Impact of diet on cardiometabolic health in children and adolescents

The manifestation of cardiovascular risk factors, such as hypertension, diabetes, and particularly obesity begins in children and adolescents, with deleterious effects for cardiometabolic health at adulthood. Although the impact of diet on cardiovascular risk factors has been studied extensively in adults, showing that their cardiometabolic health is strongly lifestyle-dependent, less is known about this impact in children and adolescents. In particular, little is known about the relationship between their dietary patterns, especially when derived a posteriori, and cardiovascular risk. An adverse association of cardiovascular health and increased intake of sodium, saturated fat, meat, fast food and soft drinks has been reported in this population. In contrast, vitamin D, fiber, mono-and poly-unsaturated fatty acids, dairy, fruits and vegetables were positively linked to cardiovascular health. The aim of this review was to summarize current epidemiological and experimental evidence on the impact of nutrients, foods, and dietary pattern on cardiometabolic health in children and adolescents. A comprehensive review of the literature available in English and related to diet and cardiometabolic health in this population was undertaken via the electronic databases PubMed, Cochrane Library, and Medline

Nutrition and cardiometabolic risk: a prospective population-based cohort study

En este trabajo, hemos examinado qué patrones dietéticos y cuáles de sus componentes están asociados con la salud cardiometabólica. Los datos se han obtenido a partir de dos estudios transversales de base poblacional realizados en España en 2000 y 2005. El primer estudio incluyó 3.058 y el segundo - 6.352 hombres y mujeres de 25 a 80 años de edad. Estas dos cohortes fueron re-examinadas en el año 2010 y 2012. Al inicio y al final del estudio se recogieron los datos dietéticos y los datos sobre los factores de riesgo cardiovascular. En el análisis a priori, encontramos que el Índice de Calidad Alimentaria derivado de un Cuestionario corto de Calidad de la Dieta tenía buena capacidad para predecir acontecimientos relacionados con la salud cardiovascular. El análisis a posteriori mostró una buena reproducibilidad y una validez modesta de los patrones dietéticos definidos mediante análisis de clústers de los datos de un cuestionario de frecuencia de alimentos. En el análisis del impacto de la declaración inferior de los niveles reales de energía consumida sobre los patrones dietéticos y las tendencias seculares en los mismos, llegamos a la conclusión de que la energía declarada por debajo de valores reales es un problema grave en la epidemiología nutricional, sobre todo en el desarrollo de guías alimentarias para la población en general. El seguimiento de una dieta mediterránea y la substitución de las bebidas gaseosas por otras bebidas calóricas, se asoció con una disminución de la adiposidad abdominal, un factor de riesgo de enfermedades cardiovasculares (ECV). Por último, llegamos a la conclusión de que el consumo frecuente de yogur se asoció negativamente con la incidencia de ECV. En conclusión, esta investigación doctoral muestra un menor aumento de la circunferencia de la cintura entre los individuos que siguen una dieta mediterránea, y lo contrario para el consumo de bebidas gaseosas. Además, los resultados apoyan la hipótesis de que el consumo de yogur actúa como cardioprotector. Por último, subraya la necesidad de controlar la declaración errónea del consumo de energía en los estudios epidemiológicos, y de validar los patrones dietéticos.Cardiovascular diseases (CVD) are the principal cause of mortality worldwide. Lifestyle plays a crucial role in preventing the development of CVD, and one of its key elements is diet, which directly affects cardiometabolic health and cardiovascular risk. Given the complexity of diet and also of cardiovascular disease etiology, a lot of recent research into the association between diet and disease have focused on dietary patterns, as this is currently the most holistic way to study dietary habits in the population. In this work, we examined dietary patterns and their components that are associated with cardiometabolic health. Data were obtained from two population-based cross-sectional surveys conducted in Girona (Spain) in 2000 and 2005. The first survey included 3,058 randomly selected free-living men and women aged 25 to 74 years. The second survey included 6,352 men and women aged 35 to 80 years. These cohorts were re-examined in 2010 and 2012, with a follow up rate of 80.6% and 78.0%, respectively. At baseline and follow-up, we collected data on diet, using a validated food frequency questionnaire (FFQ), and on cardiovascular risk. We performed validation studies of a priori and a posteriori dietary patterns. In the a priori analysis, we found that a Diet Quality Index derived from a short Diet Quality Screener had good ability to predict future cardiovascular health complications. The a posteriori analysis showed good reproducibility and modest validity of dietary patterns defined using cluster analysis of the FFQ data. In a further step, we analysed the impact of energy under-reporting on dietary patterns and secular trends in dietary patterns. We concluded that energy under-reporting is a serious problem in nutritional epidemiology, especially when developing dietary guidelines for the general population, and more solid research is urgently needed in this area. To explore the association between diet and cardiovascular risk factors and CVD, we focused on abdominal obesity, a risk factor that had received increasing interest in recent years. Adherence to the Mediterranean diet and substitution of soft drinks with other caloric beverages, such as milk and juice, was associated with decreased abdominal adiposity. Finally, we studied the association between dairy products and cardiovascular events, and concluded that consumption of dairy products does not have an adverse impact on CVD incidence, and that frequent intake of yogurt was negatively associated with CVD incidence, presumably due to its prebiotic properties. In conclusion, this PhD research shows a smaller increase in waist circumference among individuals with high adherence to the Mediterranean diet, and the opposite for soft drink consumption. Furthermore, the results support the hypothesis that yogurt consumption is cardioprotective. Finally, it underlines the need to control for energy misreporting in epidemiological studies, and to validate dietary pattern

Prenatal nutrition and the risk of adult obesity: Long-term effects of nutrition on epigenetic mechanisms regulating gene expression

Solid epidemiological evidence indicates that part of the risk of obesity in adulthood could be programmed during prenatal development by the quality of maternal nutrition. Nevertheless, the molecular mechanisms involved are mostly unknown, which hinders our capacity to develop effective intervention policies. Here, we discuss the hypothesis that mechanisms underlying prenatal programming of adult risk are epigenetic and sensitive to environmental cues such as nutrition. While the information encoded in DNA is essentially stable, regulatory epigenetic mechanisms include reversible, covalent modifications of DNA and chromatin, such as methylation, acetylation etc. It is known that dietary availability of methyl donors has an impact on the patterns of gene expression by affecting DNA methylation at regulatory regions, a likely basis for reprogramming developmental plasticity. The Agouti and Axin-fused genes, as well as the embryonic growth factor IGF2/H19 locus are examples of diet-induced modulation of phenotypic traits by affecting methylation of gene-regulatory regions. Recent work has evidenced an unsuspected role for chromatin as metabolic sensor. Chromatin is susceptible to a number of post-translational modifications that modulate gene expression, among them the GlcNAcylation of histone proteins and other epigenetic regulators. Intracellular levels of the precursor molecule UDP-GlcNAc, and hence the degree of global chromatin GlcNAcylation, depend on the energetic state of the cell, making GlcNAcylation a functional link between nutrition and regulation of gene expression. Dietary interference with these regulatory mechanisms could effectively counteract the early-life programming of adult risk.This research was supported by a grant (2FD097-0297-CO2-01) from Fondo Europeo de Desarrollo Regional (FEDER); by a scholarship for PhD training from a national program to prepare university professors (FPU), Ministry of Education of Spain (AP2010-3198); and also partially supported by FEDER [CB06/02/0029] and Red Investigación Cardiovascular, HERACLES [RD12/0042]), and AGAUR (2014 SGR 240) and (2014 SGR 0334). The CIBERESP and CIBEROBN are initiatives of the Instituto de Salud Carlos III, Madrid, Spai

Impact of diet on cardiometabolic health in children and adolescents

The manifestation of cardiovascular risk factors, such as hypertension, diabetes, and particularly obesity begins in children and adolescents, with deleterious effects for cardiometabolic health at adulthood. Although the impact of diet on cardiovascular risk factors has been studied extensively in adults, showing that their cardiometabolic health is strongly lifestyle-dependent, less is known about this impact in children and adolescents. In particular, little is known about the relationship between their dietary patterns, especially when derived a posteriori, and cardiovascular risk. An adverse association of cardiovascular health and increased intake of sodium, saturated fat, meat, fast food and soft drinks has been reported in this population. In contrast, vitamin D, fiber, mono-and poly-unsaturated fatty acids, dairy, fruits and vegetables were positively linked to cardiovascular health. The aim of this review was to summarize current epidemiological and experimental evidence on the impact of nutrients, foods, and dietary pattern on cardiometabolic health in children and adolescents. A comprehensive review of the literature available in English and related to diet and cardiometabolic health in this population was undertaken via the electronic databases PubMed, Cochrane Library, and Medline

Impact of diet on cardiometabolic health in children and adolescents.

The manifestation of cardiovascular risk factors, such as hypertension, diabetes, and particularly obesity begins in children and adolescents, with deleterious effects for cardiometabolic health at adulthood. Although the impact of diet on cardiovascular risk factors has been studied extensively in adults, showing that their cardiometabolic health is strongly lifestyle-dependent, less is known about this impact in children and adolescents. In particular, little is known about the relationship between their dietary patterns, especially when derived a posteriori, and cardiovascular risk. An adverse association of cardiovascular health and increased intake of sodium, saturated fat, meat, fast food and soft drinks has been reported in this population. In contrast, vitamin D, fiber, mono-and poly-unsaturated fatty acids, dairy, fruits and vegetables were positively linked to cardiovascular health.The aim of this review was to summarize current epidemiological and experimental evidence on the impact of nutrients, foods, and dietary pattern on cardiometabolic health in children and adolescents. A comprehensive review of the literature available in English and related to diet and cardiometabolic health in this population was undertaken via the electronic databases PubMed, Cochrane Library, and Medline.This research was supported by a grant (2FD097-0297-CO2-01) from Fondo Europeo de Desarrollo Regional (FEDER); by a national scholarship from Spain’s Ministry of Education for PhD training to prepare university professors (FPU: AP2010-3198); by portions of grants from Spain’s Ministry of Health (Ministerio de Sanidad y Consumo, Instituto de Salud Carlos III: FEDER [PI11/01900], FEDER [CB06/02/0029] and Red Investigación Cardiovascular, Programa HERACLES [RD12/0042]) and from the Catalan government’s agency that supports university research groups (AGAUR: 2014 SGR 240), and the King Abdullah scholarship program [2014, ID 2631]. The CIBERESP and CIBEROBN networks are an initiative of the Instituto de Salud Carlos III, Madrid, Spain

Worldwide adherence to Mediterranean diet between 1960 and 2011

Background: From the 1960s to the early 21st-century adherence to the Mediterranean diet (MD) declined around the world. This was partly due to the westernization of eating habits. However, in the last decade a new variable came into play, the economic crisis, which may have affected dietary patterns. Objective: We analyzed worldwide trends of adherence to the MD between the periods 1961-1965, 2000-2003 and 2004-2011. Methods: Data was obtained from the Food and Agriculture Organization Food Balance Sheets in three study periods: 1961-1965, 2000-2003 and 2004-2011. The Mediterranean Adequacy Index (MAI) was calculated for 41 selected countries using the averages of available energy intake for different food groups. Changes in MAI indicated the trends in adherence in the different periods. Results: In many countries, MAI deteriorated from 1961 to 1965 and 2004 to 2011, yet an increase was observed in 16 countries. Between the last two observation periods, MAI values stabilized in 16 of the 41 selected countries. Regional rankings for the three study periods based on descending MAI scores were: Southern Mediterranean, Mediterranean Europe, Central Europe and Northern Europe. Discussion and Conclusions: Adherence to the MD significantly decreased between 1961-65 and 2000-03, whereas from 2004-2011 there was a stabilization of MAI values and even an increase among 16 countries. Efforts are needed to preserve the dietary traditions and lifestyle habits within the Mediterranean region in order to counteract increasing rates of chronic disease

Meaningful* percentage temporal changes in absolute intake of food group consumption in grams of secular trends in all reporters and plausible energy reporters in the 1) “healthy”, 2) “mixed” and 3) “western” patterns.

<p>Only groups of food are included, which had meaningful changes. The analysis was unadjusted for population differences between the two surveys in age, sex, smoking and physical activity. The unhealthy perceived food groups go first, the healthy food groups are in continuation. A positive value means an increase from the REGICOR 2000 to the REGICOR 2005 and a negative value means a decrease from the REGICOR 2000 to the REGICOR 2005. White—all reporters, black—plausible energy reporters. *≥15% change in food group consumption compared between the REGICOR 2000 and the REGICOR 2005 surveys.</p

Prevalence of abdominal obesity in Spanish children and adolescents. Do we need waist circumference measurements in pediatric practice?

BACKGROUND: Evidence indicates that central adiposity has increased to a higher degree than general adiposity in children and adolescents in recent decades. However, waist circumference is not a routine measurement in clinical practice. OBJECTIVE: This study aimed to determine the prevalence of abdominal obesity based on waist circumferences (WC) and waist to height ratio (WHtR) in Spanish children and adolescents aged 6 to 17 years. Further, the prevalence of abdominal obesity (AO) among normal and overweight individuals was analyzed. DESIGN: Data were obtained from a study conducted from 1998 to 2000 in a representative national sample of 1521 children and adolescents aged 6 to 17 years (50.0% female) in Spain. WC and WHtR measurements were obtained in addition to BMI. AO was defined as WHtR ≥0.50 (WHtR-AO), sex and age specific WC≥90(th) percentile (WC-AO1), and sex and age specific WC cut-off values associated with high trunk fat measured by by dual-energy X-ray absorptiometry (WC-AO2). RESULTS: IOTF- based overweight and obsity prevalence was 21.5% and 6.6% in children and 17.4% and 5.2% in adolescents, respectively. Abdominal obesity (AO) was defined as WHtR≥0.50 (WHtR-AO), sex- and age-specific WC≥90th percentile (WC-AO1), and sex- and age-specific WC cut-off values associated with high trunk fat measured by dual-energy X-ray absorptiometry (WC-AO2). The respective prevalence of WHtR-AO, WC-AO1, and WC-AO2 was 21.3% (24.6% boys; 17.9% girls), 9.4% (9.1% boys; 9.7% girls), and 26.8% (30.6% boys;22.9% girls) in children and 14.3% (20.0% boys; 8.7% girls), 9.6% (9.8% boys; 9.5% girls), and 21.1% (28.8% boys; 13.7% girls) in adolescents. CONCLUSION: The prevalence of AO in Spanish children and adolescents is of concern. The high proportion of AO observed in young patients who are normal weight or overweight indicates a need to include waist circumference measurements in routine clinical practice.This work was supported by grants from Instituto de Salud Carlos III-FEDER, (PI11/01900), the Spanish Ministry of Health [RED: Alimentación saludable en la prevención primaria de enfermedades crónicas: la Red Predimed, one of the Redes Temáticas de Investigación Cooperativa Sanitaria (RETICs)] Fundación Dieta Mediterránea, Spain; and Kellogg’s España SA and Kellogg’s Company, Battle Creek, USA via the Fundación Universitaria de Las Palmas de Gran Canaria and the Fundación para la Investigación Nutricional and by a joint contract (Miguel Servet CP03/00115) with the Instituto de Salud Carlos III and the Health Department of the Catalan Government (Generalitat de Catalunya). The CIBERESP and the CIBEROBN and the RETIC Predimed are initiatives of the Instituto de Salud Carlos III, Madrid, Spai