Dietary fruits and vegetables and cardiovascular diseases risk

Diet is likely to be an important determinant of cardiovascular disease (CVD) risk. In this article, we will review the evidence linking the consumption of fruit and vegetables and CVD risk. The initial evidence that fruit and vegetable consumption has a protective effect against CVD came from observational studies. However, uncertainty remains about the magnitude of the benefit of fruit and vegetable intake on the occurrence of CVD and whether the optimal intake is five portions or greater. Results from randomized controlled trials do not show conclusively that fruit and vegetable intake protects against CVD, in part because the dietary interventions have been of limited intensity to enable optimal analysis of their putative effects. The protective mechanisms of fruit and vegetables may not only include some of the known bioactive nutrient effects dependent on their antioxidant, anti-inflammatory, and electrolyte properties, but also include their functional properties, such as low glycemic load and energy density. Taken together, the totality of the evidence accumulated so far does appear to support the notion that increased intake of fruits and vegetables may reduce cardiovascular risk. It is clear that fruit and vegetables should be eaten as part of a balanced diet, as a source of vitamins, fiber, minerals, and phytochemicals. The evidence now suggests that a complicated set of several nutrients may interact with genetic factors to influence CVD risk. Therefore, it may be more important to focus on whole foods and dietary patterns rather than individual nutrients to successfully impact on CVD risk reduction. A clearer understanding of the relationship between fruit and vegetable intake and cardiovascular risk would provide health professionals with significant information in terms of public health and clinical practice

Food and agricultural innovation pathways for prosperity

This introduction to the special issue deploys a framework, inspired by realist synthesis and introduced in Section 1, that aims to untangle the contexts, mechanisms, and outcomes associated with investments that link poverty reduction and rural prosperity within a broad agri-food systems perspective. Section 2 considers changes in contexts: Where are agricultural research investments most likely to be an engine of poverty reduction? Over the past 25 years, there have been profound changes in the development context of most countries, necessitating an update on strategic insights for research investment priorities relevant for the economic, political, social, environmental, and structural realities of the early 21st Century. Section 2 briefly surveys changes in these structural aspects of poverty and development processes in low-income countries, with particular attention to new drivers (e.g., urbanization, climate change) that will be of increasing salience in the coming decades. In Section 3, we turn to mechanisms: What are the plausible impact pathways and what evidence exists to test their plausibility? Poor farmers in the developing world are often the stated focus of public sector agricultural research. However, farmers are not the only potential beneficiaries of agricultural research; rural landless laborers, stakeholders along food value chains, and the urban poor can also be major beneficiaries of such research. Thus, there are multiple, interacting pathways through which agricultural research can contribute to reductions in poverty and associated livelihood vulnerabilities. This paper introduces an ex ante set of 18 plausible impact pathways from agricultural research to rural prosperity outcomes, employing bibliometric methods to assess the evidence underpinning causal links. In Section 4, we revisit the concept of desired impacts: When we seek poverty reduction, what does that mean and what measures are needed to demonstrate impact? The papers in this special issue are intended to yield insights to inform improvements in agricultural research that seeks to reduce poverty. History indicates that equity of distribution of gains matters hugely, and thus the questions of “who wins?” and “who loses?” must be addressed. Moreover, our understanding(s) of “poverty” and the intended outcomes of development investments have become much richer over the past 25 years, incorporating more nuance regarding gender, community differences, and fundamental reconsideration of the meaning of poverty and prosperity that are not captured by simple head count income or even living standard measures

Food and agricultural innovation pathways for prosperity

This introduction to the special issue deploys a framework, inspired by realist synthesis and introduced in Section 1, that aims to untangle the contexts, mechanisms, and outcomes associated with investments that link poverty reduction and rural prosperity within a broad agri-food systems perspective. Section 2 considers changes in contexts: Where are agricultural research investments most likely to be an engine of poverty reduction? Over the past 25 years, there have been profound changes in the development context of most countries, necessitating an update on strategic insights for research investment priorities relevant for the economic, political, social, environmental, and structural realities of the early 21st Century. Section 2 briefly surveys changes in these structural aspects of poverty and development processes in low-income countries, with particular attention to new drivers (e.g., urbanization, climate change) that will be of increasing salience in the coming decades. In Section 3, we turn to mechanisms: What are the plausible impact pathways and what evidence exists to test their plausibility? Poor farmers in the developing world are often the stated focus of public sector agricultural research. However, farmers are not the only potential beneficiaries of agricultural research; rural landless laborers, stakeholders along food value chains, and the urban poor can also be major beneficiaries of such research. Thus, there are multiple, interacting pathways through which agricultural research can contribute to reductions in poverty and associated livelihood vulnerabilities. This paper introduces an ex ante set of 18 plausible impact pathways from agricultural research to rural prosperity outcomes, employing bibliometric methods to assess the evidence underpinning causal links. In Section 4, we revisit the concept of desired impacts: When we seek poverty reduction, what does that mean and what measures are needed to demonstrate impact? The papers in this special issue are intended to yield insights to inform improvements in agricultural research that seeks to reduce poverty. History indicates that equity of distribution of gains matters hugely, and thus the questions of “who wins?” and “who loses?” must be addressed. Moreover, our understanding(s) of “poverty” and the intended outcomes of development investments have become much richer over the past 25 years, incorporating more nuance regarding gender, community differences, and fundamental reconsideration of the meaning of poverty and prosperity that are not captured by simple head count income or even living standard measures

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05-1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4-7 days or ≥ 8 days of 1.25 (1.04-1.48), p = 0.015 and 1.31 (1.11-1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care

The circadian clock goes genomic

Staiger D, Shin J, Johansson M, Davis SJ. The circadian clock goes genomic. Genome Biology. 2013;14(6): 208.Large-scale biology among plant species, as well as comparative genomics of circadian clock architecture and clock-regulated output processes, have greatly advanced our understanding of the endogenous timing system in plants