Impact of nonoptimal intakes of saturated, polyunsaturated, and trans fat on global burdens of coronary heart disease

Background: Saturated fat (SFA), ω‐6 (n‐6) polyunsaturated fat (PUFA), and trans fat (TFA) influence risk of coronary heart disease (CHD), but attributable CHD mortalities by country, age, sex, and time are unclear. Methods and Results: National intakes of SFA, n‐6 PUFA, and TFA were estimated using a Bayesian hierarchical model based on country‐specific dietary surveys; food availability data; and, for TFA, industry reports on fats/oils and packaged foods. Etiologic effects of dietary fats on CHD mortality were derived from meta‐analyses of prospective cohorts and CHD mortality rates from the 2010 Global Burden of Diseases study. Absolute and proportional attributable CHD mortality were computed using a comparative risk assessment framework. In 2010, nonoptimal intakes of n‐6 PUFA, SFA, and TFA were estimated to result in 711 800 (95% uncertainty interval [UI] 680 700–745 000), 250 900 (95% UI 236 900–265 800), and 537 200 (95% UI 517 600–557 000) CHD deaths per year worldwide, accounting for 10.3% (95% UI 9.9%–10.6%), 3.6%, (95% UI 3.5%–3.6%) and 7.7% (95% UI 7.6%–7.9%) of global CHD mortality. Tropical oil–consuming countries were estimated to have the highest proportional n‐6 PUFA– and SFA‐attributable CHD mortality, whereas Egypt, Pakistan, and Canada were estimated to have the highest proportional TFA‐attributable CHD mortality. From 1990 to 2010 globally, the estimated proportional CHD mortality decreased by 9% for insufficient n‐6 PUFA and by 21% for higher SFA, whereas it increased by 4% for higher TFA, with the latter driven by increases in low‐ and middle‐income countries. Conclusions: Nonoptimal intakes of n‐6 PUFA, TFA, and SFA each contribute to significant estimated CHD mortality, with important heterogeneity across countries that informs nation‐specific clinical, public health, and policy priorities.peer-reviewe

Incident type 2 diabetes attributable to suboptimal diet in 184 countries

The global burden of diet-attributable type 2 diabetes (T2D) is not well established. This risk assessment model estimated T2D incidence among adults attributable to direct and body weight-mediated effects of 11 dietary factors in 184 countries in 1990 and 2018. In 2018, suboptimal intake of these dietary factors was estimated to be attributable to 14.1 million (95% uncertainty interval (UI), 13.814.4 million) incident T2D cases, representing 70.3% (68.871.8%) of new cases globally. Largest T2D burdens were attributable to insufficient whole-grain intake (26.1% (25.027.1%)), excess refined rice and wheat intake (24.6% (22.327.2%)) and excess processed meat intake (20.3% (18.323.5%)). Across regions, highest proportional burdens were in central and eastern Europe and central Asia (85.6% (83.487.7%)) and Latin America and the Caribbean (81.8% (80.183.4%)); and lowest proportional burdens were in South Asia (55.4% (52.160.7%)). Proportions of diet-attributable T2D were generally larger in men than in women and were inversely correlated with age. Diet-attributable T2D was generally larger among urban versus rural residents and higher versus lower educated individuals, except in high-income countries, central and eastern Europe and central Asia, where burdens were larger in rural residents and in lower educated individuals. Compared with 1990, global diet-attributable T2D increased by 2.6 absolute percentage points (8.6 million more cases) in 2018, with variation in these trends by world region and dietary factor. These findings inform nutritional priorities and clinical and public health planning to improve dietary quality and reduce T2D globally. (c) 2023, The Author(s)

Vitamins and minerals intake from diet and supplements among subjects with a history of cardiovascular events in Polish population

Niektóre witaminy i składniki mineralne odgrywają istotną rolę w prewencji wtórnej chorób układu krążenia (ChUK). Celem pracy było ocena zawartości w diecie witamin i składników mineralnych z uwzględnieniem suplementacji przez osoby po przebytych incydentach sercowo-naczyniowych w populacji Polski. W ramach projektu WOBASZ przebadano w latach 2003-2005 reprezentatywną próbę mieszkańców Polski w wieku 20-74 lata (7257 osób). Przedmiotem analiz jest subpopulacja 803 osób, które kiedykolwiek były hospitalizowane z powodu ChUK. Wykazano, że przeciętna dieta dorosłych mieszkańców Polski ze zdiagnozowaną ChUK była niezbilansowana pod względem zawartości niektórych witamin i składników mineralnych. Stwierdzono pełne pokrycie zapotrzebowania na witaminy antyoksydacyjne (A, C i E) oraz witaminę B12 - stopień realizacji norm (RDA) kształtował się w granicach 126-310%. Wykazano niedostateczną zawartość w przeciętnej racji pokarmowej witamin B1, B2, folianów, a także potasu, wapnia i magnezu u obu płci oraz witaminy B6 u mężczyzn oraz żelaza u kobiet. Największe niedobory zanotowano w przypadku witamin B1 i B2 oraz wapnia i magnezu – stopień realizacji RDA wahał się od 54% do 82%. Udział suplementacji w odniesieniu do całkowitego spożycia kształtował się od około 1% w przypadku potasu, wapnia i magnezu u obu płci do powyżej 25% w przypadku witaminy E i B6 w grupie kobiet.Some vitamins and minerals play an important role in the secondary prevention of cardiovascular diseases (CVD). The aim of this study was the assessment of dietary vitamins and minerals intake and patterns of supplement use among subjects with diagnosed CVD in Polish population. Within the frame of the WOBASZ study, a representative sample of whole Polish population aged 20-74 (7257 subjects) was screened in 2003-2005. A subsample of 803 persons with a clinical history of cardiovascular events was analyzed. It was found, that the average diet of adult Polish citizens with established CVD was not balanced concerning the intake of vitamins and minerals. Daily intake of antioxidant vitamins (A, C and E) and vitamin B12 was satisfactory the realization degree of recommended dietary allowances (RDA) was about 126-310%. The insufficient amounts of vitamins B1, B2, folates, as well as potassium, calcium, magnesium in diet of both genders and vitamin B6 in men and iron in women were noted. The highest deficiency has been noticed in vitamins B1, B2 and calcium and magnesium intake – the realization degree of RDA has stayed on 54-82 % level. Around 1% of potassium, calcium and magnesium intake in both genders and more than 25% of vitamins E and B6 consumption in women derived from the supplementation

The use of vitamin supplements among adults in Warsaw: is there any nutritional benefit?

Background. The use of dietary supplements is widespread and can contribute substantially to total nutrient intake. However, it also generates some potential risks in the case of unreasonable and excessive use of such products. Objective. To estimate the prevalence of supplementation and the vitamin supplement contribution to total intake among Warsaw population aged 20-74 years. Material and methods. Nutrient intake and supplement use were studied in a representative sample of Warsaw population in years 2011/12 (486 men and 421 women) and in 2001 (658 and 671 respectively). The vitamin levels were analyzed in reference to the Recommended Dietary Allowance (RDA) and the tolerable upper intake level (UL). Results. In the years 2011/12 the use of dietary supplements (vitamins and minerals) was reported by 31% men and 40% women. Vitamin intake from food showed the deficiency of vitamins D, B1 and folates and adequate intake of vitamins A, C, E, B2, B6, B12. Supplementing with vitamins D and B1 as well as folic acid contributed to better RDA fulfillment. Supplementing with vitamins A, C, E, B2, B6 and B12 was not justified because these vitamins were taken in sufficient amounts with food. In 1.3%-14.9% supplement users, the total intake of vitamins A, C, E and B6 exceeded the UL. The prevalence of supplementation of vitamins A, C and E did not change between 2001 and 2011/12, but the total intake of vitamin A in both sexes and vitamins C, E in women was significantly higher in 2001. Conclusions. The use of dietary supplements in Warsaw population was widespread and in case of some vitamins- unreasonable.Wprowadzenie. Przyjmowanie suplementów diety jest popularne i może stanowić istotne źródło witamin i składników mineralnych. Jednocześnie niekontrolowane ich pobranie może stwarzać niebezpieczeństwo nadmiernego spożycia. Cel badań. Ustalenie rozpowszechnienia i zasadności stosowania suplementacji wśród mieszkańców Warszawy w wieku 20-74 lat. Materiał i metody. Sposób żywienia oraz przyjmowanie suplementów oceniono w reprezentatywnej próbie populacji Warszawy w roku 2011/12 (u 486 mężczyzn i 421 kobiet) oraz w roku 2001 (u odpowiednio 658 i 671 osób). Pobranie witamin analizowano w odniesieniu do zalecanego dziennego spożycia (RDA) oraz górnych bezpiecznych poziomów spożycia (UL). Wyniki. W latach 2011/2012 suplementy witaminowo-mineralne przyjmowało 31% mężczyzn i 40% kobiet. Spożycie witamin z żywnością było niedoborowe w przypadku witamin D, B1 i folianów oraz zgodne z zaleceniami dla witamin A, C, E, B2, B6, B12. Suplementacja witaminami D i B1 oraz kwasem foliowym przyczyniła się do lepszej realizacji RDA. Natomiast uzupełnianie diety witaminami A, C, E, B2, B6 oraz B12 nie miało uzasadnienia, ze względu na wystarczające ich spożycie z żywnością. W przypadku 1,3%-14,9% osób stosujących suplementy witamin A, C, E, i B6 notowano przekroczenie poziomów UL. Częstość przyjmowania suplementów witamin A, C i E była podobna w latach 2001 i 2011/12, ale sumaryczne pobranie witaminy A u obu płci oraz C, E u kobiet było istotnie wyższe w roku 2001. Wnioski. Wzbogacanie diety suplementami przez mieszkańców Warszawy było szeroko rozpowszechnione, a w przypadku niektórych witamin nieuzasadnione