Which Diets Are Effective in Reducing Cardiovascular and Cancer Risk in Women with Obesity? An Integrative Review

Women are more affected by obesity than men which increases their risk of cancer and cardiovascular disease (CVD). Therefore, it is important to understand the effectiveness of different types of diet in the context of women’s health. This review aims to summarize the scientific evidence on the effects of different types of diet for women with obesity and their impact on CVD and cancer risk. This review included epidemiological and clinical studies on adult women and different types of diets, such as the Mediterranean (MED) diet, the Traditional Brazilian Diet, the Dietary Approach to Stop Hypertension (DASH), intermittent fasting (IF), calorie (energy) restriction, food re-education, low-carbohydrate diet (LCD) and a very low-carbohydrate diet (VLCD). Our main findings showed that although LCDs, VLCD and IF are difficult to adhere to over an extended period, they can be good options for achieving improvements in body weight and cardiometabolic parameters. MED, DASH and the Traditional Brazilian Diet are based on natural foods and reduced processed foods. These diets have been associated with better women’s health outcomes, including lower risk of CVD and cancer and the prevention and treatment of obesity

Predictive factors of short-term survival from acute myocardial infarction in early and late patients in Isfahan and Najafabad, Iran

Background: Cardiovascular disease (CVD) is the primary cause of mortality in the world and Iran. The aim of this study was to determine the prognostic factors of short-term survival from acute myocardial infarction (AMI) in early and late patients in the Najafabad and Isfahan County, Iran. Methods: This hospital-based cohort study was conducted using the hospital registry of 1999-2009 in Iran. All patients (n = 14426) with an AMI referred to hospitals of Isfahan and Najafabad were investigated. To determine prognostic factors of short-term (28-days) survival in early and late patients, unadjusted and adjusted hazard ratio (HR) was calculated using univariate and multivariate Cox regression. Results: The short-term (28-day) survival rate of early and late patients was 96.6 and 89.4 (P < 0.001), respectively. In 80.0 of early and 79.3 of late patients, mortality occurred during the first 7 days of disease occurrence. HR of death was higher in women in the two groups; it was 1.97 in early patients was confidence interval (CI) 95%: 1.32-2.92 and 1.35 in late patients (CI 95%: 1.19-1.53) compared to men. HR of death had a rising trend with the increasing of age in the two groups. Conclusion: Short-term survival rate was higher in early patients than in late patients. In addition, case fatality rate (CFR) of AMI in women was higher than in men. In both groups, sex, age, an atomic location of myocardial infarction based on the International Classification of Disease, Revision 10 (ICD10), cardiac enzymes, and clinical symptoms were significant predictors of survival in early and late patients following AMI. © 2016, Isfahan University of Medical Sciences(IUMS). All rights reserved

The Role of Sarcopenic Obesity in Cancer and Cardiovascular Disease: A Synthesis of the Evidence on Pathophysiological Aspects and Clinical Implications

Obesity is globally a serious public health concern and is associated with a high risk of cardiovascular disease (CVD) and various types of cancers. It is important to evaluate various types of obesity, such as visceral and sarcopenic obesity. The evidence on the associated risk of CVD, cancer and sarcopenic obesity, including pathophysiological aspects, occurrence, clinical implications and survival, needs further investigation. Sarcopenic obesity is a relatively new term. It is a clinical condition that primarily affects older adults. There are several endocrine-hormonal, metabolic and lifestyle aspects involved in the occurrence of sarcopenic obesity that affect pathophysiological aspects that, in turn, contribute to CVD and neoplasms. However, there is no available evidence on the role of sarcopenic obesity in the occurrence of CVD and cancer and its pathophysiological interplay. Therefore, this review aims to describe the pathophysiological aspects and the clinical and epidemiological evidence on the role of sarcopenic obesity related to the occurrence and mortality risk of various types of cancer and cardiovascular disease. This literature review highlights the need for further research on sarcopenic obesity to demonstrate the interrelation of these various associations

Stress as a risk factor for noncompliance with treatment regimens in patients with diabetes and hypertension

BACKGROUND: We have assessed the role of stress on compliance of patients with diabetes mellitus (DM) and hypertension (HTN) with taking prescribed medications and following dietary and exercise regimens. METHODS: A total of 9544 individuals more than 19 years of age were selected from three counties in central Iran. The presence of DM and HTN were asked from participants. We defined treatment adherence (compliance) based on agreement of individual�s self-report behavior with recommendations from a physician. RESULTS: Awareness about DM and HTN was 82.6 and 49.9, respectively. Multivariate analysis showed that odds ratio (OR) of high to low stress level was lower than one for both �usage of medication� and �following exercise regimen� in diabetics even after adjustment for either �age and sex� or �age, sex and education�. In hypertensive patients, OR of high to low stress level was lower than one for �usage of medication� even after adjustment for either �age and sex� or �age, sex and education� and also lower than one for �following exercise regimen� only as crude index. CONCLUSION: Cases with higher stress level had lower compliance for accepting either medication or exercise as a treatment option for their DM or HTN. © 2016, Isfahan University of Medical Sciences(IUMS). All rights reserved

Decreased Na + /K + -ATPase activity and altered susceptibility to peroxidation and lipid composition in the erythrocytes of metabolic syndrome patients with coronary artery disease

Background: The increased generation of reactive oxygen species that occurs in the case of a metabolic syndrome (MetS) may be responsible for the increased oxidative injury to erythrocyte membranes in coronary artery disease (CAD). Therefore, we studied the effects of MetS on both indexes of oxidative damage and biochemical properties of erythrocyte membranes in CAD patients. Methods: We analyzed the markers of oxidative stress, Na + /K + -ATPase activity, total cholesterol content of erythrocyte membranes (CEM), and fatty acid compositions of the erythrocyte membrane in 82 patients with stable CAD and 39 non-CAD subjects. Results: The CAD patients had higher levels of CEM, membrane lipid peroxidation, erythrocyte superoxide dismutase (SOD) activity, and Na + /K + -ATPase activity compared with non-CAD subjects. The Na + /K + -ATPase activity was correlated negatively with membrane lipid peroxidation, and positively with the CEM. In CAD patients with MetS compared with those without MetS, we found that the membrane lipid peroxidation and CEM were increased, whereas the n-3 fatty acids content, SOD activity, Na + /K + -ATPase activity were decreased. Conclusion: These findings suggest an impairment of erythrocyte membrane biochemical properties in stable CAD patients as a consequence of oxidative injury that may contribute to the development of CAD. In addition, MetS may be related to increased oxidative injury to erythrocyte membranes. © 2019 S. Karger AG, Basel

Trends of 28 days case fatality rate after first acute myocardial infarction in Isfahan, Iran, from 2000 to 2009

Background: The purpose of the present study was the analysis of the trends in case fatality rate of acute myocardial infarction (AMI) in Isfahan, Iran. This analysis was performed based on gender, age groups, and type of AMI according to the International Classification of Diseases, version 10, during 2000-2009. Methods: Disregarding the Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA), this cohort study considered all AMI events registered between 2000 and 2009 in 13 hospitals in Isfahan. All patients were followed for 28 days. In order to assess the case fatality rate, the Kaplan-Meier analysis, and to compare survival rate, log-rank test were used. Using the Cox regression model, 28 days case fatality hazard ratio (HR) was calculated. Results: In total, 12,900 patients with first AMI were entered into the study. Among them, 9307 (72.10) were men and 3593 (27.90) women. The mean age in all patients increased from 61.36 ± 12.19 in 2000-2001 to 62.15 ± 12.74 in 2008-2009, (P = 0.0070); in women, from 65.38 ± 10.95 to 67.15 ± 11.72 (P = 0.0200), and in men, from 59.75 ± 12.29 to 59.84 ± 12.54 (P = 0.0170),. In addition, the 28 days case fatality rate in 2000-2009 had a steady descending trend. Thus, it decreased from 11.20 in 2000-2001 to 07.90 in 2008-2009; in men, from 09.20 to 06.70, and in women, from 16.10 to 10.90. During the study, HR of case fatality rate in 2000-2001 declined; therefore, in 2002-2003, it was 0.93 95% confidence interval (CI) = 0.77-1.11, in 2004-2005, 0.88 (95% CI = 0.73-1.04), in 2006-2007, 0.67 (95% CI = 0.56- 0.82), and in 2008-2009, 0.69 (95% CI = 0.56-0.82). Conclusion: In Isfahan, a reduction was observable in the trend of case fatality rate in both genders and all age groups. Thus, there was a 29.46% reduction in case fatality rate (27.17% in men, 32.29% in women) during the study period. © 2015, Isfahan University of Medical Sciences(IUMS). All rights reserved

How Are Epigenetic Modifications Related to Cardiovascular Disease in Older Adults?

The rate of aging has increased globally during recent decades and has led to a rising burden of age-related diseases such as cardiovascular disease (CVD). At the molecular level, epigenetic modifications have been shown recently to alter gene expression during the life course and impair cellular function. In this regard, several CVD risk factors, such as lifestyle and environmental factors, have emerged as key factors in epigenetic modifications within the cardiovascular system. In this study, we attempted to summarized recent evidence related to epigenetic modification, inflammation response, and CVD in older adults as well as the effect of lifestyle modification as a preventive strategy in this age group. Recent evidence showed that lifestyle and environmental factors may affect epigenetic mechanisms, such as DNA methylation, histone acetylation, and miRNA expression. Several substances or nutrients such as selenium, magnesium, curcumin, and caffeine (present in coffee and some teas) could regulate epigenetics. Similarly, physical inactivity, alcohol consumption, air pollutants, psychological stress, and shift working are well-known modifiers of epigenetic patterns. Understanding the exact ways that lifestyle and environmental factors could affect the expression of genes could help to influence the time of incidence and severity of aging-associated diseases. This review highlighted that a healthy lifestyle throughout the life course, such as a healthy diet rich in fibers, vitamins, and essential elements, and specific fatty acids, adequate physical activity and sleep, smoking cessation, and stress control, could be useful tools in preventing epigenetic changes that lead to impaired cardiovascular function