappa between BALANCE DI and primary AHA-DS was 0.66 (95% CI: 0.08–0.21), and between BALANCE DI and total AHA-DS was 0.70 (95% CI: 0.20–0.32). To improve the agreement between the tools, modifications were made to the BALANCE DI scoring system. The weighted Kappa between New BALANCE DI and primary AHA-DS was 0.77 (95% CI: 0.36–0.48), and between BALANCE DI and total AHA-DS was 0.76 (95% CI: 0.34–0.46). The mean bias observed between the New BALANCE DI as compared to the primary and total AHA-DS was −16% (−51 to 19) and −8% (−41 to 24), respectively. Our results suggest that the New BALANCE DI may be a useful tool to evaluate diet quality in post MI patients

Effects of Brazilian Cardioprotective Diet Program on risk factors in patients with coronary heart disease: a Brazilian Cardioprotective Diet randomized pilot trial

OBJECTIVE: To evaluate the effectiveness of the Brazilian Cardioprotective Diet Program in reducing blood pressures, fasting glucose levels and body mass indices in patients with established atherothrombotic disease. METHOD: This randomized controlled pilot trial included outpatients who were over 45 years of age with atherothrombotic cardiovascular disease. Group A, who received the Brazilian Cardioprotective Diet Program, had weekly sessions with dietitians. Groups B and C received the usual dietary therapy that is given to patients with cardiovascular diseases as proposed by the Brazilian guidelines. This diet had the same nutrient profile as that given to Group A, but it was customized by the integration of typical Mediterranean foods. The difference between Groups B and C was the number of sessions with the dietitian. Group B received weekly sessions, while group C only had monthly sessions. ClinicalTrials.gov: NCT 01453166. RESULTS: There was a greater reduction in systolic (7.8%) and diastolic (10.8%) blood pressures in Group A compared with Group B (2.3% and 7.3%), and Group C (3.9% and 4.9%, respectively). Fasting glucose decreased by 5.3% and 2% in Groups A and B, respectively. Fasting glucose increased by 3.7% in Group C. The BMIs decreased by 3.5% and 3.3% in Groups A and B, respectively. Group C did not present with any changes in BMI. However, none of these data showed statistical differences between the groups, which is methodologically acceptable in pilot trials. CONCLUSIONS: The Brazilian Cardioprotective Diet Program seems to be more effective in reducing blood pressures, fasting glucose levels, weights and BMIs in patients with previous cardiovascular disease compared with the diet that has been proposed by the Brazilian guidelines