The effect of berry-based food interventions on markers of cardiovascular and metabolic health: A systematic review of randomized controlled trials

Scope: Epidemiological evidence, animal, and in vitro studies suggest that berry consumption may ameliorate markers of cardiovascular disease (CVD). The aim of this systematic review is to evaluate findings from berry-based randomized controlled trials (RCTs) to establish the effects of berry consumption on markers of cardiovascular and metabolic health. Methods and results: PubMed and Web of Science are searched for RCTs investigating berry consumption on CVD risk outcomes in adults. A total of 23 studies (which includes 1168 participants) out of 1384 records meet the inclusion criteria. Of these 23 studies, 17 RCTs are of high quality, where 12 RCTs (71%) report beneficial effects of berry consumption on CVD risk markers. Overall, 4/11 RCTs that observe a reduction in systolic and/or diastolic blood pressure (BP); 3/7 RCTs report favorable effects on endothelial function, 2/3 RCTs report improvements in arterial stiffness, 7/17 studies observe benefits in blood lipids, and 3/6 studies report improvements in glycemic profile. Conclusion: Our evaluation of the literature indicates that more than two-thirds of high-quality trials have reported beneficial effects of berry consumption on markers of CVD risk. This systematic review contributes moderate to strong evidence for the inclusion of berries as part of a cardioprotective diet

Effect of an egg ovalbumin-derived protein hydrolysate on blood pressure and cardiovascular risk in adults with a mildly elevated blood pressure: a randomized placebo-controlled crossover trial

Purpose: While animal and in vitro data demonstrate vasodilatory effects of egg white-derived peptides, human studies are lacking. We investigated for the first time the effects of an egg ovalbumin-derived protein hydrolysate on blood pressure (BP) and cardiovascular risk. Methods: A double-blind, placebo-controlled randomized crossover trial was implemented in 75 adults aged 50–70 years with systolic BP (130–≤ 150 mmHg). Participants were randomized to an egg ovalbumin-derived protein hydrolysate (3 g/day) or placebo (3 g/day). Participants completed two 6-week periods separated by a 3-week washout. Results: Data from 65 participants with a mean systolic BP (135.1 ± 11 mmHg) were included. Mean office and central BP and arterial stiffness (assessed by carotid-femoral pulse wave velocity (cfPWV) or pulse wave analysis (PWA)) did not change over time and no significant differences were observed between the egg protein hydrolysate and placebo groups (P > 0.05). Similarly, no significant effects of this egg ovalbumin-derived protein hydrolysate on blood lipid and glucose concentrations (P > 0.05) were observed. Conclusion: This is the first dietary intervention to investigate the effects of egg ovalbumin-derived protein hydrolysates on cardiovascular risk in humans. Despite promising findings from animal and in vitro studies, this RCT does not support the hypothesis that consumption of an egg ovalbumin-derived protein hydrolysate for 6 weeks in adults with a high-normal BP results in a reduction in BP or the modification of cardiovascular risk

Does daily consumption of vitamin K1 from cruciferous vegetables reach the circulation and the knee joint?

Irish Section Meeting, 20–22 June 2018, Targeted approaches to tackling current nutritional issue

Dietary bioactives and cardiovascular health

The primary objective of this thesis was to investigate the efficacy of dietary bioactive compounds on cardiovascular disease (CVD) risk markers in adults with mildly elevated blood pressure (BP) through the implementation of two human dietary intervention studies: the Cardio-Rubus (blackberry-polyphenols) and Cardio-Protein (ovalbumin-derived peptides) randomised controlled trials (RCTs). Our findings indicate that the consumption of ovalbumin-derived peptides for 6-weeks does not have an effect on BP, blood lipids or glycaemic profile in adults [Cardio-Protein RCT]; similarly, supplementation with a polyphenol-rich blackberry beverage for 6 weeks does not appear to lower BP or improve blood lipids or glucose homeostasis in adults [Cardio-Rubus RCT]. In this RCT, considerable heterogeneity in participant responses to the polyphenol-rich beverage were observed. Inter-individual variation in participant response to polyphenol-based interventions has become a major challenge for the establishment of causal relationships between polyphenols and health outcomes. This was further reinforced in the findings of a systematic review evaluating evidence from berry-based RCTs on markers of cardio-metabolic health, which was conducted as part of this thesis. Of a total of 23 RCTs; 17 were ranked to be of high quality, of these 12 RCTs reported a beneficial effect on CVD risk, supporting consumption of berries as part of a cardio-protective diet. This thesis includes the first study to estimate dietary intakes of polyphenols in Irish adults, teens and children using nationally representative data. Beverages were the predominant contributor; providing a feasible method by which to increase polyphenol intakes. A modelling assessment demonstrated that hypothetically a polyphenol-rich beverage could meaningfully increase polyphenol intakes in the Irish population. Findings from this thesis inform and aim to address current challenges which face dietary interventions with bioactive compounds for the advancement of polyphenol research and the establishment of a causal link between polyphenols or peptides and cardio-metabolic health outcomes

30-Day Morbidity and Mortality of Bariatric Surgery During the COVID-19 Pandemic: a Multinational Cohort Study of 7704 Patients from 42 Countries.

BACKGROUND There are data on the safety of cancer surgery and the efficacy of preventive strategies on the prevention of postoperative symptomatic COVID-19 in these patients. But there is little such data for any elective surgery. The main objectives of this study were to examine the safety of bariatric surgery (BS) during the coronavirus disease 2019 (COVID-19) pandemic and to determine the efficacy of perioperative COVID-19 protective strategies on postoperative symptomatic COVID-19 rates. METHODS We conducted an international cohort study to determine all-cause and COVID-19-specific 30-day morbidity and mortality of BS performed between 01/05/2020 and 31/10/2020. RESULTS Four hundred ninety-nine surgeons from 185 centres in 42 countries provided data on 7704 patients. Elective primary BS (n = 7084) was associated with a 30-day morbidity of 6.76% (n = 479) and a 30-day mortality of 0.14% (n = 10). Emergency BS, revisional BS, insulin-treated type 2 diabetes, and untreated obstructive sleep apnoea were associated with increased complications on multivariable analysis. Forty-three patients developed symptomatic COVID-19 postoperatively, with a higher risk in non-whites. Preoperative self-isolation, preoperative testing for SARS-CoV-2, and surgery in institutions not concurrently treating COVID-19 patients did not reduce the incidence of postoperative COVID-19. Postoperative symptomatic COVID-19 was more likely if the surgery was performed during a COVID-19 peak in that country. CONCLUSIONS BS can be performed safely during the COVID-19 pandemic with appropriate perioperative protocols. There was no relationship between preoperative testing for COVID-19 and self-isolation with symptomatic postoperative COVID-19. The risk of postoperative COVID-19 risk was greater in non-whites or if BS was performed during a local peak

Safety of Bariatric Surgery in ≥ 65-Year-Old Patients During the COVID-19 Pandemic

Background Age >= 65 years is regarded as a relative contraindication for bariatric surgery. Advanced age is also a recognised risk factor for adverse outcomes with Coronavirus Disease-2019 (COVID-19) which continues to wreak havoc on global populations. This study aimed to assess the safety of bariatric surgery (BS) in this particular age group during the COVID-19 pandemic in comparison with the younger cohort.Methods We conducted a prospective international study of patients who underwent BS between 1/05/2020 and 31/10/2020. Patients were divided into two groups - patients >= 65-years-old (Group I) and patients < 65-years-old (Group II). The two groups were compared for 30-day morbidity and mortality.Results There were 149 patients in Group 1 and 6923 patients in Group II. The mean age, preoperative weight, and BMI were 67.6 +/- 2.5 years, 119.5 +/- 24.5 kg, and 43 +/- 7 in Group I and 39.8 +/- 11.3 years, 117.7 +/- 20.4 kg, and 43.7 +/- 7 in Group II, respectively. Approximately, 95% of patients in Group 1 had at least one co-morbidity compared to 68% of patients in Group 2 (p = < 0.001). The 30-day morbidity was significantly higher in Group I ( 11.4%) compared to Group II (6.6%) (p = 0.022). However, the 30-day mortality and COVID-19 infection rates were not significantly different between the two groups.Conclusions Bariatric surgery during the COVID-19 pandemic is associated with a higher complication rate in those >= 65 years of age compared to those < 65 years old. However, the mortality and postoperative COVID-19 infection rates are not significantly different between the two groups

Effect of BMI on safety of bariatric surgery during the COVID-19 pandemic, procedure choice, and safety protocols - An analysis from the GENEVA Study

Background: It has been suggested that patients with a Body Mass Index (BMI) of > 60 kg/m2 should be offered expedited Bariatric Surgery (BS) during the Coronavirus Disease-2019 (COVID-19) pandemic. The main objective of this study was to assess the safety of this approach. Methods: We conducted a global study of patients who underwent BS between 1/05/2020 and 31/10/2020. Patients were divided into three groups according to their preoperative BMI -Group I (BMI < 50 kg/m2), Group II (BMI 50-60 kg/m2), and Group III (BMI > 60 kg/m2). The effect of preoperative BMI on 30-day morbidity and mortality, procedure choice, COVID-19 specific safety protocols, and comorbidities was assessed. Results: This study included 7084 patients (5197;73.4 % females). The mean preoperative weight and BMI were 119.49 & PLUSMN; 24.4 Kgs and 43.03 & PLUSMN; 6.9 Kg/m2, respectively. Group I included 6024 (85 %) patients, whereas Groups II and III included 905 (13 %) and 155 (2 %) patients, respectively.The 30-day mortality rate was higher in Group III (p = 0.001). The complication rate and COVID-19 infection were not different. Comorbidities were significantly more likely in Group III (p = < 0.001). A significantly higher proportion of patients in group III received Sleeve Gastrectomy or One Anastomosis Gastric Bypass compared to other groups. Patients with a BMI of > 70 kg/m2 had a 30-day mortality of 7.7 % (2/26). None of these patients underwent a Roux-en-Y Gastric Bypass. Conclusion: The 30-day mortality rate was significantly higher in patients with BMI > 60 kg/m2. There was, however, no significant difference in complications rates in different BMI groups, probably due to differences in procedure selection